Objective To discuss the CT value measurement of the soft tissue such as sludged blood,gel foam and residual nucleus in vertebral canal at the early stage after lumbar discectomy.Methods 40 patients of lumbar disc herniation were divided into gel foam group and sludged blood group randomly.There were 22 males,18 females,with the mean age 50.6 years(ranged from 25 to 75 years).All patients underwent lumbar CT scan before operation and CT values of herniated nucleus were measured(simulating residual nucleus after operation).Same surgeon group performed posterior approach discectomy through open window in the vertebral plate.A long column roll of gel foam was placed epidurally at the site where nucleus were take out to stop bleeding in gel foam group.While in sludged blood group just douched with saline.All patients underwent lumbar CT scan one week after operation and CT values of the soft tissue in vertebral canal measured.The CT values before and after operation and between groups were compared and analyzed.Results CT values of the herniated disc of 40 patients were 43.70-66.70 HU.CT values of the soft tissue in vertebral canal of 20 patients gel foam group were(23.00?3.36)HU.Paired-samples t test of the values of herniated nucleus before operation and the gel foam showed t=12.32,P=0.00,with statistic significance.CT values of the soft tissue in vertebral canal of sludged blood group were(25.60?6.75)HU.Paired-samples t test of the values of nucleus before operation and sludged blood showed t=13.84,P=0.00,with statistic significance.Independent-samples t test of values of gel foam group and sludged blood group showed t=-0.78,P=0.46.No significant differences existed.Conclusion CT value measurement is valuable to distinguish the nature of the soft tissue in vertebral canal in clinical use.

Objective To discuss the application of cervical lateral mass plate for the treatment of fractures and dislocations of the cervical spine. Methods From January 1998 to January 2001, internal fixation with cervical lateral mass plate and bony fusion were performed in 21 patients during posterior decompression for the treatment of fractures and dislocations of the lower cervical spine . A posterior median approach was used to expose the lateral edge of the articular process. All patients received spinal decompression and reduction according to the types of fracture and dislocation. A cervical lateral mass plate was applied in each lateral mass, a suitable bicortical screw was inserted using Magerl technique (the inserting point of the screw was 2 mm medial and superior to the center of lateral mass, the direction was 20?-25? laterally and 30?-40? cranially). Results The follow-up of all 21 cases ranged from 9 months to 3 years and 9 months (with the mean of 27 months). There were 20 cases with complete reduction of antero-posterior and rotational dislocation, and 1 case with incomplete reduction according to post-operative X-ray film. Patients could sit up with the protection by wearing soft collar 4 days (2-7 days) after the surgery. The mean off-bed time of those without spinal cord injuries or with spinal cord injuries less than Frankel C grade were 9 days (3-14 days) after operation. All cases obtained solid bony fusion 6 months postoperatively. Eighteen cases with spinal cord injury improved one ASIA grade, 2 cases without root injury obtained complete recovery eventually. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Cervical lateral mass plate fixation has the advantages of wide indications, strong stability, short segment fixation and easily reduction. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

Objective To review the clinical results of percutaneous laser disc decompression(PLDD)in the treatment of cervical disc herniation.Methods PLDD was adopted in the treatment of cer-vi cal disc herniation in32patients.There were19males and13females with an average age of 54years,ranging from33to67years.The lesions were located at the levels of C 3,4 in4cases,C 4,5 in11cases,C 5,6 in13cases and C 6,7 in7cases.The laser fiber was introduced into the herniated disc space with the needle puncturing percu taneously in anterior surface of neck under fluoroscopic guidance.The ND:YAG laser was of 1060nm wave-length,and the diameter of the fiber was400?m.The laser output power was15w with1s emission and5s interval.The compression of spinal cord and surrounding tissue was eliminated by reducing the intra-disc pressure through the vaporization of the disc nucleus.The total laser output power was decid ed depending on the age of the patients,degenerative degree of the disc and the reactive process of heat.The total powers of the group were360J to1100J.Results The mean follow-up was8months,ranging from3to15months.The clinical evaluations were classified as excellent in16cases(50%),good8cases(25%),fair4cases(12.5%)and poor 4cases(12.5%).The general effective ratio was87.5%,the ex cellent and good ratio was75%.The remission ratio of the symptoms was80.7%for the neck and shoulder pain,84.2%for ra-diating pain of the nerve roots of upper extremities,60%for symptoms of the lower ex tremities and78.5%for cervi cal dizziness.No complications occured.Conclusion PLDD could relieve the symptoms and signs of patients cervical disc herniaton.PLDD is easy to manipulate,safe,mini-invasive,and the patients recov-ered sooner with less complications.

