Objective To explore the CT perfusion imaging with acetazolamide (ACZ) challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug 2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT perfusion imaging with acetazolamide challenge test,and the cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT) and time to peak (TTP) in anterior cerebral artery (ACA),middle cerebral artery (MCA)cortical branch supply area,MCA deep perforator region,posterior cerebral artery (PCA) and pons part blood supply area were examined in the elderly people of two groups.Results CBV and CBF values in ACA,MCA cortical branch supplyarea,MCA deep perforator region,PCA and pons part blood supply area after ACZ stimulation were significantly lower in case group than the control group (t=3.57,3.39,9.34,11.04,4.21,5.99,9.91,11.10,6.66,9.97,P＜0.01 or 0.001),while MTT and TTP values were significantly higher in case group than in the control group (t =7.21,6.94,16.53,4.82,11.67,6.46,6.11,6.71,6.87,4.82,all P＜ 0.001),CBV and CBF values in the control group were significantly higher after ACZ excitation than before the challenge (t=6.44,6.86,9.72,10.99,7.03,6.33,12.48,14.82,8.98,12.03,all P＜0.001),and the MTT and TTP values in the control group were significantly lower after ACZ excitation than before the challenge (t=7.98,5.77,17.29,8.28,9.74,7.01,7.52,6.32,6.01,5.54,all P＜0.001).Conclusions CT perfusion imaging with acetazolamide challenge test can increase the detection rate of chronic cerebral insufficiency with better clinical significance,and is worthy of promotion.

Objective To study the effect of hospital disposal manners after workplace violence in hos-pital on organizational commitment and turnover intention among the head nurses. Methods Self-made questionnaire about workplace violence in hospital and general condition, organizational commitment question-naire and turnover intention questionnaire were conducted in 122 head nurses who had suffered hospital vio-lence in recent years from all level hospitals of Fujian province. Results The scores of affective commitment and normative commitment of organizational commitment and turnover intention showed significant difference be-tween the groups who suffered positive disposal and who suffered negative interference by the hospital after the violence events (P<0.05), but aggregate score of organizational commitment and the scores of continuance commitment showed no significant difference between the two groups (P>0.05). Hospital disposal manners af-ter the hospital violence and hospital grade were influence factors on turnover intention among the head nurses.Hospital grade was also an influence factor on organizational commitment among the head nurses. Conclu-sions Hospital positive disposal means after the hospital violence on head nurse help to ameliorate organiza-tional commitment and reduce turnover intention among the head nurses.

Objective:To study influence of type 2 diabetes mellitus (T2DM) on coronary artery lesion and plaque sta‐bility using optical coherence tomography (OCT) in patients with coronary artery disease (CAD) manifesting unsta‐ble angina pectoris (UAP) . Methods :A total of 200 patients diagnosed as CAD manifesting UAP were selected.According to complicated with diabetes mellitus or not ,they were divided into normal blood glucose group (n=98) and complicated T2DM group (T2DM group ,n=102). Coronary angiography (CAG) and OCT were used to eval‐uate coronary artery lesion ,assess plaque nature and measure the thickness of plaque fibrous cap in order to confirm plaque stability . Results:Compared with normal blood glucose group ,there were significant rise in percentages of multi-vessel coronary disease (48.98% vs. 78.43% ) ,severe artery stenosis (20.57% vs. 40.21% ) ,lipid plaques (25.00% vs. 39.84% ) and plaques with fibrous cap thickness <65μm (25.93% vs. 45.24% ) in T2DM group , P<0.05 or < 0.01 .Conclusion :Patients with coronary artery disease have more severe coronary artery lesion and high ‐ er incidence rate of multi‐vessel coronary disease and unstable plaque when complicated with type 2 diabetes mellitus .

