Objectives:To summarize the disease characteristics of thoracolumbar adhesive spinal arach-noiditis.Methods:The clinical data of 35 patients with thoracoland lumbar adhesive spinal arachnoiditis treated in our hospital from May 2012 to July 2023 were retrospectively analyzed,including 26 males and 9 females,aged 34 to 80 years(56.0±10.4 years).There were 17 cases secondary to thoracolumbar fracture,12 cases of lumbar disc herniation or combined with lumbar spinal stenosis,3 cases of thoracic spinal stenosis,and 3 cases of intradural tumor.14 cases were primarily characterized by persistent burning pain in the trunk or lower limbs,or accompanied by limb spasms.Another 17 cases mainly presented with numbness and weakness.Additionally,13 cases experienced urinary dysfunction,and 4 cases lost the ability to walk.Com-puted tomography myelography(CTM)and MRI were used to determine the location and imaging features of thoracolumbar adhesive spinal arachnoiditis.The treatment plans of patients were recorded,and the visual analogue scale(VAS)for lumbar and leg pain and Oswestry disability index(ODI)were observed before treat-ment,at 3 months after treatment and final follow-up.The McCormick grading was used to assess the recov-ery of patients who underwent surgery at the final follow-up.Results:The lesions were located in the tho-racic spinal cord in 11 cases,the conus medullaris in 7 cases,the cauda equina in 14 cases,and long seg-ments from the thoracic spinal cord to conus medullaris or cauda equina in 3 cases.11 patients received conservative treatment,and the VAS score was 7(7,8)and ODI was 54％(32％,64％).Only 3 patients showed mild alleviation of pain symptoms after conservative treatment,with a final follow-up VAS score of 7(6,8)and an ODI of 50％(32％,64％).24 patients underwent surgical treatment,and 9 of whom showed no significant improvement in symptoms at the final follow-up,with preoperative and final follow-up VAS scores of 8(8,9)and ODI of 72％(60％,85％),and McCormick grade Ⅲ;5 patients had a significant long-term im-provement in symptoms after operation,who could walk independently or with the aid of assistive devices and recovered to some extent in bowel and bladder functions,with preoperative VAS score of 7(6,8)and ODI of 58％(33％,68％)improving to 4(3,4)and 32％(19％,35％)respectively at final follow-up,and McCormick grade Ⅰ;3 patients recovered to grade Ⅰ postoperatively,and worsened to grade Ⅱ between 2 and 6 months;6 patients recovered to grade Ⅰ to Ⅱ postoperatively,with symptoms worsening to preoperative level(grade Ⅲ)between 2 weeks and 2 years;1 patient was implanted with electrical spinal cord stimulation de-vice,who was recovered in symptoms(grade Ⅱ).Conclusions:Conservative treatment for thoracolumbar adhesive spinal arachnoiditis is relatively limited in efficacy.While surgical treatment can achieve significant clinical improvement in some patients,its effects vary significantly among individuals.Some patients show no significant improvement in symptoms after surgery,and there are even cases where symptoms recur or worsen over time.

