Objective To evaluate the role of 3 D spiral computerized tomographic angiography (SCTA) in microsurgery of separating craniopagus twins Methods A case of craniopagus twins underwent spiral CTA Image reconstruction was made by shaded surface display Result SCTA demonstrated osseous fusion in twins skull Parts of bone and dura mater were found to be absent in the fused area Two parts of brain tissues were linked together, and some area were fused Twins' one third of posterior superior sagittal sinuses were fused and converged into a common sinus One side of their transverse sinuses were fused Conclusion SCTA can clearlly reveal the abnormalities of skull, cerebrum, intracranial blood vessels, especially the stereostruction between intracranial blood vessels and skull SCTA is useful for intraoperative bone design and decision of surgical route and has important value in formulating surgical plans

Objective Evaluation of application of looping vascushunt tubes in microsurgical total removal of para sinus meningiomas Methods Eighteen patients harboring para sinus meningiomas were treated in our hospital from Feb,2000 to Mar,2002,Tumors were located in the posterior two thirds superior sagittal sinus in 17 patients and in the congenitally isolated transverse sinus in one patient Looping vascushunt were applied in all cases and tumors were removed under microscope using microsurgical techniques Results Tumors and involved sinus walls were resected (Simpson grade Ⅰ) in all patients Venous sinus reconstruction were achieved in 12 patients using artificial blood vessels,sinus walls were repaired with duramater in 4 patient, venous sinus ligation was applied in two patients because of the sufficent collateral venous drainage All patients recovered and no mortality occurred Conclusions Application of vascushunt tubes is one of the important techniques in microsurgical total resection of para sinus meningiomas

Objective To study the clinical characteristics,microsurgical methods and results of treatment of the purely intrinsic third ventricular craniopharyngioma. Methods Eight cases of craniopharyngiomas located purely in intrinsic third ventricula which were treated microsurgically were analyzed retrospectively.Their clinical manifestations,endocrinal examination,CT and MRI images,choice of operactive approaches and post-operative complications were studied.Results Total tumor removals were achieved in 7 cases.and subtatol tumor removal in 1 case.Temporary central diabetes insipidus occurred in 5 cases,and perloperative water and elecctrolyte imbalance in 6 cases. No patient died in this series. Conclusion According to clinical characteristic of purely intrinsic third ventricular craniopharyngioma, microsurgical technique is a safe and effective method for treatment by a resonable surgical approaches.

Objective To evaluate super-selective renal arterial embolization(SRAE)in treating severe renal hemorrhage when conservative treatment had failed. Methods SRAE was performed in 111 patients with severe renal hemorrhage who had failed to respond the conservative management.The clinical data,the way of embolization,the medication and the follow-up findings were retrospectively analyzed.Results Excellent results were obtained in all patients after SRAE and no serious complications occurred.The technical successful rate with single session was 95.5%(106/111).Gross hematuria disappeared within 1-4 days after the treatment.Two patients developed shock after renal embolization and had to receive surgery after the shock was controlled.Three patients had a recurrence of hematuria,the blood urine subsided after SRAE was employed again.A follow-up with a mean period of 37.4 months was carried out in 92 patients,and the follow-up checkups showed that the renal function was well preserved in all patients.Conclusion Super-selective renal artery catheterization and embolization is a safe and effective treatment for severe renal hemorrhage,it can maximally preserve the healthy renal parenchyma as well as the renal function.Therefore,this technique should be regarded as the treatment of first choice for patients with severe renal hemorrhage.

Objective To evaluate the embolic effect on rabbits arteries using self-made copper plated platinum coil.Methods 1 7 New Zealand Big Ear Rabbits were selected.Unilateral subclavian artery or carotid artery was embolized with self-made secondary level copper plated platinum micro-coils (experimental group)through 3F-catheter.Contralateral subclavian artery or carotid artery was also embolized using secondary level platinum micro-coils (control group)as a control.The level of serum copper ions and the liver and renal function were recorded during different intervals before and after embolization.The arteriography and the tissue his-tology were observed respectively during different intervals after the embolization.Results 1 5 of 1 7 rabbits were embolized success-fully.After embolization,the level of serum copper ions increased in 2 weeks(P <0.05).However,it returned to preoperative level after 4 weeks (P >0.05).The liver and renal function was similar to that of the preoperation after 2 weeks.After embolization,an-giography showed that vascular embolization effect between two groups was not significantly different at 10 min and 30 min;howev-er,the embolization effect of experimental group was superior to that of control one (P <0.01)at 3 days and 1 week,2 weeks,4 weeks,6 weeks and 12 weeks.Pathological results showed that there were a lot of thromboses inside,outside and around the copper coil.Few thromboses appeared around platinum coil in control group.The thrombosis situation in experiment group was better than that in control one (P <0.01).However,no significant difference in inflammatory cell infiltration between two groups was found. Conclusion Self-made secondary level copper plated platinum coil has good physical property,rememorability,flexibility and con-trollability.

