[Objective]To explore the reason of ulnar impaction syndrome misdiagnosed by tissue injury in wrist.[Method]From December 1998 to December 2005,216 cases who were diagnosed for soft tissue injury in ulnar wrist were checked and discriminated according to X-ray and MRI of the injured wrist,and 48 cases were re-diagnosed for ulnar impaction syndrome.The misdiagnosis rate was 22.2%.[Result]Most cases of ulnar impaction syndrome had positive lunar variance(68.8%).Carpal avascular necrosis were found in about 27.1% of cases through X-ray of wrist and 100% through MRI.Different degree changes of abnormal signal intensity were found in soft tissue,triangular fibro cartilage(TFC) and carpal bones by MRI which displayed swelling of soft tissue in carpal joint,strip-shape high signal intensity or mixed signal intensity at ligament around wrist and enhanced signal intensity at TFC area extending to ulnar carpal articular facet.The appearance of MRI in carpal bones showed local abnormal signal,articular cartilage thickening and hydropsia in bone below cartilage and marrow.[Conclusion]The misdiagnosis can be reduced through elevating acquaintance level of ulnar impaction syndrome basing on clinical symptoms,making the most use of imaging,especially MRI.

ObjectiveTo observe the changes of phosphorylated extracellular signal-regulated kinase 1/2 (pERK1/2) and c-fos in the medial prefrontal cortex (mPFC) of post-traumatic stress disorder (PTSD) rats. Methods Male Wistar rats were randomly divided into control group and PTSD model group. The model group rats were exposed to the single-prolonged stress (SPS) to set up the rat PTSD model. The expression of pERK1/2 was detected using immunohistochemistry and Western blotting, and the expression of c-fos mRNA was detected using reverse transcription-polymerase chain reaction (RT-PCR). Results The result of immunohistochemistry analysis showed that the number of pERK1/2-positive cells of control group and model group were 10.4±2.07 and 48.8±10.08 respectively (P<0.01), and integral optical density were 24.955±3.691 and 110.810±10.643 respectively (P<0.01). And Western blotting showed that relative expression quantities of pERK/β-actin were 0.510±0.052 and 1.109±0.106 respectively (P<0.01). The quantities of c-fos mRNA relative expression of control group and model group were 0.267±0.067 and 1.049±0.131 (P<0.01). Conlusion The levels of pERK1/2 and c-fos increase significantly in mPFC of PTSD model rats. The ERK signal transduction pathway in mPFC might play an important role in the pathogenesis of PTSD.

Objective To extract characteristic parameters of ECG signals a new method of non-invasive diagnosis for coronary heart disease with artificial neural network. Methods ECG signals were digitized with A/D converter and filtered to eliminating the noise. Span of QRS interval, R-R interval,and voltage of S-T segment of filtered ECG were detected. These 3 characteristics were as the input parameters of the input layer. Samples were trained with an improved 3-layers back propagation(BP) artificial neural network, as trained samples. The non-trained samples were recognized with these BP neural networks. Results After 12 samples had been trained about 1500 times, the BP neural network could accurately distinguish samples of coronary heart disease from the trained samples and also recognize 20 non-trained samples, 19 to be correct except one. Conclusion It is showed that based on BP network and characteristic parameters of ECG, a new and promising method of non-invasive diagnosis for coronary heart disease has been found.

Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP < 0.01], but lower than that in winter [32.8% (86/262) vs. 37.2% (110/296)], the difference was not statistically significant (P > 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.

Objective To explore the causes of pulmonary infection of stroke patient during recovery period. Methods 122 stroke patients combined with pulmonary infection in neural rehabilitation department from January 2008 to July 2011 were analyzed for the relative causes according to clinical nursing. Results Repeated pulmonary infection was correlated with dysphagia and tracheotomy of acute stage (P<0.05); Bilateral pulmonary infection was correlated with dysphagia, tracheotomy of acute stage and age (P<0.05). Conclusion Pulmonary infection is correlated with dysphagia, tracheotomy of acute stage and age in sequence.

