Objective To explore MR imaging features of synovial chondromatosis,and evaluate the diagnostic value of MR imaging.Methods The imaging data of 16 cases with pathologically confirmed synovial chondromatosis were analyzed retrospectively,who underwent the preoperative X-ray plain film and MR plain-scan and enhanced-scan.Two cases of should joint,4 cases of hip joint,8 cases of knee joint(ten joints),2 cases of ankle joint.Results Eleven cases (13 joints) were truly diagnosed according to X-ray plain film,the typical features of synovial chondromatosis were hyperdense free bodies in the joint space and adjacent soft tissue,which showed the concentric lamina sign.Fourteen cases (16 joints) were truly diagnosed according to MR imaging,which clearly showed thickened synovium with significant enhancement,multiple intraarticular cartilage or bony nodules with the surface enhanced,and some nodules connected with thickening synovial membrane,joint effusion and joint degeneration.MR could display the synovial abnormalities that could not be displayed in X-ray plain film,which was helpful to distinguish the characteristics of free bodies in joint,and superior to X-ray plain fdm in showing the lesions in detail.Conclusion MR could clearly show the synovial abnormalities and free body in the joints,which has important value for the diagnosis of synovial chondromatosis,determination of the extent of lesions and the characteristics of free body.

Objective To investigate children' s understanding of food,nutrition and its relation to health.Methods Participants were interviewed individually,various experimental tasks were used to explore 5-9 year old children' s spontaneous classification of familiar food and their understanding of food balance.Results Five-year-old children rely more than elders on physical cues.There was significant age difference of their criterion of classification among physical (H_((2))=12.929,P ＜ 0.01),conventional (H_((2))=5.540,P=0.063)land processing criterion(H_((2))=6.076,P＜ 0.05).There was significant SES difference of their choices(X_((1))~2=5.857,P=0.016 ; X_((1))~2=4.510,P=0.034 in two different tasks).Higher SES children tended to choose balanced food(percentage of choosing balanced food in higher SES group was 75.0% ,93.8% ;45.2% ,74.2% in lower SES group).Conclusion The criterion children used is related to their cognitive development and experience.As they become older,more and more children realize the nutritional value of foods.There were a significant age difference in nutrition-balanced food choice ,and children's social economic status influence their performance.

OBJECTIVE:To provide reference for rational application of cephalosporins in the clinic. METHODS:The applica-tion of cephalosporins antibiotics in our hospital during 2010-2014 was analyzed dynamically in respects of consumption sum, DDD,DDC,DDDs,etc. RESULTS:During 2010-2014,the proportion of total consumption sum of antibiotics in total consump-tion sum kept below 30%,and decreased year by year,decreasing from 27.35% in 2010 to 14.70% in 2014. Among antibiotics, the consumption sum and DDDs of cephalosporins were the highest;consumption sum decreased year by year,decreasing from 44.50% in 2010 to 30.49% in 2014;DDDs increased year by year,increasing from 11.00×104 in 2012 to 14.22×104 in 2014. The consumption sum and DDDs of second generation cephalosporins were the highest. The consumption sum of cefotiam ranked the first place;DDDs of cefprozi ranked the first place during 2010-2011,while cefotiam ranked the first place during 2012-2014. DDC of cefpirome was the highest during 2010-2011,and that of cefamandole was the highest during 2012-2014,indicating it was expensive. The serial number ratio of cefprozi and cefuroxim was always >1 during those years,which indicated it was cheap and used frequently;that of most drugs were close to 1. CONCLUSIONS:The application of cephalosporins in our hospital tend to be rational,but the propaganda and supervision of rational use of antibiotics should be further strengthened.

Objective To analyze the proportion of incidence of etiological agents in 133 cases with constitutional delayed puberty.Methods Clinical data of etiological agents in 133 patients with constitutional delayed puberty were retrospectively analyzed.Results Etiological agents in 133 cases with constitutional delayed puberty were as follows:Hypo-gonadotrophic hormone group(56.39%,n=75):39 cases with unknown reason(idiopathy,3 cases were female),intrapartum asphyxia/hypoxia or hemorrhage(n=23),pituitary glands dysplasia(n=6),cephal trauma(n=3),postoperative craniopharyngioma(n=2),empty sella turciea(n=2),combined hormone deficiency(n=59).Hyper-gonadotrophic hormone group(17.29%,n=23):17 cases with chromosomal disorders(n=17,male:female=7:16),3 cases with unknown reason(idiopathy).31 cases with constitutional delayed puberty(23.31%),4 cases with functional delayed puberty(3.01%).Conclusion Many etiological agents could result in delayed puberty,different origins of delayed puberty had different therapies.Classification of etiological agents in patients with constitutional delayed puberty phyed an important role in guiding option of clnical treatment.

Objective To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function.Methods A total of 43 patients diagnosed as acute myocardial iffarction were enrolled in this study.The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the following parameters before the PCI and at month 6 after the procedure:infarct mass,left ventricular ejection fraction (LVEF) and abnormal wall motion score.The subjects were divided into the following three groups by the transmural extent of myocardial infarction manifested in the DE-MRI:the transmural enhancement group,the nontransmural group and the mixed group.Laboratory test was done to detect the level of endothelin (ET),matrix metal enzyme 9 (MMP-9) and high sensitive C reactive protein (hsCRP) before PCI and at month 6 after the procedure.The t test was used to compare the differences among the groups and the multiple regression analysis was taken to explore the correlation factors for the left ventricular function.Results Compared with the parameters before PCI,the infarct mass after PCI significantly decreased in the nontransmural group and the mixed group [(4.0 ± 2.9) g/cm3 vs (9.8 ±5.6) g/cm3 and (6.0 ±3.5) g/cm3 vs (11.8 ±6.2) g/cm3,all P ＜0.05],while LVEF was significantly improved after PCI in both groups [(52.6 ± 15.4) ％ vs (41.9 ± 16.3) ％,(45.6 ± 15.4)％ vs (38.9 ± 16.3)％,all P ＜0.05].The infarct mass was an independent correlation factor for LVEF before PCI (RR =0.318,P ＜0.05) and LVEF after PCI(RR =0.293,P ＜0.05).LVEF before PCI was independently correlated with the level of hsCRP (RR =0.318,P ＜ 0.05).Conclusion The effect of PCI on the improvement of left ventricular function differs in patients with different extent of myocardial infarction,which is correlated with the amount of survival myocardium and the inflammatory factors.

