Objective:To observe the clinical efficacy and safety of radiofrequency thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation.Methods:One hundred and two patients with Lumbar disc herniation were divided into two groups.Radiofrequency thermocoagulation combined with epidural block group(group R,n=48)accepted the epidural drugs injection。1 week later radi-ofrequency thermocoagulation was taken.The epidural block group(group E,n=54)accepted the same epidural drugs injection.The VAS scores,clinical efficacy and complication were evaluated.Results:After the treatment,VAS scores in both groups decreased significantly compared with that before treatment.VAS scores on day 1,week 1 and month 1 after radiofrequency thermocoagulation were 3.13?0.99,1.35?0.34,1.05?1.22 respectively in the group R and 4.98?0.66,1.98?0.81,1.68?1.03 respectively in the group E(P

Objective To investigate the physical and mental health of Shandong medical personnel.Methods 3200 medical personnel were randomly selected from hospitals of Shandong province,selfhealth,depression and sense of work stress were measured and analyzed statistically.Results 36.3％ of medical staff was in depression state,and even about 22.5％ of the subjects was in moderate or severe depression state.Male and female medical staff showed no difference in sense of work pressure.Senior medical staff showed higher working pressure than middle-class,junior-class and low-level medical personnel,but middleclass,junior medical staff and low-level medical staff showed no significant difference.In the aspect of self-health status,male and female medical personnel showed no significant differences,senior,middle-class and junior-class medical staff reported worse self-health status than low-level medical personnel.Conclusions Managers should pay attention to physical and mental health of medical personnel,adopt pertinent measures to reduce their mental pressure in order to promote their physical and mental health.

Objective To study the clinical features and differential diagnosis of hairy-cell leukemia variant (HCL-V).Methods A case with HCL-V was reported and the literatures were reviewed.Results The patient had splenomegaly for twenty years and a history of recurrent pulmonary infection.His blood routine test showed a high white blood cell count and abnormal high proportion of lymphocytes.Peripheral smear and bone marrow smear both showed significantly higher proportion of lymphocytes,part of which had soma jagged,prominent nucleoli and villous/hairy cytoplasmic projections.His hairy leukemic cells expressed CD1 1c,CD19,CD20,CD22,and had variable expression of FMC-7,CD103 and lambda,but not CD5,CD23 and CD25.Transmission electron microscope showed many monocytes with villous exist in peripheral blood.Conclusions HCL-V is a rare and an indolent form of a small,mature,B-cell leukemia,based on the clinical,peripheral smear,bone marrow smear,flow cytometric analysis and transmission electron microscopy features,a diagnosis of HCL-V is confirmed.The differential diagnosis should always include splenic marginal zone B-cell lymphoma and HCL-C,because they have different clinical and biological features.

Objective To explore the short-term and long-term clinical effect of leep knife treatment of chronic cervicitis. Methods A single-center, prospective, randomized, controlled study was used, 120 patients with chronic cervicitis were randomly divided into observation group and control group, each group of 60 patients. Patients in the observation group were treated with (LEEP) knife, parameters setting frequency was 3.8 MHz, power was 30 ~ 40W, patients in the control group were treated with microwave. The intraoperative and postoperative recovery and relapse were compared between two groups. Results The intraoperative blood loss, operative time, postoperative vaginal discharge time in the observation group were significantly less than control group, there was a significantly statistical difference (P<0.001) . After two weeks and three months , the cure rate in observation group were 70% and 98.33% respectively, the cure rate in control group were 16.67% and 51.67%, there was a significantly statistical difference (P <0.01) . After 2 weeks and 3 months, the infection rate and recurrence rate in the observation group were significantly lower than the control group, there was a significantly statistical difference (P <0.05) . Conclusion Leep knife for treatment of chronic cervicitis patients has lower postoperative recurrence, lower infection rate and higher cure rate in short-term and long-term, and less intraoperative trauma, shorter operation time, and has important clinical significance for the prognosis of patients.

Post-infectious bronchiolitis obliterans(PIBO) is a rare serious chronic lung disease characterized by irreversible small airway fibrosis.Lower respiratory infections are the most common causes in children.Its major clinical characteristics are recurrent or persistent cough, wheezing, shortness of breath, hypoxia, crackles, and persistent for above 6 weeks.Clinical diagnosis mainly depends on clinical manifestations, lung function and high-resolution CT examination.At present, there is no unified standard of treatment, mainly empirical treatment.Most of the children have a poor prognosis, and a small number of children can achieve good results through early diagnosis and intervention.

