Objective To observe the therapeutic effect of electroacupuncture plus laser intravenous irradiation therapy on dysfunction caused by craniocerebral injury. Methods One hundred and seventy cases of craniocerebral injury were randomly and equally divided into a treatment group and a control group. The control group was managed with routine treatment, while the treatment group with the electroacupuncture plus the laser intravenous irradiation on the basis of the routine treatment. Results After the treatment, there were significant differences between the two groups in terms of Glasgow Outcome Scale(GOS), Dyscinesia Scale(DS) and Karnofsky Performance Scale(KPS) evaluations. Conclusion The therapeutic effect and clinical outcome of electroacupuncture plus intravenous laser irradiation is significantly better than that in control group, indicating that electroacupuncture plus intravenous laser irradiation is a better therapeutic option for improvement of motor functions.

Objective To investigate the method of total resection of craniopharyngioma and prevention and treatment of post-operative complications. Methods Pterion craniotomy was performed in 24 patients with craniopharyngioma which was situated in sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine volume, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were treated in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. There was not obvious deficit of nervous system function in all of the patients after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder occurred in 16 cases, 12 case, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, and diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope of tumor invasion and being familiar with the 4 sellar anatomy spaces were the keys to remove craniopharyngioma completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus and serum electrolyte disorder could effectively decrease mortality.

Objective　To discuss the methods of treatment of sellar region tumors by microsurgery via modified transpterional approach.Methods　The clinical data of 326 patients with sellar region tumors were retrospectively analyzed. All of the patients(of them 158 patients with pituitary adenomas, 89 patients with craniopharyngiomas and 79 patients with meningiomas)were treated by microsurgery via modified transpterional in our hospital in recent 4 years. The most important part of preoperative arrangement was giving glucocorticoid and anti-epilepsy drugs. Modified transpterional craniotomy was performed, and the tumors were removed by employing microsurgical techniques via the 5 anatomy interspaces in sellar region after the subarachnoid cisterns were dissected carefully under surgical microscope. Consciousness, urine volume and serum electrolyte of the patients were observed strictly after surgery, and the complications such as diabetes insipidus, serum electrolyte disorder and epilepsy were remedied in time.Results　The rate of intact frontal branch of facial nerve was 92.18% and that of intact supraorbital nerve was 95.72%. Atrophy of temporal muscle occurred in none of the patients. Total and/or subtotal resection of tumors was achieved in 95.26% patients and the rate of intact pituitary stalk was 62.44%. The major postoperative complications included diabetes insipidus and serum electrolyte disorder. Although the incidence of complications was high to 61.42%, complete restore was achieved in 97.12% of the patients with the complications within 1 month.Conclusion　The modified transpterional approach for sellar region tumors may give a lower incidence of damage to frontal branch of facial nerve, super-orbital nerve and temporal muscle, and it can achieve higher total resection rate and a less postoperative complications by employing modified transpterional approach and the microsurgical techniques, combined with the active treatments of postoperative complications, therefore it is deserved to be spread to use in clinical works.

Objective To investigate the methods of total resection of craniopharyngioma and treatment of postoperative complications. Methods The abscission of CPG was performed in 24 patients with craniopharyngioma (CPG) which situated at sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were remedied in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. All of the patients were sober after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder took place in 16 cases,12 cases, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, but diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope which tumor invades and being familiar with the 4 sellar anatomy spaces so as to be used correctly in operation are the keys to remove the CPG completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus, serum electrolyte disorder can decrease mortality observably.

Objective To explore the diagnosis and surgical management for severe injury of the pancreas. Method Fourteen patients with transected or derogated pancreatic trauma from January 1986 to December 1998 were reviewed. Result The mean age was 31 years.Injury was on the body and tail of the pancreas in 5 cases, on the neck in 6,and on the head in 3. Eleven patients suffered from compound injuries of the adjacent organs .Preoperative diagnosis was made in only 4 patients,diagnosis was achieved during first laparotomy in 9 patients ,and in second look in 1 patient.The operative procedure involved distal pancreatectomy in 5,proximal pancreatorrhaphy and distal pancreatojejunostomy in 5,head resection and distal pancreatojejunostomy in 3, and simple external drainage in 1.Fistula developed in 5 cases and perioperative mortality was 3/14.Conclusion Preoperative diagnosis for pancreas injury is difficult,and in most cases diagnosis can only be established during exploration.An appropriate operative procedure reduces the morbidity and mortality of pancreatic injuries.

