Neuroanatomy knowledge is the key to improve the teaching quality of neurosurgery and anatomy teachers' participation in neurosurgery teaching can obviously improve teaching effect. Combined with case-based teaching, we enabled medical students to master the system knowledge from the basic to the clinical , cultivating their clinical thinking ability and the ability to solve clinical problems. Cooperation between clinical medicine teachers and basic medicine teachers can promote the update of knowledge, work out teaching plans together, and improve the quality of teaching.

Objective To explore the application of monitored anesthesia care (MAC) under the guidance of bispectral index in surgical treatment of chronic subdural hematoma in elderly patients.Methods Sixty patients (33 males, 27 females, aged 65-85 years, ASA physical status Ⅱ-Ⅳ) undergoing sphenotresia drainage of chronic subdural hematoma from March, 2014 to May, 2015 were randomly divided into BIS-guided monitored care anesthesia group (group M) and local anesthesia group (group C).Propofol and remifentanil were intravenously infused into patients from group M to maintain BIS index 65-75, vital signs stability and no movement.Local anesthesia was performed before skin incision for each patient.The frequency of medication, the incidence of adverse events were record.The satisfied degree of sedation and analgesia were also evaluated.Results The frequency of movement, local anesthesia drug and additional use of esmolol, were significantly less in group M than those in group C.The satisfaction degree of sedation and analgesia were significantly higher in group M than those in group C (P<0.05).There was no significant difference of respiratory depression and airway obstruction between the two groups.No nausea vomiting reflex and respiration occurred in all groups.Conclusion Bispectral index guidance can be safely applied in surgical treatment of chronic subdural hematoma in elderly patients, which can supply more sedative and analgesic satisfaction than local anesthesia.

Coagulopathy after traumatic brain injury is a coagulation dysfunction caused by brain tissue injury, which is characterized by over activations of coagulation, fibrinolysis and anticoagulation. It is the result of the interaction of multiple factors and multiple links with complicated pathophysiology. This study reivewed the clinical features and evidence-based evidences of coagulopathy after traumatic brain injury in order to summarize and discuss the latest progress in the diagnosis and treatment of coagulopathy after traumatic brain injury.

OBJECTIVE:To estimate the uncertainty in the content determination of azithromycin granules by microbiological method.METHODS:The origin and degree of uncertainty in the content determination of azithromycin granules by microbiological method were analyzed and evaluated in accordance with the standard given in JJF1059-1999 "Evaluation and Expression of Uncertainty in Measurement".RESULTS:The expanded uncertainty was 5 420.0 IU/bag,and the results of the determination can be expressed as(103 838.0?5 420.0)IU/bag.The uncertainty was chiefly originated from method design,followed by solution dilution.CONCLUSIONS:The degree of uncertainty for the content determination of antibiotic drugs by microbiological method can be effectively reduced by suitable method design and reducing the times of dilution.

Objective To Study the clinical characteristics of the :sick sinus syndrome,(SSS) in elderly patients.Methods The disease onset age and causes, natural course and symptoms,dynamic electrocardiography(DCG) and cardiac pacing occasion were reviewed and analyzed. in 50 elderly patients had the diagnosis of SSS.Results The morbidity of SSS had increased significantly in elderly men over 70 years. The ordinary causes were coronary heart disease (CHD),specific SSS and the hypertensive heart disease,cardiomyopathy; and degenerative valvular heart disease etc.The mean natural course were about 10 years.The course of DCG type III was the longest one and the type IV was the shortest. The early symptoms were palpitation, dizzy and weakness,and the late symptoms were transient amaurosis, syncope and the worse cardiac angina and heart failure .The cardiac pacing was predicated by the clinical symptom's severity, which was determinated by both of the severity of bradycardia or sinus arrest and the patient's ability of compensation and adaptation.DCG was the commonly used diagnostic method for SSS in elderly patients.Conclusions The SSS has high incidence in elderly men over 70 and is caused by kinds of deasese,such as CHD and specific SSS,etc.The course is frequently intermittent,hide and very long the disease course. The early symptoms and DCG are atypical. The late symptoms commonly are transient amaurosis and syncope .and the late DCG has four types.The cardiac pacing was predicated by the clinical symptom's severity and DCG was the commonly used to diagnose SSS in elderly patients.

