Objective To compare the clinical effect of different percutaneous endoscopic removal of nucleus pulposus vertebral plate gap into the road in the treatment of L5 and S1 lumbar intervertebral disc protrusion.Methods 120 cases with lumbar intervertebral disc protrusion in our hospital were randomly divided into group A and group B,60 cases in each group.Group A was given the intervertebral foramen mirror vertebral plate gap into the way,group B was given the posterior intervertebral disc mirror reserves the yellow ligament treatment.The operation time,number of perspective,intraoperative blood loss,length of incision,visual analogue scale (VAS),hospitalization days,Oswestey disability index (ODI) before and after surgery were compared between two groups.The curative effect was evaluated by the Macnab criteria.Results The operation time,number of perspectives,intraoperative blood loss,surgical incision length,VAS score,hospitalization days in group A were (58.69±5.26)min,(2.56±0.52)times,(80.23±20.45)mL,(1.63±0.33)cm,(2.95±0.77)points,(4.98±0.84)d,respectively,those in group B were (60.36±5.31)min,(2.55±0.48)times,(75.69±2.96)mL,(1.56±0.21)cm,(2.98±0.69)points,(5.01±0.86)d,the differences between the two groups were not significant (all P＞0.05).Immediate postoperation and postoperative 3 months,the ODI scores of group A were (36.96±10.58)points,(9.26±0.23)points,(6.35±0.44)points,respectively,and those of group B were (37.02±9.85)points,(9.42±0.65)points,(6.30±0.39)points,immediately after operation,postoperative 3 months,the ODI scores of the two groups were lower than before operation,compared with immediate postoperation,the ODI scores of postoperative 3 months were significantly reduced,the difference was statistically significant (P＜0.05).At immediately after operation,postoperative 3 months,the ODI score between the two groups had no significant difference (P＞0.05).The excellent rate of group A was 90.00％,which of group B was 91.67％,the difference between the two groups was not obvious (P＞0.05).Conclusion Intervertebral foramen mirror the vertebral plate gap into the road and posterior intervertebral disc mirror reserves are yellow ligament in treatment of L5 and S1 lumbar intervertebral disc protrusion will achieve good operation effect,no obvious difference was found between the two methods,before undergoing surgery for the patients'' individual condition and indications for judgment,and to choose appropriate surgical method.

Objective To explore the influencing factors of degenerative lumbar spondylolisthesis (DLS).Methods Sixty-one DLS patients (DLS group) were enrolled in this study.The control group was formed by 61 patients with same gender and age matched.The lesion position was L4 in two groups.The correlation of intervertebral joint angle,degeneration degree,lumbosacral angle and lumbar spondylolisthesis were analyzed.Results The intervertebral joint and sagittal angle in DLS group was less than that in control group[(37.11 ± 7.52)° vs.(42.44 ± 7.61)°] (P ＜ 0.01).The lumbosacral angle between two groups had no significant difference (P ＞ 0.05).The degeneration degree between two groups had significant difference (P ＜ 0.01).Conclusion Intervertebral joint and sagittal angle and intervertebral joint degeneration degree have important roles in DLS.

OBJECTIVE:To establish quality control system by using modern scientific idea and advanced method in in?patient pharmacy.METHODS:Under the situation o f running authentication of ISO9001quality control system in our department,inpatient pharmacy should take the patients as focus to offer good and normative services to patients and clinical departments and continue to make our work better.RESULTS&CONCLUSION:Implementation of ISO9001quality control system has standardized the management of quality of inpatient pharmacy as well as increased the patients'satisfaction.And satisfactory social and economical benefits have been obtained and self-perfect and continuous improvement have been realized in the inpatient pharmacy.

Hepatic artery stricture (HAS) after liver transplantation can lead directly to transplanted liver function exhaustion and complications of biliary system. The early diagnosis and treatment are crucial for better prognosis. Doppler ultrasound is the first method of choice, and angiography can give further clear dignosis. The balloon dilatation is still effective for hepatic arterial stenosis. With the more adaptable usage of oronary stent, if possible, would reveal more promising result especially for tortuous stenotic hepatic artery. The vascular reconstruction or repeated liver transplantation is still the effective therapeutic methods.

Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.

Objective To investigate the feasibility,method and result of laparoscopic total gastrectomy for gastric cancer. Methods Clinical data of 63 cases of gastric cancer treated with laparoseopic total gastrectomy were analyzed retrospectively. Results In this study,52 cases underwent laparoseopic radical total gastrectomy and 5 cases did laparoseopic palliative total gastrectomy.The procedure Was hand assisted in tlle first 45 cases for fashoning esophagojejunostomy through a small incision.In six cases the procedure was converted to open surgery.The operative time was(312±35)min,the blood loss was(190±50)ml,the number of lymph nodes dissected Was(32±7).It began to pass flatus(4.0±1.2)days postoperatively.It was(4.5±1.5)days to start oral liquids.Patients were up and about on(4.0±1.5)days postoperatively. Minor postoperative complications occurred in 5 cases. Conclusion Laparoscopic total gastrectomy for gastric cancer is safe,feasible,less traumatic and of fast postoperative recovery.

