Objective To study the MRI features of the fatigue fracture of ankle.Methods 15 patients including 11 man and 4 women were studied.The age of the patients ranged from 15～45 years,with average of 22 years.All cases had no traumatic history of ankle joint and a negative result of plain radiographs,and its clinical symptoms was pain in the local site of feet.Siemens 1.5T MRI with SE and FSE were used to investigate the ankle,T 1WI(TR/TE=700/20)and T 2WI(TR/TE=4700/100) and T 2WI fat surpassion.Results All cases demonstrated abnormal MRI signals in both T 1 and T 2 weighted image:6 involving the talus,7 involving calcaneus,1 case located the navicular bone and 1 case involving both talus and calcaneus.15 cases with 16 were abnormalities of bone marrow,which 10 demonstrated hypointensity on T 1WI and hyperintensity on T 2WI,6 cases with hypointensity on T 1WI and complex signal intensity on T 2WI.Conclusion MR features of fatigue fracture of ankle joint without abnormality in X-ray films include trabecular fracture under cortical bone and edema in the trabecular bone which demonstrate irregular abnormal signal in MRI.

Computer simulation cardiac function values were calculated at different heart rate level, including left ventricular ejection fractions (LVEF), stroke volume (SV), cardiac output (CO) and so on, which was aimed to observe the effects of heart rate on cardiac function. It showed that the simulation results of LVEF, SV and CO were reliable at a low heart rate with linear regression model, but unreliable at a high heart rate. CO reached its maximum value when heart rate was 100 times per minute. Heart function values varied with heart rate. The effect of heart rate should be paid much attention to when heart function report was read.

With the advancement of the health reform and development of medical services,and performance evaluation of fine management,have become a major means to regulate medical services, improve quality of medical services, and promote healthy functioning of hospitals. The Hospital Authority worked out the performance evaluation standards for municipal hospitals. Setup of such financial evaluation indices as cost control rate,basic operation and healthcare materials for 10 000 yuan medical revenue,per-capita income and expenditure balance,implementation of fiscal input,and asset turnover.Finance and asset management of municipal public hospitals were subject to a general assessment and comparative analysis. Assessment results were linked to the hospital ’s annual performance bonuses.This enables the financial indicators and assessment to play a key role for hospitals to reduce costs,improve efficiency and strengthen fine management. Hospitals were encouraged to achieve balanced income and expenditure, surpluses, asset efficiency, performance budgeting, cost controls,decent financial operations.

Objective To investigate the functions of blood plasma homocysteine (Hcy) and high sensitivity C-response protein (hs-CRP) in the chronic obstructive pulmonary disease (COPD) in pathogenesis plays,and observe whether there was associations with disease severity and the correlations.Methods Forty-one patients with COPD were collected from August 2010 to February 2011,and 35 healthy persons as control group.Blood plasma Hcy,hs-CRP,forced expiratory volume in one second account predicted (FEV1％ predicted),and arterial pressure of oxygen (PaO2,arterial blood gases analysis) were measured in COPD patients and controls.Results Plasma Hcy concentration was (22.07 ± 12.13) μmol/L in COPD patients,but (9.89 ±4.41) μmol/L in controls,there were significant differences between two subjects (t =1.674,P ＜0.01).COPD patients had a higher serum hs-CRP concentration (8.60±3.85) mg/L than control's (4.24 ±0.57) mg/L (t =1.682,P ＜ 0.01).Along the descent of FEV1％ predicted,plasma Hcy and hs-CRP were elevated gradually,both sides show a negative correlation (r =-0.45,-0.49,P ＜ 0.05).And plasma Hcy and hs-CRP present a positive correlation in COPD patients (r =0.68,P ＜ 0.01).Conclusion Plasma Hcy was significantly elevated in COPD patients,positive correlation related to COPD severity and positive correlation related to serum hs-CRP.

Biological behavior of tumor has a close relationship with its blood supply from the tumor microvessels.The microvessel density of tumor can affect the progressiveness and prognosis of tumor directly. The application of TACE can kill the tumor cell, destroy its blood vessel, and obstruct its blood supply. The advancement of the tumor micro- vessel variation after transcatheter arterial chemoembolization is reviewed.

