Objective To explore the value of amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the assessment of neurovascular invasion(NVI)of stage T3/T4 rectal cancer.Methods The clinical and MR imaging data of 46 patients with rectal cancer were analyzed retrospectively and divided into NVI positive group and NVI negative group according to the pathological results of NVI.The differences of APT values[maximum APT(APTmax)value,minimum APT(APTmin)value,mean APT(APTmean)value]and apparent diffusion coefficient(ADC)value between the two groups were compared,and the diagnostic efficiency was analyzed by receiver operating characteristic(ROC)curve.Results The APTmax and APTmean values in the NVI positive group were significantly higher than those in the NVI negative group,while the ADC value in the NVI positive group was significantly lower than that in the NVI negative group(P＜0.05).The area under the curve(AUC)of APTmax,APTmean and ADC values for NVI identification were 0.717,0.722 and 0.751,respectively.The AUC of the three indexes combined to identify NVI was 0.858.The combined AUC of the three indexes was larger than that of APTmax,APTmean and ADC alone(P＜0.05).Conclusion APT imaging combined with DWI has a high value in the evaluation of NVI of stage T3/T4 rectal cancer,which can provide guidance for clinical treatment.

Objectives:To explore the incidence and risk factors of adjacent vertebral fractures(AVF)in pa-tients with osteoporotic vertebral compression fractures(OVCF)after percutaneous vertebroplasty(PVP)treatment.Methods:A retrospective analysis was conducted on 482 OVCF patients who underwent PVP at our hospital from June 2017 to January 2022.There were 146 males and 336 females,with an average age of 68.4±3.1 years(63-86 years).The average follow-up time was 42.9±10.2 months(24-70 months).Based on whether AVF occurred during the follow-up period,the patients were divided into an AVF group and a non-AVF group.The time of AVF occurrence was recorded,and the incidence rate of AVF was calculated using the Ka-plan-Meier method to obtain a survival curve.Intergroup comparisons were made in terms of clinical factors including gender,age,body mass index(BMI),adjacent vertebral CT value,and bone metabolism related index-es[total procollagen type Ⅰ N-terminal propeptide(tP Ⅰ NP),[3-cross-linked C-telopeptide of type Ⅰ collagen(β-CTX),and 25-hydroxyvitamin D(25-OHD)];Imaging factors such as whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accom-panied by an intravertebral vacuum cleft(IVC),preoperative vertebral body height,wedge angle,and kyphosis angle;And surgical factors including bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle,restoration of kyphosis angle and whether bone cement leakage occurred.Indicators that were significant in the univariate analysis were included in the multivariate logistic regression analysis.Results:AVF occurred in 47 cases(9.75％)in 17.9±14.7 months(1-55 months)after PVP.The Kaplan-Meier survival curve showed that the incidence of AVF in the group with upper endplate fractures was significantly higher than that in the group without upper endplate fractures(P＜0.001).There were no statistically significant differences between the AVF group and the non-AVF group in terms of gender,BMI,tP Ⅰ NP,[3-CTX,25-OHD,preoperative vertebral body height,wedge angle,kyphosis angle,bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle and restoration of kyphosis angle(P＞0.05).Statistically significant differences were found in age,adjacent vertebral CT value,whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accompanied by an IVC,and whether bone cement leakage occurred(P＜0.05).Further multivariate logistic regression analysis showed that advanced age(OR=1.187,95％CI=1.084-1.300,P＜0.001),low CT value of adjacent vertebra(OR=0.928,95％CI=0.892-0.964,P＜0.001),presence of upper endplate fracture(OR=3.514,95％CI=1.444-8.551,P=0.006),presence of IVC(OR=2.804,95％CI=1.238-6.349,P=0.013),and bone cement leakage(OR=2.415,95％CI=1.134-5.146,P=0.022)were the risk factors for AVF after PVP.Conclusions:Advanced age,low CT value of adjacent vertebra,upper endplate fracture,IVC,and bone cement leakage are the independent risk factors for postoperative AVF in OVCF patients undergoing PVP.

