Superior Mesenteric Artery (SMA) syndrome is a well-known but rare complication following corrective surgery for scoliosis. It can be easily missed if not thought of in patients presenting with abdominal pain and vomiting post-scoliosis surgery. SMA syndrome is most commonly associated with conditions resulting in significant weight loss but can also occur as a result of biomechanical changes following scoliosis surgery. We present a case of a 13 year-old girl who developed SMA syndrome following scoliosis surgery. A high index of suspicion and early surgical referral are paramount for the successful management of SMA syndrome.

Objective:To compare the differences between Workshop teaching and PowerPoint teaching being used in resident doctor/advanced doctor training,and to investigate effectiveness of Workshop teaching.Method:Over the limit of teacher on the stage and students off the stage,teacher demonstrated to students hand by hand during Workshop teaching;Over the limit of the students being accepted knowledge passively,teacher encouraged them to take part in mutually;Over the limit of theories lesson separating with practical one,teacher supply more opportunity to operate for students practically.Results:The effectiveness of Workshop teaching mode in practicability and performance ability was better than PowerPoint teaching mode'(P

Cerebral infarction is not only a focal damage,but also causes secondary damage in areas remote from the ischemic territory,which will retard the recovery of neurological function.Ephrin receptor B2 (EphB2) plays an important role in the development and repair mechanism of central nervous system.Blocking the effect of EphB2 in brain by using a specific inhibitor may enhance proliferation and migration of endogeneous neuronal stem cells after experimental cerebral infarc- tion,improve neurological function and influence angiogenesis and neuroplasticity in remote sites.It is expected to become a new approach for decreasing damages in areas remote from the cerebral infarction and promoting the recovery of neurological function.

Interleukin-24 (IL-24) is a member of IL-10 family, which was cloned from human melanoma cells by the method of subtractive hybridization. IL-24 can inhibit the growth of tumor cells and angiogenesis and enhance radiation sensitivity and immune adjustment with non-toxic effects on normal cells.As a kind of cytokine with multiple anti-tumor functions, IL-24 will become a new weapon of gene therapy against cancer. The application and mechanism of IL-24 in the treatment of cancer will be discussed in this paper.

Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)complicating anterior cervical surgery.Methods1052patients were performed anterior cervical surgery between October1997and October2002.Of 1052cases,926cases were of cervical spondylotic myelopathy(CSM),and126of ossification of posterior longitudinal ligament (OPLL).11patients suffered from cerebrospinal fluid leakage during operation.There were8males and3females aging from46to72years(average,58years).In the group of CSM,there were2cases of CSFL(0.22%)occurred in resection of osteophyte of the posterior vertebral edge,who were serious CSM of C 4,5 and C 5,6 with severe anterior compression by osseous mass to spinal cord showed on MRI.In the group of OPLL,there were9cases of CSFL(7.14%)occurred in resection of the ossified posterior longitudinal ligament accompanied with severe spinal canal stenosis and anterior compression to spinal cord on radiological imagings,4of them were con-tinuous OPLL from C 2 to C 6 combined with herniation of cervical disc,3segmental,and2mixed.Results The defect area of spinal dura were(0.6～2.0)cm?(1.0～1.5)cm.The cerebrospinal fluid was blocked with fascia and absorbable gelatin sponge during the operation.If CSFL was persistent more than3days after oper-ation,expectant treatment was performed.After the operation,no CSFL occurred in8of 11patients,and the other3cases with postoperative CSFL were cured5,14and17days by dressing change,blocking the wound with gelatin sponge,and suturing of the wound respectively.All patients were followed up for 10to62months(mean,26months).No cerebrospinal fluid cyst and infection occurred.There were no significant negative effects of CSFL on the recovery of neuromuscular function.Conclusion CSFL following cervical anterior surgery can be cured by blocking up leakage of spinal dura during operation,however,conventional conservative treatment including of dressing change,antibiotics administration,horizontal position with low pillow are necessary after operation.

