Objective To discuss microsurgical experience for transsuboccipital retrosigmoid sinus approach of large acoustic neuronomas,and improve the rate of tumor removing,and facial nerve and auditory nerve preserving Methods A retrospective analysis of 39 patients with acoustic neuronomas which were more than 4 cm in diameter were treated by microsurgery between January 1994 and December 2000 Tumor's excision was performed by transsuboccipital retrosigmoid sinus approach The surgical main points of transsuboccipital retrosigmoid sinus approach,and their experience of total removal,and rate of facial nerve and auditory nerve preservation were described Results The tumors were totally removed microsurgically in 34 patients,the total removal rate was 87 2%,and subtotal removal in 5 patients Facial nerve was anatomically preserved in 31 cases,the rate of facial nerve preservation was 79 5%,but the function of facial nerve was recovered in 22 cases (56 4%) The auditory nerve was preserved anatomically in 15 cases (38 5%) and functionally in 7 cases (17 95%) Conclusions An minimally invasive microsurgical treatment are crucial for increasing a satisfactory living quality of the patients It is considered that the total removal rate of tumor,the preservative rate of facial nerve and auditory depend upon microsurgical technique and intraoperative facial nerve monitoring in acoustic neuromas surgery

Objective For the purpose of exploring the influence exerued by the amount of template DNA on the results of automatic fluerescent detection. Method For the purpose of buiding the optimal amount of template DNA amplified, we have analyzed different amount of template DNA (9947A) by 3100 Genetic Analyzer with the multiplexing Profiler Plus Kit. Results The optimal amounts of template DNA amplified were between 0.31ng and 2. 5ng by using 3100 Genetic Analyzer. Conclusion It will produce the incorrect analytic results if the amounts of template DNA were too high or too low.

Objective To investigate the extraction of DNA from urine and urine stains and typing.Methods DNA was extracted from urine and urine stains with Chelex-100 extraction method and QIAamp Mini Kit.STR loci were typed after amplification by PCR procedures with Profiler Plus Kit.Results STR loci could be well typed in DNA extracted from the urine,which was fresh or preserved properly for less than 12 hours.Satisfactory DNA typing could be made in 50% of the urine preserved for two days.No typing results were obtained in the samples kept for seven days or much longer time,and typing was rarely available using urine stains.Conclusion DNA extracted from the fresh urine can be typed,which may be used in forensic identification.

Objective To investigate the levels of matrix metalloproteinase-9 (MMP-9) expression in different grades of glioma and the relationship with MRI characteristics. Methods Thirty-one patients of glioma confirmed pathologically were divided into two groups: low grade group (grade Ⅰ and Ⅱ, n=20) and high grade group (grade Ⅲ and Ⅳ, n=11). MMP-9 expression levels were evaluated with immunohistochemical staining. Plain and enhanced MR scan were performed in all patients before operation. Peritumoral edema index (EI), enhance percentage (EP) and the tumor's maximum diameter were recorded as characteristics of MRI. Results The expression levels of MMP-9, EI, EP and the tumor's maximum diameter were significantly higher in the high grade group than those in the low grade group (t=6.312, 4.405, 6.286 and 5.026, respectively, all P＜0.05). The expression of MMP-9 were found significantly correlated to EI, EP and the maximum diameter of tumor (r=0.516, 0.554 and 0.676, respectively, all P＜0.05). The expression levels of MMP-9 were significantly different between tumors with heterogeneity and even signal (t=2.637, P＜0.05), but not between tumors with unclear border and clear border definition (t=0.906, P＞0.05). Conclusion MMP-9 expression have close relationship with invasion of glioma. EI, EP, the maximum diameter and signal of tumor can reflect the level of MMP-9 expression, and may be used to estimate tumor's malignant behavior, being able to provide the evidence for future clinical operation.

