Objective To investigate the expression of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) and their role in pathogenesis in laryngeal squamous cell carcinoma. Methods Immunohistochemical S-P method was used to detect the expression of PI3K and p-Akt in 40 paraffin-embedded human laryngeal squamous cell carcinoma, 20 cases of polyp of vocal cords and 20 cases of laryngeal papilloma. All the samples were stained by HE method to confirm their pathologic characteristics. Positive rates of PI3K and p-Akt were evaluated by microscopy. Results PI3K and p-Akt showed low expression in the polyp tissues of vocal cords, while they were of significantly higher expression in laryngeal squamous cell carcinoma (P

Objective To study the function, effect and mechanism of prevention of pressure sore formation with stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plateshape surface electrode. Methods According to the odd number and even number of admission date, 81 patients were divided into the control group (41 cases) and the observation group (40 cases). The control group received standard pressure sore prevention nursing according to Basic Nursing, the observation group received stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plate-shape surface electrode based upon routine nursing. Results 1 case caught grade Ⅰ pressure sere,1 case with grade Ⅱ pressure sere, and the incidence rate was 4.88% in the observation group, while in the control group, 5 cases caught grade Ⅰ pressure sore,4 cases with grade Ⅱ pressure sore, and the incidence rate was 22.50%. Conclusions Combination of routine prevention method with stimulation of the dorsal ramus of spinal nerve root by transcutancous pulse to prevent pressure sore formation can reduce the incidence rate of pressure sore in high risk population. This technique is easy, painless, noninvasive, and is a novel method for early prevention of pressure sore.

BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.

BACKGROUND: The assessment of chronic nerve root injury is mainly depend on indirect evidences of imaging results.OBJECTIVE: This study is designed to find out the relationship between the degrees of the pathological changes of nerve roots and motor evoked potential (MEP) changes due to chronic compression.DESIGN: A self-controlled trial with animals as subjects.SETTING: Spine Surgery Department of the Second Clinical Hospital of Jinan University.MATERIALS: The trial was completed in the Spinal Surgery Department of the Second Clinical Hospital of Jinan University from October 2001 to May 2003. The subjects were 30 healthy cats of either gender weighing 3 to 5 kg.INTERVENTIONS: The compression model was established by wedging a Ⅴ-shape bone flap into the right intervertebral foramens between C7, C8 and T1 vertebrae. The left foramens served as controls. The cats underwent CT examination on the 2nd, 4th, 8th and 12th postoperative week to show the foramen changes. Six randomly selected cats underwent magnetic stimulation MEP each time on the 2nd, 4th, 8th, 12th and 24th week. The injuries to the compressed nerve roots were assessed according to Mackinnon Standard and they were compared with the MEP wave.MAIN OUTCOME MEASURES: Whether the superficial magnetic stimulated MEP monitoring result was in correspondence with the pathological changes of the chronically compressed nerve roots.RESULTS: The MEP did not show any abnormal changes for Grade Ⅰ injury prolonged to 9.6- 10. 2 ms. There was almost no evoke potential at all stimulation points for grade Ⅴ nerve root injury.CONCLUSION: That the injured nerve root presents dysesthesia and normal MEP results suggests grade Ⅰ injury. Prolonged latency including prolonged F wave suggests grade Ⅱ injury. And additional amplitude decrease together with widened and unclassifiable waves implies the injury be grade Ⅲ. The prominent features of grade Ⅳ nerve injury is much more decreased amplitudes and more prolonged latency. For grade Ⅴ injury there is always disappearance of whole MEP or some potential components. The superficial magnetic stimulated MEP monitoring results are in correspondence with the pathological changes of the nerve roots due to chronic compression, which means MEP monitoring results could serve as the quantitative indication to pathological changes of nerve injury.

