Objective To study the utility of inferior vena cava-collapse index (IVC-CI) for assessing fluid resuscitation for hypovolemic shock in order to look for better echocardiographic markers to assess patients' condition with hypovolemic shock,also to look for optimal guidance for the adjustment of the treatment for these patients.Methods A total of 40 patients with hypovolemic shock admitted to Emergency Department were enrolled for study.All patients were treated with 500 mL normal saline iutravenously as fluid resuscitation.The vital signs and echocardiographic findings before and after the treatment were documented.Comparison of data between pre-treatment and post-treatment was carried out.Results Of 40 patients,there were 23 male and 17 female with average age (50.00 ± 17.71) years.The time consumed for echocardiography examination was (8.68 ± 5.73) min,time required for establishing central line was (29.32 ± 8.06) min.Collapse index of inferior vena cava (IVC-CI) before and after treatment were (0.43 ± 0.16) and (0.38 ± 0.13),respectively.In hypovolemic shock group,the relationship of the peak velocity (Vpeak) of left ventricular outflow between before and after treatment was r =0.75,P =0.001.The relationship of the peak velocity of left ventricular outflow with left ventricular end diastolic volume (LEDV) before treatment was P =0.03 and after treatment was P =0.05.Conclusions (1) Between IVC-CI and the effectiveness of fluid resuscitation,there was no relationship.It was inappropriate to take IVC-CI as a marker for assessment.(2) Vpeak increased apparently after the fluid resuscitation.(3) Vpeak was proved to be associated with LEDV which supported that Vpeak is the indicator of left ventricular contractility.(4) Time consumed for echocardiography examination was shorter than that for establishing the central line in the group.

0.05),while in both groups those were decreased after treatment (P

AIM: To observe the therapeutic effect and safety of improved extra panretinal photocoagulation ( E - PRP) in the treatment of high risk proliferative diabetic retinopathy (hsPDR).
METHODS: A total of 88 consecutive cases (102 eyes) with hsPDR were diagnosed by fundus fluorescein angiography(FFA) from February 2011 to December 2014 in our hospital . Fifty two eyes had been treated by improved E - PRP with 532nm frequency - doubled laser. Fifty eyes had been treated by standard PRP. All cases were checked by FFA and fundus photocoagulation every 3mo. Patients with persisting neovascularization or non perfusion area were treated with laser again. All cases were followed up 6-36mo.
RESULTS: The postoperative visual acuity had no statistical difference between two groups ( P > 0. 05). In improved E - PRP group, retinal non perfusion area and neovascularization disappeared in 35 eyes ( 67%). Effective rate was 88%. Six eyes (12%) underwent pars plana vitrectomy because of vitreous hemorrhage, fiberosis and stretched retinal detachment. In standard PRP group, retinal nonperfusion area and neovascularization disappeared in 23 eyes ( 46%). Effective rate was 66%. Seventeen eyes(34%) underwent pars plana vitrectomy because of anterior retina bleeding or vitreous hemorrhage. The rate of neovascularization disappeared and effective rate had statistical difference between two groups (P<0. 05).
CONCLUSION: It is a safe and effective methods to treat hsPDR by improved E-PRP and it was more effective than traditional PRP.

Objective To estimate reliability of magnetic resonance elastography (MRE) in measuring liver stiffness of volunteers and patients with chronic liver disease and to assess inter-rater consistency.Methods MRE was performed on a 3.0 T scanner in all subjects,including 24 volunteers (control group) and 64 patients with liver disease (chronic liver disease group).Liver stiffness was measured blindly by two raters.The pathological fibrosis score was applied as a standard reference for liver fibrosis in 22 patients.The intraclass correlation coefficient (ICC) was used to evaluate inter-rater reliability.The differences of liver stiffness between two groups were evaluated using non-parametric MannWhitney U test.Spearman analysis was used to analyze the correlation between fibrosis stages and liver stiffness.Results The intraclass correlation coefficient of liver stiffness was perfect (ICC =0.99,P ＜ 0.01)between two raters.There was significant difference of mean stiffness between control group and patient group (U =90.5,P ＜0.01) with(2.35 ±0.34) kPa and(4.17 ± 0.47) kPa,respectively.The correlation between fibrosis stage (3,3,5,5 and 6 patients in fibrosis stage S0,S1,S2,S3 and S4) and stiffness (2.13,3.25,3.82,5.45 and 7.35 kPa) was very strong (r =0.96,P ＜0.01).Conclusion MRE is a reliable and promising tool to measure liver stiffness and to assess liver fibrosis.

