To observe the clinical outcome of degenerative lumbar spondylolisthesis treated by TFC, transpedicle instrument and bone graft, transpedicle instrument and TFC, respectively, from May 1995 to Aug. 2000, 106 patients with degenerative lumbar spondylolisthesis were conservatively treated. According to Meyerding classification system of lumbar spondylolisthesis, 56 cases were classified as degree 1, 47 cases as degree 2, 3 cases as degree 3. The patients were followed up from 6 months to 10 years and 2 months, averaged 38 months. According to different operative methods, the patients were divided into 3 groups: TFC group, transpedicle instrument and bone graft group, transpedicle instrument and TFC group. Among the 31 cases in TFC group, 22 cases were followed up, the excellent rate was 95 5%. Among the 42 cases in transpedicle instrument and bone graft group, 35 cases were followed up, the anatomical reduction rate was 83%, the excellent rate was 94 8%. Among the 33 cases in transpedicle instrument and TFC group, 28 cases were followed up, the anatomical reduction rate was 81%, the excellent rate was 96 4%. According different indications, TFC and pedicle screw systems were all effective for spondylolisthesis. They had a lower complication rate. The use of spinal instrumentation is a valuable adjunct to achieve lumbosacral fusion in patients having undergone decompressive surgery for the spine.

To evaluate the diagnosis and treatment of epidural neurilemmoma in the spinal canal, the diagnostic characteritics shown by X ray, MRI and CT were analyzed in 42 patients. Furthermore, peri operative conditions, operative time, blood loss and amount of blood transfusion during the operation, operative technique, changes in functions of the spinal cord before and after the operation were also analyzed. The results showed that there was marked recovery of nerve functions after the operation. MRI together with X ray and CT were in the diagnosis of the nature and site of the lesion. Excision of the tumor was done in all the patients. Among them, in 12 patients internal fixation was done at the same time. Follow up showed that the operation achieved good results. While radiologic examinations contributed greatly to the diagnosis, the final diagnosis depended on pathological examination. Internal fixation was optional depending on different situations.

head and neck region. Postoperative recurrence rate was 42 10%, five year survival rate was 8 33%. Not a single case was found to be malignant degeneration of neurolemmoma or neurofibromatosis, nor as a result of radiotherapy. It is suggested that MNST is a primary soft tissue malignant tumor, and early complete excision is the key treatment. The biological characteristics of this tumor as revealed in this study suggest that it is different from what was reported in the foreign literature.

Objective To study the effect of fibrin gel delivered with CT g ui ded trans-laminar injection on sacral nerve root sheath cysts. Methods From Apri l 1998 to February 2001, thirty-eight cases of sacral nerve root sheath cysts we re treated by fibrin gel injection. The location of cysts consisted of 12 L5 S1, 15 S1,2, 11 S2,3. All the fibrin gel was delivered by CT guided trans-laminar i njection. Results Thirty-eight cases were followed up for 3 to 37 months (averag e 9 months). Most of the patients obtained lower back and sacral pain and sacral nerve symptom alleviation. No infection, nerve injury, recurrence and cerebrosp inal fluid(CSF) leaking occurred. According to the critia of the clinic symptom releasing and the radiographic signs, there were 17 cases (44.7%) rated as excel lent, 18 (47.4%) good and 3 (7.9%) fair, the excellent and good rate was 92.1%. Conclusion CT-guided trans-laminar fibrin gel injection is an effective economic al and mini-invasive way to treat sacral nerve root sheath cysts.

Objective To investigate the protective effect of the ethanol extract of vacciniuin bracteatum thumb leaf on acute liver injury induced by CC14 in mice. Methods Sixty mice were allocated into 6 groups randomly, respectively as the normal control group,the model group,the positive control group,the ethanol extract low,middle and high dose group. Each group had 10 mice. Acute hepatic injury model of mice was made by using CC14. The level of ALT, AST in blood serum and SOD,MDA in hepatic tissue were observed. The hepatic tissue was HE-stained conventionally and observed. Results Acute liver injury in mice could be successfully induced by CC14 ,as demonstrated by increased serum ALT, AST levels and severe histological observations. Pretreatment with the ethanol extract of vaccinium bracteatum thumb leaf indicated its potent protective effects on acute liver injury, as demonstrated by a significant decrease in ALT, AST and MDA. Conclusion The ethanol extract of vaccinium bracteatum thumb leaf had an obviously protective effect on acute liver injury induced by CC14, which could be due to its antioxidative stress effect.

