Objective:To analyse the findings of MRI and CT in the diagnosis of spine metastases in 52 cases,and compare their sensitivity and specificity,in order to increase the early diagnosis rate of spinal metastases.Methods:The most common sources of skeletal metastases were carcinomas of lung,breast,nasopharynx.MRI and CT were performed in 52 patients with metastatic tumor.The detectability for vertebral metastasis was compared between the two modalities.Results:Of the 52 cases,there were destructions of 176 vertebral bodies,76 lesions of spinal canal involvement,68 paravertebral soft tissue.masses and pathological fractures of 47 vertebral bodies.In the cases of stage Ⅰ spinal metastases:21 were detected by MRI and nothing was detected by CT.In the cases of stage Ⅱspinal metastases:86 were detected by MRI;52 were detected by CT.In the cases of stage Ⅲ spinal metastases:68 were detected by MRI;61 were detected by CT.The sensitivity of spinal metastases by MRI(99.4%) higher than CT(64.2%).MRI demonstrated decreased signal intensity(86.9%)and other abnormal signal intensity(13.1%)on T1WI and increased signal intensity(60.8%)and other abnormal signal intensity(39.2%)on T2WI.Conclusion:The sensitivity and specificity of MRI is higher than that of CT.Two methods are complementary to each other,so MRI combined with CT can improve the sensitivity and accuracy in the diagnosis of spinal metastases.

Objective:To evaluate the value of 64-slice CT portal venography(CTPV)in demonstrating portal system and its collaterals in portal hypertension.Methods:50 cases of portal hypertension were included in the study and undergone upper abdomen examination with 64-slice CT,image post-processing techniques such as MIP,MPR and VR were applied to display the portosystemic collaterals of portal venous system.Results:CTPV simultaneously depicted fourth or fifth branches of the intrahepatic portal veins and provided images of entire portosystemic collaterals,on CTPV images,left gastric varices were seen in 48 patients(96%),esophygeal and/or fundic varices in 46(92%),paraesophageal varices in 41(82%),shnrt gatric veins or posterior gastric veins in 19(38%),shunt between spleen/gastric-renal vein in 14(28%),abdominal wall and paraumblical varices in 20(40%),retroperitioneal varices in 19(38%),portal sponge degeneration in 8(16%).Conclusion:CTPV can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension.An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease,and may play a significant role in marking a clinical treatment plan.

Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

Since it is one of the hotspots to discover the new knowledge in life science in data-intensive scientific discovery by integrating the biomedical literature and scientific data that can provide an open environment for their interactive operation , the mining of foreign and domestic biomedical literature and integration of scientific data were analyzed , the corresponding systems for different integration methods were investigated , the development trend in biomedical literature and scientific data integration was predicted .

Myelodysplastic syndromes (MDS) is one of clonal disorders of hematopoietic stem cells.Cytogenetic,molecular genetic and epigenetic aberrances are critical to diagnosis,prognosis and treatment of MDS.5q-,-7/7q-and 20q-are the most frequent cytogenetic aberrance in MDS.Fusion genes,genetic mutation and deletion are the most important mechanisms for every subtype of MDS.Aberrant methylation plays an essential role in both initial and secondary MDS.All these aberrances are very significant for the development and transformation of MDS.Genetic and epigenetic alterations are new targets for MDS diagnosis and treatment.

Objective To analyze the clinical data,radiological and pathological features of breast cancer which were understated by image,and summarize the causes.Methods The clinical features,radiological features and pathological data of 26 cases of breast cancer were retrospectively analyzed.The preoperative ultrasound and mammography BI-RADS grades of these 26 cases were both ≤ 3,and they were confirmed to be breast cancer by pathology.The clinical and pathological data of 1224 cases of breast cancer in the same period were compared.Results For the 26 cases,100％ were early breast cancer,100％ were HER2 negative breast cancer,and only 1 case had lymph node metastasis.26％ were special type of breast cancer.Mammography showed glandular multi type,and ultrasound showed atypical or typical benign features.Conclusions Breast cancer understated by image shows features of young age,early stage,well differentiated,low malignant degree,not easy to be visualized by mammography,and their ultrasound features are usually atypical.In clinical setting,analysis of the ultrasound and mammography images should be combined with other examination,to decrease misdiagnosis rate.

Cell biology is a basic medical subject,and one of earliest learned subjects concerning medical science. The teacher's teaching methods will directly influence students' interest and score. In the article we have compared the two teaching methods, the traditional method regarding teachers as dominating part and self-teaching method regarding teachers as subordinate part. The conclusion has showed that the self-teaching method can improve students' score and easily be accepted by students, compared with traditional teaching method. However,it can not be used too frequently.

Acute kidney injury(AKI) is a common clinical severe emergency in children,with high morbidity,mortality and poor prognosis.The traditional indicators such as serum creatinine and urine can't diagnose early.Recently,with the deepening research of AKI,many higher specific and sensitive biomarkers have been found.But the study of biomarkers in children is behind the adult,and the etiology,pathophysiology of AKI in children have great difference from adult.So this paper will show the advances of biomarkers in children of AKI.

Objective To compare the efficiency of acute physiology and chronic health evaluation (APACHE)Ⅱ and Ⅳ in mortality risk prediction of severe acute pancreatitis (SAP).Methods From January 2013 to December 2014,SAP patients admitted to intensive care units (ICU) were retrospectively analyzed in single center.The clinical data of the first 24 hours since the patients admitted into ICU were collected.The modified Marshall score,APACHE Ⅱ and APACHE Ⅳ score were calculated.The mortality risk predictive value of each patient was calculated by APACHE Ⅱ and APACHE Ⅳ.According to the final clinical outcome of patients,Hosmer-Lemeshow was performed to compare real mortality rate with predictive mortality rate,and calibration of APACHE Ⅱ and APACHE Ⅳ in the mortality risk of each patients was evaluated.The resoluation of the two scoring systems was compared by the area under the receiver operator characteristic curve (AUC).Results In the end,192 patients (152(79.2％) survivors and 40(20.8％) dead) were enrolled.Modified Marshall score,APACHE Ⅱ score and APACHE Ⅳ score of patients in dead group was 6.30±0.36,21.3±8.0 and 88.1± 30.2,respectively;and those of survival group was 3.70 ± 0.20,12.3 ± 5.6 and 53.4 ± 19.0,respectively,and the differences between two groups were statistically significant (t-6.436、-6.683、-6.913,all P＜ 0.01).The results of Hosmer-Lemeshowin calibration of APACHE Ⅱ and APACHE Ⅳ indicated that both two systems could predict mortality risk of SAP patients well (P＞ 0.05).The AUC of APACHE Ⅱ score (cut-off ≥26) and APACHE Ⅳ score (cut off≥91) was 0.81(95％CI 0.74 to 0.89) and 0.83(95％CI 0.75 to 0.90),respectively,and the difference was not statistically significant (x2 =0.21,P=0.644),which indicated that there was no statistically significant difference in calibration.Conclusions APACHE Ⅳ scoring system is not better than APACHE Ⅱ scoring system in prognosis prediction of SAP patients.The prognosis of SAP patients could be accurately evaluated by APACHE Ⅱ.

120 cases of nuchal ligament strain were treated with Tuina at the nape, tapping Dazhui (GV 14) with plum-blossom needle, and cupping Dazhui(GV 14). Clinical observation was made after 14-day treatments. Eighty-seven cases got cure, 28 cases improvement and 5 cases failure; the total effective rate was 95.8%.