Chiari Ⅰ malformation is a congenital anomaly of posterior brain.There has been many theories for its pathogenesis.Recent years,researchers have sunmarized new theories about the pathogenesis of syringomyelia associated Chiari Ⅰ malformation.However,the exact pathogenesis of Chiari Ⅰ malformation has not been clarified.There are a lot of surgical treatments of Chiari Ⅰ malformation.Importantly,there remains no consensus about the best and generally applicable treatment.

The purpose of this paper is to outline the progress of gadolinium chelates used as extracllular, liver-specific, RES-specific, blood-pool and other tissue-specific contrast agents for magnetic resonance imaging (MRI) on the basis of summing up the relevant research papers. Because of its safety and efficacy, the new development of tissue-specific contrast agent is the trend in the research of gadolinium chelates used as contrast agents for MRI.

Objective To study the correlation between the polymorphism of GSTM1 and GSTT1 genes and the susceptibility to the development of COPD. Methods Polymerase chain reaction (PCR) was used to detect the GSTM1 and GSTT1 genotypes in 91 cases of the patients with COPD (COPD group) and 44 cases of the subjects without COPD (control group), and their susceptibility to the development of COPD were analyzed according to their gender, age and smoking history. Results There was significant difference in the frequency of GSTM1 0/0 genotype between the two groups of male persons with more than 40 years old (P

Objective:To evaluate the rationality of drug use in the children with rotavirus enteritis by the children drug utilization index ( cDUI) . Methods:A retrospective analysis was used to investigate the cDUI, DDDs and rationality of cimetidine, saccharomy-ces boulardiiand and ganciclovir used in 78 children with rotavirus enteritis. Results and Conclusion: The value order of DDDs was saccharomyces boulardii>cimetidine >ganciclovir. Moreover, the dosage of cimetidine and saccharomyces boulardii was relatively high, while that of ganciclovir was basically rational.

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

AIM: It is well known that different injuries will result in different consequences. In this paper, we investigated the morphological change of spinal cord following crushed, hemi-sectioned and transected injury. METHODS: Sixty Wistar rats were randomly divided into 4 groups: intact group, crushed spinal cord injury group (cSCI), hem-sectioned SCI group (hSCI) and transitioned SCI group (tSCI). The models of SCI were established by the method in our laboratory. The animals in each group were sacrificed respectively at 24 hours, 7 and 24 days after operation. The L2 spinal cord which located in the caudal of injury site was taken respectively from each animal in each group and sectioned into frozen sections (20 μm). The sections were stained by hematoxylin and observed under light microscope. The number of neurons in dorsal and ventral horn was also counted. RESULTS: In cSCI group, some neurons appear to atrophy compared with that of intact group, but the number of neurons did not decrease apparently than that of intact group (P＞0.05). Comparatively, some cavities were observed in dorsal and ventral horn in hemi-sectioned and transitioned SCI group. And the number of neurons in dorsal horn and ventral horn decreased greatly at 24 hours, 7 and 21 days compared with intact group (P＜0.05). The results indicated that the decrease of neuronal number in dorsal horn and ventral horn after injury resulted from hSCI and tSCI, but not from cSCI. As a result, some different strategies should be considered for different injuries. For example, some neurotrophic factors may be useful in cSCI, but, many neurons have disappeared following hSCI and tSCI, therefore, other strategies that increase the number of neurons should be considered too. CONCLUSION: Our results provide the important morphological evidences on the change of spinal cord following cSCI, hSCI and tSCI. The data will be useful in treatment of SCI in the future.

