Objective:To explore the application value of transcranial ultrasound(TCS)in evaluating the third ventricle in cognitive impairment associated with Parkinson's disease(PD).Methods:A cross-sectional study was conducted.A total of 100 patients with PD, hospitalized and diagnosed in the Department of Neurology at Beijing Hospital from January 2021 to May 2024, were included in the study.Due to limitations related to the temporal window, the third ventricle could not be visualized in 2 patients(2%).Consequently, a total of 98 PD patients underwent TCS and cranial magnetic resonance imaging(MRI)examinations.Based on the Montreal Cognitive Assessment(MoCA)score, the PD patients were classified into three groups: normal cognitive function(18 cases), mild to moderate cognitive impairment(62 cases), and severe cognitive impairment(18 cases).The clinical manifestations and ultrasonic image characteristics of patients in each group were compared.Results:TCS and MRI demonstrate strong consistency in measuring the width of the third ventricle, with an intraclass correlation coefficient(ICC)of 0.783.Patients with severe cognitive impairment exhibit a wider third ventricle compared to those with normal cognitive function( P=0.002), and the width in patients with severe cognitive impairment is also greater than that in patients with moderate cognitive impairment( P=0.016).Additionally, the width of the third ventricle in individuals with PD shows a positive correlation with age( P<0.001), but it does not correlate with disease duration, the area of substantia nigra hyperecho, midbrain area, MoCA scores, Mini-Mental State Examination(MMSE)scores, Hamilton Anxiety Rating Scale(HAMA)scores, or Hamilton Depression Rating Scale(HAMD)scores( P>0.05).No statistically significant difference was found in the area of bilateral substantia nigra hyperecho among the three groups( P>0.05).Multiple linear regression analysis indicated that disease duration, third ventricle width, midbrain area, HAMD, and HAMA do not affect MoCA( P>0.05), while MMSE scores have a statistically significant impact on MoCA( P<0.001). Conclusions:The measurement of the third ventricle using TCS is valuable for evaluating cognitive decline.In patients with PD who exhibit severe cognitive impairment, the third ventricle is often widened; however, the width of the third ventricle does not correlate with cognitive performance.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Purpose To evaluate the diagnostic value of three-dimensional amide proton transfer weighted imaging(APTWI)in distinguishing benign from malignant bone tumors and the diagnostic efficacy of APTWI combined with diffusion-weighted imaging(DWI).Materials and Methods Sixty-nine patients with pelvic and lower extremity bone tumors,confirmed by puncture or surgical pathology at the First Affiliated Hospital of Zhengzhou University,were prospectively collected from April 2022 to July 2023.On the relevant parameter maps of APTWI and DWI,the asymmetric magnetization transfer rate at a chemical shift of 3.5 ppm[MTRasym(3.5 ppm)]and apparent diffusion coefficient(ADC)values corresponding to the lesions were measured,respectively.Comparative analysis of differences in each parameter was conducted,and the diagnostic efficacy of these parameters alone and in combination was compared.Results Among 69 bone tumor,24 were benign cases and 45 malignant cases.MTRasym(3.5 ppm)of malignant bone tumors was higher than that of benign tumors[(2.974±0.630)%vs.(2.215±0.963)%],while ADC values of malignant bone tumors were lower than those of benign tumors[(1.143±0.406)×10-3 s/mm2 vs.(1.757±0.449)×10-3 s/mm2],with significant differences between the two groups(t=3.532,-5.645;P<0.001).Receiver operating characteristic curve showed that MTRasym(3.5 ppm),ADC values,and their combination exhibited good performance in the differential diagnosis of benign and malignant bone tumors,with the area under the curve being 0.765,0.841 and 0.874,respectively.There were no statistically significant differences in the area under the curve between the combined APTWI-DWI and either APTWI or DWI alone in diagnosing benign and malignant bone tumors(combined vs.APTWI:Z=1.873,P=0.064;combined vs.DWI:Z=1.333,P=0.167).The diagnostic specificity of combined APTWI-DWI was significantly higher than that of APTWI alone(96%vs.56%,P=0.001),but there was no statistically significant difference compared with DWI alone(96%vs.80%,P=0.189).Conclusion APTWI and DWI,either alone or in combination,could serve as effective imaging indicators for distinguishing benign from malignant bone tumors.The combination of APTWI and DWI shows a trend of achieving higher diagnostic efficacy and diagnostic specificity in differentiating benign from malignant bone tumors,thus holding potential clinical application value.

