New radiofrequency ablation procedure for selective reduction in complicated monochorionic twin or triplet pregnancy using multistep, incremental expansion technique.

OBJECTIVE: Radiofrequency ablation (RFA) is the preferred approach for selective reduction in complex monochorionic (MC) multiple pregnancies owing to the ease of operation and minimal invasiveness. To optimize the RFA technique and reduce the risk of adverse pregnancy outcome resulting from the heat-sink effect of RFA therapy, we used an innovative RFA method, in which an electrode needle was expanded incrementally and stepwise. This study aimed to assess the efficacy and safety profile of this novel multistep incremental expansion RFA method for selective fetal reduction in MC twin and triplet pregnancies. METHODS: This was a single-center retrospective cohort study of all MC multiple pregnancies undergoing RFA between March 2016 and October 2022 at our center. The multistep RFA technique involved the use of an expandable needle, which was gradually expanded during the RFA procedure until cessation of umbilical cord blood flow was achieved. The needle used for the single-step RFA method was fully extended from the start of treatment. RESULTS: In total, 132 MC multiple pregnancies underwent selective reduction using RFA, including 50 cases undergoing multistep RFA and 82 cases undergoing single-step RFA. The overall survival rates were not significantly different between the multistep and single-step RFA groups (81.1% vs 72.3%; P = 0.234). Similarly, the rates of preterm prelabor rupture of the membranes within 2 weeks after RFA, procedure-related complications, spontaneous preterm delivery and pathological findings on cranial ultrasound, as well as gestational age at delivery and birth weight, did not differ between the two groups. However, there was a trend towards a prolonged procedure-to-delivery interval following multistep RFA compared with single-step RFA (median, 109 vs 99 days; P = 0.377). Moreover, the fetal loss rate within 2 weeks after RFA in the multistep RFA group was significantly lower than that in the single-step RFA group (10.0% vs 24.4%; P = 0.041). The median ablation time was shorter (5.3 vs 7.8 min; P < 0.001) and the median ablation energy was lower (10.2 vs 18.0 kJ; P < 0.001) in multistep compared with single-step RFA. There were no significant differences in neonatal outcomes following multistep vs single-step RFA. CONCLUSIONS: Overall survival rates were similar between the two RFA methods. However, the multistep RFA technique was associated with a lower risk of fetal loss within 2 weeks after RFA. The multistep RFA technique required significantly less ablation energy and a shorter ablation time compared with single-step RFA in selective fetal reduction of MC twin and triplet pregnancies. Additionally, there was a trend towards a prolonged procedure-to-delivery interval with the multistep RFA technique. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Effect of pulmonary function on bone mineral density in the United States: results from the NHANES 2007-2010 study.

The relationship between pulmonary function (PF) and bone mineral density (BMD) remains controversial. In the US population, we found a positive association between PF and BMD. Mixed variables such as age, gender, and race may influence this association. INTRODUCTION: Based on the data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010, this study explored whether there is a correlation between PF (1st second forceful expiratory volume as a percentage of expected value (FEV1(% predicted)), (one-second rate (FEV1/FVC)), and bone mineral density. METHODS: We evaluated the relationship between PF and BMD in 6327 NHANES subjects (mean age 44.51 ± 15.64 years) from 2007 to 2010. The bone mineral density of the whole femur was measured by dual-energy X-ray absorptiometry (DXA). After adjusting for a wide range of confounders, we examined the relationship between PF and total femur BMD using a multiple linear regression model. RESULTS: Correction of race, age, alcohol consumption, body mass index (BMI), height, poor income ratio (PIR), total protein, serum calcium, serum uric acid, cholesterol, serum phosphorus, blood urea nitrogen, FEV1(% predicted), and femur BMD were positively correlated (ß = 0.032, 95% CI: 0.010-0.054, P = 0.004). FEV1/FVC was positively correlated with spine BMD (ß = 0.275 95%CI: 0.102-0.448, P = 0.002). CONCLUSIONS: Our study shows that PF is positively associated with BMD in the US population. A variety of factors such as race and age influence this relationship. the relationship between PF and BMD needs to be further investigated, including specific regulatory mechanisms and confounding factors.

[The clinical characteristics of functional hypothalamic amenorrhea with hyperandrogenism].