OBJECTIVE To analyze the risk factors,clinical characteristics and prevention countermeasures of(nosocomial) fungal infection in patients with acute leukemia.METHODS To adopt investigation way to review and analyze the clinical data of nosocomial fungal infection in 39 cases from 178 acute leukemia inpatients.RESULTS The(nosocomial) fungal infection rate was 21.91%.The nosocomial fungal infection rate in elderly group was(higher) than that of younger group,and in granulocytosis group(≥0.5?10~9/L) was higher than that of

With the increasingly strengthening of economic globalization and higher education internationalization,medical imageology as an important intersecting science in life sciences has more and more international communion and cooperation.In China many hospitals and medical colleges require large quantities of medical imageology professionals,and it is very necessary and important to develop the bilingual education in medical imageology,though a series of problems appear in the process.

The developing situation of "big image" makes the medical imaging become an increasingly huge and complicated system.It offers higher request to the medical imaging teaching.The internship of last term is always influenced by attending the graduate student's entrance examination and looking for job,the effect of teaching can't be assured,and it especially important to do well in field trip,thus it can reduce or avoid the phenomenon of "practice after graduate".

Objective To perform facial nerve monitoring in patients under the low level of neuromuscular blockade during resection of acoustic neurinomas.Methods Twenty-eight patients with large,or medium acoustic neuroma underwent the surgery of acoustic neurinomas resection. During the operation,TOF and EEG monitoring were performed in order to detect the degree of muscle relaxation and the depth of anesthesia. Neuromuscular relaxation was maintained at T_4/T_1=25%～50% by adjusting doses of muscle relaxant and aneasthetic. Free-run EMG and Triggered EMG of orbicularis oris, orbicularis oculi, masseter and trapezius were recordered to monitor the function of the facial, trigeminal and accessory nerves, respectively. The function of the facial nerve was evaluated at first week and half year postoperatively according to House-brackmann classification.Results The facial never was successfully identified and mapped by neurominitoring in all 28 patients. successfully, tThe electrical stimulation was 0.1 mA-0.3 mA and no any involuntary body movement was observed in all patients ne of patients have moved during operation. The preservation of the facial nerve function following surgery was good. Five patients had a HB grade I, 13 a HB grade II, 8 a grade III and 2 a HB grade IV The facial nerve function was HB Grade Ⅰin 5 of 28 patients, HB GradeⅡ in 13, HB Grade Ⅲ in 8 and HB Grade Ⅳ in 2 immediately after operation. Six months after surgery, 10 casespatents showed demonstrated a HB GradeⅠof facial never function, 12 cases exhibited a slight palsy (HB Grade II) , and 5 cases exhibited a HB Grade III palsy and . Another 1 cases a exhibited severe palsy (HB Grade IV).Conclusions Facial nerve monitoring in patients under the low level of neuromuscular blockade can ensure the surgical safety and preserve the facial never function.

Objective To evaluate the clinical application of preoperative multi-slice computed tomography (MSCT) and multi-slice computed tomography portography (MSCTP) in performing transjugular intrahepatic portosystemic stent shunt (TIPSS) combined with gastric coronary vein embolization (GCVE). Methods A total of 126 patients with cirrhosis complicated by upper gastrointestinal bleeding or massive ascites due to portal hypertension were enrolled in this study. The patients were arranged to receive TIPSS together with GCVE. Before the treatment, MSCT and MSCTP were performed in all patients. By using post-processing techniques, including maximum intensity projection (MIP), multiplanar reformation (MPR), volume rendering (VR) and surface shade display (SSD), the anatomy of liver was comprehensively evaluated. Results Both MSCT and MSCTP could clearly display morphologic changes of liver , the spatial relationship of the portal and hepatic veins , the degree and extent of portal collateral circulation , and the severity of ascites, which provided important anatomical information for preoperative evaluation of TIPSS and GCVE. Conclusion MSCT and MSCTP are non-invasive and reliable examinations for the diagnosis of cirrhosis with portal hypertension, it can further clarify the diagnosis and guide the performance of TIPSS and GCVE.