Objective To explore the personality characteristics of abused children in order to reduce the incidence of child abuse.Methods Two hundred and ninty five middle school students were investigated with general questionnaire and Eysenck Personality Questionnaire of children. Eighty six students experiencing child abuse (CA) last year as study group and one hundred and ninety six non-abuse children as controls (NCA) were analyzed by means of Eysenck Personality Questionnaire of children.Results The score of neuroticism in CA group was significantly higher than that in the control group (55.62±10.60/52.65±10.98,t=-2.114 P=0.035). The score of lie in CA group was significantly lower than that in control group (42.21±9.87/46.04±9.20,t=3.184 P=0.002). On the impact of different sex, the psychoticism score of male was significantly higher than that in the control group(52.37±11.49/48.04±9.97,t=-2.227 P=0.028), and the lie score was significantly lower than that in control group(41.03±9.18/46.18±8.79,t=3.125 P=0.002).The scores of those in the female were not significant.Conclusions There is a close association between the unstable emotion and child abuse in children, so training emotional self-control and emotional expression of children might be a intervention strategy in the future. In addition, the frequency of lie in children is probably one of factors that determine whether children are abused or not.

Objective To study the clinical significance of end-tidal carbon dioxide partial pressure (PetCO2 ) during cardiopulmonary resuscitation (CPR) and seek the fixed value according which to decide if we should and when to give up.Methods This was a prospective,observational study.A total of 124 patients with cardiac arrest in or out-of-hospital from may 2003 to March 2009 in emergency department of our hospital were selected.All of them had definite etiological factors.Changes of PetCO2 in 124 cardiac arrest patients during CPR were tracked.Results The gender,age,rescue time in seventy-one patients with the return of spontaneous circulation (ROSC) after endotracheal intubation have a significant difference with that in fifty-three patients without ROSC (P ＜0.01 ).The PetCO2 of the survival were higher than that of patients without ROSC or with ROSC,but finally died (P ＜0.01 ).A fixed point 14.4 mmHg of PetCO2 after 20 minutes' CPR can be used as a reference value to guide CPR or predict prognosis.Conclusions Monitoring PetCO2 during CPR has a predictive value on the success of resuscitation.

Objective The study was to evaluate DWI for quantifying liver fibrosis. Methods A total of 12 volunteers, 47 patients who had chronic HBV or HCV hepatitis and underwent liver biopsy [Scheuer score for fibrosis(S) and inflammation(G)] were enrolled in this study. They were scanned using a 1.5 T MR unit with b value of 0,250,500,750, 1000 s/mm~2. ADCs at b_(250-1000) and b_(500-1000) were the average ADCs of b=250, 500, 750, 1000 s/mm~2 and b=500, 750, 1000 s/mm~2. The studied the correlation between Scbeuer scores and ADC values, and conducted Mann-Whitney U test and Logistic regression to evaluate ADC for prediction of fibrosis scores. Results The average ADCs were (1.41± 0.11),(1.37±0.09), (1.27±0.05), (1.26±0.04), (1.22±0.06) mm~2/s respectively from SO to S4, stage at b=750 s/mm~2 (F=18.31, P<0.01). With the increase of fibrosis score, the average ADC decreased gradually, the two were better negatively correlated at b_(250-1000)(r=-0.727, P<0.01) than other b values. Using b_(750) and the two combined b values, the found significantly lower ADCs in S2 or greater versus S1 or less and in S3 or greater versus S2 or less fibrosis (P<0.01). The best predictor for S2 or greater was b_(750) with the largest AUC of 0.909, sensitivity of 85.7%, and specificity of 100.0% (ADC ≤1.35×10~(-3) mm~2/s). The best predictor for S3 or greater was b_(250-1000) with the largest AUC of 0.864, sensitivity of 69.6%, and specificity of 95.8% (ADC≤1.53×10~(-3) mm~2/s). Conclusion DWI can be a good predictor for scoring liver fibrosis for S2 or S3 stage above, while b_(750) and the combined b values are suitable for evaluation.

