Objective To establish animal models of avascular necrosis of the femoral head. Methods Rat models of avascular necrosis of the femoral heads with liquid nitrogen freezing left femoral head were made. After operations, we accessed behaviors and regular observed X - ray graphy. we observed the femoral head after the rats were killed one monthe later. Results The rats in model group presented "new month syndrom" two weeks after operation,and became more and more worse. Conclusion The rat models of avascular necrosis of the femoral heads made by liquid nitrogen is economic and of low mortality. We can use it in making large - scale mordels, particularly in drug treatment' study.

STUDY DESIGN: This was a retrospective study. PURPOSE: To study the surgical outcome of synovial cysts of the lumbar spine through posterior laminectomy in combination with transpedicular screw fixation. OVERVIEW OF LITERATURE: Synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression. Cysts form as a result of arthrotic disruption of the facet joint, leading to degenerative spondylolisthesis in up to 40% of patients. METHODS: Retrospective data from 6 patients, treated during the period of March 2007 to February 2011, were analyzed. All preoperative and postoperative manifestations, extension/flexion radiographs, magnetic resonance imaging, and computed tomography records were reviewed. All underwent surgery for synovial cysts with excision and decompression combined with posterior fixation. The result of surgery was evaluated with Macnab's classification. An excellent or good outcome was considered as satisfactory. Japanese Orthopedic Association Scale was used for evaluation of back pain. RESULTS: All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities. Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period. CONCLUSIONS: Although this study included a small number of cases and we could not have statistically significant results, the good outcome of decompression of synovial cysts combined with posterior fixation and fusion encouraged us to recommend this approach for patients with juxtafacet synovial cysts.
Asian Continental Ancestry Group ; Back Pain ; Classification ; Decompression ; Follow-Up Studies ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Orthopedics ; Radiculopathy ; Retrospective Studies ; Spinal Canal ; Spine ; Spondylolisthesis ; Synovial Cyst* ; Zygapophyseal Joint

STUDY DESIGN: Retrospective study. PURPOSE: To study the surgical outcome of transforaminal lumbar interbody fusion (TLIF) combined with trans-pedicular screws fixation for management of selected cases of recurrent lumbar disc herniation. OVERVIEW OF LITERATURE: Recurrent lumbar disc herniation is a major cause of surgical failure, occurring in 5%-11% of cases. The optimal technique for treatment is controversial. Some authors believe that repeated simple discectomy is the treatment of choice, but approach-related complications can be considerable. Other surgeons prefer more removal of posterior elements (as lamina and facet joints) with posterior fusion. METHODS: The study included 15 patients who presented with symptomatic recurrent lumbar disc herniation who underwent reoperation through posterior trans-pedicular screws and TLIF in our department from April 2008 to May 2010, with a 24-month follow-up. Japanese Orthopedic Association Scale (JOA) was used for low back pain. The results of surgery were also evaluated with the MacNab classification. RESULTS: The mean JOA score showed significant improvement, increasing from 9.5 before surgery to 24.0 at the end of follow-up (p<0.001). Clinical outcome was excellent in 7 patients (46% of cases), good in 6 patients (40%) and fair in only 2 patients (14%). There was a significant difference (p<0.05) between patients presenting with recurrent disc at the ipsilateral side and those at the contralateral side. CONCLUSIONS: In spite of the small number of patients and the short follow-up period, the good clinical and radiological outcome achieved in this study encourage the belief that TLIF is an effective option for the treatment of selected cases of recurrent lumbar disc herniation.
Asian Continental Ancestry Group ; Classification ; Diskectomy ; Follow-Up Studies ; Humans ; Low Back Pain ; Orthopedics ; Reoperation ; Retrospective Studies

