Objective To evaluate the predictive value of proton magnetic resonance spectroscopy (1H-MRS)and diffusion weighted imaging(DWI)in low-grade cerebral astrocytomas. Methods Twenty patients with histological proved low-grade astrocytomas treated with postoperative radiotherapy were evaluated with cMRIMRS, DWI before-and 3 months after radiotherapy respectively, then repeated every six months. rNAA,rCho,rCr,rADC was the ratio of NAA, Cho and Cr in the residual tumors region to the those of normal control region. The difference of rCho/rCr, rCho/rNAA, rADC between deteriorative group(group Ⅰ)and stable groups(group Ⅱ)were calculated both before-and 3months after radiotherapy. Results The value of rCho/rCr, rCho/rNAA were higher in group 1 than those in group Ⅱ 3 months after radiotherapy(t =3.65 and 4. 24,all P ＜ 0. 05), while the value of rADC was lower in group Ⅰ(t = 3.43, P ＜ 0. 05). The mean difference of rCho/rCr,rCho/rNAA, rADC in group Ⅰ were smaller than those in group Ⅱ(t = 2. 02,4. 21 and 3.00,all P ＜0. 05). The value of rCho/rCr,rCho/rNAA increased and rADC decreased gradually in group Ⅰ during follow up, and these patients were histologically proved recurrence within 11 - 16 months.While in group Ⅱ , the value of rCho/rCr, rCho/rNAA decreased and rADC increased gradually or steady.And also with a stable clinical performance and cMRI. Conclusions 1H-MRS and DWI own better predictive value of monitoring tumor metabolism change, growth potential and evaluation response to radiotherapy than conventional MRI in low-grade group astrocytomas.

[Objective]To explore the change and its significance of the expression of basic fibroblastic growth factor(bFGF) and bone morphogenetic protein-2(BMP-2) of the local femoral head in nontraumatic osteonecrosis(NONFH). [Methods]Thirty samples of femoral heads of NONFH were collected as the experimental group and 10 fresh samples of femoral heads of femoral neck fracture as control group.The specimens were collected at the time of total articular replacement arthroplasty.The bone tissues from necrosis area and healthy area were made into general sections after immobility and decalcification.Pathological changes were exexamined by optical microscopy and the expression of bFGF and BMP-2 in femoral head was determined with in-situ hybridization technique.[Results]The organization structure of experimental group was disorganized,cracked,and the bone trabecula was rarefactive and non-intact.There were a great number of empty lacune in bone trabecula.The intensity and area of positive expression of bFGF and BMP-2 in femoral head of the experimental group were obviously lower than that of control group.The result had statistical significance(P

[Objective] To explore the curative effect of synthetic surgical therapy on severe flexion deformity knees.[Methods]There were 22 patients(35 knees)with flexion deformity knees who were treated by synthetic surgical therapy during March 1999 to February 2008.Evaluation with HSS scoring system at preoperative and postoperative period were made.[Results]All patients were followed up.The mean followed-up time was 3.1 years(range 13 months to 7 years).The mean HSS score of knee joint was 23.5 points at preoperative period(range-6 to 35)and it was 79.8 points at postoperative period(range 62~91).The result showed statistical significance(P

Acute undifferentiated leukemia (AUL) is a clinically rare subtype of acute leukemia (AL). AUL lacks the serial specific antigen expressions, and the blasts have no morphological features of myeloid differentiation. Due to the rarity of AUL in clinic, there is no unified understanding of clinical and biological characteristics. It′s difficult to diagnose and choose the optimal treatment for AUL patients. And the prognosis of patients with AUL is poorer compared with other types of AL. Thanks to the big development of biotechnology in recent years, the related researchers have a better understanding of this rare disease. This article reviews the progress of diagnosis and treatment in AUL.

Objective To explore the value of dynamic contrast-enhanced (DCE).MRI in the early diagnosis of brucellosis spondylitis.Methods Fifty-six patients (24 female and 32 male) with Brucellosis with average age of (49± 3)years were retrospectively analyzed.Inclusion criteria:The patients with clinically diagnosed brinell coli spondylitis,drops of serum agglutination test degree 1:100＞(++),Hu＞red plate agglutination test (+ +),enzyme-linked immunosorbent assay to detect specific antibody IgG/IgM (+).Exclusion criteria:Pregnant and lactating women,patients with MRI examination contraindications and spinal tuberculosis,myeloma or other spinal disease,patients with the cervical,thoracic and lumbar 5 vertebral body involvement.The patients were classified into early lesion group and lesion group.Early lesion group was defined as low back pain less than a month,enzyme-linked immunosorbent assay positive IgM and negative IgG results,and no abnormality in conventional MR imaging,while lesion group was defined as low back pain for longer than 3 months,enzyme-linked immunosorbent assay positive IgG and negative IgM and marked lesion in conventional MR imaging.All the patients conducted with conventional MRI and DCE-MRI scan.The differences of the Ktrans,Kep,Ve and Vp between the vertebral lesions,early lesions of vertebral body and normal tissues were measured and compared.Results The values of Ktrans,Kep,Ve and Vp were significantly different between the vertebral lesions [(0.856±0.539) ml/min,(1.482±0.711) ml/min,0.542±0.267,0.034±0.017] and normal tissues [(0.315±0.298) ml/min,(0.713±0.548) ml/min,0.358±0.259,0.056±0.03](all P＜0.05).The values of Ktrans,Kep and Vp were significantly different between the early lesions of vertebral body and normal tissues (all P＜0.05),while no difference was found for Ve between the two groups (P＞0.05).Conclusion DCE-MRI quantitative analysis plays a role in the early diagnosis of the brucella spondylitis.