Objective: To explore the clinical and biochemical discriminants of hyperandrogenism in functional hypothalamic amenorrhea (FHA). Methods: From January to September 2022, a total of 56 patients with FHA group in the Obstetrics and Gynecology Hospital of Fudan University outpatient clinic were included in this retrospective cross-sectional analysis. According to the clinical or biochemical features of hyperandrogenism, FHA patients can be divided into two subgroups, namely hyperandrogenic FHA and non-hyperandrogenic FHA. Explore the differences and its significances between hyperandrogenic FHA and non-hyperandrogenic FHA by comparing anthropometry, reproductive hormones, AMH, ultrasonic manifestation, the scores of eating attitude test, depression questionnaire and anxiety scale respectively and analyzing their correlations. Results: The age of 56 FHA patients was 15-32(23.36±4.90) years, and body mass index(BMI) was (18.91±2.49) kg/m2. The age of hyperandrogenic FHA and non-hyperandrogenic FHA was (21.76±4.40) and (24.05±5.00) (P=0.109) years old respectively, and BMI was (19.14±3.15 )and (18.81±2.18) kg/m2 (P=0.702). Compared to the non-hyperandrogenic FHA, the AMH (6.46 and 3.63 ng/ml, P=0.025) and PRL (278.78 and 149.46 mU/ml, P=0.002) levels were higher in hyperandrogenic FHA group. There was no significant difference between the hyperandrogenic and non-hyperandrogenic FHA group in body composition.GAD-7 (r=0.455, P=0.005) and PHQ-9 (r=0.664, P<0.001) were correlated with EAT-26 scores in non-hyperandrogenic FHA group, but no significant correlation was shown between PHQ-9 (r=0.091, P=0.766)、GAD-7 (r=0.304, P=0.313) and EAT-26 in hyperandrogenic FHA group. Conclusions: Some patients with FHA had clinical manifestations of hyperandrogenism and mildly elevated AMH and PRL, with underlying PCOS endocrine characteristics.

[Magnetic resonance imaging manifestation of foot injury in amateur half marathon athletes].

Eighty-four amateur half marathon athletes (168 side feet) in Beijing from October 2018 to May 2021 were recruited, and their age, gender and whether they have foot pain were collected, including 44 males and 40 females, aged from 21 to 60 (40.7±9.3) years. All participants underwent bipedal magnetic resonance imaging (MRI) examinations, and the degree of foot pain was graded by foot ankle injury scale (FASS scale). The relationship between MRI features and the foot pain of amateur half marathon athletes were analyzed. The study found that the proportion of foot pain symptoms among amateur half marathon athletes in Beijing was high(122/168), and the MRI manifestations were mainly heel tendinitis and plantar fasciitis, which accounted for about 59.5% of all cases.

[Changes of serum lipid profiles and the correlation analysis in clinic-pathological features of pancreatic cancer patients].

Objective: To examine the characteristics of blood lipid profile and the correlation with clinic-pathological features of pancreatic cancer patients. Methods: The clinical and pathological data of 265 pancreatic cancer patients who received radical surgical treatment at Department of General Surgery,Qilu Hospital,Shandong University from January 2013 to September 2020 were collected and analyzed retrospectively. Among the 265 pancreatic cancer patients,there were 170 males and 95 females,with age of (61.0±9.6)years(range:28 to 86 years). General information,lipid indicators and clinic-pathological information were collected from electronic medical record system,and follow-up information gained by telephone. According to level of serum lipid in pancreatic cancer patients,265 patients were divided into dyslipidemia group(n=115) and normal lipid group(n=150). Pearson χ2,Student's t tests, variance analysis or univariate Logistic regression was used to analyze the correlation between dyslipidemia and clinico-pathological characteristics of pancreatic cancer,respectively. Kaplan-Meier survival curve was used to assessed the influence of dyslipidemia on prognosis of pancreatic cancer patients. Results: In 265 pancreatic cancer patients,115(43.4%)of them had dyslipidemias,and the most common form was increase of triglyceride(TG)(72.2%). In pancreatic cancer with dyslipidemias group,patients with body mass index ≥25 kg/m2 had higher proportion than normal lipid group(36.1%(26/72) vs. 21.2%(21/99),χ²=4.643,P=0.031); The proportion of carcinoma located at head of pancreas(83.5%(96/115) vs. 40.7%(61/150),χ²=49.412,P<0.01), staging of T1/T2(79.1%(91/115) vs. 60.7%(91/150),χ²=10.316,P<0.01) and lymphatic metastasis(36.5%(42/115) vs. 22.7%(34/150),χ²=6.007,P<0.01) were higher. In patients of pancreatic cancer, dyslipidemias were closely associated with tumor location(OR=10.529,P<0.01)and body mass index(OR=3.671,P=0.008). Serum lipid profile results showed that TG,total cholesterol and high-density lipoprotein(HDL) disorders were associated with tumor location(P<0.05). TG disorder had association with body mass index(P<0.05), and HDL disorder had association with tumor stage(P<0.05). Moreover, the result of survival analysis showed that dyslipidemia was not a factor to impact the prognosis of pancreatic cancer patients underwent surgery(P>0.05). Conclusions: In pancreatic cancer patients,TG disorder was the most common type of dyslipidemia. Dyslipidemia has closely association with clinicopathologic features,including tumor location,body mass index,tumor stage. However,dyslipidemia had little effect on prognosis of pancreatic cancer patients.

