Objective To discuss the diagnosis and treatment of AVM bleeding without DSA in the basic hospital.Methods Clinical difference of intracerebral hemorrhage was revienly analyzed between arteriovenous malformation and hypertensive intracerebral hemorrhage.Results Boths were different at sick ages,position and shape of haematoma,change of blood pressure after bleeding,CT scan of preoperative and view in operative.Surgery was effective.Conclusion Initial diagnosised of AVM bleeding is affirmed,according to patient's age,using mannitol is effective to control blood pressure after bleeding and display of CT scans preoperative.Final diagnosis is confirmed in operation without DSA at basic hospital.Treatment of AVM bleeding with surgery is effective.

Objective To explore the diagnosis value of CT in subarachnoid hemorrhage(SAH) induced by aneurysm rupture.Methods The clinical and CT data of 119 patients with SAH induced by aneurysm rupture were analyzed respectively.Results The CT characteristic of SAH induced by aneurysm rupture was full of hyperderse in sulcus and schizenceplay,or accompaning intracerebral hematoma in the straight gyrus of frontal lobe and the hippocampal gyrus of parietal lobe.Conclusion The CT has important value for diagnosing SAH induced by aneurysm rupture in the location and the nature.But it is indispensable that the CTA or DSA must be done for ascertaining the artery of responsibility of rupturing aneurysm.

ObjectiveTo demonstrate the project scope of the afferent nerves of the lumbar intervertebral disc,on which basis to explore the mechanism of the symptoms of discgenic low back pain.MethodsThirty Wistar rats were divided randomly into three groups of 10 rats each:the L4-5,L5-6,and L6 S1 group.Each group was further divided randomly into two subgroups,the experimental group and the control group,5 rats for each group.Intervertebral disc was exposed through the posterior approach under peritoneal cavity anesthesia,after the nerve roots were pull away,2 μl of 30％ cholera toxin-horseradish peroxidase (CT-HRP) was injected into the inner layer of the intervertebral disc in the experimental group,while 2 μl of 0.9％ Nacl was used in the control group.Forty-eight hours after the surgery,all rats were perfused and bilateral dorsal root ganglions(DRGs) of T10-L3 were resected and fixxied.Each DRG was sectioned at 30 μm thickness and processed by DAB method.The sections of DRGs were coverslipped and observed by optical microscopy for the neurons or axons labelled by CT-HRP.It was judged as positive that brownish-black particles were in the neurons or axons.ResultsNot in a single dorsal root ganglions,but in a scope of dorsal root ganglions axons labled by CT-HRP could be seen in the rats in the experimental groups.No CT-HRP labled neurons or axons were seen in dorsal root ganglions in the contral groups.ConclusionAfferent nerves of the lumbar intervertebral disc project to a scope of dorsal root ganglions,which is the anatomic basis of the mechanism of the symptoms of discgenic low back pain.

Objective To investigate the possible role of plasma leptin and total cholesterol in the pathophysiology of attempted suicide in depressive episode patients. Methods The subjects were 25 depressive episode patients who had recently attempted suicide and 30 depressive episode patients without suicide attempt. The Hamilton Depression Rating Scale-24 items ( HAMD24 ), Beck Helpless Rating Scale (BHS) and Self-rating Idea of Suicide Scale (SIOSS) were used to evaluate the severity of symptoms. In addition, 32 individuals who took part in health examination were selected as health control group. Body height and weight were measured to get body mass index (BMI) of all objects, and plasma leptin and total cholesterol were measured by venous blood before taking pill. Results (1)HAMD score , BHS score and SIOSS score in patients with attempted suicide were higher than patients without suicide (P ＜ 0.01 ). (2) The total cholesterol and plasma leptin in patients with attempted suicide ( (3.3 ±0.9)mmol/L, (6.1 ±3.7)μg/L)were lower than that in patients without suicide( (3.6± 1.2)mmol/L, (9.4 ± 4.4)μg/L; P ＜ 0.05 ～ 0. 0l ), while total cholesterol and leptin in patients without suicide attempt ( (3.6 ± 1.2 ) mmol/L, ( 9.4 ± 4.4 ) μg/L) were lower than that in normal controls ( ( 4.8 ± 0.9 )mmol/L, ( 13.4 ± 6.7 ) μg/L; P ＜ 0.05 ～ 0.01 ). (3) Plasma leptin and total cholesterol of all patients were positively correlated with BMI(P＜0.01 ). Moreover, plasma leptin and total cholesterol in patients with attempted suicide and patients without attempted suicide were inversely positively correlated with HAMD score , BHS score and SIOSS score. Plasma leptin was significantly positively correlated with total cholesterol in patients with attempted suicide and patients without suicide, but there was no significant difference in normal controls(P＞ 0. 05). Conclusion The results suggest that decreased plasma leptin is related to the pathophysiology of attempted suicide in depressive episode patients.

