Objective To explore the color dopplor imaging feature of atypical persistent hyperplastic primary vitreous(PHPV) and its value in differential diagnosis of white pupil. Method Color doppler ultrasonic detection was used to observe various types of white pupil, and the follow up analysis was performed. Results Among 15 eyes of 12 patients,3cases were bilaterally abnormal.Typical PHPV imaging was displayed in 11 eyes and atypical PHPV imaging was showed in 3 eyes.One eyes with retinoblastoma was wrongly diagnosised as PHPV.The arterial flow signal was detected in the central part of hyperplastic vitreous body in 11 eyes. Conclusion The arterial flow signal in hyperplastial vitreous body was a essential evidence in the diagnosis and differential diagnosis of PHPV.

ObjectiveTo investigate the diagnostic value of ultrasound on patients with papillary thyroid carcinoma(PTC) coexisted with Hashimoto thyroiditis(HT).Methods The preoperative ultrasonography data of 2144 cases with PTC from January 2006 to December 2011 who treated with operation and diagnosed by pathology were analyzed retrospectively.Among them,265 cases coexisted with HT (PTC coexisted with HT group),1879 cases were not coexisted with HT (non-PTC coexisted with HT group).ResultsMost of the cancerous nodes in two groups exhibited in the ultrasonographic performance just like irregular shape,unclear boundary and so on (P ＞ 0.05).Most of the cancerous nodes in non-PTC coexisted with HT group exhibited hypoechoic nodules with microcalcifications,those in PTC coexisted with HT group exhibited various internal echoes with mainly microcalcifications,and the coarse calcification occupied a certain proportion(P＜ 0.01 ).The cancerous nodes in PTC coexisted with HT group were not rich in blood flow compared with non-PTC coexisted with HT group,but mostly exhibited blood disorders.When compared with non-PTC coexisted with HT group,the rate of ultrasound diagnosis in PTC coexisted with HT group was lower [ 52.8 ％( 140/265 ) vs.75.0 ％ (1409/1879),P ＜ 0.01 ],and the false positive rate in lymph node was higher [84.0％(487/580) vs.74.8％ (77/103)] (P ＜0.05).ConclusionsThe nodules are malignant when they appear as hypoechoic solid nodules,have unclear boundary and have microcalcifications should be highly suspected.The hyperechoic solid nodules or coarse calcification nodules should also be awared and taken further observation of the characteristics around the echoes and the internal blood flow,making comprehensive analysis to determine whether it could be malignant transformation and try best to reduce the misdiagnosis and missed diagnosis rates of this disease.

Objective To evaluate the usefulness of functional magnetic resonance imaging (fMRI) as a noninvasive method in recording the activities of the human brain as excited by low frequency current(LFC) stimulator. Methods The right common peroneal nerves of 6 healthy volunteers were stimulated with LFC (NMR-II stimulator). The activities of the brain were then recorded and evaluated during the scanning by the fMRI technique. Data obtained during the study were dealt with with the software SPM99. Results In both cerebral hemispheres, the area where the postcentral and superior temporal gyrus, inferior parietal lobule met were excited, and so were the operculum at both sides. Postcentral gyrus, superior parietal and paracentral lobule, and the precuneus in the left cerebral hemisphere, as well as the superior occipital gyrus and the superior parietal lobule in the right hemisphere,were involved as the excited areas. Conclusion fMRI is a useful tool for recording and evaluating the brain activities excited by LFC.

Objective To compare the influence of cryopreservation duration on quality of rozen-thawed embryo and clinical outcome in frozen-thawed transfer cycles. Methods A retrospective study was performed to evaluate the clinical outcomes and quality of rozen-thawed embryo of frozen embryo transfer(FET)cycles includ-ing freezing cycles and vitrification cycles. FET cycles were divided into 4 group acorrding to the storage duration of vitrified embryos:1~6 months group ,7~12 months group ,13~24 months group and ≥ 25 months group. Result There was no significant difference in recovery rate ,clinical pregnancy rate and abortion rate (98.1%, 99.0%,96.8%&95.7%;54.4%,55.4%,49.6%&51.5%;0.7%,8.9%,9.4%&11.1%;P>0.05). The embryos recovery rate and clinical pregnant rate after vitrification were significantly higher than programmed freezing (P<0.05). The blastocyst recovery rate in group A was significantly higher than the cleavage stage embryo recov ery rate in group B(P<0.05). Conclusions Vitrification has better effects on cryopreservation and clinical outcomes. Blastocyst may be the best stage for vitrifying and freezing of embryo.

