Objective To investigate the clinical and MR features of fungal encephalopyosis and fungal granuloma.Methods The clinical and MR data of 10 cases with fungal encephalopyosis and fungal granuloma confirmed by surgical pathology or clinical serum were analyzed retrospectively.Then we analyzed the clinical conditions,MR signals,lesion enhancement,DWI and MRS performance characteristics of the 10 cases.Results Six cases were fungal encephalopyosis,among which 2 cases occurred in the sella turcica after surgery which located in and above the sella turcica.2 cases occurred in the frontal lobe after frontal surgery and 1 case of them was multiple encephalopyosis.2 cases of encephalopyosis without operation history were located in the left frontal lobe and right cerebellum respectively.The abscess walls of these cases were thin and showed high tension.Furthermore,it had annular significant signal enhancement and high signal in DWI scan.One case of huge fungal granuloma located in the frontal lobe and into the sinuses which showed uneven signal enhancement. The Cho level was significantly increased.Three cases of cryptococcal granuloma showed multiple lesions located in the bilateral basal ganglia region and 2 out of them accompanied with cephalomeningitis.Conclusion The MR performance of fungal encephalopyosis was quite similar with bacterial brain abscesses,which makes the differential diagnosis difficult.The brain fungal granuloma MRS may display a significant increase of Cho level which might be related with gliosis.It shows certain characteristics of brain MR performance of cryptococcal granuloma which are multiple lesions,preferential distribution of basal ganglia region and accompanying cephalomeningitis.

Objective To measure neuro-biochemical changes in brain of first episode major depression (MD) patients. Methods Single-voxel proton magnetic resonance spectroscopic (1H-MRS) examination of bilateralis frontal lobe and hippocampus was conducted in 21 first episode major depression patients and 21 age-, sex-and education-matched healthy controls. After this, major depression patients took selectivity serotonin reuptake inhibitors (SSRIs) for three months. Then, we examined the changes in NAA, Cho, Cr, Glx and mI in bilaterlis frontal lobe and hippocampus of patients. Finally, we compared the metabolism of the subjects with that of the controls. Results ① Bilateralis frontal lobe NAA/Cr, right frontal lobe Glx/Cr and left hippocampus NAA/Cr and Glx/Cr were significantly lower in MD patients than in the controls, but right frontal lobe and right hippocampus mI/Cr significantly were higher than those in controls. ② After treatment left frontal lobe and left hippocampus NAA/Cr significantly increased compared with pretherapy. Right frontal lobe mI/Cr significantly decreased. Conclusion Nerve cell activity disorder, abnormal second messenger and glutamicacid and glutamine may be involved in the pathogenesis of MD. Antidepressant can regulate abnormal metabolism and improve nerve cell activity.

Objective To study the MR features and differential diagnosis of oligodendroglioma.Methods Clinical and MR data of 34 pathology-diagnosed oligodendroglioma cases were analyzed retrospectively, which included tumor location,signal,size,enhanced and MRS features.Results 22 cases were diagnosed as WHOⅡoligodendroglioma and 12 cases WHOⅢ anaplastic oligodendroglioma.22 tumors located in the frontal lobes,4 tumors in the temporal lobes, 7 tumors in both frontal and temporal lobes,1 tumor located at the optic chiasma.25 tumors located in the superficial areas of the brain.For anaplastic oligodendrogliomas,tumor necrosis and cystic degenerations were showed in 11 cases,and hemorrhage or calcification in 6 cases.For oligodendroglioma,tumor necrosis and cystic degenerations were showed in 6 cases,hemorrhage in 2 cases,calcification in 8 cases.The average tumor diameter was 35 mm for oligodendroglioma and 58 mm for anaplastic oligodendroglioma.For anaplastic oligodendroglioma,obvious irregular or ring enhancements were showed in 11 cases.For oligodendroglioma, mild enhancement was showed in 6 cases,no enhancement in 6 cases and mild or moderate irregular ring-type enhancements in 4 cases.MRS was performed in 6 anaplastic oligodendrogliomas the Cho/Cr ratio was over 4 in 5 cases.MRS was performed in 12 oligodendrogliomas the Cho/Cr ratio was between 2.3 to 3.3 in 10 cases and below 2 in 2 cases.Conclusion The main MR feature of anaplastic oligodendroglioma is that tumor is located in the frontal lobe and superficial area of the brainwith irregular or ring-type enhancement,and the Cho/Cr ratio over 4.

