Objective To observe the subarachnoid space the epidural space joint block labor analgesia (CSEA) changes of T lymphocyte subsets.Methods 100 cases of full-term mothers were randomly divided into two groups,analgesia group and the control group.The analgesic group row CSEA childbirth analgesia.Two groups of maternal cervix large 2 to 3cm (T1),when the baby was delivered (T2),24h (T3),blood was colleoted after childbirth,detected by radioimmunoassay of cortisol.Flow cytometry assay was wsed to test T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+,And the birth process,Apgar score,Labor pain visual analogue score (VAS) were recoroded.Results (1) Active phase of the first stage of childbirth analgesia group was significantly shorter than the control group (t =2.182,P ＜ 0.05).The second and third stage of Childbirth and neonatal Apgar score difference between the two groups was not statistically significant.(2)Serum cortisol concentration at T2 analgesia group was significantly lower that of than the control group (P ＜ 0.05).(3) The two groups in maternal blood of CD3+,CD4+,CD4+ / CD8+ were reduced to varying degrees,T3 was reduced significantly (P ＜ 0.05),Analgesia group was significantly lower than that of the control group (all P ＜ 0.05).Conclusion CSEA analgesia in Childbirth can shorten the first stage of Childbirth active period,has no significant effect on the Apgar score,can alleviate the pain and stress reactions such as the suppression of the maternal immune function.

Objective To observe the clinical efficacy of distant collateral needling in treating cervical spondylotic radiculopathy. Method Eighty patients with cervical spondylotic radiculopathy were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by distant collateral needling, while the control group was by ordinary acupuncture treatment. The symptom and sign scores were observed before and after intervention, and the clinical efficacies were compared between the two groups. Result The symptom and sign scores were changed significantly after intervention in both groups (P<0.01). The symptom and sign scores of the treatment group were significantly different from that of the control group after intervention (P<0.05). The total effective rate and the recovery plus markedly-effective rate were respectively 94.9% and 84.6% in the treatment group versus 89.2% and 64.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the recovery plus markedly-effective rate between the two groups (P<0.05).Conclusion Distant collateral needling is an effective method in treating cervical spondylotic radiculopathy.

Objective To explore whether childhood abuse experiences predict higher levels of depression and lower levels of self-esteem for graduate students and examine the mediating role of social support between childhood abuse and mental health.Methods A sample of 907 graduate students were investigated with the Childhood Trauma Questionnaire (CTQ-SF),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Center for Epidemiological Survey Scale (CESD).Results The scores of childhood abuse,social support,self-esteem,and depression of graduate students were (33.88±9.35),(68.31±12.01),(36.62±4.80) and (35.85± 9.20).Childhood abuse was negatively correlated with self-esteem (r=-0.32,P＜0.01),but positively correlated with depression (r=0.28,P＜0.01),and negatively correlated with social support (r=-0.44,P＜0.01).Social support was positively correlated with self-esteem (r=0.39,P＜0.01),and negatively correlated with depression (r=-0.41,P ＜0.01).Examining the mediation model indicated that social support had a partial mediation effects(42％) on the relationship between childhood abuse and self-esteem,and social support had a partial mediation effects(54％) on the relationship between childhood abuse and depression.Conclusions The childhood abuse not only affects the graduate student's self-esteem and depression directly,but also can take the same effect by social support indirectly.

Objective To study the imaging characteristics of osteosarcoma.Methods 35 patients with osteosarcoma proved pathologically were examined by radiography,of them 25 cases were examined with CT scan or MRI,and 8 cases undergone contrast-enhanced MRI.The imaging features of osteosarcoma were analysed comparatively with that of pathology.Results The lesions localized at distal part of femur in 17 cases and proximal part of tibia in 8 cases,that were most location of this tumor.The imaging characteristics of osteosarcoma included bone destruction,neoplastic bone,periosteal reaction and soft-tissue mass,in some cases,epiphyseal plate and epiphysis were involved,even the joint face and the opposite osseous of joint(skip lesions).On enhanced MR scanning,the margin of tumor was enhanced in early and the center of tumor was delayed enhancement.CT could showed "sieve sign"and small neoplastic bone.Conclusion Osteosarcoma has certain imaging characteristics;X-ray examination is the first choice in diagnosing osteosarcoma,CT and MR could provide much more comprehensive imaging information for clinic.

Objective To evaluate the soft tissue profile in adults with unoperated isolated cleft palate. Methods Twenty patients older than 16 years(median age,18.4) with unoperated isolated cleft palate were enrolled.Soft tissue lateral cephalograms were traced and compared with those of cleft operated patients and class-Ⅰocclusion individuals.The results of various measurements were analyzed with ANOVA by SPSS11.5. Results In adults with unoperated isolated cleft palate,there was restriction at the top of the upper lip,and the antelabrum of upper lip and the lower lip were found normal. Conclusion The soft tissue profile in adults with unoperated isolated cleft palate exhibits almost the same characteristics as the corresponding hard tissue,and there is covering over effect of the soft tissue to some extent.