Objectives:To summarize the disease characteristics of thoracolumbar adhesive spinal arach-noiditis.Methods:The clinical data of 35 patients with thoracoland lumbar adhesive spinal arachnoiditis treated in our hospital from May 2012 to July 2023 were retrospectively analyzed,including 26 males and 9 females,aged 34 to 80 years(56.0±10.4 years).There were 17 cases secondary to thoracolumbar fracture,12 cases of lumbar disc herniation or combined with lumbar spinal stenosis,3 cases of thoracic spinal stenosis,and 3 cases of intradural tumor.14 cases were primarily characterized by persistent burning pain in the trunk or lower limbs,or accompanied by limb spasms.Another 17 cases mainly presented with numbness and weakness.Additionally,13 cases experienced urinary dysfunction,and 4 cases lost the ability to walk.Com-puted tomography myelography(CTM)and MRI were used to determine the location and imaging features of thoracolumbar adhesive spinal arachnoiditis.The treatment plans of patients were recorded,and the visual analogue scale(VAS)for lumbar and leg pain and Oswestry disability index(ODI)were observed before treat-ment,at 3 months after treatment and final follow-up.The McCormick grading was used to assess the recov-ery of patients who underwent surgery at the final follow-up.Results:The lesions were located in the tho-racic spinal cord in 11 cases,the conus medullaris in 7 cases,the cauda equina in 14 cases,and long seg-ments from the thoracic spinal cord to conus medullaris or cauda equina in 3 cases.11 patients received conservative treatment,and the VAS score was 7(7,8)and ODI was 54％(32％,64％).Only 3 patients showed mild alleviation of pain symptoms after conservative treatment,with a final follow-up VAS score of 7(6,8)and an ODI of 50％(32％,64％).24 patients underwent surgical treatment,and 9 of whom showed no significant improvement in symptoms at the final follow-up,with preoperative and final follow-up VAS scores of 8(8,9)and ODI of 72％(60％,85％),and McCormick grade Ⅲ;5 patients had a significant long-term im-provement in symptoms after operation,who could walk independently or with the aid of assistive devices and recovered to some extent in bowel and bladder functions,with preoperative VAS score of 7(6,8)and ODI of 58％(33％,68％)improving to 4(3,4)and 32％(19％,35％)respectively at final follow-up,and McCormick grade Ⅰ;3 patients recovered to grade Ⅰ postoperatively,and worsened to grade Ⅱ between 2 and 6 months;6 patients recovered to grade Ⅰ to Ⅱ postoperatively,with symptoms worsening to preoperative level(grade Ⅲ)between 2 weeks and 2 years;1 patient was implanted with electrical spinal cord stimulation de-vice,who was recovered in symptoms(grade Ⅱ).Conclusions:Conservative treatment for thoracolumbar adhesive spinal arachnoiditis is relatively limited in efficacy.While surgical treatment can achieve significant clinical improvement in some patients,its effects vary significantly among individuals.Some patients show no significant improvement in symptoms after surgery,and there are even cases where symptoms recur or worsen over time.

Objective To discuss the treatment method and opportunity for patients with gallbladder stones and extrahepatic bile duct stones who failed endoscopic removal of common bile duct stones by endoscopic retrograde cholangiopancreaticography (ERCP). Methods 12 patients, with gallbladder stones and extrahepatic bile duct stones, failed endoscopic stone extraction (ESE), underwent emergency one-stage laparoscopic cholecystectomy (LC) and Laparoscopic common bile duct exploration (LCBDE). Results All of the patients were successfully completed LC +LCBDE and stones were completely removed. Hyperamylasemia occurred in 3 cases and there was no bile leakage, intestinal leakage, cholangitis, pancreatitis, biliary bleeding and other complications. Conclusions Emergency LCBDE has been shown to be a safe and effective salvage procedure for failed ESE.

Objective Toinvestigatethemolecularmechanismsofmitochondrialpathway-mediated apoptosisinintracranialaneurysminitiationinrabbits.Methods FifteenNewZealandwhiterabbitswere divided into 3 groups using the computer random method. After using bilateral carotid artery ligation for modeling basilar artery aneurysm,they were divided into a 2-day group (n=3),a 7-day group (n=6)(3 of them were used for real-time quantitative polymerase chain reaction [PCR]analysis),and a sham operation group (n=6)(3 of them were used for real-time quantitative PCR analysis). The tissue of apex of basilar artery was harvested and the histopathological changes in the vascular wall were observed. TUNEL staining was used to detect apoptotic cells and immunohistochemical staining,and quantitative analysis was used to analyze inflammatory cell distribution. Real-time quantitative PCR was used to detect the expression of apoptosis-related protein mRNA. Results (1 )After modeling,the apoptotic cells were found at the apex of basilar artery in rabbits (the site of internal elastic layer lesion )of the 2-day group and 7-day group. In the 2-day group after operation,the numbers of apoptotic cells (4. 02 ± 0. 21)were significantly higher than those of the basilar artery trunk (0. 40 ± 0. 13),the left posterior cerebral artery (0. 41 ± 0.22),and the right posterior cerebral artery (0. 29 ± 0. 11). The differences were statistically significant (P<0. 05). After modeling,the numbers of apoptotic cells (5. 01 ± 0. 29)of the 7-day group were significantly higher than those of the basilar artery trunk (0. 49 ± 0. 21),the left posterior cerebral artery (0. 31 ± 0. 12),and the right posterior cerebral artery (0. 41 ± 0. 19)(P<0. 05). The internal elastic layer lesions and apoptotic cells were not observed in the rabbits of the sham operation group. (2)After modeling, the expression levels of caspase 9 (1. 97 ± 0. 23)and caspase-3 mRNA (2. 31 ± 0. 40)at the apex of basilar artery in rabbits of the 7-day group were increased significantly compared with that of the sham group (P<0.01).Conclusion Apoptosisisinvolvedintheearlyprocessofaneurysmsinsimple hemodynamics-induced basilar terminus aneurysm formation. Its molecular mechanisms are activated by Bcl-2-mediated mitochondrial pathway through caspase-9.

