Objective To evaluate the acromion morphology of scapular roentgenography in the diagnosis of subacromial impingement syndrome. Methods Sixty four patients 75 shoulders with chief complaint of shoulder pain were examined roentgenographically by true scapular A-P and lateral views. The Neer impingement sign of all these patients were positive. Results In this series, there were 10 shoulders of type Ⅰ acromion, 13.3%; typeⅡ 17 shoulders, 22.7%; type Ⅲ 48 shoulders, 64.0%. Fifty nine cases 69 shoulders accepted Lidocaine test. The positive rate was: type Ⅰ, 4 shoulders, 44.4%; type Ⅱ, 8 shoulders, 53.3%; type Ⅲ, 38 shoulders, 84.4%. Among these three groups, the result of Chi test for Lidocaine tests: P0.05 (typeⅠ to type Ⅱ). Conclusion True scapular X ray film is a useful and effective diagnostic method for subacromial impingement syndrome. The incidence of subacromial impingement syndrome of the patients with type Ⅲ acromion is significantly higher than the other two types.

A Review This article reviewed the characteristics of the laser scanning confocal microscope and its application in the research of the ischemic heart disease ,including the morphology ,apoptosis and necrosis of the myocardium, the express of the adhesion molecule, and the Ca 2+ ion in the myocardium.

Objective To evaluate the effects of pulmonary static inflation with different pressures on postoperative lung function in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients,aged 26-70 yr,weighing 47-78 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =30 each):pulmonary static inflation with 5 cm H2O group (group L) and with 10 cm H2O group (group H).In L and H groups,pulmonary static inflation was performed with the pressure maintained at 5 and 10 cm H2O,respectively,after stopping mechanical ventilation during CPB.Arterial blood samples were taken before skin incision and at 1,3 and 6 h after termination of CPB for blood gas analysis.The alveolar-arterial oxygen pressure difference (D(A-a)O2),respiratory index (RI) and oxy.genation index (OI) were calculated.The indwelling time of endotracheal tube after operation and duration of ICU stay were recorded.Results Compared with group L,D(A-a)O2 and RI were significantly decreased and OI was increased at 1,3 and 6 h after termination of CPB,the incidence of OI less than 300 mm Hg was decreased (P ＜ 0.05),and no significant change was found in the indwelling time of endotracheal tube after operation and duration of ICU stay in H group (P ＞ 0.05).Collusion Pulmonary static inflation with 10 cm H2O can better improve postoperative pulmonary diffusion function than with 5 cm H2O in patients undergoing cardiac valve replacement with CPB.

Objective To compare the difference of static balance ability in different aged people, with the maximum angle of center of mass (COM) and center of pressure (COP). Methods 37 healthy people without cardiovascular and cerebrovascular diseases including 15 young people (18~40 years old), 10 middle age people (41~65 years old) and 12 old people (>65 years old) participated in this study. The maximum angle of COM-COP and the corresponding envelope areas were recorded in 4 standing posture: natural standing, close eyes standing, single leg standing and single leg standing with eyes closed. Results There was no significant difference in the maximum angle of COM-COP among 3 groups in 3 states (nature standing, close eyes standing, single leg standing with eyes closed) (P>0.05), but there was significant difference in the state of single leg standing (P<0.05) between the young and the old, and the middle-aged and the old. Conclusion The maximum angle of COM-COP in the state of single leg standing can sensitively detect the deterioration of stability of older people. It may be a new index of static balance in clinic.

