Objective To evaluate the value of lymphoscintigraphy in diagnosis of chylous ascites in children.Methods Lymphoscintigraphy was done in 6 cases,computed tomography(CT) was done in 4 cases,X-ray exam was done 42 times.And their video repore were compared.Results Lymphoscintigraphy was done in 6 cases,5 cases′ results were positive which diagnosed chylous ascites,and their leaking positions were also found.Conclusion Lymphoscintigraphy has the qualitative and orientational effect on diagnosis of children with chylous ascites.

Objective To evaluate the efficacy and safety of oxycodone hydrochloride for postoperative analgesia in patients who received spin surgery.Methods Sixty -nine patients treated with spin surgery were included in this study and randomly divided into treatment group ( n=34 ) and control group ( n=35).Half an hour before the end of operation ,the patients of the two group were given oxycodone hydrochloride and morphine 0.07 mg · kg-1 , respectively.After extubation , patient -controlled analgesia pump was given with the background dosage of 0.5 mg · h -1 and one time push 1 mg of oxycodone hydrochloride or morphine.The mean arterial pressure ( MAP) , and heart rate were com-pared in the time points of entering the operation room ( T0 ) ,tracheal in-tubation ( T1 ) , 5 min after tracheal intubation ( T2 ) , and 15 min after tra-cheal intubation(T3) between the two groups.The recovery time, extu-bation time ,visual analogue scale ( VAS) ,observer assessment of sedation ( OAA/S ) score and safety were compared between the two groups . Results The MAP and heart rate were not statistically different between the two groups and among the time points ( P>0.05 ).The recovery time , extubation time , VAS, OAA/S score in treatment group were significant lower than those of control group( P<0.05 ).The adverse drug reaction rates were 17.14%and 8.82% in the control group and treatment group respectively with statistical difference ( P<0.05 ).Conclusion Compared with morphine , oxycodone hydrochloride is more effective and safe for postoperative analgesia in patients who received spin surgery.

OBJECTIVETo evaluate clinical results of an interspinous stabilization system (Wallis) in treating lumbar degenerative disease in the short-term.

METHODSFrom August 2007 to June 2010,48 patients with lumbar degenerative disease who were treated with interspinous stabilization system, the data of patients were analyzed retrospectively. In all of the 48 cases, there were 30 males and 18 females with an average age of 54.2 years (ranged, 40 to 68 years). Forty-four cases were with single segment and 4 cases with two segments. Of them, 4 cases were in L3, 4, 40 cases were in L4, 5, 4 cases were in L3, 4 and L4, 5. The radiographic data of patients were analyzed. Clinical effects were evaluated by Japanese Orthopedic Association (JOA) score system and low back pain disability questionnaire (Oswestry) and Odom method.

RESULTSAll the patients were followed up from 1 to 2 years with an average of 18 months. According to Odom's criteria, 20 cases obtained excellent results, 24 good, 4 fair. JOA score increased from 12.4 +/- 2.7 preoperatively to 26.1 +/- 2.0 postoperatively (P < 0.01). Oswestry score decreased from 14.1 +/- 2.9 preoperatively to 5.5 +/- 1.8 postoperatively (P < 0.01). The posterior height of intervertebral space and height of nerve root canal increased compared with that of preperative height.

CONCLUSIONThe treatment of lumbar degenerative disease with interspinous stabilization system can obtain satisfactory effects in the near future. It can retain dynamic stable of corresponding segments, expand volume of vertebral canal, and is safe and feasible.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Degeneration ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Stenosis ; surgery

OBJECTIVETo explore the clinical effects of unilateral pedicle screw fixation and transforaminal lumbar interbody fusion (TLIF) through paraspinal muscle approach for recurrent lumbar disc herniation combined with lumbar instability.

