Objeetive To explore routine magnetic resonance imaging characteristics of newborn bilirubin encephalopathy(NBE).Methods MRI features and clinical data of 17 patients with Newbern bilirubin encephalopathy were retrospectively analyzed, globus pallidus (GP)and subthalamic signal intensity was evaluated.The increase of GP signal intensity and serum total bilirubin peak value were analyzed using pearson correlation analysis.Serum total bilimbin peak value between patients with high signal in the subthalamic nuclei on T1 WI and patients without high signal in the subthalamic nuclei were compared statistically.Results The main MRI presentation in the NBE group Was abnormally increased signal intensity in the GP on T1 WI,which was not apparent on T2 WI One patient showed abnormal high signal intensity in the postemmedial part of GP.Nine patients had high signal in the subthalamic nuclei on T1 WI and normal signal on T2 WI Four patients showed hiigh signal in the brainstem with sparing of dorsal pontine.The increase in value of GP signal intensity was 249.0-423.8 in 12 patients and their serum total bilirubin peak values were 366.0-983.3μmol/L A positive correlation Was found between increase of GP signal intensity and serum total bilirubin peak value.The serum total bilirubin level of abnormal subthalamic group and normal subthalamic group were 660.7±192.4 μmol/L and 513.3±107.5μmol/L respectively.The difference between the two groups was not statistically significant(t=1.914,P＞0.05).Conclusion The routine MRI has some characteristics and is useful in the diagnosis of newborn bilirubin encephalopathy.

Tissue engineering of oral and maxillofacial surgery is a newly subject and animportant branch of tissue engineering. The study is to evaluate fundamental medical ethics principle in the tissue engineering of oral and maxillofacial surgery on the view medical ethcs. Strengthening the ethical education on oral and maxillofacial surgeon and right education on patients are in favor of development of tissue engineering in the oral and maxillofacial surgery.

BACKGROUND: Cicatricial alopecia always occurs following the scalp trauma, and the optimal repairing method is scalp soft tissue expansion. OBJECTIVE: To verify the repairing effect of scalp soft tissue expansion therapy on the large-scale cicatricial alopecia. DESIGN, TIME AND SETTING: A case report was carried out in the Department of Burn and Plastic Surgery at the 180 Hospital of Chinese PLA (Quangzhou, Fujian, China) between January 1996 and April 2008. PARTICIPANTS: Thirty-six patients of cicatricial alopecia were adopted, with the size arranging 15 cm?9 cm to 24 cm?14 cm. METHODS: Scalp soft tissue expansion was performed in 36 cases of cicatricial alopecia. In later stage, the residual alopecia with small area was removed by scar excision plus suture for several times, treated with transposition repair of local flap and autologous hair transplant carrying hair follicle. The largest area to repair alopecia reached 336 cm2. MAIN OUTCOME MEASURES: Postoperative complications, repairing effect and cicatrix restitution were observed after operation; The elimination of alopecia area, hair density and appearance were detected during follow-ups. RESULTS: Psilotic scar eliminated in all cases, but 11 cases underwent scalp scar excision, transposition of local flap and autologous hair transplant because of wide incisional scar or residual small alopecia. No obvious complications occurred. It was found by a postoperative follow-up of 1-3 years that hair growth was good. CONCLUSION: Skin soft tissue expansion is an ideal method to repair cicatricial alopecia with large area. In later stage, the combination of simple repair methods can obtain better curative effect.

Objective To study X-ray, CT and MRI features of the spinal giant cell tumors (GCT)and to assess the clinical applied value.Methods Thirty cases of GCT of spine (13 males and 17 females with ages ranging from 17 to 69 years) were reviewed. Allcases underwent radiography,CT was done in 22 patients and MRI was performed in 16 cases.Results One lesion localized in cervical spine,10 in thoracic, 6 in lumbar and another 13 lesions in the sacrum.Osteolytic destruction and vertebral compression were seen on X-ray film. The main CT signs were expanding bone destruction and soft tissue mass. MRI showed low to intermediate signal intensity on T_1WI while high signal on T_2WI.Conclusion X-ray, CT and MRI are of significant value in diagnosis of the spinal GCT, and play an important role in surgical planning.

Objective To explore the value of quantitive tissue velocity imaging(QTVI) in assessing the systolic myocardial function of adriamycin cardiomyopathy.Methods Conventional echocardiography and QTVI were performed in 7 rabbit models with adriamycin cardiomyopathy and 5 health rabbits as control.The basic segments of interventricular septum of apical 4-chamber view and left ventricular post wall of parastenal left ventricular long axis view were sampled to measure maximal velocity(VIVS,VLVPW),displacement(DIVS,DLVPW),strain rate(SRIVS) and strain(?IVS) in systole.Pre-eject period(PEP) and ratio of pre-eject period and eject time(PEP/ET) were measured with electrocardiography and Doppler spectrums of mitrial and aortic orifices.Results Compared with control,VIVS,DIVS,SRIVS,?IVS and VLVPW,DLVPW decreased(P0.05).Conclusions The indices of QTVI are more sensitive to evaluate systolic function changes than EF,and QTVI may be an optimal method to early diagnose and access of adriamycin cardiomyopathy.

