Objective To understand the situation of, mental health and behavior of the residents influenced by the environment noise. Methods From Feb. till Mar. 2005 and from Sep. till Oct. 2006, the residents living in 4 functional districts in Lu'an city, Anhui Province for one year or more were investigated by questionnaire. The investigation involved the general status, noise perception, behavior, adjustability and so on. 952 available questionnaires from 84 sites were attained. Results The significant differences were seen in the environmental noise perception among sex, age, occupation and health status (P

Objective To evaluate the clinical effect of Ho:YAG laser with flexible ureteroscope on the treatment of renal calculi. Methods Fifty one cases of renal stone burdens were treated with Versa Pulse Select Ho:YAG lithotriptor through flexible ureteroscope. Results The successful rate of stone fragmentation after single session was 90%(45/51).Mean operation duration was 45 min (30～78 min).Mean duration of post operation in hospital was 2.4 days (1～6 days).Stone free time was 3～6 weeks,with a mean of 4 weeks.No ureteral perforations or pyonephrosis occurred. Conclusions Ho:YAG laser lithotripsy through flexible ureteroscope is a safe, effective treatment for renal calculi.

Objective To assess the value of CT, PET, PET/CT in diagnosis of peritoneal metastases with Meta analysis. Methods Articles of CT, PET or PET/CT on peritoneal metastases published in English or Chinese from Jan 2000 to May 2008 were collected, and histopathological and (or) surgical findings were taken as golden standards. The sensitivity, specificity, summary receiver operating characteristic (SROC) curves, area under the curve (AUC) and the heterogeneity were calculated with software of SAS 8.0, Meta-DiSc 1.4 and STATA 10.0. Results The results of Meta analysis from 11selected articals showed that PET had the highest pooled specificity [0.96, (0.91-0.98)];PET/CT had highest pooled sensitivity [0.77, (0.67-0.85)]. The AUC and Q~* of PET, PET/CT and CT was (0.92, 0.85), (0.99, 0.96), (0.91, 0.84), respectively. AUC of PET/CT was higher than that of CT (Z=2.33, P<0.05). Conclusion PET/CT is a high accuracy diagnostic tool for detecting peritoneal metastases.

Objective To analyse the results of Zephir semiconstrained or Window dynamic cervical plates with autogenous cortical bone graft in treating the cervical spondylotic myelophathy(CSM). Methods A retrospective review was performed with 43 patients who underwent anterior cervical discectomy, autogenous cortical bone graft with endplate retaining, fixation with Zephir or Window cervical plates. Follow-up period ranged from 0.5 to 4.0 years (in average of 22 months). The clinical effect, the fusion rate, the intervertebral height and the degeneration of adjacent levels were observed. Results The JOA score after operation was significant higher than that before operation (P

Objective To summarize the clinical features and diagnostic flow of cervical spondylosis with proximal upper extremity amyotrophy;and further analyze the clinical effect of cervical anterior decompression and fusion on cervical spondylosis with proximal upper extremity amyotrophy.Methods Twenty-two cases of cervical spondylosis with proximal upper extremity amyotrophy were analyzed retrospectively from June 2006 to December 2013.Seventeen males and 5 females with an average age of (55.73 ± 8.64) years (38 to 68 years) were included.The mean preoperative course of disease was (19.2 ± 21.86) months (1-72 months).Clinical symptoms,imaging findings and electrophysiological findings were analyzed.The muscular strength recovery of atrophic muscles was evaluated by Manual Muscle Testing (MMT).The clinical improvement rate was evaluated by the Japanese Orthopedic Association (JOA) score,and the clinical satisfaction was assessed at followed up.Results The muscles involved in patients of cervical spondylosis with proximal upper extremity amyotrophy are mainly the deltoid muscle,biceps and scapula levator muscle.Most cases of imaging findings showed multi-segmental degeneration,of which C4,5,C5,6 segments were most common.Neuroelectrophysiological examination showed that affected muscles experienced obvious denervation and decreased action potential.The average follow-up time was (44.14 ± 20.51) months (14 to 102 months).At the last follow-up,the JOA score (16.29 ±0.59) in 17 cases was higher than preoperative (15.12 ± 0.93),the difference was statistically significant (F=51.814,P=0.000),and the average improvement rate was 73.3％.MMT assessment showed that 19 patients (86.4％) in this group had muscle strength recovery for more than 1 grade at the last follow-up.The average clinical satisfaction was 83.7％.Conclusion The clinical diagnosis of cervical spondylosis with proximal upper extremity amyotrophy requires a combination of clinical symptoms,imaging findings and neurophysiological examination results for comprehensive judgment.Anterior cervical decompression and fusion in the treatment of cervical spondylosis with proximal upper extremity amyotrophy patients can achieve good clinical results.

