Objective To investigate the correlation between amide proton transfer-weighted(APTw)value derived from APTw imaging and Ki-67 expression in hepatocellular carcinoma.Methods Sixty patients with hepatic occupations underwent preoperative upper abdominal MRI scanning,including APTw and diffusion weighted imaging(DWI)sequences.Thirty-two patients with hepatocellular carcinoma proved by pathological results were enrolled in the prospective study.The APTw and apparent diffusion coefficient(ADC)values of the lesions were measured from the corresponding APTw and ADC images,respectively.Mann-Whitney U test or independent sample t test was used to analyze the differences in APTw and ADC values between the high and low Ki-67 expression groups.Pearson correlation analysis was used to evaluate the correlation between APTw value,ADC value and Ki-67 expression level of hepatocellular carcinoma.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of amide proton transfer(APT)parameter in differentiating high and low Ki-67 expression groups.Results The APTw values of high Ki-67 expression group(n=24)was higher than that of low Ki-67 expression group(n=8)[(1.33±0.77)％vs(0.64±0.58)％,P=0.026].There was no significant difference in ADC values between the two groups(0.82×10-3 mm2/s vs 0.86×10-3 mm2/s,P=0.679).The APTw values were positively correlated with Ki-67 expression(r=0.377,P=0.035),and the area under the curve(AUC)of APTw value＞1.24％for the diagnosis of high Ki-67 expression was 0.794,with a sensitivity of 67％and a specificity of 88％.Conclusion The APTw value of hepatocellular carcinoma is positively correlated with Ki-67 expression,which has certain diagnostic value for predicting the expression status of Ki-67.

Objective To investigate the value of extracellular volume fraction(ECV)based on CT for predicting macrotrabecular-massive hepatocellular carcinoma(MTM-HCC).Methods Data of 23 MTM-HCC(MTM-HCC group)and 56 non-MTM-HCC(nMTM-HCC group)patients were retrospectively analyzed,and CT manifestations were compared between groups.CT values of abdominal aorta(P-CTabdominal aorta,E-CTabdominal aorta),tumors(P-CTtumor,E-CTtumor)and non-tumor liver parenchyma(P-CTliver,E-CTliver)in plain phase(P)and enhancement equilibrium phase(E)CT were measured,then ECV of tumors and liver parenchyma were calculated,and ECV-related parameters were compared between groups.Receiver operating characteristic curves were drawn,and area under the curve(AUC)was calculated to evaluate the predictive efficacy of ECV-related parameters for predicting MTM-HCC.Results No significant difference of CT manifestations was found between groups(all P＞0.05).E-CTtumor,Δltumor(absolute enhancement CT value of the tumor area)and ECVtumor in MTM-HCC group were all lower than those in nMTM-HCC group(all P＜0.01).The AUC of E-CTtumor,Δtumor and ECVtumor for predicting MTM-HCC was 0.74,0.77 and 0.87,respectively,and the AUC of ECVtumor was higher than that of E-CTtumor and Δtumor(Z=2.271,2.557,P=0.023,0.011).Conclusion ECV based on CT could be used to effectively predict MTM-HCC.

Objective:To optimize the diagnosis-related groups (DRG) weight calculation method based on the perspective of hospital performance evaluation and the high-quality development orientation of public hospitals.Methods:Using the first page data of 3 256 701 inpatient medical records from secondary and tertiary hospitals in Beijing from January to December 2021, three algorithms including payment DRG weight, five-category DRG weight, and optimized DRG weight were used to calculate the weights of each DRG, and the differences between different algorithms were analyzed. The case-mix index (CMI) of the entire hospital and the clinical specialties to which the key DRG belongs in secondary and tertiary hospitals was calculated by using the three DRG weight algorithms, to reflect the performance evaluation results of different algorithms.Results:The results of one-way ANOVA showed that there was a significant difference ( P=0.019) among the three DRG weight algorithms. Comparing the optimized DRG weight with the payment DRG weight, the weight of BD29 (neural stimulator implantation or removal surgery) in the key DRG decreased from 7.77 to 4.61, and the weight of LA19 (renal tumor surgery) increased from 2.06 to 2.58; Compared with the five-category DRG weight, the weight of ES31 (respiratory infection/inflammation with severe complications or comorbidities) decreased from 2.36 to 1.72, and the weight of CB39 (crystalloid surgery) increased from 0.22 to 0.30. Comparing the use of optimized DRG weights and five-category DRG weights to calculate CMI, all types of hospitals and clinical specialties showed varying degrees of improvement in CMI. The CMI of tertiary hospitals increased from 1.02 to 1.20, and the CMI of secondary hospitals increased from 0.88 to 0.95. The difference in CMI between secondary and tertiary hospitals was even more pronounced. Conclusions:Optimized DRG weights could better reflect the value of medical technology compared with the payment DRG weights. Compared to five-category DRG weights, optimized DRG weights could better reflect the differences in CMI of different levels of hospitals.

