Objective To investigate the surgical technique and efficiency of the "Cave-in" 360°circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OPLL).Methods From October 2005 to October 2009,26 TSS cases with OPLL were surgically treated,including 17 males and 9 females.Nineteen cases had upper thoracic spinal stenosis(T1-4)with OPLL,while 14 of them also had ossification of ligamentum flavum(OLF).All the other 7 cases had middle and/or lower(T5-12)TSS with both OPLL and OFL.All patients had severe spinal cord compression,and preoperative Frankel Grade was B in 6 cases,C in 13 cases and D in 7 cases.All these cases were surgically treated by 360° circumferential decompression("Cave-in" technique).Firstly,posterior wall was removed to decompress thoracic spinal cord.Secondly,the residual facets and pedicles were removed and posterior 1/3 of vertebral cancellous bones were cut along pedicles at 60° angle inclination to make a "culvert".Finally,the culvert walls were pressed to collapse and the OPLL blocks were removed to achieve ventral decompression.Pedical screw fixations were performed in all patients.Results All cases had immediate postoperative neurological improvement except 2 who experienced transient postoperative neurological deterioration for 13-27 days.At the end of 6-30 months follow-up,all these patients had neurological improvement.At the last follow-up,Frankei Grade was C in 2 cases,D in 15 cases and E in 9 cases.Conclusion This "Cave-in"360° circumferential decompression removes ventral and dorsal spinal compression from the posterior approach in TSS cases.It is a direct decompression procedure,which reduces the rate of postoperative paralysis.

Objective To investigate the effects of carbon monoxide poisoning on the long-term cognition in elderly patients.Methods Totally 53 patients with carbon monoxide poisoning and 51 healthy persons at our Hospital from June 2005 to June 2008 were enrolled.Mini-mental state examination(MMSE) and activities of daily living(ADL) scale were utilized to evaluale the life quality of the elderly patients through a cross-sectional study on July 2011.Results MMSE score showed that the attention calculation score,delayed recall score,and total score were higher in control group (4.9±0.4,2.9±1.0,28.3±2.3,respectively) than in carbon monoxide poisoning group (4.5±0.8,2.6±0.6,25.5±3.5,respectively) (t＝3.138,3.607,4.802,all P＜0.05).ADL score of carbon monoxide poisoning group was 26.7±7.3,and that of the control group was 2.04±7.6 (t＝1.827,P＞0.05).Conclusions Elderly patients with acute carbon monoxide poisoning may cause long-term cognitive impairment with decreasing attention calculation and delayed recall.

[Summary] Traditional anterior thoracotomy surgery for thoracic idiopathic scoliosis has amount of disadvantages such as large trauma,postoperative pain,and pulmonary function decrease.Video-assisted thoracoscopic surgery (VATS),which is considered as an effective method for the treatment of idiopathic thoracic scoliosis,can avoid those disadvantages as compared with thoracotomy surgery.Common surgical procedures include anterior spinal release with intervertebral fusion and instrumentation through video-assisted thoracoscopic surgery (IVATS).This article reviewed the history,indications,contraindications,advantages,disadvantages and outcomes of VATS in the treatment of idiopathic thoracic scoliosis.

To explore the role of cerebro-spinal flu id(CSF)glutamate and nitric oxide (NO) in the pathogenesis of neonatal hypoxic- ischemia encephalopathy (HIE), glutamate and NO in CSF were determined in 24 new born infants with HIE and 8 normal control infants, respectively. The results sh owed that the levels of glutamate and NO in CSF were significantly higher in the neonates with moderate and severe HIE than those in both of the control group an d neonates with mild HIE.There was an obviously positive relationship between le v els of glutamate and NO. It is concluded that glutamate and NO play an important role in the pathogenesis of neonatal HIE.

Objective To discuss the CT and MR imaging appearances and diagnostic value of spinal lymphoma. Methods Sixteen patients with pathologically proved spinal lymphoma (aged 8 to 63 years) were retrospectively reviewed. CT were performed in all 16 patients, and MRwere performed in 12 patients. Results Totally 65 vertebrae (cervical 15, thoracic 22, lumbar and sacrum 28) were involved. Multiple lesions were found in 11 patients. The characters of these lesions were osteolytic, osteogenic or mixed on CT. The signal intensity was hypo or iso on T1WI and iso or slightly hyper on T2WI. The extradural involvements were more extensive than that of the vertebrae both on CT and MR images. Conclusion Lesions of spinal lymphoma usually demonstrate various bone destructions on CT, and hypo or iso intensity on T1WI as well as iso or slightly hyper intensity on T2WI, tending to involve paraspinal or extradural space, and longitudinal involvements are often seen along the vertebral canal. MRI is more sensitive than CT in detecting spinal lymphoma lesions.

