Objective To evaluate the effect on postoperative urinary and sexual function of the radical operation with autonomic nerve preserving for mid low rectal cancer.[WT5”HZ]Method [WT5”BZ]Radical operation with autonomic nerve preserving was performed on 188 cases of rectal cancer. Nerves were fully preserved in 98 cases of Dukes A stage,one or both side nerves preserved in 78 cases of stage B, only S 3,4 nerve preserved in 12 cases of stage C.[WT5”HZ]Result [WT5”BZ]The postoperative voluntary micturition developed at 8 5 days for Dukes A; 9 0 days for stage B; and 16 8 days for stage C. Erection and ejaculation remained in Dukes A, in 96% and 100%;stage B, in 47 4% and 50%;stage C, in 0 and 0. The local recurrence after the operation accounted for 12 8%(24/188), among them Dukes A,B,C were 4 1%,21 9%, and 33 3% respectively.The 5 year survival rate were 77 6%,52 6% and 33 3% respectively.[WT5”HZ]Conclusion [WT5”BZ]The radical operation with autonomic nerve preserving for rectal cancer effects a better life quality not at the expense of local recurrence and reduction of 5 year survival rate.

Objective To evaluate the clinical value of 16-slice spiral CTA for the diagnosis of lower extremity arterial disease.Methods A total of 103 patients with arterial disease at the lower extremities were submitted to 16-slice spiral CTA.A scanner with a slice thickness of 5 mm,pitch 1.15 mm,increment 1.0 mm,and overlapping 30% was used.Totally 90-100 ml of contrast agent was injected at a rate of 3 ml/s.The scanning was started with a Smartprep auto-trigger and persisted for 20-30 s.The reconstructed images were reformed by means of maximum intensity projection,volume rendering technique,and multiplanar reformation.Results The reconstructed images of the 103 cases were clearly demonstrated by CTA,which showed arteriosclerotic occlusion in 64 patients,arteriostenosis in 32,aneurysm in 4,and normal vessels in 3.Among the 103 patients,40 received surgical treatment,which confirmed the results of CTA.Conclusion Lesions in the lower extremity arteries can be well demonstrated by 16-slice spiral CTA,which can serve as a pre-surgery screening and evaluation.

Objective:To study the effect of hydrogen-rich saline on the prevention of liver mitochondrial injury induced by isch-emia-reperfusion (I/R) in rats. Methods:Male Sprague-Dawley rats (n=42) were randomly divided into three experimental groups (n=14), namely, sham-operated, I/R plus saline-treated (5 mL/kg, i.p.), and I/R plus hydrogen-rich saline-treated (5 mL/kg, i.p.) groups. Mi-tochondrial oxidative stress and functions, as well as morphologic changes in the mitochondria, were detected 180 min after reperfu-sion. Results:After I/R, mitochondrial swelling and vague cristae were observed. Mitochondrial functions were significantly decreased, but mitochondrial MDA and GSSH contents were increased by I/R. Hydrogen-rich saline reduced these markers, improved mitochondri-al ATP content and respiratory function, and relieved morphological mitochondrial injury (P<0.01). Conclusion:Hydrogen-rich saline attenuated I/R-induced liver mitochondrial damage and reduced mitochondrial oxidative stress.

Objective To study the effects of hydrogen-rich saline (HS) on the protection of hepatic injury induced by ischemia-reperfusion (I/R) in rats.Methods Male Sprague-Dawley rats (n =60) were randomly divided into three experimental groups:sham-operated group,I/R plus saline treatment group,and I/R plus hydrogen-rich saline treatment group.Reperfusion liver was conducted 180 mins after liver ischemia.Blood samples and liver tissues were collected.Result Serum ALT,AST levels,and MDA content,HMGB1,TNF-α,IL-1β and IL-6 levels in liver tissue were increased,but SOD and GSH activity were decreased significantly by I/R.Hydrogen-rich saline reduced oxidative stress and inflammatory reaction,and relieved morphological liver injury (P ＜ 0.01).Conclusion Hydrogen-rich saline attenuated I/R induced liver damage by reduction of oxidative injury and inflammatory reaction.

Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%(28/173); the coupled group was 9.6%(21/219), P

Objective To investigate the feasibility of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. Methods One patient with thoracic disc herniation involved the level of vertebral segment in T11/12 was treated with percutaneous transforaminal endoscopic spine system and followed up for 1 month. The targeted puncture was performed under local anesthesia and fluoroscopic guidance with patient in prone position. The foramen of T 11/12 was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The dural sac was exposed and released adequately. Drainage was placed during operation. Results The procedure was successfully carried out and the dural sac was completely released. The drainage was removed in the second day of operation. The patient could walk in the third day after operation with obvious relief of back and leg pain. At the follow-up of one month postoperation, the visual analogue scale of leg pain decreased from 8 to 1, and the Oswestry disability index (ODI) decreased from 64 to 4. According to MacNab scale, excellent result was acquired. Conclusion There is the feasibility of the percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. It is a good minimal invasive technique with good results and high technical requirements for surgeons.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus) in diabetes combined with nerve deafness using 1 H magnetic resonance spectros‐copy (1 H -MRS) ,and to discover the early warning indicator of nerve deafness in type 2 diabetes .Methods PTA was performed in 98 patients with type 2 diabetes (diagnosed by Endocrinology Department) ,and in 15 healthy sub‐jects in the control group .The patients were classified into four groups :the group of type 2 diabetes;type 2 diabe‐tes with unilateral and bilateral deafness ,and the normal control group .Cerebral metabolism was studied by assess‐ing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo-in‐ositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups . The Pearson correlation analysis was applied to determine blood glucose value with the nerve metabolites while the ROC curves were made for those metabolism markers to find the best diagnostic threshold .Results NAA/Cr and NAA/Cho were negatively correlated with AHI index and Cho/Cr ,mI/Cr was positively correlated with blood glu‐cose value .Significantly lower values of NAA/Cho ratio were found in patients'(diabetes without deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) .NAA/Cr and NAA/Cho ratio in diabetes with deafness were significantly lower than those in control group (P< 0 .05) ,Cho/Cr higher than those of in other groups (P<0 .05) .NAA/Cr and NAA/Cho ratio in injured and uninjured auditory cortex of diabetes with unilateral deafness were significantly lower than those of in control group (P<0 .05) ,then we made a self -comparison be‐tween the injured and uninjured auditory cortex ,finding that NAA/Cho ratio had a significant difference .All of the metabolisms were tested by the curve of ROC .The area of NAA/Cho under the ROC curve was 81% ,which had a higher accuracy .NAA/Cho equal to 1 .65 can be used as boundary indicators between diabetes without deafness and diabetes with deafness groups ,the areas of the remaining indicators under the ROC curve was<50% .Conclusion NAA/Cho may be the early warning marker of nerve deafness in type 2 diabetes .