Objectives:To explore the incidence and risk factors of adjacent vertebral fractures(AVF)in pa-tients with osteoporotic vertebral compression fractures(OVCF)after percutaneous vertebroplasty(PVP)treatment.Methods:A retrospective analysis was conducted on 482 OVCF patients who underwent PVP at our hospital from June 2017 to January 2022.There were 146 males and 336 females,with an average age of 68.4±3.1 years(63-86 years).The average follow-up time was 42.9±10.2 months(24-70 months).Based on whether AVF occurred during the follow-up period,the patients were divided into an AVF group and a non-AVF group.The time of AVF occurrence was recorded,and the incidence rate of AVF was calculated using the Ka-plan-Meier method to obtain a survival curve.Intergroup comparisons were made in terms of clinical factors including gender,age,body mass index(BMI),adjacent vertebral CT value,and bone metabolism related index-es[total procollagen type Ⅰ N-terminal propeptide(tP Ⅰ NP),[3-cross-linked C-telopeptide of type Ⅰ collagen(β-CTX),and 25-hydroxyvitamin D(25-OHD)];Imaging factors such as whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accom-panied by an intravertebral vacuum cleft(IVC),preoperative vertebral body height,wedge angle,and kyphosis angle;And surgical factors including bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle,restoration of kyphosis angle and whether bone cement leakage occurred.Indicators that were significant in the univariate analysis were included in the multivariate logistic regression analysis.Results:AVF occurred in 47 cases(9.75％)in 17.9±14.7 months(1-55 months)after PVP.The Kaplan-Meier survival curve showed that the incidence of AVF in the group with upper endplate fractures was significantly higher than that in the group without upper endplate fractures(P＜0.001).There were no statistically significant differences between the AVF group and the non-AVF group in terms of gender,BMI,tP Ⅰ NP,[3-CTX,25-OHD,preoperative vertebral body height,wedge angle,kyphosis angle,bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle and restoration of kyphosis angle(P＞0.05).Statistically significant differences were found in age,adjacent vertebral CT value,whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accompanied by an IVC,and whether bone cement leakage occurred(P＜0.05).Further multivariate logistic regression analysis showed that advanced age(OR=1.187,95％CI=1.084-1.300,P＜0.001),low CT value of adjacent vertebra(OR=0.928,95％CI=0.892-0.964,P＜0.001),presence of upper endplate fracture(OR=3.514,95％CI=1.444-8.551,P=0.006),presence of IVC(OR=2.804,95％CI=1.238-6.349,P=0.013),and bone cement leakage(OR=2.415,95％CI=1.134-5.146,P=0.022)were the risk factors for AVF after PVP.Conclusions:Advanced age,low CT value of adjacent vertebra,upper endplate fracture,IVC,and bone cement leakage are the independent risk factors for postoperative AVF in OVCF patients undergoing PVP.

Objective To explore the value of amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the assessment of neurovascular invasion(NVI)of stage T3/T4 rectal cancer.Methods The clinical and MR imaging data of 46 patients with rectal cancer were analyzed retrospectively and divided into NVI positive group and NVI negative group according to the pathological results of NVI.The differences of APT values[maximum APT(APTmax)value,minimum APT(APTmin)value,mean APT(APTmean)value]and apparent diffusion coefficient(ADC)value between the two groups were compared,and the diagnostic efficiency was analyzed by receiver operating characteristic(ROC)curve.Results The APTmax and APTmean values in the NVI positive group were significantly higher than those in the NVI negative group,while the ADC value in the NVI positive group was significantly lower than that in the NVI negative group(P＜0.05).The area under the curve(AUC)of APTmax,APTmean and ADC values for NVI identification were 0.717,0.722 and 0.751,respectively.The AUC of the three indexes combined to identify NVI was 0.858.The combined AUC of the three indexes was larger than that of APTmax,APTmean and ADC alone(P＜0.05).Conclusion APT imaging combined with DWI has a high value in the evaluation of NVI of stage T3/T4 rectal cancer,which can provide guidance for clinical treatment.

Objective:To observe the clinical effect of modified orbital septum fat release in the treatment of lower eyelid relaxation with lacrimal groove deformity.Methods:From January 2019 to August 2023, 52 patients with lower eyelid relaxation and lacrimal groove deformity were treated with the procedures of modified orbital septum fat release in the First People′s Hospital of Jiande, including 5 males and 47 females. The orbicularis oculi muscle supporting ligament was sutured and fixed at the periosteum of the lower edge of the orbit to achieve anatomical reduction. Suture fixation of the free edge of the orbital septum was performed at the edge of the supporting ligament in the modified orbital septum fat release method. Following-up for 6-12 months after surgery, the complications and satisfactory rate of patients were evaluated.Results:All the incision healed well with improved skin effect, and the incision scar were almost invisible. 52 patients were followed up from 6 to 12 months; 49 patients were satisfied and 2 patients were basically satisfied with their appearance, 1 patient was not satisfied with the result. No complications such as lower eyelid ectropion, lower eyelid retraction, or eyelid ball separation occurred.Conclusions:Modified orbital septum fat release is an effective method for correction of lower eyelid relaxation with lacrimal groove deformity.

Objective: To investigate the clinical application of injected autologous fat and buried polydioxanone threads for nasolabial fold filling. Methods: From April 2016 to October 2017, 64 cases of mild and moderate nasolabial fold beauty seekers from the First People＇s Hospital of Jiande were divided into group A and group B with their attitude. Group A (28 cases) were only treated with buried polydioxanone threads for nasolabial fold filling; Group B (36 cases) were treated with injected autologous fat and buried polydioxanone threads for nasolabial fold filling. The surgical effect was recorded for 18 months. Results: The most common complications were swelling, bruising and pain immediately after the surgery. Polydioxanone threads exposure occurred in two cases in each group 2 weeks after the surgery. There were satisfactory results in skin color and skin texture in both groups. 9 cases showed inadequate correction in group A while only 2 cases showed inadequate correction in group B in long-term follow-up (>3 months). Conclusions Combined treatment of autologous fat and polydioxanone threads is safe and effective for nasolabial fold filling.

