Objective To study the feasibility of minimally invasive procedure for the management of dumbbel tumors of the cervical vertebral canal. Methods Fourteen cases of dumbbel tumors of the cervical vertebral canal were treated by the approch of semi-laminectomy. Results Twelve cases underwent total resections, one case underwent subtotal resection, another case underwent great part of resection. The vertebral artery was preserved well during the operation. Nine out of fourteen cases had followed up for 6～18 months. Neurological function was improvement in all cases. No recurrence or instability of spine was found. Conclusions The approch of semi-laminectomy has the advantages of minimal invasion, less bleeding, and no influence on stability of spine. It is a good choice for dumbbel tumors of the cervical vertebral canal

Ojective To evaluate the value of computed tomographic angiography (CTA) in the diagnosis of intracranial aneurysml with acute subarachnoid hemorrhage and in making a surgical plan. Methods CTA was performed using Helical CT in sixty three cases of acute subarachnoid hemorrhage Results Twenty four patients with intracranial aneurysms were found by CTA, one case of aneurysm was found by DSA. Diagnostic results were confirmed by operation. Conclusion CTA is a rapid?safe and accurate method in the diagnosis of intracranial aneurysms, particularly for acute and severe patients.

SUMMARY Peripheral T cell lymphomas-unspecified(PTCL-U) is an uncommon malignant tumor, accounting for 5%-7% of non-Hodgkin’s lymphoma. Clinical feature of a case of PTCL-U was investigated and the optimal treatment protocol was proposed. The clinical presentation of this case was progressing limbs weakness with sudden paralysis. Multiple superficial lymph nodes swelling and decreased sensation in all modalities below T10 level were found in physical examination. Bilateral leg paralysis (Grade 0/5) with high muscle tension, overactive knee reflex, bilateral Babinski sign (+) were present. Magnetic resonance imaging(MRI) showed the mass, which was around spinal cord located in T6-T8 vertebra canal, with intense enhancement after the administration of gadolinium diethylenetriamine penta-acetic acid. Abnormal signal in multiple centrums and accessories could also be found in MRI scan. Initial diagnosis was lymphoma, multiple systems involved. Laminectomy and epidural tumor resection were performed immediately. The dural sac was narrowed obviously by surrounding tumor. The result of pathological examination was PTCL-U. After operation, the level of pain sensation was descent, and touch sensation recovered. The patient received chemotherapy and his muscle strength was partly recovered in 4 months. Early diagnosis of peripheral T cell lymphomas-unspecified was difficult and easily misdiagnosed with poor prognosis. A review of literature showed central nervous system lesions occurred in advanced stage. However, the report of representation of intraspinal mass as initial symptom like the case was rare. For acute paraplegia, laminectomy and tumor resection should be performed as soon as possible. Regular radiotherapy and chemotherapy should be considered after operation. However, the value of local chemotherapy need to be further investigated.

The Ca2+-ATPase of sarcoplasmic reticulum is a Ca2+ pump that plays a key role in regulating cytosol calcium concentration in muscle cells. It undergoes a sequential conformational transition during the transport process. According to the classical E1/E2 theory, in the E1 state the binding sites have high affinity and open to the cytoplasm, whereas in the E2 state the binding sites have low affinity and face the luminal side. Crystal structures of several states during the reaction cycle of Ca2+-ATPase have been solved recently, including a Ca2+-bound form (E1-2Ca2+), a Ca2+-unbound form stabilized by a potent inhibitor thapsigargin (TG) (E2-TG), an ATP-bound form (E1-ATP), an E1-P-ADP state, and an E2-Pi state. The details of these crystal structures and the relationship between structure and function of Ca2+-ATPase during reaction cycle were summarized, and the issues to be addressed in future research were raised.

