BACKGROUND: Nervousness, anxiety and depression are important inducing factors of migraine, while nervousness, anxiety and depression are closely correlated with the unreasonable belief and incorrect strategy. Medicine therapy is the principal method in the treatment of migraine at present, but it cannot change the unreasonable belief of the patients and thereby to reducethe occurrence of the inducing factors of headache.OBJECTIVE: To observe the near term and long term therapeutic effects of medicine therapy and rational emotional behavior therapy(REBT) to provide a safer and more effective intervention for the patients with migraine and thereby to improve their long term quality of life(QOL).DESIGN: An observatory comparative study based on patients with migraine as subjects and healthy population as controls.SETTING: A psychological consultation clinic of a municipal hospital(has been canceled now).PARTICIPANTS: Totally 86 cases of migraine including 34 males and 52females aged between 16 and 48 years old(means of 35 years old) with a course of disease between 2 and 11 years were selected from the Psychological Consultation Clinic of the 289 Hospital between March 1999 and October 2001. All 86 cases were randomly divided into REBT group and medicine group with 43 cases each. There was no significant difference of age, gender,course of the disease, situation of the disease, and education background between two groups. Another 30 healthy individuals including 12 males and 18 females with a mean age of 36 years old were selected in control group.METHODS: REBT was applied for patients in REBT group. Patients of medicine group received 50-100 mg/day of Amitriptyline and 60 mg/day of nimodipine through oral administration. Patients received 12 weeks of therapy followed by 24 weeks of observation.MAIN OUTCOME MEASURES: Therapeutic scale score on migraine (TSSM), before and after migraine-correlated potential(P300) and symptoms checklist 90 (SCL-90) scores were compared.RESULTS: SCL-90 total points of two groups of patients were significantly higher than that of control group( P ＜ 0.05); after 12 weeks of therapy,TSSM, SCL-90 total points and points of major factors of two groups of patients were significantly lower compared with the situations before therapy( P ＜ 0.05), but there was no significant difference between two therapy groups; on the 12th week after therapy, SCL-90 total points, points for major factors and TSSM, and P300 latency of REBT group were almost as the same as that after 12 weeks of therapy and the wave amplitude of P300 significantly elevated; owever, the differences in SCL-90 total points, points of major factors, and the TSSM in medicine group were significant compared with that after 12 weeks of therapy( P ＜ 0.05) . There was significant difference at the same period between two therapy groups ( P ＜ 0.05).CONCLUSION: REBT can reduce the attacks of migraine, decrease TSSM,and has similar therapeutic effects to medicine group. Simultaneously, it can ameliorate the cognitive disorder, change the unreasonable belief of the patients, and improve the strategy to cope with the disease; hence its long term therapeutic effect is better than medicine therapy.

Objective To explore the influence of family factors on physical activity behavior of central obesity patient.Methods A questionnaire investigation to 182 central obesity volunteers was carried out in a residential district of shanghai on April 2007.Results The percentage of the patients taking physical activities,at least one of whose family members participate in regular exercise,was 66.7%.It was significantly higher than that (43.6%) of other patients whose family members hardly ever participated in regular exercise any more(χ2=9.260,P=0.002).The percentage of patients taking physical activities,with highly family function,was 60.2%.It was significantly higher than that of the patients in moderately dysfunctional family (49.9%) and in severely dysfunctional family(35.5%)(χ2=6.448,P=0.04).The average APGAR score,Partnership score and Growth score of the patients in taking exercise group were 7.13±2.63,1.49±0.71 and 1.35±0.73. They were significantly higher than that of the patients in taking no exercise group (6.09±3.09,1.24±0.85 and 0.90±0.86) (t=2.095～3.845,P=0.000～0.038). While family size,family economic status and marital status showed no obvious effect on physical activity behavior of central obesity patients(χ2=0.027～1.709,P＞0.05).Conclusion Highly family function and at least one of the other family members taking regular exercise can promote activity of central obesity patient in daily life.

Orthopedics virtual surgery system is a rapidly developing domain in recent years,and has exhibited a promising application.Currently,softwares about orthopedics virtual surgery system have already been applied in medical clinic and education.This paper reviewed present situation of this system,introduced some key technology such as medical image segmentation,registration and fusion,3D visualization and 3D interactive,and discussed main application such as orthopedics virtual surgery,surgical protocol,assisting clinical diagnosis,real-time chiri-cal consmlfation,assisting medical education,training and examination,rehabilitation care,prosthetic device,or guidance in surgery.In addition,the development trend of this system is predicted.With development of orthopedics virtual surgery system,the time of surgery will be consumedly economized and the risk of surgery will be reduced,greatly benefiting orthopedics.

Transpedicular screw fixation for cervical spine is the strongest spinal posterior fixation that could provide tri-column biomechanical stability,and it has been gradually identified as a quite high value in clinical application.The pedicle of vertebral arch is adjacent to vital neurovascular structures;thereby pedicle screw fixation in the cervical spine has been considered as a potential risk of injury and been limited in clinics.This study aims to review the studies on the current situation and progress of pedicle screw fixation techniques in lower cervical disease by investigating cervical pedicle morphology,biomechanical property,transpedicular screw insertion techniques and internal fixation system,computer assisted image-guided navigation,the indication,contraindication and complications of pedicle screw fixation.The article shows that preoperative careful evaluation for the morphology of the lower cervical pedicles,using kinds of new image guided techniques and meticulous techniques of screw placement in operation are essential in reducing operational risk and offering widely application.

