Objective To investigate the clinical value of diffusion weighted imaging (DWI) in diagnosis of atypical cancerization nodules (CNs) of liver cirrhosis. Methods Totally 34 patients with atypical CNs of liver cirrhosis confirmed pathologically underwent routine MR, dynamic enhancement, and DWI (b=0, 500, 1000 s/mm~2). The detection rate of CNs of liver cirrhosis between routine MR and DWI was compared. Results Totally 21 patients with 28 cancerization nodules were diagnosed with routine and dynamic enhancement MR, while 27 patients with 37 cancerization nodules were detected with DWI. Significant difference was found in the detection rate between routine scan and DWI (P=0.025). Conclusion DWI shows more advantage than routine and dynamic enhancement MR for detection of liver cirrhosis with atypical CNs.

Objective In order to improve the teaching effectiveness of anatomy in nursing, this article made an exploration on the experimental teaching reform combined with the characteristics of nursing profession. Methods The nursing students of class 1and 2 of 2013were set as the research object. The class 1 (110) as experimental class, class 2 (110) for the control group. In the experimental class, the reform of teaching method and teaching quality was improved by adjusting the teaching syl-labus and teaching contents. The control class used the traditional experimental teaching method. The experiment class' teaching reform research of the human anatomy carried on the 1 semester. Exam achievement evaluation and the questionnaire survey were adopted to assess the teaching effect. SPSS 13.0 software was used to do statistical analysis and t test was used to compare two groups of students test scores, experiment grades, test scores and total scores. Results Experimental theory examination results [(47.80±7.30) vs. (44.85±8.38)], experiment grades [(15.48±1.76) vs. (14.55±2.19)], ex-periment test scores [(15.52±2.22) vs. (14.35±2.64)], total score [(78.80±8.99) vs. (73.75±10.53)] were better than control group (P<0.05). In questionnaire survey,more than 80% of the students think that the reformed teaching method can help to improve the teaching effect. Conclusion In human anatomy experiment teaching reform, the reformed experiment teaching method can significantly improve students' scores and the teaching effect. It is better than the traditional method, and is worth publicizing.

Objective To investigate the survival rate and its prognostic factors of laryngeal carcinoma. Methods We retrospectively analyzed 63 cases of laryngeal carcinoma. A total of 7 clinicopathologic factors were studied by univariate analysis and Cox multivariate model. Results The overall cumulative survival rate was 69.8% at 3 years,54.0%at 5 years.In univariate analysis, the survival was related to location of the tumor(P< 0.01), T status (P < 0.01), N status (P < 0.01), clinical stages (P < 0.01), pathologic grade (P < 0.01) and types of treatment (P < 0.01), while age was not correlated to prognosis (P > 0.05). In Cox multivariate model, T status (P < 0.01) and N status (P < 0.01) were independent prognostic factors. Conclusions T and N status were independent prognostic factors for patients with laryngeal carcinoma. Early detection and treatment should be given to improve the survival of patients.

Objective To evaluate the operation methods and effects of transforaminal wedge osteotomy (TWO) combined with intervertebral grafting bone for correcting the rigid thoracolumbar kyphosis.Methods From January 2003 to June 2013, treatment of 52 cases of the rigid thoracolumbar kyphosis by TWO combined with intervertebral bone graft were studied (including 33 males and 19 females, and the age range was from 15 to 72 with average age of 42.3 years old).In these 52 cases, there were 17 cases of ankylosing spondylitis, 25 cases of obsolete thoracolumbarvertebral fractures, 7 cases of chronic thoracolumbar tuberculosis and 3 cases of congenital vertebral malformations.52 cases presented as lumbar kyphosis, low back pain aggravated,with an average VAS score of 8.6;24 cases were accompanied with different extent of neurological dysfunction which obviously influenced daily life or work.Osteotomy was located at thoracolumbar intervertebral disc.Pedicle screws internal fixation system combined with intervertebral grafting bone was used to compress the vertebra and fuse after TWO for correction.Preoperative and postoperative low back pain was evaluated by visual analog score (VAS), Frankel score and Oswestry disability index(ODI) in patients with neurological dysfunction.The above indexes were compared with the PSO osteotomy group.Results Preoperative mean kyphosis Cobb angle was 65.6°(31°-137°).The average post-operative kyphosis Cobb angle was 19.2° (8°-35°), and the average correction rate was 68.4％.The mean operation time was 3.8 h (2.2-5.3 h), and the mean intraoperative blood loss was 1220ml (500-2 900 ml).Preoperative VAS score was 8.6± 1.2 while the last follow-up was 1.8±0.5;preoperative Oswestry dysfunction index was 75.6±8.2 while the last follow-up was 18.4±8.1.The results were statistically significant.The spinal function was 4 cases of Frankel C and 20 cases of Frankel D before operation, all of which dropped to E level after operation.52 patients were followed up with the average time of 41 months (from 6 to 60 months).The bony fusion rate was 94.23％ at 6 months after operation.All of the patients were fused in 3 years after operation.The average loss of kyphosis Cobb angle was 5.5°(4°-12°).Compared with PSO, the average operation time, the amount of bleeding and the improvement of neurological function after surgery all had some advantages.Conclusion Transforaminal wedge osteotomy has many advantages, such as less bleeding wounds, less nerve interference and limited multi-segmental osteotomy, with little trauma and high bony fusion rate.

