Objective To study the diagnostic value of multi-direction adjusted multiplanar reconstruction (MPR)by 64-slice CT myelography (CTM)in diagnosing cervical nerve injury,and the possibility of the MPR to replace conventional myelography and CT direct-scanning axial images.Methods Twenty-six patients with cervical nerve root injury were examined by conventional myelograpby and 64-slice CT using isotropic parameters.Then multi-direction MPR were performed to display nerve roots on coronal and sagittal planes besides axial images.Twenty-six patients were performed surgical operations and diagnosis were obtained.The coincident diagnosing rate with surgical operations results were compared statistically among multi-direction MPR,direct-scanning axial CT images,conventional myelography.The numbers of images were also compared between axial MPR and direct scanning axial CT images.Results Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in 6d-slice CT,which was found in 31 nerve roots.Indirect signs included:(1)Traumatic pseudomeningocele: 29 nerve roots showed the leak of Isovist into nerve root sheath,and extended into foramina;(2)Arachnoid cyst: 26 nerve roots clearly displays cystic distension in nerve root,which has low- density fine clew form septation from subarachnoid cavity and no nerve root in the cyst ;(3)Deformity of the subarachnoid space : deformity of thecal sac,partially lack of Isovist into arachnoid space,which was found in 17 nerve roots.The coincident diagnosing rate of cervical nerve root injury by multi-direction adjusted coronal MPR imaging was 92.6% (50/54),which was higher than by axial CT (77.8%,42/54)and conventional myelography (68.5%,37/54),There was significant difference between the conventional myelography, direct-scanning axial CT,multi-direction MPR images (Kappa = 0.686,0.772,0.920, respectively,P

Objective:To investigate the relationship between serum procollagen Ⅲ amino terminal peptide (PIIINP), collagen I carboxyl terminal cross-linking peptide (CTXI), high-sensitivity C-reactive protein (hs-CRP) and cardiac magnetic resonance (CMR) T 1 mapping value in patients with lone atrial fibrillation (AF). Methods:Fifty-five patients with lone AF in Beijing Anzhen Hospital from July 2017 to June 2018 were prospectively enrolled. Another 20 healthy volunteers were examined at the same time to provide normal reference range. All patients completed PIIINP, CTXI, hs-CRP and CMR examination within one week. CMR examination including cine, pre-contrast T 1 mapping, and late gadolinium enhancement sequences. We used t test, Mann-Whitney U test or chi square test to compare the difference of the above indexes between AF patients and the control group. Spearman correlation analysis was used to determine the associations between left ventricular native T 1 value and blood biomarker in AF patients. Results:All the patients were paroxysmal AF with an average age of (48±10) years, of which 46 (83.6%) were male. The PIIINP, CTXI, hs-CRP, left ventricular native T 1 value of AF patients were 5.83 (3.52, 12.40) ng/ml, 4.63 (3.31, 6.82) μg/ml, 3.41 (1.72, 6.61) mg/L and (1 261±23) ms, respectively, which all significant higher than those in healthy subjects (all P<0.05). The native T 1 value of left ventricular myocardium was positively correlated with PIIINP ( r=0.492, P<0.05) and hs-CRP ( r=0.516, P<0.05), but not with CTXI ( r=0.021, P>0.05). Conclusions:The PIIINP, CTXI and hs-CRP increased in patients with lone AF, PIIINP and hs-CRP were correlated with elevated native T 1 value of left ventricular myocardium.

Objective The aim of this study was to analyze the effect of gender and age on shoulder and hip range of motion (ROM) and to determine the differences of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011) in China. Methods We collected cases with unilateral injury of shoulder or hip from clinical forensic medicine. The differences of ROM of normal side joint between the data we collected and the published standards were studied. Descriptive statistics was calculated between male and female subjects in ifve age groups including 0~25, 26~40, 41~50, 51~60 and >60 years, and the ROM changes with age were also studied. Results The data collected in this study was signiifcantly different from the published standard. With age growth, the ROM of shoulder and hip were decreased and a significant difference between genders in partial activity direction of shoulder and hip was found in the individuals who were over 50 years. Conclusion Gender and age appear to be inlfuential factors to determine the normal ROM of the shoulder and hip joint, and there is signiifcantly difference of ROM of normal side shoulder and hip joints between the data we collected and the published standards (Guideline of Examination for Body Impairment in Clinical Forensic Medicine SF/ZJD0103003-2011).

