Objective To assess the influence of subglottic secretion drainage(SSD)on the prevention of ventilator associated pneumonia(VAP).Methods 63 patients in the intensive care unit(ICU)who received mechanical ventilation above 48 hours were divided into two groups named group A(31 cases)and group B(32 cases).Group A received SSD 1 time per 6 hours while group B only got SSD at 48 hours,the 4th,7th and 14th days when samples were got.We brushed away secretion from airway and also monitored bacteriology of the subglottic secretion between the two groups. Results The incidence rate of VAP in group A was 6.1%and was evidently lower than that of group B(P<0.05),which was 31.3%within 1 week.But 1 week later the incidence rate of VAP in the two groups was not statistically difierent(P>0.05).The onset time of VAP was later anti the bacteria number in the subglottic secretion was less in group A than those in group B(P<0.01).The same bacteria strain was found in the subglottic secretion and airway secretions in 13 patients out of 22 VAP patients.The dominant bacteria were P.aeruginosa,K.pneumonia,Staphylococcus aureus and Pseudomonas stenotrophomonas. Conclusion SSD could reduce the bacteria concentration in subglottic secretion,decrease VAP incidence and delay the onset of VAP.Migration of dominant bacteria from the subglottic secretion was one of the important causes of VAP.

Objective To analyze the behavioral characteristics and mental health status for patients with chronic hepatitis B,to explore the correlation between them and analyze the influence of behavioral characteristics of patients with chronic hepatitis B on their mental health.And provide a reference of clinical mental health intervention for patients with chronic hepatitis B.Methods 216 cases of patients with chronic hepatitis B in our hospital from October 2010 to October 2011 were chosen as the research object.Symptom checklist-90(SCL-90)and Eysenck personality questionnaire(EPQ)were used for evaluation.The correlation of behavioral characteristics and mental health status for patients with chronic hepatitis B and the effect of behavioral characteristics of patients with chronic hepatitis B for their mental health were analyzed.Results The SCL-90 score for 216 cases of chronic hepatitis B patients showed that its total score was significantly higher than the norm,the difference was statistically significant.The results of EPQ score showed that the neurotic or emotional stability of personality scores were significantly higher than the norm,the difference was significant.The psychotic scores were significantly lower than the norm,the difference was significant.The analysis of the correlation for nine projects in the SCL-90 scale and four items in the EPQ scale showed that introversion had a significant positive correlation with compulsion,depression,anxiety,fear and paranoia.The nervous or emotion had a significant positive correlation with compulsion,interpersonal sensitivity,paranoid,psychotic.Conclusions The behavioral characteristics of chronic hepatitis B patients have a relation with the mental health.The mental health status changes according to the changes of behavioral characteristics.

Objective To study the correlation between the fetal liver volume and gestational age by three-dimensional ultrasound,and to evaluate its clinical significance.Methods Fetal liver volume from 173 normal fetuses,ranging between 22～39 weeks old,was individually measured by three dimensional ultrasound.Results ① The reproducibility of fetal liver volume measurement by three-dimensional ultrasound was well.② The relationship between fetal liver volume and gestational age was linear(r= 0.93,P

Objective To investigate influence of nursing intervention on quality of life of hospitalized patients with peptic ulcer. Methods l00 cases of peptic ulcer patients from October 2009 to September 2011 were chosen as the object.50 patients of hospitalized patients were defined as the ward group,and 50 cases of patients in outpatient were defined as the outpatient group.The life quality questionnaire was adopted to evaluate life quality before and after treatment between two groups. Results After intervention,number of patients whose score ranged 5～7 grades were more in the ward group than those in the outpatient group. Conclusions Nursing intervention for patients with peptic ulcer has significant effect on life quality and treatment effect of them.

