Objective To investigate the imaging features of intra-osseous ganglia surrounding the ankle joints and their diagnostic value.Methods Imaging features of 40 cases of intra-osseous ganglia proved by the pathology from 1 982 to 2012 were analyzed ret-rospectively.33 cases underwent radiography,26 cases underwent computed tomography (CT)and 13 cases underwent magnetic resonance imaging (MRI).Results Intra-osseous ganglia were detected at talus in 23 cases,distal tibia in 1 5 cases (8 cases in pos-terior melleolus,6 cases in medial melloulus and 1 case in anterior part of distal tibia),and lateral malleolus in 1 case.Multiple in-tra-osseous ganglia was detected in 1 case,which located in both talus and posterior malleolus.29 cases were oval,monolocular os-teolytic lesions.1 1 cases were multilocular lesions with separation.All cases were observed with slightly sclerous edge.Articular surface disruptions were observed in 1 5 cases,and lesions were connected with the joint space.① Oval cystic translucent areas with sharp and sclerous edge adjacent to the ankle joint were observed in 34 lesions of 33 cases on radiograph.Cracks were noted on the articular surface of 12 lesions.② Round translucent areas with sharp and sclerous edge were observed in 26 isolated lesions on CT images.Cracks were noted on the articular surface of 14 lesions.③ 14 lesions of 13 cases showed low to moderate signal on T1 WI and high signal on T2 WI.Cracks were observed in 4 lesions adjacent to the ankle joint,and soft tissue swelling was noted in 6 le-sions.Conclusion Intra-osseous ganglia can be diagnosed accurately based on the typical imaging features and special locations.

ObjectiveTo evaluate the feasibility,safety and therapeutic efficiency of laparoscopic total mesorectal excision (TME) with anal sphincter preservation in the treatment of the middle-lower rectal cancer.MethodsFrom February 2008 to June 2010,37 patients with middle-lower rectal cancer received laparoscopic TME with anal sphincter preservation,while 45 patients underwent conventional open TME with anal sphincter preservation according to their wills.The operative procedures,postoperative recovery,postoperative complication and short-term outcome were collected and compared between the two groups.ResultsBlood loss was (60.6 ± 20.9) mL in laparoscope group which was significantly less than that in laparotomy group (P＜0.01),time for bowel movement retrieval and hospital stay were (3.3 ±0.6) and (9.2 ±2.8) days respectively,which were significantly shorter than those in laparotomy group (P ＜ 0.01 ).The incidence of postoperative complications was 8.1％ in laparoscope group,which was significantly lower than those in laparotomy group (P ＜ 0.05 ).The mean distance between resected margin and the tumor,the mean number of disected lymph nodes were not different between the two groups.The rate of sphincter preservation was 91.9％ in laparoscope group,which was higher than those in laparotomy group (73.3％) ( P ＜ 0.05 ).All patients were followed-up from 6 to 36 months,the recurrent rate and overall survival rate were 10.8％ and 94.6％ in laparoscope group,with no significant difference compared to those in laparotomy group (11.1％ and 91.1％,P ＞ 0.05).ConclusionsLaparoscopic TME with anal sphincter preservation which achieved the same effect of oncological clearance is a safe and feasible procedure for middle-lower rectal cancer,with less postoperative complications and better recovery after treatment,and enhances the rate of sphincter preservation,which is worthy of clinical application.

ObjectiveTo analyze the reasons of complications after laparoscopic gastrectomy with D2.MethodsThe clinical courses of 150 cases who suffered from gastric cancer treated by laparoscopy in the First Affiliated Hospital of Yangzhou University from March 2007 to December 2010 were retrospectively analyzed.ResultsFourteen cases showed complications after operation,the rate being 9.33％ (14/150).The remaining patients with postoperative complications were discharged after treatment,no death occurred during the perioperation.ConclusionEnhancing the refinement of surgical operations,the postoperative observation and the management of drainage tube are the key to the prevention and treatment of complications after laparoscopic gastrectomy.

