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

Liver transplantation,as a new treatment for terminal-stage liver diseases,has made remarkable strides in the past decades.Animal models play an essential part in liver transplantation research,but differ from one another and have different limits to be used in imitating human clinical conditions.Therefore,it is the base for the development of liver transplantation to build and improve animal models by correctly selecting and utilizing different characteristics of different animals.

OBJECTIVE:To provide reference for the implementation of national essential drugs system. METHODS:Based on the experience on the implementation of national essential drugs system in the past year,relevant policies about essential drugs system were analyzed to probe into several issues on its implementation. RESULTS & CONCLUSION:The legal place of National essential drugs system should be further confirmed and qualification authentication of pharmaceutical enterprises involved in bidding for essential drugs list need to be standardized. Subject and proportion of essential drug use must be ensured as well as the supply of essential drugs to make sure the implementation of national essential drugs system.

ObjectiveTo set up the porcine combined liver/small bowel orthotopic allotransplantation model.MethodThe donors including liver, about 2 to 3?m proximal jejunum, duodenum and a sma ll part of pancreas head were transplanted to the hybridized long-white recipie nt pigs after the resection of their livers and the majority of small bowels.ResultWithout using immunosuppressive drugs, the median survival time of the animals w as 92?h with the longest survival time being 196?h, and there was about 75?% of the animals lived for more than 24?h after operation.ConclusionThe successful establishment of the combined liver/small bowel transplantation m odel will do great favor to our future clinical practice and further study of th e combined liver/small bowel transplantation.

To compare the chemical change of Paeoniae Radix Alba (PRA) after vinegar-baking processing, as well as the effect of vinegar types exerted on the processing, 1H NMR-based metabolomic approach combined with multivariate statistical analysis was used to investigate the different metabolites between the raw and two vinegar-baked PRA. More than thirty metabolites were identified in the 1H NMR spectrum of PRA, and the multivariate statistical analysis showed that raw and two vinegar-baked PRA could be separated obviously. After vinegar-baking, the contents of isoleucine, lactate, alanine, arginine, albiflorin, and 5-hydroxymethyl furfural (5-HMF) elevated, while those of sucrose, paeoniflorin and its analogues (calculated by benzoate) decreased. The chemical compositions of two vinegar-baked PRA were also different. Shanxi vinegar- baked PRA showed higher levels of leucine, isoleucine, valine, and albiflorin, while rice vinegar-baked PRA contained more sucrose and paeoniflorin's analogues (calculated by benzoate). And the chemical changes in Shanxi vinegar-baked PRA were greater than those of rice vinegar-baked PRA. The results revealed the chemical differences between raw and vinegar-baked PRA, as well as the influence of vinegar type on processing, in a holistic manner, the results obtained suggested that the correlations between the chemical change and the drug action after processing, as well as the vinegar type used in processing, should be further studied.

Objective To evaluate the predictive value of serum macrophage migration inhibitory factor (MIF) for myocardial depression in severe sepsis patients.Methods Taken prospective study method,42 cases of severe sepsis patients were enrolled from December 2011 to June 2013.The patients were monitored by PICCO system after informing consent into ICU day,and given the corresponding treatment.According to the hemodynamic parameters were divided into two groups,myocardial depression group:cardiac index ＜ 3 L/(min· m2) and global end diastolic volume index ＞ 800 ml/m2,the remaining were in non myocardial depression group,and the patients were divided into survival group and death group according to 28-d mortality.Hemodynamic parameters and serum MIF,B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) level at the 1st,3rd,Sth day after admission.Results Fortty-two severe sepsis patients,non myocardial depression in 22 cases (non myocardial depression group),myocardial suppression in 20 cases (myocardial depression group).At 28 d,20 patients of survival (survival group),22 patients of death (death group).The serum MIF in death group was higher than that in survival group at the 1st,3rd,5th day (P ＜ 0.01) ; BNP and cTnI at the 1st day in two groups had no statistical significance (P ＞0.05),BNP and cTnI at the 3rd,5th day in death group was higher than that in survival group(P ＜ 0.01).The serum MIF at each time point in myocardial depression group was higher than that in non myocardial depression group [survival:8.70(3.53,16.80) μ g/L vs.1.20(0.80,1.77) μ g/L,2.30(1.33,8.40) μ g/L vs.0.60 (0.60,0.99) μg/L,0.50 (0.31,2.50) μg/Lvs.0.16 (0.15,0.20) μg/L;death:11.43(8.10,17.16) μ g/L vs.2.30(1.96,3.69) μ g/L,9.70(6.55,14.65) μ g/L vs.1.90(1.88,5.27) μ g/L,7.50(5.15,14.20)μ g/L vs.2.40(0.80,8.46) μ g/L] (P ＜ 0.05).The serum MIF of death patients in two groups was higher than that of survival patients (P ＜ 0.05).MIF at the 5th day had biggest prediction value,AUC was 0.952,when the cut-off point of 0.65 μg/L,the sensitivity was 100％ (22/22) and specificity was 85％ (17/20).Multivariable Logistic regression analysis results showed that only APACHE Ⅱ scores was the independent risk factor for 28-d mortality (P ＜ 0.01),while MIF couldn' t independent forecast 28-d mortality (P ＞ 0.05).Conclusions Elevation of serum MIF prompts severe sepsis patient with poor outcome,and dynamic changes of MIF is helpful to evaluate the prognosis and severity of severe sepsis patients with myocardial depression,but MIF is not an independent risk factor for predicting 28-d mortality.

