Objective To explore the value of dynamic contrast-enhanced CT for differentially diagnosing benign and malignant the solitary pulmonary nodules. Methods 117 solitary pulmonary nodules proved by histopathological examination were enrolled in this study. Thin-section CT scanning was performed before and 1,2,3,4 and 5 minutes after contrast enhancement. Results The enhanced value of malignant nodules (39.6?15.8)Hu was significantly higher than that of benign nodules (19.18?17.23)Hu (P

Through a retrospective clinical analysis of 3160 cases of severe cranio cerebral injury ( SCCI ), the aim of this study is to explore effective treatments to increase cure rate for this injury. The causes and types of trauma, operation modalities,and prognosis were reviewed. The main causes resulting in SCCI were traffic accidents and fall from a height. The main types of SCCI were subdural, extradural and multiple intracranial hematomas. The main signs and symptoms were unconsciousness, pyramidal signs and pupil changes. The rate of cure and improvement was 73 6%. The mortality rate was 19 4%. Early diagnosis and timely operation, maintenance of patency of the respiratory tract, brain protection during operation, and competent ICU care after operation were important measure to achieve good recovery of SCCI patients.

A retrospective study was made on the diagnosis and microsurgical management of 38 cases of cranial orbital tumors treated in our hospital in order to improve its clinical outcome. 29 males and 9 females with an age between 5 ～45 years (mean 32 2 years) were included in this series. 33 cases had their tumor located in anterior fossa, and 5 in middle fossa. 35(92 1%) cases showed malfunction of optic organs. 23(60 5%) cases had symptoms of intracranial hypertension. DSA and preoperative embolization of supplying arteries of tumors were performed in some cases. Microsurgical techniques and different approaches were used to remove tumors. 28 cases received total removal and others subtotal resection. No postoperative morbidity was found. 7 months～9 years follow up study showed that 24 cases resumed normal life, 6 had a dependent life and 5 had a certain recovery. One of the most frequent clinical manifestations of cranial orbital tumor was disorders in optic organs. The preoperative embolization of supplying arteries of tumors makes it possible to decrease bleeding during operation and increase the possibility to remove the total tumor. Microsurgical and piecemeal techniques as well as combined approaches may improve its clinical results.

To probe the treatment effects of the syringomyelia using microsurgical technique, a total of 127 patients with syringomyelia confirmed by CT or MRI in our department were analyzed retrospectively. The patients underwent occipitocervical decompression, syringostomy or syringo subarachnoid shunting (S S shunting) with microsurgery. All patients were followed up for more than 1 5 years and the treatment results were evaluated The results indicated that the collapse of the syrinx was achieved in 84 patients who underwent S S shunting or syringostomy. Decreased size of the syrinx was also noted in 43 Arnold Chiari malformation and spinal dysraphism patients who underwent occipitocervical decompression alone. The authors consider that the patients with syringomyelia should be microsurgically treated. The occipitocervical decompression, syringostomy or S S shunting may be an alternative method of surgical treatment for syringomyelia.

Objective To discuss the main features and experiences of surgical treatment of congenital spinal bifida and tethered cord syndrome. Methods Spinal bifida and tethered cord syndrome are congenital malformations. A study was conducted to analyse the morphology and the microsurgical operation of the diseases. During the Sept, 1993 to Feb, 2003, 528 patients were admitted to the hospital. The age ranged from 5 months to 45 years old (mean age 9 years). 239 cases(45.3%) were diagnosed as myelomeningocele, 123 cases(23.3%) were meningocele, 107 (20.3%) were spinal bifida with lipoma, and 59 cases of spinal bifida occulta (1.2%). Surgical removal of the arachnoid cyst and lipoma relieved compression of the spinal dural sac and the tethered spinal cord. Results Improvement was achieved in 322 cases (61%), no improvement in 194 cases (36.7%), and exacerbation of symptoms in 12 cases (2.3%). Conclusion Careful planning for the surgical treatment of spinal bifida is imperative. It is also important to release the compression tissues, in the spinal canal and to loosen the tethering.

Objective To evaluate the diagnosis and microsurgical treatment of intraspinal abscesses. Methods The clinical manifestations, diagnosis, and microsurgical treatment of sixty-two patients with intraspinal abscess were retrospectively analyzed. Among them, 36 were male and 26 were female, with an average age of 41 years. Thirty-seven were suffering from extradural abscesses, 23 subdural abscesses and 2 intramedullary abscesses. The diagnosis was made based on the history, clinical manifestations, MRI and myelogram. Prompt decompressive laminectomy and removal of the abscesses were carried out. Results Fifty-one patients were followed up. Of them, 27 completely recovered, accounting for 52.9%; in 18 the recovery was graded as good, accounting for 35.3%; and in 6 the recovery was fair, accounting for 11.8%. Conclusion Early diagnosis and microsurgical intervention of intraspinal abscesses could result in satisfactory recovery.

