Objective To investigate the image characteristics of Synovial Sarcoma, and improve the diagnostic accuracy. Methods The clinical materials and image findings of synovial sarcomas proved by pathology and were retrospectively analyzed in 13 cases.Results ①Most synovial sarcomas located in close proximity to joints, especially large joints of lower limbs . ②The mass diameter was usually more than 5cm ,and most masses presented moderate density, and some with calcification inside it on X-ray films. ③Most masses density was not homogeneous and lower than that of the muscle on CT, the demarcation was clear or not. ④On T2WI /STIR of MRI, most tumours presented slightly hyperintense "cobble" nodules , with hypointense septa among the nodules. After contrast, the nodules were unenhanced or enhanced slightly,the septa were markedly enhanced. Conclusion Some image features of synovial sarcoma ,especially on MRI, are helpful for the diagnosis of it.

Objective Toevaluatetheradiologicfindingsanditsclinicaluseinmassiveosteolysis (MOL) .Methods FourcasesofMOLwereretrospectivelyanalyzed .X rayexaminationwasperformedinfour, CTintwo ,andMRIinone .Results (1 )Singleskeletallesionwasdemonstratedinthreecases ,andmultiple lesionsinone .(2 )OnX ray ,tubebonelesionwasshowedastaperingintwo ,butbonedefectorbone disappearingwasfoundintheflatbonedisease .Onecasealsoassociatedwithchylothorax .(3)OnCT ,flatbone lesionhadataperingmargin ,riblesionswereshowedasflattenandirregularsurfacewithcorticalorsubcortical bonedefect.Surroundingsofttissueofskeletallesionswasatrophy .(4)NormalMRIsignalintensityofbone marrowdisappearedintwoskeletallesionsandhadalongT1andlongT2 signalintensitychanges .Conclusion X rayexaminationistheessentialmethodforMOL ,CTandMRIarecomplementaryone .

Objective To detect the levels of anti-gliadin IgA and anti-gliadin IgG antibodies in the plasma of the patients with schizophrenia, and to investigate the association between schizophrenia and anti-gliadin IgA, IgG bodies in a Chinese Han population, and to clarify the effect of gliadin on the occurrence of schizophrenia.Methods The plasma samples were collected from 428 patients with schizophrenia and 555 cases of normal control subjects in a Chinese Han population.The gliadin antibodies in plasma,including IgA and IgG,were tested using a native anti-gliadin ELISA test kit.The positive rates of plasma anti-gliadin IgA,and anti-gliadin IgG were tested by Chi-square test between the patients with schizophrenia and control subj ects. The differences of the levels of anti-gliadin IgA and anti-gliadin IgG were tested by Mann-Whitney U test between the patients with schizophrenia and control subjects.Results Compared with normal control group,the anti-gliadin IgA level and the positive rate of plasma anti-gliadin IgA in patient group were increased significantly(P<0.01),but there were no significant differences of the positive rate and the level of anti-gliadin IgG in plasma between patient and control groups (P>0.05).The anti-gliadin IgA levels in the patients with delusion of observation,delusion of being revealed,delusion of persecution, delusion of j ealousy, delusion of grandeur, incoherence of thinking, illogic thought, bizarre behavior,aggressive behavior,hallucination-delusion syndrome,poverty of thought,emotional blunting/apathy and aboulia were higher than that of the normal controls (P<0.05);the anti-gliadin IgG levels in the patients with delusion of being revealed and delusion of grandeur were higher than that of the normal controls (P<0.05 ). Conclusion Gliadin is associated with the onset of schizophrenia in Chinese Han population, and the plasma antibodies of gliadin maybe play an important rale in the onset of schizophrenia.

Vascular birthmarks are the most common disease.The morbidity is about 2.5%,most of the lesions occur in oral and maxillofacial regions which accounts for 40%-60% of the total lesions.In 1982,Mulliken and Glowacki proposed a biologic classification of vascular birthmarks on the basis of their clinical manifestations,histopathological features,and natural history.They defined hemangiomas as vascular tumors with a growth phase,marked by endothelial proliferation and hypercellularity,and an involutional phase.They recognized that many entities referred to as hemangiomas are actually structural malformations of the vasculature,derived from capillaries,veins,lymph vessels,or arteries or from a combination of these sources.The classification was confirmed and issued by International Society for the study of vascular anomality(ISSVA) in 1988.Waner and Suen amended the above category in 1995.This paper presents the new classification of vascular birthmarks and the developments in this field in re-cent years,including the pathology,clinical features and the therapy.For example,the classification of venular malformation categorized by Waner in 1989;the classification of lymphous malformation by Waner and Suen in 1995;and the treatments according to above classifications.

