Objective To investigate the method and the effect of posterior approach low lumbar spinal nerve root sheath decompression under microendoscope (MED-Ⅱ). Methods Thirty-nine patients with low lumbar disc herniation, accompanying severe preoperative limb numbness and radiculalgia, who were found obvious edema of nerve root with adhesion during surgery, entered the study. In the course of lumbar discectomy, a self-made mini-scalpel was used for the incision and decompression of the nerve root sheath, in which a 3～5 mm longitudinal incision was made along the dorsal side of the nerve root. Results Decompression was achieved under microendoscope (MED-Ⅱ) in all the 39 patients. Limb numbness and radiculalgia subsided completely in 17 patients within 24 postoperative hours, while the symptoms trailed off within 2 weeks following the surgery in the remaining patients. The time to complete disappearance of the symptoms was 1～14 d (mean, 6 5 d). Conclusions Minimally invasive spinal nerve root sheath incision and decompression can give a prompt relief from limb numbness and radiculalgia, improving the recovery of nervous system. Lumbar spinal nerve root sheath incision and decompression under microendoscope (MED-Ⅱ) is a safe and effective procedure.

Objective To explore the technical feasibility and effects of ant erior cervical discectomy and interbody fusion using endoscopic technique. Metho ds A retrospective study was undertaken in 23 patients with single segmental cer vical fracture and dislocation or cervical spondylotic myelopathy. There were 14 males and 9 females with an average age of 41.5 years (range, 23 to 64). The fr acture and dislocation patients consisted of 2 cases with complete tetraplegia e ither of C3,4 or C4,5, 3 with incomplete tetraplegia of C5,6 and 2 of C4,5 free from nervous symptoms. The operative procedures included anterior cervical disce ctomy and interbody fusion with insertion of cage or/and plate fixation through an endoscopic working canal. Results All 23 cases were followed-up from 6 to 18 months. The operative incisions healed smoothly. All patients achieved interbody fusion, and no loosening or displacement of the cage and plate occurred. For th e cervical fracture and dislocation patients, by Frankel's classification, 2 cas es with complete tetraplegia showed no any improvement, 2 cases with incomplete tetraplegia improved from grade C preoperatively to grade D postoperatively, 1 c ase with incomplete tetraplegia upgrade from C to E, 2 cases without nervous sym ptoms maintained preoperative status. For cervical spondylotic myelopathy patien ts, according to Odom's scoring system, 10 cases were assessed as excellent (dis appearance of all symptoms), 5 good (alleviation of main symptoms), 1 fair (alle viation of partial symptoms). 94% patients gained excellent and good results. No complications occurred in this series. Conclusion With the improvement of the t echnique and instrument, the endoscopic procedures can be used for anterior cerv ical discectomy, interbody fusion and internal fixation. It presents microsurgic al advantages such as minimal incision, less traumatic reaction, clear intraoper ative visualization, and less postoperative discomfort comparing to traditional approach.

Objective To analyze factors associated with long-term survival of acute leukemia(AL). Methods Clinical data is analyzed in 27 leukemia cases who had at least 5 years free survival (EFS). Combined intensive chemotherapy was administered under the principle of individualization to induce remission.Regular consolidation treatment after remission was strictly continued.Long-term follow up Was kept on,with the therapeutic regimen modified accordingly.Results Complete remission(CR) was achieved in 112 of 143(78.3%)AL patients and 27(18.9%)of them had survived more than 5 years.Conclusion The long-term survival of AL patients is related to the type of AL,leukemia cell burden,extramedullary leukemia, individual treatment,time required to achieve CR,continuous intensive chemotherapy and the regular postremission treatment.

BACKGROUND:The sodium alginate film, jointly developed by our research team and the Institute of Polymer Material of Qingdao University, has good biocompatibility and is often used for the preparation of a variety of composite materials. OBJECTIVE: To observe the effect of sodium alginate film wrapping and covering nerve anastomotic stoma on the regeneration of injured sciatic nerve in rats. METHODS: A total of 36 male Wistar rats were randomly divided into two groups after the right sciatic nerve was cut. Control group: The nerve stump was sutured through epineurial end-to-end anastomosis; Experimental group: The nerve stump was sutured through epineurial end-to-end anastomosis, and wrapped with sodium alginate film, forming a regenerative environment for sciatic nerve regeneration. The degradation and absorption of sodium alginate film, as wel as the adhesion at suture site were observed post-operation. Interleukin-2 and interleukin-4 positive expression was detected with immunohistochemistry method. The histological sections were also detected with hematoxylin-eosin staining and osmium tetroxide staining. RESULTS AND CONCLUSION:At 4-6 weeks post-operation, sodium alginate film was mostly degraded and absorbed in the experimental group. The experimental group rats had less local adhesion, slighter infiltration of inflammatory cels, and fewer fiber tissue hyperplasia than control group rats. The contents of interleukin-2 and interleukin-4 were almost the same between the control and experimental groups at 1, 7, 14 days post-operation. At 6 weeks, the regenerated nerve fibers were distributed evenly with uniform shape, the number of nerve fibers, axons and myelin sheath were significantly better than the control group (P < 0.05). Sodium alginate film has good biological degradability and histocompatibility and plays an important role in promoting sciatic nerve regeneration.