Purpose To evaluate the diagnostic value of three-dimensional amide proton transfer weighted imaging(APTWI)in distinguishing benign from malignant bone tumors and the diagnostic efficacy of APTWI combined with diffusion-weighted imaging(DWI).Materials and Methods Sixty-nine patients with pelvic and lower extremity bone tumors,confirmed by puncture or surgical pathology at the First Affiliated Hospital of Zhengzhou University,were prospectively collected from April 2022 to July 2023.On the relevant parameter maps of APTWI and DWI,the asymmetric magnetization transfer rate at a chemical shift of 3.5 ppm[MTRasym(3.5 ppm)]and apparent diffusion coefficient(ADC)values corresponding to the lesions were measured,respectively.Comparative analysis of differences in each parameter was conducted,and the diagnostic efficacy of these parameters alone and in combination was compared.Results Among 69 bone tumor,24 were benign cases and 45 malignant cases.MTRasym(3.5 ppm)of malignant bone tumors was higher than that of benign tumors[(2.974±0.630)%vs.(2.215±0.963)%],while ADC values of malignant bone tumors were lower than those of benign tumors[(1.143±0.406)×10-3 s/mm2 vs.(1.757±0.449)×10-3 s/mm2],with significant differences between the two groups(t=3.532,-5.645;P<0.001).Receiver operating characteristic curve showed that MTRasym(3.5 ppm),ADC values,and their combination exhibited good performance in the differential diagnosis of benign and malignant bone tumors,with the area under the curve being 0.765,0.841 and 0.874,respectively.There were no statistically significant differences in the area under the curve between the combined APTWI-DWI and either APTWI or DWI alone in diagnosing benign and malignant bone tumors(combined vs.APTWI:Z=1.873,P=0.064;combined vs.DWI:Z=1.333,P=0.167).The diagnostic specificity of combined APTWI-DWI was significantly higher than that of APTWI alone(96%vs.56%,P=0.001),but there was no statistically significant difference compared with DWI alone(96%vs.80%,P=0.189).Conclusion APTWI and DWI,either alone or in combination,could serve as effective imaging indicators for distinguishing benign from malignant bone tumors.The combination of APTWI and DWI shows a trend of achieving higher diagnostic efficacy and diagnostic specificity in differentiating benign from malignant bone tumors,thus holding potential clinical application value.

Objective To investigate the value of MRI of the sternal end of clavicle in bone age assessment in Chinese population,especially its applicability in the determination of criminal responsible age.Methods A total of 431 patients aged from 10.00 to 29.99 years with neck or chest MRI were retrospectively collected.According to the Schmeling grading method,the epiphyseal development of the clavicle MRI was divided into five grades.The consistency of methods was evaluated.The correlation and general descriptive analysis between MRI grades and age was analyzed.The sex difference was analyzed.Curve fitting was used to establish a nonlinear model between age and grades.Results The grades of clavicle MRI showed a significant age-related trend(Figure 2),and the correlation was 0.861(0.887 in males and 0.840 in females).Except for grade 1,there was no significant difference between males and females in other grades.The minimum age of male grade 3 was greater than 14 years old,and the minimum age of female grade 3 was greater than 16 years old.The minimum age in grade 4 and grade 5 was over 18 years old in both sexes.The best curve fitting model was cubic model for both sexes(R2=0.805 for men and 0.722 for women).Conclusion Clavicle MRI can be used for the assessment of bone age in Chinese population.Complete epiphyseal plate closure can be used as a reliable indicator for the determination of age at 18 years old,and it is expected to achieve radiation-free forensic bone age assessment.

