Objective To investigate precaution effect of ephedrine on protamine's untoward reaction. Meth-ods Forty patients, who were scheduled to have mitml valve replacement operation were randomly divided into two groups: ephedrine group(group A, n = 20) and control group (group B, n = 20). 50ml solution, mixed with protamine and 5% glucose,was injected through internal jugular vein in five minutes to neutralize the effect of heparin. In group A,3mg ephedrine was added into neutralization solution while in group B nothing was added. Arterial pressure(AP) , heart rate(HB) peripheral hemoglobin oxygen saturation(SpO2) and airway resistance(AR) were measured before injection and 1,3,5,10 minutes after injection in both groups. Results In group A, the AP, HR, SpO2 and AR had no significant difference before and after injection (P >0.05) ;while in 6 eases of group B, the AP, HR, SpO2 and AR have significant difference before and after injection. Conclusion Ephedrine can significantly improve protamine's untoward reaction, and neutralize the effect of heparin.

ObjectiveTo evaluate the effect of regional radical pancraticoduodenectomy (PD) combined with resection and reconstruction of invaded blood vessel (Fortner type Ⅰ?Ⅱ procedure) for pancreatic cancer.MethodsResult of 5 Fortner Ⅰ cases undergoing PD and resection of superior mesenteric-portal vein (SMPV),and 1 FortnerⅡ case with resection of SMPV,superior mesenteric artery(SMA)and hepatic artery(HA) was reviewed. ResultThe case undergoing Fortner Ⅱ surgery survived for 13 months.The 5 Fortner Ⅰ cases were followed-up for 5～34 months,with patent graft as identified by CT and ultrasonography and with no recurrence. ConclusionRegional pancreatectomy combined with resection of invaded blood vessel can be carried out in carefully selected patients of pancreatic cancer with favourable long term-result.

Objective To explore the MSCT characteristics of gastric schwannoma (GS).Methods 1 6 patients with pathologically verified GS were included in our study.The MSCT images were analysed retrospectively.Results 1 6 participants were determined with solitary nodule,which located in gastric antrum,body and fundus,respectively with 5 cases,10 cases and 1 case.13 of them showed morphologically as round or ovoid shape,while 3 of them grew irregularly lobulated lesion.For their growth pattern,1 3 tumors presented as bilateral growth,1 lesion appeared intra-cavitary growth,1 grew outside the cavity fields.However,1 case was hard to confirm the growth pattern due to the gastroduodenal intussusception.14 tumors appeared uniform density,1 showed a little necrosis and 1 had dotted calcification,all the lesions were emerged as progressive enhancement with inhomogeneous feature.Conclusion GS mostly located in gastric body or antrum,with round or ovoid appearence,well-defined border,and bilateral growth pattern,necro-sis and calcification are rare,enhanced progressively with homogeneous feature,with no surrounding invasion and metastasis.

Objective:To investigate the retinal toxicity of chitosan and gentamicin- chitosan gel. Methods:Sixteen albino New Zealand rabbits (weighted 1. 5-2.5 kg) were used in this study. The rabbits were divided into 4 groups randomly;each group was injected with 0.1 ml PBS, gentamicin 2 mg/ml,3% Chitosan gel, and gentamicin-chitosan gel (2 mg/ml) respectively. ①Ophtahlmoscopic examinations were done. Retina was observed prior to injection , and on 1st, 3 rd, 7 th, 14 th d and 28 th d after injection with direct ophthalmolscope observations. ②Electroretinographs (ERGs) were recorded prior to injection, and then on 3 rd,7 th,14 th d and 28 th d after injection were carried out. ③Light microscope and transmission electronicmicroscope examinations were performed four weeks after the injection. All eyes were enucleated, the retina examples were observed under light microscope and transmission electronic microscope. Results:Intravitreous injection with 3% chitosan was free of retina toxicity. The retina toxicity effects of gentamicin 200 ?g could be found with transmission electron microscope, but gentamicin-chitosan gel with the same dosage could decrease the damage. Conclusion:The result shows that chitosan can be used in the intravitreous injection.

[Objective]To evaluate the therapeutic effects of the operation of latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement for treatment of thoracolumbar more vertebral compression fractures with osteoporosis.[Method]Twenty-two patients with osteoporosis and more vertebal compression fractures received latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement.Functions of spinal cord nerve were damaged in different degrees.Preoperative auxiliary examination of X-ray,CT and MRI was used.The spinal stabilization,spinal cord function and the state of chronic lumbodynia were observed by postoperative photographs.[Result]All the patients were followed up,and the implants showed bone union.Sensation and motor function were improved in various degrees.The pain of chest and back or other complaints were obviously relieved.No recurrence occurred.Vertebral bodies by vertebroplasty had no leakage and the short-term effects were satisfactory.[Conclusion]The operation of latero-anterior internal fixation by plate screw combining vertebroplasty is profitable to simultaneously improve nerve compression of thoracolumbar kyphosis,spine instability,and other chronic pain caused by osteoporotic vertebral compression fractures.

