Objective To study the relationship between irritable bowel syndrome (IBS) and the quantity of bowel gas using plain abdominal radiographs. Methods Plain abdominal radiograph were digitized and transmitted to a computer in 48 IBS patients and 25 normal controls. The quantity of bowel gas, determined as the pixel value on images and standardized by physique, was defined as the gas volume score (GVS). The ?2s of GVS in the control group was used as the normal score. The relationship between GVS and subtype of IBS was analyzed. Results The mean GVS of normal control was 0.055?0.012, and coefficient of variation was 21.8%, and all subjects were in normal score. The mean GVS was 0.076?0.027 for the constipation type IBS, significantly higher than that for control ( t =3.599, P 0.05) and the control in the mean GVS. However, the coefficient of variation in the diarrhea type IBS was as high as 66.7%, and low score was seen in 42.9% of patients and high score in 14.3%.Conclusions There is a significant subtype related change of bowel gas volume in IBS patients. The bowel gas is increased in the constipation type, and decreased markedly in the diarrhea type.

Objective To compare the advantages between CT and MRI examination and to evaluate the applied value of diffusion weighted imaging(DWI) in acute cerebral trauma.Methods 54 cases with cerebral trauma were undergone CT and MRI simultaneously,the advantages and disadvantages of both examination were analysed using self-comparative method. Results In showing subarachnoid hemorrhage, ultra-acute cerebral bleeding and bone fracture,CT was better than MRI,but cerebral contusion in 5 cases,laceration of white matter in 5 cases,acute white matter swelling in 2 cases and subdural haematoma in one case were misdiagnosed by CT.DWI was much better to show laceration of white matter and acute cerebral matter swelling than CT and conventional MRI.Conclusion In diagnosing acute cerebral bleeding and bone fracture, CT is better than MRI, for other diagnoses MRI better than CT. DWI should be applied to be a common scan method in diagnose of acute cerebral trauma.

BACKGROUND:During ordinary plate fixation, the soft tissues around the fracture of the proximal humerus are nearly stripped to impact blood supply, and moreover, an ordinary steel plate cannot meet with the fixed requirements for severe osteoporosis, large bone defects and comminuted fractures. OBJECTIVE: To observe the functional recovery and complications in middle-aged patients with proximal humeral fractures undergoing stainless steel locking plate implantation. METHODS:From March 2011 to March 2014, 48 patients with proximal humeral fractures were treated in the 306th RESULTS AND CONCLUSION: The 48 patients were folowed up for 6-17 years, and the mean healing time was (15.3±1.2) weeks. At the last folow-up, the Neer scores were excelent in 12 cases, good in 22 cases, fair in 11 cases and poor in 3 cases, with an excelent-good rate of 71%. After internal fixation, there was one case of Hospital of PLA, including 20 males and 28 females, with an average age of 58 years. Of the 48 cases, there were 9 cases of Neer 2 fractures, 26 cases of Neer 3 fractures, and 13 cases of Neer 4 cases, al of which belonged to closed injuries. Al the patients were subject to locking plate implantation for repair of fractures of the proximal humerus, and evaluated based on Neer scores. soft tissue infection, two cases of traumatic arthritis, and no bone ununion and osteomyelitis. These findings suggest that the stainless steel locking plate implantation for repair of fractures of the proximal humerus can achieve a good anatomic reduction under minimaly invasive conditions and produce a stable rehabilitation environment for the soft tissue around the shoulder joint by internal fixation. Hence, the factures can recover faster with less complications. The stainless steel locking plate implantation can obtain good achievements in the repair of proximal humeral fractures of Neer 2, 3 as wel as Neer 4 in young patients with good bone quality.

Objective To explore the event-related potentials (ERPs) P300 is changeable or not before and after treatment. Methods 99 cases of patients with first onset of depression diagnosed by DSM-Ⅳ as case group,and 100 cases matched with patients as control group were collected. P300 of two groups were obtained before and after treatment for 6 weeks,12 weeks,24 weeks. T test was used to analysis the difference of indicators of P300 among groups; repeated measure analysis of variance was used to analysis the longitudinal changes. Results shorter latency of N2-P3 ( (P ＜ 0.01 ); and lower amplitude of N2, P3, N2-P3 (P ＜ 0. 05 ), higher amplitude of P2-tency and a upward one in N2-P3 latency in the four periods; a upward trend could also be found in P3, N2-P3 amplitude, but there were no statistical differences(P ＞ 0. 05 ). The results of paired-samples t test: P3, N2-P3 amplitude in case group were higher after treatment for 6 weeks than before, the difference was significant (P ＜ 0.01 ); no significant results were found in P300 latency or amplitude between the 62 cases of depression after treatment for 24 weeks and the 65 normal controls selected (P ＞ 0. 05 ). Conclusion P300 latencies and amplitudes tend to be partly recovered after the acute treatment in patients with depression, but after the long-term therapy not clear.

