Objective To localize precisely cerebral central sulcus on the coronal MR imaging. Methods The serieses of 4 mm thickness coronal sections and coronal MR images of brain were prepared on 30 cadaver heads. The preparation of the brain slices in correspondence with MR scan took the line perpendicular to the midpoint of intercommissural line as base one. The important cerebral gyri of cadaver were painted different colors. The coronal MR images of 6 volunteers were also prepared. The localization of central sulcus on the coronal sections was studied by the comparison of MR images with serial coronal sections of the brains. Results On the section of the central sulcus appearing for the first time, the appearing rate of dorsal thalamus was: left side 93%, right side 97%; the appearing rate of pyramidal tract was: left side 20%, right side 13%. The central sulcus almost disappeared on the section through the posterior border of splenium of corpus callosum, the appearing rate of the central sulcus on the superolateral surface was 33% on the both sides. Conclusion The central sulcus appears for the first time on the 1-2 sections which the dorsal thalamus appears on but the pyramidal tract doesn′t appear. On the section through pyramidal tract, the superior frontal, precentral and postcentral gyri can be identified according to the three medullary branches on superolateral surface of cerebral hemispheres. The central sulcus has almost disappeared on the section through the posterior border of splenium of corpus callosum.

Background The potential protective effect of ischemia postconditiomng for hypoxia has been determined in many tissues and organs.But its mechanism in retina is still lack.Objective The aim of this study was to investigate the protective effect of ischemia postconditioning on retinal ischemia reperfusion injury.Methods Thirty-six health male Wistar rats were randomized into the normal control group,sham group,ischemia reperfusion group and ischemic postconditioning group.Retinal ischemia reperfusion models were induced by elevating the intraocular pressure to 110 mmHg for 60 minutes,and then the ischemic postconditioning was performed right away,1 minute and 10 minutes after ischemia in the rats of the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ group,respectively.Electroretinogram (ERG) was recorded in the rats 7 days after operation,and the rats were sacrificed by excessive anesthesia.Retinal specimens were prepared for the histopathological examination.The retinal thickness and the recovery rates of ERG a,b waves and oscillation potentials (OPs) were compared among the groups using ANOVA of SPSS software.Results One day after experiment,the structure of rat retinas was nearly normal.However,retinal edema and vacuolar degeneration were seen in the rats of the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups primarily in the inner plexiform layer (IPL),inner nuclear layer (INL).The retinal thickness values of the entire layer,IPL and INL were significantly higher in the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups compared with the normal control group (all at P＜0.05).Seven days after experiment,the retinas were thinner in the rats of the ischemia reperfusion group than those of the rats in the sham group,but the retinal thickness values in the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups were significantly increased in comparison with the ischemia reperfusion group (all at P＜0.05).In addition,the recovery rates of ERG a,b,OPs amplitudes were significantly lower in the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups compared with the normal control group (all at P＜0.05).However,the recovery rates of ERG a,b,OPs amplitudes evidently elevated in the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups in comparison with the ischemia reperfusion group (all at P＜0.05).Conclusions Ischemia postconditioning can protect the structure and function of retina from ischemia reperfusion injury.Ischemia postconditioning plays the maximal effect immediately to 1 minute after ischemia reperfusion injury in Wistar rat.

ObjectiveTo study the morphology, normal values and lateral asymmetry of Chinese calcarine sulcus on MRI. Methods High-resolution and transverse MRI were obtained from 40 female volunteers. Brainvisa software was used to reconstruct the calcarine sulcus and measure its average length, depth and width automatically. Results The posterior branch of calcarine sulcus showed six types in the median sagittal plane: bifurcation(32.50%), single peak(25.00%), flat (16.25%), S-shaped (15.00%), double peak(7.50%) and other shape (3.75%); its location had three types: inferior(72.50%), middle(21.25%)and superior(6.25%). The depth of left calcarine sulcus was (15.24±2.67)mm, and the right one was (16.97±3.25)mm, which revealed great statistical significance (P＜0.000 1). The width of left calcarine sulcus was (3.14±0.91)mm, and it was (3.19± 0.83)mm in the right side. The bottom length of calcarine sulcus: the left was (86.47±16.85)mm, the right was (83.62±17.10)mm. The top length of calcarine sulcus: the left was (70.52±12.40)mm, the right was (64.90±15.17)mm. There were not statistical significance in width, bottom length and top length between left and right calcarine sulci. More than half of the end part of calcarine sulci turned to the lateral surface of cerebral hemisphere.Totally 63 cases (78.75%) were found with prominent calcar avis. Conclusion Significant difference of depth between left and right calcarine sulcus of female was found. Three-dimensional reconstruction is an effective method to study the anatomy of calcarine sulcus.

