Objective To evaluate the clinical effect of neuromatosis scoliosis treated by vascularized grafted rib Method The clinical date of 16 cases of neuromatosis scoliosis treated by surgical operation were analysed retrospectively Result Sixteen patients with scolisis caused by neurofibromatosis were treated by this technique The clinical result was satisfactory and solid fusion was observed in all patients within 6 months after operation Conclusion This operation is an effective method for the treatment of neuromatosis scoliosis

Objective:To investigate the prognosis of patients with liver metastasis or local recurrence after radical resection of rectal cancer,in order to provide reference for the further screening of high-risk patients for the precise therapeutic methods.Methods:The clinicopathological factor and follow-up data of 485 patients who underwent surgical treatment for rectal cancer from March 2005 to January 2016 were retrospectively analyzed.Including 75 liver metastasis and 32 local recurrence.The prognosis were compared between the patients with liver metastasis and with local recurrence.Results:The difference was statistically significant in CEA level,primary tumor position,surgical methods,tumor cell differentiation,tumor infiltration depth between liver metastasis and local recurrence after radical resection of rectal cancer (P＜0.05).The 1-,3-and 5-year overall survival rates were 76.6％,53.1％ and 18.8％ respectively of patients with liver metastasis,The 1-,3-and 5-year overall survival rates were 81.3％,62.5％ and 37.5％ respectively of patients with local recurrence,the difference was statistically significant(P＜0.05).Conclusion:There were different clinicopathological characteristics of patients between liver metastasis and local recurrence.The prognosis of patients with local recurrence was better than patients with liver metastasis.

Objective To compare total gastrectomy jejunal loop P-type esophagus jejunum Roux-en-Y anastomosis(PRY) and non-type esophageal transection of the jejunum improved Roux-en-Y anastomosis(URY) two different digestion Road reconstruction on the nutritional status of patients and gastrointestinal symptoms. Methods 152patients with total gastrectomy required of gastric cancer patients immediately divided into two groups ,76 patients in each group ,respectively PRY and URY surgical reconstruction of digestive tract, were followed up for 12 months, two groups were compared on nutritional status and gastrointestinal symptoms. Results PRY operation time and postoperative complication rate we re more than URY group(all P ＜0.05) ;two groups 12 months after the mortality and weight changes, hemoglobin, total protein, albumin, and all reflux esophagitis the incidence rate was no significant difference (all P ＞ 0.05); after 3 months and 6 months in both groups food intake ＜ 300ml/second person, eating frequency ＞5 times/d and the difference in the incidence of RSS had statistical significance (all P ＜ 0.05). Conclusion URY surgical reconstruction of digestive tract and maintain the continuity of muscle conduction,and the surgical procedure was simple,a good prognosis and relatively PRY more reasonable in terms of surgical procedures.

Objective To study the antitumor effects on human prostate cancer cell lines of a traditional Chinese medicine named atractylodes macrocephala koidz volatile oil in vitro.Methods LNCaP and DU145 cell lines were normally cultured and were divided into 4 control groups including:Blank culture without serum and without cell (group A),Blank culture with serum but without cell (group B),LNCaP cell culture with serum (group C),DU145 cell culture with serum (group D).In the meanwhile,there were 6 experimental groups:adding 50 μg/ml of atractylodes macrocephala koidz volatile oil in culture of group C1 and group D1,250ug/ml in group C2 and group D2,and 500ug/ml in group C3 and group D3.All of the 10 groups were simultaneously cultured in 24-well-plates for 48 hrs,and each group was repeatedly studied for three times.Forty-eight hours later,every 2 × 106 cells of LNCaP or DU145 was seeded into each well and atractylodes macrocephala koidz volatile oil was added in 6 experimental groups,and saline water was added into 4 control groups.Another 48 hrs later,the culture solutions of the 10 groups were separately collected for testosterone (T),estradiol (E2),progesterone (P),vascular endothelial growth factor (VEGF),basic fibroblast growth factor (b-FGF),total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) analysis with enzyme-linked immunoassay kits.The experiment was repeated for 3 times,and the mean data were statistically analyzed by SPSS One-way ANOVA.Results The growth of cultured cells was found to have been effectively inhibited in group C1 and group D2.The inhibition severity of LNCaP cells was positively related with the drug concentration and time,while DU145 cells could only be highly inhibited (60.96％) after 24hrs drug treatments.In group C and group D,we found that both T were in very low level (0 ng/ml) whereas both E2 were in high levels (269 pg/ml and 239.81 pg/ml,P ＜ 0.05),no distinct differences showed in P; In addition,VEGF,b-FGF and fPSA were all in high values,whose values were 102.96 pg/ml and 1763.40 pg/ml,0.26 ng/ml and 6.41 ng/ml,0.16 ng/ml and 0.44 ng/ml,respectively; DU145 cells had higher values than LNCaP cells (P ＜ 0.05).As regard to the 6 experimental groups,in the groups C1,C2,C3 and D3,we found that T had been unexpectedly increased from 0 to 0.37 ng/ml (P ＜ 0.05),E2 continuously elevated from 239.81 pg/ml to 649.90 pg/ml (P ＜0.05),surprisingly P were also increased from 0.98 ng/ml to 9.83 ng/ml (P ＜0.01).On the contrary,VEGF,b-FGF and fPSA levels were all graduallydecreased,dropping down to 47.79 pg/ml and 59.56pg/ml,0 and 1.79 ng/ml,0 and 0.11 ng/ml,respectively; nevertheless,in group C2 and group D2,fPSA values were surprisingly increased from 0 and 0.04 ng/ml up to 1.78 ng/ml and 0.23 ng/ml respectively.Conclusions Atractylodes macrocephala koidz volatile oil has certain anti-tumor effects on human prostate cancer.Compared with LNCaP cells,DU145 cells have many different characteristics in sex hormone,cytokine and PSA expressions.

