Objective To discuss the microsurgical treatment for tethered cord syndrome (TCS) caused by intraspinal lipomas. Methods Thirty-two patients with intraspinal lipoma TCS were treated microsurgically. On surgery the tethering lesions of lipoma were excised and anomalies restricting the spinal cord were removed. Results Following the operation, cerebrospinal fluid subcutaneous leakage had occurred in 3 patients, who were cured by expectant treatment. The patients were followed for 3~12 months (mean, 6 months). Five patients were cured, 21 got improved, and 6 had no change. Conclusions Application of microsurgical technique for intraspinal lipoma TCS has advantages of fewer complications and better improvement of nerve functions.

Objective To investigate advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of cervical intraspinal tumors. Methods Twenty-three patients with cervical intraspinal tumors were treated microsurgically with unilateral hemilaminectomy. In condition that the vertabral lamina was kept intact in bony structure, an opening (key-hole) was made in the unilateral lamina by using a drill or a small-sized bone rongeur. Then cervical intraspinal tumors were removed via the “key-hole”. Results Tumors were completely removed in all the 23 patients and no symptoms relating nerve injuries were observed. Postoperative follow-up for 3~16 months (mean, 8 months) revealed no recurrence and spinal deformity. Conclusions Unilateral hemilaminectomy for the treatment of cervical intraspinal tumors is a mini-invasive procedure which benefits the spinal stability. The pitfall of the technique lies in limited surgical field.

OBJECTIVE:To optimize the ultrasonic extraction and purification technology of total saponins from Marsdenia te-nacissima,and to prepare purified total saponins from M. tenacissima. METHODS:Using the extraction rate of total saponins from M. tenacissima as index,ethanol volume fraction,solvent-solid ratio and extraction temperature as factors,ultrasonic extraction technology of total saponins from M. tenacissima was optimized by single factor test and Box-Behnken response surface design. Us-ing the content of total saponins in elution,the effects of ethanol elution volume fraction on purification technology of total sapo-nins by D101 type macroporous adsorption resin was investigated. RESULTS:The optimal ultrasonic extraction technology was as follows as ethanol volume fraction of 85%,solvent-solid ratio of 18.5∶1 (ml/g),extraction temperature of 80 ℃. In verification test,the average extraction rate of total saponins from M. tenacissima was 4.80%(RSD=1.06%,n=3);it was close to predicted value 4.89%,and the deviation was 1.84%. The optimal purification technology was as follows as 45% ethanol as eluant,90%ethanol for purification. Verification test showed that the average content of total saponins from M. tenacissima was 62.45%(RSD=0.88%,n=3). CONCLUSIONS:The optimized technology can be used for the extraction and purification of total saponins from M. tenacissima. The technology is stable and reliable.

Gynostemma pentaphyllum belonged to the Cucurbitaceae family.It was also called theQi-Ye-Dan,licorice stem,Gong-Luo Guo-Di,and etc.It contained saponin,flavonoids,polysaccharides,terpenoids and other chemical compositions.Its pharmacological effects included cholesterol-lowering activity,antitumor activity,hypoglycemic activity,anti-aging and boost immunity.This paper reviewed the research progress on chemical constituents,pharmacological effects and in vivometabolism of gynostemma pentaphyllum,in order to provide a theoretical basis for its further research and development.

Objective:To investigate the expression of cyclooxygenase-2(COX-2) in colorectal carcinoma tissues,and understand its clinical significance.Methods:The immunohistochemistry was used to determine the expression of COX-2 in the 43 tissues of colorectal cancer and 14 tissues of normal mocusa.Results:Positive expression of COX-2 was detected in 83.72% of colorectal cancerous tissues and in 14.29% of normal tissues and there was significant difference in expression of COX-2 between cancer tissues and normal tissues(P0.05).Conclusion:COX-2 was overexpressed in colorectal carcinoma.COX-2 maybe play an important role in carcinogenesis and progression of colorectal carcinoma.

Objective To investigate the prevention and countermeasures of complications following laparoscopic cholecystectomy(LC) in aged patients.Methods The study was based on a retrospective view of clinical date of 182 aged patients(60～85 years old) who had been treated with LC from January 2000 to October 2006 in this hospital.Co-morbidities existed in 87 patients.The operation was performed under general anesthesia and endotracheal intubation,by using 3-port technique in 137 patients and 4-port technique in 45 patients. Results The LC was successfully completed in 174 patients,with an operation time of 30～100 min and a postoperative hospital stay of 3～10 d.Conversions to open surgery were required in 8 patients due to a difficult dissection(6 patients) or a diagnosis of gallbladder carcinoma(2 patients).No death or serious complications occurred.There were 3 patients with port-site infection and 2 patients with pulmonary infection.Follow-up observations in the patients for 3～12 months revealed no abdominal pain,fever,or jaundice.Conclusions Strictly following indications, properly treating the accompanying diseases,and promptly converting to open surgery are key factors to prevent and reduce complications of LC in aged patients.

