Objective: To evaluate the application value of CT enhancing scan based on bolus tracking technology in the upper abdomen. Methods:200 patients were examined by CT in the upper abdomen. Contrast agent was injected through the hand vein at 1.5 ml/kg, with pressure of 300 Pa, flow rate 2.5 ml/s. Before injection, we must complete the first scanning .Then , another 2 or 3 scans were done. Results:188 cases can show abdominal aorta, hepatic artery, splenic artery, hilar vessel branches, portal vein, inferior vena cava very well. Another two cases failed .The others were not ideal because of portal hypertension. Conclusion:CT enhancing scan based on bolus tracking technique in the upper abdomen can obtain good images to meet clinical needs.

Objective To investigate the relevant factors on the prognosis of sudden deafness. Method The clinical data of 133 patients (148 ears) with sudden deafness were analyzed retrospectively. Results Through systemic treatment, 25 cases got recovery, 18 cases were excellence and 39 cases were effective, the total effective rate was 61.7%(82/133). Univariate analysis showed that the factors related to the prognosis of sudden deafness were age, the time from onset to treatment, deafness classification,accompanied by vertigo or not and the duration of treatment. Patients with the age lower than 60, the earlier the time from onset to treatment, the lighter the deafness classification, not accompanied by vertigo and the longer duration of treatment got a better efficacy. Logistic regression analysis showed that the independent factors related to the prognosis of sudden deafness were the time from onset to treatment and deafness classification. Conclusion The etiology of sudden deafness is still unclear, the time from onset to treatment interval and the degree of hearing loss are the main factors affecting the prognosis of it, in clinic, it should be paid attention and took a early diagnosis and early treated so as to get good efficacy.

Objective To compare the clinical efficacy and onset time between Tiao Ren An Shen (regulating Conception Vessel and soothing mind) needling method and conventional acupoint selection for peri-menopausal depression, for providing theoretical evidence for the application of Tiao Ren An Shen needling method. Method Sixty patients with peri-menopausal depression aged 45~55 years were randomized into two groups after admission to hospital. In addition to oral administration of Fluoxetine, one group was intervened by Tiao Ren An Shen needling method (treatment group, n=30), and the other group was by conventional acuppoint selection (control group, n=30). Before treatment, and at 2nd, 4th, and 6th week after treatment, Hamilton Depression Scale (HAMD) was investigated, Kupperman index and traditional Chinese medicine (TCM) syndrome score were evaluated before and after intervention. The therapeutic efficacy was estimated at the end of the 6th week. Result After intervention, the HAMD and TCM syndrome score were significantly improved in both groups (P<0.05); Kupperman score was markedly improved in the treatment group (P<0.05), while the score was not significantly changed in the control group (P>0.05). Compared to the control group, the improvements of depression degree and peri-menopausal symptoms were more significant in the treatment group (P<0.05). The total effective rate was 93.3% in the treatment group versus 70.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Compared to conventional acupoint selection, Tiao Ren An Shen method can produce a more efficient effect and a higher long-term efficacy, not only improving the emotional state and easing depression, but also releasing vegetative nerve functional disturbance. As it can improve the TCM symptoms, treating both causes and manifestations, promoting the quality of life of peri-menopausal patients, this method is an effective approach.

Objective To investigate the risk factors for gastrointestinal polyps.Methods A retrospective analysis was performed.The patients who undergone gastrointestinal endoscopy and diagnosis gastric polyps were selected who hospitaled in the Navy General Hospital from January 2012 to January 2014 and divided into cases group(patients with gastric polyps and colonic polyps) and control group (patients with gastric polyps).The information was recorded.Results The case of over 60 years of age distribution in case group was significantly higher than the control group.Single factor analysis showed that the indices including age,HP infection,smoking,drinking,high cholesterol and hypertension were significantly different from that of control group (x2 =11.538,9.350,4.190,5.103,8.992,4.038;P ＜ 0.05) after adjusting the interactions of the factors.Multi factor Logistic analysis showed that the risk of gastrointestinal polyps was significantly related with sex,age over 60 years old,HP infection,diabetes,smoking,drinking and hyperlipoidemia(P＜0.05),and the OR value from small to large were age,HP infection,alcohol drinking,hyperlipidemia,smoking,diabetes and gender.Conclusion The female gastric polyp patients who were over 60 years old,HP infection positive,diabetes,hyperlipidemia,smoking,drinking are more likely to suffer from intestinal polyps,and they were suggested to perform colonoscopy.Among them,women with HP positive infection and the age over 60 are high risk population.If they complicated with hyperlipidemia,they should had a screening for colorectal carcinoma in situ.

