Objective To explore the efficacy of endoscopic electric cutters in the treatment of adenoidal hypertrophy .Methods 36 patients who underwent adenoidectomy treatment of adenoid hypertrophy were divided into the observation group and control group according to the random number table .The observation group was taken endo-scopic electric cutters treatment , the control group was taken traditional adenoid removal treatment .The therapeutic effect of the two groups was compared .Results In the observation group,the total time required for removal of the adenoids was (10.65 ±2.38)min,blood loss was (28.82 ±0.98)mL,compared with the control group,there were significant differences(t=25.93,31.79,χ2 =3.92,all P<0.05).In the observation group,there was 1 case had severe pain,but in the control group,there were 9 cases,the difference was significant (χ2 =8.86,P<0.05).In the observation group,the total effective rate was 94.45%,which was significantly higher than 55.55% in the control group(χ2 =7.26,P<0.05).Conclusion Compared to the traditional treatment of adenoid surgery ,electric cutters endoscopic treatment can significantly reduce adenoidal hypertrophy blood loss and the incidence rate of complication , improve patients'pain and clinical outcomes ,it is worth clinically further promotion .

Objective To eveluate the result of the use of prosthetic disc nucleus (PDN) for treatment of degenerative disc diseases in the lumbar spine. Methods Twenty-two patients with degenerative disc diseases were treated with PDN replacement after the removal of the degenerated intervertebral disc. Results The patients were followed-up for an average 12 months (4-18 months). Both lumbago and leg pain disappeared in all the 22 patients who resumed their work and normal life one month after the operation. PDN translocation was found in 2 out of 10 patients in the early period, but no PDN translocation was found in the remaining 12 patients in the later period. Conclusion PDN could restore disc height and flexibility after nucleotomy. Artificial nucleus replacement was a good option for the treatment of degenerative lumbar disc disease.

Objective To investigate the radiation dose differences of DTS,DR and CT in diagnostic imaging of the skeletal system and analyze the sensitivity and specificity of each modality in skeletal disease diagnosis.Methods 100 relevant patients with skeletal diseases were randomly selected,who were performed with DR,DTS and CT from Feb 2010 to Mar 2012.They were divided into three groups,respectively as the DR group,the DTS group and the CT group.The complete information including DR,DTS,CT data and the final clinical diagnosis were collected and the statistical analysis after comparing radiation dose of DR,DTS and CT examination.Two experienced experts evaluated the image of three examinations and made judgments.ROC curves of reader A and B were made by using the final clinical diagnosis as gold standard.Results The average absorbed dose and effective dose of DR,DTS,CT group were [(1.9±1.8)mGy,(0.03±0.03) mSv)],[(3.5±1.5)mGy,(0.05±0.02) mSv)],[(397.7 ± 106.0) mGy· cm、(5.60 ± 1.50) mSy] respectively.The difference among the three groups was analyzed by one-way ANOVA test(F =1377,P ＜ 0.05) and had statistically significant(P ＜ 0.05).ROC curve was drawn through analyzing lesion detection credibility of three groups.The Az values of reader A and B was (0.870 ± 0.035,0.966 ± 0.018,0.974 ± 0.015) and (0.852 ± 0.038,0.951 ± 0.021,0.959 ±0.019)respectively.Do the Z-test to these examinations' area under ROC curve of lesion detection credibility.Between DR and DTS or DR and CT,there was statistically significant(P ＜ 0.05).While for CT and DTS,there was not statistically significant.The two readers' sensitivity and specificity in diagnosing skeletal lesion with DR,DTS and CT were investigated using the x2 test:CT and DTS were no statistical significance,CT and DR were statistically significant (x2 =4.833,P ＜ 0.05).Conclusions Radiation dose of DTS only accounts for about 1％ of CT examination.While its sensitivity and specificity can meet the requirements for clinical diagnosis as CT.If the DR diagnosis is unclear or suspected,DTS should be the first recommended modality used for skeletal diagnosis with lower radiation dose.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective To know prevalence of depression, its coping strategies and risk factors among infertile women with in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection. Methods Infertile women with IVF-ET were interviewed with center for epidemiologic studies short depression scale (CES-D10) and an abbreviated version of the COPE inventory (brief COPE), and their basal sex hormone values and estradiol ( E2 ) on the day of human chorionic gonadotropin (HCG) administration were monitored, as well as the number of oocytes yielded was counted. Results Prevalence of depression was 20.6% in infertile women, higher in those with more than eight years of marriage, infertility for more than six years, and receiving treatment for at least three years. Risk of depression among the women of infertility with monthly family income less than 3000 yuan was 14 times as those with more than 3000 yuan and risk of depression among them due to the factors of their husbands was 2/5 as those not due to men's. Depressive symptoms in the women increased with increasing of their basal follicle stimulating hormone (FSH) level, counted egg number and scores of denial items. Occurrence of their depressive symptoms decreased with higher basal E2 levels, and scores of substance use and humor. Conclusions Some infertile women with IVF-ET do have depression and preventive intervention should be aimed at related factors for depression to improve their psychological health.

