Objective To explore the curative effects, side effects and complications of arterial embolization for the treatment of uterine leiomyoma.Methods Bilateral uterine arterial embolization with silk particles of 350～500 ?m was performed in 16 cases of uterine leiomyomas with uterine hemorrhage as the main complaint.Results 15 patients underwent technically successful embolization. No serious complications occurred. The patients were followed up for 3～12 months. Menses returned to regular cycle. In the patients with anemia, the hemoglobin concentration rose up to normal level. The sizes of uterine leiomyoma decreased by 52% after 6 months of the treatment.Conclusions Uterine arterial embolization is an effective and less invasive therapy with no serious complications for patients with uterine leiomyoma, especially for presentation of the uterus.

Objective The purpose of this study was to determine the changes of expression of angiogenic factor mRNA in the spinal cord of rats with protruded intervertebral disc and the effects of electroacupuncture , and to analyze the role of electroacupuncture in the spinal microvascular angiogenesis .Method Eighteen healthy male Sprague-Dawley rats were divided randomly into 3 groups:the electroacupuncture group , model group and sham-operated group .The protruded intervertebral disc models were generated by the left lateral and ventral spinal cord compression at T 13 using a self-made silicon sheet.Only the rats in the first group were treated by electroacupuncture once a day for consecutive 7 days.Spinal cord tissue samples were taken from the compression site at 7 days after operation .The mRNA levels of Ang-1, Tie-1, Ang-2, Tie-2, VEGF, Flt-1, caspase-3 and Tsp-1 were determined by RT-PCR, and the pathological changes of the spinal cord was examined using HE staining .Results The rats in the electroacupuncture treated group showed significantly im-proved hind leg function , a relatively complete spinal cord structure , and a clear boundary between grey and white matters . The expression levels of Ang-1, Ang-2, Tie-1, Tie-2, capase-3 and Tsp-1 in the spinal cord tissues of the model group were significantly higher than those of sham-operated group ( P<0.01 ) , but the levels of VEGF and Flt-1 between those two groups showed no significant difference (P>0.05).The expression levels of Ang-2, Tie-1, Tie-2, caspase-3 and Tsp-1 of the electroacupuncture group were significantly lower than those in the model group (P<0.01), while the expression levels of Ang-1, VEGF and Flt-1 were not significantly different between the two groups (P>0.05).All the indexes be-tween electroacupuncture and sham-operated groups showed no significant difference ( P>0.05 ) .Conclusions Our re-sults demonstrate that mRNA expression of relevant angiogenic factors were abnormal after spinal cord compression , while electroacupuncture can down-regulate the expression of Ang-2, Tie-2,Tsp-1 and caspase-3, and modulate the promoting and inhibiting factors of angiogenesis to return towards normal , therefore , to create beneficial conditions for the repair of spinal cord injuries .

Objective To investigate the clinical efficacy of three-dimensional (3D) and two-dimensional (2D) laparoscopic surgeries in the treatment of Todani type Ⅰ choledochal cyst.Methods The retrospective cohort study was conducted.The clinical data of 59 patients with Todani type Ⅰ choledochal cyst who were admitted to the People's Hospital of Hunan Province between January 2013 and January 2016 were collected.Thirty patients undergoing 2D laparoscopic surgery between January 2013 and June 2014 were allocated into the 2D group and 29 patients undergoing 3D laparoscopic surgery between July 2014 and January 2016 were allocated into the 3D group.There were the same Trocar placement and surgical procedure in the 2 groups,and surgical procedure completely followed the treatment principle of Todani type Ⅰ choledochal cyst.Observation indicators included (Ⅰ) surgical situations:conversion to open surgery,operation time,volume of intraoperative blood loss,(2) postoperative situations:postoperative complications,(3) follow-up.Patients were followed up by outpatient examination or telephone interview to detect postoperative recovery up to April 30,2016.Measurement data with skewed distribution were presented as M (range) and analyzed using the Mann-Whitney U test.Count data were compared by Fisher exact probability.Results (1) Surgical situations:patients in the 2 groups underwent laparoscopic choledochal cystectomy + Roux-en-Y hepaticojejunostomy.Two patients in the 2D group received conversion to open surgery and patients in the 3D group received the successful surgery without conversion to open surgery.Rate of conversion to open surgery in the 2D and 3D groups were 6.7％ (2/30) and 0,respectively,with no statistically significant difference (P ＞ 0.05).Operation time in the 2D and 3D groups were 285 minutes (range,240-390 minutes) and 190 minutes (range,140-215 minutes),with a statistically significant difference (U =40.0,P ＜ 0.05).Volume of intraoperative blood loss in the 2D and 3D groups were 50 mL (range,10-300mL) and 45 mL (range,20-250 mL),with no statistically significant difference (U =1 018.5,P ＞ 0.05).(2)Postoperative situations:patients in the 2 groups had good recovery,without occurrence of severe complications in Clavien-Dindo≥ Ⅲ stage.Four and 1 patients in the 2D and 3D groups were complicated with bile leakage (in Ⅱ stage of Clavien-Dindo) and 1 and 1 were complicated with upper gastrointestinal hemorrhage (in]][stage of Clavien-Dindo),respectively,with no statistically significant difference (P ＞ 0.05).Overall incidence of complications in the 2D and 3D groups were 16.7％ (5/30) and 10.3％ (3/29),with no statistically significant difference (P ＞ 0.05).All the patients were cured by conservative treatment.(3) Follow-up:59 patients were followed up for 5-36 months,with good recovery and without occurrence of reflux cholangitis,hepatic and intestinal anastomosis stenosis and reoperation.Conclusions 3D and 2D laparoscopic surgeries are safe and effective for Todani type Ⅰ choledochal cyst.Compared with 2D laparoscopic surgery,3D laparoscopic surgery can reduce the operation time and not increase the complications,and it should be discreetly promoted based on the experiences of surgeons.