Objective:To explore the application value of transcranial ultrasound(TCS)in evaluating the third ventricle in cognitive impairment associated with Parkinson's disease(PD).Methods:A cross-sectional study was conducted.A total of 100 patients with PD, hospitalized and diagnosed in the Department of Neurology at Beijing Hospital from January 2021 to May 2024, were included in the study.Due to limitations related to the temporal window, the third ventricle could not be visualized in 2 patients(2%).Consequently, a total of 98 PD patients underwent TCS and cranial magnetic resonance imaging(MRI)examinations.Based on the Montreal Cognitive Assessment(MoCA)score, the PD patients were classified into three groups: normal cognitive function(18 cases), mild to moderate cognitive impairment(62 cases), and severe cognitive impairment(18 cases).The clinical manifestations and ultrasonic image characteristics of patients in each group were compared.Results:TCS and MRI demonstrate strong consistency in measuring the width of the third ventricle, with an intraclass correlation coefficient(ICC)of 0.783.Patients with severe cognitive impairment exhibit a wider third ventricle compared to those with normal cognitive function( P=0.002), and the width in patients with severe cognitive impairment is also greater than that in patients with moderate cognitive impairment( P=0.016).Additionally, the width of the third ventricle in individuals with PD shows a positive correlation with age( P<0.001), but it does not correlate with disease duration, the area of substantia nigra hyperecho, midbrain area, MoCA scores, Mini-Mental State Examination(MMSE)scores, Hamilton Anxiety Rating Scale(HAMA)scores, or Hamilton Depression Rating Scale(HAMD)scores( P>0.05).No statistically significant difference was found in the area of bilateral substantia nigra hyperecho among the three groups( P>0.05).Multiple linear regression analysis indicated that disease duration, third ventricle width, midbrain area, HAMD, and HAMA do not affect MoCA( P>0.05), while MMSE scores have a statistically significant impact on MoCA( P<0.001). Conclusions:The measurement of the third ventricle using TCS is valuable for evaluating cognitive decline.In patients with PD who exhibit severe cognitive impairment, the third ventricle is often widened; however, the width of the third ventricle does not correlate with cognitive performance.

Objective To explore the value of 3D amide proton transfer weighted imaging(APTWI),diffusion weighted imaging(DWI)and the combination for differentiating benign and malignant bone and soft tissue tumors.Methods Non-contrast MRI,APTWI and DWI of pelvis or lower extremity were prospectively acquired in 96 patients with bone and soft tissue tumors.MTRasym and ADC maps were obtained based on APTWI and DWI calculation with an offset of 3.5 ppm,respectively,and the maximum asymmetric magnetization transfer rate(MTRasym)(MTRasymmax),the mean MTRasym(MTRasymmean)and the minimum MTRasym(MTRasymmin),as well as the maximum apparent diffusion coefficient(ADC)(ADCmax),the mean ADC(ADCmean)and the minimum ADC(ADCmin)values were measured.The above parameters were compared between benign and malignant tumors.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of APTWI,DWI and the combination.Results Among 96 patients,there were 41 benign and 55 malignant pelvic or lower limb bone and soft tissue tumors.In benign tumors,MTRasym(3.5 ppm)values,including MTRasymmax.MTRasymmean and MTRasymmin were significantly higher,whereas ADC values including ADCmax,ADCmeanand ADCmin were significantly lower than those in malignant tumors(all P＜0.05).AUC of MTRasymmax and ADCmin for differentiating benign and malignant bone and soft tissue tumors was 0.791 and 0.873,respectively,being not statistically different(P=0.122),but both lower than that of their combination(AUC=0.944,P＜0.001,P=0.041).Conclusion APTWI combined with DWI had high efficacy for differentiating benign and malignant bone and soft tissue tumors.

Objective:To compare the clinical and ultrasonic features of elderly-onset rheumatoid arthritis(EORA)and young-onset rheumatoid arthritis(YORA).Methods:A total of 104 patients diagnosed with rheumatoid arthritis were categorized into two groups based on their age of onset: the EORA group, consisting of 70 patients, and the YORA group, consisting of 34 patients.A comparative analysis was conducted on the clinical manifestations, laboratory findings, and ultrasonic images of patients in these two groups.Results:The male ratio in the EORA group was significantly higher than that in the YORA group(24.3% vs.8.8%, P=0.048).There were no statistical differences in the course of disease, DAS28, ESR, CRP, RF, and anti-CCP antibody positive rates between the two groups( P>0.05)when compared with the YORA group.The incidence of osteoarthritis and osteoporosis in the EORA group was significantly higher than that in the YORA group( P=0.018, P=0.011).Ultrasonic results revealed a significantly higher incidence of phalangeal bone erosion in the EORA group compared to the YORA group(14.9% vs.4.3%, P<0.01).Binary logistic regression analysis indicated that different age groups, disease duration, osteoarthritis, and osteoporosis did not have an effect on the ultrasonic changes of synovial hyperplasia, tendonitis, tenosynovitis, and bone erosion in RA patients. Conclusions:There is no significant difference in the clinical disease activity and disease progression between EORA group and YORA group.Additionally, the pattern of joint inflammation involvement is similar in both groups.Ultrasound examinations revealed a higher incidence of bone erosion in finger joints of EORA patients compared to YORA patients.

