Objective To analyze the skeletal characteristics of temporomandibular joint in patients with unilateral posterior scis-sors bite by using the cone-beam computed tomography(CBCT) .Methods Thirty-five patients of Angle class Ⅰ were scanned by CBCT (19 cases with unilateral scissors bite as the experimental group and 16 cases without scissors bite as the control group ) The CT images were reconstructed into 3D computer models by using the Dental Volume Reformat Function of the Ondemand 3D pack-age .9 anatomical landmarks were located and all data of 11 measured value were statistically analyzed .Results There were statisti-cal differences in the skeletal characteristics of temporomandibular joint in the scissors-bite side of the experimental group compared with those in the non-scissors-bite side (P<0 .01) .The side-to-side differences of the skeletal characteristics of temporomandibular in the controlled group were not statistically significant (P>0 .05) .There were statistical significances in the skeletal characteris-tics of temporomandibular joint of the controlled group compared with those in the scissors-bite side of the experimental group ,and the same with those in the non-scissors-bite side (P<0 .01) .Conclusion The CBCT is an effective tool to analyze the skeletal char-acteristics of temporomandibular joint characteristics .There were differences in the morphology of the condyle and the glenoid fossa of patients with unilateral posterior scissors bite .

Objective To investigate the MR manifestations and diagnostic value in patients with choroidal fissure cyst of the brain. Methods Characteristic MR findings in 16 patients with choroidal fissure cyst were retrospectively analyzed, and the correlation between MR imaging and clinical manifestations was reviewed. Results The cysts were situated within the choroidal fissure in all cases, representing as cystic lesion with clear border, no detectable soft tissue mass in the cyst wall or adjacent area, homogenous signal intensity identical to CSF on all sequences, with the average size of 0.9 cm?1.3 cm?1.5 cm, and no associated edema. Gd-DTPA was performed in 6 cases and revealed no evidence of enhancement. Conclusion The choroidal fissure cyst of the brain is a benign and congenital developmental abnormality, and has minor clinical significance. Because of its specific anatomic location, the choroidal fissure cysts simulate intraparenchymal cystic lesions on axial images. Coronal and sagittal MR imaging can be used to delineate its extraaxial location and make the correct diagnosis, and, thus, differentiate with other cystic lesions.

Objective Based on the Chinese full version of the Temperament Evaluation of Memphis Pisa Paris and San Diego-Auto questionnaire ( TEMPS-A) , we aimed to validated a short version of TEMPS-A for Chinese adoles-cents.Methods Taking into account the item factor loading from our previously validated full version TEMPS-A, cultur-ally-determined items, and sexual activity related items, we derived a 60-item Chinese TEMPS-A for adolescents.The internal consistency and structural validity of the Chinese TEMPS-A for adolescents was evaluated in 822 participants aged 11~17 years old.Results The Cronbach’ s alphas coefficients for depressive, cyclothymic, hyperthymic, irritable and anxious subscales were 0.67, 0.78, 0.76, 0.77 and 0.83, respectively.The anxious, irritable, hyperthymic factors were effectively distinguished by exploratory factor analysis, while the depressive and cyclothymic factors tended to correlate.The males scored significantly higher on the hyperthymic subscale than the females [(5.407 ±2.842) vs.(4.852 ±2.963), P<0.01].The females scored significantly higher on the depressive [(3.521 ±2.221) vs.(3.144 ±2.295)], cyclothy-mic [(4.484 ±2.922) vs.(3.917 ±2.823)] and anxious [(5.236 ±3.719) vs.(4.366 ±3.658)] temperaments than the males ( P<0.05) .The scores of depressive subscale and cyclothymic temperaments subscale were significantly correla-ted (r=0.625, P<0.001), so did the scores of anxious subscale and irritable temperament subscale (r=0.628, P<0.001).Conclusions The Chinese Adolescent version of TEMPS-A is a reliable and valid instrument for investigating af-fective temperaments for adolescents.

Objective To investigate the efficacy of initial polytherapy in the patients with newly diagnosed infantile spasm by evaluating the ambulatory electronecephalogram (EEG) profiles and serum neuron specific enolase ( NSE ) level.Methods Data from 108 cases of newly diagnosed infantile spasm from Sep.2007 to Nov.2010 in the Department of Pediatrics,the First Hospital of Jilin University,were respectively analyzed for the EEG profiles and serum NSE level.The patients were treated with multiple drugs.Results ( 1 )After treatment,EEG showed normal shape in 56 cases ( 62.2％ ),sporadic sharp and slow waves without hypsarrhythmia in 32 cases( 35.6％ ),and hypsarrhythmia in 2 cases (2.2％).The overall effective rate was 97.8％.(2) Serum NSE in 35 seizure-free cases were examined at the time points of hospital admission,48 hours and one month after seizure cessation,respectively.NSE level was significantly decreased at 48 hours after seizure control than that at hospital admission ( t =6.54,P ＜ 0.05 ) ; NSE at one month after seizure free was further decreased compared with that at admission point ( t =9.29,P ＜ 0.05 ).Conclusion Polytherapy for infantile spasms can ameliorate the abnormal EEGs.NSE level is decreased after seizure cessation.Intelligence is improved 6 months after seizure free and polytherapy may improve the prognosis of the children with infantile spasms.

