Objective To investigate MRI features and its clinical value in the pigmented nodular synovitis (PVNS) of the knee joint in order to improve the accuracy of diagnosis of the disease.Methods MRI signs of 9 cases with PVNS of knee joint confirmed by operation and pathology were analyzed retrospectively.Results In 9 patients, joint effusion and marginal bone erosion were found.Diffuse thickening of the synovial membrane, multiple soft tissue nodules showed hypointense on T1WI and mixed hypointense and hyperointense on T2WI,were revealed on MRI.Conclusion MRI features of PVNS of the knee joint are characteristic, which reflects the pathological basis and helps to improve the diagnostic accuracy of the disease.

Objecfive To investigate the relationship between single nucleotide polymorphism-56(SNP-56)in calpain-10(CAPN-10)gene and polycystic ovary syndrome(PCOS)in Chinese.Methods The genotypes of SNP-56 of CAPN-10 were determined through polymerase chain reaction Tm-shift genotyping method in 638 local women in Shandong Province.Among them,334 were patients with PCOS (PCOS group)and 304 were normal women(control group).The baseline parameters including levels of serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone(T)and lipid,as well as the body mass index(BMI)and waist/hip ratio(WHR)were measured.Glucose tolerance and insulin releasing before and after loading with 75 g of glucose were also assayed.Results(1)The frequencies of two allelotypes or three genotypes did not differ between PCOS women and normal women(P＞0.05).(2)In PCOS group,patients with AA genotype had a significantly higher plasma glucose of 180 minutes OGTT(5.7±2.2)mmol/L[P＜0.01 compared to Gagenotype(4.9±1.2) mmol/L,P＜0.01 compared to GG genotype(4.9±1.4)mmol/L]and serum total cholesterol(TC)level(4.9±1.0)mmol/L[P＜0.05 compared to Gagenotype(4.5±0.9)mmol/L].(3)Compared to PCOS patients with GA+GG genotype(P＜0.05,P＜0.01)or GG genotype(P＜0.05,P＜0.01),there was significantly higher attack rate of diabetes and tumor in the family history of patients with AA genotype.Conclusions These findings suggest that CAPN-10 gene SNP-56 which may not contribute to the genetic susceptibility of PCOS plays a role in glucose and lipid metabolism in Chinese PCOS patients.It may also be correlated with attack rate of diabetes and tumor in the family history of PCOS patients.

Objective To explore the security,pregnancy outcomes,and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy (RT).Methods Thirty-two young patients ＜ 40 years of age with early cervical cancer from May 2004 to July 2012 admitted in Tumor Hospital Xiangya School of Medicine of Central South University were divided into two groups based on different operation methods:vaginal radical trachelectomy (RVT) group and abdominal radical trachelectomy (RAT) group.The clinical data were analyzed by One-way Anova and multivariate Cox stepwise regression analysis.Results The operation duration,number of lymph node dissection,the height of the cervical resection,postoperative hospitalization time,incidence of vascular injury and incidence of postoperative lymphocele were respectively (250 ± 82) min,15 ± 6,(2.31 ± 0.21) cm,(9.2 ± 2.9) d,1/18 and 1/18 in RVT group,while (263 ±60) min,16 ±8,(2.32 ±0.26) cm,(10.3 ±3.5) d,0 and 1/14 in RAT group.There was no statistically significant difference between the two groups (all P ＞ 0.05).The blood loss (281 ±201) ml in RVT group was significantly lower than that in the RAT group (492 ±320) ml (P ＜0.05).The length of Vaginal hysterectomy[(2.61 ±0.50) cm] and the width of parametrial resection[(2.38 ±0.36) cm] in RVT group were significantly less than those[(2.95 ±0.10),(2.81 ±0.22) cm] in the RAT group (all P ＜ 0.05).The pregnancy rate between RVT group (3/18) and RAT group (2/14) were no significant difference (P ＞ 0.05).One-way Anova analysis showed that the recurrence of early cervical cancer was related to tumor size in diameter (F =4.911,P =0.047),while there were no correlation with age,clinical stage,histological type and surgical approach (all P ＞ 0.05).Multivariate analysis showed that tumor diameter size was an independent risk factor for tumor recurrence (3 =0.259,P =0.031).Conclusions RT for young patients with early cervical cancer is feasible.Pregnancy outcomes after RT need to be study in the future.Tumor size in diameter is the major risk factor for tumor recurrence.

Objective To provide a kind of infusion soft bag with double-pouch that avoids the compatibility reaction between medicinal fluids and improves the safety of transfusion. Methors By consulting the literature, clinical research, developed a safe infusion bag. Researching the volume and the method of tube flushing in vitro simulation experiments, observation of the experimental process, data collection, input, analysis, processing, in order to determine the capacity of the fluid structure to compare the operation time of the two methods of flushing tube. Results In vitro simulation showed that the volume of fluid needed for irrigation infusion tube was 30-50 ml. The time spent on each infusion tube when using the developed safety infusion bag and existing infusion bag was (2.81±0.18) s and (13.63±0.36) s respectively, the difference was statistically significant (t=-146.15,P<0.05). Conclusion The size of the main bag of the safe transfusion soft bag can be set according to the clinical need. The recommended storage capacity of the bag for flushing is 50 ml for the strong solution and 30 ml for the ordinary solution. Safety infusion soft bag is high safety, easy to use, reducing nurse′s workload and the risk of infection, it is worth the clinical promotion.

Objective To investigate the diagnostic value of susceptibility weighted imaging ( SWI) in patients with mild traumatic brain injury(MTBI).Methods From June 2016 to October 2017,a retrospective analysis of 89 patients with MTBI (Glasgow score 13 to 15) in the First People's Hospital of Xiaoshan District was conducted.All patients were given head CT ,MRI and SWI within 1 week after admission.Combined with CT and phase diagram ,after removing blood vessels ,calcification and skull base artifact ,the low signal intensity on the SWI was cerebral contusion and hemorrhage.The sites,the number and the size of lesion detected on CT ,MRI and SWI images were recorded and analyzed with clinical symptoms.Results According to the presence or absence of clinical symptoms in the group ,the detection rates of microbleeds hemorrhage in patients with traumatic cerebral by SWI were 94.4%,54.2%,100.0%, 95.5%,respectively,which were higher than those by CT (16.6%,4.2%,15.0%,4.5%) and MRI conventional sequences(33.3%,8.3%,20.0%,13.6%),the differences were statistically significant (χ2＝6.633,P＝0.010;χ2＝4.260,P＝0.039,all P ＜0.05),especially in MTBI patients with a history of transient coma or persistent clinical symptoms after trauma(the detection rate was 100.0%).Conclusion Compared with conventional CT and MRI,the micro-contusion and small hemorrhagic lesions of SWI is more accurate and important in the diagnosis of MTBI,and has a significant prognostic value for clinical treatment and judgment of patients with MTBI .

Hospital logistics management provides critical support for clinical work, and the management of materials is key to logistics management. Based on an analysis of current logistics management of the hospital, desirable results on logistics materials management have been harvested. The measures taken include optimizing management workflow and reinforcing cost control, in combination with such efforts as regulations improvement, higher informatization level and staff teamwork building.

Objective:To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.