Objective To investigate the effects and its mechanism of different dental alloys on proliferation and apoptosis of fibroblast.Methods Mouse fibroblast L929 cells were divided into negative control group,gold alloy group,Ni Cr alloy group and copper alloy group.Cell proliferation was detected by MTT assay.Cells were cultured for 48h.Cell cycle and apoptosis rate were detected by flow cytometry.The expression of Bcl-2,Bax,cleaved caspase-3 protein were detected by Western blot.Results Cell proliferation rate had no significant difference in gold alloy group and Ni Cr alloy group and negative control group (P ＞ 0.05),while was significantly lower in copper alloy group than the negative control group (P ＜ 0.01).G1 phase,S phase and G2 phase cells between gold alloy group and the negative control group had no significant difference (P ＞ 0.05),while G1 phase cells in Ni Cr alloy and copper alloy group was significantly lower than negative control group.S phase and G2 phase cells were significantly higher than the negative control group (P ＜ 0.05 or P ＜0.01).Cell apoptosis rate and the expression of Bcl-2,Bax,cleaved caspase-3 protein between gold alloy group and negative control group had no significant difference (P ＞ 0.05).Cell apoptosis rate and the expression of Bax,cleaved caspase-3 protein between Ni Cr alloy and copper alloy group were significantly higher than the negative control group.Bcl-2 protein expression was significantly lower than the negative control group (P ＜ 0.01).Conclusion The gold alloy,Ni Cr alloy and copper alloy can influence proliferation and apoptosis of fibroblast.The gold alloy group is minimum.Different dental alloys leads to the possible mechanism of fibroblast apoptosis was regulation of Bcl-2,Bax,cleaved caspase-3 protein expression.

Objective To investigate the effects of original antigenic sin caused by previous expo-sure to influenza A virus subtype H1N1 on the immune response to inactivated H5N1 vaccine. Methods In this study, the BALB/c mice were first infected with A/PR8 (H1N1) virus or immunized with inactivated vaccine to induce immune responses against the A/PR8 virus. Then they were injected once with inactivated H5N1 vaccine at dosages of 0. 01μg, 0. 1μg and 1μg, respectively. The levels of IgG and neutralizing an-tibodies in serum samples were detected after immunization. Four weeks after immunization, the mice were challenged with a lethal dose of H5N1 virus. Some indicators including the survival rate, body weight loss and residue virus titer in lung were recorded for further evaluation. Results The pre-existing anti-A/PR8 antibodies in mice didn′t alleviate the immune responses to inactivated H5N1 vaccine. Conclusion This study indicates that the original antigenic sin associated with the previous exposure to A/PR8 virus has no significant effect on the immune efficacy of H5N1 vaccine.

Objective To observe the clinical effect of propofol combined with sufentanil in laparoscopic ovarian cyst resection.Methods 80 cases who underwent laparoscopic ovarian cyst resection were chosen,they were divided into the observation group and control group with 40 patients in each group according to the random number table method.The observation group was anaesthetized with propofol combined with sufentanil,while the control group was anaesthetized with propofol combined with fentanyl,the recovery status,operation time,intraoperative bleeding volume,recovery time of gastrointestinal function and postoperative complications in the two groups were compared. Results The recovered spontaneous breathing time,recovery time,extubation time of the observation group were (8.4 ±2.3)min,(10.51 ±3.3)min,(12.7 ±2.3)min,which of the control group were (10.11 ±2.2)min, (12.3 ±2.6)min,(15.3 ±3.5)min,there was statistically significant difference between the two groups (t =3.378, 2.710,3.926,all P <0.05);The operation time,operation amount of bleeding,gastrointestinal function recovery time of the observation group were (44.7 ±5.4)min,(19.5 ±3.5)mL,(18.3 ±2.4)h,which of the control group were (67.5 ±7.8)min,(42.7 ±2.8)mL,(42.4 ±3.2)h,there were significant differences between the two groups(t =15.200,32.736,38.105,all P <0.05).Postoperative analgesia,postoperative awareness,emergence delirium inci-dence rates of the observation group were 25%,0%,7.5%,which were significantly lower than 57.5%,12.5%, 37.5% of the control group,the differences were statistically significant(χ2 =8.717,5.333,10.323,all P <0.05). Conclusion The propofol combined with sufentanil in laparoscopic ovarian cyst resection has more significant effect, which can shorten the operation time,promote the postoperative recovery,reduce complications,worthy to be widely used in clinical practice.

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.