Objective To study the etiology,clinical presentation,MR images,treatment and prog-nosis of spontaneous spinal epidural and subdural hematoma.Methods From1995to2002,6cases diag-nosed as spontaneous spinal epidural and subdural hematoma were reviewed retrospectively.All of the pa-tients were males aging from30to68years with an average of 47years.The onset was acute while the pa-tients were in resting or light activity without prior history of any infection,administration of drugs or trau-ma.One patient had the history of hypertension,and another one was found to have diabetes after admission.The clinical characteristics were sudden pain involving neck,shoulder,chest and back,then dysfunction of motion and sensation of extremities and sphincter within few minutes.4cases of spontaneous spinal epidural hematoma were located at T 5~6 ,T 2~4 ,C 4~5 and C 6 ~T 1 respectively,and2cases of spontaneous spinal subdu ral hematoma at C 7 ~T 1 and C 7 ~T 2 respectively.Results All cases were proved with surgery and pathology.MR imaging showed occupying mass in the posterior or posteriolateral region inside the spinal canal.T 1 -weighted imaging was most useful owing to its typical signal changes with the hematoma.T 2 -weighted gra-dient echo sequence was capable to identify epidural and subdural spinal hematoma.Total laminectomy and hematoma debridement were performed.The outcome was closely related to the interval between the onset and surgery.The patients were followed up from6to18months with an average of 10months.All cases showed no significant improvement of spinal cord function except 5cases with incomplete recovery of sphincter function.Conclusion Spontaneous spinal epidural and subdural hematoma are rare entities.MRI is a most helpful diagnostic tool for this disorder.It should be stressed that early diagnosis and prompt surgical intervention are of great importance for prognosis of spontaneous spinal epidural hematoma.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Pancreatic Ductal ; metabolism ; pathology ; surgery ; Carcinoma, Papillary ; metabolism ; pathology ; surgery ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Duodenal Neoplasms ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mucin-2 ; Mucins ; metabolism ; Neoplasm Invasiveness ; Pancreatic Neoplasms ; metabolism ; pathology ; surgery ; Pancreaticoduodenectomy

Total hip arthroplasty (THA) has developed rapidly in recent years, which reconstructs the joint function of some terminal hip joint diseases and obtains favorable efficacy. However, the stress load alters in the proximal femur following THA, leading to "adaptable bone reconstruction", which is characterized by thin cortical bone, decreased bone density, and bone loss surrounding prosthesis, in particular calcar femorale. This paper analyzed the effects of cement and cementless prosthesis, coated prosthesis, and THA approaches on stress shielding in the proximal femur to reduce stress shielding effect by improving prosthesis design, low elastic modulus materials, decreased section area of the prosthesis, cement prosthesis, appropriate coated materials and improved THA approaches.

Objective To investigate relationship between utrophin and dystrophin in muscle of patients suffered from several neurological muscular diseases.Methods Muscle biopsies of 26 cases of patients suffered from 8 categories neurological muscular diseases and 2 cases of control were analysed for utrophin and dystrophin by immunofluorescence experiments.Results In a majority of Duchenne muscular dystrophy (DMD) patients,their sarcolemma revealed absent,weak or discontinuous fluorescence for dystrophin.In non-DMD muscular dystrophies,lipid storage myopathy,myotonic dystrophy,inflammatory myopathies, neurogenic amyotrophy, polymyositis, mitochondrial encephalomyopathy, myogenic amyotrophy,immunofluorescence reactivity for dystrophin were strongly exhibited in entire sarcolemma.In normal biopsy sample,strong immunofluorescence reactivity for dystrophin was identified in entire sarcolemma,while weak and discontinuous fluorescence was identified on a minority of sarcolemma of DMD patients with severely reduced dystrophin.There was no immunofluorescence reactivity for utrophin in sarcolemma of DMD patients with moderate decreased dystrophin,non-DMD muscular dystrophies and other 6 categories of neurological muscular diseases,nor in sarcolemma of normal biopsies.Conclusions utrophin is expressed in sarcolemma of DMD patients,who have severely reduced dystrophin simultaneously. utrophin is absent in sarcolemma of other categories of neurological muscular diseases including non-DMD muscular dystrophies with normal dystrophin expression and DMD patients with moderately decreased dystrophin.

