Objective To analyze the best methods for diagnostic scanning and image processing of multi-slice spiral CT (MSCT) in the detection of renal malformations (RM). Methods From June 2008 to Februany 2012, one hundred and four patients with kidney malformation received 64-slice MSCT assay were enrolled in our Hospital. Related materials of the patients were used for retrospective analysis. Diagnostic accuracy of urinary malformation were calculated on the image of axial and MPR, Curve, MIP, VR by MSCT unenhangced scanning, enhangced cortical phase scanning, enhangced parenchymal phase scanning and enhangced excretory phase scanning. Results One hundred and four patients with kidney abnormalities received the MSCT unhangced scan axial and MPR, Curve film, enhangced cortical phase scanning, enhangced parenchymal phase scanning, enhangced excretory phase scanning and MPR, MIP, VR film, respectively. The diagnostic accuracy were as follws: renal dysplasia (72.73%, 81.82%, 81.82%, 72.73%), renal hypoplasia (83.33%, 91.67%, 95.83%, 100%), solitary kidney (100%, 100%, 100%, 100%), ectopic kidney (76.92%, 100%, 100%, 100%), horseshoe kidney (100%, 100%, 100%, 100%),misplaced renal lobe (0%,100%). Conclusion The MSCT with image post-processing techniques in the diagnosis of RM has its unique advantages, MSCT can be preferred as a method for renal malformation examination.

Objective To study the value of three dimensional contrast enhanced subtraction MRA (3D CES MRA) in the diagnosis of extremity musculoskeletal diseases. Methods Fifteen cases of extremity musculoskeletal diseases proved by operation and pathology were studied, including upper extremity ( n =5), lower extremity ( n =10), soft tissue and vascular lesions ( n =8), and skeletal lesions ( n =7). All examinations were performed with GE 1.5 T MRI scanner. Sagittal scout images were obtained by 2D FMPSPGR sequences. Before and after contrast enhancement, coronal 3D FSPGR sequence was performed in the same parameters within 32 seconds. The plain source images were subtracted by enhanced source images in the workstation. The subtracted images were processed by MIP technique, such method is so called 3D CES MRA. Results All lesions were demonstrated accurately by 3D CES MRA, including vascular lesions ( n =6), tumors in the soft tissue ( n =3), benign skeletal tumors ( n =1), and malignant skeletal tumors ( n =3). Compared with pathology, the diagnosing accuracy rate of 3D CES MRA was more than 90%. Conclusion 3D CES MRA is an advanced, safe, and noninvasive method in diagnosing extremity musculoskeletal diseases, further more, it can save time and resources. In general, 3D CES MRA has a great value in clinical application.

Objective To discuss the nursing countermeasures of common problems in patients with spinal fracture. Methods All patients received evidence- based nursing in on:ler to tackle problems such as pain, paralysis, pulmonary infection, pressure ulcer, urinary tract infection and deep vein thrombosis. Results No one complicated with pulmonary infection, pressure ulcer and deep vein thrombosis, 2 with lower limb swelling and 3 with urinary tract infection. Conclusions Evidence- based nursing is the base of clinic nursing. It can not only improve the quality of nursing and benefit patients,but also can expand the nurses' knowledge.

Objective To observe the differences in functional areas of the brain in response to two different acupuncture techniques using functional magnetic resonance imaging (fMRI).Methods Deqi and non-deqi acupuncture were performed on twenty healthy right-handed volunteers.fMRI was conducted in the process of acupuncture.The experiment adopted a single-chunk design and the procedure contained periods of stimulation and rest.The brain regions stimulated during deqi and non-deqi acupuncture were assessed using xjview software.Results After acupuncture at the Zusanli point (ST36),differences in activity were observed between the deqi and non-deqi groups in the language,sports,perception and limbic systems.Conclusions ①Under deqi conditions,acupuncture at ST36 increases circulation and the activation of brain areas dealing with language,sports,perception and the limbic system.This may be one of the mechanisms by which acupuncture can improve aphasia,coordination and perception.②Under deqi conditions acupuncture at ST36 decreases circulation and deactivates brain areas associated with the limbic system.This may explain acupuncture's analgesia and regulation of autonomic nerve and endocrine function,its amelioration of internal organ functions and regulation of immunologic function.

Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into group B (≤5 years),group C (6-10 years),group D (11-20years) and group E (＞ 20 years).Face-to-face surveys were conducted in all the subjects by trained physicians using Mini-Mental-State-Examination (MMSE) and Clock-Drawing-Test (CDT).The incidences of cognitive impairment were compared among the five groups and the relationship between duration of hypertension and cognitive function were analyzed by SPSS 18.0 software.Results (1) Compared with the normotensive group,the hypertensive group performed worse in the scores of MMSE,CDTs,the memory type cognitive function and the non-memory type cognitive function (MMSE:Z =-2.585,P =0.010;C DTs:Z =-3.689,P ＜ 0.001 ; memory type cognitive function:Z =-2.718,P =0.007 ; non-memory type cognitive function:Z =-1.994,P =0.046).(2) The incidences of cognitive impairment in the five groups were 3.6％ (8/224),6.6％ (26/393),16.6％ (72/433),19.7％ (55/279) and 33.5％(64/191),respectively.(3) Compared with the group A,the cognitive function was significantly worse in the group E (MMSE:Z =61.314,P ＜ 0.001 ; CDTs:Z =44.642,P ＜ 0.001 ; memory type cognitive function:Z =35.703,P ＜ 0.001 ; non-memory type cognitive function:Z =54.440,P ＜ 0.001).Conclusions Hypertension is a risk factor for the cognitive dysfunction.The incidence of cognitive dysfunction and the severity are positively associated with the duration of hypertension.In those with hypertension over 20 years,the cognitive dysfunction occurs much more obviously.

Objective To compare the efficiency of enhanced T2* weighted angiography (ESWAN) sequence with that of a conventional T2*-weighted gradient-recalled-echo (GRE T2*WI) sequence for the detection of hemorrhagic shearing lesions in patients with diffuse axonal injury (DAI). And combined with MRI parameters, to further discuss the principles and virtues of ESWAN sequence. Methods Seventeen patients with DAI were enrolled in this study. The raw data acquired from ESWAN scan were postprocessed by using the mean square root of multi-echoes. Then, the postprocessed images were compared with the conventional GRE T2* weighted images. The global and regional (superficial, deep and posterior fossa) lesion numbers determined by both sequences were compared by using Wilcoxon signed ranks test (two-tailed). Differences were considered to be significant at P≤0.05. Results Hemorrhagic lesions were more obvious on ESWAN images than those on conventional GRE T2* weighted images. The median and range value of the detected lesion numbers on ESWAN images were 27 and (1-239) in whole brain, 13 and (1-89) in cerebral superficial region, 5 and (0-111) in cerebral deep region and 1 and (0-39) in posterior fossa region, respectively; whereas, on GRE T2* weighted images, they were 7 and (1-34) in whole brain, 5 and (1-27) in cerebral superficial region, 2 and (0-25) in cerebral deep region and 0 and (0-4) in posterior fossa region, respectively. There were significant statistical differences between the two sequences in revealing the lesions in all the four regions (Z=-3.519,-3.182,-3.185,-2.677,P＜0.05). Conclusion In ESWAN sequence, multi-echo acquisition ensured sufficient magnetic susceptibility for detecting small hemorrhagic lesions. So, ESWAN is more sensitive to small hemorrhage, which revealed more hemorrhagic lesions than conventional GRE T2*WI and presented more valuable information for the diagnosis of DAI.

Minocycline is the second generation semisynthetic tetracycline antibiotics.A variety of animal models and clinical trials have shown that it has neuroprotective effect.Its mechanism is associated with inhibiting apoptosis, alleviating inflammatory reaction, reducing infarct volume, and alleviating vascular injury.This article reviews the neuroprotective effect of minocycline in preclinical phase and early clinical trials of acute ischemic stroke.

