Objective To analyze relationship between dual-source MDCT and pathology in renal cell carcinoma.Methods 129 patients with pathology were proved renal cell in our hospital from 2009 to 2012.According to the latest 2004 WHO pathological classification,CT features of renal carcinoma were compared with surgical and pathological results.Results The enhancement de-gree of lesions on contrast CT was correlated to the modal of renal malignant cells’ranking.There was no certain correlation be-tween integrity on the edge of the tumor in CT and pathological tumor capsular.The short-hair sign surrounding the margin of tumor strongly indicated renal capsule invasion (P <0.01).Agreement between CT-Robson staging and surgical-pathologic staging was good(Kappa=0.75).Conclusion The CT finding of renal cell carcinoma is correlated with tumor cell characteristic and inter-nal structure.Dual-source MDCT has important clinical value in the diagnosis of renal cell carcinoma.

Objective To analyze and compare the advantages and disadvantages in high-field MRI scan and LAVA enhanced in the display of hepatic carcinoma capsule,in order to improve the early diagnosis and differential diagnosis level of primary hepatic carcinoma by MRI.Methods MRI data of 233 patients of primary hepatic carcinoma were retrospective analysed by two radiologists. Results 233 cases of primary hepatic carcinoma,except for 18 cases of diffuse hepatocellular carcinoma,a total of 239 lesions (54 small hepatocellular carcinoma,76 nodular hepatocellular carcinoma,109 massive hepatocellular carcinoma )were found .Hepato-cellular carcinoma capsule display rate was 139/239(58.16%).119 T1 WI,87 cases were found in T2 WI,and 139 cases were found in LAVA enhanced scan.25 lisions showed complete capsule on T1 WI,12 lisions showed complete capsule on T2 WI,59 lisions showed complete capsule on LAVA enhanced scan.Small hepatocellular carcinoma displayed capsule 21/54 (38.9%),nodular hepa-tocellular carcinoma 53/76 (69.7%),massive hepatocellular carcinoma 65/109 (59.6%).Conclusion High-field MRI conventional scan and LAVA enhenced scan can display PHC capsule better,LAVA enhanced (portal phase + delay phase)showed PHC capsule better than T1 WI and T2 WI.

Objective To provide the endoscopic anatomic basis and anatomic parameters for endoscopic surgical therapy on orbital lesions , and to analyze the advantages and key points of this surgical approach .Methods Five fresh adult heads were used in this experiment .Endonasal thanslamina approach and endoscopic technique were applied to observe important anatomic marks while intraoperative medicalization of the medical rectus muscle was applied to observe the exposure and positioning of important structures and trends of the optic canal and intra orbit .Results Uncinate process was at the lower front corner of middle nasal concha; ethmoidalis bulla was behind the uncinate process , and ethmoidei sinus was reachable after an incision was made on ethmoidalis bulla;anterior ethmoidal artery and posterior ethmoidal artery were the important anatomic landmarks of the inner ethmoidei sinus;optic canal prominence , carotid artery prominence and OCR were the important anatomic landmarks of the inner sphenoid sinus; lamina papyracea was at the lateral wall of ethmoidei sinus , and orbital contents were approacchable after lamina papyracea was cut off ;inside orbit , the optic nerve was approachable through the gap between the medial rectus muscle and inferior rectus muscle .The ophthalmic artery of 9 out of 10 sides of the specimens was originated from the supraclinoidal segment of the internal carotid artery while the remaining one was originated from the cavernous segment of internal carotid artery .There were 7 sides in which ophthalmic artery was located at the inferior lateral of the optic nerve;there were 2 sides in which ophthalmic artery was located at the inferior of the optic nerve; the remaining one was located at the inferior medial of the optic nerve .Conclusion The endoscopic endonasal thanslamina approach can sufficiently expose the optic nerve and the structures in the medical space of the orbit.Uncinate process, ethmoid bulla, anterior ethmoidal artery, posterior ethmoidal artery and posterior ethmoid sinus are the important landmarks of the endoscopic endonasal thanslamina approach .Optic canal prominence , internal carotid artery prominence and OCR are the important landmarks for optic canal decompression .Ophthalmic artery , orbital branches , anterior ethmoidal artery , posterior ethmoidal artery , internal carotid artery are the important vessels . Medialization of the medial rectus muscle is effective to approach the orbital anatomical structures .

Objective:To investigate the clinical experience of neuroendoscopic subtemporal keyhole Kawase approach for trigeminal neurinoma resection.Methods:A retrospective study of general clinical data, postoperative effect and safety was performed in 4 patients with trigeminal neurinoma who underwent resection via neuroendoscopic keyhole Kawase approach in our hospital from September 2018 to June 2019.Results:Total resection was achieved in 4 patients, and there was no death. Two patients suffered from mild postoperative trigeminalnerve dysfunction: one had weak left bite force and facial numbness after surgery, which were not obviously improved after treatment and follow-up; one had left facial numbness and decreased left limb muscle strength after surgery, which were obviously improved after treatment and follow-up. Postoperative complications were not found in the other two patients. Follow-up for 4-13 months showed that all patients had a normal life without tumor recurrence.Conclusion:The approach has obvious advantages, such as minimal invasion, short path, wide exposure range and clear vision, which can help to safely and effectively remove trigeminal neurinoma.