Objective To explore the value of enhanced T2 weighted angiography (ESWAN) in displaying the characteristic of intracranial tumors and estimating the preoperative grading diagnosis of glioma.Methods Totally 68 patients with intracranial mass detected by CT scanning were selected.All patients were conducted with ESWAN scanning and conventional MR scan (T1WI,T2WI,T2-flair) plus T1 enhanced scan by 3.0T magnetic resonance scanner.ESWAN images was compared to conventional MR images,and their differences in displaying tumor morphological characteristics such as border of tumor,peritumoral edema,hemorrhage vascular structure and internal structure were evaluated.The ESWAN sequence was used to evaluate the size and ratio of magnetic sensitive signals in glioma,and the relationship between the magnetic sensitive signal and the benign and malignant glioma was analyzed.Results There was no significant differences among the five sequences in showing the bound of the tumors.Significant differences among the five sequences were founded in displaying peritumoral edema,hemorrhage and vascular structure,internal characteristics.The T2-flair and T2WI showed peritumoral edema well.Enhanced T1WI showed internal characteristics best.ESWAN displayed intra-tumoral hemorrhage and vascular structure best.High grade gliomas had a higher magnetic sensitive ratio than low grade gliomas.Conclusion ESWAN can better show bleeding and vascular structure of intracranial tumor than the routine MR sequence.It can provide important supplementary information for preoperative grading of the cerebral gliomas through assessment of hypointensity ratios in the gliomas.

Objective To explore the value of enhanced T2 weighted angiography (ESWAN) in displaying the characteristic of intracranial tumors and estimating the preoperative grading diagnosis of glioma.Methods Totally 68 patients with intracranial mass detected by CT scanning were selected.All patients were conducted with ESWAN scanning and conventional MR scan (T1WI,T2WI,T2-flair) plus T1 enhanced scan by 3.0T magnetic resonance scanner.ESWAN images was compared to conventional MR images,and their differences in displaying tumor morphological characteristics such as border of tumor,peritumoral edema,hemorrhage vascular structure and internal structure were evaluated.The ESWAN sequence was used to evaluate the size and ratio of magnetic sensitive signals in glioma,and the relationship between the magnetic sensitive signal and the benign and malignant glioma was analyzed.Results There was no significant differences among the five sequences in showing the bound of the tumors.Significant differences among the five sequences were founded in displaying peritumoral edema,hemorrhage and vascular structure,internal characteristics.The T2-flair and T2WI showed peritumoral edema well.Enhanced T1WI showed internal characteristics best.ESWAN displayed intra-tumoral hemorrhage and vascular structure best.High grade gliomas had a higher magnetic sensitive ratio than low grade gliomas.Conclusion ESWAN can better show bleeding and vascular structure of intracranial tumor than the routine MR sequence.It can provide important supplementary information for preoperative grading of the cerebral gliomas through assessment of hypointensity ratios in the gliomas.

OBJECTIVE:To optimize the ultrasonic extraction technology for Tianshu capsules. METHODS:Using the transfer rate of active ingredient ferulic acid in Ligusticum chuanxiong and gastrodin in Gastrodia elata of Tianshu capsules as investigation indexes,L9(34)orthogonal design test was adopted to investigate the effects of ethanol volume fraction,ethanol amount,extraction time and ultrasonic power on the extraction rate. Ultrasonic extraction technology for Tianshu capsules was optimized,and verifica-tion test was carried out. RESULTS:The optimized extraction technology for Tianshu capsules was as follow as 8-fold 70% etha-nol,extracting twice under 350 W,extracting 1.5 h every time. Results of verification test showed the average transfer rate was 94.06% for ferulic acid(RSD=0.18%,n=3)and 95.02% for gastrodin(0.47%,n=3). CONCLUSIONS:The optimized tech-nology is rapid,simple,stable and feasible,and can be used for extracting the active ingredients in Tianshu capsules.

