PurposeTo explore CT and MRI findings of pigmented villonodular synovitis (PVNS) of spine, and to improve the preoperative diagnosis.Materials and MethodsCT and MRI findings of 7 cases of PVNS of spine confirmed by surgery and pathology were retrospectively analyzed. Seven cases underwent CT scan and 5 of them underwent MRI scan. The location of the lesions, tumor size, shape, density (signal), bone destruction and enhanced features were analyzed.ResultsExcept one case with small lesion, the remaining 6 cases showed lobulated soft tissue masses centering at the facet joint area, with lytic, expansive bone destruction. On CT images (n=7), 3 cases showed the masses density similar to that of the surrounding muscles, and 4 cases showed the tumor density slightly lower than that of the surrounding muscles. On MRI images (n=5), 1 small lesion demonstrated low signal at the peripheral, 1 lesion was isointensity without obvious low-density in it, 3 cases showed characteristic multiple visible low signal nodules in the lesions.ConclusionThe possibility diagnosis of the PVNS should be considered when spinal lesions are characterized by osteolytic bone destruction centering at facet joints and soft tissue masses with distinctive MR signals.

Objective To investigate the features of the mixed epithelial and stromal tumor of kidney (MESTK) and cystic nephroma (CN) on multi-detector CT (MDCT), in order to improve the accuracy of preoperative diagnosis and differential diagnosis. Methods Based on blind-retrospective review, CT features of 6 MESTK patients and 6 CN patients were reviewed retrospectively, and compared with pathological results postoperatively. Results All the lesions were single regular multi-cystic masses. Five patients with MESTK were diagnosed as Bosniak Ⅲ and 1 as Bosniak Ⅳ. In contrast, 6 of CN were all diagnosed as Bosniak Ⅱ. Six MESTK lesions were all consisted of irregular mixture of solid and cystic components, and the average thickness of septa was 0.93 cm. Six CN lesions were entirely cystic masses without solid components, and the average thickness of septa was 0.23 cm. After contrast enhancement, the solid components of MESTK and the cystic wall of CN presented mild-to-moderate delayed enhancement. Conclusion Some signs on multi-detector CT can help to differentiate MESTK and CN, especially the presence of solid components of the tumor.

Objective To research in the effect of pertinent nursing method on therapeutic effect of postoperative intractable affective disorder. Methods We drew out all the patients who were in accordance with inclusion and exclusion criteria and accepted surgical treatment from June to September in 2008,and obtained 45 patients which were divided into the experimental group(21 participants) and the control group (24 participants) randomly.The experimental group adopted pertinent nmsing intervention in different periods,the control group accepted routine nursing measures.Two psychiatrists evaluated these patients' symptoms using the Brief Psychiatric Rating Scale (BPRS), Bech-Rafaelsen Mania Rating Scale (BRMS), and Hamilton Depression Scale (HAMD). Results The difference of total efficiency between the two groups had no statistical significance at 1 week and 1 month after operation, yet, obvious statistical significance was seen on 3 and 6 months after operation.The total points of all scales had no statistical significance at 1 week and 1 month after operation; however, obvious statistical significance appeared on 3 month and 6 month after operation.The improvement of symptoms of the experimental group was better than the control group. Conclusions The nurs-i ng interventions used in this research could improve the therapeutic effect of the postoperative intractable affective disorder, and the effects were reflected mainly in the long term effectiveness.

Objective To investigate the clinical efficacy and improvement of patients' quality of life in tension-free vaginal tape(TVT)and tension-free vaginal tape obturator(TVT-O)for surgical treatment of severe female stress urinary incontinence.Methods This study was a randomized,singleblinded,controlled trial.Patients were randomized by a computer-generated randomization schedule with allocation to either TVT or TVT-O procedure.TVT procedure was performed in 35 cases and TVT-O in 34 cases.None had received surgery for urinary incontinence or was in pregnancy.Transvaginal hysterectomy and prolapse reparation were done simultaneously in some of the patients.All patients were requested to complete the Urinary Distress Inventory(UDI-6)and Incontinence Impact Questionnaire(ⅡQ-7)as part of their pre-and postoperative assessment.Results All patients were evaluable and the mean follow-up was 14.5 months.The mean operative time was(18±5)min in the TVT-O group,Significantly shorter than in the TVT group(27±5)min(P＜0.01).The two groups did not differ significantly in perioperative blood loss,postoperative complications(including tape erosion,pain in thigh or behind pubis),postvoid residual volume,hospital stays or expenses(all P＞ 0.05).Sixty patients were successfully treated for stress urinary incontinence(88.6%and 85.3%for TVT and TVT-O groups,respectively).There were significant improvements in postoperative scores for both the ⅡQ-7 and the UDI-6(P＜0.01),except in subscale measuring symptoms of voiding dysfunction(P＞0.05).Conclusions Both techniques appear to be equally effective in the surgical treatment of severe stress urinary incontinence in a short term review.Significant improvements could also be seen in patients' quality of life.However.TVT-O has a shorter operative time.No evidence of increasing risk of urethral obstruction after the operation could be found.Long term followups axe necessary to evaluate outcomes of different types of surgery for stress urinary incontinence.

