Objective To study effects of different surgical methods in the treatment of varicose veins of lower limb. Methods A total of 236 cases of varicose veins (319 lower limbs) were treated from January 1994 to January 2005 with different surgical procedures, including 136 cases of high ligation and stripping of the great saphenous vein (184 limbs), 63 cases of high ligation and stripping combined with subcutaneous continuous circumferential suture-ligation (86 limbs), 7 cases of endovenous laser therapy (9 limbs), and 30 cases of minimally invasive arthroscopic reaming (40 limbs; Two mini-incisions were made on the leg to introduce the arthroscope and reamer respectively, and the varicose veins were removed). Results Follow-up observations were made in 207 cases (87.7%, 275 limbs) for 3~12 months (mean, 10.6 months), involving all the 7 cases of endovenous laser therapy and all the 30 cases of arthroscopic reaming. Postoperatively the sense of soreness and dragging pain and claudication disappeared. Chronic ulcers cleared up at 3~6 postoperative weeks in 125 limbs out of 137 limbs. Mild adverse effects of subcutaneous hematoma or local solid feeling subsided within 3~5 weeks. Conclusions Each of the 4 surgical procedures has its own indications. Minimally invasive arthroscopic reaming is a safe, effective and little invasive novel treatment for varicose veins of lower limb.

Objective To study the effect of the surgical procedure of primary incision & thread-drawing for behind abscess and drainage for left and right abscess in the treatment of high horsc-shoe Abscess. Methods Clinical data from 45 patients with this disease were retrospectively analysed. Results 43 cases were cured primarily, the cure rate was 96 %, among the 45 patients, 2 cases were formed anal fistula, accounted for 4 %. No anal incontinence, anorectal stenosis,and anal deformation,etc. Conclusion This surgical procedure can ensure primary cure. It is re- vealed that the procedure is of many advantages,including shorten treatment course, less lession, no malformation.

Objective To discuss the benefits of extracorporeal membrane oxygenation (ECMO) applied in the patients with primary or secondary pulmonary hypertension during the operation of lung transplantation. Methods Thirty cases of end stage lung disease subject to primary or secondary pulmonary hypertension received lung transplantation supported with ECMO between Nov. 2005 and July 2009. The single lung transplantation was performed on 18 cases and bilateral sequential single lung transplantation on 12 cases. ECMO was used in 2 patients as a bridge to the lung transplantation to maintain 19 and 6 days respectively, and ECMO support was given during lung transplantation. ECMO was removed after the transplantation if the oxygenation and hemodynamics were stable, otherwise, ECMO was applied continuously until the situation improved. Results All the operations of these patients were accomplished successfully and the ECMO was removed in 27 patients after the operation immediately. The average time with ECMO was 6. 81 + 0. 95 h, and pulmonary artery systolic pressure after lung transplantation was 31.67 + 8. 42 mmHg. The ECMO was continuously used after lung transplantation in three patients until the hemodynamics was stable, and ECMO in 2 of them was removed at 36th h and 6th day respectively after the operation, and one,receiving postoperative ECMO for 5 days, died of acute renal failure 2 weeks after the operation.Conclusion ECMO can replace CPB safely and effectively in lung transplantations for primary or secondary pulmonary hypertension patients. As a respiratory and circulatory support it can control pulmonary hypertension during operative period and can decrease the complications of lung transplantation.

