Objective To explore the changes in diffusion kurtosis imaging(DKI)and diffusion tensor imaging(DTI)parameters and their relationship with cognitive ability in patients with mild traumatic brain injury(mTBI).Methods Forty-one mTBI patients(mTBI group)and 40 normal controls(normal control group)were examined by head MRI.Fractional anisotropy(FA),mean diffusivity(MD)of DTI parameters and mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),fractional kurtosis anisotropy(FKA),axonal water fraction(AWF),axial extra-axonal dispersion(AxEAD),radial extra-axonal dispersion(RadEAD)and tortuosity(TORT)of DKI parameters were calculated in region of interest(ROI).MMSE and Montreal cognitive assessment(MoCA)were used to evaluate the cognitive ability of the two groups.Results Compared with those in normal control group,AK in all lesion areas in mTBI group were increased,AWF,RK,AxEAD and RadEAD,FKA,MK were decreased(all P<0.05).Compared with those in normal control group,FA of pontine,corpus callosum and posterior limb of internal capsule in mTBI group were significantly decreased(all P<0.05);MD of putamen,posterior limb of internal capsule and thalamus in mTBI group were significantly increased(all P<0.05).Pearson correlation analysis showed that FKA was positively correlated with MMSE score at enrollment(r=0.81,P<0.05)and MMSE,MoCA scores at 3 months of treatment(r=0.88,r=0.89;all P<0.05).FA was positively correlated with MoCA score at enrollment and 3 months of treatment(r=0.82,P<0.05;r=0.76,P<0.05).MK was correlated with MMSE and MoCA scores at enrollment(r=0.77,r=0.76;all P<0.05)and 3 months after treatment(r=0.90,r=0.90;all P<0.05).MD was positively correlated with MMSE score at 3 months after treatment(r=0.90,P<0.05).Conclusion DKI combined with DTI can determine the degree of lesion by reflecting the changes of brain tissue microstructure,and is positively correlated with the cognitive ability of TBI patients.

OBJECTIVE: To explore the correlation between the cognition on hearing protection and mental health status of noise-exposed workers. METHODS: A total of 499 noise-exposed workers from 3 enterprises of coal mine, steel and textile in Xinjiang region were selected as study subjects by stratified cluster random sampling method. The cognitive status of hearing protection and mental health status of each group were investigated by the Workplace Health Promotion Pilot Project Questionnaire. RESULTS: A total of 235 workers had abnormal mental health status.The abnormal rate of mental health status was 47.1%(235/499). The results of logistic regression analysis showed that female, age ≤40.0 years, unable to bear current noise hazards, worried about noise-induced-deafness and noise-induced discomfort were the risk factors of abnormality of mental health status(odds ratio values were 1.62, 1.87, 2.42, 2.20, 2.14, P<0.05). Using hearing protectors for ≥3.0 years was the protective factor of abnormality of mental health status(odds ratio value was 0.47, P<0.05). CONCLUSION: The subjective cognition on hearing protection has an impact on the mental health of noise-exposed workers.

Objective ToexplorethevalueofMR DKIinevaluationofmicrostructuredamageincervicalspinalcordinjury(CSCI) Methods 32casesofCSCIpatientsconfirmedbyclinicalexaminationand20casesofhealthycontrolgroupwereinvestigatedbyconventional MRIandDKIexamination.AccordingtoT2WIsignal,theinjurygroupweredividedintoA,Bgroup,Agroupofhighsignalgroup(n＝14)andBgroupofnegativegroup (n＝18).A,BgroupsandcontrolgroupweremeasuredbyFA,meandiffusivity(MD)and mean kurtosis(MK)valuesatdifferenttimes (acute,4 weeksafterinjury,2to3 monthsafterinjury)andthedata wereanalyzedby SPSS17.0statisticalsoftware.TheROCcurvewasusedtoevaluatetheabilityofdifferentparametersindiagnosingCSCI.Results In A,BgroupsFAvaluesdecreasedearlyandincreasedgradually,butwerealwayslowerthanthecontrolgroup,andthedifferencewas statisticallysignificant(P＜0.001).InAgroup MDvalueincreasedearlyanddecreasedgradually,butwashigherthanthecontrol group (P＜0.001).InAgroup MKvaluedecreasedearlyandincreasedsignificantly(P＜0.001).InBgroup MDvalueincreasedand MKvaluedecreasedintheacutephase(P＜0.001),lateron MDand MKvaluesgraduallytendtothecontrolgroup,thedifference wasnotstatisticallysignificant(P＞0.05).Conclusion DKIcannoninvasivelyreflectthemicroGdamageofCSCI,whichcannotbedisplayed byconventionalMRIfortheearlydetectionofspinalcordabnormalities.TheFAvalueisofhighdiagnosticvalue.