Objective The purpose of this study was to provide practical anatomic data for the imaging diagnosis and surgical treatment of the disease of the subphrenic spaces. Methods Sectional anatomy of the subphrenic spaces on the coronal plane were investigated on 30 sets of serial coronal sections of superior abdomen of Chinese adult cadavers and MR imaging of 2 abdomen of cadavers. Results Subphrenic spaces were divided into perihepatic spaces and perisplenic spaces on the coronal plane.The space between the anterior margin of left gastropancreatic fold and the posterior layer of hepatogastric ligament is the only direct communication between the superior and inferior recesses of the lesser sac.Its communicating type is divided into three types on the coronal plane.The right layer of the gastrophrenic ligament is continuous with the posterior layer of the lesser omentum,the left layer of the gastrophrenic ligament is continuous with the right layer of the phrenicosplenic ligament and the posterior layer of the gastrosplenic ligament.Left gastropancreatic fold is continued to the left and right layers of gastrophrenic ligament upward.The bare area of stomach is located between the left and right layers of gastrophrenic ligament,its existing rate is 100%.The bare area of spleen is located among phrenicosplenic ligament,gastrosplenic ligament,splenorenal ligament and splenocoloic ligament.Its the most width exists at the splenorenal ligament.It is divided into the part of the splenic hilus and the splenorenal part.Its maximum is 2 64?1 16 cm,4 16?2 24 cm respectively. Conclusion The coronal plane is dominant for showing left gastropancreatic fold and the communication relationship between superior and inferior recesses of the lesser sac.The superior and inferior recesses of the lesser sac that may communicate with each other is 73 3 percent of all the cases studied

Objective:To retrospectively observe the effect of oxycodone on acute postoperative pain in patients undergoing thoracoscopic surgery.Methods:A retrospective analysis was conducted on the clinical data of 404 patients undergoing thoracoscopic thoracic surgery under combined general anesthesia at the Xiangya Hospital, Central South University from April 1, 2020 to September 30, 2021. They were divided into A group ( n=99, oxycodone group) and B group ( n=305, control group) based on whether oxycodone was used during the surgery. The two groups of patients were further matched 1∶1 using the nearest neighbor matching method. We compared the Visual Analogue Scale (VAS) of activity and resting pain and the incidence of moderate to severe pain between two groups of patients 24 hours after surgery, and observed the incidence and severity of pain related adverse reactions such as nausea, vomiting, itching, and dizziness. Resultsl:After matching the propensity scores of the two groups of patients, the balance was good ( SMD<0.20). There was no statistically significant difference between the groups in age, gender, body mass index, American Society of Anesthesiologist (ASA) grade, surgical time, intraoperative bleeding, and the use of antiemetics and analgesics during the perioperative period (all P>0.05). Compared with the control group, patients in the group A had a resting VAS [(2.03±1.61)points vs (1.62±1.31)points, P=0.049], and activity VAS [(4.13±1.72)points vs (3.51±1.79)points, P=0.013] was even lower, and the incidence of moderate to severe pain (VAS≥4) during activity was lower [59.6%(59/99) vs 37.4%(37/99), P=0.003]. There was no statistically significant difference in the incidence of analgesic related adverse reactions between the two groups ( P>0.05). Conclusions:Intravenous injection of oxycodone can effectively alleviate acute pain in patients undergoing thoracoscopic surgery within 24 hours, and reduce the incidence of moderate to severe pain during activity.

Objective:To study the clinical and molecular characteristics of a family with familial hypercholesterolemia (FH) with LDLRAP1 and ABCG8 gene abnormality.Methods:In September 2020, one case of FH was included in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; peripheral venous blood samples of members of the family were collected to detect serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) indicators; use high-performance liquid chromatography to detect serum stigmasterol and sitosterol content; perform second-generation gene sequencing to detect gene mutations in probands and family members; use Pymol software to detect gene mutations point for pathogenicity analysis, and use Uniprot Modelling software to perform protein structure modeling.Results:The patient presented with anemia, multiple xanthomas and early-onset acute coronary syndrome. The coronary angiography showed severe coronary artery lesions; abdominal ultrasound showed splenomegaly; blood smear showed shaped erythrocytes and large platelets. The level of serum TC, LDL-C, stigmasterol and sitosterol was 8.54 mmol/L (2.3-5.7 mmol/L), 4.84 mmol/L (range of normal value 1.3-4.3 mmol/L), 44 μmol/L (1.0-10 μmol/L), 28 μmol/L (1.0-15 μmol/L), respectively; LDLRAP1 gene mutation was found: exon4 c.415C>T:p.Q139X; the truncated protein formed by this homozygous mutation lost multiple stable protein structure regions, which can not have a normal function. At the same time, ABCG8 gene mutations were also found: exon13 c.1895T>C (p.V632A) and exon8 c.1199C>A:p.T400K . Two cases of family members had a mild increase in HDL-C (Ⅱ5: 2.33 mmol/L, Ⅱ6∶2.96 mmol/L), 3 cases carrying the ABCG8 gene mutations had a slight increase in stigmasterol (Ⅱ8: 23 μmol/L, Ⅱ7: 24 μmol/L, Ⅰ2: 18 μmol/L) and sitosterol (Ⅱ8: 41 μmol/L, Ⅱ7: 33 μmol/L, Ⅰ2: 45 μmol/L), suggesting that its association with the concentration of plant sterols. Conclusions:FH patients with LDLRAP1 and ABCG8 gene abnormalities may have abnormal plant sterol concentrations, and their clinical manifestations are more complicated. Therefore, family history, LDL-C, plant sterol levels, and genetic test results should be considered comprehensively.

