Objective To explore the application value of simultaneous multi-slice(SMS)technique in diffusion tensor imaging(DTI)for evaluating brain glioma.Methods Thirty-four brain glioma patients were prospectively enrolled,and brain conventional DTI and SMS-DTI were acquired.The subjective scores of image quality,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were compared between SMS-DTI and conventional DTI,so were the numbers of whole brain fiber bundles,tumor relative fractional anisotropy(rFA)and relative mean diffusivity(rMD)obtained based on SMS-DTI and conventional DTI.Results Among 34 patients,there were 23 cases of high-grade glioma and 11 cases of low-grade glioma.No significant difference of subjective scores of image quality,tumor edge clarity nor magnetic susceptibility artifacts was found between SMS-DTI and conventional DTI(all P＞0.05).SNR and CNR on SMS-DTI were both lower than those on conventional DTI(both P＜0.05).No significant difference of the numbers of whole brain fiber bundles,rFA nor rMD of gliomas with different pathological grades was detected based on SMS-DTI compared with those on conventional DTI(all P＞0.05).Conclusion SMS applicated in DTI for evaluating brain gliomas was able to shorten acquisition time under the condition of ensuring image quality and quantitative analysis accuracy.

Objective:To explore the application value of multiple indexes of high-frequency ultrasound in the diagnosis of shoulder stiffness, and to provide data support and theoretical basis for the diagnosis and treatment of shoulder stiffness.Methods:Clinical data of 261 patients with unilateral shoulder pain with limited mobility admitted to the Orthopedic Trauma, Hebei Medical University Third Hospital from January to December 2023 were retrospectively analyzed. With the results of shoulder arthroscopy as the gold standard, the patients were divided into 127 patients with shoulder stiffness (observation group) and 134 patients with non-shoulder stiffness and shoulder pain (control group). The fluid accumulation of long head of the biceps tendon (LHBT), echo of rotator interval (RI) and blood flow signal, thickness of coracohumeral ligament (CHL), thickness of subacromial-subdeltoid bursa (SASD), fluid accumulation and blood flow signal, fluid accumulation of posterior glenohumeral joint capsule (PJ), the inferior capsule thickness (ICT) and the thickness of inferior glenohumeral ligament (IGHL) were observed and measured in the two groups in addition, the CHL difference, ICT difference and IGHL difference between the affected side and the contralateral side were calculated, and the difference between the two groups of ultrasound indicators was compared and the multivariate logistic stepwise regression analysis was performed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of each indicator for shoulder stiffness.Results:RI hypoecho with increased blood flow signal, SASD thickening, SASD effusion, SASD blood flow signal detection rate, IGHL thickness, IGHL difference and ICT difference in observation group were significantly higher than those in the control group (all P<0.05). Multivariate logistic stepwise regression analysis showed that SASD thickening, SASD effusion and IGHL difference were independent predictors of shoulder stiffness (all P<0.05). The area under the curve of SASD thickening, SASD effusion and IGHL difference in the diagnosis of shoulder stiffness were 0.550, 0.540 and 0.636, respectively. The diagnostic sensitivity was 89.8%, 10.2% and 60.6%, and the specificity was 20.1%, 97.8% and 67.2%, respectively. The area under the curve was 0.676, the diagnostic sensitivity was 59.8%, and the specificity was 75.4%. Conclusions:High-frequency ultrasound is an effective imaging method to assist clinical diagnosis of shoulder stiffness. SASD thickening, SASD effusion and IGHL difference may be independent predictors of shoulder stiffness. The combined application of these three indicators has higher clinical application value and provides favorable ultrasound indicators for clinical differential diagnosis of shoulder stiffness.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective: To investigate the recovery of splenomegaly and hypersplenism after liver transplantation in children and explore the necessity of splenomegaly management before and during liver transplantation. Method: The data of 22 children who were underwent liver transplantation with preoperative splenomegaly and hypersplenism who were not treated with splenomegaly before and during operation and with no recurrence of portal hypertension during postoperative follow-up in Department of Hepatobiliary Surgery, Children’s Hospital of Chongqing Medical University from December 2008 to January 2019 were collected. There were 13 male patients and 9 female patients with a median age of 6.5 months. The changes of erythrocyte, platelet, white blood cell and spleen length and thickness were analyzed by paired t-test before and at the 1st, 3rd and 6th months after surgery. Correlation analysis was performed on the change of spleen long diameter and thickness product and blood cell recovery. Results: There were 21 cases of red blood cell decreased before surgery, with a mean value of(3.1±0.5)×10¹²/L, and(3.7±0.7)×10¹²/L, (4.6±0.6)×10¹²/L and (4.3±0.5)×10¹²/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the preoperative and postoperative groups were statistically significant (P<0.05). There were 7 cases of thrombocytopenia before operation, with an average of (70.0±17.0)×10⁹/L, and (191.0±129.0)×10⁹/L, (156.0±79.0)×10⁹/L and (167.0±63.0)×10⁹/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the first, third, and sixth months after surgery were significant compared with that before surgery (P<0.05). Leukocyte count decreased in 5 cases with an average value of (3.30±0.56)×10⁹/L before surgery, (7.5±4.4)×10⁹/L, (7.4±1.4)×10⁹/L, (5.1± 2.5)×10⁹/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the two groups were significant (P<0.05). The average value of preoperative spleen length times thickness was (35.7±12.9) cm² and at the 1st, 3rd, 6th month after surgery it was (26.2±8.1)cm², (25.2±13.4)cm², (27.2±7.4)cm², respectively. The differences between the first, third months after surgery were significant compared with that before surgery (P<0.05). The white blood cell and platelet counts of children before and after surgery were correlated with spleen size negatively (correlation coefficients were -0.902, -0.933, respectively), and the differences were statistically significant (P<0.05). Conclusions In the early stage of liver transplantation, the size of spleen retracts to varying degrees, and hypersplenism can be alleviated continuously. Therefore, it is unnecessary to treat splenomegaly and hypersplenism before and during liver transplantation.

