OBJECTIVE: To summarize the subtle anatomical structures of the normal nasal bone in multi-slice spiral CT (MSCT) image through the observation of the three-dimensional images. METHODS: One hundred and twenty volunteers who had no nasal trauma and disease history were collected. The nasal was scanned using MSCT. Raw data was reconstructed into bone window images (slice thickness 0.6 mm, slice interval 0.5 mm), and then the images were imported into Syngo Imaging XS software to reconstruct three-dimensional images and to summarize the nasal bone's subtle anatomical structures. RESULTS: The subtle anatomy of normal nasal bone generally included four seams, two holes and one edge. The four seams were left and right nasal-maxillary suture, nasal-frontal seam, and internasal suture. The two holes were left and right nasal aperture. The edge of the nasal was the lower edge of the nasal bone. In addition, there was suture bone in internasal suture in some normal nose. The nasal aperture mostly was hole-like, but some nasal apertures were line shape. The nasal edge can be divided into flat type, wave-shaped type, inverted spike type, hook-shaped type and others. CONCLUSION The anatomy diversity and individual differences in nasal bone are large. MSCT and three-dimensional image reconstruction techniques, combined with the history of trauma could distinguish between the normal anatomy and fractures.
Fractures, Bone/diagnosis* ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Maxilla ; Nasal Bone/diagnostic imaging* ; Software ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

OBJECTIVE: To realize the automated assessment of the levels of epiphysis of distal radius and ulna by support vector machine (SVM). METHODS: The X-ray films of the left wrist joints were taken from 140 teenagers aged from 11 to 19 years old as training samples. The levels of epiphysis of distal radius and ulna were divided into five developmental levels. Each level contained 28 samples. Another 35 cases were selected as independent verifying samples. SVM classification models of the five developmental levels of epiphysis of distal radius and ulna were established. The internal cross validation was made by leave one out cross validation (LOOCV), while the external validation was made by histogram of oriented gradient (HOG), and then the accuracy (PA) of testing results was calculated, respectively. RESULTS: The PA of SVM, LOOCV and HOG of distal radius epiphyseal level were 100%, 78.6%, and 82.8%, respectively; whereas the PA of SVM, LOOCV and HOG of distal ulna epiphyseal level were 100.0%, 80.0% and 88.6%, respectively. CONCLUSION The SVM-based automatic models of the growth stage of distal ra- dius and ulna appear to have certain feasibility, and may provide a foundation for software development of bone age assessment by forensic medicine.
Adolescent ; Bone Development/physiology* ; Child ; Epiphyses/growth & development* ; Female ; Humans ; Image Processing, Computer-Assisted/methods* ; Male ; Radius/growth & development* ; Support Vector Machine ; Ulna/growth & development* ; Wrist/growth & development* ; Wrist Joint/growth & development* ; Young Adult

OBJECTIVE: To access application value of multi-slice spiral computed tomography (MSCT) and coronary artery calcium scoring (CACS) in investigation the coronary artery disease (CAD), and to explore the effective way of virtual autopsy to evaluate the sudden death due to CAD. METHODS: Nine cases of sudden cardiac death were collected to analyze MSCT before the autopsy. The quantitative analysis of the degree of coronary artery calcium was made by Agatston's method. The CACS of all the subjects were calculated based on the diagnostic criteria for CAD, in which calcium scoring was more than 400. The results of CACS were compared with that of the autopsy. RESULTS: Only 2 cases got the high calcium scoring which were more than 400 in the 9 cases died of CAD confirmed by the autopsy. The prediction rate of CACS for CAD was only 22.2%. Pulmonary edema of different severity was found in both autopsy and MSCT. There was a higher morbidity rate in the left anterior descending of coronary artery than the other branches. CONCLUSION Obvious calcification of coronary artery can be detected by MSCT and calculating CACS. To detect subtle calcification needs other technologies such as postmortem angiography.
Autopsy ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging* ; Death, Sudden/pathology* ; Humans ; Multidetector Computed Tomography/methods* ; Predictive Value of Tests ; Vascular Calcification/diagnostic imaging*

OBJECTIVETo assess the necessity of routine prophylactic irradiation at the level Ib for nasopharyngeal carcinoma (NPC).

METHODSNewly diagnosed NPC patients between January, 2001 and June, 2005 were enrolled in this study. The nodal distribution in each region was calculated from the data of transversal contrast enhance CT or magnetic resonance scan of the head and neck.

