Objective To investigate the ultrasonic performance of carotid atherosclerotic plaque and the correlation between microvessel density in plaque .Methods 87 cases of patients undergoing carotid artery plaque dissection were selected .113 plaques were found .All patients were taken carotid color Doppler sonography test and analysis of the plaque .The maximum thickness of plaques was taken HE stained ,and the vessel density in the plaque was counted .The correlation with sonographic performance of plaques was analyzed .Results The maximum plaque thicknesses in hard plaque ,soft plaque and mixed plaque were (0.49 ±0.05)mm,(0.36 ±0.08)mm and (0.39 ± 0.10)mm,respectively,and cross-sectional area stenosis rates were (88.32 ±6.51)%,(68.92 ±12.05)% and (71.95 ±13.04)%,respectively,the differences were statistically significant (F=16.329,23.723,all P<0.05). The maximum plaque thickness and cross -sectional area stenosis rate in hard plaque were all larger than soft plaque and mixed plaque,the differences were statistically significant (t=7.091 7,2.501 and 6.452,6.086,all P<0.05). The microvessel density values in different plaques were (2.11 ±0.48)strips/mm2,(5.91 ±1.03)strips/mm2 and (3.82 ±0.99)strips/mm2,the differences were statistically significant (F=143.541,P<0.05),soft plaque>mixed plaques>hard plaque,the differences were statistically significant (t=6.579 and 9.392,all P<0.05).Pearson cor-relation analysis showed that the maximum plaque thickness and cross -sectional area stenosis rate in soft plaque were positive correlation between microvascular density values (r=0.372,P=0.011;r=0.438,P=0.000).Conclusion Color Doppler ultrasound examination might indirectly reflect microvessel densities in carotid artery plaque .It could be used preliminary assessment of vulnerability of carotid artery plaque .

Objective To investigate the value of contrast -enhanced ultrasound combined with serum homocysteine in determining the stability of atherosclerotic plaques.Methods 96 cases with cerebrovascular disease accompanied by carotid atherosclerotic plaques were selected.All patients were taken ultrasonography and contrast -enhanced ultrasound.Semi -quantitative grading was used for plaque according to the reinforced.The serum homocys-teine levels were detected.Results A total of 146 plaques of 96 cases were found out.Hard plaques were 13(8.9%),soft plaques were 71(48.6%)and mixed plaques were 62(42.5%).All cases were divided into three groups according to the plaque ultrasound contrast semiquantitative grading.24 cases were in Ⅰ grade group,46 cases were in Ⅱ grade group,26 cases were in Ⅲ grade group.The differences of serum homocysteine levels among the three groups were statistically significant(F =59.942,P <0.05),pairwise compared,the differences were statistically significant(t =16.837,20.682 and 15.416,all P <0.05).Pearson linear correlation analysis showed that contrast -enhanced ultrasound plaque classifications were positively correlated with serum homocysteine levels(r =0.709,P =0.000).Conclusion Contrast -enhanced ultrasound could accurately assess the neovascularization in the plaque. Semi -quantitative grading of ultrasound contrast are positively correlated with serum homocysteine levels.Combined the two could provides scientific basis for early and accurate prediction the stability of plaque.

Objective To investigate the relationship between the gene polymorphism of the inducible costimulatory molecules (ICOS),CD_(28),CD_(24) and susceptibility to multiple sclerosis(MS). Methods 83 patients with MS and 110 controls selected from healthy individuals and hospital staff in Chinese Han people with non-autoimmune diseases were studied by detecting genotype of the 3 genes using PCR-RFLP method. Results The frequency of ICOS-2394 TT genotypes was significantly higher in MS patients than in controls (MS 33.7%vs controls 10.9%, P