Objective To validate the theraputic efficacy of percutaneous ethanol injection(PEI) for hyperparathyroidism caused by parathyroid adenoma.Methods One case of parathyroid adenoma underwent PEI whose diagnosis was comfirmed by biopsy. The 22 gauge needle was punctured into the adenoma under CT guidance and ethanol was injected into the lesion at multiple points. Results The CT images obtained 6 months after 2 times of CT guided PEI revealed that the volume of the adenoma decreased markedly together obviously with decrease of enhancement after the injection of contrast media. The level of serum parathyroid hormone, calcium and phosphorous returned normal 2 days to 12 months after the management. The clinical manifestations improved markedly.Conclusions CT guided PEI is a minimally invasive and highly effective theraputic modality for hyperparathyroidism. It can serve as an important supplement to surgery.

Objective To study the values of apparent diffusion coefficient (ADC) changing with time and space in cerebral infarction,and to provide the evidence in defining the infarction stages.Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute,43 acute,29 subacute,10 steady,and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging.The average ADC values,the relative ADC (rADC) values,and the ADC values or rADC values from the center to the periphery of the lesion were calculated.Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously.rADC values in hyperacute and acute stage was minimized,and progressively increased as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days.Thereafter,rADC values became greater than normal in chronic stage.There was positive correlation between rADC values and time[ (174 ±3.47)% vs (58±6.75)%,t =2.03,P ＜0.05 ].The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery.The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery.Conclusion The ADC values of infarction lesions have evolution rules with time and space.The evolution rules with time and those in space can be helpful to provide the evidence in guiding the treatment or judging the prognosis in infarction.

To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.

BACKGROUND: Therapist-assisted treadmill training is good gait training, but it consumes great physical strength of therapists, and requires many persons. Clinical application was limited. Robot-assisted treadmill training has been paid great attention. OBJECTIVE: To summarize the role of robot in recovery of walking after spinal cord injury (SCI) and its influence on muscle activation patterns and kinematic patterns.RESULTS AND CONCLUSION: Although there is currently no evidence that robot-assisted gait training improves walking function more than other locomotor training strategies. Several advantages of robotic devices are obvious for applications targeting gait rehabilitation. Robotic devices are passive in nature and focus primarily on repeated movements of the limbs via fixed kinematic trajectories. These types of training abolish the cycle-to-cycle variation in the kinematics and the sensorimotor pathways. They also cannot sensitively monitor important characteristics of the training as therapists do. Therapists need to know the robot devices, understand how to change parameters to continuously challenge the subjects, and are able to assess when the workload is inappropriate for the subject's abilities so that they can maximize voluntary locomotor performance during assisted stepping to augment the recovery of functional walking.

BACKGROUND:Several studies have demonstrated embryonic stem cells induced neural precursor cells can promote functional recovery in rats with spinal cord injury.
OBJECTIVE:To study the effect of in vitro cultured embryonic stem cells induced neural precursor cells in rats with spinal cord injury.
METHODS:Total y 144 rats were randomly divided into three groups. Experiment group and control group rats had spinal cord transection injury. Embryonic stem cells-derived cells were injected into the vertebral canal at rostral and caudal segment perilesional y for the experiment group whereas PBS solution was injected instead of cells in the control group. Sham surgery group rats had only laminectomy without any spinal cord injury and treatment.
RESULTS AND CONCLUSION:The experimental result showed that at day 21 post-injury, the regional expression of transforming growth factor-β1 was greater in rats from the control group in comparison to the experiment group (P<0.05). At each time point after spinal cord injury in rats, the expression of myelin basic protein in the spinal cord was significantly higher in the experiment group than the control group (P<0.05). After celltransplantation, Basso, Beattie, and Bresnahan scores of the experiment group at different time points were significantly higher than those of the control group (P<0.05). Transplantation of in vitro cultured embryonic stem cells induced neural precursor cells can reduce the late expression of transforming growth factor-β1, and can increase the expression of myelin basic protein which contributes to the recovery of rats with completely transected spinal cord injury.