Volume 96  ·  Issue 15  ·  2016

Magnetic resonance (MR) imaging was originally used to reflect the distribution of hydrogen protons and their related physical properties in water and lipids; After more than half a century of development, magnetic resonance imaging technology has been continuously innovated, which not only greatly shortens the imaging time, but also expands its application fields. The innovation of technology originates from the demand of practice, and practice can in turn promote and improve the development of technology. Magnetic resonance imaging techniques have changed from relatively single T₁, T₂Weighted imaging, and later diffusion, perfusion and magnetic resonance spectroscopy imaging, modern magnetic resonance has become a veritable multimodal imaging. During this development, the application of every new technology has influenced the practice of medicine. We used diffusion imaging to reflect the cell density of tissue, and then judged the benign and malignant tissue; We used perfusion imaging to judge the tissue angiogenesis, so as to know the tissue activity; We used spectral imaging to determine the metabolites of tissues, and then further analyzed the types of tissues. So, what kind of technology is next to influence and change the practice of medicine? We turn our attention to the magnetic resonance technology-amide proton transfer, which is currently at the forefront of international development and gradually applied to many clinical applications (amide proton transfer, APT).

To investigate the imaging features of uterine leiomyomas with different pathological subtypes on DWI.

Clinical records and MR images of pathologically confirmed uterine leiomyomas were retrospectively collected from the Second Affiliated Hospital of Wenzhou Medical University from June 2012 to April 2015. A total of 60 uterine leiomyomas were found and evaluated.All the patients were divided into three groups according to different pathological types, which included 17 cases of cellular leiomyomas, 10 cases of degenerated leiomyomas and 33 cases of ordinary leiomyomas.The DWI signal and ADC values in cellular portion of the lesions and adjacent normal myometrium (the control group) were measured.

(1) Most cellular leiomyomas showed hyperintensity on DWI (15/17), while degenerated leiomyomas manifested hypointensity, isointensity or hyperintensity signal on DWI, and most ordinary leiomyomas displayed isointensity signal on DWI (57.6%, 19/33). (2) The ADC values of cellular leiomyomas, degenerated leiomyomas and ordinary leiomyomas were (1.01±0.14)×10^-3 mm²/s, (1.73±0.49)×10^-3 mm²/s and (1.38±0.22)×10^-3 mm²/s respectively.The ADC values of adjacent normal myometrium (the control group) were (1.35±0.16)×10^-3 mm²/s.There were no significant statistical differences in the ADC values between ordinary leiomyomas and adjacent normal myometrium (P=0.623). There were significant statistical differences in the ADC values among other groups(all P<0.05). (3)The ROC curve showed that the diagnostic threshold for cellular leiomyomas was 1.11×10^-3 mm²/s, the sensitivity and specificity were 88.2%and 93.0% respectively.

The signal intensity on DWI and the ADC values are different in uterine leiomyomas with different pathological subtypes.Combination of these two parameters in clinical practice may be helpful to reflect the histopathological characteristics of uterine leiomyomas.

To evaluate the diagnostic performance of bi-exponential modeling of intravoxel incoherent motion (IVIM) imaging for laryngeal and hypopharyngeal carcinoma.

A total of 32 patients with pathologically proven laryngeal and hypopharyngeal squamous cell carcinoma were included in this study from November 2014 to August 2015.All patients underwent IVIM-DWI by using twelve b values (0, 10, 20, 30, 50, 70, 100, 150, 200, 400, 800 and 1 000 s/mm²). Using the IVIM approach, D, D^* and f values were extracted using a bi-exponential fit.These quantitative parameters of primary carcinoma and normal pharyngeal tissue were compared.Statistical methods were used to assess differences between the tumor and normal pharyngeal tissue.

There were no significant differences of D (P=0.903) and f (P=0.223) values observed among laryngeal carcinoma and hypopharyngeal carcinoma, and D^* value was significantly different among the two groups (P=0.028). The values of D, D^*, and f for primary carcinoma were (0.84±0.22)×10^-3 mm²/s, (65.71±19.66)×10^-3 mm²/s, and 45%±14%, respectively; for normal pharyngeal tissue were (1.48±1.04)×10^-3 mm²/s, (37.85±14.04)×10^-3 mm²/s, and 36%±12%, respectively (P=0.001, 0.000, and 0.006, respectively). Setting D value 0.949×10^-3 mm²/s was threshold to distinguish abnormal and normal tissues, the sensitivity, specificity and accuracy were 91.2%, 88.2% and 92.5%, respectively.There was no statistically significant difference of D and f values(both P>0.05)in different pathological grades of primary carcinoma, and there was statistically significant difference in D^* values found among the different pathological grades of primary carcinoma (P=0.001). There were statistically significant differences in D^* values between the well differentiated group and the other two group (both P<0.05), and there was no statistically significant difference between the moderately differentiated group and poorly differentiated group (P>0.05).

