Objective To evaluate the efficacy of comprehensive rehabilitation on cervical syndrome(CS).Methods 112 patients with CS were randomly divided into two groups.The cases in comprehensive rehabilitation group(n=56) were treated with traction,ultrashort wave and massage,while those in the control group(n=56) were treated with traction only.Results The efficient rate of comprehensive group were 91.1% 3 weeks after treatment,and the symptom scores improved significantly compared with the control group(P<0.01).Conclusion The comprehensive rehabilitation is efficient on cervical syndrome with few side-effects and complication.

Objective:To explore the clinical value of dynamic posturography in the diagnosis of peripheral vertigo. Method:One hundred and sixty peripheral vertigo patients with full clinical documents in vertigo clinic of our hospital from May 2007 to May 2008 were retrospectively analyzed in this study. All the patients firstly underwent the inspection of static and dynamic posturography and then were subjected to caloric test using videonystagmogra-phy. The results were conducted a comparative analysis. Surface of the statokinesigram (SSKG) was selected as assessment parameter of static posturography. The result of sensory organization test (SOT) were selected as assessment parameters of dynamic posturography. The unilateral weakness was selected as assessment parameter of caloric test. Twenty normal subjects were selected as control. Result: Among the 160 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 144 cases, with a sensitivity of 90. 0%; caloric test was abnormal in 110 cases, with a sensitivity of 68. 8%; static posturography was abnormal in 76 cases, with a sensitivity of 47. 5%. There existed a statistically significant difference between dynamic posturography and caloric test or static posturography. There were 40 patients(25. 0%) who had normal caloric test results in which dynamic posturograph findings were abnormal. Among the 20 cases of normal people, results of SOT in dynamic posturography were abnormal in only one case(5. 0%). Conclusion:With its superior sensitivity and specificity, dynamic posturography has been an objective and reliable approach in the diagnosis of peripheral vertigo. It can help to confirm the presence of abnormalities in some peripheral vertigo patients whose caloric results are normal.

Objective To evaluate the diagnostic value of endoscopic ultrasonography-guided fineneedle aspiration(EUS-FNA)for pancreatic occupying lesion,especially pancreatic cancer.Methods From year of 2005,37 patients with suspected pancreatic cancer by means of uhrasound,CT or MRI received EUS-FNA.Amylase and tumor markers(CEA,CA19-9 and CA125)in cyst fluid were analyzed if applicable.The patients were followed up till July 2008,and the results of EUS-FNA were compared with those confirmed during the follow-up.Results The EUS-FNA yielded diagnosis of 16 cases of pancreatic duetal adenocarcinoma,1 metastatic:renal cancer,5 suspicious malignancy,6 atypia,6 normal pancreatic tissue,and 3 normal non-pancreatic tissue.During the follow-up,25 cases of pancreatic cancer and 10 benigh lesions,including 4 chronic panereatitis,4 cyst-adenoma and 2 pseudocyst,were confirmed,and the other 2 cases still remained un-determined.The sensitivity,specificity,positive predictive value and negative predictive value of EUS-FNA were 80.0%(95% CI:59.0-93.0),100.0%(95% CI:60.0-100.0),100.0%(95% CI:80.0-100.0),and 55.6%(95% CI:27.0-79.0),respectively.No severe procedurerelated complication was observed.Conclusion EUS-FNA is a safe and effective medality for diagnosis of pancreatic occupying lesions,especially pancreatic cancer.

OBJECTIVE To study the status of five pathogen mixed infection in sexually transmitted diseases(STDs) and analyze the clinical meaning.METHODS We detected five common pathogens by fluorescence polymerase chain reaction,which were Neisseria gonorrhoeae(NG),Chlamydia trachomatis(CT),Ureaplasma urealyticum(Uu),human papilloma virus(HPV),Candida albicans(Ca),and herpes simplex virus.RESULTS We analyzed the status of infection among 4 601 patients,got 279 mixed infection cases,accounted for 6.1% in all cases;and the population with ages from 21 to 40 years was accounted for 89.6%. CONCLUSIONS Fluorescence polymerase chain reaction is a simple,rapid,high sensibility technique for quantitation testing of STDs pathogens,and we should pay great heed to its effective control.

ObjectiveTo prospectively assess the efficacy and safety of endoscopic ultrasoundguided celiac plexus neurolysis (EUS-CPN) in the management of pain caused by pancreatic carcinoma.MethodsPatients with confirmed un-resectable pancreatic malignancy were treated with EUS-CPN once or twice.The data including age,gender,pain duration,opioid consumption,tumor location,pain scores before and after the procedure,number of treatment,duration of pain relief and survival time were collected.ResultsA total of 27 cases with cancerous abdominal pain were recruited.The median pain scores were significantly lower after EUS-CPN,and pain relief was obtained in 81.5％ (95％ CI,66.8％ -96.1％ ) patients with a median duration of 56.0 days (95％ CI,17.1-94.9),whose confidence interval was comparable to that of survival time (97.0 days,95 ％ CI,82.7-111.3 ).No clinical factors could predict post-procedure duration of pain relief (x2 =6.757,P =0.239).Procedure-related transient diarrhea and fever were noted only in 1 patient.No major complications occurred.ConclusionEUS-guided CPN is safe and effective in alleviating abdominal pain associated with pancreatic cancer,even at the late stage.Moreover,no clinical factor could predict post-procedure degree or duration of pain relief.

