Objective To investigate the imaging features of post-transplant lymphoproliferative disorder(PTLD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The imaging findings of EB virus-associated PTLD(EBV-PTLD)after allo-HSCT in 8 patients with hematological diseases were retrospectively analyzed,including 1 case with acute lymphoblastic leukemia(ALL),3 cases with acute myeloid leukemia(AML),1 case with myelodysplastic syndrome(MDS)and 3 cases with aplas-tic anemia(AA).All patients were positive for EB virus(EBV)after transplantation.MRI,CT plain scan and enhanced scan were performed to analyze the imaging features of all lesions.Results Central nervous system(CNS)was involved in 5 cases,pharyngeal lymphatic ring and left lacrimal sac was involved in 1 case,liver was involved in 1 case,intraperitoneal and retroperitoneal lymph nodes was involved in 1 case.All patients were pathologically confirmed with PTLD.Conclusion PTLD may involve multiple organs and tissues after hematopoietic stem cell transplantation with different onset time.Timely MRI and CT examination,combined with PTLD screening and EBV detection,can detect and diagnose PTLD lesions in early stage,providing important clinical value.

BACKGROUND:Traditional assessment methods for knee osteoarthritis rely on clinical symptoms,physical examinations,and imaging findings of patients.However,these methods fail to reflect the dynamic changes in knee joint kinetics and do not comprehensively depict the objective status of the knee joint.The emergence of the 6 degree of freedom gait analysis system provides a more objective and practical dynamic assessment method for the severity of knee osteoarthritis.This system serves as a basis for more precise treatment strategies for different patients,thereby optimizing patient treatment approaches.OBJECTIVE:To review relevant assessment systems for knee osteoarthritis,compare the 6 degree of freedom gait analysis with traditional methods for assessing knee osteoarthritis severity,and explore the application of 6 degree of freedom gait analysis in guiding knee osteoarthritis treatment strategies.METHODS:A computer search was conducted using Google Scholar and PubMed databases for relevant articles published from January 2002 to June 2023.English search terms included"knee osteoarthritis,knee osteoarthritis severity,6DOF gait analysis,evaluation methods,WOMAC,KOOS."Chinese search terms were"knee osteoarthritis,osteoarthritis evaluation system,6 degree of freedom gait analysis."Based on inclusion and exclusion criteria,a total of 65 articles were selected for synthesis and summarization.RESULTS AND CONCLUSION:(1)The 6 degree of freedom gait analysis improves the accuracy of knee osteoarthritis severity assessment.Treatment plans based on this method significantly improved patient prognosis.(2)Current research findings suggest standardizing the integration of 6 degree of freedom gait analysis and traditional assessment methods in clinical practice for an objective and accurate evaluation of knee osteoarthritis.This enables better selection of treatment plansand evaluation of the long-term effectiveness of individualized treatment strategies.

Objective To investigate the imaging features of post-transplant lymphoproliferative disorder(PTLD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The imaging findings of EB virus-associated PTLD(EBV-PTLD)after allo-HSCT in 8 patients with hematological diseases were retrospectively analyzed,including 1 case with acute lymphoblastic leukemia(ALL),3 cases with acute myeloid leukemia(AML),1 case with myelodysplastic syndrome(MDS)and 3 cases with aplas-tic anemia(AA).All patients were positive for EB virus(EBV)after transplantation.MRI,CT plain scan and enhanced scan were performed to analyze the imaging features of all lesions.Results Central nervous system(CNS)was involved in 5 cases,pharyngeal lymphatic ring and left lacrimal sac was involved in 1 case,liver was involved in 1 case,intraperitoneal and retroperitoneal lymph nodes was involved in 1 case.All patients were pathologically confirmed with PTLD.Conclusion PTLD may involve multiple organs and tissues after hematopoietic stem cell transplantation with different onset time.Timely MRI and CT examination,combined with PTLD screening and EBV detection,can detect and diagnose PTLD lesions in early stage,providing important clinical value.

