Objective To observe the clinical effect of Shenwuyizhi capsule in the treatment of vascular dementia.Methods According to the digital table method,80 patients with vascular dementia were divided into the treatment group and control group,each group with 40 cases.On the basis of routine treatment,the control group was treated with piracetam tablets,and the treatment group was treated by the Shenwuyizhi capsule.60 d for 1 course.Before and after treatment,the simple mental state examination(MMSE) scale scores,Blessed behavior scale scores were compared between the two groups.Results Before and after treatment,the MMSE score,Bcessed behavior scale scores of the two groups were significantly improved (all P ＜ 0.05).After treatment,the MMSE score,Bcessed behavior scale scores of the treatment group were (19.83 ± 5.24) points,(7.18 ± 4.21) points,respectively,which were better than those of the control group [(20.01 ± 4.89) points,(7.23 ± 3.99) points] (t =4.148,2.141,all P ＜0.05).Conclusion Shenwuyizhi capsule can improve the light,moderate cognitive function in patients with vascular dementia,and improve memory and computing power,directional force,and enhance patient behavior ability,and reduce dementia symptoms,with good curative effect in the near future.

Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P ＞ 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P ＜ 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P ＜ 0.05 ). In experimental group anti- X a activity increased postoperative each time (P ＜ 0.05 ),compared with control group was also significant (P ＜ 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.

Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.

Objective To explore the value of the diagnosis and differential diagnosis of the sacral tumors with MRI. Methods Twenty nine patients with histologically proven sacral tumors were viewed, including sacral chordoma( n =5), giant cell tumor( n =1), neurilemmona( n =3), ganglioneuroma( n =2), malignant lymphoma( n =4), osteosarcoma( n =1), malignant neurilemmoma ( n =1), and secondary tumors ( n =12).All patients were examined with MR,CT and plain radiograph. MR findings were analyzed. Results (1) sacral tumors involved sacral bone with a regularity. Four patients with sacral chordoma involved usually above S3 level, not including S1 bone. One patient with giant cell tumor involved S2 S3. Six patients with neuromas involved S1 S3, including S1 bone. (2) signal intensity: moderate and/or low signal on T 1 weighted images, mottled signal on T 2WI. (3) sacral pores were destructed, disappeared, or enlarged. Sacral pores enlarged in six patients with neuromas, destructed in others. (4) sacral canal were destructed, disappeared, or enlarged. (5) tumors were classified into central ( n =16), centrifugal ( n =9), and mixed ( n =4) types. (6) sacral tumors were segmental on sagittal MR images. Conclusion MRI is superior to CT and plain X ray in assessing classification, segment and sacral pores and the like, so MRI is very important to the diagnosis and the differential diagnosis of the sacral tumors.

Objective: To investigate the chemical constituents from the roots and rhizomes of Rhodiola sachalinensis. Methods: The chemical constituents were isolated by repeated silica gel chromatography, medium pressure column chromatography, and semi-preparative liquid chromatography, and their structures were elucidated by chemical properties and spectroscopic analyses. Results: Eighteen compounds were isolated and identified to be gallic acid (1), p-hydroxybenzoic acid (2), salidroside (3), benzyl-O-β-D-glucopyranodide (4), phenylethyl-8-O-β-D-glucopyranodide (5), cinnamyl-β-D-glucopyranoside (6), sachalinol (7), quercetin (8), quercetin-3-O-β-D-glucopyranoside (9), kaempferol (10), kaemferol-7-O-α-L-rhamnopyranoside (11), kaempferol- 7-O-β-D-glucopyranoside (12), kaemnpferol-3-O-α-L-rhamnoside (13), kaempferol-3-O-β-D-glucopyranoside-7-O-α-L-rhamnoside (14), tricin (15), tamarixetin (16), herbacetin-7-O-α-L-rhamnoside (17), and herbacetin-3-O-β-D-glucopyranoside-7-O-α-L- rhamnoside (18). Conclusion: Compounds 9, 12, and 16 are obtained from the plants in Rhodiola L. for the first time. Compounds 2, 7, 8, 14, and 18 are obtained from this plant for the first time.

