Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.

Objective To explore a new method of parapancreatic abscess treatment and establish an idea of minimally invasive technologies for parapancreatic abscess to improve the recovery rate of acute pancreatitis. Methods The patients had experienced percutaneous puncture and placed drainage tube under the ultrasound guidance first, then the sinus tract was expanded gradually to 24F perimeter by Cook's fascia expender. Finally, the necrotic tissue and pyogenic membrane was removed and repeatedly washed under guidance of choledochoscopy. Results The recovery rate was 91.1 %(33/36). The complication incidence was 10.7% (hemorrage:2 cases, external intestinal fistula:3 cases, and fatal MOF: 1 case). Conclusions The viewpoint which parapancreatic abscess only can be cured by drainage operation can be changed by associating debridement by choledochoscope with percutaneous puncture drainage under the ultrasound guidance. It is a simple, safe and effective method. It can be used to reduce the patients' damage, complication and mortality and accomplish the idea of damage control by minimally invasive technologies.

Objective:To study the relationship between telomerase activity and the expression of proliferating cell nuclear antigen(PCNA) in oral squamous cell carcinoma (OSCC). Methods:Telomerase activity and expression of PCNA in 68 cases of OSCC,34 cases of epithelium immediately adjacent to carcinomas and 12 cases of normal oral mucosa were detected by TRAP-PCR-ELISA and immunohistochemical SP method. Results:The positive rate of telomerase in OSCC, the epithelium immediately adjacent to carcinomas and the normal oral mucosa was 67.65%(46/68), 8.82%(3/34) and 0(0/12) respectively. Telomerase activity in OSCC was related to the grade of the clinicopathology(P

0.05). At time points of end of cold preservation, 10, 30 and 60 min of reperfusion, the activity of p38MAPK in control group was significantly higher than that at the time points of before resection and 120 min of reperfusion (P0.05). The expressions of TNF-? mRNA and ICAM1 mRNA at the time points of before resection, end of cold preservation, and 10 and 30 min of reperfusion were significantly lower than those in 60 and 120 min of reperfusion in both two groups (P

0.05).But there were significant difference in operation time,blood loss,time of resumption of food,time of intestinal function recovery,length of hospital stay and complications between OC group and LC group(P

Objective To expand the utilization of minimally invasive technologies for parapancreatic abscess,and summarize the application experience of choledochoscope for treatment of parapancreatic abscess.Methods The clinical data and treatment effectiveness of 36 patients with parapancreatic abscess from Dec.2000 to Dec.2008 were analyzed retrospectively.These patients had experienced percutaneous puncture and been placed drainage tube under the ultrasound guidance first,then expanded the sinus tract gradually,and performed debridement by choledochoscope.The flexibility of choledochoscope was used to remove the necrotic tissue and pyogenic membrane repeatedly by clamping,netting and vacuum aspiration in every domain.Results Thirty-six patients were performed percutaneous puncture and placed drainage tube,3 cases were given canalis singularis,7 cases were double tube,26 cases were over three tube.The debridement times were 3-14 by choledochoscope,average 5.6 times.There were 6 cases with improving systemic symptoms,blood routine and temperature recovering normal,and drink and food recovering,then discharged from hospital with tube after 1-2 times of debridement.Length of stay was 25-132 d,average 76 d.The curing rate was 91.7% (33/36).Two cases were turned into open surgery because of broad necrotic tissue range combined with many abdominal cavity abscess with good postoperative recovery and cured.One case was dead of severe multiple organ failure combination.There were 2 patients with hemorrhage,3 patients with external intestinal fistula.Conclusions The debridement of choledochoscope for parapancreatic abscess treatment is a simple,flexible and effective method.It changes the viewpoint that parapancreatic abscess can be cured only by operation drainage,decreases the patients’ trauma and accomplishes the idea of damage control by minimally invasive technologies.

Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.

Objective To investigate the influence of age on perioperative clinical parameters, tumor resection effects and complications of patients with early stage gastric cancer for single lesion treated by ESD.Methods 60 patients with early stage gastric cancer for single lesion treated by ESD were chosen from January 2013 to July 2014 and divided into 2 groups including A group (35 patients) with < 60 years old and B group (25 patients) with ≥ 60 years old; and the operation time, intraoperative blood loss, hospital staying time, tumor curative resection and completed rate, the recurrence rate with follow-up and complications incidence of 2 groups were compared.Results All the patients were successfully performed the operation and no bleeding cases. There was no significant difference in the operation time, intraoperative blood loss, hospital staying time between 2 groups (P < 0.05). There was no significant difference in the tumor curative resection and completed rate between the 2 groups (P < 0.05). There was no significant difference in the recurrence rate with follow-up between 2 groups (P < 0.05). There was no signiifcant difference in the complications incidence between 2 groups (P < 0.05).Conclusion ESD is safe and feasible in the treatment of elderly patients with early stage gastric cancer for single lesion, and it is equivalent to short- and long-term efifcacy in non-elderly patients and not increase the operation time, the trauma degree and complications risk.

BACKGROUND: A few devices have been reported to be used for studies on trauma, but these devices are unavailable for establishing the animal models of trauma because of their limited application range. OBJECTIVE: To develop a multifunctional impact system and evaluate its application effect, thus paying ways for establishing the animal models of trauma and basic experiments.METHODS: The multifunctional impact system was designed based on the theory of energy storage device, simple multifunctional impact device and impact parameter measuring equipment, and its effectiveness and stability were detected. The rat chest and different visceral organs were subjected to the closed impact experiment using a 5 cm2 impact at the predetermined parameter of 200, 300, 400, 500 kPa, respectively. Afterwards, the rats were sacrificed for morphological observation.RESULTS AND CONCLUSION: The multifunctional impactor was successfully developed, of which the maximum impact stress could be adjusted from 0 to 200 kg and compressive and extrusion stress also could be continuously adjusted from 0 to 100 kg. The experimental results showed that the impactor made certain damage to the rat lung, liver and spleen suggesting its favorable effectiveness (P < 0.05) and repeatability (P > 0.05). These findings suggest that the impactor is easy to operate in various ways and holds good effectiveness and stability, and its impact parameters can be detected in real time. Therefore, the impactor is suitable for both establishing the animal model of trauma and basic experiments.

AIM: To investigate the significance of signal transducers and activation of transcription 3 (STAT3) in proliferation of rat intrahepatic biliary epithelial cell (BEC) induced by LPS. METHODS: Male Wistar rats were randomly divided into three groups: normal control, endotoxemia (LPS) group and rapamycin (RPM) group. Plasma LPS was detected by kinetic turbidimetric limulus test at 6 h, 12 h, 24 h, 48 h, and 72 h after injury. IL-6 secretion in liver homogenate was determined by ELISA. P-STAT3 expression in BEC was analyzed by laser scan confocal microscopy. Proliferation of BEC was detected by immunohistochemistry. RESULTS: Plasm LPS level was maximum at 6 h [(318?115) EU/L] after injury and descended closely to control level at 48 h [(29?11) EU/L]. IL-6 expression peaked at 12 h (653.4 ng/g?168.8 ng/g protein) and closed to control level at 72 h (0.013 ng/g?0.006 ng/g protein). In LPS group, significant direct correlation between p-STAT3 expression in BEC and IL-6 level in liver homogenate was found. BEC proliferation was induced by LPS at 12 h (5.2?0.5) and reached the maximum level at 24 h, which was higher than the control level even at 72 h, while RPM abrogated STAT3 activation and BEC proliferation induced by LPS. CONCLUSION: LPS induces liver IL-6 expression, which might activate BEC proliferation through STAT3 pathway.