Objective: To investigate the multivoxel proton MR spectroscopy findings of brain tumors and the clinical value in differential diagnosis. Methods:Sixty patients with brain tumors underwent multivoxel proton MR spectroscopic examination with PRESS sequence. Distribution of the 60 final diagnoses of neoplasms was as follow: meningioma (n=22), glioma (n=21), lymphoma (n=3), metastasis (n=5), acoustic neuroma, pituitary tumor, PNET (n=2, respectively), vascularblastoma, arachnoid cyst, neurofibromatosis (n=1,respectively). The concentrations of NAA, Cho, Cr, Lac-Lip were obtained in the tumors and the contralateral normal brain region. The ratios of NAA/Cr, Cho/Cr, NAA/Cho, tumor NAA/normal NAA, tumor Cho/normal Cho, tumor Cr/normal Cr were calculated. Results: 1H MRS showed decreased NAA, Cr and elevated Cho. NAA concentrations in meningioma, glioma, lymphoma decreased significantly to acoustic neuroma, metastasis, but Cho in tumors changed without significance. NAA/Cr ratio was significantly lower in glioma than in acoustic neuroma and metastasis, and p value was 0.014, 0.027, respectively. No significance was found in tumor Cho/Cr data. Conclusion:Multivoxel proton MR spectroscopy is available for study of tumor metabolites. The tumor NAA/normal NAA, NAA/Cr were helpful for the diagnosis and differential diagnosis of intracranial tumors.

Objective To study way of unloading and positioning of the new type medical shelter. Methods Through repeated testing and practical application, the ways of "3-lines" is used in the ground precession standardization. The first line is guard line of the left marginal of the shelter, the second is allocation line of the end part of the shelter and the third is front wheel alignment line of the whole unloading vehicles. Based on the lines, vehicles carrying shelters access to the ground in accordance with the order of three channel shelters ahead of five functional shelters. Results The real time of the shelter started is reduced to 35min, much lower than the time designed of 4h. Conclusion The application can be carried out precise positioning and improve the speed of the equipment spread.

Theultraperformanceliquidchromatographycoupledwithmassspectrometry(UPLC-MS)was used to investigate the metabolic difference of the decoction of Radix Aconiti Preparata ( RAP ) and its co-decoctions with Radix Paeoniae Alba ( RAP-RPA ) or Radix Stephaniae Tetrandrae ( RAP-RST ) in rat intestinal bacteria. The principal component analysis ( PCA) of the relative contents of Aconitum alkaloids after metabolism was performed by SIMCA-P software. The score plots of PCA could successfully distinguish the three groups of RAP, RAP-RPA and RAP-RST. The result indicated that the differences of biotransformation among the groups of PAP, RAP-RPA and RAP-RST were significant. With the loading plot and independent-samples T test, seven relevant markers with the significant differences were found in the group of RAP-RPA, six relevant markers were obtained in the group of RAP-RST. The relative content of four markers in RAP-RPA was higher than that in RAP, and one marker in RAP-RST was higher than that in RAP. The relative contents of other markers were all lower than that in RAP. These markers may be the effective substance for explaining the different effects of Radix Aconiti Preparata before and after combination with Radix Paeoniae Alba and Radix Stephaniae Tetrandrae.

In order to solve the problems of present quartz crystal microbalance ( QCM ) measuring instruments, such as high demand for crystal cutting technology and uncomprehensive measurements for crystal parameters, a modified quadrature demodulation-based method was proposed with broadband adaptive response capacity and high frequency resolution. Moreover, it is also capable of measuring both resonant frequencies and dissipation factor D synchronously and continuously. Experimental results at room temperature indicated that the adaptive frequency range was 1-9 MHz while the frequency resolution was less than 1 Hz, measured resonance frequency shifts of crystals in the range scale linearly with the equal thickness increments of poly acrylic acid ( PAA) membrane on the working electrode, and with the volatilization of different solvent factor D is measured continuously and effectively along the time axis. To sum up, compared with traditional ones, this new method has lower material cost and more obtained parameters.

ObjectiveTo evaluate the multi-phase imaging ability of dual source CT coronary angiography and the effects of whole-phase interval reconstruction and the four dimensional(4D)mode of"Inspace"software on the imaging quality of dual source CT coronary angiography.MethodsFifty patients performed coronary CT angiography(CTA),and the images were reconstructed from 10% to 100% of the R-R interval(the reconstruction interval was 10%).The imaging quality scores of the three main coronary arteries were assessed by two experienced radiologists using the 4D mode of"Inspace"software On workstation.ResultsThe average scores of imaging quality in the RCA.LAD and LCX at all 10 reconstruction phases were 1.71,2.57 and 2.03 respectively. The scores of imaging quality in the three main coronary arteries were all over 2.0 when the reconstruction phase were at 30%,40%and 70%of the cardiac circle.The imaging quality scores in the three main coronary arteries reached 3 at least one phase both in systole(10%-40%)and in diastole(50%-100%)in 41 cases(82%).The imaging quality scores in the left anterior descending artery reached 2 at all phases in 25 cases(50%),and reached 3 in 5 cases(10%).Conclusion Dual source CT coronary angiography can achieve good image quality in mid-late systole(30%-40%)or mid-diastole(70%).