RESULTSCervical node involvement was found in 75.1% of the 338 patients enrolled. The rates of involvement at levels Ib, IIa, IIb, III, IV, Va, Vb and in the supra-clavicular region were 0.9%, 49.1%, 60.7%, 26.0%, 5.9%, 9.5%, 3.8% and 0.9%, respectively. Skip metastasis occurred only in 2.4% of the cases. The high risk region (defined by a probable risk>5%) of nodal metastases was (1) the ipsilateral levels III, IV, Va, and Vb in case of level II involvement, (2) the ipsilateral levels II, IV, Va, and Vb in case of level III involvement, (3) the ipsilateral levels II, III, Va, Vb and the supra-clavicular region in case of level IV involvement, (4) the ipsilateral levels II, III, IV, Vb and the supra-clavicular region in case of level Va involvement, (5) the ipsilateral levels II, III, IV, Vb, and the supra-clavicular region in case of level Vb involvement, (6) the contralateral levels II, III, and Va in case of unilateral cervical node involvement.

CONCLUSIONNodal involvement in NPC patients rarely occurs at the level Ib, which is not a high risk region whatever the regions may be to have lymph node metastasis and therefore does not need routine prophylactic irradiation.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; pathology ; radiotherapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Neck ; Neoplasm Staging ; Tomography, X-Ray Computed ; Young Adult

Age estimation by the measurement method is to get the data such as the length, width, thickness, area of the ossification center, transverse diameter of the metaphysis, transverse diameter of osteoepiphysis, width of the epiphyseal line and the ratio between the diaph and the epiphyseal, by measuring the different bones of human in different ages with the radiological technology and to explore the relationship between these data and the life age by statistics. According to the relationships the personal life age may be estimated. In this article the measurement methods above mentioned and its application in age estimation were reviewed.
Age Determination by Skeleton/methods* ; Bone Development/physiology* ; Cervical Vertebrae/diagnostic imaging* ; Female ; Femur/diagnostic imaging* ; Forensic Anthropology/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Humerus/diagnostic imaging* ; Male ; Retrospective Studies ; X-Ray Film

Bipartite patella is uncommon in clinical medicine. It is formed by two or more ossification centers It is repeatedly misdiagnosed as patellar fracture in clinical practice. which do not fused in adolescence. In order to elevate the recognition of imaging signs of bipartite patella and to avoid the fault in medicolegal expertise testimony, three cases of bipartite patella were analyzed in combination of literature review, and the possible causes, histological changes, imaging signs, and clinical manifestation of bipartite patella were also discussed. The three cases concerned were all adults, two male and one female. They all felt pain after knee joint injury and were diagnosed as patellar fracture in medical institutions. Two cases were appraised on the degree of injury and one was on the degree of disability. According to Saupe's grouping, two cases were group III, and one was group II and III. In the practice of medicolegal expertise testimony, recognizing imaging signs of bipartite patella could provide more rigorous and objective conclusion.
Adult ; Diagnosis, Differential ; Female ; Forensic Medicine ; Fractures, Bone/etiology* ; Humans ; Knee Injuries/diagnostic imaging* ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pain/etiology* ; Patella/injuries* ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To further improve the accuracy of bone age identification using the time of secondary ossification center appearance and epiphyseal fusion of 7 joints to estimate the age of living individuals. METHODS: DR films were taken from 7 parts including sternal end of clavical and the left side of shoulder, elbow, carpal, hip, knee and ankle joints of 1 709 individuals who came from eastern China, central China and southern China, whose ages were between 11.0 and 20.0 years. From those 7 joints 24 osteal loci were selected as bone age indexes, which could better reflect age growth of teenagers. The characteristics of secondary ossification center appearance and epiphyseal fusion were observed, and the mean and age range of secondary ossification center appearance and epiphyseal fusion were calculated. RESULTS: The fusion time of the 24 epiphyses were advanced at different degrees, the most obvious epiphyses the sternal end of clavicle, scapular acromial end, distal end of the radius, distal end of the ulna, iliac crest, ischial tuberosity, the upper and lower end of tibia and fibula. The appearance time of sternal end of clavicle, scapular acromial end, iliac crest and ischial tuberosity epiphyses were all found to be after the age of 12, and the female's age, approximately 1 year ahead of schedule in comparison with the male's. CONCLUSION The relevant forensic information and data for bone age identification should be updated every 10-15 years so as to provide accurate and objective evidence for court testimony, conviction and sentencing.
Adolescent ; Age Determination by Skeleton/methods* ; Asian People/ethnology* ; Bone Development/physiology* ; Bone and Bones/diagnostic imaging* ; Child ; China/ethnology* ; Clavicle/growth & development* ; Epiphyses/growth & development* ; Female ; Forensic Anthropology/methods* ; Humans ; Joints/growth & development* ; Male ; Sex Characteristics ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To establish standardized methods and parameters of the isolated heart coronary angiography through the experiment of in vitro porcine heart by MSCT. METHODS: Based on different perfusion volume (50, 60 and 70 mL) and different perfusion-imaging time (5, 10 and 20 min), the in vitro porcine coronary artery was injected liposoluble and water-soluble contrast agents using remodel angiography equipment and scanned by MSCT. And the 3D image results were compared. The images were recorded and evaluated by 2 radiologists and analyzed by statistical software. RESULTS: Liposoluble contrast agent affected the images by damaging and infiltrating the fats around the coronary artery, while the water-soluble contrast agent didn't affect the images. The groups with 60 mL or 70 mL perfusion and 5 min perfusion-imaging time had the best images. CONCLUSION The suitable parameters of the angiography lay the foundation of postmortem coronary angiography.
Animals ; Coronary Angiography/veterinary* ; Coronary Vessels/diagnostic imaging* ; Heart ; Imaging, Three-Dimensional/methods* ; In Vitro Techniques ; Multidetector Computed Tomography/veterinary* ; Predictive Value of Tests ; Sensitivity and Specificity ; Software ; Software Validation ; Swine