Objective To evaluate the middle and short-term effects of integrative cognitive training on mild cognitive impairments(MCI).Methods All the participants with MCI aged over 70 years were selected from one sub-district of Putuo District,Shanghai and divided into cognitive intervention group (n=46) and control group (n=35).The integrative cognitive training was conducted in 24 sessions for 12 weeks.All subjects were assessed by Neuropsychological Test Battery for Elderly (NTBE) and by a questionnaire of Shanghai Health Survey for the Elderly (VER2006)at baseline,follow-up and one-year follow up phases.Results At baseline phase,semantic relations test in NTBE was better (t=2.13,P=0.037),verbal fluency test (vegetables) in NTBE was worse(t =-2.25,P=0.038) in intervention group than in control group,while there were no significant differences in scores of other neuropsychological tests between intervention group and control group(all P＞0.05).At follow up phase,16 subscales in reasoning test of NTBE were improved (t=-2.70,P=0.010)and 2 subscales were declined in cognitive intervention group(all P＜0.05).9 subscales in semantic relations test of NTBE (t=-2.27,P=0.013) were improved and 5 subscales were declined in control group (all P＜ 0.05).Comparison between groups at one year follow-up showed that 5 subscales in reasoning test of NTBE (F=16.80,P=0.000) were better in intervention group than in control group(all P＜0.05).General linear model (GLM) with repeated measures at three time points showed that 4 subscales in reasoning test of NTBE had a time-by group interaction (F=5.16,P=0.01).Conclusions Integrative cognitive training can improve cognitive function in patients with mild cognitive impairments,and the validity of reasoning ability can sustain one year.

Objective To investigate the clinical effect of super selective embolization combined with opera-tion for treatment of meningiomas.Methods 82 cases treated by operation and pathology in return for meningioma were collected in the study,including 44 cases of preoperative superselective embolization for aneurysms as the treat-ment group,and the remaining 38 cases without preoperative embolization of patients as the control group.The opera-tion time,bleeding amount in the operation and the rate of total tumor removal were recorded and compared between the two groups.Results The average amount of bleeding of treatment group was (330.36 ±95.41)mL.The average amount of bleeding of control group was (460.82 ±114.64)mL.The data of the two groups was statistically significant (t =5.624,P <0.01).,The treatment group bleeding amount was less than that of the control group;,the mean oper-ation time of treatment group was (5.36 ±2.62)h,,the average operation time of control group was (6.63 ±2.25)h.The data of the two groups was statistically significant (t =2.355,P =0.021 ),the operation time of the treatment group was less than that of the control group.The total resection rate was 70.4% in treatment group and 36.8% in the control group,there was statistically significant (P <0.05),and the total resection rate in the treatment group was higher than that in the control group.Conclusion Compared with single operation treatment of meningiomas superse-lective embolization combined with operation for treatment of meningiomas can shorten operation time,reduce intraoperative hemorrhage,improve the rate of total tumor removal.It can reduce the operation risk and improve the treatment effect.

BACKGROUND:Periprosthetic femoral fracture is a severe complication after total hip arthroplasty. More than 85% belongs to Vancouver B2 and B3 fractures, and the operation is difficult. OBJECTIVE:To explore the clinical effect of Cable-Ready fast system and biotype long-stem prosthesis and its effect on the recovery of joint function in patients with Vancouver B2 and B3 type periprosthetic femoral fractures after total hip arthroplasty. METHODS: A total of 60 patients receiving total hip arthroplasty suffered from Vancouver B2 and B3 type periprosthetic femoral fractures in the Huanggang Central Hospital from September 2011 to September 2012. They were equaly divided into control and observation groups according to different fixation methods. Patients in the control group were treated by ordinary steel wire cerclage fixation combined with uncemented long-stem prosthesis; those in the observation group were treated by Cable-Ready fast system combined with fast uncemented long-stem prosthesis. RESULTS AND CONCLUSION:The average operation time, the time of hospitalization and fracture healing time were shorter in the observation group than in the control group. Moreover, the intraoperative blood loss was less in the observation group than in the control group. After 1 year of folow-up, Harris hip score was higher in the observation group compared with pre-treatment (t=3.174 9,P=0.002 6), and significantly higher than the control group (t=2.479 8,P=0.015 4). The excelent and good rate of Harris hip score was significantly higher in the observation group than in the control group (χ2=11.294 5,P=0.002 6). The total incidence of complications was significantly lower in the observation group than in the control group (χ2=8.139 7,P=0.04 2). These data indicate that Cable-Ready fast system combined with uncemented long-stem prosthesis in the treatment of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty has smal injury, less postoperative complications and better recovery of hip function after operation.