Objective To investigate the relation between brain natriuretic peptide (BNP) rs198388 polymorphism and the susceptibility of essential hypertension in Han population of Hunan. Methods A total of 567 patients with hypertension (the hypertension group) and 555 healthy volunteers (the control group) were enrolled. Gender, age, smoking and drinking history of the 2 groups were not significantly different. Blood pressure was measured in the 2 groups. After fasting for 12 h or more, blood glucose, total cholesterol, triglycerides, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured. DNA polymorphism analysis was done by polymerase chain reaction-restriction fragment length polymorphism method, and genotype was determined by agarose gel electrophoresis. Results The GG, GA, and AA genotypeswere detected.The frequencies of GA and AA genotypes and A allele were significantly lower in the hypertension group (GA and AA:12.3%;A:6.9%) than those in the control group (GA and AA:18.4%; A:9.7%; P=0.009, and P=0.014, respectively). Conclusion BNP rs198388 polymorphism may be associated with essential hypertension in Han people in Hunan. Carrying rs198388 GA and AA genotypes and A allele may be the reason for low risk of hypertension.

Objective To establish classification and regression tree (CART) for differentiating benign from malignant solitary pulmonary nudules (SPN).Methods One hundred and sixteen consecutive cases with 116 solitary pulmonary nodules,which finally were pathologically proven 54 malignant nodules and 62 benign nodules,were prospectively registered in this research.Twelve clinical presentations and 22 CT findings were collected as predictors.A classification tree was established to distinguish benign SPNs from malignant ones.In the observer test,two groups (one made of junior radiologists and one of senior radiologists) were independently presented with clinical information and CT images without knowing the pathologic and machine-learning results.Performance of observers and CART were compared by receiver operating characteristic analysis.Results Receiver operating characteristic analysis showed areas under the curve of CART,senior radiologists and junior radiologists respectively were 0.910±0.029,0.827±0.038,0.612±0.052. Difference between areas (DBF) between CART and junior radiologists was 0.297 (P＜0.01).DBF between CART and senior radiologists was 0.083(P＜0.05).DBF between senior and junior radiologists was 0.214(P＜0.01).CART showed a best diagnostic efficiency,followed by junior radiologists,and then senior radiologists.Conclusion Our data mining techniques using CART prove a high accuracy in differentiating benign from malignant pulmonary nodules based on clinical variables and CT findings.It will be a potentially useful tool in further application of artificial intelligence in the imaging diagnosis.

Objective To observe the effect of gheocorticoid by oral medication or intrathoracic iniection on the expression of IL-6,IL-8 and sIL-2R in gerum and pleural fluid in patients of tuberculous pleurisy.Methods Twenty tuberculous pleurisy patients were treated with ghcocortieoid by oral medication (oral group)and 20 cases by intrathoracic injection(injection group).ELISA wag employed to detect the levels of IL-6,IL-8 and sIL-2R in serum and pleural fluid before treatment and 3,6 and 9 days after treatment.Results The levels of serum IL-6 and IL-8 decreased and sIL-2R increased obviously in injection group at 3,6 and 9 days after treatment(P＜0.01).Meanwhile the levels of IL-6 and IL-8 in pleural fluid decreased and sIL-2R increased obviously(P＜0.01).The levels of IL-6 and IL-8 were significantly lower and the levels of aIL-2R were significantly higher in injection group than those in oral group(P＜0.01).One month after treatment,the rate of complete absorpion of pleural fluid was higher in injection group(80%)than thatin oral group(45%),the rate of pachynsis pleurae was lower in injection group(10%)than that in oral group(40%),P＜0.05.Conclusions Intrathoracic injection of ghcocorticoid shows stronger suppression of cellular immune function in cavum pleurae and weaker suppression of the general immune sysmm than oral medication.Intrathoracic injection of glucocorticoid can increase the therapeutic effect and decrease side effect in tuberculous pleurisy.

Objective To discuss the optimal imaging conditions of spatio-temporal image correlatin (STIC). Methods Conventional 2D fetal echocardiography and 3D STIC volume collection were performed in 130 fetuses. The images obtained using two methods were scored and compared. Results Complete 3D volume collection with the initial view of four chamber view were abtained in 121 fetuses, the successful rate was 93.13%. There was no significant differences in total score between the two methods. Significant difference was found between the score of different condition groups.The highest scores mostly appeared in lateral four chamber heart in both method groups. The highest scores mostly appeared in 25-29 gestational weeks with 2D ultrasound, while 20-24 gestational weeks with 3D ultrasound, scores in long axis views of vessels were statistically different. Conclusion STIC has advantages over conventional ultrasonography, but needs conditions control and analysis skills.

OBJECTIVETo investigate clinical effects of arthroscopy in the treatment of medial meniscal cyst.

METHODSFrom June 2011 to January 2013, 7 patients with medial meniscal cyst were treated with arthroscopy. There were 3 males and 4 females,ranging in age from 27 to 63 years old,with a mean age of (43.93±2.10) years old. The cysts have been discovered for 3 to 30 months,with a mean time of (10.6±1.3) months. All the patients complained of knee pain,especially in the medial joint gap. The Pisani sign, Caklin sign and medial McMurray sign were all positive. Preoperative MRI examination confirmed the diagnosis. Lysholm score changes and clinical efficacy were observed through a six-month follow-up.

RESULTSThe postoperative Lysholm scores were all significantly higher than the preoperative scores. According to Sarimo standard, 6 patients got an excellent result, and 1 good.

CONCLUSIONArthroscopic treatment of medial meniscal cyst has replaced the traditional method, which could retain the normal meniscus as much as possible and repair the meniscus injury simultaneously, as well as get a good curative effect and a good recovery of knee function. This method is worthy of clinical application.

Adult ; Arthroscopy ; methods ; Cysts ; physiopathology ; surgery ; Female ; Humans ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged