Objective To explore the way and effect of minimally invasive surgery of intracranial aneurysms.Methods 42 aneurysms from 40 patients were clipped under microscope, including 15 cases assisted with endoscope, 2 cases with neuronavigation and 2 cases with endovascular technique.Results 36 aneurysms were clipped, of which 2 were removed and 4 were wrapped. There were no parental arteries clipped incorrectly and no narrowing of the parental arterys under the helping of endoscope. Endovascular technique was applied in two large paraclinoid aneurysms, one was successfully clipped and the other was failed in procedure, but we dissected and clipped it at last by pressing the ICA. Two aneurysms were successfully located and removed under the help of neuronavigation.Conclusion Microneurosurgery combined with neuroendoscope, endovascularity and neuronavigation may reduce surgical injure and improve treatment effect.

Objective To evaluate the application of the flurescence-guided resection in gliomas surgery. The value and the advantages of this system for glioma resection was assessed, points for attention of application were discussed. Method 14 patients with gliomas in different region of the brain were performed flurescence-guided resection by using high-dose fluorescein sodium . Results Of our cases, according to the imaging data, total lesion removals were achieved in 11 patients (78.6%). The clinical status of all patients showed improvement without complication after surgery, the time of surgery and the days in hospital were both shortened than those of routine method of surgery. Conclusion The flurescence- guided resection is reliable and does accurate location in surgical treatment for gliomas. It increases rate of total lesion removal of glioma without injuring the adjacent functions.

AIM: To determine the HPLC fingerprint of ultramicro decoction piece of Fructus gardeniae. METHODS: Chromatographic conditions were as follows: column: Hypersil BDS C_ 18 (4.6 mm?200 mm,5 ?m), mobile phase: acetonitrile-water (10∶90), column tempemture: 25 ℃,flow rate: 1 mL?min -1 , wavelength: 238 nm, and inject volume: 10 ?L. RESULTS: The fingerprint of ultramicro Fructus gardeniae was established and 7 common peaks in the fingerprint were indicated. CONCLUSION: It can nearly completely reflect intrinsic quality of ultramicro decoction piece of Fructus gardenian.

Objective:To optimize the influencing factors in Maillard reaction products ( MRPs) between valine and glucose/fruc-tose. Methods:The heating time, heating temperature, initial pH value and the molar ratio of amino to carbonyl as the evaluation fac-tors,and the activity of MRPs during the processing of Polygonati Rhizoma on DPPH radical scavenging as the evaluation index,the in-fluencing factors were optimized by L9 (34 ) orthogonal design. Results:The optimal reaction conditions for valine and glucose were as follows:the heating time was 24 h, the heating temperature was 110℃, the initial pH value was 7 and the molar ratio was 1∶3. The optimal reaction conditions for valine and fructose were as follows:the heating time was 8 h, the heating temperature was 120℃, the initial pH value was 9 and the molar ratio was 1∶2. Conclusion:The study provides theoretical basis for the further study on the pro-cessing of Polygonati Rhizoma.

Drug resistance of Acinetobacter baumannii ( Ab) in surgical ICU from January 2008 to December 2009 was investigated retrospectively. Total 114 clinical strains of Ab were isolated from surgical ICU and 92 strains were from respiratory tract (80.7% ). The prevalence rate of multiresistant Ab in 2009 was higher than that in 2008 (75. 7% vs 50. 0% , x2 = 7. 703, P = 0. 006). The results indicate that to monitor and control drug resistant of Ab constantly is important for the prevention of nosocomial infection.

Objective To observe the efficacy of total ankle replacement in treatment of osteoarthritis of ankle joint.Methods Between October 1999 and October 2006,42 patients with ankle osteoarthritis were admitted in Beijing Jishuitan Hospital.All the patients met surgical indications and were performed total ankle replacement with S.T.A.R.system ( Scandinavian Total Ankle Replacement) (Waldemar Link,Hamburg,Germany).The pain in patients,motion and function of joint were evaluated pre- and post-operatively according to Kofoed scoring system,and the efficacy was evaluated with the Mayo'evaluation criteria of total ankle replacement.Results According to Kofoed scoring system,the postoperative situation was obviously superior to the preoperative in pain,motion and function of joint(P ＜ 0.05 ),and the excellent and good rate was 90.32％.While,the excellent and good rate was 87.5％with the Mayo' evaluation criteria of total ankle replacement.Conclusion Total ankle replacement,which can relieve pain,restore ankle function and improve ankle activity,provides another effective method for the patients who need ankle arthrodesis.