Objective: To compare the knowledge and behavior toward hearing protection among workers in different workplaces and investigate its influence factors. Methods: 2 manufacturing companies with obvious noise hazard in workplace were selected into the study. Health management level was distinguished through field investigation and verification. Questionnaire focus on basic knowledge of hearing health, acceptance level of noise hazard, comfort of wearing hearing protectors and atmosphere in workplace was designed and was used to investigate the knowledge and behavior toward hearing protection. Results: Hearing protectors that meet the level of protection are distributed throughout the workplaces. Although company A has a lower noise hazards level, the health management system was poorly executed. The proportion of workers persisting in wearing hearing protectors throughout the work shift in company A was lower than B (P<0.01) . Workers in company A intended to underestimate the noise level (P<0.01) and the health effect of hearing loss (P<0.01) . All the workers were worry about suffering from hearing loss (P>0.05) , but those in company B had more positive attitude toward the protection of hearing protector (P<0.01) and relied on the protector (P<0.01) . The awareness of protection, in turn, help workers adapt attitude and get used to wearing hearing protectors consciously in workplace (P<0.01) . Conclusion Health management performance play a key role in help workers form good knowledge and behavior. To protect workplace health, employers need to creative a healthy supportive environment for workers.

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.

Objective To study the application value of modified urine nucleoside's detection in prognosis of patients with bladder cancer. Methods We enrolled 85 patients with bladder transitional cell carcinoma confirmed by pathological examination.The 85 patients fulfilled one-year follow-up visit after TUR-BT and were reviewed every three months.The 85 patients did not relapse in the first third month after operation.At the sixth month after operation,20 cases relapsed.18 cases and 19 cases relapsed at the ninth month and the twelfth month after operation.Patients with recurrence added up to 57 cases as the recurrent group.The remaining 28 cases did not relapse at one year after operation as the no recurrent group.Of the 85 cases,55 cases were in T(is) - T1,while 30 cases were in T2 - T4.Of the 85 cases,27 cases were with G1,40 cases were with G2 and 18 cases were with G3.In T(is) -T1,there were 35 cases in recurrent group,while there were 20 cases in the no recurrent group.In T2 -T4,there were 22 cases in recurrent group,while there were 8 cases in the no recurrent group.There were 50 normal people in the control group.Highperformance liquid chromatography/electrospray ionization-quadrupole-time-of-flight mass spectromerry was used to measure the levels of change of two urine modified nucleosides (M1A,1-MeI) which the patients with bladder cancer had different pathology grades,clinical stages,before or after operation and recurrence or no recurrence. Results The levels at third month after operation in no recurrent group ( M1A:3.24 ± 0.40,1 -MeI:5.73 ± 0.67 ) were significantly lower than that before operation ( M 1A:4.34 ± 0.98,1-MeI:14.22 ± 4.05,P ＜ 0.005 ),and remained in low status at another time points after operation.The levels at the third month after operation in recurrent group (M1A:3.31 ±0.33,1-MeI:5.67 ±0.55) were significantly lower than that before operation ( M1A:4.32 ± 1.19,1-MeI:14.31 ± 4.12,P ＜ 0.005 ),which was on the rise and indicating a high level approaching the condition before operation.According to the time point before the operation,recurrent group and no recurrent group were higher than control group (M1A:2.91 ±0.84,1-MeI:5.56 ± 1.25,P ＜ 0.01 ).The levels at the sixth month,ninth month and twelfth month after operation in recurrent group ( M 1A referring to 4.04 ± 0.48,4.11 ± 0.47,4.09 ± 0.53 ;1-MeI referring to1 1.46 ± 1.34,12.14 ± 1.22,12.33 ± 1.27) were the highest (P ＜ 0.01 ).The levels of change of two urine modified nucleosides between pathology grade and clinical stage had no statistical difference ( P ＞ 0.01 ).The levels in recurrence group in T(is) - T1 ( M1 A:5.92 ± 1.28,1-MeI:20.01 ± 8.53 )were higher than the levels in no recurrent group ( M1A:4.02 ±1.22,1 -MeI:11.21 ± 6.45,P ＜ 0.05 ),which was the same in T2 - T4. Conclusion Urine modified nucleosides detection offer a certain clinical value the prognostic of operated bladder cancer patients.

Objective To analyze the value of multi-slice spiral CT (SCT) scan in staging and subtyping of renal cell carcinoma (RCC). Methods The preoperative kidney SCT data and postoperative pathology results of 64 patients with RCC were retrospectively analyzed. The patients′ ages ranged from 33-78 years (average 54 years). There were 44 males and 20 females in the study group. According to the CUA Guidelines, the staging and subtyping of RCC were performed through the combined information of preoperative SCT attenuation in unenhanced, corticomedullary phase and enhancement pattern. The results were compared with the postoperative histopathological results. Results The SCT results showed 38 cases were clear cell RCC, 14 cases were papillary RCC and 12 cases were chromophobic cell RCC. Histopathological results showed that 40 cases were clear cell RCC, 16 cases were papillary RCC and 8 cases were chromophobic cell RCC. According to the standard of 40 HU of CT attenuation value, the sensitivity, specificity and accuracy were 75%, 79% and 78% for diagnosis of papillary RCC in the unenhanced phase. The sensitivity, specificity and accuracy by the standard of 90 HU of CT attenuation value was 90%, 88% and 89% for diagnosis of clear cell RCC in the corticomedullary phase. In chromophobic RCC, homogeneous enhancement was more common than in papillary RCC and clear cell RCC. There was no significant difference of staging and subtyping of RCC between SCT and pathological results (P>0.05). The accuracy of SCT in staging and subtyping of RCC was 88% in staging, and 89% in subtyping. Conclusions SCT is a useful preoperative tool to stage and subtype RCC

