Objective To explore rational operative methods to treat hyperextension injuries of cervical spine. Methods 47 cases of hyperextension injury of cervical spine were treated in our department from September, 2000 to October, 2004. They were followed up and analyzed retrospectively. According to the operative methods, there were 3 groups: anterior approach, posterior approach, combined approach. Their therapeutic effects were compared respectively. Results After follow- ups for 6 to 12 months, preoperative and postoperative Frankel classifications and ASIA (American Spinal Injury Association) grades were compared between the 3 groups. It was found that neural function improved significantly in the 3 groups after operation. The anterior approach and combined approach groups had significantly better outcome in neural function than the posterior approach group ( P0.05) . Conclusions Anterior decompression- graft- internal fixation is the preferred consideration to treat hyperextension injury of cervical spine, and the posterior approach is only the secondary choice. The combined approach should be carefully selected under appropriate conditions

Transarterial chemoembolization (TACE) is the standard treatment of unresectable hepatocellular carcinoma (HCC).However,high incidence of metastasis following TACE has much negative influence on patient survival.In this article,we reviewed negative influence of TACE on biological behavior of residual HCC cells to provide evidence for further application of TACE.

Objective To evaluate the modified POSSUM surgical scoring system in urologic surgery patients over 70. Methods 180 patients over 70 were retrospectively analyzed with the mo dified POSSUM surgical scoring system.A comparison between the observed and the predicted morbidity was made. Results In the complication group and noncomplication group,the mean age of the patients were 74.9?4.1 and 74.7?3.6,the mean length of stay were (42.1?4.2)d and (28.7? 14.2 )d,respectively.In the complication group,both the physiological scores and the operative severity scores of POSSUM scoring system were significantly higher than the no complication group ( 22.0 ? 4.1 vs 20.1?3.9 in pysiological score and 11.7?4.3 vs 10.3?3.5 in operative severity score, P

Objective To explore the causes,clinical manifestations,diagnosis and treatment method of femoral artery pseudoaneurysms (IFPSA) after ultrasound-guided percutaneous coronary intervention.Methods Ultrasound-guided repair by compression was applied to all cases,of which the failed cases were treated with ultrasound-guided thrombin injection.Results IFPSA was confirmed by ultrasound imaging in 39 cases,18 of which were cured by compression repair,with the average compression duration of (36.78 ± 1.71 )min.Another 21 cases were cured by the thrombin injection,after compression repair failed,with average time for thrombosis (0.33 ± 0.06 )min.All the patients were re-evaluated by ultrasound 24 h after treatment,confirming the successful closure of the pseudoaneurysms.No recurrence of pseudoaneurysm was observed during a half-year post-operative follow-up.Conclusion Ultrasound-guided compression repair and ultrasound-guided thrombin injection into the cavity are safe and effective treatments for femoral arterial pseudoaneurysms after coronary intervention.

Objective To investigate the clinical application of pulse indicator continuous cardiac output (PICCO) target oriented role monitoring technique on hemodynamics in patients with intractable heart failure.Methods Eighteen patients with intractable heart failure were selected as control group and received regular treatment including internal medicine under monitoring by central venous pressure.Another 18 patients with refractory heart failure were selected as PICCO group and given the internal medicine under PICCO monitoring.Intrathoracic blood volume index(ITBVI),global end diastolic volume index(GEDVI),extravascular lung water index (EVLWI),cardiac index (CFI),N-terminal B type natriuretic peptide precursor(NT-proBNP) and left ventricular ejection fraction(LVEF) were recorded.The data including mortality rate,ventilation time,intensive care time,APACHE Ⅱ score and the re-hospitalization rate were also record at 28th day.Results Compared with before treatment,ITBVI,GEDVI,EVLWI in PICCO group were (1 282.6 ± 196.4) ml/m2,(1 026.8 ±92.1) ml/m2,(12.9 ± 5.5) ml/kg respectively,significant different from that before treatment ((907.4±78.3) ml/m2,t =8.75,P =0.001; (715.2 ±61.8) ml/m2,t =6.48,P =0.003; (6.5 ± 1.2)ml/kg),t =2.94,P =0.033) and they are all back to normal level.The indices of CFI,NT-proBNP,LVEF in PICCO group were improved than before treatment (CFI:(3.1 ±0.5) L/min vs.(4.8 ± 1.3) L/min,t =2.56,P=0.042) ;NT-proBNP:(6 438.3 ±249.5) ng/L vs.(1 371.6 ±87.5) ng/L,t =5.12,P =0.019) ;LVEF:(26.9±3.1)％ vs.(54.3 ±2.5)％,t =2.62,P =0.040)).Mortality at 28th D in PICCO group was 16.7％,lower than that of control group (33.3％,x2 =4.99,P =0.026).The indices of assisted ventilation time,intensive care time,APACHE score of lⅡ and the rehospitalization ratein PICCO group were better than that of the control group ((8.5 ±2.3) dvs.(3.2±0.8) d,t=24.31,P＜0.05;(14.9±2.3) dvs.(8.3 ±2.0)d,t=12.26,P=0.002;(23.4±1.3) vs.(14.7±1.6),t=9.52,P=0.011;38.9％ vs.11.1％; t=5.79,P =0.020).Conclusion PICCO provides effective guidance for intractable heart failure patients hemodynamic monitoring of goal orientation.

