Objective To investigate values of Wb -dwi on diagnosis of osseous metastases compared with Spect materials.Methods 20 cases with osseous metastases underwent Wb -dwi and Spect.The bones were divided into 6 groups:skull,collarbone,trunk bone,haunch bone,upper limb bone,lower limb bone.the high uptake regions on Spect and high signal on Wb -dwi for positive groups or positive lesions were recorded.Meanwhile,the total num-bers of positive groups and positive lesions in different groups were also recorded.Finally,the diagnostic sensitivity and specificity of Wb -dwi and Spect were calculated,which was based on the total numbers of positive groups. Results Wb -dwi showed 69 positive groups,the numbers of positive lesions in each group were 2,1,85,55,22,12. Spect showed 66 positive groups,the numbers of positive lesions in each group were 4,3,79,47,20,18.The diagnostic sensitivity and specificity on Spect were 81.1%,80.3%.The diagnostic sensitivity and specificity on Wb -dwi were 86.9%,84.3%.No statistical difference was assessed between the sensitivity and specificity of two methods. Conclusion Compared with Spect,the Wb -dwi can show more osseous metastasis lesions and has higher sensitivity on diagnosis osseous metastases.In additional,it can demonstrate primary tumors and extraskeletal metastasis lesions.

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

Objective To explore the curative effect of the umbilical single port laparoscopic salpingectomy for tubal ectopic pregnancy.Methods 296 cases with tubal pregnancy were divided into single-hole group and the conventional group.Mter the operation,incision cosmetic results and patients'satisfaction were compared and analyzed in two groups.Results (1) The anal exhaust time of single hole group and conventional group was (32.6 ± 11.6) h,(34.1 ± 10.2) h (P =0.883).The intraoperative blood loss was (48.7 ± 15.2) ml (41.5 ± 10.9) ml (P =0.313).There was no significant differences(P ＞ 0.05).Operative time of single hole group was (62.6 ± 21.6) min,which was longer than that of the conventional group (42.7 ± 17.6) min,the difference was statistically significant (P =0.000).The ambulation time and demand analgesia patients of single-hole group were significantly lower than the conventional group(P =0.003,P =0.001).(2) In single-hole group,cosmetic results determined a good rate of 96.8％ and patients expressed dissatisfaction rate of 1.2％.cosmetic results of the conventional group judged good rate of 86.4％.patients expressed dissatisfaction rate of 9.3％.The judged good rate of cosmetic results between the two groups had statistically significant difference (P =0.004),and patients expressed dissatisfaction rate of single-hole group was lower than the conventional group.Conclusion For patients with tubal pregnancy,the trekking transumbilical single hole laparoscopic salpingectomy is a more minimally invasive,feasible and safe gynecological surgical procedures and with better cosmetic results,although there is a certain degree of difficulty.

Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

Objective To evaluate the feasibility of using a microsensor motion capture unit (MCU) to assess the reaching characteristics of hemiplegic stroke patients. Methods Twenty-three hemiplegic stroke patients with an average age of (61 ± 11) years and ten normal subjects of matching age were asked to sit on a chair and use the affected arm (for the patients) or the right arm (for the normal subjects) to reach for a cup on a table just in front of the shoulder at arm's length away.Four small sensor boxes which could detect movement and its speed and smoothness in three dimensions were fixed to the subject's spine,upper arm,forearm and hand.The test was repeated four times after two trial runs.The average velocity,peak velocity,degree of joint dispersion,entropy of acceleration,joint coordination and active range of motion ( AROM ) of the shoulder were analyzed.The patients and normal subjects were statistically compared.The results were correlated with Fugl-Meyer upper extremity scores using Spearman correlation analysis. Results All of the measured variables showed significant differences between the patients and normal subjects.In the correlation study,the average velocity,peak velocity,AROM of the shoulder and joint coordination showed significant correlation with the Fugl-Meyer scores.There was,however,no significant correlation between degree of dispersion of the shoulder or elbow joints or the entropy of acceleration ( which represented the quality of movement) and Fugl-Meyer upper extremity scores. Conclusions The results suggest that microsensor MCUs can quantitatively assess the kinematics of reaching among hemiplegic stroke patients.They can provide valuable and objective data about the functional quality of multiple joint movements in three dimensions.