Objective The purpose of this study was to evaluate the outcome of surgical treatment for spinal cord tumors. Methods We retrospectively analyzed a series of 660 patients with 676 intra-spinal tumors who were treated surgically from February 1993 to December 2007. The tumors located at the cervical level in 231 patients,thoracic in 202,lumbar in 159,sacral in 9,cervico-thoracic in 16,thoracico-lumbar in 42,and lumbar-sacral in 17. Totally 699 operations were performed,including posterior bilateral laminectomy approach in 599,unilateral laminotomy in 71 and laminoplasty in 6 cases.Besides,23 additional operations via lateral or ventral-lateral were performed for resection of extra-spinal component of dumbbell shaped tumors. Results In this series,Schwannomas and meningiomas were the most common extramedullary tumors accounting for 76.5% of the cases [517/676,rate of total resection: 92.3% (477/517)]. The intra-medullary tumors accounted for 23.5% (159/676),in which astrocytomas and ependymomas were the most often observed [rate of total resection: 67.3% (107/159)]. The peri-operative mortality was 1.7% (11/660). The motor and sensory functions were found to be improved after operation in 77.8% (357/459) and 79.2% (397/501) respectively. The sphincter function was improved in 72.4% (215/297). The rate of pain relief was 93.3% (361/387). The follow-up periods ranged from 0.5 to 15.1 years in 582 patients with an average of 5.9 years;during the period,87.8% (499/568) of the patients had an ASIA impairment scale E neurological function. Conclusions Intra-spinal tumors locate mostly in the subdural-extramedullary space,with a majority are Schwannomas and meningiomas. The widespread application and availability of MRI investigation provide the physician with accurate localization of the lesion thereafter ensure a minimally invasive surgical treatment strategy keeping the stability of the spine while removing the tumors with an satisfactory outcome.

The mrp gene of SS2 human strain Habb was truncated and cloned into a prokaryotic expression vector pGEX4T-2,and a fusion-expressed protein MRP-GST of 61 000 was obtained in E.coli.The GST was cut from MRP-GST with thrombin protease to gain the purified MRP of 35 000 which showed a strong reaction to the SS2 positive sera in Western blotting.BALB/c mice were immunitied intraperitoneally with purified MRP protein.Murine myeloma cells were fused with the splenocytes of the immunized mice after the third immunization.An indirect ELISA coated with purified MRP was used to screen hybridomas for production of specific antibody.The six McAb recognized MRP specially.According to the results of 71 standard strains (48 SS and 34 SS2)by Sandwich ELISA,the coincidence rate was 97.2%,but for 34 SS standard serotype was 100 %.The ELISA method has a potential value for clinical and epidemiological applicationgs.

Objective Replacement of dexmedetomidine with propofol for maintaining the anes-thesia in elderly patients undergoing laparoscopic cholecystectomy.Methods Ninety patients,over 70 years old,undergoing laparoscopic cholecystectomy were randomly divided into 2 groups,propofol combined with remifentanil (group A),dexmedetomidine combined with remifentanil (group B),45 patients in each group.Group A was not treated with any preoperative medication,while group B was treated with loading dose of 0.5 μg/kg dexmedetomidine intravenously completed within 10 minutes. Induction methods were same in both groups,3 # or 4 # laryngeal mask were inserted after induction in both groups.Maintenance of anesthesia in group A treated with propofol 2.0-3.0 μg/ml + 4.5-5.5 ng/ml TCI;Maintenance of anesthesia in group B treated with dexmedetomidine 0.25 μg·kg-1·h-1 +remifentanil 4.5-5.5 ng/ml (TCI).HR,SBP,DBP,BIS were recorded at inserting the LMA (T1 ), beginning of the surgery (T2 ),dissociate the cholecyst (T3 ),withdrawal of the laparoscope (T4 ), extubate the LMA (T5 ).Postoperative recovery time,Steward awakening score and modified OAA/S score at extubation time were recorded.Results No significant difference was found between BIS val-ue of two groups at different time point.Compared with group A,HR at T1-T5 in group B were sig-nificantly lower,SBP,DBP were significantly decreased (P <0.05).There was no significant differ-ence between Steward awakening score and modified OAA/S score at recovery and extubation time in two groups.Conclusion Dexmedetomidine replacing propofol can be safely used in laparoscopic chole-cystectomy with less hemodynamic changes during maintenance of anesthesia in elderly patients.