Objectives To observe the effects of varied doses of L-thyroxin sodium ( L-T4) on congenital hypothyroidism ( CH) and to determine appropriate dose for early therapeutic intervention. Methods Totally, 108 cases of confirmed CH were divided into two groups (54 in each group). All the cases were administered with L-T4 at varied doses( 10. 1? - 15. 0 ?g ? kg-1? d-1 for large-dose group and 6. 0 - 10. 0 ?g ?kg-1? d-1 for small-dose group) after their parents were trained for basic knowledge of CH by specialists. Their serum levels of T3, T4 and TSH, as well as their body height, weight and head circumference, were measured during follow-up. L-T4 was maintained at doses of 1. 0 - 4. 0 ?g ? kg -1 ? d-1 when their serum levels of T3, T4 and TSH returned to normal. Results All the 108 cases had their clinical symptoms quickly improved and development and growth accelerated after L-T4 substitution. Their serum level of T3 returned to normal in all cases, that of T4 did not return to normal in six cases of large-dose group and in 16 cases of small-dose group, and that of TSH did return to normal in 22 cases of large-dose group and in 39 cases of small-dose group, respectively, after one-month treatment, with a significant difference between the two groups. Cases in large-dose group gained more weight in average than those in small-dose group when they were three months old. Conclusions Early therapeutic intervention for babies with CH with L-thyroxin sodium of 10. 1 -15. 0 ?g ? kg-1? d-1 could quickly correct abnormal function of their thyroid and could avoid abnormal development of their intelligence due to CH.

Objective To investigate the effect of exercise preconditioning on the expression of nerve growth factor(NGF) and its receptor TrkA as well as learning-and-memory abilities in rats suffered from focal cerebral ischemia.Methods Thirty-six male SD rats were randomly divided into sham operation group (Sham-MCAO,n=12),focal cerebral ischemia-reperfusion group (MCAO,n=12) and exercise preconditioning + cerebral ischemia-reperfusion group (EX+MCAO,n=12).Rats in EX+MCAO group were placed in the treadmill device and accepted 4 weeks exercise training.Then method of middle cerebral artery occlusion was applied to prepare transient focal cerebral ischemia reperfusion model.Garcia's method was used to assess the neural function in rats.Western blotting was applied to test the expression of NGF and TrkA protein in the successfully established experimental MCAO rats.Morris water maze experiment was uti lized to test the learning-and-memory abilities of the rats.Results (1) Compared with Sham-MCAO group,the expression of NGF in rats' brain tissue was lower in MCAO group (cerebral ischemia 1h reperfusion 24h) (P＜0.05).The expression of NGF of EX+MCAO group was higher than that of MCAO group,but still lower than that of Sham-MCAO group (P＜0.05).(2)The expression of TrkA in rats' brain tissue was higher in MCAO group compared with Sham-MCAO group (P＜0.05).Compared with MCAO group,the expression of TrkA was even higher in EX+MCAO group (P＜0.05).(3)On the fifth day in the Morris water maze test,the latency of MCAO group was significantly longer than that of Sham-MCAO group((9.36± 1.18)s vs (4.86± 1.52) s,P＜0.05).However,compared with MCAO group,the latency in EX+MCAO group ((6.02± 1.04) s) was shorter,but still longer than Sham-MCAO group (P＜0.05).There was no significant difference among the three groups in the average swimming speed (P＞0.05).Conclusion Exercise preconditioning can up-regulate the expressions of NGF and TrkA protein,which can also improve the learning-and-memory abilities in rats suffered from focal cerebral ischemia reperfusion injury.

