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Objective: To analyze the characteristics of magnetic resonance imaging (MRI) and clinical etiology of ovarian infertility. Methods: The data of infertile women who underwent 3.0T MRI and magnetic resonance hysterosalpingography (MR-HSG) examination in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2017 to March 2020 were collected. The ovarian factors of infertility, as well as the abnormalities of bilateral fallopian tubes and uterus, were evaluated. Etiologies assessed by MRI were finally confirmed by hysteroscopy, laparoscopy, surgery, or a comprehensive clinical diagnosis. Results: Among 1 351 patients, 1 296 cases were eligible and included for further analysis. Evaluated by MRI and MR-HSG, 494(38.12%) cases had ovarian abnormalities, including 239(48.38%) cases of ovarian endometriosiss, 116(23.48%) cases of polycystic ovary syndrome (PCOS), 37(7.49%) cases of diminished ovarian reserve (DOR), 33(6.68%) cases of ovarian mass, 28(5.67%) cases of ovarian injury, and 41(8.30%) cases who had at least two kinds of ovarian diseases. Unilateral and bilateral ovarian abnormalities accounted for 52.02% (257/494) and 47.98%(237/494), respectively.In total, 453 of 494(91.7%) patients had only one kind of ovarian disease. Among the 494 patients, 103(20.85%) cases had abnormal ovary with normal uterus and fallopian tubes, and the other 391(79.15%) cases had abnormalities not only in ovary, but in fallopian tube and/or uterus. Conclusion: Infertility-related ovarian diseases have certain characteristics of MRI findings. 3.0T MRI is useful for comprehensive analysis of etiology in ovarian infertility. Combined with MR-HSG, it provides one-stop assessments of the pelvic factors in female infertility.

Objective: To summarize the application of radial artery (RA) as the second arterial graft in coronary artery bypass grafting (CABG). Methods: From January 1, 2015 to June 11, 2019, the clinical data of all patients undergoing CABG in TEDA International Cardiovascular Hospital was retrospectively reviewed. The patients who underwent RA grafting were included. The application of RA, internal mammary artery (IMA) and the saphenous vein, their target vessels, and the operative results were analyzed. Results: A total of 2 901 patients underwent CABG. Of those, 208 patients (7.2%) had RA grafting, with 197 males and 11 females. The average age was (53±8) years old and the average grafts per patient was 3.79. The target vessel for RA was first obtuse marginal (OM, 102 cases), first diagonal (50 cases), right coronary artery (RCA) or posterior descending artery (PDA) (40 cases), intermediate (22 cases), respectively. Among those, 172 were single distal anastomosis with the proximal end anastomosed to the ascending aorta (168 cases), saphenous vein (SV) graft (3 cases) and IMA (1 case). Seventy-two patients accept sequential grafting with the proximal to the ascending aorta (58 cases), SV graft (13 cases) and IMA (1 case). The left IMA was mainly anastomosed to left descending artery (LAD) (188 cases) and diagonal (10 cases). The target vessels for SV were remaining coronary arteries when the IMA and RA were used. The operative time was (5.0±1.5) h. The hospital stay was (17.4±6.4) d. There were 6 cases undergoing exploratory thoracotomy for bleeding (5 cases) or hemodynamic instability due to ventricular arrhythmia (1 case). There was no death. All patients were successfully discharged. Conclusions: Use of the RA and IMA with additional SV for CABG exhibits good results in the Chinese patients. Currently available clinical protocols are effective and safe.

Objective: To explore the value of contrast-enhanced CT combined with texture analysis in differentiating pancreatic cancer from mass-forming pancreatitis in pancreatic head. Methods: A retrospective study collected 21 patients with pancreatic head mass-forming pancreatitis confirmed by surgery or biopsy and 47 patients with pancreatic ductal adenocarcinoma confirmed by surgery. The patients visited the Affiliated Hospital of Nanjing University of Chinese Medicine and the First Affiliated Hospital of Wannan Medical College between January 2014 and December 2017. Gender, age and CT findings were collected. The parenchymal phase was selected for texture analysis. The minimum absolute shrinkage and selection operator (LASSO) method was applied for dimensionality reduction.Two independent sample t -tests or Mann-Whitney U test were used for continuous variables based on the Shapiro-Wilks normality test results. Categorical variables were tested by Chi-square or Fisher test. By multivariable regression analysis, CT findings, CT texture analysis, CT findings combined with texture analysis prediction models were established. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of individual indicators and each prediction model. The Delong test was used to compare the area under the curve (AUC) of each model. Results: The CT findings prediction model consisted of CT value of lesion on pancreatic parenchymal phase and pancreatic duct penetrating sign. The texture analysis prediction model consists of root mean square and low grey level run emphasis&#95;angle135. The AUC of them were not statistically different ( Z= 0.150, P> 0.05). The combined predictive model had the better diagnostic performance (AUC 0.944, sensitivity 83.0%, specificity 95.2%, +LR 17.43, -LR 0.18) than CT sign prediction model ( Z= 2.008, P< 0.05) and texture analysis prediction model( Z= 2.236, P< 0.05) were significantly different. Conclusions: The CT findings model and the texture analysis model have equivalent diagnostic performance in the differentiation of mass-forming pancreatitis and pancreatic cancer. The enhanced CT combined with texture analysis model has the best diagnostic efficiency and can further improve the diagnostic ability.

