Objective To compare the diagnostic performance of multi-contrast atherosclerosis characterization (MATCH) and magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for the detection of IPH with histologic analysis as the reference standard.Methods Thirty individuals were collected in this study.They were diagnosed to have carotid stenosis＞50％ by ultrasound and scheduled for carotid endarterectomy from 2014 to 2015.3 T carotid MR examinations using MPRAGE,MATCH and 3D TOF were performed in these patients.Axial images covered all plaques and centered at the bifurcation of the carotid artery.All image data sets were processed on a semi-automatic software (MRI-Plaque View,VPDiagnostics,US) to analyze the component of IPH for vulnerable plaques.The consistency between MATCH and MPRAGE was analyzed by using Cohen Kappa analysis.Comparison of the two sequences to the pathological results was performed in a similar manner.The sensitivity and specificity of the two sequences were obtained.The SNR,CNR and contrast ratio(CR) of the two regions of interest were calculated and Wilcoxon rank sum test was used to compare the difference between the two methods.Results Among 30 patients,a total of 602 available sections and 95 correponding histology specimens were included in the analysis.When all 602 available sections were included in the analysis,MATCH yielded good agreement with MPRAGE(Kappa=0.773) on the detection of IPH.With pathological specimens as the gold standard,moderate to good agreement was shown for both MATCH and MPRAGE (Kappa=0.778,0.685).The sensitivity and specificity for the detection of IPH was 93.2％ (68/73) and 90.9％ (20/22) for MATCH.For MPRAGE,the sensitivity and specificity was 87.7％(64/73) and 90.9％(20/22) respectively.The difference between MATCH and MPRAGE was statistically significant for SNR,CNR and CR.That is to say,SNR and CNR of MPRAGE were higher than those of MATCH(P＜0.05),while CR of MATCH was higher than that of MPRAGE(P＜0.05).Conclusion Compared to the MPRAGE sequence,MATCH technique demonstrates similar diagnostic performance for the detection of IPH.

Objective To investigate the diagnostic performance of stress cardiac magnetic resonance(CMR) for evaluating low-risk patients with suspected acute coronary syndrome(ACS).Methods Twenty-two patients with low risk of suspected ACS were prospectively and consecutively enrolled in this study.Diagnostic performance of stress CMR was compared with single-photon emission computed tomography(SPECT) for diagnosis of myocardial ischemia with coronary angiography (CAG) as the reference method.Results On the patient-based level analysis,the diagnostic performance of CMR for detection of ACS was sensitivity 93% and specificity 75%.The corresponding value of SPECT was 79%,63%.The area under the ROC (AUC) of CMR was 0.897, which was slightly superior to that of SPECT at 0.723 (P=0.19).On the per-vessel assessment, the diagnostic value of CMR was sensitivity 89%,specificity 87%, while the corresponding value of SPECT was 68%,83%.The AUC of CMR was 0.923,which was significantly higher than that of SPECT at 0.774 (P<0.05).Furthermore, the AUC of CMR was significantly superior to that of SPECT with AUC being 0.900 and 0.553 in the left anterior descending (LAD) vessels (P=0.009 6).Conclusion Stress perfusion CMR has excellent diagnostic performance in low risk ACS patients.Compared with SPECT,stress perfusion CMR performed better in the low-risk ACS populations.

Objective To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P < 0.05). For 109 cases with acute and convalescent paired serum samples, there was no significant difference in the positive rates between ELISA-IgG ( 75.23%) and real-time PCR (72.48%) detections (χ2=0.18, P>0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P<0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased ( Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA-IgM can be used as an assistant method to guide clinical diagnosis.

Vocal fold paralysis (VFP) refers to neurological causes of reduced or absent movement of one or both vocal folds. Bilateral VFP (BVFP) is characterized by inspiratory dyspnea due to narrowing of the airway at the glottic level with both vocal folds assuming a paramedian position. The primary objective of intervention for BVFP is to relieve patients’ dyspnea. Common clinical options for management include tracheostomy, arytenoidectomy and cordotomy. Other options that have been used with varying success include reinnervation techniques and botulinum toxin (Botox) injections into the vocal fold adductors. More recently, research has focused on neuromodulation, laryngeal pacing, gene therapy, and stem cell therapy. These newer approaches have the potential advantage of avoiding damage to the voicing mechanism of the larynx with an added goal of restoring some physiologic movement of the affected vocal folds. However, clinical data are scarce for these new treatment options (i.e., reinnervation and pacing), so more investigative work is needed. These areas of research are expected to provide dramatic improvements in the treatment of BVFP.
Botulinum Toxins ; Cordotomy ; Dyspnea ; Electric Stimulation Therapy ; Genetic Therapy ; Larynx ; Paralysis* ; Recurrent Laryngeal Nerve Injuries ; Review Literature as Topic* ; Stem Cells ; Synkinesis ; Tracheostomy ; Vocal Cord Paralysis ; Vocal Cords*