Objective To investigate the expression of of cyclooxygenase-2(COX-2) in human gastric carcinoma and to identify the significance of COX2 expression. Methods COX-2 protein expressions were deteced in 12 nomal gastric mucosa and 40 gastric carcinoma tissues by immunohistochemistry.Results The expression of COX-2 in gastric carcinoma tissues(87.5%) was significantly higher than that in normal gastric mucosa(25.0%)(P

Objective To observe the therapeutic effects of extracorporeal shock wave therapy (ESWT) combined with autologous bone marrow stem cells (BMSC) transplantation in treating early-stage osteonecrosis of the femoral head (ONFH).Methods Forty patients diagnosed as stage Ⅰ or Ⅱ according to the classification of osteonecrosis of the femoral head put forward by the Association Research Circulation Osseous were randomly divided into a treatment group and a control group with 20 cases in each group.Both groups were treated with BMSC transplantation,while the treatment group was further treated with ESWT the next day.Harris scores were assigned before the treatment and 3,6,12 and 24 months after the treatment to evaluate hip function,the degree of pain and the effects of the treatment.Frog-bit X-rays of the anteroposterior pelvis were taken to assess the stages.Results There were significant differences in the Harris scores and pain degree of the two groups before and at the different time points after the treatment.After 6,12 and 24 months,significant differences were observed in the two values between the two groups.After 12 months the number of hips rated excellent,good and medium level were 8,18 and 1 in the treatment group and 5,13 and 8 in the control group,showing significant differences.Conclusion Extracorporeal shock wave therapy along with autologous bone marrow stem cell transplantation can be used to treat patients with early stage osteonecrosis of the femoral head,relieving their pain and improving their joint function.

This study aimed to summarize the diagnosis and treatment of uncommon complications in esophageal and cardiac cancer operations as well as obtain lessons from the failure. Methods:The etiology, clinical diagnosis, treatment, prevention measures, and factors that contribute to the failure of the uncommon complications were analyzed retrospectively. Results: Results showed ten cured cases and eight death cases (except for the reported eight cases). Conclusion:The following conclusions were ob-tained. 1) The complications described in this paper were rare, but they sometimes occur clinically. If wrong treatment was taken, seri-ous consequences would be expected. 2) Once a jet-like bleeding of aortic esophagus avulsion injury occurs, the surgeon must be calm and take proper treatment to successfully patch up the wounds. 3) The right thoracic approach is a new approach to prevent the injury of azygos vein. 4) Patients with anastomotic stoma fistula easily cause a delay in diagnosis if the leakage was wrapped in the inferior phrenic. 5) Taking preventive measures is the key method for the anastomotic aortoesophageal fistula. 6) Occurrence of pulmonary em-bolism after operation should be monitored. 7) Thoracic gastric mediastinal hernia would cause serious consequences if treatment was not taken at a proper time.

AIM To evaluate the beneficial effects of isoliensinine on paraquat(PQ)-induced acute lung injury and pulmonary fibrosis and explore the mechanism of its action. METHODS PQ (45 mg·kg-1, ip)-induced acute lung injury and PQ (100 mg·kg-1, ig)-induced pulmonary fibrosis were prepared. At 8, 24 and 48 h after PQ administration, the effects of isoliensinine (20 mg·kg-1, ig, 3 times a day, from 24 h before PQ administration to the end of experiment) on activity of superoxide dismutase (SOD), alkaline phosphatase (ALP) and the content of malondialdehyde (MDA) in plasma and bronchoalveolar lavage fluid (BALF) of acute lung injury groups were evaluated respectively. On the 14 d following PQ ingestion, the effects of isoliensinine (10, 20 and 40 mg·kg-1, ig, twice a day, from 24 h before PQ administration to the end of experiment) on hydroxyproline content, transforming growth factor β1 (TGF-β1) and matrix metalloproteinase-2 (MMP-2) expressions and the histopathological changes in lung tissues of pulmonary fibrosis groups were observed. RESULTS In the acute lung injury model, isoliensinine (20 mg·kg-1) significantly increased SOD activity, and decreased MDA content and ALP activity, as well as ameliorated the histopathological damage of lung tissue compared with PQ group. However, the indexes mentioned above in isoliensinine alone group did not change obviously compared with normal saline group. In the pulmonary fibrosis model, isoliensinine (10, 20 and 40 mg·kg-1) resulted in a dose-dependent decrease of hydroxyproline content compared with PQ group [(2.11±0.21), (1.94±0.24) and (1.89±0.26), respectively, vs (2.44±0.33) mg·g-1 wet tissue]. The expressions of TGF-β1 and MMP-2 in the lung tissue of the isoliensinine 40 mg·kg-1+PQ group were significantly less than those of the PQ group. Furthermore, isoliensinine could improve the histopathological changes of fibrosis as comparison with PQ group. CONCLUSION Isoliensinine has protective effects on PQ-induced acute lung injury and pulmonary fibrosis.