Objective To develop the Chinese version of the 35-item Medical Outcomes Study HIV Health Survey (MOS-HIV) and to assess the reliability and validity of MOS-HIV among HIV-infected individuals.Methods Between April and July of 2007,a croas-sectional survey of 758 HIV-infected individuals was conducted.Responses to the MOS- HIV were analyzed for its reliability and validity.Results Pearson's correlation coefficients of items for test-retest relia- bility ranged from 0.46-0.92,all internal consistency reliability coefficients exceeded 0.69,and all items were more strongly correlated with hypothesized scale than any other scale.Eight scales of MOS-HIV were significantly associated with CD_4 cell counts.Conclusions The Chinese version of MOS-HIV offers good reliability and validity and can be used as a tool to assess the quality of life of HIV infected individuals in China,thus providing evidence for further studying AIDS related quality of life in this country.

Objective To comprehend the action mechanism of simvastatin in pulmonary hypertension(PH)when it induced by high pulmonary blood flow.Methods Abdominal aorta-inferior vena cava shunting was made in rats to establish animal model of PH induced by high pulmonary blood flow,simvastatin with dose of 2 mg/(kg?d)was used to interfere for 11 weeks.And then,pulmonary arterial pressure,apoptosis rate and proliferation rate of pulmonary vascular smooth muscle cell were determined.Results were compared with other groups.Results Simvastatin could cut down the pulmonary arterial pressure well,pulmonary arterial pressures of simvastatin group rats were lower than those of spliting groups obviously(Pa

[Objective]To compare the clinical results between allograft and autograft for treatment of scoliosis in the adolescent.[Method]A retrospective study was made in 63 cases of adolescent patients with scoliosis who were operated on with posterior instrumentation from 1996~2006.These patients were divided into two groups.In group A,32 patients aged 10 to 15 years with an average of 12.2 years,had a mean Cobbs angle of 62?(ranged,38? to 113?),were received allograft bone grafting.The patients were followed up for at least 18 months with an average of 26 months.Clinical and radiographic evaluations were performed.[Results]Operating time and blood loss in group A were less than that in group B(P

Objective To explore the efficacy and complications of surgical treatment for secondary hydrocephalus of cryptococcal menigitis. Methods The clinical data of 26 patients with secondary hydrocephalus of cryptococcal meningitis who underwent ventricular drainage (11 cases) and ventriculoperitoneal shunting (15 cases) procedures in our department from 1980 to 2002 were retrospectively reviewed. Results Both operation approaches had good effect on the secondary hydrocephalus, but ventriculoperitoneal shunting procedure was safer and more persistent. Conclusion Shunting procedure is a safe and effective therapy for hydrocephalus in patients with cryptococcal meningitis.

Objective To investigate the clinical features, diagnosis and treatment of acute mesenteric isehe-mic disease. Methods Clinical data of 15 patients with acute mosenteric ischemic disease were analyzed retrospective-ly. Results Operation was performed on 14 patients and 1 patient received conservative treatment, 9 cases recovered and 5 died postoperatively. Conclusion Color ultrasound and selective angiography are effective examinations for early diagnosis of acute mesenterie ischemic disease. Early resection of necrotic bowel and application of anticoagulant post-operatively are effective to reduce the mortality. Conservative treatment is still effective for elective patient.

Abdominal Pain ; etiology ; Child, Preschool ; Humans ; Male ; Porphyria, Acute Intermittent ; complications ; diagnosis ; therapy ; Prognosis ; Treatment Outcome