BACKGROUND:Traditional assessment methods for knee osteoarthritis rely on clinical symptoms,physical examinations,and imaging findings of patients.However,these methods fail to reflect the dynamic changes in knee joint kinetics and do not comprehensively depict the objective status of the knee joint.The emergence of the 6 degree of freedom gait analysis system provides a more objective and practical dynamic assessment method for the severity of knee osteoarthritis.This system serves as a basis for more precise treatment strategies for different patients,thereby optimizing patient treatment approaches.OBJECTIVE:To review relevant assessment systems for knee osteoarthritis,compare the 6 degree of freedom gait analysis with traditional methods for assessing knee osteoarthritis severity,and explore the application of 6 degree of freedom gait analysis in guiding knee osteoarthritis treatment strategies.METHODS:A computer search was conducted using Google Scholar and PubMed databases for relevant articles published from January 2002 to June 2023.English search terms included"knee osteoarthritis,knee osteoarthritis severity,6DOF gait analysis,evaluation methods,WOMAC,KOOS."Chinese search terms were"knee osteoarthritis,osteoarthritis evaluation system,6 degree of freedom gait analysis."Based on inclusion and exclusion criteria,a total of 65 articles were selected for synthesis and summarization.RESULTS AND CONCLUSION:(1)The 6 degree of freedom gait analysis improves the accuracy of knee osteoarthritis severity assessment.Treatment plans based on this method significantly improved patient prognosis.(2)Current research findings suggest standardizing the integration of 6 degree of freedom gait analysis and traditional assessment methods in clinical practice for an objective and accurate evaluation of knee osteoarthritis.This enables better selection of treatment plansand evaluation of the long-term effectiveness of individualized treatment strategies.

Objective:To discuss the improvement effect of Shenshuai Yingyang Capsule in the renal osteodystrophy model rats and its effect on the bone morphogenetic protein(BMP)-7/Smads signaling pathway,and to clarify the relationship between renal function and bone metabolism in the renal osteodystrophy model rats.Methods:Fifty SPF SD rats were selected,and 10 of which were randomly chosen as control group,and the remaining 40 rats were used to establish the renal osteodystrophy model.Thirty successful modeling rats were divided into model group,positive control group,and Shenshuai Yingyang Capsule group,and there were 10 rats in various groups.The rats in control and model groups were given saline,the rats in positive control group were given 0.01 mg·kg-1 calcitriol,and the rats in Shenshuai Yingyang Capsule group were given 1.2 g·kg-1 Shenshuai Yingyang Capsule,all the rats were treated for 12 weeks.HE staining was used to observe the pathomorphology of femur tissue of the rats in various groups;automatic biochemical analyzer and chemiluminescence were used to detect the kidney function and calcium-phosphorus metabolism indicators in serum of the rats in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in various groups;Western blotting method was used to detect the expression levels of BMP-7,phosphorylated BMP-7(p-BMP-7),Smad1/5/8,and phosphorylated-Smad1/5/8(p-Smad1/5/8)proteins in femur tissue of the rats in various groups.Results:The HE staining results showed that there was normal trabecular arrangement in control group with unchanged osteoblasts and osteoid area.In model group,the trabecular width and average osteoid area were increased,while the number of osteoblasts was decreased.In positive control and Shenshuai Yingyang Capsule groups,the trabecular width and average osteoid area were decreased,and the number of osteoblasts was increased.Compared with control group,the levels of blood urea nitrogen(BUN)and serum creatinine(Scr)of the rats in model group were increased(P<0.05);compared with model group,the levels of BUN and Scr of the rats in positive control and Shenshuai Yingyang Capsule groups were decreased(P<0.05);compared with positive control group,the levels of BUN and Scr of the rats in Shenshuai Yingyang Capsule group were decreased(P<0.05).Compared with control group,the level of calcium ion(Ca2+)in serum of the rats in model group was decreased(P<0.05),and the levels of phosphorus ion(P3-),parathyroid hormone(PTH),and alkaline phosphatase(ALP)were increased(P<0.05);compared with model group,the levels of Ca2+in serum of the rats in positive control and Shenshuai Yingyang Capsule groups were increased(P<0.05),and the levels of P3-,PTH,and ALP were decreased(P<0.05);compared with positive control group,the level of Ca2+in serum of the rats in Shenshuai Yingyang Capsule group was increased,and the levels of P3-,PTH,and ALP were decreased(P<0.05).The RT-qPCR results showed that compared with control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7 and Smad1/5/8 mRNA of the rats in positive control drug group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).The Western blotting results showed that compared with control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in positive control group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).Conclusion:Shenshuai Yingyang Capsule can improve the kidney function and calcium-phosphorus metabolism disorders in the renal osteodystrophy model rats,promote the proliferation of the bone marrow stromal cells,and enhances the bone metabolism;its mechanism may be related to the activation of BMP-7/Smads signaling pathway.

