More and more studies indicate that type 2 diabetes mellitus (T2DM) is an independent risk factor of the cognitive impairment. It is showed that factors such as diabetic vascular complications and inherenrt metabolism impairment, affect the cognitive functions of the diabetics, and poorly controlled blood sugar and insulin resistant may also play a role in it.

Objective To investigate the cognitive impairment of middle-aged patients with type 2 diabetes mellitus(T2DM). Methods Wechsler adult intelligence scale-Chinese revised edition (WATS-RC) was used as the tool to examine the cognitive function of middle-aged patients with T2DM and the healthy controls in 51 cases. The t-test was used to compare the differences in score between patients and the control group. The patients were divided into two groups with or without cognitive dysfunction. The logistic regression analysis was made for all the variables to confirm risk factors for the cognitive dysfunction in diabetes. Results The WAITS-RC scores of digit-symbol coding test and block design test were much lower(P<0.05) in diabetes versus control group. The other tests showed no significant difference. The cognitive function was negatively correlated with HbA_1>c and HOMA-IR by logistic regression analysis. Conclusions For middle-aged patients with type 2 diabetes, their cognitive functions such as learning ability, analysis and comprehensive capabilities are impaired. The cognitive function is closely related with HbA_1c and HOMA-IR.

Objective To differentiate between peri-prosthetic infection and aseptic loosening using quantitative analysis of triphasic bone scintigraphy.Methods Twenty-eight patients (9 males,19 females; mean age 67.5 years,range 49-80 years) with recurrent joint pain after arthroplasty were retrospectively assessed.All patients underwent triphasic bone scintigraphy.ROI of each joint was drawn and the ratios of affected to unaffected side were calculated.The ratios of blood flow phase,blood pool phase,static phase,Creactive protein (CRP) and erythrocyte sedimentation (ESR) were quantitatively analyzed by ROC curve.The final diagnosis was based on microbiological and histological examinations.The optimal cut-off value was chosen based on the ideal sensitivity and specificity.Results Nine patients were diagnosed as septic loosening,17 patients aseptic loosening,1 patient bursitis of hip joint and 1 patient suture reaction.Taking the positive results of blood flow phase or blood pool phase as standard for diagnosing septic loosening,the sensitivity,specificity and accuracy of bone scintigraphy were 7/9,78.9％ (15/19) and 78.6％ (22/28),respectively.The AUC of blood pool phase was 0.942,and the sensitivity and specificity were 8/9 and 78.9％(15/19),respectively,with the optimal cut-off value of 1.40.The AUCs of blood flow ratio and CRP were 0.816 and 0.795,with cut-off values of 1.53 and 1.20,respectively.The AUCs of static phase ratio and ESR were 0.474 and 0.722,respectively,both P＞0.05.Conclusions For the diagnosis of septic loosening,quantitative analysis of triphasic 99Tcm-MDP bone scintigraphy,particularly with the ratio of blood pool phase,is more accurate than qualitative analysis.

To explore the measures of nursing management in the treatment of large number of infants with urinary calculi. The nursing management measures included launching the preparedness and response project for sudden public health events, formulating scientific and standardized nursing management system,optimizing work flow,strengthening nurse training,focusing on the details in nursing management,implementing disinfection and isolation system seriously,and paying close attention to health education for the parents of minority infants. Scientific nursing management can ensure the treatment effectiveness and nursing safety for the infants with urinary calculi.

ObjectiveTo compare the clinical value of contrast-enhanced ultrasonography (CEUS) and conventional ultrasonography in diagnosing polypoid lesion of gallbladder (PLG).MethodsThe postoperative pathology and clinical manifestation of 49 PLG patients were retrospectively analyzed in the First Afifliated Hospital of Harbin Medical University. Of them, 7 cases were maligant lesions, 4 cases were adenomas, 24 cases were polyps of gallbladder and 14 cases were adenomyomatosis of gallbladder. With postoperative pathology as golden standard, the sensitivity, speciifcity and PLG speciifcity were calculatedfor conventional ultrasonography, CEUS and conventional ultrasonography plus CEUS.ResultsThe sensitivity, specificity and PLG specificity were 33.3%, 74.3% and 68.3% for conventional ultrasonography, and 66.7%, 85.7% and 82.9% for CEUS respectively. The conventional ultrasonography plus CEUS were 83.3%, 88.6% and 87.8%.ConclusionCEUS could signiifcantly improve the diagnostic accuracy.