Objective To explore the extent of lymphadenectomy by comparing the single left thoracotomy and cervico-right thoracic-abdominal triple incision during esophageal carcinoma radial surgery.Methods The clinical data of 95 patients with thoracic esophageal carcinoma underwent esophagectomy plus lymphadenectomy were studied.They were divided into two groups,left thoracotomy group(62 cases)and triple incision group(33 cases).The rates of lymph node metastasis and postoperative complications were analyzed statistically.Results A total of 1322 lymph nodes were dissected with an average of 13.9 lymph nodes in each case.The rates of lymph node metastasis were 45.3 ％(43/95)of all patients,40.3 ％ of left thoracotomy and 54.5 ％ of triple incision.The rates of lymph node metastasis in the neck for patients with upper or middle thoracic esophageal carcinoma were 25.0 ％(2/8)and 40.0 ％(4/10).The rate of abdominal lymph node metastasis was 53.8 ％(7/13)in lower thoracic carcinoma.The depth of tumor invasion (r =0.315,P =0.007)and tumor differentiation(r =0.239,P =0.017)were correlated to lymph node metastasis.Patients with tumor length ＞2 cm had higher rates of lymph node metastasis(x2 =34.2,P ＜ 0.001).The postoperative complication rates of left thoracotomy and triple incision were 25.8 ％(16/62)and 4.2 ％ (8/33).The mortalities rates of left thoracotomy and triple incision were 1.6 ％(1/62)and 3.0 ％(1/33).There was no significant difference in postoperative complication rates(x2 =0.017,P =0.869)and mortalities rates(x2 =0.047,P =0.651)between the two groups.Conclusion Tumor invasion,differentiation and length should be incorporated in the evaluation of lymph node status.Patients with upper and middle thoracic esophageal carcinoma should receive cervico-right thoracic-abdominal triple incision.Particular attention should be given to the resection of abdominal lymph nodes in patients with lower thoracic esophageal carcinoma.

Objective To study the clinical effect of drug intervention on the treatment of peptic ulcer with blood clots in the Department of internal medicine.Methods From 62 cases of peptic ulcer adherent blood clot were randomly divided into study group and control group according to the random number table,31 cases in each group,in each group.The control group was treated with esomeprazole infusion and subsequent oral treatment.The study group was given endoscopic hemostasis and subsequent oral esomeprazole treatment.Compare the two groups of curative effect,treatment profile and treatment before and after the study of the changes in the situation.Results The total effective rate of the study group was 90.32％,which was significantly better than that of the control group(P<0.05),which was significantly better than that of the control group 70.97％.Research group of rebleeding rate and transfer rate of surgery was significantly lower than that of control group(P<0.05),the study group,the time of hemostasis,the time of hospitalization significantly faster than that of the control group(P<0.05),study group medical expenses are significantly less than the control group(P<0.05).The two groups before treatment Blatchford score,Rockall score,SF-36 score no significant difference,after treatment in the two groups of the three scores were compared with those before treatment significantly optimized(P<0.05)study group the score optimization was significantly better than the control group(P<0.05).Conclusion Peptic ulcer adhesion blood clot give endoscopic therapy can greatly enhance the efficacy,reduce bleeding and transfer the risk of surgery,more effectively improve the acute upper digestive tract bleeding symptoms and signs,improve the life quality of the patients.

AIM:To investigate the effect of ginkgo leaf extract on oxidative stress and haemodynamics of diabetic nephropathy(DN).METHODS:The patients of DN were divided into ginkgo leaf extract treatment group and control group.The changes of serum superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA) and hemorheology indexes were observed.RESULTS:Before treatment,serum SOD,GSH-Px,MDA and hemorheology indexes had no significant difference between ginkgo leaf extract treatment group and control group.After treatment,the serum levels of T-SOD and GSH-Px were increased;the level of MDA,hemorheology indexes,erythrocyte aggregation index and platelet aggregation rate were decreased significantly in ginkgo leaf extract treatment group compared with those in control group(P

Objective To explore the clinical effects and prognostic factors of postoperative radiotherapy for malignant gliomas. Methods From June 1998 to October 2007, seventy-eight cases of malignant gliomas patients were treated with radiotherapy after surgery, including -28 cases received whole brain radiotherapy, 34 cases local field irradiation and 16 cases three-dimensional conformal radiotherapy. Thirty-one cases received chemotherapy which included semustine, semustine plus teniposide and temozolomide. Kaplan-Meier survival analysis and COX regression analysis were used to analyze the prognostic factors. Results The median survival time and 1-, 3-, 5-year survival rate were 16 months, 65.4 %, 32.8 % and 17.9 % for all patients, respectively; 24 months, 72.7 %, 41.5 % and 22.8% for grade 1 patients; 11 months, 47.8 %, 10.9 % and 5.4 % for grade IV patients. Univariate analysis showed the age, Karnofsky, pathologic grade, surgical approach and the time from surgery to radiotherapy were significantly correlated with the survival time (P <0.05). Karnofsky (P =0.000), pathologic grade (P =0.004) and age (P =0.011) were independent prognostic factors in the multivariate analysis. Conclusion Prognosis of the patients with Karnofsky ≥70, age < 50 years and grade Ⅲ is better in malignant gliomas. Postoperative radiotherapy combined with chemotherapy may prolong the survival time.