Objective To retrospectively investigate the cause of spontaneous rupture of the large intestine,pathology, diagnosis, treatment and prognosis of the relevant factors. Methods The collection of domestic medical records of 155 cases of spontaneous rupture of the large intestine in last decades,combined with 5 cases collected in our hospital since 2002. All the cases underwent emergency surgery confirmed the preoperative diagnosis of straight,colon rupture in 25 cases. Surgical repair for rupture in 5 cases,rupture of an external repair in 5 cases,rupture of the proximal colostomy repair combined with single or dual-chamber in 43 cases of ruptured bowel resection and anastomosis of the proximal intestine fistula combined with single or dual-chamber in 61 cases ruptured bowel resection stump of dual-chamber fistula in 6 cases, rupture of bowel resection and anastomosis in 5 cases, rupture of intestine directly fistula 9 cases. Surgical presentation in the remained cases were unknown. Results One hundred and seventeen patients cured, 43 cases died. Conclusions Most spontaneous colon rupture occurred in elderly patients,and is rare disease. The diagnosis rate is low and easy to delay in the treatment. Moreover, the intraabdominal infections caused by pollution would leed to a direct life-threatening toxic shock. Therefore, prompt diagnosis and timely surgery is important to improve the cure rate.

Purpose: To retrospectively analyse the characteristics of diagnosis and operative treatment of 66 cases of scwannoma in the spinal canal. Methods: Sixty-six cases, 27 of the cervical region, 13 the thoracic and 26 of the lumbar and sacral regions were treated from 1983 to 1996. Clinical manifestation and types, and results of spinal radiography, myelography, CT scannig, MR imaging, operative treatment were separately described. Results: All of the 66 cases obtained timely and accurate diagnosis and treatment. The tumors in 60 patients were completely resected; and in remaining 6 patients subtotal excision was performed. The duration of follow-up averaged two years and eleven months and excellent and good results were achieved in 90.9% of the patients. Conclusions: 1) Schwannoma in the spinal canal is not uncommon; four in this series are malignant or with malignant tendency. 2) The forms of the tumor are with lots of variations. 3)An approximate position of the lesion can be determined by clinical neurological examination. Accurate diagnosis can be made by a procedure combining clinical and imaging examinations, operative exploration and pathological examination. 4) Total resection of the tumor may result in good restoration although it is sometimes difficult and risky.

Objective To investigate the expression of nerve tissue protein S-100(S-100)and gap junctional protein connexin 43(Cx43) in rat adenohypophyseal folliculo stellate cells(FSCs) under the influence of ovariectomized osteoporosis(OVX-OP) and estrogen replacement therapy(ERT). Methods Sixty 10 month old female rats were randomly divided into sham operation control group(Sham), ovariectomy group (OVX) and ovariectomy+ERT group (OVX+ERT). L4-6 bone mineral density(BMD) of the animals in Sham group and OVX group were measured by dual energy X-ray absorptiometry(DEXA) at the end of 6 weeks after operation. From 7th week, rats in OVX+ERT group were treated with nilestriol(1 mg?kg -1?week-1) for 6 weeks. Rat L4-6 BMD in OVX+ERT group were measured at the end of 12 weeks after operation. Expression of S-100 and Cx43 in FSCs was detected using immunofluorescent histochemistry and laser scanning confocal microscopy(LSCM). Results L4-6 BMD was significantly lower in OVX group (0.193?0.006) g/cm2 than in Sham group(0.211?0.013) g/cm2 and in OVX+ERT group (0.204?0.010) g/cm2 (P

Objective To study the diagnosis and the treatment of the arachnoid cysts in the sacral canal. Methods After decompression laminectomy of the sacral canal, the arachnoid cysts were dealt with in three ways: 13 cases with excision of the most of the cyst wall and suture of redundant wall around the intracystic nerves, 8 cases with the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle, 2 cases with excision of most of the cyst wall and leaving cystic wound unsutured. The clinical results were studied with 30.2 months follow up. The radiological changes including X-ray, CT, CTM and MRI were evaluated as well as their clinical behaviors, pathologies and post operative complications. Results Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between the results of the first two surgical methods. The post operative complications included the wound erosion and intracranial infection. Conclusion The cyst seems to arise as a result of congenital defect of the thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to be a reasonable surgical method. No drain tube should be used and a supine position should not be allowed so as to reduce the complications

Objective To study the OPG/RANKL gene expression of bone marrow stromal cell under stimulation of PTHrP.Method Primary bone marrow cells were cultured under the stimulation of 45 ng/ml PTHrP. Number of osteoclasts was counted after 6-day's culture.90 ng/ml PTHrP was used to stimulate adherent bone marrow stromal cells for 3 or 6 days.OPG and RANKL gene expression level were determined by real-time PCR. Result Large number of osteoclasts were formed in primary bone marrow cell culture after 6-day stimulation of PTHrP.RANKL gene expression level was up-regulated by PTHrP,while OPG gene expression level were down-regulated.Conclusion PTHrP stimulates osteoclast formation via up-regulating RANKL level and down-regulating OPG level.

