Objective To investigate the association between brain structure abnormalities and neuropsychology impairment in CAD patients.Methods Nineteen patients with CAD and 1 7 healthy adults were examed with MRI,and T1 WI,T2 WI,FLAIR,DWI and DKI image were performed,and then comparing the acquired MRI findings between two groups.Results Significant differences were observed for MK values in splenium and body of the corpus callosum,left cerebellar hemisphere and amygdala cerebelli.MK values of CAD group were lower than those of healthy group in these regions,and differences were statistically significant(P <0.05). There were significant correlation between MK values of the left amygdala cerebelli and MoCA scores in CAD group.Conclusion DKI could detect the changes of brain tissue microstructure in CAD patients early.The correlation between MK and neuropsychologi-cal function provides an important basis for early diagnosis and treatment.

Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.

Objective To investigate the morphologic changes and hemodynamic parameters of the common carotid artery in obstructive sleep apnea hypopnea syndrome(OSAHS)in a porcine model using ultrasound and color Doppler.Methods A total of 12 pigs were randomly divided into model group and control group(n=6 for each).All pigs were fed under the same conditions with exception of th ose in the model group which were kept in a hypobaric chamber for experiments.The parameters of systolic velocity(S)and diastolic velocity(D),resistant index(RI)and S/D in Doppler as well as maximum IMT(intima-media thickness)with two-dimensional ultrasound were obtained in the carotid artery of all animals were determined,and the latter was confirmed by animal dissection when the symptoms of OSAHS appeared in the model group.Results The diameter of the lumen of the common carotid artery in model group(3.18?0.17)was smaller than that of control group(3.47?0.15,P

Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

To change the old stereotype of using literal and data information for storage and ex- change in medico—scientific records and provide a new record version rich in word and picture,a gener- al model of multi—media control system of medical records and an information storage pattern have been developed and the feasibility of development methods explored.

Objective:To analyze the consistency of HER-2 expression among endoscopic biopsy and radical operation specimens of gastric adenocarcinoma and to investigate the clinical application value of HER-2 detection in trastuzumab treated patients. Methods:From March 2013 to February 2014, 167 patients from Shanghai Changhai Hospital were diagnosed with gastric adenocarcinoma using endoscopic biopsy specimens. The corresponding surgical specimens were collected for pathological analysis. The relevant clinical and pathological data were collected. HER-2 protein expression of endoscopic biopsy specimens was detected by immunohistochemistry (IHC). HER-2 protein expression and gene amplification status of the corresponding tumor resection specimens were detected by IHC and fluorescence in situ hybridization (FISH). Results were analyzed for clinicopathological characteristics. Results:Among the 167 cas-es, 18 cases (10.8%) were HER-2 positive, including 10 cases showing IHC3+and 8 cases showing IHC2+with FISH positive. The consis-tency rate result among endoscopic biopsy and surgical operation specimens was 82%. Excluding the cases showing IHC2+, the true positive rate and the true negative rate were 73.3%and 97.0%, respectively. Conclusion:HER-2 detection of endoscopic biopsy speci-men by IHC shows great predictive value. The main reason for the difference of surgery and biopsy specimens is the heterogeneity of tumor expression. Increasing the number of specimens and combined testing with FISH are important methods to reduce misjudge-ment.

