OBJECTIVETo evaluate clinical result of the micro-decompression procedure for lumbar spinal stenosis.

METHODSFrom September 2001 to May 2006,87 patients (male 60, female 27) with lumbar spinal stenosis underwent micro-decompression. The age of patients were from 43 to 80 years with an average of 51 years. Among them,2 cases with spinal stenosis occured in L(3,4), 47 in L(4,5), 38 in L5S1.

RESULTSAll patients were followed up for 18-48 months with an average of 26 months. The results were excellent in 52 cases, good in 28, poor in 7, according to Macnab of back leg pain standard. The rate of excellent and good was 92%.

CONCLUSIONOperative treatment for lumbar spinal stenosis is focused at the areas causing symptomatic neural root compression rather than prophylactic decompression at areas of nonsymptomatic disease. The micro-decompression procedures are more likely to be well tolerated by older patients.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Stenosis ; surgery ; Treatment Outcome

Objective To summarize our experience of surgical repair for cervical aortic arch(CAA) aneurysm and eval-uate early and midterm results of these patients.Methods From January 2010 to December 2014, 22 patients with left-sided CAA aneurysm admitted in our center.There were 6 male and 16 female patients with a mean age of(34.09 ±13.14) years. Comorbidities included pseudocoarctation in 9 patients, hypertension in 4 patients, and aortic valve insufficiency, Stanford type B aortic dissection and middle cerebral artery aneurysm each had 1 patient.All of the patients underwent surgical aortic arch re-construction using artificial graft replacement.Among them, 4(4/22, 18.18%) were performed under moderate hypothermic circulatory arrest(MHCA) combined with selective antegrade cerebral perfusion(SACP) via a median sternotomy, and concom-itant aortic valve replacement(AVR) was implemented in 1 patient.18(18/22, 81.82%) were performed via posterolateral left thoracotomy through the 4th intercostal space, and adjunct methods applied included partial CPB and “simple clamping” in 10 and 8 of these patients respectively.Results The average mechanical ventilation time and ICU stay time was (13.05 ± 4.73)h and(19.14 ±8.08) h respectively.1 patient required repeat thoracotomy for bleeding, 1 patient with delayed wound healing and 1 patient suffered transient liver dysfunction.There were no in-hospital deaths.Mean follow-up time was 34.73 months, and 3 patients were lost during follow-up.There were no late deaths during follow-up.Conclusion Repair of CAA is indicated for the patients with arch aneurysm formation .According to the locations and types of aneurysms and other concomi-tant proximal cardiovascular diseases, performing one-stage surgical aortic arch reconstruction with individualized incisions , ad-junct methods and operative procedures can obtain satisfactory clinical outcomes in patients with CAA aneurysm .

OBJECTIVETo investigate the effects of prepubertal exposure to diethylstilbestrol (DES) on the testicular development and function of Sprague-Dawley (SD) rats.

METHODSNinety 21-day-old male SD rats were randomly and equally divided into 4 experimental groups (Da, Db, Dc and Dd), which were injected with DES dissolved in corn oil at the dose of 0.01, 0.1, 1.0 and 10.0 microg/(kg x d) from postnatal day (PND) 22 to 35, and a control group (C), which received vehicle only. The testicular development of all the rats was observed, and their testes were harvested in the stages of late puberty (PND 50), sexual maturity (PND 64) and adulthood (PND 130) respectively to determine the weight and histological features of the testis and examine the quality of the sperm in the epididymal cauda of the PND 130 rats.