Objective To investigate the diagnostic value of intraductal ultrasonography (IDUS) and bile tumor marker in differential diagnosis of suspected biliary stricture.Methods A total of 57 patients with biliary stricture (8 benign strictures,49 cases of malignant strictures),who underwent IDUS and tests of serum and bile tumor markers (CA19-9 and CEA),were analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were compared among the outcomes of B-ultrasonography,CT,MRCP,IDUS,as well as IDUS combined with bile tumor markers.Results The specificity of the IDUS and the combined group were 63.6％ (7/11) and 77.8％ (7/9) respectively (P ＞ 0.05).The positive predictive value of the IDUS and the combined group were 91.8％ (45/49) and 95.9％ (47/49) respectively (P ＞0.05).The diagnostic accuracy of the IDUS and the combined group were 91.2％ (52/57) and 94.7％ (54/57) respectively (P ＞0.05).Data of the two groups were significantly higher than conventional imaging like B-ultrasound,CT and MRCP.The accuracy of IDUS combined with bile CEA for the diagnosis of distal bile duct cancer was 97.9％ (46/47),significantly higher than that of IDUS.Conclusion IDUS combined with biliary tumor markers is of high value for distinguishing the bile benign from malignant stricture.IDUS combined with biliary CEA test can improve the diagnostic accuracy of distal malignant biliary stricture diseases.

ObjectiveAfter intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.MethodsTwenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.ResultsThe gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P ＜ 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P ＜ 0.05 and t =2.638,P ＜ 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

Objective To investigate the efficacy and safety of vasopressin receptor antagonist tolvaptan for treating dilutional hyponatremia casused by decompensated liver cirrhosis.Methods Ninety-six subjects with decompensated liver cirrhosis complicated by dilutional hyponatremia were divided into test group (n =56) and control group (n =40) by double blind method.Test group were treated with a single dose of tolvaptan 15 mg orally in addition to routine therapy,while control group were treated with routine therapy plus placebo.The changes in serum sodium concentration,liver functions,ascites,and edema of lower extremities between the two groups were observed.Measurement data were compared by t test,and categorical data were compared by chisquare test.Results On day 7,36 (64.3％) patients in test group and 9 (22.5％) patients in control group reached normal serum sodium concentrations (x2 =5.241,P＜0.01).All the patients in test group and only 3 patients in control group had 24 hours' total urine volume above 3500 mL.Difference of 24 hours' total urine volume during 7-day treatment between the two groups was statistically significant (t=20.899,P＜0.01).Thirty-nine patients in test group and 15 patients in control group had reduced ascites (x2 =4.260,P=0.039),but improvement of edema in lower extremities of both groups was comparable (12 cases in test group and 7 cases in control group; x2 =0.227,P=0.634).Serum alanine aminotransferase (ALT),total bilirubin (TBil),potassium and creatinine levels of test group were improved after treatment,but were not significantly different from either baseline levels (t=1.509,0.783,1.107,1.237; both P＞0.05) or those of the control group (t=1.712,1.635,1.121,0.873; both P＞0.05).Conclusions Single dose of tolvaptan (15 mg) exerts a strong diuretic effect and is able to greatly increase serum sodium concentration,thus has distinct therapeutic effect for patients with decompensated liver cirrhosis complicated by dilutional hyponatremia.

Objective To evaluate the feasibility,safety and efficacy of ESD for precancerous lesions and early cancer of remnant stomach after partial gastrectomy.Methods ESD was performed in 11 cases of high grade intraepithelial neoplasia/early cancer of remnant stomach.The short-term and long-term indices including time of procedure,complication,En Bloc resection rate,R0resection rate,local recurrence rate as well as lymph node metastasis were recorded and analysed.Results ESD was completed in all patients with only one case of delayed massive bleeding which was controlled by endoscopy successfully.Average procedure time,En Bloc resection rate,R0 resection rate were 85.5 minutes,100％ and 90％,respectively.No local recurrence or lymph node metastasis was detected during post-ESD surveillance (15 ～ 51 months).Conclusion High grade intraepithelial neoplasia and early cancer of remnant stomach after partial gastrectomy might be indication for ESD because of its safety and definite effect.Additionally,careful management of the fibre tissue is the key to procedure success.

Objective To assess the value of pulmonary artery CT obstruction index for the evaluation of the severity of pulmonary embolism (PE),and to investigate the relation between pulmonary artery CT obstruction index and D-dimer levels.Methods 125 patients were diagnosed as PE by computed tomographic pulmonary angiography (CTPA)and D-dimer.Patients were separated into high-risk group and non-high risk group.CT obstruction index,D-dimer levels,diameter of the pulmonary artery were compared between two groups. Spearman’s rank correlation coefficients were used to assess the correlation between the CT obstruction index and the D-dimer levels,diameter of the pulmonary artery.Results CT congestion index of high-risk PE group was obviously higher than that of the non-high risk group (P=0.000).The diameter of pulmonary artery in high-risk PE group was obviously greater than that of the non-high risk group,the difference was statistically significant (P=0.000).No statistically significant difference was found in D-dimer levels between the two groups (P=0.103).There was no correction with CT congestion index and D-dimer levels(P=0.71).Conclusion The D-dimer levels of serum was a predictor of pulmonary embolism,cannot evaluate the severity of PE.CT obstruction index can reflect the severity of PE in some extent as an indicator of PE,there was no correlation with CT obstruction index and D-dimer levels.