Objective To review the MR image findings in patients with neurofibromatosis type 1 (NF1) and to analyze the MR sequences and their diagnostic value so as to establish an adequate MR imaging protocol to supply the valuable imaging data for the diagnosis of NF1 Method Thirty patients fulfilling the NIH diagnostic criteria for NF1 were examined with the following MR imaging protocol, which mainly included: Axial SE T 2WI; Sagittal SE T 1WI without contrast; Axial or Sagittal SE T 1WI with contrast; Axial or Coronal FLAIR At the same time the characteristics of the disease including sites, numbers, shapes, and changes of intensity and enhancement of the lesions were recorded and analyzed Results There were three forms of lesions being demonstrated on MRI: (1) Multiple intracranial hamartomas: Hyperintense lesions on T 2WI and FLAIR images in 25 out of 30 patients (83%), which mainly located in the globus pallidus, cerebellums, and brainstems There was no definite enhancement with Gadolinium 20 out of 25 patients (80%) showed diffuse higher intensity in the region of hippocampus or parahippocampus gyrus, thalamus, and around the aqueduct (2) Optic pathway or hypothalamus glioma: Enlargement or/and elongation of the optic nerves and optic chiasms on STIR images; Masses in the region of the optic chiasm or hypothalamus with mixture high intensity on T 2WI and FlAIR images Significant and irregular enhancement was seen on SE T 1WI (3) Multiple neurofibromas in the spine: Multiple bulky tumours extending along the spinal nerves were shown on SE T 2WI and STIR images with higher signals Conclusion MR is suitable for routine imaging investigation in diagnosis and follow up of NF1 Our MR imaging protocol for NF1 could show multiple abnormalities of NF1 better

Objective To assess the value in detecting the tracheobronchial tree invasion by central lung cancer (CLC)using MSCT axial images and 4 kinds of images post-processed techniques.Methods 38 cases with CLC identified by fibrobrochoscopy or operation were scanned using MX8000 scanner with slice thickness of 3.2 mm, overlapping interval of 1.6 mm, pitch of 1.0. Multiplanar reformation(MPR), shaded surface display(SSD), volume rendering (VR) and virtual endoscopy(VE) were performed in all cases. Two radiologists assessed the invasion of tracheobronchial tree by CLC together.The imaging findings were compared with the data of surgery in 12 cases who were undergone operation.Results 38 cases of CLC, 0 grade to Ⅳ grade were assessed in 0,8,14,11 and 5 cases respectively by MSCT axial images, while in 0,10,11,12 and 5 cases by MSCT post-processing images. The concordance rate was 75% for MSCT axial images(n=9), and 100% for MSCT post-processing images(n=12) among 12 cases performed operation(? 2 test,? 2=6.0,P

Objective To discuss the clinical values of virtual endoscopy (VE) using multislice computed tomography (MSCT) in diagnosis of the aorta and iliac artery diseases.Methods MSCT angiography in 36 cases suspected of the aorta and iliac artery diseases and 40 cases underwent abdominal examination were performed, then all CT virtual endoscopy (CTVE) were obtained at the vessel with suspected lesions on work-station, and the relations between the quality of images and scanning parameters were observed.Results All internal and dual-cavity were seen in 10 cases of aortic dissection; enlarged cavity of aneurysm were showed in 16 aortic aneurysms. Calcification plaques were displayed in 48 cases. One endograft and one postoperative aorta were seen the morphology and the location of stenosis. One case of iliac artery obstruction was displayed obstructive cavity on the image of CT virtual endoscopy.Conclusion The quality of CT virtual endoscopy is related to the scanning technique,scanning parameters, motion aritiact. CT vitrtual endoscopy is the important complementary to maximum intensity projection, multiplannar reformation, surface shadow display, and axial images, and has high value in the diagnosis, treatment, and follow-up of the aortic diseases