Objective: To explore the management strategy and clinical outcome of renal transplantation in presensitized recipients using deceased donor kidneys. Methods: From January 2011 to June 2018, twenty-one presensitized patients, including 8 with positive donor specific antibodies (DSA) and 13 with positive panel-reactive antibodies (PRA) but no DSA, received renal retransplantation from deceased donors in our center. The incidence of delayed graft function (DGF) and acute rejection (AR), changes of DSA, and the graft and patient survival were retrospectively analyzed. Results: None of the renal allografts had primary non-function (PNF) and DGF after transplantation. Four of the 13 recipients with PRA(+)/DSA-had a total of 5 episodes of acute cell-mediated rejection (CMR), while 5 of 8 recipients with pre-existing DSA(+) developed AR, including 3 cases with CMR alone and 2 cases with mixed AR. All episodes of rejection were successfully reversed after targeted treatment. Interestingly, of the 8 recipients with positive preformed DSA, 4 cases with positive DR-DSA and/or class Ⅰ-DSA had their DSA disappeared after transplantation, whereas DQ-DSA remained positive in 4 of 5 recipients. After a median follow-up of 26 months, all recipients maintained normal renal allograft function, and the survival rates of both graft and recipient were 100%. Conclusions: With the use of deceased donors, kidney transplantation can be successfully performed in presensitized patients by appropriate HLA-matching screening, choosing donor kidneys with good quality, and the combination of optimal perioperative treatment.

Objective: To investigate the percutaneously looped thread transection for treatment of stenosing tenosynovitis and evaluate its treatment outcome. Methods: From January 2014 to October 2016, Eighty-four patients with stenosing tenosynovitis were randomly divided into the open decompressionand group (42 cases) and percutaneously looped thread transection group (42 cases) in Department of Orthopedics, Affiliated Laiwu Hospital of Taishan Medical College. Incision near the digit horizontal stripes, tendon sheath were cut off in the open decompressionand group. Percutaneously looped thread transection was under the guidance of ultrasound, threading from the deep and shallow transverse tendon sheath, respectively, forming loops to cut off and decompressed the flexor tendon. Visual analog scale(VAS) was used to evaluate the extent of pain before the operation and 1 or 4 weeks after the operation, the comprehensive curative effect were evaluated 3 months after the operation. Results: In the two groups pain was alleviated. The VAS improved from (7.0±1.3)prior operation to(5.2±1.6) and (2.8±1.1)1 week and 4 weeks after the operation in the open decompressionand group , respectively. The difference before and after the operation was significant( P <0.05). The VAS improved from (7.1±1.4) prior operation to(2.7±1.3) and (0.6±0.2)1 week and 4 weeks after the operation in the percutaneously looped thread transection group, respectively. The difference before and after the operation was significant( P <0.05). The difference of VAS scores between two groups at 1 week and 4 weeks after the operation were different( P <0.05). The difference of the comprehensive curative effect between two groups at 3 months after the operation were not different( P >0.05). There were no infection, poor healing, blood vessel and nerve damage after operation in both two groups. Conclusion: Percutaneously looped thread transaction under ultrasound for the surgical treatment of stenosing tenosynovitis has less trauma and rapid recovery. It has such advantage as being effective, simple , and reach the same effects as the open decompression surgery.

Objective: To explore the value of 3.0 T MRI using multiple sequences (star VIBE+ BLADE) in evaluating the preoperative T staging for potentially resectable esophageal cancer (EC). Methods: Between April 2015 and March 2016, a total of 66 consecutive patients with endoscopically proven resectable EC underwent 3.0T MRI in the Affiliated Cancer Hospital of Zhengzhou University.Two independent readers were assigned a T staging on MRI according to the 7th edition of UICC-AJCC TNM Classification, the results of preoperative T staging were compared and analyzed with post-operative pathologic confirmation. Results: The MRI T staging of two readers were highly consistent with histopathological findings, and the sensitivity, specificity and accuracy of preoperative T staging MR imaging were also very high. Conclusion: 3.0 T MRI using multiple sequences is with high accuracy for patients of potentially resectable EC in T staging. The staging accuracy of T1, T2 and T3 is better than that of T4a. 3.0T MRI using multiple sequences could be used as a noninvasive imaging method for pre-operative T staging of EC.

Objective: To explore the value of apparent diffusion coefficient (ADC) ratio in the diagnosis of bladder cancer pre-operation by analyzing its differences among different grades of bladder cancer., Methods: A total of 52 cases of bladder cancer were all definitely diagnosed with histological results.Routine examinations of magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) were performed preoperatively on each patient. ADC map was constructed in work station and ADC values of tumor and internal obturator muscle were measured (b = 800 s/mm(2)).Ratio of ADC was calculated with internal obturator muscle as reference site. Then the relationship between ADC ratio and bladder cancer grade was analyzed., Results: Mean ratio of ADC of all tumors was 0.98±0.35, G1 (1.12±0.21) and G2 (0.67±0.29), the sensitivity and specificity of ADC ratio was 90.2% and 85.3% respectively with an optimal threshold of 0.96. The ratios of ADC of low-grade group were significantly higher than those of high-grade group while the values of non-muscle-invasive group were significantly higher than those of muscle-invasive group. The ratios of ADC of tumor were inversely associated with the malignancy degree of bladder cancer (r = -0.845, P < 0.05)., Conclusion: The ratio of ADC of bladder cancer reflects the lesion tissue properties. And its measurement plays an important role in the diagnosis of bladder cancer grading pre-operation.

