Accompanying with the development of technological level,optical coherence tomography plays a more and more important role in predicting the surgical outcome for idiopathic macular hole.Preoperative morphologic parameters like minimum diameter,base diameter,maximum height,macular hole index,hole form factor,tractional hole index,macular hole closure index,photoreceptor inner-outer segment junction,cone outer segment tips line,central subfield retinal thickness and macular hole inner opening diameter were proved correlated to postoperative visual acuity and anatomical results.It has important application value to know these predictors to judge the surgical outcome and deepen understanding of idiopathic macular hole.

AlM:To evaluate the value of color Doppler ultrasound in the diagnosis of traumatic retinal detachment.
METHODS: All 50 cases ( 56 eyes ) of suspicious traumatic retinal detachment from January to June in 2013 were enrolled in this study. All first received the two-dimensional ultrasound, then the color Doppler ultrasound, finally, these results were compared with the results of surgery.
RESULTS: All 56 eyes were observed intravitreal abnormal spots by the two-dimensional ultrasound, and 39 eyes were observed color blood signal by the color Doppler ultrasound. Forty eyes were approved retinal detachment by surgery.
CONCLUSlON: lt is better to display the intravitreal abnormal spots and color blood signal by the color Doppler ultrasound than by the two - dimensional ultrasound, so there is important clinical significance of the color Doppler ultrasound in the diagnosis of traumatic retinal detachment.

Objective To evaluate the imaging characteristics of the bone infarct . Methods 13 cases of the bone infarct proved by clinical manifestation and surgical pathology were collected,there were 5 males and 8 females. All patients had X-ray films, 4 were imagedwith CT scanning , 7 were imaged with MRI , and 2 underwent all three techniques . The bone infarct were classified into the early,themiddle and later stages.X-ray , CT and MRI findings of bone infarct ,were analysed characteristics . Results Partial osteoporosin and punctate calcifications could be seen on X-ray and CT , in the early and middle stages , which presented as iso-/low-signal on T_1WIand iso-/high-signal on T_2WI in the center of the bone infarct with a tortuous low-signal on T_1WI and high-signal on T_2WI zonearound.In the later stages,the bone infarct was characterize by irregular sclerosis and tortuous calcification on X-ray and CT,and by low-signal on both T_1WI and T_2WI . Conclusion MRI is the most effective way to find the bone infarct in the early stages , X-ray is helpful in diagnosing the bone infarct in the middle and later stages , CT is more sensitive than X-ray . X-ray ,CT and MRI should be combined in diagnosing the bone infarct .

Objective To explore the role of fibrogenic cytokines and inflammatory cytokines in the pathogenesis of frozen shoulder. Methods From September, 2014 to April, 2016, 20 patients with frozen shoulder accepted arthroscopic surgery were included, ten of them were diagnosed as primary frozen shoulder (group A), the other ten were secondary frozen shoulder (group B). Other ten patients undergo-ing shoulder arthroscopy for instability (4 cases), rotator cuff injury (3 cases) and subacromial impingement (3 cases) were as the controls (group C). The mRNA levels of matrix metalloproteinase (MMP) 1, MMP3, tumour necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, IL-8, granulocyte-macrophage colony stimulating factor (GM-CSF) and M-CSF in synovium were analyzed with quantitative polymerase chain reaction. Results The expression of mRNA of MMP1, MMP3, TNF-α, IL-1, IL-6, IL-8, GM-CSF and M-CSF were more in group A and group B than in group C (P<0.05). There was no significant difference between group A and group B (P>0.05). Conclusion The fibro-genic cytokines and inflammatory cytokines may play a role in the pathogenesis of frozen shoulder.

Accidents, Traffic ; Forensic Medicine ; Hoarseness ; Humans

This article,in view of the research status and development tendency of hospital core competence,introduced the index selection process and constructed the evaluation index system of core competence.This system comprises 3 level-1 indexes (social reputation,hospital health resources and development potential)and 9 level-2 indexes,with recommendations on improvements of the existing system.

Objective To investigate the role of TL1A in the generation and differentiation of peripheral blood Th17 in rheumatoid arthritis.Methods The peripheral blood mononuclear cells (PBMCs) of RA were isolated and stimulated with PHA in the presence or absence of TL1A.Naive CD4+ T cells from RA was cultured under Th17-polarizing conditions with or without TL1A.The percentage of Th17 was detected by flow cytometry (FCM) analysis.The DR3 expression on CD4+ T cells from PBMCs of RA patients and healthy controls (HC) were analyzed by using FCM.Data were analyzed with t test and U test.Results TL1A could significantly up-regulate the percentage of Th17 in PBMCs of RA [(7.5±2.3)％ vs (5.2±1.5)％,t=2.647,P＜0.05].Compared to the HC groups,TL1A could significantly induce Th17 differentiation from naive T cells [(37.7±1.9)％ vs (29.5±2.0)％,t=6.455,P＜0.05].The percentage of CD4+DR3+ T cell in PBMCs of RA [(0.56±0.87)％] was significantly higher than that of HC [(0.13±0.04)％,P＜0.05].The percentage of CD4+DR3+ T cell in PBMCs when stimulated with PHA was increased in RA patients,[(4.51±1.34)％ vs (1.11±0.29)％,t=2.915,P＜0.05],but no obvious increase in HC [(0.199±0.104)％ vs 0.072％±0.029)％,t=1.644,P=0.1988].Conclusion TL1A can promote the generation and differentiation of Th17 in the PBMCs of RA,and this effect may be mediated by the binding of TL1A with DR3.

