Objective To determine the val ue of five MR imaging signs in diagnosing the bucket handle tears (BHT) of menisci of the knee. Methods MR imaging of 139 knees with subsequent arthroscope exams were retrospectively evaluated. Based on the results of arthroscopy, 19 knees had BHT of menisci. Two radiologists evaluated each MR exam independently, with discrepancies resolved by consensus. Each MR exam was analyzed for five signs: a double posterior cruciate ligament sign, a flipped meniscus sign, an absent bow tie sign, an internal displaced fragment sign, and an abnormal circumferential meniscus sign. Sensitivity, specificity, positive and negative predictive values, and accuracy for diagnosing BHT of menisci were calculated for the presence of each individual sign. Results The sensitivities of these five signs ranged between 52.6% and 89.5%, and specificities ranged between 83.3% and 98.3%, respectively. Positive and negative predictive values ranged between 42.9% and 88.2%, and between 92 7% and 98.3%, respectively. The accuracy of these five signs ranged between 82.7% and 96 4%. Conclusion BHT of menisci may have many signs on MR imaging. The diagnostic sensitivities of the internal displaced fragment sign and the abnormal circumferential meniscus sign are the highest. The double posterior cruciate ligament sign has the highest specificity and positive predictive value, while the internal displaced fragment sign has the highest negative predictive value and accuracy.

Objective To compare the diagnostic value of conventional MRI, X ray arthrography, and MRI arthrography in revealing rotator cuff injuries. Methods Thirty two patients with suspected rotator cuff tears were prospectively examined by conventional MRI, X ray arthrography, and MRI arthrography before the examination of shoulder arthroscope. Based on the results of the arthroscopy, the diagnostic sensitivity, specificity and accuracy of those three different methods were determined for rotator cuff tears. Results The arthroscopic findings included 14 full thickness tears, 6 partial thickness tears, and 12 without tears. For the diagnosis of rotator cuff tears,the sensitivity,specificity and accuracy were 80%(16/20), 83%(10/12), and 81%(26/32) for conventional MRI,respectively; the figures were 80%(16/20),100%(12/12), and 86%(28/32)for X ray arthrography,respectively; while the data were 100%(20/20),100%(12/12), 100%(32/32) for MRI arthrography,respectively. For the diagnosis of complete tears, the sensitivity, specificity and accuracy were 79%(11/14), 83%(15/18), and 81%(26/32) for conventional MRI, respectively; the figures were 93%(13/14),94%(17/18), and 94%(30/32) for X ray arthrography, respectively; while the parameters were 100%(14/14),94%(17/18), 97%(31/32) for MRI arthrography, respectively. Conclusion MRI arthrography is one of the best methods for the diagnoses of rotator cuff tears.

Objective To determine the diagnostic value of indirect MRI arthrography for meniscal tears.Methods 75 cases of routine MRI of the knee and 64 cases of indirect MRI arthrography of the knee were retrospectively reviewed.These patients all had subsequently arthroscopic examination.Based on the results of arthroscopic examination,the diagnostic value for meniscal tear of routine MRI and indirect MRI arthrography were compared.Results For medial meniscal tears,the indirect MRI arthrography gave a sensitivity of 72%,specificity of 100%,accuracy of 89.1%,positive predictive value of 100% and negative predictive value of 84.8%.For lateral meniscal tears,the indirect MRI arthrography gave a sensitivity of 83.8%,specificity of 90.9%,accuracy of 87.5%,positive predictive value of 89.6% and negative predictive value of 85.7%.No matter for medical meniscal tears or lateral meniscal tears,the diagnostic differences between the indirect MRI arthrography and the routine MRI were not statistical significant.Conclusion Although the diagnostic value of indirect MRI arthrography for meniscal tears was quite high,it was not different with routine MRI statistically.

