Objective To discuss the application of cephalocervical CT angiography (CTA) and ABCD2 score in evaluating arterial characteristics and interventional curative effect for patients with transient ischemic attack (TIA). Methods During the period from Jan. 2010 to Jan. 2012, a total of 64 patients with clinically-diagnosed TIA were admitted to authors’ hospital. ABCD2 score evaluation and cephalocervical CTA examination were performed in all patients. The correlation of stenotic degree and distribution of the cephalocervical arteries with the ABCD2 score was analyzed. According to the stenotic degree of the cephalocervical arteries, the patients were divided into low-risk group and mid-to-high-risk group. Twenty-two patients in mid-to-high-risk group received stenting angioplasty treatment. Follow-up was made at 3, 6 and 12 months after the treatment. Results Of 64 TIA patients, cephalocervical artery stenosis was found in 52(81.25%) A total of 149 arterial segments were involved, including intracranial segment (n=81, 54.36%) and extracranial segment (n = 68, 45.64%). Patients in low-risk group mainly suffered slight or moderate arterial stenosis, while patients in mid-to-high-risk group had moderate or serious arterial stenosis (χ2 =10.126, P=0.018). The preoperative ABCD2 score was (6.41 ± 0.50). The ABCD2 scores determined at 3, 6 and 12 months after the treatment decreased to(2.88 ± 0.69), (2.82 ± 0.63) and(3.00 ± 0.71), respectively. The differences were statistically significant (F = 86.657, P < 0.05). Conclusion Cephalocervical CT angiography and ABCD2 score can reliably evaluate the arterial stenosis and interventional curative results in TIA patients.

To study the expression of both Fos and HSP70 proteins in the early stage of acute myocardial ischemia/reperfusion(I/R) in rats with immunohistochemistry in order to search the objective morphologic evidence for the forensic pathological diagnosis.I/R rat model was established by ligation of the anterior branch of the left coronary artery.All animals were divided into 7 groups.Tissues were cut and stained immunohistochemistry with the corresponding anti Fos and anti HSP70 sera as the first antibodies.There was no expression of both Fos and HSP70 proteins in control group.The expression of HSP70 protein began to increase in myocytes 1h after I/R in the ischemic areas and increased gradually wtih the prolongation of ischemia,while it began to express 2h after I/R in the non ischemic areas.Fos protein began to express 0 5h after I/R in the ischemic areas,1h in the non ischemic areas.The expressions of both HSP70 and Fos proteins in the non ischemic areas were weaker than those in the ischemic areas.Meanwhile,the expression of HSP70 and Fos proteins appears firstly in the inner layer of myocardium and extended gradually toward the outer layer.The expression of Fos protein mainly located in the inner layer of myocardium 0 5h after I/R and then extened to the whole layer of myocardium 1h after I/R.The expression of Fos protein in outer layer was stronger than that in inner layer at 4h after I/R.The expression of HSP70 protein located mainly in the inner layer of the myocardium at 1h and 2h after I/R,and then extended to the whole layer of the myocardium at 4h and 6h after I/R.The results indicated that the I/R induced the expression of both HSP70 and Fos proteins in the early stages of myocardial ischemia.The location and the intersity of the immunoreactivity of these two proteins changed at the different stages after I/R.These changes observed in the present study might be useful for the forensic pathological diagnosis of the early myocardial ischemia.

BACKGROUND:Being used in senile intertrochanteric fracture, the third generation of Gamma nail may isolate fracture fragments and it is difficult to be secured in the rotor, so the stability is poor. Varus deformity easily appears, which is difficult to support or satisfactorily reset. OBJECTIVE:To compare the effects and stability of the proximal femoral locking plate and the third generation of the gamma nail in the treatment of stable intertrochanteric fracture. METHODS:(1) A total of 64 patients with intertrochanteric fractures were respectively treated with the third generation of the gamma nail fixation (n=32) and proximal femoral locking plate fixation (n=32). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Femoral rotor varus angle and intertrochanteric medial inclination received biomechanical measurement. (2) Eight femoral specimens whose shape and size were approximated were selected to be randomly assigned to Gamma 3 group and proximal femoral locking plate group (n=4), which respectively received Gamma 3 fixation and proximal femoral locking plate fixation. After axial compression test and destruction test, load-displacement curve was drawn. The maximum yield load value was calculated by torsion test. RESULTS AND CONCLUSION:Operative time and intraoperative blood loss were significantly more in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The fracture quality assessment results were better in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The axial stiffness and corresponding torque of various torsion angles were smaler in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). Experimental results indicated that in the course of fixating intertrochanteric fracture merged with greater trochanter fracture, the proximal femur locking plate has obtained more biomechanical stability.

