Objective To explore how to improve the sensitivity and specificity of CT cisternography (CTC) examination.Methods The clinical data of 20 cases of CTC in detecting cerebrospinal fluid rhinorrhea were analyzed,and the influence of continuous dripping of fluid and the filling time of subarachnoid space upon the image quality were observed.Results Nineteen cases of active cerebrospinal fluid rhinorrhea were found with CTC,and the fistula sites were determined by CTC.Eighteen cases received operation which confirmed the fistula sites.One case was found with no active fistula site.According to the image of ethmoid sinus leaks results,7 cases had better image quality in 9 cases whose subarachnoid space filling time was longer than or equal to 10 min.One case had better image quality in 6 cases whose subarachnoid space filling time was shorter than 10 min.There was significant difference (P =0.0406).Conclusion To raise the positive rate of CTC,the position of active fistula should be maintained and keep the time between the injection and scan longer than or equal to 10 min,which help to get better image quality.

Objective To investigate the inhibitive effects of Ad-PUMA combined with temozolomide on human glioblastoma cells growth in vivo experiments. Methods The nude mouse model with human glioblastoma cells subcutaneous transplantation was established. The mice were randomly divided into 4 groups to receive subcutaneous injection at the 14th day separately with: Normal saline 100 μl (control, n=8), Ad-PUMA 2×108 pfu/100 μl (PUMA group, n=8), 10 mg/kg TMZ (TMZ group, n=8) and 2×108 pfu/100 μl Ad-PUMA + 10 mg/kg TMZ (combined group, n=8). Mice were killed after 20 days treatment.Tumor volume, inhibition rates and apoptotic index (AI) were measured, meanwhile, apoptotic tumor cells were detected by TUNEL technology respectively. The expression of MGMT mRNA and MGMT protein were revealed by the methods of RT-PCR and Western blot. Results According to the order: control group, AdPUMA group, TMZ group, combined group, tumor volumes were (3.68±0.09), (2.63±0.13), (2.13±0.07),(0.97±0.02) cm3 respectively (P＜0.05); the inhibitive rates were 0, 28.5 %, 42.1%, 73.6 % respectively and AI were (2.0±1.2) %, (11.4±2.6) %, (7.6±3.2) %, (20.6±8.6) % (P＜0.05). The results of Western blot and RT-PCR showed that MGMT mRNA and MGMT protein levels in TMZ group were higher than other groups (all P＜0.01). Conclusion Ad-PUMA combined with TMZ greatly enhances the sensitivity of human glioblastoma cells to TMZ and could effectively inhibit the proliferation and promote the apeptosis of glioblastoma cells, its mechanism was probably related Ad-PUMA promote apoptosis and inhibit MGMT expression.

Objective To explore the effect and complications of ventricle peritoneal shunt n pediatric hydrocephalus. Methods The clinical data was analysed in 30 cases of pediatric hydrocephalus. Results A total of 27 cases (90%) of pediatric hydrocephalus were found reduction of ventricle. 3 cases were found no obvious reduction of ventricle. Post-operative complications in 3 cases (10%), subcutaneous liquid collection in 2 cases (6.67%), diverter pump in 1 case (3.33%). No patients were found infection. Conclusion Strict sterilizing procedures andhigh quality and attention-to-detail is the key to reduce postoperative complications and improve surgical outcomes.

Toxoplasmosis is a worldwide zoonosis caused by an intracellular protozoan parasite, Toxoplasma gondii. We report here a diabetic patient who was diagnosed as toxoplasmosis with multiple cranial nerve palsies and cavernous sinusitis. A 37-year-old male presented with an 11-day history of gingival pain, one day history of ptosis and diplopia. He has been having diabetes mellitus for 6 years, and has a history of contact with cats. After admission, his symptoms worsened with right 3rd to 7th cranial nerve palsies. The brain magnetic resonance imaging (MRI) showed cavernous sinusitis in the right sellar region. Serology for toxoplasma was positive for IgM and negative IgG. The patient was treated with oral clindamycin (900 mg/day) and dexamethasone (15 mg/day). The right visual acuity and lid-conjunctival swelling improved after 3 days. At follow-up after a month, the movement of the right eye significantly improved. This case demonstrate the rare occurrence of multiple cranial nerve (3rd to 7th) palsies from toxoplasmosis cavernous sinusitis, which is a potentially treatable condition.