Objective To evaluate the diagnostic value of MR arthrography for rotator cuff tear. Methods A prospective study was undertaken in 32 patients with shoulder diseases using MR arthrography. Abnormalities revealed on MR arthrography of the rotator cuff, the labrum, and the tendon of the long head of the biceps brachii muscle were recorded. The results of MR arthrography were compared with those of arthroscopy and surgery. Results Based on the results of arthroscopy and surgery, 32 patients comprised 14 complete rotator cuff tear, 6 partial rotator cuff tear, and 12 subjects without tear. For detecting rotator cuff tear, the sensitivity, specificity, and accuracy of MR arthrography were 100%, 100%, 100% respectively. For detecting complete rotator cuff tear, the sensitivity, specificity, and accuracy of MR arthrography were 100%, 94%, 97% respectively. Meanwhile, MR arthrography revealed all multi tendon tear and all abnormalities of the labrum and the tendon of the long head of the biceps brachii muscle before arthroscopy. Conclusion MR arthrography is an accurate and comprehensive method for evaluating rotator cuff tear.

Objective To assess the relationship between fat metabolic parameters and androgen concentration in the cord blood of newborns of mothers with polycystic ovary syndrome (PCOS). Methods This cross-sectional study included PCOS women (n=55) and neonatal, and 40 cases with matched body mass index (BMI) were used as control. The clinical data including height, body mass, waist circumference, hip circumference of PCOS group, and length and head circumference in newborns after delivery were measured and compared. Blood lipid level, serum insulin and testosterone level were detected using umbilical artery-vein mixed cord blood after delivery. Regression analysis was used to analyze the influence factors of neonatal cholesterol and testosterone levels. Results The neonatal birth weight, head circumference, cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride level were significantly lower, birth height and testosterone level were significantly higher, in PCOS group than those of control group (P＜0.05). Values of waist to hip ratio, BMI, cholesterol, high density lipoprotein cholesterol and testosterone levels were significantly higher in PCOS group than those of control group (P＜0.05). The insulin, cholesterol and triglyceride levels of PCOS mother were risk factors for neonatal cholesterol level(P ＜ 0.05). The cholesterol, triglyceride and free testosterone levels of PCOS mother were risk factors for increased neonatal free testosterone (P ＜ 0.05). Conclusion Mother with PCOS may affect fetal birth weight, head circumference and cord blood lipid metabolism, which may be related with the elevated level of testosterone during the fetal period.

BACKGROUND:Cel cryopreservation is required for clinical use of stem cel s, and the current process of cryopreservation however may be harmful to cel viability, pluripotency and differentiation capacity.
OBJECTIVE:To explore the effect of fructose and dithiothreitol on pluripotency and osteogenesis of cryopreserved bone marrow mesenchymal stem cel s.
METHODS:Bone marrow mesenchymal stem cel s were isolated from the bone marrow of Sprague-Dawley rats and pretreated with fructose (200μmol/L), dithiothreitol (500μmol/L) or combined components before cryopreservation. Then the cel s were cryopreseved for 6 months and the morphology of cel s was observed by inverted microscopy. The cel viability was evaluated by MTT, and real-time PCR was used to detect the mRNA expression of Nanog, OCT4 and Sox2. Alkaline phophatase activity assay and alizarin red staining were utilized to detect the osteogenic capacity of bone marrow mesenchymal stem cel s.
RESULTS AND CONCLUSION:Images captured by inverted microscopy showed no significant difference in cel morphology between groups. The MTT results indicated that fructose and combined pretreatment could promote the cel viability of bone marrow mesenchymal stem cel s after cryopreservation, while the real-time PCR results demonstrated that dithiothreitol significantly facilitated the expression of Naogo and Sox2 in bone marrow mesenchymal stem cel s. Moreover, ALP activity assay and alizarin red staining confirmed the positive effects of fructose, dithiothreitol and combined pretreatment on osteogenic capacity of bone marrow mesenchymal stem cel s after cryopreservation, and the best effects were found after pretreatment with dithiothreitol and combined components. Overal , these findings indicate that fructose pretreatment is beneficial for cel viability of cryopreseved bone marrow mesenchymal stem cel s, and dithiothreitol contributes to maintaining the pluripotency and osteogenesis capacity of cryopreseved bone marrow mesenchymal stem cel s.

