The prosthesis fitting were discussed in this paper for 48 un-reoperation of 91 cases the non-ideal stump of the lower limb amputees hospitalized in the past six years. The author suggests that silicon socks,the supplementary hang band,a combinative use of the prosthesis and orthosis,adjustment aligment of the prosthesis provide a good method for prosthesis fitting of the non-ideal stump of the lower limbamputees. It was able to wearing a good prosthesis and bring the compensatory functions into full play.

Only by dressing the prosthesis can they play their compensatory functions for the amputees.The effectiveness of the compensatory is closely related to the condition of the stumps.Because of the complications,it is impossible to dress prosthesis to some stumps.This paper is a studying discussion on the rehabilitation of the non ideal stumps impairing prosthesis dressing,which of the 81 cases among the 164 amputees hospitalized in China Rehabilitation Research Center during the last 8 years.The paper advances the conception of the non ideal stumps impairing prosthesis dressing;the categories of non ideal stumps and their impairment to the prosthesis dressing and the principle and methods of the rehabilitation and the improvement of the making of the prosthesis and the method of the operations. To improve the conditions of the non ideal stumps,a good and comfortable prosthesis will be dressed.The compensatory functions will be satisfactorily played.

Objective To evaluate the methods and the factors of affecting imaging quality of 3D CE MRA of carotid arteries.Methods 3D CE MRA in 48 patients were performed using 1.5T super conductive MR scanner,cervical and lumbar combination phased array coils. All patients were examined using intravenous injection Gd-DTPA and breath-hold 3D FLASH sequence. Results Imaging quality was satisfied in 46/48 patients (96%). MIP and MPR could clearly showed normal anatomy. The site,size and stenosis degree of the lesion were also demonstrated. Compared to surgery,DSA and/or ultrasound results , in 23 patients, the sensitivity and specificity of 3D CE MRA were 100% and 100% respeectively for the lesion of carotid arteries. Conclusion High quality images of 3D CE MRA mainly depends on determining the best acquisition delay time,optimizing injection volume and rate of contrast material,using reasonable sequence parameters and skilled level of operators.

The prosthesis fitting and the rehabilitation are discussed in this paper for 6 cases double above knee amputees hospitalized in the past six years. The author suggest that the prosthesis fitting and rehabilitation training are different between double and single above knee amputees. This paper expounds particularly the structure of temporary stubbie with peculiarity of rocker feet; the distinct demand of double knee joint of permanent prosthesis with peculiarity of artificial feet;the use of permanent stubbie in daily living. The important of physical strength training, the standing balance training, the walking functional training, some relative functional movement training and on problem of the amputees sitting wheelchair backward fall with preventive measures has been emphasized.Keyworks:amputation; prosthesis; rehabilitation

Objective To prospectively evaluate the feasibility and reliablity of low kilovoltage contrast-enhanced multi-slice CT(MSCT)to detect the myocardial viability in chronic myocardial infarcetion.with comparison to magnetic resonance(MR)myocardial perfusion and viability imaging.Methods Thirty-two patients with clinical diagnosed chronic myocardial infarction underwent the first pass and delayenhanced myocardial imaging with 64-slice MSCT and MR Left ventricle was divided into 16 segments.MSCT and MR images of all the patients were blindly analyzed.The size and extent of hypoenhanced regions in first pass phase and hyperenhanced regions in delayed phase were define.The Kappa test was used to assess the ability of identifying the viable myocardium between the two methods.Results In 32 patients with chronic myocardial infarction,MSCT showed hypoenhanced regions in 41 segments and normal in 471 segments during the first phase,while MRI revealed hypoenhanced regions in 47 segments and normal regions in 465 segments.The Kappa value was 0.650 and the concordance rate of the two techniques was 94.5%(484/512).MSCT showed 135 hyperenhanced regions which were non-transmural in 50 segments and transmural in 85 segments.And the other 377 normal segments showed no enhancement in the delayed phase.MRI revealed 120 hyperenhanced regions which were non-transmural in 56 segments and transmural in 64 segments.And the other 392 normal segments showed no enhancement in the delayed phase.The Kappa value of the two techniques was 0.609 and the concordance rate of the two techniques was 80.7% (413/512).Conclusion The study showed that low kilovolrage CE MSCT has a good concordance with MRI and has high feasibility and reliability in evaluating the myocardial viability in chronic myocardial infarction.The radiation dose is still the important aspect of MSCT application.