Objective To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve) and plasma volume fraction(Vp) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of Ktrans were(0.716 ± 0.017),(0.316 ± 0.004),(0.986 ± 0.012)min-1, the values of Kep were(1.326 ± 0.018), (0.747 ± 0.005),(2.899 ± 0.054)min-1, the values of Ve were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of Vp were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H=50.24, 52.49, 48.31, 46.54, P<0.01) among the three diseases. Conclusion DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors.

Objective To investigate the association between physical activity volume and medical care cost in elderly persons aged 70 years and over in Crane Valley, Sendal, Japan. Methods A total of 494 community-dwelling Japanese elderly persons living in residential area of Sendai City in northern Japan completed a self-administered questionnaire that included questions on physical activity. We ascertained total medical care costs through computerized linkage with claims lodged between November 2002 and December 2004 from the Miyagi National Health Insurance Association.Results After multivariate adjustment for potential confounders, the average monthly medical costs of hospitalization, hospital days, outpatient medical expenses, out-patient numbers and the total medical expenses in grade Ⅰ exercise volume group were (196.7±72.1) U.S. dollars, (0. 7±0.3) d, (308. 7±54.4) U.S. dollars, (6.2±1.1) times and (506. 95±94. 2) U.S. dollars; in grade Ⅱ exercise volume group were (139. 8±72.1) U.S. dollars, (0.5±0. 3) d, (295.3±54.6) U.S.dollars, (6.1±1.1) times and (437.8±94.5) U.S. dollars; in grade Ⅲ exercise volume group were (134.1±72.5) U.S. dollars, (0.4±0.3) d, (278.8±54.9) U.S. dollars, (5.8±1.1) times and (418. 1±95.0) U.S. dollars. With the increase in physical activity, there were significant differences between the medical costs of hospitalization and total medical expenses (F=5.85 and 8.11, both P=0.01). Conclusions This prospective study indicates that a higher volume of physical activity is associated with lower medical care costs among Japanese elderly persons.

Objective To investigate the efficacy of acupuncture combined with doctor-nurse cooperation mode on stroke-associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treat-ment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium=19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P<0.05). In the test of dilute barium, the aspiration rate was lower in the treatment group than in the control group (χ2=4.03, P=0.044), however, there was no significant difference between 2 groups in the test of thick bari-um and solid food (P>0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.

Objective To explore the effect of polychlorinated biphenyls (PCBs) on the learning and memory of gestational and lactational exposure to polychlorinated biphenyls in rats offspring.Methods The PCB mixture (A1254,0,5,10,20 mg/kg body weight) was administered to pregnant wistar rats every 3 days by gavage from gestational day (GD) 5 to postnatal day (PND) 20.To assess the effects on offspring following such exposure,Morris water maze test was performed to assess the learning and memory ability.Calcium concentration was assayed in hippocampus and the ultramicro structure was observed.Results After training for four days,the escaping latency in every group decreased significantly compared with the first day,especially the control group,the results in the fourth day decreased significantly with the early three days(P＜0.05).The offsprings of the 10 and 20 mg/kg had prolonged time of passing the aim target ((5.23± 1.16) s,(7.90±3.21) s,(11.74±6.56) s and (20.83± 8.38) s ; P＜0.05),decreased number of crossing platform ((4.14± 1.21),(3.00± 1.32),(2.65± 1.13),(2.42± 1.31) ; P＜0.05) and swimming time in the target area ((40.14±7.14)s,(33.76±5.58)s,(32.45±6.00)s and (30.63±5.10) s; P＜0.05)compared with those of the rats of control and 5 mg/kg groups.The calcium concentration increased ((121.16± 12.23) nM,(141.27±24.66) nM,(163.32±29.75) nM,(261.46±27.79) nM) and the ultramicro structure in hippocampus changed obviously in the high exposure group.Conclusion Gestational and lactational exposure to aroclor 1254 in rats could affect the leaming and memory ability of offsprings.

0.05).Conclusion The SIS method not only can determine multiple index in Chinese materia medica(CMM)simultaneously,but also be simple and accurate.It will be a good quality evaluation pattern for CMM.