Objective To discuss 64-slice CT three-dimensional reconstruction (3D) and MPR (MPR) in the application of the nasal bone fracture. Methods 102 patients with recent nasal fracture in our hospital underwent 64-slice CT scan axial thin spiral. Nasal fracture imaging was observed using workstations in the three-dimensional reconstruction (3D) and MPR (MPR). Results 102 cases of nasal bone fracture,dislocation fractures in 47 cases,non-fracture dislocation of the 55 cases,46 cases of bilateral nasal bone fracture,unilateral 22 cases(13 cases the left side of the right of nine cases),15 cases of fracture of the nasal septum,nasal bone fracture associated with maxillary The amount of bone fracture in 13 cases,only six cases of separation suture. All the nasal bone fractures 3D imaging and after the MPR can display three-dimensional fractures of the location,shape,type,degree of collapse and three-dimensional information. Conclusion 64-slice CT3D and MPR technology can improve the accuracy of diagnosis of the nasal bone fracture,and provide valuable information for clinicians in the choice of treatment program.

BACKGROUND: In recent researches the concentration of S100 proteins and neuron-specific enolase have been proved positively correlated with the degree of brain injury, and can be used for assessing the degree and prognosis of brain injury. But whether the level of serum S100 proteins and phosphopyruvate hydratase can predict the role of glucocorticosteroid in the treatment of CNS damage is unclear.OBJECTIVE: To observe the changes of serum S100 proteins and phosphopyruvate hydratase level, aiming to explore the role of methylprednisolone in the treatment of craniocerebral inju ryin rats.DESIGN: Randomized controlled study.SETTING: The First Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Neurological Research Institute of Guangzhou Medical College in September 2003. Totally 72 SD rats were enrolled in this study.METHODS: Totally 72 SD rats were randomly divided into three groups,namely normal group of 8 rats, comparison group and treatment group of 32 rats respectively, the latter two groups were then subdivided into post-trautablishment: Brain contusion and laceration was made in rats according to Feeney's method, rats in normal group were only subjected to craniotomy group, rats were given intraperitoneal injection of methylprednisolone by dosage of 30 mg/kg instantly after injury, which replace by physical saline of the same dosage in comparison group. Rats in normal group were not given intraperitoneal injection, blood specimen was obtained instantly after put to death by cutting off head; in comparison group and treatment group,blood sample was obtained from rat at post-traumatic 1, 6, 12 and 24 hours and centrifuged for collecting superuatant, the level of serum S100 proteins and phosphopyruvate hydratase was detected by using ELISA method.RESULTS: Totally 72 rats were enrolled in this experiment and all regroup was (0.35±0.029) μg/L. The difference of serum S100 proteins was not obvious between normal group and treatment group at post-traumatic 24 hours, but the level of S100 proteins in treatment group and comparison group was significantly higher than normal group (P ＜ 0.01 or P ＜ 0.05);moreover in contrast with comparison group, the level of S100 proteins was found obviously lower in treatment group at post-traumatic 6, 12 hours and hydratase was (8.35±1.01) μg/L in normal group, the difference of serum phosphopyruvate hydratase level between comparison group and treatment group was higher than normal group, displaying statistical significance at all post-traumatic time points (P ＜ 0.01), except for not obvious difference between comparison group at post-traumatic 24 hours and treatment group.While comparing to comparison group, the level of serum phosphopyruvate hydratase was found obviously lower in treatment group at post-traumatic 1,6 and 12 hours time point (P ＜ 0.01 or P ＜ 0.05).CONCLUSION: The level of serum S100 proteins and phosphopyruvate hydratase can be used as predictors for the degree of brain injury in rats, in addition methylprednisolone might exert therapeutic effect on traumatic brain.

Pancreatic fistula is a common complication after pancreaticoduodenectomy(PD),and other complications occurred secondary to it such as hemorrhage and severe abdominal infection are also the main cause of death after PD.Proper selection of anastomotic methods is essential to the success of PD.The most common anastomotic methods can be divided into pancreaticojejunostomy and pancreatogastrostomy,but the effects of these methods have always been controversial consistently.In this paper,the effects of pancreaticojejunostomy and pancreatogastrostomy in the prevention of postoperative pancreatic fistula were synthetically analyzed based on recent research results.

Objective To explore the clinical implications of MSCT and reconstruction technique of Budd-chiari syndrome diagnosis. Methods Hepatic vein and intrahepatic inferior vena cava vascular morphology were shown by 55 cases of Budd-chiari syndrome with confirmed by ultrasound and clinic in nearly two years, which used the 64-row MSCT exami- nation in upper abdominal and enhanced scan, and reconstruction techniques that is included MPR and MIP etc. Results The compression and narrow signs of hepatic vein and intrahepatic inferior vena cava can be seen by reconstruction imag- ing with post -processing techniques, at the same time, these phenomena that are varying degrees of cirrhosis, splenomegaly, ascites, and esophageal varices can be displayed by Budd-chiari syndrome imaging in plain and enhanced CT images. Conclusion MSCT reconstruction techniques can be used to manifest clearly the appearance of hepatic vein and inferior vena cava, and have important diagnostic value and clinical significance.