Abdominal Pain ; etiology ; Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Purpura, Schoenlein-Henoch ; complications ; pathology

Objective To analyze the related factors with prognosis in patients with serous ovarian adenocarcinoma and to set up a prognostic model of serous ovarian adenocarcinoma.Methods The clinical, pathological and follow-up data of 104 cases with serous ovarian adenocarcinoma were retrospectively analyzed.Kaplan-meier univariate analysis was used to screen the prognostic factors;COX univariate and multivariate analyses were used to determine the risk coefficient of each factors and different layers in each factor.Pearson rank correlation was used to reject the influence of different factors with each other.And the prognostic model of serous ovarian adenocarcinoma was set up based on the result of the above study,which could be used to deduce the survival probability of patients with serous ovarian adenocarcinoma.Results International Federation of Gynecology and Obstetrics(FIGO)stage(P=0.0029),histological grade(P= 0.0054),residual disease(P=0.0000),metastasis of lymph nodes(P=0.0000)and chemotherapy(P= 0.0000)were the related factors of prognosis in patients with serous ovarian adenocareinoma,of which FIGO stage was the most important one,followed sequentially by histological grade,metastasis of lymph node, residual disease and chemotherapy(the independent risk coefficient of each factor was 1.3392,0.9206, 0.7071,0.6004,0.4985 in sequence).We set up a prognosis model according to the prognostic index of each factors.The effect of chemotherapy and residual disease on prognosis could be quantified by this model, and the higher the score,the lower the survival probability of patients.Condusions FIGO stage, histological grade,residual disease,metastasis of lymph nodes and chemotherapy are important prognostic factors of serous ovarian adenoearcinoma.This model can be used to estimate the prognosis of patients with serous ovarian adenoearcinoma,and the effect of both chemotherapy and residual disease on the prognosis could be quantified by the model.

BACKGROUNDHyperparathyroidism (HPT) occurs at an early age and has a high disability rate. Unfortunately, confirmed diagnosis in most patients is done at a very late stage, when the patients have shown typical symptoms and signs, and when treatment does not produce any desirable effect. It has become urgent to find a method that would detect early bone diseases in HPT to obtain time for the ideal treatment. This study evaluated the accuracy of high field magnetic resonance imaging (MRI) combined with spiral computed tomography (SCT) scan in detecting early bone diseases in HPT, through imaging techniques and histopathological examinations on an animal model of HPT.

METHODSEighty adult rabbits were randomly divided into two groups with forty in each. The control group was fed normal diet (Ca:P = 1:0.7); the experimental group was fed high phosphate diet (Ca:P = 1:7) for 3, 4, 5, or 6-month intervals to establish the animal model of HPT. The staging and imaging findings of the early bone diseases in HPT were determined by high field MRI and SCT scan at the 3rd, 4th, 5th and 6th month. Each rabbit was sacrificed after high field MRI and SCT scan, and the parathyroid and bones were removed for pathological examination to evaluate the accuracy of imaging diagnosis.

RESULTSParathyroid histopathological studies revealed hyperplasia, osteoporosis and early cortical bone resorption. The bone diseases in HPT displayed different levels of low signal intensity on T(1)WI and low to intermediate signal intensity on T(2)WI in bone of stage 0, I, II or III, but showed correspondingly absent, probable, osteoporotic and subperiosteal cortical resorption on SCT scan.

CONCLUSIONHigh field MRI combined with SCT scan not only detects early bone diseases in HPT, but also indicates staging, and might be a reliable method of studying early bone diseases in HPT.

