Objective To explore the diagnostic value of GRE T2 ? WI sequences in low field strength MR with oblique coronal plane in patients with acute anterior cruciate ligament (ACL)injury.Methods 68 cases of acute traumatic hemarthrosis of the knee joint proved surgically were reviewed.The cases were divided into two groups:conventional MR group (axial image,standard coro-nal image and sagittal oblique image),and conventional with oblique coronal MR group.The diagnostic results with surgical and path-ological results were compared.The diagnostic accuracy of two images were evaluated respectively.Results For conventional MR group and conventional with oblique coronal MR group,the sensitivities in diagnosing ACL were 72.9% and 97.9%,the specificities were 80% and 85%,the positive predictive values were 89.7% and 94%,the negative predictive values were 55.2% and 85%,the accuracies were 52.9% and 82.9%,the misdiagnosis rates were 20% and 1 5%,the missed diagnosis rates were 27.1% and 2.1%, and the coincidence rates was 75% and 94.1%,respectively.The difference in diagnosis rates between two groups were statistically significant(P <0.05).Conclusion GRE T2 ? WI sequences with oblique coronal plane can significantly improve the diagnostic rate of anterior cruciate ligament injury.

Objective To evaluate the clinical value of multislice spiral CT(MSCT) reconstruction in designing the pedicle screw trajectory before operation in atlantoaxial lesions.Methods 37 patients with upper cervical abnormality treated by surgery for atlantoaxial or occipitoaxial interfixation and/or fusion were undergone MSCT scan,and the 3D anatomical data(including the length,width and height of each pedicle,the angle between the pedicle and sagittal plane,and the thickness of internal occipital crest) were measured on volume reconstruction(VR) and multi-plane reconstruction(MPR) images and used for surgeon to select advisable pedicle screws(including the proper length and diameter) and to ensure the comfortable point,depth and direction for screw position at preoperation.The patients were followed up by atlantoaxial X-ray image and/or MSCT reconstruction to estimate the veracity of the screw position.Results All the patients were operated successfully,of them,5 patients were treated by simply atlantoaxial fixation,15 by atlantoaxial fixation and fusion,4 by simply occipitoaxial fixation,11 by occipitoaxial fixation and fusion,2 by atlantoaxial fixation and occipitoaxial fusion.X-ray images and/or MSCT reconstruction revealed that atlantoaxis were reposition entirely and all the screws were at predesigned trajectory.All the patients were followed up and no screw was broken or loosen and no atlantoaxial redislocation was found.Conclusion MSCT reconstruction for designing pedicle screw trajectory in atlantoaxial lesions before operation is satisfactory and valuable for clinical application.

Objective To observe the imaging features of partiallythreaded screw fixation using in various kinds of C2 pedicel fracture.Methods CT image materials of 160 Chinese Han patients who suffered from atlantoaxial injury without vertebral body and pedicle fracture of C2 was included in this study,including 120 males and 40 females.Pedical trajectory selected according to Ebraheim method in threedimensional CT reconstruction was analyzed in ADW 4.4 workstation.The posterior wall fracture of C2 vertebral body,isthmus fracture and fractures under C2 laminar were simulated according to clinical observation.The trajectory length (partiallythreaded screw length) from entry point to anterior cortical bone of C2,bolt shank length from entry point to fracture line and fillet of screw length from fracture line to anterior cortical bone of C2 were measured.Relations between height,gender and partiallythreaded screw length bolt shank and fillet of screw length was evaluated.Results Male height was 167±7.9 cm on average,and female was 156±6.6 cm.The length of partiallythreaded screw was 29 mm in male and 25 mm in female on average.Height and gender was positively correlated with partiallythreaded screw length.In posterior wall fracture of C2 vertebral body,length of bolt shank was an average of 17 mm in male and 15mm in female,while fillet of screw length was 12 mm in male and 10 mm in female.The mean length of bolt shank was 14mm in male and 13 mm in female,while mean fillet of screw length was 15 mm in male and 12 mm in female in isthmus fracture.In fractures under C2 laminar,length of bolt shank was 10 mm in male and 9 mm in female on average,while mean fillet of screw length was 18 mm in male and 15mm in female.Conclusion The length of partiallythreaded screw used in posterior axial pedicle fracture may have a close correlation to length and height.The length of bolt shank and fillet of screw was different according to the position of the fracture.