IVIM parameters can reflect the difference between laryngeal and hypopharyngeal carcinoma and normal pharyngeal tissue, and the D value has the best diagnostic performance.D^* value in different pathological grades of laryngeal and hypopharyngeal squamous cell carcinoma is distinct, and it could reflect the pathological grade of tumor to some extent.

To investigate the correlation between R2^* value of enhanced T₂ star-weighted angiography (ESWAN) sequence and primary hepatocellular carcinoma infiltration and tumor thrombus, and investigate the biological behavior of HCC.

A total of 221 cases of patients' imaging data with MRI examination(including ESWAN sequence) diagnosed as primary HCC were retrospectively analyzed.All the patients were collected from January 2014 to September 2015 in the First Affiliated Hospital of Dalian Medical University.The differences of R2^* values in different MR types of HCC were analyzed.All patients were divided into infiltration group and non-infiltration group, tumor thrombus group and non-tumor thrombus group, the R2^* values of the paired groups were compared.The diagnostic efficiency of R2^* in HCC infiltration and tumor thrombus were evaluated by ROC curve, and to find out the threshold values.

The MR types of 221 patients included 90 cases of nodular type, 62 cases of massive type, 69 cases of diffuse type.70 patients had tumor thrombus.The R2^* values of different MR types were (21.82±8.52), (24.17±8.84)and (34.45±11.73) Hz, respectively.There was no statistically significant difference between the nodular and the massive types (P=0.144), while the difference between the nodular and diffuse type, the massive and diffuse types were statistically significant(P=0.000). The R2^* values of infiltration group and non-infiltration group were (34.45±11.73) and (22.78±8.70) Hz , the R2^* values of tumor thrombus group and non-tumor thrombus group were (31.20±12.17) and (24.21±9.90) Hz, the difference also had statistically significant(t=7.397 and 4.534, P=0.000 and 0.000). The AUC of R2^* values for infiltration and tumor thrombus were 0.804, 0.681. R2^* ≥24.68 Hz was the threshold value to diagnose the infiltration and tumor thrombus.

R2^* value can be used as a MR non-enhancement quantitative index to evaluate the biological behavior of HCC.

To compare enhancement of the central auditory pathway in cats receiving auditory stimulation between manganese enhanced magnetic resonance imaging (MEMRI) with intraperitoneal manganese injection route and MEMRI with intratympanic manganese injection route, and investigate the optimal method for displaying enhancement of the central auditory pathway.

Twenty-seven normal hearing adult cats were randomly divided into three groups, receiving intraperitoneal manganese injection, left intratympanic manganese injection or left intratympanic gadolinium injection respectively.All cats received white noise stimulation of 80 dB in twenty-four hours after injection.Three dimensionally coronal T₁-weighted imaging of the cat brain was obtained with an animal dedicated MRI scanner.The signal noise ratios (SNRs) of bilateral cochlear nuclei (CN), dorsal nuclei of the trapezoid bodies (DNTB), caudal colliculi (CC) and auditory cortices (AC) were measured on reconstructed images and compared.

Obvious increased SNRs on both sides were shown in intraperitoneal mangasese injection group while left predilection was shown in intratympanic manganese injection group: left CN 45.7±6.0, 37.4±11.9, 23.9±2.7, F=17.694, P=0.000; left DNTB 50.5±11.2, 37.1±11.2, 27.6±7.3, F=11.781, P=0.000; left CC 37.6±3.9, 22.6±3.1, 17.9±0.7, F=111.898, P=0.000; left AC 27.7±2.5, 17.3±2.3, 14.5±1.0, F=105.132, P=0.000; right CN 42.7±8.3, 23.9±3.0, 22.7±2.1, F=41.492, P=0.000; right DNTB 44.1±8.3, 21.9±3.0, 23.9±4.0, F=27.862, P=0.000; right CC 38.0±4.0, 21.9±3.0, 17.6±0.9, F=120.032, P=0.000; right AC 26.7±3.4, 17.1±2.9, 14.9±1.3, F=64.587, P=0.000.Compared with the left intratympanic gadolinium injection group, the intraperitoneal manganese injection group showed higher SNRs in bilateral CN and CC (P<0.05), and the left intratympanic manganese injection group showed higher SNRs in left CN, AC and bilateral CC.The SNRs of right CN, bilateral DNTB, CC and AC were significantly higher in the intraperitoneal manganese injection group than those in the left intratympanic manganese injection group (P<0.05).