Animals ; Bone Diseases ; diagnosis ; pathology ; Calcium ; blood ; Female ; Hyperparathyroidism ; complications ; Magnetic Resonance Imaging ; methods ; Male ; Osteoporosis ; diagnosis ; Phosphorus ; blood ; Rabbits ; Tomography, Spiral Computed ; methods

BACKGROUNDThe solitary pulmonary nodule (SPN) is one of the most common findings on chest radiographs. The objectives of clinical practice are to differentiate malignant nodules from benign nodules in the least invasive way and to make a specific diagnosis. This study was aimed to evaluate the correlation between perfusion imaging features and microvessel density (MVD) and vascular endothelial growth factors (VEGF) in SPNs using multi-slice computed tomography (MSCT); and to provide the theoretical basis for SPN blood flow pattern and blood flow quantitative features. Also, the study called for the discussion of the method's clinical application value in the differential diagnosis of benign and malignant SPNs.

METHODSSixty-eight patients with SPN underwent multi-location dynamic contrast enhanced (nonionic contrast material was administrated via the antecubital vein at a rate of 4 ml/s) MSCT. Precontrast and postcontrast attenuations on every scan was studied. Perfusion, peak height, and the ratio of the peak height of the SPN to that of the aorta were analyzed. Perfusion was calculated using the maximum gradient of the time-density curves (TDC) and the peak height of the aorta. The quantitative parameters (perfusion, peak height, ratio of peak height of the SPN to that of the aorta) of the blood flow pattern were compared with MVD and the VEGF expression of immunohistochemistry.

RESULTSThe perfusion peak heights of malignant ((96.15 +/- 11.55) HU) and inflammatory ((101.15 +/- 8.41) HU) SPNs were significantly higher than those of benign ((47.24 +/- 9.15) HU) SPNs (P < 0.05, P < 0.05). Ratios of SPN-to-aorta of malignant and inflammatory SPNs were significantly higher than those of benign SPNs (P < 0.05, P < 0.05). No significant differences were found between the peak height and SPN-to-aorta ratio of malignant SPNs and inflammatory SPNs (P > 0.05, P > 0.05). The precontrast densities of inflammatory SPNs were lower than those of malignant SPNs (P < 0.05). Perfusion values of malignant and inflammatory SPNs were significantly higher than those of the benign SPNs (P < 0.05, P < 0.05). The VEGF positive expressions appeared in 32 patients with malignant SPNs and 2 patients with benign SPNs, and the average value of the MVD was higher in patients with malignant SPNs (36.88 +/- 6.76) than in patients with either benign (4.51 +/- 0.60) or inflammatory (26.11 +/- 5.43) SPNs (P < 0.05, P < 0.05). There were statistically significant correlations between the CT perfusion feature and the MVD. The highest correlation was between the peak height of SPN and the MVD (r = 0.657, P < 0.05).

CONCLUSIONSTumor microvessel density and VEGF expression facilitate the exploration of the pathophysiological basis of CT perfusion in SPNs. Multi-slice CT perfusion has shown strong positive correlations with angiogenesis in SPNs.

Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Lung ; diagnostic imaging ; metabolism ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; Perfusion Imaging ; Solitary Pulmonary Nodule ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; methods ; Vascular Endothelial Growth Factor A ; analysis

The objective of this study was to investigate the expressions of TPO receptor (c-mpl) proteins on CD34 positive bone marrow cells (CD34+ BMCs), platelets and the expression of c-mpl mRNA in bone marrow cells of the patients with polycythemia vera (PV). The expressions of c-mpl proteins on CD34+ bone marrow hematopoietic cells of 13 PV patients and 15 normal controls were assessed by bicolor flow cytometry and the expressions of c-mpl proteins on platelets of 15 PV patients and 15 normal controls were assessed by monocolor flow cytometry, and the expressions of c-mpl mRNA in bone marrow hematopoietic cells (BMHCs) were assessed by RT-PCR. The results showed that no difference was found between the expression of c-mpl proteins on CD34+ BMHCs of PV patients (0.99% +/- 0.14%) and that of normal controls (0.92% +/- 0.12%) (p > 0.05). There was no difference too between the expression of c-mpl protein on platelets in PV patients (20.33% +/- 4.84%) and that in normal controls (23.50% +/- 3.64%) (p > 0.05). No difference between the expression of c-mpl mRNA in BMHCs of PV patients and that in normal controls was seen. In conclusion, the expressions of c-mpl proteins on CD34+ BMHCs, platelets and c-mpl mRNA in BMHCs of PV patients were not obviously abnormal.
Antigens, CD34 ; analysis ; Blood Platelets ; metabolism ; Bone Marrow Cells ; metabolism ; pathology ; Hematopoietic Stem Cells ; metabolism ; pathology ; Humans ; Polycythemia Vera ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Receptors, Thrombopoietin ; metabolism

OBJECTIVETo study the percutaneous lag screw internal fixation of LX technique for sacroiliac joint diseases or injuries.

