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.

Objective　To evaluate low magnetic field MRI findings for diagnosis of bronchogenic carcinoma.Methods　Conventional MRI of surgical-patholo-gically confimed bronchogenic carcioma(132 cases)were analysed.Results　The carcinomatous masses have generally middle signal intensity with homogeneous appearance on T1W images,and high signal intensity with heterogenous appearance on T2W images.MRI is an efficient modality to show the hilar and mediastinal lymph node metastases,pleural effusions and carcinmatous invasions of the great vessel,the bronchus,the pleura,the chest wall,and pericardium.It is possible to distinguish mass from obstuctive lesion on MRI.Conclusion　Accrding to the mentioned sign and the morphological features of the carcinomatous masses,primary diagnosis of bronchogenic carcinoma can be made on MRI.

Objective:To study the effect of Liuwei Dihuang decoction (LW) on secretion of testosterone in the testis leydig cells of senescence accelerated mouse (SAM). Methods:The level of testosterone in the testis leydig cells of SAM with aging and the effect of LW on the secretion of testosterone were observed using cultured testis leydig cells in vitro.Results:The level of testosterone in the testis leydig cells of SAMP8 with aging was significantly decreased and showed a significant difference compared with age-matched SAMR1. Chronic administration of LW (2.5 and 5.0 g/kg) for 5 months significantly ameliorated the secretion of testosterone in SAMP8 compared with control group. Conclusions:The secretory function of testis leydig cells was reduced in SAMP8 with aging. LW ameliorated the secretion of testosterone in the testis leydig cells,indicating that LW could antagonize or delay the deterioration of the testis leydig cells in SAMP8.

OBJECTIVE: To investigate the expressions of transforming growth factor beta1 (TGF-beta1) and bone morphogenetic protein-2 (BMP-2) in human mandible fracture callus and their quantity changes in the process of healing. METHOD: Thirty callus samples from the fractured mandible bone stumps were collected during operation, and two callus samples were collected from the angle-square jaw patients as controls. The expressions of TGF-beta1 and BMP-2 were test by the immunohistochemistry technic-SABC-staining in different periods of human fractured mandibular callus and in osseous tissue of normal angle of mandible. RESULT: The TGF-beta1 and BMP-2 were expressed in callus of different periods but not in normal bone tissue. The expression of TGF-beta1 increased slowly during the first three weeks after fracture and reached its maximum in the third week, and then weakened gradually. The expression of BMP-2 increased gradually during the first two weeks after fracture and reached its maximum in the second week, then the expression weakened gradually. CONCLUSION (1) BMP-2 may be one of the factors promoting the repair of fracture. (2) TGF-beta1 could be another signal pathway in repairment of fracture. (3) There could exist some synergistic effects between TGF-beta1 and BMP-2 in the process of fracture healing.
Adult ; Bone Morphogenetic Protein 2 ; metabolism ; Fracture Healing ; Humans ; Mandibular Fractures ; metabolism ; Middle Aged ; Transforming Growth Factor beta1 ; metabolism

Objective:To investigate the significance of CT imaging features in the diagnosis of first-episode paranoid schizophrenia.Methods:Forty-five patients with first-episode paranoid schizophrenia admitted to Shaoxing 7 th People's Hospital from January 2018 to January 2019 were included in the study group. An additional 40 healthy controls who received health examination were included in the control group. All participants underwent head CT scans and CT values of cerebral lobes were measured. CT imaging features of first-episode paranoid schizophrenia were analyzed. The recurrence rate of paranoid schizophrenia was calculated. The diagnostic effect of CT imaging on paranoid schizophrenia was evaluated. Results:The CT value of the frontal lobe in the study group was significantly lower than that in the control group [(33.1 ± 1.4) HU vs. (36.9 ± 2.1) HU, t = 9.914, P < 0.001]. The proportions of patients having ventricular enlargement, sulcus widening, arachnoid cyst and cisterna magna in the study group were 51.1%, 24.4%, 31.1% and 20.0% respectively, which were significantly higher than 5.5%, 2.5%, 2.5% and 2.5% respectively in the control group ( χ2 = 21.688, 8.411, 11.928, 4.675, all P < 0.05). The recurrence rate of paranoid schizophrenia in the study group was 22.2% (10/45). The CT value of the left and right frontal lobe in patients with recurrent paranoid schizophrenia was (32.1 ± 1.7) HU and (32.5 ± 1.6) HU respectively, which was significantly lower than (35.0 ± 1.9) HU and (34.9 ± 1.7) HU in patients without recurrent paranoid schizophrenia ( t = 4.348 and 3.985, both P < 0.001). Conclusion:Patients with first-episode paranoid schizophrenia have brain structural abnormalities, as manifested by ventricular enlargement, sulcus widening, arachnoid cyst, and cisterna magna. CT imaging features are of great value in the diagnosis of first-episode paranoid schizophrenia. It deserves wide popularization and has a great innovation value.

