Objective To elucidate the clinical features and treatment of hemangiopericytomas (HPCs) in different parts of the body, especially in CNS. Methods Clinical data of 41 cases with HPC which were treated at 301 Hospital from 1993 to 2004 were retrospectively analyzed with a review of relevant literature. Follow-up periods ranged from 4 to 150 months after surgery (mean 34 months). Results Among 41 patients of HPC, 21 tumors (51.2%) were found in CNS, and the rest 20 (48.8%) in other systems. Thirteen tumors were diagnosed as malignant HPC. Surgery for tumor removal was performed in all 41 patients. Among the 62 operations, total removal of tumor was achieved in 49 cases and subtotal removal in 13 cases. Recurrence in original site of the tumor occurred 21 times (33.9%) in 14 patients. Five patients (12.1%) presented one or more distant metastasis, and 5 patients died. HPCs in CNS and in other systems displayed similar clinical characteristics and pathological morphology. Conclusions HPC is a rare angioneoplasm that may arise in any part of the body. It is a great challenge to neurosurgeons as well as other surgeons to surgically manage the tumor. HPC has an unfavorable prognosis because its high rate of recurrence and metastasis. HPC in CNS and in other parts of the body should be recognized as one disease. At the same time, HPC in CNS has its distinct features.

Objective To explore the neuroprotective effects of Buchang Naoxintong Capsule on focal cerebral ischemia/reperfusion in rats.Methods Rat model of ischemic reperfusion of cerebral middle artery was established according to Zea Longa's pattern. Rats were randomly divided into pseudo-operation group, ischemia/reperfusion group and Buchang Naoxintong Capsule treated group. The ischemia/reperfusion group and Buchang Naoxintong Capsule treated group were both divided into five subgroups according to reperfusion time or administration time such as 1 d, 3 d, 7 d, 10 d and 15 d. Using immunohistochemical staining method and color image analysis, we measured the expression of vessel endothelium growth factor (VEGF) and Laminin in the region of ischemia. Pathological changes were observed with HE staining and transmission electron microscope. Besides that, the content of brain water was assayed.Results Compared with ischemia/reperfusion group, less numbers of shrinkage or swelling neurons were found in Buchang Naoxintong Capsule treated group.The content of brain water, the expression of VEGF were obviously different between Buchang Naoxintong Capsule treated group and the other two groups (all P

Different types of cervical spondylosis treated by a vartiety of operative techniques were compared with the aim at improving quality of treatment for cervical spondylosis. 1780 operations including laminectomy, open door laminoplasty, subtotoal vertebrectomy, Cloward's technique, Smith's technique, "keyhole" decompression of the intervertebral foramina, discectomy with intervertebral fusion, intervertebral fixation with titanium cage, and fixation with titanium plate. The results showed:(1)Myelopathy in 363 cases: laminectomy on 4; subtotoal vertebrectomy on 136; Cloward's technique on 201; Smith's technique on 4; intervertebral fixed with titanium on 4; discectomy with fusion on 14. 104 cases were followed up, 82 7% of them showed good and excellent recovery. (2)Myeloradiculopathy in 1106 cases: laminectomy on 3; laminoplasty on 143; subtotoal vertebrectomy on 687; Cloward's technique on 263; Smith's technique on 2; discectomy with fusion on 8. 396 cases were fouowed up, 85 6% of them showed good and excellent recovery. (3)Radiculopathy in 35 cases: posterior approach key hole decompression of the intervertebral foramina on 19; lateral approach decompression of the intervertebral foramina on 9; anterior approach decompression of the intervertebral foramina on 7. Good and excellent results reached 100%. (4)Vertebral artery compression in 9 cases: resection of the osteophyte of the uncinate processes on 5; opening of the transverse foramen on 4. The results were good. (5)Esophagus compression in 18: after removing directly the osteophyte, the symptoms disappeared. (6)Ossification of the posterior longitudinal ligament in 93 cases: subtotal vertebrectomy on 39; laminoplasty on 45; laminectomy on 9. 41 cases were followed up, good and excellent recovery was seen in 85 3%. (7)Cervical stenosis in 156 cases: laminoplasty on 149 and laminectomy on 7. Good and excellent recovery was observed in 97 5%. All the results indicated that a variety of operative techniques could be selected depending on the site of the osteophytes. Direct resection of the lesion which produced compression and fixation or fusion of vertebral bodies were both important to achieve a satisfactory result

OBJECTIVE:To summarize the experience of pharmaceutical care provided by pharmacists of Chinese medicine for AIDS sufferers in our hospital.METHODS:The practical experience of pharmacists of Chinese medicine in providing pharmaceutical care for AIDS sufferers in our hospital was analyzed to achieve rational knowledge from perceptual knowledge.RESULT:To carry out pharmaceutical care for AIDS patients by applying expertise achieved satisfactory effect.CONCLUS-ION:Pharmacists of Chinese medicine should strive to establish a new open pharmaceutical care model,attach great importance to the communication with patients,integrating psychotherapy and humanistic care into the pharmaceutical care all along so as to assure patient's compliance.