Objective To prospectively evaluate the influence of average heart rate,heart rate variability and ECG editing on image quality of 64-slice CT coronary angiography(CTCA)in patients with atrial fibrillation(AF).Methods Fifty patients who were diagnosed with AF underwent respective ECG-gating 64-slice CTCA Image quality(good,moderate,poor)were evaluated on vessel segment level pre-and post ECG editing.Chi-square test was performed to compare the image quality in patients with various average heart rate,heart rate variability,and pre-and post ECC editing.Pearson correlation analysis was performed to test the relationship between the image quality and average heart rate and heart rate variability.Sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were calculated by using the conventional angiography as the standard reference.Results The average heart rate of the fifty AF patients was(89±23)beat/min,with variability of(18.2±6.1)beat/min.Finally,24(3.4%)segments were considered to have poor image quality in 6(12.0%)patients.Image quality decreased significantly(P＜0.05)at the average heart rate of over 100 beats per minute(11 segments)or the standard deviation of heart rate of over 24 beats per minute(11 segments).There was significant correlation between the mean heart rate and the image quality for all segments,the RCA,and distal section of coronary artery(r=0.50,0.55,0.53,0.49,0.42,0.44;P＜0.05).Heart rate variability was also significant correlated with the image quality.There was significant difference on image quality pre-and post ECG editing(P=0.013).The respective overall sensitivity,specificity,NPV,PPV values were 100%(6/6),93.2%(41/44),100%(41/41),and 66.7%(6/9).Conclusion ECG editing can improve the success rate and the image quality of 64-slice CTCA effectively in patients with AF within a certain range of average heart rates and heart rate variability.

Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate and evaluate the image quality.Methods Seventy-two patients who underwent coronary CT angiography with heart rate> 70 bpm were divided into 2 groups.Group A was adaptive sequence scan, and Group B was retrospective ECG-gating helical scan.Examinations were performed on a dual-source CT scanner (Somatom Definition) .All images were transferred to a workstation for further processing and analysis.The image quality was evaluated using same criteria.The image quality of coronary artery segments was compared in two groups using rank sum test, and the radiation dose was compared using t test Results A total of 501 coronary artery segments were evaluated in group A and 400 segments in group B.The mean ranks in image quality of coronary artery segments in group A was 475.42, whereas 420.41 in group B.There was a statistical difference in image quality between the two groups (Z= - 3.509,P=0.000).The effective dose was on average (6.2±0.9) mSv in group A, whereas on average (14.7±1.9) mSv in group B, there was a statistical difference between the two groups(t= - 27.011, P=0.000).Conclusions Adaptive sequence scan in dual-source CT coronary angiography is feasible in patients with high heart rates.This scan mode can substantially reduce radiation dose and maintain the diagnostic image quality.

ObjectiveTo observe effects of the nonunion of stale humeral shaft fracture treated by using the interlocking medullary nail.Methods21cases with the stale fracture of humeral shaft were treated with the interlocking medullary nail. The effect over post operation 1 year was evaluated.ResultsAll cases were recovery after treated by the interlocking medullary nail. Conclusions It shows that the effect of treating the fracture of humeral shaft with the interlocking medullary nail is very satisfactory.

