Objective To present 3 cases of neurilemmoma of adrenal gland. Methods The clinical pathological manifestations,diagnosis and treatment of 3 cases of neurilemmoma of adrenal gland were reviewed. Results Tumor resection was undertaken in all the three and the diagnosis was assessed on pathological study. All the 3 patients have been in good condition and tumor free on 3～5 years of follow up. Conclusions Tumor resection is the treatment of choice with good prognosis.Radiotherapy may be considered as an adjuvant treatment for malignant ones.Definite diagnosis depends on pathological studies.

Objective To investigate the pathological and physiopathological difference between the ruptured” and the “degenerated” typed lumbar disc herniation (RDH and DDH) by measurement of the pressure of the herniated lumbar disc both in the herniated site and in the nucleus pulposus during the surgery, combined with the clinical,light microscopical and immunohistochemical properties. Methods Fifty seven cases of lumbar disc herniation undergone operation in the Tianjin Medical University Hospital were included in this study. The patients were divided into 2 groups. 1) Rupture typed lumbar disc herniation in which the herniated chip of the lumbar disc separated from the parent disc and was squeesed or drew out easily when the superficial posterior longitudenal ligament and anulus fibrosis were opened in the herniated site. 2) Degenerated typed lumber disc herniation in which no herniated chip of the lumber disc escaped; the herniated material can not be taken out unless the disc was resected by the instrument. Before the herniated disc was incised, the intervertebral disc pressure was measured using GENERAA710 multifunctional monitor. Both the light microscopical and the immunohistochemical difference between the RDH and the DDH was studied. Results 1) In the herniated site, the pressure in the RDH is higher than that in the DDH(P0.05). 3) In the RDH, the pressure in the herniated site is higher than that in the nucleus pulposus (P0.05). 5) The“lumbar pain score”and the pressure have obviously relationship in all of 35 patients(r=0.539,P

Magnetic resonance imaging has shown its important role in both early diagnosis of Alzheimer's disease and revealing the Alzheimer's disease pathogenesis.Structural magnetic resonance imaging include lineal mesure,volume measure and volume rendered.They can detect the abnormal brain structure,especially the change of mesial temporal lobe(hippocampus,amygdale) in early onset of Alzheimer's disease.Recent studies more focused on functional imaging which can find the functional changes in brain.Prior to structural changes,functional changes happen,so it can reflect the sutile pathological process in Alzheimer's disease.The functional imaging mainly refers to magnetic resonance spectroscopy,functional magnetic resonance imaging,diffusion weighted imaging and diffusion tensor imaging.As developing of these new technologies,we know more and more about pathogenesis and biological characteristics of Alzheimer's disease.

Objective Insulin-like growth factor-1 receptor (IGF-1R),similar to insulin receptor,is one of the families of re- ceptor tyrosine kinases.,which has been found to be overexpressed in a variety of cancer.It is the main proliferation and survival sig- nal molecule in cancer cell and plays an important role in cancer growth and progress.Blocking signal transduction of IGF-1R by vari- ous strategies can suppress tumor growth and induce regression of established tumor.This study is to construct the siRNA expression vector targeting IGF-1R and to evaluate its ability to induce cell apoptosis in human lung cancer cells.Methods Two siRNA expres- sion vector,pENTR/U6-shRNA-1 and pENTR/U6-shRNA-2 targeting IGF-1R,were constructed using pENTR/U6 vector,and a vector targeting hieiferase gene,pENTR/U6-shRNA-Iuc,was constructed as control.After vectors were transfected into A549 for 48h, knockdown of IGF-1R mRNA and protein and Akt phosphorylation were accessed,and DNA ladder and flow cytometry were used for cell apoptosis.Results siRNA expression vectors targeting IGF-1R were successfully constructed,which was confirmed by PCR and DNA sequencing,pENTR/U6-shRNA-1 and pENTR/U6-shRNA-2 demonstrated the expression were (22.1?2.5) % and (80.1? 3.9) % in IGF-1R mRNA level,(15.2?3.1)% and (47.1?4.1)% in protein level,respectively,compared with pENTR/U6- shRNA-luc.Suppression of IGF-1R by pENTR/U6-shRNA-1 blunted Akt phosphorylation,increased cell apoptosis induced by 3% ethanol,and retained 77.5 % A549 cells in the G0/G1 phase.Conclusion siRNA expression vector targeting IGF-1R can effectively suppress the expression of IGF-1R expression in A549.This study suggests that DNA vector-based RNAi has the potential to be effec- tive and practical cancer gene therapy strategy.

