Clinical progress in the diagnosis and treatment of end-stage liver disease complicated with acute kidney injury / 中华全科医师杂志

Acute kidney injury (AKI) is a devastating complications of end-stage of liver disease (ESLD), seriously affecting the prognosis of patients. With the deepening understanding of the pathogenesis, the definition, staging, diagnosis and treatment of ESLD with AKI have been gradually optimized. This article reviews the evolution of definition, pathogenesis, diagnosis and treatment of ESLD with AKI, to provide reference for early recognition, precise diagnosis and standardized treatment of this condition.

Effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain / 中国康复理论与实践

ObjectiveTo investigate the effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain (CNLBP). MethodsA total of 60 patients with CNLBP in Jiaxing Second Hospital from January, 2022 to March, 2023 were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received health education, physical factor therapy and core stability training, while the experimental group received respiratory training in addition, for four weeks. Visual Analogue Scale (VAS) score, Japanese Orthopaedic Association low back pain (JOA) score and Oswestry Dysfunction Index (ODI) were compared between two groups before and after treatment, while surface electromyography was used to detect the root mean square (RMS) and integrated electromyography (iEMG) of transversus abdominis, multifidus and triceps (movement muscles), and the activation sequence and relative activation time of transversus abdominis, multifidus and triceps were calculated. ResultsAfter treatment, the scores of VAS, JOA and ODI improved significantly in both groups (|t| > 8.515, P < 0.001), and the scores were better in the experimental group than in the control group (|t| > 2.089, P < 0.05). RMS and iEMG of transversus abdominis and multifidus improved significantly after treatment in both groups (|t| > 18.831, P < 0.001), and were significantly better in the experimental group (|t| > 3.481, P < 0.05). The transversus abdominis and multifidus in both groups were activated before the movement muscles, and the relative activation time of transversus abdominis and multifidus increased in negative (|t| > 48.115, P < 0.001), the experimental group being better (|t| > 3.229, P < 0.05). ConclusionCombination of core stability training and respiratory training is beneficial in reducing the pain of patients with CNLBP, reducing the lumbar dysfunction, improving the order of muscle activation, and strengthening feedforward control.

Research progress on mechanisms and treatments of cognitive dysfunction in atrial fibrillation / 中华神经科杂志

Increasing evidence suggests that atrial fibrillation is associated with an increased risk of cognitive impairment and dementia beyond its association with stroke and mortality. The association is independent of stroke. However, the association between atrial fibrillation and cognitive function has often been overlooked in the management and treatment in clinical practice. There is a lack of consensus on the relationship and its mechanisms between atrial fibrillation and brain dysfunction. Whether treatments targeted atrial fibrillation are effective for brain function remains unknown. Through reviewing relevant literatures, this article analyzed the association between atrial fibrillation and its underlying mechanisms. Furthermore, this article further discussed the effectiveness of atrial fibrillation treatments to cognitive function and brain health.

The effect of kinesio taping on the head and neck mobility of children with congenital muscular torticollis / 中华物理医学与康复杂志

Objective:To explore any effect of kinesio taping on the head and neck mobility of children with congenital muscular torticollis.Methods:A total of 52 children with congenital muscular torticollis were randomly divided into a treatment group and a control group, each of 26. All were given 20 minutes of routine rehabilitation training daily, 5 days a week for 4 weeks. The treatment group was additionally taped up with kinesio tape for no more than 48 hours once every 3 days for 4 weeks. Before and after the treatment the angles of head tilt and neck lateral flexion and the gaps in left and right neck rotation were measured for both groups.Results:Significant improvement was observed in both groups but there was significantly more improvement among the treatment group. The treatment had a cure rate (46.15%) and an improvement rate (50.00%) significantly superior to those of the control group and a significantly lower rate of ineffectiveness.Conclusion:Kinesio taping along with routine rehabilitation training can better improve the head and neck mobility of children with congenital muscular torticollis.

Effect of robot-assisted bilateral task-oriented upper limb training on upper limb function of patients with stroke / 中国康复理论与实践

ObjectiveTo investigate the effect of robot-assisted bilateral task-oriented upper limb training on upper limb function of patients with stroke. MethodsFrom January, 2021 to June, 2022, 52 patients with stroke in the Second Hospital of Jiaxing were enrolled and randomized into control group (n = 26) and experimental group (n = 26). Both groups received routine treatment. The control group added conventional bilateral upper limb training, while the experimental group added robot-assisted bilateral task-oriented upper limb training, for six weeks. Before and after treatment, the upper limb motor function and activities of daily living were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel Index (MBI). The upper limb proprioception test system was used to measure the average trace error (ATE) and test execution time of the upper limb. ResultsBefore treatment, there was no significant difference in the scores of FMA-UE and MBI, and ATE and test execution time between two groups (P > 0.05). After treatment, all the indexes improved significantly in both groups (|t| > 5.400, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.123, P < 0.05). ConclusionRobot-assisted bilateral task-oriented upper limb training could facilitate to improve the upper limb motor function and activities of daily living of stroke patients.

