Six new sesquiterpenoid compounds of nerve-activity were synthesized from a gorgonian neurotoxin -subergorgic acid (1). Toxicological studies and structural correlation with toxicity reveal that subergorgic acid may act on cholinesterase and make a reversible inhibition of its activity of hydrolysis.

Objective To suty the MRI manifestations of juvenile acute articular cartilage injury of the knee joint.Methods MRI findings of cartilage,subcartilage low signal line and subcarilage bone were analysed retrospectively in 53 juvenile patients (ranged in age from 4~27 years) with acute articular cartilage injury confirmed by arthroscopy.Results Sixty-nine cartilage injuries were showed by MRI in 53 patients,including patellas in 25,femoral lateral condyles in 22,femoral medial condyles in 11,trochlea of the femur in 2,and tibial plateau in 9.Acute articular cartilage injury appeared as pure cartilage fracture in 46, including complete split of the cartilage in 22 sites,partly split of the cartilage in 20 sites,and fissur-like fracture in 4 sites.Osteochondral fracture were observed in 23 sites,including avulsion fracture in 13 and osteochondral subsided in 10.Articular cartilage loose bodies and osteochondral loose bodies were found by MRI in 6 and 13,respectively.Conclusion MRI is the best non-invasive method for studying cartilage injury.

Objective To explore the imaing features of hemangioma in the long bone and improve the diagnostic level of this disease. Methods The X-ray(14 cases), CT(9 cases) and MRI(6 cases)findings of 18 patientswith histologically proven hemangioma in the long bone after surgery were retrospectively reviewed. Results Ten tumors occurred in medullary cavity or bone end(medullary type),6 on the surface of bone (periosteal type) and 3 in cortex (intracortical type). X-ray findings: among 8 cases of medullary type, 3 showed honeycomb appearance, 3 lytic areas with sclerotic borders, one purely osteolyticchanges, and 1 frosted glass; 3 cases of periosteal type showed sclerosis and thickening of the underlying cortex; 3 cases of intracortical type showed well-defined osteolytic foci. CT findings: among 6 cases of medullary type, 5 appeared as expansile lytic lesion with uneven selerotic rim (3 cases)orhoneycomb appearance (2 cases), 1 cribriform appearance in the cortical bone, 2 periostealnew bone formation in vertical radiation pattern; 1 ground-glass appearance; among 2 cases of periosteal typeone showed regular cortical thickening, and the other irregular periosteal proliferation with marrowing of medullarycavity; 1 case of intracorticaltype showed density similar to that of soft tissue, with cortical thickening and expansion . MRI findings: 2 apeared as well-defined lesions with low signal intensity on T1WI and high signal intensity on T2WI; 1 appeared as ill-defined lesion with low to intermediate signal intensity on T1 WI and T2 WI. One showed breakthrogh of cortex and formation of soft tissue mass with low signal intensity on T1 WI and high signal on T2WI. Two showed thickening of periosteumwith intermediate signal intensity in one of them and very low signal intensity in the other. Two showed abnormal signal intensity in surrounding muscles, which was high on T2 WI and intermediate on T1 WI. Conclusions The soap-bubble or honeycomb appearance is the typical radiographic finding of hemangioma in long bone. CT and MRI can provide useful information for the diagnosis of hemangioma in long bone.

Objective To explore the image quality of 3.0 T Magnetic Resonance foot and ankle array coil on Achilles tendon ab-normalities for the clinical application.Methods 26 patients (with Achilles tendon symptoms)and 5 volunteers underwent MR exam-ination.The scanning sequences were used:T1 WI、PDWI、T2 WI-FS and STIR.Image diagnoses and clinical data of all patients were obtained and analyzed.Subjective scores on image quality were used.Degrees of comfort in coil were evaluated.Results 10 patients had Achilles tendon inj ury,6 patients with Achilles tendonitis,3 patients with part Achilles tendon rupture,1 patient with tendon xanthoma,and 6 patients were normal.Image scores in patients with T1 WI、PDWI and T2 WI-FS sequences were higher,the anatom-ic structures,lesions of whole Achilles tendon were clear.On the contrary,the lower scores were in STIR sequences.In the heel, images were distorted,the level of organization was disappeared and signal intensity was increased.The volunteers felt a slight dis-comfort at the coil entrance and support point of the heel.Conclusion Patients using 3.0T foot and ankle array coil for the Achilles tendon scanning could get high image quality and degrees of comfort.