Objective To observe the role of methylprednisolone in treatment of brain injuries through comparing the changes of serum S 100B protein and neuron specific enolase (NSE) levels. Methods Seventy two rats with brain contusion made by frontoparietal bone windows plasty with extradural hitting were divided into three groups: control group ( n =32), normal group ( n =8) and treatment group ( n =32) that were subdivided into groups 1, 6, 12 and 24 hours after injury. The levels of S 100B protein and NSE were measured at different time points after hitting by ELISA. Results ①The levels of serum S 100B protein and NSE was (0.35?0.03) ?g/L and (8.35?1.01) ?g/L, respectively in normal group. The levels of serum S 100 B protein and NSE in control group and treatment group (6 24 hours post injury) were higher than those in normal group ( P

OBJECTIVE:To investigate the therapeutic efficacy and safety of Posterior pituitary injection combined with Ulina-station for injection in the treatment of severe lung contusion. METHODS:In retrospective study,60 patients with severe lung con-tusion in our hospital from Jan. 2015 to May 2016 were divided into control group and observation group according to therapy plan,with 30 cases in each group. Control group was given Ulinastation for injection 100 thousand U+0.9% Sodium chloride injec-tion 100 mL,ivgtt,bid. Observation group was additionally given Posterior pituitary injection 6 U+0.9% Sodium chloride injection 49 mL,intravenous pumping (initial rate was 0.008 U/min,adjusted to ≤0.04 U/min),bid,on the basis of control group. Both groups were treated for 1 week. The respiratory frequency,simple score of pulmonary contusion,chest X-ray score,the levels of arterial blood gas indexes(PaO2,PaCO2,SaO2,PO2/FiO2)and inflammation indexes(IL-2,IL-6,IL-10,hs-CRP,TNF-α)before and after treatment as well as clinical efficacy were observed in 2 groups. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in respiratory frequency,simple score of pulmonary contusion,chest X-ray score, the levels of arterial blood gas index or inflammation indexes between 2 groups(P>0.05). After treatment,respiratory frequency, simple score of pulmonary contusion,chest X-ray score,and the levels of IL-6,hs-CRP,TNF-αin 2 groups were decreased signif-icantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). The lev-els of PaO2,PaCO2,SaO2,PO2/FiO2,IL-2 and IL-10 in 2 groups were increased significantly,and the observation group was sig-nificantly higher than the control group,with statistical significance (P<0.05). Total response rate of observation group (100%) was significantly higher than that of control group(86.67%),with statistical significance(P<0.05). The incidence of ADR in con-trol group(13.33%)was significantly higher than observation group(6.67%),with statistical significance(P<0.05). CONCLU-SIONS:Posterior pituitary injection combined with Ulinastatin for injection show good therapeutic efficacy for severe lung contu-sion and effectively inhibit inflammatory reaction with good safety.

Objective To evaluate the diagnostic value and technique advantage of 16-slice CT angiography(16SCTA) in aortic dissection.Methods 39 cases of aortic dissection underwent 16SCTA.The data were reconstructed by multiplanar reconstruction(MPR),curved planar reconstruction(CPR),volume rendering(VR),maximum intensity projection(MIP),virtual endoscopy(VE),and generally analyzed in combination with original axial images.Results According to DeBakey's classification,DeBakey's type Ⅰ in 5 cases,type Ⅱ in one case and type Ⅲ in 33 cases were founed in the 39 cases.16SCTA clearly showed that including the ture and false lumen(39 cases,100%),intimal flaps(39 cases,100%),intimal tear(25 cases,64.1%),and thrombus inside the false lumen(17 cases,43.6%).Conclusion 16SCTA may be as the first choice method in diagnosis of aoric dissection,and which is considered as having great value.

Hidden-pathogen theory is always a leading theory of febrile disease etiology from the proposal until the Ming Dynasty and it plays a critical guiding role on development and maturity of febrile disease theory. However, along with the change of times and drift of disease spectrum, this theory is facing unprecedented challenges. The gradually in-creased clinical experiences and facts have been difficult to be explained and induced using the already existed hidden-pathogen theory. Since hidden-pathogen theory has its own theoretical status and value, which cannot be lightly given up, the question of how to develop this theory in order to better reveal the pathogenesis in the guidance of diagnosis and treatment has become the focus of attention. This paper tried to proposeemotional hidden-pathogenas an example to provide a possible paradigm to develop hidden-pathogen theory and systematically expound main ideas and reasoning processes of emotional hidden-pathogen doctrine and to explore its theoretical significance and application value.

Objective To study the risk factors of complications of 364 cases in treatment of rad-ical esophagectomy.Methods 364 patients underwent two or three-incision radical esophagectomy and the clinic data were retrospectively analyzed.After review of the reference,ten factors were regarded as the potential risk factors of postoperative complications,then univariate and multivariate analyses were per-formed.Results In 364 patients,66 patients had complications of this research field within postoperative 6 months.By univariate analysis,preoperative nutritional risk score、T-staging、preoperative complications、operation time、operation experience、anastomotic position、anastomotic extra manual suturing were deter-mined as influence factors.By multivariate analysis,preoperative nutritional risk score≥3、T-staging score≥3、preoperative complications、operation time≥240 min、cervical anastomosis were determined as risk factors,anastomotic extra manual suturing was determined as a protective factor.Conclusion The risk factors of the complications after radical esophagectomy are preoperative nutritional risk score≥3、T-stag-ing score≥3、preoperative complications、operation time≥240 min、cervical anastomosis;and the protective factor is anastomotic extra manual suturing.Paying attention and controling these risk factors may reduce the occurrence of postoperative complications.

Objective To report the microsurgical separation of the protruded cerebral tissue in the case of complex craniopagus twins and evaluate the role of the neuronavigation system in this operation Methods After the multiple bone flap were made,register again and then separate the cerebral tissue along the arachnoid plane under the guiding of the neuronavigation system(SNN) until the straight sinus was exposed Results The protruded cerebral hemisphere and cerebellar hemisphere of the twins were successfully separated Unfortunately,part of the occipital lobe of twin B(right) had to be removed because of the brain swelling Conclusion In the case of complicated craniopagus,the neuronavigation system is valuable in positioning the deep common sinus To separate the cerebral tissue along the arachnoid plane under surgical microscope can reduce the cerebral injury