Marfan syndrome(MFS)is an autosomal dominant disorder that is prone to fibrodysplasia,lens dislocation and rapid height growth,which needs to be distinguished from gigantism.This article reports a 14-year-old patient with MFS who had a typical binocular lens subluxation in both eyes,with visual impairment and rapid height growth.MRI with contrast to the pituitary suggested a pituitary microadenoma,but growth hor-mone and insulin-like growth factor 1 were in the normal range,thus excluding gigantism or acromegaly.Non-functional pituitary adenoma was considered.MFS patients need long-term follow-up and multidisciplinary col-laboration,and attention should be paid to cardiovascular system monitoring and genetic testing,which can be helpful for the diagnosis and treatment of patients and risk prevention and control.

Objective:To develop and validate gas chromatographic methods for the determination of residual benzene in carbomer copolymer,carbomer homopolymer and carbomer interpolymer,to address the issues of the current method in the Chinese Pharmacopoeia in the actual detection process,such as low sensitivity and poor repeatability of benzene detection in the mixed reference solution,and to optimize and improve the current stand-ards for series of carbomer pharmaceutical excipients.Methods:Samples were separated on a column DB-624(30 m ×0.530 mm,3.00 μm)with temperature programming,the inlet temperature of 140 ℃,the detector tem-perature of 250 ℃,and the split ratio of 5∶1.The external standard method was adopted for the quantitative deter-mination of residual benzene.Results:The linearity was great across the range of 0.04-1.00 μg·mL-1(r=0.996 8),the injection precision of benzene was 6.8％(n=6),and the average recovery rate was 96.89％(RSD=8.1％,n=9).Conclusion:The gas chromatographic method established in this research is more specif-ic,with higher accuracy and precision compared to the current method in the Chinese Pharmacopoeia.This optimized method is more suitable for the determination of residual benzene content in carbomer copolymer,car-bomer homopolymer and carbomer interpolymer,providing reference and guidance for the quality management and the control of carbomer.

To improve the current quality standards of polysorbate 80 and provide reference recommendations for the revision of the quality standards of polysorbate 80 in the fourth part of China Pharmacopoeia(2015 Edition). A total of 16 batches of polysorbate 80 samples from 6 domestic and foreign production companies were studied, optimize the detection method for some impurities. Adjust the split ratio of the ethylene oxide and dioxane check items, and appropriately increase the concentration of the reference solution solution and change the solvent. In the ethylene glycol and diethylene glycol items, the concentration of the reference solution and the internal standard solution were appropriately increased. The infrared identification and the triethylene glycol check items were added to the quality standards, and we carry out corresponding methodological investigation on the improved method. The results showed that the improved methods had good specificity, precision, linearity and recovery rate. The improved quality standard is more suitable for the detection of polysorbate 80, and can increase the quality standards of polysorbate 80 from safety and standardization.

Objective: To explore the influence of the SmartClip self-ligating bracket and traditional metal bi-wing brackets on plaque control and to provide a reference for the oral healthcare of orthodontic patients. Methods: The patients were divided into the SmartClip self-ligating bracket group, the metal bi-wing bracket group, and the control group, consisting of untreated volunteers, and the patients were examined before treatment, 1 month after the treatment started, 3 months after the treatment started, and when the treatment ended. The oral hygiene status was recorded at four time points, and the plaque index of the following six teeth was compared among the time points: the upper-right central incisor (UR1), the lower-left central incisor (LL1), the upper-right first molar (UR6), the lower-left first molar (LL6), and the upper left canine (UL3) and the lower-right canine (LR3). Results: Compared with before treatment, after first month, third month and end of treatment the plaque index of LL1, LR3, LL6 and UR6 in both the SmartClip self-ligating bracket group and the traditional metal bi-wing bracket group was increased, and the difference was statistically significant (P < 0.05). There was no significant difference in PLI index between the end of treatment and 3 months after orthodontic treatment (P > 0.05). There was no statistically significant difference in PLI index in the control group at each time period (P > 0.05). After three months of orthodontic treatment, the plaque index of LL1 and LR3 in the SmartClip self-ligating bracket group was higher than that in the traditional metal bi-wing bracket group, and the difference was statistically significant (P < 0.05). Conclusion Lower anterior and posterior areas are susceptible to plaque accumulation in treatment with fixed orthodontic appliances. The SmartClip self-ligating bracket system has no advantage over the traditional metal bi-wing bracket in terms of oral hygiene.