BACKGROUND: As a novel procedure in minimally invasive spine surgery (MISS), percutaneous laser disc decompression(PLDD) has been applied widely in the recent development in clinical practices.OBJECTIVE: This study was designed to evaluate the influences of PLDD on the stability in cervical spinal constructs.DESIGN: A before-after comparison trail based on patients.SETTING: The experiment was performed at the spine surgery department of a hospital affiliated to a university.PARTICIPANTS: Twenty-eight patients who were diagnosed as lateral cervical disc herniation at the Spine Surgery Department of Shenzhen People' s Hospital, Second Hospital Affiliated to Jinan University were involved from October 2001 to April 2003. Of all of the patients, 17 were male and 11 were female. They have 29 cervical disc protrusions altogether.INTERVENTIONS: Monitored by X-ray, a 400 μm fixed optical fiber was introduced into the injured intervertebral disc via a 9-gauge flexible trocar through an anterior cervical approach. An Nd-YAG laser system,with a 1 060 nm wavelength and an output power of 15W, was employed to ablate or decompress the inner disc tissue. The disc tissue was exposedto 500- 950 J laser powers.MAIN OUTCOME MMEASURES: Before and 6 months after the PLDD, the deviation of adjacent vertebra displacements was observed and changings of the wedge angles of the intervertebral discs were calculated respectively.RESULTS: The deviation of adjacent vertebra displacements showed no significant difference between before and after operation, when the patients were examined with a more flexed-position or a more extended-position(t=0.811 7-0.827 2, P＞ 0.05), and no significant changes in the wedge angles of the intervertebral discs could be observed either(t=0.768 7-0.827 1,P ＞ 0.05).CONCLUSION: Applying percutaneous laser disc decompression to lateral cervical disc herniation has many advantages, such as simplicity of operation, minimal invasion and having no impact on the stability in cervical spinal constructs.

Objective To explore the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters of advanced schistosomiasis patients. Methods A total of 48 advanced schistosomiasis patients were investigated and they were examined by the liver biopsy and B ultrasound imaging. At the same time,the liver fibrosis biochemical parameters,including glu-tamine transpeptidase(GGT),alkaline phosphatase(AKP),procollagenⅢ(PC-Ⅲ),collagen typeⅣ(Ⅳ-C),hyaluronic acid (HA)and laminin(LN),were detected. The liver fibrosis levels were classified by the liver biopsy and B ultrasound imaging,re-spectively,and the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters were analyzed statisti-cally. Results There was no correlation between the liver fibrosis levels classified by the liver biopsy and all the liver fibrosis bio-chemical parameters;there was a weak correlation between the liver fibrosis levels classified by the B ultrasound imaging and GGT,AKP,LN and PC-Ⅲ,respectively;there was a significant correlation between the liver fibrosis levels classified by the B ul-trasound imaging and HA andⅣ-C,respectively. Conclusions B ultrasound examination is a better,noninvasive fibrosis in-spection method. Liver fibrosis biochemical parameters combined with the B ultrasound examination may better reflect the overall condition of liver fibrosis.

Diabetic gastroparesis （DGP） is a common diabetic neuropathy that affects the normal function of gastric motility and emptying. Clinically， it often manifests as abdominal distension， nausea and vomiting， early satiety， dyspepsia， etc. The pathogenesis of DGP is multifactorial， closely related to many factors， such as chronic hyperglycemia， neuropathy， autonomic nervous system disorders， inflammation， and oxidative stress. These factors can interact with each other， leading to delayed gastric emptying and the occurrence of related symptoms. Traditional Chinese medicine （TCM） has significant advantages in the prevention and treatment of DGP， including a long history， remarkable efficacy， individualized treatment， diverse therapeutic formulations， and improvement in the quality of life. Additionally， TCM is known for its low adverse reactions， good tolerance， and multi-targeted effects， making it an important approach in the management of DGP. Previous research has found that the main mechanisms of Chinese medicine in the prevention and treatment of DGP include the regulation of gastrointestinal hormones， inhibition of inflammatory responses， reduction of oxidative stress， enhancement of interstitial cells of Cajal activity， inhibition of pyroptosis， and modulation of related signaling pathways such as stem cell factor （SCF）/cellular growth factor receptor （c-Kit）， adenosine monophosphate-activated protein kinase （AMPK）， Ras homologous genome member A （RhoA）/Rho-associated coiled-coil forming kinase （ROCK）. This article primarily summarized the research progress on Chinese medicine in preventing and treating DGP through the inhibition of inflammatory responses， reduction of oxidative stress， enhancement of interstitial cells of Cajal activity， inhibition of pyroptosis， and regulation of related signaling pathways， aiming to provide a reference and basis for further research on the application value of Chinese medicine in the prevention and treatment of DGP.