Objective To investigate the applicative value of enhanced 3D multi-echo GRE T2*-weighted angiography(ESWAN) sequence phase values in evaluating brain gray nuclei iron content in idiopathic restless legs syndrome(RLS) patients, providing imaging basis in diagnosis and treatment of idiopathic RLS. Methods In our institute from June 2012 to September 2016,forty-five RLS patients were selected as the RLS group, and 45 healthy volunteers as the control group. ESWAN sequence was performed and serum ferritin values were obtained in all patients and volunteers. The raw data of ESWAN was postprocessed , where the phase maps were obtained. Phase analysis was performed on localized brain gray nuclei regions of interest (substantia nigra, red nucleus, dentate nucleus, thalamus, pallidum, putamen and caudate nucleus ) selected on phase maps. Differences between the 2 subject groups were evaluated using ANCOVA including age as a covariate. Results The phase values of the substantia nigra, thalamus, pallidum and putamen in the RLS group were (-0.087 ± 0.021), (-0.053 ± 0.012), (-0.161 ± 0.008), (-0.125 ± 0.019) radians , respectively. The phase values of the substantia nigra, thalamus, pallidum and putamen in the control group were (-0.127 ± 0.007), (-0.066 ± 0.007), (-0.166 ± 0.007), (-0.150 ± 0.010) radians, respectively. There were significant differences between the two groups (F=142.492, 37.988, 10.558, 60.725;P<0.05). Indicating reduced iron content in several regions of brain gray nuclei of the patients with RLS. Serum ferritin concentration between the RLS patients (157.02±95.78)μg/L and healthy controls (175.49 ± 38.65)μg/L was not significant (F=1.353,P>0.05). Conclusions Phase values can make a quantitative assessment of brain gray nuclei iron content in RLS patients, our results supported the hypothesis of reduced brain iron content in RLS patents , which may have an important role in the pathogenesis of the disorder. However, iron content change in some brain regions was not correlated with serum ferritin concentration changes.

Objecyive To investigate the perioperative nursing of type Ⅱ diabetes mellitud treated by laparoscopic gastric bypass surgery.Methods Pefioperative nursing and follow up were performed for twenty five patients with type Ⅱ diabetes who were treated by laparoscopic gastric bypass surgery.Results The conditions of these patients were improved significantly by prompts of fasting blood glucose and 2h post-prandial blood glucose after glucose tolerance test was performed for every patient.Conclusions Pertinent perioperative nursing has proactive effect on recovery of patients with type diabetes mellitus and treated by laparoscopic gastric bypass.

Objective: To study the meal qanity of the patient with chronic renal failure(CRF). Methods: The nutritional state of 140 CRF patients was researched,basing on the diet history. Results: With the progression of course of CRF ,the nutritional states of patients with CRF were getting worse . Conclusions: The nutritional state of CRF patients should be paid attention to.

[Objective] Preliminarily clear the effective substance of Fuzi in treatment of AA by comparing the NO, TNF-α and toe volume in AA rats affected by diester alkaloids,monoester alkaloids and non-ester alkaloids. [Methods]Male wistar rats were randomly divided into comparing group and model group. FCA was given in the left rear toe of rat in model group(once a day,0.1mL each). After 2 weeks ’injection, model rats were randomly divided into model group, diester alkaloids group, monoester alkaloids group and non-ester alkaloids group. Rats in comparing group and model group were given physiological saline and others were given corresponding alkaloids. Detect the NO,TNF-αand toe volume after 2 weeks. [Results]Compared with the model group, the weight gain of rats in other group was suppressed(P<0.05). Compared with the model group, the toe volume and the NO, TNF-αof rats in the alkaloids groups reduced significantly(P<0.01).The toe volume of rats in monoester alkaloids group reduced more obviously. The NO of rats in diester alkaloids group and non-ester alkaloids group reduced more significantly than the rats in monoester alkaloids group( P<0.05). [ Conclusion] The diester alkaloids, monoester alkaloids and non-ester alkaloids in Fuzi al have a significant effect on AA rats and the effect of the monoester alkaloids is the best.

Objective To investigate the preliminary results of total ankle replacement with a three components of mobile bearing scandinavian total ankle replacement(STAR). Methods From October 1999 to February 2003, 13 cases of total ankle replacement were performed with STAR system (Waldemar Link, Hamburg, Germany). There were 8 males and 5 females with an average age of 63.4 years (range, 58 to 69 years). The diagnoses were posttraumatic arthritis in 6, osteoarthritis in 3, Kaschin-Beck disease in 2 and rheumatoid arthritis in 2. An anteromedial curve incision extended distally and proximally from the center of ankle joint. After the exposure and osteotomy, the uncemented tibial and talar components were implanted, a suitable sliding nucleus should be checked in order to keep the soft tissue balance. One total ankle arthroplasty was converted to ankle arthrodesis because of fracture of lateral malleolus occurred during operation. Results Among 12 total ankle arthroplasties, 8 had detailed follow-up data. The average period of follow-up was 16 months (range, 6 to 38 months). All the followed-up ankles were scored with Kofoed total ankle scoring system. The average preoperative and postoperative ankle score were 29 (6-49) and 82 (56-99) respectively. None of prosthetic loosening and migration was found radiologically. However, one case of delayed wound healing treated with dressing change for 4 weeks. One case of fractured medial malleolus was internally fixed with K wire, and the stability of tibial component was not compromised. Conclusion With current ankle arthroplasty designs, total ankle replacement is a viable treatment for symptomatic ankle arthritis that has no responses to nonoperative treatment. Although the preliminary results of total ankle arthroplasty are encouraging, there is still need for careful, long term analysis to estimate to what extent current ankle arthroplasty can relieve pain and restore ankle function. Further attention must be paid to more accurate implantation techniques that will result in a well balanced ligament and allow the ligament to act together with the replaced surfaces in a most physiologic manner.

