Objective To investigate the effects of hyperbaric oxygenation(HBO)therapy on serum cytokines and depression in post-stroke depression(PSD)and to study it's clinical implications.Methods Sixty patients with PSD were divided into two groups.Patients in routine treatment group(RT group)were treated with routine clinical treatment,whereas those in HBO group were treated with HBO therapy in addition to routine clinical treatment.The serum cytokines of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were measured by enzyme-linked immunosorbent assay(ELISA)before and after 30 days of treatment.All the patients were evaluated with Hamilton depression scale(HAMD),Chinese stroke scale(CSS)and Barthel index(BI).The evaluations were carried out at the 0 and 30 d.Results Before treatment,the concentrations of TNF-α and IL-1β in patients with PSD were significantly higher than those in patients with cerebral infarction without depression(P＜0.01),and the serum levels of TNF-α and IL-1β in those with serious depression were higher than those with moderate and mild depression(P＜0.01),and that in moderate depression patients were higher than that in mild depression patients{P＜0.01).At the 30th d post-treatment,those parameters all decreased significantly in RT group and HBO group(P＜0.01,P＜0.05).Moreover,those parameters were lower in HBO group than those in RT group(P＜0.01),and HAMD,CSS and BI scores in HBO group were significantly better than that in RT group(P＜0.05,P＜0.01).Conclusions Serum cytokines levels increased significantly in patients with PSD and were associated with the severity of depression.Serum cytokines might played an important role in pathogenesis of PSD.HBO therapy could help decrease the levels of TNF-α and IL-1β.HBO might exert therapeutic effect by reducing secondary the inflammatory injury in acute cerebral infarction.

In multilayer spiral CT heart and coronary artery imaging, image data are acquired by ECG gating technology when heart beats slowest so as to restrain pulsation pseudo-image. ECG gating technology includes foresight ECG gating and retrospective ECG gating. The principle, methods and mutual image reconstruction are introduced in this paper.

Objective To evaluate the clinical value of ulinastatin on the treatment of systemic inflammatory response syndrome in severe acute panereatitis. Method Eighty-four patients with severe a-cute pancreatitis were randomly divided into two groups. In the treatment group (42 cases),on the base of routine treatment, ulinastatin was administered intravenously for seven days after hospitalization, while in the control group only routine treatment was given (42 cases) to. Inflammatory factors in serum, the change of liver function and renal function were measured in two groups before and after the treatment, and the clinical efficacy were observed. Results There was significant difference, in the serum level of tumor necrosis factor-α, interleukin-1, interleukin-6, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and creatinine on the 7th day between two groups (P < 0.05 or < 0.01 ) ,there were significant differences in the incidence of complications, hospitalization time, incidence of multi-organ failure between two groups [14.3%(6/42) vs 38.1%(16/42), (29.4 ± 1.5)d vs (34.4 ± 1.8)d, 28.6%(12/42) vs 47.6%(20/42), P<0.01 or <0.05 ]. Conclusions Ulinastatin can suppress the secretion and release of some inflammatory factors, protect the important viscera functions and reduce the incidence of complications, and it has favorable clinical efficacy.

The construction of 64-slice-dual-source computed tomography(DSCT) is introduced.Its imaging principle and clinical application are put forward.DSCT has special advantages in diagnosing coronary stricture.The principles of DSCT and energy subtraction imaging are expatiated in detail.DSCT has great value in clinical research and application.

Objective To study the effect of image quality and radiation dose by using Z -axis automatic tube current modulation(ATCM),as well as the application of automatic tube current modulation technology.Methods A control group consisting of 25 patients underwent cervical MDCT with fixed-current technique(100-220mA).Of two study groups of 25 patients,one underwent cervical MDCT using z-axis ATCM with the noise index of NI10 and tube current intensity of 80-480 mA,and the other with the noise index of NI12.5 and tube current intensity of 80-369 mA.The noise and mean tube current-time products(mAs) were recorded.Two radiologists evaluated images for diagnostic acceptability.Results All CT examinations of study and control groups were diagnostically acceptable,though objective noise was different with z-axis ATCM than with fixed current.ATCM resulted in significant radiation dose reduction(NI10,94.8?17.9 mAs;NI12.5,74.8? 18.3 mAs),when compared with the fixed current(130.4?43.1 mAs).Conclusion Z-axis Automatic mA technique has no significant change in image quality when compared with the fixed mA technique,but the radiation dose is decreased by 27%(NI10) and 43%(NI12.5),for MDCT evaluation of neck.NI has to be selected on the basis of the tissue,lesion size and nature.

