Objective To evaluate the accuracy of preoperative MRI in the diagnosis of malformations associated with MRKH syndrome and identification of uterine endometrium to optimize the clinical management.Methods 1 8 females with primary amenor-rhea were studied with MRI performed with a 1.5T or 3.0T imager.All patients were examined in the supine position using a phased-array coil and underwent pelvic MRI.Two experienced radiologists evaluated all the examinations in consensus to assess the pres-ence,position and morphology of vagina,uterus,ovaries and any pelvic abnormalities.Results One or two rudimentary uteri were identified in 17 patients (94.4%).A total of 16 patients (88.9%)had bilateral rudimentary uteri,1 (5.6%)had unilateral rudimentary uteri(it was left sided).1 (5.6%)had no uterine remnants.4 (12.1%)of 33 uterine buds in 4 patients showed differentiation of the center of the uterus into three layer.Bilateral ovaries were present in 1 7 patients,and their shapes,sizes and signals are normal.The vagina and cervix were absent in all cases.Conclusion MRI is a useful diagnostic tool in the preoperative evaluation of MRKH syndrome and the endometrium to further optimize the treatment plan.

Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.

Tetraspanin 2-A(SjTsp2-A) gene was amplified by PCR.pcDNA3.1(+)/SjTsp2-A recombinant plasmids were constructed and transformed into E.coli DH5?.Twenty four BALB/c mice were randomly divided into pcDNA3.1(+) /SjTsp2-A group(A),pcDNA3.1(+)/SjGST group(B) and pcDNA3.1(+) group(C).Each mouse was injected through musculus quadriceps femoris by three times(two weeks interval) respectively with 100 ?g pcDNA3.1(+)/SjTsp2-A,pcDNA3.1(+)/SjGST,or pcDNA3.1(+).At two weeks after the final inoculation,mice were each challenged by 40?2 cercariae of S.japonicum.Forty-five days after infection,all mice were sacrificed,the number of worms collected and eggs in liver tisssue was counted.Anti-pcDNA3.1(+)/SjTsp2-A antibody was detected by ELISA and protein expression in quadriceps muscle by immunohistochemical staining.The worm reduction rate(44.4%) and egg reduction rate(28.4%) of group A was higher than those of group B and C(P

Objective To clone and express a membrane protein(Tetraspanin 2) gene of Schistosoma japonicum (SjTsp2). Methods A pair of primers was designed to amplify the SjTsp2 gene which was subcloned into prokaryotic plasmid pET28a(+). The recombinant plasmid was transformed into E. coli BL21(D3) and followed by expression of the protein induced by IPTG. The protein was purified by affinity chromatography and used to immunize BALB/c mice. Dilution of antibody against SjTsp2 was determined by ELISA. The protein was also identified by Western blotting. Results Big loop of SjTsp2-A, 228 bp, was amplified in vitro by PCR. Its deduced amino sequence shared 52% similarity with SmTsp2. The soluble recombinant SjTsp2-A was expressed in the experiment and high dilution antibody against the recombinant (1 ∶ 32 000 in maximum) was produced in immunized mice. SjTsp2-A reacted positively with sera of acute and chronic schistosomiasis patients but not with sera from healthy persons by Western blotting. Conclusion SjTsp2 has been expressed and shows certain antigenicity.

Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.

mended to detect possible leakage of fat within central spinal canal.

Objective To investigate the characteristics and neural mechanisms of visual attention dysfunction in patients with hypertension using the event related potentials(ERPs).Methods Visual Oddball pattern was adopted to analyze P3a and P3b components of 15 essential hypertensives and 15 normotensives,and all the participants were submitted to cognitive assessment by Mini-Mental State Examination (MMSE).Results ①Novelty stimulus:the mean amplitude of N2 in hypertensive patients ((1.56± 1.15) μV) was decreased than normal controls ((-2.19±1.15) μV,P＜0.05),particularly at forehead-central sites (P＜0.05).In addition,the amplitude of P3a of hypertensive patients ((6.27± 1.01) μV) was different from normal controls ((7.09± 1.01) μV),but there was no statistical significance(P＞0.05).The latency of visual P3a was significantly longer in patients with hypertension group ((432.83 ± 8.22) ms) than that in control group ((403.10 ± 8.22) ms,P＞ 0.05).②Target stimulus:compared with control group ((6.75 ±0.90)μV),visual P3b amplitude in hypertension group ((4.08 ± 0.90) μV) was significantly declined (P＜ 0.05).Besides,the latency of visual P3b of hypertensive patients ((440.70 ± 6.42) ms) was different from normal controls ((436.91±6.42) ms),but there was no statistical significance(P＞0.05).③Compared with control group (27.31± 1.22),the M MSE score of patients with hypertension (24.55±2.42) was decreased (P＜0.05).The amplitude of visual P3b was positively correlated with MMSE scores in parietal region(r=0.51,P＜0.05).Conclusions The abilities of visual involuntary attention and voluntary attention are damaged in patients with hypertension,the impact degree of hypertension on two kinds of attention and the neural mechanisms are different.Moreover,there is a significant positive correlation between the amplitude of visual P3b and MMSE,which prompts that visual P3b for clinical early assessment of attention in patients with hypertension provides more objective neurophysiological basis.