BACKGROUND: Many clinical cases have proved that the satisfactory reposition, fusion and internal fixation in the internal fixation for inferior lumbar spondylolisthesis are not consistent with the postoperative symptoms and physical signs, and functional restoration.OBJECTIVE: To investigate the application of somatosensory evoked potential(SEP) in the monitoring during internal fixation for inferior lumbar spondylolisthesis, and the effects of SEP monitoring on the improvement of postoperative symptoms and the spinal functions as well.DESIGN: A randomized controlled trial.SETTING: Inpatient department of spinal surgery, an affiliated hospital of a university. PARTICIPANTS: Fifty-two patients with inferior lumbar spomlylolisthesis including 23 male and 29 female cases aged between 18 and 68 years old were admitted by the Department of Spinal Surgery, Second Affiliated Hospital(Shenzhen People's Hospital) of Jinan University, from June 2000 to December 2003. All cases were randomly divided into control group(n = 20) and monitor group ( n = 32).METHODS: SEP induced by segmental stimulation in cutaneous nerve was used in the control group for preoperative and intraoperative monitoring, and postoperative follow up. The intraoperative potential changes in patients with excellent and good improvement in postoperative functions had been retrospectively investigated to confirm the effective indices for intraoperative monitoring, which thereby provided references for intraoperative monitoring in patients of monitor group.MAIN OUTCOME MEASURES: ① Evaluation of postoperative spinal function; ② SEP latency and amplitude.RESULTS: SEP values after postoperative anesthesia were set as basis.The manifestations of intraoperative potential alterations: ① If the latency reduced 10% -15% or the amplitude increases more than 40% after fixation, it suggested favorable prognosis; ② The potential indices were stable during monitoring, or the reduction of latency was less than 10%,or the increase of amplitude was less than 30%, the fixation could be continued, and partial functions of nerve root and symptoms could be improved after surgery; ③ During the surgery, if potential indices had transient lluctuation, which could be recovered to basic potential within 15 to 20 minutes, fixation should be stopped during the fluctuation. Still partial functions of nerve root and symptoms could be improved after surgery; ④If the intraoperative latency prolonged more than 5%, or amplitude reduced more than 10%, or part of the components disappeared, or the wave shape dispersed, it might suggest postoperative aggravation of pain and dyskinesia. So intraoperative adjustment was necessary. The coincident rate of the improvement of the indices of intraoperative monitoring and the improvement of postoperative spinal function reached 93.75%.CONCLUSION: SEP induced by segrmental stimulation in cutaneous nerve is an objective and effective method in the monitoring and instruction of decompression, reposition, fixation of internal fixation for inferior lumbar spondylolisthesis, which has important merits in the improvement of the function of nerve root and the restoration of spinal function.

Objective To investigate the effects of femoral nerve block combined with celecoxib on postoperative analgesia in elderly patients with hip fracture. Methods Two hundreds ASA -Ⅲ patients aged 65-89 yrweighing 35-90 kg undergoing hip fracture surgery were randomly divided into 4 groups ( n = 50 each):control group (group Ⅰ ), femoral nerve block group ( group Ⅱ ), celecoxib group (group Ⅲ ) and femoral nerve block +celecoxib group (group Ⅳ ). Operations were performed under combined spinal-epidural anesthesia. Groups Ⅲand Ⅳ were given oral celecoxib 400 mg at 1 h before operation, and 200 mg at 1 and 2 days after operation twice a day. Groups Ⅰ and Ⅲ received iv injection of sufentanil 0.06 μg/kg before the patients were placed in the position, while in groups Ⅱ and Ⅳ femoral nerve block was performed using a nerve stimulation with 20 ml of 0.5%ropivacaine and 10 min later the patients were placed in the position. All the patients received postoperative patient-controlled intravenous analgesia with sufentanil to maintain visual analogue scale score ≤ 3. The condition of satisfactory analgesia and sufentanil consumption within 24, 48 and 72 h were recorded. The coagulation function was measured on the day of admission to the hospital, at 1 day before operation and at 4 days after operation. Cardiac troponin Ⅰ (cTnI) concentrations were measured before operation, at the end of operation and at 1 day after operation. Postoperative complications was observed and recorded. Results Compared with group Ⅰ , the consumption of sufentanil was significantly reduced during each period in group Ⅳ ( P ＜ 0.01 ). Compared with group Ⅱ , the consumption of sufentanil was significantly reduced within 48 and 72 h after operation (P ＜ 0.05), while no significant change was found within 24 h after operation in group Ⅳ ( P ＞ 0.05). Compared with group Ⅲ , the consumption of sufentanil was significantly reduced within 24 h after operation ( P ＜ 0.05 ), while no significant change was found within 48 and 72 h in group Ⅳ ( P ＞ 0.05). The level of satisfactory analgesia was significantly higher in group Ⅳ than in the other three groups, and in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05). The 4 groups were comparable with respect to the increased rate of cTnI concentrations at the end of operation and after operation, and perioperative blood coagulation. No postoperative complications were found in the 4 groups. Conclusion Femoral nerve block combined with celecoxib can reduce postoperative opioid consumption and enhance postoperative analgesia in elderly patients with hip fracture.

