Objective To evaluate the application value of MSCT in the diagnosis of carotid cavernous fistula(CCF).Methods The data of 10 patients who had been confirmed with CCF by DSA were retrospectively analyzed to compare the imaging features of MSCT plain scan,CTA,post reconstruction imaging and other examination ways.Results 10 patients with CCF which were manifested by superior ophthalmic vein enlargement in CT plain scan,early appearance of superior ophthalmic vein and cavernous sinus enlargement in CTA were studied.The orificium fistulae can be displayed through the multi planar reconstruction (MPR)and the curved planar reconstruction (CPR).The focal region can be well displayed through the volume rendering (VR)and the maximum intensity projection (MIP). CT,MRI,DSA and color doppler ultrasonography have both advantages and limitations in the diagnosis of CCF.Conclusion MSCT can achieve characteristic imaging findings through scan,CTA technology and various post reconstruction methods,it has significant value in the early diagnosis and treatment of CCF.

Objective To explore the effect and factors of patellofemoral arthroplasty (PFA) for isolated patellofemoral osteoarthritis.Methods Data of 18 patients (3 males,15 females) with isolated patellofemoral osteoarthritis underwent PFA from March 2006 to December 2014 were retrospectively analyzed.There were 3 males and 15 females with a mean age of 54 years (range,46-74 years).It was strict to grasp the surgical indications according to the clinical symptoms,signs and imaging data preoperatively.11 patients were operated with AVON patellofemoral prosthesis (Stryker Inc.) and the other 7 patients were operated with the Gender Solutions patellofemoral prosthesis (Zimmer Inc.).Active and passive functional rehabilitation exercise was encouraged at the early stage after operation.Visual analogue scale (VAS) was 5.33±0.99 (range,4-7) and hospital for special surgery knee score (HSS) was 53.28±5.71 (range,44-63) before operation.Results The mean duration of follow-up was 63.98 months (range,6-104 months).VAS after operation for 1 and 3 months were 1.17±0.79 (range,0-3) and 0.72±0.67 (range,0-2),and the pain was almost relieved after 9 months.HSS after operation for 1,3,9 months were 70.06±6.33 (range,61-80),86.06±5.12 (range,77-95) and 91.39±4.83 (range,82-97).HSS score of the latest follow-up was 92.06±4.05 (range,84-97),which was improved obviously from the preoperative ones.The excellent and good rate was 100％ (excellent 15 cases,good 3 cases).The satisfactory rate was 94.4％ (17/18).Only one case got slightly knee pain when walking up and down the stairs after 2 years,and the pain was relieved after being administered with NSAIDs and rest.No incision infection,rupture,prosthesis supported bone fracture,prosthesis loosening and other complication was occurred during the follow-up period in the other patients.Conclusion The clinical outcomes of PFA are strictly related to surgical indications,implant design and appropriate surgical technique.Therefore,based on the appropriate PFA implants,strict surgical indications,appropriate patients,excellent operation skills and actively functional rehabilitation exercise,PFA could treat the isolated patellofemoral osteoarthritis effectively.

BACKGROUND:With the improvement of hemodialysis technology, the long-term survival rate of maintenance hemodialysis patients has been increased continual y. Nowadays, how to improve the quality of life in maintenance hemodialysis patients has been aroused widespread concern, and gradual y become the reliable indicator for comprehensive evaluation of the effect of hemodialysis. OBJECTIVE: To evaluate the effect of individualized intervention and col ective intervention on quality of life in maintenance hemodialysis patients. METHODS:Eighty maintenance hemodialysis patients, who had accepted more than 3 months of dialysis, were randomly divided into two groups (40 cases in the experimental group and 40 patients in the control group). Al the patients in the control group received 6 weeks of individualized intervention according to the pre-established schedule based on the hemodialysis routine care. Patients in the experimental group also have a period of six weeks of col ective intervention according to the pre-established weekly schedule based on the hemodialysis routine care. The quality of life of the patients was evaluated with MOS 36-item short form health survey and kidney disease quality of life short form before and after intervention. RESULTS AND CONCLUSION:After the intervention, both of the experimental group and the control group achieved significantly greater improvement than before in MOS 36-item short form health survey and kidney disease quality of life short form (P<0.01). The physical impact, overal health, emotional state, emotional impact, social function and energy of MOS 36-item short form health survey in the patients of the experimental group were higher than those of the control group after intervention (P<0.01);and the social quality, sleep, social support and patient satisfaction of kidney disease quality of life short form in the experimental group were higher than those in the control group (P<0.01). The results show that both individualized intervention and the col ective intervention based on the individualized intervention are effective in improving quality of life in maintenance hemodialysis patients and the col ective intervention can better improve the quality of life from physical, psychological and social aspects.

