Objective To discuss the subcutaneous hematoma of the chest wall after artificial femoral head replacement in order to improve the prognosis of patients. Methods One patient complicated with subcutaneous hematoma of the chest wall after artificial femoral head replacement on October,2009.Aborative treatment and nursing was given and the treatment effect was observed. Results The hematoma and congestion were all absorbed after two weeks of treatment and nursing. Conclusions The nursing point of subcutaneous hematoma of the chest wall after artificial femoral head replacement includes monitoring of vital signs, drainage volume, identification of anemia feature, scrupulosly systemic observation and nursing of hematoma.

Spasticity is a common complication of stroke.It may cause the function and ability of patients to be restricted significantly and affect the quality of life of both patients and their caregivers.The estimated prevalence of poststroke spasticity (PSS) is 19％ to 42.6％.PSS can be usually assessed by the Modified Ashworth Scale,Modified Tardieu Scale,and electromyography.Therapeutic methods of PSS include physical therapy and drug treatment.The treatment options should be individualized.

Objective To evaluate the diagnostic value and limits of 64-slice spiral coronary artery imaging,by com- parison with selective coronary angiography,in detection of coronary heart disease.Methods Fourty-two patients sus- pected CAD were performed 64-slice spiral CT coronary imaging and selective coronary artery angiography in two weeks, comparative analysis of results were progressed consequently.Results The sensitivity,specificity and positive and nega- tive predictive value to identify≥50% stenosis branches was 90.5%,96.6%,85.9% and 97.8%,respectively.The sen- sitivity,specificity and positive and negative predictive value to identify≥75% stenosis branches was 93.5%,98.9%, 87.9% and99.4%,respectively.Conclusion As a noinvasive quantitative assessment of coronary artery stenoses exami- nation,64-slice spiral CT is a valuable method to detect and diagnose the disease of coronary artery,but its clinical use maybe presently be limited due to image quality in a number of cases.

Objective To investigate the changes of electrode impedance,threshold(THR),maximum comfortable level(MCL),and dynamic range(DR),providing the basis for debugging after operation in congenital deaf children. Methods A respective study was carried out on 20 cases of congenital deaf children who were implanted with cochlear Med?EL SONATAti100. The measurements and changing ranges of electrode imped?ances,THR,MCL and dynamic range during the operation and at postoperative one month,three months,and six months were statistically analyzed. Results Electrode impedances were the lowest during the operation and the highest at one month after operation(P<0.01). The electrode imped?ance for the apical cochlear group was statistically different from that for other groups at one month(P<0.05). After three and six months,there were statistically significant differences between groups(P<0.01). THR at six months was lower than that at three months(P<0.05). MCL at three months was higher than that at one month(P<0.01). DR showed an increasing trend(P<0.05). There was no correlation of perioperative and post?operative electrode impedance with THR,MCL,and DR(P>0.05). Conclusion The electrode impedances varied due to different electrode posi?tion. The vales of THR,MCL and DR were unrelated with electrode impedance. DR was gradually increasing,MCL reached steady state earlier than THR. It is important that THR should be debugged at three months after operation and MCL should be debugged at six months.

