Objective: To evaluate the application value of CT enhancing scan based on bolus tracking technology in the upper abdomen. Methods:200 patients were examined by CT in the upper abdomen. Contrast agent was injected through the hand vein at 1.5 ml/kg, with pressure of 300 Pa, flow rate 2.5 ml/s. Before injection, we must complete the first scanning .Then , another 2 or 3 scans were done. Results:188 cases can show abdominal aorta, hepatic artery, splenic artery, hilar vessel branches, portal vein, inferior vena cava very well. Another two cases failed .The others were not ideal because of portal hypertension. Conclusion:CT enhancing scan based on bolus tracking technique in the upper abdomen can obtain good images to meet clinical needs.

Objective To investigate the relevant factors on the prognosis of sudden deafness. Method The clinical data of 133 patients (148 ears) with sudden deafness were analyzed retrospectively. Results Through systemic treatment, 25 cases got recovery, 18 cases were excellence and 39 cases were effective, the total effective rate was 61.7%(82/133). Univariate analysis showed that the factors related to the prognosis of sudden deafness were age, the time from onset to treatment, deafness classification,accompanied by vertigo or not and the duration of treatment. Patients with the age lower than 60, the earlier the time from onset to treatment, the lighter the deafness classification, not accompanied by vertigo and the longer duration of treatment got a better efficacy. Logistic regression analysis showed that the independent factors related to the prognosis of sudden deafness were the time from onset to treatment and deafness classification. Conclusion The etiology of sudden deafness is still unclear, the time from onset to treatment interval and the degree of hearing loss are the main factors affecting the prognosis of it, in clinic, it should be paid attention and took a early diagnosis and early treated so as to get good efficacy.

Objective:To investigate the significance of 3D printing technology in the treatment of skull base tumor.Methods: A 45-year-old male patient who felt headache and discomfort had progressive loss of vision to blindness in the left eye. Using MR plain scan found that there was a skull base tumor, so the patient was examined by brain CTA and 3.0T MR to obtain medical digital imaging of CT and MR and DICOM data which were input into computer for establishing three-dimensional model, and then printed it.Results: 3D reconstruction model can clearly display the anatomical structure of skull base tumor, three-dimensional space and peripheral blood around skull base tumor. Under the guidance of this new technology, the tumor was completely removed and the surrounding normal brain tissue was preserved as much as possible. The whole operation time was greatly reduced at the same time.Conclusion: The treatment of 3D printing technology is applied in skull base tumors can clearly display the anatomical structure, distinguish adjacent vessels around tumor; when it avoids missing tumor, also can more effectively assist preoperative planning, enhance the security for complex skull base surgery, accelerate the operation speed, improve operation accuracy; it has great application prospect in the precise treatment of neurosurgery.

OBJECTIVE:To discuss the effects of Kangshuling gel on wound treatment and infection prevention inⅡdegree burns. METHODS:60 patients with Ⅱ degree burns were randomized intro observation group and control group,with 30 cases in each group. Based on routine treatment (cleaning,disinfection,necrotic tissue removal,antibiotics use),observation group was given Kangshuling gel,and control group was treated with sulfadiazine. The average healing rate,healing time,surgical dressing exudate,inflammatory reaction around wound,the times of dressing change and inner layer gauze change,and wound infection rate were observed in 2 groups,and satisfaction survey was conducted in 2 groups. RESULTS:On 14th and 18th day after treat-ment,average rate of wound healing in observation group was significantly higher than in control group;the time of wound heal-ing was significantly shorter than control group,with statistical significance(P<0.05). Within 2 weeks after treatment,the number of gauze layer wetted by surgical dressing in observation group was significantly less than in control group,and case number of in-flammatory reaction around wound was significantly less than control,with statistical significance(P<0.05). The times of dressing change and inner layer gauze change in observation group was significantly less than in control group,and the rate of wound infec-tion was significantly less than control group,with statistical significance(P<0.05);the satisfaction of observation group was bet-ter than that of control group,with statistical significance(P<0.05). CONCLUSIONS:Kangshuling gel in the treatment of Ⅱ de-gree burns can effectively prevent and treat wound infection,reduce the rate of wound infection and the times of dressing change, shorten the time of wound healing and improve the rate of wound healing so,high satisfaction degree is obtained.

ObjectiveTo investigate the effect of bone marrow-derived mesenchymal stem cells (MSCs) on collagen-induced arthritis(CIA) and the possible mechanisms. MethodsMSCs from C57BL/6 mice bone marrow were isolated and expanded. Three DBA-I mice were as normal control group (Sodium Chloride injected on day 0 and 21) after primary immunization. After the bovine collagen Ⅱ induced-CIA models were established, fifteen male mice were randomly divided into 3 groups according to treatment regi-mens: CIA control group(0.2 ml Sodium Chloride injected through caudal vein on day 0 and 21), prevention group(1×10+6 cells MSC on day 0) and treatment group. (1×10+6 cells MSC on day 21 after primary immun-ization). The observed parameters included arthritis index (Al), articular pathology changes, levels of serum TNF-α, IL-1β detected hy ELISA. In addition, the percentage of CD4+CD25+Foxp3+Treg cells(Tregs) in CD4+ T cells of spleen or lymphoid node from mice were also analyzed by flow cytometry(FCM). Results①The Al and articular pathological score of the prevention group and treatment group were lower than the CIA control group(P<0.05). ②The levels of serum TNF-α and IL-1β of normal control, prevention group and treatment group were significantly decreased compared with CIA control group(P<0.05), and positively correlated with Al or articular pathological score (P<0.05). ③The percentage of Tregs from spleen and lymph nodes was significantly increased in MSCs treated mice(P<0.05). Conclusion MSCs transplantation is effective for CIA and suppression of TNF-α, IL-1β and up-regulation of Tregs by MSCs may be the possible mechanism in CIA.

