BACKROUND: Because the cortical somatosensory evoked potential(CSEP) is easily affected by the anaesthesia drugs, so it needs to be combined with the subcortex somatosensory evoked potential (subcortical SEP)which is less affected by the junk to monitoring the spinal orthomorphia so as to increase the accuracy.OBJECTIVE: To monitor the onset of stretch spinal injury during rhachial orthomorphia with Combined application of subcortical SEP and CSEP.DESIGN: A comparative study of two kinds of evoked potential.SETTING: Department of Orthopaedics of the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Totally 104 patients with spinal orthomorphia ,including 40 males and 64 females, aged from 5 to 19 years, were selected from the Department of Orthopaedics of Sun Yi-xian Hospital of Sun Yat-sen University from July 1997 to December 2001.INTERVENTIONS: A Nicolet Viking Ⅳ (NICDLET Company, USA) with intraoperativemonitoring software was used to Record the wave of subcortical SEP and CSEP. The peak and after-following peak of the median N45and tibial P37 cortical responses were tagged manually for peak latency and peak-to-peak amplitude measurements. Reduction of more than 50% in SEP amplitude compared with the baselines measurement was defined as deterioration.MAIN OUTCOME MEASURES: Changes of CSEP and subcortical SEP during the surgery.RESULTS: Data of all 104 patients was entered the final analysis. Among 104 cases, 31 had positive cortex somatosensory evoked potential, 11 had positive infra-cortex somatosensory evoked potential, meanwhile, 3 cases changed into normal after relative treatment, which was related with operation. Accurate of cortex recorded point was 75%, under cortex 92.2%, and combination of cortex and infra-cortex 96.7%.CONCLUSION: The SEP is easily affected by the anaesthesia drugs, but it has good signals to record, however, the subcortical SEP is the contrary condition. The monitoring by combined application of CSEP and subcortical SEP during the spinal surgery can greatly increase the reliability of result.

Objective To investigate a periosteal autograft method to repair major defects of joint cartilage in rabbits of different ages. Methods Major cartilage defects of 52 rabbits aged 4 to 52 weeks were repaired with free periosteal grafts and the results were compared in the study. The regenerated cartilage by the cambium of periosteum growing up to the cavity of joint and that growing down to the cancellus of femur were also compared. Results The macroscopical and histological observations at different intervals showed that in young and adult rabbits the grafts could develop into cartilages to repair the major cartilage defects. In adult rabbits the newly formed cartilage was the same as the normal cartilage in thickness and histology. There was no difference between the cambium growing up to the cavity and that growing down to the cancellus. Conclusions Periosteum possesses chondrogenic potential and can be used to repair the cartilage defects. Different directions of chondrogenesis leads to no significantly different outcomes. In adult rabbits the newly formed cartilage can develop into a normal one.

Objective To observe the therapeutic effect of acupuncture plus oral taking Chinese medicine compared with that of oral taking Chinese medicine only for the treatment of insomnia.Methods Totally 64 patients were randomized into treatment group(33 cases)and control group(31 cases).The treatment group was treated by acupuncture with filiform needle[Baihui(GV 20),Sishen- cong(EX-HN1),Shenting(GV 24),Neiguan(PC 6),Shenmai(BL 62)and Zhaohai(KI 6)being the main points] plus oral taking Chinese medicine.The control group was treated by oral taking Chinese medicine only.All 64 cases were examined by SPIEGEL scale. Results The treatment group was better than the control group in general therapeutic effect and improvement of quality of sleep(P

