Objective:To compare performances of Wechsler Memory Scale(WMS)and Clinical Memory Scale(CMS),to explore applicability of WMS and CMS in the different degree traumatic brain injured patients.Methods:206 patients were tested with WMS and 300 with CMS,and completed clinical diagnosis for all,to compare the performances.Results: ①There was no significant differences in the MQ between the two groups in the normal、marginal memory impairment, there were significant differences in the mild memory impairment.②There were remarkable variance between the MQ and the clinical diagnosis,WMS was even more variant.Conclusion:①There is similar outcome between WMS and CMS in the patients with normal、marginal memory impairment,CMS shows more applicable in the patients with more severe mem- ory impairment.②It is not correct to diagnose memory defect degree with MQ without more clinical information.

Objective To study multi-slice spiral CT(MSCT) features of cardiogenic hepatohemia.Methods MSCT features of cardiogenic hepatohemia were retrospectively analysed.Results All cases were showed having reflux of contrast into the inferior vena cava(IVC)during arterial phase,of them,10 cases were accompanied with abnormal hepatic perfusion and 7 cases with intrahepatic lymphostasis sign.Conclusion The features including the reflux of IVC and abnormal hepatic perfusion during arterial phase in contrast-enhanced CT scan may suggest hepatohemia caused by higher pressure level of right heart from the cardiovascular diseases.

Objective: To evaluate Raven's Standard Progressive Matrices (RSPM) for assessing validity of test performance. Methods: To compare the results of RSPM between head injured patients with and without malingering. Results:①There were significant differences in the performance between the two groups of patients in subtests A,B,C and D of RSPM. There was no significant difference on subtest E. ②Based on p

Objective:To study the validity of Binomial Forced-Choice Digit Memory Test(BFDMT) in detecting dissimulation of intellectual deficit.Methods:64 subjects with compensable head injury were assessed by BFDMT,experiential judgment and Raven's Standard Progressive Matrices (RSPM),and were finally diagnosed on intellectual deficit degrees.Results:(1)The rate of malingering was 78.1% judged by BFDMT,and 43.8% by experiential judgment.(2)All of the 16 uncertain cases by experiential judgment were assessed as malingering by BFDMT.(3)Only one case in 64 was considered as a faulted diagnosis by follow-up.Conclusion:BFDMT is useful for detecting dissimulation of intellectual deficit particularly for the difficul cases in clinical experiential judgment.

Objective:To explore the effects of cognitive impairment on the performance of Binomial Forced-Choice Digit Memory Test (BFDMT). Methods: Subjects were screened by Mini-Mental State Examination (MMSE) and the brief form of WAIS-RC.BFDMT was administered to 38 dementias and 19 controls.Results: (1) There was no significant difference in the scores of two dimensions and total score of BFDMT between dementias and controls. (2) There was significant difference in the difficult item scores and the total score among three groups of subjects with different levels of IQ. The difficult item scores and the total score of the subjects with IQ 70～84 were significantly higher than those with IQ 50～69 and IQ 34～49. There were no significant differences among all groups in the easy item scores. (3) The false positive was 15.8% by the cutoff scores of total scores of BFDMT and increased with the decline of IQ. Conclusion: The performance of BFDMT is somewhat influenced by intellectual defect. A high false positive of BFDMT particularly happens in the patients with severe intellectual decline.

Objective To analyze and explore the value of the mutislice spiral CT (MSCT) scanning,its reconstructive technology and MRI scanning for applying to the identifying diagnosis of new and old vertebral compresion fracture.Methods One hundred and sixty-seven cases with the new and old vertebral compresion fracture who have 189 vertebrae in total were examined using the MSCT scanning,their imaging information were postprocessed with 2D and 3D reconstruction at the work station.Thirty-four patients with overall 43 vertebrae were carried out by MRI scanning and their images were compared with those of MSCT.Results They had the highest proportion of vertebrae in L1 with accounting for 27.68% (31/112) and 35.06% (27/77) among the patients with new and old vertebral compresion fracture,respectively.The next was T12,L2 and T11.There were statistically significant differences between new and old cases in such appearance as fracture line clear and sharp(102 and 21),contusion and hemorrhage of spinal cord(15 and 0),parenchyma shadow beside vertebrae(103 and 11),appendant fracture(26 and 5),organ's lacerated wound around vertebral body(30 and 0),discus intervertebrales vacuum(10 and 36),derangement and hardening of vertebral bone trabecularism(29 and 51) (P＜0.01).Twenty-six vertebrae with the uneven low T1 WI signal,27 vertebrae with the T2 WI fat-suppresion irregular high signal were demonstrated in MRI scanning among 27 vertebrae of 21 cases with new vertebral compresion fracture.While 16 vertebrae with the T1WI and T2WI signals were the same as those of the normal vertebrae,16 vertebrae were the T2WI fat-suppresion low signal among 13 cases with old vertebral compresion fracture.Conclusions The MSCT plays an important role in identifying diagnosis for the most of the patients with the new and old vertebral compresion fracture, while MRI scanning may reflect the pathophysiological characteristics in diagnosis of the spinal cord and the ligament lesion.Therefore,the MSCT and MRI scanning should be integrated to be used to enhance remarkably the accurate rate of the diagnosis.

Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

Objective To investigate the role of renin angiotensin system (RAS) in pathogenesis of nonalcoholic fatty liver disease (NAFLD).Methods Twenty-four Wistar rats were evenly divided into control group and model group.The rats of control group were fed with normal diet,and model group were with high-fat diet.Rats were killed at the eighth week and serum liver function,blood lipid,glucose and insulin were tested.The liver tissues were stained with HE and Picro acid-Sirius red for pathological observation.The liver tissue concentration of angiotensin Ⅱ was determined by ELISA method and the expression of TGF-β1 in liver tissue was examined by immunohistochemistry.Results After eight weeks high fat feeding,weight,liver index,liver function,blood lipids and serum insulin of model group were significantly higher than those of control group (weight:(463.50±22.72) g vs.(404.29±10.32) g; liver index:(3.75±0.21) g vs.(2.66±0.15) g; ALT:(79.8±8.6) U/L vs.(58.8±11.6) U/L; AST:(200.01±51.72) U/L vs.(150.30±37.27) U/L; total cholesterol:(3.67±0.48) mmol/L vs.(1.50±0.23) mmol/L; triglycerides:(2.06±0.40) mmol/L vs.(0.71±0.34) mmol/L; insulin:(17.37±2.89) pmol/L vs.(11.08±2.12) pmol/L),and all the differences were statistically significant (P＜0.01).The histopathological results of model group indicated liver steatosis,inflammatory reaction in part of lobule and portal area and significant fibrosis in part of liver tissue.The liver tissue angiotonin Ⅱ concentration of model group [(32.80 ± 2.81)pg/ml] was higher than that of control group [(22.83 ± 1.75) pg/ml,t =9.559,P＜0.01].The immunohistochemistry results showed that the expression of TGF-β1 of model group was obviously higher than that of control group (Z=-2.540,P =0.011 ).Spearman correlation analysis revealed that the increasing degree of angiotensin Ⅱ concentration was positively correlated with liver steatosis scores (r=0.644,P=0.002) and the expression of TGF-β1 (r=0.470,P=0.037).Conclusion The concentration of angiotensin Ⅱ and TGF-β1 increased in the livers of model rats,which indicated that RAS may participate in the pathogenesis and progress of NAFLD.

Objective To assess the concordance of MRI diagnosis for patients suspected of lumbar disk herniation by using Kappa statistic.Methods One hundred patients(48 males and 52 females)with lumbosaeral radicular pain,aged from 17 to 86(average 61).All patients underwent fast spin-echo T1 and T2 weighted imaging on a 3.0 T MR scanner and spine surface coil.Two radiologists(doctor A and doctor B)evaluated the lumbar disks from L3-4,L4-5.and L5-S1 in 50 out of the 100 patients independently.The presence of a bulging disk or a herniation was reported.Images were interpreted twice:once before and once after disclosure of clinical information.And disks of 52 patients out of the 100 samples were interpreted by the two radiologists independently without clinical information as well.The Kappa statistics was employed to assess the concordance of each radiologist's diagnoses as well as the observer variation of the two radiologists.Results Diagnoses before and after disclosure to clinical information were concordant in 114 disks for doctor A and in 109 for doctor B.respectively.Diagnoses before and after disclosure to clinical information were not concordant in 36 disks for doctor A and in 41 disks for doctor B,respectively.The Kappa values were 0.60±0.06 and 0.57±0.06 for doctor A and doctor B,respectively.The concordance was moderate.After disclosure to elinical information.the numbers of reported bulging disks increased significantly.by 10 and 31 for doctor A and doctor B,respectively.Without clinical information,the diagnoses of the two radiologists were concordant in 77 disks,while not concordant in 79 disks.The interobserver agreement was poor(Kappa=0.24±0.06).The diffcrence on diagenoses made between with and without clinical information mainly happened on the differential diagnosis of normal disks and bulging disks.The different,diagnoses made between with and without clinical information were on 20 disks and on 30 disks for doctor A and doctor B,respectively;that accounted for 55.6%(20/36)and 73.2%(30/41)of total variation respectively.The diagnostic difference between the 2 doctors happened mainly on differentiation of bulging disks and normal disks,which happened in 56 disks,aceountiong for 70.9%(56/79)of total variation.Conclusion Variation on diagnoses of the same radiologist or between tworadiologists was mainly caused by disagreement on bulging disks.

Objective: To investigate the effects of adrenaline on pharmacodynamics and pharmacokinetics of bupivacaine for interscalene plexus block. Method:Sixteen ASA gradeⅠ-Ⅱadult patients undergoing shoulder or upper limbs operation were randomly divided into two groups (n=8)). The plexus block was induced with 0.75％ bupivacaine 2 mg/kg or 0.75％ bupivacaine 2mg/kg plus 1:200 000 adrenaline. Clinical effects and plasma concentration,the Cmax and Tmax were compared between two groups. Result:The time to reach peak analgesia and the duration of analgesia were longer in adrenaline group than in control group(P