[Objective]To probe the standard of early diagnosis of femoro-acetabular impingement(FAI),and the imageological appearance of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction,and MRI of progression of FAI patients.And to approach the significance of using the imageology result to identity doubtful FAI patients with other patients.[Methods]Six FAI patients were enrolled.CT and MRI noncontrast enhanced scan and CT three-dimensional reconstruction were performed to assess the hip joint.The CT scan was performed on the GE Lightspeed 16 row spiral at 1.25 mm slice reconstruction.The MRI scan was performed on the Siemens Avanto 1.5T supraconduction magnetic resonance meter.The CT and MRI scan included the acetabulum to the lesser trochanters.[Results]The results of DR of pelvis orthophoria discovered subtotal congenital anatomic abnormality of hip.The result of 16 row spiral CT noncontrast enhanced scan and three-dimensional reconstruction discovered total congenital anatomic abnormality of hip.The result of MRI noncontrast enhanced scan discovered phlegmasia of hip joint of midanaphase patients of FAI.[Conclusion]Non-buninoid femoral head,hyper-deep of hip,acetabular anteversion and hypsokinesis,and typical sings and symptoms lead to early and exactitude diagnosis.The results of 16 row spiral CT three-dimensional reconstruction and MRI can provid straight reference operation schedule;The result of MRI noncontrast enhanced scan can detect FAI with early avascular necrosis of the femoral head.

Objective To investigate the effect of different doses of ketamine on inflammatory cytokines in rabbits with severe burn at early stage and preliminarily approach its regulatory action on early stage of inflammatory reaction due to stress of trauma.Methods Forty healthy male New Zealand rabbits were randomly divided into four groups in accord with the random number table method: normal control group, scald model group, ketamine analgesia group and ketamine anesthesia group. Before scald, pentobarbital sodium was used for anesthesia, afterwards catheters were inserted into internal jugular vein and internal carotid artery respectively ready for use, and 24 hours later, Ⅲ degree scald at the animal back and buttocks occupying 30% total body surface area (TBSA) was performed as the scald model for all the rabbits except those in normal control group. In ketamine analgesia group, after scald for 0.5 hour, 0.5 mg/kg ketamine intravenous injection was given to the rabbits as the loading dosage and then persistent intravenous pump infusion of 9μg·kg-1·min-1 ketamine was applied for all together 24 hours. In ketamine anesthesia group, after scald for 0.5 hour, 1.5 mg/kg ketamine intravenous injection was given to the rabbits, and then persistent intravenous pump infusion of 45μg·kg-1·min-1 ketamine was applied for 4 hours to maintain systemic anesthesia. In normal control and scald model groups, only intravenous infusion of equal amount of normal saline was given to the rabbits. The amount of intravenous transfusion in each group and the total dosages of ketamine used in ketamine analgesia group and ketamine anesthesia group were recorded. Before scald and 0.5, 6, 12, 24 hours after scald, arterial blood gas analyses were made, and the levels of serum interleukins (IL-1, IL-6) and tumor necrosis factor-α (TNF-α) were determined.Results Although the indexes of blood gas analysis were changed in the four groups, they were all in the normal range, showing that the respiratory function was in the normal range and indirectly reflecting that the circulatory function was also in the normal range, thus the effects on cytokines by factors of respiratory and circulatory functions were ruled out. The levels of IL-1, IL-6 and TNF-α before scald showed no statistically significant differencesamong the four groups (allP > 0.05). From 0.5 hour after scald, the levels of IL-1, IL-6 and TNF-α were markedly higher in model group than those of normal control group [IL-1 (ng/L): 30.27±0.93 vs. 13.79±1.11, IL-6 (ng/L): 47.22±1.49 vs. 46.31±4.12, TNF-α (ng/L): 243.39±20.85 vs. 190.95±14.97, allP < 0.05], and the situation continued until 24 hours after scald; the levels of IL-1, IL-6 and TNF-α from 6 hours after scald were significantly decreased in ketamine analgesia and ketamine anesthesia groups compared with those in the model group, and from 12 hours after scald, the degrees of descent in levels of the above indexes in ketamine analgesia group were more obvious than those in ketamine anesthesia group [IL-1 (ng/L): 19.28±2.51 vs. 40.12±10.31, IL-6 (ng/L): 52.10±4.23 vs. 72.20±10.11, TNF-α (ng/L): 246.03±20.74 vs. 313.71±27.34, allP < 0.05].Conclusion The low-dose ketamine analgesia and ketamine anesthesia have certain degree of inhibitory effect on the expression and release of inflammatory cytokines at the early stage in rabbits with severe burn, the effect of long-term low-dose ketamine analgesia being more significant.

