Objective To observe the effect of selective intra-arterial thrombolytic therapy for central retinal artery thrombosis. Methods 100 000-250 000U of urokinase were injected into the ophthalmic artery via a catheter in the ophthalmic artery or the internal carotid artery to carry out the thrombolytic therapy. Results The visual acuity was significantly improved from light perception or finger counting to 0.1 in 8 of a total of 26 cases, partially improved in 10 cases, and no change in vision in 8 cases. The time interval from the onset of the disease to thrombolysis was within 8 days in the 18 patients who showed improvement, 3 of them showed significant improvement, of whom 2 received the treatment within 3 days. Conclusion Selective intra-arterial thrombolytic therapy is effective for the treatment of central retinal artery thrombosis. The effect was closely related to the time interval from the onset of the disease to thrombolysis. The thrombolytic therapy should be carried out as soon as possible.

Objective To investigate the inhibition mechanism of gallnut on biofilm formation by MRSA 41577.Methods TTC assay was used to detect inhibitory effects of biofilms formation and mature biofilms.The of PIA on biofilm formation was studied using Congo red agar method.Micro-Ultraviolet Spectrophotometer was used to detect inhibitory effects of the release of eDNA.The influence for Baicalein on icaA and cidA gene expression were detected by RT-PCR method.Results The inhibitory concentration (MIC) and minimum bactericidal concentration (MIC) of MRSA 41577 BF were 0.5 mg/mL and 1 mg/mL, respectively.The inhibitory effect of galla on MRSA 41577BF formation and mature BF was significantly inhibited.Inhibition of MRSA 41577,the MIC and MBC of mature BF were 4 mg/mL and 16 mg/mL.Congo red test results show that Galla can inhibit the synthesis of MRSA 41577 PIA, and the concentration was dose-dependent.The results showed that gallnut could inhibit the release of MRSA 41577 eDNA, and the release amount of eDNA was 3.61μg/OD595 and 11.91μg/OD595 , respectively, when the concentration of gall was 1/2MIC.The release of eDNA was reduced by 69.7% (P<0.01).The expression of icaA and cidA genes in the control group was 9.7% and 6.67%, respectively.The expression of icaA and cidA in the control group was significantly lower than that in the control group ( icaA and cidA, and cidA gene expression were 100%, the expression of icaA and cidA genes were reduced by 90.3%and 93.3%, respectively (P<0.01).Conclusion The inhibitory effect of gallnut on the biofilm of MRSA 41577 is mainly through inhibiting the expression of icaA and cidA genes, and then affecting the synthesis of PIA and the secretion of eDNA .

Objective To discuss the image characters and the technical manipulation of endovascular embolization for cerebral AVM with bleeding. Methods The cerebral AVMs with bleeding in 56 cases were confirmed by CT, MRI, and whole cerebral DSA. Depended on the nidus of AVM, the superselective endovascular embolization with NBCA or embolization combined with radiological surgery was chosen. Results The nidus was eliminated for 100% in 36 cases after embolization for 1 to 3 processes. The rebleeding was found in 2 cases with new growth and survival aneurysm in nidus during the follow-up period and treatment with X-knife, and was cured by the second embolization. Conclusion The main causes of AVM bleeding included aneurysm and aneurysm-like dilation beside and located at the nidus, fine draining veins, and growth in the ventricles. To prevent the brain from bleeding, it is favourable to eliminate the aneurysm in AVM during embolization.

Objective To kown X-ray and clinic feature of thoracic metastasis of primary malignant tumor of female genital organs,so that to improve diagnostic accuracy.Methods All 204 cases of female genital tumor were confirmed by operation and pathology.The thoracic films of postero-anterior and lateral projections were performed before and after operation and chemotherapy in all patients, CT scan was performed in 30 cases CA-125 in 48 cases and HCG in 23 cases were done.All data of patients were reviewed and analysed by 3 doctors.Results 25 cases presented pleural fluid,CA-125 rised to 125-3765 u/ml;12 cases presented pulmonal shadow,hCG rised to 92-200000 mIU/ml.One of Choriocarcinoma had appeared pulmonal metastasis in normal pregnancy.Conclusion The metastasis of pleural fluid is most seen in ovary carcinoma,pulmonary metastatic tubercle is most manifestion in choriocarcinoma.Pulmonary metastasis of choriocarcinoma can't be ignored in normal pregnancy.

