[Objective]To discuss the alterations of sesamoid position before and after opertation and its relation to the function of the metatarsophalangeal joints.[Methods]Eighty feet(39 hallux valgus feet,41 normal foot) were selected.The distance from sesamoids to the second metatarsal,the relative position of sesamoid bone to the first metatarsal bone,the function of the first metatarsophalangeal joints were determined and analyzed.[Results]The distance from sesamoid to the second metatarsal had no statistical significance in normal feet compared with the hallux valgus feet(P

AIM:To observe the effect of lidocaine to the activation of NF-?B and apoptosis in human neutrophils(PMN)in vitro.METHODS:Human PMN were divided into five groups:control group(0.9% sodium chloride);TNF-?(200 ng/L);TNF-?+lidocaine(1.0 mmol/L);TNF-?+lidocaine(2.0 mmol/L),and TNF-?+ lidocaine(4.0 mmol/L).The expression of NF-?B subunit p65 mRNA in the nuclear and I-?B mRNA in the cytosol extracts were analyzed by Western blotting,after co-incubation for 3 h and the content of p65 protein were observed by RT-PCR.PMN apoptosis was detected on flow cytometry after co-incubation 12 h and 24 h.RESULTS:The expression of NF-?B mRNA was significantly decreased and the expression of I-?B mRNA was markedly increased in lidocaine groups(P

Objective To evaluate the dynamic MR imaging findings of peripheral cholangiocarcinoma (PCC) of the liver. Methods Seventeen patients with PCC underwent dynamic MRI during the early, middle, and delayed phase after contrast medium administration. Enhancement pattern of the tumor, the wedge-like enhancement area peripheral to the tumor, dilatation of the intrahepatic biliary ducts, vascular involvement, and extrahepatic tumor invasion were evaluated. Results Early peripheral enhancement with progressive and concentric filling by contrast medium was the most frequent enhancement pattern (9 patients). A wedge-like enhancement area was observed in 10 patients. Ductal dilatation was found in 11 patients. Vascular involvement and extrahepatic invasion were seen in 8 and 2 patients, respectively. Conclusion Enhancement pattern is relative to the character of pathology (quantity and distribution of cell and fibrosis). Early peripheral enhancement with progressive and concentric filling by contrast medium may be specific for PCC.

Background and purpose:Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions.Methods:There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate:ΔT/N. ROC was used to ifnd out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging.Results:The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, speciifcity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, speciifcity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold ofΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, speciifcity and accuracy were 88.5%, 71.4% and 86.2%, respectively.Conclusion:Dual-phase18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and speciifcity. However it still has false positivity, and should be analyzed with CT and clinical history.

Adolescent ; Adult ; Catheterization, Central Venous ; instrumentation ; Device Removal ; Humans ; Male ; Vena Cava, Inferior ; Vena Cava, Superior