ObjectiveTo investigate the changes in the levels of serum adiponectin (APN) and serum ferritin (SF) in patients with nonalcoholic fatty liver (NAFL) and normal populations in Qinghai, China, as well as the significance of APN and SF in the pathogenesis of NAFL. MethodsA total of 39 patients diagnosed with NAFL in The Affiliated Hospital of Qinghai University from February to October, 2015 were enrolled as NAFL group, and 34 healthy individuals who underwent physical examination were enrolled as control group. The anthropometric parameters and routine clinical biochemical parameters were measured and enzyme-linked immunosorbent assay and chemiluminescence immunoassay were used to measure the levels of serum APN and SF. The independent-samples t test was used for comparison between two groups, and the Pearson correlation analysis was also performed. ResultsCompared with the control group, the NAFL group had a significantly higher level of SF (291.97±38.82 ng/ml vs 93.21±8.74 ng/ml, t=31.085, P＜0.001) and a significantly lower serum level of APN (11.91±2.88 mg/L vs 16.18±2.80 mg/L, t=6.383, P＜0.001). The correlation analysis showed that in the NAFL group, serum APN level was negatively correlated with TG level (r=-0.466, P＜0.01). ConclusionThe patients with NAFL in Qinghai have a reduced serum APN level and an increased SF level, and in these patients, serum APN level is negatively correlated with TG level. Serum APN monitoring may be used as a reference index to evaluate the treatment outcome of hypertriglyceridemia.

Objective To investigate the safety of the occipital condylar screw with vertical position and evaluate the selection strategy of the posterior approach of the posterior occipital condylar screw in Chinese people.Methods The clinical imaging data of 60 outpatients from September 2013 to September 2015 were retrospectively analyzed,36 male and 24 female,the average age was 41.6±9.2 (range from 25-58),Excluded occipitocervical injury,tumor and deformity patients.We built a three-dimensional digital model and simulated placing screw by utilizing CT data on Mimics software,after that we took the occipital condyle posterior medial and lateral midpoint as the entry point,then made 2 points equidistantly to the midpoint in vertical direction.We put 3.5 mm diameter virtual screws in 4 different conditions:largest cranial angle,smallest cranial angle,longest screw path and shortest screw path.Then we assessed the anatomical relationship between the screw and the hypoglossal canal or the atlanto-occipital joint by a three-dimensional window and measured the cranial angle,medial angle and length of screw path,then calculated the safety angle of the cranial angle,the successful rate of setting screw,and compared the safety of different screw points by 3-Matic software.Results 120 occipital condyles were obtained from the CT data of 60 patients by Mimics software.There was no significant difference in the data of the cranial angle,medial angle,safety range and length between both left and right sides.The obtained safe cranial angle of each point respectively was 20.9°±6.0° (lowest point),17.0°±6.2° (middle point),and 11.6°±7.1°(top point),obviously the largest angle was in the lower point and the smallest was in the top point.The difference was statistically significant.We then acquired the successful rates of different cranial angle of each point,the highest successful rate was 99.17％,96.67％,74.17％ in lowest,middle and top point when cranial angle were 3°or 4°,3°and 0°respectively.The successful rates of lower point and niddle point were significantly higher than the top point,and the difference was statistically significant.The medial angle parameters obtained were 34.41°±2.59°on left and 34.06°±2.44°on right,and there was no significant difference.The length parameters of the longest screw path acquired were 23.09± 1.47 mm,22.84± 1.40 mm and 23.15± 1.45 mm at top,middle and lowest entry point.The average value of shortest screw path of each point was 21 mm,and there was no significant difference among every entry point.Conclusion Among the occipital condyle posterior screw entering points,selecting the lower point can improve the success rate and safety;the change of nail enter point in the vertical direction has little effect on the length of the nail.We can increase the safety and reduce the risk of occipital condylar screw placement as far as possible through the three-dimensional digital technology.

BACKGROUND: After internal fixation is applied to femoral shaft fracture with medial cortical defect, the fixation device is often bended and broken due to the stress on it. So far, reliable methods have not been found to solve this problem in clinic.OBJECTIVE: To evaluate the biomechanical stability of the allograft bone plate after a bony defect of the medial cortex is reconstructed with allograft bone plate.DESIGN: A randomized controlled experimental study.SETTING: This trial was conducted in the Department of Orthopaedics, the 175 Hospital of Chinese PLA, and Laboratory of Biomechanics, First Military Medical University of Chinese PLA.PARTICIPANTS: This trial was conducted in Laboratory of Medical Biomechanics, First Military Medical University. MTS858 Biomix biomaterial testing machine was used to simulate model of femoral shaft fracture on 3male adult femurs donated voluntarily by their relatives, aged 23, 24 and 28years old.INTERVENTIONS: The fracture model of medial cortical defect was made in the femurs. Different kinds of fixation were applied and the results were compared between fixated femurs and the normal ones. The fixations included steel plate fixation(fixation for group 1 ), steel plate with allograft bone plate fixation(fixation for group 2), steel plate with allograft bone plate fixation and reduction of the medial cortical fragment(fixation for group 3).MAIN OUTCOME MEASURES: The vertical compression displacement under 500 N load, three-point bending strength under 10 N and anti-torsional angle under 300 N load are all measured.RESULTS: The vertical compression displacement and three-point bending strength of the control group were insignificantly different from those of the fixation group 3 ( P ＞ 0.05), but significantly different from those of the fixation group 1 and 2 ( P ＜ 0.05). The anti-torsional angle of the control group was significantly different from that of the three fixation groups( P ＜ 0. 05) . The result of fixation in fixation group 1 was the worst, better in fixation group 2and the best in fixation group 3.CONCLUSION: When there is a medial cortical defect in the femur, reconstruction with a bone plate can recover the integrity of the femoral medial cortex, and the successful rate of the plate internal fixation is increased.

