Next generation sequencing(NGS)has made great progress, applied from science technology to clinical diagnosis in the past several years.With a simple, fast, high-throughput, and high-resolution feature, it has been believed to be one of the most potential technology in clinical tests, especially in individual tumor diagnosis and treatment, noninvasive prenatal screening, genetic disorders screening field.This paper will briefly review the application of next generation sequencing in the field of infection disease.

Objective To investigate the CT characteristics of retroperitoneal extra-adrenal paraganglioma(PGL).Methods CT findings of 11 patients with pathologically confirmed retroperitoneal extra-adrenal PGL were analyzed retrospectively,and the relevant literature was reviewed.All patients received plain CT as well as contrast-enhancement CT scan.Results All of the 11 tumors were located in the retroperitoneal space around large blood vessels,including 2 functional and 9 unfunctional extra-adrenal paragangliomas.Eight of 11 cases were benign tumors which presented as round or oval masses with sharp margins,separated from surrounding structures clearly;while the rest 3 cases,which with indistinct edge,even more with the invasion of surrounding structures (renal artery,renal venous and pancreas),were confirmed to be malignant.Most of the tumors were heterogeneous on plain CT.It was common to see intratumoral necrosis or cystic degeneration in the tumors (9 cases),while hemorrhage or calcification was uncommon,which was found in 3 and 2 cases,respectively.Homogeneous intensity was only observed in 2 masses with diameter less than 4 cm.On contrast-enhanced CT image, the solid part of the tumors presented continuously significant enhancement.Dilated feeding artery was found in or around the masses (8 cases) in artery phase.Conclusion There are certain characteristics of retroperitoneal extra-adrenal paraganglioma on CT scanning, which are helpful for preoperative diagnosis and treatment of this disease.

BACKGROUND:Compared with total knee arthroplasty, unicompartmental arthroplasty has the advantage of minimal invasion. Regarding the gold standard of total knee arthroplasty, the survival rate of unicompartmental arthroplasty remains controversial. OBJECTIVE:To establish three-dimensional finite element model of unicompartmental arthroplasty and total knee arthroplasty, and comparatively analyze the changes in stress on the prosthetic contact surface. METHODS:One case underwent unicompartmental arthroplasty on one side, and received total knee arthroplasty on the opposite side. Knees were scanned by 3D CT before operation. Knee models were established by three-dimensional software. The matched prosthesis was designed by parameterization software. Three-dimensional models for unicompartmental arthroplasty and total knee arthroplasty were established. By finite element analysis software, maximal equivalent stress was simulated when knee flexion was 0°, 10°, 30° and 60° in standing and walking cases, and results were compared and analyzed. RESULTS AND CONCLUSION: No significant difference in maximal equivalent stress was detected when knee flexion was 0° and 10° in unicompartmental arthroplasty prosthesis and total knee arthroplasty prosthesis in standing case (P > 0.05). At knee flexion of 30° and 60° in standing case, the maximal equivalent stress was significantly greater in unicompartmental arthroplasty prosthesis than in the total knee arthroplasty prosthesis (15.01%, 6.08%;P < 0.05). When knee flexion was 0°, 10° 30° and 60° in standing case, the maximal equivalent stress was higher in unicompartmental arthroplasty prosthesis than in the total knee arthroplasty prosthesis (5.45%, 6.65%, 6.67%, 9.01%;P < 0.05). These findings verified that in the case of standing, there was no practical significance in wearing of polyethylene insert between unicompartmental arthroplasty prosthesis and total knee arthroplasty prosthesis. In the case of walking, the wearing of unicompartmental arthroplasty may be higher than that of total knee arthroplasty prosthesis, which provides guidance for the clinical practice.

