Objective To study cerebral cortical activation preoperatively and postoperatively in patients with cervical spondylotic myelopathy (CSM), and discuss effect of the surgery on cortical reorganization in functional recovery.Methods 19 cases with CSM intrial group underwent cervical vertebra canal decompression surgery according to clinical routine.Cases in trial group completed clinical assessment using the modified Japanese Orthopaedic Association Scores (mJOA) prior to decompression and 12 months following surgery, and underwent cerebral functional MRI and conventional MRI in the same time.19 controls also carried out cerebral functional MRI and conventional MRI.All subjects performed a finger-tapping paradigm with right hand during processing functional MRI.The imagings and data of trial group were divided into preoperative group and postoperative group in accordance with the time of completed and than analysed.Results The mJOA score of postoperative group was increased significantly (P<0.001).Cortical volume of activation (VOA) of preoperative group was significantly higher than the control group (P<0.05).VOA was lower in the postoperative group, but still significantly higher than the control group (P<0.05).The preoperative group was able to detect and activate the signal only in the left precentral gyrus.The postoperative group was able to detect and activate the signal in the l left postcentral gyrus, the premotor area and the supplementary motor area, and the right cerebral cortex could also detect a small amount of activation signal.Conclusion CSM patients undergo cerebral cortical remodeling, causing sensory and motor function activation areas to expand and shift.The changes of cortical reorganization after cervical vertebra canal decompression surgery are associated with functional recovery.The surgical treatment may promote the compensating cortical reorganization.

Objective The serum S100B level reflects brain injury after stroke .This study was to explore the features of ser-um S100 B in post-stroke depression patients and its change after anti-depression treatment . Methods Totally 52 of the 95 post-stroke depression inpatients were included in this study .All the patients were treated with escitalopram for 8 weeks followed evaluation of their depression status and the therapeutic effects with Hamilton Depression Scale -17.The serum S100B concentration was detected before and after the treatment .Thirty-six post-stroke patients without depression and another 36 normal controls were recruited for com-parison of the serum S100B concentration.Response is defined as the reduction rate of HAMD-17≥50% after the treatment . Results The serum S100 B levels of the post-stroke depression patients , non-depression post-stroke patients, and normal controls were ([0.44 ± 0.14] vs [0.36 ±0.09] vs [0.21 ±0.10] μg /L, F=41.88, P=0.000), those of the male and female post-stroke depression patients at the baseline were ([0.46 ±0.16] vs [0.43 ±0.14] μg /L, t=0.7062, P=0.4833), and those of the ischemic stroke and hem-orrhagic stroke patients at the baseline were ([0.42 ±0.12] vs [0.47 ±0.15] μg /L, t=1.3097, P=0.1963).The reductions of the S100B level in the response and non-response groups were ([0.13 ±0.03] vs [0.04 ±0.01] μg /L, t=11.6595, P=0.0000). Conclusion The serum S100 B level in post-stroke depression patients is higher than in non-depression post-stroke patients and normal controls, which is not associated with gender or stroke types .The decrease of serum S100B predicts the efficacy of anti-depression treatment.

The paper describes the basis, scope, and contents of the index system for assessing maternity and child care institutions in Beijing. The new system, based on the readjustment, recombination and redistribution of the original index system for assessment, has two newly added elements, viz. financial position analysis and leadership style and organization culture. In order to make a distinction between leaders' responsibilities and an institution's orientations and to reduce behavior abnormality and information bias in the process of assessment, the new system has been divided into two major parts: evaluation of the institution's conditions for survival and capabilities for development, which is jointly decided by internal and external factors, and appraisal of the institution's performance, which is decided mainly by internal factors.

Purpose To explore the role of scanning laser tomography in the assessment of macular hole surgery. Methods Fifteen eyes of 14 patients with macular holes underwent scanning of their affected macular area using the Heidelberg retina tomograph (HRT). The significance of topographic changes postoperatively were determined in eleven eyes which received vitrectomy surgery. The scan field was set at 15? of the retina and the depth was set to 1.5 mm or 2.0 mm. All the measurements were taken for 3 times and the average value of the 3 measurements was used. Results The average hole area was (0.499?0.34) mm 2 and the maximal depth of the hole was (0.284?0.11) mm. Topographic difference analysis of the eleven eyes showed a significant reduction in the height of the retina after vitrectomy. The maximal depth of the hole was (0.063?0.04) mm postoperatively. Conclusion Scanning laser tomography provides an objective evaluation of the anatomic outcome of the macular hole surgery.

The exercise prescription in the process of physiotherapy, including exercise intensity, exercise duration, frequency and type of movement, provide a consistent basis for rehabilitation to ensure the safety and efficacy of the treatment.

