Objective:To evaluate the long-term health-related quality of life (QOL) in pediatric patients with acute leukemia after hematopoietic stem cell transplantation (HSCT) and to analyze potential influence factors.Methods:Patients with acute leukemia aging 8-18 years who received HSCT in the Hematology Oncology Center of Beijing Children′s Hospital from June 2009 to June 2012 with more than 80 months survival postoperatively were recruited.All of them were subjected to a short-term QOL survey in 2013.PedsQL? Transplantation Module 3.0 in Chinese mandarin version was completed.QOL data and influence factors were analyzed.Results:Forty-one patients completed the questionnaires, involving 32 males and 9 females with the mean age of(14.29±2.72) years.The mean scores of overall long-term QOL after HSCT were above 75 (total scores: 100), which was above the average.The age, disease status before transplantation, donor sources, post-transplant complications and the parental education level were the influential factors for the long-term QOL in pediatric patients with acute leukemia at post-HSCT, which could affect a certain dimension in QOL.Conclusions:The overall long-term QOL of pediatric patients with acute leukemia who survived for more than 80 months at post-HSCT is acceptable, which is significantly better than the short-term QOL after 4 months of HSCT.The age, disease status before transplantation, donor sources, post-transplant complications and the education level of parents could affect a certain dimension of QOL.

Objective:To summarize the clinical features, treatment and outcomes of cervical neuroblastoma (NB) subjected to multi-disciplinary treatment.Methods:The clinical features of cervical NB patients who were admitted to Beijing Children′s Hospital, Capital Medical University from February 2015 to October 2018, were retrospectively analyzed.The tumor makers [lactate dehydrogenase(LDH), neuron-specific enolase(NSE), urine homovanillic acid/creatinine(HVA/Crn), and urine vanillyl-mandelic acid/creatinine(VMA/Crn)], index of tumor burden(KTB), bone marrow examination, histopathologic types, N- MYC, gene amplification and 11q23 depletion type, staging and grouping, treatment and outcomes were analyzed.Follow-up was ended on March 31 st, 2019. Results:The 13 cervical NB patients aged from 1 month to 47 months (median age: 10 months), and 8 patients (61.5%) were younger than 18 months old.The course of disease ranged from 0.5 to 24.0 months (median course: more than 1 month). Seven patients (53.8%) presented with cervical masses.According to International Neuroblastoma Staging System (INSS), 8 patients (61.5%) were identified as stage Ⅱ, 3 patients (23.1%) as stage Ⅲ, and 2 patients (15.4%) as stage Ⅳ.There were 8 patients (61.1%) at low risk, 4 patients (30.8%) at intermediate risk, 1 patient (7.7%) at high risk.As for the laboratory examinations, LDH was increased in 7 patients (53.8%), and normal in 5 patients (38.5%). NSE was increased in 9 patients (69.2%), and normal in 4 patients (30.8%). Urine VMA/Crn was increased in 5 patients (38.5%), and normal in 8 patients (61.5%). HVA/Crn was increased in 8 patients (61.5%), and normal in 5 patients (38.5%). KTB was increased in 5 patients (38.5%), and normal in 5 patients (38.5%). No NB cell was detected in bone marrow of 13 patients.The pathologic type was NB in 9 patients (69.2%), and ganglioneuroma in 4 patients (30.8%). N-MYC gene amplification and 11q depletion were not detected.All the 13 patients accepted regular chemotherapy, radiotherapy and primary tumor resection in accordance with the staging and clinical risk grouping.The range of follow-up time was 5 to 48 months (median: 24 months). All of the patients fi-nished their treatment and were followed up regularly.Nine patients (69.2%) achieved complete remission, 4 patients (30.8%) achieved partial remission, and none of the patients had progression of disease.Conclusions:Cervical NB subjected to multi-disciplinary treatment has a smaller age at admission, mostly presented with cervical masses and rarely accompanied with distant metastasis.They are mostly at low risk or intermediate risk, and can achieve good outcomes after regular treatment.

Objective To study a nucleic acid extraction method suitable for detecting methicillin‐resistant Staphylococcus aureus (MRSA) by PCR method .Methods Under different incubation conditions ,MRSA was cracked by lysozyme ,lysostaphin or chel‐ex100R resin for obtaining DNA ,then the target gene was detected by using the PCR method .Results DNA was obtained by sim‐ultaneously using lysozyme ,lysostaphin and chelex100R resin solution ,the obtained Ct value was significantly lower than that of the other components of schizolysis solutions when PCR was used to detect mecA gene of obtained DNA .There was no statistically sig‐nificant difference between adopting the 56 ℃ one‐step method and the 37 ℃ and 56 ℃ two‐step method for conducting MRSA schizolysis(P> 0 .05) ,but the steps were simplified .Conclusion Incubating MRSA in solution containing lysozyme ,lysostaphin , chelex100R resin for 30 min at 56 ℃ is the convenient and efficient schizolysis method to extract DNA ,which can be used immedi‐ately for the next step of PCR and lays the foundation for PCR rapid detection of clinical MRSA infection .

