0.05).[Conclusion]According to the electrophysiology and pathology researching for the diaphragm,it is easy to find that it is possible for respiratory function reconstruction by transposition of accessory nerve to phrenic nerve with upper cervical cord injuries.

Objective To explore the diagnosis and treatment of compartment syndromes of the foot after calcaneal fractures. Methods Between October 1994 and June 1999, the intracompartmental pressures of foot were measured with the Whitesides method for 98 patients with calcaneal fractures. The interstitial pressures in 9 patients averaged 46 mmHg (range from 30 to 55 mmHg). All of the 9 patients were treated by fasciotomy through a hindfoot medial incision, then each intracompartment pressure were measured,respectively. An interosseous compartment pressure still was 40 mmHg. The patient whose foot had a severe crushing injury had fasciotomy of his interosseous compartment through two dorsal forefoot incisions. After a week, the wounds were covered with a split thinkness skin graft. The calcaneal fractures were treated with open reduction and internal fixation at 2 weeks after fasciotomy through a lateral incision. Results All of the 9 patients were followed up for a mean of 2 years (range from 18 to 35 months) after injury. Two patients had occasional hindfoot and ankle pain after walking or standing for a long time. One of them decreased pin stick sensation and two point discrimination. None of the cases developed stiffness of the forefoot or claw toes, nor soft tissue contracture and motor deficit. Conclusion It should not be neglected that the compartment syndromes of the foot may occur after calcaneal fractures. Intracompartment pressure measurements should be performed to confirm the diagnosis. Fasciotomy, which could be performed through a medial hindfoot incision, is the optimal way of treatment.

[Objective] To analyze clinical assessment and surgical treatment of rigid cervical kyphosis. [Methods]Thirty-nine cases of rigid kyphosis were retrospectively analyzed (13 cases of idiopathic kyphosis, 8 cases of kyphosis caused by laminectomy, 11 cases caused by old fractures, and 7 cases associated with cervical degenerative kyphosis). The preoperative JOA score was 9.71 ? 2.25, and kyphosis Cobb angles were 9 ?~72 ? (average 22.4 ?). All clinical evaluation had been done to patients and different surgical methods had been implied according to their different clinical manifestations and imaging features, including simple anterior surgery, the one-step anterior-posterior combined surgery, and the two-step of anterior-posterior combined surgery.[Results]The patients were followed up from12 to 36 months (average, 27 months).In the periods of intra-operation or post-operation,no major complication occurred. Neck pain disappeared and neural functions partially recovered postoperatively. Bone graft fusion was achieved.Postoperative JOA score was 14 ? 2.73 (and compared with preoperative t =-9.68 P

Objective: To understand the use patterns, initial abuse age, initial abuse reasons and the demographic characteristic of opiates abusers at six areas in Hunan Province. Methods: Combined stratified cluster-sampling, household and cue investigation, 370 opiate abusers from 68 192 community residents aged between 15 and 50 years were interviewed. Results:About 95% opiate abuses reported that they had abused heroin in their life time, and the other had abused dolantin and/or methadone. Inhalation and Injection were the first two ways of administration (81.4% and 38.6%). The average initial abuse age was 27?6 years, 90.2% abuses reported that they had abused illicit drug before 35 years. Curiosity, peer pressures and exciting seeking were the first three main reasons of initial abuse (75.1%, 72.7% and 56.5%, respectively). Opiates abusers tended to be male (87.3%), young people aged below 35 years (71.1%), and 78.7% of the abusers got only junior school or below education. Subjects with unstable occupation and marital status had higher use rate than those with stable ones.Conclusion:Heroin was the major opiates abused, the main administration was inhalation and injection in Hunan Province. Young and middle aged male with low educational level or without stable occupation or marital status were the majority of opiates abusers.

Objective To assess the importance of initial resuscitation, prevention and management of the early complication in acute cervical spine injury. Methods Initial resuscitation of 715 early complications of 10 types and their prevention and management in 194 cases with acute cervical spinal cord injury admitted from 1996 to 1998 were reviewed. Results Mortality in early stage could be markedly reduced with routine and normal initial resuscitation, pulmonary complications were the main cause of death. Early complications delayed the possible surgical treatment, affected the treatment results, increased the cost and duration of hospitalization and difficulty of rehabilitation. Conclusions Early complications of cervical spine injury mostly occur in the first few days and can be predicted. Proper prevention and treatment of it will benefit the recovery of the neural lesion and following rehabilitation.

Objective To observe the relationship between CT signs, prognosis and the expression of CD44v3 and CD44v6 in peripheral non-small-cell lung cancer (NSCLC). Methods The expression of CD44v3 and CD44v6 was detected with immunohistochemistry (SP method) in 46 patients with peripheral NSCLC confirmed by surgery and pathology. The expression, CT signs and prognosis of NSCLC were analyzed respectively. Results The expression of CD44v3 and CD44v6 correlated with deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum (P<0.05), but not with the tumor size, vacuole sign, vessel convergence sign and pleural indentation in CT images of peripheral NSCLC (P＞0.05). The expression of CD44v3 and CD44v6 correlated with the three-year survival rate in peripheral NSCLC patients (P<0.05). Conclusion Deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum may indicate strong potential invasion and metastasis in peripheral NSCLC. The positive expression of CD44v3 and CD44v6 may suggest shorter survival time and poorer prognosis in peripheral NSCLC patients.