Objective To study the clinical outcome of thoracolumbar fractures treated by ante rior route decompression,bone-graft-fusion and internal fixation.Methods 51cases of thoracolumbar fractures from Jun1994to Mar 2002were treated by anterior route decompression,bone-graft-fusion and internal fixation,of w hich32cases by Kaneda system and 19cases by Z-Plate system.Their clinical data were analyzed.Results The patients were followed up from five months to eight years(average of 3.5years).45cases had a good anatomic reduction and maintain thoracic-lu mbar lordosis.48cases gained one to three Frankel grades of neurologic r e-covery as a consequence of operation.Conclusion Kaneda internal fixation has the characteristics of low cost,neurological decompression and reliable fixation;and Z-Plate systems has the advantages of simple manipul ation,intrinsic stability,less complications and good biocompatibility.

Objective To investigate the difficulties in posterior approach lumbar microendoscopic discectomy (MED). Methods We retrospectively analyzed records of 42 cases of lumbar disc protrusion (totally 45 interspaces) treated by MED from February 2002 to October 2003. Results Conversion to open surgery was required in 3 cases.No intra- or post- operative complications were seen.Follow-up survey for 2 ～ 22 months (mean,8 months) found the "good" or "excellent" results in 95 2% of the patients (40/42).Surgical difficulties were mainly classified into two aspects: technical and etiological,including 8 cases of failure of collimation between the passage and the interspace,5 cases of excessive bleeding disturbing the operation,3 cases of incomplete surgical apparatus,2 cases of incorrect passage localization,2 cases of hyperplasia in tiny joints,1 case of ossification of the posterior longitudinal ligament,1 case of nerve root edema,1 case of accretion,and 1 case of laceration,respectively. Conclusions Treatment of lumbar disc protrusion with MED gives satisfactory efficacy.Proper selection of patients and careful performance during surgery are essential to a successful procedure.

Objective:To study the expression of extracellular matrix metalloproteinase (MMP-9) inducer CD147 and MMP-9 protein in hepatocellular carcinoma (HCC) and explore their correlation with invasion, metastasis, and prognosis of HCC.Methods:SP immunohistochemistry was used to evaluate the expression of CD147 and MMP-9 in 83 HCC tissues and 15 normal liver tissues. Results:The positive rate was 73.5% for MMP-9 and 68.7% for CD147, significantly higher than normal tissues (MMP-9: 6.7%;CD147: 0%, P<0.05). Expressions of CD147 and MMP-9 were positively correlated with the tumor size, pTNM stages, differentiation degree, the portal vein cancer embolism, and postoperative recurrence (P<0.05), but not with the patient's age, gender, the serum level of alpha-fetal protein (AFP), and the Child-Pugh grades. Patients with positive expression of CD147 and MMP-9 had shorter survival time than those with negative expression of CD147 and MMP-9. Expression of CD147 was positively related with expression of MMP-9 in HCC tissues.Conclusion:CD147 and MMP-9 had positive correlation with tumor size, pTNM stages, differentiation degree, portal vein cancer embolism, and postoperative recurrence. Detection of the expression of CD147 and MMP-9 may be helpful to make a comprehensive prediction of the prognosis of HCC.

Objective Adopt the method of brachial plexus block by a noodle biopsy and pressing the root of interscalene,to discuss the effective of this method on the operation of shower and upper limb.Methods Summarize 182 cases of patients who got the upper limb operation,compared the patients adopting a noodle biopsy and pressing the root of interscalene to block,to the cases which un-pressing the interscalene.Evaluate the anesthesia on sense and movement and record the complicating disease.Results It got a satisfied result from a noodle biopsy and pressing the root of interscalene to block.In this case,all of the sense and movement including shower has disappeared,and has absolutely effect on analgesia.All of the patients avoid to be used herbal supplements and however to complicating symptom.Good rate 97％,compared to 73％ cases of un-pressing.Pressing the interscalene to block is better than un-pressing,on feet nerve,axillary nerves,the median nerve and C4 nerve.Conclusion A noodle biopsy and pressing the root of interscalene to block is a effective and simple method,it needn't special equipment and has a absolutely and extensively block result on the shower and upper limb operation.