Objective To investigate the clinical characteristics of gliomas in children,and assess the value of CT and MRI for diagnosing glioma.Methods Fifty-three children under 14 years old who were admitted into department of neurosurgery of Henan Provincial People's Hospital from Jan.2001 to Dec.2006 were diagnosed as glioma.Their age and sex distribution,clinical symptoms and signs,imaging examinations and pathological examinations were retrospectively analyzed.Results 1.There were 35 males and 18 females.2.The common symptoms and signs were headache and dizziness(32 cases,60.4%),nausea and vomiting(32 cases,60.4%),balance function disorder(31cases,58.5%),episodic convulsion(6 cases,11.3%) and fundus changes(33 cases,62.3%).3.There were 24 gliomas located at supratentorial and 29 gliomas located at infertentorial in this group.4.Thirty-three cases had a CT examination(1 case was wrongly diagnosed) and 28 cases had a MRI examination(all cases were positive);The positive rate of CT for displaying these tumors was 97%,MRI was 100%.5.Pathological examination revealed gliomas in 42 cases after operation.The most common histologically confirmed tumor type reported was astrocytoma,which accounted for 40.5%(17 cases),and the second was medulloblastoma,which accounted for 31.0%(13 cases).Conclusions 1.Glioma are more frequently affected in males than females in children.2.It often occurs in cranial posterior fossa and midline,which causes the symptoms of intracranial hypertension including headache,dizziness,nausea,vomiting,fundus changes,and so on.3.It often occurs in infertentorial,which causes the symptoms of balance function disorder,since it can invade cerebellum directly or indirectly.4.CT and MRI play an important role in the diagnosis of glioma in children.MRI is more valuable than CT in glioma diagnosis.5.Histological types of glioma in children are significantly different from adults.The most common histological types are astrocytoma and medulloblastoma.

Objective To explore the risk factors of neonatal necrotizing enterocolitis(NEC)and assess the effect of prophylactic use of probiotics(Bifico)in prevention of NEC and observe changes of weight.Methods Five hundred and twenty-four cases of prematures who were inpatients were divided into 2 groups randomly(prevention group,n=276,no-prevention group,n=248)and the morbidity of NEC and the increase of eight during hospitalization were observed.A case-control study and conditional Logistic regression model multifactorial analysis were made to 20 cases NEC neonates and 80 cases non-NEC neonates.Results The prevention group(276 cases)had 5 cases of NEC and the average weight increase was(8.114?8.137)g/d,the no-prevention group 248 cases had 17 cases of NEC,and the average weight increase was(6.595?5.337)g/d.The occure rate of NEC in prevention group was significantly lower than that of no-prevention group(?2=5.57 P

Objective To explore the risk factors and metastasis of non-sentinel lymph node (NSLN) in breast cancer patients with sentinel lymph node metastasis≤2. Methods 88 cases of breast cancer with sentinel lymph node metastasis≤2 were retrospectively analyzed. Factors influencing the status of NSLN were studied. Results 8 cases (9.09%) had NSLN metastasis. Variance analysis showed that tumor stage(P=0.014), histolog-ical grade(P=0.014) and ER statuts(P=0.009) were correlated with NSLN metastasis. Logistic analysis showed that only histological grade was the independent predictor for NSLN metastasis (P=0.016,OR=1.150,95%CI=0.598~7.740).18 cases had micro-metastasis of sentinel lymph node and 70 cases had macro-metastasis of sentinel lymph node. The ratio of false negative SLN was 10.23%. The mean follow-up time was 11 months. There was no case of recurrence, metastasis or death. Conclusions The metastasis rate of NSLN is relatively low in breast cancer patients with small number of positive SLNs. NSLN metastasis is related to tumor stage, histological grade, and ER expression.

