Objective To investigate the incidence,the diagnosis,the multimodal treatment and the relevant factors of the brain metastases in patients with epithelial ovarian carcinoma(EOC) Method The clinical data were analysed in 10 cases of brain metastases from 478 cases of EOC after treatment between 1996-2001 Results The incidence of brain metastases in EOC was 2 1% The most common manifestation of the brain metastases was headache,nausea and limb paralysis The most common metastatic sites were the cupular and occipital part of the cerebra.Seven of ten patients were treated with brain radiation and systemic chemotherapy, three abandoned The brain irradiation dosage was 30-38 Gy for only one focus in the brain lasting for 4 weeks and 40-45 Gy for two or three foci in the brain lasting for 5 weeks The overall survival after identification of brain metastases was

ObjectiveTo evaluate the application value of the emergency laparoscopic surgery in incarcerated inguinal hernia of children. MethodsManual reduction of incarcerated hernia was laparoscopic- assisted after anesthesia, high-ligation of hernia sac was done by one hole method of laparoscopic treatment.ResultsAll of 22 cases of pediatric incarcerated hernia were done, no complications occurred. Eighteen patients were followed up for 3 - 15 months, 9.3 months on average, without serious complications. ConclusionsThe emergency laparoscopic surgery in children of incarcerated inguinal hernia is safe and feasible,with smaller trauma, quicker recovery and smaller health risk.

Objective To observe the clinical effect of combination of clopidogrel and simvastatin on coro-nary heart disease and transient ischemic attack(TIA). Methods 76 patients with coronary heart disease and TIA were randomly divided into test group (n=40) and control group (n=36). The control group was treated with en-teric-coated aspirin 50 mg×2 every night after supper, and the test group was treated with clopidogrel 25 mg×2 and simvastatin 10 mg×2 every night before sleep. Liver and kidney function, blood coagulation function and blood lipids were measured before treatment and after. 1 year followed-up. Results The effective rate was 95.0% (38/40) in test group and 55.5% (20/36) in control group(χ2=6.45,P<0.01). LDL-C was (3.18±1.24) mmol/L and (2.60±1.03)mmol/L(t=2.67,P<0.01),TC was(5.18±1.24) mmol/L and (4.02±2.18) mmol/L(t= 4.91, P<0.01),TG was (1.50±1.02) mmol/L and (1.30±1.03) mmol/L(t=1.02, P>0.05), respectively in test group before and after treatment. However, there was no statistical difference in LDL-C, TC and TG (t=0.17, 0.00,0.52,0.57,P>0.05 for each) in control group. The two groups showed no difference after treatment (t= 1.51,2.55,0.57, P>0.05 for each). Conclusions Glopidogrel combined with simvastatin capsules is safe in pre-vention of TIA attack.

Objective Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery Method We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non surgical treatmen from 1997 to 2002 Results During the study period,67 operations were performed on 67 patients Among them,surgical procedure was completed in 58 cases Successful palliation was achieved in 64 2% of cases in which surgical correction was possible The median survival of the entire cohort was 7 8 months,and 12 6 months for the surgically successfully relieved patients and 3 7 months for those non surgical patients The rate of major surgical morbidities was 22 4 % The perioperative mortality rate was 6 0% Successful palliation was associated with the absence of two prognostic factors:multiple obstructive sites and palpable abdominal and pelvic masses Conclusion Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile,and properly selected patients are the key to its success

Objective Potassium channel is essential for excitability of neurons and is involved in the regulation of information transmission. The purpose of this study was to investigate the effect of propofol on the voltage-gated potassium channels in rat hippocampal pyramidal neurons. Methods SD rats of 5-15 days old were decapitated and brain was immediately removed. Hippocampal pyramidal neurons were freshly isolated. Whole-cell patch clamp recordings were made. Voltage-dependent sodium and calcium currents were inhibited by TTX 1?mol?L-1 and CdCl2 400 ?mol?L-1 added to the perfusate. The effects of propofol on transient outward potassium currents and delayed rectifier potassium currents were studied and also the kinetics of channels. Results All the channels studied were reversibly inhibited by propofol in a dose-dependent manner. EC50 of propofol on transient outward potassium channels and delayed rectifier potassium channels were (71?18) ?mol?L-1 and (37?18) ?mol?L-1 respectively. The maximum inhibition rates were 52%?3% and 32%?5% .Conclusion Propofol reversibly inhibits potassium currents in a does-dependent manner. It is inferred that propofol affects the excitability of hippocampal neurons.

Tissue engineering may allow obtaining patient’s own cells, seeding them on biodegradable scaffolds, thus achieving formation of a particular tissue or organs, such as bone, cartilage, muscle, or heart. These tissues or organs can be used to repair tissue or organs defects caused by disease or trauma. Many animal studies have demonstrated the efficacy of using bone marrow mesenchymal stem cells in treatment of diseases such as nervous system diseases, liver disease, respiratory diseases and kidney disease. The main ways of the stem cells therapy are local implantation and systemic transplantation of bone marrow mesenchymal stem cells, and the effect of such treatments is notable. The use of gene-modified stem cells in gene therapy is an fantastic option due to theoretical advantage of stem cells compared to somatic cells with respect to higher proliferative capacity. Bone marrow mesenchymal stem cells can deliver genes and proteins into organs or tissues with specific need for gene therapy.