Objective To study the etiology,clinical presentation,MR images,treatment and prog-nosis of spontaneous spinal epidural and subdural hematoma.Methods From1995to2002,6cases diag-nosed as spontaneous spinal epidural and subdural hematoma were reviewed retrospectively.All of the pa-tients were males aging from30to68years with an average of 47years.The onset was acute while the pa-tients were in resting or light activity without prior history of any infection,administration of drugs or trau-ma.One patient had the history of hypertension,and another one was found to have diabetes after admission.The clinical characteristics were sudden pain involving neck,shoulder,chest and back,then dysfunction of motion and sensation of extremities and sphincter within few minutes.4cases of spontaneous spinal epidural hematoma were located at T 5~6 ,T 2~4 ,C 4~5 and C 6 ~T 1 respectively,and2cases of spontaneous spinal subdu ral hematoma at C 7 ~T 1 and C 7 ~T 2 respectively.Results All cases were proved with surgery and pathology.MR imaging showed occupying mass in the posterior or posteriolateral region inside the spinal canal.T 1 -weighted imaging was most useful owing to its typical signal changes with the hematoma.T 2 -weighted gra-dient echo sequence was capable to identify epidural and subdural spinal hematoma.Total laminectomy and hematoma debridement were performed.The outcome was closely related to the interval between the onset and surgery.The patients were followed up from6to18months with an average of 10months.All cases showed no significant improvement of spinal cord function except 5cases with incomplete recovery of sphincter function.Conclusion Spontaneous spinal epidural and subdural hematoma are rare entities.MRI is a most helpful diagnostic tool for this disorder.It should be stressed that early diagnosis and prompt surgical intervention are of great importance for prognosis of spontaneous spinal epidural hematoma.

Alternaria zinniae was a plant fungal pathogen isolated from a world-wide weed Xanthium occidentale,which could cause some weeds of Asteraceae disease. It was found that the fungus made disease spot on the leaf through producing secondary metabolite—phytotoxin. The toxin-producing capability of the fungus was studied. The optimal cultural conditions for producing phytotoxin were temperature 25℃,pH 6.5,cultured period 9~11d,rotating speed 110r/min,darkness and enough dissolved O_2,crude toxin was obtained through large scale fermentation. Analysis on the influence of time,temperature,lightness for storing on the stability of phytotoxin of Alternaria zinniae showed that the phytotoxin had the potential to develop as a herbicide originating from microorganism.

Objective: To study the expression of bone morphogenetic protein (BMP)-2 during midfacial sutural distraction osteogenesis in dogs and to probe the mechanism of sutural distraction osteogenesis. Methods: Eighteen mongrel dogs (12-week old) were randomly divided into distraction osteogenesis group(n = 12) and the control group(n = 6). Rigid external distractor was used for sutural distraction of the midfacial skeleton in the experimental animals. Two experimental and one control dogs were sacrificed at defined time points (on the 5th,10th and 15th day of distraction, the 10th and 20th day of fixation, and 30th day after completion of fixation). The expression of BMP-2 was observed by means of immunohistochemistry. Results: During the period of distraction and fixation, positive staining of BMP-2 was found in the proliferated preosteoblasts, the mesenchymal cells and the newly formed bone matrix at the sutural margin of the experimental dogs; weak expression was also noticed in the control dogs. Compared with that in the control group, the expression of BMP-2 in the experimental group increased and reached the peak on the 15th of distraction, then gradually decreased, the expression of BMP-2 nearly restored to the normal level 1 month after the removal of the distractor. Conclusion: The mechanical strain can lead to the generation of endogenous BMP-2, which may play an important role in the new bone formation.

Humans ; Mineral Fibers ; toxicity ; Respiratory Tract Neoplasms ; chemically induced

Carcinoma ; complications ; therapy ; Cholangitis ; complications ; therapy ; Drainage ; Humans ; Semicircular Ducts