Objective To explore the clinical features of thoracolumbar disc herniations and to improve the quality of the diagnostic procedure.Methods Clinical data of 65 patients with thoracolumbar disc herniations confirmed by X-ray examinations,CT,MRI,and operations from September 1995 to January 2004 were retrospectively reviewed.The 65 patients were divided into three groups: lower thoracic disc herniations(T_(10-11)~T_(12)L_1) in 43 patients,upper lumbar disc herniations(L_(1-2)~L_(2-3)) in 16 patients,and multiple levels of herniations in 6 patients.Results Paresthesia and lower extremity weakness were the most frequent symptoms,with their occurrence proportions being 89.2%(58/65) and 83.1%(54/65),respectively.Among the 65 patients,9.2%(6/65) showed the presentation of upper motoneuron involvement,47.7%(31/65) manifested symptoms of lower motoneuron impairment,and 43.1%(28/65) presented as mixed motoneuron disorders.Neurological deficits were usually extensive and the cauda equino syndrome was commonly seen,while isolated radicular impairment was noticed only in 3 patients.Back pain(44.6%,29/65) and lower extremity weakness(40.0%,26/65) were the most common initial complaints.Lower thoracic disc herniations were characterized by mixed motoneuron disorders at the occurrence proportion of 58.1%(25/43),with a tendency leading to ambulatory dysfunction,drop foot,increased lower extremity muscle tension,and positive pathologic reflexes.By contrast,most upper lumbar disc herniations were manifested as lower motoneuron disorders at the occurrence proportion of 93.8%(15/16),with back pain,lower extremity pain,and the cauda equino syndrome frequently encountered.Conclusions The clinical presentation of thoracolumbar disc herniations is complicated with the large-scale distribution and diversity of the symptoms and the complexity of clinical signs.We put forward four circumstances under which a high suspicion of thoracolumbar disc herniation was recommended: ①if there is a sensory disturbance at the anterior and lateral aspect of the thigh or at the groin area;②if there is a lower extremity weakness,especially in the quadriceps and the tibialis anterior muscle(drop foot);③if an extensive and irregular range of sensory and motion disturbances exists,with a lack of typical radicular distribution;or ④if there are mixed motoneuron disorders,or lower motoneuron disorders unexplained by lumbar disc herniations.

Objective To evaluate the feasibility, safety and efficacy of selective portal vein embolization (SPVE) in treatment of liver tumor in rats and to provide the groundwork for its future clinical applications. Methods 24 healthy rats underwent the embolization. Pre and post SPVE portogram and liver chemical profile were obtained. Four rats were sacrificed at 10 min, 7,14, 21 and 28 days respectively following follow up portography. The liver, heart, lungs and kidneys were examined macroscopically and microscopically. Fifteen rats implanted with Walker 256 tumor sized from 3 to 10 mm in liver were scanned with MRI and portography pre SPVE taken. Post SPVE 3 rats were examined with MRI for each group at the same interval as above and the lives were examined microscopically. Results (1) The blood flow to the target portal branches were immediately halted after SPVE. These vessels remained occluded without collateral formation up to 28 days. (2) The liver indexes and BUN level increased after embolization, but returned to normal within 21 d. Macroscopic and microscopic changes were not found in the heart, lungs or kidneys. (3) In the healthy rats, the affected segment was atrophic and the remaining liver underwent compensatory hypertrophy. Histologic examination revealed that the targeted portal veins were coagulated, the endothelium were degenerated and the local hepatocytes were necrotic after embolization. (4) In the rats with implanted liver tumor, the affected segment including the tumor was necrotic and atrophic. The tumors were completely necrotic, and no viable tumor cell was seen under microscope in 12 among the 15 rats. Three tumors 10 mm in diameter were not completely necrotic. Part of tumor cells were still alive and infiltrated into the surrounding liver. Conclusion SPVE with ethanol is effective in the treatment of small liver tumor in rats. However,in case of bigger tumors involving several segments, SPVE should be combined with other treatment.

Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1) acted as controls.The incidence of SD and Scheuermann's signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann's signs was compared to that within segments without Scheuermann's signs.Results All except one patient in TLDH group(97.8%) had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann's signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann's signs was all higher than that within segments without Scheuermann's signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl's node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.

