Purpose: To retrospectively analyse the characteristics of diagnosis and operative treatment of 66 cases of scwannoma in the spinal canal. Methods: Sixty-six cases, 27 of the cervical region, 13 the thoracic and 26 of the lumbar and sacral regions were treated from 1983 to 1996. Clinical manifestation and types, and results of spinal radiography, myelography, CT scannig, MR imaging, operative treatment were separately described. Results: All of the 66 cases obtained timely and accurate diagnosis and treatment. The tumors in 60 patients were completely resected; and in remaining 6 patients subtotal excision was performed. The duration of follow-up averaged two years and eleven months and excellent and good results were achieved in 90.9% of the patients. Conclusions: 1) Schwannoma in the spinal canal is not uncommon; four in this series are malignant or with malignant tendency. 2) The forms of the tumor are with lots of variations. 3)An approximate position of the lesion can be determined by clinical neurological examination. Accurate diagnosis can be made by a procedure combining clinical and imaging examinations, operative exploration and pathological examination. 4) Total resection of the tumor may result in good restoration although it is sometimes difficult and risky.

Objective To study the diagnosis and the treatment of the arachnoid cysts in the sacral canal. Methods After decompression laminectomy of the sacral canal, the arachnoid cysts were dealt with in three ways: 13 cases with excision of the most of the cyst wall and suture of redundant wall around the intracystic nerves, 8 cases with the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle, 2 cases with excision of most of the cyst wall and leaving cystic wound unsutured. The clinical results were studied with 30.2 months follow up. The radiological changes including X-ray, CT, CTM and MRI were evaluated as well as their clinical behaviors, pathologies and post operative complications. Results Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between the results of the first two surgical methods. The post operative complications included the wound erosion and intracranial infection. Conclusion The cyst seems to arise as a result of congenital defect of the thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to be a reasonable surgical method. No drain tube should be used and a supine position should not be allowed so as to reduce the complications

[Objective]To evaluate the posterior approach treatment of old traumatic lumbar spinal stenosis,lumbar kyphosis,intervertebral space stenosis using vertebral plate decompression,nucleus pulposus removal,intervertebral fusion and CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.[Method]Twenty patients with low lumbar spinal canal and intervertebral space stenosis,lumbar kyphosis caused by trauma were enrolled in this study.There were 13 males and 7 females,with an average age of 31.4 years (range 22-49).Four had lesions of L3、4,10 of L4、5 and 6 of L5S1.One patient was treated at 4 years after injury,3 within 9-15 months,6 within 3-6 months and 10 within 1-3 months after injury.All patients were treated with vertebral plate decompression,some serious patients underwent laminectomy decompression,nucleus pulposus removal,intervertebral fusion,CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.One week after surgery,patients could wear thoracic waist-iliac orthosis and take out-of-bed activity.[Result]All the patients lumbodynia,lower limb pain,muscle strength and hypoesthesia improved within one week after operation.X-rays showed that both the intervertebral space and the physiological curvature improved to some degrees.Twenty patients were followed up(ranged,1 to 3 years)and the clinical outcomes were good.The average Franke1 grade was 1.4.Re-X-rays showed that interbody fusion was achieved in all 20 patients.No loss was found about the altitude of the intervertebral space and the physiological curvature.[Conclusion]For patients with old traumatic lumbar spinal stenosis,the recovery of body altitude is almost impossible.This method is simple and has less complications.It can be widely used in the clinical practice.

Objective To investigate therapeutic ways a nd effects of using prosthetic materials to repair incisional hernia of the abdo minal wall.Methods Marlex mesh was used in 32 cases and Com posix mesh in 5 cases. Positions of mesh implanted: Retromuscular placement in 1 5 cases, premuscular placement in 12 cases and inlaying mesh into abdominal wall defeat in 10 cases.Results 33 patients were followed for 3 months to 28 months postoperatively, 32 patients were cured without reccurrence. One reccurented at 6 months postoperatively.Conclusion App lication of prosthetic materials to repair incisional hernia of abdominal wall i s safe, and has a low reccurrent rate.

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.

Forty patients who underwent sub-total gastrectomy were divided into four groups, one of them for comparison, the other three groups received 10%, 30% and 100% branched-chain amino acid (BCAA) respectively. The results showed that in BCAA-10 and BCAA-3H group, negative balance was partially corrected, but in BCAA-10 group nitrogen remained an obvious negative balance on the 3rd postoperative day. There were more than ten of plasma AA lower than preoperative day in these two groups. In BCAA-30 group, after surgery, negative nitrogen balance was significantly corrected, and changes of plasma AA had no statistic significance compared with that before operation.Creatinine of urine had no significant difference between each group.In BCAA-30 group, transferrin (Tf) was increased compared with that before operation. It is suggested that the protein synthesis is corrected but the catabolism is not restrained.BCAA may play a regulatory role in muscle protein metabolism, BCAA can serve as fuel substrate to promote synthesis and reduce breakdown of muscle protein to correct negative nitrogen balance.Application of large quantities of BCAA should be based on isotonic AA solution.