RESULTSThe testis descent in the C, Da, Db, Dc and Dd groups occurred on PND 26.17 +/- 1.94, 26.83 +/- 1.47, 28.68 +/- 1.03, 33.50 +/- 1.87 and 41.50 +/- 2.74 respectively, significantly delayed in the Db, Dc and Dd groups compared with the C group (P < 0.05 or P < 0.01). On PND 50, the unilateral testis weights in the C, Da, Db, Dc and Dd groups were (1.38 +/- 0.01) g, (1.38 +/- 0.12) g, (1.30 +/- 0.14) g, (0.86 +/- 0.18) g and (0.73 +/- 0.27) g respectively, significantly less in the Dc and Dd groups than in the C group (P < 0.01). Compared with the C group, there was a slight decrease in the number of the cells in the epithelia of a few seminiferous tubules in the Db group on PND 50, maldevelopment of seminiferous tubules, reduced cell number in seminiferous epithelia, blocked spermatogenesis and aplasia of Leydig cells in the Dc and Dd groups in a dose-dependent manner. On PND 64, the unilateral testis weights in the C, Da, Db, Dc and Dd groups were (1.60 +/- 0. 06) g, (1.62 +/- 0.11) g, (1.58 +/- 0.08) g, (1.47 +/- 0.10) g and (0.99 +/- 0.37) g respectively, significantly less in the Dc and Dd groups than in the C group (P < 0.05 or P < 0.01), and the histological alteration of the testis in the Dc and Dd groups was similar to or less than that on PND 50. On PND 130, no statistic difference was observed either in unilateral testis weight or in the histological features of the testis between any experimental group and the control (P > 0.05). The sperm concentration in the epididymal cauda in the C, Da, Db, Dc and Dd groups were (73.00 +/- 16.90) x 10(6)/ml, (68.00 +/- 19.67) x 10(6)/ml, (68.67 +/- 12.15) x 10(6)/ml, (35.17 +/- 15.64) x 10(6)/ml and (19.13 +/- 5.17) x 10(6)/ml, significantly lower in the Dc and Dd groups than in the C group (P < 0.01). There was a significant decrease in sperm motility in the Dd group (P < 0.01), the percentage of grade a sperm in the Db, Dc and Dd groups (P < 0.05) and the percentage of grade b sperm in the Dd group (P < 0.01).

CONCLUSIONPrepubertal exposure to low dose of DES (0.01 microg/[kg x d] x 14 d) does not significantly affect the testicular development and function of SD rats, while high dose (1.0-10.0 microg/[kg x d] x 14 d) has significant short- (PND 50 and 64) or long-term (PND 130) toxic effect, which increases with dose and decreases with age. The mechanism of the toxic effect involves the insults to the development and function of Leydig and Sertoli cells.

Animals ; Carcinogens ; toxicity ; Diethylstilbestrol ; toxicity ; Dose-Response Relationship, Drug ; Male ; Organ Size ; drug effects ; Rats ; Rats, Sprague-Dawley ; Sexual Maturation ; drug effects ; Testis ; drug effects ; growth & development ; physiology ; Time Factors

OBJECTIVETo compare the ingredients of essential oils of Curcuma wenyujin extracted by supercritical-CO2 fluid extraction and by steam distillation.

METHODGC-MS was applied in this experiment.

RESULTThe ingredients and physical and chemical properties of essential oils of C. wenyujin extracted by supercritical-CO2 fluid extraction and by steam distillation are similar.

CONCLUSIONSupercritical-CO2 fluid extraction is better than steam distillation in extraction time, power consumption, recovery and purity.

Carbon Dioxide ; Chromatography, Supercritical Fluid ; methods ; Curcuma ; chemistry ; Oils, Volatile ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Volatilization

Objective To observe the change of expression of neuroligin1 (NL1) in injured spinal cord in rats. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into control group (n=30) and experi-ment group (n=30), and both groups were further arranged into three days, seven days, 14 days, 21 days, and 28 days subgroups. The control group accepted T9-11 laminectomy, while the experiment group was injured at T10 spi-nal cord hit by Allen's technique (10 g×25 mm). They were assessed with Basso, Beattie & Bresnahan locomotor rating scale (BBB scale), in their time-points, while Golgi-Cox staining was used to observe the variation of den-drites and density of dendritic spine in the white matter located at upper end of spinal cord injured center, and im-munofluorescence staining was used to detect the expression of NL1. Results The score of BBB scale reduced in the experiment group compared with that in the control group in every sub-group (P<0.001). Compared to the control group, both dendrites and density of dendritic spine in the white mat-ter decreased with time after injury (P<0.001), while the level of NL1 increased three days after injury, peaked on the 14th day after injury (P<0.05). Conclusion NL1 increases spontaneously after spinal cord injury, but it is not enough to promote synaptic regeneration.

