0.05). However, there was significant difference between the "open-window" or hemilaminectomy group and total laminectomy group. The time of returning to work and the rate of returning to previous work were 4.3 months and 84.6% in "open-window" group, 4.6 months and 86.4% in hemilaminectomy group and 4.4 months and 77.8% in total laminectomy group respectively. The height loss of involved disc spaces was discovered in the postoperative radiographs in all the patients. However, no segmental instability was found in the majority of these patients. Conclusion 1) "Open-window" or hemilaminectomy may achieve satisfactory long-term results for treatment of lumbar disc herniation. 2) No definite correlation exists between the height loss of involved disc space and segmental instability or nerve root entrapment. 3) Discectomy is still a reliable and effective surgical procedure for the treatment of lumbar disc herniation before the reliability of any disc replacement is confirmed in the long-term follow-up survey.

Objective To investigate the CT features and the diagnostic value in invasive mole. Methods Eleven cases (age, 30 to 53 years, mean 40 years)with invasive mole proved by operation and pathology were studied, including 3 cases during peri menopausal period of eight months, ten months and twelve months respectively. All cases were scanned by CT and enhanced study was done. Results All cases showed enlargement of uterus of varying degrees. On CT, the density of uterine cavity was similar to that of water, intermingled with spotty patchy and hazzy circular isodense shadows. High density stripe like bleeding foci were found in 3 cases.The outline of uterine cavity was locally disrupted in all case and the muscle layer was thickened in 3 cases. On enhanced CT scan, the lesions in the uterine cavity appeared markedly hyperdense, just like “the crater” and the “mole sign” .The muscle layers at the site of disruption showed inhomogeneous enhancement after contrast injection. Conclusion The CT features of invasive mole are characteristic, with important diagnostic value, especially for those during peri menopausal period.

Objective To summarize complications of knee arthroscopic surgery and the prevention and treatment for the complications. Methods A review of 679 knee arthroscopic operations in 658 patients from March 1997 to March 2002 was carried out. Results The incidence of all complications was 6.8% (46 of 679). Incidences of hemarthrosis, superficial infection, fibroarthrosis, tourniquet paresis, instrument breakage and accidental damage were 2.7% (8 of 679), 0.4%(3 of 679), 1.5%(10 of 679), 0.6%(4 of 679), 1.2% (8 of 679) and 0.4% (3 of 679), respectively. No popliteal vessel injury, intra-articular infection, neurological injury, deep venous thrombosis or compartment syndrome occurred in this group. Conclusions The incidence of complications of knee arthroscopy is relatively low. Most of them are mild and curable, if prompt treatment is given.

Objective:Using PCR to amplify filamentous fungi DNA fragments. Methods:Pour some liquid nitrogen to the hypha and grind them to powder. Then add some TE buffer and boil them for 15-20 minutes. Take a little supernatant as PCR template. After PCR do agarose gel electrophoresis. Collect the gel containing the objective fragment and add some TE. Take a little supernatant as PCR template (again.) After PCR, do agorose gel electrophoresis again. Results:We obtained a great deal of objective DNA. Conclusion:Amplifying filamentous fungi DNA fragment by this way, we can save time and money. We can also improve our work efficiently.

Objective:To investigate the effects of enteral nutrition support in inoperable advanced gastric cancer patients during chemotherapy.Methods:This was a prospective randomized study.A total of 62 patients with advanced gastric cancer were firsted evaluated according to the Nutritional Risk Screening 2002 (NRS 2002) scale,and were randomly divided into two groups.All patients received oxaliplatin combined with tegefur gimeracil oteraci.Patients in the control group (n =30) received chemotherapy along with nutrition consultation,and patients in the treatment group (n =32) were provided enteral nutrition-additionally.NRS 2002 assessment was conducted before and after chemotherapy,The body weight,BMI,serum albumin,and the efficacy and toxicity were collected during the study.Results:Patients in the treatment group had significantly higher serum albumin levels,body weight and BMI than those of the control group (P ＜ 0.05).No differences were found as for the efficacy and toxicity of chemotherapy between two groups.Conclusion:Enteral nutrition support therapy can improve the nutrition status of gastric cancer patients who received chemotherapy and reduce the risk of malnutrition.

