Objective To investigate the value of perfusion MR imaging in differential diagnosis between primary central nervous system lymphomas(PCNSL)and high grade astrocytomas.Methods Twelve patients with PCNSL and 23 patients with high grade astrocytomas were preoperatively examined using a 1.5T MR unit.Routine MR sequences were performed followed by dynamic susceptibility contrastenhanced MR perfusion imaging.The perfusion color images and the time-signal intensity curves of the two tumor groups were compared.The relative cerebral blood volume(rCBV)within the tumor parenchyma was measured and the data were analyzed with unpaired Student's t-test.Results The rCBVs within the tumor parenchyma of the PCNSL and high grade astrocytomas were 1.78±0.5 1 and 3.87±0.87 respectively.The rCBV in the PCNSL was significantly lower than that of the high grade astrocytoma(P＜0.05).When the time-signal intensity curves were compared,the PCNSL showed a trend towards the baseline after the first pass and the curves even overshot above the baseline in 7 out of 12 cases,whereas the high grade astrocytoma showed a trend to be close to the baseline but couldn't return to the baseline completely.Conclusion The MR perfusion imaging can be very useful in distinguishing the PCNSL from high grade astrocytomas.

Objective To investigate the CT and MR] features of basal cell adenoma of the parotid gland. Methods CT and MRI features of 9 basal cell adenoma cases (4 men and 5 women, median age 58) confirmed by operation and pathology were reviewed retrospectively. All CT and MR images were retrospectively evaluated with respect to location, size, morphology, margin, CT density/MR] signal intensity and enhancement behavior. Results Each of the 9 patients had only 1 tumor. Eight lesions were located in the superficial lobe and 1 in the deep lobe. Seven tumors were round without lobular appearance, and 2 tumors were elliptic with small lobular appearance. All the 9 lesions were well circumscribed with smooth contours. A capsule-like rim with low intensity on MR[ was observed in 2 lesions, and a rim with high intensity on T1 WI and T2 WI was detected in another lesion. These 3 lesions showed low intensity on T1 WI and T2 WI with heterogeneously strong enhancement and delayed enhancement. Four lesions showed cystic areas in the center with mural nodules on CT, which were moderately or obviously enhanced (the mean increase of CT values: 65.5 H U ), and 2 lesions showed homogeneous enhancement. Conclusion Basal cell adenoma of parotid gland should be first considered when the old women had single round lesion located in the superficial lobe with smooth contour and low intensity on T2WI, especially when cystic areas were observed in the center with mural nodules on CT/MR.

OBJECTIVE: To explore the value of high-resolution temporal bone CT (HRCT) multi-planar reconstruction (MPR) technique for measuring cochlear morpholog in the preoperative evaluation of cochlear implant. METHOD: We retrospectively analyzed the clinical data of 80 cochlear implant recipients. The groups were investigated in our research according to the patient's sex, age and whether the inner ear is malformed or not. Temporal bone HRCT MPR was applied to analyze the measurement parameter in the standard orientation of the cochlea image: the largest distance from the round window to the lateral wall (distance A), the perpendicular distance (B) and angle of the basal turn of the cochlea relative to the midsagittal plane (γ). Reproducibility of the measured data was evaluated and the results between the different groups were compared. RESULT: Measurement of parameter values between the intraobserver and interobserver showed good reproducibility. In normal group, distance A [(8.79±0.34) mm] and perpendicular distance B [(6.58±0.28) mm] of males' cochleae were significantly larger than A [(8.53±0.47) mm] and B [(6.22±0.43) mm] of females' (P<0.05), but the angle γ was not significantly different between the two groups (P>0.05). The A and B values didn't change with age (P>0.05), but the angle γ tended to decrease with increasing age (r=-0.25, P<0.05). In the malformation group, the value B was significantly smaller than that of the normal group (P<0.01), but for value A and angle γ, there was no significant difference between the two groups (P>0.05). CONCLUSION HRCT MPR technique is simple and reliable in measurement of cochlear morphology. It can be used to guide the surgery and provide an objective basis for designing the personalized electrode. More clinical application of this technology is recommended.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cochlea ; diagnostic imaging ; Cochlear Implantation ; Female ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective To study the probability of applying mesenchymal stem cells isolated from human umbilical cord blood (hUCB MSCs) to repair mouse skin wound in vivo. Methods hUCB MSCs isolated from full term delivery human umbilical cord blood were cultured and amplified in vitro.hUCB MSCs at passage 9 were labeled with BrdU (5-bromodeoxy-uridine) and grafted on the full-thickness skin loss wound created on the back of the severe combined immunodeficiency (SCID) mouse (treatment group), when a PBS control group was set. The wound healing rate was surveyed and compared at days 7 and 14 postoperatively. Meanwhile, the wound was biopsied at days 7, 14 and 28 after operation,and the expressions of BrdU antibody and K19 antibody were checked pathologically and immunohistochemically by HE staining, respectively. Results The wound in treatment group was healed more rapidly than that in control group (P ＜ 0.01 ). The pathological check of the biopsy sample showed that the epidermis was thicker, with more epidermal ridges in the treatment group, compared with control group.It was found that some BrdU positive cells were distributed successively on the hair follicle, the stratum basal and the spinosum layers, a few of which even expressed K19. Conclusion hUCB MSCs can be differentiated into skin tissue and cells and is possible to repair skin wound.