OBJECTIVETo study PD-1 and PD-L1 expressions during 24 weeks telbivudine antiviral treatment in patients with chronic hepatitis B (CHB) and to explore the relationship between PD-1 expression and HBeAg/HBeAb seroconversion.

METHODSTen CHB cases with HLA-A2 and HBeAg positive were treated with telbivudine 600 mg/d orally for 24 weeks. Fresh blood samples were collected at week 0, 12 and 24 after treatment. HBV-specific CD8+ T cells were expanded in vitro. Cell culture medium were collected for interferon gamma (IFNgamma) detection. Flow cytometry was used to detect the HLA-A type, PD-1, PD-L1 and HBV specific CD8+ T cells. The expressions of PD-1 and PD-L1, the counts of HBV-specific CD8+ T cells in circulating CD8+ lymphocytes, and IFNgamma concentration in culture medium were evaluated during antiviral treatment.

RESULTSAt week 0, 12 and 24 after telbivudine treatment, 7 of 10 patients were HBV DNA undetectable, 2 were HBeAg seroconversion and 2 were HBeAg lose but anti-HBe negative. The frequency of PD-1-positive PBMCs were 52.1%+/-17.0%, 39.1%+/-18.2% and 23.4%+/-16.3% (week 24 vs week 0, P < 0.01) respectively; PD-L1 positive PBMCs were 45.6%+/-15.4%, 34.6%+/-16.2% and 20.9%+/-9.5% respectively(week 24 vs week 0, P < 0.01; week 24 vs week 12, P < 0.05). The frequency of PD-1-positive CD8+ T cells were 76.2%+/-10.4%, 66.5%+/-15.4% and 49.5%+/-25.3% respectively (week 24 vs week 0, P < 0.01; week 12 vs week 0, P < 0.05; week 24 vs week 12, P < 0.05); HBV-specific CD8 cells were 1.3%+/-0.5%, 1.5%+/-1.0% and 2.2%+/-1.5%; IFNgamma levels in cell culture medium were (91.7+/-82.1) pg/ml, (99.4+/-93.5) pg/ml and (109.5+/-86.6) pg/ml. A remarkable decrease of PD-1 and PD-L1 expressions and increase of HBV-specific CD8+ T cells were observed in patients who had HBeAg/HBeAb seroconversion at week 24.

CONCLUSIONSDirect suppression of HBV replication by telbivudine in CHB patients can decrease PD-1 and PD-L1 expressions and restore HBV-specific CD8+T cells. The relationship between the changes of PD-1 expression and HBeAg/HBeAb seroconversion during antiviral therapy in HBeAg-positive patients need to confirm by future study.

Adult ; Antiviral Agents ; therapeutic use ; B7-H1 Antigen ; metabolism ; CD8-Positive T-Lymphocytes ; immunology ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; metabolism ; Humans ; Male ; Nucleosides ; therapeutic use ; Programmed Cell Death 1 Receptor ; metabolism ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Young Adult