Objective To analyze the characteristics of MR amide proton transfer(APT)imaging and enhancement signals in benign and malignant muscular soft tissue tumors and to explore the value of MR APT imaging,contrast enhancement techniques,and their combined application in the differential diagnosis of benign and malignant muscular soft tissue tumors.Methods A retrospective analysis was conducted on 34 patients with muscular soft tissue tumors confirmed by pathology,including 13 malignant and 21 benign.All patients underwent both MR with contrast enhancement and APT imaging examinations before surgery.APT values were obtained through post-processing on an image workstation.The enhancement signal characteristics and APT values were compared between benign and malignant muscular soft tissue tumors.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of the two techniques alone and in combination for differentiating between benign and malignant muscular soft tissue tumors.Results There were significant differences in enhancement signal characteristics on MR and APT values between benign and malignant muscular soft tissue tumors(P<0.05).The enhancement signal of malignant tumors was more heterogeneous,with higher enhancement degree than benign tumors;the APT value of benign tumors was(2.20±0.93)%,and the APT value of malignant tumors was(3.52±0.83)%,the ROC curve analysis determined a cutoff APT value of 2.82%for malignant tumors,with a diagnostic specificity of 90.5%and sensitivity of 76.9%.The area under the curve(AUC)for MR with contrast enhancement,APT imaging,and the combination of the two techniques were 0.694,0.857 and 0.894,respectively.No significant differences were found in the diagnostic efficacy between MR with contrast enhancement and APT imaging(Z=1.587,P=0.112 6)or between APT imaging and the combination of the two tech-niques(Z=1.217,P=0.223 4),but there was significant difference between MR with contrast enhancement and the combination of the two techniques(Z=2.428,P=0.015 2).Moreover,the combination of the two techniques showed the overall highest diag-nostic efficacy.Conclusion The combined application of MR APT imaging and contrast enhancement techniques is more beneficial for the qualitative diagnosis of muscular soft tissue tumors.

Objective To analyze the difference of rotator cuff muscle group fat content by MR proton density fat fraction(PDFF)tech-nology,and to explore the correlation between these variations and the severity grading of supraspinatus tendon injury.Methods Ninety-three patients with supraspinatus tendon injury were retrospectively selected and divided into the tendinitis group(grade Ⅰ),the partial tear group(grade Ⅱ),and the complete tear group(grade Ⅲ).The fat fraction(FF)values of the three groups of rotator cuff mus-cle group were measured using the PDFF technology,and the differences in FF values among the rotator cuff muscle group in the three groups were compared.The risk factors of the grading of supraspinatus tendon injury and the correlation between FF values and the severity grading of supraspinatus tendon injury were analyzed.Results The differences in the FF values of the supraspinatus and infraspinatus muscles among the three groups were statistically significant(P＜0.01).The FF values of both the supraspinatus and infraspinatus muscles were identified as significant factors associated with the severity grading of supraspinatus tendon injury.Further-more,the FF values of the supraspinatus and infraspinatus muscles were positively correlated with the severity grading of supraspina-tus tendon injury(r=0.576,P＜0.01;r=0.510,P＜0.01).Conclusion MR PDFF technology can effectively evaluate the extent of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury.Specifically,the FF values of the supraspinatus and infraspinatus muscles serve as reliable quantitative indicators for classifying supraspinatus tendon injury.

Objective:To investigate the clinical manifestations of medically refractory hereditary movement disorders in children and the efficacy of deep brain stimulation (DBS).Methods:A case series study.The clinical and follow-up data of 20 children with medically refractory hereditary movement disorders who underwent DBS treatment at the Neurology and Functional Neurosurgery Departments of Beijing Children′s Hospital, Capital Medical University, from July 2018 to April 2024, were retrospectively analyzed.The severity of movement disorder symptoms and surgical effects were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale Movement(BFMDRS-M) or the Unified Parkinson′s Disease Rating Scale Ⅲ(UPDRS Ⅲ).Results:There were 12 males and 8 females among the 20 children, with an onset age ranging from 4 months to 12 years and 5 months.Fourteen patients had hereditary dystonia, which is related to KMT2B in 11 patients, TOR1A in 2 patients and SGCE in 1 patient.Two patients had choreoathetosis, which is related to ADCY5-related familial movement disorders.Two patients had early-onset Parkinson′s disease, which is related to ATP6AP2 in 1 patient and VPS13C in 1 patient.Two patients had neurodevelopmental disorders with involuntary movements, which is related to GNAO1 in 1 patient, and the other patient was idiopathic.All the children were given oral Levodopa, Benzhexol, Baclofen, Tiapride Hydrochloride, Clonazepam alone or in combination.Three children showed obvious dyskinesia after Levodopa treatment.The symptoms of movement disorders in all children exhibited little to no improvement.Levetiracetam and Zonisamide had unstable effects in the treatment of myoclonia.DBS surgery was performed on all the patients aged from 3 to 16 years.Electrodes were successfully inserted into bilateral globus pallidus internus in 14 cases and bilateral subthalamic nuclei in 4 cases.The target was unknown in 2 cases.No surgery-related complications were observed.The patients were followed up for 3 months to 6 years, and the last follow-up age of the patients ranged from 5 years and 7 months to 22 years and 1 month.The rate of improvement in BFMDRS-M score was 37%-100% in 16 patients and >70% in 7 patients with hereditary dystonia.The rate of improvement in UPDRS Ⅲ score was 23% in 1 patient with VPS13C-related early-onset Parkinson′s disease. Conclusions:Childhood medically refractory hereditary movement disorders are a case series that exhibits significant phenotypic and genotypic heterogeneity.DBS surgery demonstrates significant efficacy for KMT2B-, TOR1A-, and SGCE-related hereditary movement disorders.

