[Summary] Lumbar disc herniation is rare in juveniles , which makes it more difficult to diagnose and treat .The prevalence , causes and risk factors , pathological changes , clinical characteristics , main treatment methods , and curative effects of lumbar disc herniation in juveniles were summarized in this review , for benefiting clinical diagnosis and treatment .

One hundred kinds of excellent books on basic medicine were selected from Wanfang Data Knowledge Platform to develop a books-papers citation database.Their academic levels of the selected books were evaluated by PageRank algorithm.The chapters and sections of the books were divided into 4 parts according to their PageRank value and the distribution characteristics of their citation frequencies to study the PageRank and the top 20 cited chapters and sections of the books.The advantages and disadvantages of PageRank algorithm in book evaluation were described.

Objective To evaluate the salvage surgery for papillary thyroid cancer patients with residual neck metastatic lymph nodes after thyroidectomy.Methods Clinical data of 97 patients undergoing salvage neck dissection between September 2007 to June 2010 were analyzed retrospectively.Results Among 97 patients,residual metastatic lymph nodes were found in 80 patients in lateroposterial neck,overall residual rate was 82.47％.Residual rate was 85.71％ in 56 patients who underwent initial lateroposterial neck dissection in other hospitals:100％ in 8 patients who underwent berry-picking; 93.33％ in 30 patients who underwent partial dissection; 66.67％ in 18 patients who underwent whole neck dissection.Residual rate was 78.05％ in 41 patients who did not undergo initial lateroposterial neck dissection.The number of dissected lymph nodes was 15-45,with an average of 23 nodes removed and 8.21 metastatic lymph nodes per case.Residual metastatic lymph nodes were found in 67 patients in central neck,overall residual rate was 82.47％,residual rate was 53.85％ in 13 patients who underwent initial central neck dissection,and 71.42％ in 84 patients who did not undergo initial central neck dissection.Conclusions Correct imaging diagnosis decreases cervical residual metastatic lymph nodes in patients with papillary thyroid cancer.Successful salvage operation lies in choosing correct mode of neck dissection and carrying out sufficient dissection.

Objective To investigate the difference of the protein expression in serum of rats with acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP),and to investigate serum marker for acute pancreatitis severity.Methods The model of AEP and ANP was induced by retrograde injection of 4％ or 5％ sodium taurocholate into the biliopancreatic duct.Weak cation exchange (WCX2) and surface enhanced laser desorption/ionization time of flight mass spectrometry ( SELDI TOF MS) was used to investigate the difference of the protein expression in serum of rats with AEP and ANP.Results Thirty-eight spectral peak clusters which had significantly different signal intensities between AEP and ANP sera at mass charge ratio between 1000-50 000(P ＜0.05) were detected.The peak clusters at 9500 and 9700 in the sera of AEP were higher than that in ANP rata.Conclusions Serum analysis with SELDI-TOF MS can detect the difference of the protein expression in rats with AEP and ANP.The decreased expression of the protein of molecular weight of 9500 and 9700 may be a signal of AEP transition into ANP.

Objective To explore the feasibility for the tissue dispersion quantitative analysis software of ultrasonic strain elastography in diagnosing benign or malignant of thyroid lesions.Methods Eighty-two patients with 98 lesions were examined by ultrasonic strain elastography.There were 11 parameters of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value(MEAN),standard deviation of relative strain value(SD),area ratio of low-strain region (AREA％),complexity(COMP),kurtosis(KURT),skewness (SKEW),contrast (CONT),entropy(ENT),inverse different moment (IDM),angular second moment (ASM),correlation (CORR).The receiver operating characteristic (ROC) curve was constructed if there were statistically significant differences between benign and malignant lesions,and the areas under the ROC curve were got.Results All parameters except CORR had statistically significant between the groups of benign and malignant thyroid lesions (P ＜0.05).The AREA％ and IDM were the best valuable parameters,the areas under the curve(AUC) of which were 0.965 and 0.908,respectively.Their cut-off point were 81.96％ and 0.42,the sensitivity and specificitywere 98.4％ and 89.2％,91.8％ and 86.5％,respectively.Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of benign ormalignant of thyroid lesions,parameters of AREA％ and IDM has the highest relationship with pathology and good diagnostic value.

Objective To investigate the correlation of the supine hypertension (SP) with carotid intima-media thickness (IMT) in the elderly. Methods Kailuan study is a functional community-based cardiovascular risk factor study. From June 2006, there was a physical examination every two years. In the examination, demographic data, smoking, drinking, physical exercise situation and medication situation were recorded. Levels of triglyceride, high sensitivity C-reactive protein, low density lipoprotein and other biochemical indexes were observed. Using cluster random sampling, 3 064 retired employees of 60 years of age or older were selected. A total of 2 464 subjects took part in an additional examination, including the 24-hour ambulatory blood pressure monitoring, brachial-ankle pulse wave velocity, blood pressure of different positions and urine albumin. Multiple linear regression was used to analyze the correlation between supine systolic blood pressure (SBP) and IMT. Multivariate Logistic regression was used to analyze the effect of SP on IMT. Results (1) Among 2 220 participants (67.29±6.09) years, 1 463 (65.9%) individuals were male and 757 (34.1%) were females, and the average IMT was (0.92 ± 0.18) mm. (2) There was a positive correlation between supine SBP and IMT (r=0.175, P<0.01). (3) After adjusting the confounds, supine SBP was significantly associated with IMT, with an increase of 1 SD (+20.42 mmHg, 1 mmHg=0.133 kPa) in SBP corresponding to an increase of IMT by 0.01 mm (P<0.01). (4) Multiple Logistic regression analysis showed that after adjusting for sitting SBP, age, gender and other factors, SP was still a risk factor of increased IMT (OR=1.37, 95%CI:1.03-1.80), and independent of sitting SBP. Conclusion The supine hypertension is a risk factor of increased IMT, and independent of sitting SBP.

