Superior Mesenteric Artery (SMA) syndrome is a well-known but rare complication following corrective surgery for scoliosis. It can be easily missed if not thought of in patients presenting with abdominal pain and vomiting post-scoliosis surgery. SMA syndrome is most commonly associated with conditions resulting in significant weight loss but can also occur as a result of biomechanical changes following scoliosis surgery. We present a case of a 13 year-old girl who developed SMA syndrome following scoliosis surgery. A high index of suspicion and early surgical referral are paramount for the successful management of SMA syndrome.

Objective:To compare the differences between Workshop teaching and PowerPoint teaching being used in resident doctor/advanced doctor training,and to investigate effectiveness of Workshop teaching.Method:Over the limit of teacher on the stage and students off the stage,teacher demonstrated to students hand by hand during Workshop teaching;Over the limit of the students being accepted knowledge passively,teacher encouraged them to take part in mutually;Over the limit of theories lesson separating with practical one,teacher supply more opportunity to operate for students practically.Results:The effectiveness of Workshop teaching mode in practicability and performance ability was better than PowerPoint teaching mode'(P

Interleukin-24 (IL-24) is a member of IL-10 family, which was cloned from human melanoma cells by the method of subtractive hybridization. IL-24 can inhibit the growth of tumor cells and angiogenesis and enhance radiation sensitivity and immune adjustment with non-toxic effects on normal cells.As a kind of cytokine with multiple anti-tumor functions, IL-24 will become a new weapon of gene therapy against cancer. The application and mechanism of IL-24 in the treatment of cancer will be discussed in this paper.

Cerebral infarction is not only a focal damage,but also causes secondary damage in areas remote from the ischemic territory,which will retard the recovery of neurological function.Ephrin receptor B2 (EphB2) plays an important role in the development and repair mechanism of central nervous system.Blocking the effect of EphB2 in brain by using a specific inhibitor may enhance proliferation and migration of endogeneous neuronal stem cells after experimental cerebral infarc- tion,improve neurological function and influence angiogenesis and neuroplasticity in remote sites.It is expected to become a new approach for decreasing damages in areas remote from the cerebral infarction and promoting the recovery of neurological function.

Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)complicating anterior cervical surgery.Methods1052patients were performed anterior cervical surgery between October1997and October2002.Of 1052cases,926cases were of cervical spondylotic myelopathy(CSM),and126of ossification of posterior longitudinal ligament (OPLL).11patients suffered from cerebrospinal fluid leakage during operation.There were8males and3females aging from46to72years(average,58years).In the group of CSM,there were2cases of CSFL(0.22%)occurred in resection of osteophyte of the posterior vertebral edge,who were serious CSM of C 4,5 and C 5,6 with severe anterior compression by osseous mass to spinal cord showed on MRI.In the group of OPLL,there were9cases of CSFL(7.14%)occurred in resection of the ossified posterior longitudinal ligament accompanied with severe spinal canal stenosis and anterior compression to spinal cord on radiological imagings,4of them were con-tinuous OPLL from C 2 to C 6 combined with herniation of cervical disc,3segmental,and2mixed.Results The defect area of spinal dura were(0.6～2.0)cm?(1.0～1.5)cm.The cerebrospinal fluid was blocked with fascia and absorbable gelatin sponge during the operation.If CSFL was persistent more than3days after oper-ation,expectant treatment was performed.After the operation,no CSFL occurred in8of 11patients,and the other3cases with postoperative CSFL were cured5,14and17days by dressing change,blocking the wound with gelatin sponge,and suturing of the wound respectively.All patients were followed up for 10to62months(mean,26months).No cerebrospinal fluid cyst and infection occurred.There were no significant negative effects of CSFL on the recovery of neuromuscular function.Conclusion CSFL following cervical anterior surgery can be cured by blocking up leakage of spinal dura during operation,however,conventional conservative treatment including of dressing change,antibiotics administration,horizontal position with low pillow are necessary after operation.

