Objective To summarize the MRI findings of spinal paraganglioma,in order to improve the diagnostic accuracy of imaging. Methods The MRI findings of 6 patients with spinal paraganglioma were retrospectively reviewed.All cases were proved by pathology.Results All 6 cases of spinal paraganglioma were located in lumbar spinal canal.There were serpentine vessels shade observed above the tumor in 5 cases.Two cases with smaller size of lesions exhibited as homogeneous signal intensity with homogenous enhancement. The other 4 cases with larger size of tumors exhibited as heterogeneous signal intensity because of intratumoral cystic change,hem-orrhage and hemosiderin deposit at the margin of the tumor.Conclusion Serpentine vessels above the tumor can be seen in spinal paragangliomas.Intratumoral cystic change and hemorrhage,hemosiderin deposit at the margin of the tumor are the MRI character-istics of spinal paraganglioma.

Objective To discuss the clinical effect of weight loss training and oral intake of mefformin on obese women with polycystic ovary syndrome.Methods 60 cases of obese women with polycystic ovary syndrome in Nan'an District Maternal and Child Health Hospital were studied.They were divided into 2 groups,30 cases in each group.The control group received simple weight loss training and the observation group received weight loss training combined with the oral administration of metformin.The clinical data of the 60 cases were retrospectively analyzed and the clinical efficacy and safety of different treatment methods were evaluated.Results After treatment,two groups of patients have been effectively improved.16 cases(53.3％)in the control group and 29 cases(96.7％)in the observation group resumed normal menstruation,and the differences had statistical significance.Fasting blood sugar(FBS),BMI,testosterone and luteinizing hormone levels of the two groups had significant improvement after treatment,in addition,the improvement of these indicator were more obvious in the observation group than those in the control group,and the difference had statistical significance.The difference of FBS,BMI,testosterone and luteinizing hormone levels had statistical significance between before and after treatment(P =0.003 7,0.001 2,0.002 0 and 0.002 4,respectively).Conclusion The combination therapy of weight loss training and oral intake of metformin is effective in treating obese women with polycystic ovary syndrome.It is the main method in treating obese women with polycystic ovary syndrome.

Etiquette education is an essential part of modern nursing quality education.In order to improve the general quality of the nursing students by etiquette education,the nursing teachers can infiltrate the essence of etiquette education into education reform,by theory teaching,demonstration, portrayal training,scenario training,and so on.

AIM:To explore the histopathological classification and incidence of orbital space-occupying lesions in children in order to provide references for the diagnosis of orbital space-occupying lesions in children.
METHODS:A total of 290 paediatric patients with orbital space - occupying lesions diagnosed by pathological examinations at the Second Hospital of Tianjin Medical University from January 1998 to December 2012 were retrospectively reviewed.
RESULTS:In 290 paediatric patients with orbital space-occupying lesions, venous hemangioma was the most common (58 cases,20. 0%), the other commons were as follows: hemangio lymphangioma, dermid cyst, neurofibroma, optic nerve glioma, rhabdomyo sarcoma and so on. Capillary hemangioma, venous hemangioma, optic nerve glioma had the predominant age incidence. On the other hand, optic nerve glioma, venous hemangioma, rhabdomyosarcoma had the predominant sex incidence.
CONCLUSION: The majority of paediatric patients with orbital space - occupying lesions are congenital and embryonic lesions, the most common of which is venous hemangioma. Some lesions had the predominant age and sex incidence.

Objective To evaluate the characteristics of echocardiogram in senile degenerative heart valvular disease. Methods The cardiac structure and functional changes of the 166 cases of senile degenerative heart valvular diseases were studed with HP5500(USA) and En Visor color doppler(Philips). Results Simple aortic valve calcification was found in 93 cases(56.0%); simple mitral calcification, 18 cases(10.8%);aortic valve calcification combining mitral calcification, 55 cases,(33.1%);enlarged left atrium 116 cases(69.9%);left ventricular diastolic dysfunction 142 cases(85.5%).Within 136 cases of cardiac valve dysfunction, there was aortic valvular regurgitation in 70 cases(42.2%),stenosis of aortic valve in 23 cases(13.9%),mitral regurgitation in 20 cases(12.2%),mitral stenosis in 8 cases(4.8%),aortic valvular regurgitation combining stenosis in 10 cases(6.0%),mitral regurgitation combining stenosis in 5 cases(3.0%). The highest morbidity in valvular dysfunction was aortic valvular regurgitation(42.2%),the second was aortic valve stenosis(13.9%),the lowest morbidity was mitral stenosis combining insufficiency(3.0%). Enlarged left atrium was in 116 cases(69.9%). Conclusions The senile degenerative heart valvular disease have no specific clinical manifestation. With increasing age,the proportion of complex valve calcification is increased, and the highest is the aortic insufficiency in valvular dysfunction. The proportion of enlarged left atrium is also increased.