Objective To explore the clinical application value of left atrial function with feature tracking cardiac magnetic resonance imaging (FT-CMR) by evaluating preliminarily left atrial strain and strain rate in patients with atrial fibrillation. Methods Thirty patients with paroxysmal atrial fibrillation, thirty patients with persistent atrial fibrillation and twenty-two healthy subjects were enrolled. All the subjects underwent cardiac magnetic resonance imaging with the real steady-state free precession(SSFP) sequence. FT-CMR parameters included left atrial strain and strain rate parameters, left atrial volume and function parameters were detected by using offline cardiovascular analysis software, respectively. Left atrial strain and strain rate parameters included left atrial total strain(Εs), passive strain(Εe), active strain(Εa), peak positive strain rate(SRs), peak early negative strain rate(SRe)and peak late negative strain rate(SRa). Volume and function parameters included maximum of left atrial volume(LAVmax), minimum of left atrial volume(LAVmin), total left atrial emptying fraction(LATEF), passive left atrial emptying fraction(LAPEF)and active left atrial emptying fraction(LAAEF). The differences in the general data among the paroxysmal atrial fibrillation group, the persistent atrial fibrillation group and the control group were compared by usingχ2 test or ANOVA analysis. The differences in all parameters between the atrial fibrillation group and the control group, the paroxysmal atrial fibrillation group and the persistent atrial fibrillation group were compared by using independent t test. Left atrial strain and strain rate parameters on an intra-observer and inter-observer were determined by intraclass correlation coefficient(ICC)analyses. Results Compared to control group, LAVmax and LAVmin in atrial fibrillation group were significantly increased(t=9.737,7.889,P<0.001);The LATEF and LAPEF had no significant difference, the LAAEF in two groups had statistically significant difference(t=-4.762,P<0.001).The absolute value of Es, Ee, Ea, SRs, SRe, SRa in atrial fibrillation group were significantly reduced than in control group(t=-7.732,-6.610,-6.493,-7.546, 6.864, 5.917,P<0.001). Compared with paroxysmal atrial fibrillation group, LAVmax and LAVmin in persistent atrial fibrillation group were increased obviously, LATEF and LAPEF were significantly decreased, and the differences were statistically significant(t=-4.575,-5.524, 4.002, 4.028,P<0.001).The LAAEF in two groups had no statistically significant difference. Compared with strain and strain rate in two groups, absolute value of Es, Ee, Ea, SRs, SRe, SRa in persistent atrial fibrillation group significantly decreased than in paroxysmal atrial fibrillation(t=4.310, 3.128, 4.465, 5.496,-3.290,-3.863,P<0.001). The intra-group and inter-group had well correlation coefficients between the observers in the left atrial strain and strain rate parameters of the subjects(ICC=0.85—0.94,0.81—0.90). Conclusions FT-CMR technique can be used to assess the left atrial strain and strain rate in patients with atrial fibrillation;Left atrial reservoir, conduit and booster-pump functions in patients with atrial fibrillation were impaired. Patients with persistent atrial fibrillation had worse left atrial function throughout the entire cardiac cycle compared with those with paroxysmal atrial fibrillation.

We reported a female fetus diagnosed with X-linked dominant chondrodysplasia punctata 2 with severe phenotype. The fetus was found with abnormal short limbs, thick metaphysis on the right lower limb and a narrow and small thorax by prenatal ultrasound at 24+5 weeks of gestation. Non-invasive prenatal test indicated the risks of trisomies 21, 18 and 13 were low. The pregnancy was terminated at 27 weeks of gestation and postnatal X-ray imaging showed that the fetus had short femur and humerus, a narrow and small thorax, thickened metaphysis with a "splashed paint spot" pattern, and asymmetric shortened lower limbs. Whole-exome analysis showed that the fetus carried a heterozygous pathogenic mutation c.440G>A (p.Arg147His) in the EBP gene. The mutation was confirmed to be a de novo mutation as neither of her parents carried the same mutation. Thus, the patient was diagnosed as having X-linked dominant chondrodysplasia punctata 2. The severe phenotype of this case migh be related to random X chromosome inactivation.

Objective To investigate the clinical efficacy of carotid endarterectomy in treatment of patients with suba-cute cerebral infarction. Methods Sixty patients diagnosed and treated in our hospital were analyzed and randomly di-vided into two groups. The control group was given conservative treatment and the experimental group was given carotid endarterectomy treatment. The treatment effects of the two groups were compared. Results The treatment effects were ideal for 93.3% of the experimental group, which was higher than that of the control group (80.0%) (P<0.05); After the treatment, two groups were not significantly different in indicators such as PT, TT and FIB (P>0.05); After treatment, APTT of the experimental group was (27.9±2.4) seconds, which was lower than that of the control group(30.4±6.8) sec-onds(P<0.05); The incidence of surgical adverse reactions of the experimental group was 20.0%, which was lower than that of the control group (53.3%)(P<0.05). Conclusion The incidence of subacute cerebral infarction is relatively high. The clinical application of carotid endarterectomy shows good treatment effects, can improve clinical treatment effects and reduce the incidence of complications, thereby worthy of promotion and application.