Objective To explore the localization of epileptogenic focus and select the appropriate surgical procedures for post-traumatic epilepsy. Methods The clinical data of 21 patients with post-traumatic epilepsy were studied retrospectively. Epileptogenic focus was located by comprehensively analyzing data of electro-neurophysiology, neurological imaging and clinical manifestation. Surgical procedures were performed in all patients, including resection of lesion and peripheral cortex in 12 patients, epileptogenie focus resection plus low power bipolar coagulation in five, anterior temporal iobectomy plus amygdalohippocampectomy in three and corpus callosotomy in one. Results All patients were followed up from 6 months to 3 years, which showed satisfactory outcome in eight patients, marked improvement in six, improvement in five and slight improvement in two. The total effective rate was 90%. Conclusions Surgical procedure is important for intractable post-traumatic epilepsy. The good efficacy depends on precise localization of epileptogenic focus and combined application of various surgical procedures.

With the development of instrumentation and surgical techniques,laparoscopic gastrectomy has become a promising surgical option for the treatment of gastric cancer.While laparoscopic gastrectomy is high technique-demanding,which hampered its popularization.Compared with traditional laparoscopes,Da Vinci surgical system has more special features,such as flexible robotic arms and three-dimensional imaging,which facilitates surgical procedures.A 58-year-old male patient with gastric cancer underwent Da Vinci surgical system-assisted radical total gastrectomy at the Southwest Hospital in March 2010.The mean operation time and blood loss were 270 minutes and 60 ml,respectively,and the number of dissected lymph nodes was 21.The short-term clinical effect was perfect without postoperative complications.Da Vinci surgical system-assisted radical total gastrectomy is safe and feasible,and it brings challenges to conventional laparoscopes.

Objective To investigate the relationship between the expression of eonnexin 43 (Cx43) and clinicopathologieal characteristics of gastric cancer, and to study the role of Cx43 in peritoneal metastasis of gastric cancer. Methods Thirty-two patients who had gastric cancer and with peritoneal metastasis had been admitted to Southwest Hospital from January 2000 to December 2008. Gastric cancer tissues, adjacent tissues and metastatic peritoneal tissues were obtained postoperatively, and the expression of Cx43 was detected by immunohistochemistry. The relationship between Cx43 expression and clinicopathological characteristics of gastric cancer was analyzed. All data were analyzed via Spearman rank correlation coefficient, Fisher exact probability and chi-square test. Results The expression of Cx43 was mainly detected in the cell membrane and cytoplasm. The positive expres-sion rates of Cx43 in gastric cancer tissues, adjacent tissues and metastatic peritoneal tissues were 34% (11/32), 100% (32/32) and 94% (30/32), respectively. There were significant differences in the Cx43 expression between gastric cancer tissues and adjacent tissues (X~2=28.350, P < 0.01), and between gastric cancer tissues and metastatic peritoneal tissues (X~2 = 21.989, P < 0.01). The expression of Cx43 did not correlate with age and sex of patients (r = -0.030, - 0.169, P > 0.05), but with tumor differentiation, histological type and lymph node metastasis (r = 0.750, 0.642, - 0.357, P < 0.05). Conclusions There is a decreased expression of Cx43 in gastric cancer tissues and a up-regulated expression of Cx43 in metastatic peritoneal tissues. Cx43 may play a positive role in the peritoneal metastasis.

Objective To investigate the sensitivity and variability factors that were assessed on the forced swimming test (FST) using BALB/C and Kunming mice. Methods The immobility time of FST was compared using Kunming and BALB/C mice in different experimental conditions including circadian rhythm ( day and night) ,gender and water temperature ( 12,22 and 32℃ ) . Results (①) The immobility time of BALB/C during the daytime( ( 142.42 ± 33.58) s) was significantly increased than that at night ( ( 104.89 ± 34.33 ) s). (② The immobility time of Kunming mice( (91.95 ± 40.32) s) was significantly decreased than that of BALB/C mice ( ( 142.42 ± 33.58 ) s). (③)The immobility time under the water temperature of 22 C ( ( 92.24 ± 25.81 ) s) was significant longer than that under the water temperature of 32C ( (60.72 ± 11.11 ) s). Conclusion BALB/C stain,male mice,daytime and water temperature of 22℃ should be chosen in the FST.