BACKGROUND: Scholars disagree with each other about the small saphenous vein effects on skin flap and how to dispose vascular proximal pedicles.OBJECTIVE: To analyze effects of different methods of the small saphenous vein disposal on flap survival using sural neurocutaneous island flap retrograde metastasis for repairing defects of soft tissue of instep, heelstick and ankle.DESIGN, TIME AND SETTING: The case control observation experiment was performed at the General Hospital of Guangzhou Military Area Command of Chinese PLA from March 1998 to April 2007.PARTICIPANTS: A total of 56 patients with defects of soft tissue of instep, heelstick and ankle were divided into 2 groups,small sapbenous vein deligation in proximal pedicle flap group (group A) (n=38), and proximal small saphenous vein and great saphenous vein or tributaries at recipient site anastomosis flap group (group B) (n=18).METHODS: During sural neurocutaneous island flap retrograde metastasis for repair,(3.5×4.0)cm-(4.0×4.5) cm flap was obtained in 35 cases, and (4.0×4.5) cm -(10.0×12.0) cm in 21 cases.MAIN OUTCOME MEASURES: Outcome of flap survival at different incision area and implanted methods.RESULTS: No vein articulo occurred in 21 cases, which flap areas were (4.0×4.5) cm -(10.0×12.0) cm. Five of 35 cases which flap areas were (3.5×4.0) cm -(4.0×4.5) cm developed vein articulo.The necrotic rate of flaps in group B was significantly lower compared to the group A (P=0.017 67).CONCLUSION: When the area of skin flap is smaller than (4.0×4.5) cm, the proximal end of the small saphenous vein should be anastomosed with the great saphenous vein or tributaries connecting with the great saphenous vein at recipient site.The small saphenous vein is not a superficial vein, which only cross the skin flap, but it has trophic action on the skin flap.

Objective:To find out the apoptosis mechanism of HT-29 colon cancer cell induced by NDGA,the lipoxygenase inhibitor in vitro.Methods:We applied respectively:RT-PCR to detect colon cancer cell’s expression of 5-LOX messenger ribonucleic acid(5-LOXmRNA) and that of messenger ribonucleic acid about human telomerase reverse transcriptase(hTERTmRNA)respectively,confocal laser scanning electron microscope to examine intracellular free calcium.Results:Colon cancer cell lines HT-29 showed positive expression of 5-LOXmRNA.This expression became weaker following the rise of cell’s apoptosis and so were hTERTmRNA.Intracellular Free calcium increased following the rise of cell’s apoptosis.Conclusion:The apoptosis of tumor cell is caused by a combination of factors,with 5-LOX,telomerase and free calcium all active in the course.