Objective To explore the mid-term results of the staged total aortic replacement in Stanford type A aortic dissection.Methods During March 2009 to September 2016,a total of 49 patients with Stanford type A aortic dissection in Beijing Anzhen Hospital cardiovascular center underwent total aortic replacement with a median age of 36 (27,41 years),male 36 (73.5％) cases.30 (61.2％) cases of them combined with Marfan syndrome.Results The interval between two stage operation was 23 (10,57) months.In the first stage operation,45 (91.8％) cases underwent Sun's procedure,2 (4.1％) underwent total aortic arch replacement,2 (4.1％) cases underwent classic elephant trunk and total aortic arch replacement.All patients underwent thoracoabdominal aortic repair(TAAAR).Deep hypothermic circulatory arrest surgery was 12(24.5％)cases in the second stage.7 (14.3％)cases dead postoperative.Spinal cord related complications happened in 3 (6.1％) cases with stroke in 2(4.1％) cases,acute renal insufficiency in 7(14.3 ％) cases,respiratory insufficiency in 7 cases (14.3％),re-operation for hemostasis in 3 (6.1％) cases and gastrointestinal bleeding in 3 cases(6.1％).Univariate analysis showed that the interval between two stage operation,operation time,deep hypothermic circulatory arrest surgery are risk factors for in-hospital mortality;multivariate analysis showed that deep hypothermic circulatory arrest surgery and the interval between two stage operation were independent risk factors for in-hospital mortality.3 years,5 years survival rate were 94.4％ and 78.7％.Conclusion For Stanford type A dissection especially the thoracoabdominal aortic expands,staged total aortic replacement shows good mid-term results.Block stentgraft can reduce the use of deep hypothermic circulatory arrests to decrease the mortality.

OBJECTIVE: To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy (BIPN) of patients with multiple myeloma (MM). METHODS: A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule (NVC, 0.4 g, thrice daily) were orally administrated for 30 days. Comparative analysis on parameters between pre- and post-therapy, including peripheral neuropathy (PN) grade, neurotoxicity score, Chinese medicine (CM) syndrome score, total neuropathy score (TNS), coagulation function, and serum nerve growth factor (NGF) levels were conducted. The adverse events were monitored. RESULTS: In BIPN of MM patients who received NVC, PN grade was lowered, neurotoxicity score was obviously decreased (P⩽0.01), and both CM syndrome score and TNS were remarkably decreased (P<0.01). After the therapy, activated partial thromboplastin time was prolonged (P<0.01) and fibrinogen was declined (P<0.05), showing improvement in the hypercoagulable state of patients. No significant difference of NGF recovery degrees was detected between pre- and post-therapy (P>0.05). No evident adverse reactions were observed during the course of treatment. CONCLUSION Strychnos nux-vomica L. has significantly effect with a good safety in treatment of BIPN in MM patients.

Objective    To evaluate the short- and middle-term outcomes of surgical treatment for distal aortic arch lesions using stented elephant trunk implantation combined with transposition of left subclavian artery to left common carotid artery. Methods    The clinical data of 14 patients with distal aortic arch lesions undergoing stented elephant trunk procedure with left subclavain artery transposition under hypothermic cardiopulmonary bypass (CPB) with antegrade selective cerebral perfusion from May 2009 to November 2015 in our hospital were retrospectively reviewed. All of them were males with a mean age of 52±14 years ranging from 20 to 69 years. Hypertension was observed in nine patients, coronary artery disease in five and prior cerebral infarction in one. History of percutaneous coronary intervention was noted in one patient, history of Bentall operation in one, ligation of patent ductus arteriosus in one and endovascular aneurysm repair in one. Results    There was no hospital death. Concomitant procedures included coronary artery bypass grafting in two patients and plasty of the ascending aorta replacement in one. Mean duration of mechanical ventilation and ICU stay was 21±7 h and 43±19 h, respectively. All patients survived and were discharged. One patient was lost to follow-up and no patient died during the follow-up. Postoperative computed tomography revealed good patency of  the anastomotic site between the left subclavian artery and the left common carotid artery. Conclusion    Stented elephant trunk procedure with left subclavain artery transposition obtains satisfactory surgical results in patients with distal aortic arch lesions.