In recent years,some aspects of the standardized resection of colon cancer,metastases,recurrent tumor therapy and laparoscopic applications have new concepts.In particular,the view of complete mesocolic excision(CME) is more scientific and effective from the level of embryonic development and anatomy,which lays the foundation for controlling the quality of colon surgery.

[Objective]To observe clinical value of multi-slice spiral X-ray computed tomography(MSCT)volume rendering technique(VRT)and multi-planar reconstruction(MPR)in classification and treatment of tibial plateau fracture(TPF).[Method]From August 2005 to February 2009,49 fratures in 45 patients with TPF were treated.Their clinical data were studied retrospectively.There were 32 males and 13 females.The patients were aged from 20-65 years(mean 46 years).Four patients suffered bilateral TPF.All patients were examined with standard X-rays and 64-slice spiral CT scanner.Axial CT scans were processed with VRT and MPR.Their X-ray plain films and 64-slice spiral CT seans(including VRT and MPR)were performed to determine their fracture types and protocol.[Result]According to the VRT and MPR findings,13 fractures(13/49)classified by X-ray plain film were corrected,protocols were changed for 9 fractures(9/49),and 15 fractures(46.9%)of intereondylar eminence of the tibia and 6 fractures(28.6%)of proximal fibula were underdiagnozed.[Conclusion]MSCT(VRT+MPR)can clearly show the area and degree of tibial plateau collapse,the details of TPF and the delitescence fracture,help to determine TPF types,decrease the underdiagnosis rate and choose a rational protocol.The use of combined VRT and MPR is a supplementary means for X-ray plain film and axial CT scanning.which has great clinical value.

The normal value of parameters of saccade, smooth pursuit and optokinetic nystagmus has been detected by recording the electro-oculograph in 29 healthy subjects.The results are as follows: 1.The reaction time of saccade is 259.04? 74.19,the mean velocity is 216.83?87.51/s in 15? target amplitude.No statistical significance has been found between sexes, but the reaction time is obviously longer in pre-puberty group.2.For smooth pursuit in 40% target velocity, gain is 0.976?0.08, phase lag is 3.95?7.69s,moothness is 0.925?1.49.No statistical significance has been found between sexes.3.In analysing the sequential process of saccade and smooth pursuit, it can't observed the tendency of decrement in latency.4.The gain of OKN in 14?/s velocity is between 0.689-0.808, the gain decreases following the increase of target velocity.The symmetry of OKN is 3.54?15.04% and there are 81.58% of OKN belonging macula type in healthy people.5.When the target velocity is in close each other,the velocity of fast phase of OKN is in close with the velocity of saccade.

[Objective]To explore the surgical technique and clinical results of minimally invasive incision dynamic hip screws (DHS) in treatment of intertrochanteric fractures in the elderly.[Method]From August 2001 to January 2006,37 old cases (15 males and 22 females, aged from 72 years to 92 years, mean 81.5 years) with intertrochanteric fractures were treated with closed reduction and DHS using minimally invasive technique in our hospital. The procedure included following and critical steps:1～2 k-wires was inserted into the upper part of the femoral head through great trochanter percutaneously after operation. A guide wire was inserted into the center of the femoral head according to 135? collodiaphyseal angle; then, a small incision (4～5.5 cm) was made and along the guide wire for inserting a screw into the femoral head. The guide wire was removed and the side plate was slipped under the soft tissue into to tightly contact the lateral surface of femur, and followed by the side plate barrel being seated on the screw.[Result]The operation time was 40～75 minutes (average 60 minutes) The mean amount of blood loss in, operation was 55 ml. The mean amount of hemoaleh:in showed no significant difference between postoperation and preoperation. The following-up period averaged 15 months (11～18 months) The clinical hone healing lasted for 10～15 weeks. Two cases had mild coxa vara, there were no incision infection, fixation failure or lower extremity rotatory deformity. The excellent rate of joint function was 94.6% according to DONG's assay standard. [Conclusion]Minimally invasive incision DHS has the advantages of shorter operation time, less blood loss, little trauma, less complications and quick functional recovery and is an effective and safe method for treatment of femoral intertrochanteric fractures in the elderly.