Objective To explore the biomechanical properties of posterior occipital condyle screws compared with common occipitocervical fusion internal fixation and it's impacts upon stress of hypoglossal canals.Methods Finite element models based on the occipitocervical CT data of one 28-year-old male healthy volunteer were built,including normal model,instability model,internal fixation model by occipital condyle screws,internal fixation model by occipital plate screws,and internal fixation model by transarticular screws.Fifty N gravity and 1.5 N · m torque were exerted upon the surface of occipital bone so that the models could perform lateral bending,flexion,extension,and rotational motions.The motion range and stress distribution of internal fixation were compared under varying conditions among different occipitocervical fusion models.In addition,the impact of occipital condyle screw upon hypoglossal canals was examined.Results Compared with instability model,the motion range in the internal fixation model by occipital condyle screws declined by 96.8％,95.6％,95.0％ and 98.5％ respectively in lateral bending,flexion,extension and rotation.In the internal fixation by occipital plate screws,the motion range decreased by 96.3％,95.7％,98.4％ and 99.6％ respectively.In the internal fixation by transarticular screws,the motion range exhibited a decline of 95.7％,94.0％,94.3％ and 98.9％,respectively.The stress peaks in the occipital condyle screw were 192.4 MPa,201.6 MPa and 187.6 MPa under lateral bending,flexion,and rotation conditions,respectively.The stress peaks in the occipital plate screw were 279.6 MPa,213.7 MPa,and 154.1 MPa,respectively.The stress peaks in the transarticular screw were 232.4 MPa,220.9 MPa,and 224.5 MPa,respectively.The stress impact peak of occipital condyle screw on the hypoglossal canals wall was 12.96 MPa,and the content deformationunder the hypoglossal canal was 0.64％.Conclusions The occipital condyle screw internal fixation has similar stability with common occipitocervical fusion fixations.The occipital condyle screw has more uniform stress distribution and less effect on the hypoglossal canals,and hence is safe and reliable as anchor point on the cranial side in occipitocervical fusion.

This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26％,and that of the control group was 93.89％,with statistic significance (P ＜ 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P ＜ 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P ＞ 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P ＜ 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P ＞ 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.

Objective To investigate the status of self‐management of blood pressure (BP) among elderly hypertensive patients living in new rural communities of Shanghai. Methods We enrolled a total of 2 241 hypertensive patients over 60 years old who participated in the National Key Research and Development Project "Cohort study on hypertension" of the 13th Five‐Year Plan in Langxia, Shanghai from May to July 2018. Questionnaires, physical examinations, and laboratory tests were conducted. We collected participants' demographic information, cardiovascular history, and self‐management behaviors related to hypertension. The status of self‐management of BP among participants with hypertension was analyzed. Pearson's chi‐squared test was used to explore the differences between males and females. Results Participants'mean age was (70.0±6.8) years, and males accounted for 38.8% of all participants. The systolic and diastolic BP levels of participants were (147.8±15.4) mmHg (1 mmHg=0.133 kPa) and (82.8±9.8) mmHg, respectively. The systolic blood pressure level of women was higher than that of men, and the diastolic blood pressure level of men was higher; the difference was statistically significant (all P<0.05). The awareness, treatment, and control rate of hypertension were 79.0%, 78.0%, and 25.6%, respectively. Males had a significantly higher control rate than females (P<0.05). The status of self‐management of blood pressure was as follows: (1) As to lifestyle, 84.4% of participants lacked exercise, and 69.2% were overweight or obese. The prevalence of smoking and drinking was higher in males (40.7% and 46.2%, respectively), and the proportion of females (12.4%) with anxiety and/or depression was higher than that of males (P all<0.001). (2) Concerning BP‐monitoring, only 10.1% of participants measured BP every week, 22.9% had BP measurement instruments at home, and 4.6% recorded their BP levels. There was no significant difference in self‐blood pressure monitoring behavior between men and women. (3) Regarding adherence to medication treatment, 97.6% took antihypertensive drugs regularly, and 21.6% were on combination therapy. The proportion of men taking combined drugs was higher than that of women, but there was no significant difference. Conclusions The rates of awareness, treatment, and control of hypertension in elderly hypertensive patients in new rural communities of Shanghai were above the national average. However, the status of self‐management of BP was still not satisfactory. More attention should be paid to healthy lifestyle, home BP monitoring, and effective pharmaceutical treatment strategies for hypertension.