Purpose: To study the short-term efficacy and toxicity of the neoajuvant chemotherapy with epirubicin (EPI) plus paclitaxel( TAX) in treatment of patients with breast cancer. Methods: 20 patients with stage Ⅱ,Ⅲ breast cancer were treated with paclitaxel plus epirubicin (TE) for 2 - 4 cycles every 3 weeks, their clinical response and the toxicity were assessed after 2-4 cycles of neoajuvant chemotherapy, and they are compared with those of the patients treated with vinorelbine plus epirubicin( VE) as neoadjuvant chemotherapy. Patients in TE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, paclitaxel 150 mg/m2 by 3-hour continuous infusion on d 2, 3 weeks was 1 cycle. Patients assigned to the VE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, vinorelbine 30 mg/m by intravenous injection on d 1 and d 8, 4 weeks was 1 cycle. All patients were treated by modified radical operation after neoajuvant chemotherapy. Results: The overall response rate( RR) was 80% (16/20) both in TE arm and VE arm. There were 3(15%) clinical complete response( cCR) and 2(10%) pathologic complete response ( pCR) in every arm. No patient showed progressive disease. A higher proportion of RR and pCR was observed in patients with 4 cycles of neoajuvant chemotherapy than those with 2 cycles in the two groups. The major toxicity, including leukopenia, gastroenteric reaction, flushing of face and phlebitis, were similar in both groups, but fatigue, alopecia and neurotoxicity were more severe in VE arm than in TE arm(P

Purpose: To evaluate the accuracy and feasibility of sentinel lymph node biopsyly by using radiopharmaceuticals for sentinel lymph node mapping. Methods: From April 1999 to October 2001, lymphatic mapping by using radiopharmaceuticals( either99mTc-antimony sulfide or 99mTc-sulfur colloid ) injection into subdermal directly overlying the tumor was performed on 79 patients with early breast cancer followed by SLND, then all patients received breast opreations including standard axillary lymph nodes dissection ( ALND). To analyze the results of SLND performed by radiopharmaceuticals. Results: The sentinel nodes were successfully identified by lymphoscintigraphy in 67 of 75 cases (89. 33%). Of the 68 patients in this study whose sentinel nodes were identified both by lymphoscintigraphy and handhold ?-probe ,65 patients' SLNs could predict the axillary status accurately(95. 59%) . The false negative rate is 8. 33%(3 of 36). We failed to identify SLN in 9 cases and found 3 cases SLNs to be false negative in the first 28 cases while there were only 2 cases whose SLN could not be identified and no false negative in the other 51 cases. The differences between the two groups were statistically significant(P

Objective To enrich the knowledge in large gastric folds. Methods We investigated 45 cases of large gastric folds in ten years (1990 - 2001) retrospectively. All cases were examined endo-scopically and histologically. Some of them were examined by endoscopic ultrasonography and upper gastrointestinal barium. Results Of 45 cases with large gastric folds there were 30 cases with gastritis (66. 7% ) , seven with malignant tumors( 15. 6% ) (five with gastric carcinoma and two with malignant lymphoma) , four with Menetrier disease(8. 9% ) , two with systemic lupus erythematosus, one each with Billroth II anastomosis and gastric ulcer. The diseases including tumors, Menetrier disease and connective tissue diseases were located in gastric fundus and/or body . Conclusion The diseases located in upper stomach have more clinical significance. All of endoscopic ultrasonography, upper gastrointestinal barium and endoscopic mucosal resection are helpful in differential diagnosis of the large gastric folds.

