Objective Global brain atrophy was reported as an important structural change in Alzheimer's disease (AD), while it has been detected in the older person with normal cognitive function. Therefore, this study was aimed at investigating the difference of the neural metabolites in the left hippocampus (HIP) and left frontal cortex (FC) among patients who showed global brain atrophy but with different cognitive function. Methods The 33 patients with global brain atrophy confirmed by MRI scan, underwent a comprehensively clinical and neuropsychological assessment including mini-mental state examination (MMSE), activities of daily living scale (ADL) and clock drawing test(CDT). According to the diagnostic and statistical manual of mental disorders, fourth edition(DSM-Ⅳ) and Mayo clinic rochester(MCR), 14 patients were diagnosed as AD, 9 patients as amnestic mild cognitive impairment(aMCI), and 10 patients as normal cognition. Every person was taken a cerebral proton magnetic resonance spectroscopy(1H-MRS) scan to measure the levels of n-acetylaspartate(NAA), choline(Cho), myo-inositol(MI) and Creatine(Cr) in the left HIP and the left FC. Results While compared with the group with normal cognition, the ratio of NAA/Cr in the AD group reduced 10.2% in the left HIP and 5.3% in the left FC, and the ratio of Cho/Cr increased 17.5% in the left HIP and 16.7% in the left FC, and the ratio of MI/Cr increased 39.5% in the left HIP and 19.2% in the left FC. The ratio of NAA/Cr of the left HIP in the AD group was lower than that in the aMCI group at the decrease rate of 6.4%, while the ratio of NAA/Cr of the left FC was not significantly different between the two groups. The AD group had higher ratios of Cho/Cr at the increase rate of 9.3% in the HIP and 12.3% in the FC, and higher MI/Cr ratios at the increase rate of 30% in the HIP and 17% in the FC than in the aMCI group. The aMCI group showed significantly lower ratio of NAA/Cr at the decrease rate of 4.1% and higher ratio of Cho/Cr at the increase rate of 7.5% in the left HIP than in the normal cognition group. Conclusions Among patients with global brain atrophy, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr and MI/Cr are predictive of the progress from aMCI to AD. Moreover, the decrement of ratio of NAA/Cr in the left HIP and the increment of the ratio of Cho/Cr are helpful to distinguish the aMCI and the persons with normal cognition.

Objective To investigate the recent effect and safety of magnetic resonance guided focused ultrasound (MRgFUS) for treating uterine fibroids with a Meta analysis. Methods Such databases as Cochrane Library,PubMed,EMbase, CBM,CNKI,CQVIP and Wanfang were searched from their establishment. After thestudy selected, assessment and data extraction conducted by two reviewers independently, Meta-analysis were performed by using the Comprehensive Meta-analysis V2 software. The volume of non-perfusion ratio (NPVR), fibroid shrinkage, clinical symptom severity (SSS score) and adverse reactions were analyzed.Results Nighteen retrieved articles were included, with a total of 1 549 patients. The results of Meta-analysis showed that:(1)nonperfused volume ratio (NPVR),Mean=57.1%(95%CI 45.0% —69.2%).(2)Percentage of FBs shrinkage:mean=31.4% (95% CI 29.2% —33.6%).(3)Symptom severity score (SSS):baseline mean=51.00(95%CI 41.61—60.40),3 months mean=32.50 (95%CI 25.90—39.10),6 months mean=28.62(95%CI(23.57—33.66),12 months mean=24.46(95%CI 15.44—33.49), the average of the severity score of the patient symptoms had a tendency to reduce.(4)The degree of adverse reactions were mild and could relieve itself, there was fewer serious adverse reactions. Conclusions The current evidence indicates that MRgFUS in treatment of uterine fibroidsis reliable and safe. MRgFUS can significantly reduce the volume and the symptom severity score ofthe patients.

