Objective To evaluate the clinical application of percutaneous biopsy CT-guided in spine lesions.Methods CT-guided percutaneous biopsy in spine lesions was performed in 53 cases,the final diagnosis was confirmed by operation or following-up. Results The accurate rate was 85 percent for CT -guided percutaneous biopsy in spine lesions without complication.The reason of misdiagnosis was mainly that the biopsied lesions was incorrect. Conclusion The perfect percutaneous needle is the successful key for biopsy in spine lesions, we should coordinate the relationship between imaging diagnosis and percutaneous bone biopsy.

Objective To observe the changes of the bilateral hippocampal volume (BHV) and 1H-MRS appearance of chronic alcohol dependent (CAD) patients and to provide quantitative information for the clinical diagnosis of CAD. Methods The conventional MR imaging including three-dimensional fast spoiled gradient recalled echo (3D-FSPGR) and 1H-MRS were performed on 16 patients with CAD (CAD group)and 18 cases of volunteer ( control group). The BHV were measured in both groups and the standardized BHV in CAD group and control group were compared. 1H-MRS metabolites including N-acetylaspartate (NAA), Choline compounds (Cho), Creatine (Cr), and myoinositol (mI) of the bilateral cephalic hippocampus were acquired. The ratios of Cho/Cr, Cho/NAA, NAA/Cr and mI/Cr within the bilateral cephalic hippocampus of the two groups were compared. The t test was used to compare the BHV and the ratios of 1H-MRS in the bilateral cephalic hippocampus between the two groups. Results In CAD group,the left and the right hippocampal volume were 1. 881 ±0. 292, 2. 139 ±0. 328 respectively while they were 2. 106 ±0. 245 and 2. 267 ±0. 271 respectively in the control group. The BHV had no significant difference between the left and the right in either the CAD group or the control group (t =0. 232, 0. 147 respectively,P ＞ 0. 05). The BHV had no significant difference between the CAD group and control group(t = 0. 424,0. 131 respectively ,P ＞0. 05 ). The Cho/Cr and NAA/Cr in the right cephalic hippocampus of the CAD group were 1. 225 ±0. 210 and 1. 145 ±0. 034 respectively, while they were 1. 429 ±0. 286, 1. 612 ±0. 444 respectively in the control group(t =0. 321,0. 408 ,P ＜0. 05 ). The Cho/NAA, mI/Cr in the right cephalic hippocampus and the Cho/Cr, Cho/NAA, NAA/Cr and mI/Cr in the left cephalic hippocampus between the two groups had no statistically significant difference. Conclusion 1H-MRS could potentially provide early diagnostic evidence for CAD patients before the onset of cerebral morphological changes.

Functional magnetic resonance imaging (fMRI), a newly developing technique, contains function, anatomy and image, which makes the real-time, dynamic and non-invasive measurement of the functional brain imaging availability. This paper summarized the characteristics of fMRI in health and stroke populations, introduced the advances of fMRI in neuroplasticity, rehabilitation assessment and prognosis in hand movement dysfunction in patients with stroke, and discussed the difficulty fMRI faced in rehabilitation assessment and the further researches.

Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus (T2DM).Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate (eGFR),and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR ＜60 ml/min 1.73 m2 was 10.56％.The difference of renal function in participants with different age and gender was significant(x2 =6.306,P =0.012;x2 =269.293,P ＜ 0.001).Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein (LDL),total cholesterol (TC) and triglycerides (TG),uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.

Objective To investiagte the serum adiponectin concentration in preeclampsia and its relationship with serum leptin and soluble leptin receptor levels.Method The level of adiponectin,leptin and soluble leptin receptor in serum were measured by enzyme-linked immunosorbent assay(ELISA)in 38 patients with preeclampsia and 42 patients as control.The relationship of free leptin index(leptin/soluble leptin receptor) to preeclampsia was analyzed.Results There were no significant differences in maternal age,gestational age and body mass index(BMI)between two groups.But the gestational age and birth weight were significantly lower in preeclampsia than in control.The patients with preeclampsia had significantly higher levels of serum adiponectin, leptin and free leptin index(1691.7?g/ml,37.5 ng/ml and 0.95 respectively)than the control(689.4?g/ml, 19.3 ag/ml and 0.49,respectively).But there was no significant difference in serum level of soluble leptin receptor between the groups(35.0 ng/ml vs 42.2 ng/ml).Serum adiponectin was not significantly correlated with the level of leptin,soluble leptin receptor and free leptin index.Area of serum adiponectin,leptin and free leptin index in preeclampsia under the ROC curve were less than 0.5.Conclusions The patients with preeclampsia have paradoxical higher serum levels of adiponecfin and more bioavailability of leptin,suggesting these may be important factom of this complication.