[Objective]To introduce the surgical technique of ceramic-on-ceramic total hip replacement and discuss the difference between two implant design.[Method]From November 2001 to June 2006,123 hip in 101 patients were treated by total hip arthroplasty with Osteonics ABC and Option Hip System.The prosthesis was fixed in strict position following some special technique for ceramic components.The theoretic range of motion of two hip systems were measured from experiment in vitro.The different cup positions which impingement happened were record for each prosthesises.[Result]The clinical score and the radiographic position of implants was good without evidence of wear,loosening,osteolysis and ceramic fracture.One chipping of ceramic insert happened during operation,and two patients had temporary irritation of iliopsoas.No other sever complication were found so far such as dislocation and infection.Experiment result:The deepened cup design obviously decreased the hip range of motion and "safe zone" was narrow than the flat cup design.[Conclusion]Ceramic-on-ceramic hip implant highly demands for surgical technique especially accurate cdp position.The deepened cup design cup should be posited with large anteversion.

Objective To explore effective excitation and restriction mechanisms for public hospital managers under market economy conditions and establish innovation mechanisms for hospital management posts. Methods On-the-spot surveys, literature reviews and discussions were conducted to collect data, which were then analyzed using such statistical methods as description and principal component analysis. Results Investigations into existing excitation and restriction methods and purposes for public hospital managers led to the discovery of some problems in the current mechanisms and suggestions were put forward for establishing on the basis of reform in the property right system new distribution mechanisms, competition mechanisms for appointing hospital managers, and innovation mechanisms for adopting human capital management with regard to hospital management posts. It was also suggested that restriction of hospital managers' powers by rules and health policies be reinforced. Conclusion It is proposed that excitation and restriction mechanisms that fit in with market economy conditions be established.

During the installation of a pipe pile, the soil around the pile will be squeezed out. This paper deals with this squeezing effect of open-ended pipe piles using the cylindrical cavity expansion theory. The characteristics of soil with different tension and compression modnli and dilation are involved by applying the elastic theory with different moduli and logarithmic strain. The closed-form solutions of the radius of the plastic region, the displacement of the boundary between the plastic region and the elastic region and the expansion pressure on the external surface of the pipe piles are obtained. When obtaining these solutions, the soil ping in the open-ended pipe pile is considered by employing an incremental filling ratio to quantify the degree of soil plugging. Moreover, the effects of the ratio of tension and compression moduli, angle of dilation and incremental filling ratio on the radius of the plastic region and the expansion pressure on the external surface of the pipe pile are investigated. The parametric analyses show that it is necessary and important to consider the difference between the tension modulus and compression modulus, dilation angle and incremental filling ratio for studying the squeezing effect of open-ended pipe pile installation. It is concluded that the analytical solutions presented in this paper are suitable for studying the squeezing effect of open-ended pipe piles.

Objective To investigate the presence of type 2 diabetes dyslipidemia,and the association with HDL levels and vascular complications in diabetes.Methods Of 524 cases of type 2 diabetes,fasting blood lipids,blood glucose,glycated hemoglobin results,blood basic data,the level of lipid controlling and based data of the patients were observed.The relevance between abnormal blood lipids and vascular atherosclerosis was analyzed.Results Type 2 diabetic patients have lipid metabolism,in 524 type 2 diabetes patients,58.4％ had lipid disorder;The serum level of HDL in atherosclerosis group[(0.8 ±0.26)mmol/L]was significantly lower than that in non-atherosclerotic group[(0.95 ± 0.43)mmol/L](t =1.648,P ＜ 0.05).Conclusion The decreasing of HDL had relationship to vascular atherosclerosis in patients with type 2 diabetes.

Objective To explore the possible role of vitamin D in the pathogenesis of IgA nephropathy (IgAN). Me-thods After the IgAN model was successfully induced at 12 weeks, the BALB/C mice were randomly divided into IgAN group (n=15) and IgAN+VitD group (n=15). The nephrosis mice were administrated with 100 μl/d propylene glycol or propyl-ene glycol+1,25(OH)2D, 3 ng/(100g?d), for 6 weeks. The control group was setted (n=15). The level of 24 hour urine protein was determined at week 0, 12 and 18. At week 18, the levels of serum 25(OH)D, ifbroblast growth factor 23 (FGF23) and galactose-deifcient IgA1 (Gd-IgA1) were detected. The mRNA and protein expressions of interleukin-21 (IL-21) in Peyer’s patches (PPs) were detected by lfuorescent quantitative reverse transcription-polymerase chain reaction and western blot respectively. The protein expression of Bcl-6 was detected by western blot. The percentages of Tfh cells/T lymphocytes, B220+IgM+/B lympho-cytes, B220+IgA+/B lymphocytes, B220-IgA+/B lymphocytes in PPs were determined by lfow cytometry. Results Compared with control group, the levels of 24 hour urine protein, FGF23 and Gd-IgA1 were increased, serum 25(OH)D was decreased, the mRNA and protein expressions of IL-21 and the protein level of Bcl-6 were increased, the percentages of Tfh cells/T lym-phocytes, B220+IgM+/B lymphocytes, B220+IgA+/B lymphocytes, B220-IgA+/B lymphocytes were elevated in IgAN group (P<0.05). These indicators were improved in IgAN+VitD group. Compared with the IgAN group, the differences were statisti-cally signiifcant (P<0.05), however compared with control group, some indicators showed no signiifcant differences (P>0.05). Conclusions 1,25(OH)2D may protect the microenvironment of PPs in IgAN through inhibiting the differentiation of Tfh cells and B cells and the generation of Gd-IgA1.