OBJECTIVE:To optimize the ultrafine pulverization technology in Chaige tuire powder;to compare the content and microcharacteristics between ultrafine powder and ordinary powder. METHODS:Using contents of 3 active ingredients(puera-rin,glycyrrhizin and baicalin)and powder d(0.5)as main indexes,bulk density,angle of repose and microcharacteristic as refer-ence indexes,orthogonal test was designed to optimize the initial particle size,moisture and pulverized frequency in ultrafine pul-verization technology. Contents of 3 active ingredients of ultrafine powder and ordinary powder(over 65/80 mesh sieve)and obser-vation results of calcium oxalate crystal under microscope were compared. RESULTS:The optimized technology was as follow as over 65 mesh sieve,moisture of 2.5%preliminary powder in 60 Hz of frequency for pulverization. In verification test,d(0.5)aver-age value of 3 ultrafine powder samples was 31.5 μm(RSD=0.45%,n=3);contents of puerarin,glycyrrhizin and baicalin were 0.232 mg/g(RSD=1.31%,n=3),0.212 mg/g(RSD=1.62%,n=3),8.962 mg/g(RSD=0.89%,n=3),respectively,which were increased about 30%-40% than in ordinary powder(0.158,0.15669,6.140 mg/g). There were no or little bundles of calci-um oxalate crystal that is common in ordinary powder. CONCLUSIONS:Optimized ultrafine pulverization technology is stable and feasible;contents of 3 active ingredients in Chaige tuire ultrafine powder are higher and calcium oxalate crystal are litter than ordi-nary powder,which possibly reduces the adverse reactions in clinical application.

Objective: To study the effect of gamma irradiation on the permeability of the blood brain barrier(BBB) in rat brains. Methods:The right caudate nucleuses of Sprague Dawley rats were irradiated by OUR XGD gamma units.Maximum dosages of 20,50,75 and 160 Gy were given using a 4 mm collimator.Immunohistochemistry with antibody of serum albumin was used for detecting the extravasation of endogenous serum components.Ultrastructural changes of BBB were observed through injection of lanthanum nitrate into blood vessels. Results: Extravasation of albumin and BBB opening in the right caudate nucleuses were detected as early as 12 h after irradiation at 50,75 and 160 Gy,and were detected 1 d after irradiation at 20 Gy.Immunoreactivity and emematous water reached their maximum after 3 d, gradually decreased during the following few days,and disappeared by day 7(20,50 Gy) or day 14(75 Gy).Irradiation at 160 Gy elicited persistent extravasation of albumin and BBB opening for 14 d. Conclusion: These are transient impairments to BBB after irradiation at 20,50,75 Gy,and persistent impairments after irradiaton at 160 Gy.

Objective To detect the expression of E-cadherin and ?-catenin in breast carcinoma and analyze the relationship between E-cadherin and ?-catenin and the clinicopathological features. Methods The expression of E-cadherin and ?-catenin in breast cancer, paracarcinoma breast tissue, simple mastoplasia and atypical mastoplasia were detected by immunohistochemical method and the results were compared. Results The abnormal expression rates of E-cadherin and ?-catenin in breast cancer tissue were 51.9% and 61.1 %,respectively. Abnormal expression of E-cadherin was significantly correlated with histological grade. Abnormal expression of ?-catenin was significantly correlated with TNM staging, axillary lymph nodes metastasis and postoperative distant metastasis. COX multiple factor analysis showed that neither E-cadherin nor ?-catenin expression was an independent indicator for the prognosis of breast cancer. Conclusions Abnormal expressions of E-cadherin and ?-catenin are correlated with occurrence and development of breast carcinoma. Abnormal expressions of E-cadherin and ?-catenin are good indicators to judge invasion and metastasis of breast carcinoma.

Objective To study the HLA-DRB1 genotupe and their relation with OBI infection.Methods HLA-DRB1 genotyping was conducted in 102 patients OBI infection and 201 health controls,by using polymerase chain reaction sequence-based typing (PCR-SBT)method.The association between HLA-DRB1 genotype and OBI was also studied.Results Compared to 201 health controls,the allele frequency of HLA-DRB1 * 0405 (1.980 4％) (x2 =12.477 0,P =0.000 0,OR =16.367 3) * 0803 (4.257 3％) (x2 =30.689 8,P =0.000 0,OR =36.454 5)、* 1101 (5.545 9％) (x2 =4.471 2,P =0.034 5,OR =1.903 8)、* 1201 (1.481 6％) (x2 =8.591 9,P =0.003 4,OR =12.151 5) were markedly higher.The allele frequency of HLA-DRB1 * 0701(2.230 8％) (x2 =5.585 5,P=0.018 1,OR=0.417 7)、* 1301 (0.245 4％) (x2 =4.513 7,P=0.033 6,OR=0.147 4) 、* 1302(0.491 4％) (x2=11.369 1,P=0.000 7,OR=0.000 0) 、* 1312(0.245 4％) (x2 =5.0198,P=0.025 1,OR=0.136 5) 、* 1501(4.257 3％) (x2=10.763 1,P=0.001 0,OR=0.000 0)was obviously lower than than in HBV patients.Conclusion HLA-DRB1 * 0701、* 1301、* 1302、* 1312、* 1501 are closely related with susceptibility to OBI,and HLA-DRB1 * 0405、* 0803、* 1101、* 1201 is closely related with resistance to OBI.

