Objective To assess the clinical application of microendoscopic discectomy (MED) system in the treatment of 36 cases of special lumbar disc herniation (LDH). Methods Laminectomy and decompression, and removal of fractured end plate or calcified herniated discs were performed by MED using self-made bone chisel, osteotome and L-shaped osteotome. Results Intraoperative dural laceration occurred in 2 cases, and no conversions to open surgery were required. Follow-up observation ranged (3～12) months (mean, 9.5 months). According to Macnab criteria, 28 patients had excellent, 5 had good, 2 had fair, and 1 had poor outcomes, with good or excellent results in 91.7% (33/36) of the patients. Conclusions MED may be carried out in patients in side position. Calcified herniated discs and fractured end plate can be excised by MED with self-made tools.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of fetal truncus artery. Methods Retrospective analysis was made in 10 cases with fetal truncus artery for their fetal echocardiography and follow-up findings. Echocardiographic characteristics was summed up in various fetal heart views. Results Truncus artery was confirmed by autopsy in 7 fetuses,and 3 cases were correspondingly verified by postnatal echocardiography. Echocardiographic characteristic images of fetal truncus artery was larger ventricular septal defect, only 1 great artery arising from heart, and pulmonary artery arising from truncus artery. Conclusions Echocardiography has important value in accurate diagnosis of fetal truncus artery and caution should be paid in differential diagnosis with other fetal complicated congenital heart diseases.

Objective To explore the angioarchitectrue characteristics and appropriate treatment strategies of dural arteriovenous fistula (DAVF) in foramen magnum region.Methods The clinical data of patients with DAVF diagnosed by digital subtraction angiography (DSA) were analyzed retrospectively.Results Thirteen patients intraoperative were found fistula and complete resection,patients discharged from hospital,DSA check showed that the DAVF fistula completely disappeared,all patients symptoms were improved to different extents.Conclusions The clinical features,prognosis and treatment methods of DAVF in forament magnum region depends on its angioarchitecture,especially the lesion site and venous drainage,surgical operation can usually find the fistula and can be completely removed.

Objective To investigate the feasibility of thoracoscopic minimal access anterior surgery for thoracic spine. Methods Minimal access anterior thoracic surgery was conducted under thoracoscope in 14 patients in this hospital from October 2001 to October 2002.Six patients with thoracic vertebral metastasis underwent vertebral body excision, reconstruction by cement and steel plate, and anterior internal fixation with screw-rod system;4 patients with thoracic vertebral tuberculosis received focus resection,bone graft and anterior internal fixation with screw-rod system; 2 patients with of thoracic disc herniation received discectomy and fusion;2 patients with thoracic vertebral facture and dislocation received reduction, decompression, bone graft and anterior screw-rod internal fixation. Results Postoperative imageological analysis revealed that the focus had been cleaned completely and the internal fixation was excellent. Follow-up for 4～12 months in 14 patients showed that the pain on chest and back disappeared in all the patients. Of the 13 patients with spinal compression, muscle strength recovered from grade A～D preoperatively to grade C～E postoperatively. Conclusions Thoracoscopic minimal access anterior thoracic surgery is feasible. It offers satisfactory short-term effects.

The disc degeneration disease has been main research focus in spinal surgery,but the pathogenesis of disc degeneration is still not clear.Appropriate animal models are important for the study of pathogenesis of disc degeneration.Presently,models of disc degenetation are mainly classified into two categaries:vitro models and vivo models.The animal vitro models include disc cell models and disc tissue models.The vivo models include mechanics models and trauma models.This review tries to give a short introduction about the status and progress of animal model about disc degeneration.

