Objective We aimed to study the optimal method for local compression following removal of needle after intravenous injection and protect patients' vein to the highest degree. Methods 620 patients were divided into the observation group and the control group with 310 cases in each group randomly. Comparison study was carried out by adopting interchange compression (routine method) and noninterchange compression (direct pressing with hypothenar). Results The incidence of pain, bleeding and subcutaneous stasis after removal of needle in the observation group was lower than those in the control group (P<0.01). Conclusions Local compression following removal of needle with hypothenar was superior to routine compression method and it was worth applying in clinics widely.

Objective To study the value of CT perfusion imaging(CTPI)on brain hemodynamic of the aged with cerebral infarction. Methods The 48 patients who were doubted with cerebral infarction underwent 16-slice CT plain scanning and CTPI within 24 hours of onset. The cerebral blood flow(CBF), mean transit time(MTT)and time to peak(TTP)of contrast-medium in region of interest(FOV)were used as brain hemodynamic parameters in comparation with contralateral regions. All cases were followed up with MRI after 3-10 days. Results Ischemia lesion was found on CT plain scanning in 40.9% of patients, while 93.2% of patients showed abnormal perfusion on CTPI. The sensibility of CTPI in identifying ischemia area was 93.2%, and the specificity was 100%. CBF in research area was significantly reduced, MTT and TTP were remarkably increased in contrast to counterparts(P＜0.01). Conclusions CT perfusion imaging can sensitively reveal the hemodynamic condition of cerebral ischemia, which could provide the important information for early diagnosis and treatment of the elderly with brain infarction.

Building of medical teams was a basic preparation for Beijing 2008 Olympic Games and Paralympic Games as well. In this consideration, the Beijing Organizing Committee for the Olympic Games (BOCOG) and Beijing Health Bureau developed a complete set of mechanism to integrate human resources, coveting standards development, selection, training and testing for members of medical teams. This ensures the success of medical services delivery and provides medical services delivery of subsequent Large-scale activities with valuable experiences as well

An insight of the building and operation of the medical rescue and assurance system for Beijing Olympic Games will help identify effective practices for design and implementation of medical rescue plans in large-scale activities held in cities. Practice-proven: large-scale activities call for systems designed in view of characteristics of medical assurance tasks of such events, and such systems must be improved all the way. Keys to operations of Olympic venues in the run-up period are setup of medical services, development of general medical procedures, management of medical teams in venues, and design of medical rescue flows. Focuses of venue operations during the games are reporting of medical information from the venues, seamless interconnection between venues and medical organizations in the city, and crisis management for medical operations on the venues.

Objective To analyze atypical 64-slice spiral CT imaging finings of pancreatic cancer and to improve the ability to identify CT manifestations of pancreatic cancer. Methods A retrospective analysis was performed on the atypical 64-slice spiral CT imaging findings of 12 eases of pancreatic cancer confirmed by pathology after surgery. Results All the twelve cases were pancreatic ductal adenocarcinoma.Among them, 7 cases were moderately differentiated ductal adenocarcinoma, 1 case was well-differentiated ductal adenocarcinoma, 1 case was mucinous adenocarcinoma, 3 cases were adenosquamous carcinoma. Among 8 cases with ductal adenocarcinoma, the lesions were located in the pancreatic head and (or) uncinate process in 7 cases, and in the pancreatic neck of 1 case. Tumors were expressed as isodense or low-density or cysticsolid lesions, the masses showed no enhancement in the enhanced scanning phase. Tumors were clearly exogenous or exogenous tendencies in 5 cases. Five cases had no distal pancreatic duct dilation, 2 patients had common bile duct and intrahepatic biliary dilation, and only 1 patient had atrophy of distal pancreas. There was one case of mucinous carcinoma, plain CT scan showed a cystic lesion in head of pancreas about 5cm in diameter, the solid part below the cystic lesion was slightly enhamced in the enhanced scanning phase and the body and tail pancreatic duct was moderately dilated (7 mm). There was no common bile duct and adjacent blood vessels invasion. Among 3 cases of adenosquamous carcinoma, lesions were located in the pancreatic head of 2 cases and in pancreatic body of 1 case. The maximal diameter of mass ranged 3.0 cm ～ 4.5 cm.Cystic necrotic area was observed within the lesions in 3 cases in enhanced pancreatic parenchymal phase of CT scan. Distal pancreatic duct were mildly dilated (4 ～ 5 mm) in 3 cases. There was no common bile duct and intrahepatic bile duct dilation. Conclusions Pancreatic cancer may show atypical CT imaging findings and great cautions are needed for differential diagnosis.