Objective To analyze X-ray ,CT and MRI findings of Charcot’s joint.Methods 24 cases of Charcot’s joint were collected,there were 11 males and 13 females.24 cases were examined with radiography,9 with CT ,5 with MRI,and 2 were examined with all three techniques.X-ray,CT and MRI imaging findings of Charcot’s joint were analysed.Results There were two types of Charcot’s joint,hypertrophic(12 cases) and atrophic(12 cases).X-ray and CT findings of hypertrophic type were hyperostotic osteosclerosis with osteophytes,periarticular soft tissue swelling and ossification.While the atrophic type appeared as extensive bone resorption and disappearance,periarticular debris and soft tissue swelling,articular dislocation.These imaging findings of Charcot’s joint also could be showed by MRI.The joint capsule thickened periarticular soft tissue markedly enhanced after Gd-DTPA was administrated with definite medial margin.Conclusion Charcot’s joint is of typical imaging appearances.

Objective To investigate the signal intensity ratio and signal-to-noise ratio of breast lesions in 3.0 T MR diffusion weighted imaging with different b values.Methods Ninety seven patients with 106 solid breast lesions (44 malignant,62 benign) confirmed by pathology were retrospectively analyzed.The patients were examined by 3.0 T MR DWI with different b values (b =0,400,800,1 000 s/mm2) before surgery.The signal-to-noise ratio (SNR) and signal intensity ratio (SIR) of benign and malignant lesions were observed and measured under different b values.One-way ANOVA and t test were used to analyze quantitative data.ROC curve was used to analyze the diagnostic efficiency of SIR under different b values.Results Under different b values,class A image was found in 92 cases,class B images was found in 5 cases.While b value were 0,400,800,1 000 s/mm2,SIR of benign lesions were 2.33 ± 1.36,2.25 ± 1.13,2.06 ± 0.84,2.02 ± 0.79 respectively,SIR of malignant lesions were 2.02 ± 0.79,2.27 ± 0.85,2.61±0.78,2.82 ± 1.01 respectively.While b value was 0 or 400 s/mm2,there was no significant differences for SIR between benign and malignant lesions (t value were 1.58,1.26 respectively; P value were 0.12,0.90 respectively),but there were statistically significances between benign and malignant lesions under b value 800 s/mm2 or 1 000 s/mm2 (t value were 3.41,4.29 respectively ;P ＜0.01).There was no differences in SIR for benign and malignant lesions under different b values respectively (F value is 1.21,2.22 respectively; P ＞0.05).While b value were 0,400,800,1 000 s/mm2,the diagnostic sensitivity and specificity of SIR for breast benign and malignant lesions were 56.8％ (25/44),56.8％ (25/44),75.0％ (33/44),77.3％ (34/44) and 51.6％ (32/62),54.8％ (34/62),66.1％ (41/62),66.1％ (41/62) respectively.While b value were 0,400,800,1 000 s/mm2,SNR were 170 ±93,145 ±72,84 ±41,70 ± 39 respectively.Different b values,there was statistically significant difference between groups (F =55.89,P ＜ 0.01) ; and there were significant differences between every two b values (P ＜ 0.05).Conclusion The higher b values (800 s/mm2 and 1 000 s/mm2) are superior to lower b values in the differential diagnosis of benign and malignant breast lesions using 3.0 T MR scanner.

Objective To analyze the clinical features of infantile cytomegalovirus(CMV) hepatitis with cholestasis and investigate intrahepatic cholestasis due to hepatocytic impairment caused by CMV infection.Methods Forty-seven children with CMV cholestatic he-patitis were divided into 2 groups according to the level of total bilirubin(TB):22 cases with serum TB lower than 136.8 ?mol/L(groupⅠ),and 25 cases with serum TB higher than 136.8 ?mol/L(groupⅡ).All children were treated with both gangciclovir and routine met-hods,and serum biochemistry were checked before and after treatment.SPSS 13.0 software was used to analyze the data.Results Forty-seven cases of infantile CMV cholestatic hepatitis had different degrees of jaundice,hepatosplenomegaly and abnormal liver functions.The differences of serum ALT and AST between the 2 groups had statistical significance,the levels of serum gamma glutamy transferase(GGT) and alkaline phosphatase(ALP) were lightly higher in groupⅡcompared with those in groupⅠ,but there were no statistical significance.TB,direct bilirubin(DB),ALT and AST were decreased in the 2 groups after treatment,GGT and ALP hadn′t decreased significantly after treatment.Conclusions CMV infection can injure hepatocytes and epithelials on each grade of bile duct,thus CMV hepatitis causes intrahepatic cholestasis.Cholestasis due to hepatocytic impairment deserves emphasis and intervention should be done as early as possible.Gangciclovir therapy for CMV infection manifest effective and safe in short-term.