Objective To investigate the normal anatomy and variation of Willis circle by 64-slice volume CT digital subtraction angiography(VCTDSA).Methods VCTDSA data of 174 patients with cephalocervical and cephalic scanning in our hospital from February 2006 to September 2008 were analyzed.Developmental condition,shape,size,integrity,and perforating branches of Willis circle were observed.Results(1) Hypoplasia was displayed in any component vessels of Willis circle.Incidence rate of hypoplasia was 20.1% in left posterior communicating artery,16.1% in right posterior communicating artery,13.8% in right anterior cerebral artery A1,9.2% in right posterior cerebral artery P1,7.3% in anterior communicating artery,6.3% in left posterior cerebral artery P1,and 3.4% in left anterior cerebral artery A1.Congenital arterial absence occurred more frequently in right posterior communicating artery(54.6%),left posterior communicating artery(52.3%),and anterior communicating artery(15.8%).(2) Hypoplasia or congenital absence of posterior circulation and anterior-posterior circulation occurred with a rate of 55.8% and 29.8% respectively.Integrity of Willis circle was only 9.2%.There were 17 perforating branches and 26 heubner inversion arteries observed in 174 Willis circle,with an average diameter of 0.82 mm and 0.94 mm respectively.Conclusion VCTDSA can display Willis circle completely and clearly.Using three-dimensional rotation may detect all kinds of variation and perforating branches of Willis circle.

Objective To identify the expression pattern of IGF-1 and IGF-1R in NK/T-cell lymphoma (NK/TCL) cell lines and to investigate the role of IGF-1/IGF-1R signaling in regulation of cell migration and invasion.Methods RT-PCR and immunofluorescence were performed to detect the expression of IGF-1 and IGF-1R.Transwell assay was applied to observe the effects of IGF-1/IGF-1R signaling and downstream kinases activities on cell migration and invasion.Concentrations of MMP-2 and MMP-9 were quantified by ELISA.Results Co-expression of IGF-1 and its receptor IGF-1R were identified in two NK/TCL cell lines,SNK-1 and SNK-6,while normal NK cells lack the IGF-1R expression.IGF-1R inhibitors significantly reduced SNK-1 and SNK-6 cells migration and invasion rates.Exogenous IGF-1 promoted both cell lines migration and invasion,but these effects were both blocked by IGF-1R inhibitors.Inhibition of AKT,p38 and JNK,the possible IGF-1R downstream kinases,reduced cell migration rates.Further more,exogenous IGF-1 significantly increased MMP-2 and MMP-9 secretion,while decreased secretion of MMP-2 and MMP-9 were observed when IGF-1R inhibitors were applied.Conclusion An autocrine IGF-1/IGF-1R signaling loop is aberrantly expressed on NK/TCL cells and the autocrine loop significantly promotes cell migration and invasion through activation of p38,PI3K and JNK signaling and enhances secretion of MMP-2 and MMP-9.

Using the WISC R to judge two groups childrens IQ and the structure of intelligence. The test group included 47 children studied in special educational primary school (24 girls, 23 boys, aged from 8-11 years). The control group included 50 normal children (25 girls, 25 boys, aged from 8-11 years). All children were required to perform CATEGORY TEST. The result showed that there were significant differences in IQ between two groups. The IQ in the test group ranged from 46 69. So they could be diagnosed as Mental Retardation (MR). 14 MR children were out of balance between VIQ and PIQ. One child's PIQ was over 2SD higer than his VIQ. But the intelligence structures were very similar in two groups. There were siginificant differences on Category Test between two groups, and the result of Category Test was highly related to IQ (r=0.65). This indicated that Category Test could be used to test the thinking development of children.