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.

Twenty-six patients with stenosis of the thoracic spinal canal and myelopathy caused by ossification of the ligamentum flavum were treated from 1983 to June 1991. There were 21 patients with spastic paraplegia and 5 with flaccid paraplegia in the series. The findings on radiograms, CT scans, myelograms and MRI were described. Total laminectomy was performed in all of the patients which resulted in an effective rate of 91.6% and exellent and good results in 83.3%. The mechanism of the disease our experience in diagnosis and surgical treatment, causes of misdiagnosis and surgical techniques are discussed.

Objective To establish the method of determination for rhein, emodin, chrysophanol and physcion in Niuhuang Qinghuo Pills. Methods Sample was hydrolyzed by 20% H2 SO4 , and anthraquinones were extracted by soxhlet extraction with acetone as solvent, and were determined by HPLC with Kromasil C18 as column, methanol-0.5%H3 PO4 (75:25,V/V) as mobile phase at the flow of 1.0 mL/min, 230 nm as the detection wavelength.Results The linear relationship of rhein, emodin, chrysophanol and physcion were 1.50-150, 0.950-95.0, 1.30-130 and 1.15-115 mg/L. The anthraquinones were seperated completely, the recovery of 4 anthraquinones were 98.14% -101.3%.Conclusion This method is simple, accurate, steady, and could be used for the quality control of Niuhuang Qinghuo Pills.

Objective To investigate the influence of sodium fluoride(NaF)on alkaline phosphatase (ALP)activity and bone gla protein(BGP)synthesis in yellow ligament cells from different surgical simples in vitro.Methods The human ligament cells were divided into three groups according to its sources,including normal yellow ligament cells(NLF)group(from acute traumatic thoracolumbar fractures with paraplegia in 7 patients),degenerative yellow ligament cells(DLF)group(from degenerative lumbar stenosis in 9 cases)and ossified ligament cells(OLF)group(thoracic yellow ligament from 8 patients).Twenty-four groups of cells were obtained under vitro cell culture by the method of tissue adherence.Different concentrations of NaF were added into the medium when the cells spread to the fifth generation.Then,the morphological changes were observed and ALP activity and BGP synthesis were tested.Results Human yellow ligament cells from different samples can proliferate and be passaged in vitro.The cell in ossific groups and degenerative groups were pleomorphic and could form calcium nodules.High concentration of NaF(1.0 mmol/L)can lead to cytotoxic reaction in all 24 groups.Low concentrations of(0.01-0.125 mmol/L)NaF can enhance the ALP activity and BGP synthesis in DLF groups while no effect was found in OLF and NLF groups cells under the same concentration of NaF.Conclusion The fact that fluoride can promote ALP activity and BGP synthesis in degenerative yellow ligament cells in vitro indicates fluoride may play an important role in inducing further ossification of human ligament cells.

Aim To investigate the possible roles of age, bodyheight, mass and body mass index(BMI) in Lumbar1-4 bone mineralcontent (L1-4BMC), L1-4 areal bone mineral density(L1-44BMD) and L1-4volumetric bone mineral apparent density(L1-4BMAD) of Chinese adoles-cents with early ankylosing spondylitis (AS). Methods Thirty-one maleChinese adolescent outpatients with early AS were included. Age (y),total body mass (kg), height(cn) and body mass index (BMI, kg/m2)of subjects were obtained. L1-44BMC(g) and L1-4 BMD(g/cm2) were e-valuated by using DEXA, and L1-4 BMAD(L1-44BMC/Area3/2, g/cm3)was subsequently calculated. Correlation and multiple regression analyseswere performed. Results Multiple regression revealed that height ( P =0.000) and BMI(P=0.009) were significantly positively related toL1-44BMC (R=0.759, Radj2=0.545, P=0.000 ＜0.01), and heightplayed the pivotal roles in significant correlation with L144BMC(R =0. 676 Radj2 = 0. 439, P = 0. 000) . Body mass significantly positivelycorrelated with both L-44BMD ( R = 0. 657, Radj2 = 0. 412, P = 0. 000)and L1-4BMAD (R=0.551, Radj2=0.280, P=0.001) .Therefore,height as well as BMI significantly positively correlated with L144BMC andmass was definitely associated with both L1-4BMD and L1-4BMAD in ado-lescents with early AS in this study. Conclusion Height and mass couldhave significantly positive effects on axial bone mass and densities ofadolescents with early AS.