Objective To analyze the clinical features,and prognosis of the interstitial lung disease (ILD) in patients with dermatomyositis (DM) and polymyositis (PM) by chest X-ray,chest high-resolution CT scan (HRCT) and pulmonary lung function.Methods Thirty-three patients hospitalized with DM/PM associated ILD were retrospectively analyzed.Results Thirty-three patients with ILD were confirmed by HRCT.Abnormal pulmonary function tests were available in 82% of patients.Clinical-imaging analysis revealed that the pathological features of ILD were non-specific interstitial pneumonia (NSIP,57%) and unusual interstitial pneumonia (UIP,25%).UIP types showed a poor prognosis and high mortality (70%).Conclusion This study shows that HRCT is more sensitive for the diagnosis of ILD than lung function tests and chest X-ray.Combined HRCT and chest X-ray with lung function tests and blood gas analysis have shown that the major pathological types of ILD are NSIP and UIP,in which UIP are associated with high mortality and poor prognosis.

Objective To investigate the level of follicular fluid NO, VEGF and ET-1 in assessing IVF-ET outcome. Methods Totally 131 patients undergoing IVF-ET cycles were recruited. The level of follicular fluid NO was measured by chromatometry. The follicular fluid VEGF and ET-1 were measured by ELISA. Transvaginal ultrasound was performed on human chorionic gonadotropin (hCG) injection day to determine ovarian volume and antral follicle count. Results The pregnancy rate was 37.40% (49/131). There were significantly increased level of follicular fluid NO, VEGF and decreased level of follicular fluid ET-1 in the pregnant group than those in the non-pregnant group (P<0.05). Total ovarian volume and antral follicle count on HCG injection day were significantly higher in the pregnant group than those in the non-pregnant group (P<0.05). The levels of follicular fluid NO and VEGF had positive correlations with the total ovarian volume and antral follicle count. However, the level of follicular fluid ET-1 had a negative correlation with the total ovarian volume and antral follicle count. Conclusions The high level of NO, VEGF and low level of ET-1 in follicular fluid are good predictors of ovarian blood flow and ovarian response in IVF-ET.

Objective To evaluate the clinical value and safety of prelocalization with ultrasound during internal jugular vein cannulation. Methods One hundred patients scheduled for internal jugular vein cannulation from February 2009 to April 2010 were divided into two groups by random digits table with 50 cases in each group. Group U patients were performed by ultrasound-prelocalization method and group T patients were performed by traditional technique. The first successful punctures and the first successful catheterization,puncture times,operation time and complications were recorded. Results Compared with group T, puncture times,operation time and complications were lower in group U [(1.0±0.5) times vs.(2.1±1.4) times;(4.5±1.2) min vs.(6.8±1.6) min;0 vs. 12.0%(6/50)](P＜ 0.01 ). The first successful punctures and the first successful catheterization [96.0% (48/50) and 95.8% (46/48)] in group U were obviously higher than those in group T [ 72.0%(36/50) and 77.8% (28/36)] (P ＜ 0.01 ). Two cases were failed in group T. Conclusion Ultrasound-prelocalization technique is simply and practically method for internal jugular vein cannulation under the stable body position.

