Objective To investigate the effect of vascular tortuosity and bending radius on the new type knitting stents (LVIS stent ) releasing on the cavernous sinus segment of internal carotid artery. Methods From December 2015 to January 2016,31 consecutive patients with wide-neckedaneurysm treated with LVIS stents and the proximal end of the stent released in the cavernous segment at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled. According to whether the stents completely adhered to the walls or not after the first release,they were divided into two groups:a satisfactorily release group (n =23 )or an unsatisfactorily release group (n =8 ). The differences of vascular tortuosity and bending radius of the 2 groups were compared.Results Thevascular tortuosities of the satisfactorily release group and the unsatisfactorily release group were 118° ± 23° and 147° ± 19° respectively. There was significant difference (P=0. 028). The vascular bending radii were 3. 4 ± 0. 7 mm and 2. 8 ± 0. 7 mm respectively. There was significant difference (P=0. 042). The mean vascular tortuosity was larger and the mean vascular bending radius was smaller in the unsatisfactorily release group. Conclusions The greater the vascular tortuosity,the smaller the vascular bending radius may be connected with the unsatisfactorily release in the LVIS stent. The evaluation of vascular tortuosity is conductive to the guidance of the stent release technique before stent implantation.

Objectives: To evaluate the influences of enteral nutritfion(EN), parenteral nutrition(PN) and major gastrointestinal operation on HLA DR, CRP and IL 10 level. Methods: A prospective, successive and controlled trial was taken. 39 non infection patients with intestinal fistula and severe acute pancreatitis were divided into EN group ( n =18) and PN group ( n =21). 8 patients with major gastrointestinal operation(OP) were taken as OP group.10 patients admitted with the diagnoses of cholecystopolyp and inguinal hernia were taken as control group. The blood levels of HLA DR, CRP and IL 10 were measured and compared between groups. Results: Compared to control group〔(96.35? 4.282)%〕, OP group〔(60.23? 10.419)%〕 and PN group〔(78.72? 13.21)%〕 had significant decreases ( P

Isometric exercise(IE) is an essential component of daily living activities.Lack of IE may result in deconditioning of IE capacity.IE has not been used in cardiac rehabilitation because of poor understanding in cardiovascular response to IE and the Valsalva Maneuver associated with IE.Eingteen healthy young subjects aged 23.7 yrs on average was studied by administration of beta blocker and antagonist of opioids during IE.The result demonstrated that the regulation of cardiovasular response during IE is attributed to both sympathetic system and opioids activity.Twenty patients with coronary artery disease (CAD) were also studied during brief maximal IE,sustained maximal IE and dynamic exercise(DE).The patients included 13 cases with more than one vessel lesions and 7 post myocardial infarction and/or angina.Ten age matched apparent healthy subjects were examined as the control group.The result showed that IE without the Valsalva Maneuver in patients with CAD might increase coronary artery perfusion by enhancing diastolic pressure and prolonging diastolic period,which had no harmful effect on CAD.Hemodynamic responses and cardiac function were weaker during IE than DE.The intensity of the responses to IE was correlated to the central command but not to the absolute work load.It is concluded that significant release of endogenous opioids due to strong central command during IE,especially perceived maximal sustained IE,may help to attenuate activity of sympathetic system,thus reducing risk of exercise in patients with CAD.

