Objective To investigate the effects,difficult points and technical key points of the interventional embolization in brain micro-aneurysms.Methods Retrospectively analyzed the material of the interventional embolization in 38 patients with brain micro-aneurysm.Results Twenty-six cases were treated with simple spring coil embolization technology,4 cases were treated with double micro-catheter embolization technic,2 cases were treated with embolization combining ballon assistive technic and 6 cases were treated with embolization combining stent assistive technic.All the 38 patients successfully embolized.The postoperative immediate cerebral angiogram to determine the degree of embolization:12 cases were 0 level,21 cases were 1 level and 5 cases were 2 level.The Rankin grade results showed that 0-1 score in 24 cases,2 scores in 10 cases,3-4 scores in 2 cases and 5 scores in 2 cases.Thirty-three patients were followed up for 6-12 months.No aneurysms recurred or re-raptured.Conclusions The spring coil embolization of brain micro-aneurysms is a feasible,safe and effective method,though the technics involved is difficulty.Selecting suitable embolization technics according to the characteristic of each micro-aneurysm can reduce the risk of operation,decrease complications and increase the successful rate.

Objective To compare the characteristics of remifentanil and sufentanil for tracheal intubation general anesthesia in gyneco-logical laparoscopic operation. Methods 80 patients received gynecological laparoscopic operation were randomly divided into the remifen-tanil group and the sufentanil group with 40 patients in each group, and they were performed total intravenous anesthesia with remifentanil or sufentanil respectively. Compare the changes of heart rate, mean arterial pressure in the two groups before and after induction, at the time of intubation, pneumoperitoneum, and after the operation. And differences in two groups were recorded in the recovery time, extubation time, postoperative pain in 24 hours, exhaust time and postoperative complications. Results Change trend and magnitude in heart rate, mean ar-terial pressure had no significant difference in the two groups (P>0. 05). The recovery time, extubation time in remifentanil group was shor-ter (P<0. 01), postoperative pain in 24 hours in sufentanil group was more mild (P<0. 01). Exhaust time and postoperative complications of the two groups had no significant difference (P>0. 05). Conclusion Remifentanil and sufentanil used in gynecological laparoscopic op-eration can achieve good effect. and effects of the two drugs on hemodynamics were similar. Remifentanil can recieve better effect in terms of recovery time, while sufentanil has better postoperative analgesia effect.

ObjectiveTo determined the outcome of modified trabeculecotomy (with paracentesis,mitomycin C,scleral flap adjustable suture and formation of anterior chamber at the end of the surgery)in the management of primary acute angle-closure (PAAC) with high intraocular pressure (IOP) and extremely dilated pupil. MethodsTwenty-one eyes of 21 successive cases with PAAC with high lOP(IOP ＞ 30mmHg) and large pupil (maximum vertical diameter ＞ 5 mm) were evaluated prospectively. They underwent modified trabeculecotomy between January 2005 and March 2009.The operative success was defined as IOP ≤ 20 mmHg (± medical therapy) without the necessity of further surgery for glaucoma. ResultsSuccess was achieved in all of the eyes(100％)at the postoperative first week.The mean preoperative IOP was (48.25 ± 3.14) mmHg under a mean number of 3.35 antiglaucomotous medications, but it reduced to (10.47 ± 1.15,P ＜ 0.01) mmHg without medication at the first week, (13.86 ± 0.93,P ＜ 0.01) mmHg at postoperative 3rd month respectively.Only 1 eye needed 1 kind of antiglaucomotous eye drop from the 2nd month postoperatively. The mean vertical diameter of pupils was (5.81±0.23) mm preoperatively, (5.92 ±0.21 ) mm at the first week(P ＞ 0.05). No case received section iridectomy. No serious complication was observed.ConclusionsModified trabeculectomy provides reduction of IOP and protection of pupil in cases with PAAC with high IOP and large pupil,and the procedures such as releasing aqueous humor gradually,appliance of scleral flap adjustable sutures and formation of anterior chamber at the end of the surgery can effectively reduce the risk of serious complications.