Objective To probe the feasibility of gemstone spectral CT in imaging pulmonary angiography with low dose contrast medium.Methods A prospective study with multi-slice spiral CT pulmonary angiography was performed in consecutive 48 patients suspected with pulmonary embolism.Two groups (n=24 respectively)were divided at random including Group A used Gemstone spectral CT with 35 mL of contrast medium and Group B using 64-slice CT with conventional 80~90 mL of contrast medium.The CT values of the pulmonary trunk,lobe artery,pulmonary vein and ascending aorta were measured.The contrast to noise ratio of the pulmonary artery was also calculated.In addition,the image quality of CTA was evaluated independently by two experienced ra-diologists.Results The CT values of the pulmonary trunk and the subsegmental branches,and the CNR in Group A were signifi-cantly higher than those in group B,exhibiting statistical differences (t=8.6,P <0.001;t=12.2,P <0.001;t=1 1.3,P <0.001 respectively).However,the CT value of aorta in Group A was significantly lower than that in Group B (t=-7.6,P <0.001).The evaluation results of the CTA images by two radiologists showed that the image quality in Group A was better than that in Group B (Z =-8.6,P <0.001;Z =-9.0,P <0.001 ).Conclusion The image quality of pulmonary angiography with gemstone spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.

Objective To analyze the effect of the rhinoplasty on body image in the patients receiving cosmetic surgery,to investigate the change of postoperative body image disturbance(BDD)and to analyze the influencing factors of preoperative BDD in order to provide a basis for the psychological health management and reference for the diagnosis and treatment of plastic surgery.Methods A prospective study was performed on 84 patients with rhinoplasty admitted to the Affiliated Friendship Aesthetic Plastic Surgery Hospital of Nanjing Medical University from January 2015 to March 2016.The general data were investigated.The Plastic Psychological State Self-rating Scale was adopted to evaluate the patient′s body image situation,which was reexamined at postoperative 1-3 months.Results The preoperative non-BDD accounted for 60.71％,the occurrence rate of BDD was 19.05％,the other mental disorders,mental diseases or nervous system disease which had no relation with the BDD accounted for 20.24％;the occurrence rate of postoperative BDD was significantly lower than that of preoperative BDD(P＜0.05),moreover the patients with non-BDD had no postoperative BDD occurrence.The scores of question 1-10 before operation in the BDD group were higher than those in the non-BDD group,the scores of question 1-4 after operation in the non-BDD group were decreased,the scores of question 1-4,6-10 in the BDD group were decreased,while the scores of question 1,7,9-10 in the BDD group were higher than those in the non-BDD group(P＜0.05).The proportion of preoperative rhinoplasty and plastic surgery in the BDD group was higher than that in the non-BDD group,the difference was statistically significant(P＜0.05).Conclusion The occurrence rate of BDD in the patients with rhinoplasty is higher,operation is conducive to lessen the BDD,moreover operation itself will not result in new BDD.

Purpose To implement lower artery angiography in patients with peripheral arterial occlusive disease, and to investigate the feasibility of lower extremity gemstone spectral CT angiography in improving image quality.Materials and Methods Forty-eight patients suspected with lower extremity arterial occlusive diseases were randomly divided into research group and control group. Research group (24 cases) were carried out gemstone spectral CT angiography (CTA) scan and control group (24 cases) were scanned with multi-slice spiral CT (CTA). The CT value of the common iliac artery, popliteal artery and its branches was measured and contrast to noise ratio (CNR) were calculated in both groups. The images were evaluated independently by 2 senior physicians based on a 5-level evaluation standard.Results The CT value of common iliac artery, popliteal artery, anterior tibial artery and the CNR in research group were all higher than those in control group (t=8.7, 7.9, 12.6 and 17.2,P<0.01), but the background noise was lower than that in control group (t=1.5,P<0.01). The scores of two image quality accessed by physician 1 and 2 were 110:90 and 111:93 respectively with statistical difference (Z=-7.6 and-8.0, P<0.01).Conclusion The image obtained by gemstone spectral CT optimal single energy image technique is much better than that by conventional multi-slice spiral CT in lower extremity angiography.