Objective To evaluate the prognostic value of urine paraquat (PQ) concentrations combined with poisoning time and creatinine clearance rate (CCr) on prognosis of patients with acute paraquat poisoning (APP). Methods A retrospective case control study was conducted. Clinical data of 96 patients with APP admitted to Department of Emergency of Shengjing Hospital of China Medical University from March 2014 to May 2016 were analyzed. The gender, age, body weight, urine PQ concentrations (determined by semi-quantitative colorimetric method), poisoning time (time from oral poison to urine detection) and CCr of patients were collected, and poisoning index (poisoning index = urine PQ concentrations × poisoning time/CCr) and simplified poisoning index (simplified poisoning index = urine PQ concentrations × poisoning time) were calculated. The patients were divided into death group and survival group according to 2-month outcome after poisoned with clinical data and telephone follow-up. The urine PQ concentrations, poisoning index, and simplified poisoning index between the two groups were compared. Binary classification logistic regression was used to analyze the risk factors affecting prognosis. Receiver-operating characteristic curve (ROC) and diagnostic test were used to analyze the prognostic value of the parameters. Results Compared with survival group, the urine PQ concentrations [mg/L: 30.00 (10.00, 100.00) vs. 10.00 (3.00, 10.00)], poisoning index [mg·h-1·μmol-1: 12.72 (1.86, 33.75) vs. 0.56 (0.18, 1.12)], and simplified poisoning index [mg·h-1·L-1: 600.00 (150.00, 1 000.00) vs. 60.00 (18.00, 120.00)] in death group were significantly increased (all P < 0.01). It was shown by logistic regression analysis that both urine PQ concentrations [odds ratio (OR) = 1.046, 95% confidence interval (95%CI) = 1.006-1.087, P = 0.022] and poisoning index (OR = 1.353, 95%CI = 0.029-1.815, P = 0.031) were independent risk factors affecting the prognosis of patients with APP. It was shown by ROC curve and diagnostic test that the poisoning index had greater area under ROC curve (AUC was 0.902) for evaluating the prognosis of patients with APP. When the best cut-off value was greater than 1.23 mg·h-1·μmol-1, the sensitivity was 90.91%, and the specificity was 73.08%. The AUC of urine PQ concentrations for evaluating the prognosis was 0.759. When the best cut-off value was greater than 20.00 mg/L, the sensitivity was 63.64%, and the specificity was 76.92%. The AUC of simplified poisoning index for evaluating the prognosis was 0.846. When the best cut-off value was greater than 135.00 mg·h-1·L-1, the sensitivity was 81.82%, and the specificity was 76.92%. Conclusion The poisoning index calculated with urine PQ concentrations combined with poisoning time and CCr has prognostic value for prognosis of APP patients, and the prognostic value of poisoning index is greater than that of the urine PQ concentrations alone.

Objective To investigate the safety and effectiveness of using covered stent in endovascular isolation treatment of spontaneous peripheral artery dissection.Methods A total of 9 patients with peripheral artery dissection were collected.The dissectionwas located at iliac artery in 6 patients and at subclavian artery in 3 patients.Preoperative CT angiography was performed in all patients to determine the site and degree of the dissection,based on which the corresponding covered stents were prepared.After puncturing the femoral artery with Seldinger technique,angiography was performed to confirm the lesions in all patients,then,according to the angiographic findings the implantation of covered stent was carried out.Results Among the 9 patients,the dissections were located at the right common iliac artery in 3,at the right external iliac artery in one,at the left common iliac artery in 2 and at the left subclavian artery in 3.The length of the dissection was 0.9-3.3 cm with a mean of 1.7 cm.The distance between the initial part of arterial dissection and the target vessel opening was 0.5-5.6 cm with an average of 2.3 cm.The covered stent was successfully implanted in all patients.In one patient,the implanted stent covered the non-dominant left vertebral artery.During the procedure no obvious complications occurred.The patients were followed up for 3-32 months (mean of 18 months).No procedure-related complications were observed in all patients.Color Doppler ultrasound examination showed that all the implanted stents were unobstructed.Conclusion For peripheral artery dissection,endovascular isolation therapy by using covered stent is safe and effective.