Objective To investigate the correlation of short-term systolic blood pressure variability (SBPV) with esti?mated glomeruar filtration rate (eGFR) in the elderly. Methods In physical examination for the third time of kailuan group, the method of cluster sampling was used to collect randomly retired employees, age≥60 in kailuan group. The 24-hour am?bulatory blood pressure monitoring was given to these objects. Finally, 1 405 participants with integral data were recruited in?to the survey. SBPV indices were standard deviation of systolic blood pressure (SD), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Multivariate stepwise linear regression models were used to analyze the influence of short-term SBPV on eGFR. Results (1) Among 1 405 participants (67.16 ± 5.82) years, 933 individuals (66.4%) were male and 472 (33.6%) were female. (2) Study population were divided into four groups based on the 24-hour mean SBP, daytime mean SBP, night time mean SBP (group 1:mean SBP<120 mmHg, group 2:120≤mean SBP<140 mmHg, group 3:140≤mean SBP<160 mmHg, group 4:mean SBP≥160 mmHg), respectively. Values of SD, MMD and ARV, but not VIM were increased with increased mean SBP. (3) The participants were grouped according to the median SBPV with between-group comparison of the eGFR. The average eGFR levels were lower in the high 24-hour SB?PV group (SD, VIM, MMD and ARV), day-time SBPV group (SD, VIM, MMD and ARV) and night-time SBPV group (SD, MMD and ARV) than those in the low SBPV groups (P<0.05). (4) Multivariate stepwise linear regression showed that eGFR increased with 3 indices of 24-hour SBPV (SD, MMD and ARV) and 2 indices of day-time SBPV (MMD and ARV) but not for night-time SBPV (β=-0.07,-0.11,-0.07,-0.12 and-0.07, respectively). Conclusion There is a certain degree of asso?ciation between short-term SBPV indices and eGFR.

OBJECTIVE:To systematically review the efficacy of agomelatine in the treatment of depression in acute phase, and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Cochrane Library,Medline,EMBase, CJFD,VIP,CBM,Wanfang Database,WHO Clinical Trials Registry Platform and American Clinical Trials Registry Platform, the randomized controlled trials (RCT) about agomelatine versus placebo in the depression patients in acute phase. After quality evaluation and data extraction,Meta-analysis was conducted by using Rev Man 5.2 statistics software. RESULTS:A total of 7 RCT were included,involving 2 378 patients. Results of Meta-analysis showed the effective rate in agomelatine group was obviously bet-ter than placebo group [RR=1.43 ,95%CI(1.29 ,1.59),P<0.001] ,remission rate was obviously better than placebo group [RR=1.27 ,95%CI(1.03 ,1.57),P=0.02] ,and the endpoint score of depression scales was obviously lower than placebo group [MD=-2.92,95%CI(-3.65,-2.20),P<0.001],there was statistically significance. CONCLUSIONS:Agomelatine is effective in the treatment of depression patients in acute phase. However,due to the limit of methodological quality and sample size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.

OBJECTIVE:To provide reference for vancomycin-induced neutropenia adverse reactions/adverse events in clinical diagnosis. METHODS:With a case of children with neutropenia treated by long-course and large-dose vancomycin,PubMed and CNKI were retrieved to collect related literature and the literature was analyzed. RESULTS:Neutropenia may be associated with vancomycin,based on causality criterion of adverse reaction in China. CONCLUSIONS:Vancomycin-induced neutropenia in chil-dren is most likely associated with prolonged exposure induced by infusion,vancomycin dosage should be reduced or stopped,and routine blood and plasma concentration should be closely monitored.

Objective To explore the double blood vessels bridge application and efficacy in multiple localized narrow of the anterior descending coronary artery.Methods The clinical data of 106 patients with multiple localized narrow of the anterior descending coronary artery were retrospectively analyzed.The patients were divided into two groups according to the operation methods.Fifty-six patients (improvement group) were conducted double blood vessels bridge on the anterior descending coronary artery,50 patients (control group) were conducted a single blood vessel bridge on the anterior descending coronary artery.Results The age,sex,body mass index,left ventricular ejection fraction,extracorporeal circulation time,endotracheal intubation time,length of hospital stay between two groups had no significant difference (P ＞ 0.05).One case in improvement group occurred angina pectoris,left ventricular size was (51 ± 6) mm,left ventricular ejection fraction was (60.8 ± 8.0)％.Nine cases in control group occurred angina pectoris,left ventricular size was(43 ± 6) mm,left ventricular ejection fraction was(55.1 ± 10.0)％.There was significant difference between two groups(P ＜ 0.05).Conclusion Double blood vessels bridge is safe and effective in multiple localized narrow of the anterior descending coronary artery.