BACKGROUND:Diffusion tensor imaging aad fiber tractography(DT-FT)is the only method to identify cerebral white matter fiber organization in vivo.OBJECTIVE:To observe the changes in brain areas with language function and the fiber stucture in patients with Broca aphasia.DESIGN,TIME AND SETTING:Comparative observation was performed at First Hospital of Kunming Medical College and Tiantan Hospital of Capital Medical University between November 2003 and February 2005.PARTICIPANTS:Thirty patients(9 females,21 males,aged 17-63 years)with Broca aphasia of different degree were selected.They were diagnosed by a set of Chinese aphasia examinations of Research Laboratory of Neuropsychology,First Hospital of Beijing Medical University,following by further classification according to the subitems.METHODS:3T super-high field magnetic resonance scanner was used for the data collection and processing of the entire brain.Brodmann areas 45,44,areas 22 and 39(Wernicke area),and the corresponding brain areas in the right hemisphere are selected as areas with language function.The primary commissure,commissural fibers(arcuate fasciculus,internal capsule,external capsule)that are closely correlated with language function were regarded as region of interest of fiber tracking.The neural fiber tracking was conducted.MAIN OUTCOME MEASUIURES:The tracking and distribution of neural fiber tracts,and its correlation with other brain areas,and changes under pathological conditions.All data were compared with normal brain.RESULTS:Thirty patients with Broca aphasia were included in final analysis.The mean fractional anisotropy of fiber tracts in left Brodmann areas 45 and 44 was significantly lower than that in normal Brodmann areas(t=-2.683 65,-5.300 55,P＜0.05).The inferior fiber tracts in Broca area showed interruption or displacement,loosely connected even separate from the frontal arcuate fasciculus.The fibers of precentral gyrus and medial frontal lobe were decreased.The separation of arcuate fasciculus from Broca area caused by the integrity disruption and displacement of fiber tracts of arcuate fasciculus was the main alteration of arcuate fasciculus in Broca aphasia.The number of fiber tracts of left arcuate fasciculus and the mean fractional anisotropy in Broca aphasia were significantly less than normal people(P＜0.05).CONCLUSION:The lesions of cerebral cortex and its fiber pathway in Broca area can result in Broca aphasia.

According 1o the genome sequences of α.β,e,ι toxins of Clostridium perfringens in GenBank,four pairs of primers targeting α,β,ε,ι toxin genes were designed.After the multiplex PCR reaction condition was optimized,the multiplex PCR for identification and toxintyping of C.perfringens strains was developed.The specificity test showed that the expected fragments of C.perfringens reference strains including A.B,C,D,E five toxin types were amplified successfully from genomic DNA of C.perfringens,respectively.However,a band could not be amplified from Clostidrium novyi and Clostridium septicum as negative control groups.The sensitivity test showed that the limit detection of multiplex PCR was 9.0,17.8,12.2,13.8,18.5 pg DNA of A,B,C,D,E five toxin types C.perfringens,respectively.Repetitive testing showed that the established method had a good repeatability.Nine type A strains of and 1 type C strains of C.Perfringens from 21 clinical samples of dead goat were detected by the multiplex PCR developed in this study.This study establishes the multiple PCR method which not only can detect C.perfringens rapidly but also can identify five toxin types of C.perfringens.

Objective The aim of the study is to evaluate clinical efficacy and safety of azatreonam or ceftazidime on treatment of lower respiratory tract infection .Methods Four English databases (MEDLINE、EMBASE、Pubmed、Cochrane li‐brary) and three Chinese databases (CNKI、VIP、WANFANG) were searched .Meta‐analysis was performed using Review Manager 5 .2 .Results The Meta‐analysis revealed azatreonam was superior to ceftazidime in total efficiency (RR=1 .15 ,95%CI is 1 .09‐1 .21) .No significant differences are seen between azatreonam and ceftazidime (RR=1 .03 ,95% CI is 0 .98‐1 .09) on the bacterial eradication rates or the incidence of adverse reactions (RR=0 .66 ,95% CI is 0 .39‐1 .12) .Conclusion Azatreonam is more effective than ceftazidime on the treatment of lower respiratory tract infection in the clinical practice .

Objective:To retrieve and analyze the relevant guidelines for the second and third stages of normal delivery, and summarize the evidence of high-quality guidelines so as to provide references for the formulation of clinical practice programs.Methods:We took Johns Hopkins evidence-based nursing practice model as theoretical guidance and set up an evidence-based team.We systematically searched major guideline publication websites, electronic resource databases, related academic groups and guideline networks at home and abroad, evaluated guidelines and summarized the best evidence, and the search time limit was up to June 1, 2019. The literature quality evaluation and evidence extraction were carried out independently by four researchers with evidence-based training.Results:This study included two guidelines, summarizing the 20 best evidences in 9 aspects of humanistic support, delivery companion, delivery position, fetal monitoring, delayed exertion, perineal protection, fundus compression, prevention of postpartum hemorrhage, and delayed umbilical cord clamping.Conclusions:Based on the existing evidence, it integrates the best evidence of nursing measures for the second and third stages of normal delivery. It is recommended that maternal and child institutions promote the transformation of the best evidence based on their actual conditions.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.