Objective To investigate the risk factors for hospital-acquired pneumonia (HAP) in a neurological intensive care unit (NICU).Methods The patients aged ≥ 18 years admitted in NICU of Nanfang Hospital for ≥ 48 hours from May 2010 to April 2011 were enrolled.The possible risk factors,including the general information,the worst Glasgow Coma Scale (GCS) score,as well as Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores within 24 hours in NICU,whether the occurrence of HAP,whether with some underlying disease or symptoms within the time of study and using specific drug therapy or invasive procedures were investigated retrospectively.The duration of continuous medical interventions was recorded at the same time,and the continuous variables were quantified and stratified.Results A total of 243 patients were enrolled,and 50 (20.6％) of them developed HAP.Univariate analysis showed that the proportions of coma (44.0％ vs.29.0％ ;x2 =4.091,P =0.043) and APACHE Ⅱ score ≥ 15 (60.0％ vs.38.9％ ;x2 =7.232,P =0.007) in the HAP group were significantly higher than those in the non-HAP group.There were significant differences in using antacids (＜ 6 d: 38.0％ vs.19.7％ ; ≥ 6 d: 18.0％ vs.25.9％ ; x2 =7.521,P =0.023),sedatives (＜2 d: 30.0％ vs.37.3％ ; ≥2 d: 46.0％ vs.28.0％ ;x2 =6.064,P =0.048),blood products (＜3 d: 24.0％ vs.9.8％ ; ≥ 3 d: 6.0％ vs.7.3％ ; x2 =7.150,P =0.028),endotracheal intubation (＜ 5 d:24.0％ vs.10.9％ ; ≥ 5d: 26.0％ vs.15.5％ ; x2 =10.698,P =0.005),mechanical ventilation (＜ 4 d:6.0％ vs.7.8％ ; ≥ 4 d: 30.0％ vs.7.8％ ; x2=,P =0.000) and indwelling nasogastric tube (＜ 7 d:56.0％vs.37.3％ ; ≥7d: 42.0％ vs.44.6％ ;x2 =10.410,P =0.005) between the two groups.Multivariate logistic regression analysis showed that mechanical ventilation ≥ 4 d (odds ratio [OR] 6.481,95％ confidence interval [CI] 2.522-16.654; P=0.000),indwelling nasogastric tube ＜7 d (OR 12.504,95％ CI 1.614-96.869; P =0.016) and using antacids ＜ 6 d (OR 2.271,95％ CI 1.042-4.949; P =0.039) were the independent risk factors for HAP in NICU patients.Conclusions Mechanical ventilation,indwelling nasogastric tube and using antacids are the independent risk factors for HAP in NICU patients,and thus it needs to take targeted measures.

Objective:To study the effects of gossypol acetic acid(GAA)on the methylation level and the mRNA expression of hM-LH1 in human tongue cancer Tca8113 cells.Methods:Tca8113 cells were treated by GAA at various doses for 24 h,48 h and 72 h respectively.MTT assay was used to detect the cell proliferation.Nested methylation specific PCR(nMSP)was used to detect methyl-ation level of hMLH1 .Real-time fluorescence quantitative PCR(RFQ-PCR)was applied to investigate the mRNA expression of hM-LH1 gene.Results:GAA inhibited the proliferation of Tca8113 cells dose-and-time dependently,decreased the DNA methylation level of hMLH1(P<0.05)and increased hMLH1 mRNA expression in Tca8113 cells(P<0.05).Conclusion:GAA can suppress proliferation of Tca8113 cells by demethylation of hMLH1 gene and increase of hMLH1 mRNA expression.

Objective:To evaluate the effectiveness of microport extraction of the impacted mandibular third molar removal.Meth-ods:According to the systematic review and meta-analysis,the randomized controlled clinical trials published till October 2012 were searched and collected using the method of evidence-based medicine.Results:8 clinical research papers including 1 915 subjects were collected.Complication of microport extraction(958 cases)was less than that of traditional operation(957 cases).Conclusion:Microport extraction of impacted mandibular third molar may reduce the complications.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective To investigate the radioprotective function and its mechanism of Sulforaphane (SF) in mice acute radiation-induced lung injury.Methods Totally 40 female C57BL/6J mice were equally divided into 5 groups randomly.Group A,treated by SF 3 mg/kg plus radiation;group B,treated by SF 5 mg/kg plus radiation;group C,treated by SF 10 mg/kg plus radiation;radiation group with a single dose of 12 Gy in 6 MV X-ray by a linear accelerator,and control group with sham radiation.The mice in drug group were administered intraperitoneally with different concentration of SF every other day from 7 d before irradiation to 7 d after irradiation,while the same volume of DMSO plus physiological saline solvent was given in the control and radiation groups.After being sacrificed at 14 d of SF administration,the pathomorphological changes of mice were observed in trauma lung tissue,the positioning and expression of NLRP3 was observed by immunohistochemical staining,the levels of IL-6,TNF-α and TGF-β1 in bronchoalveolar lavage fluid (BALF) were measured by ELISA,the expressions of NLRP3 and IL-1β mRNA in lung tissue were assayed by qRT-PCR,the expressions of NF-κB p65,NLRP3 and IL-1β proteins in lung tissue were assayed by Western blot,the activity of NF-κB was detected by EMSA.Results In comparison with radiation group,there was an obvious amelioration in pathological injury of lung tissue in the treatment groups:the expression of NLRP3 in lung tissue decreased;the concentration of NLRP3 in the drug intervention group (SF 10 mg / kg) markedly decreased (F =42.750,P ＜ 0.05).the IL-6,TNF-a and TGF-β1 levels in BALF decreased (tIL-6 =-62.65-21.00;tTNF-α =-32.18-16.57;tTGF-β1 =-58.22-46.11,P ＜ 0.05);the expressions of NLRP3 and IL-1β mRNA markedly decreased (tNLRP3 =-6.56-5.68;tIL-1β =-29.75--21.20,P ＜ 0.05),and the expressions of NF-κB p65,NLRP3 and IL-1β proteins decreased (tNF-κB p65 =-34.00--1.71,tNLRP3 =-25.01--16.91,tIL-1β =-73.70--55.14,P ＜ 0.05);the relative expressions of NF-κB p65 and NLRP3 were reduced in a dose-dependent manner (r =0.945,0.926);and the activity of NF-κB were obviously reduced (tNF-κB =-38.68,-614.82,-2 831.40,P ＜ 0.05).Conclusions Sulforaphane effectively alleviates the RILI in lung of mice by downregulating the expressions of inflammatory factor NLRP3.