Objective To understand the etiology of acute hepatitis B (AHB) in adults and investigate the mechanisms of hepatic injury and viral clearance in AHB. Methods One hundred and twenty adult AHB patients were enrolled. Epidemiological and clinical data were collected from the case history records or face-to-face inquiry, and serum samples were collected during hospitalization and follow-up. To observe dynamic patterns of AHB etiology, the markers of hepatitis B virus (HBV) were detected by enzyme-linked immunosorbent assay (ELISA); the level of HBV DNA and HBV genotype were determined by real-time polymerase chain reaction (PCR). Enumeration data were analyzed by non-parametric rank sum test. Comparison between groups was done by t test and that between rates of samples was done by Pearson χ2 test. Results Serum HBV DNA was positive in 48.33% of patients at the time of diagnosis with mean level of 9.84×04 copy/mL, and became undetectable after 12.5 days on average. The median levels of serum alanine aminotransferase (ALT) were 1600 U/L and 1490 U/L in HBV DNA positive and negative groups, respectively (z=-0. 678, P=0. 498). However, the mean levels of serum ALT were (2058±123) U/L and (1393±139) U/L in groups of HBV DNA<1×104 copy/mL and>1×104 copy/mL, respectively, which was significantly different (t=-2.17, P=0. 049). Genotype B accounted for 52.5%, genotype C 42.5 and genotype B and C mixed type 5.0% in 58 patients with HBV DNA positive. Eight patterns of serum HBV markers were presented at first visiting. HBsAg(+), HBeAg(+), anti-HBc(+), anti-HBc IgM(+) and HBsAg(+), anti-HBe(+), anti-HBc(+), anti-HBc IgM(+) were the most common patterns, which accounted for 38.3% and 30.0%, respectively. The dynamic patterns of serum HBV markers of 28 AFIB patients were prospectively followed up. The rate of serum FIBsAg loss was 100. 0% and the median time of negative-conversion was 3 weeks. The cumulative positive rate of anti-HBs was 85.7% after 52 weeks of follow-up. The rate of serum HBeAg loss was 100.0%. HBeAg was negative in 53.6% of patients at first visiting and the rest of patients achieved negative within 4 weeks after onset. The positive rate of anti-HBe was 82.1% during 52 weeks of follow-up. Total anti-HBc (including IgG and IgM) was keeping positive in all patients within 52 weeks, and the negative rate of anti-HBc IgM was 39. 3% after followed up for 52 weeks. Conclusions Rapid HBV clearance andserum HBV marker conversion are significantly different between AHB and chronic hepatitis B.

ObjectiveTo investigate the mechanisms of N-acetylcysteine protection against liver injury caused by biliary tract obstruction in rats. MethodsSeventy-two Wistar rats were divided randomly into the following three groups: (1) Rats received choledochus ligationon and N-acetylcysteine by intraperitoneal injection (DBL+NAC); (2) Rats received choledochus ligationon only; (3) sham operation. Six rats were killed each time after 1 d, 3 d, 5 d and7 d and their liver function was tested by TBA-40FR Automatic Chemistry Analyzer. In addition, NO production was detected by Griess Reagent System. ResultsWhen the period of biliary duct obstruction is extended, serum AST,ALT,TBIL, DBIL, NO and TNF-α increase but the increase in serum ALT,AST,NO and TNF-α(P＜0. 05) is more prominent in group DBL than group DBL+NAC at any given time. Conclusions N-acetylcysteine can effectively protect against liver injury in rats with obstructive jaundice, and this may be achieved through down-regulation of TNF-α and NO in hepatocytes.

Objective To explore the diagnostic significance of CT and MRI in dermatofibrosarcoma protuberans.Methods Analyze the CT and MRI images of 16 cases which were confirmed as dermatofibrosarcoma protuberans by pathology.The medical imaging features of dermatofibrosarcoma protuberans were summarized.In the total 16 cases(including 6 male cases,10 female cases),15 cases had suffered from dermatofibrosarcoma protuberans for more than 1 year, 11 cases for more than 5 years, and 9 cases had history of recurrence.Results On MRI, the mass was slightly hypointense on T 1 WI, inhomogeneously hyperintense on T 2 WI with inhomogenous enhancement.The diameters of mass were less than 5 cm in 3 cases,and were more than 5cm in 13 cases.Fifteen cases had clear demarcation between the masses and their adjacent muscles , 7 cases had “suspension sign” in shapes, 10 cases had “sub-nodules outward” features at the edge of the tumors , 12 cases had “multinodular” features inside the tumor , and 8 tumors grew into the surrounding fat layer like roots.Conclusion Dermatofibrosarcoma protuberans can be diagnosed accurately based on the features displayed on CT and MRI.

Objective To study the clinicopathological characteristics and the prognostic factors in metastatic pancreatic tumor.Methods The clinical data of 32 patients with metastatic pancreatic tumors were retrospectively analyzed.The survival of the patients were evaluated with the KaplanMeier method.Univariate analysis was done by log-rank test.Results The primary foei of these32 patients included:9 lung cancer,6 renal cell carcinoma,5 gastric cancer,12 others.The median survival was 15.5 months in the radical surgery group (n 8),18 months in the cryosurgery group(n=3),8 months in the group with palliative bypass operation (n=9),6 months in the group with local radiotherapy (n=3),and 5 months in the group without treatment (n=9).Univariable analysis revealed the type of primary tumor,treatment of the primary tumor,interval between diagnosis of primary tumor and pancreatic metastases,localized pancreatic metastasis,and treatment of the metastatic pancreatic tumor were associated with prognosis.Conclusions Metastatic pancreatic tumors are rare.Long term survival can be achieved with pancreatic resection in a highly selected subset of patients according to the type of primary tumor.Therapeutic cryosurgery as a new minimally invasive,targeted and immunologic method needs to be further evaluated.