Objective To evaluate the shear stiffness of brain by MR elastography (MRE) in healthy Chinese volunteers and to assess the association between the cerebral shear stiffness and age. Methods Brain MRE studies were performed on 105 healthy volunteers. The shear stiffness of brain parencham was measured by local frequency estimation (LFE) algorithm. The differences of the shear stiffness between white matter(WM) and grey matter(GM) were analyzed by independent sample t test; the differences of brain parenchyma shear stiffness between male and female were estimated by independent sample t test. Spearman test was used to analyze the correlation between age and the shear stiffness of parenchyma; the volunteers were divided into two groups (age ≤ 40 and age > 40) and the correlation between age and shear stiffness of parencbyma in each group were analyzed separately. Results The shear stiffness of whiter matter [(23.1±5.7) kPa] was higher than that of grey matter[(11.3±2.6) kPa], and the difference was significant (t = 19.34, P < 0.01). In male, the shear stiffness of WM and GM was (23.4±5.8) kPa and (11.4±2.8) kPa respectively; while in female, it was (22.8±5.6) kPa and (11.1±2.5) kPa respectively. No sex differences were found in the stiffness of white matter or gray matter (t = - 0.534, - 0.606, P > 0.05). An age-dependent trend was observed in the stiffness of grey matter(r =0.315, P < 0.01),while not in whiter matter (r = 0.183, P > 0.05). When the shear stiffness of subjects no more than 40 years old was analysed, the age-dependent trend of shear stiffness was found both in white matter and gray matter(r = 0.251,0.235, P < 0.05); While in subjects over 40 years old, the age-dependent rend of shear stiffness was not found in white matter or gray matter(r = 0.181, - 0.001, P > 0.05). Conclusions The shear stiffness of WM is significantly higher than that of GM. No obvious sex difference was found in the stiffness of brain parenchyma. The shear stiffness of GM increases with age; the age-related increase of shear stiffness of WM was only found in subjects under 40 years old.

time (r = 0. 070, -0.003, -0. 195,0. 177,P 0.05). Conclusions Compared with omnivore's, the shear stiffness of brain parenehyma was lower in vegetarians. The shear stiffness of brain parenchyma may be affected by the diet.

Objective To investigate the diagnostic value of CTP-SI in acute stroke less than 9 hours.Methods In present study."one-stop shop"CT examination were performed in 34 patients with symptoms of acute stroke in le88 than 9 hours.We divided patients into two groups according to with and without delayed perfusion on CTP-SI.and compared ASPECTS (Alberta Stroke Program Early CT Score Study)scores on non-contrast CT(NCCT),arterial phase CTP-SI,venous phase CTP-SI with follow-up imaging.The ASPECTS were analyzed on arterial phase CTP-SI and veIlous phase CTP-SI using Wilcoxon rank-sum test.then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median(min-max)scores of ASPECTS on NCCT,arterial phase CTP-SI,venous phase CTP-SI and follow-up imaging were 9.0(6.0-10.0),6.5(1.0-8.0),8.0(3.0-10.0)and 7.0(0-10.0)in group with delayed perfusion,respectively,and 9.0(1.0-10.0),8.5(1.0-10.0),8.5(1.0-10.0)and 8.0 (0～10.0)in group without delayed perfusion respectively.ASPECTs scores measured on arterial phase CTP-SI did not differ from venous phase CTP-SI in group without delayed perfusion ( Z = - 1.00, P =0.317), while there was significant difference in group with delayed perfusion (Z = -3.08, P = 0.002 ).There were significant correlation with ASPECTS scores measured on NCCT, arterial phase CTP-SI and venous phase CTP-SI to follow-up imaging ASPECTS (r =0.899,0.926,0.928,P ＜0.01 ) in group without delayed perfusion; ASPECTS measured in venous phase CTP-SI showed the best correlation to follow-up imaging ASPECTS (r = 0.762, P = 0.004) in group with delayed perfusion.Multiple linear regression showed that the correlation in only venous phase CTP-SI with foUow-up imaging ASPECTS was statistically significant:in group without delayed perfusion, Beta = 0.966, P ＜ 0.001 ; in group with delayed perfusion,Beta = 0.765, P = 0.004. Conclusion Presence of delayed porfusion in CTP-SI is quite important in identifying ischemic penumbra, which plays a critical role in imaging-guided thrombolytie therapy.