Background Bevacizumab has been widely used in the treatment of new blood vessel disease in ophthalmology.The investigation of the pharmacokinetics and safety after intracameral injection of bevacizumab can offer the basis for the management of iris neovascularization and neovascular glaucoma.Objective The present study was to observe the distribution of bevacizumab(avastin)in eye tissue and toxic effects following the injection of anterior chamber.Methods Twenty-four New Zealand albino rabbits were divided into two groups randomly.0.05 ml (1.25mg)of Bevacizumab was intracamerally injected into the left eyes in the experimental group,and a balanced salt solution of 0.05 ml was injected in the same way into the left eyes of the control group.The anterior segment of eyes and ocular fundus were examined by slit-lamp microscope and direct ophthalmoscope after injection.Intraocular pressure was measured and corneal endothelial microscopy was performed before and after the injections.Five rabbits of the two groups were sacrificed on the first day,the fourth day,the seventh day,the fourteenth day,and the thirtieth day after injection,and the eyeballs were enucleated for histopathological examination.The ultrastructure of eye tissue was observed under the transmission electron microscope on the fourth day and the thirtieth day,and then immunofluorescence staining were performed to assess the distribution of bevacizumab in the eye tissues.This experiment complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission(Version 1988).Results No abnormality in the cornea,lens,vitreous and retina was observed after the injection of bevacizumab under the slit lamp microscope and direct ophthalmoscope.No significant differences were found in intraocular pressure and corneal endothelial cell density in the bevacizumab group compared with the control group before injection and 2 hours,1 day,7 days,14 days,30 days after injection(P =0.760,P =0.956).No histopathological and ultrastructural changes of the cornea,lens,chamber angle,iris,ciliary body and retina were seen after the injection in the experimental group and control group under the light microscope and transmission electron microscope.Bevacizumab was distributed in the anterior chamber angle,iris,ciliary body,choroid and retina in injected eyes and fellow eyes after intracameral injection with red fluorescence and presented the dynamic changes with the lapse of time.The immunofluorescence response of eye tissue to bevacizumab was weaker in the fellow eyes compared with injected eyes.Bevacizumab was mainly distributed in the vessel wall and lumen.Conclusions Bevacizumab can quickly distribute in the vascular tissue of the anterior chamber angle,iris,ciliary body,choroid and retina in injected eyes after intracameral injection without obvious toxic effects to eye tissue.Bevacizumab administered intracamerally may be a new strategy or a joint strategy for iris neovascularisation.

Objective To study prevention and treatment for patients during the intermittent period of maintaining hemodialysis complicated by acute left heart failure. Methods The treating process of 126 examples suffered from acute left heart failure during the intermittent period of 14 225 person-time maintaining hemodialysis in 143 patients were retrospectively analyzed. Results In this case group, 0.89% suffered from acute left heart failure during the intermittent period of hemodialysis and the successful rescuing rate was 88.9%. Conclusions Applying the treatment of emergency hemodialysis, quickly filtering body fluid, the curative effect is reliable and rapid. It is one of the best ways to cure patients suffered from acute left heart failure during the intermittent period of maintaining hemodialysis. Combined with other treatments, it will be able to improve the successful rate, and ensure the sufficiency of hemodialysis. United with other steps of reducing blood pressure, such as using angiotensin converting enzyme inhibitors, angiotensin II receptor blocker, and ? receptor blocker, it is an effective countermeasure to prevent patients suffering from acute left heart failure during the intermittent period of maintaining hemodialysis, and effectively reduces its appearance as well.