In order to study genetic variation diversity of porcine circovirus type 2 (PCV2) strains in Shanxi,the genomic sequences of nine PCV2 strains including SXQX,SXCZ,SXTY2,SXJC,SXJX,SXLL,SXPY,SXPG and SXXY recently isolated from some areas of Shanxi from 2013 to 2016,was cloned,sequenced and received by GenBank.The amplified PCV2 genomic sequences,ORF2 sequences and Cap protein amino acid of these nine strains were analysed and compared with those of published 28 PCV2 strains by DNAStar,drawing phylogenetic tree.The results showed that the genomic sequences of SXJX,SXJC and SXXY PCV2 strains were 1 768 bp,and the others were 1 767 bp,which accounted for 33％ and 67％,respectively.The homologies of nucleotide sequences of the nine strains were 94.7％-99.8％,the homologies of nucleotide sequences of the nine strains with the 28 isolates from different regions of the world PCV strain were 93.9％-99.9％,and the homologies of nucleotide sequences of the nine strains with the domestic vaccine strains were 95.1％-99.8％.The phylogenetic analysed that SXJX,SXJC and SXXY belonged to genotype PCV-2D,SXLL,SXPY and SXCZ belonged to genotype PCV-1C,and SXTY14,SXPG and SXQX belonged to genotype PCV-1A/1B.Thus it proved that the epidemic strain of PCV2 was mainly PCV-2b in Shanxi.The homologies of ORF2 nucleotide sequences and Cap amino acid of the nine strains were 90.0％-100.0％ and 87.1 ％-100.0％ respectively,the homologies of ORF2 nucleotide sequences and Cap amino acid of the nine strains with the 28 isolates from different regions of the world PCV strain were 87.6％-100.0％ and 84.1％-100.0％ respectively,and the homologies of ORF2 nucleotide sequences and Cap amino acid of the nine strains with the domestic vaccine strains were 91.0％-100.0％ and 89.3％-100.0％ respectively.The Cap amino acids of SXQX,SXJX,SXTY14,SXPG,SXJC and SXXY PCV2 were 233,ORF2 of SXQX,SXTY14 and SXPG located at 1 033-1 734 bp,ORF2 of SXXY,SXJX and SXJC located at 1 033-1 734 bp,and the Cap amino acids of SXCZ,SXLL and SXPY PCV2 were 234,ORF2 of them located at 1 030-1 734 bp,in addition,the positions of 1 030-1 734 bp were more three bases TCA than other ORF2 genome sequence of 1 767 bp,resulting in increasing a K (Lys) of amino acid sequencein at the 234 position.Also Cap protein of 9 PCV2 strains showed more amino acid variation in addition to the only high-ly conserved glycosylation sites (NYS) (pp.143-145 amino acid).It provided theoretical basis for the PCV2 immune prevention of research in Shanxi,and the data of basic theory of molecular pathogenesis of PCV2.

Objective:To investigate the operation efficacy of anterior radius head fracture combined with lateral ligament complex injury.Methods:The patients with radial head fracture admitted from September 2017 to August 2021 were retrospectively analyzed, 51 males and 54 females, average age of 38.84±13.63 years (range of 16-70 years). Based on the radial head fractures of Mason classification of type II, the cases involving the anterior radius head fracture were divided into three subtypes according to the number of fracture blocks and the type of displacement: type A (53 cases): one part of the anterior radius head collapse fracture; type B (50 cases): two or more parts of the anterior radial head collapse fracture; type C (2 cases): anterior radius head dissociated and displaced fracture. All fractures were treated with open reduction and internal fixation. Among them, the lateral ligament complex of type B were elongated due to the injury but the continuity existed. Therefore, the lateral ligament complex in 21 cases were not repaired in the early period (unrepaired group); in recent years, 29 cases repaired the lateral ligament complex (repair group). The postoperative efficacy was evaluated by elbow range of motion, table-top relocation test, Mayo score, and Broberg Morrey score. the patients were evaluated at final follow-up, except table-top relocation test was recorded according to the actual completion time.Results:All operations were successfully completed. The mean follow-up was 14.08±1.52 months (range of 12-18 months). Type A: the flexion and extension range was 115.70°±6.35°; the completion time of the table-top relocation test was 75.68±11.90 days; the Mayo score was 93.72±2.40 point, and the Broberg Morrey score was 92.89±2.28 point. Type B: lateral ligament repair group (repaired group) 29 cases and unrepaired lateral ligament group (unrepaired group) 21 cases. The flexion and extension range of elbow in repaired group was 112.1°±4.4°, which was better than that in unrepaired group 105.8°±3.7° ( t=5.31, P<0.001). The completion time of table-top relocation test was 77.72±6.51 days in repaired group and 104.29±18.45 days in unrepaired group ( t=6.32, P<0.001). The Mayo score of the repaired group was 90.21±5.88 points and that of the unrepaired group was 87.14±5.26 points ( t=1.90, P=0.063), and there was no significant difference between the two groups. Broberg Morrey score of 90.93±6.43 points in the repaired group was better than 86.95±6.37 points in the unrepaired group ( t=2.17, P=0.035). Type C for 2 patients, the flexion and extension range of elbow were 107°and 106°; the completion time of table-top relocation test were 82 days and 98 days; the Mayo scores were 91 point and 87 point; Broberg Morrey scores were 93 point and 85 point. There was a patient developed myositis ossificans in unrepair group of tybe B. Conclusion:The elbow joint is stable when one part of the anterior radius head collapse fracture; there is a degree of instability in the elbow when two or more parts of the anterior radial head collapse fractures suggest to repair the lateral ligament complex. The elbow joint is extremely unstable when anterior radius head dissociated and displaced fractures, the lateral ligament complex should be repaired in time.