Objective To enhance the understanding of cystitis, obstructive uropathy (OU) and chronic intestinal pseudo-obstruction (CIPO) in systemic lupus erythematosus (SLE). Methods We presented a case of SLE complicated with cystitis, OU and CIPO, and reviewed relevant English and Chinese literature. Results The case was a 37 year-old female with a history of SLE for 4 years. She developed urinary irritant symptoms for 1 year and abdominal distention for 1 month before admission. Ultrasound and cystoscopic studies revealed a thickening of bladder wall and reduced bladder volume; cystoscopic study revealed inflammatory and edematours mucosa; Ultrasound study and X-ray image confirmed the existence of OU and CIPO. Symptoms of urinary irritant and CIPO were relieved after initiation of prednisone and cyclophosphamide (CTX), but reducing the dosage of prednisone and CTX had caused a relapse. Conclusion Cystitis is a rare clinical manifestation of SLE, it is likely to be misdiagnosed. The pathological change of cystitis complicated with SLE is interstitial cystitis and is the most common cause of OU in SLE. OU is closely related to CIPO and it is suggested that patients with these complications may be classified as a unique subgroup of SLE. Intestinal obstruction is a severe complication of SLE with high mortality rate, clinicians should be aware of this unique subgroup of SLE and treat it properly.

Objective To observe the effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at different doses.Methods According to the randomization table,25 healthy rabbits were randomly divided into control group,and voriconazole 50,100,200,and 400 μg groups.Therefore,there were 5 rabbits in each group.The eyes of control group received intravitreal injection of 0.1 ml balanced saline solution,and those treatment groups received 0.1 ml voriconazole injection of corresponding dose.Before the injection and 1,7,and 14 days after the injection,endothelial cell counts and corneal thicknesses were measured;full-field electroretinogram were performed and b-wave amplitudes in maximal combined reaction (Max-R) were recorded.On 14 days after the injection,histologic structures were observed by light microscope and transmission electron microscope.Results There was no significant difference in endothelial cell counts (F=0.320,0.291,0.467,0.649) and corneal thicknesses (F=0.214,0.284,0.360,0.225) with those of control group at any time points (P＞0.05).Before and 1 day after the injection,b-wave amplitudes of each voriconazole group had no significant difference compared with those of control group (F=0.220,0.106;P＞0.05).On 7 days after the injection,b-wave amplitudes decreased significantly at doses of 200 μg and 400 μg (P＜0.05).On 14 days after the injection,there was no significant difference between the the amplitude of 200 μg group and that of control group (P＞ 0.05).However,the amplitude of the 400 μg group decreased continuously and there was still significant difference (P＜0.05).Light microscopy did not reveal any corneal abnormality in both control group and voriconazole groups.The retinas were normal except that of the 400 μg group,which had a thinner and degenerated inner nuclear layer and disordered photoreceptor layer.Under transmission electron microscope,there were no ultrastructure damages of corneas in both control group and voriconazole groups,either.The rabbit retinas of the 50 μg and 200 μg group have normal inner nuclear layer and photoreceptor layer,but degrees of changes in both layers were observed in the eyes of 200 μg and 400 μg group.Conclusions There is no obvious effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at he dose less than or equal 100 μg.There are no obvious effects on rabbit corneas at the dose of 200 μg and 400 μg,while there are damages to the retinas in both functions and histological structures.

