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.

[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.

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.

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 determine the ED50 of isoflurane and desflurane in the presence and absence of epidural lidocaine using BIS value 50 as the criterion (MACBIS50 ) .Methods Forty-eight ASA I - II patients (26 male, 22 female) aged 18-70 years were randomly divided into isoflurane group ( n = 24) and desflurane group ( n = 24).Each group was further divided into 2 subgroups: general anesthesia group(GA, n = 12) and combined general-epidural anesthesia (CGEA, n = 12) . Patients with body weight over 110kg or under 50kg were excluded. The patients were premedicated with intramuscular atropine 0.01 mg?kg-1 . In CGEA subgroup epidural anesthesia was performed at T5-6 before induction of general anesthesia. A catheter was inserted into the epidural space in a cephalad direction for 3cm. A loading dose of 10ml of 1.6% lidocaine with 1:200 000 adrenaline was given after test dose followed by 5 ml 1.6% lidocaine every 40-60 min. General anesthesia was induced with fentanyl 1 ?g?kg-1, propofol 0.5-1.0 mg?kg-1 and vecuronium 0.1-0.2 mg?kg-1 . The patients were intubated and mechanically ventilated (FiO2 = 100% , FGF = 2 L?min-1 , VT = 8-10 ml?kg-1, PET CO2 = 35 mm Hg) . Anesthesia was maintained with isoflurane or desflurane. The end-tidal concentration of isoflurane and desflurane was continuously monitored and BIS also. MACBIS50 was measured using up-and-down method. The initial concentration of anesthetic for isoflurane was 1.0% and for desflurane 5.0% . A steady state end-tidal concentration of isoflurane and desflurane was maintained for 10 min. When BIS value was 50 the anesthetic concentration for the next patient increased by the same amount. Results MACBIS50 of isoflurane in GA subgroup was 1.16% and in CGEA subgroup 0.77% . MACBIS50 of desflurane in GA subgroup was 5.18% and in CGEA subgroup 3.87% . There was linear correlation between BIS value and end-tidal concentration in each subgroup. Conclusion Epidural lidocaine significantly reduces the end-tidal concentration of isoflurane and desflurane for adequate depth of anesthesia. A linear correlation is maintained between BIS and end-tidal concentration.

Circular dichroism (CD) is an useful technique for monitoring DNA conformation changes resulting from changes in environmental conditions, such as temperature, ionic strength, and pH, and also for the study of the interaction between DNA and ligands (including small molecules and proteins). CD spectroscopy of DNA arises from the asymmetric backbone sugars and by the helical structures often adopted by nucleic acids. By the interpretation of induced circular dichroism (ICD) of ligand signals resulting from the coupling of electric transition moments of the ligand, DNA bases within the asymmetric DNA environment, ligand-DNA interactions, as well as the DNA-binding mode can be assessed. A number of important conclusions have been reported that related to the observed ICD signals resulting from the interactions between intercalators and groove binders with DNA. If short oligonucleotide sequences are used in the study, sequences-specific of binding also can be deduced. CD determination requires smaller amounts of sample, and not limited by the molecular weight or size and can be performed rapidly; though CD is of low resolution, but it's a complement to NMR and X-ray diffraction methods. This review will introduce the characters of the CD spectra of DNA, and its application to the studies of DNA with small molecules; some progress of the studies in our laboratory will also be discussed. CD is expected to be used as a screening method in seeking more DNA-targeted drugs, such as, antineoplastic, antimicrobial and antiviral drugs.

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 report a new designed technique of CT-guided percutaneous puncture for atlantoaxial lateral mass arthrodesis with bone graft and discuss its clinical usefulness and effect. Methods From March 1999 to March 2001, on the base of anatomical investigation of 56 adult cadaversatlas and axis bone specimens, 9 cases with instability of atlantoaxial were treated after reduction by traction, 4 of 9 cases underwent Halo-Vest immobilization, and the other 5 cases underwent transarticular screw fixation through C2 vertebral body for atlantoaxial instability. Of all nine cases, the articular cartilage and capsule of post lateral part of atlantoaxial joints were removed by using home made surgical instruments under CT guidance. Iliac cancellous bones obtained by puncture were implanted into the joint space. Results All cases were followed up from 2 to 17 months (average 12.7 months) and 8 cases more than 6 months. Generally, at the third to fourth month after operation, CT scan showed bony union of the grafted bone and the excessive extension and flexion X-ray films showed stable movement of the atlantoaxial joints, and then the Halo-Vest stock were removed. Conclusion This technique has obvious advantages of less trauma and hemorrhage, high union rate, easy, safe and efficiencies.

Objective To discuss the feasibility and clinical significance of detecting circulating tumor cells(CTCs) in peripheral blood of patients with lung cancer in early stage. Methods Three groups of patients (Group A: 15 cases with early stage lung cancer; Group B: 20 cases with benign pulmonary disease; Group C: 20 healthy volunteers) were enrolled for detection of CTCs using immunomagnetic separation(IMS)+ immunocytochemistry(ICC) method and RT-PCR method. The patients in Group A were followed up for 6-9 months. Results By using IMS+ICC it was revealed that in 5 cases of Group A the result was positive, while it was negative in all cases of Group B and Group C. By using RT-PCR method, the result was positive in 7 cases of Group A, 8 cases of Group B and 6 cases of Group C. In the follow-up period, 2 patients of Group A, who were found positive for CTC before and after operation, showed recurrence. Conclusion IMS + ICC method was a sensitive method to detect CTCs in patients with early stage NSCLC. The detection of CTCs in patients with early stage lung cancer might be a relationship with the clinical prognosis of the patient.