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 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 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 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.