Objective To investigate the changes of vertebral-basal artery and regional cerebral blood flow(rCBF) in patients with olivopontocerebellar atrophy(OPCA).Methods 10 patients with OPCA were examined by digital subtraction angiography(DSA) and single-photon-emission-computed tomography(SPECT),and compared with the control group(patients with vertigo or transient ischemic attack).Results In OPCA group,there were 5 cases with small vertebral artery(50%),4 cases with single vertebral artery(40%),9 cases with small and little vessels(90%),10 cases with poor stain in later arterial phase(100%) could be seen by DSA.The lower rCBF in cerebellum and brain stem were seen in 8 cases(80%)by SPECT.In control group,there were 3 cases(15%),4 cases(20%),4 cases(20%),3 cases(15%) and 7 cases(35%) respectively.There were significant differences between the two groups(all P

Objective To study the imaging characters of spinal teratomas.Methods 10 cases of spinal teratomas were analyzed with clinical and radiography. 8 cases intramedullary, 2 cases extramedullary. 10 cases had MR examination. Results The location of spinal teratomas in 5 cases was in lumbar, 3 cases in thorax, 1 case in thoracolumbar, 1 case in cervical. 7 cases were multicyst type, 3 cases were singlecyst type. 10 cases of MR image showed mix signal intensity. The contrast enhancement T 1WI with fat saturation presented disappear fat signal of spinal teratomas. The teratomas heterogeneous enhancement was found in 10 cases with MR examination. 3 cases lumbosacral area of spinal teratomas united tethercord. Conclusion Neuroradiological features of spinal teratomas has specific manifestation. The T 1WI fat saturation scan is a availability nicety method for spinal teratomas.

Objective To compare the cerebral oxygenation in the patients undergoing gynecological laparoscopic surgery under sevoflurane-versus propofol-based anesthesia.Methods Fifty adult patients,aged 18-56 yr,weighing 55-72 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with hemoglobin≥ 110 g/L,undergoing elective gynecological laparoscopic surgery under general anesthesia,were equally and randomly divided into sevoflurane group (group S) and propofol group (group P) using a random number table.Anesthesia was induced with iv midazolam 0.04 mg/kg,sufentanil 1.5-2.0 μg/kg,rocuronium 0.9 mg/kg,and propofol 1.5-2.0 mg/kg.Anesthesia was maintained with inhalation of sevoflurane (2.0％-2.6％) in group S,or with target-controlled infusion of propofol (plasma concentration 2.5-4.0 μg/ml) in group P.The concentrations of sevoflurane and propofol were adjusted to maintain bispectral index value at 40-50.In both groups,remifentanil was given by targetcontrolled infusion (target plasma concentration 2 ng/ml),and vecuronium 0.06-0.08 mg/kg was injected intermittently to maintain muscle relaxation.The regional cerebral oxygen saturation (rSO2) was recorded after induction and at 10 min before pneumoperitoneum (T1),at 10 min of pneumoperitoneum in the Trendelenburg position (T2),and at 10 min after the end of pneumoperitoneum (T3).The occurrence of cerebral oxygen desaturation was recorded during surgery.Results The rSO2 was significantly higher at T2,3 in group S than in group P (P＜0.05).Compared with the value at T1,no significant change was found in rSO2 at T2,3 in group S (P＞0.05),and the rSO2 was significantly decreased at T2,3 in group P (P＜0.05).The incidence of cerebral oxygen desaturation was 12％ in group P,and cerebral oxygen desaturation was not detected in group S.Conclusion Sevoflurane-based anesthesia produces no effect on rSO2,however,propofol-based anesthesia can decrease rSO2 in the patients undergoing gynecological laparoscopic surgery,and sevoflurane-based anesthesia is more suitable for gynecological laparoscopic surgery.

