Objective To evaluate imaging diagnostic value of synovial osteochondromatosis.Methods Imaging features of synovial osteochondromatosis proved by surgery,arthroscopy and pathology in 39 cases were retrospectively analyzed.Results The lesions involving thejoints included knee in 11 cases,hip in 10,ankle in 7,shoulder in 8 and elbow in 3,and multiple joints involved in 5 cases.The loose bodies inside the joints or parajoints with different number,size,shape and calcification were seen on radiography.CT(25 cases) was superior to X-ray in showing these loose bodies and also could showed the thickened synovial membranes intra-articular effusion.MRI(30 cases)not only could showed the non-calcification cartilage nodules,but also the changes of soft tissue around the joints,the thickened synovial membranes and articular effusion,and could make the staging of this disease.Conclusion Imaging examination is of significant value in diagnosing synovial osteochnodromatosis and for clinical procedures.

Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.

Objective To explore the efficacy and safety of mosapride combined withpancreatic kallikrein in the treatment of diabetic neurogenic bladder(DNB).Methods According to the digital table,120 patients with DNB were randomly divided into the control group and the observation group,each group 60 cases,All patients received basic treatment,including reducing blood glucose,reducing blood pressure,nutrition nerve and regulating blood lipids,and the observation group was accepted the treatment of original enzyme plus mosapride pancreatic kinin on basis of the above treatment.The treatment time of the two groups was both 3 weeks,The effect,blood sugar,blood hpids,urodynamic,quality of life,and the incidence of adverse reactions were observed.Results The total effective rate of the observation group was 93.33％,which was significantly higher than that of the control group (65.00％) (χ2 =14.602,P ＜ 0.01) ；the adverse reaction rate of the observation group was 8,33％,which was significantly lower than that of the control group(20.00％)(χ2 =11.368,P ＜ 0.01),Conclusion Mosapride combined with pancreatic kallikrein in thetreatment of DNB has better effect,and could significantly improve the clinical symptoms and quality of life of patients.So it should be promoted and applied.

Objective To explore the feasibility of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy (MECT). Methods Ninety hospitalized schizophrenics undergoing MECT were randomly assigned to 3 groups which were respectively anesthetized with mixed liquor application of etomidate and propofol (group E-P), etomidate (E) or propofol (P). Charge delivered (CD), EEG seizure duration (ESD), postictal suppression index (PSI), seizure energy index (SEI) and seizure generalization index (SGI) were recorded. Mental status and memory levels were assessed with the Positive and Negative Syndrome Scale (PANSS) and Wechsler Memory Scale (WMS) before and after treatment. The adverse reactions were recorded. All data were analyzed with the software SPSS12.0. Results The ESD, PSI, SEI, SGI and WMS scores, and the minus score of PANSS were significantly higher (P < 0.05) and CD was lower (P < 0.05) in group E-P than those in group P. No significant alteration between group E-P and group E (P > 0.05). The adverse reactions such as nausea/vomiting and secretion increase in group E-P were lower than those in group E (P < 0.05). The injection pain of group E-P was lower than that of group P (P<0.05). Conclusion The mixed liquor of etomidate and propofol has an advantage over the single-application of the two drugs during MECT.

ObjectiveTo assess the association of rs1344706 and rs4667001 polymorphism of ZNF804A gene with schizophrenia,and the relationship between rs1344706 polymorphism and antipsychotic drug efficacy.MethodsThe studies concerning association of ZNF804A gene polymorphism with schizophrenia and its drug efficacy were retrieved in databases such as Medline and CNKI,and then screened according to the inclusion and exclusion criteria.Meta-analysis was performed by RevMan 5.1 following quality assessment and data extraction.ResultsEleven high-quality studies under the criteria were included.For rs1344706,T allele frequency was significant higher in the schizophrenia group than control group ( OR=1.13,95％ CI (1.06-1.21 ),P=0.0003).Moreover,for rs4667001,G allele frequency was significant higher in the schizophrenia group ( OR =1.14,95％ CI( 1.04-1.26),P =0.005 ).In addition,the difference of PANSS scores reduction between T allele and GG genotype carriers was not significant in both positive and negative symptoms after four-week treatment,and the same trend of difference was in the comparison between TT genotype and G allele carriers.ConclusionThe data supports that T allele of rs1344706 and G allele of rs4667001 in ZNF804A gene are associated with the susceptibility of schizophrenia,but rs1344706 polymorphism is not related to antipsychotic drug efficacy.

Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia.Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features.Results The most common clinical presentations were seizures( 18 cases ),headache (16 cases),altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases),the frontal lobes (14 cases),temporal lobes ( 11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases,cerebellar hemispheres and brain stem involvement was prcscnted in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases),the holohemispheric watershed (7 cases),and superior frontal sulcal (6 cases).Partial and asymmetric expression of PRES only occurred in 1 case.Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical.Except the parietal or occipital lobe,involvement of the frontal lobe,temporal lobe and basal ganglia is common,followed by the occasional presence of the splenium,cerebellar hemispheres and brain stem.Three primary PRES patterns are noted,occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES ncurotoxicity morc accurately when PRES present.

10.3969/j.issn.1000-8179.2013.12.009

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

Objective To analyze the clinical characteristics of children with knee joint diseases and discuss the curative effect of arthroscopy.Methods Eighty-nine children with knee joint diseases in Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical University from October 2012 to October 2015 were selected,and they were given knee arthroscopic surgery according to the disease types and characteristics,such as meniscal suture,suture plus angioplasty and synovectomy etc.All the symptoms,signs and the joint functions were recorded preoperatively and postoperatively.At the end of follow-up,surgical results were analyzed according to Lysholm score and International Knee Documentation Committee Knee evaluation form (IKDC) classification standard.Results The patients with discoid meniscus tear were the most,accounting for 55.55％ (55/99 knees).All patients were followed up for 6-30 months(the average time was 21 months) to find that all symptoms were relieved or disappeared within 1 year after operation.The outcome was evaluated according to the Tegner knee function:76 knees (76.76％) were markedly effective,16 knees (16.16％) were effective,6 knees (6.06％) were invalid and 1 knee (1.01％) was poor,and the excellent rate was 92.92％.The curative effect was evaluated according to Lysholm knee function score and IKDC score at the last follow-up.The Lysholm score in preoperation [(52.46 ± 4.79) scores] improved to (96.52 ± 3.97) scores in postoperation,and the difference was significant (t =-36.24,P ＜ 0.05);the IKDC score in preoperation [(46.52 ± 10.25) scores] improved to (90.67-± 5.89) scores in postoperation,and the difference was significant (t =-50.69,P ＜ 0.05).There was no joint infection,blood vessel or nerve damage and so on.Conclusions Meniscus tear is common in children with knee joint diseases,and most common is discoid lateral meniscus tear,and arthroscopy can have satisfactory outcome,with no obvious complications.Therefore,arthroscopic surgery is an ideal method for surgical treatment of children with knee joint disease.

Objective To investigate the expressions of E-cadherin (E-cad)in arterial chemoembolization interventional therapied bladder carcinoma.Methods The expressions of E-cad in bladder tumor tissues of30 non-muscle-invasive bladder carcinoma treated with preoperative interventional chemotherapy and 20 invasive bladder carcinoma treated with surgical were measured by streptavi-din-peroxidase immunohisto chemical method.The changes of E-cad expression in bladder carcinoma before and after interventional treatment were analyzed.Results The averaged normal expressions rate of E-cad in non-muscle-invasive and muscle invasive bladder carcinoma was 70.0% (21/30),25.0% (5/20)respectively.The averaged normal expressions rate of E-cad after interventional treatment was improved to 90% (27/30),the differences were statistically significant (P <0.05 ).Conclusion The expressions of E-cad in bladder carcinoma had significant relations with pathological grade and clinical stage.The abnormal expressions of E-cad in the mucosal surface, may be associated with inflammation.Interventional treatment can significantly improve the expressions of E-cad of tumor tissue and delay the progress of bladder cancer.