Objective To study the correlation between the ADC value and Fenh value,Senh value based on DWI and DCE-MRI, by measuring them in sacroiliac joint bone marrow of healthy volunteers.Methods 21 healthy volunteers performing the sacroiliac joint MR were involved.ADC value based on DWI,and TIC based on DCE-MRI were measured.The relationship of ADC values with Fenh,Senh values and peak to time,Tmax values were analyzed.Results The differences of the measured ADC values on both sides of the sacroiliac joint bone marrow region were not statistically significant (P>0.05).There were three types of TIC curve,8.3% (7/84)Ⅰ type,8.3% (7/84)Ⅱ type,83.3% (70/84)Ⅲtype;Fenh,Senh average values were within 20% 0.05).There was a positive correlation between ADC value and Fenh value in bone marrow region of sacroiliac joint.Conclusion This study determined the average value of ADC and Fenh,Senh in normal sacroiliac joint bone marrow area,the positive correlation between ADC value and Fenh value is a new thought and may be a new method of diagnosising the early disease of sacroiliac joint.

This article introduced the form of the rehabilitation evaluation discussion, which was moderated by the rehabilitation doctors, together with relevant therapists and nurses, aiming to discuss the obstacles and the rehabilitation plan for a difficult patient. This case showed the importance of early rehabilitation after stroke.

Objective To explore the feature and rehabilitation of ataxia post 5 times recurrence of hemangioblastoma. Methods A case was reviewed combined with literatures. Results The patient presented cerebellar ataxia after 5 times recurrence of hemangioblastoma. The score of Fugl-Meyer Assessment of balance increased from 4 to 13, while the modified Barthel Index from 50 to 90 after 3 months of rehabilitation. Conclusion Rehabilitation may improve the activeties of daily living and balance for patient with ataxia after multiple recurrences of hemangioblastoma.

BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.

Objective To study the changes of immune function and liver function in patients with primary biliary cirrhosis.Methods From March 2013 to March 2016 in our hospital patients with primary biliary cirrhosis 30 cases as the observation group.There were 17 patients with mild liver injury and 13 with severe hepatic dysfunction.And at the same time for the admission of 30 patients with other liver diseases in patients with liver disease as a group,30 cases underwent physical examination as healthy group were detected by flow cytometry in three groups of subjects of immunity comparison of three groups of cells,dendritic cell subsets in peripheral blood and liver function index.Results The CD4+ cells and CD8+ cells in the observation group were significantly higher than those in the healthy group(P＜0.05),while the CD11c+ cells,CD123+ cells and NK cells were significantly lower than those in the healthy group(P＜0.05).In the observation group,CD4+ cells,CD8+ cells,CD11c+ cells and CD123+ cells were significantly higher than those of other liver diseases but the NK cells were significantly lower than those of the other groups (P＜0.05).In healthy group,CD4+ cells,CD8+ cells,CD11c+ cells,CD123+ cells and NK cells were significantly higher than those of other liver disease group(P＜0.05) The CD4+,CD8+ and CD123+ cells in the liver injury group were significantly higher than those in the liver function damage group,while the CD11c+ and NK cells were significantly lower than those in the liver function group,and the difference was statistically significant(P＜0.05).The CD4+ and CD8+ cells in the AMA-M2 negative group were significantly lower than that in the AMA-M2 positive group,while those in CD123+,CD1 1c+ and NK cells were significantly higher than those in the AMA-M2 positive group,and the difference was statistically significant (P＜ 0.05).Conclusion The immune function of patients with primary biliary cirrhosis and liver function injury are associated with production of serum AMA-M2 antibodies,including CD11c+ and CD123+ or as the main factors influence the development of the disease and the AMA-M2 antibody.

Objective To analyze the clinical effect and safety of saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer. Methods A total of 109 patients who were diagnosed as helicobacter pylori-induced peptic ulcer were randomly assigned to control group and experimental group. The control group of 54 patients received a standard triple therapy, and the experimental group of 55 patients received saccharomyces boulardii combined with a standard triple therapy. Ulcer recovery, clearance rate of helicobacter pylori and adverse events were observed between the two groups. Results The total effective rate of ulcer recovery in the ex-perimental group was 92.73%, significantly higher than that of 79.63%in the control group(P<0.05); The clearance rate of helicobacter pylori in the experimental group was 90.91%, significantly higher than that of 75.93% in the control group (P<0.05); The incidence of adverse events in the experimental group was 12.73%, and P value was over 0.05 compared to that of 11.11% in the control group. Conclusion The saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer has a significantly effect, and is able to en-hance the clearance rate of helicobacter pylori and the curative effect via a rapid recovery of the dynamic equilibrium of intestinal flora, and an inhibition of the gastric epithelial value and growth of helicobacter pylori.