Objective To evaluate the prognostic factors of hepatocellular carcinoma (HCC) patients with treatment of ultrasound-guided pereutaneous radiofrequency ablation (RFA).Methods A total of 104 patients with 147 HCC tumors who had 36-month regular follow-up after percuatenous RFA therapy in the First Affi liated Hospital of Harbin Medical University between May 2008 tand June 2012 were included in this study. Contrast-enhanced ultrasound (CEUS) was the main method in evaluating the therapeutic effect of RFA. Kaplan-Meier model and Log-rank test were used in univariate analysis, and Cox regression model was used in multivariate analysis to identify the independent factors on therapeutic effect of RFA.Results The 0.5-, 1-, 2-, 3-year overall survival rates after RFA were 96.1%, 92.0%, 80.0%, 53.3% respectively, and the mediansurvival time was 19 months. 1-year local recurrence rate was 13.6%. The univariate analysis showed that Child-Pugh classifi cation, original lesion condition, intrahepatic recurrence, ablative area, and RFA priority were related to survival rate (χ2=7.119,P=0.008;χ2=20.485,P=0.000;χ2=14.160,P=0.000;χ2=11.825, P=0.001;χ2=7.979,P=0.005). The Child-Pugh classifi cation, original lesion condition, intrahepatic recurrence were identified as independent prognostic factors of survival rate (P=0.001;P=0.005;P=0.003). The univariate analysis showed that virus marker, original lesion condition, hepatic background, tumor diameter, tumor boundary, relation with adjacent organ and vessels, ablative area, RFA priority weresignifi cantly related to local recurrence rate (χ2=7.234,P=0.007;χ2=9.083,P=0.003;χ2=7.791,P=0.005;χ2=13.042,P=0.000;χ2=20.657,P=0.000;χ2=58.615,P=0.000;χ2=6.681,P=0.010). The ablative area and tumor boundary were identified as independent prognostic factors of local recurrence rate (P=0.017;P=0.002).Conclusions Child-Pugh classifi cation, original lesion condition, intrahepatic recurrence were identifi ed as independent prognostic factors of survival. And ablative area and tumor boundary were identified as independent prognostic factors of local rcurrence rate. In order to improve patient`s survival and reduce local recurrence in high-risk cases, it is importantant to establish appropriate follow-up plan and multidisciplinary cooperation framework within a standard treatment procedure.

Objective:To review the practice of introducing nuclear medicine systematic courses into the standardized residency training in imaging specialty in recent years, and to explore the effect of nuclear medicine systematic courses on the training quality.Methods:A total of 105 residents participated in the training of nuclear medicine from 2015 to 2017 were enrolled in this study. During the training period, those who took the complete nuclear medicine systematic courses were assigned to the teaching group, and the other 52 residents who participated in the standardized residency training from 2012 to 2014 but not received the systematic courses were enrolled in the non-teaching group. The results of the completion examination, including the theoretical written test and the film reading skill test, were analyzed as the evaluation index to compare the differences between the results of two groups by the Mann-Whitney U test using SPSS 22.0.Results:The median scores of the theoretical test and the reading skill test in the teaching group were 93.52 (72.00-100.00) and 92.00 (70.00-98.00), respectively; while, the corresponding scores in the non-teaching group were 88.00 (64.00-96.00) and 90.00 (60.00-96.00), respectively. The scores of theoretical test and skill test in the teaching group were both significantly higher than those in the non-teaching group ( P=0.005, P=0.001). Conclusion:It is necessary and feasible to carry out comprehensive nuclear medicine systematic courses in the standardized residency training in imaging specialty, which can improve the theoretical basis and clinical skills of students and help to improve the overall training quality.

We have made a biomechanical evaluation of titanium mesh with anterior plate fixation in anterior cervical decompression. Six fresh cervical spine specimens (C3-7) of young cadavers were used in the biomechanical test. Subtotal vertebrectomy was performed on C5, C5-6 and C4-6. We accomplished two constructions: (1) bone graft; (2) titanium mesh with anterior plate fixation. Then their biomechanic stabilities were tested in all groups and compared with those of intact specimens. We found that titanium mesh with anterior plate fixation improved the stability of the unstable spine, showing a significant difference when compared with that of the intact group (P < 0.05). The anterior cervical interbody fusion by bone graft and the titanium mesh implantation is stabler than the intact cervical sample, and the stability decreases with the increase in number of cervical segment.
Biomechanical Phenomena ; Cadaver ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; instrumentation ; methods ; Humans ; Internal Fixators ; Spinal Fusion ; instrumentation ; methods ; Stress, Mechanical ; Titanium