Headache is a common clinical symptom.Some headache disorders belong to secondary category.Many intracranial disorders,such as head trauma,cerebral vascular diseases,intracranial tumors and inflammation,can lead to headache due to mass effect,inflammation reaction,stimulation of vasoactive substances and decreased intracranial pressure.Furthermore,many drugs and other substances,disorders of eyes,nose,ear,mouth,neck and other systemic disorders can also cause headache.Many headache disorders can be determined by detailed case history and physical examination.Blood test,lumber puncture,CT,MRI and other imaging examinations are necessary methods for finding the causes and the treatment of diseases.

Angiogenesis Inhibitors ; adverse effects ; Antibodies, Monoclonal ; adverse effects ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Hemorrhage ; chemically induced ; Humans ; Hypertension ; chemically induced ; Lung Neoplasms ; drug therapy ; Proteinuria ; chemically induced ; Thromboembolism ; chemically induced

Objective To analyze the sandtray topics of the children with behavior problems according to the grounded theory method.Methods Collected and described children' s sandtray topics of different types of behavior problems,age and gender.And analyzed them base on a 3 levels coding list compiling according to the ground theory method.Results The frequency of “negative theme” (3.33 ± 1.25 ) was higher than “positive theme” (0.81 ± 1.25 ) with significant difference (P＜0.01) in feature level 1.Age factor had significant effect upon the frequency of “positive theme” in feature level 1 (P ＜ 0.05 ).And also had impact on “harmony”,“ development” in features level 2 (F =3.039,P ＜ 0.05 ).Gender factor,interaction of gender and age had significant effects on frequency of “negative theme” in feature level 1 (F =5.395,P ＜ 0.05 ; F =4.222,P ＜ 0.05 ).Conclusion The characteristics of the children' s sandtay with behavioral problems mainly are “negative theme”.And it shows different features in children with different gender or age.

Objective:To investigate the problems and improve the quality of clinical education.Method:A questionnaire was made among 200 medical students at Ji'ning medical college.Results:About eighty-eight percent of the students were satisfied with their clinical education,but there were still some problems:absence of clear objectives in clinical practice;shortage of enthusiasm of the students;lack of responsibility of some teachers and too many factors affecting clinical practice.Conclusion:The key points to improve clinical education quality are to set up clear education objectives,develop appropriate clinical practice methods,improve teaching staff quality and reform the teaching content.

ObjectiveTo observe the neuroprotective effect of basic fibroblast growth factor(bFGF)on cerebral diffuse axonal injuries (DAI)of rats.Methods40 male SD rats were randomly divided into control group, DAI injury group, bFGF group and DAI saline group. According to the survival time of rats, DAI injury group were divided into five groups, the 6h, 12h, 24h, 72h and 7th day group, The changes of bFGF expression in cerebral cortex were detected by immunohistochemical method from 6h to 7d after DAI. Two hours before DAI, bFGF 10μl was injected into right ventricle in bFGF group. ResultsThe bFGF expression appeared at 6h after DAI, increased at 12h, reached the highest level at 72h, and kept in a high level at 7d.There were obvious differences between 72h group and other groups in DAI injury group (P<0.01),cerebral cortex neurons were obviously decreased by HE staining. In each time group,injured neurons were decreased in bFGF group combined with DAI injury group(P<0.05). ConclusionsbFGF has obvious neuroprotective effect on cerebral diffuse axonal injuries of rats.

Objective To investigate the therapeutic and preventive method of foreignbodies in esophagus.Methods Clinical date of 78 cases of foreignbodies in esophagus were analyzed retrospectively.Results Among the 78 foreignbodies in esophagus,76 cases were removed from esophagus in different way.2 cases fulled into mastach.No severe complication occurred.The cure rate was 97％.Conclusions Foreignbodies in esophagus should be removed as soon as it is diagnosed.It is important that correctly treating foreignbodies in esophagus can reduce the incidence of severe complications.

