Objective To evaluate the value of MRI in the diagnosis of complex congenital heart disease.Methods Twenty-one patients with complex congenital heart disease,who had undergone MRI examination were enrolled in this research.The MRI data of every patient was analyzed and abnormalities of anatomy was counted by two experienced cardiovascular radiologist.Surgical diagnosis (17 cases) or consistent diagnosis (4 cases) of ultrasonic,cardiac catheter and cardiac CT was regarded as reference standards.Accuracy and misdiagnosis rate were obtained.Results Twenty-one patients had 63 main abnormalities,61 malformations was found by MRI examination,the diagnostic accuracy was 96.8％,and the misdiagnosis rate was 4.8％ (1 atrial septal defect (ASD) and 1 major aorta pulmonary collateral arteries (MAPCAS) were missed,1 arterialduct stump was misdiagnosed as patent ductus arteriosus (PDA).Conclusion MRI has excellent diagnosticaccuracy on complex congenital heart disease,it is another good noninvasive cardiac examination method beside ultrasonic.

Objective To explore the value of 64-slice CT coronary artery angiography in detecting anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) in infants. Methods Ten children aged from 5 months to 2 years and weighed from 5.5 to 10.0 kilograms with surgical confirmed ALCAPA were underwent contrast-enhanced retrospective ECG-gated 64-slice CT, and the data were retrospectively analyezd. Scanning were performed with 80 kV tube voltage, 150 mA tube current, 0.35 s rotation time, 0.625 mm slice thickness and 0.2 pitch. Results The heart rate ranged from 110 to 150 beats per minute. All images were good enough for diagnosis. The radiation dose was 1.11-1.62 mSv. The left coronary arteries were found to originate from the posterior-right sinuse in 4 patients, from posterior-left sinuse in 4 parients, from posterior-right wall and inferior wall above the pulmonary sinuses in 1 patient, respectively. Conclusion The 64-slice CT coronary artery angiography can reveal the location of the ectopic ostium and the course of left coronary artery in ALCAPA infants with low radiation dose.

Objective To evaluate the imaging features of benign fibrous histiocytoma (BFH).Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia (n =5 ),femur ( n =3),fibula ( n =1 ),sacrum ( n =1 ),and thoracic vertebrae ( n =1 ).X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions ( n =3 ) were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.

Objective To investigate the relationship between the tumor differentiation and the related pathologic factors in Esophago-gastric junction adenocarcinoma. Methods The pathological data from 163 patients of Esophago-gastric junction adenocarcinoma underwent radical surgical resections were randomly divided two groups (group1: well-differentiated,group2: poor-differentiated). The composition of N stages,T stages,morphological type and vessel carcinoma embolus were compared between the two groups ,respectively. The tumor sizes and the number of metastases lymph nodes were compared between the two groups. Results The cases with lower N stages or T stages in group1 were dominant(T1 and T2:55. 74%,N1 and N2:75.41%). Oppositely,those with higher N stages or T stages were dominant(T3 and T4:59.81%,N1 and N2:57.85%)in group 2. The differences were significant Incidence of vessel carcinoma embolus was 44. 26%(27/61)in group 1 and 63. 73%(65/102)in group 2,with a significant difference. There was no significant difference for morphological type in the two groups. The tumor sizes and the number of metastases lymph was 4. 27 ±2. 00 cm and 4. 15 ±5.27 respectively in group 1 ,and 5. 87 ± 3. 26 cm and 8. 80 ± 7.65 respectively in group 2. The differences were significantly different(Ps ＜ 0. 01).Conclusions The tumor differentiation has significant effect on N stages,T stages,vessel carcinoma embolus,tumor size and the number of metastases lymph nodes in Esophago-gastric junction adenocarcinoma.