Objective To investigate the correlations between histological grading of the mucosal biopsies, clinical appearances and endoscopies of patients with active ulcerative colitis ( AUC) , and their roles in the therapeutic outcomes. Methods To analyze the grading in pathological, endoscopic and clinical manifestations of 133 patients, and use the scores to estimate each clinical appearance. A prospective study and Spearman correlation coefficients analysis were taken in this study. Results Among 133 patients, the grading of histological, clinical and endoscopic results in grades Ⅰ ,Ⅱ , Ⅲ , andⅣwere 29,45 ,37 and 22; 85 , 39,9 and 0; 8,30,16 and 79 cases respectively. There were significant positive correlations between histological grading and the following parameters; melena ( r =0. 49, P= 0. 000) , bowel movement ( r =0. 30, P = 0.001) , ESR (r=0. 42, P =0.000) , AI(r=0.56, P=0.000) , clinical grade (r=0.52, P=0.000) endoscopic grade (r = 0. 35 , P =0. 000). And no significant negative correlation with Hb (r = -0. 13, P = 0. 125). In 68 mild and moderate cases after administered SASP for 6 weeks with clinical remission there were 16 and 19 cases with 0 grade in endoscopies and histology respectively, and in the former group 7 cases fall in histological grade I . Conclusion There was no agreement in the clinical, endoscopic and histological grades of the AUC patients. For the evaluation of therapy, the sequence of priority is histological grade, endoscopic grade, and then clinical grade.

Objective Since rocuronium (R) is excreted unchanged in the urine and bile, thus the duration of action may be increased in patients with liver dysfunction. The purpose of this study was to evaluate the neuromuscular blocking effect of R in patients with portal hypertension. Methods Seventy ASAⅠ-Ⅱ patients (36 males, 34 females) aged 30-60 yrs were divided into 2 groups : portal hypertension group (n=36) (PH) and control group (C) (n = 34). The liver function of the patients in PH group was classified as Child-Turcottee grade Ⅱ while those in C group had no liver dysfunction. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.02 mg?kg-1 , propofol 1.0 mg?kg-1 , fentanyl 5 ?g?kg-1 and R 0.6 mg?kg-1 and maintained with isoflurane and intermittent i.v. boluses of fentanyl. R was continuously infused. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 35-45 mm Hg . The N-M function was monitored by accelerography using TOF stimulation. (1) The onset time (from the end of R injection to maximal paralysis (T1=0). (2) Maximum depression time (the duration of completely no response to TOF stimulation. (3) Maintenance time (T1 returned to 10% ) . (4) recovery time (T1 returned to 25% after R infusion was stopped) and (5) recovery index (T1 returned from 25%-75%) were recorded. The amount of R infused every 30 min was also recorded. Results The two groups were comparable with respect to sex and age. The onset time and maximum depression time were significantly longer in PH group than in group C ( P

Objective To investigate the surgical techniques of laparoscopic procedures in the management of stones straddling between the cystic duct and the common bile duct. Methods Clinical data of 19 cases of stones straddling between the cystic duct and the common bile duct treated by laparoscopic cholecystectomy (LC) from January 2001 to June 2003 were retrospectively reviewed. Results The operations were completed by opening the gallbladder ampulla and/or the cystic duct in all the patients. The stones were 0 4~0 6 cm in diameter (mean,0 5 cm).The drainage was removed 48 hours ofter the surgery.The patients were discharged from hospital 3~5 days postoperatively.Follow-up checkups in the 19 cases for 2~24 months (mean,10 months) found no residual stones. Conclusions Thorough exposure of the union of the cystic duct with the common bile duct and the opening of the cystic duct to expel the stones is the best way to manage stones straddling between the cystic duct and the common bile duct under laparoscope, and also the most effective method to prevent postoperative residual stones.

Objective To study the feasibility of applying nanometer ceramics artificial bone in clinical repair of bone defects. Methods The animal models of bone defect was made on the unilateral radius of 45 New Zealand white rabbits, which were divided into experimental group(repair with nanometer ceramics artificial bone), control group (repair with ceramics artificial bone) and blank group (unrepaired) randomly. The reconstructive effect in each group was evaluated by gross observation, alkaline phosphatase(ALP) detection of blood serum, histopathological observation, X-ray examination and SEM detection at 4th, 8th and 12th weeks postoperatively. Results In the experimental group there was more bone formation than in the control and the blank groups. The differences in reconstructive effect were statistically significant ( P