Objective:To analyze the infectious ODDS risks of anticancer plant alkaloids and other anticancer drugs in GI cancer patients with chemotherapy regiments.Method:2384 profiles of cancer patients agreeable with studying condition were collected.All the profiles were evaluated with different variants,and then these variants were analyzed with the logistic liner.Result:The line values of ages,days in hospital,insurances,alkylating agents,platinum antitumor com- pounds and other antitumor drugs were 0.010,0.147,-0.361,-0.930,-0.390,and-1.306.Conclusion:The infection OR of the ages and days in hospital increased OR factors and the medical insurances decreased OR factors.Antitumor antibiot- ics,antimetabolites,plant alkaloids had their higher infectious risks than platinum antiturnor compounds,alkylating agents and other antitumor drugs did in GI cancer patients with chemotherapy regiments.

Objective To characterize the x-ray image of vertebral artery type of cervical spondylosis and explore its significance in rehabilitation treatment. Methods The X-ray films of 42 cases of vertebral artery type of cervical spondylosis were measured and analyzed. The treatment approaches including restriction of cervical movement,traction,epidural block and surgery were planned and implemented accordingly. Results The X-ray image revealed the following changes in the patients: the straightened physiologic curvature of the cervical spine,cervical vertebral unsteadiness,zygapophyzeal joint hyperplasia. Various treatment approaches are effective to patients with various manifestations. Conclusion Employing treatment approaches on the basis of X-ray images is of great signi-ficance for the effective treatment of patients with cervical spondylosis of vertebral artery type.

Objective To evaluate the effect of stent implantation using Multimodal CT in patients with MCA and ICA stenosis. Methods Twenty-six patients with ischemic cerebrovascular disease who received MCA or ICA stent implantation in ChongQing xinqiao Hospital were recruited. Multimodal Stroke Assessment Using CT Score (MOSAIC) was used to evaluate the Neuroimaging data before stent implantation and Alberta Stroke Program Early CT Score (ASPECTS) to evaluate the time to peak (TTP) of CTP before and after stent implantation. Results Patients were divided into 4 groups based on scores: 4 scores, 5 scores, 6 scores, and 7 scores groups. the improvement degree was increase by 31.7%±14.17%、38.6%±15.73%、43.3%±10.3%、358.6%±13.45% in 4 scores, 5 scores, 6 scores, and 7 scores groups, respectively. The paired t test demonstrated that there were a statistically significant difference among four groups(H=10.673, P <0.05). Preoperative MOSAIC score was positively correlated with the improvement of ASPECT score for TTP, with a correlation coefficient of 0.579 ( P <0.002). Conclusions Multimodal CT is a sensitive assessment for the evaluation of ischemic cerebrovascular disease and patients with a higher MOSAIC score may benefit more from stent implantation.