Objective To analyze the MRI characteristics of hematospermia seminal vesiculitis(HSV) and evaluate the diagnostic value of MRI in HSV. Methods The MRI parameters of 25 HSV patients underwent magnetic resonance imaging(MRI) imaging with SE T 1WI(TR/TE 558/14ms), Flash 2D water excitement(TR/TE 18.5/5.2ms), TSE T 2WI(TR/TE 4000/99ms) and fat suppression sequences were retrospectively analyzed. Results The bilateral seminal vesicles in all 25 patients with HSV enlarged. On SE T1-weighted images, intraseminal vesicle hemorrhage appeared as high signal intensity, which appeared more bright on Flash 2D water excitement sequence. The hypointensive duct wall of seminal vesicles could be clearly seen because of hyperintensive hemorrhage. On TSE T2-weighted images, intraseminal vesicle hemorrhage appeared as relatively lower signal intensity, and the duct wall of seminal vesicles could not clearly be depicted for being covered with relatively hypointensive hemorrhage. Conclusion Hematospermia seminal vesiculitis could be identified by MRI, and MRI was the best imaging method for examining hematospermia seminal vesiculitis.

Objective To make spinal cor injury model of rabbit in order to investigate the feasibility and accuracy of diffusion tensor imaging in diagnosis of early ASCI. Methods In 30 Chinese rabbits ,24 rabbits were randomly selected as the experimental group and the other 6 as the control group. Allen′s technique were used to make moderateacute spinal cord injury in the experimental group. In the control group ,the operation only exposed the spinal membrane ,wihthout damage on the spinal cord. All rabbits were performed in routine MRI , DTI ,diffusion tensor tractography and post-processing. After the MRI scan ,the rabbit spinal cord was removed to have pathological examination at 1 ,3 ,5 ,7 days. Results The number of inflammatory cells and spinal motor neurons were closely correlated with FA values and ADC values. DTT images showed the spinal cord defects, curling and breaking. Conclusion The parameters of DTI (FA ,ADC) can reflect the pathological changes of acute spinal cord injury in early stage ,and therefore may be used as an routine evaluation method for clinical acute spinal cord injury.

Objective To evaluate the short-term efficacy, safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with radioactive 125I seed implantation in treating advanced non-small-cell lung cancer (NSCLC). Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study. The patients were divided into study group (n = 26) and control group (n = 22). Patients in the study group were treated with EGFR-TKIs combined with radioactive 125I seed implantation; while patients in the control group only received EGFR-TKIs treatment, which was kept on until the disease progressed. The clinical efficacy, and the incidence of side effect as well as the survival rate were determined, and the results were compared between the two groups. Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively, the difference was statistically significant (P= 0.033), while the effective rate was 76.9% and 54.5%respectively, the difference was not significant (P=0.101). Progression-free survival (PFS) time of the study group and the control group was 14.1 months and 9.7 months respectively (P< 0.05). The one-year survival rate of the study group and the control group was 80.8%and 63.6%respectively (P<0.05), and the median survival time was 26.9 months and 17.1 months respectively (P < 0.05). The major complication caused by radioactive 125I seed implantation was pneumothorax. Conclusion For EGFR mutation-positive advance NSCLC, EGFR-TKIs together with radioactive 125I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy. At present, this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.