Objective To explore the gender difference in clinical features and outcomes of elderly patients with coronary true bifurcation lesions after percutaneous coronary intervention (PCI).Methods A total of 169 consecutive patients were included in the study, who were diagnosed coronary true bifurcation lesions by coronary angiography (CAG)and received PCI in our hospital from December 2013 to December 2015.All patients were divided into 2 groups according to their gender (71 femals and 98 males).Angiographic characteristics of the coronary lesions and clinical data were analyzed in both groups.Clinical outcomes during follow up were recorded and studied.Results The levels of total cholesterol (TC), triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in the female group were significantly higher than in the male group (all P<0.05).The levels of BUN,Cr,UA,CyC and TBIL in the female group were significantly lower than in the male group (all P<0.05).Comorbidity rates of hypertension and diabetes were higher in female patients without significant differences (P>0.05).The median follow-up time was 17 months and the incidence rate of overall adverse events in women was higher than that of men (25.4% vs.11.2%, P<0.05).Conclusions The clinical outcomes of elderly patients with coronary true bifurcation lesions after PCI had gender differences.The rates of adverse events in female patients was found significantly higher than male patients.

The clinical data of a child with paroxysmal kinesigenic dyskinesia (PKD) and being diagnosed and treated in the Department of Pediatrics of the First Affiliated Hospital of Zhengzhou University in October 2018 were analyzed retrospectively.The male patient was 13 years old.The clinical manifestation was the change of body position, and the temporary movement cannot appear.The manifestations included the turning of head to one side, the falling back of neck, head shaking, swinging, the tightly hugging of hands in front of the chest, the touching of two tiptoes to the ground, numb sole, and ache.Gene detection: chromosome 16p11.2 (chr16: 29594293-30189789) had about 595.5 kb heterozygosity deletion.A total of 8 cases of 16p11.2 microdeletion in children with PKD were reported in details.16p11.2 microdeletion is another form of gene expression that causes PKD.16p11.2 microdeletion should be screened for genetic evaluation in patients with PKD.

Objective To analyze the expression feature and function of microRNAs in exosomes secreted by leukemia cells (LCEX). Methods The mice leukemia cell line L1210 was taken as the example, and LCEXL1210 was obtained by isolating supernate of L1210 cells through density gradient centrifugation. MicroRNAs isolated from LCEXL1210 were analyzed by microarray analysis, compared with miRNA from L1210 cell line, and then some of miRNAs with different expression were verified by real-time PCR and were analyzed by Gene Ontology (GO) database. Results The number of miRNAs identified in LCEXL1210 was 1 044, and that in L1210 cell line was 872. The number of shared miRNAs between LCEXL1210 and L1210 cell line was 732, accounting for 70.1 % of LCEXL1210 and 83.9 % of L1210 cell line, respectively, which indicated that 70 % of LCEXL1210 was derived from the parental cells. Interestingly, 312 miRNAs in LCEXL1210 were found to be underrepresented in the parental cells, indicating their specificity in LCEXL1210. Some miRNAs were significantly highly expressed in LCEXL1210 compared with those in L1210 cell line, including miR-16-1, miR-210, miR-195 and so on, which showed that miRNAs isolated from LCEXL1210 were differentially expressed with those from the parental cells. Some differentially expressed miRNAs from LCEXL1210 were verified by real-time PCR, and then were analyzed by GO database, which demonstrated that these highly expressed miRNAs participated in the processes of various biological function and signal transduction. Conclusions MiRNAs isolated from LCEXL1210 show a high similarity to miRNAs isolated from L1210 cells, whereas of which one-third are specific. The highly expressed miRNAs participate in the processes of various biological function and signal transduction.

Objective To explore the CT characteristics of mycobacteria intracellulare lung disease.Methods CT imaging data of 37 patients with mycobacteria intracellulare lung disease in our hospital were analyzed retrospectively.Results The main CT signs of mycobacteria intracellulare lung disease included centrilobular nodules (97.3%), bronchiectasis (73.0%) and patchy consolidation (54.1%).Fibrous lesion(43.2%), diameter≥1 cm nodules(35.1%)and thin-wall cavity(29.7%) were also common found in patients.Thick-wall cavity and pleural effusion were not common.The typical CT manifestation was bronchiectasis accompany by the centrilobular nodules occurred in the right middle lobe and (or) left lingular lobe.Conclusion CT manifestations of mycobacteria intracellulare lung disease have some characteristics, and CT examination has a certain value in the diagnosis of this disease.

