Objective:To improve the CT and MRI diagnostic accuracy of intracranial atypical cavernous angiomas(ACA).Methods:We retrospectively analyzed CT and MRI appearances,operative and pathological findings of 12 cases with ACA.Of them,11 cases were seanned by CT,10 cases by MRI and 9 by both CT and MRI.Results:Of 12 cases:One case as located at the sella ,1 case was at the fourth ventricle,5 cases were located at the cerebral hemisphere,4 cases were located at the middle cranial fossa and 1 case was at the posterior cranial fossa.There was edema in 3 cases,1 case had cystic component and 4 cases had cerebral hemorrhage.The localized rate of ACA by CT and MRI was 100%,but 11 cases were misdiagnosis and 1 case did not made the qualitative diagnosis. Conclusion:The qualitative diagnosis of ACA have some difficulty,so that the emphasis should be on the analysis of the combination imagiology and clinic.

Objective To quantitatively evaluate the influence of fluid attenuated inversion prepared recovery (FLAIR) on apparent diffusion coefficient (ADC) and its clinical application value. Methods The data of DWI and FLAIR-DWI of 139 stroke were retrospectively reviewed. Paired t-test was used to analyze DWI (ADCCON ) and FLAIR-DWI (ADCFLAIR) values at varying time points from hyperacute to chronic stage. All of the lesions were further divided into cortex involved infarction and subcortical infarction. The ADCCON and ADCFLAIR values in the lesion sides and the contralateral sides were compared separately. Results The mean ADCCON values for lesions less than 6 hours, 7--12 hours, 13--24 hours, within 2 days, 3-4 days, 5-7 days and 8--14 days were not significantly different from those of the ADCFLAIR values(P >0.05) [ADCCON were (0.55±0.07), (0.50±0.09), (0.50±0. 13), (0.50 ± 0. 13), (0.62 ± 0. 14), ( 0. 60 ± 0. 12), (0. 72 ± 0. 20) × 10-3 mm2/s; ADCFLAIR were ( 0. 53 ± 0. 09 ), (0.49±0.06),(0.49±0.10),(0.48±0.08),(0.58±0. 14), (0.60±0.09),(0.73±0.15) × 10-3 mm2/s]. Lesions of 15 to 30 days [ (0. 95±0. 21 ) × 10-3 mm2/s and ( 1.02±0. 27) × 10-3 mm2/s for ADCFLAIR and ADCCON ] and the chronic stage ( >31 days) [ ADCFLAIR and ADCCON were (1.10 ± 0. 30) × 10-3 mm2/s and (1.36±0. 41 ) × 10-3 mm2/s respectively], had a significantly lower ADCFLAIR than those of the ADCCON (P <0. 01 ). For patients with a symptom duration of less than 14 days, the mean ADCFLAIR values of the cortex involved and subcortical lesions were all not significantly different from the mean ADCCON (P > 0. 05 ) [ ADCCON were ( 0. 55 ± 0. 16 ), ( 0. 61 ± 0. 14 ) × 10-3 mm2/s ; ADCFLAIR were (0.53±0. 14), (0.60±0. 13) × 10-3 mm2/s]. For patients with a symptom duration of longer than 14 days, the mean ADCFLAIR values of the cortex involved and subeortical lesions were all significantly lower than those of the mean ADCCON values [ ( 1.16±0. 36) × 10-3 mm2/s vs. ( 1.35±0. 48) × 10-3 mm2/s for cortex involved lesions and (0. 97±0. 19) × 10-3 mm2/s vs. ( 1.15±0. 33) × 10-3 mm2/s for subcortical lesions ] (P < 0. 01 ). The ADC values of the normal contralateral sides were significantly decreased after the fluid inversion prepared pulse was conducted [ ADCFLAIR, ( 0. 76 ± 0. 05 ) × 10-3 mm2/s and ADCCON, (0. 82 ± 0. 11 ) × 10-3 mm2/s ] ( p < 0. 01 ). Conclusions The FLAIR significantly decrease the absolute ADC values of the ischemic lesions 14 days later after the stroke onset, which may be helpful in determining individual lesion age. Meanwhile, the application of FLAIR can have a more accurate relative ADC value by reducing the free fluid partial volume effect of the normal contralateral side, and hence enhance the ability of detecting the subtle ischemic pathophysiological changes.

The article expounds systematically the status quo of nursing management in the medical alliances from four aspects: exploring the nursing management model; standardizing, normalizing and optimizing the nursing management; completing the training system of nursing talents, and improving the training of nursing management talents; supporting orderly flow of quality nursing resources within the medical alliance. The authors pointed out the development trend of nursing management in medical alliances as informatization, the long-term training mechanism for management talent, and the last is achieving the homogenization of nursing management.

OBJECTIVETo calculate the volume embolization ratio of densely packing experimental aneurysms by three dimensional digital subtraction angiography (3D-DSA).

METHODSSix experimental crotch aneurysms were created microsurgically in the common carotid artery of white rabbits. Two weeks later, each aneurysm's volume was measured with 3D-DSA surface shaded display(SSD) and the correction of lacteprene balloon calibration method. In the same time, the aneurysms were densely packed with electric detachable coils. The volume of coils that were used in each aneurysm was calculated separately. The ratio of coils volume and aneurysm volume was the volume embolization ratio (VER).

RESULTSThe aneurysms volumes measured by 3D DSA SSD ranged from 0.037 to 0.087 ml. The VER ranged from 23.5% to 32.5% (average 27.4%).

CONCLUSIONThe minimum VER of densely packing experimental crotch aneurysms with electronic detachable coils was 23.5%.

Angiography, Digital Subtraction ; Animals ; Embolization, Therapeutic ; methods ; Intracranial Aneurysm ; diagnostic imaging ; therapy ; Rabbits

Objective:To investigate whether nursing students face the transition shock problems in the stage of clinical practice, and analyze the performance in the dimensions of physical, emotional, intellectual, sociocultural and developmental, and provide reference for formulating clinical intern training programs for nursing students.Methods:A cross-sectional survey of nursing students on the impact of transition shock and its influencing factors were conducted using the General Survey Form and the Transition Shock of Newly Graduated Nurses Scale.Results:The transition shock score of nursing students was 64.49±16.33. The score of physical dimension was 15.73±5.22, intellectual dimension was 13.13±3.80, emotional dimension was 19.15±5.32, sociocultural and developmental dimension was 16.47±5.41. The proposed academic qualifications ( F value was 5.96, P<0.01), the reason for choosing nursing profession ( F value was 7.28, P<0.01), family support level ( t value was -2.75, P=0.01), first internship department ( F value was 5.22, P<0.01), and internship intention ( F value was 3.43, P=0.03) cause the differences in the transition shock of nursing students. Conclusions:Nursing students will face the transition shock problems in the stage of clinical practice, and the impact of physical dimension is the most obvious. In the development of clinical internship training programs, hospitals and institutions should take into account the transition shock of nursing students, as earlier as possible perceive and prevent the occurrence and intensification of nursing students' clinical transformation problems, and assist them to successfully pass the transitional impact stage.