Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

Objective To explore the clinical skills and curative efficacy of Glubran (NBCA-MS) embolization of cerebral arteriovenous malformations. Methods Ninety-six cases of cerebral arteriovenous malformations were treated by 187 endovascular embolizations with different concentrations of Italy GEM company's Glubran (NBCA-MS). Follow-up was performed to 96 cases of cerebral arteriovenous malformation with NBCA-MS embolization. Results During the follow-up in 96 cases, clinical symptoms completely disappeared in 92, were improved in 3 and reoccurred in 1. The malformation was totally got rid of in 44 of 48 cases DSA examinated, and the 80%-90% embolization was achieved in the rest who need further γ-knife therapy. In all cases, γ-knife therapy was performed in 32 cases after embolization, and among them 26 cases received DSA examination 1-2 years after γ-knife therapy, and 21 cases were proved to have no malformation. Conclusions The method ofendovascular emdolization with NBCA-MS is safe, reliable and effective to treat the cerebral arteriovenous malformation.

Objective To study the relationships between hypertensive intracerebral hemorrhage (HICH) and family history of hypertensive disease, gender, age and disease course in Guangzhou. Methods The clinical profiles of 425 (269 male and 156 female) patients with HICH admitted to Nanfang Hospital, Guangzhou from 2000 to 2004 were collected. The relationships between disease incidences in different family histories of hypertensive disease, genders, ages, courses of disease and blood pressure were analyzed. Results In all 425 cases with HICH, the ratio of male to female of people with family history of hypertensive disease was significantly higher than that without in male.There were no obvious differences between with and without family history in female. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in the male than in the female in young group. In middle-aged group and elder group, there were no significant differences in SBP and DBP between the male and the female. The distributions of SBP and DBP were all acute stage＞ subacute stage＞ convalescence stage. Conclusions Hypertensive disease should be supplied with different strategies of prevention and cure in accordance with different ages, genders and courses of disease, which can decrease the incidence of hypertensive intracerebral hemorrhage maximally.

Objective To compare the therapeutic efficacy, safety and complication incidence of three minimally invasive surgical procedures for hypertensive hemorrhage in basal ganglia. Methods According to the operation procedure, 78 patients with basal ganglia hemorrhage (GCS 6-12) were divided into endoscopic surgery group, stereotactic burr-hole aspiration group and small bone flap craniotomy group. The time of operation, and the blood loss volume during operation were compared among the 3 groups. CT was reused to calculate the residual volume and clearance rate of hematoma within 2 d after operation. The neurological outcomes, case fatality rate were analyzed after 6 months of the surgery according to the Glasgow Outcome Scale (GOS). Results The small bone flap craniotomy group had the longest operation time [(175.7±55.7) min, P＜0.05]. The blood loss volume [(296.5±158.6)mL] during operation in small bone flap craniotomy group was relatively more than those in the other 2 groups (P＜0.05). The endoscopic surgery group had the highest hematoma clearance rate (84.5%±8.2%,P＜0.05). The therapeutic outcomes evaluated by GOS in the endoscopic surgery group were more satisfactory than those in the other 2 groups (P＜0.05). Conclusions Endoscopic surgery not only leads to less tissue damage, but also has advantages of higher hematoma clearance rate and effective hemostasis resulting in better neurological functional outcomes, therefore is an ideal choice for cerebral hemorrhage patients who has no need of large bone flap craniotomy.

Objective To study the short-term and long-term effectiveness of intracranial aneurysm occlusion with expandable hydrocoil. Methods Forty-one patients with intracranial aneurysms (n=45) were treated by endovascular occlusion with expandable hydrocoil. Follow-up interviews in the forms of DSA, CTA or MRA were conducted to the 41 patients within 6-24 months after the treatment to find out the tumor recurrence and complications. Results In the 41 patients, 1 died, 1 suffered from recurrence, 3 developed cerebral infarction, 1 got oculomotor paralysis, 2 got hydrocephalus. According to modified Rankin scale, grade 0 in 8 cases, grade 1 in 19, grade 2 in 7, grade 3 in 3, grade 4 in 2, grade 5 in 1 and grade 6 in 1. Conclusions Endovascular embolization with expandable hydrocoil is an effective treatment method for intracranial aneurysms, especially for parent artery occlusion, but it may be able to cause more complications in the treatment of small aneurysms (＜5mm), so the caution should be taken.

Objective To study the therapeutic effect of pramipexole in Parkinson's disease (PD). Methods Forty patients with PD were treated with pramipexole for 12 weeks and evaluated with Unified Parkinson's Disease Rating Scale (UPDRS) before and after therapy.Among them, 6 cases were treated with pramipexole without any anti-PD drugs, and the rest with pramipexole and other anti-PD drugs. Some cases received follow-up at week 2, 4, 8, 12 to evaluate the therapeutic effect.Results After the therapy ofpramipexole, the symptoms of PD were alleviated in 35 patients (87.5％).The alleviation was statistically significant in UPDRS scores, daily activities, motor function, trembling,splinting, mental symptoms and on-off phenomenon.Futhermore, the post-therapeutic follow-up revealed that the patients get much better. Conclusions Pramipexole is effective in the treatment of PD.It is a safety and good effctive anti-parkinson drug.

