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 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 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.

Objectives: To investigate the distribution of common pathogens and their antibiotic resistance from patiens with catheter related sepsis (CRS).Methods: Catheter bacteria cultrure and antibiotic sensitivity test were performed from 69 patiens with CRS.Results: The common pathogens in CRS were fungi (41.1%),Gram-positive cocci (35.6%)and Gram-negtive bacilli (23.3%). Non-C. albicans species were major pathogen (19/30 stranins).The most strains were staphylococcus epidermidis in Gram-positive cocci and the most of them were Methicillin resistant.No vancomycin resistant strains were found. The Gram negative bacilli were often resistant to third generation cephalosporens.Conclusions: The dorminant pathogens of CRS are fungi and gram positive cocci and we should pay more attention to pathogens of resistence to antibiotics. In order to control CRS, CVC must be used reasonably and shorten the duration of retention.

Objective: To compare the preliminary efficacy and nursing care of radioprotective agent skin relief cream and Biafine for the prevention and treatment of neck radiation-induced skin damage in patients with nasopharyngeal carcinoma. Methods: Sixty-seven nasopharyngeal carcinoma patients initially treated with intensity-modulated radiotherapy in Sun Yat-sen University Cancer Prevention and Control Center from 2016 to 2017 were recruited and assigned into the control (n=36) and experimental groups (n=31). In the control group, Biafine was applied to the skin in the radiation field and radioprotective agent skin relief cream was applied in the experimental group. The degree of radiation skin injury and adverse reactions were statistically compared between two groups. Results: No grade IV radiation-induced skin damage occurred in two groups. The incidence rates of grade 1, 2 and 3 radiation-induced skin damage in the experimental group were 45%, 42% and 13%, and 17%, 64% and 19% in the control group, respectively (P=0.04). Radioprotective agent skin relief cream could control the radiation-induced skin injury within grade Ⅱ and significantly increase the proportion of grade I skin injury. Conclusion Medical radioprotective agent is superior to Biafine in the prevention and treatment of radiation-induced skin damage in patients with nasopharyngeal carcinoma.

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.

BACKGROUND:The Pilon fracture has a complex fracture line and a comminuted fracture fragment.It is often associated with bone loss and soft tissue damage and is one of the most difficult fractures to treat clinically. OBJECTIVE:To analyze the correlation between tibial and fibular fractures in Pilon fractures. METHODS:A retrospective analysis was conducted on 188 patients with Pilon fracture in the Department of Trauma Orthopedics,The Second People's Hospital of Lianyungang City from January 2014 to January 2022.Imaging data of these patients were collected.Fibular fracture level,fibular fracture type,number of fibular fracture blocks,tibial position status,main fracture blocks of the tibia,size of medial fracture blocks of the tibia,tibial fracture angle,Topliss classification(sagittal plane)and Topliss classification(coronal plane)were summarized into a database.SPSS 25.0 was used to analyze the data of tibia and fibula in Pilon fractures by Spearman correlation analysis.On the basis of the correlation,multiple disordered Logistic regression was used to further analyze the correlation. RESULTS AND CONCLUSION:(1)Spearman correlation analysis showed that tibial fracture angle was positively correlated with fibular fracture type,fibular fracture level and fibular fracture number.Tibial position status was positively correlated with tibial fracture angle and Topliss classification(coronal plane),but negatively correlated with major tibial fracture blocks and Topliss classification(sagittal plane).The level of fibular fracture was positively correlated with the type of fibular fracture and the number of fibular fractures.The main fracture blocks of the tibia were positively correlated with Topliss classification(coronal plane)and negatively correlated with Topliss classification(sagittal plane).(2)Multiple Logistic regression analysis showed that:the level of fibular fracture was correlated with the type of fibular fracture(P<0.05);the number of fibular fractures was correlated with the main fracture block of tibia(P<0.05).(3)It is indicated that the more inclined the ankle joint was to the valgus,the more likely it was to lead to fibular fracture,and the higher the fibular fracture level,the more serious the fibular fracture degree,the more complex the fibular fracture type,the larger the tibial fracture angle,the more the tibia presented Topliss classification(coronal plane)fracture.(4)When the ankle joint was more inclined to be in varus or varus + dorsiflexion,the fibula often did not fracture or simple fracture occurred,and the lower the fracture level,the smaller the tibial fracture angle,the more Topliss classification of the tibia(sagittal plane),the more main fracture blocks of the tibia,the larger the medial fracture block.When the ankle joint is in the dorsiflexion,it often results in a simple fibular fracture with a posterolateral tibial fracture.