BACKGROUND:Nasolabial fold flap has been widely used in clinical surgery. The facial artery anatomy has been widely used in clinical research. Angular artery dissection is becoming more and more important to nasolabial groove area surgery, but at present, there is a lack of anatomical analysis of internal angular artery.
OBJECTIVE:To study the anatomy of the angular artery, and to provide anatomical data for protecting the nasolabial flap during surgery.
METHODS:Twenty sides of adult cadaver specimens on head and face were dissected. A reference coordinate system was made based on the line between the connection of two medial angles of eyes (axis X) and the facial midline line (axis Y). The location of the angular artery was measured taking A-F as reference points.
RESULTS AND CONCLUSION:(1) The slant angles of the angular artery on BC section, CD section, DE section and EF section were (11.1±4.3)°, (34.1±8.8)°, (21.5±10.5)°, and (17.0±4.7)°, respectively. (2) The angular artery sourced from facial artery was more than it sourced from ophthalmic artery. The diameter of right blood vessel was larger than that of left side. (3) The angular artery sourced from ophthalmic artery comes from the location which extended 8.1 mm to both sides from the point which was 10 mm up from the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.7±0.2) mm. The whole range was 20.1 mm. (4) The angular artery sourced from facial artery comes from the location which extended 25.8 mm to both sides from the point which was 40 mm down to the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.9±0.3) mm. Point to the wing of nose the lateral distance was (5.0±1.2) mm. The whole range was 68.7 mm. The surface projecting of angular artery coming from research results provided anatomic basis for surgery of nasolabial flap.

Objective To investigate the clinical and imaging features of mild encephalitis/encephalopathy with a reversible splenial lesion of corpus callosum (MERS) in children.Methods Four patients of MERS, who were diagnosed and treated in the First Hospital of Jilin University during 2013-2014, were collected retrospectively.Their clinical, laboratory, radiologic data and the related literatures were reviewed.Results Four patients onsetted as gastrointestinal symptom (3 cases) or respiratory (1 case) symptom, in accompany with disturbance of consciousness (3 cases of drowsiness, 1 case of lethargy), convulsions (4 cases), headache (1 case) as the main symptoms.Abnormal neurological signs included positive cervical resistance (3 cases), positive bilateral Babinski sign (3 cases), bilateral chemosis (2 cases).Laboratory test showed the average blood sodium was 131.6 mmol/L, while the cerebrospinal fluid test only showed abnormality in 1 case.In etiology examination, 2 cases showed human rotavirus antigen positive, and Mycoplasma pneumoniae antibody was found positive in 2 cases.Cranial MRI showed reversible lesion in the splenium of corpus callosum (patchy iso-or hypo-intensity on T1 WI and apparent diffusion coefficient, hyper-intensity on T2WI, FLAIR and DWI, clear boundary).After active treatment, clinical symptoms disappeared within 1 week, and cranial MRI lesions disappeared within 2 weeks.Conclusion The clinical presentations of MERS, which is a clinical-radiological syndrome, are sudden onset and mild, with characteristic changes in brain MRI and good prognosis.