Objective The purpose of this study was to investigate the differences of cognitive impairment and neuropsychiatric behavior disturbances between Alzheimer's disease (AD) and frontotemporal dementia (FTD) patients,as well as their relationships with dementia severity.Methods A total of 38 FTD patients and 46 AD patients were recruited in this study.The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the degree of cognitive impairments.The Neuropsychiatric Inventory Brief Questionnaire Form (NPI) and Frontal Behavioral Inventory (FBI) were used to measure behavioral disturbances.The 21-items Hamilton Depression Rating Scale (HAMD-21) was used to evaluate the mental or emotional state of patients.Clinical dementia rating scale (CDR) was used to divide the dementia severity.Results FTD patients were younger ((70.13 ± 8.36) years vs (66.46 ± 7.04) years,t =2.124,P =0.037),earlier at age of onset ((68.58 ± 8.51) years vs (64.43 ± 6.82) years,t =2.396,P =0.019),with lower MoCA scores (12.50 (8.00,16.25) vs 17.00(10.75,21.00),Z=-2.428,P=0.015),higher NPI (15.00(7.00,25.50)vs 9.50(4.00,17.75),Z=-2.251,P=0.024),FBI (21.00(13.00,27.00)vs 16.00(10.75,23.00),Z=-2.159,P=0.031),FBI-A (13.00 (8.00,16.00)vs 9.00(6.00,12.00) Z=-2.159,P=0.041),FBI-B (9.00(7.00,14.00) vs 7.00(3.00,11.00),Z=-2.051,P=0.040) and HAMD-21 scores (7.00(2.75,14.00) vs 5.00 (3.00,8.00),Z =-2.061,P =0.039).A detail analysis of different cognitive domains showed the executive functions (Z =-2.140,P =0.032),language (Z =-3.357,P =0.001),abstraction (Z =-2.498,P =0.012) and delayed recall (Z =-4.317,P =0.000) of the MoCA scale were lower in FTD patients than that in AD patients,while AD patients had lower scores in memory (Z =-1.999,P =0.046) and orientation (Z =-2.941,P =0.003) of the MMSE scale.Within the subscale scores of the NPI,the agitation (Z =-3.255,P =0.001),disinhibition (Z =-3.093,P =0.002) and irritability (Z =-2.214,P =0.027) scores were higher in FTD patients than in AD patients.The total scores of NPI (r=0.279,P=0.010),FBI (r =0.353,P=0.001),FBI-A (r=0.386,P=0.000) and FBI-B (r =0.273,P =0.012) were positively correlated with the CDR scores,whereas MoCA scores were negatively correlated with the CDR scores (r =-0.760,P =0.000).The subscale scores on MoCA and NPI areas changed corresponding with dementia severity in both groups.Conclusions The cognitive function,behavioral and psychological symptoms between FTD and AD patients are different.FTD patients have poorer executive function,language,abstraction and delayed recall ability,whereas AD patients perform worse in memory and orientation.With the progression of the disease,FTD patients gradually emerged disorientation,while the cognitive impairment in AD patients almost affected all the areas.FTD patients are more likely to have agitation,disinhibition and irritability behavior,and AD patients are more likely to have depression in the late stage.Dynamic evaluation of the cognitive function,behavioral and psychological symptoms in clinical practice can help to distinguish FTD and AD.

Objective To explore the gray matter changes in aggressive patients with schizophrenia,and the relationship between the gray matter and aggression in patients.Methods Eighteen aggressive patients with schizophrenia (SZ1),18 age-and gender-matched un-aggressive patients with schizophrenia (SZ2) and 18 normal controls (NC) were enrolled in the study.Then a 3.0 T magnetic resonance imaging (MRI) scan was conducted for each participant.The voxel-based morphometry (VBM) approach and the Chinese version of Buss & Perry aggression questionnaire (B&P) were used to explore imaging data and to assess the aggression,respectively.Results Compared with NC,patients with schizophrenia showed changes in gray matter volume (GMV) in the frontal,temporal and the occipital lobes (P＜0.05,AlphaSim corrected).Compared with SZ2,SZ1 showed increased GMV in the right supramarginal gyrus,right postcentral gyms,bilateral insula and orbito-frontal gyri (P＜0.05,AlphaSim corrected).The GMV of the right insula,right postcentral gyms and right supramarginal grus were positively associated with B&P scores in patients with schizophrenia (P＜0.01,AlphaSim corrected),respectively.Conclusions These preliminary findings support that the aggression in schizophrenia is associated with GMV changes of brain regions in patients with schizophrenia.The right postcentral gyrus,the right insula and the right supramarginal gyrus may be involved in the neural mechanism of aggression in schizophrenia.

