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.

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.

Objective:To discuss the value of low dose scanning technique of 16-slice spiral CT for the diagnosis of pulmonary diseases.Methods: A retrospective analysis was adopted to analyze 43 image documents were scanned by 16-slice spiral CT and to evaluate their qualities.Results:All of patients were examined in accordance with the requirements and all of image qualities were more than good. Although their background noise were increased, the image quality did not affect the display of anatomical structure. Therefore, it can satisfy the requirements for the diagnosis of pulmonary diseases.Conclusion:The pulmonary multi-slice spiral CT based on low-dose scanning technology can improve the detection rate of lesions, reduce radiation dose for patients, prolong the service life of the tube and reduce the maintenance cost, therefore it is worthy for further promotion.

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.

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

AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drug Bevacizumab on connective tissue growth factor(CTGF) and pigment epithelium derived factor (PEDF) in proliferative membranes in patients with proliferative diabetic retinopathy (PDR).METHODS: From January 2015 to December 2016, 117 patients (126 eyes) with PDR were analyzed using the case-control study.The selected cases were randomly divided into two groups, respectively, Group A of 60 cases (63 eyes) and Group B of 57 cases (63 eyes).The Group A was treated with vitrectomy alone, while the Group B received intravitreal injection of 0.05mL/1.25mg bevacizumab before vitrectomy.The peeled epiretinal membranes in patients were stained and then the histopathological changes were observed for primitive cells and angiogenesis, the expression of CTGF and PEDF were tested.RESULTS: The expression of CTGF and PEDF in the proliferative membrane of the two groups were expressed in the cytoplasm.The Group A showed positive expression in 38 cases, the positive rate was 60.3%.Compared with Group A, the positive expression rate of CTGF in Group B (92.1%) was significantly higher (P<0.05).The positive expression rates of PEDF in the two groups were 90.5% and 95.2% respectively, and there was no significant difference between the two groups (P>0.05).CONCLUSION: In patients with PDR after intravitreal injection of bevacizumab, the retinal neovascularization is significantly reduced, which is conducive to vitrectomy.The positive expression rate of CTGF significantly increased in patients with PDR after intravitreal injection of bevacizumab, but there was no significant change in the expression of PEDF in the anterior membrane.

AIM: To study the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) on best corrected visual acuity (BCVA) and multifocal-electroretinogram (mfERG) before and after treatment for choroidal neovascular disease.METHODS: A total of 264 patients (332 eyes) with macular neovascularization (MCNV) and idiopathic choroidal neovascular disease (ICNV) who underwent pathologic myopia from January 2015 to January 2017 were enrolled in this study.Intraocular pressure and BCVA, fundus using 90D front mirror and slit lamp detection, and the fundus photograph, OCT, ICGA and FFA angiography, mfERG detection were taken.One month after the drug, 1mo after the final treatment, we recorded BCVA, intraocular pressure and mfERG and so on.RESULTS: Ranibizumab was injected into the 254 eyes, and 78 eyes were injected with conbercept.There were 37 eyes injected once, 147 eyes were injected twice, 72 eyes were injected 3 times, 57 eyes were injected 4 times, 19 eyes 5 times.There were no significant differences on intraocular pressure between the two groups (P>0.05).The BCVA before treatment was significantly different compared with those 1mo after treatment and 1mo after the final treatment (P>0.05).The amplitude of Ring1, Ring2 and Ring4 increased after treatment, the difference was statistically significant.(P<0.05).The amplitude of Ring3 and Ring5 increased at 1mo after final treatment(P<0.05).CONCLUSION:Intravitreal injection of anti-VEGF drugs has a significant effect on BCVA and mf ERG in patients with choroidal neovascular disease and is safe.

Objective To explore the effects of sports training on endothelin-1 ( ET-1 ) and endothelin-1 receptor (ETR) and its subtypes in the myocardium in rats. Methods After sports training, levels of endothelin-1 were measured using radioimmunoassay, and changes in ETAR and ETBR levels by radioligand binding assay. Results The endothelin-1 level in myocardial cells was significantly reduced ( P

To improve the quality of health care by improving the quality of residency training,the Accreditation Council for Graduate Medical Education of USA has renewed the standards and methods of residency training to improve health care,and issued the compe- tence-based training standards. The residents have to achieve six key competences when they finish the training. The University of Washington,School of Medicine,responds to the new re- quirements and standards by reforming its residency training pathway,enriching formal teach- ing/training activities,and improving its supervision and the evaluation. We should use for refer- ence reforming the residency training in China.