Objective To study the feasibility of diffusion tensor imaging(DTI) in assessment of lumbosacral neuropathy. Methods Eighteen patients with lumbosacral neuropathy (experimental group) and 20 healthy volunteers (control group) were enrolled prospectively in the neurological department by clinical symptoms and neuroelectrophysiology. The experimental group were divided into experimental subgroup A(demyelination group, 6 cases),subgroup B(axonal injury with demyelination group, 12 cases) based on electrophysiology.All of L4-SN nerves of the experiment group and the control group received DTI examination."Sowing points"as ROIs were placed in the proximal, middle and distal of bilateral L4-SN nerves by two experienced physicians.The average of the DTI parameters of 3 ROIs at each nerve were used as its final DTI parameters.Independent sample t test was used to evaluate the difference of the L4-SN DTI parameters between the experimental group and the control group.The differences of DTI parameters among the control group, the experimental subgroup A and the experimental subgroup B were compared by the nonparametric independent samples Kruskal-Wallis H test and the Nemenyi test. The ROC analysis was performed on the FA values and λ⊥values of the control and experimental groups.Results (1)The L4-SN FA values in the experimental group was significantly lower than those in the control group (t range from 4.11 to 6.36, P<0.05). The L4 and S1-SN ADC values of the experimental group were significantly higher than those of the control group (t range from - 4.77 to - 1.17, P<0.05). The L4-SN λ ⊥ values in the experimental group were significantly higher than those in the control group (t range from -5.30 to -2.57，P< 0.05). (2) L4-SN FA values (H values ranged from 18.5 to 30.6, P<0.05), λ⊥ values (H values ranged from 6.8 to 29.2, P<0.05) and L4, S1-SN ADC values (H values ranged from 6.8 to 19.6, P<0.05) were significantly different among control group, experimental subgroup A and experimental subgroup B. Nemenyi test showed there were significant differences in FA values (H values ranged from 18.4 to 30.1,P<0.05) and λ⊥ values (H values ranged from 6.2 to 29.0, P<0.05)) of L4-SN and in ADC values (H values ranged from 6.4 to 19.54, P<0.05) of L4，S1-SN between control group and experimental subgroup B. (3) The analysis of ROC of the experimental group and control group showed the AUC values of L4-SN FA values were 0.834, 0.745, 0.860, 0.772, 0.811 respectively, the sensitivity were 66.7%, 72.2%, 77.8%, 83.3% and 66.7% respectively, and the specificity were 91.7%,69.4%,80.6%,61.1% and 88.9% respectively. The AUC values of L4-SN λ⊥ values were 0.796, 0.656, 0.791, 0.701, 0.843 respectively, and the sensitivity were 55.6%, 50.0%, 66.7%, 97.2% and 88.9% respectively,and the specificity were 91.7% , 77.85% , 86.1% , 36.1% and 66.7% respectively. Conclusion DTI has the feasibility to evaluate lumbosacral neuropathy and it can identify patients with axonal injury with demyelination and healthy subjects.

A patient with steroid-resistant acute rejection 50 days after ABO-compatible orthotopic liver trans-plantation(LT)received regular infusion of allogeneic mesenchymal stem cells(MSCs)after three ses-sions of steroid pulse therapy which failed to control the pathogenetic condition as shown by biopsy.Liver function improved gradually after intravenous injection of MSCs once weekly for 10 weeks(as confirmed by biopsy)and remained stable under administration of conventional immunosuppressive agents.There was no evidence of neoplasms 5 years after treatment.MSCs infusion appears to suc-cessfully reverse resistance to immunosuppressive agents and may be a useful treatment for post-liver transplant steroid-resistant rejection.