OBJECTIVE:To study the stability of Fuke zhidai capsule at accelerated testing and room temperature. METHODS:HPLC was conducted to determine the content of berberine hydrochloride in the preparation:the column was Diamonsil C18 with mobile phase of B methanol-0.7% triethylamine(pH adjusted to 3 by phosphate)(50:50,V/V)at a flow rate of 1 ml/min;detec-tion wavelength was 265 nm,with a column temperature at 45 ℃,and the injection volume was 5 μl;its moisture,disintegration time,accelerated stability and long-term stability were studied according to the 2015 edition of Chinese Pharmacopoeia. RE-SULTS:The linear range of berberine hydrochloride was 0.0217-0.1736 mg/ml(r=0.9999);RSDs of precision,stability and re-producibility tests were lower than 2%;recovery was 97.24%-101.73%(RSD=1.72%,n=6). CONCLUSIONS:The moisture,dis-integration time,accelerated stability and long-term stability were all in line with the quality standards.

Objective To investigate the X-ray,CT and MRI features of peripheral primitive neuroectodermal tumors (pPNETs).Methods 14 patients were pathologically diagnosed with pPNETs.The imaging of X-ray (twelve image),Computed Tomography(eleven image) and Magnetic Resonance Imaging(five image) were retrospectively analyzed.Results Of 14 patients,there were two sites of tumour:soft tissue( eight patients) and bones( six patients).For tumoura of the soft tissue region,the appearance of X-ray and CT imaging showed equal or lower density soft mass without dear boundary.In some cases,tumours invaded adjacent bones.The appearance of MRI imaging showed large heterogeneous masses inside soft tissue without clear boundary.Tumours displaced adjacent cortical bone and cavitas medullaris.All masses were heterogeneous enhancement on contrast images.For tumours of bone region,X-ray and CT scan showed large scale osteolysis osteoclasia in bone surrounding with soft tissue masses of various size.The lesions were equal or lower signal on T1 WI.All masses were intermediate or hyperintense signal with heterogeneous midrange or obvious enhancement on T2WI.Conclusion Imaging characteristics of pPNETs were described.X-ray,CT and MRI were useful in understanding the property,extent and staging of tumor and very useful in the diagnosis.

Objective To explore whether patients with bipolar disorder are deficit in their theory of Mind (ToM) and the factors influencing the ToM.Methods Three groups (27 with bipolar disorder,27 with schizophrenia,and 26 in health control) were tested.All subjects' ToM was assessed by Faux pas Questions and IQ by WAISR.The symptoms of groups of patients were measured by Positive and Negative Symptom Scale (PANSS).Results Three groups' scores of Faux pas Questions(ToM scores) displayed significance(One-Way ANOVA:F(2,77) =13.686,P =0.000) ; Post-hoc test (Games-Howell) showed that ToM scores (13.81 ± 5.66) of bipolar disorder group were lower than those of the control group (17.04 ± 3.79) and higher than the schizophrenia group (9.44 ±6.13).The difference was significant (P =0.048,0.024).Independent sample t test showed that ToM scores of gender in bipolar disorder group were not significant (male:13.20 ± 6.07,femal:14.58 ± 5.26,t =-0.623,P =0.539).There was no correlation between ToM scores of patients with bipolar disorder and their age,years of education,age of onset,duration of illness,scores of negative,positive and general psychiatric rating scale of PANSS,and IQ (＞ 70).Linear regression by stepwise regression was used on each specific symptom of the PANSS,and according to the outcome,related factor was selected as independent variables,the ToM scores as the dependent variable.The regression equation was ToM scores =21.79-1.53 G12-3.16 N6 ;R2adjust was 0.46.Conclusion Patients with bipolar disorder as a whole compared to the control have deficit in their ToM,and the deficit is less than that of patients with schizophrenia.G12 and N6 of the PANSS are the influencing factors,which explain 46％of the variation sources.