AIM To investgate the changes in the expression of CREB and p-CREB in the cortex of ethanol dependent rats. On other hand, the effects of fluoxetine on these changes were also studied. METHODS Ethanol was administered in drinking water at the concentration of 6% V/V, for 28 d. The expression of CREB and p-CREB in the rat cortex were measured by immunohistochemistry methods. RESULTS It was found that chronic ethanol treatment and its withdrawal did not modify the expression of CREB in the rat cortex. However, the levels of p-CREB in the frontal and piriform cortex of rats were significantly decreased during ethanol withdrawal, and respectively decreased 57.28%?55.84% compared to control rats at 24 h after ethanol withdrawal. When fluoxetine (ip, 10 mg?kg -1) were administried concurrently with ethanol, it can significantly dampen alcohol withdrawal symptoms and antagonize the down-regulation of the phosphorylation of CREB in the frontal and piriform cortex of rats at 24 h after ethanol withdrawal, the expression of p-CREB protein respectively increased 292 58%,128 44% compared with rats intaking ethanol. CONCLUSION CREB may be one of the substance of the signal transduction process for ethanol dependence. Fluoxetine can reverse the decreased p-CREB levels in rat cortex induced by ethanol withdrawal, which may be the part reason of fluoxetine dampening alcohol withdrawal symptoms.

Objective To evaluate the efficacy and safety of rabeprazole sodium injection in the treatment of non-esophageal variceal upper gastrointestinal bleeding in comparison with the positive control,omeprazole.Methods From January 2010 to January 2011,231 patients with non-esophageal variceal upper gastrointestinal bleeding from 20 hospitals were divided into rabeprazole group and omeprazole group in this multicenter,randomized,blind,parallel-group,positive drug controlled clinical trial.Hemostasis rate in 72 hours was the primary endpoint.Hemostasis rate in 120 hours,time to hemostasis,blood transfusion volume and the rate of switching treatments were the secondary endpoint.And safety was also analyzed.Chi square test and Wilcoxon rank sum test were performed for statistical analysis.Results At 72 hours after treatment,the hemostasis rates of rabeprazole group and omeprazole group were 98.20％(109/111)and 98.25％(112/114), respectively, and the difference was not statistically significant (P＞0.05).The 95％ confidence interval (CI) of the rate difference between the two group was-3.50 ％ to 3.40 ％.The result of non-inferiority test indicated that the lower limit of the 95％CI of the rate difference between the two groups was-2.95％ (U=5.652,P＜0.01),and rabeprazole group was not inferior to omeprazole group.At 12 hours after treatment,the hemostatic rates of rabeprazole group and omeprazole group were 63.06％(70/111) and 53.51％(61/114),respectively,and there was no statistically significant difference (P＞0.05).At 120 hours after treatment,the hemostasis rates of rabeprazole group and omeprazole group were 99.10 ％ (110/111) and 98.25 ％ (112 /114),and there was no statistically significant difference (P＞0.05).The median time of hemostasis of two groups was 24 hours.During the treatment,there were two cases and seven cases of rabeprazole group and omeprazole group received blood transfusions,respectively;there were 0.90％ (1/111) and 2.63 ％ (3/114) patients switched to other treatment,and no statistically significant difference was found (P＞0.05).The rates of adverse event of rabeprazole group and omeprazole group were 11.61％ (13/112) and 5.26％ (6/114),respectively.The rates of adverse reaction were 6.25％ (7/112) and 4.39％ (5/114),respectively.The differences in the rates of adverse event and adverse reaction between two groups were not statistically significant(both P＞0.05).Conclusion Rabeprazole sodium injection is an effective and safe drug in the treatment of non-esophageal variceal upper gastrointestinal bleeding.

Objective To investigate the analgesic effect of epidural labor analgesia with contin-uous background infusion and its impact on obstetric outcome.Methods This was a retrospective co-hort study.In the two months of march 2014 and march 201 5,503 nulliparas women who had re-ceived epidural analgesia for labor were enrolled and assigned to two different study groups according to their analgesic protocol.Two hundred and fifty-eight nulliparas in group C received only patient-controlled analgesia while two hundred and forty-five nulliparas in group P received patient-controlled analgesia with continuous background infusion.The basic and perinatal data of all enrolled nulliparas women were collected and analyzed to compare the analgesic effect and the impact on obstetric risk of two different analgesic protocol.Results The NRS pain score during the second labor stage was lower in group P [3 (3-4)scores vs.5 (4-5)scores](P <0.001).The second stage prolonged [50 (29-82) min vs.38 (24-62)min](P =0.001)and intrapartum hemorrhage increased [200 (100-250)ml vs. 1 50 (100-200)ml](P =0.003)in group P.There were no significant differences between the two groups with regard to the delivery mode (P =0.656)and the morbidity of postpartum hemorrhage (9.8% vs.10.9%,P =0.697).Analgesic protocol with background infusion was not associated with postpartum hemorrhage,instrumental delivery risk and cesarean risk.Conclusion Epidural labor an-algesia with continuous background infusion provided more effective analgesia in nulliparas,without additional obstetric risk.