OBJECTIVE: To investigate the applicability of EuroQol 5-Dimension 3-Level questionnaire (Chinese Version 1.0) (EQ-5D-3L) in the assessment of life quality of patients with idopathic sudden hearing loss. METHOD: In this retrospect study, the EQ-5D-3L was assigned to 60 patients with idopathic sudden hearing loss before and after drug therapy. Audiometry examinations were undertaken and concomitant symptoms were recorded. A Wilcoxon rank sum test was applicated to the comparisons of results of EQ-5D-3L before and after the treatment, a t-test for results of EQ-VAS and a Kappa measurement for the consistency of certain dimension correlated with the symptoms. RESULT: Sixty patients completed the five questions and visual analog scale of the EQ-5D. A statistically significant changes of pain/discomfort, anxiety/depression before and after the treatment were observed (P < 0.05). The domains of mobility, self-care and usual activities did not show statistically significant different (P > 0.05). The dimension of pain/discomfort was in agreement with the concomitant symptoms. And the result of EQ-VAS was in agreement with the therapeutic outcome. CONCLUSION It is suitable for the EQ-5D to be a general health measure with sensitivity to clinical change in idiopathic sudden sensorineural hearing loss, which monitors the patients' outcomes.
Depression ; Hearing Loss, Sensorineural ; diagnosis ; Humans ; Quality of Life ; Self Care ; Surveys and Questionnaires ; Treatment Outcome ; Visual Analog Scale

Objective To provide reference for establishing diagnosis and differential diagnosis methods of rare yeast-like fungal bloodstream infection for clinical microbiology laboratory.Methods Trichosporon asahii (T.asa-hii)and Geotrichum capitatum (G.capitatum)bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis,morphological examination,biochemical reactions,and molecular biology technology. Results Two types of yeast-like fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy,such infections were serious and highly similar.The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination.Hyphae,arthro-spores and microconidia were visible in the former,thickness of hyphae branches and length of arthrospores were different,most presented rectangular and barrel shape;the latter can be seen hyphae with transparent septum bro-ken up into arthrospores,presented rectangular shape,did not produce blastoconidia.Identification with API 20C AUX showed that they were T.asahii and G.capitatum.The PCR product sequences were compared with NCBI, suggesting that T.asahii and G.capitatum were at sexual stage.Conclusion Comprehensive application of a varie-ty of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeast-like fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal in-fection,choose antifungal agents rationally,and improve clinical prognosis.

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.

Objective To study the clinical value of using a four-point method (FP) in measuring joint angles.Method Methods Twenty-five subjects without knee dysfunction were studied.Every knee joint was tested in extension,below 90° of flexion and above 90° of flexion with the traditional three-point method (TP) and the new four-point method.X-rays were taken as a gold standard measurement.The reliability and validity were analyzed using Bland-Altman plots,which can yield 95% limits of agreement (LOA).Results (1) The joint axis centers moved with changes in joint angle.(2) The 95% LOA of inter-tester reliability was (-5.0,2.7) with the FP and (-6.5,4.4) with the TP.The 95% LOAs of intra-tester reliability were (-3.6,4.0) for tester A and (-4.1,4.8) for tester B with the FP,while (-5.0,6.4) for tester A and (-6.1,5.8) for tester B with the TP.(3) The 95% LOAs in the three positions were (3.5,2.6) in extension,(-3.3,3.6) in mild flexion and (-1.9,5.7) in greater flexion with the FP,and ( 6.8,1.1),(-4.0,7.1) and (0,8.5) with the TP.Conclusions The FP gives better reliability and validity than the TP in joint angle measurement.

Objective To discuss the frequency of ventilator pipe replacement in ICU ward for reducing the frequency of VAP occurrence caused by bacterial colonization in ventilator-line. Methods 30 patients hospitalized to ICU ward from Janurary,2008 to June, 2009 who had mechanical-ventilation above 48h were randomly divided into group A, B and C with 30 patients in each group, then bacteria culture and strain analysis were employed for the pipeline sample of ventilator inspiratory side at the time point to be use and used mechanical ventilation for 1 day, 3 days and 7 days. Results There was no bacteria grew after ventilator-line sterilization, and positive ratio of bacterial culture in 1d, 3d and 7d were 46.66%,53.33% and 100.00%, respectively. Conclusions The frequency of ventilator pipe replacement should be shortened in patients with abdominal infection, to replace every 3 days is suitable in ICU where infectious patients gathered.

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.