Affiliated Hospital. Second Military Medical College. ShanghaiForty-two cases of chronic subdural hematoma were treated by irrigation and drainage. Symptoms of elevated intracranial -pressure, localizing neurologic signs and cerebral angiography established the diagnosis. Operative treatment consisted of evacuation of the hematoma by repeated irrigation through burr holes made on the frontal and parietal side of the hematoma. A plastic tube was placed through the parietal hole for continuous drainage for three to four days. The above mentioned treatment is simple to perform and rather safe even for the senile and debilitated patients. Among 44 patients all 19 preoperatively unconscious patients regained consciousness postoperatively. Twenty-three cases were followed up from one to seventeen years. All patients recovered completely without recurrence of hema-toma or epilepsy, except one patient who is still having hemiparesis at present.

Objective To study the expression of E2F-3 and pRb in primary prostate cancer(PCa) and its clinical significance.Methods The expression of E2F-3 protein and pRb was detected in 49 PCa,20 benign prostatic hyperplasia(BPH),10 normal prostate tissues(NP) by EliVision~(TM) plus immunohistochemical staining.Results The positive expression rate of E2F-3 in PCa,BPH,NP was 63.27%(31/49),20%((4/20)) and 10%(1/10),respectively.The expression level of E2F-3 in PCa was significantly higher than that in BPH(P

Objective To discuss the value of combination of various clinical laboratory methods in the diagnosis of Mycobacteri-um tuberculosis(MTB) .Methods T-SPOT .TB ,sputum smear ,sputum culture ,and MTB-DNA detection were used to detect MTB .The sensitivity ,specificity ,rate of missed diagnosis ,coincidence rate and correct diagnosis index for tuberculosis diagnosis of the four methods and their pairwise combinations were analyzed and compared .Results Comparing with other methods ,T-SPOT . TB combined with MTB-DNA detection had the highest sensitivity ,coincidence rate and correct diagnosis index ,and the lowest rate of missed diagnosis ,with significant difference(P<0 .05) .Conclusion T-SPOT .TB combined with MTB-DNA detection could be used as an adjuvant method for the early diagnosis of tuberculosis .

BACKGROUND:It has been recently indicated that nervous factors are able to adjust and dominate bone fracture healing. Type Ⅰ collagen is a major factor to promote the differentiation of osteoblasts and enhance the adhesion of osteoblasts; while, it is also a matrix protein for composing bone framework. Type Ⅱ collagen is derived from chondrocytes. OBJECTIVE: To study changing law of type Ⅰ and Ⅱ collagen expression during denervated bone fracture healing. DESIGN, TIME AND SETTING: Randomized controlled anima study was performed at the Animal Laboratory and Cell Biology Laboratory, the Second Military Medical University of Chinese PLA between May and December 2005. MATERIALS: Forty 3-month-year healthy male SD rats were randomly divided into fracture group (tibial fracture alone) and combination group (spinal cord injury combined with tibial fracture), with 20 rats at each group. METHODS: A φ 0.8 mm Kirschner wire was inserted into anterior border of left tibial plateau to establish tibial fracture models in the fracture group. A 0.3-cm spinal cord transection was cut at T10 segment to establish tibial fracture models with entire spinal cord injury. MAIN OUTCOME MEASRUES: Type Ⅰ and Ⅱ collagen protein expressions of callus were detected using Western blot technique in week 1, 2, 4, and 5 post-injury. RESULTS: One week after injury, type Ⅰ and Ⅱ collagen was represented in callus in the two groups, while the expressions in the combination group were significantly higher than fracture group (P<0.05); two weeks after injury, type Ⅱ collagen expression reached at the peak in the combination group, and the expression was significantly higher than the fracture group (P<0.05); four weeks after injury, type Ⅰ collagen expression reached at the peak in the fracture group, and the expression was significantly higher than the combination group (P<0.05), while type Ⅱ collagen still highly expressed in the combination group; five weeks after injury, type Ⅰ and Ⅱ collagen expressions were decreased in the two groups. CONCLUSION: Secretory law of type Ⅰ and Ⅱ collagen during denervated bone fracture healing is similar to normal bone fracture healing; however, the differences at time points, in particular expression at peak, are remarkable between them.

BACKGROUND: Increased expression of survivin in various tumor tissues can regulate cell proliferation, division, and plays an important role in protecting cells from apoptosis.OBJECTIVE: To construct the specific micro RNA (miRNA) expression vector that can block the C_(57)BL mice survivin gene by RNA interference (RNAi) technique.DESIGN, TIME AND SETTING: The single sample observation was performed at the experimental center of Department of Neurology, The First Afliliated Hospital of Chongqing Medical University from June to November 2008.MATERIALS: Ring-shaped pcDNA~(TM)6.2-GW/EmGFPmiR and BLOCK-iT~(TM) Pol II miR RNA interfered Expression Vector Kit with EmGFP was produced by Invitrogen Company. DH5a E. coli was preserved at the laboratory. Xho I and BamH I enzyme, spectinomycin were provided by Shanghai Sangon Biological Engineering Technology & Services Co., Ltd.METHODS: According to sequence of mRNA of C_(57)BL mice survivin provided by Genebank, four pairs of specific oligonucleotide sequences were designed and synthesized by using the software. The annealed oligonucleotide fragment was sub-cloned into pcDNA~(TM)6.2-GW/EmGFPmiR expression vector by gene clone technique and transformed into DH5a E. coli, subsequently, a single colony was incubated into liquid medium containing spectionmycin. Finally the plasmid was extracted.MAIN OUTCOME MEASURES: The recombinant vector was identified by sequencing and agarose gel electrophoresis.RESULTS: The sequencing revealed that insertion element was correctly cloned into the vector without nucleotide mutation, absence or insertion abnormality. The result of double enzyme digestion demonstrated that the fragment length was coincidence with expectation.CONCLUSION: The C_(57)BL mice survivin miRNA expression vector is successfully constructed.