ObjectiveTo assess the value of simulation craniotomy (SC) technique in evaluation of superficial cerebral veins(SCVs)and its relationship with convexity,parasagittal and falcine meningiomas.MethodsForty-nineconsecutivepatientswithconvexity,parasagittal,andfalcine meningiomas performed SC technique and three-dimensional contrast enhanced MR venography (3D CE MRV) in a prospective study.The number of SCVs ( diameter ＞ 1 mm) within 2 cm around the margin of tumors detected by two techniques were compared with the paired t test.Furthermore,49 cases were divided into groups according to the tumor largest diameter,position,and dural enhancement.The image quality of SC technique in different groups were analyzed by Wilcoxon test in order to find influence factors.Results The number of SCVs within 2 cm around the margin of tumor in SC was 4.4 ± 1.9,which was significantly less than that on 3D CE MRV (5.1 ± 2.7) ( t =3.131,P ＜ 0.05 ).The relationship between meningiomas and the SCVs was demonstrated well on SC in majority of cases with the score of image quality was 2.5 ±0.7.The score of image quality of 12 patients with obvious dural enhancement was 1.5 ± 0.5,which was significantly lower than that of 37 patients without dural enhancement ( 2.8 ± 0.3 )( Z =- 3.093,P ＜ 0.05 ).The score of image quality of 18 patients with tumor larger than 4 cm in diameter ( 2.2 ± 0.9 )was significantly lowed than that of 31 patients with small tumors (2.7 ± 0.5 ) ( Z =- 2.057,P ＜ 0.05 ).The score of image quality of convexity group ( n =10) and parasagittal and falcine group ( n =39 ) was 2.2 ± 0.9 and 2.6 ± 0.6,and there was no significant difference between different location group ( Z =- 0.604,P ＞ 0.05).ConclusionsSimulation craniotomy can exactly display SCVs avoiding the influence of deep cerebral veins and skull veins.This simple technique can provide useful information about the SCVs and their relationships with cortical structures and tumors for preoperative surgical planning.

ObjectiveTo observer the effect of autograft of semitendinosus and interference screws for reconstruction of lateral ankle ligaments. MethodsA total of 12 cases of injured lateral ankle ligaments were selected, including 7 males and 5 females with an average age was 29.4 years, with a course of disease from 3 to 6 months. All lateral ligaments were reconstructed by autograft of semitendinosus & bio-interference screws. A 4.5 mm diameter tunnel was drilled on the lateral ankle, where the tendon of semitendinosus was permeated through, both ends of semitendinosus tendons were fixed with bio-interference screws on talus of at the end of anterior talofibular ligament and calcaneus of at the end of calcaneofibular ligament, maintaining ankle neutral and moderate valgus position. Following operation, the ankle was fixed in neutral position and slightly valgus position with plaster cast. The wound healing, the outcomes of American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and stress radiographic evaluation were assessed at the follow-up. ResultsAll 12 patients showed no infection and the wound healed well at the primary stage. At 3, 6, 12, 24 months after operation, all patients were followed-up. According to AOFAS and FAOS of preoperation and final follow-up postoperation, function of ankle in all patients was significantly improved (P＜0.01), the scores of Chrisman-Snook group were more lower than this approach. No patients complained of instability of the ankle, and stress radiograph confirmed this improvement. ConclusionReconstruction of lateral ligaments of the ankle with autograft of semilendinosus & biointerference screws is a practical and reliable treatment, which restores stability and function of the ankle.

The clinical data and findings in MRI enhanced scanning of 16 patients with meningeal carcinomatosis were analyzed retrospectively.Meningeal carcinomatosis with subacute- or chronic-onset deteriorated progressively presenting the characteristics of intracranial hypertension and meningeal irritation.Fourteen out of 16 patients showed abnormal linear and strip signal enhancement of meninges by enhancement scanning.Meningeal carcinomatosis presented in diversified patterns and contrast-enhanced MRI is of referential value for the diagnosis of the disease.