Objective To investigate the effect of 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma. Methods One hundred and eighteen patients of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from February 2011 to August 2015 were prospectively enrolled and randomly divided into two groups by table of random number, including observation group (3S jejunal interposition) and control group (esophageal remnant gastric posterior wall anastomosis), with 59 patients in each group. Postoperative complications, operative time, nutritional parameters and postoperative quality of life were compared between two groups. Results The operation time in observation group was (152.3 ± 13.1) min, in control group was (146.0 ± 12.5) min, and there was no significant difference (P>0.05). The rate of complication in observation group was 8.5%(5/59), in control group was 13.6%(8/59), and there was no significant difference (P>0.05). The levels of total protein, albumin, hemoglobin, and Vitamin B126, 12, and 18 months after operation in observation group were significantly higher than those in control group (P<0.05). The rate of reflux esophagitis 6, 12 and 18 months after operation in observation group was significantly lower than that in control group (P<0.05). The gastric emptying time 6, 12 and 18 months after operation in observation group was significantly prolonged, compared with that in control group (P<0.05). The scores of whole quality of life, emotional function, body function, pain, tired, appetite, nausea and vomiting, diarrhea and constipation 6 and 18 months after operation in observation group were significantly better than those in control group (P<0.05). Conclusions The 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma is a better method. The effect of antirelux is better and can improve the nutriture and quality of live for long time.

Objective: To investigate the clinical value of Bayesian network in predicting survival of patients with advanced gallbladder cancer(GBC)who underwent curative intent surgery. Methods: The clinical data of patients with advanced GBC who underwent curative intent surgery in 9 institutions from January 2010 to December 2015 were analyzed retrospectively.A median survival time model based on a tree augmented naïve Bayes algorithm was established by Bayesia Lab software.The survival time, number of metastatic lymph nodes(NMLN), T stage, pathological grade, margin, jaundice, liver invasion, age, sex and tumor morphology were included in this model.Confusion matrix, the receiver operating characteristic curve and area under the curve were used to evaluate the accuracy of the model.A priori statistical analysis of these 10 variables and a posterior analysis(survival time as the target variable, the remaining factors as the attribute variables)was performed.The importance rankings of each variable was calculated with the polymorphic Birnbaum importance calculation based on the posterior analysis results.The survival probability forecast table was constructed based on the top 4 prognosis factors. The survival curve was drawn by the Kaplan-Meier method, and differences in survival curves were compared using the Log-rank test. Results: A total of 316 patients were enrolled, including 109 males and 207 females.The ratio of male to female was 1.0∶1.9, the age was (62.0±10.8)years.There was 298 cases(94.3%) R0 resection and 18 cases(5.7%) R1 resection.T staging: 287 cases(90.8%) T3 and 29 cases(9.2%) T4.The median survival time(MST) was 23.77 months, and the 1, 3, 5-year survival rates were 67.4%, 40.8%, 32.0%, respectively.For the Bayesian model, the number of correctly predicted cases was 121(≤23.77 months) and 115(>23.77 months) respectively, leading to a 74.86% accuracy of this model.The prior probability of survival time was 0.503 2(≤23.77 months) and 0.496 8(>23.77 months), the importance ranking showed that NMLN(0.366 6), margin(0.350 1), T stage(0.319 2) and pathological grade(0.258 9) were the top 4 prognosis factors influencing the postoperative MST.These four factors were taken as observation variables to get the probability of patients in different survival periods.Basing on these results, a survival prediction score system including NMLN, margin, T stage and pathological grade was designed, the median survival time(month) of 4-9 points were 66.8, 42.4, 26.0, 9.0, 7.5 and 2.3, respectively, there was a statistically significant difference in the different points(P<0.01). Conclusions The survival prediction model of GBC based on Bayesian network has high accuracy.NMLN, margin, T staging and pathological grade are the top 4 risk factors affecting the survival of patients with advanced GBC who underwent curative resection.The survival prediction score system based on these four factors could be used to predict the survival and to guide the decision making of patients with advanced GBC.