Objective To investigate the safety and effectiveness of digital subtraction angiography (DSA) in the surgical treatment of intracranial arteriovenous malformations (AVMs) in children.Methods Between December 2015 and February 2017,the clinical and imaging data of 9 children with AVM (2-14 years) underwent hybrid surgery at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.According to the Spetzler-Martin grade,there were 2 patients with grade Ⅰ,3 with grade Ⅱ,2 with grade Ⅲ,and 2 with grade Ⅳ.All the children were treated with microsurgery,and their AVMs were removed by real-time assistance using DSA technique during the operation.The imaging cure rate of surgical treatment and the complications of intraoperative angiography of the children were analyzed.The children were followed up clinically after procedure.According to the modified Rankin scale (mRS) score,their prognoses were evaluated.Results Intraoperative angiography revealed that the AVMs in 8 of 9 children were resected completely,and 1 had a residual lesion,then it was resected completely.Immediately after the resection of the nidi,the angiography confirmed that the nidi of 9 children were resected completely.No related complications caused by intraoperative angiography were observed.Nominal aphasia occurred in 1 child after procedure,and he recovered gradually after 6 months.Pulmonary infection occurred in 2 children,and they were cured after anti-infection treatments.Postoperative follow-up mRS scores were 0-1 in 8 children,2 in 1 child,and no rebleeding was observed.Conclusions In children undergoing AVM surgery,initial observation of DSA is safe and effective.Intraoperative angiography can guide the complete resection of the lesions in real time,improve the surgical cure rate of AVMs,and improve the prognosis of children.

Objective　To evaluate the value of CT MRI in diagnosing skull base chondromas.Methods　8 cases of skull base chondromas were analyzed with etiology,pathology,imaging fetures and differential diagnosis.5 cases were female,3 cases were male,age ranged from 25 to 48 years.The clinical presentation of 8 cases of skull base chondromas had neurologic syndrome.And 3 cases were examined with CT,MR imaging ,4 cases with MR imaging,1 case with CT scanning.Results　In this series of 8 chondromas,3 located in the cavernous sinus,2 in the clival region,2 in the region of jugular foramen,1 in the frontal cranial fossa.Intratumoral calcification was found in 4 cases with CT examination.Heterogeneous enhancement was found in 4 cases with CT examination.The margin of chondromas on CT was well defined.Conclusion　CT have a very important diagnosis values for detecting tumors on chondromas.MRI is superior to CT for delineating the growth style of the tumor and its relationship to the surrounding anatomic structures.

Objective To develop the ego depletion aftereffects scale (EDA-S) and test its validity and reliability.Methods Based on literature analysis and the open questionnaire survey this study compiled the preliminary questionnaire.A sample of 801 subjects coming from a university in Beijing was investigated with preliminary questionnaire and 406 students were retested for test-retest reliability with 2 week interval.Results The EDA-S was composed of 38 items in nine factors,which were emotional regulation difficulty,social withdrawal,low efficacy,working memory impairment,low processing fluency,work burnout,fatigue,somatic distress and low adherence.The eleven factors explained 72.09％ of the variances.Furthermore,the result of CFA indicated that the model fitted the data with well construct validity(x2 =1744.62,df=629,x2/df =2.77,RMSEA =0.06,NFI =0.98,NNFI =0.98,CFI =0.98,IFI =0.98,GFI =0.85,SRMR =0.05) and its factors scores were positively correlated with the SFR-S scores(r=0.31-0.59,P＜0.001).The Cronbach α coefficients were 0.95 for the total questionnaire and 0.73-0.91 for the eleven factors.The test-retest reliabilities were 0.60 for the total questionnaire and 0.26-0.57 for the nine factors.Conclusion It suggests that the EDA-S is reliable and valid enough to be applicable to measure the depletion degree of adolescents.

Objective:To analyze the reasons of early failure of the PHILOS in proximal humerus frac-tures.Methods:From Nov.2010 to Nov.2014,there were 117 patients with humerus fractures treated with PHILOS locking plate in Department of Orthopaedics,Xuanwu Hospital.All of the patients were treated with the plate by open reduction internal fixation,and we analyzed these cases retrospectively. After the operation,we removed the drainage tube within 48 h,and the patients were allowed to do the passive motion 3 days after the surgery if the X-Ray showed the plate and screws were reliable.Eight ca-ses failed within 4 weeks after the operation.We analyzed the reasons of the failure.Results:The rate of the failed cases was 6.83%(8 /117).The average age was 72.4(66 -82)years.In the 8 failed cases, 3 were on the right side,and the other 5 on the left side.As for the reason of the fractures,2 cases were because of car accidents,and the other 6 because of daily life injury.According to the Neer classifica-tion,3 cases were 2-part fractures,and the other 5 3-part fractures.Three cases were total failure,and the other 5 partial failure.All the 8 failed cases failed within 4 weeks after the operation,of which 1 was on the sixth day after surgery,the other 7 2 to 4 weeks after the surgery.The 3 totally failed cases were treated by removing the screws and plates,the other 5 by conservative methods.All of the cases were malunion at the end.Conclusion:The early failure of the PHILOS locking plate in proximal humerus fractures is related to the bad reduction during the operation,the loss of medial cortex support,the limi-tation of screw length,the osteoporosis and the improper rehabilitation after operation.It is very important to do good preoperative plan for a surgeon.During the operation,we should try our best in the fracture reduction,use the appropriate plate and screws,and then pay attention to the rehabilitation after the operation.After all of this,the rate of failure may be decreased.