Objective To analyze the clinical characters of the different degrees nonalcoholic fatty liver (NAFLD) and the relationships with blood uric acid.Methods Two hundred and eighty-two cases body examinational and hospitalized patients were selected.According to whether complicated with NAFLD and liver steatosis degree,patients were divided into 4 Groups.Group A was control group that without NAFLD,Group B was mild NAFLD group,Group C was moderate NAFLD group and Group D was severe NAFLD group.Clinical data,blood lipids,blood uric acid and other biochemical indicators of four groups were compared.Results In 282 cases of patients,there were 78 cases (27.66％) without NAFLD patients,94 cases (33.33％) mild NAFLD,92 cases (32.62％) moderate NAFLD and 18 cases (6.38％) severe NAFLD.As the severity of fatty liver increased,body mass index (BMI) higher and higher ((24.51 ± 2.55),(27.06± 2.81),(28.37± 3.23),(30.71 ± 2.96) kg/m2),and the differences among four groups were statistically significant (F =35.976,P ＜0.05).Gglycerin trilaurate (TG),low density lipoprotein cholesterol (LDL-C) of D group were hihger than other groups ((3.04± 1.22) mmol/L vs.(1.73± 1.46),(2.59 ± 1.78),(2.81 ± 1.94) mmol/L,(2.99± 0.52) mmol/L vs.(2.28±0.78),(2.47±0.75),(2.41±0.74) mmol/L),high density lipoprotein cholesterol (HDL-C) was lower compared with group A,B,C (1.00± 0.23) mmol/L vs.(1.15± 0.24),(1.05± 0.21),(1.00 ±0.21) mmol/L),the differences were statistically significant(F=6.818,4.597,6.414;P＜0.05).In 4 groups the blood uric acid(UA) of groups B,C,D was higher than group A,group D was higher than group B,C,and the differences were statistically significant((316.13±71.86),(356.98±83.00),(355.37±81.01),(409.67 ±50.90) μmol/L;F=8.797;P＜0.05).Conclnsion Obese patients are more susceptible to NAFLD,and NAFLD with a certain degree of lipid and uric acid metabolism,and the severity of NAFLD has a positive correlations with lipids and serum uric acid levels.It is particularly obvious in patients with severe NAFLD,which prompting that blood uric acid level can be used as an independent risk factor in the pathogenesis of NAFLD,and as an auxiliary judge for NAFLD severity index.

Objective To investigate the reason of fracture internal fixation of locking plates and conventional plate in the treatment of femoral fractures.Methods A total of 198 patients with femoral fracture taken plate fixation were selected as our subjects.Of which,the locking plate were used in 87 cases served as control group and 111 cases had traditional plate fixation served as study group.Fracture fixation rate in patients were follow-up and the reasons for broken were analyzed.Results Fracture fixation occurred 5 cases (4.5％,5/111) in the locking plate,and 3 cases (3.4％,3/87) in traditional plate,and the difference was not significant (x2 =0.053,P =0.987).Fracture reason included plate fracture (4 cases),fracture of screws (2 cases) and plate fracture complicated with breakage of screw (2 cases).Iatrogenic factors lead fracture fixation was 30.0％ (3/10),significantly higher in patients with rehabilitation exercises errors (6.9％,2/29; x2 =3.851 ; P =0.046).Both iatrogenic factors and rehabilitation exercises errors caused fracture fixation rate was 100％.Conclusion Iatrogenic factors combined rehabilitation exercises error was the main reasons in fracture fixation.We should properly choose fixation methods and correctly guide the postoperative functional exercise for patients.

Objective To investigate the influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury.Methods A total of 89 elderly patients with articular injury from Jan.2013 to Oct.2014 were randomly divided into observation group and control group.In control group,40 cases were treated with conventional surgery and anti-inflammatory therapy.In observation group,49 cases were treated intraarticular injection of hyaluronic acid added to conventional therapy.The apoptosis rate of articular cartilage cells,cell cycle and proliferation index were compared between the two groups.Results The apoptosis rate of articular cartilage cells was lower in observation group than in control group [(4.08±0.74)％ vs.(6.41±0.54)％,t=16.403,P＜0.001].The ratio of G0/Giin articular cartilage cells was lower in observation group than in control group[(83.5 ± 3.5)％ vs.(91.7± 4.3)％,t10.275,P＜0.001].The ratios of S and G2/M and the proliferation index in articular cartilage cells were lower in control group than in observation group[(3.5 ± 0.3)％ vs.(8.2± 2.4)％,(4.7±0.6)％ vs.(8.5±1.8)％ and (9.1±1.1)％ vs.(16.7±1.9)％,t=12.293,12.731 and 22.198,respectively,all P＜0.001].Conclusions Intra articular injection of hyaluronic acid at early stage decreases the apoptosis rate of articular cartilage cells,helps articular cartilage cells turnover and improves the recovery of articular injury in elderly patients.

Objective:To investigate the significance of 3D printing technology in the treatment of skull base tumor.Methods: A 45-year-old male patient who felt headache and discomfort had progressive loss of vision to blindness in the left eye. Using MR plain scan found that there was a skull base tumor, so the patient was examined by brain CTA and 3.0T MR to obtain medical digital imaging of CT and MR and DICOM data which were input into computer for establishing three-dimensional model, and then printed it.Results: 3D reconstruction model can clearly display the anatomical structure of skull base tumor, three-dimensional space and peripheral blood around skull base tumor. Under the guidance of this new technology, the tumor was completely removed and the surrounding normal brain tissue was preserved as much as possible. The whole operation time was greatly reduced at the same time.Conclusion: The treatment of 3D printing technology is applied in skull base tumors can clearly display the anatomical structure, distinguish adjacent vessels around tumor; when it avoids missing tumor, also can more effectively assist preoperative planning, enhance the security for complex skull base surgery, accelerate the operation speed, improve operation accuracy; it has great application prospect in the precise treatment of neurosurgery.

Objective To investigate the therapeutic effect of flupentixol and melitracen tablets for irritable bowel syndrome (IBS).Methods Relevant concerned with the therapeutic effect of Flupentixol and melitracen tablets and routine medicine were reviewed by China national knowledge infrastructure.All reviewed literatures were accessed by Jadad quality scale.Statistic data was analysed by RevMan5.0 and Stata.Results Twelve articles of randomized controlled trial were collected.Among these study,there were 1384 patients,which divided into treatment group (n =704) and control group (n =680).The results of heterogeneity showed that x2 =25.48,P =0.008,I2 =57％.Therefore the random effects model was selected.The combined relative risk is 1.39 and the 95％ CI was 1.27-1.53.Conclusion Compared with traditional treatment,flupentixol and melitracen tablets can obviously improve the therapeutic effect of IBS.

BACKGROUND:Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE:To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI).METHODS:Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm~2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION:The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia rnyocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance (P＜0.01).The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.