Objective To investigate the effect and mechanism of salidroside on1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)in mice.Methods C57BL/6J mice were induced by MPTP to establish a PD mouse model and the movement track of mice was re-corded by open field experiment.The expression of tyrosine hydroxylase(TH),α-synuclein(α-syn),nuclear factor E2 associated factor 2(Nrf2)and quinone oxidoreductase 1(NQO1)were detected by immunohistochemistry in brain tissue of mice.SN4741 cells were stimulated by MPTP to establish a PD cell model in vitro.MPTP stimulation of SN4741 cells to establish an in vitro cell mod-el of PD.After pretreatment with salidroside,TUNEL was used to detect cell apoptosis in each group.The expressions of TH,α-syn,Nrf2 and NQO1 were detected by immunofluorescence.Nrf2 expres-sion was knocked down by being transfected with si-RNA,and apoptosis condition was detected by TUNEL assay.The expression levels of interleukin-1β(IL-1β)and interleukin-18(IL-18)protein in brain tissue extract and cell culture were detected by enzyme-linked immunosorbent assay(ELISA).Results The open field experiment results showed that salidroside could improve 3 min total distance of activity,average speed and activity track of PD mice(P＜0.05).Compared with the PD model mice,the salidroside treated mice showed significantly increased expression of TH,Nrf2 and NQO1 in the brain,and reduced expression of IL-18,α-Syn,IL-1β.Compared with the MPTP stimulated cells,the salidroside pretreatment group showed a decrease in cell apoptosis and an increase in the expressions of TH,Nrf2 and NQO1,but reduced expressions in α-Syn,IL-1β and IL-18.After si-RNA knockdown of Nrf2 expression,the protective effect of salidroside on MPTP stimulated cells weakened or even disappeared.Conclusion Salidroside may alleviate neuronal apoptosis by activating Nrf2-ARE signaling pathway,which is expected to be a new drug for PD treatment.

Objective:To observe the efficacy of pars plana vitrectomy (PPV) in the treatment of different types of chorioretinal coloboma with retinal detachment (RD).Methods:A single-center, retrospective clinical study. From April 2021 to March 2023, 24 eyes of 23 patients who were diagnosed as chorioretinal coloboma with RD in Henan Provincial Eye Hospital were included in this study. There were 11 males with 12 eyes and 12 females with 12 eyes. The mean age was (33.3±13.7) years old. Best corrected visual acuity (BCVA), spectral domain optical coherence tomography were performed. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. According to the types of chorioretinal coloboma, the affected eyes were divided into the coloboma involved the optic disc group and the coloboma not involved the optic disc group, with 15 eyes and 9 eyes. According to whether the RD containing the coloboma area, the affected eyes were divided into RD containing the coloboma area group and the RD not containing the coloboma area group, with 15 eyes and 9 eyes. All eyes underwent standard pars plana three-channel 25G PPV, retinal laser photocoagulation combined with silicone oil tamponade. The follow-up time after surgery was (19.5±16.3) months. The last follow-up was the time point for efficacy determination. The retinal reattachment, BCVA recovery and postoperative complications were observed. Paired t-test or t test was performed for comparison of quantitative data. Fisher's exact test was performed for comparison of qualitative data. Results:At the last follow-up, retinal reattachment was achieved in 20 eyes (83.3%, 20/24). The logMAR BCVA of the coloboma involved the optic disc group before and after surgery were 1.85±0.62 and 1.71±0.71, the difference was no significant ( t=0.845 , P=0.412). The logMAR BCVA of the coloboma not involved the optic disc group before and after surgery were 1.75±0.45 and 0.84±0.26, the difference was statistically significant ( t=6.153 , P<0.001). The improvement of BCVA in the coloboma not involved the optic disc group was significantly higher than that in the coloboma involved the optic disc group after surgery, with statistically significant differences ( t=3.024 , P=0.006). There was no significant difference in the retinal reattachment rate between the two groups ( P=0.615). There was no significant difference in the retinal reattachment rate between the RD containing the coloboma area group and the RD not containing the coloboma area group ( P=0.259). Postoperative complications included elevated intraocular pressure in five eyes, cataract progression in ten eyes, recurrent RD in two eyes, bullous keratopathy in one eye and band-shaped keratopathy in one eye. Conclusion:PPV combined with silicone oil tamponade is safe and effective in the treatment of chorioretinal coloboma with RD, the improvement of visual acuity in the coloboma not involved the optic disc group is better than that in the coloboma involved the optic disc group after surgery.