Objective To understand the mental health, especially the anxiety of patients suffering from acute trauma in order to adapt the patients to the situation of acute trauma and cope with acute trauma better in physiological and psychological health. Methods Questionnaire designed by means of Symptom Checklist 90(SCL 90) and Self rating Anxiety Scale(SAS) was used to survey the stress response of the patients to anxiety induced by acute trauma. Results The parameters in SCL 90 of acute trauma patients were significantly higher than those of the normal control( P

Objective To investigate the reason of fracture internal fixation of locking plates and conventional plate in the treatment of femoral fractures.Methods A total of 198 patients with femoral fracture taken plate fixation were selected as our subjects.Of which,the locking plate were used in 87 cases served as control group and 111 cases had traditional plate fixation served as study group.Fracture fixation rate in patients were follow-up and the reasons for broken were analyzed.Results Fracture fixation occurred 5 cases (4.5％,5/111) in the locking plate,and 3 cases (3.4％,3/87) in traditional plate,and the difference was not significant (x2 =0.053,P =0.987).Fracture reason included plate fracture (4 cases),fracture of screws (2 cases) and plate fracture complicated with breakage of screw (2 cases).Iatrogenic factors lead fracture fixation was 30.0％ (3/10),significantly higher in patients with rehabilitation exercises errors (6.9％,2/29; x2 =3.851 ; P =0.046).Both iatrogenic factors and rehabilitation exercises errors caused fracture fixation rate was 100％.Conclusion Iatrogenic factors combined rehabilitation exercises error was the main reasons in fracture fixation.We should properly choose fixation methods and correctly guide the postoperative functional exercise for patients.

Objective To investigate the influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury.Methods A total of 89 elderly patients with articular injury from Jan.2013 to Oct.2014 were randomly divided into observation group and control group.In control group,40 cases were treated with conventional surgery and anti-inflammatory therapy.In observation group,49 cases were treated intraarticular injection of hyaluronic acid added to conventional therapy.The apoptosis rate of articular cartilage cells,cell cycle and proliferation index were compared between the two groups.Results The apoptosis rate of articular cartilage cells was lower in observation group than in control group [(4.08±0.74)％ vs.(6.41±0.54)％,t=16.403,P＜0.001].The ratio of G0/Giin articular cartilage cells was lower in observation group than in control group[(83.5 ± 3.5)％ vs.(91.7± 4.3)％,t10.275,P＜0.001].The ratios of S and G2/M and the proliferation index in articular cartilage cells were lower in control group than in observation group[(3.5 ± 0.3)％ vs.(8.2± 2.4)％,(4.7±0.6)％ vs.(8.5±1.8)％ and (9.1±1.1)％ vs.(16.7±1.9)％,t=12.293,12.731 and 22.198,respectively,all P＜0.001].Conclusions Intra articular injection of hyaluronic acid at early stage decreases the apoptosis rate of articular cartilage cells,helps articular cartilage cells turnover and improves the recovery of articular injury in elderly patients.

Objective To compare the clinical efficacy and onset time between Tiao Ren An Shen (regulating Conception Vessel and soothing mind) needling method and conventional acupoint selection for peri-menopausal depression, for providing theoretical evidence for the application of Tiao Ren An Shen needling method. Method Sixty patients with peri-menopausal depression aged 45~55 years were randomized into two groups after admission to hospital. In addition to oral administration of Fluoxetine, one group was intervened by Tiao Ren An Shen needling method (treatment group, n=30), and the other group was by conventional acuppoint selection (control group, n=30). Before treatment, and at 2nd, 4th, and 6th week after treatment, Hamilton Depression Scale (HAMD) was investigated, Kupperman index and traditional Chinese medicine (TCM) syndrome score were evaluated before and after intervention. The therapeutic efficacy was estimated at the end of the 6th week. Result After intervention, the HAMD and TCM syndrome score were significantly improved in both groups (P<0.05); Kupperman score was markedly improved in the treatment group (P<0.05), while the score was not significantly changed in the control group (P>0.05). Compared to the control group, the improvements of depression degree and peri-menopausal symptoms were more significant in the treatment group (P<0.05). The total effective rate was 93.3% in the treatment group versus 70.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Compared to conventional acupoint selection, Tiao Ren An Shen method can produce a more efficient effect and a higher long-term efficacy, not only improving the emotional state and easing depression, but also releasing vegetative nerve functional disturbance. As it can improve the TCM symptoms, treating both causes and manifestations, promoting the quality of life of peri-menopausal patients, this method is an effective approach.

BACKGROUND:Extracorporeal cardiac shock wave therapy (CSWT) can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE:To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase (eNOS) in pigs following acute myocardial infarction (AMI).METHODS:Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm~2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION:The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia rnyocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance (P＜0.01).The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.