National traditional Chinese medicine (TCM) master professor Ban Xiuwen had rich experiences on treatment of gynecological diseases with unique insights on diagnosis and treatment for disorders of menstruation, leukorrhea, pregnancy and delivery. FemaleYin-Wei, which was a gynecological disorder, was recorded in the book ofHuang-Di Nei-Jing. However, due to different reasons, TCM study on femaleYin-Wei was far less than the study on male impotence. ProfessorBan Xiuwen had specific considerations for this disease on the book of Treatment of Miscellaneous Gynecological Diseases. In his understanding, femaleYin-Wei was due to four aspects, which were the innate deficiency, yang deficiency and coldness of the uterus; seven emotion damage, liver-qi soothing disorder; spleen-stomach deficiency,qi-blood deficiency; and phlegm-dampness stasis,qi stagnation. Through the analysis and study on case records of femaleYin-Wei treatment by national TCM master professorBan Xiuwen, this article briefly elaborated professorBan Xiuwen’s understandings on femaleYin-Wei treatment from etiology, pathogenesis, treatment according to syndrome differentiation, and clinical experiences. Two femaleYin-Wei cases treated by professorBan Xiuwen were given as examples in order to analyze the etiology, pathogenesis, treatment according to syndrome differentiation and treatment experiences in details. The therapeutic effects of both cases were obvious, which were also important study documents.

Objective To determine the sensitivity of autofluorescence bronchoscopy (AFB) in the assessment of tumor size and therapeutic strategy.Methods Patients with imaging suspected of malignancy were examined with both white light bronchoscopy (WLB) and AFB.The area of tumor infiltration,imaging information and pathological results were analyzed.Results A total of 212 patients were enrolled,including 180 male and 32 female.In 24 patients (13.2％),greater tumor volume was revealed by AFB than by WLB alone.In these patients,the median diameter of tumor was ＞ 1 cm wider on AFB examination than on WLB.Therapeutic strategy was changed in 18 patients (9.9％) after receiving AFB,including 15 patients with expanded scope of removal and 3 patients with avoidance of surgery.In the univariate analysis,the pathological type of squamous cell carcinoma and tumor invasion in two or more segments of bronchus were independent predictive factors.Diagnostic sensitivity of AFB group was 85.7％,specificity 73.3％,positive predictive value 95.1％,false predictive value 45.8％.Diagnostic sensitivity of WLB group was 72.5％,specificity 60.0％,positive predictive value 91.7％,false predictive value 26.5％.Conclusion Our study suggests that compared with WLB alone,autofluorescence bronchoscopy plus WLB significantly improves the diagnostic value and treatment outcome of central lung cancer.

Objective To evaluate the safety and efficacy of the endoscopic resection of large nonampullary duodenal adenomas.Methods Twenty cases with large nonampullary duodenal adenomas(≥ 1.0 cm) were referred for EMR.After submucosal injection of the mixture of glycerin fructose solution and methylene blue,either en bloc or piecemeal snare polypectomy was performed.All resected specimens were retrieved for pathologic study.Follow-up gastroscopy was performed in patients after EMR.Results Among 20 lesions,six were found located in the 1st part(30％),13 were in the 2nd part(65％),and one in the 3rd part(5％)of the duodenum.The mean diameter of the lesions was 1.9 ± 1.1 cm.Endoscopic ultrasonography (EUS) was performed in 12 patients,and all lesions were originated from the mucosa.EMR was performed successfully in 20 patients.The en bloc resection rate was 75％ (15/20),and the mean time for EMR was 33.8 ± 16.7 min.The perioperative complication rate was 20％ (4/20).Bleeding occurred within 24 hours after EMR in 4 cases.There were no perforations.The complete resection rate was 100％.Of these 20 adenomas,14 adenomas were tubulous and 6 was tubulovillous.During the follow-up period (2-39 months),1 patient showed recurrence within 6 months after EMR.Conclusion Endoscopic resection of large nonampullary duodenal adenomas is safe and effective treatment.

Objective To construct the double-H1promoters siRNA expression cassettes(SECs) targeted to human telomere retrotranscriptase(hTERT),and investigate the interfering effect of its siRNA on hTERT gene expression in HepG2 cells.Methods SECs were constructed by fusing PCR,based on two different human telomerase hTERT gene fragments.When SEGs transferred into HepG2 cells respectively,the SECs were transcripted to the siRNA.The interfering effect of SECs on the telomerase activity in the cells was assessed by telomeric repeat amplification protocol(TRAP) and PCR-EIA.Results SEGs were successful constracted,and the telomerase activity was significantly inhibited when the HepG2 cells were tranfected with SECs.Conclusions The siRNA SECs display a definite RNA interference effect on the expression of telomerase.This method of SECs preparation can be applied for RNAi research in tumor inhibition.

Aged ; Humans ; Lymphoma, T-Cell, Cutaneous ; pathology ; Skin Neoplasms ; pathology