Objective To study the relationship between breast symptom, characteristic of ultrasound image and sex hormone level in women with different menstruation status.Methods 50 women with normal men-strual cycle, 129 women in menopause transition and 318 menopausal women were recruited.Breast ultrasound were performed.Breast section thickness, ductal width, breast structure and blood flow were measured.Serum estradiol( E2 ) and progesterone( P) level were measured by enzyme immunoassay on the day when ultrasound was performed.Onset and persistent days of breast pain were recorded.Results ①32(60.4%)women with normal menstrual cycle and 74(57.4%)women in menopause transition women experienced cyclic mastalgia.The aver-age serum E2 level and serum progesterone level were higher in women with cyclic breast pain than in women with-out breast pain.12.5%of menopausal women had breast pain.There was no significant difference of average ser-um E2 level between women with cyclic breast pain and women without breast pain②Breast section thickness was (14.4 ±4.3)mm,(13.0 ±3.7)mm and(10.6 ±3.2)mm, and ductal width was(0.62 ±0.18)mm,(0.88 ± 0.39)mm and(0.90 ±0.47)mm in normal menstrual group, menopause transition group and menopausal group, respectively.The difference had statistical significance.③26 women ( 49.1%) in normal menstrual group had breast structure changes, while 42 cases ( 32.6%) and 60 cases ( 18.9%) in menopause transition group and menopausal group had breast structure changes.Conclusions Most women in normal menstruation and meno-pause transition group experience mastalgia.About 1/3 breast structure change in women of normal menstruation are inversible.About 1/2 breast structure change in menopause transition and menopausal group are similar to those with normal menstruation.

ObjectiveTo investigate the clinical efficacy of points Shenmai(BL62)and Zhaohai(KI6)in treating cervical vertigo. MethodSixty-eight patients meeting the diagnostic criteria were randomly allocated to treatment and controlgroups, 34 cases each. The treatment group received conventional acupuncture at heel vessel points Shenmai and Zhaohai plus cervical Huatuo jiaji points and the control group, conventional acupuncture at cervical Huatuo jiaji points alone. In the two groups, the vertigo symptom score was recorded, and the clinical therapeutic effects and pre-/post-treatment change in the score were observed.ResultThe total efficacy rate was 94.1% in the treatment group and 79.4% in the control group. The therapeutic effect was significantly better in the treatment group than in the control group (P<0.05). The vertigo symptom score decreased significantly in the two groups after the course of treatment compared with before (P<0.01). Vertigo improved significantly more inthe treatment group than in the control group (P<0.05).ConclusionAcupuncture at points Shenmai and Zhaohai is significantly effective by comparison with conventional acupuncture in clinicaltreatment of cervical vertigo.