Objective:To explore the clinical efficacy of a wearable robot for improving the balance and walking function of stroke survivors.Methods:Eighty stroke survivors were randomly divided into an observation group and a control group, each of 40. Both groups were given routine rehabilitation, but the observation group additionally received 20 minutes of training assisted by a wearable robot six days a week for 4 weeks. Before and after the experiment, both groups were evaluated using the Berg Balance Scale (BBS) and functional ambulation categories (FACs). Their movement distance and ellipse area were measured using a Prokin balance instrument, and their step length and pace on the affected side were recorded.Results:Significant improvement in the average BBS and FAC scores, exercise length, ellipse area, and step length and speed on the affected side was observed in both groups. On average, the experimental group′s results were significantly better than those of the control group.Conclusion:Supplementing conventional rehabilitation with wearable robot assistance can significantly improve the balance and walking function of stroke survivors.

Objective: To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A. Methods: This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods. Results: There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ²=8.379, P=0.015) . Ultrasound showed abnormalities in 18.3% (20/109) joints, X-ray showed abnormalities in 3.8% (3/79) joints and HJHS showed abnormalities in 25.3% (20/79) joints. There was no correlation between ultrasound and HJHS (r=0.015, P=0.895), no correlation was found between X-ray and HJHS (r=-0.101, P=0.390) either, which suggested that joint structural and functional examination could not replace each other. The related risk factors of arthropathies in this group were >4.91 years old (OR=3.917, 95%CI:1.610-9.528) and combining with target joint (OR=3.530, 95%CI:1.316-9.465). Conclusions Detecting the joint structure and function on no bleeding history joints in pre-school hemophilia A children could reveal the arthropathies and majority of them were ankle arthropathies. Joint structural and functional examinations could not replace each other. For patients more than 5 years old and those with target joints, the joints with no complaint of bleeding should be examined regularly to reveal the arthropathies in time.

Objective:To understand the relationship between joint bleeding and joint disease in hemophilia children, and to provide a theoretical basis for clinical treatment and prognosis.Methods:The patients with severe hemophilia A between 1 and 7 years old and with relevant nodal bleeding records were selected.All the patients admitted in Beijing Children′s Hospital, Capital Medical University, and Chengdu New Century Women′s and Children′s Hospital since June 2016 to January 2017.All the joint bleeding of each child was taken as the study joint, and the joint bleeding was collected during the last 3 months.The joints were assessed by using ultrasound, X-ray, magnetic resonance imaging(MRI) and Hemophilia Joint Health Score (HJHS) scoring systems.The correlation analysis was conducted between the joint bleeding, ultrasound, X-ray, MRI and HJHS scores.The correlation analysis was conducted for baseline ultrasound, X-ray, MRI and HJHS scores.Results:(1) There were 18 patients enrolled.The mean age was (5.6±1.8) years old.There were 30 joints bleeding in the observation period in total, with the annul median joint bleeding times of 4 (4-16 times), and the annul median target joint bleeding times of 8 (4-16 times). (2) Joint bleeding times of was correlated with ultrasound and X-ray evaluation ( r=0.390, P=0.033; r=0.517, P=0.008), and not correlated with HJHS or MRI(all P>0.05). (3) There was significantly positive correlation among ultrasound, X-ray, HJHS and MRI [ r=0.815(ultrasound vs.X-ray), r=0.510(ultrasound vs.HJHS), r=0.812(ultrasound vs.MRI), r=0.666(X-ray vs.HJHS), r=0.911(X-ray vs.MRI), r=0.781(HJHS vs.MRI), all P<0.01]. (4) There was no correlation between times and assessment for joints whose ultrasound and /or MRI in joints with abnormal ultrasound and /or MRI evaluation( P>0.05). Conclusions:The results of joint bleeding and joint evaluation are inconsistent.Joint bleeding can not truly reflect the situation of joint diseases.The assessment of hemophilia should include comprehensive evaluation of joint structure, function, activity ability and other aspects to guide the treatment of haemophi-lia children.