Objective To establish a RP-HPLC method for determining the content of puerarin in Xinkeshu Tablets. Method The analysis was carried on a column of Zorbax Eclipse XDB-C_(18)(4.6 mm?150mm,5?m)at 25℃,with methanol-water-phosphoric acid(23:77:0.5)as mobile phase.The flow rate was 1.0 mL?min~(-1),and the detection wavelength was 250 nm.Result A good linearity was found in the range of 27.1～271.0 ng.The average recovery rate was 100.5 %,and RSD was 1.8%(n=5).Conclusion The method is simple,rapid,accurate,reproducible,and can be used to control the quality of Xinkeshu Tablets.

Objective To summarize the classification and surgical treatment of double or above disruptions of the superior shoulder suspensory complex(SSSC)retrospectively.Methods From June 2006to March 2010,26 consecutive patients with double or above disruptions of the SSSC were treated and entered in the study,including 18 males and 8 females with an average age of 42 years(range,16-80).All patients received surgical treatment,these included clavicle fracture and scapular neck fracture in 9 cases (type Ⅰ),distal clavicle fracture or dislocation and coracoclavicular ligament and acromioclavicular joint injury in 10(type Ⅱ),distal clavicle fracture and other injuries in the SSSC in 7(type Ⅲ).The duration from injury to surgery was 6.4 days(range,3-10).Scapular neck fracture and scapular area dishes fracture were fixed with reconstructive plate and canulated screws,acromial fracture was treated with reconstructive plate and canulated screws,clavicle fracture was fixed with reconstructive plate or hook plate,coracoid fracture was fixed with canulated screw.All patients were treated with primary repair for ligament injuries.The surgery effect was assessed with Rowe and Constan-Murley systems after the fractures reunion.Results All patients were successfully followed up,and the average time was 18.7 months(range,12-32).Fractures were healed with an average of 8.2 weeks(range,6-12 weeks).There was no inferior shoulder knocking syndrome after surgery.Patients all felt shoulder in a stable status.Two patients appeared deltoid muscle power decline,3 appeared shoulder fatigue and aching pain.The average score was 89.7(range,71-97)according to the Rowe system.Eighteen cases were grade as excellent,5 as good,and 3 as fair.The average score was 92.4(range,70-100)according to the Constant-Murley system.Sixteen cases were grade as excellent,6 as good,and 4 as fair.Conclusion Double or above disruptions of the SSSC can be classified into three types,and surgical treatment with constructive plate and canulated screws for them is a good option.

OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

Arthroplasty, Replacement, Hip ; methods ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans

Animals ; Brain Injuries ; drug therapy ; metabolism ; Cerebral Cortex ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Taurine ; pharmacology ; therapeutic use

OBJECTIVETo investigate the results of using the modified Jaslow technique to treat the recurent lumbar disc herniation.

METHODSFrom January 2002 to December 2008,62 patients with recurrent lumbar disc herniation were treated with a modified Jaslow technique. There were 42 males and 20 females with an average age of 53.6 years old, ranging from 36 to 70 years. The primary surgical procedures were enlarged fenestration in 20 cases, unilateral semi-laminectomy in 20 cases, bilateral semi-laminectomy in 8 cases and total-laminectomy in 14 cases. The procedures were performed at L3.4 level in 2 cases, L4.5 in 32 cases, L5S1 in 15 cases, L3.4-L4.5 in 3 cases and L4.5-L5S1 in 10 cases respectively. The clinical symptoms included low back pain and radicular pain. Pre-and postoperative JOA score (including subjective symptoms, self-care ability and pain), ratio of disc height and the fusion condition of the involved segments were applied to assess clinical outcome.