[Analysis of treatment costs for pneumoconiosis patients in Hunan Province].

Objective: To explore the level and influencing factors of treatment costs for patients with pneumoconiosis, and to provide a basis for reducing the economic burden of patients with pneumoconiosis and optimizing the rational allocation of medical resources. Methods: In August 2020, the multi-stage stratified sampling method was used to obtain the treatment cost information of pneumoconiosis patients from January to December 2018 in 1123 sample medical institutions. The average cost per time of 2178 outpatients and 7425 inpatients was described, and the differences in the distribution of hospitalization costs for patients with pneumoconiosis were compared by one-way analysis of variance, and a multiple linear regression model was constructed to analyze the influencing factors of hospitalization costs for patients with pneumoconiosis. Results: The average cost of outpatients with pneumoconiosis was 465.88 yuan, and the average cost of inpatients was 12280.63 yuan. There were statistically significant differences in hospitalization expenses among different age, institution level, institution type, length of hospital stay and type of insured (F=10.49, 402.92, 416.35, 2390.48, 1298.14, P<0.001) . Age, length of hospital stay, reimbursement ratio, and institution level were influencing factors of the total hospitalization expenses of patients with pneumoconiosis (t=5.27, 62.20, 22.35, 21.20, P<0.001) . Conclusion: Patients with pneumoconiosis have a heavy burden of treatment costs. Age, length of hospital stay, institution level and reimbursement ratio are the main influencing factors of hospitalization costs. It is recommended to strengthen the prevention and treatment of key populations, standardize the use of medical insurance, and promote the rational allocation of medical resource to reduce the cost burden of pneumoconiosis patients.

[Spatial structure of talus trabeculae based on high resolution X-ray and micro-CT].

Objective: To study the specific alignment and structure of cancellous bone within the talus in order to understand the mechanism of force transmission within the bone and to provide some theoretical basis for the repositioning of talar fractures and the design of prostheses. Methods: In January 2020, a total of 40 adult talar bone specimens were scanned by Micro-CT in 20 pairs obtained from the Department of Orthopedics of Tianjin Hospital. The bone volume fraction, bone surface area fraction, trabecular thickness, number of trabeculae, trabecular pattern factor of the head, neck and body of the talus were calculated, and the differences in each parameter were compared between different parts of the same side and different sides of the same part, respectively. The talus was cut into 2 mm thick slices in the coronal, sagittal and horizontal planes using a hard tissue slicer, and the slices were then scanned using high-resolution X-rays to describe the bone structure. Results: There were no statistically significant differences between the medial and lateral talar and right and left side in lateral trabecular bone volume fraction, bone surface area fraction, trabecular thickness, trabecular number, trabecular pattern factors (all P>0.05). The number of trabeculae in the talar head, neck and body was 1.608±0.150, 1.639±0.142 and 1.749±0.159, respectively; trabecular thickness (µm) in the talar head, neck and body was 0.378±0.054, 0.370±0.053 and 0.331±0.062, respectively; and the trabecular pattern factors (mm-1) in the talar head, neck and body was -0.407±0.699, -0.478±0.848 and -1.029±0.851, respectively. There were significant differences between talar head, neck and the talar body trabeculae in terms of the number of trabeculae, trabecular thickness,trabecular pattern factor parameters(all P<0.05). The structure of the talar body trabeculae was found to consist of plate trabeculae arranged vertically parallel to each other in the coronal, sagittal and horizontal planes. The talar neck trabeculae were twisted, external-superior to internal-inferior reticular plate structure that travelled posteriorly and anteriorly, and the talar head trabeculae consisted of similarly parallel aligned semi-arc-shaped external-superior and internal-inferior trabeculae. Conclusion: The talar trabeculae are clearly directional and functional, so anatomical reduction should be achieved after the fracture; at the same time, the design of the talar prosthesis should take into account the stress distribution and direction of the prosthesis during walking and standing.

