Objective To explore the influence of patient-controlled epidural analgesia(PCEA) on incidence of postpartum depression after cesarean section. Methods 256 cases of singleton term primary cesarean delivery were randomly divided into the study group( 130 cases)and the control group( 126 cases).The study group retained analgesia pump connected with epidural catheter,analgesic liquid was injected.In the control group,epidural catheter was removed,and was given intramuscular injection of pethidine hydrochloride 100 mg 4～6 h after operation,repeated 6 h later,total dosage was 200 mg.Postoperative observation time was 48h.Plasma prolactin(PRL) concentration was determined by radioimmunoassay in prenatal,postnatal 24 h and 48 h.Edinburgh postnatal depression scale (EPDS) was used to assess depression state 6 weeks postpartum in the two groups.The incidence of postpartum depression was compared between two groups. Results The plasma PRL level in the study group was significantly higher than the control group 24 h,48 h postpartum.The incidence rate of depression in the study group was 6.15％,while was 16.67％ in the control group,the differences were statistically significant. Conclusions The application of PCEA after cesarean section can significantly reduce the incidence of postpartum depression,and has very important practical significance in preventing the incidence of postpartum depression.

Objective To investigate the role of contrast-enhanced ultrasound (CEUS) on the diagnostic efficacy of ultrasound-guided percutaneous biopsy of peripheral lung lesions. Methods Ninty-six patients with pleural-based lesions underwent percutaneous ultrasound-guided biopsy. Of the 96 patients,54patients underwent CEUS before biopsy and enhancement information was referred for the selecting of tissue sampling site. The rest of 42 patients didn' t undergo CEUS before biopsy. The difference in the diagnostic accuracy between the two groups was analyzed to evaluate the value of CEUS before biopsy.Results Of the 52 patients in the CEUS group,48 were malignant,and 6 were benign. Of the 42 patients in the un-CEUS group,36 were malignant, and 6 were benign. Necrosis (areas lacking of enhancement) was demonstrated in 41.7％ (20/48) of the patients with malignant lesions in CEUS group, and necrosis incidence was increased with the increase of the dimension of the malignant lesions. No necrosis area was demonstrated in 6 benign lesions. The rate of successful initial biopsy in CEUS group (98.1 ％ ,53/54) was statistically higher than that in un-CEUS group ( 85.7％, 36/42 ) ( P ＜ 0.05 ). Tissue necrosis and denaturalization attributed to most of the inconclusive pathologic diagnosis. Conclusions CEUS before transthoracic peripheral lung lesion biopsy improved the diagnostic accuracy of the procedure by providing information for differentiating viable or necrotic tissue and consequently provide more accurate information about the site of biopsy.

Objective To discuss the value of Time-Resolved Imaging of Contrast Kinetics (TRICKS) in the diagnosis of lower extremity diseases. Methods 24 cases (27 times) with lower extremity, skeleton and blood vessel diseases undergoing TRICKS were retrospectively analyzed. There were 14 cases with both lower extremities two -segment scan, 5 cases(6 times) with one-segment scan(thigh), and 5 cases (7 times) with one-segment scan(calf). Conventional sequences were performed followed by enhanced MR angiography with the TRICKS technique. Results The TRICKS images for all cases satisfied the vascular changes and structure demonstration in arteriovenous phase, and the full circulative process of those pathological vessels were observed. The diagnostic accuracy of TRICKS angiography has been validated. Conclusion The TRICKS provides a method for imaging the change of blood flow. The vascularity in the target vascular and tumor can also be obtained. Hence TRICKS provide important information in clinical decision making.

Objective To discuss the inspect technique and methods of magnetic resonance urography(MRU)in pediatric urinary system. Methods 16 cases with urinary system diseases were analyzed retrospectively,including axial routine FRFSE T2WI with fat saturation and three-dimensional MRU. The three-dimensional(3D) imaging data were sent to AW4.2 workstation,then edited and reconstructed with maximum intensity projection(MIP) and rebuilt. Results 12 cases in 16 cases were congenital abnormality by MRU diagnosis,3 cases were Urinary system diseases and 1 case was normal. 10 cases in 16 cases were performed with surgical intervention,6 cases with medical treatment,which clinical diagnosis were consistent with MRU. 16 cases were accepted examination with B -ultrasonic,6 cases CT and 9 cases IVP. Diagnose accordance rates with MRU were B-ultrasonic 93.7%(15/16),CT 66.7%(4/6),IVP 66.7%(6/9).Conclusion MRU is a safe,convincible and convenient technique,which can provide high quality imaging,so it will be a kind of non-injury imaging method in diagnosing the diseases of pediatric urinary system diseases.