Objective To investigate the pharmaeokinetics of levofloxacin in rat's pancreatic tissue. Methods Pancreatic tissue and blood were sampled in vivo by microdialysis simultaneously. The concentrations of levofloxacin in beth blood and tissues were measured by high performance liquid chromatography. All date were analyzed by WinNonlin software. Results The maximum concentration of free levofloxacin in blood and pancreatic tissue were (65.23 ± 12.9) μg/ml at 10min and (30.56±3.22) μg/ml at 20 min, respectively, then beth continuously decreased. Concentration of free levofloxacin in pancreatic tissue was higher than that in blood from 20min to 100min, then returned to similar level. The area under the concentration curve(AUC)of unbound levofloxacin was(2465.11±258.56)min·μg~(-1)·ml~(-1) in pancreas,and (2914.38±205.73)min·μg~(-1)·ml~(-1) in blood.Conclusions Microdialysis with reversed phase high performance liquid chromatography established in this essay could be used to determine the pharmacokinetics of levofloxacin objectively. High concentration of levofloxacin in pancreatic tissue and blood was observed.

Objective To evaluate the value of material decomposition imaging of spectrum CT in overcoming renal cyst pseudoenhaneement.Methods Totally 80 patients with renal cysts (total 75 cysts) who underwent CT imaging with GSI mode were collected.The renal cysts were divided into 3 groups according to diameters,group A (diameters 0.5-＜1.5 cm,n=25),B (1.5-＜2.5 cm,n=25) and C (2.5-＜3.5 cm,n=25) respectively.The iodine-water density imaging was reconstructed by using the GSI Viewer analysis software.The CT value and iodine-water concentration of the cysts were recorded.The difference of CT value,iodine-water concentration in unenhanced and enhanced dual phases in each group was compared.Results The difference of CT value between plain scan and parenchyma phase among the 3 groups had statistically significant difference (F=204.128,P＜0.001),and the differences comparing any two were statistically significant (all P＜0.05).The postcontrast attenuation increased more than 10 HU in group A and B,indicating renal cyst pseudoenhancement,and less than 10 HU in group C,which had no pseudoenhancement.There were statistical difference in iodine concentration of the cysts of the 3 groups in unenhance,cortical and parenchyma phases (all P＜0.001),but the difference value in unenhance,cortical and parenchyma phases were less than 10 (100 μg/cm3),and the difference value of the 3 group was group A＞group B＞group C (all P＜0.05).The water concentration of the cysts in group A descend in renal cortical and parenchyma phase with statistical difference (P＜0.001),but the difference value was less than 10 mg/cms.Conclusion The measurements of iodine-water concentration appear to drift as well,the smaller the greater,The degree of the iodine concentration shifting is more obvious than water concentration.

Objective To observe the effects of Baishile Capsules on the hippocampal PI3K signaling pathway in chronic mild unpredictable stress (CUMS) rats; To discuss its mechanism of action for anti-depression. Methods SD rats were randomly divided into 6 groups, control group, model group, fluoxetine group, Baishile Capsules high-, medium- and low-dose groups, with 10 rats in each group. The cums depression model was established, and gavage for medication was conducted at the same time for 21 days in a row. The behavioral changes of rats in each group were detected by the novel feeding experiment and Open-field experiment; monoamine neurotransmitter in serum were detected by ELISA; the expressions of PI3K, AKT and SGK1 in rat hippocampus were detected by immunofluorescence and Western blot test. Results Compared with the control group, feeding latency of rats in model group was significantly prolonged (P<0.01), horizontal and vertical activities were significantly reduced (P<0.01); the content of serum monoamine neurotransmitter decreased (P<0.01); the expressions of PI3K and AKT in hippocampus decreased, while the expression of SGK1 increased (P<0.01, P<0.05). Compared with the model group, Baishile Capsule high- and medium-dose groups can significantly shorten the incubation period of feeding rats (P<0.05), and increase the number of horizontal and vertical activities (P<0.01); the 5-HT and NE levels in serum were significantly elevated (P<0.05, P<0.01); the expressions of PI3K, AKT in hippocampal increased; the expression of SGK1 decreased (P<0.05, P<0.01). Conclusion Baishile Capsules can alleviate the depression like behavior in rat models, and regulate key factors of hippocampal PI3K signaling pathway, so as to exert antidepressant effects.

