General anesthesia combined with epidural anesthesia and postoperative epidural analge-sia is capable of accelerating the recovery of gastrointestinal function,providing better postoperative pain re-lief,improving the patient's satisfaction as well as shortening hospitalization dates.The article summarized the mechanisms of epidural analgesia influencing the recovery of gastrointestinal function.

Objective To compare the low-intensity focused ultrasound (LIFU) and high-intensity focused ultrasound (HIFU) in treating pain due to chronic soft tissue injury.Methods Ninety-three patients with pain due to chronic soft tissue injury, aged 18-80 yr, with body mass index of 18-31 kg/m2,course of the disease 3 months-10 yr, and pain intensity of 4-8 in a numeric rating scale, were randomly divided into 2 groups using a random number table: low intensity group (group LI, n =49) and high intensity group (group HI, n =44).In group LI, the patients received LIFU with the minimum ultrasonic intensity causing senses (acid, hemp, swelling, pain) , and the treatment was continued for 10 min.In group HI, the patients received HIFU with the focused uhrasound intensity that could not be tolerated by the patients, the treatment was continued for 1 min each time and then suspended for 1 min, and the total time for treatment was 10 min.The patients received the treatment once a day, and the course of treatment was 5 days in both groups.When numeric rating scale score ＞ 4 during the treatment, parecoxib sodium 40 mg was injected intramuscularly as rescue analgesic.Both the therapeutic index and improvement in movement were used to evaluate the therapeutic effect, and the quality of life and depression were assessed and scored.The treatment-related adverse events were also recorded.Results The total effective rate was 98％ and 84％ in LI and HI groups, respectively.Compared with group HI, the total effective rate was significantly increased, the quality of life score was increased, and no significant change was found in depression score in group LI.No patients used parecoxib sodium or developed treatment-related adverse events in group LI.One patient (2％) required parecoxib sodium, the incidence of skin burns, nerve damage and abnormal pain was 4％, 2％ and 2％, respectively, and no patients developed tissue swelling in group HI.Conclusion LIFU has higher therapeutic effect than HIFU in treating pain due to soft tissue injury, and the safety is good.

Objective:To evaluate the application status and change trends of insulin and its analogs in Nanjing area during 2011 to 2013. Methods:The varieties, sales amount and DDDs of insulin and its analogs in 43 hospitals of Nanjing during 2011 to 2013 were analyzed. Results:The use of insulin and its analogs was increased year by year from 2011 to 2013 with the average annual growth rate of 16%. Glargine, pre-mixed insulin 30R, aspart 30, human insulin and aspart ranked the top five in the sum of money with the proportion above 80%. Pre-mixed insulin 30R, aspart 30, glargine, human insulin and common insulin ranked the top 5 in DDDs. Conclusion:The application of insulin and its analogs is wide in clinics, and the usage and sum of money both show rapid growth trend.

Autonomic nervous system(ANS) activity plays an important role in the pathogenesis of cardiovascular disease,including organic cardiovascular disease(such as hypertension,coronary artery disease,etc) and functional cardiovascular disease (such as vasovagal syncope,postural orthostatic tachycardia syndrome,etc).Many methods was used to evaluate ANS function.Heart rate variability is a widely accepted method to assess cardiac autonomic nerve function.Autonomic nervous affected cardiac action potential and let electrocardiogram changes.Through the sympathetic and parasympathetic neurotransmitters which acting on the corresponding receptors.Electrocardiogram changes reflects autonomic nervous function.Present researches suggest that electrocardiogram has an important significance in the evaluation of autonomic nerve function in functional cardiovascular disease.

Objective To evaluate clinical utility of contrast-enhanced ultrasonography (CEUS) in percutaneous liver biopsy of liver occupying lesions.Methods According to intralesional microperfusion situation observed with CEUS,31 of 32 patients with liver occupying lesions underwent liver biopsy under the guidance of conventional ultrasound.Acquirement of adequate quantity of specimen for pathological examination was successfully achieved.Results Of 32 patients with liver occupying lesions,conventional ultrasound indicated intralesional necrosis and liquefaction in 3 patients,while CEUS indicated necrosis and liquefaction in 10 and multiple occupying lesions in 4 patients,of which 1 of the 2 lesions of 1 patient showed a rapid wash-in and washout of a focal contrast agent,the other lesion of the same patient showed synchronized enhancement with liver in all the three phases,and the remaining 3 patients showed rapid wash-in and washout.Of 6 patients conventional ultrasound indicated no blood flow,CEUS showed varying enhancement in 5 patients and no enhancement during all the three phases in 1 patient considered as focal nodular necrosis and did not undergo biopsy.All the 31 patients with liver occupying lesions underwent biopsy in the enhanced area in the arterial phase of CEUS.On the average,each patient was punctured for 2.13 times (66/31) .The successful rate of biopsy was 100% (31/31) .The confirmation rate was 96.80% (30/31) .Conclusion reflecting the situation of microperfusion sensitively,distinguishing necrosis and liquefaction accurately,determining benign or malignant initially and guiding to puncture accurately,CEUS is of grest clinical importance in biopsy of liver occupying lesions.