Objective To investigate CT manifestations of pulmonary graft-versus-host disease(GVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods A total of 311 children with pulmonary GVHD who underwent allo-HSCT were retrospectively analyzed.According to the onset time of pulmonary GVHD within 100 days after allo-HSCT or not,the patients were divided into acute group(n=82)and chronic group(n=229).Chest CT manifestations were observed and compared between groups,and children survival after treatments were recorded an d compared between groups.Results The main CT manifestations of pulmonary GVHD after allo-HSCT in children included ground glass opacity(GGO)(82/311,26.37％),air trapping(78/311,25.08％),thickening bronchial wall(32/311,10.29％),bronchiectasis(28/311,9.00％),pleural effusion(43/311,13.83％),thickening interlobular septum(43/311,13.83％),thickening pleura(41/311,13.18％)and thoracic air leak syndrome(41/311,13.18％).The proportion of localized GGO,diffuse GGO,pleural effusion and thickening interlobular septum in acute group were all higher,while of air trapping and bronchiectasis were both lower than those in chronic group(all P＜0.05).No significant difference of other menifeatations was found between groups(all P＞0.05).After treatments,85 cases died,and the mortality rate was 27.33％(85/311),which in acute group(30/82,36.59％)was higher than in chronic group(55/229,24.02％)(x2=4.802,P=0.031).Conclusion CT manifestations of pulmonary GVHD after allo-HSCT in children had certain characteristics.

Objective To investigate CT manifestations of pulmonary graft-versus-host disease(GVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods A total of 311 children with pulmonary GVHD who underwent allo-HSCT were retrospectively analyzed.According to the onset time of pulmonary GVHD within 100 days after allo-HSCT or not,the patients were divided into acute group(n=82)and chronic group(n=229).Chest CT manifestations were observed and compared between groups,and children survival after treatments were recorded an d compared between groups.Results The main CT manifestations of pulmonary GVHD after allo-HSCT in children included ground glass opacity(GGO)(82/311,26.37％),air trapping(78/311,25.08％),thickening bronchial wall(32/311,10.29％),bronchiectasis(28/311,9.00％),pleural effusion(43/311,13.83％),thickening interlobular septum(43/311,13.83％),thickening pleura(41/311,13.18％)and thoracic air leak syndrome(41/311,13.18％).The proportion of localized GGO,diffuse GGO,pleural effusion and thickening interlobular septum in acute group were all higher,while of air trapping and bronchiectasis were both lower than those in chronic group(all P＜0.05).No significant difference of other menifeatations was found between groups(all P＞0.05).After treatments,85 cases died,and the mortality rate was 27.33％(85/311),which in acute group(30/82,36.59％)was higher than in chronic group(55/229,24.02％)(x2=4.802,P=0.031).Conclusion CT manifestations of pulmonary GVHD after allo-HSCT in children had certain characteristics.

Objective To analyze the clinical characteristics,pathology,CT characteristics and targeted therapy of primary retroperitoneal leiomyosarcoma treated at our institution during the past 20 years.Methods A retrospective review was performed among 11 patients of this disease.The main performances were hematuria,abdominal mass and abdominal pain.Non-enhanced CT scanning showed soft tissue density in all cases.Tri-phase enhanced scanning showed reinforcement in different degrees.Pathology results showed tissue necrosis.The pathology featured by routine HE and immumohistochemical staining.Results Surgical treatment was performed in all 11 patients.Postoperative pathology showed that median tumor diameter was 14.40cm.Spindle cell,cellular abnormity and mitotic figures could be seen through light microscope.During follow-up,3 cases recurrenced after 2 months,3 years and 5 years respectively.Conclusions Primary retroperitoneal leiomyosarcoma might have a high fatality rate and high recurrence rate.The clinical and CT features are unapparent.Pathology diagnosis is reliable,surgery is necessary to prolong life and cure disease.

Objective To observe the clinical efficacy of electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in treating rheumatoid arthritis (RA) due to liver-kidney yin deficiency.Method Totally 126 patients with active RA due to liver-kidney yin deficiency were randomized into a treatment group and a control group, 63 cases in each group. The control group was prescribed with orally taking Methotrexate tablets and Leflunomide tablets, while the treatment group was intervened by electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in addition to the medications given to the control group. The Disease Activity Score 28 (DAS28) was evaluated before and after intervention, and the therapeutic efficacies were compared based on the criteria of the American College of Rheumatoid (ACR) and syndrome of traditional Chinese medicine (TCM).Result The ACR total effective rate was 87.3% in the treatment group versus 65.1% in the control group, and the difference was statistically significant (P<0.01). The total effective rate based on TCM syndrome was 87.3% in the treatment group versus 73.0% in the control group, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the DAS28 score between the two groups after intervention (P<0.01).Conclusion Electroacupuncture plus oral administration of Chinese medication and western medication is an effective approach in treating RA due to liver-kidney yin deficiency, and it can significantly enhance the therapeutic efficacy based on ACR20 and TCM syndrome.

