Episodic tension-type headache is the most common headache in the general population and is usually self managed.Chronic tension-type headache may be highly disabling and often prompts medical consultation.Diagnosis is clinical,based on widely accepted and validated criteria and algorithm.Peripheral factors are implicated in episodic tension-type headache,whereas central factors probably underlie chronic tension-type headache.Simple analgesics,such as aspirin,are used for acute treatment.Amitriptyline and biofeedback assisted relaxation training have the best evidence of effectiveness for headache prevention.

Objective:To evaluate functional recovery of nerve and muscle after end-to-side neurorrhaphy.Methods:10 SD rats were randomly and evenly devided into group A and group B.Right common peroneal nerve was amputated in all the rats.Then the distal stump was sutured to the ipsilateral tibial nerve by the end-to-side way through a epineurial window in group A. The right common peroneal nerve was severed in group B as denervated control.After 1.5 months all the rats were subjected to walking track analysis,histological and ultrastructure observation.Results:In group A peroneal nerve index (PFI) achieved -41.634,density of collateral axons 51.437?12.041/1 000 ?m 2,synapsin (SYP) 439?120.5.In group B PFI was -100,SYP 0. In normal control PFI was 0, density of collateral axons 18.847?1.078/1 000 ?m 2,SYP 842?84.7.Conclusion:End-to-side neurorrhaphy may induce nerve sprout plenty of collateral axons.The axons can reach target muscle to reconstruct functional neuromuscular junction,and recover the function of the muscle in some degree.

Objective To investigate the trends of colorectal cancer incidence in Shanghai Xuhui District from 2001 to 2011.Methods Total 3042 cases of colon cancer and 1958 cases of rectal cancer were collected from the Shanghai Cancer Reporting System.The results were age-adjusted according the census data of 2000 as the standardized incidence.Results The standardized incidence rate of colorectal cancer in Xuhui District rose from the 21.83/100 000 in 2001 to 27.35/100 000 in 2006 and increased by 25.29％ ; from 2009 to 2011 the incidence rate was stabilized.The ratio of colon to rectal cancer was 1.55:1,and the incidence of colon cancer was significantly higher than rectal cancer.The incidence rate of male and feinale colorectal cancer increased with age,especially at ＞ 45 y group accounting for 98.70％ and 98.37％ of total incidence rate respectively.The ratio of male to female in colon cancer incidence rate was 0.98∶ 1,while that of rectal cancer was1.25∶ 1.Conclusion The incidence of colorectal cancer in Xuhui District from the last 11 years is significantly higher than of national level.More effective preventive measures should be taken.

Objective To evaluate the effects of pulmonary static inflation with different pressures on postoperative lung function in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients,aged 26-70 yr,weighing 47-78 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =30 each):pulmonary static inflation with 5 cm H2O group (group L) and with 10 cm H2O group (group H).In L and H groups,pulmonary static inflation was performed with the pressure maintained at 5 and 10 cm H2O,respectively,after stopping mechanical ventilation during CPB.Arterial blood samples were taken before skin incision and at 1,3 and 6 h after termination of CPB for blood gas analysis.The alveolar-arterial oxygen pressure difference (D(A-a)O2),respiratory index (RI) and oxy.genation index (OI) were calculated.The indwelling time of endotracheal tube after operation and duration of ICU stay were recorded.Results Compared with group L,D(A-a)O2 and RI were significantly decreased and OI was increased at 1,3 and 6 h after termination of CPB,the incidence of OI less than 300 mm Hg was decreased (P ＜ 0.05),and no significant change was found in the indwelling time of endotracheal tube after operation and duration of ICU stay in H group (P ＞ 0.05).Collusion Pulmonary static inflation with 10 cm H2O can better improve postoperative pulmonary diffusion function than with 5 cm H2O in patients undergoing cardiac valve replacement with CPB.

Objective To investigate curative effects of endoscopic sternocleidomastoid muscle amputation for the treatment of congenital muscular torticollis.Methods A total of 23 children with congenital muscular torticollis were treated in this department.Their age was 1 month ~ 12 years old(median,30 months).A 5 mm trocar was inserted through the right axilla along the cleavage lines.Under the endoscopic visualization,the sarcolemma on the inferior portion of the muscle was bluntly dissected and a subcutaneous space was established by CO_2 inflation at the pressure of 6 mm Hg.Another two 3 mm incisions were made along the cleavage lines at lower lateral part of the neck and the anterior chest wall for the introduction of curved forceps and electric knife,respectively.The sternocleidomastoid muscle was transected with electrocautery and the external fascia within which the sternocleidomastoid muscle resides was also adequately divided. Results The operation was successfully completed under endoscope in all the 23 children.The mean operation time was 51.2 min(range,(35~)135 min) and the intraoperative blood loss was