Objective To investigate the circadian change of autonomic nervous system in hyperthyroidism (HT) patients. Methods Recording 24 h dynamic electrocardiography from 33 HT patients( HT group) and 35 controls (control group). The cardiac autonomic nervous function was evaluated by the time domain and frequency domain analysis of heart rate variability( HRV). Results Comparing with control group, the SDNN, SDANN, ASDNN and rMSSD were significantly lower in HT group[ (82.3 ± 29.0)ms vs. (139.4±40.2 ) ms, ( 75.0 ± 27.4) ms vs. ( 130.3 ± 43.9) ms, (29.9 ± 14.9 ) ms vs. (57.3 ± 14.4) ms,( 19.8 ± 10.9 ) ms vs. (29.5 ± 9.4) ms ] (P ＜ 0.01 or ＜ 0.05 ), the long term total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) were significantly lower in HT group [ (566.1±573.2) ms2/Hz vs. ( 1894.2 ± 984.3)ms2/Hz, (68.1 ± 88.9 ) ms2/Hz vs. (232.7 ± 155.5 ) ms2/Hz, ( 127.4 ±163.0) ms2/Hz vs. (551.3 ± 390.6) ms2/Hz, (330.3 ± 300.6) ms2/Hz vs. (1073.2 ± 570.2) ms2/Hz] (P ＜0.01 ). Comparing with control group, short term VLF was higher in HT group during most time in 24 hours (P＜ 0.05 ). Short term LF was higher in HT group mainly in day time (P＜ 0.05 ). Short term HF was higher in HT group occasionally in the whole day (P＜0.05). Short term LF/HF didn't show significant difference between HT group and control group at most time points (P＞0.05).Conclusion In HT patients, cardiac chronotropic property is impaired, sympathetic activity increases in whole day, vagal activity increases correspondently but the increase in day is more marked than that in night.

Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

BACKGROUND:Traumatic auricle defectsin upper 1/2 or lower 1/2,seriously involve theauricular cartilage and skin blood vessels. The autogenic rib cartilage graft and acelular dermal matrix have good histocompatibility, and expanded flapis a kind of thin and achromatic tissue for skin defect repair. OBJECTIVE:To explore theapplication ofacelular dermal matrix and expanded flap in half auricular reconstruction,and to find out the fine carving and anastomosis of autogenic rib cartilage graftas wel as its similarities with the ear and clinical significance. METHODS:Eight cases of half auricular defects were treated with expanded flap, autogenic rib cartilage graft, fine anastomosisofautogenic rib cartilage graft and residual earfor half auricular reconstruction,during which theacelular dermal matrixwas usedto promote residual ear docking and skul auricle angle formation. The reconstructionwasperformed in three stages:first,anexpander(volume, 80mL)wassubcutaneously implanted attheretro-auricular area;second, the auricular defects were reconstructed with fine rib cartilage graft, acelular dermal matrix and auriculoplasty;finaly, acelular dermal matrixwas usedto promote residual ear docking. Thenthehalf auricular reconstructionwas evaluatedby objective measurement and subjective rating. RESULTS AND CONCLUSION:Half auricular reconstruction was successful in al the eight caseswithout obvious complications, and the cartilage grafts were in good condition.During thefolow-up,thereconstructed auriclewasshapedwel andformed a good involution withtheresidualauricle. In addition, the flange was smooth withoutobviouscolor difference and edema, and its position, size and shape were consistent with those of thecontralateralone. Afterthefolow-up of 6 months, objective indicators showed that the affected side had no significant differencefromthe contralateralone(P> 0.05). In conclusion,theacelular dermal matrixcanobviously decrease the complications of the cartilage grafts andcontributeto agood shaped auricle;and half auricular reconstructionby expanded flap, autogenic rib cartilage graft,andfine anastomosis of autogenic rib cartilage graftcanachieve significant clinical effects.

Objective To study the effect of simvastatin on improve ventricular remodeling in rats after myocardial infarction(MI). Methods The MI models of rat were constructed,and divided into three groups:(1)MI group(MI-C),only ligation of left anterior descending coronary artery(LAD);(2)Simvastatin group(MI-S),ligation of LAD and gavage with simvastatin 40 mg?kg~(-1)?d~(-1);(3)Sham group(sham),no ligation of LAD.Cardiac architecture and function were determined by the echocardiography.The TNF-? mRNA expression in infarction and non-infarction regions was measured by RT-PCR. TNF-? protein was determined by Western blot and immunohistochemical staining.Results The echocardiography showed that the left ventricular end-diastolic diameter(LVEDd,(7.5?0.4)mm versus(4.5?0.3)mm) significantly increased in MI-C group,compared with sham group.The fractional shortening(FS,(20.5?2.5)% versus(51.6?3.1)%) and ejection fraction(EF,(41.4?4.3)%versus(85.2?3.7)%)markedly decreased in MI-C group,while compared with sham group. Simvastatin obviously reduced left ventricle(LV) expansion and improved LV function(P

Objective To explore the features of high-frequency ultrasonography and contrast-enhanced ultrasonography (CEUS) of papillary thyroid microcarcinoma (PTMC).Methods The CEUS data and ultrasound data of 147 PTMCS which were reconfirmed by pathology were analyzed retrospectively,and the CEUS and ultrasonic characteristics of them were summarized.Results Among 147 nodules,144 (97.9％) nodules were hypoechoic,and 3 nodules were isoechoic.Vague edge was found in 136(92.5％) PTMCs,and 126(85.7％) PTMCs were irregular in shape.Totally 92(62.6％) PTMCs were A/T ＞ 1,microcalcifications were found in 81 (55.1％) PTMCs.Besides,26(74.2％) PTMCs were found microcalcification in 35 PTMCs combined with Hashimoto's thyroiditis (HT),while 55 (49.1％) PTMCs were found microcalcification in 112 PTMCs combined with HT.There were significant differences between them (P ＜ 0.05).The blood distribution of 129 (87.8％) nodules was type Ⅱ.The contrast-enhanced pattern of 147 (100.0％) PTMCs showed in-homogeneous enhancement in 144 (97.9％) nodules,hypoenhancement in 136(92.5％) nodules,and all the nodules without amicula.Conclusions The typical PTMCs are hypoechoic,irregular shapeand vague edge,usually were found as A/T ＞ 1,microcalcification,and type Ⅱ blood distribution.With the method of contrast-enhanced ultrasonography,these nodules usually without amicula showed inhomogeneous and hypoenhancement.The incidence of microcalcification is more common when patients with Hashimoto's disease coexisting PTMC.