Objective To study the risk factors of periventricular-intraventricular hemorrhage (PIVH) in extremely low birth weight infants(ELBWI). Methods A retrospective study was performed in 41 ELBWI hospitalized between January 2001 and August 2008. Univariate analysis and Logistic regression analysis were performed to detect the risk factors of PIVH. Results Of 41ELBWI, twenty-three suffered from PIVH with the incidence of 56.1%. Univariate analysis revealed that,in PIVH group,gestational age,mean blood pressure and the minimum values of blood pressure were lower than non-PIVH group[ ( 27.1 ± 1.9 ) weeks vs ( 28. 7 ± 1.6) weeks, t = 2. 834, P ＜ 0. 05 ;(28.9±4.8) mm Hg vs (33.1±4.9) mm Hg, t=-2.747,P＜0. 05; (24.4±4.3) mm Hg vs (31.4 ± 6.6) mm Hg,t= -3. 863, P＜0. 05], while blood pressure fluctuation and the highest values of PaCO2 during the first week of life were higher[(19.0 ± 5.2) mm Hg vs (13.7 ± 4. 8) mm Hg;(60. 2± 19. 4) mm Hg vs (49.5±12.1) mm Hg] (t= 3. 310 and 2. 166, P＜0. 05), the incidence of administration of pulmonary surfactant, neonatal respiratory distress syndrome, shock, hypotension before 4 days of age, hyperglycemia and mechanical ventilation therapy were higher[73. 9 % (17/23) vs 27. 8%(5/18), 60. 9%(14/23) vs 27.8%(5/18),52. 2%(12/23) vs 5.5%(1/18),73. 9%(17/23) vs 33.3%(6/18) ,78. 3%(18/23) vs 44. 5%(8/18),87. 0% (20/23) vs 44. 5% (8/18)]( all P＜0.05).Multivariate Logistic analysis revealed that blood pressure fluctuation (OR = 1. 260, 95% CI: 1. 009-1. 572, P = 0. 041 ) and lowest mean blood pressure(OR = 0. 805,95 % CI: 0. 672-0. 965, P = 0. 019)were risk factors of PIVH. Among twenty-eight ELBWI received mechanical ventilation, only peakinspiratory pressure(OR=- 2. 086,95% CI: 1. 140-3. 819, P= 0. 017) was the risk factor of PIVH by Logistic analysis. Conclusions Low blood pressure and blood pressure fluctuation may be risk factors of PIVH in ELBWI. The high values of peak inspiratory pressure is a risk factor of ELBWI with mechanical ventilation.

Objective To evaluate the radiation dose and image quality of MinDose techniques in dual-source CT coronary artery angiography.Methods 120 consecutive patients undergoing cardiac CT scans were randomly assigned into 2 groups: Group A1 with the tube current reduced to 20% of the normal tube current outside the pulsing window,and Group A2 with the tube current reduced to 4% of the normal tube current outside the pulsing window (MinDose).The image quality,noise,volume CT dose index (CTDIvol),and effective dose (E) of these two groups were evaluated.Results The mean score of imaging quality of Group A1 was (4.3 ± 0.3 ),not significantly different from that of Group A2 [(4.5 ±0.4),t=0.16,P＞0.05].The value of CTDIvol of Group A1 was (40.2 ±9.6) mGy,significantly higher than that of Group A2 [( 36.4 ± 9.1 ) mGy,t = 3.2,P ＜ 0.05].The E value of Group A1 was (9.1± 2.2) mSv ,significantly higher than that of A2 [( 8.1 ± 1.9) mSv,t = 2.7,P ＜ 0.05].Conclusion Application of the MinDose technique not only reduces the radiation dose to the patient,but also meets the requirement of diagnosis.

