0.05);the disappearance rate of varices of fundus of stomach and esophagus in the combined devascularization group was higher than that in control group(P0.05).The long-term(fourth to seventh year)survived rate of the combined devascularization group was higher than that of control group(98.3% in the combined devascularization group,90.0% in control group)(P

Objective:To study the methods of protecting recurrent laryngeal nerve(RLN) in endoscopic thyroidectomy through the upper part of sternum.Methods:The clinilical data of 46 cases underwent endoscopic thyroidectomy through the upper part of sternum was analyzed.RLN was revealed when we performed nodulectomy or partial thyroidectomy.But during subtotal and near-total thyroidectomy the RLN was always revealed.Results:Forty-five of forty-six cases were compeleted successfully with endoscopic thyroidectomy.One case was converted to open thyroidectomy because of thyroid carcinoma.No intraoperative or postoperative hemorrhage,RLN injuried and deadlimb occurred.Conclusion:In order to reduce the injury of RLN,we should select the fitting cases strictly,master the opportunity and methods of revealed RLN.

Objective To compare the contents of astragaloside Ⅳ and polysaccharides in radix astragali with different growth years, providing reference for the better harvest time of radix astragali. Methods HPLC-ELSD was used to determine the content of astragaloside Ⅳ. A Hypersil-Keystone C18 column was used with the mobile phase consisting of acetonitrile-water (33∶67). The flow rate was set at 1.0 mL/min. The parameters of drift tube and gas flow rate of the detector were set at 105 ℃ and 2.7 L/min respectively. Phenol-sulfuric method was employed to determine the content of polysaccharides, and the detection wavelength was set at 490 nm. Results The linear range of astragaloside Ⅳ was within 1.25-6.28 μg. The average recovery was 97.28%, with RSD=1.42%. The linear range of polysaccharides was 10-100 μg. The average recovery was 99.02%, with RSD=0.94%. The content of astragaloside Ⅳ in radix astragali cultivated for more than 1 year was higher than the standard in Chinese Pharmacopoeia, and radix astragali cultivated for 3 years showed the highest content. The content of polysaccharides in radix astragali cultivated for more than 3 years was the highest, and radix astragali cultivated for 2 years was slightly lower. Conclusion The better harvest time for radix astragali is at least two years of growth, which is judged from the content of astragaloside Ⅳ and polysaccharides.

Newcastle disease virus-like particles (NDV VLPs) are composed of matrix protein (M) as the skeleton,with the insertion of hemagglutinin-neuraminidase and/or fusion protein.NDV VLPs are reported to be immunogenic and can induce specific humoral and cellular immune responses.However,its relationship with innate immunity remains elusive.Dendritic cells (DCs) are a group of specialized antigen presenting cells,which are crucial in connecting innate immunity and adaptive immunity.In this study,NDV VLPs and murine DCs were used to investigate the connection between NDV VLPs and innate immunity.The DC maturation induced by NDV VLPs (M+ HN) was evaluated.The results showed that NDV VLPs could be effectively taken up by DC and presented to naive T cells.NDV VLPs-induced DC significantly up-regulated the expression of MHC Ⅱ and costimulatory molecules on DC surface,and subsequently promoted the secretion of proinflammatory cytokines.This experiments also showed that different assembled NDV VLPs induced significant stimulating ability in cytokine levels.In summary,NDV VLPs can induce DC maturation,which gives insights to better understanding of VLPs-mediated innate immunity and provide information in selecting preferred NDV VLPs candidate.

Objective To investigate the relevant factors for development of early postoperative complications in patients with portal hypertension due to advanced schistosomiasis, and to offer a theoretical basis for preventing the occurrence of postoperative complications. Methods The cases of advanced schistosomiasis with portal (hypertension) operated upon over the past 40 years were retrospectively reviewed. Results In 8 240 cases, the complication rate was 19.66% at one month after operation, and the mortality rate was 15.31%. The main causes of death were MDOS, massive hemorrhage into abdominal cavity, hepatorenal syndrome and (recurrence) of bleeding of upper alimentary tract. Conclusions The relevant factors for development of early complications after operation in patients with portal hypertension is related to the cause of portal hypertension, whether or not there is a history of ascites, the timing of operation and the stage of liver function(Child′s classification).

Objective To investigate whether increased signal intensity (ISI) can help assess the prognosis in patients with cervical spondylotic myelopathy (CSM) by means of measuring the ratio of signal intensity. Methods A retrospective study with two or more years follow-up of 57 patients with CSM underwent posterior cervical decompression were carried out from February 2000 to February 2006. 1.5T MRI was performed in all patients before surgery. T2-weighted images (T2WI) of sagittal ISI on the cervical spinal cord were obtained, For those with ISI, the values of signal intensity of the spinal cord on T2-weighted image (T2Wl) and TI-weighted image (TIWI) of sagittal view were measured at the location where there was ISI on T2WI, and the ratio of signal intensity of T2WI / T1WI (T2/T1 ratio) at the same level of the spinal cord and with similar area was calculated on the computer. Patients with ISI were subdivided into 2 groups according to T2/T1 ratio. Results ISI was not observed in 20 patients (group 1). The range of T2/T1 ratio of other 37 patients was from 1.28 to 2.80 and the median was 1.65. Nineteen patients were divided into group 2 (ratio range, 1.28-1.63), and 18 into group 3 (ratio range, 1.67-2.80). Significant differences were noted in age at surgery, duration of disease, recovery rate, pre and preoperative JOA score among three different groups.Spearman's rank correlation showed that T2/T1 ratio was positively correlated with age at surgery and duration of disease, negatively with pre- and postoperative JOA score and recovery rate. Conclusion Patients with ISI and higher T2/T1 ratio tend to have relatively severe preoperative state of illness and poor prognosis after surgical intervention. Spinal cord signal intensity change on T2-weighted MRI might be a predictor of a poor outcome in terms of functional recovery rate in patients underwent operations for multi-level CSM.