Objective To observe changes of erythropoietin (EPO) and rheology in moderate and severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients after the noninvasive positive pressure ventilation (NPPV) treatment. Methods Healthy adults were selected as control group (n=40) while moderate to severe OSAHS patients were selected as OSAHS group. OSAHS group was underwent NPPV treatment then, Levels of sleep apnea hypopnea index (AHI), sleep mean minimum oxygen saturation (LSaO2) and serum erythropoietin (EPO) were assessed, routine blood test and hemodynam-ic indexes were also checked before treatment and 1 and 3 months after treatment in both groups. Results In both groups serum EPO, blood, blood rheology indexes, AHI, LSaO2 were analysised at each time point by ANOVA repeated measures, all of which show significant different between groups and between each time points within the same group. Indexes in OSAHS group improved with prolonged treatment , but they are in the normal range in the control. Conclusion OSAHS pa-tients with NPPV therapy can significantly relieve hypoxia, reduce serum EPO level and blood viscosity. So NPPV has impor-tant clinical significance in prevention and treatment of OSAHS.

Objective To evaluate the characteristics and clinical application value of Dual Source CT(DSCT),3.0T MR and DSA in the diagnosis of intracranial aneurysm.Methods The imaging characteristics of DSCT,3.0T MR and DSA in 102 patients of in-tracranial aneurysm were analyzed retrospectively.Results The cerebral DSA were performed in 102 patients,and the sensitivity and accuracy of DSA were 100%.60 patients were detected by DSCT/CTA,and the sensitivity and accuracy of DSCT/CTA were 93.1% and 97.2% respectively.52 patients were detected by 3.0T MR/MRA,and the sensitivity and accuracy of 3.0T MR/MRA were 89.1% and 92.7% respectively.10 patients were detected simultaneously by CT and MR.The diagnostic sensitivity and accu-racy of these three methods had no significant difference(P >0.05).Conclusion The sensitivity and accuracy of DSCT,3.0T MR and DSA in the diagnosis of intracranial aneurysm are high and had no significant difference,each had its characteristic.Reasonable application of the three methods produces higher clinical value.

Objective To explore inhibition of nicotine on apoptosis of chondrocytes induced by monosodium iodoacetate ( MIA) .Methods Rat primary chondrocytes were isolated by enzyme digestion, and the cells were treated with 10 -8 , 10 -7 , 10 -6 , 10 -5 mol/L nicotine for 48 h.The cases were randomly divided into five groups, except for normal group, the other four groups were treated with 4μmol/L MIA 24 h, and three groups were treated 10 -8 , 10 -7 , 10 -6 mol/L nicotine.The viability of chondrocytes was detected by MTT assay.The apoptosis of chondrocytes was examed by Annexin V-FITC/PI flow dual-staining method.The activity of cysteinyl aspartate specific proteinase 3 ( Caspase 3 ) was measured by spectrophotography method.The activation of phosphatidylinositol 3 kinase ( PI3K)/protein kinase B ( AKT) and the expression of down-stream molecule Bax, Bcl-2 was assayed by western blot.Results 10 -7 , 10 -6 mol/L nicotine increased chondrocytes' viability (P<0.05), 10 -5mol/L nicotine reduced chondrocytes' viability (P<0.05), and 10 -8 mol/L nicotine didn't effect on chondrocytes' viability (P>0.05).10 -8, 10 -7, 10 -6 mol/L nicotine could increase MIA-induced chondrocytes' viability (P<0.05), suppress MIA-induced chondrocytes' apoptosis and the activity of MIA-induced Caspase 3 (P <0.05).Moreover, 10 -7, 10 -6 mol/L nicotine could increase the expression of PI3K and phosphorylation of AKT ( P<0.05) , down-regulate the expression of Bax and up-regulate the expression of Bcl-2 in MIA-induced rat chondrocytes ( P<0.05 ) .Conclusion These results suggested nicotine could exert anti-apoptosis in MIA-induced rat chondrocytes, which might be related to PI3K/AKT signal pathway.