[Well differentiated grade 3 gastroenteropancreatic neuroendocrine tumors:new insights into diagnosis and therapeutic strategy].

Gastroenteropancreatic neuroendocrine tumor G3(GEP-NET G3) is a novel subtype of neuroendocrine neoplasms proposed in 2019,which has unique biological behavior characteristics. However,there are still many challenges and controversies in its diagnosis and treatment. There are obvious differences between GEP-NET G3 and neuroendocrine carcinoma (NEC) in genetic alterations and molecular profiles. The most frequently mutated genes in NET G3 are MEN1,DAXX/ATRX,while in NEC,TP53 and Rb are the most frequently mutated genes. Currently,the mainstream view is that NET G3 and NEC are two distinct diseases with different genetic backgrounds,and NET G3 will not develop into NEC. Several clinical and pathological factors should be considered to distinguish GEP-NET G3 and NEC,which including patients' medical history,histopathological morphology of neoplasms,Ki-67 index,immunohistochemical results of TP53,Rb,DAXX/ATRX and other markers. Multidisciplinary treatment,including radical resection,chemotherapy,targeted therapy,peptide receptor radionuclide therapy,immunotherapy should be applied in patients with GEP-NET G3. Overall,given its relatively indolent biological behavior,the therapeutic strategy should be more actively. Although the cure strategy of NET G3 has many similarities with NET G1/2,it is completely different from NEC.

[Magnetic resonance imaging of normal anatomy and injury of the peroneal tendon].

Objective: To explore the MR characteristics of normal anatomy and injured peroneal tendon and the diagnostic value of MR in the peroneal tendon injuries. Methods: From February 2018 to December 2018, a total of 20 healthy volunteers (40 ankle joints) were selected, 10 males and 10 females, with an age range of 20-30 (26±3) years. Retrospective analyzed 62 patients with ankle sprain and peroneal tendon injuries confirmed by operation, 34 males and 28 females, with an age range of 14-78(41±14) years. All volunteers and patients underwent MR examination. The MRI characteristics of the normal anatomy of peroneal tendon were analyzed. The patients were classified according to the MR diagnostic criteria of injury. Then the MRI features of different types of injured peroneus longus tendon and peroneus brevis tendon were analyzed. At last, imaging findings were compared with surgical results. Results: The peroneal tendon of 20 healthy volunteers showed oval and elliptical band-like structures on T(1)WI and PD-FS sequences, with natural alignment, clear boundary and uniform low signal. The whole length of the peroneal tendon can't be displayed completely on the same imaging plane. It needed multi-dimensional observation combined with axial, coronal and sagittal directions. There were 62 cases of peroneal tendon injury, including 46 cases of peroneal tendon tear (7 cases of partial-thickness tear, 11.3% of the total injuries, 39 cases of full-thickness tear, 62.9% of the total injuries), 16 cases of peroneal tendon dislocation (15 cases of intrathecal dislocation, 24.2% of the total injuries, 1 case of extrathecal dislocation, 1.6% of the total injuries). In 7 cases of partial-thickness tear (4 cases of peroneus brevis tendon tear, 3 cases of peroneus longus tendon tear), MR showed irregular tendon shape and local continuity interruption. In 39 cases of full-thickness tear (31 cases of peroneus brevis tendon tear, 8 cases of peroneus longus tendon tear), MR showed that the tear was penetrated through the whole layer of tendon from dorsolateral side to plantar side of foot, and the range of tear was different. The torn tendon could be accompanied by tendinitis or effusion of tendon sheath; 15 cases of intrathecal dislocation (3 cases of type A, 12 cases of type B), MR findings of type A dislocation showed that the peroneus longus tendon was located in the deep part of the peroneus brevis tendon, MR findings of type B dislocation showed that the peroneus longus tendon was displaced into the longitudinal tear of peroneus brevis tendon. In 1 case of extrathecal dislocation (type Ⅲ), MR showed that the SPR and the attached cortex of lateral malleolus were avulsed together, and the peroneal tendon was displaced under the avulsed fracture piece. Conclusion: MR can accurately demonstrate the fine anatomical structure of peroneal tendon and the imaging features of injuries. It has important clinical application value for the early diagnosis and accurate treatment of peroneal tendon injuries.