BACKGROUND: Early education is an important step in raising children. Many facts prove that early education can promote infants' intellectual development so as to lay good foundation for their future development.OBJECTIVE: To understand the status of infants' intellectual development with Wechsler Intelligence Scale for Children and analyze the effects of early education.DESIGN: Comparative observation.SETTING: Wards of the Department of Pediatrics and Department of Obstetrics, Xuanwu Hospital of Capital University of Medical Sciences.PARTICIPANTS: We recruited 100 normal newborn infants born in the Department of Obstetrics, Xuanwu Hospital of Capital University of Medical Sciences, between January 2000 and December 2001. Guardians of the infants were informed of the research objective. Infants were divided into 2 groups according to their birth date: early education group (n=50) in which the infants were born on Monday, Wednesday, Friday or Sunday; control group (n=50) in which the infants were bom on Tuesday, Thursday or Saturday.METHODS: ① All the parents of the infants in the two groups received the guidance of feeding, infection prevention, inoculation and other health care guidance. On this basis, the parents of the infants in early education group were informed of intellectual development disciplinarian and educational guideline for 0-3 year-old infants when physical examination was performed on the infants at newborn period (twice) and 42 days after birth (once). The parents were asked to raise their infant according to the requirements of the guideline and communicate with the physicians at any moment. In control group, routine physical examination was performed on the infants at new-born period (twice) and 42 days after birth (once), and their parents were not given the early education of pediatric system. ② At 4 months and 3 days to 4 months and 29 days after birth, the infants in the two groups were taken back to hospital. Status of intellectual development was evaluated with intelligence scale for children revised and standardized by the Institute of Psychology of the Chinese Academy of Sciences and China Children Development Center according to Bayley's Scales of Infant Development [It consisted of intellectual scale and movement scale. Intellectual scale was used for 4.0-5.3 months babies (4 items, Item E: reaching out for building blocks, hand-eye coordination when reaching out, pick up building blocks, and keeping reaching out for things; Item G: noticed small pills; Item H: approached ocular; Item C: fond of playing with him).Movement scale was used for 4.0-5.3 months babies (4 items, Item A: turning their heads freely; Item E: from lying on the back to lying on the side;Item D: part of pollex face to face when holding building blocks; Item C:could sit independently for a moment)]. The primary scores of the infant was obtained from the number of an item which the infant could complete in intellectual development scale, then intellectual index and psychological movement development index were obtained according to his age span from the scale. Those with scores ＞130 were considered excellent, and those with scores ＜ 69 were mental retardation. ③ t test and U test were used in comparison of the differences in metrical and quantitative data.MAIN OUTCOME MEASURES: ① Comparison of intellectual development index and psychological development index between the infants in the two groups. ② Status of infants' intellectual scale and movement scale completion.RESULTS: Totally 100 infants entered the result analysis. ① Intellectual development: Intellectual development index and psychological movement development index were significantly higher in early education group than in control group (103.94±7.64, 111.20±9.40; 93.92±5.18,99.22±5.52, t=8.3,4.7, P ＜ 0.01). ② Status of intellectual scale completion: The number of infants who could complete Items E, D and C was obviously greater in early education group than in control group [36 infants (72%), 8 infants (16%), u=5.6, P ＜ 0.01]. ③ Status of movement scale completion: The number of infants who could complete Items E, D and C was obviously greater in early education group than in control group [45 in fants (90%), 32 infants (64%), 48 infants (96%); 30 infants (60%), 12 infants (24%), 42 infants (84%), u=2.0-4.89, P ＜ 0.05-0.01].CONCLUSION: Early education can improve infants' intellectual development, especially manipulative ability.

