Objective To explore the MRI features of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) for providing early evidence in differential diagnosis. Methods The MRI features of 24 patients with MSA, 30 patients with PD and 30 healthy people as controls were retrospectively analyzed. Abnormal intensity in MRI included the hot-cross bun sign and the slitlike changes. The atrophies of brain included cerebellar, middle cerebellar peduncles, medulla oblongata and pon. Cerebral ventricle dilatation included fourth ventricle and cisterna pontis. The midbrain area, pons area and middle cerebellar peduncles width were measured. Results All patients with MSA had at least one of the features observed on MR images, and there were some differences in the subtypes of MSA. The high sensitive features were the atrophies of middle cerebellar peduncles (79.2%), the atrophies of pons (79.2%) and the hot-cross bun sign (75.0%). The parameters with high specificity and high positive predictive value were hot-cross bun sign (both 100%), the slit-like sign (both 100%), the atrophies of middle cerebellar peduncles (93.3% and 90.1%), and the atrophies of pons (96.7% and 95.0%). MSA group had the statistically significantly decreased values of pons area, midbrain area and middle cerebellar peduncles width [(288. 7±75. 4) mm2, (127.8±25.8) mm2 and (10. 7±2.8) mm, respectively], as compared with PD group [(477. 5 ± 54. 3) mm2, (145.9±21.6) mm2 and (16.2±1.3) mm, respectively] and healthy group [(454. 5±36. 8) mm2 , (146.4±17.4) mm2 and (16.7±1.2) mm, respectively] (all P ＜0. 05). Conclusions The routine MRI is helpful in differential diagnosis between MSA and PD and has some values in diagnosing the subtypes of MSA.

BACKGROUND:Under different induction conditions,bone marrow mesenchymal stem cells can differentiate into the mesodermal tissues such as osteoblasts,chondroblasts,muscle cells,adipocytes and so on.OBJECTIVE:To verify the effect on repairing the rabbit articular cartilage injury using bone marrow mesenchymal stern cells (MSCs)induced by tissue engineering method.DESIGN,TIME AND SETTING:Randomized controlled animal experiment was performed in the Clinical Center Laboratory of Shenyang Medical College between May 2005 and December 2007.MATERIALS:Twenty health New Zealand rabbits,irrespective of genders,aged 2-3 months,were used.METHODS:①Rabbit bone marrow MSCs were cultured in vitro,experiment group was cultured for one week withdexamethasone,basic fibroblast growth factor and vitamin C,then for additional 3 weeks with transforming growth factor-β instead of basic fibroblast growth factor;calls without inductors served as controls;②Twenty rabbits were used to establish knee articular cartilage defect models,which were then divided into three groups at random. Experiment group (n=5) was transplanted with the induced bone marrow MSCs;control group with the non-induced cells;blank control group with saline. At 2,4,6,8 weeks postoperation,two rabbits in the experiment group were killed,while one animal in control group and blank control group was killed for the index determination.MAIN OUTCOME MEASURES:①Cell morphology. ②Alkaline phosphatase activities.③General observation. ④X-ray observation.⑤Histological observation.RESULTS:①The morphology of the induced bone marrow MSCs was changed,from long fusiform to polygon,which was similar to cartilage calls-like morphology.②After the bone marrow MSCs were induced for 4 weeks,the alkaline phosphatase activities were obviously enhanced(P＜0.05).③Eight weeks after transplantation,the specimens in the experiment group exhibited smooth surface and unclear outlines with surrounding cartilage;X-ray results showed joint space broadened,subchondral bone sack was improved;histological slices observation revealed similarity with normal chondrocytes.CONCLUSION:Autologous MSCs transplantation can repair articular cartilage injury.

Objective To investigate the correlation between serum hepcidin level and iron, mineral metabolism in maintenance hemodialysis (MHD) patients. Methods Seventy-five MHD patients were selected. The serum hepcidin, serum iron and mineral metabolism indexes were detected by enzyme-linked immunosorbent double antibody sandwich method, and their correlation was analyzed. Results The level of serum hepcidin in 75 MHD patients was 87- 264 μg/L. The patients were divided into 3 groups according to serum hepcidin level. In group A, the serum hepcidin level of 26 cases was＜120 μg/L; in group B, the serum hepcidin level of 24 cases was 120- 200 μg/L; in group C, the serum hepcidin level of 25 cases was>200 μg/L. There were no significant differences in age, gender, albumin and serum calcium among 3 groups (P > 0.05). The levels of ferritin, transferrin saturation (TS), serum phosphorus and parathyroid hormone (PTH) increased in the 3 groups as the hepcidin level increased, while hemoglobin, serum iron, total iron binding capacity (TIBC), and 25 hydroxy vitamin D decreased significantly, and there were statistical differences (P＜0.05). The Pearson correlation analysis result showed that serum hepcidin was positively correlated with ferritin, PTH, serum phosphorus (r = 0.862, 0.536 and 0.320; P＜0.01); and serum hepcidin was negative correlation with serum iron, TIBC, hemoglobin, 25 hydroxy vitamin D (r=-0.358,-0.270,-0.284 and-0.614; P＜0.01); but there was no correlation between serum hepcidin and albumin and serum calcium (r=0.018 and-0.005, P＞0.05). Conclusions The serum hepcidin level in MHD patients is closely related to iron and mineral metabolism.

Clinical data of 26 patients with proton pump inhibitor dependent gastroesophageal reflux disease (GERD) who underwent anti-reflux mucosectomy (ARMS) in Nanjing Drum Tower Hospital from July 2017 to December 2020 were reviewed, and the GERD questionnaire (GERD-Q) score, the short-form reflux-qual (RQS) score, esophageal motility and 24 h esophageal pH parameters before and after ARMS were compared. With a median follow-up period of 18.4 months (6-27 months), 23 (88.5%) patients reported symptomatic improvement and 15 (57.7%) patients discontinued the use of proton pump inhibitors. After ARMS, the mean scores of GERD-Q (6.23 VS 13.19, P=0.004) and RQS (26.67 VS 10.98, P<0.001) were significantly improved, the mean DeMeester score (10.69 VS 53.15, P<0.001), the mean acid exposure time percentage (3.56% VS 9.92%, P<0.001) and the mean number of acid reflux episodes (36.9 VS 139.9, P=0.001) were lower, and the mean rest pressure at lower esophageal sphincter (LES) (25.19 mmHg VS 13.63 mmHg, P<0.001) and the mean distal contractile integral (1 819.15 mmHg·s·cm VS 1 007.67 mmHg·s·cm, P<0.001) were significantly increased compared with those before surgery. ARMS has significant short-term efficacy in the treatment of proton pump inhibitor dependent GERD, which can effectively improve reflux symptoms and life quality of patients, and strengthen the rest pressure of LES and peristalsis of the esophageal body.