Objective To explore the efficacy of acupuncture in the treatment of nonalcoholic fatty liver disease by using magnetic resonance iterative decomposition of water and fat with echo asymmetry and least-squares estimation-quantitative FAT/R2 * imaging (IDEAL-IQ) technique.Methods Totally 36 patients with nonalcoholic fatty liver were divided into acupuncture group (25 cases) and control group (11cases).The patients were performed liver magnetic resonance IDEAL-IQ and the liver fatty component value (F value) was measured before and after the treatment,at the same time clinical indicators of liver function and blood lipid were measured.The Spearman correlation analysis was used to compare the consistency of F value and blood lipid in all patients.The t test was used to compare the differences of liver F values,liver function,blood lipids and other clinical indicators of two groups before and after the treatment.Results There were significantly positive correlation between the fat component and triglyceride (TG),total cholesterol (TC) level (r =0.836,0.852,P ＜ 0.05),and significant negative correlation between the fat component and high density lipoprotein (HDL) level in the fatty liver group (r =-0.735,P ＜0.05),The liver F values,alanine aminotransferase (ALT) and aspartate aminotransferase (AST) contents and TG,HDL,low density lipoprotein (LDL) and TC contents of the acupuncture group after treatment were statistically significant (P ＜ 0.05).Comparison of each index in the acupuncture group after treatment with the control group,the differences were statistically significant (P ＜ 0.05).Conclusions Acupuncture is an effective approach to treat nonalcoholic fatty liver disease,as it can improve liver function and down-regulate lipid level.Magnetic resonance IDEAL-IQ technique can quantitatively detect its therapeutic efficacy.

Objective To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high?resolution magnetic resonance imaging (HR?MRI), and to investigate HR?MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF?MRA) and HR?MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross?section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LAMLN), vessel area (VAMLN) at maximal lumen narrow (MLN) and LAreference, VAreference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VAreference, LAreference, VAMLN and RI of the TIA group and the acute cerebral infarction group were (19.89 ± 1.34) mm2, (15.19 ± 2.04) mm2, (20.78 ± 1.78) mm2, 1.09 ± 0.11 and (19.70 ± 1.34) mm2, (14.60 ± 2.33) mm2, (21.53 ± 2.34) mm2, 1.10 ± 0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WAMLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm2, (4.00±3.00) mm2, 20.92%± 9.18%, 19.05% ± 14.93% and (11.10 ± 1.88) mm2, (6.00 ± 2.25) mm2, 28.56% ± 8.67%, 27.30% ± 7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ2=6.475, P<0.05). LAMLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm2 and (10.43±2.08) mm2 respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high?risk plaques to a certain extent.

Objective To evaluate the performance of MRI in predicting pathological response of different breast cancer subtypes after neoadjuvant chemotherapy(NAC).Methods The MRI images and postoperative pathological results of 91 patients with breast cancer after NAC were analyzed retrospectively.The correlation between the imaging features of different molecular subtypes of breast cancer and postoperative pathological results was studied,and the diagnostic performance of MRI in predicting pathological response after NAC was evaluated,with postoperative pathological results referred as the diagnostic standard.Results Of 91 patients,27(29.7％)and 35(38.5％)cases were diagnosed as imaging complete response(iCR)and pathological complete response(pCR),respectively.The accuracy of MRI in predicting pathological response after NAC was 84.62％,with 94.64％sensitivity,68.57％specificity,and positive predictive value(PPV)and negative predictive value(NPV)of 82.81％and 88.89％,respectively.Conclusion MRI can accurately predict the pathological response of the human epidermal growth factor receptor-2(HER-2)+and triple-negative breast cancer after NAC.

OBJECTIVETo investigate the prevalence of occult HBV infection in the normal population in Xiamen.

METHODS4 437 registered permanent residents, aged 1-59 years old, were selected in Xiamen using stratified random sampling method from September to October in 2006. Serum samples were obtained, the basic characteristics, inoculation of HBV vaccine, and liver disease were surveyed. The serum samples were tested five HBV seroimmunological markers. The HBsAg-negative specimens were subjected to HBV-DNA detection by nested PCR targeting for multiple gene segments. The amplified products were sequenced and the sequence was used for determination of HBV genotype and mutation analysis of amino acids located in HBsAg "a" epitope. Subjects with serum detectable HBV-DNA and negative result of HBsAg were considered as occult HBV infection.