Objective To investigate the xenotransplantation model of fetal pig skin precursor tissue and its development after transplantaion. Methods Porcine skin precursor tissue was obtained from the embryo of gestation day 56 (E56), and made into microskin or stamp skin graft. The microskin was transplanted to the dorsal wound in BALB/c nude mice, then covered with human corpse skin. The stamp skin graft was imbedded subcutaneously into the back of nude mice, and microskin was injected subcutaneously into the auricles of nude mice. Their growth and development were observed and they were examined by HE staining at 6th and 12th week after transplantation respectively. Two-sample t test was used to analyze the size of newly grown skin tissue. Results Porcine skin precursor tissue graft in three models above survived and continued growth after transplantation, and growth ability of the dorsal wound transplantation model was significantly stronger than that of the auricle model. Epidermis and hypodermis were detected in newly grown skin tissues. Hair follicles, a few of sebaceous glands, but no sweat glands were observed in auricle model, while many sebaceous glands and sweat glands were observed in the dorsal wound model. Conclusion Transplantation of microskin to dorsal wound is the optimal model of investigating the xenotransplantation of fetal pig skin precursor tissue and its development after transplantion.

Objective To investigate the image features of congenital pyriform sinus fistula (CPSF). Methods We retrospectively analyzed the clinical features and preoperative images of 80 patients with confirmed diagnosis of CPSF by surgical and pathological outcome in Guangdong general hospital from January 2007 to December 2014. At least one of the following imaging examinations were performed for all the patients, including Barium swallow X-ray (BSX), CT and MRI. Among them, 63 patients were examined with BSX, while 42 patients underwent plain and enhanced CT scans, wherein 40 of them were exanimated shortly after BSX. Thirty-two patients underwent plain and enhanced MRI scans. Patients were divided into two groups according to their age, young age group (≤14 years old) and older age group (>14 years old). Furthermore, they were also grouped based on inflammatory or quiescent stage clinically. The images of BSX, CT, and MRI from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ2 tests. Results For the patients examined with BSX, sinuses in 35 of 63 were depicted from pyriform and fistulas in 9 of 63 were depicted from the pyriform. The overall PDR of BSX was 74.6%(47/63),wherein 46.2%(12/26)in young age group , 94.6%(35/37)in older age group, 52.9%(9/17) in inflammatory stage group ,and 82.6%(38/46)in quiescent stage group. The inter-group differences were statistically significant (χ2 were 18.911 and 5.766,both P<0.05). The PDR of CPSF with CT was 85.7%(36/42), MRI was 84.4%(27/32), BSX+CT was 87.5%(35/40). The courses of fistula or sinus were showed on CT and MRI. The presence of air bubbles at the inferomedial edge of cricothyroid joints or around the upper lobe of the thyroid gland, the changes of the morphology of thyroid grand as well as the inflammatory change along the fistula region were detected much clearly on CT and MRI. There was no statistical difference between CT and MRI groups(P>0.05).Conclusions BSX could be a screening method for suspected cases of CPSF in quiescent stage. However, the PDR could be affected by many factors (age and inflammation). CT and MRI could provide valuable information for diagnosis. An examination combined BSX and CT is preferred to improve the positive detective rate of CPSF.

Objective Non-invasive detection is the focus of intense research in diagnosis of acute renal allograft rejection currently. Urine protein is considered the cue to reflect the pathological changes in kidney disease. In this study, we explored the urine markers for early acute renal allograft rejection. Methods The urine protein of two patients with acute renal allograft rejection were examined by 2D gel electrophoresis and bioinformatics. We adopted pH 4-7 ready strip IPG and stained the gel with Sypro-Ruby. The digitized 2D maps of urine protein were quantitatively analyzed using 2D-analysis software packages. By analyzing the differential expressions of proteome between different time points (1, 2, 3 days before acute rejection and 7, 14, 21 days after acute rejection), 30 protein spots were selected and analyzed by MALDI-TOF-MS/MS. Results We obtained 2D gel electrophoresis maps of urine protein of the patients with acute renal allograft rejection, which are of good reproducibility and resolution. Sixteen protein spots were identified, resulting in thirteen corresponding proteins. Out of these proteins, we screened three proteins (alpha-1-antichymotrypsin, tumor rejection antigen gp96, Zn-Alpha-2-Glycoprotein) closely related to acute rejection. Conclusion The urine protein spots on 2D gel electrophoresis maps for the patients with acute renal allograft rejection were of obvious difference when detected at different time points of acute rejection. Alpha-1-antichymotrypsin, tumor rejection antigen gp96 and Zn-Alpha-2-Glycoprotein might be the candidate protein markers to diagnose acute renal allograft rejection after renal transplantation.