AIM:To evaluate optical quality, intraocular scatter, and determine the impact of retinopathy on optical quality in macular edema(ME)patient by using the Optical Quality Analysis System(OQAS^TMⅡ).

METHODS: This was a prospective case-control study. Fifty-eight eyes of 49 macular edema patients who were confirmed by ophthalmic examination in our hospital from August 2019 to January 2020 were selected as the ME group, and 30 eyes of 30 healthy volunteers who were matched with gender and age range for the study were selected for the normal control group. The clinical data of the two groups of patients were recorded. Under the same test conditions, the same operator used OQAS^TMⅡ to check the visual quality of the study object, including the cutoff of the modulation transfer function(MTF cutoff), strehl ratio(SR), OQAS^TMⅡ values(100%, 20%, 9%)and contrast levels(OV100%, OV20%, OV9%). The difference of data between the two groups were analyzed, and the correlation between the visual quality and the thickness and volume of the macular fovea in the ME group were analyzed.

RESULTS: The average best corrected visual acuity in the macular edema group was significantly lower than the control group, and the thickness and volume of macular fovea were significantly higher than the control group(P<0.001). Compared with the control group, the OSI of the macular edema group was significantly higher, and MTF cutoff, SR value, OV(100%, 20%, 9%)significantly decreased(P<0.001). In the macular disease group, the thickness of macular fovea was positively correlated with OSI(r=0.566, P<0.001), while MTF cutoff(r=-0.336, P=0.010), OV100%(r=-0.326, P=0.013), OV20%(r=-0.349, P=0.007)and OV9%(r=-0.321, P=0.014)were negative correlation, but it had no correlation with SR. In the macular edema group, the volume of macular fovea was positively correlated with OSI(r=0.574, P<0.001). It was negatively correlated with MTF cutoff(r=-0.367, P=0.005), SR(r=-0.265, P=0.045), OV100%(r=-0.351, P=0.007), OV20%(r=-0.385, P=0.003)and OV9%(r=-0.375, P=0.004).

CONCLUSION: The optical quality of patients with macular edema is lower than the normal population, and the changes in macular retina morphology and thickness could affect the optical quality and intraocular scattering. The optical quality parameters measured by OQAS^TMⅡ may provide new clinical reference for macular function evaluation.

Objective To explore the significance of signal classification by multimodal magnetic resonance imaging(MRI)(including conventional MRI,diffusion imaging,and susceptibility-weighted imaging)on neonatal punctate white matter lesions(PWML).Methods Between March 2011 and February 2013,neonates with PWML who underwent 3.0T MRI examination were recruited.The routine protocols included T1 weighted imaging (T1WI),T2 weighted imaging(T2WI),diffusion tensor imaging(DTI),and 3D-enhanced susceptibility-weighted angiography(ESWAN).Apparent diffusion coefficient(ADC)map,magnitude image,and phase image were obtained from DTI and ESWAN,respectively.The signal of PWML was one-to-one observed on T1WI,T2WI, ADC map and magnitude image.The combined signals were classified and the number of cases of each type was counted.Results Totally 84 neonates with PWML were included(preterm/term,47/37).Seven signal types were found and classified into three groups: ① Type Ⅰ was the most,59 cases,accounting for 70.24%,with the performance of high-signal intensity on T1WI,low-signal intensity on T2WI,low-signal intensity on ADC map,and high-signal intensity on magnitude image. ② Type Ⅱ,7 cases,accounting for 8.33%,high-signal intensity on T1WI,low-signal intensity on T2WI,low-signal intensity on ADC map,and low-signal intensity on magnitude image.③ Type Ⅲ - Ⅶ,26 cases,accounting for 30.95%,high-signal intensity on T1WI,low/iso-signal intensity on T2WI,low/iso-signal intensity on ADC map,high/iso-signal intensity on magnitude image.There was no significant difference in the incidence of different signal types between preterm and full-term PWML neonates. Conclusion Magnetic resonance signal may reflect the characteristics of PWML lesions.Signal classification of PWML by multimodal magnetic resonance imaging is helpful in determining injury type and has certain significance in guiding clinical treatment.