Objective: To determine the respiratory indices capable of improving predictive accuracy of extubation success through serial measurements of during spontaneous breathing trial (SBT) in automatic tube compensation (ATC) pattern of mechanical ventilation., Methods: For this prospective observational study, patients ventilated over 48 hours were enrolled according to the weaning criterion and underwent a 60 minutes spontaneous breathing trial (SBT) in ATC pattern (ATC = 100%, FiO2 = 0.4, PEEP = 0 cm H2O, PS = 0 cm H2O). During SBT, heart rate (HR) and mean artery pressure (MAP) were monitored continuously and minute volume (VE), respiratory rate (RR), tidal volume of spontaneous breath (VT), rapid shallow breathing index (RSBI), change and rate of change (ΔRSBI60&#95;1 and ΔRSBI60&#95;1/RSBI1, etc.) were recorded or calculated at the first, 30(th) and 60(th) minute of SBT. Patients tolerating the trial were extubated immediately. Clinical data and respiratory indices during SBT were compared between patients in extubation success group and those in extubation failure group. Predictive accuracy of extubation success was assessed by area under the receiver operating characteristic (ROC) curve (AUC) for each index., Results: The duration of mechanical ventilation was longer in patients of extubation failure group than that of extubation success group (10.75 ± 2.73: 7.47 ± 5.11, P = 0.035) and extubation failure rate was 17.14%. During SBT, RSBI increased initially and then decreased in patients of extubation success group, but increased continuously in patients of extubation failure group. There were significant difference of ΔRSBI60&#95;1 and ΔRSBI60&#95;1/RSBI1 in patients between extubation success and failure groups (-11.5 ± 16.6: 12.1 ± 38.9, P = 0.001 and -17 ± 26: 13 ± 39, P = 0.028). AUCs of RSBI60, ΔRSBI60&#95;1 and ΔRSBI60&#95;1/RSBI1 were 0.75, 0.73 and 0.72 and the sensitivity, specificity and diagnostic accuracy 81.0%, 66.7% and 78.5% respectively., Conclusion: It is important to observe change of various respiratory indices dynamically during SBT in patients ventilated in ATC pattern. ΔRSBI60&#95;1 and ΔRSBI60&#95;1/RSBI1 have greater predictive value for extubation success. Stable or decreased RSBI60 means higher extubation success rate.

Objective: To explore the diagnostic features of collecting duct carcinoma (CDC)., Methods: A total of 7 CDC patients were retrospectively examined by multi-slice computed tomography (MSCT). The relevant diagnostic parameters were assessed., Results: All lesions were located in renal medulla. Among them, infiltrations extended to renal calyx (n = 3) and cortex (n = 5). There were indistinct boundaries (capsule sign) on enhanced phase (n = 6) and pre-capsule (n = 1). On non-enhanced CT, CDC attenuation was greater than normal renal cortex or medulla (43.8 ± 5.3 vs 37.6 ± 5.1 or 32.6 ± 4.1, P < 0.05). The degree of enhancement was less than normal renal cortex and medulla during all enhanced phases (P < 0.05 or 0.01). Excellent consistency existed between CT appearances of CDC and pathological characteristics., Conclusion: Dynamic contrast enhanced-CT can show distinct imaging features of CDC correlated with pathological characteristics so as to allow a better differential diagnosis.

Objective: To explore the therapeutic efficacy of a novel complex material of shape-memory alloy brace and artificial dura (nitinol brace and NormalGEN) for the reconstruction of skull base in a canine model with lateral media skull base defect., Methods: The complex of nitinol brace and NormalGEN was developed with corresponding apparatus. A common adult dog model with lateral media skull base defect was established and then reconstructed with the complex. At Month 3 post-operation, cranial lateral radiographic projection, three-dimensional reconstruction of computer tomography, 1.5T magnetic resonance imaging and histopathological examination were detected., Results: Five animal models and cranial reconstructions were made. All survived without any complication, such as leakage of cerebrospinal fluid, local tissue eminence and neurological function defect. The imaging detection showed that nitinol brace was distinct and satisfactorily positioned without shift and artifact. And histopathological examination showed that granulation tissue substituted NormalGEN and grew around the brace with numerous fibroblasts., Conclusion: The complex of shape-memory alloy brace and artificial is suitable for the reconstruction of skull base on dog model with lateral media skull base defect.