Objective To explore effects of atorvastatin on the expressions of cyclooxygenase-2(COX-2) and membrane-associated prostaglandin E2 synthase-1 (mPGES-1) in the carotid atherosclerotic plaques of rabbits.Methods Totally 33 male New Zealand white rabbits(≥ 36months of age ) were assigned into normal control group (n=8) and animal model group with carotid atherosclerotic stenosis (n =25).The rabbit models were randomly divided into non-intervention group,celecoxib treatment group (15 mg · kg-1 · d-1,twice daily) and atorvastatin treatment group (5 mg · kg-1 · d-1,once daily) (n=8 each).Four weeks after treatment,the mRNA and protein expressions of COX-2 and mPGES-1 in carotid plaques were determined by RT-PCR and Western blot,respectively.Results The mRNA expressions of COX-2 (0.97±0.09,0.44±0.05,0.60±0.04vs.0.23±0.04,F=66.77,P＜0.01) and mPGES-1 (0.92±0.07,0.41±0.04,0.61±0.03 vs.0.17±0.03,F=54.87,P＜0.01)in carotid atherosclerotic plaques were significantly higher in non intervention group,celecoxib treatment group and atorvastatin treatment group than in normal control group.The mRNA expressions of COX-2 and mPGES-1 were decreased in celecoxib treatment group and atorvastatin treatment group as compared with non-intervention group ( both P ＜ 0.01 ).The protein expressions of COX-2 (0.89±0.06,0.42±0.07,0.62±0.04 vs.0.18±0.05,F=61.75,P ＜0.01) and mPGES-1(0.91±0.05,0.44±0.05,0.63±0.05 vs.0.21±0.04,F=86.44,P＜0.01)in carotid atherosclerotic plaques in non-intervention group,celecoxib treatment group and atorvastatin treatment group were increased as compared with those in normal control group.The mRNA and protein expressions of COX-2 and mPGES-1 were decreased in celecoxib treatment group and atorvastatin treatment group as compared with non-intervention group(all P＜0.01 ).The expressions of COX-2 and mPGES-1 in carotid atherosclerotic plaques were reduced in celecoxib treatment group as compared with atorvastatin treatment group (P ＜ 0.01).Conclusions As COX-2 inhibitor celecoxib,atorvastatin may inhibit the expressions of COX-2 and mPGES-1,and interfere with the inflammatory response which plays key role in the pathological progress of carotid atherosclerotic plaques,and thus slow the progress of carotid atherosclerosis.

BACKGROUND: There are few reports about vascularization in the repairing of bone defect by heterogeneous deproteinized bone.OBJECTIVE: To verify the vascularization characteristics of heterogeneous deproteinized bone, tissue engineering scaffold material, in the repairing of large segmental bone defect.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed between March 2005 and February 2007 at the Third Military Medical University, Chongqing, China.MATERIALS: Twenty-four 10 to 12 months old goats, weighing (22.5±2.5)kg, were obtained from the Animal Center of the Third Military Medical University, Chongqing, China. Segmental bone defects of 20 percent right tibia middle and inferior diaphysis of the 24 goats were made.METHODS: The 24 goats were divided into test group (n=16) and control group (n=8) randomly. Goats in test group were implanted with deproteinized bone+autologous MSCs+recombinant human bone morphogenetic protein-2 (rhBMP-2), goats in control group were implanted with autograft bone, and all fixed with half-ring sulcated external fixator. Every 4 weeks, 3 goats were killed after ink perfusing through femoral artery. A thick slice of new bone tissue was made to observe the vascularization.MAIN OUTCOME MEASURES: Vascularization of new bone observed through gross anatomy and imaging; vascular network of new bone observed through thick section, blood vessel amount and area measured by Image-proplus really image analysis software.RESULTS: No goat was infected or dead. Animal soft tissue was dyed black, blood vessels'size, ditribution and network structure were observed in subcutaneous tissue, fascia and periosteum. At 4 weeks postoperation implant margin became crude in the defect area; at 8 weeks postoperation transparent bone absorbing area of different size and irregular shape appeared; after 12 weeks postoperation high-dense calcification shadow appeared at the ends of defect bone and new bone connected with the ends completely. On 4 to 24 weeks postoperation, the blood vessel amount became large, alignment became regular, and their size and distribution became uniform. It showed no significant difference in blood vessel amount and area between 2 groups (P>0.05).CONCLUSION: Composite of heterogeneous deproteinized bone+autologous MSCs+rhBMP-2 has the same vascularization degree. of autogeneous bone graft in repairing of large segmental tibia defect.

