Objective To study the clinical characteristic and the surgical treatment of the patients with familial adenomatous polyposis(FAP). Methods Retrospective analysis was made on the clinical feature and operative procedures of 28 patients with FAP in our hospital in recent 14 years. Of the 28 patients, 20 patients had familial history, 6 had cancerization. Results All the patients received operation, ileal pouch- anal anastomosis(IPAA) were performed on 25 cases(89.29%) , 3 cases underwent other operations. No severe complications had taken place postoperatively. All the patients received non-steroid anti-inflammatory drugs(NSAIDs) or tamoxifen treatment. All the patients were followed-up for 2-14 years, 4 patients died(14.29%) during follow-up period. Life quality and bowel function after operation were good in the aliving patients. No polyp in ileum pouch was seen. Conclusions Surgical treatment is the main methods for FAP, it can prevent bowel polyp carceration. Use of NSAIDs or tamoxifen as an adjuvant treatment of FAP is useful in the prevention of FAP recurrence.

As an important way to maintain the internal environment of the human body, the renin-angiotensin system (RAS) plays an important role in the diabetic cognitive dysfunction, which may associate with insulin resistance, inflammatory reaction, oxidative stress and other mechanisms. Traditional Chinese Medicine can improve cognitive function of diabetes, in which RAS may play a role.

AIM: To study the dynamic expression of protease - activated receptors - 1 (PAR- 1 ) after intracerebral hemorrhage (ICH) and the influence of Nao Xue Kang Tablet (NXKT) on it's expression. METHODS: 72 Wistar rats were divided into normal group, ICH model groups (ICH, 6 h, 24 h, 3 d, 7 d), Nao Xue Kang groups (NXKT, 6 h, 24 h, 3 d,7 d).ICH models were produced with the induction of collagenase typeⅦ - S, except normal group. Immunohistochemical method was used to detect PAR- 1 protein and RT- PCR technique was used to detect PAR- 1 mRNA in brain tissues around the haematoma at different time points of different groups. RESULTS: PAR - 1 protein and mRNA were mildly positive in normal group. In ICH model groups, intensity of PAR - 1 expression started to increase at 6 h, and further increased at 24 h. PAR - 1 expression reached the peak at 3 d and began to descend. At 7 d the decent was obvious. At 6 h, 24 h, 3 d, and 7 d time points, the PAR-1 protein positive cell number and PAR- 1 mRNA absorbance ratio in ICH model and NXKT groups were significantly higher than those in normal group ( P ＜0.05 or P ＜ 0.01). The PAR- 1 protein positive cell number and PAR- 1 mRNA absorbance ratio in NXKT group were significantly lower than in ICH model group ( P ＜ 0.05 or P ＜ 0.01 ). CONCLUSION: After ICH,PAR - 1 is continuously activated because of the stimulation of thrombin. Action of thrombin after ICH may be mediated by PAR- 1; NXKT may inhibit the activation of PAR- 1, so the praxiology is improved. This may be one of the main mechanisms that NXKT could facilitate the recovery of nervous function.

Objective To analyse the clinical characteristics of male hypogonadotropic hypogonadism.Methods Clinical data of 87 cases of male hypogonadotropic hypogonadism were retrospectively analyzed.Results Mean age was(18.8?4)years old,and 25 patients were diagnosed as Kallman syndrome.The level of serum LH,FSH,and T was low,and LH responded poorly to GnRH stimulation.Most patients' bone age was delayed,and all patients' CT or MRI of pituitary was normal.Conclusion According to the above clinical features,and testosterone replacement or hCG and/or plus hMG are the choice of treatment.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

AIM: To study the dynamic expression of protease-activated receptors-1 (PAR-1) after intracerebral hemorrhage (ICH) and the influence of Nao Xue Kang Tablet (NXKT) on it's expression. METHODS: 72 Wistar rats were divided into normal group, ICH model groups (ICH, 6 h, 24 h, 3 d, 7 d), Nao Xue Kang groups (NXKT, 6 h, 24 h, 3 d,7 d). ICH models were produced with the induction of collagenase typeⅦ-S, except normal group. Immunohistochemical method was used to detect PAR-1 protein and RT-PCR technique was used to detect PAR-1 mRNA in brain tissues around the haematoma at different time points of different groups. RESULTS: PAR-1 protein and mRNA were mildly positive in normal group. In ICH model groups, intensity of PAR-1 expression started to increase at 6 h, and further increased at 24 h. PAR-1 expression reached the peak at 3 d and began to descend. At 7 d the decent was obvious. At 6 h, 24 h, 3 d, and 7 d time points, the PAR-1 protein positive cell number and PAR-1 mRNA absorbance ratio in ICH model and NXKT groups were significantly higher than those in normal group (P

