Objective Analyze the influence of applying background music on heart rate,blood pressure and dysphoric state of patients during gynecologial examination.Methods A total of 564 patients were randomly divided into music and control group 282 cases each.In control group,the 282 patients were just actualized the routine psychological care.And the other 282 patients of music group were actualized music therapy based on the routine psychological care.After these patients of music group entered examination room,the doctor broadcasted some good background music for them.After 30 minutes,the doctor recorded their heart rate and blood pressure changes and evaluated the anxiety level by using S-AI.Results After the patients of music group had listened to background music for 30 minutes,their systolic pressure and heart rate reduced evidently and the level of anxiety mitigated obviously.Conclusions Applying background music during gynecological examination can relieve anxiety emotion,stabilize heart rate and blood pressure and improve comfort of gynecological examination.It's an effective,simple and convenient nursing care method.

Objective To analyze the X-ray,CT and MRI appearances of primary synovial osteochondromatosis.Methods CT scanning was performed in 22 cases,of which 16 cases underwent X-ray examination and 2 cases underwent MRI scan.Results Of 22 cases of synovial osteochondromatosis,13 cases were male and 9 cases were female.The monoarticular involvment was found in 20 cases,and double-articular involvment in 2 cases.Variable size and number of the cartilaginous nodules with calcification and ossification within and surround the joints were showed in 20 cases.The soft mass with calcification were showed in 2 cases.Bone destruction were found in 2 cases,which were induced by compression of the cartilaginous nodules,this was confirmed by operations.Conclusion The cartilaginous nodules with calcification or ossification can be shown by X-ray and CT san.The cartilaginous nodules without calcification or ossification can be shown by MR san.

Objective:The research was performed to understand the expression of CD80,CD86 and its ligand CD28 on peripheral lymphocytes in patients suffered from idiopathic thrombocytopenic purpura(ITP).Methods:The expression of co-stimulatory molecules(CD80,CD86 and its ligand CD28)on peripheral lymphocytes from 34 ITP patient samples and 34 normal samples was detected by immunofluorescence and flow cytometry.Results:The expression of CD80 and CD86 on peripheral lymphocytes from ITP patients(4.21?2.27%,7.19?5.16%) was higher than that of the normal samples as control(2.34?0.87%,4.08?1.96%,p

Objective To explore the role of apparent diffusion coefficient (ADC) value of diffusion-weighted imaging (DWI) in the differentiation between benign and malignant bone tumors. Methods Echo planar imaging DWI was performed in 18 patients with benign tumor or tumorous lesion and 26 patients with malignant tumor of bone. Three b-values (0, 500 and 1000 s/mm2) were applied. The lowest, highest, and whole ADC values were measured for each lesion, respectively. Results The lowest ADC values of benign bone tumor[ mean( 1.28±0. 49) ×10-3mm2/s ] were significantly higher than that of malignant tumor [ mean ( 0. 92±0. 35 )×10-3mm2/s, t = 2. 839, P < 0. 01 ]. The whole ADC values of benign bone tumor [ mean (1.62±0. 51 ) ×10-3mm2/s] were significantly higher than that of malignant tumor [ mean ( 1.21±0. 36) ×10-3mm2/s, t = 3. 092, P < 0. 01 ]. However, there were much overlapping between benign and malignant bone tumor in the lowest and whole ADC values. There was no significant difference for the highest ADC values between benign [. Mean ( 2. 02±0. 55 )×10-3mm2/s] and malignant bone tumor[ mean( 1.71±0. 65 ) ×10-3mm2/s, t = 1. 669, P > 0. 05 ]. Excluding cases of bone cyst and aneurismal bone cyst, the lowest, highest, and whole ADC values of benign bone tumor was (1.11± 0. 31 )×10-3mm2/s, ( 1.88±0. 49)×10-3mm2/s, and( 1.45±0. 35 )×10-3mm2/s, respectively. There was no significant difference for the lowest, highest, or whole ADC values between benign and malignant bone tumor (t = 1. 728, 0. 964, and 2. 012, respectively, P > 0. 05). Conclusion ADC value is useless for the differentiation between benign and malignant bone tumors.

Objective To determine the diagnostic value of the change of different parts of electrocardiogram in treadmill exercise test (TET) for coronary heart disease (CHD).MethodsFrom Jan.2006 to Mar.2011,445 patients with CHD underwent treadmill exercise test and coronary angiography (CAG) in our hospital.We analyzed retrospectively the diagnostic value of the change of different parts of electrocardiogram in TET test.Results ( 1 ) There were 200 cases who had positive results during treadmill exercise test and 150 cases of them had been diagnosed of CHD by coronary angiography;The other 245 cases had negative results during treadmill exercise test and 39 cases of them had been diagnosed as CHD by coronary angiography.The sensitivity and specificity rates of treadmill exercise test in diagnosis of CHD were 79.36％( 150/189 ) and 80.47％ ( 206/256 ) respectively. ( 2 ) Of the 200 positive cases tested by coronary angiography,150 cases were diagnosed of CHD,including 22,58 and 70 cases with limb,chest and combined chest and limb leads positive results respectively.The positive rates for the groups of combined chest and limb leads and limb ST leads were significantly higher than that of the chest leads only group ( x2:6.34,3.93 ; P ＜0.05).(3)R wave amplitude of the CAG negative group after exercise (17.54 ± 2.52)mm was significantly lower than the CAG positive group ( 19.42 ± 3.46 )mm ( t =6.33,P ＜ 0.05 ).( 4 ) For the 200 cases with positive TET,there were no significant statistical difference ( P ＞ 0.05 ) on CAG positive rate between T wave normalization group [ 73.3％ (44/60) ] with and TET positive group [ 75.0％ (105/140) ].But these two groups had significantly higher ( x2:80.21,132.82 ; P ＜ 0.05 ) CAG positive rates than TET negative group [ 15.9％ (39/245) ].ConclusionThe treadmill exercise test is valuable in noninvasive diagnosis of CHD.The severity of CAG can be preliminarily estimated by analyzing the pattern of the change of different parts of electrocardiogram

