Objective:To observe the clinical efficacy and safety of radiofrequency thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation.Methods:One hundred and two patients with Lumbar disc herniation were divided into two groups.Radiofrequency thermocoagulation combined with epidural block group(group R,n=48)accepted the epidural drugs injection。1 week later radi-ofrequency thermocoagulation was taken.The epidural block group(group E,n=54)accepted the same epidural drugs injection.The VAS scores,clinical efficacy and complication were evaluated.Results:After the treatment,VAS scores in both groups decreased significantly compared with that before treatment.VAS scores on day 1,week 1 and month 1 after radiofrequency thermocoagulation were 3.13?0.99,1.35?0.34,1.05?1.22 respectively in the group R and 4.98?0.66,1.98?0.81,1.68?1.03 respectively in the group E(P

Objective To study the clinical features and differential diagnosis of hairy-cell leukemia variant (HCL-V).Methods A case with HCL-V was reported and the literatures were reviewed.Results The patient had splenomegaly for twenty years and a history of recurrent pulmonary infection.His blood routine test showed a high white blood cell count and abnormal high proportion of lymphocytes.Peripheral smear and bone marrow smear both showed significantly higher proportion of lymphocytes,part of which had soma jagged,prominent nucleoli and villous/hairy cytoplasmic projections.His hairy leukemic cells expressed CD1 1c,CD19,CD20,CD22,and had variable expression of FMC-7,CD103 and lambda,but not CD5,CD23 and CD25.Transmission electron microscope showed many monocytes with villous exist in peripheral blood.Conclusions HCL-V is a rare and an indolent form of a small,mature,B-cell leukemia,based on the clinical,peripheral smear,bone marrow smear,flow cytometric analysis and transmission electron microscopy features,a diagnosis of HCL-V is confirmed.The differential diagnosis should always include splenic marginal zone B-cell lymphoma and HCL-C,because they have different clinical and biological features.

Objective To investigate the physical and mental health of Shandong medical personnel.Methods 3200 medical personnel were randomly selected from hospitals of Shandong province,selfhealth,depression and sense of work stress were measured and analyzed statistically.Results 36.3％ of medical staff was in depression state,and even about 22.5％ of the subjects was in moderate or severe depression state.Male and female medical staff showed no difference in sense of work pressure.Senior medical staff showed higher working pressure than middle-class,junior-class and low-level medical personnel,but middleclass,junior medical staff and low-level medical staff showed no significant difference.In the aspect of self-health status,male and female medical personnel showed no significant differences,senior,middle-class and junior-class medical staff reported worse self-health status than low-level medical personnel.Conclusions Managers should pay attention to physical and mental health of medical personnel,adopt pertinent measures to reduce their mental pressure in order to promote their physical and mental health.

Objective To explore the short-term and long-term clinical effect of leep knife treatment of chronic cervicitis. Methods A single-center, prospective, randomized, controlled study was used, 120 patients with chronic cervicitis were randomly divided into observation group and control group, each group of 60 patients. Patients in the observation group were treated with (LEEP) knife, parameters setting frequency was 3.8 MHz, power was 30 ~ 40W, patients in the control group were treated with microwave. The intraoperative and postoperative recovery and relapse were compared between two groups. Results The intraoperative blood loss, operative time, postoperative vaginal discharge time in the observation group were significantly less than control group, there was a significantly statistical difference (P<0.001) . After two weeks and three months , the cure rate in observation group were 70% and 98.33% respectively, the cure rate in control group were 16.67% and 51.67%, there was a significantly statistical difference (P <0.01) . After 2 weeks and 3 months, the infection rate and recurrence rate in the observation group were significantly lower than the control group, there was a significantly statistical difference (P <0.05) . Conclusion Leep knife for treatment of chronic cervicitis patients has lower postoperative recurrence, lower infection rate and higher cure rate in short-term and long-term, and less intraoperative trauma, shorter operation time, and has important clinical significance for the prognosis of patients.

Post-infectious bronchiolitis obliterans(PIBO) is a rare serious chronic lung disease characterized by irreversible small airway fibrosis.Lower respiratory infections are the most common causes in children.Its major clinical characteristics are recurrent or persistent cough, wheezing, shortness of breath, hypoxia, crackles, and persistent for above 6 weeks.Clinical diagnosis mainly depends on clinical manifestations, lung function and high-resolution CT examination.At present, there is no unified standard of treatment, mainly empirical treatment.Most of the children have a poor prognosis, and a small number of children can achieve good results through early diagnosis and intervention.