Objective To investigate the drinking pattern and the condition of alcoholic fatty liver disease in a certain coal mine workers in Shanxi Province.Methods A total of 1501 workers in a coal mine in Shanxi Province were surveyed by field investigation method.Contents include questionnaire, physical measurement, abdominal ultrasound liver and fasting blood glucose, blood lipid, liver function, cholesterol, blood biochemical indicator detection.ALD diagnostic criteria for fatty liver and alcoholic liver disease group were .recommended by the Chinese Medical Association in 2010.The t test,X2 test and multiariable logistic regression analysis were conducted by SPSS17.0 software.Results This study involved ALD patients with 265 people, accounting for 17.65％ of the total survey.The drinking pattern, such as drinking patterns in the initial drinking age,long duration of drinking, drinking frequency, drunkenness, fasting drinking, average daily alcohol intake as the risk factors of alcoholic liver disease.The Logistic regression analysis of alcoholic liver disease related factors showed that, drinking age, drinking way and daily average alcohol intake were closely related to the occurrence of ALD(OR=0.942,P=0.769;OR=2.811,P=0.000;OR=1.756,P=0.000;OR=542.844,P=0.001) .Conclusion In the coal mine workers, drinking pattern in the initial drinking age, drinking age, daily average alcohol intake are closely related to ALD illness.

Objective To discuss the treatment and clinical results of acetabular fracture. Method Clinical data of 78 cases of acetabular fracture was analyzed retrospectively on treatment methods and clinical effects from August 1988 to December 2007, 41 cases were performed operation and 37 cases were performed non-operative management. Result The treatment effects were excellent in 43 cases, good in 22 cases, fair in 10 cases, poor in 2 cases and dead in 1 cases, with a good rate of 83.3%, and 20 cases had complications: 1 posterior dislocations of hip, 13 posttraumatic arthritis, 1 incisional infection, 5 ectopic ossi-fication. Conclusions It is very important to choose appropriate treatment methods by judging the real state of acetabular fractureexactly. Acetabular reconstruction plate is convenient, safe, and reliable in treat-ment of posterior wall and superior wall fractures.

Objective To investigate the impact of prior cerebral infarction (PCI) on in-hospital mortality in patients with Acute Myocardial Infarction (AMI).MethodsA retrospective analysis of documents of a total of 3572 consecutive patients with AMI admitted to Xuanwu Hospital of Capital Medical University from 2002 Jan.1 to 2009 Dec.31 were performed.Results There were 564 patients ( 15.8% )with PCI.Compared with the group of without PC1,the group with PCI were substantially older[(69.4 ±9.9) vs (64.2 ± 12.9)years,P =0.000],and had a higher prevalence of hypertensive disease,diabetes mellitus,prior myocardial infarction (MI) and non-ST-segment elevation myocardial infarction(NSTEMI)( respectively,71.0% vs 57.3%; 41.0% vs 25.7%,12.9% vs 9.5%; 14.9% vs 10.7%,P ＜ 0.01 ),and a higher in-hospital mortality ( 16.5% vs 10.0%,P= 0.000).Univariate analysis demonstrated that in-hospital mortality associated with age,gender,extensive anterior MI,anterior MI,diabetes mellitus,prior cerebral infarction,prior myocardial infarction,coronary angiography and percutaneous coronary intervention.Logistic regression analysis found that risk factors were age,extensive anterior MI,anterior MI,diabetes mellitus and prior cerebral infarction,and protective factors were coronary angiography and percutanous coronary intervention.PCI was independently associated with in-hospital mortality,OR 1.368,95% CI 1.047-1.787,P = 0.022.Conclusion In patients with acute myocardial infarction,the presence of PCI increases the risk of worse in-hospital outcome.