RESULTSAmong the 4 437 subjects, 482 individuals were observed HBsAg positive and 3 944 were observed negative. Of the 3 955 HBsAg- negative specimens, 27 occult HBV infections were determined with the positive rate of 0.68% (27/3 955). There were 16 samples with genotype B and 11 with genotype C. 3 types of amino acid (AA) mutation (M133T, T140I, G145R) that influence "a" epitope conformation were observed in 9 subjects with occult HBV infection. S region was successfully sequenced in 312 of the 482 HBsAg positive samples. In subjects with occult HBV infection, the infection rate of genotype C HBV (40.74%, 11/27), inoculation rate of HBV vaccine (62.96%, 17/27), positive rate of HBsAb (51.85%, 14/27), and mutation rate of critical amino acid of "a" epitope (33.33%, 9/27) were higher than HBsAg positive individuals (22.76% (71/312), 13.78% (43/312),0.32% (1/312),0.99% (31/312), respectively), and all the difference were significant (χ(2) = 4.29, 41.26, 156.00, 13.07, respectively, and P value = 0.038, <0.001, <0.001, <0.001, respectively). While the average age in subjects with occult HBV infection (18.3 ± 16.2) were lower than that in HBsAg positive infection (34.4 ± 11.6), and the difference was significant (t = 6.67, P < 0.001). The reactive rate of HBeAb (11.11%, 3/27) and HBcAb (62.96%, 17/27) in subjects with occult HBV infection were lower than that in HBsAg positive infection (74.36% (232/312), 98.40% (307/312)), and the difference were significant (χ(2) = 46.74, 73.78, respectively, and P value <0.001, <0.001, respectively).

CONCLUSIONIn normal population in Xiamen, the infection rate of genotype C, the positive rate of HBsAb, the HBV vaccination rate, and the key AA mutation rate in "a" epitope are significantly higher in occult HBV infection than in HBsAg positive infection, and the age, the positive rate of HBeAb and HBcAb are significantly lower.

Adolescent ; Adult ; Child ; Child, Preschool ; DNA Mutational Analysis ; Genotype ; Hepatitis B ; diagnosis ; Hepatitis B Antibodies ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Hepatitis B virus ; Humans ; Infant ; Middle Aged ; Mutation ; Prevalence ; Vaccination

OBJECTIVE: To investigate the prevalence and risk factors of multi-site work-related musculoskeletal disorders(WMSDs) among workers in the industry of electronic equipment manufacturing. METHODS: A total of 815 workers in three factories of electronic equipment manufacturing in Guangdong Province were selected as study subjects by convenience sampling. The prevalence of multi-site WMSDs in the past year was investigated using Musculoskeletal Disorders Investigating Questionnaire and the influencing factors were analyzed. RESULTS: The total prevalence of WMSDs was 69.4%(566/815). The prevalence of multi-site WMSDs was 54.5%(444/815), and the prevalence of one-site WMSDs was 15.0%(122/815). Multiple logistic regression showed that female workers had higher prevalence of multi-site WMSDs than males [odds radio(OR) and 95% confidence interval(CI): 1.59(1.12-2.26), P<0.05]. The prevalence of multi-site WMSDs in left-handed workers was lower than that of right-handed workers [OR(95% CI): 0.42(0.19-0.91), P<0.05]. The longer service of current position and the more neck forward movement, the higher prevalence of multi-site WMSDs [OR(95% CI) were 1.33(1.09-1.63) and 1.62(1.23-2.15), P<0.01]. The workers who had long-time sitting at work, adopted uncomfortable working posture, could decide when to work on their own, kept head down for a long time, or often bending wrists up/down had higher prevalence of multi-site WMSDs [OR(95% CI) were 1.41(1.16-1.73), 1.82(1.40-2.38), 1.79(1.16-2.75), 1.92(1.38-2.69) and 1.60(1.14-2.24), respectively, P<0.01]. The workers who could take turns with colleagues to finish work or had enough rest time had lower prevalence of multi-site WMSDs [OR(95% CI): 0.57(0.41-0.78) and 0.67(0.48-0.92), P<0.05]. The workers who worked >10 h per day had lower prevalence of multi-site WMSDs than those who worked ≤8 h per day [OR(95% CI): 0.57(0.37-0.87), P<0.05]. CONCLUSION: Multi-site WMSDs were more common than one-site WMSDs among workers in the industry of electronic equipment manufacturing, and the prevalence of multi-site WMSDs was high. The risk factors include personal factors, work organization and adverse ergonomic factors.