METHODSA total of 35 patients with recurrent lumbar disc herniation combined with lumbar instability were treated between March 2008 and May 2010, including 15 patients managed by the paraspinal muscle approach with unilateral pedicle screw fixation and transforaminal lumbar interbody fusion (TLIF) (unilateral fixation group) and 20 patients by the posterior midline approach with bilateral pedicle screw fixation and posterior lumbar interbody fusion (bilateral fixation group). Operation time and intraoperative blood loss were observed, preoperative and postoperative JOA score and VAS score in low back pain and legs pain, the interbody fusion condition were compared between two groups.

RESULTSAll patients were followed up from 6 to 30 months with an average 16.8 months. All clinical symptoms had obviously improved postoperatively. X-rays showed good interbody fusion (only 1 case did not obtain fusion in bilateral fixation group) without cage displacement or settlement and implant loosening or breakage. There was significant difference in operation time and the intraoperative blood loss between two groups (P < 0.05). Postoperative JOA score had obviously decreased than preoperative one (P < 0.05). At 1 week after surgery, there was significant difference in VAS score of low back pain between two groups and there was no significant difference in VAS score of legs pain between two groups (P > 0.05); at final follow-up, there was no significant difference in VAS score of low back pain and legs pain between two groups (P > 0.05).

CONCLUSIONTwo methods both can obtain satisfactory effect in treating recurrent lumbar disc herniation combined with lumbar instability. Through the paraspinal muscle approach with unilateral pedicle screw fixation and TLIF has advantages of smaller surgical incision, shorter operation time, less intraoperative blood loss, faster relief in low back pain after operation, etc.

Aged ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; surgery ; Lumbar Vertebrae ; physiopathology ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Recurrence ; Spinal Fusion ; methods

Objective:To explore the clinical effects of unilateral pedicle screw fixation and transforaminal lumbar inter-body fusion (TLIF) through paraspinal muscle approach for recurrent lumbar disc herniation combined with lumbar instability. Methods:A total of 35 patients with recurrent lumbar disc herniation combined with lumbar instability were treated between March 2008 and May 2010,including 15 patients managed by the paraspinal muscle approach with unilateral pedicle screw fixation and transforaminal lumbar interbody fusion (TLIF) (unilateral fixation group) and 20 patients by the posterior midline approach with bilateral pedicle screw fixation and posterior lumbar interbody fusion (bilateral fixation group). Operation time and intraoperative blood loss were observed ,preoperative and postoperative JOA score and VAS score in low back pain and legs pain,the interbody fusion condition were compared between two groups. Results:All patients were followed up from 6 to 30 months with an average 16.8 months. All clinical symptoms had obviously improved postoperatively. X rays showed good in-terbody fusion (only 1 case did not obtain fusion in bilateral fixation group ) without cage displacement or settlement and im-plant loosening or breakage. There was significant difference in operation time and the intraoperative blood loss between two groups (P<0.05). Postoperative JOA score had obviously decreased than preoperative one (P<0.05). At 1 week after surgery, there was significant difference in VAS score of low back pain between two groups and there was no significant difference in VAS score of legs pain between two groups (P>0.05);at final follow up,there was no significant difference in VAS score of low back pain and legs pain between two groups (P>0.05). Conclusion:Two methods both can obtain satisfactory effect in treating recurrent lumbar disc herniation combined with lumbar instability. Through the paraspinal muscle approach with unilateral pedicle screw fixation and TLIF has advantages of smaller surgical incision,shorter operation time,less intraoperative blood loss,faster relief in low back pain after operation,etc.

BACKGROUNDBlood transfusion has been found to be a devastating factor for outcomes of hepatectomy. This study was to assess the value of major hepatectomy without blood transfusion.

METHODSWe retrospectively studied 51 patients who had undergone major hepatectomy without blood transfusion, including 29 patients with primary liver cancer, from August 1997 to December 2000. Sixty patients undergoing major hepatectomy with blood transfusion including 48 patients with primary liver cancer served as controls. Hepatectomy was performed through normothermic interruption of the porta hepatis. Intraoperative ultrasonography was performed to define tumor margins, and an ultrasound dissector was used to dissect liver parenchyma.