Objective To evaluate the application of exponential apparent diffusion coefficient (eADC)value in differentiating benign from malignant thyroid nodules.Methods Routine MR sequences and axial diffusion weighted imaging (DWI)sequences with different b-values(0, 300,500,800 s/mm2)were performed in 46 patients with 51 histopathologically confirmed thyroid nodules,including 35 malignant nodules and 1 6 benign nodules.The eADC values of each thyroid nodules’solid component with different b-values were measured and assessed by independent samples t test.Receiver operating characteristic (ROC)curves were drawn and used to determine the diagnostic threshold and assess the screen test.Results The eADC values of the malignant nodules were higher than that of benign nodules (P<0.05)in all of the three different b-values.The eADC values of the malignant nodules and the benign nodules were 0.618±0.080 and 0.492±0.071 (b=300 s/mm2),0.520±0.104 and 0.371±0.077 (b=500 s/mm2)and 0.407±0.114 and 0.286±0.097 (b=800 s/mm2)respectively. According to the ROC curve,the area under the curve(AUC)was 0.883,0.890 and 0.824 when the b-value was set as 300,500 and 800 s/mm2respectively.When the b-value was set as 500 s/mm2and the diagnostic threshold was 0.454,the sensitivity,specificity, positive predictive value,negative predictive value and Youden index were 74.3%,93.8%,96.3%,60.9% and 0.68,respectively.Conclusion The eADC value is helpful in differentiating benign from malignant thyroid nodules,and the best result can be obtained by using DWI with b-value of 500 s/mm2.

Objective To evaluate the diagnostic value of preoperative ultrasonography(US)and magnetic resonance imaging (MRI) for the extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 90 patients with PTC from January 2013 to June 2016 were analyzed retrospectively,and all patients were examined by US and MRI before operation.The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of minimal ETE, extensive ETE and ETE (minimal ETE + extensive ETS) were compared between UC and MRI.Results The diagnostic minimal ETE sensitivity of UC was significantly higher than that of MRI (81.9% vs.60.0%), and there was statistical difference (P<0.05).The diagnostic extensive ETE specificity of MRI was significantly higher than that of UC(80.9% vs.63.5%),and there was statistical difference (P<0.01).The diagnostic ETE sensitivity and NPV of UC were significantly higher than those of MRI(97.4% vs.88.3% and 80.0% vs.50.0%),and there were statistical differences (P<0.05 or <0.01).Conclusions US has a higher sensitivity, compared with MRI for diagnostic minimal ETE.MRI has a higher specificity for diagnostic extensive ETE,compared with US.And US has a higher sensitivity and NPV for diagnostic ETE,compared with MRI.

Objective To compare the image features of magnetic resonance imaging (MRI) and ultrasound (US) for papillary thyroid carcinoma(PTC).Methods From January 2015 to April 2016,86 consecutive patients underwent surgery and pathologically confirmed PTCs in the People 's Hospital Affiliated to Jiangsu University were selected.All patients received neck US and MRI examination before thyroid surgery .For each case,the US and MRI features emphasized included the echogenic /signal,margin,shape,anteroposterior to transverse diameter ratio (A/T), microcalcifications and lymph node metastasis .Statistical analysis was performed using the χ2 test.Results In the comparison of US and MRI features,A/T≥1(41.9％in US and 62.8％in MRI) and lymph node metastasis(88.0％in MRI;56.0％in US) demonstrated statistically significant differences (χ2 =7.551,P=0.009;χ2 =6.349,P=0.025),and no significant differences were observed in the margin ,shape(P=0.724,P=0.316).Conclusion The MRI features of PTCs included A/T and lymph node metastasis was superior to US .