Objective To observe heterotopic osteogenesis of autogenous marrow stromal cells on ?-tricalcium phosphate (?-TCP) scaffold, and the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) and transforming growth factor-beta (TGF-?) on osteogenesis. Methods The Newzealand rabbits autogenous marrow stromal cells were cultured by mineralized condition medium. The cell suspension was collected. All the cells with concentration of 5 ?106 ? mL-1 were divided into four groups. Group A: rhBMP-2 (15 ?g) /TGF-? (30 ng) were added; group B: TGF-? 30 ng was administered; group C: without growth factor as control; group D: continual cultured and no loading on ?-TCP. MSCs in group A, B, C were planted on ?-TCP. Alkaline phosphatase (ALP) activity was examined by histochemistry. Then MSCs loading on ?-TCP were embedded in autogenous subcutaneous. Four weeks later, the osteogenesis was observed by HE staining, type I collagen and bone morphogenetic protein synthesis were examined by immunohistochemistry stains. Results The ALP activities in groups A and B were significantly higher than those in group C and D (P

Objective:To study the application value of different operation methods in the treatment of left hepatolithiasis in special position (the stone is located in the sagittal section of left portal vein and/or near the proximal end of left hepatic vein).Methods:From July 2015 to June 2018, 58 patients with left hepatolithiasis in special position in Department of General Surgery, the First People′s Hospital of Tianmen City of Hubei Province were analyzed retrospectively. According to the different operation methods, they were divided into two groups: left liver excision under laparoscopy and gallbladder incision stone group (left liver excision group, n=28) and laparoscopic left-half liver excision and bile tube excision stone removal group (left half liver excision group, n=30). The operation time, intraoperative bleeding, postopera-tive hospital stay, postoperative biliary fistula, postoperative bleeding, postoperative stone residue and stone recurrence were compared between the two groups.The measurement data with normal distributions were represented as ( Mean± SD), and comparison between groups was done using the t test. The chi-square test and Fisher precision test were used for comparison between counting data. Results:All 58 patients underwent laparoscopic surgery. Left liver excision group surgery time, in-serum bleeding, number of days hospitalized after surgery, number of postoperative bile fistula cases, number of postoperative bleeding cases were (161.53±30.56) min, (203.45±26.69) mL, (9.26±3.3. 86) days, 1 case, 1 case, left half liver excision group (153.16±42.63) min, (198.79±30.82) mL, (9.59±4.01) days 1 case, 1 case, The difference between the two groups was not statistically significant ( P>0.05). The number of postoperative stone residues was more than that of the left liver and outer leaf excision group (4 cases) than that of the left half of the liver excision group (1 case), and the number of postoperative stone recurrence cases was more than that of the latter (1 case), all of which were statistically significant ( P<0.05). The number of stone residues and stone recurrences after left liver excision group was 4 and 5 cases respectively, and the left half liver excision nurses were 1 case and 1 case, respectively, and the difference between the two was statistically significant ( P<0.05). Conclusion:For the left hepatolithiasis in special position (the stone is located in the sagittal section of the left branch of the portal vein and (or near the proximal end of the left hepatic vein in imaging), the lower abdominal left hemihepatectomy + choledocholithotomy is a safer and more effective treatment.

BACKGROUND:There are stil about 10%-30%of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are col ectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons. OBJECTIVE:To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor. METHODS:From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, al patients were fol owed-up to evaluate the effect of the treatment. RESULTS AND CONCLUSION:The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. Al incisions healed by first intention. Al patients were fol owed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the fol ow-up after 1 month and (25.35±2.61) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). According to reforming Macnab standard, the results were excel ent in 53 cases and good in 9 cases at the last fol ow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimal y invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.

Objective To summarize the surgery effect of removal of tuberculum sellae meningiomas by anterior interhemispheric approach.Methods The data of 18 cases of removal of tuberculum sellae meningiomas by anterior interhemispheric approach were analyzed retrospectively.Results Simpson grade Ⅰ resection was achieved in 5 cases;grade Ⅱ in 10 cases and grade Ⅲ in 3 cases.15 patients were followed up for 6 months to 7 years,3.1 years on average.6 patients recovered normal ability in work and life,6 patients' symptom was improved after sugery,3 patients' postoperative visual acuity remained unchanged,2 patients got the result of medium disability and 1 patient died.Conclusion Large tuberculum sellae meningiomas that grows anteriorly and superiorly can be well exposed through anterior interhemispheric approach,the amount of page pull is reduced,so the satisfactory sugical effect can be achieved.

OBJECTIVETo explore a simple but novel method of strengthening gypsum material by cyanoacrylate infiltration. To evaluate the influence of cyanoacrylate on the mechanical properties of dental gypsum models.

METHODSGypsum specimens were polished to the dimension of 35 mmx4 mmx4 mm. Butyl-cyanoacrylate was diluted with chloroform at different concentrations, namely 20% and 30% cyanoacrylate. Gypsum specimens were infiltrated by diluting one component of cyanoacrylate at different concentrations for 8 h and then dried for analysis. The changes in elastic modulus, fracture toughness, compressive strength, biaxial strength, brinell hardness were measured. The data were analyzed using software OriginPro 8.

RESULTSThe viscosity measurements indicated that diluted cyanoacrylate were Newtonian fluids and the viscosity increased slightly within the 48 hours of preparation but still similar as water at room temperature, which could be used to infiltrating gypsum. The gypsum infiltrated with cyanoacrylate exhibited good physicochemical properties. The biaxial strength, fracture toughness, compressive strength and brinell hardness of the gypsum were improved by 39%, 30%, 63% and 18%, respectively.

CONCLUSIONCyanoacrylate can significantly improve the strength of gypsum model which indicates the potential clinical application.