Objective To assess the patient enablement level in a general hospital and its related factors,to investigate the relationship of patient enablement with patient's overall satisfaction and doctor's empathy levels.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete a questionnaire survey which included general characteristics,overall satisfaction;the Patient Enablement Instrument (PEI) and the Consultation and Relational Empathy Measure Scale (CARE) after the consultation.Results Total 2 326 questionnaires were issued and 1 818 were retrieved,of which 1 478 were qualified questionnaires.The qualified rate of PEI was 81.3％ and the qualified rate of patient overall satisfaction was 96.28％.The positive rate of patient enablement was 97.70％ (1 444/1 478),and the mean score of PEI was 8.21 ±3.33.Multivariate linear regression analysis showed that the PEI scores were not influenced by gender and education level of the patients,gender of the consulting doctors and initial/follow up consultation.The PEI scores were influenced by the age of the patients,the types of clinic (general practice/chronic practice clinic) and the reasons for consulting (P ＜ 0.05).There were correlations between PEI score and overall satisfaction of patients (r =0.383,P ＜ 0.001),patient's recommendation of the clinic (r =0.595,P ＜ 0.001) and CARE scores (r =0.546,P ＜ 0.001).Conclusion The results show that the PEI scores of patients visiting family medicine clinic of this hospital are higher than those reported in other studies.The PEI score may be influenced by the age of the patients,the types of clinic and the reasons for consulting.Positive correlations between patient enablement and the overall satisfaction,patient's recommendation and doctor empathy were observed.

Objective To assess the empathy level of general practitioners (GPs) in the outpatient clinics of a general hospital,and to investigate the related factors.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete the questionnaire which included general characteristics,overall satisfaction and the Measure-Consultation and Relational Empathy Measure (CARE) Scale after the consultation.Results Of the 1 818 questionnaires retrieved,1 690 CARE scales were completed (intact rate was 92.96%).The overall satisfaction rate was 95.92% (1 621/1 690).And 97.28% (1 644/1 690) of the patients would recommend family medicine service to their friends or relatives.The total score of CARE scale was (45.47±6.26),and the scores of 4 CARE components were (4.63 ± 0.59),(4.43 ± 0.81),(4.54 ± 0.69) and (4.55 ± 0.66),which showed significant difference (P<0.01).The multivariate linear regression analysis showed that the mean CARE scores were not influenced by gender and education levels of the patients,gender of the consulting doctors,initial/follow up consultation,and the location of the consultation.The mean CARE scores were influenced by age of patients and the reasons for consulting (P<0.05).There was a moderate correlation of the CARE scores with the overall satisfaction of patients (r=0.613,P<0.001) and patient's recommendation of the clinic (r=0.466,P<0.001).Conclusion Doctors who were evaluated in this study have a higher empathy level than results from other countries.There is positive correlation between doctor's empathy level and patient's overall satisfaction.The result of doctor's empathy level may be influenced by patient's age and the reasons for consulting.

Objective To explore the normal range of the volume of frontal lobe in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain. Methods This is a clinical multi-center study. Two hundred Chinese healthy volunteers (age range= 18 to 70) recruited from 16 hospitals were divided into 5 groups, i. e. , age range from 18 to 30, age range from 31 to 40, age range from 41 to 50, age range from 51 to 60, and age range from 61 to 70. Each group contained 20 males and 20 females. All of the volunteers were scanned by MR using T1 weighted threedimensional magnetization prepared rapid acquisition gradient echo sequence. We used the manual method to trace the region of interest and measured the left and right frontal lobe volumes separately. All the data were analyzed with SPSS (version 13.0). The sex differences in the frontal lobe volumes were analyzed by independent-samples t test, and the side differences were analyzed by paired-samples t test. Correlation and regression analysis was used between the age and the frontal lobe volumes. Results In 200 healthy Chinese Han volunteers, the total frontal lobe volumes was (563 ± 73) cm3. For male, the volumes of the left and the right frontal lobe were (288±42) cm3 and (292 ±41 ) cm3 ,respectively. The volumes of the left and right frontal lobe in 100 women were (273 ±30) cm3 and (274 ± 30) cm3 respectively. The differences of sex (t = 3. 334, P < 0. 05 ) and side ( t = - 3.09, P < 0. 05 ) in the total frontal lobe volumes reach significant. There was no significant differences in women ( t = - 1. 304, P > 0. 05 ). There were negative correlations between the frontal lobe volumes and age in men and women ( r = - 0. 586, - 0. 498, P <0. 01 ). Conclusions The total frontal lobe volume of men was larger than that of women. The volume of the right frontal lobe was larger than the left frontal lobe in men, and the asymmetries didn't exist in women.The total frontal lobe volumes were both shrinking with age in men and women, which was more rapid in men than in women.