OBJECTIVE: To review the characteristics changes of calcium phosphate cement (CPC) as drug delayed release carrier before and after carrying different drugs, analyze dynamic principle and influential factors of drug delayed release system, and summarize new advances of CPC in animal experiments and clinical studies.DATA SOURCES: A computer-based online search of CNKI (www.cnki.net/index.htm) and PubMed (http://www.ncbi.nlm.nih.gov/PubMed) was performed for articles published between 1985 and 2009 with the key words of "calcium phosphate cement, CPC, drug delivery system, release" in Chinese and English.DATA SELECTION: Articles highly related with CPC; articles concerning CPC as drug delivery system. Repetitive articles were excluded.MAIN OUTCOME MEASURES: Changes in physico-chemical properties and drug release dynamics of CPC as delivery carrier of different drugs.RESULTS: CPC is an outstanding skeletal defect restorative material. Considering physico-chemical properties, drug release dynamics and histocompatibility, CPC is good delayed release carrier of drugs. However, its clinical application is limited only in bone defect repair of unloading sites due to its bad compressive strength and adhesivity. Therefore, studies on these aspects require exploration.CONCLUSION: CPC as a drug delivery system is a novel administration method. It can repair bone defect and release drug to achieve favorable treatment effects. CPC has been extensively used in osteomyelitis, bone tuberculosis, bone tumor, bone fracture, bone nonunion, and artificial joint replacement.