Objective To investigate the relationship and mechanism of the serum vitamin D levels with insulin sensitivity and adipokines APN,RBP4,visfatin and TNF-α in patients with gestational diabetes mellitus(GDM). Methods A total of 101 patients with gestational diabetes( GDM group) and 50 pregnant women with normal blood sugar( control group) were recruited to detect the serum levels of correlative biochemical indexes,APN,RBP4,visfatin,TNF-α and 25OHD3 using an HPLC method. Twenty-four patients in the GDM group diagnosed with vitamin D deficiency(<25 nmol·L-1 ) were randomized to receive either 1,25(OH) 2D3(0. 25 μg·d-1) orally or no treatment. Serum levels of correlative biochemical indexes were detected after 1 month. Results GDM patients had 25OHD3 levels significantly lower than the control group(P<0. 05),APN levels lower than the control group,and RBP4,visfatin,TNF-α levels significantly higher than the control group(all P<0. 05). After 1 month of 1,25(OH) 2D3 treatment,HOMA-IR increased,while HOMA-β decreased. APN levels was positively correlated(r= 0. 526) with 25OHD3;RBP4,visfatin,TNF-α decreased and were negatively correlated with 25OHD3( r values were -0. 272,-0. 153,-0. 072). Conclusion Vitamin D can reduce the adipokines RBP4,visfatin,TNF-α,increase APN,and thus play a protective role for gestational diabetes.

OBJECTIVE: To evaluate the instructional effect of Multi-slice (MSCT) in the cochlear implantation pre- and post-operatively, and to contrast the image feature between the X-ray and the MSCT three-dimensional reconstruction of inner ear with implanted electrode. METHOD: Twenty-four cochlear implant (MEDEL Combi 40+) recipients,in No. 1 Hospital of China Medical University from January to October 2014, were involved in this study. Among them, 18 were male and 6 female,with an average age of 4 years. MSCT and three dimensional reconstruction of inner ear were performed in all of the 24 implanted inner ears pre- and post-operatively. And X-ray plain film were examined by using 60° lateral oblique position postoperatively. All data of the spiral CT scan with axial 1 mm image slices were transferred to workstation for three-dimensional reconstruction (direct volume rendering) of the inner ear. RESULT: In 1 of the 24 cases, preoperative three-dimensional reconstruction CT scan reveal that the length of the cochlear was shorter than the electrode. And this was confirmed by MSCT postoperatively that the electrode couldn't be inserted by full length. The insertion depth of the electrode can be evaluated directly by MSCT. Moreover, each of the electrode pairs can be identified clearly. CONCLUSION MSCT plays an indispensable role in the preoperative evaluation of cochlear implantation. Postoperative evaluation by three-dimensional reconstruction of inner ear provide more accurate image to show the electrode insertion depth in the cochlea. MSCT combined with curved planar reformation to measure cochlear length could provide guidance in choosing the more adaptive electrode. And MSCT is superior to DR in demonstration of electrode postoperatively.
Child, Preschool ; China ; Cochlea ; anatomy & histology ; Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Female ; Humans ; Male ; Postoperative Period ; Preoperative Care ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

ObjectiveTo study the chemical constituents from the roots of Flemingia philippinensis.MethodsThe chemical constituents were isolated and purified by combination of silica gel column,Sephadex LH-20,polyamide,and ODS column chromatography.The structures of the isolated compounds were identified by means of spectral data.ResultsTen compounds were isolated from F.philippinensis and identified as isoderrone (1),dalparvin A (2),prunetin (3),7,3'-dihydroxy-5,4',5'-trimethoxyisoflavone (4),pratensein-7-O-β-D-glucoside (5),sissotrin (6),sophororicoside (7),formononetin (8),orobol (9),and biochanin A (10).ConclusionCompounds 1-6 are obtained from this plant for the first time.