Objective The difficulty of full thoracoscopic Ivor-Lewis is the lack of a safe and low cost anastomosis.By improving the surgical process,to explore the application of circular stapler in the intrathoracic esophagogastric anastomosis.The thoracoscopic operation mode of esophageal cancer changes from simply following the McKoewn procedure to Ivor-Lewis and McKoewn procedure.Methods Retrospective analysis 123 cases of implementation thoracoscopic esophageal cancer from July 2009 to February 2013,which including the cases of intrathoracic anastomosis and cervical anastomosis.Divided it into two groups:intrathoracic anastomosis groups,which including thoracoscopic esophagectomy resection,gastroesophageal anastomosis and anastomotic pedicled omentum embedding,the cervical anastomosis groups,which including thoracoscopic esophageal free and gastroesophageal neck anastomosis.To comparing the incidence of ARDS,postoperative hoarseness,anastomotic complications (Anastomotic leakage and anastomotic strictures within two months after surgery),guardianship time of ICU and postoperative hospital stay between the two groups.Results All the patients were no deaths.The cervical anastomosis group operative time was significantly lower than the intrathoracic anastomosis group.The incidence of anastomotic fistula and anastomotic stricture of intrathoracic anastomosis group was significantly lower than that of the cervical anastomosis group,total hospitalization time of the intrathoracic anastomosis group were significantly lower than that of the cervical anastomosis group,there is no significant differences in postoperative hoarseness and ARDS incidence between the two groups.Conclusion For the lower esophageal carcinoma,it is technically mature and safe to apply the circular stapler for Ivor-Lewis surgery and sleeve omentumembedding anastomotic technique in full thoracoscopic,and the technology should be widely applied; for the upper esophagealcarcinoma,McKoewn procedure should be applied.

Objective To explore the risk factors of surgical treatment for children’ s tethered cord syndrome. Methods Retrospective-ly analyzed the clinical data of 43 tethered cord syndrome children who had undergone surgical treatment from January 2007 to December 2009,and to evaluate the efficacy of the surgical treatment. Meanwhile,The Cox proportional hazards regression model was adopted to evaluate the surgical efficacy. Results 28 children received effctive curative effect after the surgical treatment in 43children with tethered cord syn-drome,the total effective rate was 65. 12%. Cox medol showed that tight filum terminale(P<0. 05), operation methods (P<0. 05)and the duration of the disease(P<0. 05)were independent risk factors of surgical treatment for children’s tethered cord syndrome. Conclusion The operativeefficacy of children’ s tethered cord syndrome were influence by the tight filum terminale,operation methods and the duration of the disease.

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
Anastomosis, Surgical ; Bronchi/*surgery ; Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pneumonectomy/*methods ; Pulmonary Surgical Procedures/*methods ; Recovery of Function ; Treatment Outcome

Presented in this study were three cases of lung cancer undergoing pulmonary venoplasty. In the 3 patients with central type of carcinoma of lung involving pulmonary vein, the main branch of right superior pulmonary vein and the distal end of the superior-lobe vein were occluded. The root part of the vein of right-middle lobe, plus part of vessel of of right superior vein was resected. The right superior vein was reconstructed by continuous 6-0 Prolene sutures. After the operation, the reconstructed was patent and the surgical margin was tumor-free. Postoperatively, clinical manifestations and plain chest films did not show any signs of venous blockade. The patients were discharged healed 3 weeks after the operation. The technical details of the surgery were presented, the improvements on the basis of traditional methods were discussed and its clinical application was evaluated. It is concluded that pulmonary venoplasty is a safe and feasible operation. Further improvement of the surgery will help conserve more lung tissue and benefit more patients because of expanded indications.
Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pulmonary Veins/*surgery ; Vascular Surgical Procedures/*methods