[Magnetic resonance imaging of the elbow joint tendon: imaging technique and clinical application].

Objective: To explore the magnetic resonance imaging (MRI) imaging technique and the clinical application in ligament and tendons of elbow. Methods: The study was reviewed and approved by an institutional review board of Beijing Jishuitan Hospital. A total of 20 normal volunteers with 40 elbows including 12 males and 8 females, aged from 20 to 55 years, with an average age of 35 years and 38 patients with 38 elbows who complained elbow pain with elbow injuries including 23 males and 15 females, ranged in age from 9 to 77 years, with an average age of 41 years old were chosen to undergo magnetic resonance examination between May 2013 and October 2018.All subjects underwent examination on coronal T(1)WI scan and PD-FS on three planes respectively in a prone position. Then the MRI characteristics of tendons in elbow of healthy volunteers and patients with elbow injuries were studied and the MRI features of tendon injury were compared with the surgical results and confirmed by double-blind method. Results: Twenty normal volunteers without tendons or ligament injures showed homogeneous low-signal-intensity on T(1)-weighted and proton fat saturation sequence (PD-FS) images.In the 38 patients with elbow injuries, there were 44 tendon injuries, including 14 cases of common extensor tendon injuries, 10 cases of common flexor tendon injuries, 3 cases of biceps tendon injuries, 7 cases of brachialis tendon injuries and 10 cases of triceps tendon injuries. The injuried tendons became thicker and discontinuity in T(1)WI and demonstrated heterogeneously increased signal intensity with effusion of tendon sheath in PD-FS. Partial tear showed discontinuity and thickening of tendons and the complete tear showed that the tendons were interrupted, retracted, the fiber structure disappeared and was filled with liquid, and the surrounding soft tissue edema was found. Conclusions: MRI can demonstrate the anatomy and injuries features of tendons in elbow joint accurately. It is significance for the early diagnosis and treatment protocols of the tendons injuries.

[The situation and related factors of satisfaction of HIV-infected people towards the follow-up management of primary medical and health care institutions in rural areas of Jiangxi Province].

The HIV-infected people were investigated for their satisfactory situation towards the follow-up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients' Follow-up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow-up management. Compared to farmers and other follow-up modes, non-farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow-up service in responsible institutions (OR=6.44, 95%CI: 3.12-13.30) were more satisfied with follow-up management.

Pharmacogenomics of 17-alpha hydroxyprogesterone caproate for recurrent preterm birth: a case-control study.

OBJECTIVE: To compare maternal genotypes between women with and without significant prolongation of pregnancy in the setting of 17-alpha hydroxyprogesterone caproate (17-P) administration for the prevention of recurrent preterm birth (PTB). DESIGN: Case-control. SETTING: Three tertiary-care centres across the USA. POPULATION: Women (n = 99) with ≥ 1 prior singleton spontaneous PTB, receiving 17-P. METHODS: Women were classified as having successful prolongation of pregnancy during the 17-P treated pregnancy, in two ways: (1) Definition A: success/non-success based on difference in gestational age at delivery between 17-P-treated and untreated pregnancies (success: delivered ≥ 3 weeks later with 17-P) and (2) Definition B: success/non-success based on reaching term (success: delivered at term with 17-P). MAIN OUTCOME MEASURES: To assess genetic variation, all women underwent whole exome sequencing. Between-group sequence variation was analysed with the Variant Annotation, Analysis, and Search Tool (VAAST). Genes scored by VAAST with P < 0.05 were then analysed with two online tools: (1) Protein ANalysis THrough Evolutionary Relationships (PANTHER) and (2) Database for Annotation, Visualization, and Integrated Discovery (DAVID). RESULTS: Using Definition A, there were 70 women with successful prolongation and 29 without; 1375 genes scored by VAAST had P < 0.05. Using Definition B, 47 women had successful prolongation and 52 did not; 1039 genes scored by VAAST had P < 0.05. PANTHER revealed key differences in gene ontology pathways. Many genes from definition A were classified as prematurity genes (P = 0.026), and those from definition B as pharmacogenetic genes (P = 0.0018); (P, non-significant after Bonferroni correction). CONCLUSION: A novel analytic approach revealed several genetic differences among women delivering early vs later with 17-P. TWEETABLE ABSTRACT: Several key genetic differences are present in women with recurrent preterm birth despite 17-P treatment.

