Objective To investigate the role of magnetic resonance (MR) imaging in the diagnosis of early rheumatoid arthritis (RA).Methods Seventy-six patients with polyarthralgia (fifty-four were finally diagnosed as RA,and twenty-two were non-RA) were selected to undergo MR scanning of bilateral hands and wrists.The signs including synovial enhancement or thickening,bone erosion,bone marrow edema,tendonitis,and effusion were observed on MR imaging.The value of various MR manifestations was evaluated.Bayes discriminant analysis was used to investigate the MR imaging criterion for the diagnosis of RA.Results MR imaging first diagnosed twelve of the fifty-four RA patients.When using bilateral synovial enhancement or thickening as criterion,the sensitivity and specificity were 85.19% and 86.36%,respectively.Conclusion MR imaging is one of the reliable diagnostic indexes of RA and it is extremely useful in early diagnosis.The diagnosis of early RA was highly suggested when bilateral synovial enhancement presented.When both the bilateral synovial enhancement or thickening and at least one of bone erosion/bone marrow edema/tendonitis/effusion presented,or when both the unilateral synovial enhancement or thickening and at least two of them presented at the same time,the diagnosis of RA should be considered.

Objective:To establish the post-discharge disease management program for patients with chronic heart failure,and observe the effects of disease management on prognosis.Methods:Totally 207 patients with chronic heart failure,who were ad-mitted to hospital due to acute exacerbation,were enrolled.After discharge these patients were randomly divided into the study group (103 cases)and the control group (104 cases).Disease management program was implemented in the study group,and only routine outpatient follow-up was implemented in the control group.The clinical follow-up results one year after discharge were compared between the two groups.Results:Excluding the patients lost during follow-up,totally 1 88 patients completed the data collection,among which 98 cases were from the study group and 90 cases were from the control group.There was no significant difference regarding the baseline of clinical characteristics between the two groups (P >0.05 ).Follow-up results showed that compared with that in the control group,within the six months after discharged,the readmission rate,the multi-ple readmission rate,and the readmission or death joint events rate in the study group decreased significantly (P <0.05).The percentage of cardiac function NYHA class I to II and the left ventricular ejection fraction in the study group were higher than that in the control group (P <0.05),and the left ventricular end-diastolic diameter was in contrast (P <0.05).The score of Minnesota Living with Heart Failure Questionnaire in the study group was superior to that in the control group (P <0.05 ). Conclusions:The implementation of post-discharge disease management for the patients with chronic heart failure can signifi-cantly reduce the risk of the readmission,the multiple readmission,and the readmission or death joint events within the six months after discharge,and improve the patients’cardiac function and quality of life.