Objective:To explore the predictive value of computed tomography (CT) texture analysis for the recurrence in children with acute pancreatitis (AP).Methods:The clinical diagnostic test was conducted. The clinical data of 56 children with primary AP who were admitted to Wuhan Fourth Hospital from January 2016 to January 2018 were collected. There were 13 males and 43 females, aged from 3.5 to 13.0 years, with a median age of 5.5 years. Based on follow-up in other hospitals, 20 children with recurrence of AP were allocated into recurrence group, and 36 children without recurrence were allocated into non-recurrence group. All the 56 children underwent abdomen plain and enhanced CT scan within 24 hours after first admission. Observation indicators: (1) comparison of clinicopathological features between two groups of children with AP. (2) comparison of CT texture parameters between two groups of children with AP. (3) diagnostic efficacy of clinical features and CT texture parameters. Follow-up using outpatient reexamination and telephone interview was conducted to detect recurrence of AP up to February 2020. The duration of follow-up required more than or equal to 24 months. The Shapiro Wilk test was used to analyze normality of measurement data. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range) or M ( P25, P75), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. Clinical parameters and CT texture parameters with statistical differences were multivariate analyzed using the Logistic regression model. Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive efficacy of parameters for recurrence of AP. Results:(1) Comparison of clinicopatholo-gical features between two groups of children with AP: cases with or without complications were 14 and 6 for the recurrence group, versus 7 and 29 for the non-recurrence group, showing a significant difference between the two groups ( χ2=14.021, P<0.05). Cases with minimal, moderately severe or severe disease (severity of disease) were 2, 5, 13 for the recurrence group, versus 19, 11, 6 for the non-recurrence group, showing a significant difference between the two groups ( Z=5.414, P<0.05). (2) Comparison of CT texture parameters between two groups of children with AP: the energy value in the arterial phase on CT examination was 0.186(0.174,0.206)for the recurrence group and 0.413(0.405,0.425) for the non-recurrence group, showing a significant difference between the two groups ( Z=9.413, P<0.05). The energy value and entropy value in the venous phase on CT examination were 0.084(0.078,0.092) and 0.961(0.210,1.720) for the recurrence group, versus 0.135(0.124,0.156) and 0.372(0.210,0.535) for the non-recurrence group, showing significant differences between the two groups ( Z=4.763, 7.243, P<0.05). (3) Diagnostic efficacy of clinical parameters and CT texture parameters: results of multivariate analysis showed the complications, severity of disease, energy value in the arterial phase on CT examination were related factors for recurrence in children with AP, energy value and entropy value in the venous phase on CT examination were related factor for recurrence in children with AP ( odds ratio=0.874, 0.765, 0.837, 0.902, 0.813, 95% confidence interval as 0.802?0.985, 0.581?0.914, 0.753?0.897, 0.862?0.948, 0.765?0.873, P<0.05). Results of ROC analysis showed that that areas under curve (AUC) of complications, severity of disease in the clinical parameters were 0.734 and 0.832, the AUC of single CT texture parameter was 0.811?0.867, the AUC of clinico-pathological parameters combined with CT texture parameters was 0.882. Conclusion:CT texture analysis can early and non-invasively predict the recurrence of AP in children, and the combination of clinicopathological parameters with CT texture parameter has a better predictive efficacy.

Cognitive behavioral therapy (CBT) has been widely used in many clinical fields, especially the mental illness, as well as the somatic diseases, behavior disorders in children, and intervention for the caregivers and family members of patients with various diseases.

Objective To investigate the effect of complementary dynamic scalp acupuncture on motor function in stroke. Methods 36 stroke patients were randomly allocated to control group (n=19) and treatment group (n=17). The control group received traditional scalp acupuncture and rehabilitation training, while the treatment group received scalp acupuncture and rehabilitation training in the same time,for one month. Their motor function and activities of daily living (ADL) were assessed with the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT) and modified Barthel Index (MBI) before and after treatment, respectively. Results The scores of FMA, WMFT and MBI increased significantly in both groups after treatment (P<0.01). The difference of scores of FMA of the lower extremities and MBI was statistically significant between the two groups after treatment (P<0.05), while the difference of scores of FMA of the upper extremities and WMFT was not (P>0.05). Conclusion Complementary dynamic scalp acupuncture is more effective on lower limbs motor function and activities of daily living in stroke patients.

Objective To report outcomes of patients with PSA ≥ 30 μg/L with initial negative transperineal template-guided saturation biopsy (TTSB). Methods From 2003 to 2010,a total of 1824 patients underwent transperineal saturation biopsies with the prostate template at the Peking Union Medical College Hospital.44 of them had initial negative biopsy with PSA ≥ 30 μg/L were reviewed in this study.The mean age was 68 years old (range,51 to 80).The mean biopsy cores were 28.7 (range,11 to 44).The median PSA level was 40 μg/L (range,30 to 128),and the median prostate volume was 73 ml (range,30 to 190).They were divided into four groups:TURP group,chronic prostatitis group,repeat biopsy group and miscellaneous group. Results Patients were followed up for a mean of 49 months (range,12 to 91).All patients of TURP group (15 cases) were identified as prostatic hyperplasia by postoperative pathology.2 of them had a second TTSB for PSA ＞ 10 μg/L after TURP,which were negative.5 patients of chronic prostatitis group had a declining PSA level after antibiotic therapy for 3 to 4 weeks.One patient took a second biopsy,which was identified as prostatitis.All patients of repeat biopsy group (18 cases) showed no significant decrease in PSA level during follow-up and undertook biopsies 2 to 4 times,6 of which were proved to be prostate cancer.All patients of the miscellaneous group (6 cases) had a declining PSA and didn't take a second biopsy. Conclusions Close follow-up and regular PSA testing for patients who had a high PSA level with initial negative biopsy would be help to avoid both false negative of prostate cancer and unnecessary biopsy.