BACKGROUND: The total knee replacement is considered as one of the most effective and successful operations to cure terminal or severe gonarthritis. How to lower the revision rate as well as increace the effect of prostheses after the knee replacement should be solved urgently.OBJECTIVE: To retrospectively analyse the clinical applications and curative effects of different knee prostheses.DESIGN: Based on patients who accepted knee replacement, preoperative and postoperative condition was observed and compared so as to compare the postoperative effect of different types of knee prostheses replacements.SETTING: Department of Orthopedics, General Hospital of Chinese PLA.PARTICIPANTS: A total of 398 patients (523 knees) were selected from the Department of Orthopedics, General Hospital of Chinese PLA from January 2002 to January 2005, including 276 unilateral knee replacements (276 knees) and 122 bilateral knee replacements (244 knees). Patients were respectively diagnosed as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), pigmented villonodular synovitis (PVNS), etc.METHODS: According to the pathogenetic condition, patients received total knee replacements with different knee prostheses. Types of knee prostheses: ① According to the replacing range, it could be divided into unicondylar prostheses and total condylar prostheses; total condylar prostheses could be subdivided into posterior cruciate ligament (PCL)-retaining and PCL-substituting prostheses. ②According to the degree of mechanical constraint, it could be divided into unconstrained, semiconstrained or fully constrained prostheses. ③ According to whether imitating meniscus-function, it could be divided into tibial plateau rotatable sliding type and fixed type. Follow-up was conducted on patients that mentioned above after half a year. Knee joints were scored by using knee joint scoring system of American special surgical hospital (HSS scoring with the total score of 100 points, those above 85 were considered as excellent; 70-84 as good;60-69 as fair; below 60 as poor). Feller scoring (total score of 30 points; the higher the points were, the better the symptom was) criteria was used in patellar scoring. Investigation and comparison on pain-degree of anterior region of knee,range of motion of knee joint and the stabilization were done during the follow-up, ap and lateral views of patella from 30 degrees and 90 degrees were taken in radiography.MAIN OUTCOME MEASURES: Preoperative and postoperative scores of HSS, patella, anterior pain of knee, function of patella, the maximum flexion and tibiofemoral angle.RESULTS: Follow-up was conducted in 372 patients (490 knees) with the follow-up rate of 93.4%. ①Therapeutic effect:Excellent and good rate of the operation was 89%. Pain and function of patients after operation were obviously ameliorated, effect on pain-amelioration and range of motion of knee joint activation were significant. ② Score of HSS, patellar,anterior pain of knee, function of patellar and the maximum flexion were markedly increased than those before operation (P ＜ 0.01). ③ There were no marked significances in comparison of score of HSS, patellar, anterior pain of knee, function of patellar, the maximum flexion and tibiofemoral angle on different knee prostheses replacements (P ＞ 0.05).CONCLUTION: Prostheses should be chosen carefully and appropriately according to the indications, contraindications,anticipated attainable functions, service life as well as pathogenetic conditions, and then satisfactory curative effect will accordingly be achieved.

Doctor-patient trust plays an important role in doctor-patient knowledge transfer.Investigating the basic features and trust performance of the patients, the authors classified by means of a cluster analysis, the patients into four groups with such criteria as the trust on hospital, trust on doctors, patient's awareness of the knowledge, and patient's compliance to the doctor's advice. The four groups are rational and suspicious, passive compliance, high self-confidence, and blind trust groups. In view of behavioral characteristics of the patients, different doctor-patient knowledge transfer strategies are suggested, in an effort to perform effective doctor-patient communication and to gain patient's trust.

Objective To study the effects of ETP-508,a novel endothelin receptor antagonist,on the proliferation of pulmonary arterial smooth muscle cells(PASMCs) of rat cultured in hypoxia environment.Methods Primary culture of rat PASMCs was prepared by the method of tissue block anchorage,and they were assigned into four groups: normoxia group(21% O2),hypoxia group(2% O2),hypoxia+BQ-485 group(10-6,10-7,10-8,10-9mol/L) and hypoxia + ETP-508 group(10-6,10-7,10-8,10-9mol/L).MTT(492nm) assay was used to detect the A value of the four groups after cells were cultured for 24,48 and 72h.Flow cytometry and radioimmunoassay were respectively used to detect the cell cycle and ET-1 content at 48h time point.Results MTT assay demonstrated that A value of each group did not significantly differ at 24h time point.At 28h time point,A value of hypoxia group was markedly increased(P

Objective Due to the incompleteness and complexity of fault diagnosis for power transformers, a comprehensive rough-fuzzy scheme for solving fault diagnosis problems is presented. Fuzzy set theory is used both for representation of incipient faults' indications and producing a fuzzy granulation of the feature space. Rough set theory is used to obtain dependency rules that model indicative regions in the granulated feature space. The fuzzy membership functions corresponding to the indicative regions, modelled by rules, are stored as cases. Results Diagnostic conclusions are made using a similarity measure based on these membership functions. Each case involves only a reduced number of relevant features making this scheme suitable for fault diagnosis. Conclusion Superiority of this method in terms of classification accuracy and case generation is demonstrated.

Doctor-Patient knowledge transfer plays an important role in clinical service.In an evidence-based investigation on their basic features and preference,patients investigated fall into six categories according four influence factors.These factors comprise,set as the criteria,information preference,decision-making preference,perceived severity of disease and influence of reference group.The six groups are the contradiction group,reactive group,ego group,decision preference group,total equality group,and positive group.Doctor-Patient knowledge transfer stategiea are suggested based on the preference features of the six groups.These strategies serve as references and paramedics for doctors to perform effective doctor-patient communication.