Establishment of a novel composite rat model of chronic skeletal muscle injury / 中国实验动物学报

Objective To establish a novel rat model of chronic skeletal muscle composite injury in the lumbar region,to explore its mechanism and treatment method in depth.Methods Twenty-eight SD rats were randomly divided into control group(n = 10),Hitting injury model(HIM)group(n = 9),Composite damage model(CDM)group(n = 9)(vertical blow combined with forced prolonged sitting).Open field test,HE staining and PCR sequencing were performed 3 days after modeling.Results The open field distance of rats in HIM group was significantly shorter than that in the CDM group,and both groups had shorter distances than the control group.HE staining showed multiple muscle fiber breaks,significant widening of muscle gaps,uneven distribution of muscle nuclei,and visible congestion in the model group of simple blow injury;In the CDM group,muscle fibers were ruptured,the muscle gaps were slightly widened,and inflammatory cell infiltration was observed between the muscles,especially around the muscle fiber breakage,with muscle fiber nuclei gathering.A volcano plot of the sequencing result suggested significant differences in the Pf4 gene.GO analysis of muscle tissue in model group rats showed upregulation of oxygen binding and carrier activity pathways.Conclusions This study attempted to establish a composite skeletal muscle injury model to study the pathological changes of chronic skeletal muscle injury in the low back pain and evaluate the efficacy of treatment method.It has practical application value in animal experiments for chronic non-specific low back pain.

Integrated metabolism and epigenetic modifications in the macrophages of mice in responses to cold stress / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.

Effect of alcohol consumption on coronary heart disease in male patients with type 2 diabetes mellitus / 中华健康管理学杂志

Objective:To explore the effect of alcohol consumption on the severity of coronary atherosclerotic heart disease (CHD) in male patients with type 2 diabetes mellitus (T2DM).Methods:A total of 155 male T2DM patients with CHD were enrolled in the study and admitted at the Third Hospital of Hebei Medical University. Clinical and serum biochemical parameters were collected. The effect of alcohol consumption on the severity of CHD was assessed using the Gensini scoring system. Multiple linear regression was performed to analyze the risk factors of CHD in T2DM patients.Results:About 63% of male T2DM patients with CHD were regular (moderate) alcohol consumers and among them, about 60% were classified as excessive drinkers. Compared to patients who did not consume alcohol, the following parameters were all significantly increased (all P<0.05): body mass index [(26.1±3.6) vs (24.9±3.1) kg/m 2]; systolic blood pressure [(142.0±17.6) vs (131.2±17.8) mmHg (1 mmHg=0.133 kPa); diastolic blood pressure (88.6±12.1) vs (83.8±8.9) mmHg)]; total cholesterol [(4.8±1.3) vs (4.3±1.3) mmol/L]; uric acid [(370.9±89.6) vs (349.6±84.3) mmol/L]; smoking rate (76.0% vs 13.3%); and prevalence of hypertension (76.0% vs 13.3%). Compared with patients in the moderate drinking subgroup, the level of low-density lipoprotein cholesterol [LDL-C, (3.2±0.9) vs (2.8±0.9) mmol/L] and plasma fibrinogen [(3.5±0.5) vs (3.9±0.4) mmol/L] were significantly higher ( P<0.05). In addition, the smoking rate and the prevalence of hypertension in the excessive drinking subgroup were significantly higher than those in the moderate drinking subgroup ( P<0.05). Excessive alcohol consumption was the risk factor ( OR=0.259,95% CI: 0.074-0.904, P<0.05), but not the severity factor ( t=-0.58, P=0.565) for CHD in male patients with T2DM, hemoglobinA 1c ( t=3.11, P=0.019), triglycerides ( t=2.30, P=0.039) and LDL-C ( t=4.24, P<0.001) were the risk factors for the severity of CHD. Conclusions:Excessive alcohol consumption may be a risk factor for CHD in male patients with T2DM, but its effect on the severity of CHD still needs further exploration.