Objective To explore the influencing factors for usage of the official App of a hospital, based on Unified Theory of Acceptance and Use of Technology (UTAUT).Methods 616 outpatients were randomly sampled from outpatient clinics of three tertiary hospitals in Hangzhou for questionnaire survey, to learn the usage and intention for hospital′s official App.Results It was found that women (0.134), high performance expectancy (0.321), facilitating conditions (0.256), high effort expectancy (0.224), and desirable social influence (0.100) all contributed positive influence (P<0.05) to usage of such App.Conclusions It is recommended to enhance service functions of such App and simplify its usage, in addition to better promotion and online security measures.

Objective To evaluate our self-designed guide used clinically in percutaneous placement of lumbosacral pedicle screws in surgery of lumbar vertebral fractures.Methods From May 2012 to March 2015,143 patients with lumbar vertebral fracture were treated with reduction and fixation using percutaneous lumbosacral pedicle screws in our department.Percutaneous placement of lumbosacral pedicle screws was assisted by our self-designed guide in 69 of them(guide group) but not in the other 74 cases (manual group).The 2 groups were compatible in preoperative general data (P ＞ 0.05).The 2 groups were compared in terms of localization time for a single screw,puncture accuracy,times of intraoperative fluoroscopy,operation time,intraoperative blood loss,and hospital stay.Results The guide group had significantly better localization time for a single screw,puncture accuracy,times of fluoroscopy and operation time than the manual group (P ＜ 0.05),but the 2 groups showed no significant differences in intraoperative blood loss and hospital stay (P ＞ 0.05).The guide group obtained an average follow-up of 12.9 months (from 12 to 16 months) while the manual group obtained an average follow-up of 13.2 months (from 12 to 18 months).All fractures healed primarily,without complications like injuries to nerve root or dural sac.Conclusion Our self-designed guide is recommendable because it can obviously improve accuracy of placement of lumbosacral pedicle screws,shorten operation time,and decrease times of intraoperative fluoroscopy.

Objective To investigate the diagnosis and treatment of cystic renal cell carcinoma.Methods The clinical data of 67 cases of cystic renal cell carcinoma treated from January 2005 to April 2013 were analyzed retrospectively.Preoperative imaging procedures indicated masses of renal cysts in 67 cases,including malignant tumors in 59 cases.Intraoperative pathological examination was performed in 59 cases and the pathological results showed malignant tumors in 56 cases,renal cyst in 2 cases and multilocular cyst of kidney in 1 case.The surgical procedures included radical nephrectomy (n=19),partial nephrectomy (n =12),retroperitoneal laparoscopic radical nephrectomy (n =9),retroperitoneal laparoscopic partial nephrectomy (n =20),retroperitoneal laparoscopic cyst unroofed then transferred to radical nephrectomy (n =6),and retroperitoneal laparoscopic partial nephrectomy transferred to radical nephrectomy (n =1).Results The 67 cases were diagnosed as renal carcinoma,including clear renal cell carcinoma with cystic changes in 31 cases and multilocular renal cell carcinoma in 36 cases.Sixty-two cases were followed up for 10-110 months (median 56 months),and there was no recurrence or metastasis,among which 7 cases diagnosed as benign pre-operation or intra-operation but malignant by pathological examination after surgery were followed up for 61-103 months (median 82 months).Conclusions Imaging plays an important role in the early diagnosis of cystic renal cell carcinoma.Intraoperative pathological examination should be performed in suspected cases.Nephron-sparing surgery is preferred with good outcome.

Objective To explore the feasibility of repairing the skin and soft tissue defect at finger palm side with the reversed free thenar mini-perforator flaps.Methods From October,2010 to October,2016,7 patients were treated with reversed free thenar mini-perforator flap to repair skin and soft tissue defects at finger palm side,including 5 males and 2 females,which the age were between of 17 and 56 (average,35 years old).Cause of injury:1 case of abrasive wear,1 case of machine twist injury,and 5 cases of heavy injury.All cases with varying degrees of phalanx and tendon exposed.The wound size was from 1.3 cm × 2.0 cm to 2.2 cm × 5.0 cm.According to the origin of the artery in the thenar area,3 kinds of reversed free thenar mini-perforator flaps were designed to repair the defective wound.In the middle of the large fish,the width less than 2.5 cm perforating flap was designed,so that the area can be directly sutured.Results All 7 flaps survived.The flap size was from 1.5 cm × 2.4 cm to 2.5 cm × 5.5 cm.All patients were followed-up from 3 months to 17 months (average,9 months).The appearance and skin texture of flaps was close to the normal finger palm side of the skin,with a clear fingerprint.Two-point discrimination was between 9 mm and 15 mm.The sensory recovery to S3 in 3 cases,S4 in 4 cases.Linear scars were left in the donor areas,with no discomfort.Conclusion This technique has the advantages of good appearance,such as good appearance and small damage to the donor area.However,the surgeon is required the super microscopic techniques.

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.