Objective To analyze the CT findings and mechanisms of intracranial hemorrhage complicating infective endocarditis(IE).Methods The clinical materials of 5 cases with intracranial hemorrhage complicating IE were collected. Unenhanced CT was performed in all cases. Results Intracranial hemorrhage complicating IE included parenchymal hematomas, subarachnoid hemorrhages and hemorrhagic infarcts. Parenchymal hematomas could be sporadic or multiple and were all located in cortical or subcortical regions. Conclusion Perfectly understanding the mechanisms of the intracranial hemorrhage complicating IE is helpful to understand its CT findings and helpful for etiological diagnosis .

Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the total scores of BEHAVE-AD and the factor scores of affective disorder, anxiety and terror (P<0.001). The interactive effect of time×group was significant in the total scores of BEHAVE-AD and the factor scores of delusion and affective disorder (P<0.05). ② Intergroup comparison of the BEHAVE-AD scores indicated that by the end of 6 months, factor scores of hallucination, circadian rhythm disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, total scores of BEHAVE-AD, and factor scores of delusion, conduct disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③ There was no significant difference in the scores of MMSE, ADL, QOL-AD and GQOLI-74 between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.

Objective To study the effect of ecdysterone (EDS) on rabbits chondrocytes that is injuried by lipopolysac?charide (LPS). Methods Aricular chondrocytes were isolated from rabbits and randomly divided into three groups:control group;chondrocytes with LPS induced injury (LPS group);injury chondrocytes treated with EDS (LPS+EDS group). The cell proliferation and cell apoptosis of chondrocytes were determined by MTT method and flow cytometry assay respectively. The mRNA and protein expression levels of inducible nitric oxide synthase (iNOS) were detected by RT-PCR and western blot. In addition, the content of NO and IL-1βwere measured by nitric acid reductase assay and enzyme-linked immunosorbent assay (ELISA) respectively. Results Attenuated proliferation, increased cell apoptosis, iNOS, NO and IL-1βwere seen in LPS group , but all these changes were significantly reversed by EDS treatment (P<0.05). Conclusion Ecdysterone exhib?ited a protective effect on LPS induced rabbits chondrocytes injury through inhibiting the expression of iNOS.

Objective: To study the antimicrobial effectiveness against traditional She medicine-Gardeniae Radix and determine the titer of Gardeniae Radix.Methods: The antibacterial activity of five standard strains(Escherichia coli , Staphylococcus aureus , Pseudomonas aeruginosa , Candida albicans and Aspergillus niger)was investigated.A method for the biological value evaluation of Gardeniae Radix was established by using a turbidity method, and compared with the content of chikusetsu saponin Ⅳa determined by HPLC.Results: The sensitivity of Gardeniae Radix to Staphylococcus aureus and Escherichia coli was high.The recovery of the turbidity method was within the range of 90%-110%, and the reliability limit rate was less than 5%.The content of chikusetsu saponin Ⅳa in Gardeniae Radix was not completely consistent with the result of the bioassay method.Conclusion: The bioassay method established in the experiment can be one of the methods for the quality evaluation of Gardeniae Radix.

The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.

Objective To prepare a new type of micropore porcine acellular dermis matrix with the aid of laser (LPADM),and to validate the healing effect of the LPADM through the phrase Ⅰ composite transplanting on the back of the full- thickness skin defects in SD rats.Methods In vitro,the allogeneic fibroblasts were separately cultured with the LPADM (LPADM group) or the non-pore PADM (non-pore LPADM group),while fibroblasts cultured by pure medium were used as control.After culture of 1 day,3 days and 5 days,the contents of IL-10,IL-6,TGF-β1,LN,VEGF expressed by fibroblasts were determined by double-antibody sandwich ELISA method.In vivo,the phrase Ⅰ transplantations of LPADM graft with split-thickness autologous skin were carried on the backs of the full-thickness cutaneous defects of SD rats.The healing condition was observed and analyzed by histological tests.Results The differences of the absorbance value between the LPADMgroup,PADM group and control group in each day were not statistically significant (F=0.050-1.763,P＞0.05).The transplantation of LPADM graft with split-thickness autologous skin graft resulted in high rate of surviving without signs of rejection 3 weeks later.After 1-month of transplantation,the regenerated skin was well enough to be lifted without any serious scars.Conclusions The phrase Ⅰ transplantation of LPADM graft with split-thickness autologous skin graft can accelerate the healing process of full-thickness skin wounds with high biological safety.