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 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 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.

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 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.

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 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.

Objective To investigate causes and treatment strategy of cage retropulsion after lumbar interbody fusion.Methods Data of 11 patients with cage retropulsion after lumbar interbody fusion from December 2005 to October 2011 in our hospital were retrospectively analyzed.There were 7 males and 4 females.Their age ranged from 36 to 78 years (average,52.3 years) at the time of the primary operation.Six cases occurred cage retropulsion 0.5 to 3 months after the primary operation,while 5 cases occurred cage retropulsion 14 to 36 months after the primary operation.The causes of cage retropulsion were analyzed.Moreover,corresponding managements were performed and results were recorded.Results The early cage retropulsion was associated with mismanagement of intervertebral space,too much residual of nucleus pulposus,insufficient erasion of cartilage end plate,too small size of cage,malposition of cage,insufficient fixation and so on.The late cage retropulsion was associated with improper choice of surgical strategies,multi-level fusion,preoperative unsteady of vertebrae,advanced age,osteoporosis,diabetes and so on.Three patients underwent conservative treatment and 8 patients underwent revision surgery.All 11 patients were followed up for 6 to 72 months (average,34 months).There was no re-migration of cage,fusion failure,pedicle screw loosening and other complications during the follow-up period.Conclusion The causes of cage retropulsion after lumbar interbody fusion were complex and diverse,and the time of cage retropusion had some clinical value for the cause analysis.It was more advisable to make an individualized treatment program based on the causes of cage retropulsion,clinical manifestations and imaging results.

Objective To examine the differences in the structure of brain white matter among deficit schizophrenia, nondeficit schizophrenia and healthy controls by using voxel-based morphometry (VBM). Methods Ten deficit schizophrenic patients, eleven nondeficit patients and fifteen healthy comparison subjects participated in the study. All the subjects were scanned by GE Twin Speed 1.5T MRI system. Whole brain, voxel-wise analyses of regional white matter volume were conducted by the VBM toolbox on the Matlab7.6 and SPM5. t -test was then used for the comparison between groups. Results Compared to the healthy controls, nondeficit schizophrenic patients significantly decreased the density of gray matter in the frontal, parietal, temporal, occipital lobe and basal ganglia , while the deficit patients showed the characteristically broad and significant decreasion in the frontal lobe, including left medial frontal gyrus, bilateral inferior frontal gyrus, left middle frontal gyrus, and left orbital gyrus (Cluster ≥ 30 mm3, P<0.01). Moreover, deficit patients showed the decreasion in the temporal cortex and the limbic lobe (right insula). Relative to the nondeficit schizophrenic patients, deficit patients had significant regional gray matter decreases in the left medial frontal gyrus, bilateral inferior frontal gyrus, right precentral gyrus, and right superior temporal gyrus (Cluster ≥ 30 mm3, P<0.01). Conclusion Structural heterogeneity in schizophrenia may relate to specific patterns of gray matter density reductions in deficit and nondeficit patient. However the two subtype of schizophremia patients share a common prefrontal-temperal pattern of structural brain alterations.