Objective To evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain. Methods Seventy-one lumbar disc nucleuses were collected intra-operation,and they were divided into four groups. Group A: 30 cases of disc herniation, Group B: 22 cases of sequestered disc herniation, and the patients in Group A and B received discectomy; Group C: 10 cases of discogenic pain were confirmed by discography, and the painful disc was excised through anterior retroperitoneal approach; Group D: 9 cases of lumbar bust fracture who received anterior subtotal corpectomy and discectomy, and the nearly normal caudal disc was collected as control. The disc nucleuses were processed in the following methods: 1) HE stain and pathological observation; 2) Immunocytochemical test using monoclonal antibodies to CD68 and CD45RO molecule for macrophage and T lymphocytes, respectively. The positive cells were counted and analyzed with statistic method. Results 1) Pathological observation with HE stain: compare to control group, the degeneration of nucleus cell was evident in the other groups. There were obvious infiltration of inflammatory cells and focal neovascularization in group A and especially in Group B.In Group C, only diffuse inflammatory cells was found without neovascularization, but the degeneration of matrix was more severe. 2) Positive rate of CD68 cells: Group B (63.6%)＞Group C (40.0%)＞Group A (26.7%)＞Group D (0%). There were significant differences among groups (P＜0.05). 3) Positive rate of CD45RO cells:Group B (59.1%)＞Group A (13.3%), Group C and D were negative, and the positive cell were found in slice of the same site of positive CD68 cells. The differences between each group were significant (P＜0.05). Conclusion The nucleus of herniated disc has evident inflammatory and autoimmunity reaction. The nucleus of discogenic pain is infiltrated with diffuse inflammatory cells and some macrophages, without T lymphocyte and neovasularization, so the autoimmunity course is not evident.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus)in patients with metabolic syndrome combined with sensorineural deafness using 1 H magnetic resonance spectroscopy (1 H-MRS),and to find out the early warning indicators of sensorineural deafness in patients with metabolic syndrome.Methods The pure tone audiometry (PTA)was performed in 142 pa-tients with metabolic syndrome (diagnosed by endocrinology department),and 15 healthy subjects as the control group.The patients were divided into four groups:the metabolic syndrome group;the metabolic syndrome group with unilateral,the bilateral deafness group,and the control group.Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate contrast to choline (NAA/Cho)as well as to creatine (NAA/Cr),myo-inosi-tol to creatine (mI/Cr)and choline to creatine (Cho/Cr)ratios in the auditory cortical separately in these groups. ROC curves were made for those metabolism markers to find the best diagnostic threshold.Results Significantly lower values of NAA/Cho ratio and higher values of Cho/Cr were observed in metabolic syndrome in the control group (P<0.05),Cho/Cr higher than those (P<0.05).NAA/Cho ratios in the injured and uninjured auditory cortex of MS with unilateral deafness were significantly lower than those in the control group (P<0.05).A self-comparison was made between the inj ured and uninj ured auditory cortex,the result showed that NAA/Cho ratio had significant differences.All of the metabolisms were tested by the curve of ROC.The area of NAA/Cho under the ROC curve was 81%,which had a higher accuracy.NAA/Cho equating to 1 .82 could be used as the boundary indi-cators between metabolic syndrome without deafness and with deafness groups.The areas of the other indicators un-der the ROC curve were <50%.Conclusion NAA/Cho may be the early warning marker of sensorineural deafness in patients with metabolic syndrome.

BACKGROUND: Minimally invasive transforaminal interbody fusion (Mis-TLIF) for spondylolisthesis has been introduced to reduce muscle trauma, minimize blood loss, and achieve earlier rehabilitation. However, there is a lack of evidence-based medicine concerning the therapeutic efficacy of Mis-TLIF versus open TLIF for spondylolisthesis. OBJECTIVE: To systematically evaluate the clinical efficacy and safety of Mis-TLIF versus open TLIF for spondylolisthesis.METHODS: WanFang, CNKI, PubMed, and Cochrane Library databases were searched using the keywords of spondylolisthesis, minimally invasive transforaminal interbody fusion, open transforaminal interbody fusion in English and Chinese, respectively. The quality evaluation and data extraction of the included literatures were conducted by two authors independently. A meta-analysis was performed on RevMan 5.3 software.RESULTS AND CONCLUSION: Ten literatures were included, including 7 retrospective and 3 randomized controlled trials; 963 cases were enrolled (489 cases of Mis-TLIF, 474 cases of open TLIF). (1) Meta-analysis results showed that there were no significant differences in the operation time, postoperative complication rate, and fusion rate at the last follow-up between two groups, suggesting that the two methods expose analogical effects on the pain relief and functional recovery. (2) There were significant differences in the intraoperative blood loss and radiological times between two methods. (3) To conclude, Mis-TLIF holds similar operation time, incidence of complications and functional recovery with open TLIF, accompanied by minimized trauma, and reduced intraoperative and postoperative blood loss, which is considered as a safe and effective surgical method.