Objective To explore effects of arterial self-expanding stents implanted in different position for treating lower limb ischemia.Methods Follow-up records of 65 patients of lower limb ischemia(71 limbs) teated by stent implantation from January 2002 to March 2006 were retrospectively reviewed.Out of the 71 patients,there were 38 patients(52.3%) of diabetic lower limb ischemia and 33 patients(47.7%) of non-diabetic ischemia.Stent implantation included 2 abdominal aortic stents in 2 patients,1 abdominal aortic and 2 iliac stents in 1 patient with the Leriche syndrome,38 iliac stents in 33 patients(35 limbs),12 stents for iliacofemoral lesions in 6 patients(6 limbs),23 femoral stents in 16 patients(19 limbs),10 stents for femoral and prioxiaml popliteal arterial lesions in 5 patients(6 limbs),and 2 stents for distal popliteal arterial lesions in 2 patients(2 limbs).Results The patients were followed for 2~50 months(mean,16.1 months).The patency rate was 100% in 3 patients with abdominal aortic stent implantation or abdominal and aortoiliac stent implantation.Iliac artery occlusion occurred in 4 patients(4 limbs),with the patency rate of iliac arterial stents being 88.6%(31/35).The patency rate of femoral arterial stents was 78.9%(15/19),and that of femoral and prioxiaml popliteal arterial stents was 83.3%(5/6).Stents in distal popliteal artery were occluded in all the 2 patients.Stents remained patent after a mean of 5.6 months postoperatively in 3 patients with 2 femoral stents in 2 limbs and 1 femoropopliteal stent in 1 limb while distal outflow arteries were blocked.Conclusions Stent implantation can be the first choice for aortoiliac stenosis or occlusive arterial diseases.It is also recommendable for stenotic or occlusive femoral and proximal popliteal arterial diseases.It is a proper option for the senile patients or those who can not stand bypass procedures.However,for tibial arterial stenosis or occlusion,it is not a favorable consideration.

Objective: To describe 3D-TOF MRA features of anomalous vertebral artery(VA) and evaluate its clinical significance in healthy adults who were accepted physical examination. Methods: A total of 442 cases in which 3D-TOF MRA was performed were retrospectively reviewed to discuss the incidence and relationship between VA origin and course variation. Results: Among this 442 cases, the incidence of origin variation was 4.75%(21/442) in which all cases were unilateral(19 cases in the left and 2 cases in the right). In these cases, the anomalous VA originated from the aortic arch or the right common carotid artery. All of the 21 cases with origin variation had the aberrant entrance position into the transverse foramen (4th or 5th). The incidence of abnormal entrance position into the transverse foramen was 9.50%(42/442),of which most cases(95.24%, 40/42)were unilateral. Of 40 cases, the incidence of both sides was the same(50.00%(20/40)). Conclusion: The VA origin variation always happened in the left side, and often combined with the course variation. 3D-TOF MRA plays an important part in the detection of the anomalous vertebral artery in healthy adults. It can provide useful information for the surgery and the therapy of related diseases.

Objective:To investigate morphologic variations of circle of Willis in healthy adults using 3D-TOF MR angiography in medical examination and its clinical significance. Methods:To analyze the characteristics of the vascular morphology in 442 healthy adults of head 3D-TOF MRA in the post processing workstation retrospectively. Results: All the 442 cases, the variations of circle of Willis were found in 152,the variations of A1, A2, ACoA, PCoA, P1 were found in 76(50.00%), 23(15.13%), 7(4.61%), 101(66.45%), 68(44.74%). The variation of A1 was positively correlated with PCoA, the variation of PCoA in female was more than in male. Conclusion:Medical examination-3D-TOF MRA has important value to display morphologic variations of circle of Willis in healthy adults, which can provide important guide value in the clinical.

Objective To observe the effects of insulin pump therapy on type 1 diabetes mellitus children with diabetic keto or diabetic ketoa-cidosis(DK/DKA).Methods Forty-three children with DK/DKA were randomly divided into treatment group(n=26)and control group(n=17).The patients in treatment group were treated with insulin pump,control group were received small amount insulin injravenous injection.The changs of blood sugar,urine ketone bodies,incidence of hypoglycemia and length of stay were observed.Results 1.The effect of decreasing sugar was the same between two groups.2.There was no hypoglycemia events in treatment group.But 2 cases in control group had hypoglycemia.3.There was significant difference of length of stay between two groups(P

Objective To detect the feasibility of patients with specific behaviors in the facial trauma clinical teaching. Method 47 medical students were randomly divided into experimental group ( n = 22 ) and control group(n=25). Students from experimental group at least dealed with 5 ～ 10 facial trauma patients with specific behaviors, while specific behaviors patients in control group were not more than 2. Teaching results were compared. Results There was no significant difference in operation test scores between the two groups ( (84.68 ±3.41 ) vs ( 83.96 ± 3.46 ), P = 0. 476 ). Composite score of teachers in the experimental group was significantly higher than that in control group( (90.09 ± 5.69 ) vs (83.48 ± 5.19), P ＜ 0.01 ). The results of questionnaire survey showed that two in five self-assessment results were higher in the experimental group(P ＜ 0. 01 ). Conclusion Medical students are more appropriately involved in treating special behaviors patients, which can improve the overall quality of students. Teaching with special behaviors patients has good effect, and is feasible.