Objective To analyze the characteristic and the clinical application of high -frequency stimulation ABR for the patients with unilateral sudden deafness .Methods 40 patients aged 17~45 with unilateral sudden deaf-ness(40 health ears ,subject group)and 20 normal volunteers (40 ears ,control group)were selected to receive high and low frequency stimulation ABRs and pure tone audiometry .Results There were no statistical differences be-tween subject group and control group in pure tone audiometry .The wave Ⅰlatency of high -frequency ABR was longer in the subject group than that in the control group(P<0 .001) .The abnormal rate of Ⅰ - Ⅴ interval between high and low frequency stimulation ABRs was 62 .5% (25/40) in the subject group ,and 5% (2/40) in the control group .There were statistical differences between the two groups (χ2 =29 .574 ,P<0 .001) .Conclusion The waveⅠlatency of high-frequency ABR was longer and the abnormal rate of Ⅰ - Ⅴ interval markedly increased in the health ear of patients with unilateral sudden deafness .This may suggest that the contralateral ear may have an ab-normal blood supply of the inner ear when single side sudden deafness happened .High frequency stimulation ABR can be used to detect the potential changes of contralateral ear before the hearing loss occurred .

Objective:To explore a simple and effective method of local hypothermia, and to testify its neuroprotective effects . Methods:This experiment adopts twelve adult and healthy New Zealand rabbits as experimental animals. These rabbits were randomly assigned to two groups : ① MCAO (n=6),② MCAO and hypothermia (n=6). The middle cerebral artery (MCA) was exposed through the left orbital approach, and was clipped 2 hours by a 3 mm straight aneurysm clip to establish the MCAO model. We assign 2 cavities ventricle tube to puncture the frontal angle of the lateral ventricle, then 22℃ physiological brine was dropped into the lateral ventricle to reduce the brain temperature in MCAO and hypothermia group. Temperature thermister probes were inserted for measuring the brain and rectal temperatures. The neurological deficits and histological changes of brain tissue were evaluated in all experimental animals.Results: Brain temperature below cortex was descend to 35℃within 20 minutes after hypothermia in MCAO and hypothermia group while rectal temperature has maintained normal. The neurological deficits and histological changes of brain tissue of MCAO and hypothermia group were better than those in MCAO group. Conclusion: The local intra-ventricle hypothermia model is a reliable, cooling rapidly and useful method for selective brain cooling.

Objective: To explore the effects of continuous trickle of low temperature liquids through the lateral ventricle on neural cell apoptosis after rabbit local cerebral ischemia/reperfusion. Methods:The middle cerebral artery (MCA) of New Zealand rabbit was clipped by micro aneurysm clip for 2 hours and reperfused for 24 hours. Immediately after clipping the MCA, we trickled the left lateral ventricle continuously with low temperature liquids(22℃) to decrease the brain temperature to mild hypothermia (33℃-35℃)and maintained for 2 hours. After reperfusion for 24 hours , we assessed TUNEL method to determine the apoptotic cell rate in the sham-operated group, the control group and the mild hypothermia group respectively. Results:The apoptotic cell rate of the cortex tissues accommodated by MCA in the mild hypothermia group was obviously lower than that in the control group(P0.05). Conclusion:Trickling ventricle with low temperature liquids could decrease the apoptotic cell rate and alleviate cerebral ischemia/reperfusion injury.

The peripheral blood T- lymphocyte percentage, lympocyte percentage in white blood cell (WBC) of mice in heat environment (45C, 15 min) were diminished, and serum corticosterone increased. Ginseng root saponins (GRS) 50, 100 mg/kg were administered ip at 15 min before the heat-stress, the suppression of peripheral blood T-lymphocyte percentage were prevented, but could not inhibit the increase ofserum corticosterone. GRS 50mg?kg-1ip could inhibit the redution of peripheral lymphocyte percentage. GRS 50mg?kg-1 ,reserpine 0.5mg? kg-1or physostigmine salicylate 0.3 mg?kg-1ip abolished the inhibiting effect of heat-stress on DTH reaction in mice.