RESULTSIn the study group, the operative mortality and morbidity and 1-, 2-, and 3-year recurrence rates were 0%, 9.8%, 24.1%, 27.6% and 31.0%, respectively. In the control group, they were 3.3%, 28.3%, 43.5%, 54.3% and 58.7%, respectively. Significant differences were seen in morbidity and recurrence rates of patients with liver cancer between the two groups (P < 0.05).

CONCLUSIONMajor hepatectomy without blood transfusion can reduce postoperative morbidity and recurrence rate of patients with liver cancer.

Adult ; Aged ; Blood Transfusion ; Female ; Hepatectomy ; methods ; mortality ; Humans ; Liver Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; prevention & control

Adult ; Aged ; Aneurysm ; diagnosis ; pathology ; Computed Tomography Angiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Splenic Artery ; pathology

Objective To investigate the protective effect of Echinococcus granulosus hydatid cyst fluid protein (HCFP) on ovalbumin (OVA)-induced allergic rhinitis (AR) in mice. Methods Twenty-four BALB/c mice at ages of 8 to 10 weeks, each weighing approximately 20 g, were randomly divided into four groups, including groups A (blank control group), B (blank intervention group), C (AR model group) and D (AR+HCFP intervention group), with 6 mice in each group. On days 0, 2, 4, 6, 8, 10 and 12, mice in groups A, B, C and D were injected with 200 μL sterile phosphate buffered saline (PBS), 200 μL sterile PBS containing 20 μg HCFP, 200 μL sterile PBS containing 50 μg OVA and 5 mg Al(OH)₃ gel, and 200 μL sterile PBS containing 50 μg OVA, 5 mg Al(OH)₃ gel and 20 μg HCFP, respectively. On days 14 to 20, mice in groups A, B, C and D were administered with 40 μL sterile PBS, 40 μL sterile PBS containing 20 μg HCFP, 40 μL sterile PBS containing 2 mg OVA and 40 μL sterile PBS containing 2 mg OVA and 20 μL HCFP by nasal drop, respectively. Mouse behavioral changes were observed and behavioral scores were estimated. The serum levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), IL-5, IL-10, transforming growth factor-β (TGF-β) and OVA-specific IgE antibody (OVA-sIgE) were measured using enzyme-linked immunosorbent assay (ELISA), and the pathological changes of mouse nasal mucosa were observed by hematoxylin and eosin (HE) staining. Results The mean behavioral score was significantly greater in Group C (6.83 ± 0.50) than in groups A (1.17 ± 0.52) and B (1.33 ± 0.52) (P < 0.05), while a lower mean behavioral score was estimated in Group D (3.50 ± 0.50) than in Group C (P < 0.05). There were significant differences among the groups in terms of serum IFN-γ (F = 4.08, P < 0.05), IL-4 (F = 275.90, P < 0.05), IL-5 (F = 96.82, P < 0.05), IL-10 (F = 77.67, P < 0.05), TGF-β (F = 9.98, P < 0.05) and OVA-sIgE levels (F = 44.69, P < 0.05). The serum IFN-γ level was significantly lower in Group C than in groups A, B and C (P < 0.05), and the serum levels of IL-4, IL-5 and OVA-sIgE were significantly higher in Group C than in groups A, B and C (P < 0.05), while the serum IL-10 and TGF-β levels were significantly greater in Group D than in Group C (P < 0.05). Microscopy showed apparent loss of nasal mucosa cilia, increased number and enlargement of goblet cells, interstitial edema and submucous vascular dilation in Group C, while the pathological changes of nasal mucosa were alleviated in Group D relative to Group C. Conclusions E. granulosus HCFP has a protective activity against OVA-induced allergic rhinitis in mice.