Objective:To evaluate the effects of increasing end-tidal concentrations of sevoflurane and increasing stimulation voltage on motor evoked potentials,so as to provide evidence in making anesthesia plan for intraspinal tumor surgery.Methods:In the study,48 patients scheduled to undergo intraspinal tumor surgery [American Society of Anesthesiology,(ASA)Ⅰ-Ⅱ,18-65 years old]were enrolled. After general anesthesia induction,the patients were assigned to receive sevoflurane anesthesia of increa-sing end-tidal concentration in the sequence of 0.0%,0.5%,1 .0% and 1 .5% respectively,under a background of propofol and remifentanil.All the observations were done before the important steps of sur-gery.Remifentanil infusion rate was 0.2 μg /(kg·min),while the propofol infusion rate was adjusted to maintain the bispectral index values within the range of 30-50.At each concentration,4 stimulation voltages of 300 V,400 V,500 V and 600 V were employed to elicit motor evoked potentials (MEPs). The amplitude and latency of each MEP were compared.The success ratio was also recorded.Results:The concentration of sevoflurane and the stimulation voltage had impacts on the amplitude and latency of MEPs.Under each stimulation voltage,the MEPs amplitude decreased following increasing end-tidal sevoflurane concentrations,and significant differences were found in comparing 1 .5% sevoflurane (left 20.50 μV,70.71 μV,135.97 μV,190.00μV ,right 14.29 μV,50.71 μV,73.10μV,77.50μV) with 0.0% sevoflurane (left 143.00 μV,388.10 μV,484.53 μV,500.00 μV,right 176.00 μV, 407.60 μV,384.35 μV,451.00 μV)and 0.5% sevoflurane (left 100.00 μV,362.57 μV,444.05μV,435.00 μV,right 115.00 μV,207.15 μV,258.34 μV,358.50 μV),left χ2 =27.46,P<0.01,right χ2 =60.49,P<0.01;left χ2 =20.73,P<0.01,right χ2 =55.05,P<0.01;left χ2 =34.25,P<0.01,right χ2 =33.58,P<0.01;left χ2 =28.61,P<0.01 ,right χ2 =49.04,P<0.01;while there were no statistical differences in the latency changes (P =0.26 ).Under each end-tidal sevoflurane concentration,the MEPs amplitude increased following increasing stimulation voltages,and significant differences were found in comparing 300 V (left 143.00 μV,100.00 μV,61.50 μV,20.50μV ,right 176.00 μV,115.00 μV,41.07 μV,14.29 μV)with 400 V (left 388.10 μV,362.57μV,198.81 μV,70.71 μV,right 407.60 μV,207.15 μV,89.00 μV,50.71 μV)and 500 V (left 484.53 μV,444.05 μV,216.24μV,135.97 μV,right 384.35 μV,258.34μV,187.50μV,73.10μV)and 600 V (left 500.00 μV,435.00 μV,344.00 μV,190.00 μV,right 451.00 μV,385.50μV,156.00μV,77.50μV),leftχ2 =45.55,P<0.01,rightχ2 =25.73,P<0.01;leftχ2 =46.67, P<0.01,right χ2 =55.30,P<0.01;left χ2 =47.36,P<0.01,right χ2 =47.82,P<0.01;left χ2 =38.67,P<0.01,right χ2 =45.87,P<0.01;while the latencies were decreased,and significant dif-ferences were found in comparing 300 V with 400 V and 500 V and 600V(left F=7.50,P=0.01 ,right F=13.33,P<0.01),but the differences had little clinical significance.The success ratio decreased by increasing end-tidal sevoflurane concentration,and significant differences were found in comparing 1 .5%sevoflurane (left 43.8%,70.8%,77.1%,81.3%,right 37.5%,60.4%,75.0%,66.7%)with 0.0%sevoflurane (left 79.2%,87.5%,95.8%,93.8%,right 75.0%,95.8%,95.8%,95.8%)and 0.5%sevoflurane (left 72.9%,89.6%,95.8%,95.8%,right 66.7%,89.6%,95.8%,97.9%);the suc-cess ratio increased by increasing stimulation voltage,and significant differences were found in comparing 300 V(left 79.2%,72.9%,62.5%,43.8%,right 75.0%,66.7%,60.4%,37.5%)with 400 V(left 87.5%,89.6%,77.1%,70.8% ,right 95.8%,89.6%,79.2%,60.4%)and 500 V(left 95.8%, 95 .8%,9 1 .7%,77 .1%,right 95 .8%,95 .8%,8 1 .3%,75 .0%)and 600 V (left 93 .8%,95 .8%, 89.6%,81.3%,right 95.8%,97.9%,89.6%,66.7%),but there were no statistical differences in the success ratio of MEPs between the group with stimulation voltage of 600 V ,end tidal sevoflurane concen-tration of 1 .5% and the group with stimulation voltage of 300 V,end tidal sevoflurane concentration of 0.0% (P=0.22).Conclusion:Sevoflurane inhibited MEPs in a dose-dependent manner.It can de-crease the amplitudes and prolong the latencies.But increasing stimulation voltage will facilitate MEPs monitoring and increase the success ratio.Sevoflurane can be used in larger parts of MEPs monitoring surgery by increasing the stimulation voltage.

Primary intraventricular hemorrhage is a rare type of non-traumatic cerebral hemorrhage neurological disorder.Not only has it higher mortality and morbidity,but also complicated etiologies.However,there is still lack of standard diagnostic techniques and treatment methods for decreasing mortality rate and improving prognosis of primary,intraventricular hemorrhage.Rational use of ultra-early hemostatic therapy and acute surgery therapy are considered as clinical treatment strategies to increase survival rate and improve the quality of life for primary intraventricular hemorrhage patients.This paper aims to give review on some etiology,diagnosis and therapy methods of primary intraventricular hemorrhage,and to provide new ideas for the treatment.