Objective:To investigate the association of ocular dominance with the severity of chronic primary angle-closure glaucoma (PACG).Methods:Ocular dominance was assessed via the " hole in card" method.The anatomical symmetry (including anterior chamber depth, lens thickness and axial length) in both eyes was analyzed via A scan ultrasound.The severely glaucomatous eye was determined by the mean defect of visual field.The association of ocular dominance with the severity of chronic PACG was then analyzed.This study followed the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong.Written informed consent was obtained from all subjects prior to their entering the study cohort.Results:Visual acuity (LogMAR) was 0.39±0.24 in the dominant eye group, and 0.43±0.29 in the non-dominant eye group.Anterior chamber depth was (2.53±0.26)mm in the dominant eye group, and (2.54±0.29)mm in the non-dominant eye group.Lens thickness was (4.96±0.31)mm in the dominant eye group, and (4.92±0.33)mm in the non-dominant eye group.Axial length was (22.58±0.61)mm in the dominant eye group, and (22.73±1.11)mm in the non-dominant eye group.No significant difference was found in visual acuity, anterior chamber depth, lens thickness or axial length between the dominant and non-dominant eye groups ( t=-1.643, -0.797, 1.867, -1.345; all at P>0.05). The vertical cup-disc ratio of the dominant eye group was lower than that of the non-dominant eye group (0.55 [0.40, 0.80] vs. 0.80 [0.63, 0.90]). The mean defect in the visual field of the dominant eye group was lower than that in the non-dominant eye group (-6.54 [-16.70, -3.85]dB vs.-18.77 [-28.19, -8.55]dB), and the intraocular pressure in the dominant eye group was lower than that in the non-dominant eye group (21.00 [17.00, 27.75]mmHg vs. 24.50 [19.00, 36.25]mmHg) (1 mmHg=0.133 kPa). Significant differences were found in mean defect, vertical cup-disc ratio and intraocular pressure between the two groups ( Z=-3.781, -3.528, -2.126; all at P<0.05). The ratio of the severely glaucomatous eye being the non-dominant eye was 84.09%, which was much higher than that of the severely glaucomatous eye being the dominant eye (15.91%). The non-dominant eye was related to the severity of chronic PACG ( χ2=40.909, P<0.001, Pearson contingency coefficient r=0.563). Conclusions:The non-dominant eye is associated with the severity of chronic PACG.

【Objective】 To explore the relationship between the intraoperative plasma transfusion volume, the changes of blood coagulation test values and the clinical prognosis of surgical patients, so as to provide a theoretical basis for guiding the rational use of blood during the operation. 【Methods】 The clinical data of 556 surgical patients who received plasma infusion from January 2017 to December 2020 in Sun Yat-sen Memorial Hospital were collected. Patients were divided into low plasma dose group (<15 mL/kg) and high plasma dose group (≥15 mL/kg). The univariate regression analysis, logistic multivariate regression analysis and linear regression analysis were used to explore the relationship of plasma dose, the changes of coagulation indicators and the clinical prognosis. 【Results】 A total of 556 surgical patients were included in the study and the median (interquartile range) of plasma transfusion volume for all patients during the operation was 10.5 (8.5~14.0) mL/kg. In multivariate regression analysis, an increase of 1 mL/kg of intraoperative plasma dose resulted in an increased risk of red blood cell infusion within 24 hours after surgery[OR(95% CI) 1.16(1.01, 1.33), P<0.05], an increase in the ICU stays[Mean(95%CI) 0.19(0.03, 0.35), P<0.05] and an increase in the hospitalization days[Mean(95%CI) 0.55(0.27, 0.81), P<0.05]. The preoperative INR value increased the risk of red blood cell infusion within 24 hours after surgery[OR(95% CI) 1.82(1.33, 2.50), P<0.05], and increased the hospital mortality of postoperative patients[OR (95% CI) 2.15 (1.09, 4.24), P<0.05]; the decrease in INR reduced the risk of red blood cell infusion in patients 24 hours after surgery[OR(95% CI) 0.47(0.27, 0.84), P<0.05]and reduced hospital mortality[OR(95% CI) 0.23(0.13, 0.50), P<0.05]. 【Conclusion】 In surgical patients undergoing intraoperative plasma infusion, abnormal preoperative INR value and high intraoperative plasma infusion are related to poor clinical prognosis, while INR decrease (preoperative-postoperative) was related to better clinical results.

Objective: To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy. Methods: The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ² tests. Results: Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ²=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ²=0.31, χ²=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ²=6.68, P<0.05). Conclusions MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.