Objective: To assess the methods of establishing an orthotopic nude murine model of human pancreatic cancer and explore the manifestations of MRI (magnetic resonance imaging) and its pathological fundamentals so as to provide research rationales for human pancreatic cancer., Methods: The BXPC-3 cell of human pancreatic cancer was orthotopically planted in nude mice. And the animals were examined by a clinical 3.0 T magnetic resonance imager. The MRI examinations were analyzed along with their pathological findings., Results: Among 18 mice, 15 of them grew tumors with a success ratio of 83.3%. The pathological findings conformed to those of high differentiation pancreatic parenchyma cancer. Comparing with the neighbor muscles, the tumors were homogeneous (66.7%, 10/15) or heterogeneous (33.3%, 5/15) of hypointense on T1-weighted images while homogeneous (26.7%, 4/15) or heterogeneous (73.3%, 11/15) hyperintense on T2-weighted images with heterogeneous enhancement. The border became obviously enhanced and there was mild central enhancement while the necrotic part showed no enhancement., Conclusion: 3.0T MRI can detect pancreatic neoplasms ≥ 2 mm and visualize clearly their locations, shapes, dimensions and internal structures in an orthotopic nude murine model. Thus it provides a visible framework for further studies of human pancreatic cancer.

Objective: To investigate the radiographic and computerized tomographic features of chest in patients with acute chlorine poisoning and its diagnostic value., Methods: Twenty-eight cases of chlorine poisoning were reviewed. And their radiographic and computerized tomographic features were compared and analyzed., Results: Radiographic findings: among 28 patients, 9 cases were normal and 2 cases had no abnormalities on the first chest X-ray and became abnormal one or two days later. And there were abnormal findings in first chest X-ray in 17 patients:acute tracheal inflammation of peribronchitis (n = 3), acute chemical bronchopneumonia (n = 6) and diffuse interstitial and central pulmonary edema (n = 8). CT manifestations: At Days 1-3, the patients of mild poisoning had scattered patchy dense shadow; those of moderate to severe poisoning showed multiple patchy or diffuse infiltration (ground-glass opacity). And partial consolidation, air bronchogram and pleural effusion could be observed. At Days 4-10, the manifestations of mild poisoning were largely absorbed; those of moderate to severe poisoning manifested the absorption of diffuse or multiple patchy effusion and a fading of shadow. And the size of lung consolidation became smaller than before. At Day 10 after onset, 4 patients completely recovered. At Days 30-40, 6 cases showed traces of fibrous shadow and one case showed small punctiform opacities in both lungs. And at Day 42, there was slight ground-glass change., Conclusion: Acute chlorine gas poisoning in varying degrees may manifest acute bronchial pneumonia and acute pulmonary edema. During treatment, a series of chest X-ray examinations will help to follow the changes of disease. And CT examination can offer a more accurate evaluation of lung lesions.

Objective: To estimate the burden of disability and health services use by people with knee pain, with or without radiographic evidence of osteoarthritis (OA), in rural northern China., Methods: A population-based cross-sectional survey was conducted among 1030 residents of Wuchuan County, Inner Mongolia, aged 50 years old and over. The participants completed an interviewer-based questionnaire and obtained bilateral weight-bearing posterior-anterior semi-flexed knee radiographs., Results: Of 1027 participants with knee radiographs, 513 (50%) participants reported knee pain in most days of at least a month over the past 12 months. Of those with knee pain, 109 (21%) had radiographic OA (Kellgren Lawrence grade > or =2) in symptomatic knees. Adjusting for age, gender, BMI, education and back pain, the presence of knee pain was associated with a significantly greater difficulty in walking, climbing 10 steps, stooping, performing cleaning chores and preparing meals. Among 513 subjects with knee pain, the presence of radiographic disease was significantly associated with the presence of unbearable pain (36% vs. 59%), restricted activity (39% vs. 64%), use of NSAIDs (78% vs. 88%) and consulting a doctor over the last 12 months (33% vs. 59%)., Conclusion: Knee pain is associated with significant physical disability in rural China The prevalent use of NSAIDs for knee pain and a low use of knee surgery should be of particular concerns. These findings will be useful to guide the distribution of future health care resources and preventive strategies.

Objective: To evaluate the effects of tissue engineered allogeneic platelet lysates (PL) upon bone reconstruction., Methods: After preparation of recombinant material with PL, allogeneic decalcified bone granules (ADBG) and collagen type I (CG), 30 healthy Wistar rats were used to prepare the bilateral bone defects in femoral condyles. The defects were filled with equivalent PL/ADBG/CG, ADBG/CG and CG in different groups of A, B and C (with 10 rats each) respectively. At 4 weeks, the defect reconstruction was evaluated with radiology, histology, immunology and biomechanics., Results: (1) The X-ray showed that bone density in group A (4.18 +/- 0.96) was close to that of normal bone and it was significantly higher than that in group B (2.36 +/- 0.87) and group C (1.09 +/- 0.55) (P < 0.01). (2) In comparisons with B and C, the histological assay revealed that there were markedly more activities of new bone formation and more implanted bone granules surviving without significant lymphocyte infiltration, as well as more osteoclastic bone resorption in group A. The bone histomorphometric assay showed the newly formed bone area in group A (286.73 +/- 17.22) was significantly higher than that in group B (94.34 +/- 33.56) and group C (19.12 +/- 14.53) (P < 0.01). (3) Anti-press mechanical measures showed that the destructive load in A, B, C and normal control group was 259.63 +/- 34.57, 187.90 +/- 21.07, 91.33 +/- 26.58 and 311.93 +/- 82.45 respectively. The destructive energy in A, B, C and normal control group was 10.82 +/- 1.44, 7.83 +/- 0.88, 3.81 +/- 1.11 and 12.97 +/- 3.43 respectively. These results showed either destructive load or destructive energy in group A was markedly higher than that in group B and group C with significant difference (P < 0.01), but still lower than that in normal controls (P < 0.01). (4) Three-color flow cytometry assay showed that the T lymphocyte subsets of CD3+CD4+CD8-, CD3+CD8+CD4- and the ratio of CD4/CD8 showed no significance difference within these three groups as well as normal controls., Conclusion: Tissue engineering PL (PL/ADBG/CG) is capable of accelerating the regenerative repair of bone defect and promoting the bone regeneration and osetointergretion of allograft bone after transplantation.

