Objective To investigate the development of the cervical cord in children by using diffusion tensor imaging.Methods Ninety healthy children were undergone with diffusion tensor imaging of the cervical cord by using single-shot spin-echo echo planar image sequence.The values of apparent diffusion coefficients (ADC), fractional anisotropy (FA), average length(Ltract) and volume of tracts(Vtract) were measured in the cervical regions.Results The measurements of each group were as follow:ADC value:0.9747 ±0.2777,0.8493 ±0.2236,0.8210 ±0.1432,0.9198 ± 0.1444,0.9048 ±0.1676;FA value:0.4117 ±0.0391,0.4712 ±0.0199,0.4944 ±0.0439,0.5608 ±0.0443,0.6169 ± 0.0551;Ltract:25.61 ±8.63,24.66 ±7.14,27.03 ±7.23,34.93 ±10.99,37.63 ±10.22;Vtract:3.07 ±1.49,3.00 ± 1.52,3.81 ±1.33,5.41 ±2.35,6.64 ±2.84.FA value, Ltract and Vtract showed significance in different age groups , while ADC value was found no difference ( P<0.001) .Post-Hoc test revealed that FA value was significantly different between age group I and Ⅱ.FA value, Ltractand Vtract presented significantly different between group ⅢandⅣ.FA value difference was also found between group Ⅳand V.FA value, Ltract and Vtract were all positively corelative with age (F=1.758, P=0.145 ) .Conclusion Development of the cervical cord shows periodicity with periodic features .Diffusion Tensor Imaging can be used as a tool to observe and evaluate development of the cervical cord in children .

Objective To investigate the elinicopathologic features of atypical endometriosis(AEM) and to discuss the relationship between AEM and tumors. Methods A retrospective analysis was performed of 163 cases of AEM, which were retrieved from the Department of Pathology files at the Tianjin Central Obstetrics and Gynecology Hospital between Jan 2004 and Dec 2006. The pathologic changes of AEM including its glandular epithelium, stroma, background and the conditions coexisting with tumor were observed. Results The AEM accounted for 4.38% (163/3724) of the endometriosis (EM) eases. Of 172 AEM foei of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa respectively. The rate of ovarian AEM was 6.81% of endometriosis. AEM associated with tumour was found in 26 cases (15.95% )and among 27 of ovarian AEM, 15 were malignant, 9 borderline and 3 benign. The AEM epithelia were mainly arranged in the form of surface epithelium. They present with characteristic features of moderate to marked pleomorphism, epithelial tufting and bud structures by microscopy. The walls of AEM cyst were presented with three layers of epithelium, endometrioid stroma and fibrosis-collngen. The endometrioid stroma were usually thin in contrast to the fibre-collagen tissue, which was often thick with scarred background. The transformation from AEM to tumor was found in most of the malignant tumors( 14/15,93% ). Conclusions AEM lesions hold some features of both EM and tumor, which may have a relatively higher potential for tumorigenesis and cancerafion. The process of damage and repair in EM foci during a long course may play a role in the development of EM into AEM and finally into tumor.

Objective To evaluate the application of dual-source CT (DSCT) using low-dose technology in diagnosing complex congenital heart diseases. Methods The DSCT data of 31 cases with complex congenital heart diseas-es conifrmed by operation were retrospectively analysed and classiifed into four groups:group A(≤4 months old, n=12); group B (>4 months old~1 year old, n=3);group C (>1 year~6 years old, n=8) and group D (>6 years old, n=8). Results The diagnosis conformation rate of DSCT with surgery were 94.59%. The diagnostic conformation rate of intracardic anormalies using DSCT was 92.86%. And the diagnostic conformation of DSCT in patients with abnormal connection of atrium or ventri-cle to great vessels and the extrocardic anormalies was 95.65%. The average effective dose in each group were 1.16±0.06 mSv, 1.28±0.07 mSv, 1.96±0.54 mSv and 2.77±0.38 mSv, respectively. The ratio of the high quality images was 90.32%. Con-clusions The application of low dose technology in DSCT can clearly display the anomalies, and signiifcantly reduce the radiation dose without losing image quality as well.

