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.

Objective To evaluate the efficiency and safety of amiodarone in patients with acute myocardial infarction (AMI) complicated ventricular tachyarrhythmia (CVT). Methods 106 CVT patients of AMI with stable haemodynamics was randomized into trial group (53 cases) and control group (3 cases). Based on routine therapy, the trial group was intravenously given amiodarone. Electrical cardioversion is necessary if the haemodynamics turns to unstable. Intravenous amiodarone will be used for at least 24 hours to maintain sinus rhythm. The control group was administrated intravenous lidocainein. If the patients made no response to lidocainein, given amiodarone as substitute. Electrical cardioversion is necessary when the haemodynamics turns to unstable and lidocainein was followed for at least 24 hours after successful cardioversion to maintain sinus rhythm. The therapeutic effects, cardiac function and the changes of arrhythmia were compared between the two groups. Results The incidence of angina pectoris, consumption of nitrates were decreased in trial group when compared with that in control group, whereas the ejection fraction, left ventricle fast filling interval and the mitral valve peak velocity of blood flow during left atrium contraction(E/A) all were higher than that in control group (all P<0.01). The total effective rate in trial group was higher than that in control group (75.5% vs 62.3%, P<0.01), especially the ventricular tachycardia control rate is significantly higher than control group (86.7% vs 50.0%,P<0.01). Conclusion Intravenous injection of amiodarone efficaciously control the complicated ventricular tachy-arrhythmia in patients with acute myocardial infarction as well as to improve the cardiac function.

Objective To explore the application value of new pre-operation auxiliary chemotherapy(NACT)in treating cervical carcinoma. Methods Two periods of chemotherapy were conducted on 53 cervical carcinoma patients;the chemotherapy projects were PVB and BIP;operation was made two weeks afterwards. Results The total effective rate of NACT was 77.4% ,26.4% of which was complete remission;50.9% of which was partial remission;local carcinoma bulk decreased significantly; the post-operation pathology indicated that there was 3.8% of uterus infiltration and 7.1% of pelvic cavity lymph node metastasis. Those patients received chemotherapy after the operation,all patients were followed up. Conclusion NACT is safe and effective for the pre-operation treatment of cervical carcinoma,which can reduce the carcinoma bulk and increase the successful rate of the operation.

Objective To investigate the expression of fragile histidine triad (FHIT) gene in cervical carci-noma and relationship with its clinical-pathological implication. Methods The expression of FHIT was detected by immunohistochemistry SP method in 42 cases of cervical carcinoma and 13 cases of adjacent tissue. Results 47.6% (20 of 42) of cases expressed FttIT in the tumor cells,and 92.3% (12 of 13) of cases of the adjacent tissue were present. There was a significant positive correlation between cervical carcinoma and adjacent tissue(P <0.01). The positive rates of FHIT in high and middle desrees of differentiation were significantly higher than that in low degree of differentiation(54.2% vs 38.9%). Tumors with lymph node metastases(45.9%) had loss FHIT protein expression than those without metastasis(60.0%) (P <0.05). The FHIT expression between Ⅰ and Ⅱ stage,the difference was significant(55.0% vs 45.5%) (P < 0.05). Conclusion FHIT gene plays an improtant role in the occurrence and development of cervical carcinoma. It is suggested that FHIT can be a useful marker for predicting invasion and metas-tasis ability of cervical carcinoma.

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.