Objective To evaluate the impairment of ulnar nerve and its relationship with sensory symptoms in the ulnar territory in patients with carpal tunnel syndrome (CTS) through electrophysiological approach.Methods We retrospectively reviewed 55 cases with CTS admitted in our hospital from January 2012 to February 2013.Patients with CTS were graded as mild-moderate (35 cases) and severe (20 cases) according to Stevens standard and were divided into symptomatic and non-symptomatic group according to the presence of sensory symptom in little finger region.Twenty healthy volunteers were included as control.Median and ulnar nerves electrophysiological study were performed using the Keypoint.net (Medoc Ltd) electromyogram device.Results Finger 5-wrist sensory conduction velocities (SCVs) of ulnar nerve were reduced ((51.71 ± 2.93) m/s vs (58.62 ± 3.21) m/s,t =8.80,P ＜ 0.01) in CTS group,compared with control group.But the sensory nerve action potential (SNAP) amplitudes had no difference.Pearson correlation analysis showed that finger 5-wrist SCVs and the SNAP amplitudes of ulnar nerve were negatively correlated with the distal motor latency of the median nerve,while positively correlated with the compound muscle action potential amplitudes,finger 1-wrist,finger 3-wrist SCVs and SNAP amplitudes of median nerve,in mild-moderate group,finger 5-wrist SCVs of ulnar nerve were slowed and the SNAP amplitudes were reduced ((51.59 ±2.70) m/s vs (53.72 ±2.58) m/s; (13.51 ± 1.84) μV vs (15.21 ±2.16) μV,t =2.24,2.30,P ＜ 0.05 respectively) in the symptomatic group,compared with the non-symptomatic group.However,in severe group,only 2 cases had sensory symptom in little finger region.Conclusions CTS patients may have impairments due to ulnar nerve entrapments at wrist,which aggravate with disease progression.Sensory symptoms in ulnar territory are more frequent during the mild-moderate stage,and may relate with ulnar nerve involvement.

Objective To evaluate the impact of different ages, different gender, with or without exercise and different fracture sites on the nutritional status using mini nutritional assessment (MNA-SF) in hospitalized elderly fracture patients. Methods A total of 1 353 hospitalized elderly patients with fracture were included. The MNA-SF investigations were completed within 3 days after admission. The diet, body weight, physical activity, psychological trauma or stress, psychological problems, body mass index (BMI), calf circumference (CC), history of aerobic exercise and the fracture sites were recorded three days after admission. The nutritional status were evaluated including normal nutrition, risk of malnutrition and malnutritional status. The relationships of nutritional status were analyzed between different ages, different gender, with or without exercise, different fracture sites. Results There were significant differences in the incidence of normal nutrition, risk of malnutrition malnutrition and non-normal nutritional status between different ages, different gender, with or without exercise, femoral intertrochanteric fracture and upper limb fracture. There were also significant differences in the incidence of normal nutrition, risk of malnutrition and malnutrition between femoral neck fracture and upper limb fracture. Conclusion There is a higher incidence of non-normal nutritional status in patients older than 80 years, female, with no regular exercise and with femoral intertrochanteric fracture.

Objective To study the roles of the contact heat evoked potential (CHEP) in evaluating the small nerve fibers of cranial and spinal in elderly diabetic patients,and to analyze the feature of the small fibers in order to provide scientific foundations for early diagnosis of diabetic neuropathy (DN).Methods Totally 50 diabetic patients and 40 healthy subjects were included in this study.The diabetic patients were divided into the normal nerve conduction group (n=17) and the abnormal nerve conduction group (n=33).CHEP was determined and thermal stimuli was given to the area of eyelid,forearm and peroneal.Sensory and motor nerve conduction velocity in the upper and lower limbs were tested in all diabetic patients.Results Compared with the healthy group,the N wave latencies were prolonged and the N-P amplitudes were reduced in the area of eyelid,forearm and peroneal in diabetic patients (all P＜0.01).Compared with the healthy group,the logarithm of N-P amplitudes were reduced in areas of forearm and peroneal [(1.70±0.10) vs.(1.60±0.14),(1.65±0.078) vs.(1.54±0.15),both P＜0.05] and N wave latencies were prolonged in eyelid area [(343.1±18.2) ms vs.(385.4±26.5) ms,P＜0.05] in normal nerve conduction group.Compared to group with normal nerve conduction velocity,the logarithm of N-P amplitudes was reduced in peroneal area [(1.54±0.15) vs.(1.44±0.15),P＜0.05] in abnormal nerve conduction group.Conclusions CHEP can detect the early impairment of the small fibers in elderly diabetic patients.The early smallfiber impairments in diabetic neuropathy may be axon-oriented in spinal nerves and myelin-oriented in cranial nerves.