Objective To evaluate the effect of minimally invasive therapy for treating intraventricular hemorrhage.Methods The minimally invasive therapy with unilateral or bilateral drainage were received according to quantity and shape of intraventricular hemorrhage.Results It was operated 22 cases with unilateral drainage and 28 cases with bilateral drainage in the 50 cases intraventricular hemorrhage.Death was 3 cases and mortality rate was 6% in the minimally invasive therapy.ADL1 15 cases(30%),ADL2 18 CRSeS(36%),ADL3 8 cases(16%),ADLA4 cases(8%),ADL5 2 cases(4%)in leave hospital.Conclusion Minimal invasive therapy of intraventrieular hemorrhage has great superiority,such as it can operate simple,trauma mild,decrease complications and enhance curative effect.It can generalize in the basic hospital.

Objective - To analyze the relation between classes and prognosis of the brain.stem hemorrhage.Methods 37 patients with spontaneous brainstem hemorrhage were divided into three groups according to con-sciousness and breathing function: Ⅰ group 13 cases with consciousness; Ⅱ group 11 cases without consciousness; Ⅲgroup 13 cases without consciousness and respiration, according to the classes, using different ways and means. Re-suits Ⅰ group 13 cases survival in 13 cases; Ⅱ group 10 cases survival and 1 case death in 11 cases; Ⅲ group 1 case survival and 12 cases death in 13 eases. Conclusion The classes of the brain.stem hemorrhage is propitious to select therapeutic measure and prognostic estimate. The intensive care and the surgery can reduce mortality rate.