Objective To analyze the clinical characteristic,treatment and prognosis of traumatic macular holes resulted from ocular contusion.Methods The clinical data of 47 cases with traumatic macular hole was retrospectively reviewed.The general condition of the patients was summarized,optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes.The patients were divided into observation group and surgery group by the treatment they received,and the prognosis was evaluated.Results Traumatic macular hole occurs mainly in male.In the observation group,the mean diameter of macular hole was(490.0±86.9) μm.During the 12 month follow up,the holes in 7 cases (33.3％) were closed spontaneously,Vision and diameters of 14 cases (57.1％) maintained stable for a long time,the vision of 1 case (3.3 ％) declined mildly and the diameter of 1 case (3.3％) enlarged slightly.Visual acuity was improved significantly at last follow up (Z=-2.40,P＜ 0.05).The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30,5.06;P＜0.05).These data suggests that the macular function was recovered well.In the surgery group,the mean diameter of macular hole was (643.3 ± 125.0) μm and statistically larger than that of the observation group (t=-4.76,P＜0.05).At the last follow-up,visual acuity were not improved significantly (Z=-1.79,P＞0.05).The amplitudes of N1 wave in 6 cases (23.1 ％) improved merely and the difference was not statistically significant (t =1.98,P ＞ 0.05).These data suggests that the macular function was recovered slightly only in a few patients.Conclusions A part of the patients with smaller diameters of macular holes may close spontaneously,and they may get better visual acuity.Vitrectomy may help to close the macular holes in some severe cases,but the improvement of functional outcomes is not significant.

Objective To investigate the association between expression of PHH3 and CyclinD1 and their significance in breast invasive ductal carcinoma.Methods Immunostoemical MaxVision staining was used to detect the expression of PHH3 and CyclinD1 in 89 samples of breast invasive ductal carcinoma and 30 samples of normal breast tissues.The correlation was then analyzed between the expression of PHH3 and CyclinD1 and the clinical path-ological parameters as well as prognosis.Results The positive rate of PHH3 in breast invasive ductal carcinoma tis-sues(68 /89,76.4%)was significantly higher than that in normal breast tissues(2 /30,6.7%)(χ2 =45.051,P <0.05).The expression level of PHH3 was significantly correlated with tumor histological degree(χ2 =10.540,P <0.05),anillary lymph node metastasis(χ2 =6.852,P <0.05)and TNMstage(χ2 =5.634,P <0.05),but it was not related to the age(χ2 =1.054,P >0.05 )and the tumor diameter(χ2 =0.014,P >0.05 ).The positive rate of CyclinD1 in breast invasive ductal carcinoma tissues(62 /89,69.7%)was significantly higher than that in normal breast tissues(3 /10,10.0%)(χ2 =32.223,P <0.05).The expression level of CyclinD1 was significantly correlated with tumor histological degree(χ2 =13.328,P <0.05),anillary lymph node metastasis(χ2 =5.041,P <0.05)and TNMstage(χ2 =4.419,P <0.05),but it was not related to the age(χ2 =0.500,P >0.05)and the tumor diameter (χ2 =1.836,P >0.05).The expression of PHH3 was directly correlated to the CyclinD1 (r =0.497,P <0.05). Kaplan-Meier analysis showed that the expression of PHH3 was negatively correlated with prognosis.Log-Rank test indicated that there was significant difference(χ2 =10.468,P <0.05),CyclinD1 was negatively correlated with prog-nosis.Log-Rank test indicated that there was significant difference (χ2 =7.906,P <0.05 ).Conclusion High expression of PHH3 and CyclinD1 may be correlated with evolution and metastasis of breast invasive ductal carcino-ma.Combined analysis of PHH3 and CyclinD1 may provide a theoretical basis for prognostic information and treatment of patients with breast cancer.