ObjectiveTo investigate the clinic and pathologic features of one patient diagnosed with neurocutaneous melanosis ( NCM ) by biopsy.MethodsA 21-year-old woman presented with a 2-month history of tinnitus,headache,vomiting and 1-month history of impaired vision.At birth,a massive nevus covering most of the posterior abdomen had been noted as well as the presence of multiple smaller lesions all over the body.Magnetic resonance imaging demonstrated a posterior fossa cyst compatible with the Dandy-Walker syndrome and extensive leptomeningeal enhancement. Surgery was performed to cystectomy and to obtain pathologic specimens from the leptomeninges. Biopsy and immunohistochemical study was performed.ResultsAt surgery,diffuse black pigmentation of the leptomeninges and the cyst was found.Under microscope,the cyst and leptomeninges were composed with melanocytes with variable pigmentation.Those cells positive for HMB45,MelanA,S100 and vimentin.Ki-67 positive cells ＜ 1％.The pathologic diagnosis wasleptomeningeal diffusemelanocytosis. Thepatientdied 2months after thesurgery.ConclusionsNCM is characterized by a focal or diffuse proliferation of melanin-producing cells in both the skin and the leptomeninges.NCM could be compatible with the Dandy-Walker syndrome.Definite diagnosis relies upon the histological data obtained by mean of biopsy.

Undifferentiated pleomorphic sarcoma (UPS) is commonly found in deep soft tissues, but cutaneous and subcutaneous lesions are relatively rare. The lack of specific symptoms and characteristic manifestations under the microscope makes the diagnosis and treatment of UPS difficult. In April 2022, a patient who was initially diagnosed with cyst infection of the scalp through superficial ultrasound and symptoms was admitted to the Medical Cosmetic Center of the First Affiliated Hospital of Zhengzhou University. After the lesion was resected through surgery, the pathological result showed that the lesion combined UPS. Subsequently, the patient underwent a tumor extended resection, followed by chemotherapy. After 8 months of follow-up, the patient’s prognosis was favorable. This case report aims to provide a reference for the diagnosis and treatment of cutaneous UPS by thoroughly reviewing the diagnostic and therapeutic process of this patient and systematically reviewing related literature.

Undifferentiated pleomorphic sarcoma (UPS) is commonly found in deep soft tissues, but cutaneous and subcutaneous lesions are relatively rare. The lack of specific symptoms and characteristic manifestations under the microscope makes the diagnosis and treatment of UPS difficult. In April 2022, a patient who was initially diagnosed with cyst infection of the scalp through superficial ultrasound and symptoms was admitted to the Medical Cosmetic Center of the First Affiliated Hospital of Zhengzhou University. After the lesion was resected through surgery, the pathological result showed that the lesion combined UPS. Subsequently, the patient underwent a tumor extended resection, followed by chemotherapy. After 8 months of follow-up, the patient’s prognosis was favorable. This case report aims to provide a reference for the diagnosis and treatment of cutaneous UPS by thoroughly reviewing the diagnostic and therapeutic process of this patient and systematically reviewing related literature.

Objective To evaluate the clinical application of TCM nursing therapies and identify the problems during the therapy implementation, in order to explore the countermeasures to promote its clinical improvement. Methods A descriptive cross-sectional study was conducted,and a self-designed questionnaire was employed to investigate 218 nurses from 148 grade A class three TCM hospitals in China. Results 25 TCM nursing therapies were implemented in these hospitals. Ear acupressure therapy was the most frequently implemented,accounting for 83.5%(182/218);while wax therapy was the least implemented, accounting for 7.8%(17/218). The implementation frequency of these technologies varied significantly, 0~860 times a week. The top three of them were acupoint application therapy, hot compression of Chinese medicine and ear acupoints therapy.TCM nursing therapies were considered to be the most frequently used in insomnia, headache, edema, arthralgia, cold, epigastric pain, hypochondriac pain and fever.Storage of TCM nurses,lacking of TCM knowledge and inapposite therapy implementation were the main problems in the application. Conclusions Scientific and rational allocation of human resources, cultivation of the TCM-specific nursing professional, enhancement of nurses'awareness of Chinese medicine, establishment of a reasonable charging standard, and strengthening the risk management in implementation will promote its clinical development.