OBJECTIVE:To analyze the rules and characteristics of adverse drug reactions(ADR)induced by Shuxuetong in-jection,and provide reference for clinical rational drug use. METHODS:ADR cases induced by Shuxuetong injection in Beijing collected by national ADR monitoring center in 2012 were retrieved,and 35 cases of the ADR were statistically analyzed. RE-SULTS:ADR induced by Shuxuetong injection had relatively high incidence in elder over 60 years old(68.57%);ADR might oc-curred after 5 min with off-label use and it mainly occured after 10 min-2 h(40.00%);clinical manifestations were mainly systemic damage and nervous system damage,and all patients were returned to normal after symptomatic treatment except one with unclear outcome. CONCLUSIONS:ADR induced by Shuxuetong injection is related to age and dosage. Clinical medication should be strict-ly in accordance with the instructions,strengthen medication monitoring and reduce incidence of ADR to ensure medication safety.

Objective To know the cognition,attitude and needs among middle-aged andaged women with urinary incontinence(UI) in communities. Methods A questionnaire survey wasconducted in 66 middle-aged and aged women with UI in two communities and the results were an-alyzed. Results Most patients lacked the knowledge of UI;UI had impact on their physical andmental heahh.Must patients wished to know about the treatment knowledge,and health education of med-ical staff was the most promising way.The mastering degree of knowledge about disease was not related tothe serious degree of disease and age,but was positively related to education degree and economic income.Conclusions We should publicize the knowledge about UI and provide health education and emotionalsupport to patients.And we should emphasize the training about UI among medical staff.

BACKGROUND: Studies have demonstrated that the freeze-dried and irradiation-sterilized allogeneic bone is an ideal material for bone transplantation, they are present with good biocompatibility and biomechanical property, also maintains some necessary enzymes for bone morphogenetic protein and morphogenesis protein in bone matrix with some osteninductivable potentials. OBJECTIVE: To observe the effect of the compound of placenta tissue injection and allogeneic lyophilized bone on the reconstruction of jaw bone defects of dogs, and to compare with single allogeneic lyophilized bone. DESIGN, TIME AND SETTING: A comparative observational trial was performed in the Animal Experimental Center of Harbin Medical University between December 2007 and September 2008. MATERIALS: Eight healthy hybred adult dogs; allogeneic lyophUized bone was offered by Hubei Osteolink Biomatedals Co.,Ltd; placenta tissue injection was purchased from Livzon Pharmaceutical Factory Zhuhai (2 mL per injection); allogeneic lyophilized bone: placenta tissue injection=(4-5):1.METHODS: A total of 96 experiment areas from hemisphere jaw defect models at 1.0 cm diameter were established in dog jaw bone site corresponding with central incisor, canine teeth and root apex of the first molar. In the experiment group, the allogeneic lyophilized bone and bone particles were soaked in placenta tissue injection and under saturation state, then the compound of placenta tissue injection and allogeneic lyophilized bone were implanted to jaw bone defect. In the positive control group, the allogeneic lyophilized bone and bone particles were soaked in sodium chloride injection and under saturation state, then implanted to jaw bone defect. In the negative control group, nothing was implanted to jaw bone defect. Each experiment area comprised four materials in each group.MAIN OUTCOME MEASURES: The radiological and histological observations were performed at 2, 4, 8 and 12 weeks after operation.RESULTS: In the experiment group, there was obvious cartilaginous osteogenesis in the earlier period and intramombranous osteogenesis in the late period. The new bone was well integrated with the surrounding tissues. In the positive control group, new recovered bone existed but the combination between the new bone and the original bone was not well. In the negative control group, jaw bone defects were not filled with bone trabecula. Histological examination results showed that there were more new bones in the experiment group than the control groups at 2, 4, 8 and 12 weeks after operation. Statistical difference could be observed among them (P < 0.05, P < 0.01 ).CONCLUSION: The compound of placenta tissue injection and allogenalc lyophilized bone can promote recovery of jaw bone defect actively and shorten recovering time effectively.

