ObjectiveTo investigate the influential factors of delayed diagnosis in the patients with cerebral palsy.Method50 cases with cerebral palsy were divided into 2 groups: beyond-12-months-group(20 cases) and under-12-month-group(30 cases). Their social facters were investigated and analyzed. SPSS statistical software was used.ResultThere is significantly difference between diagnosing group of under 12 months and that of beyond 12 months(the group of delayed diagnosis) in the factors of parents' educational level, the region where patients came from(urban or rural) and the type of cerebral palsy(P<0.01), While there is no difference in high risk factors(P>0.05). ConclusionIt is necessary for reducing delayed diagnosis to raise national cultural level, to eliminate difference between town and country, to spread the knowledge of early diagnosis and evaluation in cerebral palsy, to improve diagnosing ability in local hospitals, and to establish high risk newborns' long-term monitor system.

BACKGROUND:Problems regarding the prosthesis in the horizontal plane and the rotation of the femur and tibia prosthesis on line are relatively weak. The distal femoral rotation axis is mainly the transepicondylar axis. Due to patient differences as wel as anatomy and intraoperative display, it is difficult to accurately locate the axis in the process of knee arthroplasty. OBJECTIVE:To investigate application of magnetic resonance technique in determining the axis of rotation of the distal femur, to provide reference and basis for femoral rotational alignment during total knee arthroplasty. METHODS:Data of 122 cases without knee joint disease, who were diagnosed and treated in the Department of Orthopedics of Nanyang City Center Hospital from September 2014 to October 2015, were analyzed. Magnetic resonance technique was used to measure femoral epicondyle axes (STEA), femoral epicondyle axes (CTEA), the anteroposterior axis (APL) and femoral shaft (PCL). Simultaneously, magnetic resonance technique was utilized to measure femoral ankle angle (PCA), ankle twist angle (CTA), axis vertical line and ankle axis angle (PAPA). Each data were tested three times, and the average value was calculatd. We analyzed the method of magnetic resonance technique to determine reference axis of distal femoral rotation. RESULTS ANDCONCLUSION: (1) Accuracy of the angle close to surgical transepicondylar axis: 3° PCL> CTEA > APL verticalline. (2) No significant difference in PCA was detected in two sets of measurements (P> 0.05). CTA and PAPA parameters in the first measurement by magnetic resonance imaging diagnosis were significantly lower than the second measurement (P< 0.05). (3) Results indicate that magnetic resonance technology provides ideal reference for distal femoral rotation, can accurately measure the CTA, PCA, PAPA andother indicators. It is a more reliable determination method and can be used in scientific determination of femoral rotational alignment reference axis in total knee arthroplasty. Except STEA, the accuracy of 3° PCL is highest.

Objective To explore the correlation between MRI performance and biological factors of estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor 2 (c-erbB-2)and p53 through a group cases of breast cancer.Methods The MRI characteristics of 39 cases with breast cancers confirmed by surgery were analyzed .The MRI characteristics of rim enhancement,speculate, the type of time-intensity curve (TIC),the early-phase enhancement ratio,peak to time,apparent diffusion coefficient (ADC)value were recorded and the lesions’pathological results of inmmunohistochemistry:the expression of ER,PR,c-erbB-2,p53 were aslo collected.The correlation between MRI characteristics and biological factors were analyzed with statistical software SPSS1 9.0.Results Spiculate was positively correlated with ER positive expression in breast cancer.Peak time of breast cancer and positive expression of p53 was negatively correlated.ADC value of breast cancer and positive expression of p53 was negatively correlated.Conclusion There are certain correlations between MRI characteristics and biological factors of breast cancer ER,PR,c-erbB-2,p53.

Objective To investigate the specific absorption rate (SAR)in 3.0T MR brain examination.Methods All 280 patients underwent 3 .0 MR brain examination.And the patients were divided into three groups:a group of 0-3 years old without hands intersection, inluding 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old without hands intersection,including 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old with hands intersection,consisting of 40 cases through MRA.The SAR values of each group were recorded,respectively.And the independent samples t test was used to compare statistical difference of different SAR values between groups.Results Compared the group of 0-3 years old without hands intersection and the group of more than 20 years old without hands intersection,the SAR values of all six sequences in front group were significantly higher than that those in latter one,but not exceed the safety standard of 3 w/kg in the United States FDA.There was no significant statistical differences in the SAR values of two groups which more than 20 years old with hands intersection or not (P>0.05).Conclusion The SAR values of each sequence in the group of 0-3 years old without hands intersection were significantly higher than those in the group of more than 20 years old without hands intersection,but in a safe and reasonable range.The brain scanning with two hands intersect of 20 years old and above,and there was no significant increase on the SAR values in the brain examination of the group of more than 20 years old with hands intersection.So it is of great significance to guide the daily work,settle doubts and improve success rates of the MR examination.

Objective:To investigate the cause of death, survival time, and risk factors in patients diagnosed with Alzheimer′s disease (AD) at memory clinic.Methods:The patients with AD were enrolled from the memory clinic at Huashan Hospital, Fudan University between August 2002 and December 2006. Baseline data were collected and 7 rounds of telephone follow-up visits were conducted to track clinical outcomes. For death cases, the date and cause of death were recorded. Patients were divided into several subgroups based on gender and baseline cognition [Mini-Mental State Examination (MMSE) score]. Kaplan-Meier analysis and Cox proportional hazards regression models were constructed to analyze the survival time of patients and identify the risk factors.Results:A total of 499 patients were enrolled, including 199 males and 300 females. The follow-up time was 5.5(3.4,7.4) years, with longest follow-up time of 19.3 years. The median survival time after symptom onset was 11.8 years (95% CI 10.2-13.4 years), which was 12.4 years (95% CI 11.2-13.5 years) in females, significantly longer than that in males (10.2 years, 95% CI 9.6-10.8 years, logrank test, P=0.010). The median survival time after diagnosis was 8.3 years (95% CI 7.3-9.4 years), which was 8.8 years (95% CI 6.9-10.6 years) for women, significantly longer than that for men (6.8 years, 95% CI 5.7-7.9 years, logrank test, P=0.001). Patients with baseline MMSE scores≥15 ( n=265) had a median survial of 11.4 years (95% CI 9.5-13.2 years), significantly longer than those with poorer cognitive function (baseline MMSE scores<15; n=234, 7.4 years, 95% CI 6.4-8.4 years, logrank test, P<0.001). Multivariable Cox proportional hazards regression analysis showed that aging ( HR=1.027, 95% CI 1.002-1.052, P=0.034), lower body mass index (BMI; HR=1.081, 95% CI 1.023-1.139, P=0.007), lower baseline MMSE score ( HR=1.056, 95% CI 1.026-1.086, P<0.001), diabetes ( HR=1.716, 95% CI 1.076-2.735, P=0.023), and history of falls ( HR=1.536,95% CI 1.007-2.341, P=0.046) were independent risk factors for death (all P<0.05). During the follow-up, 224 of the participants died. Except for 62 cases of unknown reason, the top 6 causes of death were pneumonia (39 cases, 24.1%), cerebrovascular disease (24 cases, 14.8%), circulatory system disease(21 cases, 13.0%), multi-organ failure (17 cases, 10.5%), tumor (13 cases, 8.0%), eating disorders and malnutrition (13 cases, 8.0%). Conclusions:In the current study, the median survival time after onset for patients with AD was 11.8 years; aging, lower BMI, lower baseline cognition, comorbidities, and history of falls were independent risk factors for death; pneumonia was the most common cause of death.