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.

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 discuss the selection of approaches for CT-guided percutaneous biopsy of thoracic and lumbar spine. Methods One hundred and forty-one cases of thoracic (70 cases) or lumbar (71 cases) vertebral undiagnosed lesions underwent CT-guided percutaneous biopsy. Appropriate needle approaches were designed according to different locations of lesions in the vertebra, including 63 cases of paravertebral path, 45 cases of transpedicular path, 11 cases of transcostovertebral path, and 22 cases of other paths. Results Out of the 141 cases, a definite diagnosis was obtained in 128 cases. The diagnostic accuracy of biopsy was 90.8%. No complications occurred. Conclusions The needle approach for CT-guided percutaneous biopsy of the thoracic and lumbar spine should be selected according to different locations of lesions, which should be based on principles of safety, enough specimen, and minimally invasive to patients.

Objective To analyze the selection of puncture needles in CT-guided percutaneous biopsy in musculoskeletal system diseases.Methods Three hundred and sixty-four undiagnosed lesions of musculoskeletal system underwent CT-guided percutaneous biopsy from January 1996 to March 2005.Proper selection of different puncture needles,including biopsy gun,bone biopsy needle,or both,was made according to different locations and characteristics of the lesions.Results Among 255 lytic lesions,the biopsy gun alone was used in 47 cases and both biopsy gun and bone biopsy needle were used in 208 cases.Among 73 mixed lesions,the bone biopsy needle alone was used in 49 cases,biopsy gun alone in 14 cases,and both in 10 cases.The bone biopsy needle was used in all 36 sclerotic lesions.Enough specimens were obtained in all the cases,and no complications occurred.A correct biopsy diagnosis was made in 334 cases,the diagnostic accuracy of biopsy being 91.8%(334/364). Conclusions The puncture needles for CT-guided percutaneous biopsy of the musculoskeletal system lesions should be selected according to different locations and characteristics of lesions.For sclerotic lesions or lesions containing relatively more sclerotic contents,the bone biopsy needle should be used.For lytic lesions,the biopsy gun should be used.And the combined use of both bone needle and biopsy gun should be utilized for mixed lesions.

Objective To investigate the improvement role of aspirin combined with statins on carotid plaque of patients with cerebral thrombosis.Methods80 cases of patients with cerebral thrombosis in our hospital from May 2014 to May 2016 were selected, these patients were divided into aspirin combined with statins treatment group (combined treatment group, 40 cases) and single aspirin treatment group (single treatment group, 40 cases) two groups according to the treatment methods, the NIHSS scores, Barthel indexes, clinical curative effects, IMT, plaque areas of the two groups were statistically analyzed.ResultsThe NIHSS score of the combined treatment group was significantly lower (P<0.05), the Barthel index was significantly higher (P<0.05), the total treatment efficiency 95.0% (38/40) was significantly higher than the single treatment group 80.0% (32/40) (P<0.05), the IMT was significantly shorter (P<0.05), the plaque area was significantly smaller than the single treatment group (P<0.05).ConclusionAspirin combined with statins can more effectively improve the carotid plaque of patients with cerebral thrombosis than aspirin alone, so is worthy of promotion and use in the clinical.

Early diagnosis and symptomatic therapy of amyotrophic lateral sclerosis(ALS)can profoundly influence care and quality of life of the patient and relatives,and may increase survival time.Medication with riluzole should be initiated as early as possible.PEG is associated with improved nutrition and should be inserted early.Noninvasive positive pressure ventilation improves survival and quality of life.Palliative end-of-life care should be provided to ALS patient.