Objective:To compare the efficacy and safety of CT and ultrasound-guided percutaneous biopsy of lung or pleural lesions.Methods:The clinical data of 193 patients with lung space occupying lesions near the pleura who underwent CT or ultrasound-guided percutaneous puncture in Shiyan People's Hospital Affiliated to Hubei University of Medicine from February 2017 to October 2020 were analyzed retrospectively. According to the puncture mode, the patients were divided into CT-guided group ( n=115) and ultrasound-guided group ( n=78) . The general clinical data, pathological examination results, puncture success rate and complication rate were compared between the two groups. Logistic regression was used for univariate and multivariate regression analysis. Results:The detection rate of malignant tumors in the CT-guided group (60.00%, 69/115) was higher than that in the ultrasound-guided group (50.00%, 39/78) , with no statistically significant difference ( χ2=1.89, P=0.170) . The puncture success rate in the CT-guided group (88.70%, 102/115) was slightly lower than that in the ultrasound-guided group (93.59%, 73/78) , with no statistically significant difference ( χ2=1.32, P=0.251) . The incidence of postoperative complications in the CT-guided group (18.26%, 21/115) was higher than that in the ultrasound-guided group (6.41%, 5/78) , with a statistically significant difference ( χ2=5.60, P=0.018) . The incidence of pneumothorax in the CT-guided group (13.04%, 15/115) was higher than that in the ultrasound-guided group (3.85%, 3/78) , with a statistically significant difference ( χ2=4.65, P=0.031) . The incidence rate of bleeding in the CT-guided group (5.22%, 6/115) was higher than that in the ultrasound-guided group (2.56%, 2/78) , with no statistically significant difference ( χ2=0.82, P=0.364) . In the CT-guided group, 1 patient (0.87%) had severe bleeding requiring surgical treatment, 5 patients (4.35%) required closed thoracic drainage for treatment. In the ultrasound-guided group, no patients had pneumothorax or bleeding requiring drainage or surgery. Univariate analysis showed that the puncture method was an independent risk factor for the puncture success rate in patients with lesion-pleura contact arc length (LPCAL) ≥38 mm ( OR=7.82, 95% CI: 1.57-35.50, P=0.039) . Multivariate analysis showed that puncture method is an independent risk factor affecting the puncture success rate in patients with LPCAL≥38 mm ( OR=7.75, 95% CI: 1.44-41.36, P=0.042) . Among patients with LPCAL≥38 mm, the puncture success rates of CT- and ultrasound-guided puncture were 84.38% (54/64) and 98.00% (49/50) , respectively, and the puncture success rate of CT-guided puncture was lower than that of ultrasound-guided puncture, with a statistically significant difference ( χ2=4.52, P=0.034) . In LPCAL<38 mm patients, the puncture success rates of CT- and ultrasound-guided puncture were 94.12% (48/51) and 85.71% (24/28) , respectively, and the CT-guided puncture success rate was higher than that of the ultrasound-guided puncture, with a statistically significant difference ( χ2=0.71, P=0.399) . Conclusion:Ultrasound-guided percutaneous puncture biopsy of lung or pleural lesions has the advantages of high diagnostic rate and few complications. Both ultrasound-guided and CT-guided puncture biopsy are feasible methods for puncture of chest wall lesions. When LPCAL≥38 mm, ultrasound-guided puncture biopsy may have more advantages.

Objective: To investigate the prevalence of Internet addiction and depression of students, and to analyze the co-occurrence and trend, so as to provide a theoretical basis for prevention and controlling measures of Internet addiction and depression. Methods: A total of 6 317,7 152,81 808,71 180 and 89 932 students aged 10 to 24 years from 12 leagues (103 banners) in Inner Mongolia Autonomous Region were selected by stratified random cluster sampling in September each year from 2017 to 2021. The Internet Addiction Scale and the Central for Epidemiologic Studies Depression Scale(CES-D) was used to measure Internet addiction and depression. And the annual inspection rate, group difference and annual change trend in students were calculated. Multivariate linear regression and restricted cubic spline analysis were used to estimate the linear and non linear associations between Internet addiction and depression in students. Results: The Internet addiction proportion in students gradually decreased from 4.1% in 2017 to 2.1% in 2020, but increased to 3.9% in 2021. And the depressive symptoms proportion increased from 20.9% in 2017 to 28.0% in 2020 and 27.0% in 2021. The detection rate of Internet addiction and depression comorbidities remained at 1.8% to 2.5 %. The Internet addiction proportion in boys was higher than that in girls( χ 2=42.82， P <0.05). The depressive symptoms prevalence in girls was higher than that in boys( χ 2= 553.90， P <0.05). Taking reversal in prevalence of Internet addiction in urban and rural areas was observed in 2019. The detection rates of depressive symptoms and comorbidity were higher in urban areas than these in suburban counties on the whole, and the difference showed a trend of decreasing or even equalizing year by year. Internet addiction was positively correlated with depressive symptoms score ( B=1.67, 95%CI =1.64-1.71), the proportion of depressive symptoms ( OR=1.39, 95%CI =1.38-1.41) and the proportion of major depressive symptoms ( OR=1.35, 95%CI =1.33-1.36) among students in 2021 ( P <0.05). An N-shaped curve was found in the significant nonlinear associations between internet addiction and depression across sex, region and school stage. Conclusion Internet addiction and depression in students show significant linear and non-linear associations, which are consistent in different sexes, regions and school stages. Therefore, relevant measures should be made and implemented in each region, especially in suburb areas, so as to prevent the increasingly development of adolescents and children s Internet addiction and depression.