Objective: To investigate the action of low level soybean isoflavones (genistin, genistein and daidzein) on the oxidative modification of lipoproteins in serum. Methods: After a system of lipoprotein oxidation mediated by Cu 2+ was established in a dilute serum, the effects of soybean isoflavones on the course and the end of lipoprotein oxidation could be reflected by monitoring the production of conjugated dienes and thiobarbituric acid-reactive substances (TBARS) respectively when isoflavones were added. Results: After 0.5-10 ?mol/L genistein, daidzein, genistin or ?-tocopherol was added into the lipoprotein system respectively before the oxidation initiated by Cu 2+ , the production of conjugated dienes or TBARS in the system was significantly reduced with a dose-dependent relationship. When the lipoprotein oxidation was initiated by Cu 2+ at 37 ℃ for 1 h or 1.5 h, soybean isoflavones also revealed strong inhibition on the oxidation in a weakening way. In comparison with soy isoflavones, ?-tocopherol had smaller inhibition on the production of conjugated dienes, but had promotion on the increase of TBARS. Conclusion: Lipoprotein oxidative modification in serum was weakened by low level soybean isoflavones, and its action after the oxidation initiated was more effective than that of ?-tocopherol.

Objective To study the effect and its possible mechanism of p66shc on endothelial dysfunction induced by hydrogen peroxide(H2O2).Methods Human umbilical vein endothelial cells (HUVEC) were used and cultured.H UVEC cells were untreated(control group)or treated with four groups of H2O2,H2O2 plus protein kinase C (PKC) inhibitors,H2O2 plus PKC activator,H2O2 plus P38 inhibitor for 30 minutes respectively,and cells were collected after 24 hours.The apoptosis,viability,proliferation of HUVEC were detected with immune fluorescent staining,MTT and Ki-67 respectively.P66shc and ser36 p66shc (p-p66shc)protein expressions were assessed using Western blotting.P66shc mRNA expression was measured with real-time quantitative polymerase chain reaction (RT-PCR).Results H2O2 induced HUVEC dysfunction which decreased HUVEC proliferation and increased the apoptosis of HUVEC.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly increased after treating with H2O2.PKC inhibitor inhibited a H2O2 induced HUVEC dysfunction through increasing HUVEC proliferation activity and reducing cell apoptosis.The expressions of p66shc,p-p66shc protein and p66shc mRNA were significantly decreased after treating with H2O2 plus PKC inhibitor.PKC activator enhanced H2O2-induced HUVEC dysfunction and increased the expressions of p66shc.P38 inhibitor had no obvious effect on H2O2-induced HUVEC dysfunction and the expressions of p66shc.Conclusions p66shc may play an important regulatory rote in endothelial dysfunction caused by H2O2.P66shc may regulate a H2O2-induced endothelial dysfunction through PKC signal pathway.

Objective To investigate the effects of divitamins notonginseng and cinnarizine capsule(DNCC) on acute cerebral ischemia.Methods ICR mice were administered three doses of DNCC(420,210,and 105mg/kg;ig.) for ten days,then the gasping time after decapitation was recorded.After three doses of DNCC(292,146,and 73mg/kg;ig.) were given respectively for ten days in rats,the effects of DNCC on the infarct size,histological changes and neurological function scores caused by focal cerebral ischemia which was induced by middle cerebral artery occlusion were investigated.Results DNCC prolonged the gasping time of mice after decapitation and improved the neurological function scores,cerebral ischemia injury and decreased the infarct size in rats.Conclusion DNCC has a protective effect against acute cerebral ischemia.

Objective To evaluate the safety and feasibility of hepatectomy for huge focal nodu-lar hyperplasia of the liver. Methods The clinical data of 29 cases of huge FNH of the liver with an average diameter of 12.5 cm (10-26 cm) who were admitted to our hospital from 1996 to 2007 were retrospectively analyzed. Lesions protruded from the liver in 26 cases, compressed extrahepatic organs in 10 and adjoined or compressed hepatic hila in 19. Results All the lesions were successfully resected without operative death. The mean intraopreative blood loss was 747 ml (100-4000 ml). The first he-patic portal blocking was performed in 27 cases and the mean blocking time was 26 min (13-78 min).Among 19 cases of huge FNH involving hepatic hila, the mean intraopreative blood loss was 1011 ml,the mean blocking time 30 min and the liver cross-section was not completely sutured in 7 of these ca-ses. The intraoperative hemorrhea occurred in 7 and postoperative biliary fistula in 1. Twenty-seven cases were followed up for a median of 46 months (4-132 months) with no recurrence and the longest survival time had reached to 11 years. Conclusion Hepatectomy is a safe and feasible means for huge focal nodular hyperplasia of the liver. For those involving hepatic hila, distinguishing between the le-sion and intrahepatic vessels, performing resection closely around the lesion and dealing with the liver cross-section properly may be helpful to reduce the surgical complications.