Objective To investigate the different effects of different resection position of fibula on shape of tibiofibular syndesmosis,and explore the best position of cut fibula,providing reference for clinical surgeon to use fibula reasonably.Methods Ten adult male cadaverie specimens 172-176 cm long were used for 20 shank-ankle specimens.10 cm long fibula was cut proximally at the lower point 1/6,lower point 1/4,lower point 1/3,middle point 1/2 respectively,which was compared with the nornlal one to analyze the changes of shape of tibiofibular syndesmosis.Results Normally,the distance oftibiofibular syndesmosiswas(0.30±0.10)mm.Underthe condition of cut at the lower point 1/6,the distance of tibiofibular syndesmosis was enlarged[(0.54±0.20)mm](P＜0.05).In contrast,under the condition of cut 10 cm long fibula proximally at the middle point 1/2.the distance of tibioffbu1ar syndesmosis hadlittle effect[(0.31±0.20)mm](P＞0.05).Conclusion The best resection position of fibula is in the proximity of the fibula at the point 1/2.

Objective To explore the effects of electroacupuncture on the expression of glucose transporter 4 (GLUT4) and protein kinase Bβ (Akt2) in the skeletal muscles of insulin-resistant (IR) rats. Methods Twentyfour male Wistar rats were randomly divided into a normal control group, a model group and an electroacupuncture (EA) group. The rats of the model group and the EA group were fed with high fat diets to establish a model of insulin resistance. The rats in the EA group were then treated with electroacupuncture for 2 weeks, while those in the model group were not. Blood samples were collected to evaluate fasting insulin (FINS) and fasting blood glucose (FBG) to calculate the insulin sensitivity index (ISI). GLUT4 and Akt2 mRNA in the skeletal muscles were determined with reverse transcription-polymerase chain reactions (RT-PCRs) after 2 weeks of EA treatment. Results Compared with the control group, the FINS in the model group increased significantly, and ISI decreased significantly. Compared with the model group, the FINS in the EA group decreased significantly and ISI increased significantly. The expression of GLUT4 and Akt2 mRNA in the model group was significantly lower than in the control group or the EA group. Conclusion Electroacupuncture might improve the condition of IR rats, probably by enhancing the transposition of GLUT4 in the phosphatidylinositol 3-kinase/protein kinase signaling pathway.

BACKGROUND:It has been demonstrated that shortening of femoral eccentricity would lead to decreased abductor muscle strength,and overlengthening eccentricity would increase the risk of femoral neck prosthesis fracture and the compressive stress of cemented femoral stem prosthesis after artificial hip replacement,which easily causes prosthetic loosening and subsidence.OBJECTIVE:To investigate the importance of eccentricity adjustment in the artificial hip replacement for treatment of femoral neck fracture in elderly patients.DESIGN,TIME AND SETTING:An observational study was performed at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2004 and December 2005.PARTICIPANTS:A total of 30 patients with femoral neck fracture,12 males and 18 females,averaging 73.8 years of age (range 62-90 years old),received treatment at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and were recruited into this study.METHODS:All patients underwent artificial hip replacement operated by the same team of surgeons.Prior to surgery,some indices on the uninjured side were determined through the anteroposterior radiographs of pelvis using X-Caliper measurement tool,including rotation center of femoral head,rotation center of hip joint,collodiaphyseal angle,femoral transverse eccentricity,abduction moment arm,and moment arm of gravity.These indices were precisely calculated using trigonometric function.The angle of osteotomy plane was determined.Proper prosthesis was selected and eccentricity was adjusted.Following artificial hip placement,a comparison was made between uninjured and injured sides.MAIN OUTCOME MEASURES:Eccentricity and hip joint function.RESULTS:The eccentricity on uninjured side of 30 patients averaged 38.7 mm (range 22-57 mm) prior to surgery and that on the injured side averaged 39.2 mm (range 21-59 mm) after surgery.Limb discrepancy ranged 1.8-8.7 mm,with a mean of 3.4 mm,after surgery.There were 26 patients (86.7%) presenting long limbs and 4 patients (13.3%) showing short limbs after surgery.All patients were followed-up 0.5-2.5 years old.Harris hip score results were excellent in 10 patients,good in 19 patients,and fair in 1 patient,with an excellent and good rate of 97%.CONCLUSION:In treatment of femoral neck fracture,eccentricity adjustment during artificial hip replacement is closely associated with hip joint function after surgery.

Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of ⅡA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system (Depuy). The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months (ranging 4.5-36.0 months), postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had tow-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°-110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.