Objective: To investigate the characteristics of gene structure in facioscapulohumeral muscular dystrophy (FSHD)-related 4q35 subtelomere, to analyze the distribution of 2 alleles (4qA and 4qB) distal to D4Z4 of this locus, and to further elucidate the genotype-phenotype correlation in Chinese Han FSHD patients., Methods: Peripheral blood samples were collected from 52 unrelated families including 62 FSHD-affected and 57 unaffected members. Genomic DNA was extracted from the lymphocytes according to the specific procedure designed to minimize DNA shearing, then digested with EcoRI or HindIII, or double digested with EcoRI and BlnI. The cleaved DNA was separated by pulsed field electrophoresis (PFGE) and Southern blotting with the probes p13E-11, 4qA, and 4qB. The size of FSHD-causing 4qA allele and its distribution was analyzed by "curve fitting". Then the characteristics of translocation and mosaicism, the frequencies of two allelic variants of chromosome 4q and their genotypes were calculated to analyze the genotype-phenotype correlation., Results: It was found that 69 patients carried a short chromosome 4-type allele of 4qA origin with the length 10-38 kb. The mean length of these pathogenic EcoRI/4qA arrays was 20 kb+/-7 kb, without significant difference between the sporadic cases and familial cases (t=1.413, P>0.05). Three different translocation types were observed with a translocation rate of 14.49%. The rate of 4q-->10q translocation was 13.04%, significantly higher than that of 10q-->4q translocation (1.45%, chi2=6.900, P<0.05). Somatic mosaicism was detected in a male sporadic case and a female asymptomatic familial case. In 57 cases with standard configuration distribution, the frequency of 4qA/4qB heterozygote was 61.40%, significantly higher than that of 4qA/4qA homozygote (38.60%, (chi2=5.930, P<0.05). There were not significant differences in the repeat size distributions and assessment of clinical severity between the sporadic and familial cases (t=-0.039, P>0.05; H=0.693, P>0.05)., Conclusion: About 95% of Chinese FSHD patients carry a pathogenic 4-type allele of 4qA origin less than 30 kb long. The frequent translocations between chromosome 4q and 10q may play an essential role for FSHD mechanism. The frequency of 4qA/4qB heterozygote is significantly higher than that of 4qA/4qA homozygote, while the allelic variant genotypes do not contribute to modify FSHD manifestations.

Objective: To study the changes of amplitude of low-frequency fluctuation (ALFF) of the resting-fMRI in the mesial temporal lobe epilepsy (mTLE) with bilateral hippocampal sclerosis (HS), and discussed its underlying neuro-pathophysiological mechanism., Methods: The resting-fMRI data of 20 TLE patients with HS and 20 normal volunteers were performed ALFF analysis. The amplitude of the blood oxygenation level-dependent activation of the resting-state brain was investigated. The brain structures showing increased and decreased ALFF in TLE patients were demonstrated by comparing to normal subjects with 2-sample t-test with threshold of P < 0.01., Results: By comparison with that of normal subjects, the regions showing increased and decreased ALFF in TLE patients were distributed in the brain symmetrically and bilaterally. The regions showing increased ALFF were distributed with center of limbic system, such as parahippocampal gyri, amygdala, hypothalamus, dorsal anterior cingulate gyrus and part of posterior insular lobe, as well as the neocortices such as primary sensorimotor cortices, occipital cortices, inferior temporal gyri, orbital gyri, and the subcortical structures of verbal brainstem and mesial cerebellum. The point with maximal increased ALFF (T = 6.02) located in the right precentral gyru (15, - 12.51). While the regions showing decreased ALFF covered the areas of default mode, such as posterior cingulate cortex/ precuneus and medial prefrontal cortex /ventral anterior cingulate cortex, as well as other structures such as dorsal lateral prefrontal cortices, superior temporal gyri, caudate heads, dorsal brain stem and the posterior cerebellum (3, -78, -21) with the maximal decreased ALFF (T = -4.42)., Conclusion: The method of ALFF allows the direct observation to the epileptic activation in TLE. The increased ALFF is considered the facilitation such as the epileptic activity generation and propagation; while the ALFF decrease is considered the function inhibition in these regions, especially implies the suspension in the default mode activity.