Objective Analysing the CT manifestations of the crura of diaphragm space occupying lesions and disucssing the diagnosis and differential diagnosis of lesions.Methods 56 cases of the crura of diaphragm space occupying lesions were observed retrospectively,these lesions were confirmed by clinic and pathology.Results The lesions of crura of diaphragm space followed up:15 cases of spinal metastases;5 cases of spinal tuberculosis;27 cases of lymphadenia;1 case of abdominal aorta false aneurysm;3 cases of azygos vein and semiazygos vein dilatory;1 case of taint caused by esophageal perforation;4 cases of invaded by tumour directly. Conclusion We should recognize the nodes and space of crura of diaphragm correctly,that is helpful to recognize the occupying lesions of crura of diaphragm space properly.

Objective To evaluate the safety, efficiency and feasibility of HLA-identical sibling using culture-expanded mesenchymal stem cells and hematopoietic stem cells in treatment for myelodysplastic syndrome (MDS). Also to investigate for valid preventive measures to avoid the infection of HBV originated from donor. Methods A 46-years-old male patient with myelodysplastic syndrome-refractory anemia (MDSRA) got a cotransplantation of culture-expanded mensenchymal stem cells (MSC) and hematopoietic stem cells (HSCs) from HLA-identical sibling donor (his sister) who was infected by hepatitis B virus (HBV). Some measures were applicated in order to avoid the recipient from getting a HBV infection. The antiviral therapy to the donor was began early at the time 1 month before transplant, and HBV vaccine inoculation was used 2 month before transplant. High titer of anti-hepatis B immunoglobulin was used 1 week before transplant and 1 month after transplant the use of prophylactic anti-hepatis B drug treatment was begun. A non-myeloablative preparative regimen included fludarabine monophosphate (Flu, 120 mg/m2), cyclophosphamide (Cy, 1200 mg/m2)and antithymocyte globulin (ATG, 15 mg/kg) was given to him before culture-expanded mesenchymal stem cell and allogeneic peripheral blood stem cell from his HLA-matched sister. Results The regimen was well tolerated, and hemopoiesis was reconstituted on day 10 after transplant, idiochromosome detected by fluorescent in situ hybridization on day 30 showed XY 47/300 and on day 90 it was 7/300. No evidence of HBV infection was detected on day 60 after transplant. Conclusion The clinical course of this patient indicate that HLA-identical sibling culture-expanded mesenchymal stem cell transplantation combined with non-myeloablative stem cell transplantation can be an effective and safe approach in treatment of MDS.