20 adult healthy rats were used for microelectropheretic delivery of horseradish peroxidase (HRP). The diameter of the tip of the glass electrode was around 20～50?. It was inserted into nucleus raphe magnus, 20% HRP was delivered microelectrophoretically(5 ?A for 30 min; 10 ?A for 10 min). In eight rats the microelectrode was withdrawn immediately after the delivery and in the rest it was removed 10～20 minutes after delivery. Afterward the animals were allowed to survive for 40 hrs before decapitation, except 2 for 20 and 2 for 60 hrs. The brains were dissected out for cryostat sections and DAB reaction for peroxidase.The tip of the electrode was located in the nucleus raphe magnus, at the level of nucleus facialis. The diameter of the brain tissues occupied by HRP at the points of microelectophoretic delivery was 0.2～0.4mm and the maximum reached 0.6～0.7mm. The exogenous HRP granules were not visible in the cases with electrodes withdrawn immeditely after delivery and in the survivors of 60 hrs. In most cases the electrodes were left inside for more than 10 minutes after the delivery. The exogenous HRP granules were large, coarse, brown, steroscopic and distributed evenly in the perikaryon of some neurons in several levels of the brain. Those in the axon and dentrite were distributed just like strings of pearls. There were much more neurons with exogenous HRP positive granules dispersed in the reticular formation of the medula oblongata, most of them were polydendritic. Small and fusiformed HRP-positive cells are observed occasionally in the gray substance of subventriculum, reticular formation pontis and ventrolateral side of locus coeruleus. Weaker reactions were found in a few cells in the periaquaductous gray substance of the midbrain, nucleus raphe centro-superior, substantia nigra pars compacta and in the area around the nucleus supraopticus. Besides no HRP-positive cells were discovered in thalamus and subcortex structure.There were two types of cells with HRP positive granules around some blood vessels in reticular formation and subventricular gray substance: One was a small protoplasmic astrocyte with broad cytoplasma, small nucleus, and thick, short and irregular processes and another kind was polydendritic neurons filling with brown positive granules in perikarya and cytoprocesses, in the latter, the HRP positive granules were arranged as strips of pearls.

Objective To explore the protective effects of polysaccharide from Panax japonicus on free fatty acid in different parts of hepatic cell injury. Methods Polysaccharide of Panax japonicus was prepared through different concentrations of ethanol precipitation and was named as 30%polysaccharide component (pc), 60% pc and 90% pc. Palmitic acid (PA) was used to induce a cellular model of steatosis in HepG2 cells in order to screen the intervention viability of polysaccharide of Panax japonicus. MTT method was used to detect cell viability, and Oil Red O staining was used to demonstrate steatosis. Total RNA was extracted to detect the expression level of the relevant genes. Results MTT results showed that the 30% pc significantly increased cell viability compared with the model group;Oil Red O staining showed that the number of intracellular lipid droplets was significantly reduced in the 30% pc compared with the model group;RT-PCR results showed that expressions of the endoplasmic reticulum stress-related gene glucoese-regulated protein, CCAAT enhancer binding protein homologous protein and TNF-αwere significantly lower in the 30% pc compared with the model group, and there was no significant difference compared with normal control group. Conclusion The 30%ethanol precipitation fraction of polysaccharide from Panax japonicus significantly reduced PA-induced steatosis in HepG2 cells. Its mechanism was possibly realized through intervention in endoplasmic reticulum stress-related response.

Objective To compare the toxicity and anti-inflammatory effect of total saponins from Panax japonicus by different extraction technology. Methods The total saponins of sample 1, sample 2, sample 3, sample 4, sample 5 and sample 6 was prepared respectively by different process, and RAW264.7 cells were treated with the samples of different concentration. Then cells morphology was observed under microscope, thiazolyl blue (MTT) method was used to detect cell activity, the nitric oxide (NO) release of RAW264.7 cells was detected with NO kit. Results The cell toxicity of different samples from low to high was as follows:sample 4sample 5>sample 2>sample 6>sample 1>sample 3. Conclusion Among these six different kinds of extraction process of total saponins from Panax japonicus, the total saponins extract by foam fractionation has not only the minimal toxicity, but also the best primary anti-inflammatory effect.