Objective To establish the subcutaneous transplantation tumor models with Lewis lung adenocarcinoma in C57BL/6 mice, and to observe the influence of oHSV2, DDP and drug combination on tumor volume, median survival time and weight of tumor-burdened mice.Methods Subcutaneous transplantation tumor models were established with Lewis lung adenocarcinoma in tumor-burdened mice.Tumor-burdened mice were randomly divided into the control group, oHSV2 group, DDP group, oHSV2/DDP sequential group, DDP/oHSV2 sequential group and oHSV2+DDP combination group with 12 rats in each group using the random number table method.The tumor size and weight of mice were measured every 3 days.Results On the 21st day, the tumor size of tumor-burdened mice in every group was as follows: control group (1.82±0.06)cm3, oHSV2 group (0.63±0.05)cm3, DDP group (0.58±0.03)cm3, oHSV2/DDP sequential group (0.49±0.05)cm3, DDP/oHSV2 sequential group (0.42±0.04)cm3, and the difference was statistically significant (F=1 359.01, P=0.000).The data in oHSV2+DDP group were put away because of premature death in mice.The differences were statistically significant between control group and oHSV2 group (P=0.000), control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.017), DDP group and DDP/oHSV2 sequential group (P=0.000), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.001).The weight of tumor-burdened mice in every group was listed as follows: control group (21.64±0.40)g, oHSV2 group (21.34±0.37)g, DDP group (15.96±0.43)g, oHSV2/DDP sequential group (19.04±0.31)g, DDP/oHSV2 sequential group (16.34±0.30)g, and the difference was statistically significant (F=588.67, P=0.000).The difference was not statistically significant between control group and oHSV2 group (P=0.076).However, the differences were statistically significant between control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.000), oHSV2 group and oHSV2/DDP sequential group (P=0.000), DDP group and DDP/oHSV2 group (P=0.013), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.000).The median survival time of tumor-burdened mice in every group was displayed as follows: control group 23 d , oHSV2 group 32 d, DDP group 30 d, oHSV2/DDP sequential group 37 d, DDP/oHSV2 sequential group 39 d, oHSV2+DDP combination group 16 d, and the difference was statistically significant (χ2=120.81, P=0.000).The differences were statistically significant between control group and oHSV2 group (χ2=10.88, P=0.001), control group and DDP group (χ2=10.69, P=0.001), oHSV2 group and DDP/oHSV2 sequential group (χ2=10.09, P=0.001), DDP group and DDP/oHSV2 sequential group (χ2=9.67, P=0.002).However, the differences were not statistically significant between oHSV2 group and DDP group (χ2=0.00, P=0.996), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (χ2=2.70, P=0.100).Conclusion On the premise of that the weight of mice is no affected, oHSV2 can inhibit the tumor size and prolong the median survival time of tumor-burdened mice effectively, and the effect of DDP/oHSV2 sequential group is the most significant.This article provides an experimental basis for exploring therapeutic methods of lung adenocarcinoma.

Objective To investigate the role of synaptic plasticity on the formation of visceral hypersensitivity induced by transient intestinal infection in rats. Methods Thirty male Sprague-Dawley rats were divided into normal control, acute infection and chronic infection groups with 10 each. The area under curve (AUC) of electromyography (EMG) in 10 s was used to evaluate the visceral sensitivity induced by different eolorectal distention (20,40,60 and 80 mmHg). Histological change of the colon was evaluated by H-E staining. Synaptic uhrastrueture such as synaptic cleft and synaptic vesicles was observed using transmission electron mieroseope. The mRNA and protein expressions of synaptophysin and postsynaptic density protein-95 (PSD-95) were examined by RT-PCR and Western blot, respectively. significantly higher than those of normal controls(P=0. 012, 0. 005, respectively ). In contrast, AUC of acute infection were significantly lower than those of normal controls ( P = 0. 018,0. 012, respectively ). Under the distention of 20 and 80 mmHg, no significant difference was observed among three groups (P= rats compared to normal controls(23.45±4.10 vs. 9.10±2.42, P=0. 027),but there was no statistical difference between chronic infection rats and normal controls (13. 95±7.96 vs. 9.15±2.42, P=0.78). increased. In acute infection rats, mitochondria cristae disappeared, synaptic vesicles and the length of controls, mRNA and protein of synaptophysin in ileocecum, proximal colon and distal colon were significantly increased in chronic infection rats (P＜0. 05 ), but decreased in acute infection rats with no significant difference. Compared with controls, no significant downregulation was noted in the expression protein expressions of PSD-95 were both increased in chronic infection rats (P＜0.05), and decreased in acute infection rats (P＜0.05). Conclusion Synaptic plasticity plays an important role in the formation of visceral hypersensitivity induced by transient intestinal infection in rats.