Application of holographic image and navigation in robotic assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective:To evaluate the clinical value of the holographic image and navigation in robotic assisted laparoscopic radical prostatectomy (RARP) .Methods:From Sept. 2020 to Dec. 2020, 5 patients diagnosed with prostate cancer in Beijing United Family Hospital were included in this study. The mean age was 57 years(38-69 years). Before the operation, the engineers established the holographic image based on the enhanced MRI images. The holographic images were used in pre-surgery planning. During the operation, the navigation was achieved by real time fusing holographic images with the robotic surgery endoscopic views. Some important structure such as prostate, bladder neck and the tumor could be observed and monitored in real time. The No.1 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection; The No.2 patient had low-risk prostate cancer, underwent RARP, and the right side neurovascular bundle (NVB) was preserved; The No.3 patient had low-risk prostate cancer, underwent RARP, and the bilateral side NVB was preserved; The No.4 patient had low-risk prostate cancer, underwent RARP, and the right side NVB was preserved; The No.5 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection, and the bilateral side NVB was preserved.Results:All the 5 cases surgeries were successful, no conversion to open surgery, the mean operation time was 161.7min (160-250min), the mean blood loss was 426.7 ml(60-1000 ml). The pathological results were pT 3bN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0 and pT 3aN 1 cM 0, respectively. There was no over Clavien Dindo Ⅱ perioperative complications. 4 patient achieved continence when catheter removal. The PSA level and erectile function were monitored in the follow up. Conclusions:Holographic image navigation might have clinical value in RARP.

Robot assistance can improve lower limb function and knee proprioception after cerebral infarction / 中华物理医学与康复杂志

Objective:To explore the effect of a pelvis-assisting rehabilitation robot on lower limb function and knee proprioception after cerebral infarction.Methods:Forty hemiplegic cerebral infarction survivors were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week for four weeks. Before and after the intervention, motor function, balance, walking function and knee joint proprioception were assessed using the simplified Fugl-Meyer lower limb assessment, the Berg balance scale, functional ambulation categorization and the Humac Norm isokinetic tester.Results:After the treatment, significant improvement was observed in all of the above measurements in both groups, but the improvements were significantly greater in the experimental group.Conclusions:Robotic pelvic assistance can effectively improve lower limb motor function, balance, knee proprioception and walking after cerebral infarction.

Application of holographic image navigation in urological laparoscopic and robotic surgery / 中华泌尿外科杂志

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.

Research progress of update on inflammation and hemorrhagic transformation / 中华神经科杂志

Acute ischemic stroke is the most common type of stroke. Hemorrhagic transformation is one of the serious complications of acute ischemic stroke, which can aggravate the deterioration of neural system function and adverse prognosis. Several studies have shown that the occurrence of hemorrhagic transformation after acute ischemic stroke is associated with risk factors such as old age, massive infarction, diabetes mellitus and cardiogenic embolism. In recent years, many studies have confirmed that there is a significant correlation between inflammation and hemorrhagic transformation in acute ischemic stroke. Inflammatory cells were activated and aggregated in the blood vessel and brain parenchyma of acute ischemia-reperfusion injury, which released many inflammatory factors, caused the destruction of blood-brain barrier and hemorrhagic transformation. This review aims to explore the role of inflammation in the risk of hemorrhagic transformation and clinical prognosis in acute ischemic stroke.

Effect of vitamin D intervention on the outcome of glucose metabolism in patients with impaired glucose regulation / 中华临床营养杂志

Objective To explore the intervention effect of low-dose vitamin D on glucose metabolism of patients with impaired glucose regulation. Methods A total of196 subjects receiving oral glucose tolerance test were enrolled in this study, including individuals with normal glucose tolerance ( NGT group, n=67) and indi-viduals with impaired glucose regulation (IGR group, n=129). The IGR group was divided into intervention group ( n=64) and non-intervention group ( n=65) according to vitamin D intervention ( for 1 year) performed or not. Clinical data and biochemical parameters were collected. Results The level of serum 25(OH)D3 was significantly lower in the IGR group than that of normal control group ( P<0. 05) . After 1 year of low-dose vita-min D intervention, insulin sensitivity increased and insulin resistance decreased in the intervention group as compared with non-intervention group. Diabetes developed less frequently in the intervention group ( 25 of 64 [ 39. 1％] ) compared with non-intervention group ( 30 of 65 [ 46. 2％] ) . But there was no significant differ-ent in diabetes prevalence between the two groups. Conclusions Vitamin D intervention can improve insulin sensitivity and reduce insulin resistance in patients with impaired glucose regulation. Low dose vitamin D can improve the abnormal glucose metabolism outcome in patients with impaired glucose regulation.