Objective To study the clinicopathological and imaging features,key points of diagnosis and prognosis of endolymphatic sac tumor.Methods Seven cases of endolymphatic sac tumor were studied with routine histopathological,immunohisochemical staining and CT,MRI scanning.Patients' prognosis and life quality were aesessed by follow-up.Results The clinical symptoms of patients were progressive sensorineural deafness,tinnitus,vertigo and affection of cranial nerves.CT revealed reticular of moth-eaten bony destruction of the petrosal region,and MRI revealed a region of high-signal intensity void of vascular flowing signals.The histopathologic examination of the tumor presented a papillary-cystic pattern.The tumor cells were round or cubaid in shapen,with nuclei in similar shape and size.There were cyst-like structares filled mith pinkish gelatinous.Tumor cells were roundor cuboid in shape,and some of them contained clear cytofrlasm.There was materials,which were stained strongly with PAS.Hemorrhage,cholesterol crystal and foreign body giant cells were found in the tumor stroma with abundant small blood vessels and extravasation of blood,cells with intracellular hematin,and giant cells collagen.There was also proliferation of fibrous connective tissues.Necrosis and bone destruction were also found in some cases.Immunohistochemical results showed that CK and NSE were positive in all the tumors,and CD56 and S-100 were positive in part of cases,GFAP,EMA,CgA,TG and Syn were negative in all the specimens.One patient had received radiotherapy after partial resection.Relapse occurred only in one patient two years after the first surgery,and no metastasis or relapse occurred in the rest of patients.Conclusions Endolymphatic sac tumor is a rare neoplasm.The diagnosis relies mainly on histopathological and immunohisochemical findings.The patients often have good prognosis.

AIM: To study the effect of three kinds of drying methods on quality of Radix Angelicae Sinensis. METHODS: TLC, HPLC determination of volatile Oil and ethanol-extra ctives were used. RESULTS: The constitutents in three kinds of dried samples are the same, the contents of vo latile oil and ferulic acid have evident difference in three kinds of aried samp les. The content of fumed sample is the highest. CONCLUSION: The fuming method is the best drying one.

Objective To investigate the methods of X-ray diagnosis of various displacement of unstable pelvic fracture in three-dimensional space and its instructive significance in closed reduction.Methods A normal adult pelvic specimen was selected and fixed in a wood-frame at supine position after soft tissue rejection and ligament preservation.With the breakage at the unilateral anterior-posterior ring,models of hemipelvic rotation in the transverse and sagittal planes and hemipelvic vertically upward displacement were induced.Anteroposterior radiographs of the pelvic specimen were made and picture archiving and communication system (PACS) was used to measure width of iliac wing,suprainferior diameter of hemipelvis,vertical displacement of iliac crest,acetabulum roof,pubic tubercle and sciatic tuber and area of obturator foramen.Methods of X-ray diagnosis of various displacements of hemipelvis were concluded and applied in treatment of 43 patients with unstable pelvic fractures.Operation time and intraoperative blood loss were recorded.Postoperative images were evaluated by Matta standard.Results Hemipelvic rotation in transverse plane included eversion and inversion.Width of iliac crest was enlarged and area of obturator foramen was shrunk while extroversion ; on the contrary,an opposite result was observed while inversion.Sagittal rotation included pronation and supination.Pubic tubercle had obvious downward shift,iliac crest presented no change or slight upward shift,suprainferior diameter of hemipelvis was lengthened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was shrunk while pronation; on the contrary,pubic tubercle had obvious upward shift,iliac crest presented no change or slight downward shift,suprainferior diameter of hemipelvis was shortened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was enlarged while supination; iliac crest,acetabular roof,pubic tubercle and sciatic tuber presented equidistant upward shift while the hemipelvis displaced upward vertically.Average operation time was 55 minutes (range,15-85 minutes) and intraoperative blood loss was 26 ml (range,10-50 ml).According to Matta standard,pelvic radiography evaluation at postoperative 3 days was excellent in 31 cases and good in 12 cases,with excellent and good rate of 100％.Conclusion Pelvis X-ray films are able to diagnose various three-dimensional displacement of unstable pelvic fractures and guide closed reduction timely and rapidly to achieve satisfactory result.