Adult ; Cartilage ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear Auricle ; surgery ; Esthetics ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; surgery ; Tympanoplasty ; methods

Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Glioma ; pathology ; Humans ; Sesquiterpenes ; administration & dosage ; pharmacology ; Time Factors

Objective To investigate the role of synaptic plasticity on the formation of visceral hypersensitivity induced by transient intestinal infection in rats. Methods Thirty male Sprague-Dawley rats were divided into normal control, acute infection and chronic infection groups with 10 each. The area under curve (AUC) of electromyography (EMG) in 10 s was used to evaluate the visceral sensitivity induced by different eolorectal distention (20,40,60 and 80 mmHg). Histological change of the colon was evaluated by H-E staining. Synaptic uhrastrueture such as synaptic cleft and synaptic vesicles was observed using transmission electron mieroseope. The mRNA and protein expressions of synaptophysin and postsynaptic density protein-95 (PSD-95) were examined by RT-PCR and Western blot, respectively. significantly higher than those of normal controls(P=0. 012, 0. 005, respectively ). In contrast, AUC of acute infection were significantly lower than those of normal controls ( P = 0. 018,0. 012, respectively ). Under the distention of 20 and 80 mmHg, no significant difference was observed among three groups (P= rats compared to normal controls(23.45±4.10 vs. 9.10±2.42, P=0. 027),but there was no statistical difference between chronic infection rats and normal controls (13. 95±7.96 vs. 9.15±2.42, P=0.78). increased. In acute infection rats, mitochondria cristae disappeared, synaptic vesicles and the length of controls, mRNA and protein of synaptophysin in ileocecum, proximal colon and distal colon were significantly increased in chronic infection rats (P＜0. 05 ), but decreased in acute infection rats with no significant difference. Compared with controls, no significant downregulation was noted in the expression protein expressions of PSD-95 were both increased in chronic infection rats (P＜0.05), and decreased in acute infection rats (P＜0.05). Conclusion Synaptic plasticity plays an important role in the formation of visceral hypersensitivity induced by transient intestinal infection in rats.

To observe the changes in content of monoamine neurotransmitters in the serum of rhesus macaques, and explore the role of serum monoamine neurotransmitters in premenstrual syndrome (PMS) and liver-qi depression induced by anger-in emotion.

Objective:A patient with L3-5 lumbar disc herniations and right spinal recess stenosis at L4-5 level associated with type IIB lumbosacral nerve anomaly(LSNA) at right side according to Neidre and Macnab classification system missed preoperatively and initially misdiagnosed as type IIA intraoperatively was reported. The reasons leading to missed diagnosis preoperatively and misdiagnoses intraoperatively were analyzed. Methods: A 62-year-old female was admitted to our hospital for intermittent radiating pain and claudication to the right lower extremity for about 20 years, radiating pain to the left lower extremity for 2 weeks. Physical examination found the left L5 nerve and right L4 and L5 nerves were impinged. CT and MR scannings revealed L3-4 disc herniation at right side, L4-5 disc herniation at central and left side with severe lateral recess stenosis at right L4-5 level. Image examinations failed to find a nerve root anomaly preoperatively. Following failed conservative treatment, the patient accepted decompression operation initially at left side. Left L5 nerve compressed by the herniated L4-5 disc was found firstly, which was liberated by discectomy. When doing decompression exploration at right side, it was found that two lumbar nerve roots exited L4-5 intervertebral foramen while the upper one was compressed by the herniated L3-4 disc which was liberated by discectomy and the lower one was free of compression. With exposing the right side and partly unroofing of stenosed right L4-5 lateral recess, no typical L5 nerve root was found passing over the posterior surface of the herniated L4-5 disc except that there was a slim membrane-like structure covering it. The patient was initially considered as type IIA LSNA skeptical according to Neidre and Macnad Classification. But detailed observation of the axial CT and MR sequences at L4-5 lateral recess space and sagittal CT and MR sequences at L5S1 intervertebral foramen found there was nerve-like structure, which was further confirmed to be the L5 nerve root by total unroofing of stenosed lateral recess. The membrane-like structure covering the L4-5 disc was confirmed to be the flattened right L5 nerve root compressed by herniated L4-5 disc and stenosed lateral recess, which emerged from the dura’s ventral-lateral side just above the L4-5 disc, the L5 nerve was stripped and pushed medially from its lateral boundary meticulously, L4-5 discectomy was done at right side. Intervertebral cages were inserted after L3-4 and L4-5 disc spaces preparation, following pedicle screw system fusion. Results: No nerve damage occurred intraoperatively. The patient was free of radiating pain to the left lower extremity the day after operation, two weeks later the radiating pain to the right lower extremity alleviated after temporary aggravating. Conclusion: type II lumbar nerve anomalies were not easily to be detected by CT or MR images preoperatively, that closer distance between the conjoined nerves existing the L4-5 foramen and careless observation was responsible for missed diagnosis preoperatively. That the flattened right L5 nerve covering the L4-5 disc was difficult to be recognized intraoperatively for losing its typical contour and color was responsible for misdiagnosing type-IIB anomaly as IIA LSNA.. The operators should be alert and observed carefully in case of misdiagnosing.