0.05) . The sensory block reached T7 in levobupivacaine group and T6 in bupivacaine group respectively. The motor blocked was somewhat more intense in bupivacaine group. Conclusion The efficacy and safety of epidural anesthesia with levobupivacaine and bupivacaine are comparable.

BACKGROUND: Posterior internal fixation and fusion system is a main method for chronic back pain caused by intervertebral disc degeneration, but more postoperative adverse reactions occur. Dynamic stabilization system can reduce adjacent-segment degeneration, and theoretically, repair intervertebral disc degeneration.OBJECTIVE: To investigate the efficacy and safety of K-rod dynamic stabilization system in the repair of lumbar degenerative diseases.METHODS/DESIGN: We conducted a prospective, single-center, self-controlled, clinical trial at the Orthopedic Hospital of Shenyang, China. Sixty-seven patients with lumbar degenerative diseases were enrolled, and treated with K-rod dynamic stabilization system. All patients were followed for 2 years. The primary outcome was the changes in the Oswestry dysfunction index scores at baseline, 3, 6, 12 and 24 months postoperatively. The secondary outcomes were the ratio of height vertebral space to body and lumbar lordotic angle at baseline, 3, 12 and 24 hours postoperatively; the visual analogue scale scores for back pain and morphological changes in the lumbar vertebrae on x-ray preoperatively and 3, 6, 12 and 24 months after surgery; the incidence of adverse reactions at 3, 6, 12 and 24 months postoperatively.This trial has been registered at ClinicalTrials.gov (identifier: NCT03214042). The study protocol has been approved by the Ethics Committee of Orthopedic Hospital of Shenyang. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient after they indicated that they fully understood the treatment plan.DISCUSSION: This trial was designed to investigate the efficacy and safety of K-rod dynamic stabilization system for lumbar degenerative diseases, thus providing reference for its clinical application. Partial results demonstrated that the Oswestry Dysfunction Index and Visual Analogue Scale scores at 24 months postoperatively were significantly improved (P < 0.01), but the ratio of height vertebral space to body and lumbar lordotic angle did not differ significantly at different time points (P > 0.01). These results suggest that K-rod dynamic stabilization system can alleviate pain and improve lumbar function in the patients with lumbar degenerative diseases.

Objective To investigate the influence of impulsivity on the functions of the conflict monitoring and the conflict resolution process for heroin addicts.Methods 80 heroin addicts were drawn randomly using simple random sampling method and finished Opioid Addiction Severity Inventory ( OASI ) and Barratt Impulsivity Scale ( BIS-11) .High impulsivity group( 7 females of 22) and low impulsivity group (8 females of 21) were divided according to 27%of the total BIS-11score followed the grouping method in psychometrics.Then the event-related potentials (ERPs) technique with the classical color-word Stroop task was used to reveal the influence of impulsivity on the executive function for heroin addicts.Results ( 1) The scores of motor impulsivity(23.00±1.73) and no-plan impulsivity(27.77±3.22) were higher in high im-pulsivity group than those in low impulsivity group(19.31±2.80,23.38±3.59)(P<0.01);and there was posi-tive correlation between impulsivity and addiction severity( r=0.415, P<0.05).(2) The behavioral data showed significant Stroop interference effects in both groups(P<0.01).(3) ERPs data showed that there were significant incongruent-N450 and SP effects in the low impulsivity group,whereas incongruent N450 and SP effects disappeared in high impulsivity group ( Low impulsivity group incongruent vs congruent condition N450:(2.82±3.09)μV vs (4.51±2.77)μV, P<0.05; SP:(3.54±1.25)μV vs (2.84±1.03)μV, P<0.05;High impulsivity group incongruent vs congruent condition N450:(4.98±4.10)μV vs (3.39±3.31)μV, P<0.05;SP:(3.43±3.84)μV vs (4.66±4.53)μV, P<0.05).Conclusion The brain time-interval change of executive function such as the conflict monitoring and the conflict resolution process is influenced by the im-pulsivity levels of heroin addicts.

Objective:To evaluate the effect of iliac bone graft and radial forearm flap in the reconstrucion of maxilla.Methods:Maxilla defects were reconstructed using iliac bone graft and radial forearm flap in 4 patients.The effects were evaluated clinicaly.Results:In all the 4 cases,palatal defects resulted from maxillectomy were optimally reconstructed with non-vascularized iliac graft and radial forearm flap.The masticatory function of the upper jaw,intelligible speech,swallow and natural facial appearance were recovered.As a result,quality of life of the patients was improved.Conclusion:Iliac bone graft and radial forearm are feasible in the reconstruction of maxilla defects.