Objective To evaluate the effectiveness and safety of 25G illumination aided scleral buckling surgery for treatment of rhegrmatogenous retinal detachment (RRD).Methods This is a retrospective case control study.Fifty-seven RRD patients (57 eyes) were enrolled in this study.There were 35 males (35 eyes) and 22 females (22 eyes).The patients were randomly divided into ophthalmoscope group (29 patients,29 eyes) and illumination group (28 patients,28 eyes).There was no differences in the data of gender,age,onset time,logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity(BCVA) and information of retinal tears between the two groups (P＞0.050).The patients in the ophthalmoscope group received operation of conventional scleral buckling with binocular indirect ophthalmoscope.The patients in the illumination group received scleral buckling surgery with the aid of intraocular illumination and noncontact wide-angle viewing system.The follow-up was ranged from 6 to 12 months.The BCVA,intraocular pressure,fundus examination and complications were observed and recorded.Results The difference of operation time between two groups was significant (t=2.124,P=0.031).In the ophthalmoscope group,26 eyes (89.7％) achieved retinal reattachment,3 eyes (10.3％) failed in retinal reattachment.In the illumination group,26 eyes (92.8％) achieved retinal reattachment,2 eyes (7.2％) failed in retinal reattachment.There was no difference of retinal reattachment rate (P=I.000).Five eyes failed in retinal reattachment,3 eyes received sclera buckling surgery,2 eyes received vitrectomy with silicone oil tamponade.The final reattachment ratios were both 100％.BCVA increased in both groups compared with pre-surgery BCVA (t=4.529,5.108;P＜0.001).The difference of BCVA between two groups was not significant (t=0.559,P=0.458).There was no significant difference of intraocular pressure and complications before and after surgery in both two groups (t=-1.386,-1.437;P=0.163,0.149).The difference of intraocular pressure between two groups was not significant (t=0.277,P=0.730).Subretinal hemorrhage occurred in 1 eye in the ophthalmoscope group.There was no iatrogenic retinal break,choroidal hemorrhage and endophthalmitis in the two groups.Conclusion 25G intraocular illumination aided buckling surgery for treatment of RRD is fast,safe and effective.

Objective To study the scan parameter of spiral CT angiography in aortic dissection.Methods 34 cases with aortic dissection successively underwent SCTA were studied retrospectively.The CT scan parameters,methods of posteriorimage treating were reviewed and analysed one by one.Results In 34 cases,32 cases were diagnosed as aortic dissection and classified correctly,in accordance with the result of operation and DSA,the quality of image was satisfied and the rate of success at least above 88.9%.The use of main scan parameters:(1)the ascend aortic dissection:slice thickness 4 mm,reconstruction interval 2 mm,pitch 1.25;tube current 175 mA;(2)involed in ascend,arch,descend and throacic aorta dissection:slice thickness 5 mm,reconstruction interval 2～3 mm,pitch 1.5;tube current 150 mA;(3)involved in abdominal aortic dissection:slice thickness 6～8 mm,reconstruction interval 2～3 mm,pitch 1.5 or 1.75;tube current 125 mA.The tube voltage all were 120 kV,the dosage of contrast media was 90～100 ml;the delayed scan time was choiced 20 second in throacic aortic and 25 second in abdominal aortic.The posterior image methods main used MPR,SSD,MIP and VR. Conclusion To set a sensible scaning plan,choose and match scan parameters properly according to the scaning length,can avoid the shortage of restrain SCTA scaning length and get satisfied image.

Objective To investigate the percentage of CD5-positive B cells in peripheral blood mononuclear cells(PBMC) of patients with chronic HCV infection and its clinical significance.Methods The expression of CD5 molecule on B cell surface was detected by flow cytometry and HCV RNA copies were detected by real-time PCR.Results The percentage of CD5+-B cells significantly increased in the patients with chronic HCV infection(58.4%?9.8%) compared with healthy controls(22.5%?5.9%)(P