OBJECTIVETo study the MRI features of proximal femur bone marrow edema syndrome for further improve the understanding of the disease.

METHODSMRI imaging of 10 patients with proximal femur bone marrow edema syndrome was retrospectively reviewed,including 6 males and 4 females with an average age of 41.5 years old ranging from 36 to 57. The courses of diseases ranged from 1 week to 3 months. Among them, 9 cases had clinical manifestations of sudden hip pain, 7 cases had limited ability of walking and hip movement;all patients had no obvious injury history, non of the female patients was pregnant. All patients were followed up from 3 to 12 months, the following-up were topped after MRI when the symptoms disappeared for 3 months.

RESULTSThe MRI demonstrated diffuse bone marrow edema involving the femoral head, neck and the inter-trochanteric region, 13 hips of 10 patients with bone marrow edema included 6 cases in grade 1, 5 cases in grade 2,2 cases in grade 3; 9 hips with hip hydrarthrosis included 6 hips in grade I ,1 hip in grade II, 2 hips in grade III. After treatment for 3 to 12 months the hip symptoms of the patients disappeared and MRI images were normal.

CONCLUSIONMRI is useful in defining the location and extent of proximal femur bone marrow edema syndrome.

Adult ; Bone Marrow Diseases ; diagnosis ; pathology ; Edema ; diagnosis ; pathology ; Female ; Femur ; pathology ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Syndrome

Humans ; Muscular Dystrophy, Duchenne ; Research ; trends

Age-related macular degeneration ( AMD ) is a kind of age-related blinding degenerative fundus lesions, totally about 30 million patients suffering from AMD all over the world, with about 500 000 people blind for it yearly. As the development of economy and the aging of the population intensified, incidence of AMD indicates a trend of rising year by year, being the third major cause of blindness in our country. At present, the pathogenesis of AMD is not fully clear, as reported it may be related to oxidative stress, inflammatory immune response, VEGF and genetic manipulation. Clinical treatments mainly include photodynamic therapy, drug therapy, radiation therapy, laser photocoagulaory operation, the pupil warm treatments, Chinese medicine and intravitreous injection VEGF antagonists such as Ranibizumab, Conbercept and so on. ln this issue, we mainly expound on the progress in the epidemiological studies of AMD, especially elaborate the progress made on genetic manipulation in recent years.

Objective To analyse the clinicopathological characteristics of synovial sarcoma (SS) from histomorphology,immunohistochemical (IHC) and fluorescence in situ hybridization (FISH),and to investigate the related factors influencing the prognosis of SS patients.Methods 94 cases were collected,including 60 SS cases and 34 in dined to SS cases.The expressions of common antibodies related to the diagnosis of SS Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were detected by IHC,and the SYT-SSX fusion gene was detected by FISH.The clinical pathologic factors that affecting the prognosis of patients were analyzed through the statistical method.Results The positive rates of Vimentin,CD99,AE1/AE3,EMA,CD34,Calponin,Ki-67 were 100.00 ％,74.47 ％,36.17 ％,28.72 ％,17.02 ％,90.43 ％ and 60.64 ％ respectively.FISH results showed that 81 patients were tested with SYT gene translocation,including 54 cases who were considered as SS,and 27 cases who were suspected/inclined to SS,and the number of positive cells surpassed 80 ％.The gene translocation was not related with the patient' s age,sex,tumor position,histological type,differentiation of the cancer (all P ＞ 0.05).Single factor survival analysis showed that the degree of differentiation,tumor diameter,the recurrence and metastasis had certain influences on patients' survival time (all P ＜ 0.05).Multiple factors regression analysis showed that the degree of differentiation and tumor diameter were the risk factors influencing the prognosis of SS (risk coefficients ＞ 1,P ＜ 0.05).Conclusions IHC combined with FISH SYT-SSX fusion gene detection have the vital significance in the diagnosis of SS.The degree of differentiation and tumor size are the risk factors influencing the prognosis of SS.