Objective To compare the spine intensity modulated radiation therapy (IMRT) and the conventional radiation therapy on the beagle spinal cord neurons,in order to prove the biological safety of IMRT of the spinal cord.Methods Twelve selected purebred beagles were randomly divided into 2 groups.A beagle clinical model of tumor was mimiced in the ninth and tenth thoracic vertebrae.Then the beagles were irradiated by 2 different models of intensity modulated radiotherapy and conventional radiation therapy,with the total irradiation doses of 50 and 70 Gy.The samples of spinal cord were taken out from the same position of the nine and tenth thoracic vertebrae at the third month after radiation.All the samples were observed by the electron microscope,and the Fas and HSP70 expression in spinal cord neurons were evaluated by immunohistochemistry method.Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spinal cord.Results The neurons in the spinal cord of IMRT group were mainly reversible injury,and those in the conventional radiation therapy were mainly apoptosis.Compared with the conventional radiation therapy group [50 Gy group,(7.3±1.1)% ;70 Gy group,(11.3 ±.4)%],the apoptosis rate of the spinal cord neurons of the intensity modulated radiotherapy group[50 Gy group,(1.2 ±0.7)%;70 Gy group(2.5 ±0.8)%] was much lower[(50 Gy group,t＝0.022,P＜0.05;70 Gy group,t＝0.017,P＜0.05)].The expression levels of Fas in the IMPT group(50 Gy group,4.6 ±0.8;70 Gy group,7.4 ±1.1)were also much lowerthan those in the other group(50 Gy group,15.1 4-6.4;70 Gy group,19.3 ±7.6.50 Gy group,t＝0.231,P＜0.05;70 Gy group,t:0.457,P＜0.05),while the expression levels of HSP70 in the IMPT group(50 Gy group,9.1 ±0.8;70 Gy group,7.3±1.4)were much higher than those in the conventional radiation therapy group(50 Gy group,2.1 ±0.9;70 Gy group,1.7±0.3;50 Gy group,t＝0.153,P＜0.05;70 Gy group,t＝0.223,P＜0.05).The expression of Fas/HSP70 was positively correlated with the apoptosis rate of the spinal cord neurons(r＝0.996,t＝1.14.P＜0.05).Conclusions The late radiotherapy response of the spinal cord neurons was obviously observed on the third month.Comparison of the morphology and apoptosis rate of the spinal cord neurons after radiotherapy,the expression of Fas and HSP70 indicated that the biological safety in the 1MRT might be much better than that the conventional radiation therapy.

0.05).The mRNA expression of Cyclin B1 of IMRT group was significantly higher than that of ART group at each dose point(P

Mycoepoxydiene is a novel antitumor agent extracted from marine lignicolous fungi HLY-2, which is Diaporthe phaseolorum by molecule identification. The medium optimization for mycoepoxydiene by orthogonal design and the comparison of submerged fermentation and solid state fermentation were studied. The rusult is that the maximal yield of the compound is 543mg/L, which is 43 times compared to the customary half-seawater PD medium and 15 times to the best submerged condition. This optimum culture medium included potato 250g/L, seawater 300mL/L, glucose 30g/L, lactose 50g/L, KH_ 2 PO_ 4 0.65mmol/L and (NH_ 4 )_ 2 SO_ 4 1g/L in the solid state condition. Differentiation analysis between submerged and solid state fermentation, and antitumor activity of these ferment products were also studied. The antitumor activity of products of the optimum medium approached the pure compound.

Objective To evaluate the effects of ambroxol on prevention of bronchopulmonary complications after thoracotomy in patients with chronic obstructive pulmonary disease(COPD).MethodsTotal 161 elderly patients aged ≥70 years with COPD undergoing thoracotomy were randomly allocated to two groups:ambroxol group (300 mg/d,6 d) and placebo group as control.Pulmonary complications were evaluated by clinical symptoms,radiographic changes,and blood gas analysis. Results The incidence rates of atelectasis were 8.6％ in ambroxol group and 28.8％ in placebo group,respectively.The PaO2 values after surgery in ambroxol group decreased more than in placebo group (P＜0.05) compared with the preoperative values.Side effects were not found in all patients.Conclusions Ambroxol should be considered as an alternative pharmacologic approach for the prevention of post-thoracotomy pulmonary complications in the elderly patients with COPD.