OBJECTIVE:To provide reference for developing effective interventions to self-medication and promoting reason-able self-medication. METHODS:Questionnaires were designed based on the modified Anderson's behavioral model of health ser-vices. By using cluster sampling,residents were randomly selected from 4 districts of Wuhan city to analyze the self-medication be-havior and its influential factors. RESULTS:Totally 204 questionnaires were sent and 199 were recovered with effective rate of 97.5%. The result showed 47.7% residents who perceived discomfort within 2 weeks medicated themselves,and the rate was high-er thansee the doctor. Among self-medication residents,the rate of mild disease,general and serious disease was separately 50.5%,46.3% and 3.2%. The length of illness<7 d and the length of illness ≥7 d accounted for 95.8% and 4.2%,separately. Cold and cough was the highest cost disease for self-medication. The reasons for selecting self-medication were:no need tosee the doctor(43.2%),trouble-saving(23.1%),high medical costs(14.6%),no time to see the doctor(14.6%). 54.1% residents acquired basic medication knowledge from the past experience,25.5% from other's recommendation,and the other from the inter-net,newspaper and magazines. As for the effect of self-medication in the past one year,75.4% residents considered most were ef-fective. 18.6%had suffered from ADR due to self-medication;the incidence of ADR in the residents reading the instruction was sig-nificantly lower than those not reading the instruction(P<0.05);the ratio of reading the instruction in residents with low education level was significantly lower than that with high education level(P<0.05). Single factor analysis showed that residents'choice of self-medication were significantly influenced by the marital status,education,monthly income,medicare,accessibility of medical institutions,the severity of disease and duration of illness(P<0.05). The proportion of self-medication for married group was sig-nificantly higher than unmarried group;the proportion of self-medication for low education level group was significantly higher than high education level group;the proportion of self-medication for low monthly income group was significantly higher than high monthly income group;the proportion of self-medication for group with business medical insurance or self payment was significant-close to medical institutions;the proportion of self-medication for mild disease group was significantly higher than serious disease group;the proportion of self-medication for length of disease≥7 d was significantly lower than length of disease<7 d. Results of multivariate analysis showed that severity of disease and length of disease were the important influential factors for the choice of self-medication(P<0.05). CONCLUSIONS:Self-medication is common in Wuhan city,and mainly for general and chronic dis-ease. Residents don't pay enough attention to reading the drug instructions. Self-medication is affected by various factors which has a certain health risks.

BACKGROUND: Multiwaled carbon nanotubes can accelerate the proliferation and differentiation of osteoblasts, and exert a therapeutic effect on steroid-induced necrosis of femoral head (SNFH). OBJECTIVE:To investigate the function of multiwaled carbon nanotubes in the establishment of a rabbit model of SNFH. METHODS:Thirty-six New Zealand white rabbits were divided randomly into three groups. In treatment group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL liquor of multiwaled carbon nanotubes (0.1 g/L) into the bilateral femur medulary space every week. In model group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. In control group, four rabbits were given intraglutealy injection of 2 mL normal saline every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. RESULTS AND CONCLUSION: Four weeks after hormone injection, the trabeculae began to exhibit a smal amount of thinner fractures, an accumulation of fatty tissue in the bone marrow were obvious, bone marrow fat cels became bigger and microvascular thrombosis appeared in the model group, while there was no positive histopathological manifestation in the treatment group. This indicates that the multiwaled carbon nanotubes can extenuate pathological damage to the femoral head to a certain extent.

Objective To investigate the risk factors and treatment strategy in treating adjacent segment diseases (ASD) after anterior cervical decompression and fusion.Methods Fourteen patients with ASD after anterior cervical decompression and fusion from December 2005 to August 2012 were analyzed.The overall curvature of the cervical spine,local curvature of surgical segments,and the distances between the plate and the upper and lower intervertebral space were measured and analyzed.10 males and 4 females,age at initial surgery was 36 to 68 years old,the mean was 52.0±11.0 years old.The secondary surgery was taken,according to the number of involved segments and other factors.Anterior decompression and fusion and internal fixation was taken to patients who segment number ≤2 without severe ossification of posterior longitudinal ligament or ossification of the ligamentum flava; posterior decompression and laminoplasty was conducted in patients whose segment number ≥3,but not accompanied with significant kyphosis,instability and serious ossification of the ligamentum flava; and posterior laminectomy and fusion was performed in patients with significant kyphosis,instability and not suitable for anterior decompression due to technical reasons,as well as patients with serious ossification of the ligamentum flava.Results The average time of occurrence of ASD after the initial surgery was 9.3±4.4 years,and the average age of reoperation was 61.3±12.4 years old.The overall curvature of the cervical spine,surgical segment local curvature after the initial surgical procedure were 12.4°± 10.8 o,1.5o±6.8o,respectively; and the distances between the plate and the upper and lower interyertebral space were:0.9± 1.8 mm,3.8±3.2 mm.The secondary surgeries were taken as follows:9 cases anterior decompression and fusion and internal fixation,3 cases posterior decompression and laminoplasty,and 2 cases posterior laminectomy and fusion.All 14 patients were followed up 30.4± 17.8 months,and the average improvement rate of Japanese Orthopaedic Association scores at the last follow up was 73.9％±9.7％.Conclusion The smaller distance between the plate and neighboring intervertebral space,and poorer local curvature of surgical segments might be the risk factors for ASD after anterior cervicad decompression and fusion.The appropriate secondary surgery was taken after comprehensive analysis of the number of adjacent segments,compression factors,cervical curvature and other factors.