Objective To investigate the diagnosis and treatment of pseudotumorous pancreatitis. Methods A retrospective clinical analysis was made on 20 cases with pseudotumorous pancreatitis in one stage from 1983.7 to 2004.5. Resulds There were 14 males and 6 females. Jaundice and abdominal pain were the major complaints. 17 cases underwent surgery, including cholangiojejunum Roux-en-Y anastomosis in 11cases, pancreatoduodenectomy in 3 cases, laparotomy and biopay in 3 cases . 3 cases underwent US-guided needle biopsy. All the 15 cases who were followed up had no jaundice at all after operation and abdominal pain relief was achieved to various degree. Conclusion It's difficult to diagnose pseudotumorous pancreatitis before operation. Hepatojejunal Roux-en-Y anastomosis was suitable for the patients with obstructive jaundice. When refractory abdominal pain was encountered or intraoperative pathologic diagnose was diffcult, pancreaticoduodenectomy should be recommended.

Objective　The aim of this study was to approach the effects of percutaneous transluminal coronary angioplasty (PTCA) and stenting on QT dispersion (QTd) in patients with coronary heart disease. Methods　PTCA and stenting were performed successfully on 42 patients with coronary heart disease. QTd and corrected QTd (QTcd) were obtained with a standard 12-lead ECG before and after PTCA+ Stent. Results　QTd and QTcd after PTCA+Stent were reduced significantly compared to those before PTCA+Stent (P<0.01). There were no significant difference in QTd and QTcd before PTCA+Stent between single vessel lesion and multi-vessel lesion, but after PTCA+Stent, QTd and QTcd in single vessel lesion were decreased significantly compared to those in multi-vessel lesion. The ventricular arrhythmia in 9 patients was over after PTCA+Stent. Conclusions　QTd and QTcd were decreased significantly after PTCA+Stent because of the improvement of myocardial ischemia and heterogeneous repolarization in patients with coronary heart disease. The degree in decreasing QTd and QTcd was associated with compensatory circulation in coronary artery.

Objective To investigate the effect of prostaglandin E1(PGE1) on the expression of monocyte chemoattractant protein-1(MCP-1)in human umbilical vein endothelial cells (HUVECs) and its possible mechanism. Methods Endothelial cells were incubated with oxidized low-density lipoprotein (ox-LDL group) in the presence or absence of prostaglandin E1. The level of MCP-1 in the supernatants was determined by enzyme linked immunosorbent assay (ELISA), the expression of MCP-1 mRNA in cultured endothelial cells was detected by in-situ hybridization and the protein expression of NF-κB was analyzed by Western blot. Results Compared with ox-LDL(100 μg/ml),PGE1 markedly lowered the levels of MCP-1[(0. 327±0. 051),(0. 214±0. 213),(0. 247±0. 228)pg/ml vs. (0. 655±0. 013)pg/ml], inhibiting the expression of MCP-1 mRNA [(0. 061±0. 008), (0. 033±0. 006),(0. 026±0. 004)A/μm2 vs. (0. 220±0. 032)A/μm2] in the cultured HUVECs in a dosedependent manner (0. 001, 0. 01, 0.1 mol/L). Western blot analysis demonstrated that the amount of NF-κB p65 was attenuated after treatment with prostaglandin E1 for 24 hours. Conclusions Prostaglandin E1 can downregulate the expressions of MCP-1 and NF-κB induced by ox-LDL in HUVECs, which may thereby defend the blood vessel endothelial cell function.

Objective To evaluate the distribution of Schmorl's nodes (SN) in patients with low back pain or radiculopathy,and to analyze the correlation between SN and degeneration of lumbar intervertebral discs.Methods In 2012,1024 patients with low back pain or sciatica were examined by magnetic resonance (MR) scan and plain film.There were 448 males and 576 females,with an average age of (54.3 ± 12.7) years (range,22-90).The features distribution of SN in lumbar endplate on age,sex,segment and the type and grade of intervertebral disc degeneration were analyzed retrospectively.Results Among 5120 lumbar intervertebral segments of the 1024 patients,295 (28.8％) cases and 532 (5.2％) endplates were involved with SN,302 located in the cranial and 230 in the caudal endplate.According to percent prevalence per lumbar segment,L1,2 was the most common level (29.1％),followed by L3,4 (23.7％) and L2,3 (21.1％).The incidence of SN was positively correlated with elder age,but not with sex,body weight,height,or body mass index.SN occurred more often in bulging,extrusion,Modic changes,spondylolisthesis and osteophyte comparing with normal disc or protrusion or high intensity zone.The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent SN.Intervertebral discs with adjacent SN were more degenerated than those without adjacent SN.The number,size and volume of SN were associated with the degrade of intervertebral discs degeneration.SN was divided into two types,i.e.,acute edematous SN and non-acuteSN,according to the signal type on T1-and T2-weighted MR images,and the degeneration of the corresponding intervertebral discs was more severe in the latter than the former group.Conclusion SN occurred more often in the upper lumbar spine and cranial endplate in patients with low back pain or radiculopathy.SN were correlated with elder age and the degeneration of lumbar intervertebral discs.The number,size,volume and signal type on MR images of SN impacted on its correlation with lumbar intervertebral disc degeneration.