Objective To assess regional cerebrovascular reactivity (CVR) and cognition impairment of subcortical ischemic vascular disease (SIVD). To show whether CVR affects cognitive impairment of SIVD patients. Methods Arterial spin-labeling (ASL) by MR image was applied in measuring regional cerebral blood flow (rCBF) of frontal lobe, temporal lobe, parietal lobe, occipital lobes after 5% CO2 inhalation, and the CVR was demonstrated by increase rate of rCBF in all the subject areas. Results (1)The patients with SIVD had reduced CVR in cortex of frontal lobes, white matter of frontal lobes, temporal lobes and occipital lobes(P < 0.05). (2) CVR in the SIVD patients with cognitive impairment decreased in frontal cortex and white matter when compared with the patients without cognitive impairment(P < 0.01). Conclusion These results showed that CVR decreased significantly in cortical gray matter and white matter in elderly patients with SIVD. Also the reduction of CVR in the frontal cortex and white matter was associated with cognitive impairment.

Objective To explore the imaging characteristics of hepatic primary leiomyoma.Methods The CT and MR imaging findings of three pathologically proven primary leiomyoma of the liver were analyzed,and the correlation between the imaging features and pathological results was analyzed.Two patients underwent CT scanning.Two patients underwent MRI.Results The lesions appeared hypodense in CT images,and with elongated T_1 time and elongated T_2 time in MRI.One lesion was homogenous both in CT and MRI,with significant homogenous enhancement.The other two lesions were inhomogeneous,with inhomogeneous enhancement in one lesion.All the three lesions had the sign of pseudocapsule.Neither hepatic cirrhosis nor venous tumor emboli were present.Pathological examination showed proliferation of spindle- shaped neoplastic cells and hyperplasia of capillary.One tumor had central hyalinization and another tumor had central necrosis.Conclusion Primary leiomyoma of the liver is one kind of hypervascular tumors with pseudocapsule.CT and MR can provide helpful information to the diagnosis.

Objective To analyze the features of intracrayze the features of intracranial cystic diseases on ~1H MRS,and to evaluate the applicable value of ~1H MRS.Methods Fifty-two patients were examinated by single voxel ~1H MRS,included Ⅰ-Ⅱ graded astrocytomas(n=8),glioblastomas(n=9),metastasis(n=13),brain abscesses(n=10),epidermoids(n=4),anachnoid cysts(n=5),brain Cysticerciasis(n=3).Results(1)There was only Lac in Ⅰ-Ⅱ graded astrocytomas.But in glioblastomas,as were as all showed Lac,4 cases showed low Cho and NAA and 2 cases Lip.(2) In(13 metastasis) patients,7 cases only presented Lac,6 cases showed Cho,3 cases showed low NAA and(6 ones) Lip.(3) In brain abscesses,all showed Lac,9 cases displayed AA,6 cases showed Ace,5 cases appeared Suc and Ala,2 cases had Lip.(4) Four cases of epidermoid showed Lac,one showed Lip.In(4 arachnoid) cysts,2 cases had low Lac,one showed Lip.Three cases of cysticerciasis showed Lac,Ace,Suc,Ala and no AA,Cho,NAA.Conclusion Lac is the most common resonance peak on ~1H MRS in intracranial cystic diseases and for no diagnostic specificity.AA combined Ace,Suc,and Ala are highly specificity for brain abscess.Ace,Suc and Ala appearance cues the the possible existence of cysticerciasis.~1H MRS is helpful for the qualitative diagnosis of intracranial disease.

Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

Objective To explore the pathogenesis of myelodysplastic syndrome (MDS)transformation, JAK2V617F mRNA expression levels were compared in peripheral blood of MDS-RA(refractory anemia,RA)and MDS-RAEB(RA with excess blasts,RAEB)patients.Methods JAK2V617F mRNA expression level was detected by fuorescent quantitative polymerase chain reaction(FQ-PCR),and this research reviewed 22 patients diagnosed with MDS,including outpatient and hospitalized patients.20 cases of normal control group were healthy ones.FQ-PCR method was applied to monitor JAK2V617F mRNA expression level in peripheral blood of MDS-RA and MDS-RAEB patients.Results The JAK2V617F gene was not expressed or expressed in healthy subjects,and the copy number was (3 851.96 ±470.46).The patients with MDS-RA(4 631.11 ±3 851.96)was significantly higher than that in healthy subjects(t =3.61,P <0.01);MDS-RAEB patients was (22 545.98 ±11 084.17),and was significantly higher than that in MDS-RA patients(t =4.87,P <0.01).Conclusion JAK2V617F signal transduction can play a role in the pathogenesis and transformation of MDS,and the detection of JAK2-V617F mRNA expression level is use-ful for monitoring progression,judging prognosis and gene regulation therapy of MDS.