Objective To compare the biomechanical properties of Gamma3 and InterTan nails in the fixation of femoral intertrochanteric fractures. Methods Twelve synthetic femora of 4th generation were randomized into 4 equal groups ( n=3 ) for assessment of the 2 constructs of fracture fixation ( Gamma3 versus InterTan nails ) . Groups A and B were made into models of stable femoral intertrochanteric fracture (AO/OTA type 31-A1. 1) and groups C and D into unstable ones(AO/OTA type 31-A2. 3) . The biomechanical properties of Gamma3 and InterTan nails in the 4 models were tested and compared. Results For stable fracture models, the fracture gap movement increased with the increasing axial load and the torque increased with the increasing torsion angle. There were significant differences between groups A and B in fracture gap movement and torque ( P <0. 05 ) . There was no significant difference between groups A and B in failure load ( 5, 855. 5 ± 627. 8 N versus 5, 547. 1 ± 365. 4 N ) ( P > 0. 05 ) . For unstable fracture models, there were no significant differences between groups C and D in fracture gap movement when the axial loads were 500 N, 600 N or 700 N ( P > 0. 05 ) , but there was a significant difference between the 2 groups when the axial load was larger than 800 N ( P <0. 05 ) . With the increasing torsion angle, the torque increased in groups C and D. There was a significant difference between the 2 groups in the torque at the same torsion angle ( P <0. 05 ) . There were a significant difference between groups C and D in failure load ( 2, 781. 5 ± 600. 6 N versus 3, 150. 5 ± 633. 8 N ) ( P=0. 007 ) . Conclusions For stable femoral intertrochanteric fractures, InterTan and Gamma3 nails may exhibit similar biomechanical properties. For unstable femoral intertrochanteric fractures, InterTan nails may provide obviously better biomechanical stability than Gamma3 nails.

Objective To research the effect of GGCX gene on MMP13 in rabbit osteoarthritis cartilage cells and investigate its effect on osteoarthritis cartilage degeneration.Methods Six Japanese big ear rabbits weighted (2.0±0.2)kg were randomly di vided into three groups,each group seted a rabbit as control.Anterior cruciate ligament transection method was used to build osteoarthritis cartilage degeneration model at second,forth,sixth week.Articular cartilage was separated successfully after the model were built,cartilage cells were divided from articular cartilage and cultured in 6-well cell culture plate.Cartilage cells were divided into blank group,negative control group and transfection group.PCR method and Western blot were conducted to detect GGCX and MMP13 expressed at the level of mRNA and protein.Results Compare with blank group and negative control group,the expressin level of GGCX incresed,while the MMP13 expression level dcresed(P＜0.05).Conclusion Over expression of GGCX gene can ob viously decrease the expression of MMP13,it provide experimental basis for osteoarthritis of the in vitro gene therapy.

Objective To compare the efficacy of single-tunnel single-bundle and double-bundle reconstruction in patients with anterior cruciate ligament reconstruction.Methods A total of 64 patients with anterior cruciate ligament rupture in our hospital were randomly divided into single-bundle group with 32 cases and double-bundle group with 32 cases, given single-tunnel single-bundle anterior cruciate ligament reconstruction, and single-tunnel double-bundle anterior cruciate ligament reconstructions.The IKDC, Tegner, Lysholm and KT-2000 scores were compared in two groups preoperation and at 12 months after operation.Results Thee were no significant difference in sex, age, injured site and injured time in the two groups(P>0.05).The IKDC, Tegner and Lysholm scores after operation were higher than operation before, and the KT-2000 scores was lower than operation before in two groups, and the differences were statistically significant(P<0.05).But there were no significant differences in IKDC, Tegner, Lysholm and KT-2000 scores between two groups before and after treatment(P>0.05).Conclusion The subjective and objective function scores of two groups showed no significant difference.But single-tunnel double-bundle for anterior cruciate ligament reconstruction is characterized by simplicity, firmly fixation and effectively restoration of knee stability.

Objective To compare the efficacy of single-tunnel single-bundle and double-bundle reconstruction in patients with anterior cruciate ligament reconstruction.Methods A total of 64 patients with anterior cruciate ligament rupture in our hospital were randomly divided into single-bundle group with 32 cases and double-bundle group with 32 cases, given single-tunnel single-bundle anterior cruciate ligament reconstruction, and single-tunnel double-bundle anterior cruciate ligament reconstructions.The IKDC, Tegner, Lysholm and KT-2000 scores were compared in two groups preoperation and at 12 months after operation.Results Thee were no significant difference in sex, age, injured site and injured time in the two groups(P>0.05).The IKDC, Tegner and Lysholm scores after operation were higher than operation before, and the KT-2000 scores was lower than operation before in two groups, and the differences were statistically significant(P<0.05).But there were no significant differences in IKDC, Tegner, Lysholm and KT-2000 scores between two groups before and after treatment(P>0.05).Conclusion The subjective and objective function scores of two groups showed no significant difference.But single-tunnel double-bundle for anterior cruciate ligament reconstruction is characterized by simplicity, firmly fixation and effectively restoration of knee stability.