Objective To evaluate the diagnostic performance of preoperative multi b values of DWI and ADC for the prediction of extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC).Methods Between January 2013 and February 2017,MR images including dynamic contrast-enhanced MR imaging (DCE-MRI) and DWI images of 81 patients diagnosed as papillary thyroid carcinoma in the Affiliated Renmin Hospital of Jiangsu University were retrospectively analyzed.ADC values were measured on solid regions of tumors.The differences of ADC were compared between tumors with total ETE(minimal ETE,extensive ETE) and without ETE by independent-samples t test.Results When b=500 s/mm2,ADC values of PTCs with ETE[(1.27±0.17)× 10-3mm2/s]were significantly lower than those from PTCs without ETE [(2.12±0.72)× 10-3mm2/s,(t=9.126,P=0.000)].ADC values of PTCs with extensive ETE[(1.23±0.17)× 10-3mm2/s] were significantly lower than those from PTCs with minimal ETE[(1.29±0.16)× 10-3mm2/s,(t=1.467,P=0.147)].When b=500 s/mm2,the cutoff value of ADC to discriminate PTCs with and without ETE was 1.530×10-3 mm2/s with a sensitivity of 69.0％,specificity of 93.7％,positive predictive value of 77.6％,negative predictive of 77.5％ and ROC curve area of 0.887.Conclusion ADC values of the solid tumor tissue of PTC with ETE are significantly lower than those of PTC without ETE.DWI may be helpful in the determination of thyroid papillary carcinoma ETE.

Objective: To study the relation between the upper first molar root tips and the maxillary sinus floor in patients with different vertical facial patterns using cone-beam computed tomography (CBCT) and to explore the reference data for safe clinical orthodontic treatments. Methods: Three-dimensional images were reconstructed from CBCT data. The CBCT data from 120 adolescents and adults were divided into three groups (low-angle group, average-angle group, high-angle group) based on vertical facial type. For each subject, the distance from the maxillary sinus floor to the upper first molar root tips was measured, and the types of contacts were classified. ANOVA and LSD t tests were used for statistical comparisons and performed using SPSS 19.0. Results: Of the 120 samples, only 27% of the upper first molar root tips lost their contacts with the maxillary sinus floor, and the other 73% of the root tips contacted the sinus to different extents. Significant differences in the distances from the maxillary sinus floor to the upper first molar root tips were found for different vertical facial types (P < 0.05). The high-angle group had the lowest sinus floor, relative to the root tips, of the three adult groups (P < 0.05). In the adult group with a low angle, the measured value for the palatal root tips was the lowest and was significantly different from those in the other groups (P < 0.05). Conclusion Seventy-three percent of the upper first molar root tips contacted the maxillary sinus floor. The maxillary sinus floor tended to be lower relative to the first molar root tips in patients with a high-angle facial pattern than in others. The roots protruded into the sinus to a greater extent.

Objective To understand the geographical features of malaria in Yunnan Province,so as to provide the refer?ence for malaria elimination. Methods The data of malaria in Yunnan Province from 2012 to 2015 were collected and ana?lyzed. Results Totally 2 586 malaria cases were reported in Yunnan Province from 2012 to 2015,in which 274(10.60%) were local cases and 2 311(89.37%)were abroad imported,and one(0.03%)was domestic imported. The imported malaria cases and local cases were analyzed according to the sources and locations respectively,and the arithmetic means of the num?bers of imported and local cases were 96.29 and 10.96 respectively,the standard deviations of the numbers of imported and local cases were 421.18 and 19.12 respectively,and the difference of the means was not significant(Z=-0.326,P>0.10). Both the imported and local malaria cases could be clustered into five sections by the number of 5. The Herfendal?Hirshman indexes of the imported and local malaria cases were 8 121 and 1 598 respectively. Conclusions There is no significant difference of the distribution between the imported and local malaria cases,and they should be attaching equal importance. The non?uniform de?gree of imported cases is higher than that of the local cases,while both of them could be divided into five major clusters in the prevention and control work.