Objective To research the possible influence of operation and human chorionic gonadotropin(HCG) therapy on the development of antisperm antibody (AsAb) and serum levels of estradiol (E_2) and testosterone (T) of cryptorchidism boys after orchiopexy. Methods Forty cryptorchidism boys were studied who were divided into HCG treatment group and without HCG treatment group. Twenty boys who underwent inguinal operation were studied as the operation control group and 20 normal boys as the control group. The serum were collected for detection AsAb, E_2,and T. Results There were no significant difference in serum levels of E_2 and T among the three groups(P 0.05 ). Conclusions The level of AsAb is associated with the destroy of blood barrier and the disorder of immune modulation and endocrine. Treatment with HCG has no effect on AsAb level.

Objective To assess MR characteristics of supratentorial intraparenchymal ependymomas(SIEs)in different age groups.Methods 40 patients with SIEs confirmed by surgery and pathology were analyzed retrospectively.All patients were examined by head MRI without or with contrast.Patients were divided into two groups according to age:child and adult group.T test was used to analyze the difference of tumor volume of two groups.Mann-Whitney U test was used to compare cystic,edema and pathological types of two groups.χ2test was used to distinguish sexual distinction.Results 39 cases of SIEs were located in cerebral surface,1 case located in inside cerebral essence.SIEs of child group(n=13)were male dominance(n=11),5 cases were located in the frontal lobe,all lesions were cystic solid masses.In the adult group(n=27),13 cases were male,9 cases were located in the frontal lobe,solid tumors were seen in 3 cases.There were significant difference among two groups in sexual distinction(χ2=3.921,P=0.048)and cystic change(U=98.50,P=0.02).There were no significant difference in the volume of tumor(t=1.828,P=0.087),edema(U=219.00,P=0.49)and pathological types(U=258.00,P=0.10).Conclusion There are MR characteristics differences in the SIEs in different age groups.Child has a superiority of male,tumors are mainly as cystic-solid mass,edema of the tumor is mild and has a high incidence cystic necrosis,the border is clear.In adult group,tumors are mainly as cystic-solid mass,and can also be solid mass, the solid portion of the lesion is easy to bleed,edema of the tumor is serious.

Objective To explore the value of DWI and 1 H-MRS in evaluation of malignant degree of primary osteosarcoma.Methods A retrospective analysis was performed in 41 patients with osteosarcoma confirmed pathologically and examined with DWI and 1 H-MRS.The b values were 0,400,800,1 000 and 1 500 s/ mm2 in DWI,respectively.ADC map was obtained,and ROIs were selected to measure ADC values.Eighteen cases which had stable spectral lines in MRS were selected and analyzed.The spectral lines,Choline (Cho),Creatine (Cr) and Cho/Cr ratio were obtained.Analysis of ADC values of high and low grade osteosarcoma were performed with Kruskal-Wallis H test,and Cho/Cr values were analyzed with Mann-Whitney U test.Results When b values were 400,800,1 000 s/mm2,ADC values of high and low grade osteosarcoma were significantly different (x2=6.26,4.37,4.87,P=0.01,0.04,0.03).When b value was 1 500 s/mm2,ADC value of high and low grade osteosarcoma had no statistical difference (x2 =2.39,P=0.12).Moreover,when 400 s/mm2 was taken as the optimal b value,the specificity and sensitivity of ADC value for identifying high grade osteosarcoma was 73.30 ％ and 72.70 ％,respectively.Cho/Cr values between high and low grade osteosarcoma were significantly different (Z=-2.45,P＜0.05).As a diagnostic parameter,the best threshold value of Cho/Cr was 2.21.And the specificity and sensitivity for diagnosing high grade osteosarcoma was 75.00 ％ and 92.90 ％,respectively.Conclusion ADC (b=400 s/mm2) and Cho/Cr values may be helpful to identifying malignant degree in osteosarcoma.