MEMRI with intraperitoneal manganese injection might be the optimal method for displaying enhancement of the central auditory pathway in cats receiving auditory stimulation.

To study the information processing speed and the influential factors in multiple sclerosis (MS) patients.

A total of 36 patients with relapsing-remitting MS (RRMS), 21 patients with secondary progressive MS (SPMS), and 50 healthy control subjects from Xuanwu Hospital of Capital Medical University between April 2010 and April 2012 were included into this cross-sectional study.Neuropsychological tests was conducted after the disease had been stable for 8 weeks, including information processing speed, memory, executive functions, language and visual perception.Correlation between information processing speed and depression, fatigue, Expanded Disability Status Scale (EDSS) were studied.

(1)MS patient groups demonstrated cognitive deficits compared to healthy controls.The Symbol Digit Modalities Test (SDMT) (control group 57±12; RRMS group 46±17; SPMS group 35±10, P<0.05) and Paced Auditory Serial Addition Task (PASAT) (control group 85±18; RRMS group 77±20; SPMS group 57±20,P<0.05) impaired most.SPMS patients were more affected compared to patients with RRMS subtypes, and these differences were attenuated after control for physical disability level as measured by the EDSS scores.MS patients, especially SPMS subtype, were more severely impaired than control group in the verbal learning test, verbal fluency, Stroop C test planning time, while visual-spatial function and visual memory were relatively reserved in MS patients.(2) According to the Pearson univariate correlation analysis, age, depression, EDSS scores and fatigue were related with PASAT and SDMT tests (r=-0.41――0.61, P<0.05). Depression significantly affected the speed of information processing (P<0.05).

Impairment of information processing speed, verbal memory and executive functioning are seen in MS patients, especially in SPMS subtype, while visual-spatial function is relatively reserved.Age, white matter change scales, EDSS scores, depression are negatively associated with information processing speed.

To analyze the long-term results and risk factors of surgical revascularization in patients with ischemic heart disease (IHD) and left ventricular dysfunction (LVD).

From January 2003 to July 2013, 2 132 patients underwent coronary artery bypass grafting (CABG) in our institution. Among them, 318 patients with LVD[left ventricular ejection fraction (LVEF) ≤50%]were included in the final study. There were 26 6 male and 52 female patients with age from 36 to 83 (63±9) years old. 76 patients underwent off-pump CABG (OPCAB) and 242 patients underwent conventional CABG (CCABG). Risk factors, perioperative results and follow-up data were collected and analyzed with cox hazard ratio model.

Among 318 patients, 6 cases died of the operation with a hospital mortality of 1.9%. With follow-up time from 1 to 128(45.5±32.4)months, 25 patients were lost of follow-up, causing a follow-up rate of 92.0%. Among the 287 cases with long-term follow-up results, all-cause death, cardiogenic death and re-hospitalization due to heart failure were 14.6% (42/287), 5.9%(17/287), 14.6% (42/287), respectively. Re-revascularization rate, recurrent angina and myocardial infarction rate and cerebral incidence were 3.5%(10/287), 13.6% (39/287), 1.7%(5/287), respectively. The five-year survival rate was 85.6%. With all-cause death as the endpoint, preoperative LVEF (HR=0.943, 95%CI: 0.893-0.995, P=0.031) and perioperative implantation of IABP (HR=2.509, 95%CI: 1.051-5.992, P=0.038) emerged as the risk factors that affected the long term survival. The five-year survival rate of patients with severe LVD (LVEF≤35%) was significantly lower than that of patients with mild to moderate LVD (35%<LVEF≤50%) (70.4% vs 86.1%,P=0.025).

Preoperative LVEF and perioperative implantation of IABP had adverse effect on long-term survival of patients with IHD and LVD undergoing surgical revascularization. The long-term survival of patients with severe LVD was significantly lower than those with mild to moderate LVD. The long-term survival significantly decreased among patients undergoing peri-operative implantation of IABP.