Objective To analyze the imaging characteristics of gastric lipoma.Methods The clinical appearances and imaging characteristics such as size,margin,density or intensity,ulceration and so on of gastric lipomas in 13 cases were retrospectively analysed.Results 13 gastric lipomas were all solitary and intracavitary growth,origined from submucosal of every part of stomach.6 gastric lipomas showed submucosal filling defect and soft gastric wall,3 cases with ulcer presenting "bull eye sign" on barium meal.8 gastric lipomas on CT showed variable-size round or oval low-density masses with-50~-120 HU CT value.2 gastric lipomas on MRI were high intensity on T1/T2WI and low intensity on fat supression T2WI.Conclusion X-ray,CT and MRI are of respective value in diagnosing the gastric lipoma.

Objective To analyze the DWI characteristics of intracranial epidermoid cyst (ECs),and to evaluate “T2 shine-through” effect. Methods There were 15 cases of ECs confirmed by pathology, in which 3 cases had the residual tumor after surgery. The ADC value was measured in ECs,deep white matter and CSF,and the comparison was made between DWI and FLAIR in showing the tumors. Results (1) The lesions in 15 cases were high intensity on DWI, their ADC value was from 0.80?10 -3mm2/s to 1.23?10 -3mm2/s, the average was (1.05?0.14)?10 -3mm2/s. But the ADC value of deep white matter was from 0.74?10 -3mm2/s to 1.09?10 -3mm2/s, the mean was (0.88?0.09)?10 -3mm2/s. The ADC value of CSF was from 2.98?10 -3mm2/s to 3.78?10 -3mm2/s,the mean was (3.31?0.21)?10 -3mm2/s. The ADC value of ECs was significant lower than that of CSF ( P

Objective To analyze a potential outbreak mechanism 0f Pseudomonas eruginosa by investigating the homology of pan-drug resistance isolates(PDR)isolated in four hospitals of Guangzhou from March 2005 to March 2007.Methods The pulse-field gel lectrophoresis(PFGE)was used to detectl34 strains of pan-drug resistant Pseudomonas eruginosa in four hospitals,and determined whether they were derived from the same clone.Results 1 34 strains were classified into 56 types based on PFGE pattern. Type A Was the commonest clone among four hospitals,45 strains belonged to type A,mainly spreaded in hospital A. The rest strains were identified:7 for type B,6 for type C,6 for type D,which were isolated from hospital B to hospital D,respectively.There were 40 strains classified for individual types.General comparison showed there Was no a large clone existing in all four hospitals,though type Q clone appeared in hospital B and hospital D.One strain from hospital B and one strain from hospital C had 80%homology with type A from hospital A.The environment survey showed there was no clonal strain of type A found in hospital A,although various samples from respiratory therapy equipment,bronchoscopes and medical erosols were collected and cultivated for three times during the period.However,six patients arrying type A Pseudomonas aeruginosa had been admitted to the same ICU of hospital A for many times.Analysis of antimicrobial resistance of the common clone from four hospitals revealed that 42 of 43 type A of Pseudomonas aernginosa produced IMP-9 metallo β-lactamase.The strains of type B,type C and type D didn't produced metallo B. 1actamase.Conclusions The various degree of clonal spread of pan-drug resistance Pseudomonas aeruginosa had occurred in four hospitals individually in two years.There Was also clonal spread among some hospitals. It is important to monitor the patients colonized with epidemic clones to prevent clonal spread.