Objective To explore the perioperative management and surgical outcomes of fracture-dislocation of the upper cervical spine complicated with vertebral artery injury.Methods We retrospectively analyzed the clinical data of 19 patients diagnosed with fracture-dislocation of the upper cervical spine complicated with vertebral artery injury who had been treated at our department from January 2008 through December 2012.They were 14 males and 5 females,aged from 22 to 53 years (mean,35.2 years).All the patients had fractures of the atlas and/or axis,and disordered atlanto-axial relationship as well.According to Frankel grading system,8 cases were Grade D and 11 Grade E.The cervical posterior fixation with pedicle screws was adopted for all and hemostasis was conducted for those with bleeding from the broken vertebral artery.Their Frankel grade,Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) score were compared between preoperation and final follow-up.Results Intraoperative hemorrhage occurred in 2 patients from the injured vertebral artery.Hemostasis was achieved through direct tamponade with bone wax and gelatin sponge in one and through endovascular intervention after bleeding control by direct tamponade in another.Neither of them presented with symptoms of posterior circulation ischemia after operation.The mean operation time was 153.5 min,and the mean blood loss was 542.1 mL.All the patients were followed up for an average time of 28 months.Bony union was obtained in all after an average time of 13.5 weeks.Follow-ups revealed no ischemic stroke in this series.Symptoms of transient ischemic attack,like transient dizziness and blurred vision,appeared in 2 patients.At the final follow-up,all the patients were assessed as Frankel Grade E.Their mean JOA and VAS scores were significantly improved from 8.1 ± 1.2 and 7.0 ± 1.7 preoperatively to 12.7 ± 1.6 and 1.3 ± 1.2,respectively (P ＜ 0.05).Conclusions Angiography examination is routinely indicated for the patients with fracture-dislocation of the upper cervical spine perioperatively.Preoperative evaluation of the vertebral artery and its adjacent structures and effective intraoperative hemostasis can avoid uncontrollable bleeding during operation,reduce postoperative complications,and improve surgical outcomes.

Objective To discuss the value of prenatal ultrasound and MRI in diagnosis of fetal agenesis of corpus callosum (ACC). Methods Sixty-seven fetuses from Hubei Maternal and Children's Hospital performed fetal MRI from July 2013 to December 2014 were included in this study. All fetuses (67 cases) with suspected ACC were studied with a 1.5T MR unit within 3 days after ultrasound examination. Prenatal ultrasound and MRI findings were studied. Results All the 67 ACCs previously suspected on ultrasound were confirmed by MRI. Among the 67 ACCs, 58 cases were complete ACC and 9 cases were partial ACC. Corpus callosum body and/or splenium absence was found in all 9 partial ACC cases. In all cases, on MRI, corpus callosum complete or partial absence was showed on the median sagittal images, and mild to moderate ventriculomegaly and abnormal morphology in lateral ventricle was shown on the axial or coronary images. Conclusions MRI has high value in diagnosis of ACC. When ACC is found or suspected by ultrasonophy, MRI examination is suggested to confirm the diagnosis.

ObjectiveTo explore the imaging features of fetal tuberous sclerosis complex by ultrasonography and magnetic resonance imaging.MethodsRetrospective analysis on the imaging characteristics of the 10 cases of fetuses confirmed as tuberous sclerosis complex who were examined in Hubei Maternal and Child Healthcare Hospital in July 2013 to December 2014 by ultrasonography and MRI, which was compared with the pathological data of specimens and follow-up after birth.ResultsEighteen cases were diagnosed as fetal cardiac rhabdomyoma by ultrasonography among all of the 996 fetuses, in which lesions were located on the ventricular wall near septum or elsewhere in the heart cavity on ultrasonography. Fetal cardiac rhabdomyoma was characterized by circular, homogeneous high echo (singleton in 4 cases, multiple in 14 cases). Among them no subependymal nodule was found by ultrasonographic. Ten cases of subependymal nodule were found by magnetic resonance imaging, which were diagnosed as tuberous sclerosis complex with cardiac rhabdomyomas, including 3 cases of brain subcortical tubers. The subependymal nodules under the lateral ventricle wall showed characteristic low signal nodules on T2WI, protruding from the ependymal surface. Of 18 cases, only 4 cases of fetal cardiac rhabdomyoma were found by MRI. Nine cases of ifnally had termination of pregnancy. Two cases were conifrmed as cardiac rhabdomyoma with intracranial nodules after pathological examination, and 1 case was conifrmed as tuberous sclerosis complex after birth. ConclusionsPrenatal ultrasonography can diagnose fetal cardiac rhabdomyoma successfully, and MRI can diagnose the fetal brain nodules sensitively. Once ultrasonography finds cardiac rhabdomyoma, it may be promising to diagnose fetal tuberous sclerosis complex by ultrasonography combined with MRI.