BACKGROUND: The anatomical position of facial nerve is often abnormal because of the acoustical neuroma growth, so sometimes, the facial nerve injury is inevitable in the surgery treatment for acoustic neuroma.OBJECTIVE: To investigate the technology, veracity and practicality as well as the relationship between intraoperative monitorning and prognosis of facial nerve, and the clinical experiment was summed up of facial nerve function monitoring in 120 cases of acoustic neuroma surgery.DESIGN: Self-control observation.SETTING: Department of Neurosurgery, General Hospital of Chinese PLA.PARTICIPANTS: Totally 120 patients with acoustic neuroma who received treatment in the Department of Neurosurgery, General Hospital of Chinese PLA from May 1996 to February 2000 were recruited. Among them, 3 cases suffered from small-type acoustic neuroma (＜ 2 cm in diameter), 9 cases from middle-type acoustic neuroma (＞ 2 cm in diameter) and 108 from large-type acoustic neuroma (＞ 3 cm in diameter), including 1 case of bilateral acoustic neuroma and 1 cases of recrudescent acoustic neuroma; Suboccipital retromastoid approach was used in 119 cases and transretrolabyrinthine approach in 1 case.METHODS: American Viking-Ⅳ type monitor was used to monitor facial nervous function. When facial nervous function was monitored, recording electrode was put on orbicular muscle of eye, orbicular muscle of mouth or quadrate muscle of upper lip. When trigeminal motor branch was monitored, recording electrode was put on masseter muscle; When accessory nerve was monitored, recording electrode was put on trapezius muscle.Measurement of evoked auditory brainstem potential: recording electrode was positive electrode and was put at the midline in the frontal region (electroencephalogram 10-20 classification system). The recorded waveshape presented upward deflection. Reference electrode A1 or A2 and ground electrode were put in the midline of frontal pole (relevant to root of nose); Recording electrodes were all needle electrodes and were fixed with adhesive tape. Common stimulus intensity was 80 to 90 nHL, and 40 nHL noise was used in contralateral ear. Facial nerve was reserved following intraoperative monitoring. CT (enhancement scanning was necessary) or MRI was rechecked after operation to investigate the cutting degree of tumor; Facial nerve function was evaluated by H-B scoring (at 2 weeks, or 6 to 9 months following operation).MAIN OUTCOME MEASURES: Facial nerve function by H-B scoring before and after acoustic neuroma surgery.RESULTS: Totally 120 patients were enrolled, and no one dropped out.① Facial nerve anatomy was reserved in 117 cases; One case was failure to reserve facial nerve anatomy because pinnate facial nerve lay behind of acoustic neuroma, and electrical stimulation was not given at the beginning of neuroma resecting, then he received anastomosis of hypoglossal and facial nerve. Nerve of 2 cases was pulled and broken carelessly, and its two stumps were long enough that end-to-end anastomosis of facial nerve was performed with 7-0 absorbable suture following trimming. H-B score was Ⅳ to Ⅴ in the 6th month after surgery. ②Grade Ⅰ of facial nervous function at postoperative 2 weeks was found in 10 cases, grade Ⅱ in 57 cases,grade Ⅲ in 44 eases, grade Ⅳ in 4 cases, grade Ⅴ in 2 cases and gradeⅥ in 3 cases. ③Grade Ⅰ of facial nervous function at postoperative 9 weeks was found in 94 cases, grade Ⅱ in 18 cases, grade Ⅲ in 4 cases,grade Ⅳ in 1 case and grade Ⅵ in 2 cases.CONCLUSION: Spontaneous and evoked facial muscle electromyogram may be helpful to make sure the facial nervous position exactly and estimate the prognosis of facial nerve.

ObjectiveTo analyze the effect of Tetrandrine (Tet) on neuronal apoptosis and reletted gene expression after acute spinal cord injury (ASCI) in SD rats so as to provide experimental basis for treatment of ASCI.MethodsA total of 95 adult SD rats were.randomly divided into four groups,ie,control group ( n =5 ),ASCI group ( n =30),Tet treatment group ( Tet group,n =30) and methylprednisolone treatment group ( Mp group,n =30).The ASCI model was established with the aid of modified Allen method.The five rats from each group were sacrificed at postoperative 8 hours and 1,3,7,14,21 days respectively to observe the morphology of the injury spinal cord and expressions of cell apoptosis regulation genes ( Bcl-xl,Bcl-xs).The flow cytometry ( FCM ) was used to semiquantitatively analyze the apoptotic cells. ResultsExcept for the control group,the other three groups had morphological changes.Tissue edema,neuronal degeneration with some necrosis and marked inflammatory cell infiltration were founded in the ASCI group.Tissue injury was alleviated in the Tet group and was relatively much milder in the Mp group,with no obvious necrosis or inflammatory cell infiltration.Except for the control group,the number of Bcl-xs positive cells at the same time point was the most in the ASCI group in comparison with the Tet and Mp groups.Meanwhile,the expression of Bcl-xl in all groups reached the peak at day 7 post-injury.The semiquantitative analysis of the apoptotic cells displayed that,except for the control group,the number of apoptotic neurons in other three groups reached the peak at day 7 postinjury and then declined gradually.At the same time point,the apoptotic neurons in the Tet group were less than that in the ASCI group,but more than that in the Mp group. ConclusionsAfter ASCI,Tet plays an active role in intervening the expression of the apoptosis regulation gene and can evidently decrease neuronal apoptosis.Tet treatment can work within 7 days and should be given for ASCI as early as possible.However,Tet exerts weaker effect on ASCI in comparison with MP.