Objective To assess intraplaque hemorrhage before carotid artery stenting (CAS)by use of 3D-MPRAGE and DWI sequence.Methods Thirty-two symptomatic patients who had carotid artery plaque suspected by color Doppler ultrasonography and prepared for CAS underwent 3.0T carotid high-resolution MR scans,including regular sequence,T1-weighted gradient echo three-di-mensional magnetization prepared (3D-MPRAGE ) sequence,diffusion-weighted imaging (DWI ) sequences.According to 3D-MPRAGE sequence hemorrhage and non-hemorrhage groups were divided,and measured the mean ADC values of the two groups, hemorrhage and non-hemorrhage part in the hemorrhage group.Meanwhile preoperative cerebral hemorrhage group underwent brain DWI scans.Independent samples t-test analysis was utilized by SPSS V20.0 statistical software.Results High-resolution MRI dis-played 40 plaques,fourteen hemorrhagic plaques showed by 3D-MPRAGE sequence.The mean ADC values of hemorrhage and no-hemorrhage group were(1 233.5±283.5)× 10 -6 mm2/s,(1 688.9 ± 449.6)× 10 -6 mm2/s respectively,the difference of both was significant (t=3.43,P <0.05).The mean ADC values of hemorrhage and non-hemorrhage parts in the hemorrhage group mean ADC values were (934.0 ± 387.9)× 10-6 mm2/s,(1 313.9 ± 295.0)× 10-6 mm2/s respectively;the difference of both was statistically significant (t=2.92,P < 0.05 ).The difference of mean ADC values between non-hemorrhage part in the hemorrhage group and hemorrhage group was statistically significant (t=2.80,P <0.05).Conclusion 3D-MPRAGE and DWI sequences can be evaluated intraplaque hemorrhage before CAS,and provided a reliable basis for timely clinical interventions to prevent stroke.

Objective To analyze the MRI characteristics of cavernous angioma of the epidural space in spine.Methods MR imaging features of cavernous angioma of epidural space in 3 cases confirmed by surgery-pathology were analysed with literature review . Results Among the three cases,the tumors located in the lumbar spine in one and in the thoracic spine in 2.The tumors were all at posterior to the spinal cord and shuttle-shaped,the major axis was consistent with the spinal ordinate axis,the corresponding plane spinal cords were compressed and resulting in distortion and shift.The tumors were high signal intensity on T_2WI,and obviously homogeneous enhanced after Gd-DTPA administration. Conclusion MRI examination is the best method to diagnose this kind of disease.

Objective To study MRI features of pituitary stalk interruption syndrome(PSIS).Methods 10 cases in 42 with growth retardation patients diagnosed as PSIS by MRI,all of them were male,age ranged from 5 to 18 with average 13.6 years.Results The anterior-pituitary superior border was depressed,anterior-pituitary volume decreased(average height 2.1 mm,average width 7.8 mm),ectopic posterior-pituitary lobe located at infundibulum stem and pituitary stalk was absent in all cases.The blood hormorne test showed the growth hormone deficiency and multiple growth hormone deficienty.Conclusion PSIS often see in men,MRI findings of PSIS are characteristic.

Objective To investigate the correlation between HCY (Homocysteine),folate,vitamin B12 and head and neck vascular stenosis in patients with ischemic cerebrovascular disease.Methods 225 patients with ischemic cerebrovascular disease in Tangdu Hospital of the Fourth Military Medical University were enrolled in the study from April 2016 to October 2016.The serum levels of HCY,folate and vitamin B12 were detected.CT angiography (CTA) was uesd for patients with head and neck vascular scanning.According to whether the presence of vascular stenosis,patients were classified as no vessel stenosis group and vascular stenosis group.According to the degree of stenosis,patients were classified as no vascular stenosis group,mild moderate stenosis group and severe stenosis group.Results The HCY levels in the vascular stenosis group were significantly higher than no vessel stenosis group,while the levels of folate and vitamin B12 were significantly lower than no vessel stenosis group,the differences were statistically significant (t=9.656,7.140 and 8.350,all P＜0,01).The HCY levels in mild moderate stenosis group and severe stenosis group were significantly higher than no vessel stenosis group,and the HCY levels in severe stenosis group were significantly higher than mild moderate stenosis group,the differences were statistically significant (t=6.108,9.401 and 5.273,all P＜0.01).The folate levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=5.574 and 5.988,all P＜0.01).The vitamin B12 levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=4.548 and 7.816,all P＜0.01).The degree of head and neck vascular stenosis and serum levels of HCY were positively correlated (r=0.331,P＜0.01).The degree of head and neck vascular stenosis and levels of vitamin B12 were negatively correlated (r=-0.279,P＜0.05).Conclusion The levels of HCY,folate and vitamin tB12 were closely related to the degree of head and neck vascular stenosis.HCY,folate,vitamin B12 and head and neck CTA play important roles in patients with ischemic cerebrovascular disease clinically.