BACKGROUND: Early education is an important step in raising children. Many facts prove that early education can promote infants' intellectual development so as to lay good foundation for their future development.OBJECTIVE: To understand the status of infants' intellectual development with Wechsler Intelligence Scale for Children and analyze the effects of early education.DESIGN: Comparative observation.SETTING: Wards of the Department of Pediatrics and Department of Obstetrics, Xuanwu Hospital of Capital University of Medical Sciences.PARTICIPANTS: We recruited 100 normal newborn infants born in the Department of Obstetrics, Xuanwu Hospital of Capital University of Medical Sciences, between January 2000 and December 2001. Guardians of the infants were informed of the research objective. Infants were divided into 2 groups according to their birth date: early education group (n=50) in which the infants were born on Monday, Wednesday, Friday or Sunday; control group (n=50) in which the infants were bom on Tuesday, Thursday or Saturday.METHODS: ① All the parents of the infants in the two groups received the guidance of feeding, infection prevention, inoculation and other health care guidance. On this basis, the parents of the infants in early education group were informed of intellectual development disciplinarian and educational guideline for 0-3 year-old infants when physical examination was performed on the infants at newborn period (twice) and 42 days after birth (once). The parents were asked to raise their infant according to the requirements of the guideline and communicate with the physicians at any moment. In control group, routine physical examination was performed on the infants at new-born period (twice) and 42 days after birth (once), and their parents were not given the early education of pediatric system. ② At 4 months and 3 days to 4 months and 29 days after birth, the infants in the two groups were taken back to hospital. Status of intellectual development was evaluated with intelligence scale for children revised and standardized by the Institute of Psychology of the Chinese Academy of Sciences and China Children Development Center according to Bayley's Scales of Infant Development [It consisted of intellectual scale and movement scale. Intellectual scale was used for 4.0-5.3 months babies (4 items, Item E: reaching out for building blocks, hand-eye coordination when reaching out, pick up building blocks, and keeping reaching out for things; Item G: noticed small pills; Item H: approached ocular; Item C: fond of playing with him).Movement scale was used for 4.0-5.3 months babies (4 items, Item A: turning their heads freely; Item E: from lying on the back to lying on the side;Item D: part of pollex face to face when holding building blocks; Item C:could sit independently for a moment)]. The primary scores of the infant was obtained from the number of an item which the infant could complete in intellectual development scale, then intellectual index and psychological movement development index were obtained according to his age span from the scale. Those with scores ＞130 were considered excellent, and those with scores ＜ 69 were mental retardation. ③ t test and U test were used in comparison of the differences in metrical and quantitative data.MAIN OUTCOME MEASURES: ① Comparison of intellectual development index and psychological development index between the infants in the two groups. ② Status of infants' intellectual scale and movement scale completion.RESULTS: Totally 100 infants entered the result analysis. ① Intellectual development: Intellectual development index and psychological movement development index were significantly higher in early education group than in control group (103.94±7.64, 111.20±9.40; 93.92±5.18,99.22±5.52, t=8.3,4.7, P ＜ 0.01). ② Status of intellectual scale completion: The number of infants who could complete Items E, D and C was obviously greater in early education group than in control group [36 infants (72%), 8 infants (16%), u=5.6, P ＜ 0.01]. ③ Status of movement scale completion: The number of infants who could complete Items E, D and C was obviously greater in early education group than in control group [45 in fants (90%), 32 infants (64%), 48 infants (96%); 30 infants (60%), 12 infants (24%), 42 infants (84%), u=2.0-4.89, P ＜ 0.05-0.01].CONCLUSION: Early education can improve infants' intellectual development, especially manipulative ability.

Objective To observe the effect of neoadjuvant chemotherapy for patients with advanced cervical cancer.Methods According to the digital table ,106 patients with advanced cervical cancer were randomly divided into the two groups ,53 cases in each group .The observation group was given TP Scheme neoadjuvant chemotherapy before surgery ,the control group underwent surgery directly .The total effective rate of chemotherapy and the changes of diameter of tumor before and after chemotherapy were observed .The serum levels of vascular endothelial growth fac-tor(VEGF) and matrix metalloproteinase-9(MMP-9) of the observation group were detected ,and the operation condi-tions were compared between the two groups .Results After chemotherapy ,the total effective rate of the observation group was 60.4%.Before and after chemotherapy ,the average tumor diameter of the observation group was (5.24 ± 1.35)cm,(2.64 ±0.67)cm,respectively,the difference was significant (t=3.947,P<0.05).The operative time, blood loss and lymph node metastasis in the observation group were significantly less than those in the control group (t=3.725,5.392,χ2 =4.28,P<0.05 or P<0.01).After chemotherapy,the serum levels of VEGF and MMP-9 were significantly lower than that before chemotherapy (t=3.130,4.724,all P<0.05).Conclusion Neoadjuvant chemotherapy in the treatment of advanced cervical cancer can significantly reduce serum VEGF and MMP-9 expression.

Objective To evaluate the effect of long-term and low-dose aspirin therapy on the severity of acute ischemic stroke. Method 321 acute ischemic stroke patients were randomly divided into two groups: aspirin group and Non-aspirin group. In addition, a pair study was made.Clinical scores were used to indicate the severity of acute ischemic stroke. Results Clinical scores showed that there were no significant differences statistically in the two random groups and pair study. Conclusions Long-term and low-dose aspirin therapy can not reduce the severity of acute ischemic stroke.