Objective: To assess the enhancement characteristics of plaques in patients with intracranial atherosclerotic stenosis using three-dimensional high-resolution magnetic resonance imaging (3D HR MRI), and to analyze the correlation between the enhancement characteristics of plaques and the time from onset of stroke symptoms to MRI examination. Methods: The enhancement characteristics of plaques were retrospectively analyzed in 61 patients with cerebral infarction who were scanned in MRI room of the Affiliated Hospital of Yangzhou University from January 2014 to January 2016. According to the elapsed time between symptom onset and MR examination, 61 patients were classified into early stage group (<4 weeks, n=26), middle stage group (4-12 weeks, n=20) and late stage group (>12 weeks, n=15). All cases underwent three-dimensional sampling perfection with application optimized contrast using different angle evolutions (3D-SPACE) T₁WI and enhanced 3D-SPACE T₁WI sequence scans, as well as routine head MRI examinations. The signal intensities of plaques before and after enhancement scanning were compared on the 3D-SPACE T₁WI sequence. The degrees of plaque enhancement were qualitatively analyzed, and the enhancement rates of plaques were quantitatively calculated. The correlation between the enhancement characteristics of plaques and time of symptom onset of stroke was analyzed. Results: Sixty-one intracranial atherosclerotic plaques on the 3D HR MRI showed eccentric thickening or annular thickening of the vessel wall, and slightly higher signals on the T₁WI. They showed different degrees of enhancement or no enhancement after enhancement scans. The characteristics of plaque enhancement in 61 patients with cerebral infarction were analyzed. The results showed that 26 plaques in the early stage group were obviously enhanced for 21 cases (80.8%), mildly enhanced for 4 cases (15.4%), no enhancement for 1 case (3.8%), and the enhancement rate was 80.49%±18.64%. Twenty plaques in the middle stage group were obviously enhanced for 2 cases (10.0%), mildly enhanced for 14 cases (70.0%), no enhancement for 4 cases (20.0%), and the enhancement rate was 52.09%±18.17%. Fifteen plaques in the late stage group were mildly enhanced for 2 cases (2/15), no enhancement for 13 cases (13/15), and the enhancement rate was 12.16%±10.44%. There were statistically significant differences in the degrees of plaque enhancement and plaque enhancement rates among the three groups (χ²=22.834, P<0.01; F=78.403, P<0.01). Further analysis showed that there was a statistically significant difference in the degree of enhancement and enhancement rate of plaques between the early stage group and the middle stage group (χ²=-4.177, P<0.01; t=5.179, P<0.01), and there was a statistically significant difference between the middle stage group and the late stage group (χ²=-2.484, P<0.05; t′=8.189, P<0.01), and the difference between the early stage group and the late stage group was also statistically significant (χ²=-3.796, P<0.01; t′=15.044, P<0.01). There was a significant negative correlation between the time from onset of stroke symptoms to MRI examination and the enhancement rate of plaques (r=-0.903, P<0.01). Conclusions Enhanced HR MRI scanning can clearly show the enhancement of intracranial atherosclerotic plaques. With the prolongation of the onset time interval, the enhancement of intracranial atherosclerotic plaques gradually weakens, which can assess the vulnerability of plaques and has important guiding significance for secondary prevention of ischemic stroke.

Objective: To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high-resolution magnetic resonance imaging (HR-MRI), and to investigate HR-MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods: A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF-MRA) and HR-MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross-section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LA_MLN), vessel area (VA_MLN) at maximal lumen narrow (MLN) and LA_reference, VA_reference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results: The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VA_reference, LA_reference, VA_MLN and RI of the TIA group and the acute cerebral infarction group were (19.89±1.34) mm², (15.19±2.04) mm², (20.78±1.78) mm², 1.09±0.11 and (19.70±1.34) mm², (14.60±2.33) mm², (21.53±2.34) mm², 1.10±0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WA_MLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm², (4.00±3.00) mm², 20.92%±9.18%, 19.05%±14.93% and (11.10±1.88) mm², (6.00±2.25) mm², 28.56%±8.67%, 27.30%±7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ²=6.475, P<0.05). LA_MLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm² and (10.43±2.08) mm² respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high-risk plaques to a certain extent.