[The classification and MR imaging of scapholunate ligament injuries].

Objective: To explore the MRI characteristics of injuries of scapholunate ligament (SLL), and provide imaging basis for the early diagnosis and treatment of the injuries. Methods: A total of 20 healthy volunteers without wrist injuries and 30 patients who complained dorsoradial-sided wrist pain and were highly suspected as the injury of SLL underwent the wrist magnetic resonance examination and X-ray examination in Beijing Jishuitan Hospital from January 2013 to September 2017.All subjects underwent anterior and lateral radiographs of the wrist joint and examination on coronal T(1)WI scan and PD-FS on 3 planes respectively in a prone position.Then the MRI characteristics of 20 healthy volunteers and 30 patients with SLL injuries that confirmed by operation were analyzed.According to the comparative analysis of normal anatomy and Geissler grades, the injuries were graded and MRI features of different types of injuries were analyzed.At last, imaging findings were compared with surgical results. Results: Twenty healthy volunteers without injuries showed mainly in low signal intensity on T(1)WI and PD-FS images.According to Geissler grades, there were 11 GradeⅠ injuries (5 had triangular fibrocartilage complex (TFCC) and SLL injuries and 1 had fracture of scaphoid and SLL injuries simultaneously), 8 GradeⅡ injuries (2 had TFCC and SLL injuries, 1 had TFCC, lunotriquetral ligament (LTL) and SLL injuries and 1 had distal radius fracture, TFCC and SLL injuries simultaneously), 7 Grade Ⅲ injuries (3 had TFCC and SLL injuries, 2 had fracture of scaphoid and SLL injuries and 1 had TFCC, LTL and SLL injuries simultaneously) and 4 Grade Ⅳ injuries (2 had TFCC and SLL injuries and 1 had fracture of scaphoid and SLL injuries simultaneously) among 30 patients.A tear can be confidently diagnosed when the ligament segment was absent or there was a fluidfilled discontinuity.A tear that involves 1 or 2 of the 3 segments (volar, proximal, or dorsal) of either the SLL was considered a partial tear, whereas a tear of all 3 segments was a complete tear. Conclusion: MRI can demonstrate the anatomy of interosseous ligaments accurately, evaluate and make the general grades of injuries.It is of significance for the early diagnosis and treatment protocols of the interosseous ligaments injuries.

[MRI anatomy and injury of the lateral collateral ligaments of ankle].

Objective: To explore the MRI features of the lateral collateral ligament injuries of the ankle and determine the value MRI in diagnosing the ligament injuries of the ankle. Methods: The study was reviewed and approved by an institutional review board of hospital. Retrospective analysised 10 healthy volunteers and 26 ankle injury cases underwent surgery since January 2013 to September 2016, the MR imaging findings of patients were compared with volunteers' and operative documents, to analysis the MRI feature of the ligament injuries of the ankle. Results: The normal anterior talofibular ligament and posterior talofibular ligament can be manifest in 3-4 layers of MRI, and can be fully displayed in 1 layer. The normal calcaneofibular ligament can be manifest in 3 layers of MRI, but can not be fully displayed in 1 layer. 26 cases of lateral ligament injury (including 1 case of ATFL injury, 1 case of CFL injury, 3 cases of ATFL conjunction with CFL injury, 3 cases of ATFL conjunction with CFL and PTFL injury) manifested the heterogeneous signal of the T(1)-weighted image, the ligament disruption, the increased signal intensity on fat-suppression PD-weighted image , the surrounding soft tissue edema and bone marrow edema. Conclusion: MR imaging is an accurate method for evaluation of the ligament injuries of the ankle, and it is a useful tool for diagnosis and treatment.

[MR imaging of flexor tendon and pulley system of the fingers: normal anatomy and injury].

