We observed the normal variations of metatarsal and phalangeal bones in 1363 cases of normal children and youngsters (city group and countryside group), described occurring rate, area, ages and sex of 6 types of the variations, contrasted the difference between city group and country side groups, and discussed some characterastics and clinic significances of normal variations.

Objective To study the manifestations of perfusion change in small heptic cell cancer(SHCC) on dynamic contract-enhanced MRI. Methods 18 cases of SHCC(21 lesions) proved by pathology were presented. Dynamic contrast-enhanced MRI was performed using 2D T_1-turbor-FLASH sequence for 18 SHCC.Results Among all 18 cases of SHCC, 17 cases were obvious enhanced, and one case was no enhancement. In 17caese of enhanced tumors, the maximal peak of enhancement was in the first set (6~23 s) in 2 cases and in the second set (33~51 s) in 15 cases. The average maximal peak of contrast-enhanced time was 42.5 s(23~50.5 s),and the average maximal peak of signal intensity increased up to 30.5 (19.5~45.0). The pattern of time-intensity curve was rapid wash-in followed by washout in 17 cases.Conclusion Dynamic contract-enhanced MRI is important on study and diagnosis of SHCC.

Objective To investigate the rule of the talar growth and establish a normal radiographic measurement scale of the talus from postnatal infants to adults. Methods Radiographic measurements were performed with the lateral radiographs of right talus in 1*!765 normal cases(age 1 to 18). Results The talar growth velocity was the fastest before two years old.It was consistent with the development of physiques(e.g.height and weight),and then there was not a remarkable increase in the talar growth.At puberty,a temporal sudden increase was not found in the talus.Conclusion Radiographic measurements not only provide a normal contrast for the flats of the talus or the abnormal shapes caused by some congenital or acquired disease,but also was useful to the other subject(e.g.anthropology,forensic science).

Objective To explore the characteristics and survival of connective tissue disease (CTD) patients with both of pulmonary arterial hypertension (PAH) arnd interstitial lung disease (ILD),and to compare with CTD patients with isolated PAH.Methods All adult CTD patients who visited one of the three referral centers in China with a diagnosis of PAH confirmed by right heart catheterization from July 2006 to May 2011 were enrolled.They were then divided into two groups (ILD with and without-ILD group) based on chest CT and then the comparison of baseline characteristics and survival at the endpoint of follow up were made between the two groups.T test,Mann-Whitney U test,x2 test,Kaplan-Meier survival analysis and Cox regression analysis were used for statistical analyses.Results One hundred and twenty-six patients were recruited into the study.Patients with ILD (n=27) were older than those without ILD (n=99).Lung function results including FVC [(75±18)％ vs (83±13)％,t=2.212,P=0.037] and DLCO [(54±22)％ vs (68±20)％,t=2.392,P=0.019] in ILD group were significantly wose than those without-ILD group.Although some important hemodynamic parameters such as mean pulmonary arterial pressure and pulmonary vascular resistance were better in the ILD group than the without-ILD group,Kaplan-Meier analysis showed that the short term survival of ILD group was significantly worse than that of the without-ILD group (72.7％ versus 94.7％ at 1 year and 63.6％ versus 81.1％ at 3 year,P=0.047).In ILD group,Cox regression analysis showed that SvO2 was the only independent factor for the short term survival [HR=0.19,95％CI (0.04,0.83),P=0.027],and Kaplan-Meier analysis showed patients with SvO2＜60％ had significantly lower short term survival than patients with SvO2 ≥60％ (1 and 2 year survival were 60.0％ and 40.0％ versus 92.9％ and 77.4％ respectively,P=0.002).Conclusion Patients with both PAH and ILD is a special subtype in CTD.Although with the superiority of hemodynamics,these patients have significantly worse survival than CTD patients with isolated PAH.Low SvO2 is the independent risk factor for the short term mortality in patients of CTD complicated by both PAH and ILD.More attention should be paid to these patients and the management strategy should be investigated further.