Objective:To explore the value of synthetic MRI in quantitative monitoring of knee joint structural and cartilage changes of amateur marathon runners before and after the whole marathon.Methods:Totally 26 amateur marathon enthusiasts from Zhuhai City, Guangdong Province were recruited from October 2019 to January 2020. The right knee joints were scanned 1 week before the race and within 48 h after the race. The scanning sequence included the three-dimensional proton density weighted image with isotropic (3D-CUBE-PD) sequence and synthetic MRI sequence. The conventional contrast weighted images T 1WI, T 2WI, proton density (PD) weighted imaging, short-T 1 inversion recovery (STIR) and T 1, T 2, PD mapping were obtained by the latter scans. The 3D-CUBE-PD sequence was used as a reference to evaluate the detection of knee joint lesions. The knee articular cartilage was divided into 8 subregions: central medial femoral condyle (CMFC), posterior medial femoral condyle (PMFC), central lateral femoral condyle (CLFC), posterior lateral femoral condyle (PLFC), medial tibia plateau (MTP), lateral tibia plateau (LTP), patella and trochlear. Based on the synthetic MRI quantitative mapping, the T 1, T 2 and PD values of each cartilage subregion were measured independently by 2 radiologists. The ICC was used to evaluate the consistency of the measurement between observers. The T 1, T 2 and PD values of knee cartilage before and after marathon exercise were compared by Wilcoxon signed rank test. Results:The 2 radiologists had good consistency in the measurement of T 1, T 2 and PD values of knee articular cartilage with the ICC values of 0.912, 0.933 and 0.954, respectively. The synthetic MRI quantitative mapping sequence can detect all cartilage damage ( n=3) and joint effusion ( n=15), and 7 of 9 meniscus injuries were detected. The T 1, T 2 and PD values of the knee cartilage as a whole before the race were higher than those after race, and the differences were statistically significant (all P<0.05). The T 1 values were statistically significant except patellar cartilage and trochlear cartilage, and T 2 values were significantly different in the CMFC, LTP, MTP ( P<0.05). Conclusion:Synthetic MRI has a good display of knee joint structural lesions, and its quantitative parameters T 1, T 2 and PD can detect the changes of knee cartilage before and after marathon.

Objective To campare the diagnostic value of contrast-enhanced ultrasound(CEUS) and International Ovarian Tumor Analysis (IOTA) simple rules in the differential diagnosis of adnexal tumors . Methods For the 101 suspicious malignant adnexal tumors discovered by conventional ultrasound ,IOTA simple rules and CEUS were performed before operation . Tumors were divided into benign ,uncertain and malignant according to IOTA simple rules . Tumors were scored by CEUS according to the membrane integrity ,coating thickness uniformity ,separation enhancement ,enhance strength ( no enhancement ,low enhancement ,equal or high enhancement) ,and enhanced performance( uniform and non-uniform) . The ROC curve was drawn with the pathological results as the gold standard ,and the best boundary value was obtained . Finally ,the diagnostic efficiency of the diagnostic methods were analyzed . Results ①According to the ROC curve analysis ,the area under the curve of IOTA simple rules was 0 .757( P ＝0 .000) . When the uncertainty type was classified as benign ,the random index was 0 .41 ,the sensitivity was 61 .54% ,and the specificity was 79 .59% . When the uncertainty type was classified as malignant ,the random index was 0 .31 ,the sensitivity was 96 .15% ,and the specificity was 34 .69% . When the uncertain types were excluded the Youden index was 0 .77 ,the sensitivity was 76 .19% ,and the specificity was 89 .47% . ②The differences in the membrane integrity , coating thickness uniformity , separation enhancement , enhance strength , enhanced performance between benign and malignant tumors were statistically significant( P ＜ 0 .01) . ③According to the ROC curve analysis ,the area under the curve of CEUS was 0 .914( P ＝ 0 .000) ,cut-off value was 3 score . The Youden index ,sensitivity and specificity of evaluating benign and malignant adnexal tumors were 0 .80 ,78 .85% and 91 .84% respectively . ④ The tumors evaluated as benign by IOTA simple rules was classified as benign . The tumors evaluated as malignant by IOTA simple rules were classified as malignant . The tumors evaluated as uncertain by IOTA simple rules and scored less than or equal to 3 points according to CEUS were classified as benign . The tumors evaluated as uncertain by IOTA simple rules and scored more than 3 points according to CEUS were classified as malignant . According to the ROC curve analysis ,the area under the curve of CEUS combined with IOTA simple rules was 0 .831 ( P ＝0 .000) . The Youden index ,sensitivity and specificity in evaluating benign and malignant adnexal tumors were respectively 0 .66 ,86 .54% and 79 .59% respectively . Conclusions CEUS has a higher diagnostic efficiency than IOTA Simple Rules and the two combined in the diagnosis of adnexal tumors .