To evaluate the hypothalamic-pituitary-testicular axis (HPTA) function and spermatogenesis in male patients with X-linked adrenal hypoplasia congenita (AHC) due to DAX-1 gene mutation.

Twenty-four adult male patients from Peking Union Medical College Hospital between November 2007 and December 2014 were included.Their DAX-1 gene mutations were confirmed by polymerase chain reaction (PCR) and clinical features, hormone level and semen assay were collected.

All patients presented with adrenal deficiency symptom.21 patients (87.5%) showed the symptoms before the age of 10 years old.The average testicular volume was 2.0 (2.0, 3.8) ml at the baseline in 24 patients.Three patients had cryptorchidism.Serum testosterone level increased from 0.1 (0, 0.5) nmol/L to 13.5 (7.6, 15.4) nmol/L (n=16) after human chorionic gonadotropin (HCG) stimulation.23 out of 24 patients were diagnosed as hypogonadotropic hypogonadism (HH) and only one patient was diagnosed as azoospermia with normal gonadotropin and testosterone level.Combined gonadotropin therapy was administered in seven patients and their serum testosterone level reached 15.3(8.4, 25.3) nmol/L, but no obvious testicular enlargement was observed [(4.0±2.9) vs (4.9±3.3) ml , P=0.270] and seminal analysis revealed persistent azoospermia.Another patient showed response to pulsatile GnRH therapy.Luteinizing hormone(LH) level increased from 1.0 U/L to 9.3 U/L, and follicle stimulating hormone(FSH) level increased from 3.0 U/L to 13.5 U/L.Serum testosterone level increased from 0 nmol/L to 10.0 nmol/L, but testicular volume maintained 3 ml after treatment for two months.

Male patients with DAX-1 gene mutations presented with primary defect in spermatogenesis and hypogonadotropic hypogonadism.Their Leydig cell function was almost normal, while Sertoli cell and seminiferous tubule function were seriously damaged.

To study the sensitivity of the quantitative fluorescence polymerase chain reaction (QF-PCR) in detecting group B streptococcus (GBS) in late pregnant women and the influence of vaginal/rectal GBS colonization on the maternal-neonatal outcomes.

A total of 2020 swabs were taken from 505 women who received routine culture and QF-PCR screening at 35 and 37 weeks of gestation from September, 2013 to April, 2014 at Peking Union Medical College Hospital.For each subject, two vaginal and two rectal swabs were collected.Samples with discordant results from these two methods were further analyzed by gene sequence determination.GBS isolates were subjected to antimicrobial susceptibility testing using the Kirby-Bauer method.The laboratory results were collected and the pregnant outcomes were followed.

Of the 38 GBS positive cases , GBS could be detected for 13 by both culture and QF-PCR methods, for 24 only by QF-PCR, for 1 exclusively by culture.GBS colonization rate, sensitivity and negative predictive value (NPV) for culture were 2.8%, 36.8%, and 95.1%, respectively.GBS colonization rate, sensitivity and negative predictive value (NPV) for QF-PCR were 7.3%, 97.4%, and 99.8%, respectively.There was significant difference between the two methods (P<0.001). A higher proportion of GBS were isolated from the rectum (6.7%) as compared to the vagina (2.8%) (P<0.01). GBS isolates were all (100%) sensitive to penicillins, cephalosporins, vancomycin and linezolid.Erythromycinresistance was present in 47.4% of the GBS isolates, while clindamycin resistance was present in 36.8%.Compared with the GBS negative group, the GBS positive group had higher incidence of gestational hypertension and colpitis mycotica (allP<0.05), but had similar incidence of maternal and neonatal outcomes, like neonatal infection, septicemia, puerperal disease.

QF-PCR assay provides an accurate and rapid method for detecting GBS in late pregnancy.Rectum is also an important site for detection of GBS.Penicillin therapy remains an appropriate first-line antibiotic choice for intrapartum GBS chemoprophylaxis, with erythromycin and clindamycin resistance rate being high.The relationship between maternal GBS colonization and the pregnancy outcome needs to be further studied.

To investigate the expression and the effect of connective tissue growth factor (CTGF) on rheumatic myocardial fibrosis of rheumatic heart disease (RHD).