OBJECTIVETo evaluate the correlation of venous return disturbance (VRD), bone marrow edema (BME) and the amount of joint fluid with clinical symptoms in osteonecrosis of the femoral head (ONFH).

METHODSTwenty patients (25 hips) with ONFH proved by pathology were parallelly examined by 1.5 T MR and medullograph.

RESULTIn total 25 hips VRD was observed in 16 hips with medullograph and 13 hips with the clinical symptoms (P <0.05). BME was found in 17 with MRI (P <0.01), and the was found in 15 hips with MRI (Spearman=0.949). VRD were found in 16 hydrarthrus.

CONCLUSIONONFH patients with clinical symptoms have VRD, BME and the hydrarthrus. The medullograph is of value in monitoring the development of ONFH.

Adult ; Bone Marrow ; pathology ; physiopathology ; Edema ; pathology ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; pathology ; physiopathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Regional Blood Flow ; physiology ; Veins ; physiopathology

Objective To construct RNAi combinant adenoviral expressive vectors specific to p65 subunit of NF-?B and to observe their gene silencing effect on p65 subunit.Methods Three pairs of complementary. single-strand DNA oligos targeting three various sites of p65 mRNA were designed and synthesized.Annealling was used to generate double-strand oligos(ds-oligos),and then the ds-oligos were cloned into pENTR~TM/u6 to generate the entry clone named pENTR.Recombination reaction in vitro with the pENTR and pAd/BLOCK-iT~TM- DEST was used to creat the adenovirus plasmid which contains the RNAi cassette.Then,the adenovirus plasmids digested with PacI were transfected into HEK293A cells to product adenovirus,and latter infected the HEK293A cells to amplify the adenoviral stock.Plaque forming assay was used to titer the adenoviral stock.The p65 gene silencing effect induced by the RNAi adenovirus was detected by Western blot and immunocytochemistry assay in ECV304 cells.Results The RNAi adenovirus specific to p65 subunit of NF-?B were produced with titer of 3.0 x 10~9pfu/ml to 2.5?10~10pfu/ml.The expression of p65 protein in ECV304 cells could be down-regulated efficiently by the RNAi adenovirus 48-72 h after infection,which would last for more than 6 days after infection.Conclusion RNAi adenovirus is an important tool inhibiting the expression of target gene efficiently.

OBJECTIVEThe objective of this study is to review cerebrospinal fluid leakage (CSFL) after thoracic decompression and describe its regular and special features.

DATA SOURCESLiterature cited in this review was retrieved from PubMed and Medline and was primarily published during the last 10 years. "Cerebrospinal fluid", "leakage", "dural tears", and "thoracic decompression" were the indexed terms. Relevant citations in the retrieved articles were also screened to include more data.

STUDY SELECTIONAll retrieved literature was scrutinized, and four categories were recorded: incidence and risk factors, complications, treatment modalities, and prognosis.

RESULTSCSFL is much more frequent after thoracic decompression than after cervical and lumbar spinal surgeries. Its occurrence is related to many clinical factors, especially the presence of ossified ligaments and the adhesion of the dural sac. While its impact on the late neurological recovery is currently controversial, CSFL increases the risk of other perioperative complications, such as low intracranial pressure symptoms, infection, and vascular events. The combined use of primary repairs during the operation and conservative treatment postoperatively is generally effective for most CSFL cases, whereas lumbar drains and reoperations should be implemented as rescue options for refractory cases only.

CONCLUSIONSCSFL after thoracic decompression has not been specifically investigated, so the present study provides a systematic and comprehensive review of the issue. CSFL is a multi-factor-related complication, and pathological factors play a decisive role. The importance of CSFL is in its impact on the increased risk of other complications during the postoperative period. Methods to prevent these complications are in need. In addition, though the required treatment resources are not special for CSFL after thoracic decompression, most CSFL cases are conservatively curable, and surgeons should be aware of it.

Cerebrospinal Fluid Leak ; diagnosis ; Decompression, Surgical ; adverse effects ; Humans ; Incidence ; Postoperative Complications