The research advances of correlation between statin use and spontaneous intracerebral hemorrhage / 中华神经科杂志

Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are established first line treatments for hypercholesterolemia because of their proved efficacy. However, the results of several studies have raised concerns that statin use increases the risk of spontaneous intracerebral hemorrhage(ICH). At the same time, other researches make the adverse conclusion that statin use does not increase the risk of ICH, but improves clinical outcome and decreases the mortality after ICH. Additional randomized controlled trials are required to clarify the correlation between statin use and ICH, and whether to continue statin use after ICH. This paper reviews research advances of correlation between statin use and ICH.

The research advances of correlation between statin use and spontaneous intracerebral hemorrhage / 中华神经科杂志

Statins, 3?hydroxy?3?methylglutaryl coenzyme A reductase inhibitors, are established first line treatments for hypercholesterolemia because of their proved efficacy. However, the results of several studies have raised concerns that statin use increases the risk of spontaneous intracerebral hemorrhage(ICH). At the same time, other researches make the adverse conclusion that statin use does not increase the risk of ICH, but improves clinical outcome and decreases the mortality after ICH. Additional randomized controlled trials are required to clarify the correlation between statin use and ICH, and whether to continue statin use after ICH. This paper reviews research advances of correlation between statin use and ICH.

The effects of robot assistance on the gait kinematics of hemiplegic stroke survivors / 中华物理医学与康复杂志

Objective To explore the effect of robot assistance on the gait kinematics of hemiplegic persons after a stroke.Methods Forty hemiplegic stroke patients were randomly divided into an experimental group and a control group,each of 20.Both groups were given routine neurological medication and rehabilitation training,while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily,six times a week,for 8 weeks.Before and after the intervention,both groups' motor function,balance,step length and pace were evaluated,as well as their pelvic rotation angles,side inclination,vertical displacement and lateral displacement.The Fugl-Meyer assessment for the lower extremities (FMA-LE) was used along with the Berg balance scale (BBS),the gait analysis system of Biodex Gait Trainer-2 equipment.Results After the treatment,the average FMA-LE score,BBS score,pace and step length of the experimental group were all significantly better than the before the treatment and significantly better than the control group's averages after the treatment.The improvements observed in the pelvic rotation angle,side inclination,vertical displacement and lateral displacement were all significant.Conclusion Robot assistance can usefully supplement routine rehabilitation training after stroke.It can improve control of the pelvis,enhance walking and balance and generally improve the motor function of the lower extremities.

Effects of narrative nursing on posttraumatic growth for patients with amputation / 中国实用护理杂志

0bjective To explore the effects of narrative nursing on posttraumatic growth for patients with amputation. Methods From December 2016 to March 2018,a total of 62 hospitalized patients with amputation were randomly assigned into the control group and the intervention group by random number table.The control group received routine nursing,the intervention group received narrative nursing on the basis of control group.Two groups were evaluated by Posttraumatic Growth Inventory(PTGI) before and after intervention. Results Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the control group were (19.87 ± 5.22), (7.90 ± 2.53), (8.83 ± 3.62), (9.73 ± 3.13), (10.63 ± 3.01), (56.97 ± 17.21) points, respectively. After intervention,the scores were (20.80±5.89), (8.80±2.17), (8.90±3.39), (10.27± 2.75), (11.07 ± 3.12), (59.83 ± 16.91) points, respectively, except new possibilities, the scores of each dimension and total scores of posttraumatic growth in the the control group were higher than before,the differences were statistically significant(t=3.00- 5.34, P＜0.05).Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the intervention group were (20.28±4.94), (8.17±2.58), (8.59±3.48), (9.55± 2.90), (11.07±2.83), (57.66±16.42) points, respectively. After intervention, the scores were (23.79±4.70), (10.10±2.17), (10.72±3.34), (11.69±2.22), (12.79±3.28),(69.10±14.92) points, respectively, the scores of each dimension and total scores of posttraumatic growth in the intervention group were statistically higher than those in the control group and before intervention,the differences were statistically significant (t=10.61-16.75, P＜0.05). Conclusion Narrative nursing can effectively improve the level of posttraumatic growth and psychological state for patients with amputation.