The red cell deformability (RCD) has been taken as a diagnostic aid in recent years. The dilute red cell suspension passes through the silicon microch annels under constant suction pressure. Such three parameters of RCD are measure d as IF (filtration index), and The results show that the above-mentioned parameters can reflect the changes of cell rheological characteristics from dif ferent aspects. With the observation of the flow passage, the rehological charac teristics can be evaluated accurately and comprehensively.

Objective:To compare the personal characteristics between the patients with paradoxical insomnia and the patients with primary insomnia or the normal sleepers.Methods:A case-control study with the proportion at 1∶1∶1 was carried out.The patients with paradoxical insomnia were diagnosed in Sleep Medicine Center of West China Hospital of Sichuan University between March 2013 and December 2013.A case of paradoxical insomnia was matched with two controls:a primary insomnia patient and a normal sleeper.A total of 63 matched cases were collected.A face-to-face survey was conducted by using the following scales:General Data Scale and Eysenck Personality Questionnaire (EPQ).Results:The average scores of psychoticism,extraversion,and neuroticism for paradoxical insomnia cases were (52.1±10.2),(49.6±9.8),and (56.0±12.0),respectively.In general,31.7% of paradoxical insomnia patients had psychoticism or psychoticism tendency in their personality,which were more obvious than those in primary insomnia patients (7.9%) (x2=l 1.228,p<0.0125) and normal sleepers (0) (X2=23.774,P<0.0125).Moreover,19.0% of paradoxical insomnia patients had extroversion or extroversion tendency in their personality,which were more significant than those in primary insomnia patients (3.2%) (Z=-4.047,P<0.0125) but less obvious than those in normal sleepers (60.3%) (Z=-4.754,P<0.0125).Also,46.0% of paradoxical insomnia patients had neuroticism or neuroticism tendency in their personality,which were more significant than those in normal sleepers (0) (x2=37.670,P<0.0125) but similar to those in primary insomnia patients (52.4%) (x2=0.508,P>0.0125).Conclusion:The personal characteristics for paradoxical insomnia patients did not reached obviously abnormal level.However,their psychoticism tendency,extroversion tendency and neuroticism tendency needed to be paid attention.

Objective To solve the limitation of the wide-bound imaging from aortic arch to the bifurcation of internal and external carotid artery by changing 3D TOF MRA scan parameters, and discuss the clinical value of this technology in carotid artery angiography. Methods 108 patients with cerebrovascular disease were performed with carotid artery 3D TOF MRA. Images were performed under MIP, MPR and VR. The images of bilateral common carotid arteries, external and internal carotid artery, and vertebral artery were evaluated interactively by two independent radiologists blinded to results. Results 864 blood vessels were observed with 3D TOF MRA, including 672 normal clearly, 17 unclear, 17 congenital variants, 73 un -smooth lesion, 63 vascular stenosis, 9 vascular occlusion, 5 not display, 4 depressed downward, 4 vascular enlargement. Totally,unclear, variation and lesion blood vessels were 192. The results in combination with original image analysis could meet the need of diagonosis. Conclusion 3D TOF MRA as a noninvasive and non contrast agent imaging method can be used to select the carotid stenosis and is quite good in the value of application.

Objective To study clinical application of no phase wrap(NPW) technique in MRI. Methods 139 patients were selected and performed two sequences with and without no phase wrap in the same condition. The two kinds of images were compared. Results In the same parameter, phase wrap artifacts were seen in all images without the option of NPW. In the opposite, with the option of NPW, the artifacts disappeared. Conclusion NPW can avoid the Phase wrap artifacts .

Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found. The 18 cases under surgery included endoscopic approach(12 cases), extra-nasal approach(4 cases), transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

Objective To evaluate the clinical efficacy of pingyangmycin (PYM) injection on infantile hemangioma located in the parotid gland region. Methods Twelve patients were treated by intralesional injection of PYM. When necessary, the injections were repeated at an interval of one week, but not more than 3-4 sessions within a therapeutic period. Normally, the secondary therapeutic period was performed 1 month later. The general and local adverse responses were recorded and the clinical outcomes were assessed with a follow-up of 1 to 3 years. Results Complete clinical resolutions were achieved in 10 patients. 2 patients received one injection, 3 patients received 2 injections, 3 patients received 3 injections, and 2 patients received 4 injections. The remaining 2 patients with partial resolution received 6 and 7 injections respectively. No clinical recurrence was observed during the follow-up of 1 to 3 years. No ulcerations or postoperative sears in injection regions were presented. The function of facial nerve was remained normality in all patients. The systematic side effects included transient pyrexia and poor appetite appeared in partial patients. No allergy cases were found. Conclusion Treatment of infantile hemangioma located in parotid gland region with PYM injection reveals a high rate of complete clinical resolution, with fair cosmetic results and short treatment time, and it does not damage the facial nerve or form local scar.The treatment time of PYM injection seems to be positively related to size of the lesions.