Objective To explore current situation of depressive symptoms and analyze its influencing factors in stage 1-4 chronic kidney disease (CKD) patients. Methods From August 2014 to September 2014, a cross-sectional study was performed, and 214 outpatients chronic kidney disease ( CKD ) were recruited by convenience sampling method to evaluate depressive scores using the Zung self-rating depression scale in a grade A class three hospital of Sichuan province. Using single factor analysis method, a preliminary study was performed to explore the influencing factors of depression symptoms including gender, residence, education and the family income per capita. Results A total of 214 CKD depression scores was (47. 98 ± 10. 38), which was significantly more than that of norm (t=20. 472, P<0. 01). Single factor analysis showed gender, residence, education and the family income per capita all influenced the depressive incidences (χ2 =14. 929, 5. 413, 7. 290, 9. 917;P<0. 05). Multiple stepwise regression analysis showed gender, residence, education and the family income per capita all were depression influencing factors (P<0. 05). Conclusions Medical and health institutions should give great importance to depressive symptoms in CKD patients, especially for stage 1-4 CKD patients. Focus on assessment and early intervention can reduce the incidences of the depression and improve the prognosis.

Objective To investigate the diagnosis and prognosis value of plasma microRNA-30d (miR-30d)in acute coronary syndrome(ACS)patients.Methods It retrospectively recruited 170 cases of ACS patients from TEDA International Cardiovascular Hospital between September 2011 to February 2012, including 70 STEMI(male 54,female 16), 52 NSTEMI(male 34,female 18),48 UAP(male 29,female 19).At the same time,41 healthy controls(male 24,female 17)were enrolled into the study.Plasma miR-30d levels were determined by real-time quantitative PCR.In order to evaluate the dynamic change of miR-30d and other cardiac biomarkers,20 plasma samples of AMI patients were collected at 0-3 h,4-6 h,7-9 h, 10-12 h after pectoralgia.ROC curves and Kaplan-Meier survival curve were used to investigate clinical value of miR-30d in ACS.Results At 0-3 h after pectoralgia, miR-30d were significant higher in STEMI 7.208(0.170-11 070.735)and NSTEMI 7.989(0.836-151.391)than the controls 1.561(0.044-17.520)（Z1＝-5.792,Z2 ＝-6.113,P＜0.001）, but there were no statistic differences between UAP 1.073 （0.051-11.095）patients and the controls（Z＝-0.325,P＝0.745）.In 20 AMI patients,miR-30d levels peaked at 4-6 h and then dropped following 7-9 h, both earlier than cTnI, and the variation tendency was positive correlated with cTnI（r＝0.402,P＜0.01）.At 0-3 h after pectoralgia, the AUC, sensitivity and specificity of miR-30d for differentiating AMI and UAP were 0.882（95％ CI:0.830-0.935）,0.795（95％CI:0.711-0.861）and 0.854（95％ CI:0.716-0.935）respectively.When combined miR-30d and cTnI, the diagnostic AUC and specificity were 0.937（95％ CI: 0.902-0.972）and 0.937（95％ CI:0.818-0.984）,both enhanced when compared with miR-30d or cTnI alone.Kaplan-Meier survival curves revealed that there were no significant correlations between the miR-30d levels and MACE in both 30 days and 12 months（χ$lt@span sup=1$gt@2$lt@/span$gt@＝0.506,P＝0.477 and χ$lt@span sup=1$gt@2$lt@/span$gt@＝0.002, P＝0.963 respectively）.Conclusion Plasma miR-30d may be used as a potential biomarker for early diagnosis, but not prognosis in ACS patients.