Liver resection is the most effective treatment for hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is commonly accepted as a guideline for HCC treatment, but it only recommends liver resection for the patients with HCC at stage 0 to A1. The surgical indications of the BCLC staging system need to be re-evaluated. 120 HCC patients undergoing curative liver resection were retrospectively stratified to the BCLC staging system, and the survival of the patients at stages A, B and C was analyzed. The justification of the BCLC staging system was re-evaluated. Fifty-two patients were classified at stage A, 51 at stage B and 17 at stage C respectively. The hospital mortality of this cohort was zero and the morbidity was 24.1%. The 1-, 2-, 3-year overall survival rate of this cohort was 81.6%, 68.3%, and 57.5% respectively. There was no significant difference in the survival rate between the patients at stage A and B (P>0.05). If the treatment guidelines of BCLC staging system were followed, the majority of the patients at stages A and B (77.7%, 80/103) would not have been treated surgically. Our data suggest that the surgical indications of the BCLC staging system are not justified for HCC treatment. More studies may be needed as for how to further broaden the surgical indications of the BCLC staging system in the future.

BACKGROUND: The proximal tibia is the second common site for primary bony sarcomas,which lacks adequate soft tissue coverage.Resection and reconstruction by any technique leave the reconstructed area in a subcutaneous position.This has been a major source of necrosis of skin and infections.OBJECTIVE: To observe the effect of gastrocnemius muscle transfer to obtain soft-tissue coverage and extensor mechanism reconstruction for limb-sparing resection of the proximal tibia with endoprosthetic reconstruction.METHODS: From January 2001 to June 2008,27 patients with osteosarcoma of the proximal tibia confirmed by biopsy were selected.All the tumours were assigned to stage IIB based on Enneking's classical staging system.Neoadjuvant chemotherapy(Bacci,IOR/OS-N4)was utilized for the patients.All the patients adopted limb-sparing surgery,i.e.resection of proximal tibia with endoprosthetic reconstruction.A gastrocnemius flap was utilized to improve implant coverage and enhance the patellar tendon repair.MSTS was used to measure the functional status of patients with a sarcoma in the leg.RESULTS AND CONCLUSION: The follow-up was averagely 53.1 months.Of 27 patients,2 cases(7%)died of lung metastasis within 2 years,1(4%)suffered from amputation due to infection and underwent amputation.The others developed no complications or recurrence.The MSTS score was averagely 25.1 points.Results show that resection with endoprosthetic reconstruction utilizing a gastrocnemius muscle flap for osteosarcoma of the proximal tibia is reliable and predictable in combination with neoadjuvant chemotherapy.

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

Objective:To analysis the appearances and to evaluate the diagnostic value of X-ray CT and MR imaging in osteoid osteoma.Methods:22 cases 19 females and 3 males of osteoid osteoma proved by surgical pathology and their X-ray,CT and MRI were reviewed.The ability of X-ray,CT and MRI to demonstrate the nidus and surrounding reaction were analyzed.Results:The nidus were appeared as round or oval shape and the diameter was less than 2 cm.It was fomd in 17 cases of X-ray film，22 CT and 20 of MRI .There were different degree of bone sclerosis,periosteal reaction and soft tissues or bone marrow edema around the nidus.The diagnostic accuracy was 77.3% for X-ray，100% for CT and 90.9% for MRI.Conclusion:Most of osteoid osteoma have the typical appearances and is no difficult to make diagnosis.CT scan is the most accuracy method to demonstrate the nidus.It is possible to make misdiagnosis only with X-ray or MRI for the case that the hidus not be demonstodted.

Objective Pathogens from the nosocomial infection have been analyzed by MALDI‐TOF microbial identification system ,to evaluate mass spectrometry analysis advantage and explore the mass spectrometry method .Methods The pathogens have been analyzed by MALDI‐TOF microbial identification system ,by compared with the VITEK‐2 compact detection in the tes‐ting time ,detection rate and the amounts of identified strains .The homology differences have been analyzed by comparison calcula‐tion of common peaks from the fingerprint spectrums .Results Thirty‐one Escherichia coli strains ,28 Klebsiella pneumonia strains and 9 unusual pathogen strains have been identified by MALDI‐TOF MS for only 1 hours .It has more advantages than VITEK‐2 in the testing time and other aspects .Conclusion Nosocomial infection of pathogen shows a point source propagation mode centering on the department .MALDI‐TOF mass spectrometry is able to rapidly and correctly identify the pathogen .MALDI‐TOF microbial i‐dentification system is expected to be the major detecting technique in the field of the pathogen monitor and resistance monitoring a ‐nalysis .