Objective To observe the influence of systemic and intraperitoneal hyperthermic perfusion chemotherapy on serum vascular endothelial growth factor(VEGF) and human epididymis protein 4 (HE4) in patients with ovarian cancer.Methods 116 cases with ovarian cancer were,randomly divided into the observation group and the control group according to the number table,58 cases in each group.The observation group was given systemic and intraperitoneal hyperthermic perfusion chemotherapy,and the control group received systemic chemotherapy,they all completed a total of two cycles of chemotherapy.Serum VEGF and HE4 were measured before and after chemotherapy.Results The total effective rate of the observation group was 74.1％,and that was 56.9％ of the control group,the difference was significant (x2 =4.290,P ＜ 0.05).After chemotherapy,the serum VEGF and HE4 were signifi cantly decreased in two groups,and compared with the control group,the observation group decreased more significantly(t =3.180,2.725,all P ＜ 0.05).Conclusion Systemic and intraperitoneal hyperthermic perfusion chemotherapy in treatment of patients with ovarian cancer can significantly reduce serum VEGF and HE4.

Objective To comfirm the importance of WHO"warm chain" by investigating neonatal body temperature after birth.Methods Axillary temperatures of 302 neonates born in our hospital in spring,summer and winter of 1995 were monitored immediately after cord ceased and 1,2,4,6,8,10,12,14,16,18,20,22,24,48,and 72 hours after birth.The incidence of low body tem- perature in each time was calculated.Resultes The time after birth that average body temperature need to reach 36.5℃ was ten hours in spring,14 hours in summer and winter.The incidence of low body temperature at 2 hours after birth in summer was 95 %,at 6 hours in winter was 97%.The in- cidence of low body temperature at 72 hours were still 16% in spring,34.1% in summer and 27.7% in winter respectively.Conclusion Key point in carrying out"warm chain"is to enhance the re- sponsibility of medical staff not only in rural hospitals,but also in urban hospitals.

Objective To investigate the correlation between serum insulin,lipid expression substances and breast cancer.Methods From January to August 2002,blood samples were collected from 90 patients with breast cancer,40 patients with breast benign disease and 100 healthy control subjects in Shanxi Province People Hospital.Serum insulin was measured by ELISA,serum leptin was measured by radioimmunoassay (RIA) and serum lipid substances were measured by Biochemistry Auto-machine.Results The serum insulin,leptin and TG concentration were significantly higher,but the HDL level was significantly lower in breast cancer group than in the groups of breast benign disease and healthy control(P＜0.01,respectively);There was no statistically significant difference between postmenopausal and premenopausal women in patients with breast cancer and breast benign disease(P＞0.05);There was no statistically significant difference in serum insulin level between positive lymph node breast cancer and negative lymph node breast cancer(P=0.642);The relative risk (RR) of serum insulin level and body mass index(BMI) in breast cancer group was 0.164(P＞0.05).The increased serum insulin level was independent of diet and other known risk factors for breast cancer;Multiple logistic regression analyses observed a statistically significant association between serum insulin,leptin,TG and HDL levels and breast cancer,OR=1.120(95% CI:1.017～1.209),1.117(95% CI:1.046～1.193),OR=1.879(95% CI:1.148～3.076),OR=0.035 (95% CI:0.007～0.162),respectively.Conclusion The increased serum insulin,leptin and TG levels may be the risk factors of breast cancer.The increased serum HDL level maybe the protective factor of breast cancer.

Objective To assess the efficacy of the laryngeal mask airway i-gel (LMA i-gel) in patients undergoing neuro-interventional surgery. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes, aged 20-60 yr,body mass index ＜ 30 kg/m2, undergoing elective neuro-interventional surgery, were randomized into 2 groups (n = 20 each):LMA i-gel group (group I) and LMA ProSeal group (group P). After induction of anesthesia with TCI of propofol and remifentanil, LMA i-gel and LMA ProSeal were inserted in group I and P respectively. The patients were mechanically ventilated and PETCO2 was maintented at 35-40 mm Hg,SpO2 at 99%-100%. BP and HR were monitored and recorded before induction, immediately after induction, at 1, 3 and 5 min after insertion of LMA and immediately after removal of LMA. The success rate, LMA placement time, leak pressure, peak airway pressure and complications were recorded. Results There was no significant difference in the success rate, the LMA platcement time and peak airway pressure between the two groups (P ＞ 0.05). BP and HR were within the normal range during operation in both groups. The leak pressure and incidence of blood stain and sore throat were significantly lower in group I than in group P (P ＜ 0.05). Conclusion LMA i-gel can provide adequate ventilation during operation with less complications and can be used effectively for neuro-interventional surgery.