BACKGROUND:The levels of interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) are increased during infectious brain edema, and are positively relevant to the degree of brain damage. However, whether TNF-α can enhance blood brain barrier (BBB) permeability remains unclear, especially in vitro.OBJECTIVE: To understand the changes and possible mechanism of the BBB permeability induced by TNF-α in vitro.DESIGN: Randomized controlled cell model study in vitro.SETTING:Department of Pediatrics, Xiangya Hospital, Central South University; Department of Biochemistry, Xiangya Medical College, Central South University.MATERIALS: Twenty 7-day-old healthy Sprague-Dawley rats, of clean grade and either gender, were provided by the Animal Center, Xiangya Hospital, Central South University. TNF-α was purchased from sigma Company; DMEM fluid medium and fetal bovine serum were purchased from Hyclone Company; Y-27632 was purchased from Alexis Company,and rabbit anti-human factor Ⅷ -related antigen was purchased from Zymed Company; Mouse anti-rat glial fibrillary acidic protein (GFAP) was purchased from Neomarkers. Other biochemical reagents were imported (Sigma Company).METHODS: This experiment was carried out in the Xiangya Hospital, Central South University between March 2004 and April 2005. Brain microvascular endothelial cells and astrocytes were co-cultured 10 days to set up rat models of BBB in vitro. Then, the cells were divided into 4 groups: model group(BBB models were prepared), TNF-α group ( BBB model incubated with 0.01 g/L TNF-α for 5 hours), Y-27632 pretreated group ( BBB model incubated with 30 μmol/L Y-27632 for 1 hour before 0.01g/L TNF-α challenge ) and Y-27632 control group (BBB models only incubated with Y-27632 as those in the Y-27632 pretreated group). The effect of TNF-α on BBB permeability was observed by detecting the 125 I -BSA, which passed through the inserts at each time point (30,60,120 and 240 minutes) using .γradioimmunoassay counter.MAIN OUTCOME MEASURES: The 125 I -BSA, which passed through the inserts in rat models of BBB at different time points after intervention.RESULTS: The 125 I -BSA, which passed through the inserts in rat models of BBB, was all significantly higher in the TNF-α group than in the other groups at 30, 60, 120 and 240 minutes after intervention, respectively (P ＜ 0.01), and reached the peak at 240 minutes; The 125 I -BSA, which passed through the inserts, was lower in the Y-27632 pre-treated group than in the TNF-α group at 30 and 60 minutes after intervention (P＜ 0.01). There was also significant difference in 125 I -BSA permeation between Y-27632 pretreated group and Y-27632 control group after 120 minutes (P ＜ 0.05).CONCLUSION: TNF-α can increase BBB permeability, and Y-27632 pretreatment can early reverse the effect of TNF-α on BBB permeability.

Objective To investigate the clinical significance of prenatal ultrasound examination in the diagnosis of fe?tal digestive tract development. Methods Twenty-nine cases of congenital digestive tract malformation were examined in according to the different characteristics of their different fetal ultrasound images. Results There were 11 cases with non-magenblase or less magenblase (37.93%), 4 cases with combination of multiple malformations, and 9 cases with combination of amniotic fluid in the 29 cases. There were 7 cases (24.14%) with dilatation of intestine and intestinal vesicles, in which 3 with multiple malformations and 3 with polyhydramnios. There were 8 cases (27.58%) with double bubbles, in which 1 case with multiple malformations and 7 cases with amniotic fluid. Conclusion The prenatal ultrasound examination in 30 to 32 weeks of pregnancy is very valuable in diagnosis of fetal digestive tract development, which is worthy of clinical application.

Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.

Objective To explore the influencing factors of the implementation of general hospital guiding principles of nursing classification (trial) in clinical nursing work.Methods 152 nurses and 143 doctors were selected from three 3A-level hospitals in Changchun and were investigated with self-designed questionnaires,and the data were statistically analyzed.Results The first three influencing factors were the responsibility,quantity and basic qualities of nurses.Grading nursing standards,leadership value degree and the differences of disease had lower influencing degree.There were cognitive differences between nurses and doctors on the influencing factors on implementation of the principle.Conclusions To improve execution of the principles,the cognition of doctors and nurses on the principles must be unified.Increasing nurses' basic quality and responsibility and carrying out effective human resources management are very useful.