75% compared with the pre-embolism;the intra-operative bleeding ranged 500 to 2000 ml and averaged 810 ml;the surgical removal was successful;the tumor cell necrotic rate was 91% to 95% through post-operative sample pathological examination;and the painful remission rate was 95% to 100%.No severe complications occurred in this series.Conclusion The pre-operative chemotherapy and SAE for spinal tumor are effective,simple,safe and reliable methods

Objective To explore the safety, therapeutic-effect-evaluating standards and clinical value of the interventional treatment used as preoperative chemotherapeutic embolism of pelvic tumors and palliative treatment of the patient unsuitable for surgery. Methods Twenty-nine cases of pelvic tumors with complete materials were selected from the cases treated by Seldinger’s interventional techniques from March 1997 to March 2002 and comprehensively analyzed. Results After the chemotherapeutic embolism, most of the arterial supply to the tumors were blocked off; the tumor stains were decreased by more than 75 %; the intra-operating bleeding ranged from 820 to 1530 ml and averaged 1220 ml; the surgical removals were successful. The pathological examinations of the postoperative specimens showed that the necrostic rate of tumor ranged 91%～98%; the remission rate of painful symptoms reached 100%. No severe complications were found in this series.Conclusion The interventional treatment of pelvic tumors is safe, reliable and simple in operation, and can reduce the intra-operative bleeding and improve the successful rate of the surgery. It is regarded not only as the effective auxiliary therapy before surgical removal, but also as the first-selected method for the palliative treatment of the patient unsuitable for the surgery.

Objective To analyze the nutrient constituents of the gonad from Hemicentrotus pulcherrimus.The results could provide a theoretical basis for the development of the H. pulcherrimus.Methods The contents of the water,ash and protein were determined by the national standard methods,total sugar by phenol-sulfuric acid method,rude fat by soxhlet's method,fatty acids by gas chromatography-mass chromatography,and inorganic elements by atomic absorption spectroscopy method.Results The contents of water,ash,rude fat, protein and total sugar were 64.20%,12.70%,2.34%,12.25%and 5.59%,respectively. The contents of arachidonic acid and EPA were higher in fatty acids.Inorganic elements, such as Ca,Mg,Fe were also in higher level.Conclusion The gonad of H.pulcherrimus was useful in the exploitation of nutrient food.

AIM:To investigate the role of high glucose in primary hepatocytes of mice fed with a high fat di-et.METHODS:Male C57BL/6J mice were fed a high fat (45%of calories) diet ad libitum for 6 weeks to induce hepatic steatosis.Primary hepatocytes were isolated from the mouse liver by the 2 step collagenase perfusion method .The cells were incubated in low glucose ( 5 mmol/L ) , low glucose plus mannitol ( 30 mmol/L ) , or high glucose ( 35 mmol/L ) DMEM medium for 12 h.The cell viability , apoptosis , mitochondrial membrane potential , and caspase enzymatic activities were measured.Furthermore, proteins related to the stress-sensitive signaling pathway of regulating high glucose-induced apoptosis in primary hepatocytes were determined by Western blotting .RESULTS:Incubation with 35 mmol/L glucose re-sulted in a significant decrease in cell viability and an increase in apoptosis , whereas mannitol had no significant effect on the cell viability or apoptosis .A progressive depolarization of the mitochondria , an increase in cytosol cytochrome C and a dramatic decrease in mitochondrial cytochrome C in high-glucose stressed hepatocytes were observed .The enzymatic activi-ties of caspase-9 and caspase-3, but not caspase-8, were significantly increased in high glucose-stressed hepatocytes ( P<0.05).High glucose treatment suppressed the expression of Bcl-2 and Bcl-xL, while it increased the expression of the pro-apoptotic factor Bax .CONCLUSION:High glucose stress reduces mitochondrial membrane potential , initiates mitochon-dria-mediated apoptotic pathways and promotes apoptosis of hepatocytes with steatosis .This may be an important pathologi-cal mechanism of hyperglycemia-induced progression of nonalcoholic fatty liver disease .

Objective To analyze the short-term clinical efficacy of the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis through total hip arthroplasty combined with internal fixation.Methods From January 2011 to June 2014 a total of 28 cases of ipsilateral femoral intertrochanteric fractures with femoral head necrosis were selected,and they were all treated with open reduction and greater trochanter plate fixation combined with total hip arthroplasty.The time of operation, amount of bleeding,time of bone healing of the greater trochanteric fracture,postoperative complications, rate of internal fixation device loosening,incidence of infection,and the Harris score of the hip joint before and after operation were recorded and statistically analyzed.Results The mean operative time was (174.0±27.1)min and the mean blood loss was (530.0±132.0)mL.There were 2 cases of deep venous thrombosis in the lower extremities,and there was no serious complications occured among the remaining cases.All patients were followed up for 12 to 24 months,averagely (16.3±7.0) months.All the 28 patients get bony union of the large trochanter,with the average healing time of (5.0±1.5) months.The preoperative Harris score was (28.0±7.1) points, while it was (86.5±5.3) points after the surgery, and the difference was statistically significant(t=-21.699,P=0.000).At the end of the follow-up,there was no internal fixation device loosening, no cable breakage,and no infection cases.Conclusion Total hip arthroplasty combined with internal fixation for the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis, especially the large trochanteric fractures, were of reliable fracture fixation, good initial stability and good joint function recovery.And it can maintain fracture stability and early recovery of joint function,so that intertrochanteric fractures and femoral head necrosis were treated simultaneously,and its recent clinical results were satisfactory.

