BACKGROUND:Hyperbaric oxygen therapy can improve the microenvironment of the injured spinal cord, and hyperbaric oxygen combined with Schwann cel transplantation is expected to improve the therapeutic efficacy on spinal cord injury. OBJECTIVE:To investigate the effect of Schwann cel transplantation plus hyperbaric oxygen on the neural functional recovery of rats with spinal cord injury. METHODS:A total of 80 female SD rats with spinal cord injury were randomized into 4 groups, with 20 in each group:blank control group, injection of L-DMEM via the tail vein at 6 hours after modeling;cel transplantation group, injection of 3×106 RESULTS AND CONCLUSION:The motor function of the lower limbs was better in the combination group than the cel transplantation and hyperbaric oxygen groups, as wel as better in the cel transplantation group and Schwann cel suspension via the tail vein at 6 hours after modeling;hyperbaric oxygen group, hyperbaric oxygen therapy at 1 hour after modeling;combination group, combined therapy of Schwann cel transplantation and hyperbaric oxygen. Inclined plane test, modified Tarlov score, Basso-Beattie-Bresnahan score for motor function evaluation of rat hind limbs were performed and measured at 1, 3 days, 1, 2, 3, 4 weeks after treatment. SRY gene expression in the spinal cord was measured at 4 weeks after transplantation using PCR method. Horseradish peroxidase tracer and electroneurophysiology detection was done at 8 weeks after transplantation.hyperbaric oxygen groups than the blank control group. SRY expression was detected in the cel transplantation group and combination group, but not in the blank control group and hyperbaric oxygen group. The number of nerve fibers positive for horseradish peroxidase was higher in the combination group than the cel transplantation and hyperbaric oxygen groups fol owed by the blank control group, and there were significant differences between different groups (P<0.01). In addition, the latencies and amplitudes of somatosensory evoked potential and motor evoked potential in the combination group were also better than those in the other groups (P<0.05 or P<0.01). These findings indicate that the combined therapy of Schwann cel transplantation and hyperbaric oxygen can promote the synaptic regeneration, improve limb motor function and electrophysiological function in rats with spinal cord injury, which is superior to hyperbaric oxygen or Schwann cel transplantation alone.

Objective:To observe the effect of thrombolysis in treating acute deep vein thrombosis (DVT) in the lower limbs.Methods:For the 14 patients diagnosed by colour Doppler ultrasonographic examination,intravenous drip of urokinase,dextran and mailuoning was ministered alternatively through the superficial venosus dorsalis pedis in the involved side.Meanwhile,oral intake of aspirin and dipyridamole was also prescribed.Results:Ten patients healed and four significantly improved.Conclusion:The efficacy of thrombolysis for treatment of DVT in the lower limbs is valid.This intervention is especially suitable for those patients who missed the optimum time window of operation.

Objective To discuss the clinical outcomes of surgical treatment on epididymal obstructive azoospermia (EOA) and the factors affecting clinical results. Methods The clinical data of 51 EOA patients who underwent single layer longitudinal 2-suture intussusception vasoepididymostomy (LIVE) were retrospectively analyzed. The months of follow up, mean level of sperm count per ejaculate and percentage of grade A sperm were collected. Patency and pregnancy rates were recorded during followups. Results A total of 51 men were taken scrotal exploration. Sperms were bilaterally or unilaterally present in epididymal fluid in 49 cases, including 1 case had sperm in one side of the epididymal fluid and the contralateral vasal fluid. No sperm was found in epididymis in 2 cases. Bilateral and unilateral LIVE were performed in 48 cases. 44 were followed for more than 6 months and 39 for more than 1 year. Sperm was present in ejaculate in 32 of cases, the overall patency rates were 72.7%. The mean sperm count was (24±23) × 106 per ejaculate. Grade A sperm was present in the ejaculate in 28 cases with a mean levels of (12± 11.2)%. A total of 10 cases achieved pregnancy.Pregnancy was achieved only when the site of anastomosis was at cauda epididymis. Conclusions Loupe-assisted LIVE, with lower cost and simplified surgical procedure, could achieve optimistic patency outcomes and pregnancy results. Data of this paper also suggested that it should be taken into account that pregnant outcome was related to the site of anastomosis.

One-hundred and sixty-nine women with polycystic ovarian syndrome (PCOS)and 95 healthy women were enrolled. All subjects were genotyped for rs290487 ( transcription factor 7-like 2 gene) by TaqManMGB probe hybridization assay. The results showed that polymorphism rs290487 had association with PCOS in Han people in Anhui area. The allele C was associated with the risk of PCOS. Genotype CC seems to be the risk factor of insulin resistance in PCOS patients.

Objective To analyzed the effects of the positioning errors and weight variability of the head and neck cancer patients with intensity modulated radiation therapy (IMRT),or volumetric modulated arctherapy (VMAT) based on the kilovoltage cone-beam computed tomography (kV-CBCT).Methods CBCT images of 102 patients with head and neck cancer patients receiving IMRT or VMAT were screened by CBCT once a week for consecutively 6 weeks.The positioning errors were measured by comparing CBCT and planning CT in left-right (LR),anterior-posterior (AP) and cranio-caudal (CC) directions.Meanwhile,the weight of patients were measured every week.Results The positioning errors were (0.011 5±0.125 3) cm,(-0.017 6±0.123 3) cm and (-0.014 1±0.156 7) cm in LR,AP and CC directions,respectively.The mean systematic errors were all less than 0.02 cm in three axial directions,while the mean random errors were all within 0.2 cm.There was no statistically significant difference was observed among the setup errors in all three axial directions according to different week.Though the body weight of patients continued to drop during the radiation by with the mean weight loss of 3.5 kg and had a negative correlation with treatment course.Bivariate correlation analysis showed just the positioning errors in CC direction were significantly correlated with body weights loss.Conclusion There is no statistical relationship with in position errors of the patients with their treatment course,and the body weight loss seemed to influence the position errors in CC direction.