Objective To investigate the expression of nuclear factor kappa B(NF-?B) in carotid artery of hypercholesterolemic rabbits injured by balloon and its relationship with intimal hyperplasia.Methods Twenty-five New Zealand male rabbits were fed with atherogenic diet and balloon injury was conducted in right carotid artery 4 weeks later.The rabbits were killed at the 6th hour,24th hour,1th week,2th week and 4th week,respectively.Blood samples and right carotid artery were collected in time and intimal hyperplasia was studied by histological morphology method.The expression of NF-?B was measured by in-situ hypridization(ISH).Results Intimal hyperplasia was present at the 7th day after balloon injury in hypercholesterolemic rabbits and it became more obvious with the increasing of the time.The intimal hyperplasia was not detected in the media area.The intima/media ratio was increased as time went on.The expression of NF-?B mRNA was observed in the carotid atery of hypercholesterolemic rabbits at the 6th hour after balloon injury and the expression reached its peak at the 2th week.The expression of NF-?B was much higher in injury group than that of control group.Conclusion The expression of NF-?B is up-regulated in carotid artery of hypercholesterolemic rabbits injured by balloon,which is involved in the inflammatory reaction and restenosis caused by balloon injury.

Objective To compare the difference of adjacent segment degeneration (ASD) following one-level mini-open or conventional open posterior lumbar interbody fusion (PLIF).Methods From October 2005 to September 2008,108 patients underwent one-level instrumented PLIF using two different approaches: mini-open approach in 56 patients including 32 males and 23 females,aged from 32 to 68 years (average,53.8 years) and conventional open approach in 52 patients including 24 males and 28 females,aged from 27 to 69 years (average,52.6 years).The follow-up rates of the mini-open and conventional open groups were 91.1％ and 88.5％,respectively.The visual analog scale (VAS),Oswestry disability index (ODI),multifidus muscle injury and ASD were evaluated.Results There were no significant differences in VAS and ODI scores between two groups preoperatively,but the two scores in the mini-open group were significantly lower than those in conventional open group after surgery.Compared with the conventional open approach,less decrease of cross sectional area and less severe fatty degeneration of the multifidus muscle were observed in mini-open group.There were 4 cases of radiographic ASD in the mini-open group including two symptomatic cases,and 11 cases in the conventional open group including 4 symptomatic cases among them 2 required surgical intervention.Both radiographic and symptomatic ASD were correlated with the decrease of cross sectional area and degree of fatty degeneration of the multifidus muscle,but only symptomatic ASD was associated with the clinical results.Conclusion Compared with the conventional open approach,the mini-open PLIF has many advantages,such as better clinical outcomes,lower incidence of multifidus muscle atrophy,and lower incidence of radiographic ASD.

Objective To observe the correlation between bone mineral density (BMD) and surgical outcomes of posterior lumbar interbody fusion (PLIF) for lumbar degenerative spondylolisthesis (DS).Methods From January 2006 to December 2010,69 patients with DS had undergone PLIF by the same surgical team.According the BMD,the cases were divided into two groups.Normal group (T ≥-1.0) had 33 cases [Male 16 cases,Female 17 cases; mean age,(56.5±9.0) yrs; L,,5 20 cases,L5S1 13 cases].The osteopenia group (T ＜-1.0) had 36 cases [Male 13 cases,Female 23 cases; mean age,(60.5±7.8) yrs; L4.5 21 cases,L5S1 15 cases].Blood loss,surgical duration,intra-and post-operative complications were collected.The clinical improvement was quantified by measurement of pain (visual analogue scale,VAS) and Roland-Morris (RM) Disability Questionnaire.Between two groups,the differences of age,body mass index,blood loss,VAS improvement,and RM improvement were compared.The correlation between BMD and sex,age,segment,screw loose,nonunion,and cage subsidence was analyzed.Results In two groups,the difference between pre-and post-operative RM and VAS was significant respectively.The blood loss was 415.5± 105.8 ml in normal group,significantly less than 528.3±128.7 ml in osteopenia group.There was no significant difference in the duration between normal group (169.7±44.3 min) and osteopenia group (176.4±42.6 min).The improvement of VAS and RM between two groups had no significant difference.There was a negative correlation between the BMD and blood loss (r=-0.407,P=0.001).The other surgical outcomes (surgical duration,VAS improvement,RM improvement,cage subsidence,nonunion,screw loose and etc.) had no correlation with BMD.Conclusion There is a negative correlation between the BMD and blood loss in DS patients managed by PLIF.BMD has no effect on other surgical outcomes.