Objective To investigate the clinical efficacy of induced membrane technique for reconstruction of large tibia bone defects in adults.Methods From February 2010 to February 2014,28 cases with tibia bone defect (16 cases caused by traumatic,9 cases caused by chronic osteomyrlitis,and 3 cases caused by tumor resrction)were treated in our deparment.There were 21 males and 7 females,with a mean age of 36.7 years old.The mean bone loss after final debridement and tumor resrction was (6.2 ±2.6)cm,and the maximum length of bone loss was 16 cm in this series.All the patients were treated by induced membrane technique,and the healing rate,occurrence of complications and limb function were recorded.The bone union was assessed by Paley scores.Results The average duration of follow-up ranged from 12 to 37 months,averagely (23.4 ±4.7)months.The healing rate was 85.7% at a mean time of 5.2 months.According to the Paley scores,there were 20 cases of excellent,6 cases of good,2 cases of moderate.There were 2 patients with pin site infection,2 patients with deep infection re-quiring operative debridement,1 patient with superficial iliac incision infection,1 patient with nonunions of one ends of the bone gap,and 1 patient suffered the implant failure due to fullweight-bearing early.Conclusion The induced membrane technique is a valid option for the management of large tibia bone defects in adults caused by traumatic,tumor resection and removal of chronic osteomyelitis lesions,which sig-nificantly shorten treatment cycle,provide satisfactory results with minimal complications,and promote good recovery of limb function.

BACKGROUND:Transformation growth factor-β(TGF-β) and brain-derived neurotrophic factor (BDNF) are the main regulatory factors in the process of spinal cord injury. There are many researches for TGF-βand BDNF pathogenesis in the spinal cord injury, but the regulation of Ginsenoside Rg1 intervention on TGF-βand BDNF in the spinal cord injury is rarely reported.
OBJECTIVE:To observe the effect of Ginsenoside Rg1 intervention on TGF-βand BDNF expression at themolecular protein levels, and to study the protection effect of Ginsenoside Rg1 on the spinal cord and nerve function after spinal cord injury.
METHODS:Experimental rats were randomly divided into blank control group, model group and Ginsenoside Rg1 group. In the model and Ginsenoside Rg1 groups, spinal cord injury model was established with the impact method in rats. In the Ginsenoside Rg1 group, rats were intraperitoneal y injected with 10 mg/kg Ginsenoside Rg1 24 hours after modeling, once per day, for 14 days. Rats in the blank control and model groups were injected with equal saline.
RESULTS AND CONCLUSION:Compared with the control group, serum malondialdehyde levels increased, the content of superoxide dismutase decreased, TGF-βexpression levels in spinal cord tissue increased, and BDNF expression levels decreased in the model and Ginsenoside Rg1 groups. Compared with the model group, serum malondialdehyde levels decreased, the content of superoxide dismutase increased, TGF-βexpression levels in spinal cord tissue decreased, and BDNF expression levels increased in the Ginsenoside Rg1 group. Ginsenoside Rg1 can protect the injury spinal cord in rats after spinal cord injury.

Objective To review the relevant causes for and treatment of nerve injuries in the anterior cervical surgery. Methods From January 2008 to December 2009,859 cages of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma were treated by anterior cervical surgery.This study retrospectively analyzed the clinical data of seven cases who were with worsened symptoms of spinal cord injury and related nerve injury. Results Of 859 cases,five cases(0.58%)were with spinal cord injury,one(0.12%)with recurrent laryngeal nerve injury and one (0.12%)with laryngeal nerve injury.Hematoma occurred in four cases after surgery caused spinal cord injury and all the four patients recovered to normal after removal of the hematoma and timely treatment with mythylprednisolone and hyperbaric oxygen.Cervical spine trauma was worsened in one patient after the anterior cervical surgery.The patient restored to its original level of spinal cord gradually through some measures such as tracheotomy,ventilator support,hormone therapy and hyperbaric oxygen treatment.Laryngeal nerve injuries in two cases recovered to normal after conservative treatment with hormone,dehydration and other drugs within three months after surgery. Conclusions Anterior cervical surgery of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma are likely to induce the related nerve damage.The good prognosis can be obtained under timely prevention and treatment.