Objective To analyze and summarize the cause of false positive results of the cervical liquid-based preparation screening,to improve the accuracy of cervical cytology diagnosis.Methods 20 353 cases were col-lected.The cytological diagnosis was statistically analyzed.Test positive results contrast analysis of the histologic diag-nosis was conducted.Cytological diagnosis of positive and histology diagnosis of non -neoplastic to review the original cytology.Results The incidence of 637 cases of cytology screening for positive.Among the 388 cases with histologic control,228 cases of histological diagnosis of abnormal change.Include:low -grade squamous intraepithelial lesion (LSIL),high -grade squamous intraepithelial lesion (HSIL),cervical squamous cell carcinoma (SCC),cervical ade-nocarcinoma(ACC),endometrioid carcinoma,malignamt melanoma.The other 160 cases did not check out the abnor-mal lesions.Conclusion Incidence of false positive results in 160 cases,accounting for 41.2%.It almost focused on atypical squamous cells of undetermined significance (ASC -US)and LSIL for a variety of reasons.Standardized work process should be taken to strengthen the training of the doctors,summarize continuously improve,as far as possi-ble to avoid false positive diagnosis.

Aim To investigate the effect of CD44 anti-body-A3 D8 on the expression of IL-3 Rα and down-stream PI3K/Akt in NB4 cells. Methods The ex-pression of IL-3 Rα mRNA was detected by real-time quantitative RT-PCR, the IL-3Rα protein expression and changes of PI3 K/Akt signal pathway in NB4 cells treated with A3D8 were analyzed by Western blot. An-nexin-V-FITC/PI double staining flow cytometry was u-tilized to detect the apoptotic cells. The inhibitor of PI3 K/Akt signaling LY294002 combined with A3 D8 was used to inhibit the PI3K/Akt in NB4 cells. Re-sults After treated with A3 D8 , both the transcription-al level and translational level of IL-3 Rα were remark-ably reduced, and the PI3K/Akt pathway was inhibi-ted. LY294002 improved the inhibitory and apoptotic effects of A3D8 on NB4 cells. Conclusion CD44 antibody A3 D8 can downregulate the expression of IL-3Rα and inhibit the downstream PI3K/Akt pathway.

Objective To explore the efficacy and safety of ticagrelor plus cilostazol of different dosage in the treatment of low-weight patients after PCI.Methods A total of 148 consecutive ACS patients (body weight ≤ 65 kg) past PCI and with aspirin intolerance were enrolled and randomly divided into four groups.Patients given cilostazol 50mg twice daily plus clopidogrel 75 mg daily were named as the CC50 mg group.Patients in the CC100 mg group were given cilostazol 100 mg twice daily plus clopidogrel 75 mg daily.The TCS0 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90mg twice daily and the TC100 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90 mg twice daily.All patients were followed up clinically for 6 months.The clinical endpoints were MACEs and bleeding events.Platelet aggregation at 7 and 30 days after treatment the incidence of clinical endpoints during followup were compared between the four groups.Results Patients in the TC100mg group had the lowest platelet aggregation rates tested on both the 7th and 30th day after treatment among all the 4 groups.After 6 months of follow up,the MACEs rate was not significantly different between the four groups (P =0.930).Bleeding events rates in the TC100 mg group the highest among the 4 but without groups significant differences.Conclusions In ACS patients with low body weight ≤ 65 kg) past PCI and with aspirin intolerance,cilostazol 50mg twice daily plus ticagrelor is a safe and efficacious therapeutic regimen.