Objective To study the effect of olanzapine combined with repetitive transcranial magnetic stimulation(rTMS) in the treatment of phonism dominated schizophrenia.Methods From August 2015 to November 2016,112 patients with phonism based schizophrenia in Ningbo Kangning Hospital were selected in the research . According to the different treatment ,the patients were divided into observation group and control group ,with 56 cases in each group.The observation group was treated with olanzapine combined with rTMS chemotherapy ,the control group was treated with olanzapine.Before and after treatment,the positive and negative symptom scale ( PANSS) score, Wisconsin Card Sorting Test ( WCST) score of the two groups were observed.The clinical efficacy was compared between the two groups.Results Before treatment,there were no statistically significant differences in PANSS score and WCST score between the two groups ( all P＞0.05).After treatment for 1 week,2 weeks,4 weeks,the PANSS scores of the two groups were significantly lower than those before treatment (F＝170.710,106.028,28.530,30.328, 25.806,10.832,203.342,372.253,all P＜0.05).The PANSS scores decreased more significantly in the observation group.After treatment for 1,2,4 weeks,the scores of positive symptoms in the observation group were (25.95 ±3.50)points, (24.72 ±4.50)points and(16.51 ±2.70)points,respectively,which were significantly lower than those in the control group[(27.27 ±2.03)points,(27.80 ±5.37)points,(19.53 ±3.07)points](t＝2.441,3.290,5.528,all P＜0.05).After treatment for 1 week,2 weeks,4 weeks,the continuous response scores in the observation group were (45.62 ±5.41)points,(44.69 ±4.91) points,(35.89 ±3.30) points,respectively,which were significantly lower than those in the control group[(50.61 ±5.35)points,(46.80 ±5.14)points,(42.70 ±5.04)points](t＝4.908, 2.221,8.459,all P＜0.05).The scores of continuous errors in the observation group were (49.47 ±4.59) points, (46.53 ±6.05) points and (36.35 ±5.18) points,respectively,which were lower than those in the control group [(83.1 ±6.58)points,(81.85 ±6.70)points and (76.86 ±76.86)points](t＝31.369,29.279,38.464,all P＜0.05).After treatment for 1 week,2 weeks,the classification scores in the observation group were (4.21 ±2.03) points and (5.35 ±2.23) points,respectively,which were significantly higher than those in the control group [(3.35 ±1.24)points and (3.95 ±1.24)points] (t＝2.705,4.106,all P＜0.05).The effective rate was 91.0%in the observation group ,which was 89.2%in the control group,there was no statistically significant difference (χ2＝0.022,P＞0.05).Conclusion Olanzapine combined with rTMS is effective in the treatment of schizophrenia ,and olanzapine combined with rTMS is more effective in improving the cognitive ability of patients than olanzapine alone .