Objective To evaluate the efficacy and safety of mesalazine modified-release tablets in the treatment of mild and moderate active ulcerative colitis (UC).Methods This study was a multicenter,single-blinded and randomized controlled study.A total of 251 active UC patients in 18 hospitals were enrolled into this study from November 2010 to January 2012.The subjects were divided into the mesalazine modified-release tablets group (n=123) and the mesalazine enteric-coated tablets group (n=128),three times daily,each of which took mesalazine modified-release tablets or mesalazine enteric coated tablets 800 mg,respectively,and the course of treatment was eight weeks.The difference of UC disease activity index (UC-DAI),UC-DAI at the beginning minus UC-DAI at the final evaluation,was calculated at final evaluation.And this was the primary efficacy parameter.Complete remission rate and effective rate were considered as the secondary efficacy parameter.Adverse drug reactions rates of two groups were calculated and taken as safety evalution.If the lower limit of the 95 ％ confidence interval was more than-0.1 in the difference of the decrease in UC-DAI between the two groups,the non-inferiority of mesalazine modified release tablets to mesalazine enteric-coated tablets was demonstrated.The analysis of covariance model was used for the primary efficacy parameter and the sub-group analysis.And chisquare test was used for the comparison between the two groups in the secondary efficacy parameter and in the adverse drug reactions.Results At the final evaluation,the decrease in UC-DAI of mesalazine modified-release tablets group was 2.84 and that of mesalazine enteric-coated tablets group was 2.56.The reduction degree was 0.27.The lower limit of the 95 ％ confidence interval in the difference of the decrease in UC DAI between the two groups was-0.34,which demonstrated the non-inferiority of mesalazine modified release tablets to mesalazine enteric-coated tablets.The complete remission rates of mesalazine modified release tablets group and mesalazine enteric-coated tablets group were 48.33％ (58/120) and 55.65％ (69/124) and the effective rates were 63.33％ (76/120) and 66.94％ (83/124),and there was no statistically significant difference between the two groups (all P＞ 0.05).At final evaluation,the decrease in UC DAI of mild patients (UC DAI 3 to 5 at enrollment) of mesalazine modified-release tablets group and mesalazine enteric-coated tablets group were 2.16 and 2.05,respectively; the difference of mesalazine modified release tablets group and mesalazine enteric coated tablets group of reduction degree of UC-DAI was 0.11,that of moderate patients (UC-DAI 6 to 8 at enrollment) were 3.49 and 3.03,respectively,the difference of mesalazine modified-release tablets group and mesalazine enteric-coated tablets group of reduction degree of UC DAI was 0.46,and there was no statistically significant difference between the groups (all P＞0.05).The adverse drug reactions rates of mesalazine modified-release tablets group and mesalazine enteric coated tablets group were 6.61％ (8/121) and 10.24％ (13/127),and there was no statistically significant difference between the two groups (P＞ 0.05).No serious adverse drug reactions were found in two groups.Conclusion Mesalazine modified release tablets has good efficacy and high safety in the treatment of mild to moderate active UC.

Objective To evaluate the efficacy and safety of mesalazine modified-release tablets in the maintenance treatment of patients with ulcerative colitis (UC) in remission phase.Methods This study was a multi-center,single-blinded and randomized controlled study.From November 2010 to August 2012,251 patients with UC from 18 hospitals were enrolled.According to the randomization table,all patients were divided into the mesalazine modified-release tablets group (n 126) and the mesalazine enteric-coated tablets group (n=125).The course of treatment were both 48 weeks.The primary efficacy parameter of the two groups including the rate of non-recurrence of bloody stool,and the secondary efficacy parameter including period of non-recurrence of bloody stool,period of non-recurrence of UC,incidence of adverse events and adverse drug reactions were observed.The GENMOD model was applied to calculate 95％ confidence interval (CI) of the rate of non-recurrence of bloody stool of the two groups.If the lower limits was over-10％ of the setting,it indicated that the former was not inferior to the latter.Results In 48 weeks of maintenance treatment,the rate of non-recurrence of bloody stool of themesalazinemodified-release tablets group was 82.99％(95％CI 73.53％ to 92.45％) and 73.30％ (95％ CI 64.04％ to 82.56％) in the mesalazine enteric-coated tablets group,respectively,and the difference between the two groups was 9.69％(95％CI-1.15％ to 20.53％ (＞-10％)) which indicated the mesalazine modified-release tablets group was not inferior to the mesalazine enteric-coated tablets group.There was no significant difference in the period of non recurrence of bloody stool and period of non recurrence of UC between the two groups (both P＞0.05).The incidence of adverse events was 48.78％ (60/123) in the mesalazine modified-release tablets group and 48.00％ (60/125) in the mesalazine enteric-coated tablets group,and the difference was not statistically significant (P=0.902).The incidence of adverse reactions was 16.26 ％ (20/123) in the mesalazine modified release tablets group and 13.60 ％ (17/125) in the mesalazine enteric-coated tablets group.There was no statistically significant difference (P =0.556).Conclusion Mesalazine modified release tablets can help maintain long-term remission in patients with UC,and can be used as a safe and effective alternative medicine in the treatments of UC in remission phase.