This study was aimed to explore the clinical efficacy of Shen-Kang Injection (SKI) combined with hemodialysis in the treatment of chronic renal failure (CRF) patients. A total of 41 end-stage CRF patients under the hemodialysis treatment were randomly divided into the SKI treatment group of 19 cases and a control group of 22 cases. Both groups were treated with standard dialysis and the hemodialysis was maintained in the same symp-tomatic treatment conditions. Patients in the control group underwent three hemodialysis treatments in one week, while those in the treatment group were given hemodialysis twice a week based on the symptomatic treatment. And SKI was given after each time of hemodialysis in the treatment group. Indexes and changes in serum creati-nine (Scr), blood urea nitrogen (BUN) level, dialysis adequacy, nutrition status, traditional Chinese medicine ( TCM ) syndrome and other aspects of both groups were observed . The results showed that in the treatment group and control group, there were no significant differences in the renal function, dialysis adequacy, nutrition indica-tors and electrolyte ( P > 0 . 05 ) . In the treatment group , the total efficiency of TCM syndrome was 84 . 21%. And the total efficiency of TCM syndrome in the control group was 45.45%. The treatment group was better than the control group (P < 0.05). Symptoms such as scaly dry skin, numbness of the four limbs and dry stool were not obviously improved . And there was no statistical significance ( P > 0 . 05 ) . Symptoms such as fatigue , shortness of breath, poor appetite, dizziness, headache, lower back pain and spontaneous sweating were improved significantly. And there was statistical significance ( P < 0 . 05 ) . The treatment group was better than the control group . There were no abnormalities in the routine tests of blood, urine and stool, electrocardiogram, liver function, renal func-tion and electrolyte. In the treatment group, there was no significant adverse reactions during patients received SKI. The SKI has good safety. It was concluded that SKI combined with hemodialysis in the treatment of CRF is able to improve the clinical symptoms of patients and improve the patients' quality of life. When patient received adequate dialysis, SKI may reduce the dialysis frequency per week.

Objective To test the strength of different suture fixation of tendon or ligament end and evaluate appropriate stitches number in cruciate ligament reconstruction. Methods Twenty-four specimens of patellar tendon with free ends, which was, divided into 3 groups according 2 or 3 stitches and 6 subgroups using different suture materials, either with No1 Ethilon or 0.4 mm diameter stainless steel wire, fixed with Krackow locking stitch, the tensile test were undertaken respectively, so as to find out the least stitches and efficient suture pattern. Results Two Krackow locking stitches had more strength than that of 0.4 mm diameter stainless steel wire itself, the fixation strength of 2 stitches which used No1 Ethilon was more than 80 N, superior to the failure strength of material itself, it still maintained the same strength if the first stitch was across the tendon tissue transversely. On the basis of testing results, this modified stitches pattern was used in 17 cases, all could be well withstand an accelerated postoperative ROM rehabilitation program in clinical practice. Conclusion There is no significant difference between 2 and 3 Krackow locking stitches in suture strength statistically, the fixation strength is superior to the suture material, it can lessen the suture exposure when the first stitch is across the tendon tissue while maintains a comparable strength to other suture. If attempt to make a higher strength of suture, one should focus on selecting a stronger materials or adding the suture materials in number, therefore, a rapid early ROM rehabilitation is possible and reliable in practice.

Objective To investigate the therapeutic effect of anti-infecti ve reconstituted bone xenograft(ARBX)on osteomyelitis. Methods A proximal tibia os teomyelitis rabbit model was used. Twenty animals were randomly assigned to 4 gr oups and all of them were injected with staphylococcus aureus through a bone win dow. Two weeks postoperatively the animals underwent clearance of the focal lesi on, followed by implant of 3 pellets of ARBX containing 30 mg of gentamicin in g roup Ⅰ, 3 pellets of reconstituted bone xenograft (RBX) in conjunction with 30 mg of intramuscular gentamicin for 5 days in group Ⅱ, 3 pellets of RBX without antibiotic in group Ⅲ, and those in group Ⅳ were left without bone grafting. S pecimens were harvested 8 weeks after the above procedures and were then subject ed to gross observation, radiological, histological and bacteriological examinat ions to compare their therapeutic effect on osteomyelitis. Results 1) In group Ⅰ the bacteria counting and modified Norden scoring were by far the smallest am ong all 4 groups (P