Objective To sum up the experiences in microneurosurgical treatment of spinal cord cavernous hemangiomas (SCH). Methods A retrospective analysis was made of 17 cases of SCH admitted from March 1992 to December 2002. Operations were performed via a posterior midline approach under a microscope. Results Total SCH resection was done in 13 cases, and subtotal removal in 4. The postoperative neurological status was improved in 11 cases, unchanged in 4, and aggravated in 2. No postoperative death occurred. Conclusion Spinal MRI examination is a reliable diagnostic method of SCH. Skillful microneurosurgical technique can achieve a rather good result.

Objective To study the effective methods of diagnosis and microsurgical treatment for tumors in spinal canal. Methods The diagnosis, treatment, and prognosis of 192 patients with spinal tumors admitted to our department ( from Jan,1992 to Dec,2002) were retrospectively analyzed. Results All the patients in this group underwent operative treatment. Total removal of tumor was achieved in 162 cases (84.4%), subtotal removal of tumor in 18 cases (9.4%), and removal a large portion of tumor with decompression in 12 cases (6.3%). Postoperatively, 163 patients (84.9%) were cured, the neurological symptoms were apparently improved in 27 patients (14.1% ), and unchanged in 2 patients (1.0%). No operative death occurred. Conclusion Early diagnosis and treatment of spinal tumor are important measures to improve prognosis. Imaging and microsurgery play a key role in the diagnosis and treatment of spinal tumors.

Abstract: Objective　To observe the expression of peripheral blood stimulating molecules CD80 and CD86 in children with severe hand, foot, and mouth disease (HFMD), and to analyze the relationship between them and the therapeutic effects of children. Methods　The clinical data of 252 children with severe HFMD treated in Wuhan Hospital of Traditional Chinese Medicine from March 2017 to March 2021 were collected retrospectively. All children were treated with standardized treatment and the therapeutic effects was evaluated. The baseline data and laboratory test results of children were recorded, and the positive rates of CD80 and CD86 cells in peripheral blood were detected by flow cytometry. Logistic regression was used to analyze the relationship between the above indexes and the therapeutic effects of children. The receiver operating curve (ROC) was drawn to evaluate the value of the above indicators in predicting the therapeutic effects of children. Results　After standardized treatment, 48 children were ineffective, and 204 children were effective; the levels of serum CD80 [(2.28±0.84)% vs (2.12±0.33 )%] and CD86 [(3.35±0.96)% vs (2.23±0.41)%] in children were significantly lower than those at admission (t=2.851, 16.991; P<0.05). The levels of blood lactic acid, serum C-reactive protein (CRP), matrix metalloproteinase-9 (MMP-9), CD80 and CD86 at admission in the ineffective group were significantly higher than those of the effective group (P<0.05). Logistic regression analysis showed that the overexpression of serum CRP (OR=10.929), MMP-9 (OR=1.926), CD80 (OR=3.943) and CD86 (OR=1.947) at admission might be the risk factors of ineffective (all P<0.05). The results of the goodness of fit test for the model showed that, the goodness of fit was high (χ2=6.245, P=0.620); the model collinearity results showed that the variance inflation factors (VIF) values of each variable were <2, and there was no collinearity among the main indicators; the results of the individual independence test for the model showed that Durbin-Watson statistics (D-W)=0.279 and there was poor mutual independence among main indicators. ROC curve analysis showed that the area under the curve(AUC) of serum CD80 at admission in predicting the therapeutic effects of children was 0.762, the cut-off value was 2.390%, and the specificity, sensitivity and Youden index were 0.598, 0792 and 0.390 respectively; the AUC predicted by CD86 was 0.739, the cut-off value was 3.280%, and the specificity, sensitivity and Youden index were 0.510, 0.896 and 0.406 respectively; the AUC by combined prediction was 0.823, and the specificity, sensitivity and Youden index were 0.696, 0.833 and 0.529 respectively. Conclusions　Peripheral blood stimulating molecules CD80 and CD86 are involved in the progression of HFMD. Their overexpression may suggest a high risk of treatment ineffectiveness in children with severe HFMD. Early dynamic monitoring of the expression of serum CD80 and CD86 has a certain predictive value for the therapeutic effect of children.

Objective To investigate the present status and developments of Chinese military neurosurgery, make an objective analysis about the achievements and deficiencies, and propose a developing trend for the field of Chinese military neurosurgery. Methods The scientific literatures of neurosurgery published domestically and abroad in recent 5 years were partially reviewed. The advances and achievements in basic researches and clinical works of neurosurgery acquired during the period of the 11th Five Year Plan were analyzed. Results During the period of the 11th Five Year Plan, Chinese military neurosurgery was still in the lead position in traditional areas such as traumatic brain injury. In the meantime, great achievements were obtained in the researches of brain and spinal cord tumors, endovascular treatment and functional neurosurgery, and 47 items of Army Science and Technology Advancement Prizes or Military Medical Achievement Awards were acquired. A great progress was made in personnel training. However, unbalanced development in neurosurgery field still existed within military departments, between military and civil departments and between different regions, so an enhanced technical interchange and cooperation is needed. Conclusions On the coming period, the research work of military neurosurgery should focuse on basic and clinical research of gene therapy to keep in step with neurosurgical trends in the world. On the other hand, attention should be paid to technological innovation with military features such as professional and general treatment of traumatic brain injury and researches on the development of protective equipments.