Objective To assess the outcome of de-epithelialied ileocystoplasty combined with strengthened pelvic floor in patients with neurogenic bladder.Methods Twelve patients (9 male,3 female) aged from 18 -27 years (averaged 25 years) with neurogenic bladder received de-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor,and were evaluated by urodynamic parmeters,upper urinary tract image appearance,and serum creatinine before and one year after operation.Results After operation,the max cystometric capacity (412 ± 32 ml),bladder compliance (26.2 ± 4.0ml/H2O),relative safety cystometric capacity (368 ±26 ml) and max flow rate (20 ±3 ml/s) were respectively significantly higher than those preoperation(247 ±27 ml,4.4 ± 1.2 ml/cm H2O,206 ±24 ml,11 ±2ml/s,P ＜ 0.05).Moreover,the post voided residual (26 ± 8 ml) and detmsor leakage point pressure (17.8 ±3.6 cm H2O) were significantly lower than those of preoperation (136 ± 25 ml,63.1 ± 4.9cm H2O,P ＜0.05).The vesicoureteral reflux disappeared in five (63％) cases,and was relieved in the remaining three cases.Of the five cases with renal insufficiency,three (60％) cases had normal serum creatinine level,none had increased serum creatinine levels.After operation,late healing occurred in two ( 17％ ) cases,intestinal obstruction in one (8％),vesicoabdominal fistula in one (8％),and no cases had mucous urine.Clean intermittent self-catheterization was performed in one case (8％) to empty the bladder due to a fever resulting from urinary tract infection,the remaining 12 (92％) cases could empty their bladders through abdominal pressure.Conclusions De-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor results in a good outcome for the patients with neurogenic bladder.

Objective To investigate the relationships between genetic polymorphism of CYP2A6 alone or in combination with smoking and hereditary susceptibility to bladder cancer.Methods Based on case-control study,CYP2A6*4 was determined by the nested polymerase chianreaction(nPCR)in 186 patients with bladder cancer and 192 nontumorous controls.The relations between the genetypes of CYP2A6*4 alone or combinated with smoking and bladder cancer was estimated with the X2 test and logistic regression model.Results In the case subjects,the number of the wil/wil genetype was 168,the number of the wil/del genetype was 13,and the number of the del/del genetype was 5.In the control subjects,the number of the wil/wil genetype was 150,the number of the wil/del genetype was 32,and the number of the del/del genetype was 10.The frequency of CYP2A6 del allele was significantly lower in the case Subjects(9.68%)than the controls(21.88%,P＜0.05,OR:0.383).When eombinated with smoking,the risk of bladder cancer in smokers was significantly higher than nonsmoker(P＜0.05,OR=2.322).In smokers,the frequency of CYP2A6 del allele was significantly lower in cases(7.88%)than controls(28.00%,P＜0.05,OR=0.221).In smoking people,the one with CYP2A6 del genotype had a lower risk of bladder cancer than the one with CYP2A6 wild genotype(OR=0.221,95%CI:0.092,0.534).Conclusions Genetic polymorphisms of CYP2A6 are associated with the susceptibility to bladder cancer and have interaction with smoking in carcinogenesis of bladder cancer.Deficient CYP2A6 activity to genetic polymorphism mayreduee bladder cancer risk in smokers.

Objective To study the relationship between cyclooxygenase 2 (COX-2) polymor phisms and the susceptibility of bladder cancer.Methods Polymerase chain reaction restricted frag ments length polymorphism (PCR-RFLP) and the primer introduced restriction analysis (PIRA-PCR)assay were used to genotype the COX-2-765G/C, 1195G/A and 8473T/C polymorphisms in a case control study of 180 bladder cancer cases and 180 cancer free controls in a Chinese population.Re stilts The distribution of the genotype frequencies of 765G/C and 1195G/A were not statisticallydifferent between the cases and controls (P=0.582 for-765G/C and P=0.270 for-1195G/A).Poly morphisms of COX 2-8473T/C were associated with the susceptibility to bladder cancer.The individ uals with the 8473C allele had a decreased risk of bladder cancer (OR=0.56,95% CI=0.35 0.88).Conclusions Polymorphisms of COX-2-765G/C and-1195G/A are not associated with the suscepti bility to bladder cancer.However,COX-2-8473T/C can reduce the risk of bladder cancer.