Objective:To explore the application effect of optimizing diet management in patients with hyperphosphatemia.Methods:Seventy-seven patients who underwent regular hemodialysis in the blood purification department of the First Affiliated Hospital of Guangxi Medical University from September 2018 to June 2019 were selected. Patients were randomly divided into control group (39 cases) and intervention group (38 cases) by the method of random number table. The control group received routine nursing, while the intervention group received optimized dietary management intervention. The blood phosphorus, blood calcium, hemoglobin, albumin, dietary phosphorus related knowledge level and phosphorus control diet compliance of the two groups before and after the intervention were compared respectively.Results:After 3 months of intervention, the scores of knowledge about food phosphorus, compliance of phosphorus control diet and total score of the intervention group were (22.00±3.92), (34.82±4.69) and (56.82±7.48) points, which were higher than (18.46±3.57), (30.54±3.52) and (49.00±6.13) points of the control group, the difference was statistically significant ( tvalues were 4.146, 4.536 and 5.022, P<0.05). After 6 months of intervention, the scores of knowledge about food phosphorus, compliance of phosphorus control diet and total score of the intervention group were (25.74±3.36), (41.63±5.27) and (67.37±7.67) points, which were higher than (20.97±3.81), (32.36±4.38) and (53.33±6.80) points of the control group, the difference was statistically significant ( tvalues were 5.815, 8.403 and 8.504, P<0.05). After 3 months of intervention, the blood phosphorus level in the intervention group was 1.81 (1.67, 2.10) mmol/L, which was lower than 2.13 (1.87, 2.32) mmol/L in the control group, the difference was statistically significant ( Zvalue was-3.237, P<0.05). After 6 months of intervention, the blood phosphorus level in the intervention group was 1.75 (1.63, 1.91) mmol/L, which was lower than that in the control group 1.90 (1.83, 2.13) mmol/L, and the difference was statistically significant ( Zvalue was-3.343, P<0.01). Conclusion:Optimizing dietary management can improve patients' knowledge level of food phosphorus and dietary compliance of phosphorus control, effectively reduce blood phosphorus level, and have no obvious effect on nutritional status.

Objective To investigate the reasons and the methods of prevention and cure for serious complications of radiofrequency ablations in the treatments of hepatocellular carcinomas. Methods A total of 410 patients with BCLC at A or B stage of hepatocellular carcinomas in our hospital were enrolled between November 2014 and June 2009. These patients underwent a total of 504 times radiofrequency ablations for the treatments of liver lesions. This retrospective study analysed the reasons and the strategies of prevention and cure for the serious complications. Results In the patients with a total of 504 times radiofrequency ablations, 2 patients had massive hemorrhage caused by puncture injuries, 2 patients had the tumors which were close to the liver capsules and 1 patient had bile peritonitis caused by the injury of thermal ablation on the gallbladder. The maximum diameter of tumor was 5 cm. That tumor was close to the gallbladder. 2 patients had needle tract metastases caused by incompletely needle path ablations. 1 of the 2 patients had a tumor near the liver capsule, and the other patient had un-enough temperature for needle path ablation. Tumor outbreaks were happened in 2 patients. 1 of the 2 patients had a tumor which was located in the liver capsule and close to the portal vein. The other patient had a 12 cm diameter tumor with rich blood supplement. 2 patients had liver abscesses. 1 of the 2 patients had a tumor near the ascending colon, and the other patient had diabetes. 1 patient had colonic perforation caused by thermal ablation. The tumor in that patient was located in the right hepatic lobe segment and adjacent to the ascending colon. The incidence of serious complications was 1.98% (10/504). Conclusions The incidence of the serious complications of radiofrequency ablations for the treatments of hepatocellular carcinomas is relatively low. The main reasons for the serious complications were direct injuries caused by punctures, heat radiation injuries, tumors adjacent to large blood vessels, gallbladders and intestines, tumors with abundant blood supplement, needle paths fail to cross normal liver tissues, low scores of liver function, weak immune system and diabetes. The key points for avoiding and reducing the serious complications are preoperative evaluations of patients' basic situations, choices of appropriate puncture channels and control ranges of ablations when tumors are close to important blood vessels, intestines and gallbladders.

