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 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).

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 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.

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

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

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

AIMTo develop a real-time PCR method for quantifying low abundance mRNA expression in rat arterial tissues and examine differential changes of angiotensinogen (AGT) gene expression in basilar and femoral arterial tissues after 8 weeks simulated weightlessness.

METHODSAfter 8-wk of simulation, basilar and femoral arteries were harvested from both simulated weightless (SUS) and control (CON) rats. Then total RNA was extracted and reverse transcribed. The real-time PCR using TaqMan-MGB probe was performed to quantify AGT mRNA expression. The amplification efficiency (E) of PCR was calculated from the slope of standard curve. The threshold cycle (Ct) was detected by changes in fluorescence during a real-time PCR. Finally, the relative expression ratio of the target gene (AGT) to the reference gene (GAPDH) was calculated using E and Ct according to the mathematical model derived from the equation calculating the starting fluorescence (Ro).

RESULTSAfter a 8-weeks simulated weightlessness, the AGT mRNA expression increased by 240 percent in basilar arterial, and decreased by 66 percent in femoral arterial tissues.

CONCLUSIONThe specificity, sensitivity, precision, reproducibility, and simplicity of real-time PCR method using TaqMan-MGB probe make it particularly suitable for quantification of low abundance mRNA in arterial tissue from rats.

Angiotensinogen ; genetics ; metabolism ; Animals ; Blood Vessels ; metabolism ; Gene Expression ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Reproducibility of Results ; Weightlessness Simulation

Objective To investigate the clinical characteristics of incomplete Kawasaki disease(KD).Methods Clinical data includi-ng test results,therapeutic methods were analyzed retrospectively in 579 patients with Kawasaki disease.They were divided into classic KD and incomplete KD and made a compared analysis.Results There were no significant differences in gender,age,symptom and laboratory examination between classic and incomplete KD.But the rate of coronary artery lesions was higher in incomplete KD(18.4%) than that of classic KD(11%).Conclusion The rate of coronary artery lesions was higher in incomplete KD,and it should be paid more attention to earlier diagnosis and earlier treatment.

Small intestinal obstruction is a common complication of primary gastrointestinal cancer or metastatic cancers.Patients with this condition are often poor candidates for surgical bypasses,and placement of self-expanding metal stent (SEMS) can be technically challenging.In this study,we examined the feasibility of combined application of single-balloon enteroscope (SBE) and colonoscope for SEMS placement in patients with malignant small intestinal obstruction.Thirty-four patients were enrolled in this study,among which 22 patients received SEMS placement by using SBE and colonoscope,while the other 12 patients received conservative medical treatment.The patients were followed up for one year.Stent placernent was technically feasible in 95.5％ (21/22).Clinical improvement was achieved in 86.4％ (19/22).For the 19 clinical success cases,the average time of benefits from a gastric outlet obstruction scoring system (GOOSS) increase ≥1 was 111.9±89.5 days.For the 12 patients receiving conservative medical treatment,no significant improvement in GOOSS score was observed.Moreover,a significant increase of Short-Form-36 health survey score was observed in the 19 patients at time of 30 days after stent placement.By Kaplan-Meier analysis,a significant survival improvement was observed in patients with successful SEMS placement,compared with patients receiving conservative medical treatment.Taken together,combined use of SBE and colonoscope makes endoscopic stent placement feasible in patients with malignant small intestinal obstruction,and patients can benefit from it in terms of prolonged survival and improved quality of life.