Objective To understand the functional exercise situation of the total hip arthroplasty(THA)patients in hospital. Methods Using self-designed functional exercise in patients with TKA outline the structure of observation, observation and collection of Orthopedic Surgery,71 cases (91 hips)received THA in patients with relevant information. Results After the former 3d,22.5% of patients did not exercise;After 14 d continuous passive motion (CPM) ,hip joint exercises were separately accounted for 71.8% and 81.7% ,and static muscle contraction,straight leg raising were accounted for 40.8 percent and 81.7 percent. The four exercise started lately, training methods were not standardized the patients, insisted on a shorter time;single-and double-hip replacement hip replacement in patients with Shimoji routing practice started time respectively, after (6.51 ± 2.90 ) d and ( 10.30 ± 3.21 ) d. In the functional exercise process,CPM was assisted by nurse,in other exercises was assisted by retaining workers and patients families. Conclusion THA patients hospitalized during the actual exercise of the number,frequency,timing and methods vary, nursing staff should be further explored how to ensure that patients really effective rehabilitation exercise to further enhance the effect of patients with rehabilitation exercises.

Objective To assess the clinical diagnosis value and treatment effect of anti-Müllerian hormone(AMH)and inhibin B(INHB)in polycystic ovary syndrome(PCOS)patients.Methods Total of 300 cases of PCOS patients were enrolled in this study from January 2014 to January 2016 in the First Affiliated Hospital,Hunan University of Chinese Medicine,and those patients were randomly divided into group A,group B and group C.There were 100 patients in every group.The patients in group A were interfered by traditional Chinese medicine.The patients in group B were treated with Western medicine and those in group C were treated with traditional Chinese medicine combined with western medicine.Total of 264 cases health volunteers were enrolled as the control group.The effect was evaluated.The level of AMH and INHB in serum of PCOS patients were detected by chemiluminescent assay before treatment and three months after treatment.Results The cutoffs of AMH and INHB were 6.98 ng/ml and 150 pg/ml,respectively.The AUC of AMH combined with INHB was significantly larger than that of AMH or INHB(0.945 vs.0.859,0.945 vs.0.784).In the PCOS group,the positive PCOS rate of AMH combined with INHB was significantly larger than that of AMH or INHB[87.00％(261/300)vs.83.33％(250/300)vs.93.67％(281/300),x2=15.593,P=0.000].The sensitivity[93.67％(281/300)],specificity[92.42％(244/264)],positive predictive value[93.36％(281/288)],negative predictive value[92.78％(244/264)]and Jordanian index(0.659)of AMH combined with INHB was significantly larger than that of AMH[87.00％(261/300),87.88％(232/264),89.08％(261/293),85.61％(232/271)and 0.612]or INHB[83.33％(250/300),90.15％(238/264),90.58％(250/276),82.64％(238/301)and 0.571].After treatment,AMH[(9.06±2.13)ng/ml vs.(6.34±1.12)ng/ml,t=10.595,P=0.000;(9.08±2.08)ng/ml vs.(6.02±1.02)ng/ml,t=13.209,P=0.000;(9.13±2.31)ng/ml vs.(3.53±0.83)ng/ml,t=22.814,P=0.000]and INHB[(173.13±14.22)pg/ml vs.(145.26±13.05)pg/ml,t=14.440,P=0.000;(174.28±13.82)pg/ml vs.(145.39±12.98)pg/ml,t=15.238,P=0.000;(174.98±13.77)pg/ml vs.(133.15±12.04)pg/ml,t=22.869,P=0.000]in 3 groups had decreased.After treatment,the AMH of group C [(3.53±0.83)ng/ml] was significantly lower than that of group A and B[(6.34±1.12)ng/ml and(6.02±1.02)ng/ml,F=237.936,P=0.000],and the level of AMH in group C [(133.15±12.04)pg/ml] was significantly lower than that in both group A and group B[(145.26±13.05)pg/ml and(145.39±12.98)pg/ml,F=30.645,P=0.000].Conclusions AMH combined with INHB can be used to diagnose PCOS.AMH and INHB can be used to evaluate PCOS efficacy.