Objective To explore the diagnostic value of post processing techniques of MSCT for diagnosing congenital heart disease associated with tracheobronchial stenosis in children. Methods Thirty four patients with congenital heart disease complicated by tracheobronchial stenosis were evaluated with MSCT. MPR, CPR, MinIP and VR were performed to show the tracheobronchial morphology. Findings in 43 segments of 32 cases were compared with the findings of surgical operation. Mann-Whitney test was employed to assess the significance of measurement between the post processing techniques and the operation. Results The lenghth of stenotic segments were variable seen at operation, with values between 4-39 mm in trachea, 4-33 mm in main bronchi and 3-12 mm in lobe bronchi, respectively. The biggest difference between the measurement of operation and MSCT was 4 mm (3 segments). Other differences ofstenotic segments were within 3 mm. Six segments exhibitee mild, 16 moderate and 21 severe stenosis at surgery. By contrast, five segments exhibited mild, 17 moderate and 21 severe stenosis by MPR or CPR,2 mild,9 moderate and 32 severe stenosis by MinIP and 4 mild, 11 moderate and 28 sever stenosis by VR,respectively. There was no significant difference in measuring the degree of tracheobronchial stenosis between MPR or CPR, VR and the surgery (Z =-0. 105,- 1. 479;P ＞0.05), while MinIP frequently overrated the degree of stenosis compared with the measurement at surgery (Z=-2.484,P =0. 013). Conclusion The integrated three dimensional reformations of MSCT scan can accurately evaluate the degree and extent of congenital heart disease associated with tracheobronchial stenosis in children and provide valuable information for clinical management.

Objective To characterize the clinical factors which influence water suppression and auto-shimming line width for liver 3.0 T 1H-MRS.Methods Fifty-seven cases with liver 1H-MR spectroscopy(1H-MRS) were retrospectively studied, including chronic type B hepatitis (n=5), fatty liver (n=14), chronic type B hepatitis combining fatty liver (n=3) and normal situation (n=35).Independent t test was used to characterize the difference of general condition (height, weight, body mass index etc.) between different water suppression effect groups and between different shimming effect groups.Using Chi-square test to analyze whether water suppression rate and auto-shimming line width between fatty liver groups and non-fatty liver exist significance difference .Results By comparing WS ≥90% (n=47)group with WS < 90% (n=10) group, the former showed smaller average height[(164.7±8.0) and (170.5±3.7) cm respectively], weight[(61.8±10.4) and (73.4±5.4) kg respectively], BMI [(22.7±3.2) and (25.2±1.3)kg/m2 respectively]and LW[(17.7±3.7)and(24.6±6.3) Hz respectively]than the latter (t=-3.488,-3.415,-4.002 and-3.327, P < 0.05).By comparing LW 20 Hz (n=41) group with LW 20 Hz (n=16) group, the former showed better water suppression rate [(93.0±2.7)% and (86.1±8.5)% respectively]than the latter(t=3.213,P <0.05), whereas larger weight[(62.2±11.6) and (68.1±6.1)kg respectively]and BMI[(22.8±3.4) and (24.2±1.9)kg/m2 respectively](t=-2.516,-2.024,P <0.05).LW≤20 Hz in the fatty liver and non-fatty liver group was 7/17 and 34/40, respectively (X2=11.347, P < 0.05).WS < 90% in the fatty liver and non-fatty liver group was 10/17 and 0/44, respectively (X2=28.536, P < 0.05) .Conclusion Hepatic steatosis exerts an adverse effect in water suppression and shimming.

Objective To establish a function model to modulate the tube current according to the chest circumference at Coronary CTA scan,and to evaluate the feasibility of using the function model individually.Methods Sixty-eight consecutive patients who underwent thoracic scan with automatic current modulation were studied to establish a function model of tube current and chest circumference.The other 64 consecutive patients underwent coronary CTA scan using the new function model.The image quality was scored,and the noise,tube current and radiation dose were recorded and statistically evaluated.Results The POW function model was the best one to adjust tuber current to the chest circumference (R2 =0.691,P ＜ 0.05).The mean image quality score,noise,tube current,radiation dose (CTDIvol) and dose-length product (DLP) were (3.38±0.72) scores,(31.02 ±3.97) HU,(390.63± 89.30) mA,(34.83±10.72) mGy,(751.67 ±175.16) mGy·cm,respectively.Conclusions Tube current modulation based on the chest circumference would be feasible to reduce the radiation dose individually in coronary CT angiography.