Objective To investigate the characteristics of adenovirus infection in hospitalized children with respiratory tract infection in Shenzhen.Methods Nasopharyngeal swabs obtained from 25 602 children hospitalized with respiratory tract infections in Shenzhen Children's Hospital during 2014 to 2016,were tested for adenovirus with direct immunofluorescence assay.The detection rate of adenovirus and diagnosis in hospitalized children with respiratory tract infection were analyzed.Results The total adenovirus detection rate was 2.97 ％ in 25 602 samples,with a male to female ratio of 2.04:1,no significantly difference in detection rate in male (3.12％) and female (2.70％).Accounted for 724 (95.14％) of the total adenovirus positive detection children below six years old,and 409(53.75％) children were detected below two years old.There was a distinct seasonality;the detection rate was higher in summer and winter (x2 =36.631,P＜0.01).In 761 hospitalized patients of ADV positive,431 were pneumonia,109 were bronchitis,74 were tonsillitis,14 were conjunctivitis pharynx and 133 were acute upper respiratory infection.Conclusion Our study demonstrates that respiratory adenovirus infection is an important cause of hospitalization in children below the age of 6 years in Shenzhen,China.The detection rate was higher in summer and winter than spring and autumn.Most adenovirus positive children were diagnosed by pneumonia,bronchitis and acute upper respiratory tract infection.

Objective To explore the methods for solving the neck two-point T2-DIXON fat-water separation misalignment. Methods During August 2015 to July 2016, 140 patients with fat-water separation on the nasopharynx and cervical axial T2-DIXON images were prospectively recruited from Sichuan Cancer Hospital. There was no metal implant in the fat-water separation misalignment area. The patients were divided into 7 groups by random number table method with 20 patients in each group for the axial T2-DIXON scan: Group A adopted plan 1( increasing localized shim box on the fat-water separation misalignment area);Group B adopted plan 2(increasing the times of repeated acquisition to 2 of the T2-DIXON sequence);Group C adopted plan 3 (placing the shimming assist device on the inspection area);Group D adopted plan 1+plan 2;Group E adopted plan 1+plan 3;Group F adopted plan 2+plan 3;Group G adopted plan 1+plan 2+plan 3. The images quality of two scans were graded and compared. We compared the signal-to-noise ratio (SNR) of T2-DIXON image on the same muscle tissue between the two scans of each group. The difference of SNR on the two scan images was compared with the paired t test, the difference of SNR among seven groups was conducted with independent sample t test, and the comparison of image quality classification was conducted by rank sum test. Results The image quality of all the seven groups was improved to some different degrees. The cases with image quality reaching level 3 were 12, 15, 15, 16, 17, 18 and 18 in A to G groups, respectively. It was better to use the combination of two or more methods to improve the quality of the image than to use a single method. There were no statistically significant differences in SNR between two scans in A, C and E group (all P>0.05).There were statistically significant differences in SNR between two scans in groups of B, D, F and G(all P<0.05). There were statistically significant differences among the 7 groups, with the best quality in G group (P<0.05). There was no significant difference in the first SNR among the 7 groups (P>0.05);there were significant differences in the second scans among the 7 groups (P<0.05) .Conclusions This study suggests that placing localized shim box, increasing the times of repeated acquisition, and use of shimming assist device in MRI correct the fat-water separation misalignment, help to provide images with high quality. The combination of the above method was better than using the single method. The SNR can be improved when increasing the times of repeated acquisition.

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .

Objective To investigate the effect and mechanism of liver cancer derived mesenchymal stem cell (LCMSC) on the invasion of liver cancer cells. Methods The expressions of interleukin (IL)-6, IL-8 and chemotactic factors CXCL1, CXCL5 and CXCL12 mRNA in the bone marrow derived mesenchymal stem cell (BMSC) and LCMSC were detected by reverse transcription-polymerase chain reaction (RT-PCR). The expression of protein CXCL12 in the supernate of LCMSC was detected by enzyme-linked immunosorbent assy (ELISA) and Western blot. Different cells were co-cultured and divided into the HepG2+BMSC, HepG2+LCMSC and HepG2+LCMSC+siRNA-CXCL12 groups. The effect of CXCL12 on the invasion of liver cancer HepG2 cells were detected by Transwell migration assay. The experiment data were compared using one way analysis of variance and LSD-t test or t test. Results The expression of CXCL12 mRNA in LCMSC was 60.3±2.4, significantly higher than 13.8±1.8 in BMSC (t=15.68, P<0.05). The expression of protein CXCL12 in the supernate of LCMSC was (31.5±1.7) ng/L, significantly higher than (14.3±1.5) ng/L in BMSC (t=7.60, P<0.05). And the expression of protein CXCL12 was up-regulated. Transwell migration assay indicated that the quantity of membrane-invasion cells in the HepG2+LCMSC group was 110±12, significantly higher than 65±9 in the HepG2+BMSC group and 76±7 in the HepG2+LCMSC+siRNA-CXCL12 group (LSD-t=5.25, 4.86; P<0.05). Conclusion CXCL12 is highly expressed in LCMSC. LCMSC may enhance the invasion of HepG2 cells through up-regulating the expression of CXCL12. The invasion of liver cancer cells can be effectively weakend by silencing the CXCL12 gene with siRNA.

Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.

Adult ; China ; epidemiology ; Humans ; Male ; Middle Aged ; Sunlight ; Vitamin D ; blood ; Vitamin D Deficiency ; epidemiology