Objective:To study on the effect of ultrasound-guided thoracic paravertebral nerve (TPVB) block on quality of recovery from general anesthesia in tuberculosis patients with fiberboard exfoliation in post anesthesia recovery unit (PACU).Methods:From May 2018 to December 2019, 40 tuberculosis patients in Changsha Central Hospital with pulmonary fibreboard exfoliation and focal abscess lesions cleaning were randomly divided into two groups, with 20 patients in each group. The patients in group A received endobronchial general anesthesia and in group B received ultrasound-guided TPVB combined with endobronchial general anesthesia. Patients in the two groups were maintained under anesthesia by propofol, and the bispectral index (BIS) was maintained within the range of 40-50. The dosage of propofol and sufentanil was adjusted according to changes in BIS and hemodynamics. The mean arterial pressure (MAP), heart rate (HR) in two groups of patients were recorded at before anesthesia induction (T 0), before cutting leather (T 1), cut skin after (T 2), the end of operation (T 3), extubation time (T 4), and T 5 (time of leaving PACU). The visual analogue scale (VAS) of all patients in resting and cough state was recorded at 5, 30 min after extubation and the time of leaving PACU. The dosage of propofol and sufentanil in the operation and the additional dosage of sufentanil in PACU were recorded in both two groups. And the respiratory recovery time, consciousness recovery time, extubation time and sedation agitation scale(SAS) were observed. The adverse reactions such as nausea, vomiting, drowsiness and hypotension were observed in PACU. Results:Compared with group A, MAP and HR of patients at T 2, T 3, T 4, T 5 in group B were more stable during anesthesia, and VAS of patients in group B were lower than that in group A at each time point after extubation ( P<0.05). The dosage of sufentanil and propofol in group B were (35.92±8.12)μg and (749.56±95.30)mg respectively, which were significantly lower than those in group A [(45.74±4.42)μg and (862.83±105.34)mg, P<0.05]; the dosage of sufentanil in postoperative anesthesia recovery room of group B was (5.26±2.10)μg, significantly less than that of group A (10.35±5.86)μg ( P<0.05). The respiratory recovery time, consciousness recovery time and extubation time in group B were (12.92±5.12) min, (20.56±5.10) min and (26.87 ± 6.16) min, which were shorter than those in group A [(15.74±4.72)min, (25.83±5.34)min and (35.35±5.80)min, P<0.05]. The incidence of postoperative nausea, vomiting, lethargy and hypotension in group B were 10%, 10%, 35% and 20%, which were significantly lower than those in group A (30%, 20%, 75% and 45%, P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block may significantly reduce the dosage of opioid analgesics for general anesthesia in tuberculosis patients with fiberboard exfoliation, accelerate the speed of anesthesia recovery, reduce the agitation during recovery, and improve the quality of anesthesia recovery.

Objective: To develop a high efficient expression, purification system of recombinant arginine deiminase(ADI).Methods: cDNA fragment encoding for mycoplasma ADI was obtained by artificial synthesis and was cloned into prokaryotic expression vector(pBV220). The recombinant ADI was generated by the transformation of the recombinant vector into the host strain DH5?. Anion exchange and gel filtration chromatography was carried out for purification of the recombinant ADI. The biological activity of final product was detected by the assay of agrinine degradation in vitro. Results: A prokaryotic expression plasmid pBV220-ADI was generated successfully, and was identified by DNA sequencing; the recombinant protein was highly expressed in DH5?, the proportion of the recombinant protein is exceeded 35% of the whole protein. The inclusion bodies were solubilized with 6mol/L guanidine hydrochloride under reducing conditions in order to avoid incorrect disulfide-bond formation of the recombinant ADI molecules. Dilution and dialysis at lower degrees temperature were the optimum renaturation methods. After gel filtration, the purity and specific activity of rADI reached 95% and 80 IU/mg respectively. Conclusions: A set of protocols for high efficient rADI expression and purification has been established, which is simple, efficient and applicable.

OBJECTIVETo assess the indication and efficacy of surgical treatment for patients with hepatic metastases from gastric cancer.

METHODSClinical data of 43 patients with hepatic metastases from gastric cancer undergoing surgery from September 1995 to May 2002 were analyzed retrospectively.

RESULTSNo relationships were found between the number of hepatic metastases and patient's gender, age, tumor invasion depth, lymphatic node metastases and differentiation P> 0.05. All of 43 patients underwent surgery. Four cases undergoing hepatic resection for metachronous hepatic metastases had a higher survival rate than those who had curative resections for synchronous hepatic metastases (median survival 35 months vs. 10 months) (P=0.0233). 39 patients had synchronous hepatic metastases, of whom 32 patients received gastric resection only and 7 patients received both gastric and hepatic resections, there was significant difference of median survival between synchronous group and metachronous group(median survival 6.0 vs. median survival 10.0 months)(P=0.2799). There was significant difference of the postoperative survival rate among H (1) (7.5 months), H (2) (6 months) and H (3) (4 months) in the patients with palliative gastric resections (P=0.0007).

CONCLUSIONHepatic resection for metachronous hepatic metastases from gastric cancer has a better prognosis. Resections of gastric and hepatic lesions at the same time may not benefit the patients with liver metastases from gastric cancer. H(3) is not feasible for palliative gastric resections.

Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; surgery ; therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; therapy

OBJECTIVE: To compare the outcome of mini-tract vs standard-tract percutaneous nephrolithotomy (PCNL) in staghorn calculi. METHODS: Between May 2009 and May 2011, 122 patients with renal staghorn calculi were treated by PCNL. Fifty-six patients underwent mini-PCNL and the others underwent standard-PCNL. The therapeutic effect and complication of the 2 groups were compared. RESULTS: The two groups had comparable demographic conditions. Although the operation time was significantly longer in mini-PCNL group [(126±24.5) min vs (98±18.9) min], there was no striking difference in hospital stay [(5.7±1.3) d vs (5.3±1.1) d], hemoglobin drop [(9.5±3.2) g/L vs (10.5±3.3) g/L], stone-free state before charge (91.1% vs 89.4%) and complications. CONCLUSION The efficacy and safety of mini-PCNL and standard-PCNL are not significantly different.
Adult ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Miniaturization ; Nephrostomy, Percutaneous ; methods ; Postoperative Complications ; etiology ; Retrospective Studies