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 systematically integrate the qualitative studies on body image experience in breast cancer patients,in order to provide references for the clinical formulation of corresponding intervention programs.Methods Systematical search was conducted for qualitative studies on the body image experiences of breast cancer patients in databases including PubMed,Web of Science,Cochrane Library,CINAHL,PsycINFO,CNKI,WanFang Database,VIP and CBM.The search period was from the establishment of the database to July 2024.The quality of the literature was evaluated using the 2016 edition of the qualitative research appraisal tool from the Evidence-Based Health Care Center of the Joanna Briggs Research Institute in Australia,and the results were integrated using the pooled integration method.Results A total of 14 pieces of the literature were included,and 36 research results were extracted and summarized into 7 new categories.Totally 3 integrated results were obtained,namely the negative impact of changes in body image,patients' self-adjustment and growth,and patients' need for external support.Conclusion Breast cancer patients are plagued by multiple body images.Medical staff should pay attention to the psychological state of patients,do a good job in health education,improve the understanding and support of the society,provide targeted professional guidance,promote the psychological adaptation of patients,meet the emotional needs of patients,establish multiple support systems,and improve the body image and quality of life of patients.

Objective To systematically integrate the qualitative studies on body image experience in breast cancer patients,in order to provide references for the clinical formulation of corresponding intervention programs.Methods Systematical search was conducted for qualitative studies on the body image experiences of breast cancer patients in databases including PubMed,Web of Science,Cochrane Library,CINAHL,PsycINFO,CNKI,WanFang Database,VIP and CBM.The search period was from the establishment of the database to July 2024.The quality of the literature was evaluated using the 2016 edition of the qualitative research appraisal tool from the Evidence-Based Health Care Center of the Joanna Briggs Research Institute in Australia,and the results were integrated using the pooled integration method.Results A total of 14 pieces of the literature were included,and 36 research results were extracted and summarized into 7 new categories.Totally 3 integrated results were obtained,namely the negative impact of changes in body image,patients' self-adjustment and growth,and patients' need for external support.Conclusion Breast cancer patients are plagued by multiple body images.Medical staff should pay attention to the psychological state of patients,do a good job in health education,improve the understanding and support of the society,provide targeted professional guidance,promote the psychological adaptation of patients,meet the emotional needs of patients,establish multiple support systems,and improve the body image and quality of life of patients.

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 establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

Parkinson's disease (PD) is a common neurodegenerative disease,pathogenesis of which is extremely complex.To explore the potential pathophysiological mechanism of PD and find effective treatment methods to improve symptoms,modify the disease and delay the progression are the major problems to be solved urgently.Studies have shown that transcranial magnetic stimulation (TMS) has a broad clinical application prospect,which might help clinicians to explore the pathophysiological mechanism of PD and provide new ideas for exploring new targets for diagnosis and treatment in the future.Meanwhile,TMS might play important roles in the treatment of PD motor and non-motor symptoms through enhancing synaptic plasticity,protecting monoamine neurons,increasing the monoamine neurotransmitter level in the brain,and adjusting the brain network with dysfunction.

OBJECTIVE: To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11C-methionine positron emission tomography (11C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. MATERIALS AND METHODS: Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. RESULTS: The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. CONCLUSION: The combination of MRS and 11C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11C-MET PET approach in clinical applications.
Diagnosis ; Electrons ; Glioma ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Methionine ; Positron-Emission Tomography ; Sensitivity and Specificity

Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective The purpose of this study was to evaluate the practicability and efficiency of iFlow assistant function in lower extremity vascular disease angioplasty.Methods Retrospective analysis to 22 patients with lower extremity vascular disease in our single center from Septmber 2013 to November 2013, 19 males and 3 females with mean age(66.31 ± 7.46)years, iFlow technology was utilized to analyze the Region Of Interest(ROI) Peak Time(PeakTime) in pre-and post-angioplasty of lower extremity artery and assessed the state of vessel stenosis and blood flow perfusion, as well Doppler ultrasound in postoperative was used to double identify iFlow results.The results of vessel lesion, such as state of stenosis and occlusion were diagnosed by two senior doctors individually, as well as ROI Peak Time was recorded by technician.Results The iFlow technique performed that the ROI PeakTime in the region of interest was significantly decreased in postoperative in comparison to pre-angioplasty [(0.48 ± 0.39) s vs.(1.32 ± 0.60) s, t =8.836, P ＜ 0.001].The Doppler ultrasound in postoperative showed that the ankle-brachial index was significantly increased compared within preoperative (0.97 ± 0.16 vs.0.49 ± 0.11, t =-10.205, P ＜ 0.001).The results of iFlow technique in intraoperative were consistent with those of Doppler ultrasound in postoperative.Conclusion iFlow technique is effective to evaluate hemodynamic change of blood flow in vessel lesion in pre-and postangioplasty, which is assistive technique to assess the efficiency and prognosis in angioplasty.