Objective: To determine the optimal target plasma concentration of propofol required to induce EEG burst suppression administered by TCI in order to decrease cerebral metabolic rate and increase tolerance to cerebral ischemia and hypoxia., Methods: One hundred and fifty ASA I-II patients(aged 18-55 years-old, BMI < 30, Mallampati Score I-II) scheduled for elective surgery undergoing general anesthesia were enrolled in this study. Patients with systemic diseases or other factors effecting the electrical activity of brain were excluded. ECG, IBP, SpO2, PetCO2, Temperature and EEG (two-channel referential montage system) were continuously monitored during the procedure. Patients were induced with TCI propofol (the target plasma concentration was initially set at 5.4 microg/ml), After induction and intubation, target plasma concentration was increased by 0.3 microg/ml increment and sustained 15 minutes until EEG burst suppression appeared(stable burst suppression waveform and BSR > 50%), and this target concentration was recorded., Results: The mean target plasma concentration of propofol with TCI required to induce EEG burst suppression was 6.1 +/- 0.6 microg/ml with 95% confidence interval of 5.99-6.19 microg/ml. There was no significant difference between the genders., Conclusions: The target plasma concentration of propofol reached 6.2 microg/ml can induce EEG burst suppression, which is better for intraoperative cerebral protection.

Objective: To compare the CT enhancement degree in pancreatic carcinoma (PC) and inflammatory pancreatic mass (IPM), and to study the diagnostic value of CT to these two diseases., Methods: Eighty-five patients with PC or IPM, 47 males and 38 females, aged 62 (37-79), underwent plain CT scanning and enhanced CT scanning in pancreatic phase and delay phase. The CT values of the pancreatic mass and relative normal pancreatic tissue were measured. The diagnosis of PC and IPM was verified by operation, biopsy, etc. Sixty persons without pancreatic diseases were used as controls., Results: Among the 85 patients, 66 were proved to be with PC, and 19 patients were proved to be with IPM. In plain CT scanning, pancreatic-phase CT enhancement, and delay-phase CT enhancement, the CT values of PC were (34+/-7) HU, (54+/-10) HU, and (61+/-14) HU respectively; and the CT values of the relatively normal pancreatic tissue were (42+/-6) HU, (105+/-12) HU, and (77+/-10) HU respectively. In plain CT scanning, pancreatic-phase CT enhancement, and delay-phase CT enhancement, the CT values of IPM were (37+/-6) HU, (58+/-17) HU, and (64+/-10) HU respectively; and the CT values of the relatively normal pancreatic tissue were (40+/-8) HU, (85+/-10) HU, and (72+/-9) HU respectively. The pancreatic-phase enhanced CT values of the mass in the PC group and the IPM group showed no remarkable differences (P>0.05). The pancreatic-phase enhancement intensity of the relatively normal pancreatic tissue is greater in PC than in IPM (P<0.01)., Conclusion: There is a certain limit for CT enhancement in differentiating between PC and IPM. Comprehensive analysis is necessary in diagnosis of PC and IPM.

Objective: To investigate the manifestation of impairment of peritubular capillary (PTC) in chronic aristolochic acid nephropathy (CAAN) and the influence of hypoxia caused by PTC impairment on the progression of CAAN., Methods: Fifty-four Wistar rats were randomly divided into 2 groups: Group A (n = 30, perfused intragastrically with decoction of Caulis aristolochia manchuriensis for 8 weeks) and Group B (n = 24, perfused intragastrically with drinking water for 8 weeks). At weeks 8, 12, and 16 ten rats in Group A and 8 rats in Group B were killed. Specimens of blood and urine were collected before the killing of the rats to detect the blood urea nitrogen (BUN), serum creatinine (Scr), and urine protein. HE and Masson staining and microscopy were used to observe the pathology of the kidney. Immunohistochemistry and Western blotting were used to detect the expression of hypoxia-inducible factor-1alpha (HIF-1alpha), vascular endothelial growth factor (VEGF), and CD34. Correlation analysis was conducted to study the relationships among these indices., Results: Since week 8 BUN, Scr, and urine protein of Group A began to increase in comparison with Group B (all P < 0.05). Pathological changes of the kidney began to appear in Group A since week 8 with the decrease of PTC density. HIF-1alpha was not expressed in Group B, and in Group A HIF-1alpha expression began to increase since week 8 and became significantly higher than that of Group B since week 12. At week 16, the PTC density and VEGF-IOD of Group A were 8.10 +/- 2.28/0.13 mm(2) and (2.78 +/- 0.78) x 10(3) respectively, both significantly lower than those of Group B [(42.80 +/- 4.49)/0.13 mm(2) and (26.49 +/- 9.34) x 10(3) respectively, both P < 0.01], and the HIF-1alpha-IOD of Group A was (7.11 +/- 1.20) x 10(3), significantly higher than that of Group B [(0.44 +/- 0.10) x 10(3), P < 0.01]. CD34 was highly expressed in Group B, and the CD34 expression of Group A began to decrease since week 16. HIF-1alpha expression was positively correlated with Scr (r = -0.945, P < 0/01), and PTC density and VEGF expression were negatively correlated with Scr (r = -0.907, P < 0.01 and r = -0.690, P < 0.01). PTC density was negatively correlated with HIF-1alpha expression (r = -0.880, P < 0.01)., Conclusion: Severe hypoxia exists following PTC injury in CAAN. Hypoxia is correlated with the progression of CAAN.