BACKGROUND: Degenerative lumbar spinal stenosis could be treated by laminectomy internal fixation placement,unilateral or bilateral decompression,posterior laminectomy and so on.However,whether laminectomy internal fixation placement can be used remains unclear.OBJECTIVE: To evaluate the efficacy of interbody fusion cage implantation of pedicle screw fixation,in combination with posterior lumbar laminectomy,bilateral resection and decompression of the inferior articular process,autologous facet joint bone transplantation in the treatment of degenerative lumbar spinal stenosis.METHODS: A total of 41 patients of degenerative lumbar spinal stenosis,who failed after 3 months of conservative therapy,including 23 males and 18 females,at a mean of 60.3 years,Received posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autologous facet joint bone and cage interbody fusion implant pedicle fixation.They were followed up for 24 months,preoperative and postoperative Japanese Orthopedic Association(JOA)score evaluations were performed to assess the therapeutic efficacy of the patients,radiological examination was done to investigate the graft fusion and vertebral stability of surgical segments in patients.RESULTS AND CONCLUSION: During the follow-up,JOA score significantly increased compared with the preoperative score(P＜0.01)and clinical excellence rate was 90%; 40 cases obtained bony fusion,with a fusion rate of 98%,1 patient exhibited signs of lumbar instability.There was no loosening,fracture and other complications after internal fixation,but 2 cases appeared dural tear,1 case pedicle position deviation,1 case pseudoarticulation formation.The results suggest that the posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autogenous facet joint bone and cage interbody fusion implanted pedicle screw fixation show good clinical effects for the treatment of degenerative lumbar spinal stenosis.

Objective To evaluate the effectiveness of rehabilitative treatment after extended open-doorlaminoplasty of the cervical spine for cervical spondylotic myelopathy.Methods Sixty patients(mean age 61.7 ±12 years)who had undergone extended open-door laminoplasty of the cervical spine for cervical spondylotic myelopa-thy were studied for an average of 40.7 months.They are divided into a rehabilitation group and a control group with 30 patients in each.The patients in the rehabilitation group received systematic rehabilitation therapy pre-and post-operation.In both groups,the neurological recovery rate,the cross-sectional areas of the cervical posterior muscles,and the incidence of axial symptoms and post-operative complications were recorded and compared. Results The wounds of patients in the rehabilitation treatment group healed with no complicating infections,but the wounds of three patients in the control group became infected.There was no statistically significant difference in neurological recovery between the two groups.In the rehabilitation treatment group,the rate of atrophy and the cross-sectional areas of the cervical posterior muscles were significantly lower than in the control group.At the same time,the rate of neck axial symptoms was 23% in the rehabilitation group but 60%in the control group.a difference which was statistically significant. Conclusions Although rehabilitation treatment pre-and post-operation may not speed up neurological recovery,it may prevent postoperative atrophy of the cervical extensors and lower the incidence of neck axial symptoms.

Advanced schistosomiasis is the most serious clinical type of schistosomiasis. Its diagnosis and treatment are relat?ed to many special departments,such as gastroenterology,general surgery,neurology,endocrinology,radiology,traditional Chinese medicine,blood purification,endoscopy,intervention,and ICU. It is necessary to apply a multidisciplinary treatment (MDT)mode. However,the mode has no universal standard and guide in practice. It is very important for the implementation of MDT mode of advanced schistosomiasis to form a treatment expert team,formulate the formal working procedures,and standard?ize the treatment schedules. The standardized implementation of MDT mode will be important to provide a more effective clinical decision on advanced schistosomiasis.

Objective To investigate the efficacy and safety of the resection of cervical posterior longitudinal ligament (PLL) in Bryan cervical disc arthroplasty. Methods Thirty-one patients underwent Bryan cervical disc implantation only in one level from August 2006 to January 2009 were investigated in this study. Cervical PLL was preserved in 14 patients, but not in other 17 patients. The clinical (JOA score,VAS score for neck and arm pain) and radiographic parameters (the FSU angle, ROM and diameter of the spinal cord) were compared between the two groups. Results No differences were found in terms of age, affected segment, gender, follow-up period, operation time and blood loss between the two groups. Patients underwent removal of cervical PLL were significantly superior to those underwent reservation of cervical PLL in term of clinical outcomes. There were no differences between the two groups with regard to the increase of FSU angle and ROM. However, the diameter of the spinal cord had a significant increase in patients underwent removal of cervical PLL. No severe complication was found in the two groups. Conclusion Removal of the cervical PLL is beneficial for the clinical outcomes and does not have an impact on the angle and ROM of the affected segment. The procedure is safe and feasible.