Objective:To investigate the correlation between the enhancement characteristics in arterial phase and the prognosis of patients with massive intrahepatic cholangiocarcinoma (IMCC).Methods:The imaging and clinical data of 92 patients with IMCC who were pathologically confirmed and underwent enhanced MRI or CT in Central Hospital of Lishui from June 2004 to February 2019 were retrospectively analyzed. According to the enhancement pattern of the primary lesion in the arterial phase, patients were divided into rich arterial blood supply group （17 cases） and deficient arterial blood supply group （75 cases）. The clinical data and imaging features of these patients were studied. Differences between measurement data and count data between the two groups were compared using t test and Fisher test. Kaplan-Meier analysis and log-rank test were used to analyze overall survival. The Cox regression multivariate analysis was used to study the relationship between the variables and the risk of death. Result:The enlargement of lymph nodes, long diameter of the primary lesion, CA19-9, treatment and HPD around the primary lesion in arterial phase were statistically different in the two groups ( P<0.05), others were no statistical difference. CA19-9>200 U/ml, lymph node enlargement, HPD around the primary lesion in arterial phase and deficient arterial blood supply were independent factors for the prediction of prognosis in IMCC patients with surgery ( P values were 0.008, 0.002, 0.049 and 0.005, respectively). Lymph node enlargement and deficient arterial blood supply were independent risk factors for the prediction of prognosis in IMCC patients with surgery ( P values are 0.049 and 0.045, respectively). Conclusion:The blood supply characteristics of arterial phase are independent factors for the prognosis of patients with IMCC.

Objective To analyze the echocardiographic findings , associated anomalies and chromosomal characteristics in fetuses with pulmonary atresia with ventricular septal defect ( PA/VSD ) . Methods T he echocardiographic data and follow‐up materials were retrospectively reviewed in 30 256 fetuses from December 2012 to M arch 2018 in the consultation center of fetal heart disease in maternal‐fetal medicine in Anzhen hospital . Of all the fetuses ,59 cases ( 0 .19% ) had PA/VSD . T he echocardiographic findings ,associated anomalies and chromosomal characteristics were retrospectively analyzed in all the 59 fetuses with PA/VSD . Based on w hether the presence of the native pulmonary arteries and the major aortopulmonary collateral arteries ( M APCAs) or not ,the PA‐VSD was classified into type A ,type B ,and type C . Results A large ventricular defect was demonstrated in five‐chamber view with 61 .7% of the mean ratio of the aortic overriding . O ther fetal echocardiographic features of all the 59 fetuses with PA/VSD included :the right aortic arch ( n ＝19 ) ,reversal flow in the ductus arteriosus ( n ＝40 ) ,M APCAs ( n ＝24) . T he classification of the PA/VSD included :type A ( n ＝35) ,type B ( n ＝5) and type C ( n ＝19) . Associated anomalies :persistent left superior vena cava ( n ＝ 13 ) ,anomalous pulmonary vein connection ( n＝5 ) ,complete atrioventricular septal defect ( n ＝ 5 ) ; single umbilical artery ( n ＝ 3 ) ,right atrial isomerism ( n ＝3) . Of all the 30 cases performed chromosomal test ,3 cases had aneuploidy and 7 cases had microdeletion of chromosome . Conclusions The fetal echocardiographic findings of the PA/VSD are characteristic . For prenatal diagnosis of PA/VSD ,the type of PA/VSD should be defined and chromosomal test should be performed ,w hich can be helpful for prenatal consulting .

AIM: Previous studies have suggested that big stick design (BSD) method can only be used in clinical trials of two treatments with equal proportion, which has good statistical performance and has become the recommended choice of randomized methods. This study expands BSD method, so that it can be applied to three groups, and provides more randomized methods for clinical trials. METHODS: On the basis of BSD method used in two treatments with equal proportion, the derivation conditional allocation probability of BSD method used in three treatments with equal proportion was carried out. BSD method was compared with simple randomization (SR) method, permuted block design (PBD) method and block urn design (BUD) method by Monte-Carlo simulation in balance and randomness. RESULTS: In terms of balance, PBD method was the best, followed by BUD method, BSD method, and SR method was the worst. In terms of randomness, SR method was the best, followed by BSD method, BUD method and PBD method. The comprehensive performance showed that BSD method was better than BUD method, PBD method and SR method. CONCLUSION: The expanded BSD method used in three treatments with equal proportion has good comprehensive performance, and it can be the recommended randomization method for clinical trials of three treatments with equal proportion.