Objective To analyze the epidemiological trends of leprosy and evaluate the effectiveness of control in Zhejiang Province. Methods A retrospective study was conducted. Results By the end of 1999, 16 262 leprosy patients had been registered, of them 11 935 had been cured and only 97 were still remained. In 1999, active cases decreased by 99.02％ over 1973. The epidemiological trends of leprosy showed the increase of mean age at onset and type ratio, and the decrease of incidence in children. Conclusion The epidemicity of leprosy has been continuously dropping in Zhejiang Province due to the sustained effort and effective control.

Objective To analyze the change of the shear stress in atherosclerotic carotid artery of rabbits and its effect on the plaque and intimia-media pathological morphology. Methods Totally 36 male Japanese White rabbits were randomly divided into blank control group (n=6), sham operation control group (n=6) and the surgery group (n=24). The blank control group was fed by normal diet. The sham operation control group was fed by the high-cholesterol diet. The surgery group was fed by high-cholesterol diet and treated by air-drying. In the 2nd, 4th, 8th and 12th week after operation, the hemodynamic parameters were measured using Color Doppler Flow Imaging. Blood viscosity was determined and the degree of artery stenosis was showed by digital subtraction angiography (DSA). The stenosis rate, mean shear stress, intimia-media ratio and mean integrated optical densities (IOD) of media smooth muscle cells (SMC) were calculated respectively. Results The typical atherosclerotic plaque was presented in surgery group. The thickness of media and mean IOD of SMC were increased at the 2nd week after operation. However, following the increase of the stenosis rate and shear stress, the flow field was changed on the stenotic artery. The pathological morphology showed the character of vulnerable plaque such a large lipid core, thin fibrous cap, and plaque rupture at 4th, 8th week after operation. The media showed atrophy and became thin, mean IOD of SMC was decreased. Statistic analysis showed significant difference in the 2 week group compared with other group. Conclusion Following the increase in the degree of stenosis, the flow shear stress is increased, turbulent flow presents, and flow field changes on the stenotic artery. Thus the plaque become unstable , and the vessel occurs remodeling.

Uterine artery embolization(UAE)is a safe and effective method for uterine leiomyomas but its long and middle term effects are definite. Furthermore it bears some exguisite comparision with the conventional therapy but not as a radical one, with a tendency. However, to develop new leiomyomas and recurrence after UAE, there for all patients should be monitored with clinical and imaging examinations for more than 2 years after the procedure. At present,a few literatures involving the factors that could influence the effects of UAE have been issued. It is necessary to carry on large-scale clinical research of the related factors influencing the results of UAE in order to guide clinical practice correctly and swiftly.(J Intervent Radiol, 2006, 15: 503-506)

Chinese medicine health care industry is in a well developmenting atmosphere, though there are still some problems restricting the development, such as small scale of business assert and sales, lack of new products. These happened mainly due to people’s attitudes, such as thinking highly of treatment than prevention, few policies supporting and not perfect regulations. It is recommended to strengthen innovation at the premise of a combination of government and market leading, and establish appropriate safeguards.

TCM health-care service industry is in a rapid growth phase. It is important to stimulate consumption and boost domestic demand in health-care industry. Although TCM has unique advantages in health-care industry, lack of technical standards, industry standards and related policy have led to market chaos. Limited by inherent concept of TCM health-care services and the existing enterprise scale and level, health-care services cannot get sufficient play. This article analyzed current situation and main problems of TCM health-care service industry, and provided measures and suggestions for management system, industry access, and personnel quality.

Objective To evaluate Effects of general anesthesia combined with thoracic paraver-tebral block(TPVB)on postoperative recovery after thoracoscopic pulmonary lobectomy. Methods Eighty patients were randomized into the general anesthesia group( G group)and general anesthesia combined TPVB group(GT group). Under the guidance of ultrasound,patients in the GT group received 20ml of 0. 5% ropivacaine for TPVB,and sevoflurane and propofol for combined anesthesia. Patients in the G group received sevoflurane,propofol and remifentanil for combined anesthesia. Extubation time,postoperative vis-ual analogue scale(VAS),quality of recovery(QoR)score,and adverse reaction were all recorded. Results Patients in the GT group had less extubation time and earlier ambulation time compared to the G group. Postoperatively,at the 1st,24th and 48th hour,patients in the G group had significantly higher VAS values both at rest and on movement than GT group(P < 0. 05). The opioid consumptions in GT group were lower than the G group(P < 0. 05). The QoR values of GT group at 24th and 48th hour[(152 ± 21)min and (175 ± 17)min]were significantly higher than the G group[(134 ± 25)min and(162 ± 20)min]respec-tively. There were significant differences in hospitalization expenses,the hospitalization stay and the inci-dence of complications between the two groups. Conclusion The ultrasound-guided paravertebral block can improve the quality of recovery in patients undergoing thoracoscopic pulmonary lobectomy.