Objective To observe the changes of the blood pressure after intracerebral hemorrhage (ICH) in spontaneously hypertensive rats (SHRs) as well as the expressions of α2A-adrenergic receptor (AR) in center (brain tissue) and peripheral (renal tissue) α1A-AR and to investigate the correlation between α1A-AR/α2A-AR and blood pressure regulation in acute hypertensive ICH. Methads A total of 30 six-month-old male SHRs were randomly divided into a sham-operation group and ICH (day 1,3, 7 and 14) groups (n =6 in each group). Blood pressure was measured by the tail-cuff method. Collagenase Ⅳ was injected into caudate-puta-men nucleus to induce a model of ICH. The expressions of α1A-AR and α2A-AR were detected by using immunohistochemistry and reverse-transcription polymerase chain reaction. Results One day after ICH, the blood pressure was 195.4 ± 8.39 mm Hg, and it was significantly higher than 177.8 ± 8.69 mm Hg (P = 0. 000) before ICH and 184. 1 ± 3.76 mm Hg in the sham-operation group (P=0. 002). At day 3 it was 185.3 ±9.22 mm Hg, and it was lower than that at day 1. It was 177.7 ±5.62 mm Hg and 176.7 ±6. 06 mm Hg at day7 and 14 respectively, which almost returned to the normal level before ICH. The α1A-AR mRNA and protein in renal tissue at day 1 after ICH were 0. 91 ±0. 013 and 0. 944 ±0. 142%, respectively, They were higher than 0. 89 ±0. 018 and0. 779 ±0. 103% in the sham-operation group, and they reached the peak (0. 93 ±0.015, P =0.008; 1.526 ± 0.296%, P =0.010) at day 3. The α2A-AR mRNA and protein in brain tissue were 0. 93 ±0. 020 and 2.64 ±0. 293% at day 3 after ICH, and they were significantly higher than 0. 86 ±0. 019 (P =0. 001) and 1. 070 ±0. 155% (P = 0. 020), and0.87 ±0. 029 (P =0. 000) at day 1 after ICH and 1. 629 ±0. 488% (P =0. 023) in the sham-operation group. The changes of blood pressure in the ICH day 1 to day 7 grottos in SHRs and correlation coefficient of α2A-AR mRNA absorbance in brain tissue r was - 0. 509 (P = 0.031), and the correlation coefficient of α2A-AR protein-expression volume fraction in brain tissue r was - 0. 473 (P = 0. 047). Conelusions Regulation of blood pressure during acute ICH may have certain correlation with the up-expressions of α2A-AR in brain tissue and α1A-AR in renal tissue.

Objective To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) in congenital coronary artery fistula(CAF) in adults. Methods CDE was used to examine 31 adult patients with CAF and the imaging characteristics and regularity were observed. Angiocardiography was performed in 26 cases. Seven of the 31 cases were treated interventionally and 24 of them surgically. Results Of the 31 patients, 29 were correctly diagnosed according to the CDE characteristics (diagnosis accuracy was 93.5%) and all the complicated anomalies were correctly diagnosed. artery is the origin and whichever heart chamber is the entry site of the fistula, the left atrium and the left showed abnormal blood flow signals in the heart chamber into which the fistula drained and in pulmonary drained into the right ventricle was more common than that into the right atrium, the left atrium, the left or the pulmonary artery was easily misdiagnosed because left ventricular systolic pressure was equal to aortic pressure which made the abnormal blood flow in CDFI indistinct. Conclusions CDE showed obvious imaging characteristics and regularity for CAF in adults and has specific value for the diagnosis of this disease. But CAF that drained into the left ventricle or the pulmonary artery is easily misdiagnosed.

Objective To investigate the effects of oral glucose-electrolyte solution (GES) on resuscitation of hemorrhagic shock induced by 40% blood volume loss in rats. Methods SD rats were randomly divided into three groups; oral GES without hemorrhagic shock (GES group, n = 16) , hemorrhage shock without fluid resuscitation (HS group, n = 20) and hemorrhagic shock resuscitated with oral GES (HS + GES group, n = 20). About 40% of total blood volume was bled from carotid artery of rats to produce a model of hemorrhagic shock. GES with a volume of three times of blood loss was given three times intragastrically at 0.5, 1 and 6 hours after hemorrhage. Mean arterial pressure (MAP) was measured constantly. Blood flow in liver, kidney, stomach and small intestines, and parameters like hemato-crit, plasma osmotic pressure, alanine aminotransferase (ALT) , creatinine (Cr) and diamine oxidase (DAO) were determined 24 hours after hemorrhage. Survival rates of the rats in three groups were calculated 24 hours after hemorrhage. Results MAPs of HS + GES group were 9. 7% and 10. 9% higher than those of HS group 4 and 24 hours after hemorrhage (P < 0. 05). The blood flow of liver, stomach and small intestines in HS + GES group were 18.6% , 88.4% and 22.0% respectively, higher than those in HS group(P <0.05 or P <0.01) 24 hours after hemorrhage. The hematocrit level of HS + GES group was significantly lower than that of HS group, while the levels of ALT, Cr and DAO in HS + GES group were significantly lower than those in HS group (P <0.01). The survival rate of rats in HS + GES group was 80% , which was significantly higher than 30% in HS group (P <0.01). Conclusions Oral rehydration can significantly improve MAP and tissue perfusion, maintain blood volume and plasma osmotic pressure, alleviate organ damage and hence promote the survival rates of rats with hemorrhagic shock.