Value of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome / 中华妇产科杂志

Objective@#To explore the role of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome (OVSS) .@*Methods@#A retrospective analysis of the clinical records and pre-operative MRI images of 19 patients with surgery proved OVSS was carried out. Two experienced radiologists reviewed the pre-operative pelvic MRI of the 19 patients in consensus blind to the surgery results. Characteristics including malformations of the uterus, cervix and vagina, the diagnosis of the disorder and classification were evaluated. Pre-operative MRI diagnosis and classification were correlated with surgical findings.@*Results@#Mean age of onset of symptoms for the 19 patients was 15 years (ranged 9-25 years) , and mean age of menarche was 12 years. Ten patients suffered from dysmenorrhea or lower abdominal pain, 5 patients complained of vaginal discharge, 3 patients had a history of irregular menstruation, 1 patient suffered from primary infertility. All 19 patients showed uteri didelphys. Eighteen patients showed vaginal oblique septum.One patient showed cervical atresia.MRI was completely correlated with the surgery in the pre-operative diagnosis of OVSS. MRI classification was in line with surgery in 17 patients, including 9 patients with imperforate septum (typeⅠ) , 6 patients with perforate septum (type Ⅱ) , 1 patient with imperforate septum and cervical fistula (type Ⅲ) , and another one with cervical agenesis (type Ⅳ) . One case of type Ⅱ was misdiagnosed as type Ⅰ, another one of type Ⅰ was misdiagnosed as type Ⅲ. Pre-operative MRI classification was correlated with surgery in 17 out of 19 patients.@*Conclusion@#Pre-operative MRI allows excellent manifestation and accurate diagnosis of OVSS, and could also facilitate the evaluation of the classification.

Efficacy and outcome of transcatheter closure of patent foramen ovale in patients with cryptogenic stroke / 中华心血管病杂志

Objective@#To investigate the efficacy and outcome of transcatheter patent foramen ovale (PFO) closure in patients with cryptogenic stroke (CS).@*Methods@#Sixty consecutive patients with cryptogenic stroke who undertook transcatheter PFO closure between May 2015 and September 2017 in Beijing Tiantan Hospital were enrolled in this prospective study.Transcranial Doppler (TCD) bubble test was performed and right-left shunt(RLS) was confirmed in all patients.Closure success rate,effective closure rate, complications, recurrence of ischemic stroke and new onset atrial fibrillation were evaluated.@*Results@#A total of 60 patients (42 male,age range 24-68 (47±11)years) were included in the study.PFO size (motionless state) was (1.6±0.6)mm.RLS before closure was graded and 11 patients had moderate RLS and 48 patients had large RLS (include 41 patients who experienced shower or curtain effect).Closure success rate was 100% (60/60).No severe complications were observed.At 6 months,45 patients completed TCD bubble test.Of these, 4 patients suffered from moderate to large residual and thus effective closure rate was 91%(41/45).The mean follow-up period was 2-29 (median 12) months. During the follow-up, only 1 patient experienced recurrent cerebral infarction.New onset atrial fibrillation was not detected.@*Conclusion@#Transcatheter PFO closure is effective,safe and related with a good outcome in reduction of recurrent CS for patients with PFO.

MRI Features and Pathological Basis of Aggressive Angiomyxoma in Pelvic and Perineal Areas / 中国医学影像学杂志

Purpose To summarize the clinical features, MRI features and pathological features of aggressive angiomyxoma (AAM) occurring in pelvic and perineal areas. Materials and Methods The clinical, MR and pathological data of 7 patients with AAM pathologically confirmed were retrospectively analyzed. Results Seven cases of AAM were all females, aged from 12 to 45 years old. Among them, 5 cases were treated due to perineal area tumors, and 2 cases due to relapses after surgical treatment of perineal area AAM in other hospitals. MRI findings: 7 cases were single occurrence with the maximum diameter of 5.9-15.7 cm; 6 cases were in irregular shape, with no envelope and unclear borders with adjacent tissues or organs; 1 case was in long column shape with clear boundary and pseudocapsule visible. On T1WI, AAM showed equal signal (4/7) or equal, low mixed signal (3/7). On T2WI, AAM showed high and low mixed signals with 5 cases of "vortex sign". 5 cases underwent routine enhancement examinations, all demonstrating significant enhancement, 4 cases of which displayed heterogeneous enhancement ("vortex sign" was detected in 2 cases) and 1 case homogeneous enhancement. On diffusion weighted imaging, AAM manifested as homogeneous (3/7) or heterogeneous (4/7) high signal. Pathological examination showed that a large amount of mucin-like matrix was contained in AAM, and there were scattered fusiform and astral tumor cells and abundant arterial and venous blood vessels seen locally. Tumor cells infiltrated the peripheral fat or muscle tissues at the border. Conclusion The characteristic MRI of AAM is manifested as "vortex sign", which corresponds to its pathological features such as sparse tumor cells, mucin-like matrix in large amount, and locally rich blood vessels, suggesting great significance for imaging diagnosis.