Objective To study the clinical and pathological manifestations of microsporidian encephalitis.Methods The clinical findings and the brain pathological features of a patient with microsporidian encephalitis hospitalized in 2004 were studied.Results The onset was subacute or chronic. The body temperature was usually normal or below 37.5℃,but it rose when patient's condition deteriorated and coma appeaxed.The patient had hypoimmunity but without human immunodeficiency virus infection. Multifocal lesions in the whole brain,signs of meningeal irritation and infective myelogram were observed. Rheumatoid factor increased in the early stage and indirect bilirubin,proteins in cerebrospinal fluid(CSF), and immunoglobulin IgG,IgA increased in the middle stage.Cytological examination of CSF showed lymphocyte reaction.Blood routine test showed normal eosinophil granulocyte count.The patient was found to have pleurisy,peritonitis and cystitis.Brain magnetic resonance image(MRI)manifested plaque-like isometric T1 weight image and long T2 weight image signal in white matter of bilateral cerebral hemisphere and cerebella where FLAIR sequence showed hyperintensity.No apparent mass was identified.Contrast- enhanced MRI scan showed patchy and ring-like intensification.The neural system impairments were permanent and not improved after treatment.The pathology of brain tissue showed neuronal degeneration, karyopycnosis and Derivasculitis.The infectious agents were observed in the cytoplasm of neurons.Wister rats had muhiple organ inflammatory reaction 2 weeks after intraperitoneal inoculation of the patient's CSF and a large quantity of pathogens were found in the peritoneal lavage fluid.Conclusions The patient was PAS staining method is useful for detecting the pathogen in neurons and the rate can be raised by animal intraperitoneal cultivation

Objective To evaluate the preventive effects of Haishe capsules on the conversion of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease(AD).Methods Patients (n=120) with aMCI from our department were recruited and randomly divided into the treatment group and the control group (n=60 in each group).The treatment group was given 0.9 gram of Haishe capsules three times a day while the control group received no drug treatment.Data on the conversion ratio,memory and cognitive function were comparedbetween the groups in a 24-months follow-up.Results By the end of the study,12 patients in the treatment group and 15 in the control group dropped out.Valid data for 93 patients were available for statistical analysis (48 in the treatment group and 45 in the control group).The number of aMCI patients who converted to AD was 6,with a conversion ratio of 12.5％ (6/48);and the number of patients who went through conversion in the control group was 13,with a conversion ratio of 28.8％ (13/45).The difference in conversion between the two groups was statistically significant (x2 =3.83,P＜0.05).After 24 months,MMSE scores for the treatment group (25.52± 1.07) had no significant change compared with baseline levels,while MMSE scores for the control group decreased significantly(24.75--1.49) and were markedly lower than thosefor the treatment group (t=2.85,P＜0.05).MoCA scores for the treatment group (19.39 ±2.01) did not show decline until the end of the study,while those for the control group started to decrease about half way through the study and were lower than scores for the treatment group (t =2.41,P＜0.05).Compared with baseline levels,ADAS-Cogscores for the treatment group (7.62± 1.06) did not increase significantly during the course of the study.ADAS-Cogscores forthe control group were higher at both half way (7.70±0.75) and the end of the study (8.18±0.80)than base line levels,and there was a statistically significant difference in end-of-study ADAS-Cog scores between the two groups(t =-2.6,P＜ 0.05).Conclusions Haishe capsules not only effectively maintain memory and cognitive function,but also delay the conversion from aMCI to AD.

Objective To investigate the integrated perinatal management and prognosis of prenatally diagnosed congenital diaphragmatic hernia (CDH).Methods Clinical data of 32 cases of neonatal CDH that were diagnosed and treated in the Third Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were collected and retrospectively analyzed.All cases were classified into mild,moderate and severe groups based on prenatal lung-to-head ratio (LHR),observed to expected LHR and observed to expected total fetal lung volume.The integrated perinatal management included prenatal management (prenatal diagnosis and consultation),intrapartum management (delivery) and postnatal management (postnatal diagnosis,neonatal treatment and surgical treatment).Neonatal outcomes were analyzed.Statistical analysis was performed using Chi-square test and t-test.Results All of the 32 cases were diagnosed by prenatal ultrasonography and assessed by MRI.There were 18 mild,nine moderate and five severe CDH cases,respectively.Left-sided and right-sided CDH were respectively found in 27 and five cases.Thirty neonates underwent surgery when the diagnosis had been confirmed after birth and the conditions were stable after comprehensive treatment.The total survival rate was 81％ (26/32).The neonatal survival rates of severe and mild groups were 1/5 and 18/18,respectively.The more severe the CDH,the lower the survival rate (x2=16.538,P＜0.001).Among the 18 neonates with mild CDH,five neonates underwent minimally invasive laparoscopic surgery had shorter fasting time,duration of postoperative antibiotic administration and hospital stay than those received open surgery (n=13)[(2.4±0.5) vs (4.6±1.2) d,t=-3.939;(7.6±1.2) vs (9.8±1.4) d,t=-3.144;(14.4±1.1) vs (19.7±2.8) d,t=-4.064;all P＜0.01].Neonates who were discharged alive received a three months to two years postoperative treatment and follow-up and one received a second operation due to recurrence and all recovered.Conclusions Prognosis of neonatal CDH are closely related to prenatal conditions.Integrated management is of great significance in CDH.