Objective To investigate the clinical effect of modified anterior approach to manage fracture of the ulnar coronoid process via the space of brachial artery and vein with median nerve.Methods From June 2012 to January 2013,11 patients with ulnar coronoid fracture were fixed via the modified anterior approach.The operation time,intraoperative blood loss and postoperative complications were recorded.Flexion and rotation range of motion about the injured and normal elbow were observed during postoperative follow-up period.Function of elbow joint was evaluated by mayo elbow performance index (MEPI).Results There was approximate 8 cm in length and 5 cm in width between the brachial vessels and median nerve.Operated angle from radial to ulnar side was fifty degrees and from proximal to distal end was sixty degrees.All the patients were available for follow-up.The fracture healed,that is the elbow flexion restored [(130.7 ±5.0) °] was 96.6％ of the unaffected elbow,elbow extension restored [(7.6 ± 8.1) °] was 84.0％ of the unaffected elbow,pronation restored [(86.9 ± 3.8) °] was 98.2％ of the unaffected side,and supination restored [(85.6 ± 6.0) °] was 96.7％ of the unaffected side.MEPI of the elbow joint was over 75 points.Conclusion Modified anterior approach is relatively safe and simple in operation and results in satisfactory function recovery of the elbow joint,providing a new surgical approach for treatment of coronoid process fracture.

BACKGROUND:Currently, the morphologic changes of the discoid lateral meniscus (DLM) remain unclear, and morphological indexes used to evaluate the injuries of DLM stil need to be explored. OBJECTIVE:To compare the MR imaging difference between symptomatic and asymptomatic DLM in adults, and to select reliablemorphologicalparametersfor assessing DLM. METHODS:A total of 36 patients (36 knees) with a symptomatic DLM (study group)and 34 patients (34 knees) with an asymptomatic DLM (control group) were included in this study. GE Healthcare Centricity RIS/PACKS System was used to measure the primary morphological parameters of two patients with DLM on coronal MR imaging. Intergroup comparison was performed with the Wilcoxon test. RESULTS AND CONCLUSION:On the coronal MR imaging, the width of the body portion and height of the free edge of the DLM was significantly increased in the study group compared with the control group (P< 0.001), while the height of the peripheral portion which connects with the capsule of the DLM was significantly decreased in the study group compared with the control group (P= 0.002). The heightof the middle of the DLM and the width of the lateral femoral condyle showed no significant differences between the both groups (P> 0.05). The width ratio of the body of the DLM to the lateral femoral condyle and the height ratio of height of the free edge to the middle of the DLM were significantly increased in thestudy group compared with the control group (P< 0.001), while the height ratio of the peripheral portion to the middle for the DLM was significantly decreased compared with the control group (P< 0.001). These findings suggest that compared with asymptomatic discoid lateral meniscus, the width of the body portion and the height of the free edge for the DLM are increased;however,the height of the peripheral portion which connects with the capsule of the DLM is decreased. The width ratio of the body portion of the DLM to the lateral femoral condyle and the height ratio of the free edge to the middle for the DLM may be reliable morphological parameters for the assessment of the DLM in adults.

Objective To evaluate bone marrow mesenchymal stem cells combined with VEGF gene in the treatment of limb ischemia in rabbits.Methods The right hind limb ischemia model of New Zealand rabbit was established by superficial femoral artery excision and deep femoral artery ligation.Rabbits then were divided randomly into 4 groups: empty plasmid control group(EP group),bone marrow mesenchymal stem cells group(BMSC group),VEGF gene therapy group(VEGF group),combination bone mesenchymal stem cells and VEGF gene therapy group(BV group).There were 8 rabbits in each group.Angiogenesis was detected by arteriography on day 28 after treatment and expression of VEGF was detected by immunohistochemical staining on day 30 after treatment.Results There were no differences of collateral vessel count between the EP group,BMSC group and VEGF group.The collateral vessel count in BV group was higher than that of the other three groups.Immunohistochemistry of VEGF showed that the integrated optical density(IOD)in BMSC and VEGF groups increased significantly compared with the EP group; the IOD in BV group was the highest compared with the other three groups.Conclusions Combination bone marrow mesenchymal stem cells and VEGF gene in the treatment of limb ischemia in rabbits can obtain stable and effective expression of VEGF along with significant improvement of limb ischemia.