Objective To investigate the efficacy and safety of microsurgery for trigeminal neuralgia (TN) in elderly patients.Methods Totally 143 patients with intractable primary TN who received microsurgery were retrospectively analyzed.There were 92 cases in the elderly group with age of 65-82 years,and the other 51 cases in control group with age of 40-62 years.All the patients in both groups were classified as American Society of Anesthesiologists (ASA) Scale Grade 1 to 3.After suboccipital retrosigmoid craniotomy,microvascular decompression (MVD) was performed in 136patients and partial sensory trigeminal rhizotomy in 7 patients.The complications and efficacy were compared between the two groups.Results 87 cases in the elderly group and 49 cases in control group underwent MVD procedure,complete and part pain relief were achieved in 78 cases and 9 cases in the elderly group,45 cases and 4 cases in control group,respectively.After an average follow-up period of 2.6 and 2.1 years,4 cases (5.1％) among 79 follow-up cases and 3 cases (6.5％) among 46follow-up cases experienced TN recurrences in the elderly and control groups,respectively.No statistically significant differences existed in the efficacy and recurrence rate between the two groups (P＞0.05).There were 3 cases with aseptic meningitis,1 cases with hearing decrease,1 case with cerebrospinal fluid leakage,1 case with pulmonary infection and 1 cases with deliration in the elderlygroup,meanwhile,1 cases with aseptic meningitis,1 case with tinnitus and 1 case with cerebrospinal fluid leakage after surgery in control group (P＞0.05).No facial hypoesthesia appeared in the patients receiving MVD.5 cases in the elderly and 2 cases in control group underwent partial trigeminal rhizotomy with facial hypoesthesia,but the pain released,and no recurrence was found.There were no dead cases in both groups.Conclusions With cautious and proper treatment,microsurgical procedure can be performed safely and effectively in the elderly TN.

Objective To compare the treatment effect between Duply combined with Duckett and Koyanagi surgical methods in severe hypospadias.Methods Forty-two cases of severe hypospadias were divided into two groups according to the surgical method,23 cases was enrolled in Duply combined with Duckett group while 19 cases in Koyanagi group.The operation time,the incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion were compared.Results The operation time between two groups had no significant difference (P ＞ 0.05).The incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion between two groups had no significant difference (x2 =0.04,0.31,0.03,1.16,P ＞ 0.05).The total incidence rate of complications between Duply combined with Duckett group and Koyanagi group had significant difference [69.6％ (16/23) vs.6/19] (x2 =4.59,P ＜ 0.05).Conclusion Each of the two methods can be a choice in treatment of severe hypospadias.

Objective To analyze the clinical manifestations,diagnosis and treatment of cerebral amyloid angiopathy (CAA) associated intracerebral hemorrhage.Methods The clinical manifestations,treatment and prognosis of CAA associated intracerebral hemorrhage were analyzed in 4 patients who were identified as CAA-related hemorrhage (CAAH) by pathology.Results All of the 4 patients showed massive lobar intracranial hemorrhage,and underwent craniotomy evacuation of hematoma.One patient had postoperative hemorrhage,and 2 patients were treated with recombinant activated factor Ⅶ after operation.In the next 6 months,re-hemorrhage was found in 3 patients in whom one patient died due to massive hemorrhage.Conclusions CAAH has varied clinical manifestations with high risk of cerebral hemorrhage,and pathological diagnosis is necessary for a definite diagnosis.The very elderly patients with CAAH can benefit from the craniotomy evacuation of hematoma.Although surgery for massive hemorrhage has risks in very elderly patients,it is a better treatment to save their lives.