Objective To compare the effect of natural antioxidants TA9001 and EGb761 on c-jun, NOS expression and survival of spinal motoneurons following brachial roots avulsion. Methods One hundred and eighty adult Sprague-Dawley female rats were randomly divided into TA9001, ECb761 and control groups. The right C 5～T 1 nerve roots were avulsed and then the introperitoneal injection of 1ml of 0.5% TA9001, 0.5% EGb761 or normal saline was given immediately and once daily to the rats, respectively. The rats were killed after survival for 4 h, 12 h 1 d,3 d,5 d,and 1 week, 2 weeks, 4 weeks and 6 weeks. The cryostat sections of C 7 segment were prepared and carried with c-jun immunocytochemistry, NADPH-d histochemistry and neutral red counter stain. Results The c-jun and nNOS gene expression was only appeared in injured motoneurons. c-jun was first appeared at 4 h, reached its maximum at 1 d, and grandually decreased till 2 weeks. NOS was first checked at 5 d, mostly at 2 weeks and decreased until 6 weeks. Avulsed motoneuron death started at 2 weeks, reached its peak at 4～6 weeks. Both TA9001 and EGb761 can cause c-jun up-regulation, nNOS down-regulation and more motoneuron survival as compared to control. Furthermore, EGb761 had more power to enhance c-jun expression than TA9901 at each time point. Conclusion It seems that nNOS is more important in motoneuron death mechanism than c-jun. Treatment of either TA9901 or EGb761 can protect the injured motoneurons following root avulsion.

Objective To observe the impact of hemoperfusion on chronic renal failure patients with secondary hyperparathyroidism maintaining hemodialysis.Methods Forty patients with hemodialysis in our hospital were selected and grouped.Single hemodialysis in connection with hemoperfusion(HD+HP)was used in group 1 and single hemodiafiltration(HDF)was used in group 2 to compare the clearance power and clearance rate of blood parathyroid hormone(PTH)and phosphate(P).Results Blood PTH was decreased and blood calcium was increased in patients with chronic renal failure maintaining hemodialysis after HD+HP treatment.Conclusion The clinical osteopathic symptoms of patients are improved after HD+HP treatment,secondary hyperparathyroidism in patients with hemodialysis.

Hospital performance evaluation based on lean management is discussed in the paper, which covers all hospital staff by means of appropriate evaluation tools,accurate division of groups to evaluate,precise setting of evaluation indexes,refined relationship between evaluation and remuneration, and strict execution and feedback.This contributed to overall performance betterment of the hospital, and rational performance evaluation and remuneration patterns.

0.05).In terms of toxicity,Aleucocytosis,phlebitis and constipation were more common in NP group while thrombocytopenia and skin rash were more common in GP group(P

ObjectiveTo evaluate the sufficiency of dialysis and nutri ti onal status of 44 end-stage renal disease (ESRD) with urea metabolic parameters such as TACurea,KT/V and PCR.MethodClinical data were collecte d and analyzed with statistic methods.ResultsTACurea and PCR w ere significantly lower in patients in insufficient dialysis group than those in sufficient dialysis group.There was no statistical difference between the two g roups in terms of KT/V.PCR was not influenced by KT/V in sufficient dialysis gro up,while it was significantly influenced by KT/V in insufficient dialysis group. ConclusionTACurea and PCR are significant indicators to assess whether the blood dialysis is sufficient or not in the long run.KT/V can direct ly indicate the effectiveness of single dialysis.Therefore,it is the best indica tor for adjusting the dialytic strategy.However,it is not important if the dialy sis is not sufficient.

Objective To investigate the clinical application of magnetic resonance cholangiopancreatography(MRCP) in diagnosis of obstructive jaundice.Methods Thirty-three patients with obstructive jaundice were examined by MRCP and the accurate rate of MRCP was evaluated according to the result of operation and pathology examination.Results The positive rate of the orientation diagnosis of MRCP in obstruction was 100%(33/33).The accurate rates of qualitative diagnosis for benign disease and malignant obstructive jaundice were 87.5%(21/24) and 90%(9/10) respectively.The general qualitative diagnose accordance rate was 87.9%(29/33).Conclusion MRCP is simple,hurtless and safe for the diagnosis of obstructive jaundice and it deserves generalization in the clinical application.