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.

Objective To investigate the diagnostic value of ultrasound and MRI in fetal bronchopulmonary sequestration (BPS). Methods The 7 pregnant women with suspected fetal BPS were examined with a 1.5 T MR unit within 24 h after prenatal ultrasound in Hubei Maternal and Children's Hospital during July 2013 to February 2015. The imaging protocol included half-fourier acquisition single shot turbo SE (HASTE), true fast imaging with steady state precession (True FISP) in axial, frontal and sagittal planes relative to the fetal thorax. Prenatal MRI findings have been compared with postnatal enhanced computed tomography or biopsy. Results The locations of BPS were in left side in 5 cases and in right side in 2 cases. One case was complicated with congenital cystic adenomatoid malformation (CCAM) of lung. Ultrasound showed the intrathoracic mass as a hyperechoic lesion and the feeding artery could be found by Doppler ultrasonography. T2WI could reveal not only the hyperintense lesions with clear boundary, but also the hypointense feeding artery originating from systemic circulation. Compared with pathological examination or enhanced CT, both of the ultrasound and the MRI could locate the lesions;however 2 feeding arteries were misjudged. Conclusions Prenatal ultrasound is the first-choice diagnostic modality for BPS. MRI can demonstrate the location, morphology and the feeding arteries of the fetal BPS, and also estimate the volume of normal lungs, which could be an important supplement to prenatal ultrasound in prenatal diagnosis and prognostic prediction of BPS.

Objective To analyze the risk factors of low birth weight (LBW) in infants who were conceived through flesh embryo transfer after in vitro fertilization.Methods We retrospectively reviewed the medical records of 4 930 live babies born after in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University between January 2011 to December 2016.They were 3 474 singletons and 1 456 pairs of dizygotic twins.According to their birth weight,all singletons were divided into two groups:the LBW singleton group (＜2 500 g,n=252) and the control singleton group (≥ 2 500 g,n=3 222).Two dizygotic twin groups,the LBW dizygotic twin group (＜2 500 g,n=1 014) and the control dizygntic twin group (≥ 2 500 g,n=442),were set up as well.Clinical characteristics of the infants in different groups and risk factors of LBW were analyzed.Independent samples t-test,Mann-Whitney U test,Chi-square test,and logistic regression were used for statistical analysis.Results (1) The rates of LBW were 7.25％ (252/3 474) in singletons and 69.64％ (1 014/1 456) in dizygotic twins.(2) In singleton pregnancies,the maternal body mass index (BMI) of the LBW group was lower than that of the control group [(20.9± 2.8) vs (21.3 ± 2.7) kg/m2,t=-2.162,P=0.031],while the rates of preterm delivery and blastocyst transfer were higher [61.7％ (153/252) vs 5.7％ (182/3 222),8.7％ (22/252) vs 5.1％ (163/3 222),x2=814.232 and 6.234,respectively,all P＜0.05].(3) In dizygotic twin pregnancies,maternal age,paternal age,the rate of preterm delivery and estradiol (E2) level [M(P25-P75)] at trigger were higher than those of the control group [(31.0±3.7)vs (30.5±3.9) years,(33.7±5.0) vs (32.7±4.5) years,63.0％ (631/1 014) vs 28.0％ (123/442),11 362.3 (7 549.2-16 716.1) vs 10 444.8(7 079.4-14 569.9) pmol/L;the values of t or x2 or Z were-2.498,-3.680,150.295 and-2.570,all P＜0.05].(4) Multivariate logistic regression analysis revealed that preterm delivery,maternal BMI＜18.5 kg/m2 and girl baby were independent risk factors for LBW in singleton pregnancies (adjusted OR=28.45,1.59 and 1.45,95％CI:20.87-38.80,1.06-2.41 and 1.06-1.97,all P＜0.05).Preterm delivery,high E2 level at trigger (＞10 970 pmol/L) and different gender of twins were independent risk factors for LBW in dizygotic twin pregnancies (adjusted OR=4.51,1.35 and 1.45,95％CI:3.50-5.82,1.06-1.74 and 1.09-1.93,all P＜0.05).Conclusions High maternal serum E2 level after controlled ovarian stimulation (COS) in fresh embryo transfer cycle may be one of the risk factors for LBW in twin pregnancies.