Objective To explore the diagnosis, treatment strategies and clinical outcomes of spontaneous subarachnoid hemorrhage in elderly patients. Methods A total of 68 patients aged over 60 years presenting with spontaneous subarachnoid hemorrhage underwent cerebral angiography. And 72 intracranial aneurysms were detected in 60 patients, among whom 47 patients with 59 aneurysms underwent endovascular coil embolization, 6 aneurysms in 6 patients were clipped in microneurosurgery operation, and 7 patients chose conservative treatment. Results A total of 57 aneurysms (96.6%) were embolized successfully, among which 40 aneurysms (70.2%) reached dense occlusion and 17 aneurysms (29.8%) reached incomplete occlusion. Among 47 patients undergoing endovascular treatment, 39 patients (83.0%) were evaluated as good, 7 patients (14.9%) were moderately to seriously disabled according to Glasgow Outcome Scale when they were discharged, and one patient died. Conclusions Active treatment such as endovascular coil embolization can acquire good outcome in elderly patients with spontaneous subarachnoid hemorrhage, especially in elderly patients detected with aneurysms.

Objective To compare the characteristics of dose distribution between hypofractionated intensity modulated radiotherapy (IMRT) and hypofractionated stereotactic radiotherapy (SRT) plans in lung tumor and to select an optimal clinical approach. Methods SRT plans were designed for 16 patients with lung tumors who had received IMRT between April 2007 and April 2008. The dose distribution of target volume and normal tissues, conformal index (CI) and heteregenous index (HI) were analyzed using the dose-volume histogram (DVH) for the IMRT and SRT plans. Results The mean dose and equivalent uni-form dose of planning target volume (PTV) in IMRT were similar to those in SRT. SRT had significantly better CI and HI than IMRT (t = 2.77, P < 0.05 and t = - 4.38, P < 0.01 ). The mean lung dose of IMRT and SRT was (492.4 ±368.5) cGy and ( 310.0 ± 73.1 ) cGy, respectively ( t = 1.68, P > 0.05 ). The lung V20 of IMRT and SRT was 6.9% ± 2.1% and 4.2%± 1.9%, respectively ( t = 3.30, P < 0.01 ). No sig-nificant differences were found in the mean dose to the heart or the spinal cord between IMRT and SRT. Conclusions When PTV is less than 57 cm3 or the long diameter of tumor is less than 4.7 cm, hypofrac-tionated SRT has similar dose distribution to hypofractionated IMRT, while the lung dose was lower in the former.

Objective To reduce the screening positive rate (SPR) and improve clinical efficiency of maternal serum screening for Down's syndrome.Methods Nine thousand and thirty-three cases of second trimester maternal serum screening for Down's syndrome were included from Apr.2013 to Apr.2014 in the present study.The screening results,all basic data and equation curves were analyzed retrospectively.Based on the data from the authors' laboratory,the important adjustment parameters were simulated.Combined with postnatal follow-up results,the quality and clinical performance of second trimester serum screening for Down's syndrome were evaluated.Results The SPR of second trimester serum screening for Down's syndrome was 6.69％(604/9033),the detection rate (DR) was 75％(3/4),and FPR was 6.65％(601/9033).The median multiple of median (MOM) of alpha-fetoprotein (AFP) was low and SPR was high,and MOM of free human chorionic gonadotropin β subunit (free hCGβ) were high and SPR was high,while MOM of unconjugated estriol (uE3) were a little bit low,and SPR was slightly high.Considering these three factors,it is believed that the screening positive rate is high.By the simulation adjustments of MOM value equations (AFP and free hCGβ) and weight correction equation,the SPR reduced to 4.11％(371/9033) after recalculating the risk,FPR declined to 4.07％(368/9033),and no more Down's syndrome fetus were missed compared with postnatal follow-up results.Conclusion Based on a localized setting depending on the local laboratory data,we suggest that the MOM value distributions(AFP,free hCGβ and uE3) and maternal weight should be regularly adjusted since it is a useful way to reduce the false-positive rate and improve clinical efficiency of maternal serum screening for Down's syndrome.