Objective To evaluate the influence of extraocular counterpulsation on ocular fundus blood vessels using high-frequency color Doppler ultrasonography. Methods Twenty-one patients with ischemic optic neuropathy were treated with extraocular counterpulsation. During treatment, the Doppler spectra were detected with high-frequency color Doppler ultrasonography. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance retinal index (RI) of central retinal artery and posterior ciliary artery were measured instantly before treatment and 1 min,5 min and 15 min after treatment. Results The instant PSV and EDV of central retinal artery and posterior ciliary artery were significantly increased (P＜0.05) after treatment, then decreased gradually. Fifteen min after treatment ,they returned to the level before treatment. Conclusions We can observe the changes of ocular fundus blood vessels noninvasively on high-frequency color Doppler ultrasonography. The method may be regarded as one of the basis for evaluating the effect of extraocular counterpulsation.

Objective To detect the initial results of total hip arthroplasty (THA) after failure of internal fixation of femoral neck fractures and investigate the key points in surgical procedures and prosthesis selection.Methods A retrospective analysis was performed on 36 cases who had THA for femoral neck fractures due to the initially failed internal fixation between January 2007 and December 2012.There were 21 males and 15 females,with age ranging from 46 to 72 years (mean,58.6 years).After internal fixation,13 cases were complicated by femoral head necrosis,eight fracture nonunion,and 15 fracture nonunion combined with femoral head necrosis.All the 36 cases had cementless THA,including proximally fixed stem in 25 cases and distally fixed stem in 11 cases.Harris hip score was assessed before operation and at follow-up.Results All the cases received a follow-up of 26-52 months (mean,32.5 months).Mean Harris hip score improved from 26.3 to 83.6,including excellent results in 12 cases,good in 22,and fair in two,with excellence-good rate of 94％.Conclusion With respect to the failed internal fixation of femoral neck fractures,THA is an effective remedial method to improve hip function and quality of life of the patients.

[Objective]To explore the surgical management and its results of intercondylar fracture of humerus through approach of osteotomy of olecranon(AOO) with dual anatomical steel plate DASP.[Method]From July 2002 to March 2006,26 patients of intercondylar fracture of humerus were treated surgically through AOO,and the fracture was reduced and fixed with DASP.The patients were 19 males and 7 females with a mean age of 35 years (range 15～46 years),According to Riseborough and Radin classification,type Ⅱ fracture was found in 6 cases,type Ⅲ in 18,type Ⅳ in 2.Early rehabilitation exercises was taken.[Result]Twenty-five fractures were satisfactory reduced but one not too good,none had incision infection,injuries of the ulnar nerve.Twenty-two patients were followed up from 6 months to 19 months(average 13.5 months),of these 22 patients,all the osteotomies healed in 17 weeks averagely(range 14～24 weeks) and the injuried ulnar nerve recovered completely.The function of the elbow(according to Cassbaum scale) showed excellent in 5 cases,good in 13,fair in 3 and poor in 1.the good-excellent rate was 81.8%.[Conclusion]The technique of DASP for the treatment intercondylar fracture of humerus through transolecranon approach offers many advantages,such as sufficient exposure easy to get anatomical reduction,stable fixation and earlier exercise.

Patient engagement is considered as one pillar of new stage of health care reform and new vitality of health care quality improvement.In recent years,the rapid development of E-Health technology provides richer opportunities for patients to actively participate in health care.The article concludes the basic connotation of patient electronic engagement and proposes the framework on the basis of foreign actions as well as literature reviews,expounds the type,media and methods of patient electronic engagement as well.From the views of projects support,patient education and information rights,feasible policy measures are proposed for patient electronic engagement advancement under E-Health environment.

Aged ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; surgery ; Laryngeal Muscles ; transplantation ; Male ; Middle Aged ; Pyriform Sinus ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

Objective To estimate reliability of magnetic resonance elastography (MRE) in measuring liver stiffness of volunteers and patients with chronic liver disease and to assess inter-rater consistency.Methods MRE was performed on a 3.0 T scanner in all subjects,including 24 volunteers (control group) and 64 patients with liver disease (chronic liver disease group).Liver stiffness was measured blindly by two raters.The pathological fibrosis score was applied as a standard reference for liver fibrosis in 22 patients.The intraclass correlation coefficient (ICC) was used to evaluate inter-rater reliability.The differences of liver stiffness between two groups were evaluated using non-parametric MannWhitney U test.Spearman analysis was used to analyze the correlation between fibrosis stages and liver stiffness.Results The intraclass correlation coefficient of liver stiffness was perfect (ICC =0.99,P ＜ 0.01)between two raters.There was significant difference of mean stiffness between control group and patient group (U =90.5,P ＜0.01) with(2.35 ±0.34) kPa and(4.17 ± 0.47) kPa,respectively.The correlation between fibrosis stage (3,3,5,5 and 6 patients in fibrosis stage S0,S1,S2,S3 and S4) and stiffness (2.13,3.25,3.82,5.45 and 7.35 kPa) was very strong (r =0.96,P ＜0.01).Conclusion MRE is a reliable and promising tool to measure liver stiffness and to assess liver fibrosis.

