Objective:To explore and assess the clinical application and clinical value of dual helical CT and magnetic resonance imaging (MRI) in the diagnosis of knee bone tumor. Methods: Sixty-nine patients with knee bone tumors were randomly divided into three groups: group A, group B and group C. Group A was detected by double-helical CT scanning; group B was detected by MRI; group C was detected by dual-helical CT scan combined with MRI. After the end of the testing, the clinical diagnostic results of the three detection methods were compared.Results: There was no significant difference between group A and B (x2=0.825,P>0.05). The detection rate of group C was higher than that of group A. The differences were statistically significant (x2=2.936,x2=3.718;P<0.05). The detection rate of group C was significantly higher than that of group B. The differences were statistically significant (x2=3.967,x2=4.285;P<0.05).Conclusion: Double helical CT combined with MRI can effectively improve the clinical detection rate of knee bone tumor.

BACKGROUND: It is always the key issue of rheumatoid arthritis(RA) to treat articular gall. A kind of medicine with favorable therapeutic effects and safety is urgently needed in the clinics. 99Tc-methylene diphosphonate 99(Tc-MDP) receives generalized attentions on its therapeutic effects and safety since its application into RA therapy.OBJECTIVE: To explore the characters of 99Tc-MDP in the amelioration of articular dysfunction in RA patients.DESIGN: A before-and-after controlled study by employing patients as subjects.SETTING: Department of rheumatism and immunology of an affiliated hospital of a university.PARTICIPANTS: Totally 67 patients with RA at active phase including 11males and 56 females aged between 29 and 71 years old with the course of disease between 9 and 78 months and admitted by the Department of Rheumatism of Huaxi Hospital Affiliated to Sichuan University were in accordance with the RA diagnostic criteria established by American Rheumatism Association(ARA) in 1987. Serious heart,liver or kidney dysfunction,active gastrointestinal pathological changes, hematology and endocrinology diseases,allergic complexion,and women during pregnancy or breast-feeding period were eliminated.METHODS: Clinical indicators including articular edema index, articular pain,grip,morning stiffness duration,rest pain,erythrocyte sedimentation rate (ESR) and C reactive protein(CRP) were compared before and after therapy in 67 cases received 99Tc-MDP treatment. Integrated evaluation was performed after the completion of therapy. Effective meant 30% of improvement in symptoms and physical signs,and reduction in ESR and CRP. Side effects were observed and recorded simultaneously. Data were statistically analyzed.RESULTS: After 99Tc-MDP treatment,RA condition significantly improved,as well as each clinical indicator including articular edema index,articular pain index,morning stiffness duration,rest pain,ESR and CRP(P<0.05) . The total clinical effective rate of this medicine was 81% and the incidence of side effects was small and mild.CONCLUSION: 99Tc-MDP can ameliorate the articular dysfunction of RApatients,which is a safe medicine with strong effect.

Objective To explore the effects of three- stage swallowing rehabilitation on the swallowing a-bility of stroke patients with dysphagia. Methods 60 stroke patients were divided into primary cerebral infarction and primary cerebral hemorrhage groups, then further divided into treated and control groups randomly. All groups were given the same routine internal medicine treatment. Patients in the treated group were given three stage swallo-wing rehabilitation training additionally. All patients were assessed using Caiteng's Grading Method at the outset and at the end of the 2nd week, the Ist month and the 2nd month. Results Swallowing function scores in the treated groups were higher than those in the control groups at every stage (P≤0.05). The treated groups' scores also im-proved more quickly than those in the control groups. Conclusion Three stage swallowing rehabilitation can signifi-cantly improve stroke patients' swallowing function.

