Objective To investigate the pathogenesis of gallbladder chaotic dynamics after partial gastrec-tomy. Methods 140 cases operated by partial gastrectomy after 6 months were randomly examined, they in-cluded one group of 40 cases by Billroth type and the other 100 cases by Eiselsberg type. The ultrasonograph was applied to evaluate the function of gallbladder dynamics and radio-immunity method to determine the content of CCK at the time of having no food and 30 minutes after med. Results BV and RV of Eiselsberg group were bigger than Billroth Ⅰ obviously P<0.05. Gallbladder contraction rate displayed not well obvi-ously as too. The plasm level of CCK had no manifested distinctions in empty stomach cases of the 2 groups, but the increasing gradient plasm level of CCK in Billroth Ⅰ exceeded Eiselsberg type. Conclusions The pathogenesis of gallbladder chaotic dynamics after partial gastrectomy was correlated with the alterative type of partial gastrectomy, the reduction of CCK plasm level, the damage of anterior vagal trunk hepatic branches during the operations and so on led to the disorder of gallbladder emptying and induced cholecystolithiasis.

Pseudomonas sp. M18, one of plant-growth-promoting rhizobacteria, can produce secondary metabolites including phenazine-1-carboxylic acid (PCA) and pyoluteorin (Plt). PA2572 gene coding protein is a probable two-component response regulator in Pseudomonas according to homologous speculations. In order to investigate its genetic function, PA2572 homologous gene, ppbR, was amplified from M18 genome, inactivated by inserting a Gm cassette. The resulting reconstruct was introduced into the M18 genome using homologous recombination technique, so as to obtain the null mutant M18P. The results showed that the M18P has less flagellar swimming and swarming motility, and yielded fewer PCA. The production of PCA was only 50% of the wild type. However, there was no remarkable difference between mutant and wild type in producing pyoluteorin in KMB medium.

Objective To study the relationship between P16,CyclinD1 and P53 anti-oncogene and the gen- esis of hydatidiform mole.Methods 30 samples of hydatidiform moles and normal early pregnant aborted placenta villi respectively were obtained to detect the P16,CyclinD1 and P53 anti-oncogene expression in two kinds of tissues by using SP immunohistochemical staining.Results Compared with that of normal villi,the expressions of P16,P53 and CyclinD1 anti-oncogene were quite different in hydatidiform moles.The expression of P16 was all positive,while CyclinD1 and P53 were all negative in the chorion of early gestation.A descending tendency of P16 expression was found,while the expression of CyclinD1 showed an ascending tendency.The positive rate of P16,CyclinD1 and P53 expression was significantly different between the groups.It was also observed that there was significant difference between the P16 and the proliferation trophocyte.Conclusion P16,CyclinD1 and P53 anti-oncogene have a close relationship with the genesis of human hydatidiform mole.

Objective To evaluate the safety of surgical procedures for patients after heart valve prosthesis implantation.Methods Clinical data of 12 cases with heart valve prosthesis implantation undergone other surgical treatment from November 1996 to December 2005 were retrospectively analyzed.All the cases had routine oral warfarin with prothrombin time (PT) of 20.0—28.3 s averaged 23.5 s, international normalized ratio (INR) for prothrombin of 1.79—2.23 averaged 1.95 and heart functional class Ⅰ—Ⅲ.Among them,appendectomy was performed in three cases with acute appendicitis,reposition and repair in one with inguinal hernia,radical gastrectomy in two with gastric carcinoma,left hemicolectomy in one,cholecystectomy in three,left femoral head replacement in one,and bilateral high ligation and ablation of great saphenous vein in one.Elective surgical operation was performed in seven cases,and emergency operation in five.In those with elective surgery,warfarin was stopped 2—3 days before operation,while 5—10 mg vitamin K_1 was injected intramuscularly 6—8 hours before emergency surgery with preoperative median PT of 15.1 and 15.3 s and median INR of 1.24 and 1.30,respectively.In operation,5—10 mg vitamin K_1 were injected intravenously into the patients by drip depending on their bleeding on the surface of wound.ECG,blood pressure,hemoglobin and oxygen saturation were routinely monitored for all the cases intraoperatively and postoperatively.For the cases with heart function above class Ⅱ,fluid infusion was adjusted based on intubated central venous pressure,and for those with general anesthesia,analyses of blood gases and electrolyte were monitored routinely in operation.Results OPeration time averaged 20—160 rain in all the 12 patients,with blood loss 5—280 ml in average and without complications of massive hemorrhage,thrombosis and heart failure.Conclusions Surgical operation was safe for patients with heart valve prosthesis implantation,if preoperative PT and INR were adjusted to about 15 s and 1.30,respectively by cessation of warfarin or application of vitamin K_1,combined with careful manipulation and strengthened perioperative management.

Objective To evaluate the sensitivity of computed tomography during splenoportographg (CTSP) in the diagnosis of hepatic metastases. Materials and Methods CTSP was performed in 22 cases of hepatic metastatic tumor with dynamic sequence contrast scanning, and the results were compared with those of B ultrasound, precontrast CT and contrast-enhanced CT scans. Results The total sensitivity rates of ultrasonic, precontrast CT, contrast-enhanced CT and CTSP scans were 57.7%, 60.4%, 68.9% and 91.7%, respectively. The sensitivity rates for small lesions (f≤1cm) were 32.7%, 38.6%, 48.3% and 91.8% respectively, showing significant difference between CTSP and the other methods (P<0.01). When the lesions were larger than 1 cm, the 4 methods were not significantly different in making diagnoses (P> 0.05). Conclusion CTSP is sensitive in detecting the hepatic metastatic tumor, providing accurate orientation for metastatic deposits, and therefore facilitating the best imaging determination of the target for surgical treatment.