Objective:To observe the functional remodeling of the default mode network (DMN) of patients with post-stroke cognitive impairment (PSCI) in response to transcranial direct current stimulation (tDCS) and to explore the mechanisms involved.Methods:Eighteen PSCI patients and twenty healthy controls were enrolled. The PSCI patients were given 20 minutes of tDCS at 2.0mA on the dorsolateral prefrontal cortex every weekday for four weeks. The subjects were scanned using resting state functional magnetic resonance imaging before and after the intervention to explore any functional changes in the DMN. Montreal cognitive assessment (MoCA) scoring was performed before and after the treatment.Results:Compared to the healthy controls, the cognitively impaired patients showed significant abnormalities in the DMN on admission, including decreased functinal connection (FC) in the posterior cingulate cortex and/or precuneus (PCC/PCu), as well as increased FC in the medial prefrontal cortex (MPFC) and left hippocampus. After the treatment, a significant improvement in the PSCI patients′ average MoCA score was observed. The average FC of the PCC/PCu had also increased significantly, while that of the left hippocampus had decreased significantly, on average. The FC in the PCC/PCu after tDCS was found to be positively related to the MoCA score measured at 4 weeks after admission.Conclusions:PSCI patients show functional abnormalities in the DMN. tDCS applied to their dorsolateral prefrontal cortex can significantly improve their average MoCA scores, which may be related to the increasing FC of the PCC/PCu.

Objective To investigate the clinical value of 2 dimension late Gadolinium enhancement MRI (LGE-MRI) technique for the evaluation of atrial myocardial fibrosis in patients with atrial fibrillation. Methods Forty-nine cases of atrial fibrillation in our hospital from March 2015 to December 2016 were retrospectively collected. The LGE-MR was acquired by the Siemens 3.0 T MR machine before the catheter ablation.The findings of LGE-MR were evaluated by two experienced doctors. The left atrium(LA)were manually segmented into 8 regions in axial view.All patients were classified into 4 stages based on the extent of enhancement, stage 0: absence of enhancement, stage Ⅰ: enhancement appeared in minimal two consecutive slices in single region,stageⅡ:enhancement in two regions,stageⅢ:enhancement in three or more regions. All electroanatomic maps were obtained after electrical conversion during catheter ablation. The Kappa test was used to assess the consistency of LGE-MRI left atrial myocardial fibrosis and CARTO system of the left atrial endocardial voltage reconstruction. Results Forty-nine cases of atrial fibrillation with LGE-MRI and CARTO were included. There were 17 cases of atrial fibrosis stage 0,10 cases of stageⅠ,11 cases of stageⅡ,11 cases of stageⅢaccording to LGE-MRI findings;There were 17 cases of atrial fibrosis stage 0,19 cases of stageⅠ,12 cases of stageⅡ,11 cases of stage Ⅲ with reference to CARTO findings. The diagnostic accuracy of the LGE-MRI atrial fibrosis was 81.6%(40/49),of which the correlation was good(Kappa= 0.751,P<0.001). Conclusions LGE-MRI can accurately assess the degree of left atrial myocardial fibrosis in patients with atrial fibrillation,help to select the proper candidate and strategy in catheter ablation.

