Objective To evaluate the clinical effect of endovascular embolization for traumatic carotid cavernous fistula (TCCF).Methods In 20 patients with TCCF,10 were treated with the detachable balloon embolization,4 were treated with the detachable balloon embolization and coils,2 were treated with coils alone,3 were treated with coils and Onyx,and 1 was treated with covered stenting.Two of them were embolized again because of leaking balloon.Results Eighteen of the 20 patients were embolizeded successfully once,2 were embolizeded successfully twice.The patency rate of internal carotid artery was 100％.No operation-related complications occurred.Conclusions Endovascular embolization is a simply,safe and reliable method of curative effect for the treatment of TCCF.

Objective To explore the microanatomy technique of the endoscopy-assisted extreme lateral supracerebellar infratentorial keyhole approach and clinical significance.Methods The extreme lateral supracerebellar infratentorial keyhole approach was imitated in 10 vascular perfusion adult cadaveric heads fixed in formalin,the dorsolateral mesencephalon region was dissected and observed by microscopy and neuroendoscopy from December 2012 to March 2013.Results The extreme lateral supracerebellar infratentorial keyhole approach could be fully exposed the ambient cisterns,the posteromedial tentorial incisura,the dorsolateral mesencephalon region,the trochlear nerve,the root of the trigeminal nerve,the superior cerebellar artery,the posterior cerebral artery and other important anatomical structures.The temporal lobe and parahippocampal gyrus could be exposed when the tentorial was incised.The application of neuroendoscopy could clearly reveal the trigeminal nerve and surrounding structures.Conclusion The extreme lateral supracerebellar infratentorial keyhole approach is suitable for the surgical resection in dorsolateral mesencephalon region.The application of neuroendoscopy can make up for the lack of the trigeminal nerve observed under microscopy and expand the operative field.

A H5N2 subtype avian influenza virus isolated from goose belongs to highly pathogenic avian influenza virus, and the intravenous pathogenicity indexes (IVPI) =2.99. But ducks are not sensitive to this isolated influenza virus. The virus can infect mouse but only replicates in lung and has no pathogenicity. HA and NA gene of this isolated strain share 99.4% and 99.8% nucleotide sequence identity to the HA gene of A/chicken/Hubei/ 489/2004 (H5N1) and the NA gene of A/chicken/Jilin/53/01 (H9N2), and share 99.3% and 99.6% amino acid sequence identity to the HA protein of A/chicken/Hubei/489/2004 (H5N1), A/swan/Guangxi/307/2004 (H5N1), A/wild duck/ Guangdong/314/2004(H5N1), A/chicken/Henan/210/2004(H5N1) and the NA protein of A/chicken/ Jilin/53/01 (H9N2). There are several continuous basic amino acids (-RRRKKR-) at the cleavage site of HA protein. Phylogenetic trees analysis of HA and NA gene suggests that the isolated influenza virus probably originated from the reassortment of H5N1 and H9N2 subtype influenza virus.

Objective To investigate the micro-anatomical approach to resect both intracranial and extracranial jugular foramen tumors in one-stage. Methods With the aid of surgical microscope, fifteen cadaver heads were used to study the microsurgical anatomy of high cervical part and jugular foramen, measure relative data. Results Detailed dissection was performed on high cervical part between the 1st cervical vertebra and the 4th cervical vertebra, resect foramen processus transversi of the 1st cervical vertebra, free vertebral artery 2nd and 1st cervical vertebra segment and horizontal segment. The jugular tubercle, jugular tunisia and part of the occipital condylus was drilled away as much as possible, total exposure of lateral semicircular canal was completed after the removal of the mastoid revealed labyrinthinem. Then the sigmoid sinus and jugular bulb were skeletonized. The vertical of segment of facial nerve was fully skeletonized to study the necessity of the facial nerve translocation. Full exposure to the sigmoid sinus, open jugular foramen. JF areas expanded, and the measured parameters revealed. The distance was (29.65 ± 3.24)mm from mastoidalec to oncentrated focus of condyle (10.18 ± 0.81)mm from hinder margin of condyle to endostoma of hypoglossal canal. The left distance was (6.8 ± 0.35)mm from jugular foramen to perpendicular part of facial nerve, right was (4.6 ± 0.33)mm. Conclusions Total exposure of JF can be achieved through the approach we described, and will enable the facial nerve, cochlea, and the structure of the vertebral artery to be performed. Both intracranial and extracranial tumors can be removed in a one-stage procedure related to anatomical parameters. Improve the cure, reduce complication and lower mortality.

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

Objective:To investigate the clinical effect of autologous nano-fat injection to correct upper eyelid depression.Methods:From March 2016 to March 2020, a total of 191 eyes were treated in 110 patients with upper eyelid depression, including 81 cases on both sides and 29 cases on one side. The fat was obtained by negative pressure liposuction from the thigh. After the nano treatment, the obtained nano fat was injected into the subcutaneous layer, ROOF layer and orbital septum evenly with multi-tunnel without tension.Results:Among 110 patients, 1-2 ml of nano-fat was filled to the upper eyelid unilaterally, with an average of 1.5 ml. 95 patients were followed up for 2-24 months, with average 6 months. After one injection, the depression of the upper eyelid was significantly improved in all patients, and the correction of the depression of the upper eyelid was insufficient in 28 patients. After 3 months, autologous nano fat filling was performed again, and the results were satisfactory. Temporary ptosis occurred in 5 patients and recovered naturally after 3-6 months. Local ecchymosis and swelling were observed in 12 patients, and resolved spontaneously within 7-14 days. No infection, nodules or other complications occurred in all the patients.Conclusions:Nano-fat is a safe and effective method, which can effectively fill the orbital depression area and correct the depression of upper eyelid, with less adverse reactions.

Objective To understand the situation of knowledge,attitude and practice (KAP) of sheep farmers and field veterinarians towards brucellosis prevention,and find out the potentially influential factors.Methods From March to September in 2017,1 067 sheep farmers and 401 field veterinarians were selected as participates,and questionnaire survey was carried out.Percentage rate was used to describe the situation of KAP.Nonparametric test was used to compare the KAP score difference.Results The overall awareness in sheep farmers and field veterinarians was 64.2％ and 80.1％,respectively.In addition,there were 17.3％ (185/1067) sheep farmers and 12.2％ (49/401) field veterinarians had never heard of brucellosis.The knowledge awareness in sheep farmers and field veterinarians was 62.6％ and 79.0％,respectively,75.8％ and 83.8％ of them had positive attitude to brucellosis prevention,54.1％ and 77.6％ of them had good practice habit.They hoped in the future,more information could be received through TVs,and then was internet or broadcasting.Sheep farmers who from first class region,age less than 45 years,education higher than junior high school,feeding time less than 5 years and sheep ever infected with brucellosis (U =4.85,3.08,3.29,2.20,6.62,P ＜ 0.05 or ＜ 0.01),had higher KAP scores than others.Field veterinarians,who had lower education,had lower KAP scores (U =4.29,P ＜ 0.01).Conclusions The awareness of sheep farmers and field veterinarians still need to improve and strengthen.Some suggestions are put forward:improve intervention pattern,optimize content and method,pay attention to use new media.