ObjectiveTo investigate the effects and indication of intermittent catheterization(IC) by relative safe bladder capacity(RSBC) to treat vesical-ureteral reflux(VUR).MethodsThere were 23 male complete SCI patients, aged between 7～45 years, including 15 patients without vesicao-ureteral reflux injuried 1～3 months as control group, 3 patients in mild group affected only ureter, and 5 patients in severe group affected not only ureter but also the pelvis. All the patients were taken intermittent catheterrization according to their own RSBC companied with supersonic device. The times of IC per day is that the average total urine volume one day was divided by RSBC. The observation time is over 2 years. During the oberservation some medicine was used to enlarge some patients bladder capacity.ResultsThere were no reflux in the control group; the reflux in the mild group improved a lot, some even disappeared, and there were no change in the severe group.ConclusionIC by RSBC is effective to prevent and cure vesical-ureteral reflux in some SCI patients.

Objective To investigate the effect of all-trans retinoic acid (ATRA) on the expression of matrix metalloproteinases-9 (MMP-9) in perihematomal brain tissue after intracerebral hemorrhage in rats.Methods Forty Sprague-Dawley rats were randomly allocated into ATRA and normal saline control groups.Each group was redivided into 2 h,48 h,72 h,and 7 d subgroups (n = 5 in each subgroup).The autologous blood was injected into the rat caudate nucleus for establishing a model of intracerebral hemorrhage under the guidance of stereotaxic apparatus.Intraperitoneal ATRA (1 mg/d) and the same volume of saline were injected respectively after the success of modeling.The expression of MMP-9 at different time points was detected by using immunohistochemical staining.Results The expression of MMP-9 in microvascular endothelial cells in perihematomal brain tissue in rats was upregulated 24 h after intracerebral hemorrhage in the ATRA and normal saline control groups,and it reached the peak at 48 to 72 h.The expression of MMP-9 in the ATRA group at different time points was lower than that in the normal saline control group (all P＜0.05).Conclusions ATRA inhibits the expression of MMP-9 in perihematomal brain tissue after intracerebral hemorrhage in rats,and thus may reduce the brain edema.

Objective To investigate the value of fused 3D-SPACE and 3D-TOF images in diagnosis of intracranial neurovascular compression syndrome.Methods 26 patients with intracranial neurovascular compression syndrome were examined using 3D-SPACE sequence and 3D-TOF sequence.After 3D-SPACE and 3D-TOF were fused by different times,the quality of image as well as the ability of j udging the relationship between nerves and blood vessels was analyzed and compared between the original images and the fused images.Results In this study,the fused images by adding one 3D-SPACE sequence and one 3D-TOF sequence showed the highest accurate than others(2 1 cases),and the j udgement of the relationship between the responsible blood vessels and nerve accor-ded with the surgical results to the highest extent (P<0.05).Conclusion The fusion image of 3D-SPACE sequence and 3D-TOF se-quence can improve the diagnostic ability of the intracranial neurovascular compression syndrome,and the appropriate proportion of the fusion image can show the relationship between the nerve and blood vessel.

Objective To observe the effect of Boari bladder muscle flap surgery in nephron sparing surgery for patients with middle and lower ureteral carcinoma. Methods Totally 80 patients with middle and lower ureteral carcinoma underwent surgery in our hospital from March 2009 to March 2012 were selected and divided into the control group and the observation group,with 40 cases in each group. Patients of the control group were treated with ureteral carcinoma radical prostatectomy while patients of the observation group were treated with Boari bladder muscle flap surgery,and all of them were followed up for 3 years after operation. Observed the renal function,renal tumor markers and the level of inflammatory symptoms of the 2 groups before the operation and 3 months after the operation,and compared the long-term progno-sis of the 2 groups. Results There was no significant difference between the 2 groups in renal function index before operation. The level of BUN,Scr,blood urea and serum uric acid index in the 2 groups were all increased compared with those before operation,but the increase of the control group was significantly higher with statistically significant differences (P<0. 05). The tumor markers CA19-9, Survivin and in-flammatory marks WBC,NEC%,IL-6,hs-CRP had no significant difference before operation,and all the level of the 2 groups were decreased after operation,but there was still no difference between the 2 groups (P>0. 05). The survival rate 1 year,2 years and 3 years after operation also had no significant difference between the 2 groups (P>0. 05). Conclusion The use of Boari bladder muscle flap surgery in nephron sparing surgery for patients with middle and lower ureteral carcinoma can effectively maintain the renal function of patients without affecting the radical and long-term prognosis.

