Objective To investigate the ECG atypical changes in acute myocardial infarction(AMI). Meth-ods 352 patients with AMI were selected sequentially and examined by electrocardiogram(ECG) ,Holter of 24h,my-ocardial enzymes testing and coronary angiography, and electrocardio-monitoring was performed at the same time. Data were analyzed by statistics. Results The incidence of ECG atypical changes in patients with AMI was 14. 5%. The ECG atypical changes including Q wavelet with the elevation value of ST segment, the delays of Q wave and the only changes of ST-T. Conclusion The above several kind of ECG performane are present in atypical AMI.

Objective:To explore the influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study.Methods:Tirty-seven breast cancer patients underwent echocardiography at baseline before chemotherapy (T0) and after the second (T2), fourth (T4), sixth (T6) chemotheraphy cycles in Qilu Hospital of Shandong University from March 2017 to March 2018. According to different guidelines[ASE lower limit of normal left ventricular ejection fraction(LVEF-LLN) 53%, ESC LVEF-LLN 50% and the WASE study (Women LVEF-LLN 58%, Asian Women LVEF-LLN 59%)], the number of patients with myocardial injury during chemotherapy was evaluated, and compared with the global longitudinal strain(GLS) standard, the percentages of patients with myocardial injury in different standards were analyzed.Results:With the up-regulation of LVEF-LLN, more patients with early myocardial damage were found. During chemotherapy, 1 patient showed left ventricular ejection fraction (LVEF) fell by >10% from baseline to LVEF<50% (2016 ESC Guidelines), 3 patients showed LVEF fell by >10% from baseline to LVEF<53% (2014 ASE Guidelines), 7 patients for LVEF fell by >10% from baseline to LCVEF<58%, and 9 patients for LVEF fell by >10% from baseline to LVEF<59%, which was still less than the number of patients detected by GLS criteria (18 patients), but the sensitivity of LVEF fell of >10% from baseline to LVEF<59% was not statistically different from GLS standard ( P>0.05). Conclusions:With the up-regulation of LVEF-LLN, the sensitivity of LVEF in evaluating early myocardial damage was increased, but GLS was still the most sensitive index to monitor the cancer therapeutics-related myocardial damage.

Objective The questionaires of the ONFH aegers who were hospitalized in Kanggu hospital,during 2005-2008 ,were collect-ed to evaluate the therapeutic effects of acupotomy by proper statistical methods. Methods Four indexes according to the criteria of Therapeutic effect of adult ONFH recovery and reconstruction (ZHAO Dewei, 1996) were measured to evaluate the effect of the treatment. Results Monofac-torial analysis showed that the treatrnent was effective,but some phenomena could not be correctly explined in specialized field. This problem was re-solved appropriately by structural equation model(SEM). Conclusion By the method of SEM, the confounding factors could be better controlled and the evaluation was more reliable.

Humans ; Podocytes ; physiology ; Proteinuria ; physiopathology

0.05).The annual incidence of haemorrahagia was 0.49% in the low intensity group compared with 3.74% in the standard intensity group,and there was significant difference (P

Objective To study the clinical effect of SCOFIX on thoracolumbar fracture.Methods The clinical data of twenty-five cases with thoracolumbar fracture treated with SCOFIX system were retrospectively anal- ysed.Results With six to twenty-two months follow-up,anterior height of compressed vertebral bodies was restored from 46.8 %(12%～60%)preoperatively to 92%(90%～100%)postoperatively,and that of posterior height was from 77.5%(26%～86%)to 96.7%(90%～100%).Cobb's angle was from 15.7?(12?～26?)preoperatively to 1.4?(0?～6?)postoperatively.Conclusion SCOFIX system was simple structured,easily used and strongly fixed, and it was a good system in spinal internal fixation and for deeply reseach.

Objective To study the possibility of establishment of an animal model of hydronephrosis by ureteropelvic junction obstruction,and to evaluate the value of CT perfusion imaging in assessment of the renal function in the animal models. Method Fifty 10-week-old male New Zealand rabbits were randomly assigned to two groups:sham-operated group with separation of the left ureter (20 rabbits),and model group (30 rabbits) with the left ureter embedded at the ureteropelvic junction under the psoas major muscle. The left kidney function in the two groups was confirmed to be normal by SPECT before operation. CT perfusion and SPECT imagings were performed to assess the left kidney function in the two groups at three months after surgery,and the results were compared with that of pathological examination. Statistical analysis was performed on the parameters of SPECT and CT perfusion imaging and glomerular filtration rate (GFR). Results The success rate of model establishment was 70%,showing pathological changes of chronic hydronephrosis. CT perfusion demonstrated that BF,BV,PS of the left renal cortex and medulla were decreased,and had a good positive correlation with the changes of GFR. Conclusions It is feasible to establish a rabbit model of chronic hydronephrosis by embedding the left ureter at ureteropelvic junction under the psoas major muscle,and CT perfusion imaging parameters can be used to evaluate the renal function in the animal models.

OBJECTIVETo analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes.

METHODSAmong 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS).

RESULTSAll the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries.

CONCLUSIONAnkle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.

Adolescent ; Adult ; Ankle Fractures ; False Negative Reactions ; Female ; Fractures, Bone ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Pronation ; Rotation ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective To study the clinical features of aged patients with sudden cardiac death(SCD) for improving the resuscitation rate. Methods Hie usual etiology of SCD,electrocardiogram(ECG),echocardiography, dynamic electrocardiography(DCG), X-ray and electrolytes were analyzed. Results Most sudden death had inducement. Electrolytes disorder,ventricular ectopic beats,high grade atrioventricular block, auxocardia, left ventricular hypertrophy, cardiac insufficiency and myocardial ischemia could cause serious arrhythmias (.all P <0.05). Conclusion It could be related to heart functional class,left ventricular enlargement,myocardial ischemia,hypokalemia in aged patients with SCD.

Objective To investigate the possible pathogenesis of type 2 diabetes mellitus (T2DM) combined with Alzheimer's disease (AD). Methods Wistar rats were randomly divided into control, T2DM, AD and T2DM +AD groups. The blood glucose levels were assayed, and the behavior changes were tested by Morris water maze. The glycogen synthase kinase-3β (GSK-3β) and hyperphosphorylation of tau protein were detected by immunohistochemistry staining. Results Compared with the control rats, the learning and memory abilities were weakened significantly in the model rats (F=28. 65, P<0.001). The expression of GSK-3β was higher in T2DM + AD group (4319. 02±653. 24) than in AD group (304. 39 ± 175. 83), T2DM group (540.43 ± 558.49) and control group (315. 56 ± 91. 64, H=19. 335, all P<0. 01). The level of hyperphosphorylation of tau protein was significantly increased in T2DM + AD group (8583. 81 ± 2236. 11) and AD group (2799. 61±1070. 02) than in control group (252. 02 ± 58. 37) and T2DM group (287. 75 ± 192. 53, H=32. 950, P< 0.001). There was no significantly difference of hyperphosphorylation of tau between T2DM group and control group (H = 32. 950, P>0. 05). Conclusions The increasing of GSK-3β activity in T2DM may be caused by hyperphosphorylation of tau.