OBJECTIVE: To explore the treatment of sudden sensorineural hearing loss with steroid from different administration routes. METHOD: One hundred and eighty-eight patients with diagnosis of sudden sensorineural hearing loss were selected, in accordance with the random number table, and all patients were divided into three groups. With different administration routes, they were devided into systemic steroid therapy group, intratympanic steroid therapy group and postauricular steroid therapy group,and the curative effects were collected and analyzed. RESULT: The total effective rate was 78.26% in systemic steroid therapy group, 80.70% in intratympanic steroid therapy group and 80.65% in postauricularsteroid therapy group,and no statistical difference was detected among these three groups (P > 0.05). CONCLUSION The treatment of sudden sensorineural hearing loss with steroid from different adminsthation routes all can achieve a relatively favorable prognosis, and there were no obvious different among those different treatments.
Administration, Oral ; Audiometry, Pure-Tone ; Dexamethasone ; administration & dosage ; Glucocorticoids ; administration & dosage ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; drug therapy ; Humans ; Prognosis ; Steroids ; Treatment Outcome ; Tympanic Membrane

Compared with the education model of German medical doctors,the education of medical doctors in our country starts late,still need exploration and improvement.Based on the history of the education mode of modern higher medical education in Germany,the educational characteristics of German medical PhD were analyzed and a comparative study on the Chinese and German education mode of medical doctors in terms of training objectives,admission requirements,mentoring system were conducted,which provides reference for the reform of the education mode of medical doctors in our country.

Objective To investigate the efficacy and safety of Technetium 99m Tc methylenediphos-phonate injection (Yunke) and various combination therapy on rheumatoid arthritis.Methods All 137 patients enrolled in trial group.Among them 67 patients received Technetium 99m Tc methylenediphosphonate alone,42 patients received combination therapy with methotrexate and mobik and 28 patients received calcium orally meanwhile.Clinical manifestations and lab markers were observed carefully.Results The conditions of 67 patients receiving Technetium 99m Tc methylenediphosphonate alone were improved,42 patients received combination therapy had better effect and 28 patients in middle and old-age taking calcium orally simultaneously showed superiority in remission of rest pain and descent of ESR.Conclusion Technetium 99m Tc methylenediphosphonate is an effective and safe drug in the treatment of rheumatoid arthritis.Results is suggest calcium be taken in the same time.

ObjectiveTo investigate the improvement of speech in patients with increased blood pressure(BP) and stable blood pressure during speech therapy. MethodsAfter monitoring blood pressure with dynamic blood-pressure meter during speech therapy, patients were divided into increased BP group and stable BP group. Patients received two-month speech therapy, then their score changes in ABC examination of pre-treatment and post-treatment were compared. ResultsIn oral expression, score changes in increased BP group were significantly different from those in stable BP group (P<0.05). In listening comprehension, score changes had no significant difference between two groups(P>0.05). Conclusions Patients in increased blood pressure group progressed obviously in oral expression.

ObjectiveTo analyze the clinical outcome of locking plate and hemiarthroplasty in treatment of Neer three- and four-part proximal humeral fractures.Methods A totalof 63 consecutive patients aged over 55 years with Neer three- and four-part proximal humeral fractures were treated surgically from June 2006 to June 2010.In the retrospective study,36 patients were treated by open reduction and locking plate fixation ( locking plate fixation group) and 27 patients treated by hemiarthroplasty (hemiarthroplasty group).Clinical outcomes including operation time,blood loss,visual analog scale ( VAS),Constant-Murley score and complications were evaluated.ResultsThe average 19.7 months follow-up showed complication rate of 28％ in the locking plate group,including one patient with varss malunion,one with axillary nerve injury,one with humeral head necrosis,one with heterotopie calcification and four with impingement syndrome.The complication rate was 24％ in the hemiarthroplasty group,including two patients with tuberosity nonunion,one with tuberosity migration,one with impingement syndrome and one with joint semiluxation.The mean Constant-Murley score of three-part fractures in the locking plate group was ( 76.5 ±5.8) points,better than (69.2 ±7.2) points in the hemiarthroplasty group (P ＜0.05 ).While the two groups showed no significant differences with regards to operation time,blood loss and visual analog scale (VAS).As for the four-part fractures,the mean operation time was shorter and the mean blood loss was less in the hemiarthroplasty group compared with the locking plate group (P ＜0.05),while there were no obvious differences in VAS score and Constant-Murley score between the two groups. Conclusions Both locking plate and hemiarthroplasty are the reliable methods for the three- and four-part proximal humeral fractures.The patients' age,bone quality,fracture type,comminution degree and evaluation of osteonecrosis possibility,are critical for surgery decision.