Objective To explore the relationship between disorders of lipid metabolism and avascular necrosis of femoral head after operation of femoral neck fracture .Methods 160 patients with a diagnosis of fresh femoral neck fractures treated with AO cannulated compressed screws in orthopedic department of our hospital from January 2007 to January 2012 were involved .All the patients were divided into two groups :ANFH or non ANFH group according to the features of femoral head .The levels of blood lipid were examined .Then ,Logistic regression was used to screening risk factors and evaluate the influence of blood lipid factors ac-cording to βrisk factor .Results The levels of TC ,TG ,LDL and Apo B in ANFH group were (5 .99 ± 1 .05)mmol/L ,(2 .63 ± 0 .85)mmol/L ,(4 .16 ± 1 .21)mmol/L ,(0 .99 ± 0 .28)g/L respectively ,which increased remarkably compared with the control group ;while HDL ,Apo A1 levels in the ANFH group were (0 .88 ± 0 .19)mmol/L ,(1 .20 ± 0 .17)g/L ,which was remarkably lower compared with the control group ,and there were statistically significant difference (P=0 .000) .Serum TC and LDL levels were risk factors impacted on postoperative ANFH .Conclusion Postoperative ANFH was related to disorders of lipid metabolism .Serum TC and LDL levels could be diagnostic values on postoperative ANFH .Early control of blood lipid levels may prevent the development of ANFH in patients treated with AO cannulated compressed screws .

Objective To discuss the treatment strategy of medial collateral ligament and combined injury in the terrible triad of elbow.Methods The data of 21 patients with terrible triad of elbow who received treatment from February 2010 to April 2012 was retrospectively analyized.There are 17 males and 4females with12 cases left and 9 right elbows.The average age of them was 37.6 years (16-57).MRI examination was performed routinely,and used as guidance of treatment strategy of medial collateral ligament and combined injury.For the patients without or with partial damage of anterior bundle of medial collateral ligament(AMCL) injury while the continuity of ligament remains complete in MRI image,exploration and repair of the medial collateral ligament is not conventional.For the patients with MRI image showing AMCL avulsion or body disruption,we routinely used antero-medial approach to explore and repair,suture-anchors were used for suture the bony avulsion of the medial collateral ligament,body disruption of ligament and combined flexor-pronator teres complex injury were also be suture repaired.None of the patients used hinged external fixator during operation.A hinged brace was applied after operation.Results All patients were followed up for an average of 12.4 months (6-26).At the last follow-up,the average range of motion of the elbow was 135.2 ±10.2 degrees,average straight limited degrees,6.7±2.2 degrees,an average of 142±11.0 degrees of flexion.Mayo elbow performance score was 92 points (85-100).17 cases were excellent and 4 were good.Complications included:a transient ulnar nerve palsy in 3 cases,heterotopic ossification in 2 cases,tardive ulnar neuritis in 1 case,no elbow residual instability,dislocation,elbow stiffness and other complications.Conclusion Anterior bundle of medial collateral ligament avulsion or body disruption should be routinely suture repaired,which is in favor of restoring elbow immediate stability favoring restore elbow immediate stability.

Objective To evaluate the imaging diagnosis value of glomus tympanicum tumors.Methods Images of 10 patients with surgically and pathologically confirmed glomus tympanicum tumors were reviewed.The image characteristics and diagnostic value were summarized.Results In 8 patients with high resolution CT scan and 2 patients with routine CT scan,soft tissue nodules within the tympanic cavity were identified on axial or coronal images in 7 of them.And in 3 patients with chronic tympanitis,glomus tympanicum tumors were not differentiated on CT images.Eight patients had undergone MR examination,on T2WI the tumors were moderate hyperintense(n=6)and hyperintense(n=2),and the tumors were enhanced obviously after contrast.In 3 patients with chronic tympanitis,moderate high signal of the tumor can be differentiated with the high signal of tympanitis on T2WI.On contrast MRI,the signal of enhanced tumor or unenhanced tympanitis was identified clearly.Conclusion On diagnosis of glomus tympanicum tumors,MRI is prior to CT,especially in patient with glomus tympanicum and tympanitis.

Aim The aim of the present study is to in-vestigate the effect of the specific antagonist NVP-AAM077 and Ro25-6981 of NMDA receptor subunit NR2A and NR2B on global cerebral ischemia-induced neuronal injury in the CA1 region. Methods Male C57BL/6 mice subjected to global ischemia by the three-vessel occlusion( 3-VO) method,were divided into four groups: sham-operated group,ischemia/reperfusion control group,NVP-AAM077 treatment group,and Ro25-6981 treatment group. Hippocampal sections were processed for Fluoro-Jade B staining to detect degenerating neurons and for Nissl staining to identify surviving neurons. The expression of brain derived neurotrophic factor( BDNF) were measured by Western blot. Results ① Transient brain ischemia induced selective and delayed neuron death in the CA1 region of the hippocampus at 12-minute ischemia after reperfusion 3 days. NR2A subtype specific antagonist NVP-AAM077 enhanced neuronal death after transient global ischemia ( P