AIM: To establish an HPLC method for determining sophocarpine,sophoridine and oxymatrine in Sophora flavescens Ait,so as to investigate their contents in different years and different parts. METHODS: An Elite Hypersil NH2 column(250 mm ? 4. 6 mm,5 ?m) was used with the mobile phase being acetonitrile-absolute alcohol-3% phosphoric acid solution(82 ∶ 10 ∶ 8),flow rate being 1 mL/min,determinating wavelength being 220 nm,the column temperature being 26 ℃,The injection volume was 5 ?L. RESULTS: The calibration curves of sophocarpine,sophoridine and oxymatrine were in good linearity over the ranges of 0. 004 99 - 0. 149 7 ?g(r = 0. 999 9),0. 025 08 - 0. 752 25 ?g(r = 0. 999 9),0. 075 38 - 2. 261 25 ?g(r = 0. 999 9); and the average recovery of sophocarpine,sophoridine and oxymatrine was 99. 91% ,99. 26% ,100. 27% with RSD of 1. 11% , 0. 82% ,2. 18% respectively. CONCLUSION: The HPLC method shows a good separation,reproducibility and accuracy,there are obvious differences in the contents of three alkaloids in different years and different parts of Sophora flavescens Ait. The results provide important data for quality evaluation and utilization of Sophora flavescens materials.

Objective To evaluate the clinical value of ~(99m)Tc-MAA imaging in patients with lower extremital posttraumatosis and postoperation(LEPP).Methods 21 LEPP patients with clinical highly suspected acute pulmonary embolism(APE) underwent ~(99m)Tc-MAA veins imaging and pulmonary perfusion imaging(PPI).Vena caval filters were inserted and thrombolysis were given in patients with big area APE and/or iliofemoral vein thrombosis indicated by ~(99m)Tc-MAA imaging.Thrombolysis was given in patients with small area APE and/or subpopliteal vein thrombosis.PPI was reexamined after 2～4weeks` treatment.The lung segments with 100% lack of perfusion were marked 3,those with 25%～75% were marked 2,those with less than 25% were marked 1 and normal was marked 0.The therapeutic results were assessed using this marking system.Results There were 13 patients with big area APE,8 with small area APE,14 with iliofemoral vein thrombosis,and 7 with subpopliteal vein thrombosis.2 cases(9.5%) died before thromobolytic therapy.The marks were significant different before(10.2?3.8) and after(2.8?1.4) treatment(t=7.75,P

BACKGROUND:Nasolabial fold flap has been widely used in clinical surgery. The facial artery anatomy has been widely used in clinical research. Angular artery dissection is becoming more and more important to nasolabial groove area surgery, but at present, there is a lack of anatomical analysis of internal angular artery.
OBJECTIVE:To study the anatomy of the angular artery, and to provide anatomical data for protecting the nasolabial flap during surgery.
METHODS:Twenty sides of adult cadaver specimens on head and face were dissected. A reference coordinate system was made based on the line between the connection of two medial angles of eyes (axis X) and the facial midline line (axis Y). The location of the angular artery was measured taking A-F as reference points.
RESULTS AND CONCLUSION:(1) The slant angles of the angular artery on BC section, CD section, DE section and EF section were (11.1±4.3)°, (34.1±8.8)°, (21.5±10.5)°, and (17.0±4.7)°, respectively. (2) The angular artery sourced from facial artery was more than it sourced from ophthalmic artery. The diameter of right blood vessel was larger than that of left side. (3) The angular artery sourced from ophthalmic artery comes from the location which extended 8.1 mm to both sides from the point which was 10 mm up from the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.7±0.2) mm. The whole range was 20.1 mm. (4) The angular artery sourced from facial artery comes from the location which extended 25.8 mm to both sides from the point which was 40 mm down to the intersection of facial medial angle of eyes connection and midline. The blood vessel diameter of the starting point was (0.9±0.3) mm. Point to the wing of nose the lateral distance was (5.0±1.2) mm. The whole range was 68.7 mm. The surface projecting of angular artery coming from research results provided anatomic basis for surgery of nasolabial flap.