Objective To review our experiences of diagnostic methods and surgical treatment of the left superior vena cava (LSVC) draining into the left atrium.Methods Nineteen patients with LSVC draining into the left atrium were diagnosed and treated surgically from February 1998 to January 2012.All the cases were combined with other congenital heart diseases including patent ductus arteriosus,ventricular septal defect,atrial septal defect,single atrium,triatriatum,partial endocardial cushion defect,anomalous pulmonary venous drainage,right ventricle outflow stenosis,pulmonary valve stenosis,tetralogy of Fallot,double outlet right ventricle,complete endocardial cushion defect,tricuspid atresia.The patients were diagnosed through different methods including echocartiographic examination,cardiac catheterization,computer tomography,and explored during the operation,even postoperatively.All were treated surgically with four techniques including simple ligation to the LSVC,including ligation during a redo procedure; intra atrial rerouting to drainage the flow from the LSVC to the right atrium,atrial septum reconstruction to make the outlet of the LSVC lying in the right side of the patched atrial septal,and bidirectional Glenn shunt to get a physiological result.Results No mortality postoperatively.All the cases were uneventful postoperatively.And the main postoperative course was related only to the main diagnosis of congenital heart disease,not to the left superior vena cava draining into the left atrium.The echo examination result was satisfied before the discharge.The early and long term follow-up(1-11 years) results are excellent,no arrhythmia,no cardiac deficits after echo examination,including stenosis obstruction and residual shunt.No death.Conclusion The diagnostic methods of the LSVC draining into the left atrium are difficult,the only way to make the diagnosis clearly enough before the operation is depending on improving of more and more comprehending to this rare cardiac anomaly,by the pediatric cardiologists,the sinologist,the intensive care unit,and the pediatric cardiae surgeons.The choice of different surgical treatment is depending on the diagnosis and the findings during the operations,and the results are excellent after a suitable choice made.

Objective To investigate the change of levels of related cytokines,including transforming growth factor-β2 (TGF-β2),basic fibroblast growth factor (bFGF),platelet-derived growth factor (PDGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) and behavior in streptozotocin-induced diabetic rats between the before and after fracture,at the same time,to analyse the relativity of them.Methods The rat models of diabetic were induced by intraperitoneal injection of streptozotocin,which were divided into different diabetes mellitus group (DM group) randomly.The right tibiofibula of all the rats of diabetes mellitus group and normal control group(NC group) were broken,and then treated with external fixation.The bone callus formation was evaluated by X-ray.When all the operation above was completed,the rats were domesticated in different cages.The concentration of related cytokines of the DM groups and NC group was detected at different time.Results The behavior changes of diabetes fracture rats were distinct and appeared a series symptoms such as bradykinesia,dull,polydipsia,polyphage,polyuria,emaciated obviously.The concentration of related cytokines (TGFβ2,BFGF,PDGF,IL-6,IL-8 and TNF-α) of the two groups was detected at 1,2 and 4 weeks.The difference between them was significantly(TNF-α:the concentration of NC group were (9.87 ± 1.06) ng/ml,(14.07 ± 1.43)ng/ml and(12.02 ± 1.02) ng/ml; the concentration of DM group were (11.65 ± 1.18) ng/ml,(16.29 ± 1.24)ng/ml and(13.87 ± 1.25)ng/ml ; P ＜ 0.05).X-ray films showed that the fracture healing of NC group was more superior than that of DM group.Conclusion The reduction of TGF-β2,BFGF,PDGF and the increase of IL-6,IL-8,TNF-α in early fracture are one of important reasons for delayed union and nonunion in diabetic rats.At the same time,there is a cooperative action between them.Dynamic observation of the concentration of related cytokines will provide eliable experimental data to estimate fracture healing,delayed union and nonunion.It is favourable to acquaint the regulatory mechanism of fracture healing at molecular level.