Objective To explore the clinical value of color Doppler ultrasound in the diagnosis of asymptomatic carotid distortion.Methods 319 cases found no asymptomatic carotid distortion in healthy physical examination were examined with color Doppler ultrasonography.The images of color Doppler ultrasound were observed.Results The two-dimensional ultrasonography of carotid distortion was carotid artery shape S or C or U type twisted.Vascular tortuosity at eddy turbulence,distorted flow speed were seen in color flow.Distortion of vessel after color blood flow and blood flow spectrum had no obvious abnormality.Conclusion Color Doppler ultrasound can be used as a routine health examination,to determine whether asymptomatic carotid distortion existed.

Objective To check the neutrophil count and the expression of cell surface adhesion molecule,lymphocyte function associated antigen?1(LFA?1)in peripheral neutrophils in severe preeclamptic patients and normal pregnant women in order to investigate the correlation of neutrophil activation with preeclampsia. Methods Totally 28 pregnant women in the department of gynecology and obstetrics in Shengjing Hospital from No?vember 2013 to January 2014 were included in the study,and divided into the severe preeclampsia group(n=14),and the control group(normal pregnant women,n=14). There was no statistically significant difference in age and gestational weeks between the two groups. The expression of LFA?1 in peripheral neutrophils was detected by flow cytometry in the two groups. Mean blood pressure(MBP)was measured in the severe preeclamptic group,and the correlation of MBP with expression of LFA?1 was analyzed. Results The neutrophil count was 8.40±2.23 ×109/L in the severe pre?eclamptic group,significantly higher than(6.71±1.58)×109/L in the control group,(P<0.05). The positive rate of LFA?1 in peripheral neutrophils was 63.25±38.025%in the severe preeclamptic patients,significantly higher than 8.32±38.65%in the control group(P<0.05). The expression lev?el of LFA?1 in peripheral neutrophils was significantly correlated with mean blood pressure in severe preeclamptic patients(r=0.64,P=0.013). Conclusion The neutrophil count and the expression of LFA?1 in peripheral neutrophils were significantly increased in severe preeclamptic pa?tients compared to normal pregnant women,and significantly correlated with severity of preeclampsia,suggesting that neutrophil activation participat?ed in the pathogenesis of preeclampsia.

Objective To study the application of multi-slice spiral CT(MSCT) portography in diagnonsis of pancreatic portal hypertension. Methods Forty-seven patients with lesion in body or tail of pancrease,47 normal subjects and 126 patients with portal hypertension underwent MSCT portography with LightSpeed 16 CT scanner. The inner diameter of portal system and the main collateral veins were measured in maximun intensity projection (MIP) image. The volume of liver and spleen were also measured in volume rendering (VR) image. The liver parenchyma and main portal vein enhancement in portal vein phase were also taken. The endoscopy examination was made in 57 patiens with portal hypertension. Results In 47 patiens with lesion in body or tail of pancreas , stenosis or occlusion of spleen vein were found in 38 patients(pancreatic portal hypertension in 27 patients, chronic and acute pancreatitis in 11 patients). In 38 patients with pancreatic portal hypertension, esophageal varices was found in 5 patients(13.2%), gastric fundus varix in 25 patients (65.8%), gastric body variees in 22 patients (57.9%), short-gastric vein/post-gastric vein(SGV/PGV) in 26 patients (68.4%), coronal gastric vein in 26 patients (68.4%),dilated gasto-omenta vein in 24 patients(63.2%), mesenterica varicesin 1 patient, splenic vein occlusion in 14 patients (36.8%), splenic vein stenosis in 23 patinets(63.2%). Conclusions The patients with pancreatic portal hypertension were demonstrate characteristic changes in MSCT portography. The MSCT portography is helpful in etiological diagnosis of pancreatic portal hypertension by supplying images in vessel morphology.

OBJECTIVE: To investigate the clinical outcomes of artificial bone (hydroxyapatite) and bone cement implantation in treating young patients with avascular necrosis of the femoral head caused by different reasons. METHODS: A total of 18 patients (23 hips) with Ficat stage Ⅲ and Ⅱ avascular necrosis of the femoral head were treated with dead bone debridement, artificial bone and cement implantation in Department of Orthopedics, Third Affiliated Hospital of Guangxi Traditional Chinese Medical College from October 2003 to July 2008. The patients were followed up for 24.6 months (ranging 3 months to 5 years). The affected hip function was evaluated by modified Merled'Aubigne Scores and X-ray. RESULTS: Mean hip scores improved significantly from 11.65 to 15.09 after surgery. Postoperative radiographs demonstrated the improved collapse and restoration of femoral head sphericity. The femoral heads of most patients remained the appearance after surgery, and the necrosis range did not enlarge. The patients were satisfactory to the treatment results. CONCLUSION: Artificial bone and cement implantation could restore head sphericity and prevent further collapse. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ and Ⅲ, especially for young patients.