Aim: To study the antitumor activities of the constituents of Cephalotaxus fortunei distributed in Guizhou province. Methods: The constituents were isolated by column chromatography and identified by physical and spectral analysis. Meanwhile, the anti-tumor activities of some compounds were evaluated by sulforhodamine B( SRB) and MTT assay. Results: Eleven compounds were isolated and identified as apigenin (Ⅰ), β-sitosterol (Ⅱ), acetylcephalotaxine (Ⅲ), chrysoeriol (Ⅳ), drupacine ( Ⅴ), 1-hentriacontanol ( Ⅵ), 7, 3', 4' -trihydroxyfla-vone (Ⅶ), sugiol ( Ⅷ), cephalotaxine (Ⅸ), wllsonine (Ⅹ), and hainanolide (Ⅺ), respectively. Biological screening results demonstrated that some of the tested compounds exhibited the antitumor activities in vitro. Conclusion: Compounds Ⅱ, Ⅵ-Ⅷ were isolated from this plant for the first time. Compound Ⅺ has a better inhibitory activity on cell line A549 and K562 .

Objective To summarize the clinical features and diagnostic flow of cervical spondylosis with proximal upper extremity amyotrophy;and further analyze the clinical effect of cervical anterior decompression and fusion on cervical spondylosis with proximal upper extremity amyotrophy.Methods Twenty-two cases of cervical spondylosis with proximal upper extremity amyotrophy were analyzed retrospectively from June 2006 to December 2013.Seventeen males and 5 females with an average age of (55.73 ± 8.64) years (38 to 68 years) were included.The mean preoperative course of disease was (19.2 ± 21.86) months (1-72 months).Clinical symptoms,imaging findings and electrophysiological findings were analyzed.The muscular strength recovery of atrophic muscles was evaluated by Manual Muscle Testing (MMT).The clinical improvement rate was evaluated by the Japanese Orthopedic Association (JOA) score,and the clinical satisfaction was assessed at followed up.Results The muscles involved in patients of cervical spondylosis with proximal upper extremity amyotrophy are mainly the deltoid muscle,biceps and scapula levator muscle.Most cases of imaging findings showed multi-segmental degeneration,of which C4,5,C5,6 segments were most common.Neuroelectrophysiological examination showed that affected muscles experienced obvious denervation and decreased action potential.The average follow-up time was (44.14 ± 20.51) months (14 to 102 months).At the last follow-up,the JOA score (16.29 ±0.59) in 17 cases was higher than preoperative (15.12 ± 0.93),the difference was statistically significant (F=51.814,P=0.000),and the average improvement rate was 73.3％.MMT assessment showed that 19 patients (86.4％) in this group had muscle strength recovery for more than 1 grade at the last follow-up.The average clinical satisfaction was 83.7％.Conclusion The clinical diagnosis of cervical spondylosis with proximal upper extremity amyotrophy requires a combination of clinical symptoms,imaging findings and neurophysiological examination results for comprehensive judgment.Anterior cervical decompression and fusion in the treatment of cervical spondylosis with proximal upper extremity amyotrophy patients can achieve good clinical results.

ObjectiveTo investigate the relationship between tumor-infiltrating mast cell (TIM) and the clinicopathological and prognostic factors of patients with colorectal cancer.MethodsA total of 282 cases of paraffin-embedded colorectal cancer specimens were obtained from the First Affiliated Hospital of Sun Yat-sen University from January 2002 to December 2005.The density of TIM was determined by immunohistochemical staining.According to the mean TIM density detected [ ( 8.4 + 6.5 )/HPF ],all the patients were divided into low-TIM density group (mean TIM density ＜8.4/HPF) and high-TIM density group (mean TIM density ＞8.4/HPF).The clinicopathological factors and the prognosis of patients between high-TIM density group and low-TIM density group were compared.All data were analyzed using the t test or chi-square test.The survival curve was drawn using the Kaplan-Meier method,and the survival of the patients was analyzed by the Log-rank test.The clinicopathological factors were analyzed retrospectively with the univariate and multivariate COX regression model.ResultsTIM was detected in all the patients with colorectal cancer.Significant differences were observed in the number of patients in N stage and TNM stage between patients in the high-TIM density group and those in the lowTIM density group (x2 =6.025,7.410,P ＜ 0.05 ).All patients were followed up till September 2010,the 5-year overall and tumor-free survival rates of patients were 82.9％ and 63.1％ in the low-TIM density group,79.0％ and 59.3％ in the high-TIM density group,with significant difference between the 2 groups (P ＜ 0.05 ).COX proportional hazard regression model revealed that high density of TIM was associated with short overall survival time and tumor-free survival time of colorectal cancer patients ( RR =2.119,95 ％ CI 1.326- 3.386; RR =2.084,95 ％ CI 1.357-3.199,P ＜0.05).The resuhs of multivariate analysis showed that high density of TIM was the independent factor influencing the overall survival time and tumor-free survival time (RR =1.651,95％ CI 1.009-2.702; RR =1.680,95％ CI 1.074-2.629,P ＜ 0.05 ).ConclusionHigh density of TIM is correlated with the N stage and TNM stage of colorectal cancer,and it is an independent predictor of poor survival for patients with colorectal cancer.