Objective To evaluate the clinical and radiological features of Gorham disease. Methods Clinical and radiological features of Gorham disease were retrospectively analyzed by reviewing the eleven cases from our hospital and the cases reported in the domestic literature in the past fifty years. The diagnoses of all these 11 patients were in accordance with the diagnostic criteria established by Wells and Gray et al. All patients had X?ray plain film, four had CT scan and five had MR examination, with one had additional contrast?enhanced MR examination. Results There were 7 males and 4 females, age ranged from 16 to 66 years with a median age of 32 years. There were six cases involving hand, one involving ulnar and radial bones, one involving acetabulum and three involving jaw bones. The main clinical manifestations were pain, swelling, limited activity, and focal muscular atrophy occurred in 7 cases. On X?ray plain films, the affected bone became thin and the cortexes were not smooth and became coarse in 6 cases. Local lucent area was seen in 5 cases and massive bone absorption was seen in 6 cases. The residual bones showed a tapering appearance in 1 case. Pathological fracture occurred in 1 case. On CT scans, the affected bone became thin and the cortexes became coarse in 4 cases. Local lucent area was seen in 1 case. Massive bone absorption was seen in 3 cases. The adjacent muscular atrophy and widened intermuscular fat space occurred in 2 cases (atrophic bone absorption). On MRI, normal signal intensity of bone marrow disappeared and demonstrated low signal on T1WI and high signal on T2WI. The signal could be homogeneous or heterogeneous. There were widespread strip and patchy high signal areas in the soft tissue around the absorption areas in 4 cases, which resembled the edema?like signal. In 1 case, there was irregular widespread soft tissue mass around the absorption areas with heterogeneous high signal on T2WI. The adjacent muscle showed atrophy, and the intermuscular fat space became wide. There were a total of 92 cases reported cases in the literature including our 11 cases. There were 63 males and 29 females. The onset age ranged from 10 to 40 years in 66/92(72%)cases. The lesion affected one bone in 24 cases, affected two or more bones in 68 cases, out of which 9 cases had single center distribution, 59 cases had multiple centers distribution. Pectoral girdle, pelvis, maxillofacial bones, and hand were the most common sites of involvement in decreasing order. Forty three cases had muscle atrophy and 8 cases had soft tissue mass. Conclusion Gorham disease should be considered when atrophic bone absorption in one bone or continuous bones occurs that does not match clinical symptoms, with soft tissue atrophy but no bone sclerosis or periosteal reaction in the osteolytic areas.

Objective To investigate the etiology,clinical manifestations,diagnosis and outcomes of lichen scrofulosorum (LS).Methods Clinical data collected from 7 infants with LS,who visited Department of Dermatology,Tianjin Children's Hospital between 2010 and 2018,were analyzed retrospectively,and the etiology,clinical manifestations,diagnosis,development and outcomes of LS were investigated.Results All the 7 infants developed LS after bacillus Calmette-Guérin (BCG)vaccination,and the clinical manifestations of LS were reddish or hazel papules mainly distributed on the trunk with small scales attached to the surface.No abnormal laboratory examination results were observed.Histopathological examination showed granuloma in the dennis.Without any treatment,all rashes of the 7 patients disappeared within 6 months,and no scar or hyperpigmentation remained.Conclusions Infant LS usually appears 2-3 months after BCG vaccination,clinically presents as papules mostly on the trunk,pathologically characterized as granuloma in the dermis,and can heal spontaneously.

Objective To analysis the imaging features of the chondroblastoma in the tarsal bone. Methods The locations of 134 cases of pathologically confirmed chondroblastoma were retrospectively analyzed. Eleven of them were in tarsal bones and their X-ray and CT findings were analyzed. Results Of the 11 cases of tarsal chondroblastoma, 6 were in talus, 3 were in calcaneus and 2 cases were in navicular bones. They were examined by the X-ray and 5 cases had additional CT scans. The common locations were the posterior portion of the talus and calcaneus. The X-ray findings included expansive destruction (10/11), mild osteosclerosis (11/11), bone ridge (9/11), articular facet destruction (7/11) and spot or patching calcification(6/11). The imaging findings of CT included articular facets destruction (5/5), bone ridge (5/5) and spot or patching calcification (2/5). Conclusion The talus and the calcaneus are the frequently involved location of tarsal chondroblastoma. Its X-ray and CT findings are characteristic but not exclusive.