Objective To establish a novel method for simultaneous determination of three ingredients (codeine phosphate, brompheniramine maleate and ephedrine hydrochloride) in compound codeine phosphate solution by using capillary electrophoresis (CE) coupled with electrochemiluminescence (ECL). Methods Based on enhanced ECL intensity of tris (2,2′-bypyridine) ruthenium (Ⅱ) with codeine phosphate, brompheniramine maleate and ephedrine hydrochloride, as well as the linear correlation between enhanced sensitivity intensity and drug concentration, Parameters affecting separation and detection were optimized. Results Under the optimized conditions, we determined the linear range, regression equation and detection limit for the three ingredients. The relative standard deviation of ECL intensity for twelve consecutive injections of 1.0×10~(-5)kg/L standard sample of three kinds of drug was 2.89% for codeine phosphate, 3.76% for brompheniramine maleate and 3.32% for ephedrine hydrochloride, respectively. Satisfactory results were obtained without interference from sample matrixes. Conclusion The method was successfully applied to the determination of three ingredients in oral solution of compound codeine phosphate, with the recovery rate of 100.4% for codeine phosphate, 101.9% for brompheniramine maleate and 99.8% for ephedrine hydrochloride.

Objective To study the effect of high intensity focused ultrasound(HIFU)ablation on microvessel density(MVD)and vascular endothelial growth factor(VEGF)in rabbit hepatcocellular carcinoma (HCC)models.Methods The VX2 t umor cells were planted in the hepatic left-central lobe on 30 rabbits.All animals were divided into two groups randomly:HIFU group(n=25)and control group(n=5).The MVD and the expression of VEGF in the HCC was detected by immunohistochemical SABC methods in control group and 0,1,3.7,16 d after the operation in HIFU group.Results The MVD and the expression of VEGF in the HCC tissue after HIFU treatment in the HIFU group were decreased significantly as compared with those in the control group (P＜0.01).However,there was no significant difference in MVD and the expression of VEGF in the HCC tissue after HIFU treatment in the HIFU group among the different time points(P＞0.05).Conclusions HIFU treatment can effectively destroy the micovessel,repress the neovascularization and reduce the blood supply of the HCC.

Objective To assess the value of contrast-enhanced ultrasonography(CEUS)in evaluating the therapeutic efficacy of uterine leiomyoma treated by radiofrequency ablation(RFA)and to discuss the value of its application.Methods Forty-four patients which were diagnosed as uterine leiomyomas by ultrasonic guidance needle puncture biopsy preoperation were examined by CEUS before and one week after RFA treatment respectively,and the patho-results were got again after the surgery.Routine ultrasonography was performed in 1,3,6,12 months after the treatment to compare the volume change of uterine leiomyomas with the change of the clinical symptoms.Results After the treatment,CEUS showed that the contrast agent didn't appear in thirty-five patients'uterine leiomyomas and the nonperfusion regions matched the size of the uterine leiomyomas completely.The contrast agent enhanced on the edge of the uterine leiomyomas in nine,the patho-results confirmed that the nonperfusion regions of the contrast agent were necrosis tissues and the marginal local enhancement regions were incomplete necrosis.Three month after RFA treatment,the uterine leiomyomas began to shrink,which showed obviously in 6 months after the treatment.There were significant differences in the parameters before and after the treatment(P＜0.05).Clinical symptoms improved obviously in thirty-five patients(90%)after the treatment.Conclusions RFA is an effective minimally invasive surgery of the uterine leiomyoma.CEUS can identify the treatment range and the remaining tissues.It has significant value in guiding the supplementary treatment.