[Objective]To observe the surgical treatment for the huge disc herniation of C3、4.[Method]Sixteen patients with huge disc herniation of C3、4 were operated upon with combined posterior decompression of expansive open-door laminoplasty with anterior decompression,bone graft and plate fixation.After operation,neurological findings,height of the interbody space and fusion rate of the space were observed.[Result]All the patients were followed up for an average of more than six months,all of them did not get secondary nerve injuries in operation,neurological function were improved obviously and all the affected interbody space got solid fusion.Based on the standard of Odom,50% of the patients were very good,25 % good,25 % general,and the effective rate was about 100%,excellent rate was about 75%.[Conclusion]The combined posterior with anterior decopression and interbody fusion for treatment of huge disc herniation of C3、4 has advantage of more security in removing the prolapsed disc,improvement of the interbody fusion rate,keeping the height ofinterbody space.This procedure is one of the effective operative methods in the treatment of huge disc herniation of C3、4.

Objective To explore the job tasks and qualifications of midwives in China for the next five years.Methods Anonymous surveys were sent by email to 80 professionals to learn the job tasks and qualifications of midwives in China using the Delphi method.The recipients include senior midwives, nursing administrators and nursing educators,senior obstetricians and gynecology department chiefs,as well as health administrators.Results Learnt in the survey were the qualifications and job tasks of professional midwives in China for the next five years.The system concludes 77 job tasks of midwives, among which 31 items are supposed to be completed independently.Conclusion China should develop the midwife system as soon as possible,strengthen the midwife training and education,develop the midwife access system and the corresponding laws and regulations for midwives,standardize midwife management,clear the midwife qualifications and job tasks,formulate normative midwife promotion system,and realize the midwifery scientific management.

Objective To investigate the diagnostic value of dual-source CT angiography (DSCTA) for vertebrobasilar atherosclerosis in patients with transient ischemia attack (TIA).Methods 80 TIA patients underwent DSCTA.Common data were collected.Vertebrobasilar plaques and stenosis degree were analyzed by using CT reconstruction.Results 152 plaques were found in 69 patients(86.2％,69/80),59 plaques(38.9％,59/152)in unilateral vertebral artery in 31 patients,83 plaques (54.6％,83/152) inbilateral vertebral artery in 28 cases,10 plaques (6.6％,10/152) in basilar artery in 10 patients,among which 51(33.6％,51/152)plaques were hard,69(45.3％,69/ 152)plaques were soft,32(21.1％,32/152)plaques were mixed.There were 31 cases (44.9％,31/ 69) with mild stenosis,27 cases (39.1％,27/69) with moderate stenosis,7 cases (10.1％,7/69) with severe stenosis,and 4 cases (5.8％,4/69) had vascular occlusion.Conclusions Vertebrobasilar atherosclerosis is a common cause of TIA.DSCTA can be used to analyze the vertebrobasilar plaques and stenosis degree.Soft plaques and severe stenosis promote TIA.

PurposeTo evaluate the value of dual-source CT angiography (DSCTA) in the diagnosis of carotid atherosclerosis, and to explore the relationship between carotid atherosclerosis and diabetes mellitus (DM).Materials and Methods 145 patients with ischemic stroke were divided into DM group (n=80) and non-DM group (n=65). All patients underwent DSCTA. The location and characteristic of carotid atherosclerosis were analyzed using curve planE reconstruction (CPR), maximum intensity projection (MIP), multi-plane reformation (MPR) and volume rendering (VR). The differences between two groups were analyzed.Results Compared with non-DM group, the body mass index and high blood cholesterol were higher in DM group (t=6.197,P<0.05;χ2=8.372,P<0.01). The incidence of carotid atherosclerosis and vulnerable plaques were also higher in DM group than non-DM group (χ2=11.617 and 9.388,P<0.01). There was no significant difference between DM group and non-DM group in the location of carotid atherosclerosis (χ2=0.160, 0.509, 0.419 and 0.016,P>0.05). Carotid atherosclerosis was more common in carotid bifurcation and carotid artery siphon.Conclusion DSCTA can demonstrate the location and characteristics of carotid atherosclerosis in ischemic stroke patients with diabetes mellitus. Diabetes is a risk factor for the formation of carotid atherosclerosis, especially vulnerable plaques.