Objective: To explore the magnetic resonance imaging (MRI) features of the anatomy and injuries of flexor tendon and pulley system of the fingers. Methods: Clinical and imaging data of 20 healthy volunteers without injuries and 36 patients from Beijing Jishuitan Hospital with flexor tendon and pulley system injuries in the fingers between March 2013 and March 2016 were retrospectively analyzed. All subjects underwent magnetic resonance imaging (MRI) examination. The MRI findings of patients were compared with healthy volunteers. In addition, imaging findings of patients were compared with the surgical results and confirmed by double-blinded method. Results: Twenty volunteers without flexor tendon and pulley system injures showed homogeneous hypointensity on both T1-weighted and Proton Density-weighted images with fat saturation (PD-FS). There were 36 patients with finger injures, including 21 cases of flexor tendon injury, 10 cases of pulley system injury, 5 cases of compound injury, which demonstrated unclear signal, discontinuity on T1-weighted images and heterogeneously increased signal intensity of the involved structures on PD-FS images. Edema was detected in the soft tissues surrounding the injured sites. Conclusions: MRI is an accurate method for evaluation of the anatomy and pathologic conditions of flexor tendon and pulley system of the fingers and a useful tool for diagnosis and treatment of flexor tendon and pulley system injuries.

[MRI of the finger ligament and tendon injuries: imaging technique and clinical application].

Objective: To explore the MRI technique and the clinical application in ligament and tendons of fingers. Methods: The study was reviewed and approved by an institutional review board of hospital.A total of 20 normal volunteers and 50 patients from Beijing Jishuitan Hospital between May 2012 and May 2015 with finger injuries were chosen to undergo magnetic resonance examination by using Achieva 3.0 T MR produced by Philips.Scanning from coronal, sagittal and axial view in T(1)-weighted and proton fat saturation sequence (PD-FS), choosing suitable parameters, in order to get clear images of finger tendons and ligaments. Results: Twenty normal volunteers without tendons or ligament injuries showed homogeneous low-signal-intensity on T(1)-weighted and proton fat saturation sequence (PD-FS) images.In the 50 patients with finger injuries, there were 33 cases of ligament injuries, 10 cases of extensor tendon injuries and 7 cases of flexor tendon injuries. There were 8 cases of all the 50 cases combined with bone fracture.The injured ligaments and tendons became thicker and discontinued in T(1)WI and demonstrated heterogeneously increased signal intensity with edema in the soft tissues surrounding the injured sites in PD-FS. Conclusion: MRI can demonstrate the anatomy and injuries features of ligament and tendons in fingers accurately.It is significance for the early diagnosis and treatment protocols of the ligament and tendons injuries.

[The application and influence factors of FACIT Fatigue Scale in SLE patients].

Objective: To evaluate the application and influence factors of the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue) scale in patients with systemic lupus erythematosus (SLE). Methods: SF-36 questionnaires were used to estimate the health-related quality of life (HRQOL) of SLE patients in Chinese Han population.FACIT-Fatigue scale was applied to measure fatigue.Disease activity was determined by SLE disease activity index (SLEDAI), meanwhile demographic parameters such as gender, disease duration, etc. were recorded. Results: A total of 223 patients with SLE were enrolled in the survey.FACIT-Fatigue scale was negatively correlated with SF-36 (P<0.05). FACIT-Fatigue scale of patients with SLE were correlated with education, erythrocyte sedimentation rate (ESR), C3, and SLEDAI score (P<0.05). The degree of bodily pain, the status of mental health and the amount of complement C3 were the independent factors of FACIT-Fatigue (P<0.1). Conclusion: FACIT-Fatigue scale is related to disease activity, quality of life, age and ESR in patients with SLE.There fore, reduce the disease activity and improve the quality of life of SLE patients may be helpful to reduce the fatigue of patients with SLE.

Adsorption dynamics and rate assessment of volatile organic compounds in active carbon.

In this paper, an investigation was presented about terahertz time-domain spectroscopy (THz-TDS) as a novel tool for the characterization of the dynamic adsorption rate of volatile organic compounds, including isooctane, ethanol, and butyl acetate, in the pores of active carbon. The THz-TDS peak intensity (EP) was extracted and corresponded to the measurement time frames. By analyzing EP with time, the entire process could be divided into three physical parts including volatilization, adsorption and stabilization so that the adsorption dynamics could be clearly identified. In addition, based on the pseudo-second-order kinetic model and the relationship between EP and time in the adsorption process, a mathematical model was built in terms of the adsorbed rate parameter and the THz parameter. Consequently, the adsorption rate of isooctane, ethanol, and butyl acetate could be assessed by the THz measurement, indicating that THz spectroscopy could be used as a promising selection tool to monitor the adsorption dynamics and evaluate adsorption efficiency in the recovery of pollutants.