Objective To study the feasibility and practicability of contralateral saphenous vein bypass in the treatment of chronic femoral vein obstruction.Methods A retrospective analysis was consisted of 33 patients who received contralateral great saphenous vein bypass during the period of June 2013 to June 2017 in the Deperrtment of Biloary Vascular Surgery of Shengjing Hospital of China Medical University.All patients after operation were followed up of 2 months deadline to August 2017 by telephone or outpatient,the follow-up content including lower limb activity after resting and subjective sensation,lower limb swelling degree and so on.The measurement data was expressed by mean standard deviation ((x) ± s),paired samples t test was used for comparison among groups.Linear correlation coefficient was used to describe the difference between ankle circumference and the time to maintain anticoagulation therapy after acute thrombosis,then we explored the effect and advantages of this surgical methods.Results Compared with the preoperative index,the activated partial thromboplastin time [(21.93 ± 3.36) svs(18.11 ±2.24)s,P＜0.05],the thrombus elastic map R value[(5.45 ±0.73)min vs(4.20 ± 0.39) min,P ＜ 0.05],the D-dimer [(3 502.79 ± 4 028.02) μg/L vs (5127.76 ± ± 4722.42) μg/L,P ＜ 0.05] and the ankle circumference [(22.23 ± 1.28) cm vs (25.38 ± 0.78) cm,P ＜ 0.05] were improved,and the prothrombin time [(12.63 ± 1.74) s vs (12.32 ± 1.14),P ＞0.05] showed no difference before and after the operation (P ＞ 0.05).With the extension of time,the effect of bypass on the treatment of lower limb edema weakened.Postoperative follow-up indicated that 33 cases of patients were unobstructed and returned to normal state,21 cases could tolerated normal physical activity and had no or mild swelling,12 cases occasional had moderate swelling while the swelling could disappear after lying down for a rest,symmetric of double lower limbs in all patients returned to acceptable degree and did not affect the clothing or appearance.Conclusion The contralateral saphenous vein bypass operation has better effect and less trauma,it can improve the lower limb edema and endogenous coagulation system of chronic obstructive iliac vein disease,and the effect is better after conservative treatment for half a year.

Objective:To assess the association of cytotoxic T lymphocyte-associated antigen-4 ( CTLA-4) gene polymorphisms with the prognosis of patients with Bladder urothelial carcinoma (BUC). Methods:From February 2019 to October 2020, 256 BUS patients treated at the Xinxiang Central Hospital were selected as the study group, whilst 250 healthy individuals were selected as the control group. Genotypes of rs5742909 (-318C/T), rs231775 (+ 49A/G) and rs4553808 (-1661A/G) were determined by PCR-restriction fragment length polymorphism assay. The frequencies of genotypes and alleles of the CTLA-4 gene were compared between the two groups. All patients had undergone surgical treatment and were followed up for 3 years and divided into good prognosis group ( n=166) and poor prognosis group ( n=86) based on the status of disease. The distribution of alleles and genotypes were compared, and Kaplan-Meier analysis was used to assess the association of genetic polymorphisms with the prognosis. Results:No significant difference was found in the gender, age, BMI, smoking history and alcohol use between the two groups ( P>0.05). The frequencies of GG genotype and G allele for the rs231775 (+ 49A/G) and rs4553808 (-1661A/G) loci were significantly higher in the study group compared with the control group ( P<0.05), whilst no statistical difference was found in the genotypic and allelic frequency for the rs5742909 locus between the two groups ( P>0.05). Among the 252 subjects who had completed follow-up, 86 had poor prognosis and 166 had good prognosis. The frequencies of GG genotype and G allele at the rs231775 (+ 49A/G) and rs4553808 (-1661A/G) loci were significantly lower in the good prognosis group compared with the poor prognosis group ( P<0.05). Kaplan-Meier survival curve analysis showed that the survival time of patients with GG genotype for the rs231775 (+ 49A/G) and rs4553808 (-1661A/G) loci was significantly shorter than patients with AA or AG genotypes (Log Rank 2 = 13.654, 9.974, P<0.001). Conclusion:The polymorphisms of the rs231775 and rs4553808 loci of the CTLA-4 gene are associated with genetic susceptibility and poor prognosis for BUC, and a higher GG genotypic frequency may increase the risk for infection and poor prognosis of the patients.