Objective To study the clinicopathological characteristics,diagnosis and treatment of patients with mucinous cystic neoplasms (MCNs) of the pancreas.Methods The clinical data of 42 patients with mucinous cystic neoplasms of pancreas were retrospectively analyzed.Chi-square test and independent sample t-test were used for statistical analysis.Results The mean age of the patients was 53.1 yeas (ranged from 29 to 78 y).There were 32 female (76.2％).The patients were divided into two groups according to symptoms (the symptomatic group and the asymptomatic group).There were significant differences in tumor size,tumor location,operation type,operation time and adhesions with the surrounding tissues between the 2 groups of patients.The patients were then divided into three groups according to pathological type.There were significant differences in age,tumor marker,tumor location,operation type,operation time,adhesions with the surrounding tissues,operative blood loss,and postoperative hospital stay among the 3 groups of patients.There was no tumour recurrence in the patients with cystadenoma.Patients with cystadenocarcinoma developed tumor recurrence at a mean of 16.4 months (range,0-50) and died of tumor recurrence even after radical surgery at a mean of 22.9 months (range,3-58).Conclusion MCNs were seen most commonly in middleaged women.The presence of symptoms was a sign of malignancy.Resection of the tumor in the early stage is the key in dealing with MCNs.

OBJECTIVE: To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma. METHOD: A retrospective study of 112 patients with laryngocarcinoma treated. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society. After the patients were given the general anesthesia and oral intubation, the tumors in the study group were resected along the margin of the tumor under larynscope, and the safety margin was reserved as 3-5 mm. All the patients were followed-up for 12-62 months. RESULT: Eight relapses were detected in 112 cases of glottic laryngeal carcinoma after CO2 laser surgery. The local recurernce rate was 7.14% (8/112),of the rate for T1a, T1b and T2 were 0.89%, 0.89% and 5.04% respectively, with significant differences among groups (chi2 = 5.306, P < 0.01) . The rate of local recurrence rate of anterior commissure involvement was 7.14% and that was 7.14% when this site was not compromised by the tumor, which has no statistically significant differences (chi2 = 0.000, P > 0.01). CONCLUSION According to our reaserch, endoscopic CO2 laser sur gery is an effective treatment for early laryngocarcinoma.
Adult ; Aged ; Aged, 80 and over ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

Objective: To observe the effect of electroacupuncture (EA) on cytochrome c oxidase (COX)activity of hippocampal mitochondria in senescence-accelerated mouse prone 8 (SAMP8) mice, and to explore the EA mechanism on Alzheimer disease (AD) in improving energy metabolic disorder.
Methods: Twelve SAMP8 mice were randomly divided into a model group and an EA group, with six in each group. Six senescence-accelerated mouse resistance 1 (SAMR1) mice were prepared as blank group. Mice in the EA group received EA on Baihui (GV 20) and Yongquan (KI 1), once a day for 7 d as a course, altogether 3 courses with one day intervalbetween two courses. Mice in the model group and the blank group were manipulated and fixed as those in the EA group. After interventions, Morris water maze was employed to test spatial learning and memory ability to evaluate EA effect; spectrophotometry was used to detect the activity of hippocampal mitochondria COX.
Results: Compared with the blank group, mean escape latenciesof the EA group and model group were prolonged significantly in Morris water maze tests (P<0.01), the residue duration in the former platform quadrant significantly decreased (P<0.01). Compared with the model group, mean escape latencies on 1 d, 2 d and 3 d of the EA group were significantly reduced (P<0.05), and those on 4 d and 5 d continued the decreasing tendency (P<0.01), the residue duration on the former platform quadrant was significantly prolonged (P<0.05). The COX activity tests showed that, compared with the blank group, COX activities of the model group and the EA group were significantly decreased (P<0.01); compared with the model group, COX activity of the EA group was significantly elevated (P<0.01).
Conclusion: It’s plausible that EA improves AD learning and memory ability by increasing mitochondria COX activity, protecting the structure and function, and improving energy metabolism.