Objective To explore the use of Swedish medical company CMS 4.6.4 radiotherapy XIO system for the design process of cervical cancer postoperative IMRT plans in different iterative times of the same case,and to observe the Segment Weight Optimization(SWO)effect generated after the plan results.Methods Ten cases of cervical cancer patients were chosen ,the use of XIO 4.6.4 CMS treatment system was performed for the development of the intensity modulated radiation therapy .In the SWO process , iterative times were used to generate different plans ,without affecting the clinical dose target area requirements , and compared the organs at risk( OAR) by determining whether there were differences between dose and the number of segments ,monitor units (MU).Results For the same patients,different iterative times within a certain range of SWO IMRT plan were selected to compare the different iterative times plan ,femoral head,rectum and the bladder dose did not change the basic plan.The total number of segments and MU did not change significantly (P>0.05).Conclusion IM-RT plans in the use of CMS XIO 4.6.4 design of cervical cancer after operation in the process of using the itera-tive times below 100 times for SWO is the most suitable method for ensuring the organ dosimetry in radiotherapy . The total number of segments and the MU reduces the radiotherapy plan time so as to improve work efficiency .

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression. Methods Sixty-nine cases of depression were randomly divided in?to study group (n=35 patients) and control group (n=34 patients). The study group received duloxetine combined with 1Hz rTMS treatment on the right dorsolateral prefrontal cortex area for 6 weeks whereas the control group received duloxetine combined with pseudo-rTMS treatment for 6 weeks. The Hamilton Depression Rating Scale (HAMD-24) and Treatment Emergent Symptom Scale (TESS) were used to assess the clinical efficacy and the adverse reactions before, 2, 4 and 6 weeks after the treatment, respectively. Results Four patients (two from each group) dropped out of the study. The main effects of time (P<0.001) and groups (P=0.029) were significant and so was the interactive effect of time and group (P<0.001). The clinical curative effect of the study group were significantly better compared with the control group at the 2, 4, 6 weeks following treatment (P<0.001). The adverse reactions were mild in these two groups. Conclusions The combi?nation of 1 Hz rTMS with duloxetine is superior to either medication alone for the treatment depression.

Background Schizophrenia patients are often accompanied by negative symptoms and severe cognitive impairment,but effective interventions intended to alleviate such condition are currently limited.Existing researches on group play therapy for schizophrenia is still in its initial stages,and such therapy has the potential to contribute to symptoms improvement.Objective To explore the efficacy of group play therapy on improving cognitive function and negative symptoms in hospitalized female patients with schizophrenia,so as to provide references for clinical intervention in such group.Methods This study involved 40 female patients with schizophrenia who received inpatient treatment at the Third People's Hospital of Fuyang from April 2022 to May 2023 as well as met the diagnostic criteria of the International Classification of Diseases,tenth edition(ICD-10).They were divided into study group(n=20)and control group(n=20)according to the random number table method.Both groups received routine treatment,and the study group received 10 sessions of group play therapy for 5 weeks on the basis.At baseline,Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptoms(SANS),Self-rating Depression Scale(SDS),Nurses' Observation Scale for Inpatient Evaluation(NOSIE),and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)were used for assessment.Post-therapy evaluation was conducted by using SAPS,SANS and RBANS.Patients' baseline SAPS scores,SANS scores,RBANS total scores,and various factor scores of RBANS were used as covariates,and covariance analysis was adopted to compare the scores of each scale between the two groups after treatment.Results A total of 39 patients went through the whole study.Results of covariance analysis showed that the SANS score of study group was lower than that of control group,while several scores of RBANS(including total score,immediate memory factor score,speech function factor score and attention factor score)were all higher than those in control group.Significant difference was observed between two groups in scores of both scales above(F=13.408,10.331,4.932,9.967,10.010,P<0.05 or 0.01).Conclusion Group play therapy may help improve negative symptoms and cognitive function in hospitalized female patients with schizophrenia.