BACKGROUND: It is discovered by administrating different emetics to vomiting animals, like cats, that there are a large amount of Fos positive neuronal expressions in the arc region from nucleus of solitary tract, lateral tegmentum to ventrolateral area. And it has been viewed that the arc region from area postrema, nucleus of solitary tract to ventrolateral reticular structure is the main emetic region. Whether do the non-vomiting animals reflect in response or not after emetic injection?OBJECTIVE: To observe the distribution of Fos positive neurons in relevant emetic regions of brain and spinal cord in rats after abdominal injection of emetic, cisplatin.DESIGN: Randomized controlled experiment based on animals.SETTING: Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University.MATERIALS: The experiment was performed in Neural Physiological Research Room of Life Science College in Hebei Normal University and Physiological Room of Basic Medicine Institute in Hebei Medical University from March to August 2003. Twelve SD male rats were employed, body weighted varied from 220 to 250 g, of clean-grade. They were randomized into experimental group of 6 rats and the control of 6 rats.INTERVENTIONS: In experimental group, the emetic, cisplatin, was injected abdominally 10 mg/kg. In the control, the physiological saline of same dose was injected. Afterwards, the activity changes in rats were observed at room temperature, quiet and light-avoided environment. Six hours later, the brain tissue was collected for frozen continuous sectioning. Immunohistochemical staining method was used to observe the distribution of Fos positive neurons in brainstem and forebrain nuclei and to count positive cell.MAIN OUTCOME MEASURES: ① Behavior observation in rats after emetic injection. ② Counts of Fos positive cell in relevant regions of brain in rats.RESULTS: Twelve rats all entered result analysis. ① In 20 minutes after injection, the rats in both groups were in tranquilizing state, lying prone with body curled, almost without any movement. In 60 minutes after injection, the rats in the control were recovered to normal, free of eating or drinking. The rats in experimental group were in prone-lying state with body curled. They rose up or shook the heads occasionally, and they breathed fast and uneven.In 2 hours after injection, in experimental group, the rats were still in abdominal prone tightly in the cage, with heads lowed and irregular shaking of noses. In 5 hours, the rats in experimental group began standing up and moving, with normal breathing, but they still did not eat or drink. ② Fos positive neurons in solitary tract, area postrema and lateral parabrachial nucleus and paraventricular nucleus, supraoptic nucleus and arc nucleus in hypothalamus (64.3 ±9.6, 83.4 ±15.0, 148.8 ±19.9, 80. 2 ± 11.8, 20.7 ±3.8, 86. 6 ± 10.8) were remarkably higher than those in the control(56. 2 ±6.3,73.5±9.9,136.9±17.8,66. 1±10.3,17.3±3.4,78.8±10.5).CONCLUSION: Emetics induce discomforts in internal organs of rats, due to which, there probably exist emetic regions similar to vomiting animals in central neural system. But it is probably lack of vomiting-related adjusting mechanism. Emetics irritate the increase of Fos positive neurons in relevant regions in the brain of rat, which suggests that there exist relevant neural chemical pathways similar to nausea in the brain of non-vomiting rats.

Objective To investigate the role of different therapeutic regimens in primary biliary cirrhosis (PBC)complicating Sj(o)gren syndrome (SS).Methods A total of 79 patients diagnosed as PBC complicating SS were enrolled and randomly divided into three groups:Group U (29 patients) received ursodeoxycholic acid (UDCA) alone,Group UP (37 patients) received UDCA and prednisolone,Group UA (13 patients) received UDCA and azathioprine.The clinical and laboratory data were collected at 0,3,6 and 12 months after treatment.Results Fatigue and pruritus were improved in each group with no difference among them(P ＞ 0.05).The levels of ALT,AST,alkaline phophatase (ALP),gamma-glutamyl transferase (GGT),TBil,DBil,IgG,and IgM in the three groups were all decreased after treatment(P ＜0.05),while there were no statistical differences among the three groups (P ＞ 0.05).Conclusions The combination therapy of UDCA with prednisolone or azathioprine was not better than UDCA alone.The therapeutic policy of PBC complicating SS involved in the liver should settle PBC mainly.

Objectives To investigate medical students' satisfaction degree clinical practice,to find out the shortages of the clinical practice teaching,and to further put forward the measures of clinical practice.Methods By using a selfdesigned questionnaire,115 student interns were surveyed with anonymous questions,to collect data about the satisfaction degree of the hospital teaching conditions,conditions of teachers,practice quality of clinical departments,management department intern management work,the practical effect and views of clinical practice and other information.99 effective copies were retrieved using Excel analyze data.Results Interns' overall satisfaction with clinical practice is not high,and the satisfaction degree to the management department' work is the lowest,the satisfaction degree to the conditions of teachers of hospital is the highest.Conclusion Medical students'clin-ical practice satisfaction needs improving.To this end,we should improve the system and teaching conditions and strengthen management to meet the needs of students and improve their practice quality.

For medical service provision for the Olympic Games, a special medical service mechanism for important international sport events eventually took shape, based on task analysis and medical services provided in test games for two years including 2006 and 2007 Qingdao Sailing Regatta. This mechanism features the following: First, "7-Special" sport event medical practice - Medical zones, medical teams, service flows, service signs, medical papers, and drug management, all exclusively earmarked for the event; Second, medical services up to international standard; Third, special flows for medical rescue; Fourth, Special system for information reporting. Thanks to this special mechanism, the hospital provided its medical assurance for the Olympic Games successfully, and upgraded its routine medical services as a result.