Objective:To investigate the people's cardiopulmonary resuscitation (CPR) ability in Hunan Province and whether there are differences in the skill level of CPR among respondents of different ages and education levels.Methods:A self-made questionnaire was conducted to survey people in Hunan Province by means of WeChat from May 2018 to April 2019. The questionnaire referred to 2016 National consensus on cardiopulmonary resuscitation in China issued by Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association and 2017 version of American Heart Association (AHA) CPR operational guide, and combined with the CPR assessment scale of Hunan Provincial People's Hospital. The contents of the survey included the basic information of the subjects, the common knowledge and skills of first aid, the willingness to learn CPR skills and implement CPR, and the operational requirements of high quality CPR, etc. Results:A total of 6 563 people received the on-site first aid knowledge questionnaire, and 4 355 people completed and submitted the questionnaire. The recovery rate was 66.36%, of which 3 602 valid questionnaires were from IP in Hunan Province, and the qualified rate was 82.71%. Among the subjects, 1 532 were men (42.53%) and 2 070 were women (57.47%). The majority aged group from 19 to 30 (59.41%) and from 31 to 50 (36.70%). 307 were rural (8.52%) and 3 295 were urban (91.48%); and the majority levels of education were senior or technical secondary school (38.26%) and undergraduate or junior college (44.50%). Of the 3 602 respondents, 39.09% indicated that they had been exposed to CPR knowledge and only 0.36% indicated that they did not wish to participate in CPR training. 69.93% of the respondents said they would actively to help if they wet cardic arrest, and 97.92% of those were willing to do so if the patients were relatives or friends. The survey results showed that only 8.91% of respondents chose relatively high-quality CPR options (chest compressions were performed first, the pressing point was located in the sternum of the midpoint of bilateral nipple line, the pressing frequency was 100-120 times/min, pressing depth was 5-6 cm, the ratio of chest compression to artificial ventilation was 30∶2). Among these people, the correct rate was higher in the ages of 31-50 years old and ≤ 18, 19-30 than those ≥51 years old (12.71% vs. 0%, 6.87%, 8.70%, χ2 = 41.420, P < 0.01). The correct rate of education at graduate level and above was higher than those in junior middle school and below, high school or technical secondary school, undergraduate or junior college (19.57% vs. 2.07%, 3.41%, 13.72%, χ2 = 152.262, P < 0.01). Conclusions:The public in Hunan Province have a strong sense of first aid, and some of the theoretical knowledge of CPR. People between 31 years old and 50 years old of age and with graduate education and above know more about CPR, but the overall mastery of CPR skills is poor. It is necessary to further improve the ability of the public as the first witness by teaching various skills of CPR in various forms.

Objective:To Analyze the risk factors and prognosis of patients with hyperfibrinolysis after severe trauma.Methods:A prospective case-control study was conducted to analyze the clinical data of severe trauma patients whose injury severity score (ISS)≥16 points admitted to First People's Hospital of Taicang from October 2017 to December 2018. Blood clot dissolution rate parameter (LY30) ≥3% was diagnosed as hyperfibrinolysis. The patients were divided into hyperfibrinolysis group ( n=27) and non-hyperfibrinolysis group ( n=27). Data were collected including patients' general information, hemoglobin (Hb), hematocrit (Hct), platelet count (PLT), fibrinogen (Fg), lactic acid value and thrombelastograghy (TEG). Univariate and multivariate Logistic regression analysis were used to identify risk factors of hyperfibrinolysis after severe trauma. Prognostic indicators and K-M survival curve of the patients were analyzed. Results:(1) A total of 142 patients with severe trauma were enrolled. There were 101 males and 41 females, aged 45-65 years (mean, 56 years). The incidence of hyperfibrinolysis was 14.8%. (2) Univariate analysis showed that ISS, abbreviated injury scale (AIS) ratio of pelvic limbs ≥3 points, shock index (SI) ratio >1, temperature, PLT, Fg and lactic acid value were correlated with the occurrence of hyperfibrinolysis after severe trauma ( P<0.05). (3) Multivariate Logistic regression analysis showed that PLT ( OR=1.035), ISS ( OR=0.898) and lactate acid value ( OR=0.735) were independent risk factors for hyperfibrinolysis after severe trauma ( P<0.05 or 0.01). (4) Hyperfibrinolysis group required more massive transfusion (38.1% vs. 2.5%), were more prone to multiple organ dysfunction syndrome (MODS) (90.5% vs. 48.8%), and had a higher 24-hour mortality (47.6% vs. 8.3%), when compared with non-hyperfibrinolysis group ( P<0.01). K-M survival curve indicated that the median survival time in hyperfibrinolysis group after trauma was 1.33 days ( IQR, 0.40-17.20 days). Conclusions:The incidence of hyperfibrinolysis after severe trauma is low. ISS, PLT and lactic acid value are the independent risk factors for hyperfibrinolysis after severe trauma. Patients with severe post-traumatic hyperfibrinolysis are characterized by high probabilities of massive transfusion and MODS, short survival time and high early mortality.

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.