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 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

Diabetic vascular complications are the key cause of the poor life quality and high mortality in diabetic patient. Advanced glycation end products (AGEs) and its cross-links play important roles in the diabetic vascular complications. Endothelial cells damage induced by AGEs may account for the initial agent for diabetic vascular complications. Recent studies have shown that AGEs inhibitors and breakers can prevent and reverse these complications. This article reviewed the research progress of AGEs and endothelium dysfunction. The potential therapeutic method was also stated.

Objective: To investigate the influence of lidocaine on systemic inflammation in the perioperative ventricular septal defect (VSD). Methods: Twenty patients, scheduled for ventricular septal defect were randomly divided into 2 groups: lidocaine and control groups. Before rebeat lidocaine 1 mg/kg was given.The venous blood samples were obtained from the central venous at the following points: after induction of anesthesia and before cardiopulmonary bypass(CPB,T1),1 h after CPB(T2),2 h after CPB(T3), and 4 h after CPB(T4). IL-6 and IL-8 were determined by radio-immunoassay. Results: Compared with those at T1, the levels of white blood cells,polymorphonuclear neutrophils,IL-6 and IL-8 increased significantly from T2 to T4 in both groups. IL-6 and IL-8 levels reached the peak at T2. Compared with those in control groups, IL-6 level decreased obviously in lidocaine group from T2 to T4, but IL-8 level remained unchanged significantly. Conclusion: Under CPB and VSD repair the systemic inflammation is obvious, reaches the peak 30 min after CPB and persists to 4 h after CPB. Perioperative administration of lidocaine is effective against the inflammation.

Objective To investigate the diagnostic value of 64-slice CT angiography (CTA) to head and neck artery pathological changes.Methods One hundred patients with clinical suspicion of head and neck vascular lesions were retrospectively analyzed.Sixty four cases of lesions were detected by 64-slice CTA,and were checked by Digital Subtraction Angiography (DSA) within a week.First,the correlation of 64-slice CTA and DSA diagnosis of head and neck artery stenosis grade was counted.Then DSA was taken as the gold standard.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA to diagnose head and neck arteries stenosis were calculated.Results Of 64 cases of patients,2 cases of congenital vascular dysplasia,including 1 case with internal carotid artery in 2 cases,the remaining 60 patients had different degree of stenosis.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA was 95.34％,99.48％,97.62％,and 98.98％,respectively.Among 60 narrow patients,the plaque number was 205,including 88 soft plaques,56 mixed plaques,and 61 calcified plaque.Conclusions The 64-silce CTA has multiple advantages including rapid,noninvasiveness,high accuracy and safety,and high application value in the diagnosis of head and neck vascular lesions.It is worth promoting.

Objective To simulate the dynamic procedure of bullet damage to the three-dimensional(3D) finite element(FE) model of mandible from different angle with computer-aided engineering.Methods A mandible was scanned by thin-layer CT,and then CT images were analyzed and managed with Dicom standard and Mimics software.At the same time,a simulation of the 3D FE model penetrated by a 7.62-mm bullet was carried out through LS-DYNA software from different angle.Results A 3D FE model of human mandible was established with highly-identical geometric size,and the dynamic process of bullet damage to the model was successfully simulated.The results of this work indicated that the exit wounds in model tended to be larger than the entrances resulting from the same shot.Conclusion Thin-layer CT and Dicom standard can improve the efficiency of establishment of a more precise 3D FE model of mandible.The procedure of bullet damage to the mandible can be simulated by the finite element.