Objective To investigate the effects of different approaches of periacetabular osteotomy(PAO)on traumatic stress,lower limb strength and prognosis of acetabular dysplasia(DDH).Methods Ninety-seven patients with DDH in our hospital from January 2021 to January 2022 were randomly divided into two groups.Among them,48 patients in the control group received conventional ilioinguinal approach PAO treatment,while 49 patients in the study group received modified ilioinguinal approach PAO treatment.The surgical and postoperative rehabilitation indexes,Mckay clinical efficacy,lower limb line of force,complications,traumatic stress factors before and after surgery[adrenalin(NE),cortisol(COR),angiotensin Ⅱ(AngⅡ)],hip imaging indexes[anterior CE Angle(ACEA),lateral CE Angle(LCEA),acetabular index(AI)]and changes were compared between the two groups Good Harris hip function Score(mHHS),hip outcome score Daily Living Ability Scale(HOS-ADL).Results The operation time of the study group and the control group were(128.64±18.73)min and(141.80±21.59)min respectively,the intraoperative blood loss were(472.95±35.18)ml and(495.68±40.26)ml respectively,the postoperative drainage were(242.39±32.74)ml and(305.81±39.56)ml respectively,and the hospital stay were(11.57±2.29)D and(12.86±2.41)d respectively,with significant differences between the two groups(P＜0.05);The excellent and good rate of McKay's clinical efficacy in the study group(95.92％)was higher than that in the control group(81.25％),and the differences were statistically significant(P＜0.05);Serum NE in the study group and control group at 1 d,3 d,and7 d postoperatively were(73.16±8.07)ng/L and(81.33±8.52)ng/L,(65.81±7.29)ng/L and(72.24±7.65)ng/L,(45.98±6.31)ng/L and(50.37±7.02)ng/L,respectively,and COR were(164.84±19.35)ng/L and(178.62±21.46)ng/L,(142.69±17.81)ng/L and(157.36±19.22)ng/L,(88.79±16.13)ng/L and(97.62±17.50)ng/L,respectively,and AngⅡ was(138.74±20.51)mmol/L and(150.19±21.36)mmol/L,(128.35±17.69)mmol/L and(137.18±19.24)mmol/L,and(119.82±17.41)mmol/L and(128.73±18.50)mmol/L,respectively,and the differences between the two groups were all statistically significance(P＜0.05);ACEA at 3,6,and 12 months postoperatively in the study and control groups were(29.71±4.81)° and(27.68±4.53)°,(29.80±4.75)° and(27.72±4.60)°,(29.64±4.79)° and(27.63±4.51)°,respectively,and LCEA was(33.79±6.12)° and(31.04±5.83)°,(33.82±6.10)° and(31.10±5.90)°,(33.75±6.08)° and(31.05±5.77)°,and AI was(6.15±1.86)° and(7.03±1.94)°,(6.08±1.82)° and(7.01±1.89)°,(6.12±1.84)° and(7.06±1.90)°,respectively.mHHS scores was(72.15±7.65)and(68.23±7.71),(76.51±7.52)and(72.19±7.94),(90.13±5.16)and(86.76±5.72),and HOS-ADL scores were(79.92±7.50)and(76.26±7.62)points,(80.85±7.42)and(77.13±7.66)points,(89.73±6.37)and(86.25±7.15)points,and the differences between the two groups were statistically significant(P＜0.05);the comparison of lower limb force lines and complications between the two groups showed no statistically significant differences(P＞0.05).Conclusion Modified ilioinguinal approach PAO in the treatment of DDH can optimize the operation,reduce traumatic stress factors,further improve the curative effect,improve the status of femoral head coverage and hip function,and improve the quality of life,with high safety.

This paper reports a case of multiple myeloma complicated with Primary systemic light chain amyloidosis peripheral neuropathy.Patient was a male,60 years old with subacute onset of peripheral neuropathy.Patient had previous history of hypertension,coronary heart disease and stable angina pectoris.His urine routine examination 2 months ago showed urine protein(+++).The first clinical symptom with peripheral neuropathy characterized by progressive numbness and weakness of both lower limbs.The diagnosis was made after completing electromyography,lumbar puncture,renal puncture,bone puncture and other related examinations,and relevant treatment was given.As a rare disease of nervous system,the incidence rate is low.Early diagnosis is an important step to reduce mortality and improve prognosis.However,the disease is easily misdiagnosed as diabetic peripheral neuropathy and chronic inflammatory demyelinating polyradiculoneuropathy,thereby delaying diagnosis and treatment.

PURPOSE: Caffeine is the most widely consumed psychostimulant. It is often adopted as a tool to modulate brain activations in fMRI studies. However, its pharmaceutical effect on task-induced deactivation has not been fully examined in fMRI. Therefore, the purpose of this study was to examine the effect of caffeine on both activation and deactivation under sustained attention. MATERIALS AND METHODS: Task fMRI was acquired from 26 caffeine naive healthy volunteers before and after taking caffeine pill (200 mg). RESULTS: Statistical analysis showed an increase in cognition-load dependent task activation but a decrease in load dependent de-activation after caffeine ingestion. Increase of attention and memory task activation and its load-dependence suggest a beneficial effect of caffeine on the brain even though it has no overt behavior improvement. The reduction of deactivation by caffeine and its load-dependence indicate reduced facilitation from task-negative networks. CONCLUSION: Caffeine affects brain activity in a load-dependent manner accompanied by a disassociation between task-positive network and task-negative network.
Brain ; Caffeine* ; Eating* ; Healthy Volunteers ; Magnetic Resonance Imaging ; Memory ; Memory, Short-Term*

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.