Objective To measure the related anatomical parameters of lumbosacral nerve root and adjacent structures by magnetic resonance neurography,and to analyze operative safety of transforaminal lumbar interbody fusion in Chinese people.Methods A total of 12 healthy volunteers,including 6 males and 6 females,underwent magnetic resonance neurography of lumbosacral nerve root using a Siemens 3.0T MRI machine.The Osirix software was used to reconstruct the three-dimensional imaging and measure the following anatomic parameters: 1) the distance between the nerve root and the superior pedicle; 2) the distance between the nerve root and the inferior pedicle; 3) the angle between the nerve root and the sagittal plane; 4) the distance between the superior and inferior nerve roots; 5) the distance between the superior and inferior pedicles.Results L1-L5 nerve roots got a good imaging by magnetic resonance neurography in all 12 volunteers.The distance between the nerve root and the superior pedicle and the angle between the nerve root and the sagittal plane gradually became smaller from L1 to L5.But the variation in the distance between the nerve root and the inferior pedicle and the distance between the superior and inferior pedicles was not obvious.The distance between the nerve root and the inferior pedicles,which was closely related to the operating space of TLIF,ranged from (8.99±0.88) mm to (10.72±1.01) mm for males and from (7.76±0.46) mm to (8.54±0.65) mm for females; it was less than 10 mm in each segments in the majority of subjects,and the data of females was significantly smaller than that of males.No significant differences were found in parameters between the left and right sides in the same segment.Conclusion Based on the above anatomical study and measurement analysis,we believe that there is some harassment to the upper nerve root in TLIF for Chinese patients,and for some patients there is a certain injury risk.

Objective To investigate causes and treatment strategy of cage retropulsion after lumbar interbody fusion.Methods Data of 11 patients with cage retropulsion after lumbar interbody fusion from December 2005 to October 2011 in our hospital were retrospectively analyzed.There were 7 males and 4 females.Their age ranged from 36 to 78 years (average,52.3 years) at the time of the primary operation.Six cases occurred cage retropulsion 0.5 to 3 months after the primary operation,while 5 cases occurred cage retropulsion 14 to 36 months after the primary operation.The causes of cage retropulsion were analyzed.Moreover,corresponding managements were performed and results were recorded.Results The early cage retropulsion was associated with mismanagement of intervertebral space,too much residual of nucleus pulposus,insufficient erasion of cartilage end plate,too small size of cage,malposition of cage,insufficient fixation and so on.The late cage retropulsion was associated with improper choice of surgical strategies,multi-level fusion,preoperative unsteady of vertebrae,advanced age,osteoporosis,diabetes and so on.Three patients underwent conservative treatment and 8 patients underwent revision surgery.All 11 patients were followed up for 6 to 72 months (average,34 months).There was no re-migration of cage,fusion failure,pedicle screw loosening and other complications during the follow-up period.Conclusion The causes of cage retropulsion after lumbar interbody fusion were complex and diverse,and the time of cage retropusion had some clinical value for the cause analysis.It was more advisable to make an individualized treatment program based on the causes of cage retropulsion,clinical manifestations and imaging results.