Objective To evaluate the action research method in the effect of swallowing disorder in patients with tongue cancer recovery path. Methods Based on the recovery path construction, according to the questions, plan, action, observation and reflection, improvement of summarizing the research process, through two stages of the research, assessment, diagnosis, planning, implementation, evaluation and comparison of stage 1 and stage 2 swallowing disorder in patients with rehabilitation evaluation, quality of life score, spirit to adapt to the score. Results Nearly 79.69% (51/64) of first phase swallowing rehabilitation effectively, and 93.75% (60/64) effectively in the second stage. Compared to the first stage,the second stage had an obvious increase. Two stages at the university of Washington Quality of Life Score, the first phase of (770.400 ±87.299) points, (1117.100 ± 43.153) points in the second stage, two stages of life quality score comparison, the difference was statistically significant (t=-19.500, P=0.012). The comparison of two stage patients mental adjustment scale scores, the first phase of (15.933±1.285) points, (31.733±2.083) points in the second stage, two stages score spirit to adapt to the comparison, the difference was statistically significant (t=-35.357, P=0.003). Conclusions Tongue cancer patients with swallowing disorder treatment on the basis of action study method to build and implement path specification, can improve the quality of care and quality of life of patients.

Objectives To investigate characterization of imipenem resistance among imipenem non susceptible Pseudomonas aeruginosa isolated from patients who treated without imipenem and explore risk factors of imipenem resistance.Methods From April,2006 to March,2008,a total of 37 non-susceptible to imipenem without imipenem therapy isolates were collected from affiliated 3201st Hospital of Medical College of Xi'an Jiaotong University.The minimum inhibition concentration (MIC) to 11 antimicrobial agents were determined by the broth dilution method.We also tested imipenem MIC combined with efflux pump inhibitor PAβN.PCR was performed to check for the presence of carbapenem-hydrolylzing MBL genes and oprD gene.The expression level of oprD2 and ampC were evaluated by qRT-PCR.Molecular typing was performed using PFGE.Results There is significant difference ( t =- 2.9004,P ＜ 0.01 ) of the average number days of therapy between with two or more antibiotics in the 16 patients (20.0 ± 9.5 ) d and that with only one antibiotic in the other 21 patients ( 12.6 ± 4.4 ) d before imipenem-non-susceptible strains were isolated.In all 37 strains,32 strains showed resistance to more than three antibiotics.The MBL gene ( IMP-9 ) was only found in one strain,but its phenotype is negative,oprD2 gene from the 29 strains were found forward inserted by ISpa1328.Thirty-five isolated were considered to have no oprD expression.The patterns of the total DNA of 37 strains appeared six PFGE types.The 26 strains belonged to C2 PFGE type.In the presence of PAβN,all 37 strains increased sensitivity to meropenem.Conclusion Fluoroquinolones and cephalosporins treatment could play an important role in imipenem non-susceptible production in the research isolates.

Objective To observe the effect of different analgesic methods including patient controlled epidural analgesia (PCEA) and patient controlled intravenous analgesia (PCIA) on stress response and anxiety in surgical patients with lower limb fracture. Methods A total of 120 surgical patients with lower limb fractures were employed and divided randomly into Groups PCEA, PCIA and C (40per group). All patients were anaesthetized by using combined spinal-epidural anesthesia. After operation, PCEA and PCIA were applied in the patients of Groups PCEA and PCIA, respectively. No analgesic method was employed in the Group C. The dynamic indices including mean blood press (MAP) and heart rate (HR), blood serum cortisol (COR) and blood sugar (BS) were measured at different time points,ie, T0 ( pre-anesthesia), T1 ( the end of the operation), T2 (24 hours after operation) and T3 (48 hours after operation). The visual analogue pain score was conducted at time points of T1, T2 and T3. The measurement of anxiety score was done at pre-operation and at days 1 and 7 after operation. Results There were no significant changes in HR and MAP of Groups PCEA and PCIA (P＞0.05, compared with T0) at every time point after operation. Whereas, HR and MAP of Group C were increased at time points of T1 and T2 (P ＜ 0.05, compared with T0 ), with statistical difference compared with Groups PCEA and PCIA at the same time points (P ＜ 0.05 ). VAS in Group PCEA was lower than that in Group PCIA at time points of T2 and T3 ( P ＜ 0.05). Meanwhile, VAS in Groups PCEA and PCIA was lower than that in Group C (P＜0. 05). COR and BS in Group PCEA were significant lower than those in group PCIA at time points of T2 and T3 (P ＜ 0. 05 ). Meanwhile, COR and BS in Groups PCEA and PCIA was lower than that in Group C (P＜0.05 or ＜0.01 ). Moreover, the changes were more significant in Group PCIA than that in Group PCEA (P ＜ 0. 05 ). The anxiety score in Groups PCEA and PCIA was lower than that in Group C (P ＜ 0.05). Conclusions Two analgesic methods of PCEA and PCIA can provide safe and effective postoperative analgesia and attenuate the stress response and anxiety in surgical patients with lower limb fracture. Meanwhile, PCEA takes more advantages than PCIA.