Objective To analyse the relationship between lumbar discectomy outcomes and herniated type and annular integrity. Methods Two hundred and sixty patients who underwent conventional posterior discectomy for lumbar herniated disc were reviewed and followed-up for 6-14 years, with an average of 8.5 years. The criteria of enrolled patients include: all of the cases with low lumbar disc herniation at a single level, laterally protruded disc(one side sciatica) without spinal canal stenosis. Four categories of intraoperative findings were found basing on the defect size of annular and extruded fragments, and postoperative outcomes was compared statistically. Results The patients with larger disc fragments and minimal annular defects had the better outcomes and lowest incidence of recurrence after surgery. On the contrary, small fragments with massive annular defects did worse by comparison. Conclusion The outcomes of lumbar discectomy have close relationship with herniation type and annular integrity. Patients with mild clinical symptoms, small and broad-based disc herniations should be exempted from open discectomy. If open discectomy unavoidable, annular integrity and bony stability should be preserved as much as possible.

Objective To study the multi-slice spiral CT (MSCT) perfusion imaging in evaluating the changes of blood supply of hepatocellular carcinoma( HCC ) before and after transcatheter hepatic arterial chemoembolization (TACE). Methods Before and after TACE, MSCT perfusion was performed in 17 patients with HCC. The perfusion indexes such as hepatic blood flow (HBF), hepatic blood volume(HBV),mean transit time (MTT),hepatic arterial fracture (HAF),permeability surface (PS), hepatic artery perfusion (HAP), portal venous perfusion (PVP) were calculated. The hemodynamic changes of HCC after TACE were evaluated according to perfusion parameters. Results After TACE, HBF,HBV and HAP found in MTT and PS before and after TACE (P > 0.05). Conclusion The parameters of MSCT perfusion imaging( HBF, HBV and HAP) can effectively evaluate the hemodynamic changes of HCC after TACE, and has important value in chnical application.

Degeneration of the lumbar facet joints is considered to be one of the main causes of low back pain,which severely impact the life quality of people.This article sums up the research advancement of the lumbar facet joints degeneration of domestic and foreign scholars in recent years,and summarizes the characteristics of the X-ray,CT and MRI and clinical significance of the degeneration of articular process,of which the characteristic of MRI was rarely reported domesticly.The purpose is to provide ideas and references for domestic scholars aiming to further clinical research of related fields in the future.

Objective To investigate the clinical value of modified BI?RADS classification by using the coronal plane of automatic breast volume scaner. Methods The total of 201 BI?RADS 3~5 classification of breast masses were retrospectively analyzed. All masses underwent conventional ultrasound and ABVS examination. Using BI? RADS classification standard terms to describe various information of breast masses, and record the coronal image of the masses on the complete interface echo, convergence sign, angle, burr, which classified BI?RADS ultimately. Results The coronal plane of convergence sign, complete interface echo, angulation and burr were significantly different between benign and malignant tumors (P<0.0001). The sensitivity of ABVS convergent sign in diagnosing breast malignant tumors was 68.2%, specificity was 93.4% and accuracy was 82%. The conventional ultrasound combined with the coronal feature of ABVS modified by BI?RADS classification showed that 3 kinds of malignant rate reduced from 8.5%to 3.2%. The rate of malignant 4a decreased from 25.2%to 12.1%and the rate of malignant 5 increased from 94.2% to 98%. Conclusion The convergence sign of ABVS can be used as a significant independent predictor of breast malignant tumors;ultrasound combined with ABVS is helpful to improve the accuracy of ultrasound BI?RADS classification.

Clinical pharmacology is a cross subject of clinical medicine sciences and basic pharmacology.Only by making a lot of efforts to teach clearly,newly and lively,can we increase the students'interest and improve the teaching quality.

[Summary] With populational proportional sampling (PPS) method in Baiguo village,one central primary sehool was selected,and villagers aged 20-80 in nearly village were chosen as control.Cross-seetional survey methodology was employed,B-type ultrasonography was used to determine thyroid volume and nodule of ebildren.Arsenic cerium catalytic spectrophotonetric assay was employed to detect urinary iodine.A direct titration measurement was used to determinate iodine content in salt.180 children aged 6-12 were surveyed,2 cases of goiter were found (1.11％).16 cases of thyroid nodules were discovered(8.89％),including 3 boys(3.45％,n =87) and 13 girls(13.98％,n =93).Girls had a higher prevalence than boys (x2 =6.154,P =0.015).The prevalence of thyroid nodules in that village was 24.51％,being statistically significant between 2 groups (x2 =17.368,P =0.001),and increasing with the age.