METHODSThere were 38 patients (25 male and 13 female) with an average age of 35.6 years ranged from 18 to 59 years. Among them, thirty-one cases with trauma of Tile B type, five cases with sacroiliitis and two cases with sacral cystis degeneration. There were 11, 15, 5 cases of Tile B1, B2, B3 type respectively. Pelvic anterior-posterior radiography and spiral computed tomography (CT) were undertaken for all patients. Axis planar, coronal planar, sagittal planar and curve planar of sacral reconstruction of spiral CT images were obtained for every patient. There were 28 cases with delitescence posterior ring injury. All these patients were performed percutaneous lag screw fixation procedures of LX technique under epidural anesthesia. Localization with spiral CT guidance was performed by the radiologist using spiral CT followed by the orthopaedic surgeon. Percutaneous fusion of sacroiliac joint was performed for seven patients who suffered from sacroiliac joint diseases.

RESULTSThe blood loss were from 25 to 70 ml (means 36 ml) during operation. All patients were followed up for 3 to 39 months (means 15.6 months). There were no postoperative complications such as infection, fracture nonunion, iatrogenic injuries of nerve and blood vessel, breakage and slippage of fixtors. According to the evaluation of pelvic injuries, the results of imageology were excellent in 34 cases and good in 4, the results of clinical were excellent in 32 and good in 6.

CONCLUSIONPercutaneous lag screw internal fixation of LX technique minimizes operation injury during a short procedure with few subsequent complications and allows early mobilization of the patients. That is an ideally safe and effetive operation technique for the sacroiliac joint diseases and injuries.

Adolescent ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators ; Male ; Middle Aged ; Sacroiliac Joint ; diagnostic imaging ; injuries ; surgery ; Tomography, Spiral Computed ; Treatment Outcome

OBJECTIVETo explore the association between genetic polymorphisms of TGF-beta (TGF-beta) and susceptibility to pneumoconiosis.

METHODSOne hundred and seventeen patients with pneumoconiosis were selected as case. The control group was workers exposed to dust but without pneumoconiosis who had the same sex, nationality, and workshop or work site as case. The differences in the age and cumulative exposure time between the case and control group were not move than five years and two years, respectively. The case matched with the control according to 1:1. Polymerase chains reaction-restriction fragment length polymorphism was used to determine the frequencies of TGF-beta genes in the two groups.

RESULTSThe frequencies of this TGF-beta (-509) genotypes were CC (22.2%), CT (43.6%) and TT (34.2%) in cases, which was significantly different from the control group, respectively (OR = 1.390, P < 0.05). There was no significant difference for frequency of TGF-beta+869 genotypes and allelic between case and control (P > 0.05). The frequencies of the TGF-beta (+915) genotypes in case [GG (70.9%), GC (29.1%)] were significantly different from the control group (OR = 1.455, P < 0.05). The frequency of TGF-beta (+915) * C allele in the case and control was 14.5% and 8.5%, respectively (P < 0.05). The frequencies of carrying TGF-beta (-509) CC and (+915) GG genotypes were 12.8% and 29.9% in case and control. The frequencies of carrying TGF-beta (-509) * T and (+915) * C alleles were 9.8% and 5.1% in pneumoconiosis and control (P < 0.05).

CONCLUSIONSTGF-beta (-509)CC genotype may be the protective factor for the pneumoconiosis. TGF-beta (+915)GC genotype may be a susceptible factor for the pneumoconiosis. The workers of carrying TGF-beta (-509) * T and (+915) * C alleles are more susceptible to pneumoconiosis.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; genetics ; Polymorphism, Single Nucleotide ; Transforming Growth Factor beta1 ; genetics