Three methods for isolation of nitrite oxidizers-dilution method, silica-gel plate method and enrichment culture-capillary pipette method were compared. Among them the dilution method was most feasible and efficient.

Objective:To evaluate the application values of small FOV surface coil and BLADE sequence in MR imaging on assessment of talar cartilage injury of ankle joint under traction.Methods:The clinical and imaging data of 53 patients with ankle cartilage injury in the Affiliated Suzhou Hospital of Nanjing Medical University from December 2018 to July 2020 were prospectively analyzed. All patients underwent the following MR sequences: sequence Ⅰ was fast spin echo proton density weighted (FSE-PD) BLADE sequence with surface coil small FOV, and sequence Ⅱ was FSE-PD-BLADE imaging of small FOV under horizontal load traction of ankle joint. Paired sample Wilcoxon rank sum test was used to compare the thickness of talus dome cartilage, cartilage space and subjective assessment score of image quality (including the outline of the upper surface of the cartilage at the injury, the thickness of the cartilage layer at the injury, the rupture of the cartilage at the injury, the relationship between cartilage and subchondral bone, subchondral bone collapse or trabecular fracture line) between sequence I and sequence Ⅱ.Results:There was significant difference in the thickness of central cartilage of talus between sequence Ⅰ and sequence Ⅱ [0.70 (0.60, 0.90) mm and 0.80 (0.70, 0.90) mm, Z=-2.900, P=0.004, respectively]. There was no significant difference in the thickness of medial and lateral talus cartilage between sequence Ⅰ and sequence Ⅱ (P>0.05). There were significant differences between sequence Ⅰ and sequence Ⅱ in the center [0.10 (0, 0.15), 0.89(0.63, 1.00) mm], medial [0.10(0, 0.31), 1.20(0.70, 1.25) mm] and lateral cartilage space [0.18(0.08, 0.23), 0.90(0.76, 0.94)mm] (all P<0.001). As for the subjective assessment score of talus cartilage injury, except for score in subchondral bone collapse or bone trabecular fracture line between sequence Ⅱ and sequence Ⅰ ( Z=-1.480, P=0.139), significant differences were found in all other scores ( P<0.05). Conclusion:MRI of the ankle under traction is safe and feasible. Under the condition of horizontal traction, small FOV surface coil combined with BLADE sequence can better display talus cartilage injury.

Objective To compare the imaging quality of articular cartilage of the knee with 3D-sampling perfection with applica-tion optimized contrast using different flip angle evolutions (3D-SPACE),3D-true fast imaging with steady-state precession (3D-True FISP)and 2D-fast-spin-echo-proto-density(2D-FSE-PD)sequences.Methods 40 healthy volunteers and 20 patients of knee joints were examined with 3D-SPACE,3D-True FISP and 2D-FSE-PD sequences at 1.5T MRI.Signal-noise ratio (SNR),contrast-to-noise ratio (CNR)and lesion visualization of articular cartilage were compared.Results 3D-SPACE showed the highest SNR of cartilage and CNR of fluid/cartilage among the three sequences (P <0.05).3D-SPACE had the better capability for showing the lev-el I 、level Ⅱcartilage injury comparing with 3D-True FISP,but no significant difference between the cartilage injury at level Ⅲ and level Ⅳ.For all levels of cartilage injury,3D sequence was better than the 2D sequence.Conclusion Compared with the 3D-True FISP sequence and 2D-FSE-PD sequence,3D-SPACE sequence can show the structure of knee and knee cartilage injury better.

Objective To compare the accuracy rate of talar osteochondral lesions between the small field of view (FOV) surface coil MR imaging and 2D FSE proton density weighted imaging (2D-FSE-PD),3D-SPACE sequences MR imaging with boot-shaped coil.Methods Totally 43 patients (45 ankles) underwent 3D-SPACE sequence after 2D-FSE-PD sequence scanning using the boot-shaped coil,then the PDWI sequence was scanning after the boot-shaped coil was replaced by the small FOV surface coil at 1.5T MRI.The results of the arthroscopic examinations was regarded as the standard for assessing the accuracy rate of the three methods.Results The accuracy rate of 2D-FSE-PD sequence with small FOV surface coil was 86.67％ (39/45),the accuracy rate of 2D-FSE-PD sequence with boot coil was 60.00％ (27/45),the accuracy rate of 3D-SPACE sequence with boot coil was 68.89％ (31/45).The accuracy rate of small FOV surface coil was higher than those of boot coil used 3D-SPACE sequence (x2 =4.114,P =0.002) and boot coil used 2D-FSE-PD sequence (x2 =8.182,P＜0.001).There was not significant difference between 3D-SPACE sequence using boot coil and 2D-FSE-PD sequence using boot coil (x2 =0.776,P=0.125).Conclusion Compared with the 2D-FSE-PD and 3D-SPACE sequences with boot-shaped coil,the small surface coil scanning with routine sequence can show talar osteochondral lesions better.