Objective To explore the perioperative application of extracorporeal membrane oxygenation (ECMO) in lung transplantation. Methods Thirty patients with primary and end-stage pulmonary disease accompanied by pulmonary hypertension were subjected to operation under the accessory of ECMO. Eighteen patients received single-lung transplantation and 12 patients bilateral sequential lung transplantation without sternal division in our hospital from November 2005 to July 2009. In 2 patients ECMO was given before operation and maintained for 19 days and 6 days respectively. In the remaining patients, ECMO pipeline was placed after anesthesia. After lung trarnsplantation,ECMO was removed after the recipients' oxygen saturation and hemodynamics were stable. Results In all recipients lung transplantation was successfully done. ECOM was removed in 27recipients after operation, and the rest 3 recipients were supported by ECMO after operation: the ECMO was removed at 36th h and 7th day after lung transplantation in two patients respectively,and another one was supported by ECMO for 5 days after operation and suffered acute kidney failure, and died of multiple organ failure 2 weeks post-transplantation. Two recipients were infected in thigh arteriovenous cut and one suffered femoral artery thrombosis, but all of them got better and discharged from hospital after treatment. Conclusion ECMO can be used for lung transplantation on patients with primary and secondary pulmonary hypertension. The complications may be associated with patients'serious condition and unstable hemodynamics. Early detection and active and effective treatment can improve patient's prognosis.

As the dilution procedure was applied, a simple, rapid and cost-effective high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of aflatoxin B1, B2, G1, and G2 was successfully by performed in a total 83 samples of 10 traditional Chinese medicines (TCMs), which were collected from 5 different hospital pharmacies and 5 different medical stores in Guangzhou city. Matrix effects of these 10 TCMs were ranged from 80.23% to 115.5% in low, intermediate and high concentration levels, indicating that the negative effect was overcome in this study. Meanwhile, the analysis method was proved to be stable and reliable during the whole analysis using Semen Armeniacae Amarum spiked 3 concentration levels of standard solution as quality control samples and the RSD < 6.6% was obtained. The contamination levels of 83 investigated samples were 13.89% and 17.02% in hospital pharmacies and medical stores, respectively. The result was presented to provide relevant reference and supplement to those researchers in TCMs analysis and screening.
Aflatoxin B1 ; analysis ; Aflatoxins ; analysis ; Chromatography, High Pressure Liquid ; methods ; Drug Contamination ; Medicine, Chinese Traditional ; Quality Control ; Tandem Mass Spectrometry ; methods

OBJECTIVESTo investigate the surgical results of one-stage total en bloc spondylectomy (TES) and reconstruction via a single posterior approach for thoracic symptomatic vertebral hemangioma associated with spinal cord dysfunction and evaluate its curative effect.

METHODSA total of 9 patients treated with one-stage TES (7 cases) and total vertebrectomy (2 cases) by posterior approach from March 2006 to January 2010 were retrospectively reviewed. The cases included 2 males and 7 females with a median age of 33.6 years (range 14 to 77 years), and with 1 case of Grade A, 3 cases of Grade B, 3 cases of Grade C, 2 cases of Grade D according to Frankel grade system. All patients suffered from moderate to severe pain and neurological deficit with an average symptom duration of 14.4 months (range 3 - 24 months) MRI revealed severe spinal cord compression. The spinal reconstruction was obtained by titanium mesh filled with autograft and posterior internal fixation with rod-screw system.

RESULTSThe operation time was 210 minutes on average (180 - 270 minutes) and the average blood loss was 1800 ml (1000 - 5000 ml). The follow-up period lasted from 18 months to 5 years. All cases with preoperative pain relieved after operation. The visual analogue scale pain scores decreased to 1.1 from 8.3 at 3 months after surgery. No disruption of dural mater, cerebrospinal fluid leakage, iatrogenic spinal cord injury and major vessel damage occurred. Up to now, there was no local recurrence in all cases. Significant neurological function improvement was achieved in all patients with one to three grades in Frankel grade system. Fusion of the autograft was well achieved and no internal fixation failure in all patients.

CONCLUSIONSOne-stage TES and spine reconstruction by a single posterior approach is feasible, safe and effective to this disease. It is favourable in decreasing the hemangioma recurrence and improvement of the neurological function.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Hemangioma ; complications ; surgery ; Humans ; Male ; Middle Aged ; Paraplegia ; etiology ; Retrospective Studies ; Spinal Neoplasms ; complications ; surgery ; Thoracic Vertebrae ; surgery ; Young Adult