BACKGROUND: Foreign scholars use thermotherapy, a new pathway for synthetic therapy of tumor, to perform hyperpyrexia combined with chemical drug radiotherapy of intraperitoneal infiltration and metastasis or to study on the therapeutic effect of metaphase and advanced stage tumor. Especially, establishing thermal biology and thermal dosiology is a scientific and quantified track for synthetic therapy of thermal radiotherapy, thermal chemotherapy and hyperthermal perfusion of tumor.OBJECTIVE: To analyze the thermal dose effect of regional radiofrequency (RF) hyperthemia combined with radiotherapy, chemotherapy and thermal perfusion on metaphase and advanced stage tumor.DESIGN: Controlled observation.SETTING: Key Department of Traditional Chinese and Western Medicine for Tumor, the 107 Hospital of Chinese PLA (General Center for Non-traumatic Treatment and Diagnosis of Tumor).PARTICIPANTS: Totally 1 455 patients with metaphase and advanced-stage tumor admitted to the General Center for Non-traumatic Treatment and Diagnosis of Tumor, the 107 Hospital of Chinese PLA between June and September 2006 who received conservative palliative treatment in the Department of Internal Medicine were recruited in this study. They were all confirmed by pathology and imageology. ECOG was scored 2 to 4 points. Informed consents of detection and treatment were obtained from all the involved patients. The study was approved by the Hospital Ethics Committee.According to the therapeutic regimen, the patients were assigned into thermal perfusion group (n =53), thermal radiotherapy group (n =874), thermal chemotherapy group (n =458) and simple hyperthemia group (n =70).METHODS: After admission, patients in each group were performed peritoneal and pelvic cavity perfusion,intensity-modulated radiation therapy, routine chemotherapy and integrated traditional and western medicine palliative therapy, respectively. Meanwhile, they received RF hyperthemia using in vitro endogenic magnetic field hyperthermia system. A thermocouple was placed in the abdominal cavity. Temperature at 3 different sites in the abdominal cavity was collected, and meanwhile two different sites for measuring temperature at rectum and external acoustic meatus were monitored. The maximal temperature (Tmax), minimal temperature (Tmin) and the average temperature (Tave) of therapeutic target were recorded. 40 ℃/min was used as thermal dose, thermal perfusion was performed once a week, and RF hyperthemia was conducted twice a week, 60 minutes once. Target temperature was 39.5 to 43 ℃, and the thermal dose of 40 ℃/min was calculated out. Intensity-modulated radiation therapy was conducted within 1 hour before heating at (3-5)Gy/time, 3 to 4 times a week. Total dose was DT 30 to 50Gy. Thermal perfusion was conducted 2 to 3 times a week, and intensity-modulated radiation therapy was conducted once to twice a week and 6 to 8 times a course of treatment. The thermal effect of each patient was analyzed at different temperature and different diseases.MAIN OUTCOME MEASURES: ① To analyze the effect of effective thermal dose. ② To evaluate the therapeutic effect and the improvement of quality of life according to World Health Organization (WHO) objective therapeutic effect evaluation criteria and Zubrod-ECOG-WHO scores. ③To observe the changes in abdominal dropsy.RESULTS: Altogether 1 455 patients with metaphase and advanced stage participated in the final analysis. ①After perfusion, body temperature was over 39.5 ℃ in most cases after 15-minute warming, over 40.0 ℃ after another 25-minute warming, over 41.0 ℃ after additional 35-minute arming, and even to 43.0 ℃ after frequent such a thermal therapy. Temperature over 41 ℃ was found in 91 cases, at 40 ℃-40.9 ℃ in 414 cases and at 39.5 ℃-39.9 ℃ in 950 cases. ② The thermal effect of 40 ℃/min could obviously improve the therapeutic effects of graded intensity-modulated radiation therapy, low-dose chemotherapy and thermal perfusion group. The total effective rate of thermal perfusion group, thermal radiotherapy group, thermal chemotherapy group and simple hyperthemia group was 81.6%, 81.9%, 80% and 50%, respectively. The clinical therapeutic effect of 40 ℃-40.9 ℃ and 39.5 ℃-39.9 ℃ in the thermal perfusion group, thermal radiotherapy group and thermal chemotherapy group was significantly better than that in the simple hyperthemia group (P ＜ 0.05). ③ Comparison of Zubrod-ECOG-WHO score of patients before and after therapy: After therapy, Zubrod-ECOG-WHO score was enhanced in 76.3% patients. ④The changes in abdominal dropsy of patients before and after therapy: After therapy, abdominal dropsy changed in 75% patients.⑤The therapeutic effects of different diseases at different temperature: For the same disease, the therapeutic effects over 41 ℃ and at 40 ℃-40.9 ℃ were significantly different from those at 39.5 ℃-39.9 ℃(P ＜ 0.05); However, the therapeutic effects over 41 ℃ were not significantly different from those at 40 ℃-40.9 ℃ (P ＞ 0.05).CONCLUSION: ①The effects of regional RF hyperthemia combined with intensity-modulated radiation therapy are confirmed in the treatment of metaphase and advanced-stage of tumor. ② The therapeutic effects strengthen correspondingly with 40 ℃/min thermal dose increase or temperature increase.

Purpose　The aim is to study the influence factors of recombinant E.coli cell growth,product expression and purification,in order to raise the product rate of rhGM-CSF.Methods　Three pH media were planed to observe the effects of pH on E.coli cell growth and expression with the indexes of the cell density and expression level.The influences of various treatments on product rate were observed with the indexes of the volume and purity of inclusion bodies and the yield,purity,activity of product.Using SDS-PAGE method for analysis of purity.The product bioactivity was determined by using TF1 cell and MTT colorimetric method.Results　The cell density in the medium pH 7.0 was 2.22 g/L;the product expression rate was 23%.It was two times higher than other pH media.The inclusion body prepared by bacteria without freezing store was 2.5 times volume than freezing store.During renatura-tion PEG 4000 could raise 0.8 times active product.The optimum conditions used rhGM-CSF product rate could raise 8 times.Concluston　The product rate of rhGM-CSF expressed in E.coli was affected by many factors.The optimum condition for culture,expression and purification could raise quite a number of product rate.

Objective To optimize the process of extracting total saponins from Platycodon grandiflorum by orthogonal experimental design and central composite design-response surface method. Methods Independent variables were concentration of ethanol, reflux extraction time, reflux time and solvent fold. Dependent variables were extraction rate of total saponins in Platycodon grandiflorum and the yield of dry extract.Linear or nonlinear mathematic models were used to estimate the relationship between independent and dependent variables. Results The result of the orthogonal experimental design was 70%ethanol, 180 min for reflux, 6 fold of solvent and 2 times for extraction. The result of central composite design-response surface method was 70% ethanol, 140 min for reflux, 10 fold of solvent and 2 times for extraction. Conclusion The central composite design-response surface method is better than orthogonal experimental design in studying extraction process of Platycodon grandiflorum, which provides basis for feasibility of application of central composite design-response surface method in optimization of extraction process of Chinese traditional medicine.