Objective In attempt to improve the reconstruction of small defects in the facial and frontal regions, we developed a modified radial artery perforator-based free flap. Methods The free proxi-mal radial forearm flap was based on the distal perforator of the radial artery and the concomitant radial vein. The vascular pedicle passed through deep fascia. The free flap was transferred to repair the defects of the fa-cial and frontal regions. Results In 6 patients with frontal defects and 4 patients with facial defects, all flaps survived completely. After following up for 6-12 months, flaps underwent plastic surgery to become thin-ner. The flaps of 10 cases were good in skin texture and color at recipient sites. The scars were cosmetically acceptable. The superficial sensibility recovered well. Conclusion A modified radial artery perforator-based free flap was useful in coveting small defects of the facial and frontal regions.

Objective:To explore the impact of the number of pathological lymph node metastasis areas on the prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery.Methods:The clinicopathologic data of 153 patients with ESCC treated by radical surgery at the Department of Thoracic Surgery of the Affiliated Taixing People′s Hospital of Yangzhou University from January 2012 to December 2014 were retrospectively analyzed. Among these patients, 76 had no adjuvant therapy, and 77 received adjuvant radiotherapy or chemoradiotherapy after surgery. According to the lymph node classification criteria of American Thoracic Association and the number of pathological lymph node metastasis areas, the patients were divided into non-regional lymph node metastasis group ( n=68), oligo-regional lymph node metastasis group (1-2 regional lymph node metastasis, n=54) and multi-regional lymph node metastasis group (≥3 regional lymph node metastasis, n=31). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed by log-rank test. The Cox proportional hazards model was used to analyze prognostic factors, receiver operating characteristic (ROC) curve was used to analyze the predictive value of the number of lymph node metastasis areas. Results:The median overall survival (OS) was 37.0 months for the 153 patients, and the 1-, 3- and 5-year OS rates were 97.4%, 51.0% and 30.7% respectively. In the non-regional lymph node metastasis group, the median OS was 46.0 months, and the 1-, 3- and 5-year OS rates were 97.1%, 58.8% and 39.7% separately. In the oligo-regional lymph node metastasis group, the median OS was 39.0 months, and the 1-, 3- and 5-year OS rates were 94.4%, 55.6% and 35.2% respectively. In the multi-regional lymph node metastasis group, the median OS was 26.0 months, and the 1-, 3- and 5-year OS rates were 98.1%, 25.8% and 3.2% separately. There was a statistically significant difference among the three groups ( χ2=18.257, P<0.001). Among the 76 patients without adjuvant treatment, the 1-, 3- and 5-year OS rates were 94.7%, 50.0% and 34.2% in patients with non-regional lymph node metastasis, 90.9%, 36.4% and 9.1% in patients with oligo-regional lymph node metastasis, 97.4%, 18.8% and 0 in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=8.201, P=0.017). Among the 77 patients with adjuvant therapy, the 1-, 3- and 5-year OS rates were 97.7%, 66.7% and 46.7% in patients with non-regional lymph node metastasis, 96.9%, 68.8% and 53.1% in patients with oligo-regional lymph node metastasis, 93.3%, 26.7% and 6.7% in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=18.083, P<0.001). Univariate analysis showed that age ( HR=1.534, 95% CI: 1.041-2.260, P=0.030), T stage ( HR=1.757, 95% CI: 1.197-2.579, P=0.004), N stage ( HR=1.548, 95% CI: 1.043-2.297, P=0.030), TNM stage ( HR=1.392, 95% CI: 1.114-2.459, P=0.015), adjuvant therapy ( HR=0.545, 95% CI: 0.370-0.803, P=0.002) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.385, 95% CI: 0.238-0.624, P<0.001; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.442, 95% CI: 0.269-0.726, P=0.001) were closely related to OS in patients with ESCC after operation. Multivariate analysis showed that T stage ( HR=1.699, 95% CI: 1.143-2.525, P=0.009), adjuvant therapy ( HR=0.577, 95% CI: 0.386-0.864, P=0.008) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.553, 95% CI: 0.411-0.996, P=0.011; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.550, 95% CI: 0.328-0.924, P=0.024) were independent prognostic factors for OS. The number of lymph node metastasis areas (AUC=0.648, 95% CI: 0.560-0.735, P=0.004) was better than the number of lymph node metastasis (AUC=0.595, 95% CI: 0.497-0.694, P=0.061) in predicting OS of patients with ESCC after radical surgery. Conclusion:The number of postoperative pathological lymph node metastasis areas in thoracic ESCC has important value in predicting survival prognosis, and adjuvant therapy can significantly improve the OS of patients with oligo-regional lymph node metastasis.