Objective To investigate the status of musculoskeletal articles and musculoskeletal injury articles published in the major journals of radiology in China and compare with abroad during the last decade.Methods Statistic analysis and comparison were done with musculoskeletal injury articles published in the major journals of radiology in China and abroad.The number,category,exam methods,study region and study contents were analyzed respectively.The journals in China included Chinese Journal of Radiology,Journal of Clinical Radiology and Journal of Practical Radiology.The journals at abroad included Radiology,the American Journal of Roentgenology(AJR),the British Journal of Radiology(BJR)and Skeletal Radiology.Results The rate of musculoskeletal articles among the treatise articles was 13.O%(827/6352)in China and 10.4%(900/8659)in three kinds of compressive jonrnals at abroad.The rate of musculoskeletal injury articles in musculoskeletal articles was 21.5%(178/827)in China and 10.8%(97/900)abroad.Among the review articles,the rate was 9.9%(73/741)and 13.7%(10/73)in China.respectively,while that was 4.3%(34/783)and 23.5%(8/34),respectively abroad.Among the case reports,the rate was 17.0%(675/3971)and 3.4%(23/675)in China respectively,while that was 8.8%(177/2019)and 14.7%(26/177),respectively abroad.The rate of exam methods which onlv used X-ray plain film in injury articles was 11.7%(26/222),mainly CT was 42.8%(95/222)and mainly MR was27%(60/222)in China,while that was10.9%(32/295),9.8%(29/295)and 32.5%(96/295),respectively in four kinds of journals at abroad.The combination examination was 16.2%(36/222)in China and 42.0%(124/295)at abroad respectively,The other was 2.3%(5/222)in China and 4.8%(14/295)at abroad.As for the study region,the rate of vertebrate column was 22.5%(50/222).knee joint was 21.1%(47/222),cranial and facial bones was 15.3%(34/222),hip joint was 7.2%(16/222).thoracic region was 6.8%(15/222),foot and ankle was 4.5%(10/222),hand and wrist was 4.1%(9/222),respectively,while that was 14.6%(43/295),14.6%(43/295),1.7%(5/295).6.4%(19/295),3.7%(11/295),12.9%(38/295)and 7.5%(22/295)at abroad,respectively.As for the study contents,the rate of bone was 64.9%(144/222),articular capsule and ligament was 8.6%(19/222),cartilage and osteoepiphysis was 7.7%(17/222),dislocation with or without fracture was 5.8%(13/222),menisci was 5.4%(12/222),combination study was 4.0%(9/222)and the other was 3.6%(8/222),respectively,while that was 62.4%(184/295),24.1%(71/295),4.7%(14/295),0.3%(1/295),2.7%(8/295),2.4%(7/295)and 3.4%(10/295)at abroad,respectively,The number of experimental articles in Chinese Journal of Radiology was 7,while that of Radiology was 29.Conclusion The rate of article on bone and bone injury was lower in all articles.Emphasize should be laid on experimental research and non-bone musculoskeletal injury in china.

Objective:To establish a mice model that is more in line with the human immunocompromised state,and to inves-tigate the regulatory effect of Rosa laevigata Michx.,probiotics and their combination on their immune function.Methods:Immunosup-pressive model of mice was established by using cyclophosphamide with different dosage,time and end point,and compared with im-munosuppressive model induced by hydrocortisone and cyclosporine A,immunosuppressive model of mice was established by injecting 25 mg/kg cyclophosphamide 7 times every other day,without recovery period;changes in the proportion of lymphocytes in spleen(CD4+T cells,CD8+T cells,CD19+B cells)were analyzed by flow cytometry;qRT-PCR was used to detect expression levels of inflam-matory factors(IL-1β and IL-6)mRNA in spleen.Results:After continuous injection of 80 mg/kg cyclophosphamide for 3 days,the thymus was atrophied,the spleen was significantly swelling,proportion of immune cells CD4+T cells,CD8+T cells and CD19+B cells in spleen were significantly decreased,while mRNA expressions of IL-1β and IL-6 were up-regulated.After 7 injections of 25 mg/kg cyclophosphamide every other day,the thymus and the spleen were significantly atrophied,proportion of CD4+T cells and CD8+T cells in spleen showed an increasing trend,and mRNA expressions of IL-1β and IL-6 were up-regulated;after 1 week or 2 weeks recovery period from cyclophosphamide injection,weight and index of immune organs,proportion of spleen lymphocytes and mRNA expres-sions of inflammatory cytokines in spleen were significantly reversed;Rosa laevigata Michx.combined with probiotics could signifi-cantly reverse the up-regulation of CD4+T cells and inflammatory factor IL-1β caused by cyclophosphamide.Conclusion:In this study,an immunocompromised mice model has been established with 7 injections of 25 mg/kg cyclophosphamide every other day and without recovery period.And a certain positive immunomodulatory effect of the combination of Rosa laevigata Michx.and probiotics has been found.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.