RESULTSAll patients were followed up for 1 to 5 years (averaged 3 years). The space height ratio increased from (62.5 +/- 10.4)% to (90.5 +/- 10.3)%, fusion rate was 96.8% (60/62) at the last follow-up. Mean JOA score was (10.42 +/- 2.50) preoperative, improved to (24.26 +/- 2.35) at last follow-up (P < 0.001). The clinic results was excellent in 39 cases, good in 14, fair in 9.

CONCLUSIONThe modified Jaslow technique was a good alternative method for the treantment of recurent lumbar disc herniation with complete decompression, solid interbody fusion and satisfactory clinical result.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods

OBJECTIVETo explore the value of spinal canal and dural sac dimensions for the treatment of lumbar disc herniation in MRI.

METHODSThe clinical data of 144 patients with single-level lumbar disc herniation underwent nonsurgical or surgical treatment from January 2010 to December 2012 were retrospectively analyzed. There were 91 patients in the nonsurgical group, including 55 males and 36 females, ranging in age from 20 to 68 years old with an average of (43.37±12.48) years; and there were 53 patients in the surgical group, including 28 males and 25 females, ranging in age from 20 to 64 years old with an average of (42.98±12.95) years. JOA scores (29 scores) were used to evaluate clinical manifestation (including subjective symptoms, objective findings, limitation of daily activities and bladder function) and outcomes. The parameters related to spinal canal and dural sac dimensions (including spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac cross-sectional area) in the initial axial T2-weighted MRI were measured, and odds ratio of available diameter to midsagittal diameter, odds ratio of lateral recess width to midsagittal diameter and area ratio of dural sac to spinal canal were calculated. Then, the differences of all parameters between two groups, and the correlations with initial JOA scores were analyzed.

RESULTS(1) All patients were followed up from 1 to 3 years with an average of 2.1 years. JOA scores before treatment were 16.27±2.96 in nonsurgical group and 12.64±3.30 in surgical group, there was statistically significant difference (t=6.319, P<0.01). At final follow-up time, there was no statistically significant difference in JOA scores (25.41±2.22 vs 25.76±2.29), improvement rate [(72.95±12.54)% vs (76.80±9.45)%], and the excellent and good rate (84.91% vs 78.02%) between two groups (P>0.05). But, the relapse rate of nonsurgical group was higher than surgical group (14.29% vs 5.67%). (2) Spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac area, the ratio of available diameter to midsagittal diameter, and the ratio of lateral recess width to midsagittal diameter in surgical group were smaller than that of nonsurgical group, but the area ratio of dural sac to spinal canal was larger, and there were statistically significant differences between two groups (P<0.01). (3) The initial JOA scores showed significantly positive correlation with spinal canal midsagittal diameter and available diameter, lateral recess width, and canal and dural sac area (P<0.01); also presented positive correlation with the ratio of available diameter to midsagittal diameter and the ratio of lateral recess width to midsagittal diameter (P<0.05); but there was a significantly negative correlation between initial JOA scores and the area ratio of dural sac to spinal canal.

CONCLUSIONBoth nonsurgical and surgical treatment of lumbar disc herniation can obtain good effect, but the recurrence rate of non-surgical treatment is higher. Preoperative MRI measurement parameters of spinal canal and dural sac dimensions has certain value for the treatment selection of lumbar disc herniation, but further refinement and validation is still required.

Adult ; Aged ; Dura Mater ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; pathology ; therapy ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Spinal Canal ; pathology