Wuhan Pu Ai Hospital implemented the pharmaceutical direct supply mode since October 2006 as an experiment.The pilot proved the mode as successful in reducing drug costs proportion,promoting rational use of drugs,and raising business volume of the hospital.Authors also recommend to further efforts in drug supply price supervision mechanism,government subsidy mechanism,direct supply catalogue and drug supply mode among others.Other recommendations include innovation in directly supply mode,hospital internal reform,packaged performance appraisal and incentive mechanism for medical workers,and building a ceiling mechanism for total medical expense control.

Objective To understand the relation between smoking and serum uric acid level and to investigate whether the ser-um uric acid has the correlation with the gender,age and smoking history.Methods The data of the gender,age,blood uric acid in1 847 individuals aged 20-80 years with the healthy physical examination and without underlying diseases were performed the statisti-cal analysis.Results With male and female as the research objects,the serum uric acid level of smokers were higher than that of non-smokers and occasional smokers,the difference was statistically significant;the serum uric acid level had no statistically signifi-cant difference between smokers and occasional smokers;the serum uric acid level had no statistically significant difference among non-smoking,occasional smoking and smoking groups for males as the research objects alone;to divide the male subjects into groups according to age,the serum uric acid level of non-smokers,occasional smokers and smokers were not statistically significant among all age groups;serum uric acid level showed the increasing trend with the increase of smoking history,but there was no statistically significant difference.Conclusion The serum uric acid level of smokers is significantly higher than that of non-smokers and occa-sional smokers with male and female as the research objects;the difference in serum uric acid level between smokers and occasional smokers has no statistical significance;excluding the gender factor interference,the serum uric acid level of males is not affected by smoking or age;serum uric acid mean value demonstrates the increasing trend with the increase of smoking history.

Objective: To construct subtracted cDNA libraries of stomach tumors and normal stomach tissue using suppression subtractive hybridization(SSH).Methods: cDNA Library subtraction was performed using the protocol described in the Clontech PCR-Select cDNA Subtraction Kit. cDNA was synthesized from 2 μg of poly A+RNA from the tumor and normal tissues using AMV reverse transcriptase. The tester and driver cDNAs were digested with RsaⅠ, a four-base-cutting restriction enzyme that yields blunt ends. The tester cDNA was then subdivided into two portions, and each was ligated with different cDNA adaptor. Two hybridizations were performed. In the first, an excess of driver was added to each sample of tester. Hybridization kinetics led to equalization and enrichment of differentially expressed sequences. During the second hybridization, the two primary hybridization samples were mixed together without denaturing and thus the templates were generated from differentially expressed sequences for PCR amplification. Using suppression PCR, only differentially expressed sequences were amplified exponentially and after second PCR amplification the background was reduced and differentially expressed sequences were further enriched. The cDNAs were then directly inserted into a T/A cloning vector to generate a stomach tumor-specific subtracted cDNA library. Results: The amplified library contained 800 positive clones. Plasmid inserts were PCR amplified and showed 250－700 bp inserts. Conclusions: The successfully constructed subtracted cDNA library of gastrocarcinoma and normal tissue enables us to compare two populations of mRNA and obtain clones of genes that expressed in one population but not in the other.The characterization of these genes will allow them to be exploited for their diagnostic and therapeutic potentials.

Objective To evaluate the CT features and the role of CT in the diagnosis of Crohn′s disease. Methods CT manifestations of 18 patients with pathology confirmed Crohn′s disease were retrospectively analyzed. The majority of the patients were scanned with spiral CT or multidetector row CT.Results All 18 patients, segmental thickening of the bowel wall was detected. There were two different appearances in contrast-enhanced CT scans: (1) mural thickening without enhancement or mural stratification, and homogeneous attenuation in the thickened wall were observed in 7 patients; (2) mural thickening and stratification, resulting in the target or double-halo appearance, were detected in 11 patients, and the bowel wall thickening ranged from 5 to 10 mm. Nine patients had perienteric abnormalities including fibrofatty proliferation, phlegmon and mesenteric hypervascularity. According to the CT manifestations, 5 patients were initially diagnosed as other diseases including intestinal obstruction (1 case), tuberculosis (1 case), cancer (2 cases), and abscess (1 case), respectively. Conclusion CT has the unparalleled ability to depict the abnormalities in the bowel wall, mesentery, abdominal and pelvic viscera, and contrast-enhanced CT can distinguish active Crohn′s disease from quiescent Crohn′s disease. These features make CT particularly valuable in the management of Crohn′s disease.