Objective To discuss the application value of shear wave elastography (SWE) and superb microvascular imaging (SMI) in pathological grading of breast invasive ductal carcinoma (IDC).MethodsSixty patients with breast tumor were selected,which were totally 64 lesions.Before operation,SWE and SMI pattern were started to detect the lesions.And images in SWE and SMI pattern were saved.All lesions were proved to be IDC and pathological gradings were got according to the pathological result.The mean of Young′s modulus(AveT1) and maximum of Young′s modulus(AveT2) were recorded in SWE pattern,and degree of blood was recorded in SMI pattern followed Adler′s grading standard.Then differences of AveT1,AveT2 and degree of blood in different pathological grading of invasive ductal carcinoma were evaluated.Results ①In pathological grading 1 group,the average of AveT1 was (62.1±10.4)kPa,and the average of AveT2 was (93.0±20.1)kPa.In pathological grading 2 group,the average of AveT1 was (79.8±8.6)kPa,and the average of AveT2 was (120.6±18.7)kPa.In pathological grading 3 group,the average of AveT1 was (92.6±12.1)kPa,and the average of AveT2 was (137.3±21.5)kPa.The AveT1 and AveT2 were gradually growing with higher pathological grading of breast invasive ductal carcinoma,which were statistically significant (P<0.05).②In pathological grading 1 group,there were 7 cases in the degree of blood 0-Ⅰ and 14 in the degree of blood Ⅱ-Ⅲ.In pathological grading 2 group,there were 3 cases in the degree of blood 0-Ⅰ and 18 cases in the degree of blood Ⅱ-Ⅲ.In pathological grading 3 group,there were only 1 case in the degree of blood 0-Ⅰ and 21 cases in the degree of blood Ⅱ-Ⅲ.There were more lesions of rich blood with higher pathological grading of breast invasive ductal carcinoma,which was statistically significant (P<0.05).Conclusions There are differences of elastography and degree of blood in different pathological grading of breast invasive ductal carcinoma,SWE and SMI can prompt pathological grading and provide important clinical reference value.

Objective To compare the hemostasis effect of Sanguisorbae Radix (SR) and charred Sanguisorbae Radix (CSR) before and after baking.Methods Totally 60 Kunming mice were randomly divided into six groups:control group,Yunnan Baiyao (positive drug group,0.667 g/kg),SR high and low dose (8,2 gcrude drug/kg) group,and CSR high and low dose (8,2 gcrude drug/kg) group.Mice were continuously ig with relatively drug once a day for 3 d.The bleeding time and clotting time were tested 1 h after the last administration,the prothrombin time (PT),thrombin time (TT),and activated partial thromboplastin time (APTT) were detected by blood coagulation analyzer,and the number of platelet was count.Results Compared with control group,SR of high dose,and CSR of high and low doses can obviously shorten the bleeding time,clotting time,PT,TT,and APTT.SR of high and low doses and CSR of high dose can elevate the blood platelets count.Compared with SR high dose group,CSR of high dose can obviously shorten the PT,TT,bleeding time,and clotting time,but could not be statistically significant on the blood platelets count and APTT.Conclusion SR and CSR have different hemostasis mechanisms,the function of hemostasis was more effective after charcoal by baking.

The morbidity of inflammation-associated tumor is high .Prevention and treatment of inflammation play a positive role in delaying the occurrence and development of cancer .Antrodia camphorata, an endemic fungus in Tai-wan, possesses significant anti-inflammatory effect.So far, 35 anti-inflammatory active components from Antrodia camphorata have been identified , among which triterpenoids account for the most .Studies have revealed that triterpenoids , including ergostanes and lanostanes , have significant anti-inflammatory activities .Because of their structures , especially those of the ergostanes , are similar to the structures of cholesterol and steroid hormones , their anti-inflammatory mechanism may be related to mimic the steroid hormones or interfere with the effect of cholesterol .

The rates of chronic obstructive pulmonary disease ( COPD) and lung cancer morbidity in Xuanwei city of Yunnan province are among the highest nationwide , and COPD is an major risk factor for lung cancer .The concur-rence of COPD and lung cancer is a common disease .There are common causative environmental risk factors and pathogenic processes between the two diseases , which provides new ideas for the research , prevention and treatment of both diseases .Additionally the discussion of the relationship between COPD and lung cancer can provide refer -ences for further studies of both diseases .