AIM: To explore the effect of oxides of low density lipoprotein (OX - LDL)on apoptosis in vas- cular endothelial cells(EC) and its possible mechanisms. METHODS: Culted vascular ECS were incubated with OX - LDL(0.1?g/L or 0. 3?g/L) for 4 hours, flow cytometer with PI staining methed was used to determine the rate of cellular apoptosis, gel - electrophoresis was performed to observe foe DNA ladder of apoptosis, cellular RNA was isolated and reverse transcription-polymerase chain reaction (RT - PCR)was performed to determine Fas antigen ex- pression. RESULTS:OX - LDL treatment induced apoptosis in EC dose - dependently. No DNA ladder was ob- served in control EC. But it presented in EC beated with low dose of OX - LDL, and was even more when beted with higher dose of OX - LDL. RT - PCR revealed Fas antigen baldly had any expression in basic condition, OX - LDL treatment induced Fas antigen in EC in a dose dependent manner. CONCLUSION: OX - LDL can induce apoptosis in EC, upregulaton of Fas antigen expression maybe one of the possible mechanisms.

Objective To evaluate the diagnostic value and clinical significance of 1.5T MR multiple sequence for atrial septal defect (ASD) and ventricular septal defect (VSD).Methods To collect the data of MRI and transthoracic echocardiography(TTE)of 46 patients with ASD/VSD,Among them,12 patients had surgical treatment,27 patientsDSA treatment and 7 patients no surgery or DSA treatment. The biggest defect diameter was recorded which measured by TSE,GRE,PC-MR and TTE,and the main deformity,valvular regurgitation, atrioventricular enlargement,cardiac function,maximum aperture of ASD/VSD were recorded which were confirmed by surgery.Al-so,myocardial delayed reinforcement was recorded.Results Multiple sequence check of MRI found different number of defects in 39 patients(7 patients without surgery or treatment removed );the largest defect aperture of ASD/VSD measured by TSE、GRE、PC-MR had no statistically significant(P >0.05)with TTE measurements,they had good correlation with TTE (r=0.86,0.94,0.99) (P >0.05),and PC-MR had the highest consistency with TTE.The measured results of GRE,TTE,surgical in 14 ventricular sep-tal defects of 12 cases had no statistically significant(P >0.05).the largest defect aperture between myocardial delayed reinforce-ment and not delayed reinforcement had statistically significant in 41 cases of ASD(P <0.05).MRI had more advantage in the right heart enlargement and right heart function than TTE,the differences between the two had statistically significant(P <0.05).And MRI could find intracardiac deformity and outside the heart malformation in ASD/VSD,especially outside the heart malformation. Conclusion 1.5T MR multiple sequence inspection have high diagnostic value for ASD/VSD,which can display ASD/VSD clearly, measure the defect aperture accurately,find merged deformity accurately,and can also show myocardial delayed reinforcement and judge heart function.

Objective To provide guidance for patients and enhance their trust in the hospital by achieving openness and transparency in medical fees. Methods The modular structure of the three-tiered process was employed and various information machines, inquiry devices and doctors' workstations were connected to the Hospital Information System to form an integrated inquiry system of hospital-wide coverage. Results The Hospital Information System, with its versatile functions, easy operation, strong compatibility and good reliability, could provide patients with accurate information and more convenience. Conclusion The Hospital Information System can meet different needs of all patients.