Objective To analysis the health related quality of life (HRQOL)in emigrants with rheumatoid arthritis(RA) in Three‐Gorge Reservoir area ,and to study the influencing factors on HRQOL .Methods Self‐rating depression scale(SDS) was used to assess degree of depression in emigrants with rheumatoid arthritis in Three‐Gorge Reservoir area ,and SF‐36 scalec was used to assess the HRQOL of these patients .The one‐way ANOVA and stepwise regression analysis were used to study the influence fac‐tors of HRQOL .Results SDS scores showed that there were 110 peoples with depressive symptoms (67 .5% ) ,including mild de‐pression 58 cases(35 .6% ) ,moderate depression 39 cases(23 .9% ) ,severe depression 13 cases(8 .0% ) .Stepwise regression analysis showed that :SDS score ,DAS‐28 classification ,age ,sex ,treatment ,education ,occupation ,physical exercis ,economic income ,health insurance and alcohol consumption influenced the HRQOL scores of patients with IBS .DAS‐28 classification ,economic income , health insurance ,sex ,treatment were the main influencing factors ,with the unstandardized partial coefficients of -39 .211 ,31 .512 , 25 .866 ,-42 .348 ,-51 .235 .Conclusion Most of emigrants with RA in Three‐Gorge Reservoir area suffering from depressive symptoms ,and the HRQOL scores of them is not optimistic .The results suggested that more attention must be paid to the elderly , low‐income ,women ,low education ,DAS‐28 classification and no occupation .Quiting drinking ,receiving treatment ,psychological treatment ,strengthen exercise and expanding the scope of medical insurance all can improve patients′health related quality of life .

Objective To explore the clinical application of treponema pallidum enzyme-linked immunosorbent assay (TP-ELISA),syphilis toluidine red unheated serum regain test (TRUST) and treponema pallidum particle agglutination assay (TPPA) for the diagnosis of syphilis,improvement of the process of sequence syphilis screening program and thus assisting clinical diagnosis and treatment of syphilis.Methods The serum samples were both screened by TP-ELISA and TRUST simultaneously.The positive was confirmed by TPPA test.Syphilis serological test results of patients were collected and retrospectively analyzed.Results The 3 618 cases out of total 82 026 serum samples were reactive by TP-ELISA,453 were reactive to TRUST,and 1 684 were confirmed positive on TPPA;thepositive rate were 4.41%,0.55%and 2.05%;The TP-ELISA,TRUST and TPPA positive conformity rate or titer were rising with the TP-ELISA S/CO and TRUST titer increasing.Conclusion There is a positive correlation of TP-ELISA S/CO among the TPPA,TRUST of positive conformity rate and titer.Using TP-ELISA and TRUST as screening,TPPA as confirmed test,the diagnostic efficiency of the process of sequence syphilis screening program can be improved.

Objective To determine the contents of methylophiopogonanone A (MOA) and methylophiopogonanone B (MOB) in Radix Ophiopogonis and its extracts. Methods An HPLC-UV method was used for determining the contents of MOA and MOB in all samples. Analytical column was Kromasil C18 (250 mm?4.6 mm, 5 ?m). Mobile phase was acetonitrle-water (55∶45) and detection wavelength was 298 nm. The flow rate of mobile phase was 1 mL/min, and temperature was 30 ℃. Results The contents of MOA in Radix Ophiopogonis cropped in Sichuan and Zhejiang Provinces were 0.004 0%-0.009 6%, 0.006 7%-0.013 4%, and the contents of MOB were 0.002 1%-0.006 2%, 0.015 9%-0.028 2%, respectively. The contents of MOA in the extract of Radix Ophiopogonis cropped in Sichuan and Zhejiang Provinces were 0.007 5%-0.008 8%, 0.011 2%-0.012 6%, and the contents of MOB were 0.003 8%-0.005 1%, 0.020 7%-0.023 8%, respectively. Conclusion The contents of MOA and MOB in Radix Ophiopogonis cropped in Zhejiang Province and its extracts are more than those in Sichuan Province and its extrouts. The method can be used for the purpose of the quality control of Radix Ophiopogonis and its extracts.