Objective To evaluate the effects of various resection and reconstruction method on pain relief and function restoration for periacetabular metastatic destruction in different grade. Methods This study involved 20 patients, 11 males and 9 females, with the average age of 52 years(range, 43-82 years). The original tumor consisted of 5 renal cell carcinoma, 4 breast carcinoma, 3 lung carcinoma, 2 thyroid carcinoma, 1 prostate carcinoma, 1 rectum carcinoma and 4 unknown primary cancers. A solitary periacetabular metastatic lesion was demonstrated in 14 patients and multi-metastases were seen in 6 patients, and accompanying periacetabular pathologic fractures in 4 patients. As to the Harrington grading system for the periacetabular metastatic destruction, there were 8 grade Ⅰ, 5 grade Ⅱ, and 7 grade Ⅲ. And according to grade Ⅰ, curettage and cement packing (5 cases) as well as stability reconstruction in iliac and acetabulum (3 cases) were performed; grade Ⅱ, curettage, cement packing and total hip arthroplasty with reinforcement ring was performed; grade Ⅲ, en bolc resection of acetabular lesion and modular prosthesis reconstruction was performed. The average score was 5.4(ranged from 3 to 9) according to Tomita scoring system. The pain relief and functional recovery were investigated from the regular follow up postoperatively. Results All patients showed the improvement in pain relief and mobility postoperatively. No prosthetic dislocation, deep infection and leg length discrepancy occurred. The prosthesis or internal fixation loosening happened in 5 of 15 patients at different stage. The median survival time of all patients was 16.5 months (range from 4.2 to 63 months). 2 patients survived over 5 years, 3 over 2 years, 6 over 1 year, 6 over 6 months, and 3 less than 6 months. According to the Enneking functional scoring system, the patients were rated as excellent in 10 cases, good in 8, fair 1 and poor 1 at the 3rd month postoperatively, and for the 7 cases with grade Ⅲ, excellent 2, good 2, and poor 2. The functions of 11 patients survived one year after surgery were excellent in 3, good 4, fair 2 and poor 2. Conclusion The favorable resections and reconstructions for periacetabular metastatic destruction could lead to remarked improvement in pain relief, functional recovery and quality of life.

Objective To elucidate the expression of Toll-like receptor 3 (TLR3) on dendritic cells(DCs) in patients with chronic hepatitis B (CHB), and to explore the correlation between hepatitis B virus (HBV) persistent infection and TLR3 expression. Methods Sixty CHB patients (CHB group) and 20 healthy controls (control group) were enrolled. The peripheral blood mononuclear cells (PBMCs) were isolated and CD14~+ monocytes were sorted by immunomagnetic beads. Immature DCs (imDC) were induced and proliferated in vitro and mature DCs (mDC) were obtained after the poly I:C stimulation. The expression of intracellular TLR3 mRNA was detected by real-time polymerase chain reaction (PCR), and surface markers [CD80 and human leucocyte antigen (HLA)-DR] were determined by flow cytometry after 48 h of stimulation. The comparison of quantitative data was done using t test. The qualitative data were compared using chi-square test.Results The mean fluorescence intensities (MFI) of intracellular TLR3 of imDC before poly I:C stimulation in CHB group and control group were 1212.05 ± 250.80 and 1192.95 ± 301.40,respectively, which were not significantly different (t = 0. 280, P>0. 05). While after stimulation,those were 1352.98± 313.67 and 1593. 00± 349. 65, respectively, the latter was significantly higher than the former (t = 2. 880, P<0. 05). The levels of TLR3 mRNA inside mDCs in both groups were increased after poly I:C stimulation, which were 0. 1204 ±0.0267 and 0. 1780 ± 0.0664, respectively in CHB group and control group, and that in control group was significantly higher (t = 3. 909, P<0.05). Furtherly, patients in CHB group were divided into HBeAg(+ ) and HBeAg( -) subgroups.After stimulation, the MFI and mRNA of TLR3 inside mDC were greatly elevated in both subgroups,but there were no difference between these two subgroups (t = 0. 366, P>0. 05). Conclusions The intracellular expressions of TLR3 in mDC in CHB group and control group are obviously increased after the poly I:C stimulation, but the increased level in CHB group is lower than that in control group. The results suggest that the insufficiency of TLR3 synthesis may be related to the HBVpersistent infection.