Objective: To learn the disease entities and medical costs of the patients admitted in the Pediatric Department of a general hospital.Methods: We collected from the Hospital Information System(HIS) the related data of the patients admitted in the Department of Pediatrics from October 2001 to October 2007 and analyzed the patients' main types of diseases and medical expenditure.Results: Among the total number of 8 062 patients,diseases of the genitourinary,respiratory and digestive systems and of blood and hematogenic organs accounted for 47.82%,36.78%,4.22% and 3.16%,ranking as the first 4 disease entities.The per patient medical costs in the first 4 places were those of the diseases of the musculoskeletal system and connective tissues($6 368),tumors($5 845),diseases of the genitourinary system($5 818) and congenial anomalies($5 469).Conclusion: The largest number of patients were those with genitourinary system diseases,and the highest medical costs per patient were those of the diseases of the musculoskeletal system and connective tissues in the Department of Pediatrics.

With the modernization of the medical records and the planning implementation of informationalized strategy,the management of medical records has been extended to the stage of supervising resources electronic and digital,also the informationalized features is more evident.one reason is the integration and storage of medical records information need informationalized technology support,and the other is the socialization of utilizing medical records needs the internet technology as platform,and the third is the exploration and utilization of resources in medical records requires advanced data warehouse and data mining technology as guaranty,at the same time,the management of medical records information have the man-made risk of divulging secrets,the risk of damage to the integrity,the risk may be to deny the fact,as well as the risk of information systems security.The corresponding preventive measures taken to standardize the medical records management processes,improve its management system and the law,will be a long-term and arduous task to the quality manager.

Objective To explore the relative factors with the accidents in the cerebral palsy rehabilitation wards, and preventive measures.Methods The accident cases in the rehabilitation wards were recorded respectively.Results There was a relationship between the rehabilitated patient's accident and their parents, the patients themselves, the surroundings and the staff's consciousness of safety.Conclusion Building the safe management organization, strengthening the safety health education, promoting the surroundings in the wards and training for the staff can reduce the accident rate effectively in the rehabilitation wards.

Objective To investigate the role of dual-source parallel radio frequence (RF) and single-source excitation in liver imaging at 3.0 T MR.Methods This study was a retrospective analysis.One hundred and seven subjects underwent a 3.0 T TX MR scanning including axial spectrally selective attenuated inversion recovery (SPAIR) T2WI,axial DWI and coronal balanced-fast field echo( Balanced FFE).Each sequence was carried out with both single-source and dual-source RF excitation.Student＇s t test was used to compare the differences between single-source and dual-source RF excitation in the image uniformity,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Wilcoxon signed rank test was used to determine whether there was difference between conventional and parallel transmission in the score of image quality.Reader agreement was assessed using the Cohen＇s Kappa test.Results For the image uniformity,there was significant difference between single-source and dual-source excitation (418.40 ± 66.75 for single-source vs.416.26 ± 50.61 for dual-source,t =2.524,P ＜ 0.05 ).There also existed significant difference between single-source and dual-source excitation in SNR and CNR,respectively.The SNR and CNR of parallel transmission (22.03 + 12.16 and 18.33 ± 10.01,respectively) were both higher than those of single transmission (20.36 ± 11.21 and 15.22 ± 8.95,respectively) ( t =- 2.630,P ＜ 0.05 for SNR and t =- 4.238,P ＜ 0.05 for CNR).Image quality comparisons revealed significantly better results with dual-source than single-source RF excitation at SPAIR T2 WI ( 1.40 + 0.42 vs.1.81 ± 0.27 ),DWI ( 1.08 ± 0.40 vs.1.63 ± 0.36 ) and Balanced FFE sequence ( 0.95 ± 0.45 vs.1.65 ± 0.37,Z =- 5.894,- 5.801 and - 6.985,respectively,P ＜ 0.01 ).In the comparison of image quality,the agreement between the two readers was very good ( Kappa ＞ 0.8,P ＜ 0.05 ).Conclusion Dual-source parallel RF excitation MR imaging in liver enables reducing dielectric shading,improving homogeneity of the RF magnetic induction field,and increasing SNR and CNR at 3.0 T.