At present,the doctor-patient relationship in China is a little tense,communication between doctors and patients is not smooth,and the doctor-patient communication skills of the young doctor is obviously insufficient and need to be improved.In this paper,we analyze the factors that affect the communication between doctors and patients in the Department of Neurology through the complexity of professional knowledge,the current background and so on.In addition,we discuss multiple methods of improving communication capability among this group doctors,hoping to strengthen young physicians' clinical basic skills training,and impart doctor-patient communication skills from the linguistic modifiers,oral expression,words and deeds,use of metaphor,simulation training and other aspects,and establish dynamic assessment system of doctor-patient communication ability.

Objective To investigate the sedative effect of propofol combined with different doses of midazolam in patients undergoing long-time microsurgeries.Methods Forty ASA(American Society of Anesthesiologists)Ⅰ～Ⅱ patients were randomly divided into 4 groups.Normal saline(NS) 2 mL was administered in groupⅠ,while midazolam 0.01,0.02 and 0.04 mg/kg was administered in groupⅡ,Ⅲ,Ⅳ respectively.one min later,propofol was infused at a rate of 5～10 mg/kg?h combined with midazolam based on the abovementioned dosage per hour for groupⅡ,Ⅲ,Ⅳ respectively.Taking auditory evoked potential index(AAI) as a parameter,after it decreased to 40,the infusion rate of propofol was adjusted to keep AAI at the level of 30～45,and maintained the level by infusing propofol and midazolam for 5 hours.The dosage of propofol required for induction and maintenance was recorded.The emergence time and whether patients had awareness during the operation were recorded after the infusion stopped.Results At the target sedative level of AAI 30～45,the Observer's Assessment of alertness/sedation(OAA/S) score of all patients in the four groups reached 0～1.The induction period was obviously shortened and the propofol dosage was dramatically reduced in group Ⅱ～Ⅳ as compared with groupⅠ.At the stage of maintenance of sedation,the dosages of propofol in both groupⅠandⅡ were larger than those in group Ⅲ and Ⅳ.The emergence time in group Ⅳ was dramatically longer than the other groups(P

Object To study the chemical constituents of Stelmatocrypton khasianum (Benth.) H. Baill.. Methods Some constituents were isolated by chromatographic methods and identified by physicochemical constants and their structures were elucidated by spectral data. Results Seven compounds were isolated from the stem of S. khasianum and their structures were identified as ?-sitosterol-3-O-?-D-glucoside-6′-O-eicosanate (Ⅰ), 2?, 3?, 23-trihydroxy-olean-12-ene-28-oic acid (Ⅱ), 2?, 3?, 23-trihydroxy-urs-12-ene-28-oic acid (Ⅲ), ?-sitosterol-3-O-?-D-glucoside (Ⅳ), stearic acid (Ⅴ), glucose (Ⅵ), and sucrose (Ⅶ) respectively. Conclusion All compounds were obtained from this plant for the first time, and compound I is new.

PcoI-PcoR is a quorum-sensing (QS) system influencing the biofilm formation and rhizosphere colonization in Pseudomonas fluorescens 2P24. The expression of the pcoI, a N-acyl-homoserne lactone (AHL) biosynthase gene, is under the regulation of a number of chromosomal factors, such as the GacS-GacA two-component system. In this paper, we investigated the upstream regulators that influence the transcription of pcoI gene using a chromosomal pcoI-lacZ fusion reporter strain PM203. Cosmids containing genomic DNA of the wild-type strain 2P24 were introduced into the reporter strain PM203 (gacA—, pcoI-lacZ) to screen positive transcriptional regulators of pcoI gene. One of them named pP32-24, which contained a 5-kb Pst I functional fragment was selected. Further analysis identified that the pcoI was the gene responsible for the increase of the pcoI-lacZ expression. The expression of pcoI-lacZ reporter was alsoimproved in both PM101 (pcoI-lacZ) and its gacAmutant PM203 after addition of exogenous AHL, indicating that the expression of pcoI is positively regulated by AHL (autoinduction) in strain 2P24. In addition, deletion mutagenesis and complementation experiments demonstrated that the transcriptional regulator PcoR positively controlled the expression of pcoI and the formation of biofilm. These results suggest that, in strain 2P24, the expression of PcoI-PcoR QS system is auto-inducted, and the transcriptional factor PcoR is involved in the regulation of pcoI transcription and the biofilm formation.