Objective:To investigate the effect of rapamycin on cell growth and migration of gallbladder cancer GBC-SD cells, and to discuss its potential in clinical therapy of gallbladder cancer. Methods: Proliferation of GBC-SD cells treated with different concentrations of rapamycin (12.5, 25, and 50 mmol/L) was examined by MTT assay. Cell cycle distribu-tion and apoptosis of GBC-SD cells treated with different concentrations of rapamycin were determined by flow cytometry. Migration ability of GBC-SD cells was assessed by Transwell assay. The expression of mTOR (mammalian target of rapam-ycin) and its phosphorylation in GBC-SD cells were examined by Western blotting assay. Results: Rapamycin significant-ly inhibited the phosphorylation of roTOR, but had no influence on the expression of roTOR in GBC-SD cells. Rapamycin significantly inhibited the growth of GBC-SD cells in a dose-dependent manner (P < 0.01). Raparnycin induced apoptosis of GBC-SD cells and arrested them at the G_1/S phase. Furthermore, rapamycin also significantly suppressed migration of GBC-SD cells as showed by Transwell assay (P < 0.01). Conclusion: Rapamycin can remarkably inhibit the growth and migration of gallbladder cancer cells, probably by inhibition of p-roTOR pathway, induction of apoptosis and cell cycle ar-rest of gallbladder cancer cells.

Objective To provide coronary sectional anatomical basis for imaging diagnosis of the injure and disease of the knees.Methods 5 right knees of male adults cadavers were used . After the MR imaging examination,all specimens were frozen and cut into 6 coronary sections . Results The morphological charactenstics relation and the law of variation of the articular facets,articular capsule,articular cavity,cruciate ligaments,menisci,synovial plicae and its surrounding structures on all coronary sections of knees were observed, and compared with the corresponding MR images .Conclusion The variation of morphology and structures of all coronary sectional specimens of knee joint provided foundation of dependable anatomy and clinical value for medical imaging diagnosis .

Purpose　To study the effects of α-tocopherol on activator protein-1(AP-1)binding and TGF-β1 expression induced by high glucose in rat mesangial cells and further to clarify the molecular mechanism of antioxidant in treating diabetic nephropathy.　Methods　AP-1 binding of the rat mesangial cells exposed to high glucose was detected by gel shift assay.The Jun,Fos compositions of AP-1 dimer were determined by supershift assay.Protein expression of TGF-β1 was detected by Western blot.Additionally,the effects of α-tocopherol on AP-1 binding and TGF-β1 expression induced by glucose in rat mesangial cells were also studied.　Results　High glucose stimulated AP-1 binding of mesangial cells in time-and-dose-dependent manners .This AP-1 binding increase involved JunD and Fos as shown by gel supershift.Glucose also increased protein expression of TGF-β1 at same time.The increased AP-1 binding and TGF-β1 were inhibited with pretreatment with α-tocopherol in glucose-treated mesangial cells.　Conclusions　This study suggests that α-tocopherol can significantly inhibit AP-1 activity and TGF-β1 expression by glucose in rat mesangial cells,which may be one of its antioxidation mechanisms to retard diabetic nephropathy.