Objective To investigate variation in the carotid bifurcation geometry of adults of different age by MR angiography images combining image post-processing technique. Methods Images of the carotid bifurcations of 27 young adults (≤40 years old) and 30 older subjects ( >40 years old) were acquired via contrast-enhanced MR angiography. Three dimensional (3D) geometries of the bifurcations were reconstructed and geometric parameters were measured by post-processing technique. Results The geometric parameters of the young versus older groups were as follows: bifurcation angle (70.268°± 16.050° versus 58.857°±13.294°), ICA angle (36.893°±11.837° versus 30.275°± 9.533°), ICA planarity (6.453°±5.009° versus 6.263°±4.250°),CCA tortuosity (0.023°0.011 versus 0.014± 0.005), ICA tortuosity (0.070±0.042 versus 0.046±0.022), ICA/CCA diameter ratio (0.693± 0.132 versus 0.728±0.106), ECA/CCA diameter ratio (0.750±0.123 versus 0.809±0.122), ECA/ ICA diameter ratio (1.103±0.201 versus 1.127±0.195), bifurcation area ratio (1.057±0.281 versus 1.291±0.252). There was significant statistical difference between young group and older group in bifurcation angle, ICA angle, CCA tortuosity, ICA tortuosity, ECA/CCA and bifurcation area ratio (F= 17.16,11.74,23.02,13.38,6.54,22.80,respectively, P<0.05). Conclusions MR angiography images combined with image post-processing technique can reconstruct 3D carotid bifurcation geometry and measure the geometric parameters of carotid bifurcation in vivo individually. It provides a new and convenient method to investigate the relationship of vascular geometry and flow condition with atherosclerotic pathological changes.

Objective To apply a non-invasive and feasible method for the quantification of local wall shear stress (WSS) in vivo using magnetic resonance imaging. Methods The fight common carotid artery of a young healthy male volunteer was examined using cine phase-contrast MR sequence. The cross- sectional area, average flow velocity, maximum velocity and flow rate were obtained. Three dimensional paraboloid model was applied to measure WSS value at common carotid artery. Results The mean/peak WSS was (0.75±0.41)N/m2 for the common carotid artery; The mean (range) velocity was (23.4± 12.0) cm/s; The mean (range) luminal vessel area was (32.2±2.9) mm2; The blood flow rate was (7.8±4. 6) ml/s; Conclusion WSS's magnitude, distribution and changes can be determined by MR imaging combining with the three-dimensional paraboloid method.

Objective To evaluate the value of MR angiography in thrombolytic therapy of acute ischemic stroke. Methods According to inclusion criteria, 65 patients who also having large vessel occlusion were selected, and they were performed rt-PA treatment (38 patients) and routine treatment (27 patients) within 3-6 hours of onset of symptoms, respectively. Mann-Whitney U test and chi square test were performed to compare the clinical and MR imaging baseline index and the clinical outcome between the two groups respectively. Clinical outcome was assessed after 3 months using a dichotomized modified Rankin scale score.Data were also compared with the combined analysis of the ATLANTIS, ECASS, NINDS rt-PA trials. Resets The difference of clinical outcome in 3 months between the two groups was significant (P < 0. 05) and the median of the two group was 1 and 3, respectively. The ratio of favorable outcome (mRS 0-1) in the two groups was 52. 6% (20/38) and 33.3% (9/27), respectively. Conclusion MR angiography plays an important role in thrombolytic therapy of acute ischemic stroke and it should be used to consummate the conventional inclusion criteria, the patients with large vessel occlusion should be treated by rt-PA.

Objective To investigate the potential values of magnetic resonance elastography (MRE)for evaluating the brain tumor consistency in vivo.Methods Fourteen patients with known solid brain tumor(5 male,9 female;age range:16-63 years)underwent brain MRE studies.Informed consent was obtained from all patients.A dedicated external force actuator for brain MRE study Was developed.The actuator was fixed to the head coil.During scan.one side of the actuator was attached to the patients'head.Low frequency oscillation Was produced by the actuator and caused shear waves propagating into brain tissue.The pulse sequence used in the study Writs phase-contrast gradient-echo sequence.Phase images of the brain were obtained and the shear waves within the brain were directly imaged.Phase images were processed with local frequency estimation (LFE) technique to obtain the elasticity image.Consistency of brain tumors Was evaluated at surgery and Was classified as soft,intermediate,or hard with comparison to the white matter of the brain.Correspondence of MRE evaluation with operative results was studied.Results The elastic modulus of the tumor Was lower than that of white matter in 1 patient,higher inll patients,and similar in 2 patients.At surgery,the tumor manifested a soft consistency in I patient,hard consistency in 11 patients,intermediate consistency in 2 patients.The elasticity of tumors in 14 patients evaluated by MRE was correlated with the tumor consistency on the operation.Conclusion MRE Can noninvasively display the elasticity of brain tumors in vivo,and evaluate the brain tumor consistency before operation.