OBJECTIVE To investigate the clinical distribution and drug resistance of clinical Pseudomonas aerugilosa isolates,and offer reasonable experimental data for clinical therapy.METHODS P.aerugilosa was identified by ATB Expression system,and its drug resistance was determined by Kirby-bauer and ATB Expression method.RESULTS The main departments in which frequently P.aerugilosa infection accurred were Intensive Care Unit(41.2%) and Respiration Departments(19.3%).The common site of P.aerugilosa infection was respiratory tract(68.2%).The sensitive rate of P.aerugilosa to polymyxin E and cefoperazone/sulbactam was the highest(95.1% and 91.4%),while to meropenem and imipenem was 77.5% and 70.6%.The highest resistant rate of P.aerugilosa to trimethoprim/sulfamethoxazole,ampicillin/sulbactam was 97.1% and 95.1%.The resistunce to ciprofloxacin,ticarcillin and piperacillin,were 64.9%,63.3% and 56.3%.CONCLUSIONS P.aeruginosa is major pathoge in our hospital.It is important to select antibiotics correctly according to the results of susceptibility tests.

Objective To monitor the performance constancy of the HS-126E automatic X-ray film processor and to investigate the effects of chemical processing time on the reproducibility of film dosimetry.Methods With films having identical exposure,15 ready-pack Kodak X-omat-V films from the same batch were divided into 5 groups and exposed one by one under the identical conditions.One group of test film was processed per day from Monday to Friday with identical temperature and time.All films were digitized with a Vidar VXR-16 bit film digitizer. The average optical density(A) at irradiation field center was analyzed with RIT113 film dosimetry system software.At the same time,another 10 films in 5 groups from the same batch were exposed with vertical method and processed to get the calibration data and sensitometric curves.The film sensitivities,i.e.,ratio of A to delivered dose,were calculated and compared between groups.Another 15 films in 5 groups were exposed with horizontal method and processed similarly to the test films,the point dose at 1.5?cm depth on the central axis was calculated with sensitometric curve and compared with the value measured by ion chamber.Results Variations of A value in each group was less than 2%.During the processing period,a trend of decrease along with time in mean A value decreased day by day was observed.Both the standard deviations and coefficients of variation in all groups were within 2%.One-way ANOVA showed that there was a significant difference of the mean A value among all films from Monday to Friday(P

OBJECTIVETo investigate the clinical features, surgical transcranial approaches and outcomes of giant pituitary adenomas.

METHODSA series of 112 consecutive cases of giant pituitary adenomas underwent microsurgery through transcranial approaches at People' s Liberation Army General Hospital were retrospectively analyzed. Of the 112 patients, 58 were male and 54 were female, with age ranging from 3 to 72 years(mean age 44. 3 years). There were 91 non-functioning adenomas and 21 hormone-secreting adenomas. The maximum tumor diameter varied from 4. 0 to 7. 2 cm, with mean diameter of 4. 8 cm. Unilateral subfrontal approach was chosen in 16 cases, pterional approach in 41 cases, anterior interhemispheric approach in 34 cases, transcallosal-interforniceal approach in 6 cases, transcortical- transventricular approach in 5 cases, combined approach in 6 cases and other approaches in 4 cases. Postoperative MRI and endocrine function were re-examined routinely to evaluate the therapeutic efficacy. Staged operation through transsphenoidal approach or adjuvant treatments including medical and radiation therapies were administered in patients with hormone-secreting adenomas when hormonal excess persisted after surgery and in patients with non-functioning adenomas who had postoperative MRI evidence of residual tumor.

RESULTSTotal removal of the lesion was achieved in 57 cases (50. 9%) , 26 patients (23. 2%) underwent subtotal resection, and 29 patients (25. 9%) underwent partial removal. Postoperative mortality occurred in 3 patients (2. 7%). Major surgical morbidity occurred in 38 patients (33. 9%). Vision was preserved or improved in 98 patients (87. 5%). The postsurgical follow-up period varied from 3 to 64 months (mean 19. 5 months) . Nineteen of the 21 patients with hormone-secreting adenomas were considered to be in hormonal remission, and 87. 2% of the cases were capable of normal work and life and 8 patients suffered recurrence during the followed-up period.