Objective Toinvestigatetheroleofcontrolledanticoagulationinocclusionofvertebral arteriesforthetreatmentofgiantfusiformaneurysmsofthebasilartrunkinchildren.Methods The clinical data of 3 children with giant fusiform aneurysms of the basilar trunk were analyzed retrospectively. Three children underwent bilateral vertebral artery occlusion with endovascular intervention,and conducted controlled anticoagulation by intravenous infusion of heparin sodium (10-30 U/[kg·h])after procedure. Results Intheprocessofanticoagulation,2patientshadsomeseverebleedingcomplications,including epistaxis,gastrointestinal bleeding,and after transient cessation of anticoagulation,they had severe brainstem ischemic symptoms,including vomiting,hemiplegia,loss of consciousness and respiratory dysfunctions (one recovered after using low-molecular weight heparin and one died),another patient did not have any serious complicationsandwascuredafteradjustingtheanticoagulationstrategy.Conclusion Inthetreatmentof basilar artery trunk giant fusiform aneurysms in children through the bilateral vertebral artery occlusion,the controlled anticoagulation after procedure may reduce the occurrence of brain stem infarction and severe bleeding complications. It may be an important measure for improving the safety and effectiveness of bilateral vertebral artery occlusion.

Objective To investigate the changes of expression of N-methyl-D-aspartate receptor(NMDAR)and mitogen activated protein kinase(MAPK)in Alzheimer disease(AD)rat model. Methods AD rat model was established by injection of amyloid-beta protein 1-40 1?l(10 g/L)into hippocampus of rat.NMDAR-mRNA and MAPK protein were immunostained by in situ hybradization histochemistry and immunohistochemistry respectively.Learning and memory ability,LTP were determined by Morris water maze and electrophysiological methods respectively. Results The escape latent was prolongated in Alzheimer rats two weeks after injection of A? than in control rats and in rats before the injection of A?(P

Objective:To validate the Chinese Version of Depletion Sensitivity Scale (DSS) and test its validity and reliability.Methods:A sample of 499 postgraduates coming from a university in Beijing was investigated with preliminary questionnaire,249 of them were assessed for exploratory factor analysis(EFA) and 250 of them were assessed for confirmatory factor analysis (CFA) and testing of validity and reliability.The criterion validity was tested with the Self-Regulatory Fatigue Scale (SRF-S),Dual-Mode of Self-Control Scale (DMSC-S) and Adolescent Self-rating Life Events Check-list (ASLEC).Totally 280 students were retested for test-retest reliability with 2 week interval.Results:DSS was composed of 8 items in two factors,which were cognitive factor and behavioral factor.The two factors explained 60.7％ of the variances.The confirmatory factor analysis identified a two factor model (x2/df=4.18,RMSEA =0.09,NFI =0.95,NNFI =0.94,CFI =0.96,IFI =0.96,GFI =0.96,SRMR =0.05).The scores of depletion sensitivity were positively correlated with the scores of cognitive fatigue,behavioral fatigue,emotional fatigue poor control,punished,loss,relationship pressure and adaption problem (r =0.13-0.55,Ps ＜0.001).The Cronbach α coefficients were 0.80 for the total questionnaire and 0.79 and 0.73 for the two factors.The test-retest reliability were 0.52 for the total questionnaire and 0.46 and 0.58 for the two factors.Conclusion:It suggests that the Chinese version of Depletion Sensitivity Scale (DSS) is reliable and valid enough to be applicable to measure the depletion sensitivity of Chinese graduate students.