Objective 　To investigate the anatomic characteristics of optic canal in chinese adults. Methods　Twenty chinese cadaveric speciments fixed in formalin of chinese patients without intracranial and intraorbital disease. We measured the width and height of the intracranial opening and the intraorbital opening of the optic canal of all cases. The length of roof, floor, medial and lateral wall of the optic canal, and the width, the height of the middle protion were also measured after unroofing the canal with high-speed drilling. The degree of pneumatization of ethmoidal and sphenoidal sinuses was recorded. Results　The intracranial opening of the optic canal was a horizontal oval shape. The width of it was (5.05±0.42) mm and the height was (4.61±0.27) mm. The length of optic roof, optic floor, medial wall and lateral wall of the optic canal was (9.67±1.51) mm, (5.41±0.84) mm, (9.58±0.72) mm and (9.26±0.66) mm, respectively. The intraorbital opening of the optic canal was a vertical oval shape, the height and width of it was (5.30±0.64) mm and (5.62±0.83) mm respectively. Conclusions　The wall of the optic canal is thinner and there is a narrow portion in the middle of it. Depending on the degree of the pneumatization of sphenoidal and ethmoidal sinus, three types were divided into: 1. reversal U shape, 2. C shape, 3. D shape. The dura fold of the optic canal is long and its edge is sharp.

Objective To study transcerebellomedullary fissure approach to the fourth ventricle and the lateral brainstem without splitting vermis and depict its adjacent structure, and provide clinicians with anatomical information.Methods Five cadaveric heads fixed with formaldehyde and perfused with color latex in their arteries and veins were dissected with microsurgical anatomical skills. The composition of cerebellomedullary fissure and the distribution of the tela choroida, the inferior medullary velum and the posterior inferior cerebellar artery, and study anatomic base of this approach.Results Cerebellomedullary fissure is a natural anatomical gap which is located between the cerebellar tonsil, biventral lobule and medulla oblongata. The tela choroida and inferior medullary velum do not contain nerve tissue, and thus can be dissected to expose the fourth ventricle. The tonsil- medulla segment and telovelotonsillar segment of the posterior inferior cerebellar artery are the most important blood vessels of the cerebellomedullary fissure approach.Conclusions The transcerebellomedullary fissure approach can reach the fourth ventricle and dorsal brain stem through normal anatomic spaces without splitting the vermis, thus reducing the post-operative complications.

Objective To investigate the ultrasonographic performance of infantile hepatic hemangioendothelioma(IHHE).Methods Clinical and ultrasonographic findings in 14 cases with IHHE were reviewed retrospectively,and compared with CT and MR.Results Among 14 cases,there were 6 cases with single mass,5 cases with multiple masses and 3 cases with diffuse masses.Ultrasonography displayed single mass and multiple masses with clear boundary,heterogeneous inner echo,calcification was detected in 4 cases and anechoic areas were detected in 6 cases.Diffuse masses were small,ill-defined,the echogenicity of the whole liver was extremely disorder.The hepatic artery and the proximal abdominal aortic dilatation was found in 4 cases,and the abdominal aorta which below the coeliac artery became relatively thinner in these cases.Color Doppler showed rich blood supply and intratumoral vasodilation in 8 cases,PW detection of intratumoral arteriovenous fistula in 4 cases.Conclusions Ultrasonography findings of IHHE have some characteristic feature.

Objective To assess the value of acoustic radiation force impulse (ARFI) imaging in the pathological damage of Henoch-Schonlein purpura nephritis on children by comparison with renal biopsy.Methods 50 cases of healthy control group as group A; 58 children with HSPN were divided into three groups according to pathological grading:Ⅰ ～ Ⅱ class (group B),Ⅲ class (group C) and Ⅳ ～ Ⅵ class (group D).ARFI was then used to measure the shear wave velocities(SWV) of renal cortex of each group,compared the differences SWV of each group.Results SWV values of children's renal cortex with HSPN were significantly higher (t =5.883,P =0.017) than those in the group A.Pairwise comparisons found that there were statistically significant differences between group D and the other three groups (P ＜0.05).According the ROC curve,the cut-off value of SWV was 2.59 m/s when the maximum area under the curve equal to 0.719,the sensitivity and specificity were 63％ and 67％.Conclusions ARFI technology can quantify the elastic properties of the kidney,which is expected as an important indicator to evaluate the pathological extent of damage of the HSPN.

BACKGROUND:Recent studies have shown that the large-dose regular insulin therapy used to control blood glucose levels can cause 50%of patients suffering from vascular, optic nerve and kidney complications. Previous results from authors exhibit that when al ogeneic hematopoietic stem celltransplantation is applied for treatment of leukemia, diabetic symptoms in patients disappear. Dose it prompt that al ogeneic hematopoietic stem celltransplantation is an effective therapy for treatment of diabetes mel itus? OBJECTIVE:To explore the feasibility of hematopoietic stem celltransplantation for treatment of diabetes mel itus. METHODS:A retrospective analysis was done regarding the data of patients with hematological diseases complicated with diabetes mel itus who underwent al ogenetic hematopoietic stem celltransplantation. Four patients with acute lymphocyte leukemia, chronic myelogenous leukemia, aplastic anemia, and myolodysplastic syndromes, respectively, were complicated with diabetes mel itus. Conditioning regimen was cyclophosphamide+total body irradiation protocol. Cyclosporin A and short-term methotrexate were used for graft-versus-host disease prophylaxis. Blood glucose was control ed by oral hypoglycemic drugs or insulin injections before transplantation. RESULTS AND CONCLUSION:Al the four patients were successful y engrafted. Fasting glucose level of the four patients recovered at 4-6 months after hematopoietic stem celltransplantation (without hypoglycemic drugs). One patient died of leukemia relapse after 12 months of hematopoietic stem celltransplantation. The other three patients had disease-free survival until the time of fol ow-up.

Objective To evaluate the efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of leukemia relapsed after first allo-HSCT from one sibling donor.Methods One patient with acute myeloid leukemia (AML-M4) underwent sibling donor bone marrow transplant (conditioning regimens was Bu/Cy) and relapsed after 18 months. The patient received the same donor's peripheral blood stem cell (PBSC) for second transplantation after receiving CY-TBI regimens,and reduced intension of prophylaxis of GVHD. Results The patient achieved stable engraftment after second HSCT. The patients suffered acute GVHD (intestinal Ⅳ and cutaneous Ⅲ) and had been complete remission to +8 months. Conclusion Second related HSCT is feasible in relapsed patient who had undergone related allo-BMT.

[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.