Objective: To explore the value of dynamic enhanced magnetic resonance (MR) in diagnosis of pancreatic carcinoma and endocrine tumors., Methods: Twenty-two patients with pancreatic carcinoma and 9 patients with pancreatic endocrine tumors underwent routine MR scanning and dynamic contrast enhanced MR examination before they underwent operation., Results: No tumor image was seen in 4 of the 22 patients with pancreatic carcinoma by routine MR scanning. Fat-saturated T(1)-weighted imaging (FS-T(1) WI) showed that 11 of them were hyposignal, 6 slightly hyposignal, and 1 isosignal; and fat-saturated T(2)-weighted imaging (FS-T(2) WI) showed that 5 were hypersignal, 7 slightly hypersignal, 5 isosignal, 1 slightly hyposignal, and 13 with heterogeneous signals. After dynamic MR imaging no tumor was enhanced in the arterial phase (AP); and all the tumors were obviously enhanced during the pancreatic phase (PP) and portal venous phase (PVP), 5 of which showed isosignal intensity, 10 slightly hyposignal intensity, and 3 hyposignal intensity. Four of the 5 cases with small pancreatic carcinoma were demonstrated as isosignal and one was slightly hyposignal. During the delayed enhancement phase (DEP) the signal intensity of the tumors became slightly weaker. No tumor image was seen in 14 of the 9 patients with pancreatic endocrine tumors by routine MR scanning. FS-T(1) WI showed that 5 of them were hyposignal, and 3 slightly hyposignal; and FS-T(2) WI showed that 2 were hypersignal, 4 slightly hyposignal, and 2 isosignal. After dynamic MR imaging 2 cases were moderately enhanced and 6 cases mildly enhanced during AP, and all pancreatic endocrine tumors were obviously enhanced during PP and PVP, with isosignal intensity in 2 cases, slightly hyposignal intensity in 1 case, and slightly hypersignal intensity in 5 cases. Peritumor thin-walled enhancement was seen in 6 cases., Conclusion: Dynamic enhanced MR has a certain value in the diagnosis of pancreatic carcinoma and endocrine tumors. Pancreatic carcinoma shows various enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form not surpassing that of normal pancreatic tissue. Pancreatic endocrine carcinoma shows obvious enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form surpassing that of normal pancreatic tissue. Peritumor thin-walled enhancement is a characteristic feature of pancreatic endocrine carcinoma.

Objective: To explore the effects of chemotherapy in recurrent endometrial carcinoma., Methods: A retrospective study was carried out on the clinical data of 20 cases of recurrent endometrial carcinoma hospitalized from May. 1992 to Jun. 2002., Results: The recurrence rate of these 20 cases was 11.0%. The recurrence occurred (17 +/- 10) months after the first therapy. Eleven of the 20 patients (55.0%) had accepted chemotherapy with (6 +/- 4) courses and were followed up for (17 +/- 16) months after the second therapy. Fifteen cases (75.0%) died of cancer, 4 cases survived with tumor, and only 1 case (5.0%) was tumor-free. Univariate model revealed that chemotherapy and number of chemotherapy course were related with the prognosis (P = 0.0146, P = 0.0353). Radiotherapy affected the prognosis too (P = 0.0414). But pathologic subtype, stage, tumor cell differentiation, age, recurrent time, surgery, chemotherapy scheme, drug infusion way , and endocrine therapy had no relation with the prognosis (P = 0.5517, 0.5763, 0.1879, 0.880, 0.453, 0.0672, 0.0795, 0.5956, and 0.2035). Multivariate model revealed that chemotherapy had influence on the prognosis (beta = -1.349, OR = 0.259, P = 0.026)., Conclusion: Combined treatment raises the survival of the recurrent endometrial carcinoma patients, in which chemotherapy plays a leading role and influences the prognosis remarkably.

Objective: To investigate the value of multislice spiral CT (MSCT) coronary angiography in the diagnosis of anomalous origin of coronary arteries., Methods: 5000 patients diagnosed or suspected as with diseases of coronary artery underwent MSCT coronary angiography (retrospectively ECG-gating; 0.5 s rotation; one-sector or two-sector reconstruction algorithm; intravenous contrast agent) 2001-2005., Results: Anomalous origin of coronary artery was incidentally found with multislice spiral CT in 39 patients (0.78%), including anomalously high origin of the right coronary artery (n = 20), anomalous origin of the right coronary artery from left coronary sinus (n = 11), aberrant circumflex artery arises from the right coronary sinus or right coronary (n = 3), anomalous origin of the right coronary artery from the posterior coronary sinus (n = 1), anomalous origin of the left coronary artery from the posterior coronary sinus (n = 1), single coronary artery (n = 2), separate origin of circumflex and left anterior descending arteries from left coronary sinus (n = 1). These signs were better shown by MSCT coronary angiography., Conclusion: MSCT coronary angiography is a useful adjunctive technique to invasive coronary angiography in the diagnosis of anomalous origin of coronary arteries.