Objective To evaluate the prognostic factors in locally advanced non-small-cell lung cancer (LA-NSCLC) for selectively carrying out prophylactic cranial irradiation (PCI).Methods 114 patients with LA-NSCLC between Jun 2006 and Oct 2010 were retrospectively analyzed. Related risk factors and features about brain metastases were analyzed.Results The 2-year incidence rate of brain metastases was 31.58 ％ (36/114),the first brain metastases was 20.18 ％ (23/114),and sole brain metastases was 9.65 ％(11/114),respectively.Variables involved in the equation of binary logistic regression analysis were pathology (OR =5.892) and treatment mode(OR =2.888).The incidence rate of brain metastases in patients of non-squamous carcinoma and single treatment mode was higher than others (P ＜ 0.01) Model fitting is better (P ＞ 0.05).Overall accuracy rate of predicting brain metastases is 67.7 ％.The increased rate of lactate dehydrogenase in the patients with brain metastases or death was 17.54 ％, which was higher than that in the survival patients without brain metastases (P ＜ 0.01).At the same time,the station number and the number of mediastinal lymph node metastases were positively correlated (r =0.716, P ＜ 0.01).The incidence rate of brain metastases or mortality rate was higher in the adenocarcinoma cases than that in the squamous carcinoma cases (P ＜ 0.01,P ＜ 0.05),with more frequent occurrence of mediastinal metastases.The mean diameter of squamous carcinoma and adenocarcinoma were 5.8 cm and 3.9 cm, respectively (P ＜ 0.01).Conclusions The incidence rate of brain metastases was higher in patients with single treatment.Large primary tumors, high lactate dehydrogenase, non-squamous carcinoma, multiple stations, and multiple mediastinal lymph nodes metastases can be regarded as risk factors of brain metastases to perform PCI.

OBJECTIVETo study the cause of X-ray misdiagnosis of the avascular femur head necrosis, so as to reduce the misdiagnosis rate and raise the early diagnosis level.

METHODSThe clinical and X-ray data of 99 patients(123 hips) with avascular femur head necrosis diagnosed by MRI were analyzed retrospectively. Among the patients, 56 patients were male and 43 patients were female,ranging in age from 21 to 84 years old,with an average of 53 years old. The patients had symptoms such as hip pain,functional restriction in flexion, adduction, abduction and internal rotation,and some patients had limping. The duration of the disease ranged from 1 week to 2 years.

RESULTSAmong 99 patients(123 hips),46 patients(52 hips) was misdiagnosed by the X-ray, the misdiagnosis rate was 42.27%, 100.00% in 0 stage, 100.00% in I stage, 83.67% in II stage, 18.18% in II stage, 0.00% in IV stage, 0.00% in V stage; the X-ray stage was negatively correlated with the rate of misdiagnosis. The careless film-reading and invigorating large enterprises while relaxing control over small ones was the main reason of misdiagnosis,then the lack of clinical histories and low-quality of X-ray projection.

CONCLUSIONThe relevant clinical history and comprehensive careful film-reading is the key to reduce the rate of misdiagnosis.

Adult ; Aged ; Aged, 80 and over ; Diagnostic Errors ; Female ; Femur Head Necrosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Radiography ; X-Rays

Objective To investigate the epidemiology and relevant risk factors of invasive fungal infection (IFI) in hospital old patients for non-respiratory tract. Methods Seventy-eight patients of IFI in non-respiratory tract were enrolled in this investigation. The incidence and risk factors of IFI were analyzed by prospective case-control study. Results In 78 old patients, 84 strains were isolated from different parts, and the most was Candida spp 82 strains (97.62%,82/84), followed by Candida albicans 55 strains (67.07%,55/82), Candida glabrata 13 strains ( 15.85%, 13/82), Candida krusei 6 strains (7.32%, 6/82), Candida tropicalis 4 strains (4.88% ,4/82), Candida parapsilosis 3 strains (3.66% ,3/82), Candida lusitaniae 1 strain ( 1.22%, 1/82). Aspergillus 2 strains (2.38%,2/84). Multivariate Logistic regression analysis showed that age, pathogen detection time, underlaying disease,glucocorticoids, immunosuppressants were the risk factors for IFI in non-respiratory tract. Conclusions Candida albicans is the main pathogens of Candida infections in old patients. To efficiently control the risk factors should be emphasized in old patients, including early diagnosis and treatment underlying diseases, appropriate use drugs, right to shorten hospital stay.