Neuroendocrine tumors of the epiglottis were extremely rare. Patients normally had no obvious symptoms and signs of early stage. Epiglottis lingual except (without) tubercle of epiglottis, and hyperplastic mass were observed by using laryngoscopy and also confirmed by biopsy and immunohistochemistry. Immunohis- tochemical studies showed that Syn, a broad spectrum endocrine marker, and CgA, a specific marker of endocrine tumor, were both positive. Which is consistent with the diagnosis of neuroendocrine carcinoma.
Carcinoma, Neuroendocrine ; pathology ; Epiglottis ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; pathology ; Laryngoscopy

Objective To investigate the relationship between expression of REG Iα gene and its clinicopathologic parameters, the survival rate in the patients with primary gastric cancer. Methods Using RT-PCR after extracting RNA from paraffin-embedded materials and immunohistochemical techniques, REG Iα gene expression was investigated in 235 samples. And the relation among their results with the clinicopathologic parameters of primary gastric carcinoma was discussed in experiment by SPSS 13.0 statistic software. Results The positive REG Iα mRNA was 78% (183/235) of primary gastric carcinoma and the positive rate of REG Iα protein was 31.1% (73/235) in 235 patients with primary gastric carcinoma. REG Iα gene expression in infiltrating tumors was found to be significantly higher compared with localized tumors ( P <0.05). REG Iα gene was closely linked to the infiltrative growth pattern, signet ring cell and poorly differentitated adencarcinoma. The incidence of venous invasion of REG Iα gene-positive differentiated adenocarcinoma was significantly higher than that of REG Iα gene-negative tumors. Moreover, the patients with REG Iα gene-positive differentiated adenocarcinoma were found to have a significantly poorer prognosis as compared with REG Iα gene-negative tumor patients. Conclusions The results of the experiment demonstrated that the expression of the REG Iα gene is closely related to the infiltrating property of primary gastric carcinoma. Signet ring cells and poorly differentiated adencarcinoma significantly enhance the risk of venous invasion of REG Iα gene-positive differentiated adenocarcinoma and might be as a prognostic indicator of differentiated adenocarcinoma of the stomach in clinic diagnosis.

Objective To establish a primary culture of human melanocytes from tiny skin sheets harvested by using a suction blister method, to carry out a serial subcultivation of the melanocytes with human amniotic membrane (AM) as a scaffold, and to observe the influence of AM on the adhesion, proliferation and dendrite development of melanocytes. Methods Tiny skin sheets were collected from the flexual forearm or lower abdomen of a healthy male volunteer by a suction blister method and melanocytes in the skin sheet were counted following Dopa staining under a microscope. The trypsinized skin sheets were scraped with a scalpel to harvest melanocytes which were subjected to a primary culture. Then, the melanocytes were inoculated onto fresh or cryopreserved AM followed by a culture for various durations (4, 8 and 12 days). The morphology and dendrite development of melanocytes were visualized under an inverted microscope after dopa-staining, cell viability evaluated by MTT assay, the adhesion to AM examined by hematoxylin and eosin (HE) staining protocol. Results The density of melanocytes was 1543.1±13.3 cells per mm2 and 857.4±101.7 cells per mm2 in skin sheets obtained from the forearm flexure and lower abdomen of the volunteer, respectively. A skin sheet of about 25.1 mm2 from approximately two blister roof was required to ensure the success of primary culture of melanocytes within 1 month. After culture on fresh or cryopreserved AM for 4, 8, and 12 days, most melanocytes were bi-polar with extended slender dendrites compared with those cultured in common cell culture medium. HE staining showed that melancytes adhered and were evenly distributed on the basement membrane of AM. MTT assay showed that the AM inhibited the proliferation of melanocytes, and no statistical difference was observed in the inhibitory effect between fresh AM and cryopreserved AM (P＞ 0.05). Conclusions Enriched with melanocyes, flexural forearm is a preferable donor site to offer skin sheets for primary culture of melanocytes. Human AM could improve the adhesive growth and dendrite development of melanocytes, and may serve as a promising bioscaffold for in vitro expansion of melanocytes.

ObjectiveTo evaluate magnifying endoscopy combined with flexible spectral imaging color enhancement(FICE)for diagnosis of early gastric cancer.MethodsThe suspicious small depressive lesions(SDL) was further studied with magnifying endoscopy or magnifying endoscopy combined with FICE from April 2009 to March 2011 in our hospital.The endoscopic diagnostic criteria of early gastric cancer was made according to the structure of the pit,the microvascular and the demarcation line.ResultsIn 74 SDL,17 were pathologically diagnosed as cancer,and 56 were noncancer.The sensitivity,specificity and accuracy of magnifying endoscopy were 41.18％,94.74％and 82.43％,respectively,which were 86.67％,96.49％ and 91.89％,respectively for magnifying endoscopy combined with FICE.The diagnostic sensitivity of magnifying endoscopy combined with FICE was significantly higher than that of magnifying endoscopy (P ＜0.05 ).ConclusionMagnifying endoscopy combined with FICE can reveal the structure of the pit,microvascular and demarcation line more clearly.The endoscopic diagnostic criteria is a more comprehensive description of the mucosal micro-morphological features of early gastric cancer.

Objective To study the CT and MRI features of the chordoma in the mobile spine.Methods The CT and MRI fea-tures were retrospectively analyzed in twenty-four cases of chordoma in the mobile spine.Results In all the twenty-four cases,bone lesions were solitary in eight cases and multiple in sixteen cases,mostly occurred in cervical,occasionally occurred in thoracic or lum-bar vertebra.Both vertebral body and part appendix were involved in all cases.CT imaging showed that all the lesions mainly mani-fested as osteolytic bone destruction,peripheral osteosclerosis and the cortical bone were incomplete.Soft-tissue mass involved para-vertebral and intraspinal.Five lesions appeared vertebrae compression.Eight lesions appeared intervertebral foramen expansion.Le-sions appeared honeycomb or annular enhancement after contrast media injection.Lesions were presented as heterogeneous slightly hypo-isointensity on T1 WI,hyperintensity on T2 WI.Low signal fibrous septa within the tumors were seen.Lesions appeared hon-eycomb enhancement after Gd-DTPA injection.Conclusion CT and MRI findings of chordoma in the mobile spine can be regarded as characteristic,which are helpful for clinical diagnosis.