Objective To observe the short-term and long-term effect of mask bi-level positive airway pressure (BiPAP) combined with recombinant human brain natriuretic peptide (rhBNP) on acute heart failure.Methods One hundred cases of acute heart failure patients were divided into BiPAP combined with rhBNP group (51 cases) and conventional treatment group (49 cases) by random digits table.Conventional treatment group was given routine drug for heart failure treatment,and BiPAP combined with rhBNP group on the basis of routine treatment,was given BiPAP combined therapy with rhBNP.Arterial blood oxygen partial pressure (PaO2),arterial blood oxygen saturation (SaO2),and the change of clinical symptoms were recorded before and 30 min,2 h after treatment.All patients were followed up for 3 months,and cardiovascular events,related parameters of echocardiography and 6 min walking distance test were compared between two groups.Results Clinical symptoms (respiratory frequency and heart rate) and blood gas analysis index (PaO2,SaO2) were significantly improved after treatment in two groups,and BiPAP combined with rhBNP group improved more significantly.There was significant difference (P ＜ 0.05).After 3 months' follow-up,the incidence of cardiovascular events in BiPAP combined with rhBNP group was lower than that in conventional treatment group [17.6％ (9/51) vs.38.8％ (19/49),P ＜ 0.05].The left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF) in BiPAP combined with rhBNP group was better than that in conventional treatment group [(55.0 ± 6.1) mm vs.(63.3 ± 6.5) mm,(52.5 ±7.2)％ vs.(44.7 ± 6.8)％] (P ＜ 0.05).The 6 min walking distance test in BiPAP combined with rhBNP group was higher than that in conventional treatment group [(325.6 ± 36.4) m vs.(210.2 ± 34.1) m] (P ＜0.05).Conclusion BiPAP combined with rhBNP in short-term treatment of acute heart failure is effective and safe,and can improve the long-term prognosis of patients.

Objective To evaluate the reliability of axial view of patella with the knee joint flexed at 60 and 90 degrees on imaging diagnosis of patellar subluxation with DR (digital radiography). Methods 60 cases confirmed patella subluxation were reviewed retrospectively. In addition to routine anteroposterior and lateral DR views, axial DR views of patella with the knee flexed at 60 degrees and 90 degrees were taken meanwhile. Results Of the 60 cases, 45 failed to provide any patellar problems, while the other 15 cases revealed suspicious imaging view of patella subluxation in their normal AP and lateral DR views. In the axial DR views of patella with the knee flexed at 60 degrees and 90 degrees, 50, 4 and 6 cases revealed subluxation, suspicious subluxation and normal alignment of patella. Conclusion Axial DR view of patella with the knee joint flexed at 60 and 90 degrees could provide helpful roentgenographic information in determining the existence of patella subluxation.

Aim To evaluate the inhibitive and induc-tive effects of Polygonum capitatum water extract on main cytochrome P450 isoforms in human and liver mi-crosomes of mouse in vitro for predicting the herb-drug interactions in clinical application. Methods The in vitro inhibitory effect was evaluated by incubating Po-lygonum capitatum water extract with the probe sub-strates of main phase I metabolic enzymes in human liver microsomes, including CYP1A2, CYP2E1, CYP2C9,CYP2C19 and CYP3A4. Mice were adminis-tered with Polygonum capitatum water extract at dosage of 0 . 58 g · kg-1 and 1 . 16 g · kg-1 by gastric lavage for successive 7 days and 14 days, then the cocktail-LC-MS/MS method was applied to assess the inductive effect of main CYP450 isoforms in mouse liver micro-somes. Results The IC50 values of Polygonum capita-tum water extract on main CYP450 isoforms in human liver microsomes were from 849 . 6 mg · L-1 to 2 287 mg·L-1 . Compared with the blank control group, the activites of CYP2C9 and CYP3A4 in 1. 16 g·kg-1 7 d group were about 49 . 9 % and 21. 1 % higher ( P <0. 01, P < 0. 05 ) respectively, the activities of CYP2C9 and CYP3A4 in 0. 58 g·kg-1 7 d group were 27. 6 % and 15. 5 % higher ( P <0. 01 , P <0. 05 ) respectively, the activities of CYP2C9 and CYP3A4 in 1. 16 g·kg-1 14 d group were 67. 5 % and 32. 1 %higher (P<0. 01) respectively, while the activities of CYP1 A2 , CYP2 E1 and CYP2 C19 were not increased significantly in Polygonum capitatum treatment group. Conclusions Polygonum capitatum water extract do not show the inhibitory effect on main CYP450 in hu-man liver microsomes. There is induction on CYP2C9 and CYP3 A4 in mouse liver microsomes by Polygonum capitatum water extract.