Objective: To research the expression of PTEN and its influence on biological ability in breast cancer cell in vivo. Methods: PTEN-shRNA plasmid was transtected into M231 breast cancer cells to knock down the expression of PTEN. The changes of PTEN expression, proliferation, adhesion and metastasis of PTEN knocked down cell were tested by western-blot, colony formation, adhesion and invasion assay. Results: PTEN-shRNA was successfully transfected into M231 cells and it inhibited PTEN expression efficiently.The capabilities of colony formation, migration and invasion of transfected cell were much greater than those of the controlling cell line. But the transfected cells were more difficulty in adhesion than the scrambled ones. Conclusion: PTEN genecan enhance the adhesion, but restrict the proliferation, migration of breast cancer cells in some degree, so that inhibit the development of the breast cancer. PTEN loss can be a prognostic factors for the patients with breast cancer.

Deafness ; Diabetes Complications ; diagnosis ; epidemiology ; Diabetes Mellitus ; epidemiology ; Hearing Loss ; diagnosis ; etiology ; Humans

Adult ; Female ; Humans ; Male ; Mercury Poisoning ; diagnosis ; therapy ; Middle Aged

Objective To investigate the functional and structural changes of connectivity of default mode network (DMN) in relapsing-remitting multiple sclerosis (RRMS) by functional MRI (fMRI) and diffusion tensor imaging (DTI) and to study the relationship between them.Methods Twenty-seven RRMS patients(clinically diagnosed as RRMS)and 27 healthy volunteers (matched to the patients in age and gender) were selected to participate in this study.All the subjects underwent 3.0 T MR scanning.Softwares such as DPARSF,MICA,TrackVis were used for data post-processing.Medial prefrontal cortex (mPFC) and posterior cingulate cortex(PCC) of DMN were chosen as ROIs,and functional and structural changes of DMN and the relationship between them were analyzed.Values of r reflecting the functional connectivity and fractional anisotropy(FA) of two groups were obtained.Then statistical analysis was performed by using student t test and Pearson correlation analysis.Results The DMN space pattern of the RRMS patients was mostly identical to that of controls,but with specific difference in the connectivity strength with respect to that of controls.Particularly,the patient group showed increased DMN connectivity in the mPFC,but decreased connectivity in the inferior parietal lobule (IPL) and PCC.Compared with controls,the r value (0.695 ±0.151 vs.0.796±0.085),FA value(0.261 ±0.012 vs.0.285 ±0.017) between mPFC and PCC in RRMS patients were decreased (t =-3.020,-6.206,P ＜ 0.05).In addition,functional connectivity (r value) was found to correlate with structural connectivity(FA value) between the PCC and mPFC (r =0.704,0.735,P ＜ 0.01).The number of MS lesion,had no correlation with r value or FA value (P ＞ 0.05).Conclusions The functional connectivity and structural connectivity of DMN change in RRMS patients.The functional connectivity and structural connectivity between mPFC and PCC are both decreased in RRMS patients compared with the controls.The injury of structural connectivity may be the structural basis of the decrease of functional connectivity.

Hepatic eosinophilic granuloma (HEG) is a rare benign liver disease,which belongs to histocytosis.Preoperative diagnosis of HEG was difficult because its clinical manifestation was not characteristic.In this article,the clinical data of 1 patient with HEG who was treated at the Jinhua Municipal Central Hospital of Zhejiang Province in September 2012 were retrospectively analyzed,and the diagnosis,differential diagnosis and treatment for HEG were investigated.

Case based learning/problem-based learning ( CBL/PBL ) is a new teaching method based on traditional medical education methods.In order to conquer the deficiency of traditional education methods in autonomous study motivation and ability of knowledge integration, CBL/PBL has been introduced into vascular surgery teaching procedure since 2006.The quality and effort of CBL/PBL compared with lecture-based learning ( LBL ) were evaluated and scored. The outcome of this teaching innovation shows CBL can arouse students' desire in autonomous study and enhance their ability in clinical analysis.But, its superiority is difficult to develop in the current medical education system.