Objective To observe the therapeutic effect of the sacral nerve stimulation (SNS)on the neurogenic bladder. Methods SNS was used to treat 94 patients with neurogenic bladder. The ICI-Q-SF scores, voiding diary (including urinary incontinence times, urinal pad test, urination times,nocturia times and urinary volume) and urine dynamics test (including bladder volume, pressure of detrusor, maximum urinary flow rate, average urinary flow rate, pressure of bladder neck, maximal urethral pressure, functional urethral length and residual urine volume) were observed before and 1 week after SNS. And the data was analyzed statistically. Results The ICI-Q-SF scores were 17.2±1.8 before the treatment of SNS and 8.3±1.6 after SNS (P＜0.05). The urinary incontinence times, urination times and nocturia times were significantly decreased (P＜0.05) compared with those before treatment. The weight of urinal pads was lessened significantly (P＜0.05), while the urinary volumes were increased significantly (P＜0.05). The bladder volume, the maximum urinary flow rate and the average urinary flow rate were increased significantly (P＜0.05) while the residual urine volumes were decreased significantly (P＜0.05). There were no differences in pressure of detrusor, pressure of bladder neck, maximal urethral pressure and functional urethral length (P＞0.05). No complication occurred in our study and total effective rate was 75.5%. Conclusions The therapeutic effect of SNS on the neurogenic bladder is sure, and the symptom of the neurogenic bladder is well improved with few complications. It should be widely used.

Objective To study dystrophin expression in Duchenne muscular dystrophy (DMD) and non-DMD patients. Methods With immunohistochemistry method, using monoclonal antibody of dystrophin, expression of dystrophin was analyzed in 7 DMD patients (experimental group)and 7 non-DMD patients (control group). Results In 7 non-DMD patients, uniform and continuous dystrophin expression was found along the sarolemma, while not in 7 DMD patients. Conclusions Dystrophin expression in myocyte membrane is negative in DMD patients, which indicates that dystrophin loss may be involved in the pathogenesis of DMD. It can be used as a "gold standard" in diagnosing DMD.

Objective To investigate the polymorphism of human cytomegalovirus (HCMV) UL144 gene of the low passage clinical isolates in Guangzhou and explore the role of UL144 gene in HCMV pathogenicity. Methods The clinical isolates of HCMV were obtained from the urine sample collected from those infants with intra-uterus HCMV infection in Guangzhou. The virus genome DNA was extracted. According to the genome sequence of Toledo, primers for UL144 gene were designed and used to amplify the complete open reading frames (ORF) of the UL144 gene in our 3 different clinical isolates. These ORFs of the UL144 gene were cloned into pMD18-T vector and their sequences were confirmed by sequencing. Bioinformatics methods were used subsequently to analyze the polymorphisms of these genes in different stains. Results Three HCMV low passage clinical isolates were successfully isolated, named D2, D3 and D52. As shown by PCR, all of these three strains contained UL144 ORF region. Three complete ORFs were amplified in total and their sequences were submitted to GenBank (Accession No.: DQ180368, DQ180382 and DQ180355). In D2, D3 and D52 isolates, their UL144 ORFs consisted of 531 nucleotides. DNA sequences were quite conservative,all variability were base substitution, and the amino acid sequences were high conservative, the rate of amino acid variability was 1.1%. There were no additional or deleted sites of posttranslational modification of UL144 protein in all clinical isolates. There were some differences in the secondary structure among different isolates. The isoelectric point of UL144 protein of all clinical isolates was 8.97. Conclusions All DNA and deduced amino acid sequences of UL144 gene share great similarity among Guangzhou HCMV clinical strains regardless of their polymorphism. It implies that maybe UL144 gene plays an important role in congenital infection.

Objective To study the clinical significance of bone reconstruction at cranial base for severe traumatic comminuted fractures of anterior skull base. Methods Forty-six bone defect cases were divided into treatment group and control group randomly. Treatment group was treated with the bone reconstruction therapy, while the control group was not. All the patients received the follow-up ranging 6 months to 1 year, and examined with CT and/or MRI to observe leakage of cerebrospinal fluid,intracranial infection and encephalomeningocele. Results In the treatment group, one of the 18 survivals developed mild cerebrospinal fluid leakage, which was cured later. In the control group, 5 of the 17 survivals had cerebrospinal fluid leakage, 3 had intracranial infection and 3 encephalomeningocele.The total incidence of complications of the treatment and control groups was 1/18 and 5/17, respectively,and the former was significantly lower than the latter (P＜0.05). Conclusions Bone reconstruction can avoid intracranial infection, cerebrospinal fluid leakage and encephalomeningocele during the operation for traumatic comminuted fractures of anterior skull base.