Objective:This paper discussed the law of drugs used in the treatment of damp-heat syndrome of hematochezia in ancient books of Traditional Chinese Medicine (TCM) in the Chinese Medical Classics. Methods:The medical records of Chinese medicine for treating blood convenience were retrieved in the Chinese Medical Classics (5th Edition), and the prescriptions of internal medicine were included in the prescription of internal medicine for the treatment of the damp and heat syndrome of the bowel of the blood, and the information of the origin, classification and composition of TCM were extracted into excel 2019. The database was established and the frequency analysis was carried out. The high frequency drugs were cluster analyzed by SPSS statistics 22.0, and the correlation degree between the Chinese medicine was analyzed by SPSS modeler 18.1. Results:A total of 143 prescriptions used to treat damp-heat syndrome of hematochezia were collected, with 196 TCM drugs. The high-frequency drugs were Angelicae Sinensis Radix, Sanguisorbae Radix, Coptidis Rhizoma, Moutan Cortex, Sophorae Flos, and Sophorae Fructus. The cluster analysis and association analysis showed that, the herbs with potential association rules were Angelicae Sinensis Radix and Moutan Cortex, and the core drug was Angelicae Sinensis Radix, and the core drug pairs were Coptidis Rhizoma- Scutellariae Radix, Sophorae Flos-Phellodendri Chinensis Cortex, Sophorae Flos-Schizonepetae Herba, Sophorae Fructus-Poria, Sophorae Fructus-Platycladi Cacumen, Schizonepetae Herba-Aurantii Fructus, Glycyrrhizae Radix et Rhizoma-Paeoniae Radix Alba. Conclusion:The ancients mostly used Huaijiao pill, Huaihua powder and Diyu powder to treat the damp-heat syndrome of hematochezia, and attached importance to the compatibility of drugs that can strengthen the spleen and remove dampness, replenish qi and blood, and promote blood circulation and remove blood stasis.

Aged ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Lipoma ; pathology ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; S100 Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To investigate the diagnostic values of direct lymphangiography for the thoracic duct outlet obstruction.Methods The image data of direct lymphangiography were retrospectively analyzed in 124 patients with lymphedema,Chylothorax,chylous ascites,chyluria and intestinal lymphangiectasis,and compared with the results of neck thoracic duct surgical exploration,2 radiologists reviewed DLG DSA images in a double blind manner.The number of neck stem,subclavian stem,bronchialmediastinal stem and TD terminal into blood obstruction on the operation side showed by DLG were assessed using Kappa analysis.Results Of 124 patients,80 patients had the left cervical lymphatic stem reflux on DLG,75 patients with the left subclavian lymphatic stem reflux,30 patients with the left bronchial-mediastinal lymphatie stem reflux,118 patients showed the thoracic duct outlet barrier into the blood.The consistency rate of DLG were 89.9％ (80/89),92.6％ (75/81),90.9％ (30/33) and 95.2％ (118/124) compared with the neck thoracic duct surgical exploration.Tow radiologists had a high degree of diagnostic consistency (K =0.82,P ＜ 0.05).In addition,114 patients (91.9％) had tortuous,dilated waist lymphatic stem,only 10 patients (8.1％) were normal.The cisterna chyli reflux were found in 92 patients (74.2％),intestinal stem reflux in 16 patients (12.9％),reflux to the kidney area in 11 patients (8.9％),to the pericardium reflux in 5 patients (4.0％),vaginal lymphatic leakage in 7 patients (5.6％),retroperitoneal lymph leakage in 2 patients (1.6％),pleural lymphatic leakage in 3 patients (2.4％),tracheal lymph leakage in 1 patient (0.8％).Conclusion Direct lymphangiography has a high consistency with the cervical thoracic duct surgical exploration in displaying thoracic duct outlet obstruction.

OBJECTIVE To investigate the feasibility of endoscopic sinus surgery under local anesthesia.METHODS A total of 810 patients underwent endoscopic sinus surgery from January 2000 to December 2007 with complete follow-up data were included in this study.Validity of anesthesia was evaluated using VAS(visual analogous scale).Operation time,bleeding quantity during operation,operation therapeutic efficacy,hospitalization cost and patient's evaluation to the operation were recorded.RESULTS The mean VAS score of local anesthesia was 3.18?0.46.Cases with no pain and mild pain accounted for 78.28%,with moderate pain 16.71%,and with severe pain 5.01%.The average bleeding quantity during operation,operation time,complication incidence,cure rate at 6 months after operation,hospitalization cost,patients' evaluation in local anesthesia were(43.25?27.46)ml,(41.14?9.479) min,1.78%,78%,4000～6000 yuan(RMB),9.28? 2.21 respectively.CONCLUSION For the endoscopic sinus surgery,most cases can be operated under local anesthesia if the indication were selected correctly and the sophisticated skills and advanced instrument were available.