CONCLUSIONSSelection of appropriate transcranial approaches is the key to successful microsurgery for giant pituitary adenomas according to the morphological characteristics presented in image examinations and clinical symptoms. Staged transsphenoidal operation and/or adjuvant therapies including medical and radiation therapies offer the best chances to control the residual tumors after the maximal surgical removal of giant adenomas through transcranial approaches.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Postoperative Period ; Retrospective Studies ; Young Adult

ObjectiveTo discusses the MSCT multiplanar reconstruction manifestation (MPR) of localized fat collection adjaction to subdiaphragmatic inferior vena cava (IVCfat).MethodsThe thoracic and abdominal MSCT scan data of 8246 patients were browsed,45 patients with presumed IVCfat on axial CT scans were further studied prospectively with MSCT MPR.The predisposing position of IVCfat and its relationship with IVC were observed.It was divided into two kinds of intraluminal type and extraluminal type according to the angle of IVCfat with respect of the wall of IVC.The other 50 patients without IVCfat were randomly selected as the control group.The sagittal inclination angle (SIA) and diameter ratio (DR) between supra- and sub-diaphragmatic IVC between the two groups were compared by using t test.Results The detection rate was 0.55％ (45/8246).Of which hepatic vein lacuna 8 patients,subdiaphragmatic gap medial to IVC 28 patients and IVC groove 9 patients.The shape of IVCfat showed mainly for the round,oval and crescents on axial CT scans,of 15 patients intraluminal type,4 showed target signs .The shape of IVCfat showed mainly for half-moon at MPR.The SIA and DR at IVCfat group were 21.62° ± 8.42°and 2.01 ±0.84 respectively,at control group were 16.75° ±7.82°(t =1.594,P ＞0.05) and 1.31 ±0.28(t =2.341,P ＜ 0.05 ) respectively.ConclusionThe round,oval or half of limited fat density shadow adjaction to subdiaphragmatic inferior vena cava which similar to in the lumen is the characteristic performance of IVCfat,it may be an anatomical variation.

ObjectiveTo assess the safety and efficacy of retrograde ureteroscopy lithotomy (URSL)assisted antegrade percutaneous nephrolithotomy (PCNL) for complex upper ureteral calculi in semisupine-lithotomy position.MethodsFrom March 2007 to December 2010,a total of 95 patients with complex upper ureteral calculi underwent retrograde URSL assisted antegrade PCNL in semisupine-lithotomy position.Ureteral calculi size was 12 mm × 6 mm to 38 mm × 15 mm,24 cases combined with renal calculus.Firstly retrograde URSL was performed,once the stone fragments moved up to renal pelvis,a 16-22 F PCNL working channel was established under the ultrasound guidance through which lithotripsy was performed using an ureteroscope.Finally a 6-7 F double-J tube was indwelled.ResultsOperations were successfullycompleted in 93 patients.However,in it 2 patients were converted to open surgery because of significantureteral distortion due to previous open surgery.Operative time was(42.7 ± 14.9) min; estimated blood loss was(34.5 ± 26.1 ) ml.The ureteral calculi clearance rate was 100.0％,and renal calculus clearance rate inthose combined with renal calculus was 95.8％ (23/24).There were no major intraoperative and postoperative complications excepted early urinary leakage in 2 cases and fever ≥39℃ in 3 cases.ConclusionsRetrograde URSL assisted antegrade PCNL in semisupine-lithotomy position is safe and feasible for complex upperureteral calculi,especially non-opaque calculi,combined with renal calculus,easily ascending ureteral calculi and large calculi burden which has low calculi clearance rate after URSL.The outcomes are encouraging with fewer complications.It also avoids intraoperative change of patient's position.

Objective To summarize the experiences of microsurgery for treatment of middle cerebral artery aneurysms (MCAA). Methods The clinical data of 35 patients with MCAA treated by microsurgery in General Hospital of PLA from 2004 to 2008 were retrospectively reviewed. Of them there were 20 males and 15 females, aged 18 to 72 years with a mean of 40 years. Of the 35 patients, subarachnoid hemorrhage occurred formerly in 22, intracerebral hemorrhage occurred in 11 and subdural hematoma in one patient. The MCAA located in the middle cerebral artery trunk in 10 patients, at the bifurcation in 20 patients (including one patient with 2 MCAAs), and in the distal segment in 5 patients. MCAA located on the left side in 13 and on right side in 22 patients. There were 7 patients with giant aneurysms, 11 with large aneurysms and 17 with small aneurysms. Microneurosurgery was performed in all cases, and different approaches were taken according to the locations of aneurysms. Superior temporal gyrus approach was conducted in 3 patients with giant intracerebral hematoma. Bypass of superficial temporal artery to middle cerebral artery was performed before occlusion of the afferent artery in one patient with giant aneurysm. Bypass with saphenous vein to middle cerebral artery was performed in another patient with giant aneurysm. Results The giant and large MCAAs consisted of 51.4% of all cases. Excellent outcomes were achieved in 20 patients, no marked change in 12 patients, and post-operative complications were observed in 3 patients. No perioperative death occurred. Conclusions Giant and large aneurysms are more common in middle cerebral artery aneurysms. Proper surgical approaches based on different situations during operation should be considered to achieve satisfactory outcome.