Young talents are the reserve forces of hospital's discipline construction.The First Affiliated Hospital of Chongqing Medical University has made remarkable achievements in the young talent construction by taking some innovative measures.These measures included actively exploring evaluation methods for new staff during probation period,strengthening their scientific,English and clinical skills,selecting excellent young talents and encouraging them to further their study abroad,setting up position of scientific research assistant and cultivating backbone professionals.The hospital has gradually formed a complete step and strategy for implementing talent construction and disciplinary development.

Objective To study the feasibility of semi-laminectomy procedures for the management of intradural extramedullary tumors of the spinal cord.Method Retrospective analysis of 19 cases of in-tradural extramedullary tumors of the spinal cord were treated by the approach of semi-laminectomy.including 11 cases of neurilemmoma and 8 cases of meningioma.Results Seventeen cases of extraspinal tumors were totally resection,2 of dumbbell neurilemmomas underwent subtotal resection.No new neurologi-cal disfunetions as well as recurrence or comphcations were found in all cases after the operation.Conclu-sion Semi-laminectomy procedures for the management of intradural extramedullary tumors of the spinal cord is a mini-invasive procedure,and is beneficial to the stability of spine,with the advantages of short hos-pitalization time,slight postoperative reactions and less complications.

Objective　To explore the efficacy of large dose of magnesium sulfate used to treat patients with brain trauma. 　Methods　According to standards 32 patients were chosen and divided into experimental group and control group at random. Sixteen patients in experimental group received 16 mmol magnesium sulfate intravenously over 15 minutes, followed by 65 mmol over 24 hours; while 16 patients in control group received nothing. Serum NSE, GCS and GOS of all the patients were measured after 3 days, 2 weeks and 6 months, respectively and the data were analyzed statistically. 　Results　The serum NSE, GCS and GOS in experimental group were (24.8±19.2) μg/L, 12.3±3.3 and 3.6±1.4, respectively; while the serum NSE, GCS and GOS in control group were (49.7±23.1) μg/L, 9.8±2.8 and 3.1±1.6, respectively. Between the two groups the serum NSE and GCS were different significantly (P<0.01, P<0.05, respectively) while the GOS was not (P>0.05).　 Conclusions　Large dose of magnesium sulfate is effective to treat patients with brain injury at least within a short term.

Objective To evaluate the association between stress hyperglycemia and clinical out-comes among patients with and without diabetes mellitns admitted to medical intensive care unit (MICU).Methods We reviewed the medical ICU records of 1016 consecutive patients admitted to Wu Han Univer-sity Ren Min Hospital. According to admission glucose level, 126 patients with debates and 890 patients without known debates were divided into group 1 ( <6 mmol/L), group 2(6 ～ 8mmol/L), group 3(8 ～10mmol/L), and group 4( > 10mmol/L). The primary end point of the study was in-hospital mortality. Secondary end points included length of hospital stay, length of ICU stay, the ratio of mechanical ventila-tion, blood transfusions, antibiotics and blood glucose treatment. Results The hospital mortality among patients without a history of diabetes mellitus was 4. 7%, 12. 1%, 20. 5%, 30. 3% in group 1, 2, 3, 4,respectively. The ratio of mechanical ventilation, blood transfusions, and antibiotics increased progressively as glucose values increased. Conclusions Hyperglycemia was a common disease, and it may be an impor-tant marker of poor clinical outcome and mortality in patients without history of diabetes.

Objective To investigate the expression of human telomerase reverse transcriptase(hTRT) in meningiomas,the correlation with malignancy grade and the prognostic significance of hTRT activity.Methods The expression of hTRT and proliferating cell nuclear antigen(PCNA) in 43 meningiomas was examined by immunohistochemical technique.Postive rates of hTRT between histopathologically different grades were analyzed,and so did between initial detected case group and recurrent case group.The labelling indexes of PCNA between hTRT-positive group and hTRT-negative group were also analysed.Results Of 43 meningiomas examined,19(44%) demonstrated the expression of hTRT.hTRT was present in 3 of 26 benign meningiomas(11 5%),10 of 11 atypical meningiomas(90%) and 6 of 6 malignant meningiomas(100%),respectively(P