Objective To investigate the clinical effect of laparoscopic reverse papillary intubation through cystic duct and laparoscope combined with duodenoscope in the treatment of cholecystolithiasis and thining choledocholithiasis.Methods The retrospective cohort study was adopted.The clinical data of 192 patients with cholecystolithiasis and thining choledocholithiasis who were admitted to Chengdu Second People's Hospital between May 2012 to August 2015 were collected.The 96 patients who underwent laparoscopic reverse papillary intubation through cystic duct were allocated into the case group,and the other 96 who received surgery by laparoscope combined with duodeuoscope were allocated into the control group.All the patients underwent laparoscopic cholecystectomy (LC) according to routine approaches.The 96 patients in the case group received the placement of 4 Fr ureter catheter via cystic duct and placement of common bile duct inserted through the duodenal papilla under laparoscope,and then the duodenal papilla was resected using needle knife along the ureter catheter and stones were removed by basket lithotriptor and ball lithotriptor.The 96 patients in the control group received the intubation using the bow knife with zebra guidewire,and stones were removed by basket lithotriptor and ball lithotriptor.During the operations,it was observed whether there were residual stones by nasobiliary radiograph.The comparison was made between the 2 groups concerning (1) surgical situation:intubation and operation time.(2) Postoperative alanine transaminase (ALT),postoperative aspartate transaminase (AST),postoperative total bilirubin (TBil),postoperative blood amylase,postoperative lipase,complications and extubation time.(3) Situation of follow-up:follow-up was done by outpatient examination or telephone interview up to November 2015.The stones recurrence was detected by retrograde cholangiography through nasal bile duct,magnetic resonance cholangiopancreatography (MRCP) or ultrasonic examination.Measurement data with normal distribution were represented as x ± s.Comparison between groups was done by the t test.Count data were analyzed by the chi-square test.Results (1) Surgical situation:2 groups both underwent successful LC.Ureteral catheter in the case group was successfully imbedded through cystic duct,including 8 patients with being difficult to intubate.Five patients in the control group were failed in endoscopic sphincterotomy (EST) due to periamullary diverticula or other causes,and then EST was performed again by the duodenal papilla through ureteral catheter which was intubated through cystic duct.Operation time of the case group and control group was (89 ± 17) minutes and (105 ± 26) minutes,respectively,with a statistically significant difference between the 2 groups (t =5.05,P ＜ 0.05).(2) Postoperative situation:ALT,AST,TBil of the case group and control group were (163 ±54)U/L,(87 ±38)U/L,(43 ± 18)tmol/L and (147 ±49) U/L,(101 ± 26) U/L,(37 ± 17) μmol/L,respectively,showing no statistically significant differences (t =0.97,1.21,0.84,P ＞ 0.05).Postoperative blood amylase and lipase of the case group and control group were (151 ± 41) U/L,(198 ± 72) U/L and (395 ± 142) U/L,(549 ± 217) U/L,respectively,showing statistically significant differences (t =16.18,15.05,P ＜ 0.05).No pancreatitis was found in the case group while 6 patients in the control group complicated with mild pancreatitis were improved by symptomatic treatment of fasting,somatostatin administration and acid suppression,with no severe pancreatitis.No complications such as intestinal perforation,bile duct perforation and massive hemorrhage were detected in both groups after operation.No death occurred.The nasal bile duct in the patients without pancreatitis was removed at postoperative day 3.The nasal bile duct in the patients with pancreatitis was removed after the remission of abdominal pain and diet intake.In the case group,it was difficult to remove the nasal bile duct of 1 patient.Nasal bile duct radiograph showed that the bending section of nasal bile duct was mistakenly sutured by the absorbable thread at the lower margin of incision of junction of cystic ducts,and yet there was unobstructed biliary drainage.The nasal bile duct was removed and the patient was discharged from hospital at postoperative day 19.The abdominal drainage tubes were removed at postoperative day 3 to5 in both groups.(3) Of 192 patients,151 were followed up for a median time of 10 months (range,3-12 months).Patients had good recovery without recurrence of abdominal pain,jaundice and stones.Conclusion Laparoscopic reverse papillary intubation through cystic duct for the treatment of cholecystolithiasis and thining choledocholithiasis is safe and feasible,and it can also reduce incidence of pancreatitis after nasobiliary drainage.