Objective To investigate the risk factors and treatment strategy in treating adjacent segment diseases (ASD) after anterior cervical decompression and fusion.Methods Fourteen patients with ASD after anterior cervical decompression and fusion from December 2005 to August 2012 were analyzed.The overall curvature of the cervical spine,local curvature of surgical segments,and the distances between the plate and the upper and lower intervertebral space were measured and analyzed.10 males and 4 females,age at initial surgery was 36 to 68 years old,the mean was 52.0±11.0 years old.The secondary surgery was taken,according to the number of involved segments and other factors.Anterior decompression and fusion and internal fixation was taken to patients who segment number ≤2 without severe ossification of posterior longitudinal ligament or ossification of the ligamentum flava; posterior decompression and laminoplasty was conducted in patients whose segment number ≥3,but not accompanied with significant kyphosis,instability and serious ossification of the ligamentum flava; and posterior laminectomy and fusion was performed in patients with significant kyphosis,instability and not suitable for anterior decompression due to technical reasons,as well as patients with serious ossification of the ligamentum flava.Results The average time of occurrence of ASD after the initial surgery was 9.3±4.4 years,and the average age of reoperation was 61.3±12.4 years old.The overall curvature of the cervical spine,surgical segment local curvature after the initial surgical procedure were 12.4°± 10.8 o,1.5o±6.8o,respectively; and the distances between the plate and the upper and lower interyertebral space were:0.9± 1.8 mm,3.8±3.2 mm.The secondary surgeries were taken as follows:9 cases anterior decompression and fusion and internal fixation,3 cases posterior decompression and laminoplasty,and 2 cases posterior laminectomy and fusion.All 14 patients were followed up 30.4± 17.8 months,and the average improvement rate of Japanese Orthopaedic Association scores at the last follow up was 73.9％±9.7％.Conclusion The smaller distance between the plate and neighboring intervertebral space,and poorer local curvature of surgical segments might be the risk factors for ASD after anterior cervicad decompression and fusion.The appropriate secondary surgery was taken after comprehensive analysis of the number of adjacent segments,compression factors,cervical curvature and other factors.

Objective To assess the risk of sympathetic nerve injury in oblique lumbar interbody fusion (OLIF) in different lumbar spine segments based on anatomical study.Methods Twenty-four healthy adult volunteers (12 male and female) were selected and routine lumbar spine scanning was performed with MAG MAGOMOM Verio 3.0 T.The anatomical structures of left lumbar sympathetic trunk,abdominal aorta and left psoas muscle were identified on T2 images of L2,3,L3,4,L4,5 intervertebral space.And the anatomical parameters of the OLIF operation approach and the anatomical parameters of the left sympathetic trunk and adjacent structures were measured.The t-test was used to compare the parameters between the different sexes.The comparison of the data between the different segments was performed by the least significant difference (LSD) single factor analysis of variance.Results From the L2,3 to L4,5 segments,the anatomical parameters of the OLIF operation approach and the anatomical parameters of the left sympathetic trunk and the adjacent structures showed regular changes.The distances between the anterior margin of the left psoas muscle and the abdominal aorta from L2,3 to L4,5 were 13.65±4.10 mm to 9.42 ± 4.00 mm in adult healthy male individuals,and 13.89±3.18 mm to 8.38 ± 3.33 mm in female individuals,showing a significant downward trend.The distances between the left sympathetic trunk and the abdominal aorta from L2,3 to L4,5 were 10.76±3.89 mm to 6.68±3.39 mm in adult healthy male individuals,and 11.52±3.02 mm to 6.12±2.95 mm in female individuals,also showing a significant downward trend.There were significant differences in the operation area of OLIF surgery between different segments.The operation area of OLIF surgery was relatively large in L 2,3 segment,and the risk of sympathetic nerve injury was relatively small.The left lumbar sympathetic trunk in the L3,4 intervertebral space was walking front and inside,and there was a greater risk of injury in the OLIF surgery.Conclusion The left lumbar sympathetic trunk located in or close to OLIF surgery operation field in L2-L5 segments.There was a certain risk of sympathetic nerve injury in OLIF surgery,and the risk of sympathetic nerve injury was different in L2,3,L3,4,L4,5 segments.