Objective To analyze the characteristics of MR amide proton transfer(APT)imaging and enhancement signals in benign and malignant muscular soft tissue tumors and to explore the value of MR APT imaging,contrast enhancement techniques,and their combined application in the differential diagnosis of benign and malignant muscular soft tissue tumors.Methods A retrospective analysis was conducted on 34 patients with muscular soft tissue tumors confirmed by pathology,including 13 malignant and 21 benign.All patients underwent both MR with contrast enhancement and APT imaging examinations before surgery.APT values were obtained through post-processing on an image workstation.The enhancement signal characteristics and APT values were compared between benign and malignant muscular soft tissue tumors.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of the two techniques alone and in combination for differentiating between benign and malignant muscular soft tissue tumors.Results There were significant differences in enhancement signal characteristics on MR and APT values between benign and malignant muscular soft tissue tumors(P<0.05).The enhancement signal of malignant tumors was more heterogeneous,with higher enhancement degree than benign tumors;the APT value of benign tumors was(2.20±0.93)%,and the APT value of malignant tumors was(3.52±0.83)%,the ROC curve analysis determined a cutoff APT value of 2.82%for malignant tumors,with a diagnostic specificity of 90.5%and sensitivity of 76.9%.The area under the curve(AUC)for MR with contrast enhancement,APT imaging,and the combination of the two techniques were 0.694,0.857 and 0.894,respectively.No significant differences were found in the diagnostic efficacy between MR with contrast enhancement and APT imaging(Z=1.587,P=0.112 6)or between APT imaging and the combination of the two tech-niques(Z=1.217,P=0.223 4),but there was significant difference between MR with contrast enhancement and the combination of the two techniques(Z=2.428,P=0.015 2).Moreover,the combination of the two techniques showed the overall highest diag-nostic efficacy.Conclusion The combined application of MR APT imaging and contrast enhancement techniques is more beneficial for the qualitative diagnosis of muscular soft tissue tumors.

Objective To analyze the difference of rotator cuff muscle group fat content by MR proton density fat fraction(PDFF)tech-nology,and to explore the correlation between these variations and the severity grading of supraspinatus tendon injury.Methods Ninety-three patients with supraspinatus tendon injury were retrospectively selected and divided into the tendinitis group(grade Ⅰ),the partial tear group(grade Ⅱ),and the complete tear group(grade Ⅲ).The fat fraction(FF)values of the three groups of rotator cuff mus-cle group were measured using the PDFF technology,and the differences in FF values among the rotator cuff muscle group in the three groups were compared.The risk factors of the grading of supraspinatus tendon injury and the correlation between FF values and the severity grading of supraspinatus tendon injury were analyzed.Results The differences in the FF values of the supraspinatus and infraspinatus muscles among the three groups were statistically significant(P＜0.01).The FF values of both the supraspinatus and infraspinatus muscles were identified as significant factors associated with the severity grading of supraspinatus tendon injury.Further-more,the FF values of the supraspinatus and infraspinatus muscles were positively correlated with the severity grading of supraspina-tus tendon injury(r=0.576,P＜0.01;r=0.510,P＜0.01).Conclusion MR PDFF technology can effectively evaluate the extent of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury.Specifically,the FF values of the supraspinatus and infraspinatus muscles serve as reliable quantitative indicators for classifying supraspinatus tendon injury.