BACKGROUND: Tibia open fracture is a common disease, and intramedullary fixation has become the first choice, but the high risk of postoperative infection limits its clinical application.OBJECTIVE: To investigate the early prevention effect of vancomycin-hydroxyapatite (VCM-HA) coated titanium intramedullary nail in a rabbit model of open femoral fracture combined with wound infection.METHODS: Titanium intramedullary nails coated with three different concentrations of VCM-HA were prepared using biomimetic deposition, and subsequently in vitro bacteriostasis experiment was performed. Forty healthy male New Zealand white rabbits were selected and the model of mid-femur open fracture with wound infection was prepared. The rabbit models were then divided into ordinary intramedullary nail, low-, middle- and high-concentration VCM-HA coated intramedullary nail groups (n=10 per group). The wound appearance of the animals was dynamically observed. The body mass, anal temperature, white blood cells and C-reactive protein contents in the venous blood were monitored. The pathological examination of the soft tissue around the fracture and injured limb X-ray were conducted regularly.RESULTS AND CONCLUSION: The prepared VCM-HA coated titanium intramedullary nail exerted obvious antibacterial effects in vitro. The anal temperature in the ordinary nail group was significantly higher than that in the other three groups at 3 days after modeling (P < 0.05). The white blood cells and C-reactive protein contents in the venous blood in the VCM-HA groups were significantly lower than those in the ordinary nail group at 3, 7, 14 and 28 days after modeling (P < 0.05). The hematoxylin-eosin staining of the peripheral tissues displayed the inflammatory response in the VCM-HA groups was milder than that in the ordinary nail group at each time point after modeling. The injured limb X-ray displayed that the callus grew slowly accompanied with sequestration in the ordinary nail group, while the callus growth in the VCM-HA groups was significantly better than that in the ordinary nail group. To conclude, the VCM-HA coated intramedullary nail can effectively reduce postoperative infection in an animal model of open femoral fracture combined with wound infection.

Objective Through observing the change of serum cTnT level and other biochemical markers such as T3 and TNF-αin acute ischemic stroke patients , to investigate the correlation between the indictors change and short-term prognosis and stroke severity .Methods This study observed 68 patients (male 35 cases ,mean age 68 ±11.4 years; female 33 cases, mean age 69 ±10.3 years).All cases were collected fasting blood sample to test cTnT ,T3 and TNF-α.Death and other unexpected events were recorded in the form of telephone follow-up within one month in survival patients during and discharge from hospital.Results According to cTnT detection level ,all cases were divided into two groups , normal group (54 cases,79.4%) and positive group(14 cases,20.6%).There was statistical significance between posi-tive cTnT and NIHSS score neurological deficits ( p <0.01).cTnT was negratively correlated with T3( r =-0.324 , P <0.05 ) ,but positively with TNF-α( r =0.67 , P =0.017 ) .All patients were followed up for one month.14.7%patients died including 11.7%during hospital and 3% after discharge.After age, NIHSS adjustment cTnT remains an independent risk factor for death ( RR=2.34 ,95%CI=1.22-5.02 , P<0.01 ) .Conclusion After acute ischemic stroke , cTnT is correlated with dropping T 3 level and in-creasing TNF-αlevel, suggesting that both stress and inflammatory response may be involved in heart dam-age.Abnormal elevation of cTnT influenced short-term prognosis of acute ischemic stroke , which can be used as short-term indicators of poor prognosis in the clinical observations .

Objective To investigate the effects of polysaccharide sulfate(PSS)on the growth of vascular endothelial cell cultured in vitro and the adhesion of vascular endothelial cell to polymorphonuclear neutrophils(PMN).Methods ECV-304,a kind of human umbilical vein endothelial cells,was cultured in vitro with different concentrations of PSS(0,50,100,150,200,250 g?mL-1),the growth of ECV-304 was observed by means of MTT.Hypoxia/ reoxygenation(H/R) model of ECV-304 was established,the adhesion rate of PMN from patients with cerebral infarction to cultured ECV-304 was detected with or without treatment of PSS and H/R.Results The growth of ECV-304 in PSS-treated subgroups(final concentrations: 50,100,150,200 g?mL-1) were much better than in non-PSS subgroup,especially in subgroup with PSS final concentration of 100 g?mL-1.The adhesion rate of cultured ECV-304 to PMN from patients with cerebral infarction was higher significantly than that from the healthy subject,which was increased when ECV-304 being treated with H/R.The adhesion rate of cultured ECV-304(whether treated with H/R or not) to PMN was decreased significantly when ECV-304 being treated with PSS(100 g?mL-1).Conclusion The experiments in vitro showed that PSS could promote the growth of cultured ECV-304 and decrease the adhesion rate of H/R ECV-304 to PMN.