The papillary muscles samples were obtained from patients with RHD during mitral valve replacement.The expression of TGF-β_1, CTGF mRNA and CTGF protein were detected with semiquantitative RT-PCR technique and immunohistochemistry technologyin the papillary muscles cell from 41RHD patients and 20 normal papillary muscles samples.The area of myocardial fibrosis was measured by imaging analysis system. SPSS package was used to analyze the relationship between the expression of CTGF and the area of myocardial fibrosis.

Compared with normal controls (PU 2.4±0.9), the mean level of CTGF protein expression in the papillary muscles samples of the RHD patients (PU 44.7±6.0) was significantly increased(P<0.01). The expression of CTGF protein in papillary muscles of RHD was positivelycorrelated with the expression of CTGFmRNA (r=0.862, P<0.01) and the area of myocardial fibrosis (r=0.856, P<0.01).

Compared with normal controls, CTGF expression in the papillary muscles of the RHD patients is significantly increased, which suggests CTGF may play animportant role in myocardial fibrosis of RHD.

To observe the efficacy of the circumferential decompression with posterior transpedicular osteotomy and segmental instrumentation with interbody fusion for thoracic ossification of posterior Iongitudinal ligament (T-OPLL).

From May 2012 to June 2015, 16 consecutive patients underwent posterior transpedicular osteotomy and segmental instrumentation with interbody fusion.Osteotomy range was depended by length and types of OPLL.Patient's data included level, clinical presentation, blood loss, length of surgery, complications, VAS, JOA, and Frankel grading system before and after the surgery. All data were collected, retrospectively.

The follow-up period was (30±19) months (range from 12 to 50 months). The operation time was (261.6±51.3) min (range from 190 to 310 min). The blood loss was (980.3±370.5) ml (range from 600 to 2 100 ml). All patients were well treated with posterior compression and segmental instrumentation with interbody fusion.The VAS score was (4.2±0.2) in all patients at a week, improving to (2.7±0.1) points at 3 months, (2.4±0.2) at 1 year, and (2.0±0.1) at last fellow-up.The statistical analysis of the results showed a significant improvement of pain at 3 months (P<0.05) when compared to the preoperative status.The preoperative JOA score was (4.2±1.7) in all patients, improving to (7.8±2.5) points at 3 months, (8.5±2.7) at 1 year, and (9.0±1.0) at last fellow-up.The mean recovery rate for the total JOA score was (72%±8%). Differences in the overall JOA Scores showed significant postoperative improvement.Frankel grade improved by either 1 or 2 grades in 16 patients at the last follow-up.None of the patients showed any signs of instrument migration or failure during follow-up.

The results suggested that the procedure achieved a total resection of the ossified posterior longitudinal ligament.The treatment method with posterior transpedicular osteotomy and circumferential decompression was found to be safe, effective, reliable, and technically feasible.

To optimize the dose of lipid infusion in treatment of patients with acute dexmedetomidinepoisoning, in order to further guide the rational use of medication in clinical practice.

A total of 80 patients with acute dexmedetomidinepoisoning were admitted in this study from January 2012 to October 2014 at our hospital and divided into three groups based on the intensity of poisoning, including: slight poisoning (28 cases), moderate poisoning (32 cases) and severe poisoning (20 cases). Patients in each group were given 10% lipid infusion or 20% lipid infusion for treatment.Stable blood dexmedetomidineconcentrations of patients in pre-treatment and at different time points after treatment (pre-treatment and 0.5, 1, 2, 5, 10, 20 h after treatment) and the length of hospital stay, awake time in each group were investigated and compared.Ramsay sedation scores were recorded and compared in different time points (0.5 h before treatment and 2, 5, 20 h after treatment) in each group for different treatments.Side effects and complications were recorded, and follow-up was conducted during 1-3 d post discharge to record the recovery condition in patients.

In each group, patients receiving 20% lipid infusion waked earlier than those receiving 10% lipid infusion.And the hospitalization duration for patients receiving 20% lipid infusion was significantly shorter than those receiving 10% lipid infusion [(4.6±1.6) h vs (6.7±2.0) h, (2.6±0.4) d vs (4.0±0.6) d, P<0.05]. The Ramsay sedation scores were significantly lower for patients receiving 20% lipid infusion than those receiving 10% lipid infusionat 2 h and 5 h after treatment in each group [(3.4±0.3) vs (4.7±0.4), (2.6±0.3) h vs (3.5±0.3) h,P<0.05]. The stable plasma concentrations of dexmedetomidine were gradually reduced after the treatment, and which were lower when compared with the theoretical metabolic concentration.What's more, the plasma concentrationsat 1 h, 2 h and 5 h after treatment were significantly lower for patientsreceiving 20% lipid infusion than those receiving 10% lipid infusion in each group (P>0.05). All patients in our study were cured and discharged without severe side effects and complications, and follow-ups showed that no patients showed evidence of rebound phenomenon.