Objective To investigate the CT imaging features of solid pseudopapillary tumor of the pancreas (SPTP) and to improve the preoperative diagnostic accuracy. Methods A retrospective analysis was performed on the CT manifestations of 21 cases of SPTP confirmed by pathology and surgery. Results In the 21 cases of SPTP, 19 were young and middle-aged female (range: 9～29 years old). The lesions were located in the pancreatic head and neck in 13 cases, and in the pancreatic body and tail in 4 cases each. The maximum diameter of tumor was 3 ～ 15 cm (mean 7.5cm). CT showed a single, round-like, cystic and solid mass in the pancreas. Eighteen cases had a complete capsule, and 3 cases had poorly defined margin with surrounding tissue. 5 cases of tumor were encapsulated or appeared scattered calcification in the center, only 1 case had pancreatic duct dilation (about 5mm in diameter), and no patient had bile duct changes. After enhanced scanning, the tumor capsule and the solid part were mildly to moderately enhanced during arterial phase, and they were significantly enhanced during portal venous phase and equilibrium phase. The cystic part was not enhanced, but the capsule was significantly enhanced. Conclusions CT manifestations of solid pseudopapillary tumor of the pancreas have certain characteristics, and when combined with clinical and imaging manifestations, accurate diagnosis generally can be made.

Objective analysis the pathogenesis and the treatment strategies of the hypertrophic obstructive cardiomyopathy (HOCM) with the concomitant mitral valve abnormalities. Methods From October 1996 to June 2009, 62 patients suffered from HOCM underwent surgical treatment. There were 41 males and 21 females with age ranging from 6 to 68 ( 34.05 ±15.26) years old. The body weight were 27 -83 kg [mean (60. 42 ± 12.71 ) kg]. Detected by preoperative echocardiography, all patients had the systolic anterior movement of the mitral leaflet ( SAM ) and 50 patients had mitral regurgitation (MR). Ventricular septal myomectomy was performed under general anesthesia and cardiopulmonary bypass (CPB) with a moderate systemic temperature and low volume blood flow. The concomitant operations included mitral valve replacement ( MVR 12 cases), mitral valve plasty ( MVP9 cases). During the perioperative period the patients were evaluated by echocardiography. Left ventricle ( LV ), left ventricular outflow tract ( LVOT), left atrium ( LA ), left ventricalar ejection fraction ( LVEF), mitral valve construction and function were evaluated. Results The time of CPB and the sortic occlusion were (104.23 ±47.14) (402290) min and (66.76 ±36.32) (20-195) min, respectively. The endotracheal intubation time was ( 13.23 ± 11.76 ) ( 5 -21 ) h and ICU stay was (42.53 ± 37.41 ) ( 11 ～ 183 ) h. Comparing with the parameters before operation: the sizes of the LA were (43.46 ± 7.21 ) mm vs. ( 34.56 ± 6.45 ) mm, pressure gradients through LVOT ( 103.84 ±44.04) mm Hg vs. (23.54±17.78) mm Hg and the thickness of the septal (26.93±5.23) mm vs. (17.12±5.67) mm.All parameters were significantly decreased( P ＜0.05 )postoperatively. All surviving patients had no or only trivial MR and SAM. Four patients (6.4% ,4/62 ) died during the perioperative period. The cause of death included severe low cardiac output, heart failure, severe ventricular arrhythmias and severe acute renal failure. The main complications were: left bandle branch block in 33 cases, intraventricular conduction block in 7, complete AV block in 6, anterior hemiblock in 5, type Ⅰ artioventricular conduction block in5, atrial fibrillation in 4. All surviving patients were in New York Heart Association functional class Ⅰ or Ⅱ during the follow-up from 1 month to 10 years. Cardiac symptoms were markedly relieved. Mitral valve construction and function were significantly improved. There were no death, no complications and none required additional mitral valve or myecomy surgery. Conclusion Ventricular septal myomectomy alone is sufficient to eliminate or significantly reduce the severity of MR and SAM. In patients with HOCM and MR due to the congenital mitral valve disease, concomitant MVP may be the first choice. Considering the inherent risks of prosthetic valves and anticoagulation complications, MVR should be the second choice.

Objective To investigate the relationship between the ADAM gene expression and unknown reason infertile patients. Methods With RT-PCR mehtod, we checked from normal group semen 30 cases and infertile group semen 30 cases in order to know the ADAM1,2,3,32 mRNA expression. Results there are the ADAM1,2,3,32 gene expression in all 30 cases of normal group whereas in 30 cases infertile patients there exists 1 case ADAM1,2,32 lacking expression, 1 case ADAM2,32 lacking expression, 1 case ADAM1 and 1 case ADAM3 lacking expression. Conclusions The lacking of ADAM1,2,3,32 may be one of the most reasons which cause the infertility.

Objective To understand the human resource status of the community rehabilitation management in Shanghai and provide evidence for the construction of this human resource. Methods Census institutions of community rehabilitation management in Shanghai were investigated with self-questionnaire. Results Shanghai has initially established personnel of community rehabilitation management,which contains rehabilitation coordinators and street community administrator. However, the structure and number of the personnel has yet to be improved. Conclusion Personnel building must focused on optimizing the personnel structure of rehabilitation coordinator, moderately expanding the street community administrators, filling the community rehabilitation service gap between city and urban in next stage.