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 investigate the effect of sevoflurane preconditioning on the expression of Toll-like receptor 4(TLR4) during myocardial ischemia reperfusion(IR) in rats.Methods Thirty male SD rats weighing 250-300 g were randomly divided into 3 groups (n=10 each):sham operation group (S group) , IR group and sevoflurane preconditioning group(SP group).Myocardial ischemia was produced by temporary ligation of anterior descending branch of left coronary artery for 30 min followed by 2 h reperfusion. In SP group, the animals inhaled 2.5% sevoflurane for 30 min followed by 15 min washout before ischemia. The rats were sacrificed at 2 h of reperfusion, hearts removed and myocardial tissues obtained for microscopic examination.The expression of TLR4, NF-κB and TNF-α was detected using Western blot. Results The expression of TLR4, NF-κB and TNF-α was significantly up-regulated in IR and SP groups compared with group S (P＜0.05).The expression of TLR4, NF-κB and TNF-α was significantly down-regulated in group SP compared with group IR (P＜0.05).The myocardial injury was attenuated in group SP.Conclusion Sevoflurane preconditioning can attenuate myocardial IR injury by inhibiting the up-regulation of TLR4 expression and reducing the inflammatory response.

BACKGROUND: Some studies have demonstrated that the degradation of extracellular matrix (ECM), which matrix metalloproteinases (MMPs) participates in, plays a key step in the corneal neovascularization (CNV). Tissue factor pathway inhibitor 2 (TFPI-2), a new type serine proteinase inhibitor found recently, can effectively inhibit the activity of MMPs. Whether TFPI-2 gene transfection can influence CNV is unclear.OBJECTIVE: To investigate the effect of TFPI-2 gene transfection on CNV.DESIGN: Randomized controlled experiment.SETTING: Laboratory for Department of Surgery, Wuhan Union Hospital; Central Laboratory, the Affiliated Third Hospital of Sun Yat-sen University.MATERIALS: This study was carried out in the laboratory for Department of Surgery of Wuhan Union Hospital and State Central Laboratory of the Third Hospital Affiliated to Sun Yat-sen University between June 2004 and March 2006. Sixty healthy purebred adult New Zealand rabbits of either gender, weighing 2.5 to 3.0 kg, were involved. Preoperatively, no obvious anterior segment ocular lesion was found by slit-lamp examination. pBos-Cite-neo/TFPl-2 was kindly gifted by Dr. Zhong Ren (Department of Hematology, Union Hospital). Peroxydase blocking agent, nonimmune goat serum,mouse anti-human MMP-1, 2 and 3 monoclonal antibodies, biotin labeled goat-anti-mouse IgG second antibody (Santa cruz Company) were used in this study.METHODS: Experimental intervention: Experimental rabbit models of CNV were created in each group by silver nitrate cautery. Then, the rabbit models were randomized into 3 groups and 20 rabbits for each group. Different reagents were subconjunctivally injected via many points in each group: saline in the group Ⅰ, empty vector in the group Ⅱ, plasmid encoding TFPI-2 in the group Ⅲ. Experimental evaluation: CNV growth was observed under the slit-lamp biomicroscope.The expression of TFPI-2 in each rabbit model was detected by reverse transcription-polymerase chain reaction (RT-PCR) method 2 weeks after modeling; the expression of MMPs in corneal tissue was detected by immunohistochemical method at 3,5,7,9 and 14 days after modeling.TFPI-2 gene expression was significantly higher in the group Ⅲ than in the group Ⅱ and group Ⅰ (P ＜ 0.01); The MMP-1, 2, 3 expressions in the corneal tissue were significantly lower in the group Ⅲ than in the group Ⅱ and group Ⅰ,respectively, especially MMP-1, 3.

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 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 and analyze of informed consent in assisted reproductive technology ( ART) institutions, understand the status and problems.Improve the content and methods of informed consent. Methods:A questionnaire was investigated for the medical staffs and patients anonymously in ART institutions. Results:The implementation of informed consent need to be improved.Medical staffs protect the patient privacy inadequately.The patients also not pay attention to the informed consent.Medical staffs look forward to ethics training.Conclusions:The current situation of informed consent is not optimistic in ART institutions.The ethics training need to be strengthen to improve the awareness of medical staffs about informed consent.The content and methods of informed consent should be standardized,and explore the evaluation methods to enhance the effect of in-formed consent.

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.