Objective To investigate the effects of gemcetabine and LY294002 monotherapy or combination on the proliferation and poptosis of pancreatic cancer cell lines BxPc-3 and MiaPaCa-2.Methods Cell proliferation and poptosis were detected by MTT and Annexin V-FTTC,respectively.Results Both gemcetabine and LY294002 could inhabit the proliferation of the two cell lines.Their inhibitory effects were increased accompanied with increased drug concentrations and the cell survival rates was negatively correlated with logarithmic of the drug concentrations (r＜-0.95,P＜0.01).The inhibitory effects of gemcetabine and LY294002 to the BxPc-3 proliferation were significantly stronger than to the MiaPaCa-2(P＜0.05).For BxPc-3 and MiaPaCa-2,the IC50 of gemcetabine were(10.07±1.83),(36.45±2.71)μmol/L(P＜0.05),and the IC50 of LY294002 were(7.84±1.48),(17.89±1.98)μmol/L(P＜0.05),respectively.Gemcetabine and LY294002 could induce cell apoptosis(P＜0.01).Though both the concurrent or consecutive use of these two drugs could promote cell apoptosis,the effect of the concurrent group was significantly stronger(P＜0.05).The order of these two drugs in the concurrent group had no significant influence on their effects(P＞0.05).Conclusion Both gemcetabine and LY294002 could inhibit the proliferation of pancreatic cancer cell lines.Their concurrent application shows a significant inhibitory effect on the cell apoptosis.

In order to assess colonic motility of chronic constipation, colonic transit test was carried out in 34 patients with chronic constipation and in 20 healthy subjects. 20 radiopaque markers are ingested at 8 am before the day test, and plain abdominal films were obtained at 24 h, 48 h and 72 h. The normal value of colonic transit test was 16(80%), or more markers passed after 72 h. By means of transit time study, 34 constipated patients were classified into 2 groups: 12 normal transit patients and 22 slow transit patients. There was no difference in colonic transit time between normal transit patients and controls (P＞0.05). Patients with slow transit had more markers left in right colon, left colon and rectosigmoid colon at 48 h (P＜0.01, respectively) and 72 h (P＜0.01, respectively). According to the transit index, 22 slow transit patients were divided into 3 types: 10 cases colonic stasis, 8 cases outlet obstruction and 4 cases colorectal stasis. The study suggests that chronic constipated patients have abnormalbilities of colonic transit.

To study the expression of bone morphogetic protein(BMP) and transforming growth factor β１（TGF-β１) in regenerative gap during lengthening period. Method: The right tibia of 14 mature rabbits were lengthened using metaphyseal osteotomy. Distraction was started on the 4th day postoperatively, 1mm per day and conducted twice each day. The expression of endogenesis BMP and TGF-β１ in regeneraive gap were observed during ten weeks after distraction by histology and immunohistochemisty. Results: The result showed that bone morphogetic protein(BMP) and transfoming growth factor β１(TGF-β１) were expressed in chondrocytes, osteoblasts, and fibroblasts. The expression of BMP was at a high level in initial two weeks after distraction while the expression of TGF-β１ was increased step by step. Then both of them decreased alonged with lengthening proceeding. Two weeks after distracting stopped, the expression of BMP could not being observed. But the expression of TGF-β１ could being observed all stage after distraction stopped. Conclusion: BMP and TGF-β１ were expressed persistently in regenerative gap during bone lengthening.

Objective To evaluate the efficacy of recessive placement of nasolacrimal stent in the treatment of nasolacrimal duct obstruction and factors affecting the prognosis of the procedure.Design Retrospective case series.Participants One hundred eighty six patients(207 eyes) with nasolacrimal duct obstruction.Methods One hundred eighty six patients(207 eyes) of nasolacrimal duct obstruction confirmed by dacryocystography had undergone recessive placement of nasolacrimal stent after probing and dilation of nasolacrimal duct.All patients received regular postoperative nasolacrimal duct syringe.Main Outcome Measures Status of postoperative lacrimal syringe.Results The stents were removed 3～12 months postoperatively,the patients were followed-up average 6 months.The operation success rate was 97.1%.167 eyes achieved complete success(80.7%).25 eyes became better(12.1%),and nasolacrimal duct obstructed again in 15 cases(7.2%).Conclusions Recessive placement of nasolacrimal stent combined with postoperative nasolacrimal duct syringe is a simple,effective and safe technique in the treatment of nasolacrimal duct obstruction.Selecting correct patients,skillful technique of nasolacrimal duct probing and regular postoperative syringing of nasolacrimal duct are the main factors of successful procedures.

Pituitary hyperplasia may be found in patients with primary hypothyroidism as the decreased thyroid hormone level attenuates negative feedback effect.Sometimes the enlarged pituitary may be misdiagnosed as a pituitary tumor.Patients with long term untreated hypothyroidism often have extremely high level of serum creatine kinase and thus may be misdiagnosed as suffering from myositis.In order to increase the awareness of the nonspecific symptoms of primary hypothyroidism,this article introduces the diagnosis and treatment of a patient with primary hypothyroidism with raised serum creatine kinase level and pituitary hyperplasia.

Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.