Objective: To investigate the expression of uteroglobin-related protein 1(UGRP1) in thyroid cells induced by interleukin-1β(IL-1β) and its correlation with Fas/FasL mediated apoptosis. Methods: Control group, IL-1β group and IL-1β+anti-FasL antibody group were established, rat thyroid cells(FRTL-5 cells) were culturedin vitro. The expression levels of UGRP1 and Fas mRNA of each group were detected by real-time PCR and the apoptosis rate of each group was detected by flow cytometry. Results: Compared with control group, the mRNA expression levels of UGRP1 and Fas in IL-1β group and IL-1β+anti-FasL antibody group increased, and the difference was statistically significant(P<0.05). Compared with control group, the early apoptosis rate of thyroid cells in IL-1β group increased(7.49%±1.91%vs28.46%±3.17%), and the difference was statistically significant(P<0.001). Compared with IL-1β group, the early apoptosis rate of thyroid cells in IL-1β+anti-FasL antibody group decreased(28.46%±3.17%vs19.20%±1.75%), and the difference was statistically significant(P<0.05). Compared with IL-1β group, the expression levels of UGRP1 mRNA(2.22±0.31vs2.66±0.28) and Fas mRNA(2.75±0.18vs3.03±0.16) in IL-1β+anti-FasL antibody group were not significantly different(P>0.05). Conclusion IL-1β induces the high expression of UGRP1 and Fas and apoptosis of thyroid cells, the high expression of UGRP1 is not associated with Fas/FasL mediated apoptosis.

【Objective】 To investigate the effect of leukocyte-depleted suspended red blood cells (lds-RBCs) storaged for different time on blood transfusion effect of patients with hematologic diseases and malignant tumors, as well as to evaluate the storage quality of lds-RBCs in blood stations. 【Methods】 Seven hospitals (4 tertiary-A hospitals and 3 secondary-A hospitals), applying for blood from our blood center, were selected. Blood transfusion cases (medical record) and related data (indicators) of patients with blood diseases and malignant tumors in those hospitals from December 2018 to May 2019 were collected, including disease diagnosis (type) before transfusion, demographic characteristics, date of solo transfusion of lds-RBCs, units of lds-RBCs [(1~2)U/bag, 1 U=200 mL whole blood], different storage duration (1~5 weeks) (bar code), and hemoglobin (Hb) 48 h before and after transfusion. The efficacy of lds-RBCs (storaged for different time) transfusion in patients with hematologic diseases and malignant tumors was evaluated by statistical analysis. 【Results】 A total of 3 557 patients with hematologic diseases and malignant tumors were enrolled in this study. No significant changes were noticed in transfusion efficacy by blood transfusion unit, gender and previous transfusion history (P > 0.05). The effective rate of lds-RBCs in patients with blood diseases and malignant tumors, stratified by storage duration, i. e. storaged for >1~2 weeks, >2~3 weeks, >3~4 weeks and more than >4~5 weeks, was 78.77% vs 77.68% vs 75.06% vs 70.37%, and 79.32% vs 76.73% vs 72.79% vs 67.65%, respectively(P<0.05), with lds-RBCs of 4-5 storage weeks presenting the lowest transfusion efficacy in both groups of patients. 【Conclusion】 The storage time of most lds-RBCs supplied by our center is moren than 3 weeks, and the transfusion effect of lds-RBCs stored for 5 weeks needs further observation. In order to ensure and improve the efficacy of blood transfusion, evidence-based medicine and information management are needed to help the clinical gasp the advantageous time of blood products and shorten the storage-to-transfusion time of red blood cells.