In recent years, w ith the w idespread use of advanced neuroimaging techniques and the aging of the population, more and more asymptomatic smal unruptured intracranial aneurysms (sUIAs) are incidentaly detected in clinical practice. Studies have show n that the prevalence of unruptured intracranial aneurysm (UIA) is 2%-3% in adults, and more than 2/3 of them are smal aneurysms of < 7 mm in diameter. Usualy these sUIAs do not have any symptoms and the risk of rupture is low er. They are also know n as incidental or asymptomatic aneurysms, but they are not w ithout the risk of rupture. At present, there is no unified opinion about w hether to conduct conservative treatment or surgical clipping or endovascular interventional therapy. This article review s the latest research progress of sUIAs ( < 7 mm in diameter), hoping to provide more evidence for clinical assessment, decision -making, and individual treatment of this kind of aneurysms.

Objective:To explore the anti-fatigue effect of Tibet maca in mice. Methods: The mice were respectively given the powder or the alcohol extract of Tibet maca. The lactic acid concentration in blood, serum lactate dehydrogenase ( LDH) , the time of weight loading swimming and serum urea ammonia level after the exercise in the mice were detected, and the anti-fatigue effect of the powder and the alcohol extract of Tibet maca was compared. Results: After the 30-day feeding, the serum LDH activity of the mice taking the powder or alcohol extract of Tibet maca was obviously higher than that of the mice in the control group(P<0. 05), the time of weight loading swimming was significantly longer than that in the control group (P<0. 05), and the blood lactic acid concentration after the exercise was obviously lower than that in the control group (P<0. 05). Conclusion: Tibet maca can improve the time of weight loading swimming of mice, and reduce the level of serum urea ammonia after exercise and blood lactic acid concentration, sug-gesting the powder and alcohol extract of Tibet maca have obvious anti-fatigue effect.

Objective:To explore the prevalence of posttraumatic stress symptoms among preschool children and its related factors after the Ludian earthquake.Methods:A total of 62 children's guardians were visited.They were interviewed with the Posttraumatic Stress Disorder Semi-Structured Interview for Infants and the Young Children and the Child Behavior Checklist-Posttraumatic Stress Disorder scale (CBCL-PTSD) consisted of 15 items from the CBCL.All of the participantsresided in Longtoushan settlement and Longtoushan town (the epicenter).They were randomly visited from west to east in that region.Results:The rate of scored 9 (or more) on the CBCL-PTSD among children was 51.9％ (27/52) in 1-2 months after the earthquake.However,based on the Semi-Structured Interview,the rate of the children's posttraumatic stress symptoms was 26.9 ％ (14/52).The numbers of posttraumatic stress symptoms,intrusion symptoms,avoidance symptoms,hyperarousal symptoms,the new symptoms and the CBCL-PTSD scores were positively correlated (0.30-0.73,P ＜0.05),except the relation between intrusion symptoms and hyperarousal symptoms.The rate of intrusion symptoms was significant higher among those who experienced earthquake than those who didn't (96.2％ vs.60.0％,P ＜0.01).And the rate of intrusion symptoms was also higher among those who was injured during the earthquake than those who wasn't (100％ vs.84.6％,P ＜ 0.05).And the other symptoms were not difference in children under different conditions (P ＞ 0.005).Conclusion:The preschool children who experienced earthquake or were injured suffer more posttraumatic stress symptoms.

Objective To observe the therapeutic effect of Sanzi Yangqing Decoction (Decoction of three kinds of seeds) for mammary cystic hyperplasia.Methods Totally 113 patients with mammary cystic hyperplastia were randomized into a treatment group (58 cases) which was prescribed Sanzi Yangqing Decoction and a control group (55 cases) which was given Ruhe Sanjie Tablet (Tablet for dissolving mammary masses). Both were treated for 3 courses. Before and after treatment the clinical symptoms and signs, hormones in serum of both groups, and the indices of hemodynamics of the treatment group were observed.Results The total effective rate of the treatment group was 89.66%, while that of the control group was 65.45%, there was significant difference (P

Objective To evaluate the scan technique and clinical value of multi-slice spiral CT angiography(MSCTA) of coronary artery.Methods MSCTA was performed in 86 patients,and 25 of them were also investigated with selective coronary angiography(SCA).The imaging quality of MSCTA in different scanning condition were analyzed.The patency of coronary artery and other branches were examined.The distribution and extent of coronary arterial stenoses were assessed.The findings demonstrated on MSCTA were compared with those seen on SCA.Results(1)The imaging quality on MSCTA of coronary artery was significant better in patients with a heart rate below 60 beats per minute,contrast flowing rate 3.0~3.5 ml/s,volume 120~150 ml and delayed time 22~25 s;(2)in 25 cases,of 71 coronary artery and branches without stenoses examined with MSCTA,68 had identical appearance on both MSCTA and SCA.The distribution and extent of 19 coronary arterial stenoses revealed by MSCTA were correlated exactly with SCA in 29 coronary arterial stenoses.The negative and positive predicted value were 95.8% and 65.5% respectively.Sensitivity,specificity and accuracy were 86.4%,87.2% and 87.0% respectively.Conclusion MSCTA as a noninvasive examination is a valuable method in detecting diseases or variations of coronary artery.