Objective:To investigate the predictive value of estimated renal perfusion pressure (eRPP) for acute kidney injury (AKI) in severe multiple trauma patients.Methods:Severe multiple trauma patients were collected based on the inclusion criteria and exclusion criteria from the Trauma Center, the Third Xiangya Hospital, Central South University. Subsequently, patients were divided into the AKI group and non-AKI group according to the occurrence of AKI during 72 h admission to hospital. Further clinical information, ISS score, SOFA score, APACHE Ⅱ score, mean arterial pressure (MAP), central venous pressure (CVP) and intra-abdominal pressure (IAP) were collected, and eRPP were calculated. Additionally, the differences of parameters in the AKI group and non-AKI group were analyzed and logistic regression analysis was performed to identify the independent predicted risk factors for AKI. Finally, ROC curve was conducted to identify specificity, sensibility and best cut-off point.Results:A total of 173 severe multiple trauma patients were finally analyzed. Compared with the non-AKI group, the serum albumin [(32.21±5.20)g/L vs. (34.83±4.20)g/L, P =0.001] and 24 h urine output [(711.90±241.38)mL vs. (1 101.21±509.86)mL, P =0.001] were significantly lower and serum lactate [(2.80±0.96)mmol/L vs. (1.89±0.63)mmol/L, P<0.001], ISS score [(29.05±5.91) vs. (22.17±4.02), P <0.001], APACHEⅡ score [(38.84±21.47) vs. (31.45±18.24), P <0.001] and SOFA score [(5.26±2.08) vs. (3.14±1.34), P <0.001], in-hospital mortality (9.52% vs. 2.29%, P=0.038), and ICU stay [(8.43±6.46)d vs. (6.42±3.78) d, P =0.01) were significantly higher in the AKI group. Moreover, 6, 12 and 24 h of CVP and eRPP after admission were associated with the incidence of AKI. Logistic regression analysis showed that 24 h urine output, CVP and eRPP were the independent predictive factors (P <0.05) and 24 h of eRPP after admission applied a better predictive value of the incidence in AKI. Conclusions:24 h of eRPP might be the most suitable independent predictive factor for AKI in severe multiple trauma patients.

Objective To investigate the relationships of MR indexes such as acromio humeral intervals (AHI),lateral extension of the acromion (LEA) and inclination angle of the acromion with the subacromial impingement syndrome (SIS).Methods 151 patients underwent MRI examination of shoulder joints,they were grouped according to age,gender and location of acromion.The differences in age,gender and MR indexes were compared between SIS group and non SIS group.The distribution statuses of SIS in different groups were compared at the same time,the relationships of various MR indexes with SIS were investigated and analyzed.Results There were no statistical differences in age,location distribution,the average shortest AHI value and the thickness of the subacromial bursal effusion between SIS group and non SIS group (P ＞ 0.05).There showed statistical difference in gender between the two groups (P =0.000),and there were more males than females in both groups.The acromion exactly covered the supraspinatus tendon in 79 patients,the average value of LEA in the SIS group was greater than that in the non SIS group,and there showed statistically significant difference between the two groups (P =0.002),the Youden index of LEA was 0.40,the sensitivity was 61％ and the specificity was 79％.The inclination angle of the acromion in the SIS group was smaller than that in the non SIS group,and there was a statistically significant difference between the two groups (P =0.019),the Youden index of the inclination angle of the acromion was 0.18,the sensitivity was 62％ and the specificity was 56％.47 patients in the SIS group had subacromial bursal effusion,51 patients in the non SIS group had subacromial bursal effusion.The thickness of the subacromial bursal effusion in the SIS group was greater than the non SIS group,and there showed statistically significant difference between the two groups (P =0.002),the Youden index of the thickness of the subacromial bursal effusion was 0.34,the sensitivity was 78 ％ and the specificity was 56 ％.Conclusion LEA,the inclination angle of the acromion and the thickness of the subacromial bursal effusion can be used as quantitative MR diagnostic criteria of SIS.The LEA measured by cardiothoracic ratio is simple and easy to use.