Objective The aim of this study was to investi-gate the changes of brain function in patients with drug-naive idiopath-ic epilepsy ( DNIE ) using resting-state functional MRI ( rs-fMRI ) amplitude of low-frequency fluctuation ( ALFF) , analyze the correlation of abnormal brain regions with the clinical variable ( disease course) , and gain a deeper insight into the pathophysiological mechanisms of idiopathic epilepsy. Methods This study included 25 cases of DNIE (15 males and 10 females) and 34 cases of drug idiopathic epilepsy (DIE, 22 males and 12 females).Another 25 healthy volunteers matched with the DNIE patients in sex, age, education and handedness were recruited as normal controls.The rs-fMRI data obtained from all the subjects were processed, subjected to ALFF analysis, and compared among the DNIE, DIE, and nor-mal control groups.The correlation was evaluated between the ALFF statistical brain mapping and the course of disease. Results Obvious differences were found in ALFF among the DNIE, DIE and control subjects.Compared with the normal controls, the DNIE pa-tients showed increased ALFF in the right inferior temporal gyrus, right lingual gyrus and right cuneus, but decreased ALFF in the right insula, left hippocampus, right midbrain, right middle frontal gyrus, left anterior cingulated gyrus, left middle cingulate gyrus and right inferior parietal lobule.In comparison with the DIE patients, those of the DNIE group exhibited increased ALFF in the left inferior occipital gyrus, right middle occipital gyrus and left middle occipital gyrus, but decreased ALFF in the right inferior frontal gyrus, left insula, right superior temporal gyrus and right middle frontal gyrus.In the DNIE patients, the disease course was found to be correlated positively with ALFF in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus, left orbital gyrus, left middle oc-cipital gyrus, left corpus callosum, left caudate nuclear, left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middle frontal gyrus, but negatively with ALFF in the right parahippocampal, right superior temporal gyrus, left superior temporal gyrus and right post-central gyrus. Conclusion The ALFF of resting-state cerebral function is abnormal in DNIE patients.The correlation between ALFF and the clinical variable ( disease course) provides a new insight into the pathophysiological mechanisms of epilepsy.

OBJECTIVETo explore the CT angiography features of the involved arterial branches of the spontaneous isolated superior mesentery artery dissection(SISMAD).

METHODSClinical and CT angiogram data of 6 patients with SISMAD confirmed by dual source energy CT angiography were analyzed retrospectively. The CT angiography features and prognosis of patients were investigated.

RESULTSAverage age of 6 patients was(45.83±5.60) years old. Ten branches of jejunoileal artery were involved in 4 patients. All the dissections of the superior mesenteric arteries(SMA) were extended from its proximal to its end. Intramural hematoma was found in all the involved branches, which showed eccentric target sign in the transverse section and sandwich sign in the longitudinal axial section. In 7 branches of 3 patients, the involved branches originated from the false lumina of the SMA. In one patient, the intramural hematoma of the jejunoileal arteries was found to be completely absorbed in a repeated CT angiography one year late.

CONCLUSIONSFor the SISMAD, the involvement of the branches of the SMA may be associated with the extension of the dissection of the SMA. The inflation of the false lumina of the branches is worse than that of the SMA. With the improvement of the dissection of the SMA, the intramural hematoma of the branches can be absorbed. The conservative treatment may be the first choice for SISMAD without emergency.

Angiography ; Humans ; Mesenteric Artery, Superior ; diagnostic imaging ; Middle Aged ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

Poly(ADP-ribose)polymerase-1(PARP-1)plays a vital role in the regulation of DNA repair and apoptosis. Breakthrough has been made in the treatment of cancer with PARP-1 inhibitors, but the emergence of drug resistance has limited its further application in clinic. This paper reviews advances in the research on PARP-1 inhibitors combined with other drugs to overcome drug resistance, highlights and evaluates the existing drug combination strategies and their therapeutic effects in clinical practice. It is proposed that the development of dual-target or multi-target drugs will become a promising approach to overcome the resistance of PARP-1 inhibitors and broaden their indications.

Clinical pathway is an important quality management tool for regulating medical behavior both at home and abroad, and an important means of controlling medical costs in the reform of medical insurance payment methods.The author reviewed the current development status of clinical pathways both at home and abroad, focusing on summarizing the development experience of foreign countries, and analyzing the shortcomings in the development of clinical pathways in China from the perspectives of formulation, implementation, and evaluation. It is proposed that China should establish and improve the regulatory and incentive mechanisms for clinical pathways, accelerate the construction of supporting medical security systems, explore new incentive transmission models, attach importance to the role of patient participation in the formulation and implementation of clinical pathways, and so on, in order to provide reference for promoting the efficient development of clinical pathways in China.