Objective:To establish a model of patellar dislocation by femoral osteotomy or surgical release of medial retinaculum in immature rabbits, and observe morphological and trabecular microarchitectural changes in the trochlea.Methods:Forty rabbits at 3 months of age were included. All right knees underwent surgery, 20 knees were treated with femoral osteotomy and internal rotation of distal femur to increase femoral anteversion angle (Osteotomy group, OS group), and another 20 knees were treated with surgical release of medial retinaculum and overlap suture of lateral retinaculum (Soft tissue group, ST group). All left knees were acting as internal controls. Micro-CT scans for distal femur were acquired after 4 months post surgery. the height of Medial, central, and lateral trochlear, sulcus angle, and lateral and medial trochlear slope were measured to describe the trochlear morphology, and bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular spacing (Tb.Sp), and bone mineral density (BMD) were calculated to evaluate the microarchitectural structure. All parameters were compared between groups.Results:In OS group, one rabbit sustained a hip dislocation without patellar dislocation. Three knees developed complete patellar dislocation in daily flexion position, and the remaining 16 patellae were dislocated when the knee was placed in the maximal extension position. In ST group, 15 knees were complete patellar dislocation in daily flexion position, and 5 knees were without dislocation. A local boss was formed proximal to the entrance of the groove and the articular cartilage was smooth, and no obvious osteoarthritis was observed in OS group. In ST group no boss was formed, while obvious cartilage degeneration and defect was seen. Compared to the control group, the central trochlear height and sulcus angle were greater in both groups, but without significant difference between the two groups. The Tb.Th was increased in both medial and lateral condyle, and Tb.N was decreased in medial condyle compared with its control knees in OS group. The BV/TV, Tb.Th, Tb.N and BMD were decreased and Tb.Sp was increased in both medial and lateral condyle compared with its control knees in ST group. Compared to the OS group, the BV/TV, Tb.Th, Tb.N and BMD were smaller and Tb.Sp was greater in both medial and lateral condyle in ST group, with significant differences.Conclusion:The model of patellar dislocation could be successfully achieved by femoral rotational osteotomy to increase femoral anteversion or surgical release of medial retinaculum and overlap suture of lateral retinaculum, and subsequent morphological and trabecular microarchitectural changes in the trochlea are different. Different bony and soft tissue factors should be addressed for different patients with patellar dislocation in clinical practice.

Thimerosal has been widely used as a preservative in drug and vaccine products for decades.Due to the strong propensity to modify thiols in proteins,conformational changes could occur due to covalent bond formation between ethylmercury(a degradant of thimerosal)and thiols.Such a conformational change could lead to partial or even complete loss of desirable protein function.This study aims to investigate the effects of thimerosal on the capsid stability and antigenicity of recombinant human papillomavirus(HPV)18 virus-like particles(VLPs).Dramatic destabilization of the recombinant viral capsid upon thimerosal treatment was observed.Such a negative effect on the thermal stability of VLPs preserved with thimerosal was shown to be dependent on the thimerosal concentration.Two highly neutralizing antibodies,13H12 and 3C3,were found to be the most sensitive to thimerosal treatment.The kinetics of antigenicity loss,when monitored with 13H12 or 3C3 as probes,yielded two distinctly different sets of kinetic parameters,while the data from both monoclonal antibodies(mAbs)followed a biphasic expo-nential decay model.The potential effect of thimerosal on protein function,particularly for thiol-containing proteinaceous active components,needs to be comprehensively characterized during formulation development when a preservative is necessary.

Objective To evaluate the immunostimulatory effects of polysaccharides, including Lycium barbarum polysaccharides ( LBP) , Angelica polysaccharides ( AP) , Licorice polysaccharides ( LP) and Inulin polysaccharides ( IP) , used alone or in combination with aluminum adjuvant on the recombinant protein of varicella-zoster virus (VZV) glycoprotein (gE) as an immunogen in mice. Methods BALB/c mice were randomly divided into 11 groups with five in each group. Intramuscular injection was given at Days 0 and 14. Serum samples were collected at weeks 0, 2, 3, 4 and detected for total anti-gE IgG titers and an-tibody subtypes by indirect ELISA. The mice were sacrificed at week 4 to collect spleen lymphocytes aseptic-ally. CCK-8 method was used to evaluate the proliferation of spleen lymphocytes. The levels of IFN-γ and IL-4 were measured by ELISA. The percentages of CD3+CD4+ and CD3+CD8+ T cell subsets were deter-mined by flow cytometry. Results The four plant-derived polysaccharides in combination with aluminum adjuvant showed good adjuvant activities. LP combined with aluminum adjuvant effectively increased the titer of IgG2, promote the proliferation of splenocytes and enhanced the secretion of IFN-γ and IL-4. Further-more, it also induced CD3+CD4+ and CD3+CD8+ T cell proliferation in vivo. Conclusions The four plant-derived polysaccharides in combination with aluminum adjuvant could all enhance antibody production. LP combined with aluminum adjuvant could induce cell-mediated immune responses, suggesting that it might be a promising adjuvant for varicella-zoster subunit vaccines.