Objective To evaluate the middle and short-term effects of integrative cognitive training on mild cognitive impairments(MCI).Methods All the participants with MCI aged over 70 years were selected from one sub-district of Putuo District,Shanghai and divided into cognitive intervention group (n=46) and control group (n=35).The integrative cognitive training was conducted in 24 sessions for 12 weeks.All subjects were assessed by Neuropsychological Test Battery for Elderly (NTBE) and by a questionnaire of Shanghai Health Survey for the Elderly (VER2006)at baseline,follow-up and one-year follow up phases.Results At baseline phase,semantic relations test in NTBE was better (t=2.13,P=0.037),verbal fluency test (vegetables) in NTBE was worse(t =-2.25,P=0.038) in intervention group than in control group,while there were no significant differences in scores of other neuropsychological tests between intervention group and control group(all P＞0.05).At follow up phase,16 subscales in reasoning test of NTBE were improved (t=-2.70,P=0.010)and 2 subscales were declined in cognitive intervention group(all P＜0.05).9 subscales in semantic relations test of NTBE (t=-2.27,P=0.013) were improved and 5 subscales were declined in control group (all P＜ 0.05).Comparison between groups at one year follow-up showed that 5 subscales in reasoning test of NTBE (F=16.80,P=0.000) were better in intervention group than in control group(all P＜0.05).General linear model (GLM) with repeated measures at three time points showed that 4 subscales in reasoning test of NTBE had a time-by group interaction (F=5.16,P=0.01).Conclusions Integrative cognitive training can improve cognitive function in patients with mild cognitive impairments,and the validity of reasoning ability can sustain one year.

Objective To evaluate the effects of compositive cognitive training on reasoning ability for healthy community elderly.Method All the participants were selected from one district in Shanghai by every 50 samples.151 community healthy elderly who accorded with the standard were collected at last.They were divided into cognitive intervention group ( n =90) and control group ( n =61 ) by sequence.The interventions ( includes reasoning,memory training,et al) were conducted in 24 sessions over 12 weeks.All individuals were assessed by Neuropsychological Test Battery for Elderly (NTBE) at baseline,follow-up,half a year follow-up and one year follow-up phase,and Raven' s Standard Progressive Matrices on reasoning classes.Results The scores of Raven' s Standard Progressive Matrices were significantly higher after reasoning training in intervention group( (15.54 ±5.70),(10.35 ± 5.10),t =3.595,P ＜ 0.01 ).Compared with baseline,the reasoning test scores of NTBE were significantly higher after cognitive intervention in treatment group at follow-up phase,and were also significantly higher than control group (P ＜ 0.05 or P ＜ 0.01 ).Conclusion Results support the effectiveness of compositive cognitive training in improving reasoning ability are positive,and can last for one year.

ObjectiveTo explore the effect of the microsurgical treatment for intramedullary spinal cord tumors.Methods38 patients with intramedullary spinal cord tumors were retrospectively analyzed,and the removal of the tumor cases and functional changes in patients after surgery was summarized.Results38 cases of intramedullary spinal cord tumors,17 cases of ependymoma were all totally removed under the microscope;13 cases of astrocytoma resection achieved in 5 cases,near total resection in 4 cases,partial resection in 4 cases;5 patients most of the lipoma removed;3 cases of hemangioblastoma resection were done.32 patients before surgery in patients with different degrees of movement disorders at discharge in 29 patients with different degrees of improvement,no change in 1 case,2 cases decreased compared with preoperation ;29 patients with varying degrees of preoperative sensory disturbance,21patients at discharge with improvement,5 patients had no change,three cases aggravated; 14 patients had sphincter dysfunction,12 patients improveed than before surgery 2 patients had no change.ConclusionEarhy diagnosis and taking early microsurgical treatment was the preferred method in treatment of Intramedullary spinal cord tumors in clinical application.