Objective To investigate the effects of N - acetylcysteine (NAC) on apoptosis and the expressions of Fas/FasL mRNA in lung tissue of rats with paraquat - induced acute lung injury.Methods Forty five male SD rats were randomly (random number) divided into normal control group,paraquat (PQ) group,and NAC treatment group.The rat model of acute lung injury was made with 2％ PQ induction in dose of 25 mg/kg injected,and NAC was injected into the PQ poisoning rats (200 mg/kg) 30 minutes after PQ administration in NAC treatment group.In the control group,equal amount of saline instead was injected into the rats.Apoptosis was detected by using TUNEL method and the expressions of Fas/FasL mRNA were evaluated by using reverse transcription polymerase chain reaction (RT- PCR),and the levels of Fas/FasL protein were detected by using western blot analysis.Results Compared with control group,cell apoptosis and expressions Fas/FasL mRNA in PQ group were significantly different ( P ＜ 0.05 ).Compared with PQ group,cell apoptosis and expressions Fas/FasL mRNA in NAC group were significantly decreased,were significant lower (P ＜ 0.05).Conclusions NAC inhibited apoptosis in lung tissue of rats with paraquat induction by regulating the activation of Fas/FasL systems.

Objective To evaluate clinical significance of the grade of ischemia by QRS complex on the admission electrocardiogram(ECG)to predict severe arrithmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to emergency department from July 2003 to April 2008 were enrolled.A total of 223 patients met the criteria(ischemic chest pain ≥ 30 min,2 or more adjacent leads of ST segment elevation and onset time within 12 h).Exclusion criteria were bundle branch block and left ventricular hypertrophy.All enrolled patients were divided into two groups based on the enrollment electrocardiogram:grade 2 ischemia(ST elevation without terminal QRS distortion; n =134)and grade 3 ischemia(ST elevation with terminal QRS distortion; n =89).Patients of the two groups had comparable genderproportion,average age and coronary heart disease risk factors etc.All patients received thrombolytic therapy.The incidence rate of ST segment resolution(STR)and severe arrithmia in hospital stay were observed.Numerical variables were expressed mean ± standard deviation and compared by unpaired Student't test,Categorical variables were expressed percentage and compared by chi square test.Multiple logistic regression analysis was used to determine independent predictors of severe arrithmia.Results Patients with grade 3 ischemia had greater Σ ST on admission and 2 h after thrombolysis ECGs(P ＜ 0.01),the incidence rate of STR in patients with grade 3 ischemia was lower than that in patients with grade 2 ischemia(P ＜0.01).The peak creatine kinase MB fraction was higher in patients with grade 3 ischemia than that in patients with grade 2 ischemia(P ＜ 0.01).There was no significant difference of the incidence of severe arrithmia,such as ventricular premature beat,ventricular tachycardia or fibrillation,second-degree or third-degree atrioventricular block,and sinus arrest between the two groups(P ＞ 0.05),but there was a trend of higher incidence of severe arrithmia in patients with grade 3 ischemia compared with that in patients with grade 2 ischemia.Multiple logistic regression analysis demonstrated that the independent predictors of severe arrithmia were duration from symptom to thrombolysis and initial.Σ ST,whereas grade 3 ischemia remained a strong predictor of severe arrithmia.Conclusions Grade 3 ischemia on admission is associated with lower incidence of STR in patients with ST-segment elevation myocardial infarction(STEMI)after thrombolysis and a strong predictor of severe arrithmia.

Objective:Combined with the actual work requirements of brucellosis in Qinghai Province, to design a management information system for brucellosis patients, in order to realize the information of diagnosis and treatment of brucellosis patients.Methods:Based on the theory of management information system, according to the functional requirements of the actual work and performance parameters, the general framework of management information system was designed, the establishment of the management information system was gradually completed, and the system was improved through the system testing.Results:The system was easy to use and easy to operate, and patient's detailed information, diagnosis and treatment results and treatment plan could be obtained quickly. At the same time, follow-up, trace investigation, and brucellosis prevention and treatment propaganda could be carried out.Conclusions:The established brucellosis management information system can realize the electronic management of patient information, master the disease development and diagnosis and treatment results of brucellosis patients. Through follow-up investigation, the system can increase active screening and early warning of suspected cases, and provide health education to realize early diagnosis and early treatment of the patients.

[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.

Objective To explore the image quality of 3.0 T Magnetic Resonance foot and ankle array coil on Achilles tendon ab-normalities for the clinical application.Methods 26 patients (with Achilles tendon symptoms)and 5 volunteers underwent MR exam-ination.The scanning sequences were used:T1 WI、PDWI、T2 WI-FS and STIR.Image diagnoses and clinical data of all patients were obtained and analyzed.Subjective scores on image quality were used.Degrees of comfort in coil were evaluated.Results 10 patients had Achilles tendon inj ury,6 patients with Achilles tendonitis,3 patients with part Achilles tendon rupture,1 patient with tendon xanthoma,and 6 patients were normal.Image scores in patients with T1 WI、PDWI and T2 WI-FS sequences were higher,the anatom-ic structures,lesions of whole Achilles tendon were clear.On the contrary,the lower scores were in STIR sequences.In the heel, images were distorted,the level of organization was disappeared and signal intensity was increased.The volunteers felt a slight dis-comfort at the coil entrance and support point of the heel.Conclusion Patients using 3.0T foot and ankle array coil for the Achilles tendon scanning could get high image quality and degrees of comfort.