Objective: To study the effectiveness of adjuvant endocrine therapy on the prognosis of endometrial carcinoma and to analyze the influence of progesterone receptor on the curative effect of adjuvant endocrine therapy., Methods: A retrospective study was carried out on 171 patients of endometrial carcinoma with similar pathological examination. 82 of the 171 patients with endometrial carcinoma (48.0%), aged (57 +/- 9) years, underwent endocrine therapy, mainly by progesterone (245 +/- 51) mg/d for (1.3 +/- 0.9) years. 55 cases (67.1%), aged (57 +/- 10) years, underwent endocrine therapy for more-than-one-year (more-than-one-year subgroup), and 27 cases (32.9%), aged (59 +/- 9) years, underwent endocrine therapy for less-than-one-year (less-than-one-year subgroup). 24 of the 82 patients (29.3%) underwent adjuvant radiotherapy. 89 of the 171 patients (52.0%), aged (57 +/- 11) years, were in the control group 31 of the 89 patients in the control group (34.8%) underwent adjuvant radiotherapy, and 39 patients (43.8%) underwent adjuvant endocrine therapy. Follow-up was performed by correspondence, phone call, or outpatient department visit for 3 approximately 4 years., Results: The rate of recurrence and/or metastasis of the endocrine therapy group was 13.4%, not significantly different from that of the control group (23.6%, P > 0.05); the death rate of the endocrine therapy group was 12.2%, not significantly different from that of the control group (20.2%, P > 0.05). The rate of recurrence and/or metastasis of the less- than-one-year subgroup was 25.9%, significantly higher than that of the more-than-one-year subgroup (7.3%, P = 0.012); the death rate of the less- than-one-year subgroup was 22.2%, significantly higher than that of the more-than-one-year subgroup (7.3%, P = 0.036). Cox regression showed that stage, the operation, tumor cell differentiation, and duration of endocrine therapy significantly affected the recurrence/metastasis remarkably (OR = 5.199, OR = 0.507, OR = 1.796, OR = 0.538) and the death rater (OR = 5.488, OR = 0.482, OR = 1.516, OR = 0.547). The rate of recurrence/metastasis of the endocrine therapy group patients with positive progesterone receptor was 4.7%, significantly higher than that of the patients with negative progesterone receptor (26.7%, P = 0.034)., Conclusions: The prognosis of endometrial carcinoma patients can be improved with adjuvant endocrine therapy, especially for those with positive progesterone receptor. Endocrine therapy should be continued no less than 1 year.

Objective: The purpose of this work was to study the correlation of pancreatic phase CT enhancement, intratumoral microvessel density (MVD) and histopathological grades in pancreatic carcinoma and to evaluate the relationship between CT enhancement degree and the malignancy degree of pancreatic carcinoma., Methods: 34 patients with pancreatic carcinoma underwent CT scanning before resection. The enhancement degrees and forms of tumor were observed in pancreatic-phase. The operational sample was stained with HE and CD34 marked by immunohistochemistry. MVD and histopathological grades of pancreatic carcinoma were examined. CT enhancement of the tumor, MVD counting in hot spots areas of neoplastic parenchymal cells and pathological grades of pancreatic carcinoma were comparatively analyzed., Results: Highly differentiated pancreatic adenocarcinoma was identified in 16 patients, moderately differentiated tumor in 7 and poorly differentiated tumor in 11. Isodensity CT enhancement was demonstrated in 13 cases, slight low density enhancement in 9, slight low density enhancement along with small cyst lesion in 9 and slight low density enhancement along with large cyst lesion in 3. The counting of MVD with CD34 marked by immunohistochemistry in hot spot areas of neoplastic parenchyma cells were small in 10 cases, medium in 16 and large in 8. The pathological grades correlated with CT enhancement of tumor (r = 0. 785 7, P < 0.001). The pathological grade correlated with MVD counting of tumor (r = 0.361 3, P < 0.05). The CT enhancement of tumor correlated with MVD (r = 0.676 8, P < 0.001)., Conclusion: There was obvious and significant correlation between CT enhancement, pathological grades MVD numbers in the hot spot areas of tumor. The malignant degree of pancreatic carcinoma was inversely proportional to the extent of CT enhancement and inversely proportional to MVD numbers in the hot spot areas of tumor.

Objective: To investigate the translocation between chromosomes 4q and 10q and its putative correlation with facioscapulohumeral muscular dystrophy (FSHD)., Methods: Double digestion of the genomic DNA of 50 controls and 45 FSHD cases, 16 cases of sporadic FSHD and 19 cases of familial FSHD from 7 families, with restriction enzymes BglII and BlnI was followed by separation and Southern blotting with the probe p13E-11. By Scion Image program, the density of hybridized fragments was analyzed and the 4q:10q density ratio was then calculated to infer the types of 4q-10q translocation. The frequencies of translocation among the controls, sporadic FSHD cases, and familial cases were compared., Results: In the 95 subjects 4 different translocation types were detected with a translocation rate of 17.89%. Both the rate of 4q-->10q translocation and the rate of 10q-->4q translocation were 8.0% among the healthy controls. Only 4q-->10q translocation was found in sporadic FSHD cases with a frequency of 43.75%, while only 10q-->4q translocation was found in familial FSHD patients with a frequency of 6.89%. The frequency of 4q-->10q translocation in the sporadic FSHD cases was significantly higher than that in the control group (chi(2) = 11.154, P < 0.001), while the frequency of 10q-->4q translocation in the familial FSHD cases was not significantly different from that in the controls (chi(2) = 0.012, P > 0.5)., Conclusion: Frequent translocations between chromosomes 4q and 10q occur in normal population and FSHD cases, while the 4q-->10q translocation is only related to sporadic FSHD. Excessive loss or conversion (to 10q26) of 4q35 D4Z4 repeats, caused by 4q-10q interactions, may be essential for the mechanism of this disorder.