Objective To investigate the correlation between procalcitonin (PCT) and infarct related artery (IRA) spontaneous recanalization (SR) in patients with ST-segment elevation myocardial infarction (STEMI), and to investigate the value of PCT in predicting SR. Methods A retrospective study was conducted. A total of 263 STEMI patients who received emergency coronary angiography from January 2013 to April 2016 in cardiology department of Gansu Provincial Hospital were retrospectively included. Depending on the thrombolysis in myocardial infarction trial (TIMI) grade, the patients were divided into two groups, SR group (TIMI 2-3 grade) and non-SR group (NSR group, TIMI 0-1 grade). The baseline characteristics, serum PCT, high sensitivity C-reactive protein (hs-CRP) and biochemical makers before primary percutaneous coronary intervention (PCI) were compared. According to the value of PCT, the patients were divided into four quartile groups. SR rate of every groups were compared. Multiple logistic regression analysis was used to determine the independent predictor of SR. Receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of PCT for SR. Results In 263 STEMI patients, SR occurred in 77 patients and SR rate was 29.3%. There were no statistical differences in gender, age, body mass index (BMI), past medical history and IRA between the two groups, indicating that the baseline characteristics were matched. Compared with NSR group, utilization rate of the statins were significantly higher (35.1% vs. 22.6%, P < 0.05), the value of PCT, hs-CRP, uric acid (UA) in SR group were significantly lower [PCT (μg/L): 0.059±0.036 vs. 0.103±0.048, hs-CRP (mg/L): 3.07±4.13 vs. 5.93±7.80, UA (mmol/L): 321.4±77.4 vs. 354.2±114.1, all P < 0.05]. The quartile value of PCT were < 0.058, 0.058-0.078, 0.079-0.110, > 0.110 μg/L. SR rate were 48.5% (32/66), 29.9% (20/67), 26.9% (18/67) and 11.1% (7/63), respectively. SR rate of Quartile 1 was significantly higher than the other three groups (all P < 0.05). It was shown by multiple logistic regression analysis that PCT [odds ratio (OR) = 0.432, 95% confidence interval (95%CI) = 0.108-0.863, P = 0.016], hs-CRP (OR = 0.708, 95%CI = 0.516-0.905, P = 0.037) were independent predictors for SR. The area under the ROC curve (AUC) of PCT for predicting SR was greater than that of hs-CRP [0.784 (95%CI = 0.721-0.847) vs. 0.686 (95%CI = 0.619-0.753), P < 0.05]. When the cut-off value of PCT was 0.067 μg/L, the sensitivity was 81.6%, and the specificity was 66.7%. Conclusion PCT was independent predictor of SR, which has a power value in predicting IRA recanalization in patients with STEMI.

Objective To measure metabolism in brain of first episode major depression patients with 1H-MRS.Methods Single-voxel proton magnetic resonance spectroscopic(1H-MRS) examination of bilateralis frontal lobe and hippocampus was conducted in 23 patients with first episode major depression and 23 age-,sex-and education-matched healthy controls.We examined the metabolism such as NAA,Cho,Cr,Glx and mI in bilaterlis frontal lobe and hippocampus of patients.Results Bilateralis frontal lobe NAA/Cr,right frontal lobe Glx/Cr and left hippocampus NAA/Cr and Glx/Cr were significantly lower in MD patients versus controls,but right frontal lobe and right hippocampus mI/Cr significantly higher than in controls.Conclusion Nerve cell activity disorder,abnormal second messenger and glutamicacid and glutamine may be involved in the pathogenesis of major depression.

Objective To study the precaution and nursing for the acute complication after traumatic cervical spine cord injury. Methods 56 patients with acute traumatic cervical spine cord injury were analyzed retrospectively.Results All the complication had been cured and none died because of the complication. Conclusion It is important to do something to relieve or prevent the complication as soon as possible.

Objective To summarize the long-term outcomes and safety of childhood Hodgkin lymphoma (HL) with protocol ABVD. Methods The clinical data of 20 children with HL admitted to the Union Hospital of Fujian Medical University from July 2010 to June 2017 were retrospectively analyzed. Among the 20 children with HL, 15 were male and 5 were female. The median age of initial diagnosis was 6.5 years old (3-12 years old). The pathological types were as follow: 1 case was nodular lymphocyte-predominant HL (NLPHL) and 19 cases were classical HL (cHL), including 9 cases of mixed cell type, 9 cases of nodular sclerosis type and 1 case of lymphocyte rich type. Basing on Ann Arbor staging system, 1 patient was evaluated as stage Ⅰ, 4 patients were stage Ⅱ, 10 patients were stage Ⅲ, and 5 patients were stage Ⅳ. There were 3 patients in the low-risk group, 7 patients in the intermediate-risk group, and 10 patients in the high-risk group. There were 9 patients with B symptoms. All patients were treated with the ABVD regimen. Results All the 20 patients completed all chemotherapy courses. After 2 courses, the effective rate was 100％(20/20), including 12 cases of complete remission (CR) and 8 cases of partial remission (PR). After the treatment, 19 cases achieved CR, and at the end of the 6 courses, the evaluation showed that 1 case had residual lesions. Follow-up to February 2018, clinical symptoms of 18 cases achieved CR, 2 cases relapsed (all high-risk group); the median follow-up time was 42 months (10.1-87.9 months), the overall survival rate was 100 ％ (20/20), the estimated 5-year rate of freedom from treatment failure (FFTF) was (89.1 ±7.3) ％.Conclusions According to the risk stratification, ABVD regimen has good safety and long-term efficacy for children with cHL. Even the patients in low-risk or intermediate-risk group do not achieve CR after 2 courses and do not receive radiotherapy, the prognosis of them is still good.