Different concentrations of lipid infusionare safe and effective in relieving the intensity of dexmedetomidinepoisoning, and promoting the clinical recovery.What's more, the therapeutic efficacy of 20% lipid infusion is greater than 10% lipid infusion.

To investigate the characteristics of cognitive function changes of different infarct sites among patients after acute ischemic stroke, so as to provide theoretical basis for preventing and treating vascular cognitive dysfunction.

One hundred and five cases of acute ischemic stroke within fourteen days meeting the standard set were enrolled, and they were tested by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). And the characteristics of cognitive changes with different infarction sites were analyzed.

Patients with acute stroke suffered cognitive impairment.The significantly impaired cognitive domains in MMSE were: graphics execution in patients with left hemisphere infarction (P=0.027); verbal repetition in frontal infarction (P=0.003); short memory (P=0.04) and verbal repetition (P=0.007) in parietal infarction.The significantly impaired cognitive domains in MoCA were: language (P=0.002), naming (P=0.011), attention (P=0.028) and time orientation (P=0.031) in frontal infarction; delayed memory (P<0.001), attention (P=0.041), language (P=0.049) and visual space and executive ability (P=0.049) in parietal infarction; attention in temporal infarction (P=0.045); language (P=0.009) and time orientation (P=0.026) in basal ganglia region infarction.

Most ischemic stroke patients at acute phase suffered cognitive impairment and the characteristics of cognitive changes differed according to different infarction sites.Comprehensive assessment of cognitive impairment after acute stroke is of great importance.

To investigate the structural changes of gray matter in women with primary dysmenorrhea (PDM) and discuss the potential relationships between the changes and etiology of the disease.

We used an optimized voxel-based morphometry (VBM) approach to compare total and regional volumetric changes of gray matter in 20 primary dysmenorrhea patients with 20 healthy age and menstrual cycle matched controls.All subjects were patients from the outpatient department of Tongji Hospital in 2015.

Abnormal volumetric decreases of gray matter were found in the left and right parahippocampus, the left and right middle temporal gyrus, the left and right superior parietal lobule, the left postcentral cortex, the left and right inferior parietal lobule, which involved in pain transmission, pain modulation and somatic sensation.

Abnormal gray matter volume changes are present in some encephalic regions of PDM patients.The functions of these regions are associated with pain modulation and somatic sensation, which suggests the changes are related with PDM.

To discuss the influence factors of dislocation after bipolar prosthetic replacement.

A total of 374 patients who received bipolar prosthetic replacement in our hospital from October 2001 to October 2015 were retrospectively studied. The clinic data of patients with dislocation after operation was summarized to analyze the causes.

Dislocation happened in 12 patients among all the 374 patients.10 cases received manual relocation, 2 cases open relocation. Most of the 12 patients were accompanied with neurological and psychiatric disorders, such as Alzheimer's disease, Parkinson's disease, sequelae of cerebral infarction, etc. Some factors like improper body position caused by these complications were the main influence factors of dislocation.

Accompanied with neurological and psychiatric disorders is the important influence factor of dislocation after bipolar prosthetic replacement.

To investigate folic acid (FA) supplementation status among Chinese rural reproductive women in their early pregnancy, and to provide evidence for the evaluation of FA supplementation project from national basic public health services.

The data on intake status of FA supplementation from "National Free Preconception Health Examination Project (NFPHEP)" database between January 1, 2010 and December 31, 2012 was used and analyzed.A total of 902 270 women who achieved follow-up during early pregnancy from 220 pilot counties of 31 provinces were recruited.

From 2010 to 2012, the rate of FA intake among women recuited were 73.58% (134 131/182 289), 75.88% (329 288/433 970) and 76.53% (218 896/286 011), respectively, which increased year by year (χ_trend²=13 371.8, P<0.001). Among 682 315 women who took FA, 350 738(51.40%) women began to take FA 3 months before amenorrhea; 130 683 (19.15%) women began to take FA 1-2 months before amenorrhea, and 200 894 (29.44%) began to take FA after amenorrhea.Among 682 315 women who took FA, 645 310 (94.58%) women took it regularly, and 342 418 (50.18%) women took FA in a standardized way.