Objective To analyze and determine the clinical, molecular pathology and genetic features of a Chinese family with dystrophinopathy. Methods Clinical data of the proband and his family members were collected. Immunohistochemistry staining was performed on muscular biopsy tissues with antimerosin, emerin and the N, C and central rod domains of dystrophin. Genomic DNA was extracted using standard procedures from the peripheral blood leukocytes. Multiplex ligation-dependent probe amplification (MLPA) was used to test Duchenne muscular dystrophy (DMD) gene to determine the ways and sites of genetic mutation, and analyze the relationships between genotype and phenotype. Results Patients from this family were clinically diagnosed as muscular dystrophy, and they presented serious manifestations although the immunohistochemistry analysis for the proband exhibited partial loss of dystrophin staining, and positive expression with merosin and emerin. Further test with MLPA detected the loss of exons 45--54 in DMD gene in the proband, while his mother had heterozygositic loss in exons 45--54. Conclusions The losses of exons 45--54 in the proband are all derived from his mother, who carries genetic mutation with normal phenotype. He has been diagnosed as dystrophinopathy. At the same time, his partial loss of dystrophin is not parallel to the out-of-frame mutation of the gene and his severe clinical manifestations. Abnormal expression of dystrophin is the pathological basis for dystrophinopathy phenotype. Its clinical outcome depends not only on the degree of the protein expression, but also on the function of the sites where the DMD gene less occurs.

Objective To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods From Feb.2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy,effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV( with 10 keV increment) in late arterial phase [(36±13)HU vs. (62±23)HU, (26 ±8)HU vs. (40±15)HU, and (19±6)HU vs. (27±10)HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [ (43 ± 14 )HU vs.(61 ±25)HU and (30 -10)HU vs. (40 ± 16)HU respectively], effective-Z (late arterial phase 7.80 ± 0. 16 vs. 8.05 ± 0. 21, and portal venous phase 7. 87 ± 0. 15 vs 8.02 ± 0. 22 ), concentration of calcium (water) [late arterial phase (5 ±3) g/L vs. (11 ±4) g/L, t= -3.836, P=0.001 and portal venous phase (7 ± 3 ) g/L vs. ( 10 ± 5 ) g/L, t = - 2.071, P = 0. 049 ] and iodine (water) [ late arterial phase (0.38 ±0.24) g/L vs. (0.78 ±0.32) g/L, t = -3.755, P=0.001 and portal venous phase (0.48 ± 0. 24) g/L vs. (0. 72 ± 0. 34 ) g/L, t = - 2. 161, P = 0. 041 ] were lower in serous oligocystic adenoma than those in mucinous cystic neoplasms. In discriminant analysis, multiple parameters [ age, symptom,tumor size, CT values on 40 keV to 50 keV, effective-Z, concentration of iodine (water) in late arterial phase and concentration of calcium (water) in portal venous phase] showed high accuracy (100%, 27/27 )of joint diagnosis between serous oligocystic adenoma (100%, 15/15 ) and mucinous cystic neoplasms (100%, 12/12). Conclusions The serous oligocystic adenoma and mucinous cystic neoplasms had distinct characteristic findings on CT spectral imaging. CT spectral imaging is highly accurate in the differential diagnosis between serous oligocystic adenoma and mucinous cystic neoplasms.

Objective: To investigate the clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture after the treatment through a model of orthopedic-geriatric co-care, in order to provide prevention and control strategies. Methods: Clinical data and laboratory results of elderly patients with hip fractures admitted into our hospital from January 2016 to May 2016 were collected.The differences in treatment outcome and adverse reactions were retrospectively compared between the two groups of patients with versus without pulmonary infection, and univariate and multivariate analysis of lung infection were performed. Results: Of 207 patients, 43 were infected with pneumonia and 164 were not.The proportion of patients with the time interval<48 h from admission to surgery was 48.6%(86/177), and the time interval<1 week from admission to surgery was 98.9%(175/177). The average length of hospital stay was(7.9±3.5)days.There was no significant difference in the time interval from admission to surgery, the time spent on surgery, length of hospital stay, surgical procedure and inflammatory indicators between the pneumonia and non-pneumonia groups.Univariate analysis showed that advanced age, multiple primary diseases, primary lung diseases, chronic respiratory failure, cerebrovascular disease, sequelae of cerebrovascular disease, immune system disease or long-term oral hormone therapy and preoperative anemia were risk factors for pulmonary infection in elderly patients with hip fracture(P<0.05 or<0.01). Multivariate regression analysis showed that advanced age(OR=1.239, 95%CI: 1.016~1.595, P=0.051), preoperative anemia(OR=2.491, 95%CI: 1.148~5.403, P=0.021), sequelae of cerebrovascular disease(OR=3.987, 95%CI: 1.354~11.741, P=0.012), primary lung diseases(OR=4.404, 95%CI: 1.800~11.078, P=0.001)and immune system diseases(OR=17.166, 95%CI: 1.750~168.409, P=0.015)were independent risk factors for pulmonary infection in elderly patients with hip fracture. Conclusions The orthopedic-geriatric co-care model seems to be in favour of controlling the progress of pulmonary infection in elderly patients with hip fracture, and to shorten waiting time before surgery and length of hospital stay.However, advanced age and chronic diseases are unpreventable risk factors for pulmonary infection in elderly patients with hip fractures.Clinicians should pay attention to the high-risk population and take prevention and control strategies to prevent the occurrence and development of lung infections.