Objective:To investigate the etiology of acute pancreatitis (AP) in Inner Mongolia and its correlation with gender, age and severity of the disease.Methods:From January 2015 to December 2018, the clinical data of 4 168 patients with AP admitted to six large tertiary general hospitals in Inner Mongolia were retrospectively collected and the etiology of AP was summarized. The etiology of different gender, age and severity of AP was analyzed. Chi-square test and adjusted chi-square test were used for statistical analysis.Results:The etiology of 4 168 patients with AP included 2 060 cases (49.4%) of biliary diseases, 608 cases (14.6%) of hypertriglyceridemia, 579 cases (13.9%) of idiopathic causes, 399 cases (9.6%) of alcohol intake, 256 cases (6.1%) of overeating and 266 cases (6.4%) of other causes. The proporation of biliary AP in male patients was lower than that in female patients (39.2%, 917/2 340 vs. 62.5%, 1 143/1 828), however the proporations of hypertriglyceridemic AP, alcoholic AP, overeating AP and AP caused by other causes were all higher than those of female patients (17.4%, 406/2 340 vs. 11.1%, 202/1 828; 14.9%, 349/2 340 vs. 2.7%, 50/1 828; 7.6%, 178/2 340 vs. 4.3%, 78/1 828 and 7.1%, 165/2 340 vs. 5.5%, 101/1 828), and the differences were statistically significant ( χ2=223.645, 32.693, 175.859, 19.858, and 4.001, all P<0.05). The proporation of biliary AP in patients aged between 19 and 59 years was lower than that in patients aged less than 18 years and over 60 years (42.4%, 1 100/2 593 vs. 55.1%, 54/98 and 61.3%, 906/1 477), and the differences were statistically significant ( χ2=6.199 and 134.746, both P<0.016). The proporation of hypertriglyceridemic AP in patients aged over 60 years was lower than that in patients aged between 19 and 59 years and less than 18 years (6.9%, 102/1 477 vs. 18.9%, 491/2 593 and 15.3%, 15/98), and the differences were statistically significant ( χ2=109.403 and 9.430, both P<0.016). The proporation of idiopathic AP in patients aged between 19 and 59 years was higher than that of patients aged over 18 years (14.8%, 384/2 593 vs. 6.1%, 6/98), and the difference was statistically significant ( χ2=5.750, P<0.016). The proporation of alcoholic AP in patients aged between 19 and 59 years was higher than that of patients aged less than 18 years and over 60 years (11.7%, 303/2 593 vs. 1.0%, 1/98 and 6.4%, 95/1 477), the differences were statistically significant ( χ2=10.718 and 29.435, both P<0.016). And the proporation of other causes of AP of the patients aged less than 18 years was higher than those of patients aged between 19 and 59 years and over 60 years (14.3%, 14/98 vs. 5.9%, 152/2 593 and 6.8%, 100/1 477), and the differences were statistically significant ( χ2=0.559 and 0.959, P<0.016). Among the biliary causes, the proporation of moderate severe acute pancreatitis (MSAP) was higher than those of mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP) (59.6%, 336/564 vs. 47.5%, 1 522/3 204 and 50.5%, 202/400), and the differences were statistically significant ( χ2=27.959 and 7.814, both P<0.016). In terms of hypertriglyceridemia and other causes, the proporation of MAP was the lowest (12.7%, 407/3 204 and 4.0%, 127/3 204), and the proporations were statistically significant compared with the proporation of MSAP and SAP (23.0%, 130/564; 12.2%, 69/564 and 17.8%, 71/400; 17.5%, 70/400; χ2=42.013, 7.874, 66.520 and 126.094, all P<0.016). The proporation of MSAP was the lowest among the idiopathic causes (0.7%, 4/564), and the difference was statistically significant compared with the proporation of MAP and SAP (16.6%, 533/3 204 and 10.5%, 42/400; χ2=99.540 and 49.369, both P<0.016). The proporation of SAP was lower than that of MAP, and the difference was statistically significant ( χ2=9.983, P<0.016). In alcoholic and overeating causes, the proporation of MAP was the highest (11.4%, 365/3 204, 7.8%, 250/3 204), and the differences were statistically significant compared with MSAP and SAP (3.5%, 20/564; 0.9%, 5/564; 3.5%, 14/400 and 0.2%, 1/400; χ2=32.182, 23.537, 36.358 and 31.307, all P<0.016). Conclusions:Consistent with reports in most areas of China, the etiology of AP in Inner Mongolia area is mainly biliary diseases and hypertriglyceridemia. Most of the patients with biliary acute pancreatitis are female, mostly in patients more than 60 years old and most of them are MSAP. Hyperlipidemic and alcoholic AP are more common in middle-aged and young male patients, and are mostly MSAP and SAP; while most of alcoholic AP is MAP.