Objective To assess the effectiveness of arthroscopic debridement techniques for osteoarthrosis of the elbow in nonathlete patients. Methods Twenty-six nonathlete patients with elbow osteoarthrosis were treated with arthroscopic debridement from January 1999 to January 2006.Of the 26 patients,23 were followed for 4～86 months (mean,23 months).All of the 23 patients had complained of pain and loss of elbow motion and 4 patients had symptoms of ulnar neuritis. The Mayo Elbow Performance Score was used as evaluation criteria of the efficacy. Results Twenty-three patients were followed for 4～86 months (mean, 23 months). Twenty elbows (87%) were not painful or were only mildly painful, and three (13%) were moderately painful. The mean arc of flexion-extension was improved from 99.6? (range, 65?～135?) preoperatively to 122.1? (range, 80?～150?) at the time of follow-up. According to the Mayo Elbow Performance Score, the result was excellent in 16 elbows, good in 4, and fair in 3, with a rate of excellent or good results of 87%. Symptoms of ulnar neuritis disappeared in the 3 patients and continued without aggravation in the remaining 1 patient. Fourteen patients were greatly satisfied with the results, 6 satisfied, and 3 unsatisfied, the satisfactory rate being 87%. One patient reported a delayed ulnar nerve symptoms after operation. Conclusions Arthroscopic debridement techniques for elbow osteoarthrosis in nonathlete patients can yield satisfactory pain relief, significant increase in the range of motion, and quick recovery.

Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelopathy caused by anterior compression were studied retrospectively.The patients included 16 males and 6 females,aged from 36 to 72 years(average 54.2 years).There were thoracic ossification of posterior longitudinal ligament(OPLL)in 11 cases,thoracic disc protrusion with ossification in 8 cases,thoracic vertebra posterior osteophytes in 2 cases,ankylosing spondylitis with thoracic pseudoarthrosis in 1 cases.Preoperative Japanese Orthopaedic Association(JOA)score was 5.2(range,2-9).The characteristic of thoracic degeneration was analyzed by CT and MRI examination.Posterior decompressive laminectomies were performed by the technique of "cap uncovering".The facet joints were removed bilaterally.Anterior ossified compressions were cut via posterior-lateral approach,and then intervertebral bone graft and bilateral pedicle screws were implanted.Results All patients were followed up for 8 to 38 months.According to the revised Epstein standard,there were excellent in 7 patients,good in 9,fair in 4,and poor in 2.The total effective rate was 90.9%(20/22).The excellent and good rate was 72.7%(16/22).The mean postoperative JOA score was 8.7(range,2-11).Surgical complications included dural laceration in 1 patient,pleura injury in 1 patient,epidural hematoma in 2 patients.There were no cases of spinal instability or deep infection.Conclusion The anterior compression can be solved completely via trans-facet joints approach in thoracic degenerative disease patients.

BACKGROUND:Percutaneous vertebroplasty with bone cement plus hyperextension position reset for acute thoracolumbar vertebral osteoporotic compression fractures has been reported to achieve good clinical efficacy.OBJECTIVE:To evaluate the efficacy of unilateral percutaneous vertebroplasty with bone cement plus hyperextension position reset for Kümmell disease in the elderly.METHODS:Twenty-two old patients with Kümmell disease were included,involving 8 males and 14 females,aged 55-84 years old,and the injuried vertebrae included T11 (n=2),T12 (n=8),L1 (n=7),L2 (n=4),L3 (n=2),L4 (n=2),and L5 (n=1).All patients underwent the unilateral percutaneous vertebroplasty with bone cement plus hyperextension position reset.The visual analogue scale and the Oswestry Disability Index scores,vertebral body height as well as vertebral kyphosis angle were determined before and after treatment.RESULTS AND CONCLUSION:(1) All patients were successfully operated,pain relieved or disappeared within 24 hours postoperatively.No spinal cord injury,pulmonary embolism and other complications were found.One patient presented with cement leakage without obvious clinical symptoms;two patients had non-adjacent vertebral fractures during follow-up.(2) The visual analogue scale and Oswestry Disability Index scores at 1 day postoperatively were significantly lower than those at baseline (P ＜ 0.05).(3) The anterior,medial and posterior height of involved vertebral body,kyphotic angle of involved vertebral body at 1 day postoperatively were significantly higher than those at baseline (P ＜ 0.05).(4) These results manifest that unilateral percutaneous vertebropiasty with bone cement plus hyperextension position reset to treat Kümmell disease in the elderly can significantly relieve back pain,restore partial vertebral height,correct local kyphosis and improve functional recovery of the injured vertebrae.

Objective To discuss the technique and clinical efficacy of percutaneous vertebroplasty (PVP) in the treatment of vertebral malignant lesion.Methods PVP was performed in 13 patients (15 vertibrae) including metastasis in 11 and primary tumor in 2 cases,thoracic vertebrae involved in 6 cases and lumbar vertebrae involved in 7 cases.13 cases aged between 45 and 73,median age 59 years.Under C-arm fluoroscopic or CT monitoring,needle the puncture of the vertebral body was performed through the pedicle of vertebral arch using 11~13G,15 cm long needle.Omnipaque was injected into the vertebral body to understand the information of large drain veins,then 3~7 ml of polymethylmethacrylate (PMMA) bone cement mixture(with the ratio of powder/contrast agent as 3GA9552GA9551 )was injected.The patients were followed up for 6~12 months.Results The successful rate of puncture was 100%.76.9%(10/13) of patients get better in symptoms in 3 days after operation,pain relieved in 6 months was 69.2%(9/13),in one year was 54.5%(6/11).In followed up period,CT showed the PMMA distribution was good,the vertebral body had no compression,the patients had no serious complications.Conclusion PVP is an effective and safe method for malignant lesion of vertebral body in anti-pain,preventing the compression vertebral body and secondary paraplegia.