This study was to investigate the diagnosis value of simplified uredynsmic test in stress urinary incontinence. Fifty patients with stress test-confirmed urine incontinence underwent simplified urodynamic test before routine urodynamic test. Detrusor instability, max bladder volume, average flow rate, and residual urine of simple urodynamic test were compared. Simplified urodynamic test showed a sensitivity of 87%, specificity of 9/12, positive predictive value of 92%, and negative predictive value of 9/14. There was no significant difference in max bladder volume, average flow rate, and residual urine between the two tests. Simplified urodynamic test might be a reliable method for diagnosis of stress urinary incontinence, and could be used for detrnsor instability screening.

Objective To investigate the protection of the lung function in liver transplantation for the liver failure patients with hepatopulmonary syndrome. Methods Clinical data of 8 liver transplanted patients with hepatopulmonary syndrome from 52 cases of liver transplantation were retrospectively analyzed to summarize the protection of the lung function in liver transplantation for the liver failure patients with hepatopulmonary syndrome. The protection of liver and renal function, the effect of microbes ferments for enhancing immunologic function of mucosal system, and the proper application of oxygen treatment was observed. Results The lung function of 8 cases has been all reversed in 2~6 weeks and recovered in 2 months after operation. One year person/liver survival rate was 75% . Conclusions The liver transplantation was an effective therapy for the liver failure patients with hepatopulmonary syndrome. The lung function of patients can be reversed and recovered through a comprehensive therapy of lung function.

Objective To discuss the feature of transient intrahepatic cholestasis in early stage of orthotopic liver transplantation. Methods Based on the review of early (within 1 month) postoperative hyperbilirubinemia in consecutive 200 patients undergoing liver transplantation, we summarized the occurrence, development and outcome of early postoperative intrahepatic cholestasis. Results Early transient intrahepatic cholestasis was identified in 112 patients. The characteristic of early intrahepatic cholestasis is that DBIL and?-GT increasingly elevated from the second or third day postoperatively, with a peak on the 7 - 14th d, then descended to normal level on approximately 21 -28th day. The average peak level of DBIL and?-GT were( 157. 32?82. 08)?mol/L and (172?80) IU/L respectively. During the period of DBIL and?-GT ascending, AST and ALT kept descending, and within 1 week it could fall to normal level. Acute rejection, drug toxicosis and bile duct obstruction were excluded. Conclusions Postoperative early transient intrahepatic cholestasis associated with ischemia-reperfusion injury has its special clinical process and most patients recover themselves without the need for special therapy.

Objective To explore the effect of cognitive behavior intervention on anxiety and depression of patients with acute myocardial infarction(AMI).Methods Seventy patients with acute myocardial infarction were randomly divided into observation group and control group,35 cases in each group. All cases were cared with routine nursing method. Besides,cognitive behavior intervention was applied in the observation group. The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to measure the patients' mental status before and after the intervention.Result The SAS and SDS scores of the observation group after intervention were significantly lower than those of the control group(P<0.05).Conclusion The cognitive behavioral intervention is effective in alleviating anxiety and depression in patients with acute myocardial infarction,promoting them to establish the correct attitude and keeping calm in face of disease so as to relieve the anxiety and depression of AMI patients.

Objective To observe the change of oxidalive stress indexes in the patients with diabetic perineuropathy (DPN), and investigate the protection role of glutathione (GSH) on neuroprotective effect. Methods The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) and sensory nerve conduction velocity (SCV) were detected in 54 cases with DPN (DPN group) and 30 cases of health examination (control group). Fifty-four cases with DPN were divided into GSH group (given basic treatment and GSH 1.8 g/d) and CON group(given basic treatment and B vitamin) with 27 cases each by random-digits table. After treatment of 2 weeks, the levels of SOD, MDA and SCV were compared. Results The levels of MDA in DPN group were significantly higher than those in control group, while the activity of SOD was significantly lower than that in control group [(7.23 ±2.31) μmol/L vs. (4.87 ± 1.17) μmol/L, (59.72 ± 13.58) kU/L vs. (76.19 ± 7.55 ) kU/L](P＜ 0.01). After treatment, the level of MDA was decreased and the activity of SOD was increased in GSH group and CON group (P ＜0.05),but there was no significant difference between the two groups(P＞ 0.05). After treatment, the level of SCV was significantly increased in GSH group,while there was no significant difference in CON group (P ＞0.05). Conclusions Oxidative stress exists in DPN patients. The antioxidant treatment with GSH can improve impaired nerve and has a better effect of nerve protection than classical nerve nutrition therapy.

ObjectiveTo explore the characteristics of the metabolite concentrations of the precentral gyrus in healthy Chinese adults using proton magnetic resonance spectroscopy (1H-MRS).Methods 1H-MRS was carried out in 92 healthy Chinese adult volunteers. The metabolite ratios of NAA/Cr, Cho/Cr and NAA/Cho were compared and analysed.ResultsNo significant changes of NAA/Cr, Cho/Cr and NAA/Cho ratios were observed between the left and right precentral gyrus, nor between the male and female. However, the precentral gyrus NAA/Cr and NAA/Cho ratios were decreased gradually with aging and Cho/Cr ratios were increased gradually with aging.ConclusionThe characteristics of the precentral gyrus metabolite concentrations in healthy Chinese adults have been obtained.