Objective To consider the clinical significance of retroperitoneal laparoscopic adrenalectomy for adrenal diseases. Methods We analyzed 33 cases of adrenal diseases treated by retroperitoneal laparoscopic adrenalectomy in this hospital from October 1996 to December 2001. Results Retroperitoneal laparoscopy was successfully applied in 31 cases, whereas conversions to open adrenalectomy were required in the other 2 cases. The mean operation time was 158 min (120 min～200 min). The mean intraoperative blood loss was 150 ml, without blood transfusion needed. The mean length of hospital stay was 6.4 days. Conclusions Compared with open surgery, retroperitoneal laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery and shorter hospital stay length. This procedure can be applied to in the absence of contraindications (such as tumor size being more than 10cm, metastatic carcinoma and vital organs or blood vessels being involved).

Objective To explore the relationship between serum HBV DNA level , expression of PD-1 on CTL and liver functions in patients with hepatitis B virus cirrhosis. Methods 109 HBV hepatic cirrhosis patients with , HBV DNA positive , HBeAg positive and HLA-A2 positive were divided into two groups according to their HBV DNA levels,52 cases in group A, HBV DNA 2-4 log10 copies/mL, 57cases in group B, HBV DNA 5-7 log10 copies/mL , differences of HBV specific CTL surface PD-1 expressions , HBV specific CTL levels and liver functions were compared between two groups. Results HBV specific CTL surface PD-1 expressions of group A were lower than that of group B (t = 11.101, P < 0.01), HBV specific CTL levels of group A were higher than that of group B (t = 24.424, P < 0.01), ALT of group A were lower than that of group B (t = 2.652, P < 0.01), ALB of group A were higher than that of group B (t = 2.347, P < 0.05). Child-pugh rating, grade C of group A was lower than that of group B (χ2= 4.262,P < 0.05). Conclusions HBV specific CTL surface PD-1 expression levels were higher in those hepatic cirrhosis patients with , high level of serum HBV DNA, and HBV specific CTL levels were lower, liver functions damage were much serious. So, lower HBV DNA levels , lower HBV specific CTL surface PD-1 expression levels and higher HBV specific CTL levels can product relatively good effect of anti-viral treatment.

Objective To investigate the expressions of brain-derived nerve growth factor (BDNF) and growth-associated protein 43 (GAP-43) in the hypothalamus of rats inflicted with restraint stress and their relationship with behavioral changes.Methods Forty male SD rats were divided into control group,restraint stress 7-day group,restraint stress 14-day group,restraint stress 21-day group according to the random number table,with 10 rats per group.Behavior changes were observed by open-field test,serum levels of corticotrophin releasing hormone (CRH) by enzyme-linked immunosorbent assay,and expressions of BDNF and GAP-43 in the hypothalamus by western blotting.Results Restraint stress 7-day group exhibited increases in spanning lattice times (50.0 ± 7.0),standing times (11.4 ± 2.1)and modification times (11.2 ± 2.7) compared with all other groups (P ＜ 0.05).Restraint stress 14-day group and restraint stress 21-day group showed significant decreases in spanning lattice times (35.5 ±7.5,29.4 ± 6.8),standing times (7.8 ± 4.9,5.6 ± 3.9) and modification times (6.7 ± 2.9,4.4 ±2.6) compared with control group (42.6 ± 5.4,8.9 ± 4.3,and 7.9 ± 3.0) (P ＜ 0.05).Restraint 14-day and 21-day groups showed significant increases in serum CRH level [(750.73 ± 123.68) pg/ml and (793.06 ± 115.84)pg/ml] compared with that in restraint stress 7-day group [(500.48 ± 88.71)pg/ml,P ＜0.05],but all were lower than (336.72 ±45.34) pg/ml in control group (P ＜0.05).Levels of BDNF and GAP-43 in the hypothalamus were the lowest in control group (0.672 ± 0.185 and 0.694 ±0.253).However,restraint stress increased the expressions of BDNF and GAP-43 in the hypothalamus,with the highest level in restraint stress 21-day group (1.357 ± 0.524 and 1.486 ± 0.679) (P ＜ 0.05).Conclusion Restraim stress can up-regulate BDNF and GAP-43 proteins in the hypothalamus,and lead to plasticity changes that may relate to stress-related behavior.