Objective To explore the effects of electro-acupuncture combined with surface gastric pacing on gastrointestinal dysfunction for patients with spinal cord injury (SCI).Methods Seventy-five SCI patients with gastrointestinal dysfunction were divided randomly into an electro-acupuncture group (group A),a gastric pacing treatment group (group B) and a group for which electro-acupuncture was combined with gastric pacing (group C).There were 25 cases in each group.Members of group A were given 30 minutes of electro-acupuncture per day ; those of group B had 30 minutes of gastric pacing treatment twice per day ; group C was provided with both 30 minutes of electro-acupuncture and one 30-minute gastric pacing treatment per day.All of the interventions lasted ten days.Before and after the treatment,all patients were assessed using a clinical symptoms score and with electrogastrograms,and any adverse effects were observed.Results There was a significant improvement in upper abdominal pain and epigastric discomfort,bloating and early satiety,nausea,vomiting,as well as belching and loss of appetite in each group after treatment.Before treatment there was no significant difference in the average clinical symptom scores of the three groups.After treatment the values had decreased,and those of group C were significantly lower than group A or B.The average scores of groups B and A were not significantly different.The electrogastrogram results showed than after treatment there was significant improvement in N％ and T％ in groups A and B,and also significant improvement in N％,B％ and T％ in group C compared to before treatment.Group C's improvements were all significantly greater than those observed in groups A and B.Conclusion Electro-acupuncture or gastric pacing alone can give some improvement in gastrointestinal function and its electrophysiological indicators,but their combined effects are better than when either is used alone.

Objective To compare the clinical effect of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus pesticide poisoning.Methods 86 patients with organophosphorus pesticide poisoning were selected and randomly assigned to the observation group and the control group according to the digital table,43 cases in each group.The two groups were given conventional treatment,while the control group was treated with atropine,the observation group was given penehyclidine hydrochloride.The disappearance time of main symptoms, rescue success rate and adverse reactions of the two groups were observed.Results After salvage treatment, the rescue success rate of the observation group was 97.8%,which of the control group was 88.4%,the difference was statistically significant (x2=1.433,P<0.05).The disappear time of M like symptoms,N like symptoms and central nervous system symptoms in the observation group was significantly shorter compared with the control group (all P<0.05).The number of drugs,dosage,cholinesterase recovery time and hospitalization time between the two groups had statistically significant differences (P<0.05).The incidence rates of blurred vision,restlessness,heart rate and urinary retention in the control group were significantly higher than those in the observation group (all P<0.05).Conclusion Penehyclidine hydrochloride for acute organophosphorus pesticide poisoning can significantly reduce the incidence of symptoms,shorten the disappearance time of symptoms,reduce hospitalization time,improve the efficacy of rescue,reduce the incidence of adverse reactions, it is safe,effective and has great clinical significance.

Objective To observe the effect of constraint-induced movement therapy combined with motor imagery on unilateral spatial neglect (USN) in stroke patients. Methods Fifty stroke patients with USN were randomly divided into a treatment group ( n = 27 ) and a control group ( n = 23 ). Both groups received routine physical therapy training, including with the Bobath technique and low frequency electrotherapy, while the treatment group received constraint-induced movement therapy and motor imagery in addition. All the patients were assessed with 4 scales of the regular USN assessment ( cancellation tests, line bisection tests, clock drawing tests,copying drawing tests) and with the Barthel index (BI) before and after 8 weeks of treatment. Results After 8 weeks of treatment, both groups' average USN assessments and Barthel indices improved significantly. Furthermore, both the USN results and the Barthel index scores in the treatment group were, on average, significantly better than those in the control group. Conclusion For USN stroke patients, constraint-induced movement therapy combined with motor imagery improves the symptoms of USN and ADL ability significantly better than routine physical therapy treatment alone.

Objective To evaluate the application of the inlay butterfly cartilage graft technique in myringoplasty.Methods Thirty--eight ears in 38 patients (experiment group) with dry central drum perforations were treated with inlay butterfly cartilage myringoplasty,and 46 ears in 46 patients with underlay temporalis fascia myringoplasty (control group).Results After a mean follow-up of 6 months,the healing rate did not differ between two groups (92.1% in experiment group,91.3% in control group,P＞ 0.05).Average pure-tone hearing threshold improved than 10 dB and closure of the air-bone gap (ABG) within 10 dB were not different (P ＞ 0.05).The cured patients were followed up for 12-38 months,there was no ear perforation of drum in experiment group,but 4 ears in control group.Condusion Inlay butterfly cartilage myringoplasty is the reliable and ideal method for tzeating dry central drum pedoration with high success rate.