Objective To investigate the status quo of quality of life and family environment of children and adolescents with diabetes, also to explore the relationship between family environment and the quality of life, so as to give some support for family nursing. Methods A total of 58 diabetic children and adolescents were asked to complete Pediatric Quality of Life Inventory,meanwhile their parents were asked to complete the family environment scale, relativity of life quality of diabetic children and adolescents with family environment was analyzed. Results The physical function, school function, psychosocial health and total quality of life of diabetic children and adolescents' were lower than healthy children; family conflicts and control were higher than normal, while knowledge was lower than normal. Their quality of life was positively correlated with family knowledge and control, family control and success contributed a lot to life quality. Conclusions The health professionals should improve the communication between children and parents, sharing the diabetes responsibility, reduce the family conflict, in order to manage diabetes effectively and improve the quality of life.

Objective To determine the risk factors of ruptured hepatocellular carcinoma (HCC) and to study the prognostic factors of long-term survival.Methods Of the 4209 patients with HCC diagnosed and treated at the Eastern Hepatobiliary Surgery Hospital from Apr 2002 to Nov 2006,200 patients (4.8％) presented with ruptured HCC.These patients were studied retrospectively and the results of treatment were evaluated and compared with a randomly selected group of 202 patients who had no history of rupture and were treated during the study period.Results On multivariate logistic regression analysis,co-existing hypertension and cirrhosis,tumor size ＞5 cm,vascular thrombus and extrahepatic invasion were predictors of spontaneous rupture of HCC.For the 200 patients with spontaneous rupture of HCC,105 patients underwent elective one stage hepatic resection,33 received transcatheter arterial chemoembolization (TACE),and 62 were treated conservatively.The median survival time (MST) for patients with spontaneous rupture of HCC was 6 months (range,1-72 months),and the overall survival rates at 1-,3-and 5-year were 32.5％,10％ and 4％,respectively.The MST was 12 months (range,1-72 months) in the surgical group,4 months (range,1-30 months) in the TACE group and 1 month (range,0-19 months) in the conservative group.The 1-,3-and 5-year overall survival rates in patients with ruptured HCC who received partial hepatectomy were 57.1 ％,19.0％ and 7.6％,respectively,compared with 77.1％,59.8％ and 41.2％ in 98 patients who underwent partial hepatectomy for HCC without rupture (P＜0.001).Conclusions For patients with HCC who had underlying of hypertension and cirrhosis,extrahepatic invasion and tumor size ＞5 cm,there was a high propensity to rupture.Prolonged survival could be achieved in selected patients who received one-stage partial hepatectomy,although the survival results were inferior to the patients had no rupture.

Objective To estimate the prevalence and associated factors of adult female urinary incontinence in Hebei province. Methods Stratified and multistage sampling method was used, between January 2016 to May 2016, to investigate the target population in Hebei province. While, logistic regression was used to analyse datas. Results A population-based survey was conducted in 2 450 women in Hebei province, there were 2 408 effective questionnaires after deleting 48 invalid questionnaires. According to the results, the average age of subjects was (56±15) years old, and the urinary incontinence prevalence of adult female in Hebei province was 27.70%(667/2 408). Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 23.13%(557/2 408), 1.58%(38/2 408) and 2.99%(72/2 408), respectively. There were only 2.85% (19/667) urinary incontinence patients seeking medical help. The results of logistic regression analysis showed that age, daily water intake, pulmonary diseases, urinary tract infection, hypertension, chronic low back pain, dysmenorrhea, vaginitis, abortion, mode of delivery, postpartum infection were statistically significant (all P≤0.05). Among these factors, cesarean section was the protective factor for urinary incontinence (OR=0.365, 95%CI: 0.195-0.685, P<0.01). Conclusions The prevalence of urinary incontinence in adult female in Hebei province is high, and there are few patients seeking medical help. It is a common disorder in women and is associated with many factors;among these factors, cesarean section is the protective factor for urinary incontinence.