Objective Retrospectively analyze of urate crystal deposition using dual-source CT in asymptomatic hyperuricaemia and symptomatic gout patients.Methods Sixty patients with asymptomatic hyperuricemia (uric acid ≥540 μmol/L) and 48 patients with gout (without any change in the appearance of the limbs and obvious gout nodules) were selected.All patients underwent dual-energy CT imaging.The location number and size were analyzed using CT gout software.Results Eighteen patients with asymptomatic hyperuricemia with urate crystal deposition in limb joints (13 in foot and ankle, 7 in the hand and wrist, 2 in knee), the average size of crystal was (0.12±0.04) cm3.Forty-eight gout patients (28 cases of early gout and 20 cases of late gout and 20 gout cases) had urate crystal deposition (48 in foot and ankle, 39 in hand and wrist, 27 in knee), the average size of crystal was (1.7±0.7) cm3.The number and size of urate crystals deposited in the joints, tendons and ligaments was higher in patients with gout than asymptomatic hyperuricemia (x2=52.076, P＜0.001;t=44.834, P＜0.001).There was no difference between the early gout and late gout in the size of urate crystals (t=0.163, P＞0.05).Conclusion Urate crystals can deposite in asymptomatic hyperuricemia.However, more and larger urate crystals appear in gout patients, there is no difference in size and number of urate crystals between the course duration of gout.

Objective To explore the value of distinguishment of hepatocellular carcinoma (HCC), cirrhosis nodules and normal liver based on neural networks in the ~(31)P-MR spectroscopy. MethodsA total of 66 data of ~(31)P-MRS were analysed using back-propagation neural network, including 37 samples of liver cirrhosis, 13 samples of HCC and 16 samples of normal liver. ResultsThe cross-valiation experiments showed that diagnostic accuracy rate of HCC increased from 85.47% to 92.31% with neural network model based on the ~(31)P-MR spectroscopy data analysis. Conclusion ~(31) P-MRS data analysis based on neural network model provides a valuable diagnostic tool of HCC in vivo.

Objective To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods A 1:1 matched case?control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low?medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values<0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low?medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.

Objective To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods A 1:1 matched case?control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low?medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values<0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low?medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.

Objective To observe the effect of different doses of octreotide acetate on the clinical efficacy of patients with severe acute pancreatitis (SAP).Methods Ninety patients with SAP were admitted to the Department of First Aid Medicine Second Section of the First Hospital of Jilin University from September 2013 to January 2016, and according to difference in drug doses, they were divided into octreotide small dose, moderate dose and large dose groups, 30 cases in each group. All the three groups were given the basic treatment, and in the mean time octreotide 0.2, 0.3, 0.4 mg respectively was dissolved in 0.9 % sodium chloride 100 mL, then the low, moderate and high dose solutions were intravenously continuously infused by a micro pump into the veins of patients in respective small, medium and large dose groups, once every 12 hours, for a total of 20 days. The times of improvement of clinical symptoms (such as abdominal pain, nausea, vomiting), blood amylase recovery time, hospitalization time and clinical efficacy, the incidence of shock, renal insufficiency and other complications were compared among the three groups.Results With the increase of drug dosage, the symptom improvement time (days) was gradually decreased (5.0±1.2, 3.0±1.2, 2.8±1.2) in small, medium and large dose groups, the recovery time of blood amylase and hospitalization time were the shortest in medium dosage group, less than those in large and small dosage groups [blood amylase recovery time (days): 4.5±1.0 vs. 6.0±1.0, 4.6±1.0, hospitalization time (days) 12.0±1.5 vs. 15.0±1.5, 12.5±1.5], the total effective rate was the highest in the middle dosegroup, higher than those in the large and small dose groups [96.7% (29/30) vs. 93.3% (28/30), 83.3% (25/30)]; the incidence of complications was the highest in the lowdose group, higher than those in the middle and large dose groups [26.67% (8/30) vs. 10.0% (3/30), 13.3% (4/30)].Conclusions When using micro infusion pump for intravenous infusion of octreotide, the efficacy of moderate dose is better than that of small dose, but compared with the efficacy in large dose group, no significant difference is seen.