Objective To evaluate the sensitivity of computed tomography during splenoportographg (CTSP) in the diagnosis of hepatic metastases. Materials and Methods CTSP was performed in 22 cases of hepatic metastatic tumor with dynamic sequence contrast scanning, and the results were compared with those of B ultrasound, precontrast CT and contrast-enhanced CT scans. Results The total sensitivity rates of ultrasonic, precontrast CT, contrast-enhanced CT and CTSP scans were 57.7%, 60.4%, 68.9% and 91.7%, respectively. The sensitivity rates for small lesions (f≤1cm) were 32.7%, 38.6%, 48.3% and 91.8% respectively, showing significant difference between CTSP and the other methods (P<0.01). When the lesions were larger than 1 cm, the 4 methods were not significantly different in making diagnoses (P> 0.05). Conclusion CTSP is sensitive in detecting the hepatic metastatic tumor, providing accurate orientation for metastatic deposits, and therefore facilitating the best imaging determination of the target for surgical treatment.

OBJECTIVETo determine the three-dimensional stability of C1-C2 after anterior approach screw fixation through C2 vertebral body to C1 lateral mass for C1-C2 instability or dislocation.

METHODSThe three-dimensional range of motion of atlantoaxial joint were measured in 16 human cadaveric specimens under four conditions: the intact state (1st group), odontoid fracture of type II (2nd group), instrumentation with posterior C1-C2 trans-articular screw fixation (Magerl technique) (3rd group) and anterior approach screw fixation through C2 vertebral body to C1 lateral mass (4th group) respectively.

RESULTSThere was generally significant difference between 1st group and other groups and between 2nd group and other groups by statistics analysis (P < 0.001). Range of motion significantly decreased in 3rd group and 4th group in all directions. There was generally no significant difference between the two methods by statistical analysis (P > 0.05).

CONCLUSIONAnterior approach screw fixation through C2 vertebral body to C lateral mass provides satisfied stability. It provides the equivalent effect to Magerl technique. It is a kind of reliable surgery choice for the treatment of instability or dislocation of C1-C2 joint.

Adult ; Atlanto-Axial Joint ; surgery ; Biomechanical Phenomena ; Bone Screws ; Cadaver ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators ; Male

Objective To investigate the efficacy of the bioactive artificial vertebrae of a nano- hydroapatite crystals and polyamide 66 composite(n-HA/PA66)to restore the height and architecture of thoracolumbar burst fracture.Methods From December 2003 to February 2006,38 patients(29 males and 9 females)with a mean age of 35.6 years(17-63 years)were treated surgically through anterior ap- proach for decompression and implanted with the bioactive artificial vertebrae of n-HA/PA66 composite to reconstruct the structure of the thoracolumbar burst fractured vertebra.Results All the patients were successfuly followed-up for an average of 8 months,ranging from 6 to 21 months.The bioaetive artificial vertebrac of n-HA/PA66 composite were fused with the receptor bone 3-4 months after operation.The neu- rological function of the patients was restored partially or completely.The thoracolumbar spine was stable during physical examination and the height of thoraeolumbar burst fractured vertebrae that had been restored did not changa during the follow-up.Conclusions Our results show the bioaetive artificial vertebrae of n-HA/PA66 can restore the height and structure of thoracolumbar burst fractured vertebrae and reconstruct the structure of the tboraeolumbar vertebrae effectively,indicating that the bioaetive artificial vertebrae of n- HA/PA66 can be used extensively in clinical spinal surgery.

OBJECTIVEto explore the effectiveness and safety of vertebral column decancellation (VCD) for the management of rigid scoliosis.

METHODSfrom May 2004 to February 2008, 32 patients with rigid scoliosis underwent VCD were reviewed. There were 12 males and 20 females with an average age of 18 years (range, 10 - 56 years). The operation techniques included multilevel vertebral body decancellation and residual intervertebral disc resection, followed by realignment and posterior correction with pedicle screws. The effectiveness was evaluated by preoperative and postoperative radiography and three-dimensional CT scan reconstruction at final follow-up. The intraoperative and postoperative complications of all patients were recorded.

RESULTSa mean of 2.1 vertebrae were performed with VCD and a mean of 10.6 vertebral levels were instrumented and fused (range, 8 - 13 vertebrae). The mean duration of surgery was 270 minutes (range, 215 - 380 minutes). The average intraoperative blood loss was 1560 ml (range, 900 - 4800 ml). Complications were encountered in 4 patients. There were 2 cases with transient neurological deficits, 1 case with CSF leak, 1 case with epidural hematoma. The average time of follow-up was 31 months (range, 24 - 48 months). The correction rate was 61% on the coronal plane (from 108° to 42°), and the correction rate was 65% on the sagittal plane (from 82.0° to 28.7°). All patients had solid fusion at osteotomy site, and no instrumentational failure and loosening were found over the follow up.

CONCLUSIONsingle stage posterior VCD is an effective option to manage rigid scoliosis.

Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteotomy ; adverse effects ; methods ; Retrospective Studies ; Scoliosis ; surgery ; Spine ; surgery ; Treatment Outcome ; Young Adult