Objective To assess the feasibility of low-dose MDCT pulmonary angiography (MDCTPA) by using low kVp combined with individual-adapted low tube current protocol and noise reduction filter algorithms.Methods Fifty-six consecutively patients with MDCTPA were enrolled in the study.The patients were randomly divided into group A (120 kVp,100 mAs) and group B (100 kVp,individual-adapted tube current about 1.0 mAs/kg).Two series of images were reconstructed in group B:B1 with standard filter algorithms (FC13,B1) and B2 with noise reduction filter algorithms (FC11,B2).The image noise,quality and radiation dose in two groups were compared.Results The CTDIvol,DLP and E of group B were 5.1 mGy,83.3 mGy· cm and 1.4 mSv respectively,which were reduced by 64.3％,66.4％ and 66.7％,respectively (F =32.57,12.32,11.98,P ＜ 0.05) when compared with those in group A.Compared with group A,the image noise in B1 was increased by 118.2％ (t =10.05 P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 51.5％,46.6％,50.8％,45.3％and 20.4％,respectively(t =7.20,6.30,6.58,5.54,8.35,P ＜ 0.05).Compared with B1,the image noise in B2 was reduced by 32.5％ (t =6.12,P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 46.2％,46.2％,45.9％,46.9％ and 18.4％ (t =3.19,3.55,2.95,3.37,5.42,P ＜0.05).Compared with group A,the image noise in B2 group was increased by 47.3％ (t =4.03,P ＜0.05),the central and peripheral SNR and CNR and scores were reduced by 29.1％,21.8％,28.2％,19.6％ and 8.2％(t =4.06,2.82,3.68,2.22,3.02,P＜0.05).Conclusions Keeping effective diagnostic image quality,the protocol with low kVp and individual-adapted low tube current for low-dose MDCT pulmonary angiography would be effective and feasible,and the radiation dose would be significantly reduced.

Objective To study the feasibility of reducing radiation dose in aorto-iliac and lower extremity arteries CT angiography (CTA) with low tube voltage (100 kV) and automatic tube current modulation(ATCM).Methods Totally 61 patients requiting aorto-iliac and lower extremity arteries CTA for clinical reasons were prospectively enrolled in study.The patients were randomly assigned to 3 groups:Group A(120 kV),Group B (100 kV) and Group C (100 kV with automatic tube current modulation).Both quantitative and qualitative analysis were included in this research.Group C was divided into obese group(BMI≥ 24.9 kg/m2) and normal group(BMI ＜ 24.9 kg/m2).The radiation doses were analyzed respectively among two groups.Results The subjective evaluations of image quality for axial,MIP and VR were good.There were no significant differences among group A,B and C in SNR and CNR (P ＞0.05).The effective dose of group A,B and C was 8.20 mSv,5.36 mSv,and was 7.48 mSv,respectively Group B was 34.6％ less than group A.Group C was 39.5％ more than group B,and there was no significant differences between group A and C (P ＞ 0.05).The effective dose of group C1 was 7.11mSv,group C2 was 9.69 mSv,the E with group C1 were significantly less than group C2 (t =-3.163,P ＜0.05),the effective dose of group C1 was 13.3％ less than group A (Z =-2.822,P ＜ 0.05),but the group C2 was more than group A (P ＞ 0.05) and group B (Z =-3.426,P ＜ 0.05).Conclusions Lowkilovoltage (100 kV) CT scanning protocol is feasible in multi-detector CT angiography for aortoiliac and lower extremity arteries.Automatic low tube voltage (100 kV) with automatic tube current modulation (ATCM) scanning protocol can be used for someone with BMI less than 24.9 kg/m2.

OBJECTIVE: To better understand the characte ristics of the neurogenic motor evoked potential (NMEP) before and after acute s pinal cord injury. METHODS: We recorded and characterized the spinal cord NMEP fro m 48 normal rats and from 38 rats with spinal cord hemisection lesion. Spinal co rd NMEPs were elicited by applying a range of current intensities with bipolar m icroelectrode stimuli to the C4 cord segment and recording the responses from sc iatic nerves with bipolar microelectrodes placed in the neurilemma. RESULTS: The evoked potentials consisted of three stable and re producible negative and three positive peaks. The meanplus minusSD latencies of N1 were 2.89plus minus0.22 ms on the right side and 2.89plus minus0.24 ms on th e left side. The mean conduction velocity was 47.9 m/s. The meanplus minusSD am plitudes of N1 were 3.61plus minus2.10 muV on the right side and 3.83plus minus2.3 2 muV on the left side. The amplitudes of N1 were signific antly different among the eight stimulus intensity groups (right side: F=2.22, df=7201, P=0.03; left side: F=2.11, df=7206, P=0.04). The amplitude was largest when the stimulus intensity was 1.1-2.5 mA. The latencies of N1 were not si gnificantly different among the eight stimulus intensity groups (right side: F=0.40, df=7201, P=0.9; left side: F=1.20, df=7206, P=0.3. The amplitudes and latencies of N2, N3 were not significantly different among the eight stimulus intensity groups. There were no significant changes in latency and amplitude between the left and the right side nerve responses. Thirty-eight rats underwent T9 cord right side hemisection. Among them, 20 (53%), 30 (79%), and 32 (84%) rats could not be reco rded in corresponding to N1, N2, and N3, respectively, in the right-side sciati c nerves; and 13 (79%), 18 (47%), and 21 (55%), in corresponding to N1, N2, and N3 in the left-side sciatic nerves. The latency was significantly delayed on th e both right and left sides. The amplitude N1 was significantly depressed on the both sides, with N3 significantly depressed on the right side and N2 not signif icantly depressed. CONCLUSIONS: The amplitude of N is significantly different amon g the eight stimulus intensity groups. The amplitude is largest when the stimulu s intensity is 1.1-2.5 mA. The light injury results in a significant la tency delay in N1, N2, and N3 waves and a significant amplitude attenuation in N1. The N1 amplitude is sensitive to the degree of the lesion and conducts bilate rally. N2 and N3 conduct mainly along the ipsilateral posterolaterial tracts in the rats.

Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group.