The status of FA intake among Chinese rural women in the first trimester of pregnancy was good, and 75.62% (682 315/902 270) of them took FA.It is also important for basic public health services to improve the rate of FA intake and increase the rate of taking FA in a standardized way in Chinese rural pregnant women.

delayed onset muscle injury (DOMI) is a common phenomenon after exercise, which can cause a variety of symptoms such as muscle soreness, pain, tenderness, swelling, stiffness and muscle weakness, and even cause muscle and connective tissue damage. DOMI can lead to the decrease of muscle strength, movement and functional range, which affects the performance of athletes, and also affects people's daily life. Therefore, the repair of skeletal muscle sports injury has been a hot research topic at home and abroad. In this paper, we tracked the research on reactive oxygen species (ROS), Ca^2＋The research progress of TCM and Western medicine related treatment of muscle motor injury, ROS accumulation, Ca^2＋The relationship between imbalance and DOMI was summarized, and the current research status of physical therapy and traditional Chinese medicine to inhibit and repair skeletal muscle cell injury caused by DOMI to a certain extent by regulating their signaling pathways was summarized, in order to provide new ideas for the research of treating skeletal muscle sports injury.

miRNAs (microRNAs, miRNAs) are non-coding regulatory small RNAs, which regulate gene expression in a "gene silencing" manner at the post-transcriptional level, and play an important role in regulating tumor epithelial-mesenchymal transition (EMT), invasion and metastasis^[1]。 miRNAs can be divided into two categories according to their regulatory effects on tumor bone metastasis: anti-tumor bone metastasis miRNAs and pro-tumor bone metastasis miRNAs. The expression of miRNAs is tissue and spatiotemporal specificity, and the expression and function of miRNAs may be very different in different types of tumors and different stages of progression. In general, the expression of anti-tumor bone metastasis miRNAs in malignant tumors (especially breast cancer, thyroid cancer and prostate cancer with high incidence of bone metastasis) is down-regulated, and the expression of pro-tumor bone metastasis miRNAs is up-regulated, and the overall effect is to promote tumor bone metastasis. Studies have shown that reversal of miRNAs expression by biological or physical means can produce anti-tumor bone metastasis effects. miRNAs can be used as a predictive, diagnostic and therapeutic means for bone metastasis of malignant tumors.

Alzheimer's disease (AD) is the most common neurodegenerative disease in the elderly, mainly manifested as progressive comprehensive cognitive dysfunction; The main pathological manifestations were the formation of intracellular neuro fibrillary tangles (NFTs) and extracellular amyloid senile plaques (SP). From the genetic point of view, AD can be classified into familial AD (FAD) and sporadic AD (SAD). FAD is familial, with a young onset age and often accompanied by various non-cognitive neurological symptoms and signs; However, SAD has no obvious genetic predisposition, sporadic onset, and the main clinical manifestations are progressive cognitive decline and memory loss. The main mutant genes associated with FAD are amyloid precursor protein (APP), presenilin1 (PSEN1) and presenilin2 (PSEN2). These genes are involved in or influence the amyloid A β production process: increasing total A β, A β 40, A β 42 production or altering the A β 42/A β 40 production ratio. However, recent studies have also found that mutations at some sites of APP gene can significantly reduce A β 42^[1,2]Even inhibiting A β production^[3]； Based on the amyloid waterfall hypothesis, these APP gene mutations may have neuroprotective effects, but their specific mechanisms are still unclear. The pathogenicity of APP gene mutation and its possible protective mechanism will be reviewed in this paper.

autoinflammatory bone diseases (autoinflammatory bone diseases) are a new branch of autoinflammatory diseases. Due to innate immune abnormalities, immune cells infiltrate the bone, followed by osteoclast differentiation and activation, and finally cause aseptic inflammation of the bone, often accompanied by skin and intestinal inflammation^[1], pathogenic culture and histopathology lack any etiological evidence^[2,3,4]。 This group of diseases includes monogenic and polygenic diseases, the former including: suppurative aseptic arthritis-pyoderma gangrenosum-acne (PAPA) syndrome, Majeed syndrome, interleukin (IL) -1 receptor antagonist deficiency (DIRA); The latter include: chronic aseptic osteomyelitis (CNO) /chronic recurrent multifocal osteomyelitis (CRMO), synovitis-acne-impetigo-bone hypertrophy-osteomyelitis (SAPHO) syndrome^[5,6,7]。