Objective To evaluate the usefulness of MR imaging in follow-up of osteosarcomas treated with high intensity focused ultrasound (HIFU). Methods The images of nonenhanced and multiphase gadolinium-enhanced MR imaging before and after HIFU treatment in 16 patients with osteosarcomas pathologically confirmed were interpreted prospectively and correlated with the results of ~ 99mTc-MDP bone scan. Results The results of HIFU in 14 osteosarcomas were evaluated correctly. Before HIFU, 16 osteosarcomas demonstrated hypointensity on T1WI and heterogenous hyperintensity on T2WI and obvious enhancement during capillary and delayed phases and abnormal radioactivity accumulation were detected.One to Four weeks after HIFU treatment, the osteosarcomas became slightly hyperintense on T1WI and heterogenously hyperintense on T2WI, and no enhancement during capillary and delayed phase was noted. There was a clear boundary presenting between the targeted and untreated areas, and abnormal radioactivity accumulation disappeared. Both the signal intensity on T2WI and the tumor size reduced gradually after HIFU treatment 3 to 25 months. Conclusion HIFU is an effective local therapy for osteosarcomas, and MRI can accurately evaluate the efficacy of HIFU.

Objective To study the changes of the putamen metabolites with magnetic resonance spectrum(MRS),and to explore possible underlying unrecongnised aetiological factor and pathophysiology mechanism in the central nervous system of the patients with Tourette' s syndrome.Methods Twenty-two cases of Tourette' s syndrome,and twenty-two gender and age-matched subjects ( the control subjects ) were performed on a clinical 3.0 T MRI system.Proton prob-voxel spectroscopy imaging (1H-MRS) was obtained from two sides of the putamen.The metabolites included N-acetylaspartate (NAA),creatine and phosphocreatine ( Cr),choline-containing compounds (Cho),and myoinositol ( MI ).The value of the NAA,Cr,Cho,and MI were calculated by integration of their peaks.The ratios of NAA/Cr,Cho/Cr,ML/Cr were calculated respectively.Repeated measures analysis of variance ( ANOVA ) was used to test both the value of NAA/Cr,Cho/Cr,MI/Cr of the putamen for group difference,with group as between-subjects factor and side as within-subjects factor.Results The NAA/Cr ratio in patients ( left:1.29 ± 0.13 ; right:1.34 + 0.15 ) was significantly lower than that in the control subjects ( left:1.50 ± 0.08,T =1.962,P ＜0.05 ; right:1.52 ± 0.11,T =1.865,P ＜ 0.05 ).There was no significant difference in the Cho/Cr and MI/Cr ratio between both groups.Conclusion The abnormalities of the structure and(or) function in the putamens of patients may be the one of the underlying anaetiological factors and pathophysiology mechanisms of the Tourette' s syndrome.

ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.

Objective This paper analyzed the characteristics and changes in the disease spectrum of internal medicine inpatients of a tertiary hospital in Zhongshan City.It aimed to explore the evolving trends in disease ranking and treatment charac-teristics to provide a scientific basis for enhancing hospital management.Methods This paper selected 26 053 patients dis-charged from the internal medicine department of the tertiary hospital in Zhongshan City between January 1,2018,and December 31,2022.A retrospective analysis was used to classify these patients by ages,hospitalization date,and relative weight.Results In the past five years,those discharged patients showed no significant increase in the number,but a significant increase in age and ase Mix Index(CMI).Conclusion Since the outbreak of COVID-19,intractable inpatients in the hospital has steadily in-creased in number each year,while the diseases spectrum remains stable.The CMI of circulatory system,respiratory system,and nervous system diseases is relatively high.As key tricky components of internal medicine,these sub-specialties should concentrate on enhancing diagnostic and treatment capabilities as well as service quality to offer improved healthcare services to the public.

Objective: To study convention MRI compared with conventional MRI combined with diffusion-weighted imaging (DWI) in the evaluation of T-staging of gallbladder carcinoma, and to determine the relationship between the apparent diffusion coefficient (ADC) value and histological grading. Methods: Fifty-one patients with gallbladder carcinoma confirmed by surgery and pathology were enrolled into this study. The T-staging was performed according to conventional MRI or with conventional MRI combined with DWI and the results were compared with pathological studies. Results: The ADC value of tumor was measured to determine the correlation with T staging, pTNM staging and pathological tumor differentiation. For conventional MRI, the T-staging rate was 84.3%, which was consistent with the pathological T scoring (Kappa value 0.7580). After DWI, the T staging coincidence rate was 92.2% and the Kappa value was 0.8813. A comparison between conventional MRI versus conventional MRI combined with DWI T-staging compliance rates was performed using the Chi-square test (χ²=1.5111, P>0.05). The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation (r=-0.672, -0.749, 0.707, respectively, all P<0.05). Conclusions Conventional MRI helped in the diagnoses of T-staging in gallbladder cancer. MRI combined with DWI helped to improve the coincidence rate of T-staging. The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation. Conventional MRI combined with DWI better evaluated the T-staging of gallbladder cancer, and could better guide the choice of treatment methods.

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor.Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected,including 37 males and 15 females,with a mean age of (56.2 ± 8.5) years.Referring to the results of next-generation sequencing (NGS) and other-omics,we designed individualized therapy options for each patient.Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST).Results Of 52 patients,median follow-up was 10 months (range 3-31 months).14 (26.9％) patients achieved a complete response (CR).8 (15.3％) patients achieved a partial response (PR).14 (26.9％) patients had stable disease (SD).16 (30.8％,including 4 deaths) had progressive disease (PD).Objective response rate and disease control rate were 42.3％ (22/52) and 69.2％ (36/52),respectively.The median progression-free survival (PFS) was 7 months.6-and 12-month overall survival rates were 100％ (48/48),87.5％ (21/24),respectively.Conclusions Precision medicine has good guidance on the treatment of refractory recurrence of hepatobiliary tumors.The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application.