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Objective To describe the single needle running suture method for the urethrovesi-cal anastomosis during laparoscopic radical prostatectomy(LRP). Methods Forty-five patients of prostate cancer underwent LRP with the single needle running suture method. The technique was initi-ated by performing a fixing suture at the posterior lip of bladder neck at 4 o' clock and tying the first knot. Another suture at the nearby position of the first suture was performed to leave the first knot outside. From 5 o' clock to 8 o' clock, sutures were performed every one o' clock to secure posterior approximation, then every two o'clock a suture. To avoid a loose anastomosis, lock sutures were per-formed every 3 sutures. After completing the full circumference, the needle was drawn at the 2 o' clock for the second knot. The needle was always driven full-thickness outside-in in the bladder neck and inside-out on the urethra. Any remaining leakage could be closed with additional interrupted su-tures. Results All urethrovesical anastomosis were completed successfully. The mean anastomosis time was 16 rain(from 12 to 25 min), and mean operative time was 132 rain (112 to 185 rain). The mean catheterization time was 9 d(7 to 14 d). Three temporal urinary leaks requiring prolonged cathe-terization were identified. Forty-four patients had total urinary control in 1 year postoperatively and no other short-term or persistent complication was found with a mean follow-up of 21 months. Conclu- sion The single needle running suture method could be a simple and safe method for urethrovesical anastomosis during LRP.

0.05). Within 8.9 months of mean follow-up, 3 new fractures occurred in 3 patients in group 1, 2 new fractures occurred in 2 patients in group 2, showing no significant difference. The average increase in vertebral body height on the X-ray plains at 1 week after PVP was 2.2 mm anteriorly, 2.3 mm centrally and unchanged posteriorly. Comparing with the plain film at 1 week after PVP, the heights of vertebrae showed no significant difference at 3 and 6 months of follow-up respectively the heights of vertebrae were unchanged at 1 week after conservative therapy. Average reduction in vertebral body height was 1.9 mm anteriorly, 2.1 mm centrally, unchanged posteriorly at 3 months, but no more collapse at 6 months after conventional treatment. The vertebral body height was significantly higher in the group 1 than in group 2 at 3 months after treatment. Conclusions PVP is aneffective and safe procedure for treating persistent painful osteoporotic vertebral compression fractures and shortening the course of disease. Pain relief showed no difference at 6 months follow up with conventional treatment\ a outcoming with increase of vertebral body height and preventing further collapse of the vertebra. New fractures following vertebroplasty may actually represent presence of osteoporosis rather than a complication of the procedure.

The single needle method for urethrovesical anastomosis with strengthened posterior fixation during laparoscopic radical prostatectomy was explored. The method was initiated by performing a fixing suture with a knot at 4 o'clock of the posterior lip of bladder neck, and another suture at nearby position was performed to leave the knot outside. From 5 o'clock to 8 o'clock, sutures were performed every one o'clock to secure posterior approximation, then every two o'clock a suture. To avoid a loose anastomosis, lock sutures were performed every 3 sutures. The needle was always driven full-thickness outside-in in the bladder neck and inside-out on the urethra. After completing the full circumference, the needle was drawn near the 4 o'clock and tied at the tail end. Any leakage could be closed with additional interrupted sutures. The clinical data of 89 patients who underwent this method were retrospectively compared with those of 23 patients who underwent the single knot method. The results showed that the anastomosis, operative and catheterization time was 17.6+/-4.7 min, 134.0+/-10.7 min and 6.5+1.6 days respectively. There were 3 temporal urinary leakages identified in 89 cases requiring prolonged catheterization. No urinary leak and anastomotic stricture was confirmed, and 95.2% patients had total urinary control. It was concluded that this method was simple and safe for urethrovesical anastomosis.

Objective To investigate the protective function of edaravone in the compressed spinal cord.Methods There were 150 rabbits enrolled in each group in the experiment.Rabbits in both operation group and edaravone (EDA) treating group received mild spinal cord compressionby setting a flap head screw between C6 C7 after the neck.The spinal cord decompression was conducted seven days later.After 6 hours,rabbits in the EDA treating group were injected with a large amount of EDA through ear border veins,while the rabbits in the operation group only received 0.9％ sodium chloride injection.The transmission electron microscope was used to observe the apoptotic bodies at 1 day,3 days and 7 days after compression,and 1 day,3 days,7 days,and 14 days after decompression.Flow cytometry was used to test the rate of apoptosis of spinal cord cells.Immunohistochemistry was used to test the expression of Bax protein that is related to apoptosis.Results The neuronal apoptosis appeared after compression in both operation group and EDA-treating group.The Basso Beattie Bresnahan (BBB) score,neuronal apoptosis rates,and Bax protein expressions in both groups were statistically different (P ＜ 0.05) when the spinal cord was compressed in the first day and the third day,while there was no statistically different when spinal cord compressed at the seventh day (P ＞ 0.05).After decompression of the spinal cord,the BBB score,neuronal apoptosis rates,and Bax protein expressions in both groups were becoming lower at the seventh day (P ＜0.05).Conclusions EDA has protective function for compressed spinal cord.However,only the compression of spinal cord compression period of sufficient decompression can fundamentally protect the spinal cord.