Objective To valuate the left ventricular function and myocardial fibrosis using Dopple tissue imaging(DTI) and integrated backscatter(IBS) in diabetic cardiomyopathy(DCM) rats. Methods Diabetes mellitus(DM) in healthy male SD rats was induced by single injection of streptozotocin (STZ,Sigma) into intraperitoneal at a dose of 65mg/kg body weight. Left ventricular fractional shortening (LVFS),ratio of peak early to late diastolic mitral inflow velocity(E/A) by color Doppler flow imaging-pulsed wave (CDFI-PW), ratio of peak early to late diastolic mitral annulus velocity (Ea/Aa) by DTI,myocardial calibrated IBS (IB%), cyclic variation of IBS(CVIB) by IBS, were determined in rats of 4,12 and 24 weeks after DM was induced. Heart weight index(HWI), Masson's trichrome staining, expression of connective tissue growth factor(CTGF) and activity of sarcoplasmic reticulum Ca2+ -ATPase(SERCA2a) in heart were measured, while the age-matched health rats served as control group. Results ① Diastolic dysfunction of left ventricular was found in diabetic rats detected by CDFI-PW(E/A<1) at the 4th week,and developed gradually. Pseudonormal filling(E/A>1) was found in major diabetic rats at the 24th week,which could be identified by DTI(Ea/Aa<1). The IB% of left ventricular posterior wall was significantly higher in diabetic rats than those in the control group( P<0.05), but the CVIB of the 24th week diabetic rats was lower(P<0.05). The LVFS had no great alteration in six groups(P>0.05).②Compared with the control group, the activity of SERCA2a was reduced, while HWI, collagen volume fraction(CVF),perivascular collagen area(PVCA) and the expression of connective tissue growth factor(CTGF) protein in heart were increased in diabetic rats (P<0.05), and correlation between IB% and HWI, CVF, PVCA,CTGF was significant (P<0.05). Conclusions DTI and IBS can assess early left ventrieular diastolic function and fibrosis of diabetic cardiomypathy in STZ-induced diabetic rats. DTI echoeardiography can identify "pseudonormal" mitral inflow patterns. DCM may be relatived with overexpression of CTGF and decreasion of SERCA2a activity.

Based on a discussion on PACS and the way its image workstation obtains scanned sequential images, this paper presented a method of 3D surface construction and visualization on PACS workstation. Guest/Server structure was used between PACS application entities. Image storing and transmission were realized by service classes established by DICOM standards. Relation database was used to arrange the stored sequential images. Image workstation transformed the sequential images obtained from PACS net into volume data field. 3D reconstruction and rendering results were obtained by using surface-rendering and volume-rendering methods, which made the 3D construction results acquire vivid 3D structure details of high fidelity and strong sense of reality. 3 sets of application results were also presented in this paper.
Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Radiology Information Systems ; Tomography, X-Ray Computed ; User-Computer Interface

Objective To explore the relationship between left ventricular diastolic function and the dynamic changes of myocardial ultrastructure and argyrophilic fiber in diabetic rats on the different periods of lesions(week 4,12 and 24).Methods The diabetes mellitus(DM)in healthy male Sprague-Dawley rats was induced by a single injection of streptozotocin(STZ,Sigma)into intraperitoneal at a dose of 65 mg/kg body weight.The left ventricular diastolic function was measured by Color Doppler Flow Imaging-Pulsed Wave(CDFIPW)and Doppler Tissue Imaging(DTI)echocardiography.Heart tissue at the apex was obtained rapidly for transmission electron microscope study.Argyrophilic staining was used in the study of argyrophilic fiber volume fraction(APFVF)in heart interstitial tissue.Results Diastolic dysfunction of left ventricle was detected in STZinduced diabetic rats by CDFI-PW(E/A ＜ 1)at week 4,and progressed gradually.Pseudonormal filling (E/A ＞ 1)was found in diabetic rats at week 24,which could be identified by DTI(Ea/Aa ＜ 1).Diastolic function of normal rats was not impaired(E/A ＞ 1 and Ea/Aa ＞ 1).Transmission electron microscopy revealed a spectrum of subcellular remodeling in myocardium which was characterized by myofibril content decrease,disorganization,mitochondrial degeneration,sarcoplasmic reticulum,structural disorder.Compared with the control group,APFVF in myocardium was increased significantly in diabetic rats(P ＜ 0.05).Conclusion The diastolic dysfunction in STZ-induced diabetic rats correlates with damage of ultrastructure and increase of myocardial argyrophilic fiber.

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa?tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec?utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com?pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol?low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la?cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.