[Objective]To evaluate the clinical characteristics and effect of operative treatment for the ossification of ligamentum flavum thoracic spinal stenosis (OLF-TSS). [Methods]From October 1998 to February 2007,38 patients with OLF-TSS were treated with en bloc hemi-articular process laminectomy. In this group,25 cases were male,and 13 cases were female. The average age was 48 years (range,29～71 years). Totally 81.6% of the lesion was between T10～L1 intervertebral disc space.The average history was 10 months. There were 5.3 percent with protrusion of intervertebral disc of thoracio spine.[Results]Thirty-eight cases were followed-up for 1～8 years,with an average of 3 years and 6 months. Dural injury occurred in 4 cases of 38,3 cases appeared postoperative cerebrospinal fluid leakage. All cases were cured conservatively mainly with bed rest in the prostrate position. According to WANG's evaluation,25 had excellent results,11 had good results,2 had no change and none was poor,The excellent to good rate was 94.7% in this group. There were no patients with the wrong level. No patient neurological functions were deteriorated.[Conclusion]The chinical features of OLF-TSS are very complex. The common symptoms of the disease are progressive onset of numbness,weakness,low back pain,intermittent claudication of the lower extremities,constriction on trunk or lower limbs and sphincter dysfunction. The clinical presentation and neurological examination associated with X-ray film,MRI and CT were the important means of the diagnosis of the disease. Removal of the posterior wall of the thoracic spinal canal via the technique of en bloc hemi-articular process laminectomy is safe and effective to treat OLF-TSS. The strategy for diminishing fault and complications is to discriminate pathogenic segment (locating-diagnosis) and follow the principles of surgical procedure.

[Objective]To evaluate the surgical management and its results of type A fractures of distal humerus in children utilized with double tension hands(DTB).[Method]From January 1999 to May 2005,52 patients of type A fractures of distal humerus in children were treated surgically through approach of DTB.Seven patients suffered open fractures(Gustilo scale Ⅰ in 5,and Ⅱ in 2).Fourty-five patients suffered closed fractures.According to AO/ASIF classification,type A2 fracture was found in 41 cases and type A3 in 11 cases.The elbows were flexed to 90?and immobilized with long-arm casts for 2 weeks.The rehabilitation exercises began at 2～3 weeks post-operatively.[Result]All the patients were followed up,with the duration from 6 to 18 months(averaged,12.5 months).All the fractures were healed,no cubitus varus deformity.The function of the elbow was evaluated according to Flynnet's scale,the results showed excellent in 41 cases,good in 10cases,and poor in 1 case.[Conclusion]The use of DTB for the surgical management of type A fractures of distal humerus in children has many advantages,it provides a new sufficient internal fixation with simple technical procedure,anatomical reduction under direct vision,reliablestability,facilitates rehabilitation exercises and low complication rate.DTB is a better choice in treatment of type A fractures of distal humerus in children.

[Objective] To summarize the clinical characteristics of type C2 fractures of tibia,to study the surgical management and its results of type C2 fractures of tibia through intramedullary interlocking nail and minimal invasive internal fixation.[Method]From May 2000 to March 2006,30 patients of type C2 fractures of tibia were treated surgically through intramedullary interlocking nail and minimal invasive internal fixation.The patients included 21 men and 9 women with a mean age of 41.5 years(range 20~ 63 years).Forteen closed fractures were treated by the limitedly reamed interlocking intramedullary nail.Sixteen open fractures(including Grade I and Ⅱ injuries)were treated by the unreamed interlocking intramedullary nail.All fractures were fixed statically.The mean time from the injury to surgery was 4.5 days(rang,2 hours~ 12 days).[Result]Mean follow-up period was 16.5 months(7~ 21 months).All patients had bony union within 4~9 months,with the average time of bone union being 6.2 months.The function recovery was evaluated by Johner-Wruch system in which 24 cases were excellent,3 cases were good.No osteofascial compartment syndrome of the lower leg,deep part infection,anterior kneeache,broken nails and screws and malunion were found in this series.Two cases were found delay union.[Conclusion]The type C2 fractures of tibia are often caused by high energy injuries.Most of type C2 fractures happen at the field of tibial shaft.The treatment of type C2 fractures of tibia using intramedullary interlocking nail and minimal invasive internal fixation has advantages of easy operation,less trauma,rigid fixation,high healing rate,lower complications,and satisfactory effect.It is a perfect method.The standard and less invasive operative methods should be paid more attention.