Objective:To establish a new classification of lateral clavicle fractures and to evaluate its clinical value.Methods:The data of 67 patients with lateral clavicle fractures admitted from January 2016 to December 2020 were included. Thirty-seven cases were from Shanghai First People's Hospital, including 22 males and 15 females, with an average age of 49.1 years (22-78 years). Thirty cases were from the Second Upper Limb Ward of Tianjin Hospital of Tianjin, including 20 males and 10 females, with an average age of 47.6 years (19-76 years). The ligament injury was determined by measuring the coracoclavicular space on Zanca view X-ray and the distance between the fracture fragment on the inferior surface of the 3D-CT and the distal end of the clavicle. All patients were classified according to the new classification (based on the measurement on Zanca view X-ray and 3D-CT reconstruction, the relationship between the fracture and the coracoclavicular ligament footprint, coracoclavicular ligament injury, the injury of the acromioclavicular joint and the stability of the fracture), conservative treatment is preferable for stable fractures, and surgical treatment for unstable fractures. Three experienced orthopaedic surgeons and three radiologists independently observed the imaging data of 67 patients with distal clavicle fractures, determined the fracture type according to the new classification, and randomly reclassified after 4 weeks interval. Finally, 15 cases were randomly selected for internal control (2 junior orthopedic physicians), and the ICC value was used to assess the reliability. Results:The lateral clavicle fractures were divided into 5 types according to the Gongji classification. Type 1: isolated conical tubercle avulsion fracture, and the fracture line is located medial to the coracoid process; Type 2: complete involvement of the trapezoid & conical ligament at the clavicle insertion, and the fracture line extends to the middle of the clavicle, mean while the acromioclavicular joint is intact; Type 3: fracture fragments on the inferior surface involving the trapezoidal/conical ligament, respectively; Type 4: rupture of the conical ligament, and avulsion fracture of the trapezoid ligament; Type 5: conical ligament intact, and avulsion fracture of clavicle insertion of the trapezoid ligament. There were 18 cases of type 1, 4 cases of type 2, 8 cases of type 3, 32 cases of type 4, and 5 cases of type 5. The inter-observer and intra-observer agreement of all included cases was good (inter-group: first ICC=0.764, second ICC=0.778; intra-group: shoulder specialist ICC=0.782, radiologist ICC=0.750, internal control ICC=0.793). Types 1 and 2 fractures were fixed with anatomical plate and coracoid anchor. Type 3 and 4 fractures were fixed with clavicle hook plate and coracoid anchor. And type 5 underwent conservative treatment. At the last follow-up, all patients had no obvious shoulder joint instability and pain, and no internal fixation failure or fixation breakage was found. Conclusion:The Gongji classification has moderate reliability between observers and intra-observers, and the Gongji distal clavicle fracture classification has a good significance for evaluating the stability of the fracture and guiding the selection of the treatment.

Objective To analysis the change of hip joint in healthy infants by ultrasound,and establish the normal reference value of the developmental dysplasia of the hip(DDH). Methods A total of 8 000 healthy infants from 0 to 24 weeks were collected from the Multi-center study of 10 children′s medical centers. Among them,3 855 infants(2 065 females and 1 790 males) with complete data and follow-up were included in this study. All subjects were divided into 6 groups ( ＜4,4～7,8～11,12～15,16～19 and≥20 weeks group). α angle,femoral head length and width,femoral head coverage ratio by acetabulum ( FHC) were measured in the coronal view on the neutral position;distance from pubis to femoral head ( P-H) and distance from ischium to femoral head ( I-H ) were measured in the transverse view on neutral position;distance from femoral head topubis ( H-P) was measured in the posterolateraltransverse view on the flexion position. The results of each group changes with age were analysised. Results ① The α angle of healthy infants from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05),but there was no significant difference between 16～19 and ≥20 weeks group( P ＞0.05). ②The femoral head length and width of all age groups were increased with age,the difference among all the groups was statistically significant( all P ＜0.05). ③ FHC from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05) except between 16～19 and ≥20 weeks group( P ＞0.05). ④ The P-H and I-H in all age groups showed no statistically significant ( all P＞0.05). ⑤The H-P of all age groups were increased with age,the difference between the groups were statistically significant(all P ＜0.05).Conclusions The development of hip joints have the certain regular developmental pattern in healthy infants less than 5 months of birth and are relatively constant after birth more than 5 months. The ultrasound normal reference value of the hip joints can be used for the early diagnosis of the DDH.