Objective:To investigate the clinical manifestations of medically refractory hereditary movement disorders in children and the efficacy of deep brain stimulation (DBS).Methods:A case series study.The clinical and follow-up data of 20 children with medically refractory hereditary movement disorders who underwent DBS treatment at the Neurology and Functional Neurosurgery Departments of Beijing Children′s Hospital, Capital Medical University, from July 2018 to April 2024, were retrospectively analyzed.The severity of movement disorder symptoms and surgical effects were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale Movement(BFMDRS-M) or the Unified Parkinson′s Disease Rating Scale Ⅲ(UPDRS Ⅲ).Results:There were 12 males and 8 females among the 20 children, with an onset age ranging from 4 months to 12 years and 5 months.Fourteen patients had hereditary dystonia, which is related to KMT2B in 11 patients, TOR1A in 2 patients and SGCE in 1 patient.Two patients had choreoathetosis, which is related to ADCY5-related familial movement disorders.Two patients had early-onset Parkinson′s disease, which is related to ATP6AP2 in 1 patient and VPS13C in 1 patient.Two patients had neurodevelopmental disorders with involuntary movements, which is related to GNAO1 in 1 patient, and the other patient was idiopathic.All the children were given oral Levodopa, Benzhexol, Baclofen, Tiapride Hydrochloride, Clonazepam alone or in combination.Three children showed obvious dyskinesia after Levodopa treatment.The symptoms of movement disorders in all children exhibited little to no improvement.Levetiracetam and Zonisamide had unstable effects in the treatment of myoclonia.DBS surgery was performed on all the patients aged from 3 to 16 years.Electrodes were successfully inserted into bilateral globus pallidus internus in 14 cases and bilateral subthalamic nuclei in 4 cases.The target was unknown in 2 cases.No surgery-related complications were observed.The patients were followed up for 3 months to 6 years, and the last follow-up age of the patients ranged from 5 years and 7 months to 22 years and 1 month.The rate of improvement in BFMDRS-M score was 37%-100% in 16 patients and >70% in 7 patients with hereditary dystonia.The rate of improvement in UPDRS Ⅲ score was 23% in 1 patient with VPS13C-related early-onset Parkinson′s disease. Conclusions:Childhood medically refractory hereditary movement disorders are a case series that exhibits significant phenotypic and genotypic heterogeneity.DBS surgery demonstrates significant efficacy for KMT2B-, TOR1A-, and SGCE-related hereditary movement disorders.

Objective To investigate the effect of microRNA-214-3p (miR-214-3p) expression in cancer-associated fibroblasts (CAFs) on the cisplatin sensitivity of ovarian cancer cells and its mechanism. Methods Sixty-four ovarian cancer patients were selected as study subjects and divided into platinum-partially sensitive group and platinum-sensitive group based on progression-free survival after chemotherapy. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of miR-214-3p in ovarian cancer tissues from the two groups, and the 2-year survival rates of patients with different clinical characteristics were compared. CAFs and normal ovarian fibroblasts (NFs) were primarily cultured, and qRT-PCR and immunofluorescence experiments were used to detect the expression of miR-214-3p and p62 protein in CAFs and NFs. The expression levels of SQSTM1 gene in different types of ovarian cells were searched through the CSIOVDB database. CAFs were transiently transfected with miR-214-3p mimic (mimic group) and miR-214-3p mimic NC (NC group), and untransfected CAFs were selected as control group. Cell culture supernatants from each group were collected, and an indirect co-culture model of ovarian cancer cell line SKOV3 with CAFs from each group was established. The CCK-8 method, DCFH-DA method, qRT-PCR, and immunoblotting were used to detect the proliferation rate, half-maximal inhibitory concentration of cisplatin (IC50), reactive oxygen species (ROS) content, and relative expression levels of miR-214-3p, cisplatin resistance gene CCND1, and autophagy protein p62 in SKOV3 cells under different culture conditions. Results The relative expression of miR-214-3p was lower in the platinum-partially sensitive group than in the platinum-sensitive group (P < 0.01). There were statistically significant differences in the 2-year survival rates among patients with different International Federation of Gynecology and Obstetrics (FIGO) stages, platinum partial sensitivity, and low miR-214-3p expression (P < 0.01). The relative expression of miR-214-3p was lower in ovarian CAFs than in NFs, while the expression level of p62 protein was higher in CAFs than in NFs (P < 0.01). Online analysis of the CSIOVDB database showed that the expression level of SQSTM1 gene in ovarian CAFs was higher than that in ovarian cancer epithelial cells and NFs (P < 0.01). Compared with SKOV3 cells indirectly co-cultured with CAFs in the control group and CAFs in NC group, SKOV3 cells indirectly co-cultured with mimic CAFs showed reduced proliferation rate, cisplatin IC50, and ROS content, increased relative expression of miR-214-3p, and decreased relative expression of CCND1 mRNA and p62 protein (P < 0.01). Conclusion The expression of miR-214-3p in CAFs is correlated with the sensitivity of ovarian cancer cells to cisplatin. Low expression of miR-214-3p in CAFs can promote the proliferation of ovarian cancer cells and ROS-mediated autophagy, thereby reducing the sensitivity of ovarian cancer cells to cisplatin.