OBJECTIVE:To establish the quality standard of Tongfeng granules.METHODS:Coix lacryma-jobi,Radix Paeoniae Rubra and Radix et Rhizoma Glycyrrhizae in the granules were identified by TLC,and the content of sarsasapogenin in Tongfeng granules was determined by HPLC-ELSD.RESULTS:The TLC characteristics were distinctive and specific.The linear range for sarsasapogenin was 0.546～4.368 ?g(r=0.999 8) and the average recovery was 97.74%(RSD=1.3%,n=6).CONCLUSION:The established standard can be used for the quality control of Tongfeng granules.

[Objective]To investigate the efficacy and the application value of interlocked intramedullary nailing(IIN) for bilateral femoral shaft fracture(FSF).[Method]Twenty-one cases of bilateral FSF were treated by IIN between March 1998 and March 2005.Their average age was 39.6(ranged 29～48).Thirty-five limbs of them were closed fractures,and 7 limbs were opened.Among them,18 limbs had fractures in the upper third of the femoral shaft,11 limbs in the middle third and 13 limbs in the lower third.The continuous passive motion began averaging 5 days after operation.[Result]The average follow-up period was 11.5 months(6 to 32 months).Clinical bone healing was achieved after 15.5 weeks(10~30 weeks).NO fat embolism syndrome(FES),shortening,infection or break of nail occurred in all patients.The long term effect was evaluated according to Ma Yuanzhang's evaluation standard,90.5%(19/ 21) showed excellent function of joints and limbs.[Conclusion]IIN provides a satisfied approach to the treatment of bilateral FSF.It has the advantages of fewer invasions,less blood loss,steady fixation,short healing time,early function recovery and less complication.This kind of treatment is worth to be recommended for the bilateral FSF,prevention of FES should be emphasized on.

[Objective]To summarize the surgical management and clinic results of the minimally invasive percutaneous plate osteosynthesis(MIPPO) technique in treatment of proximal metaphyseal fractures of tibia.[Method]Twenty-five patients with proximal metaphyseal fracture of tibia underwent the MIPPO operation in our department.There were 18 males and 7 females,with a mean age of 42.6 years(ranged from 21 to 66 years).According to AO classification,17 cases were type 41-A,and 8 cases were type 41-C,of the 25 cases,8 were multiple injuries,4 of these were open fractures(2 cases of Gustilo-Anderson type Ⅱ and 2 cases of type ⅢA).According to creiteria of Johner-Wruch,excellent in 14 cases,good in 9 cases,fair in 2 cases,the excellent and good rate was 92%.[Result]The average intra-operative time was 90 minutes(ranged from 70 to 115 minutes).The average blood loss was 260 ml.No patient received blood transfusion.There were no superficial and deep infection occurred in this group.All patients were available for follow-up at an average of 1.8 years(ranged,1 to 2.5 years) after surgery.The mean time for bony union on X ray was 13.8(10～20)weeks,while the mean time for full weight bearing was 14.5(11～28) weeks.No malunion and failure of fixation were observed.[Conclusion]MIPPO is a safe and effective technique for the proximal metaphyseal fracture of tibia with the advantage of less invasion,steady fixation,low infection rate and higher union rate,which is accordant with biological fixation.