OBJECTIVE:To compare the clinical effect of different materials for cranioplasty. METHODS:The incidence rate of complication and the degree of moulding satisfaction of patients with skull defect which were repaired using net-added silica gel,auto-cranial bone,three-dimensional Ti frame and digital three-dimensional reconstructed Ti frame were retrospectively analyzed in the Department of Neurosurgery of Xixiang People's Hospital from January 2000 to December 2007. RESULTS:The incidence rate of complication and the degree of moulding satisfaction were 50% and 27.8% in the net-added silica gel group,12.1% and 90.9% in the auto-cranial bone group,27.3% and 45.5% in the three-dimensional Ti frame group,5.6% and 100% in the digital three-dimensional reconstructed Ti frame group,respectively. The incidence rate of complication in the digital three-dimensional reconstructed Ti frame and auto-cranial bone groups was significantly lower than other two groups,while the degree of moulding satisfaction was also significantly different from other two groups (P

Objective:To explore influence of dexmedetomidine on Riker sedation -agitation scale (SAS) score and Ramsay sedation score in patients with hypertensive cerebral hemorrhage after borehole drainage . Methods :A total of 96 patients with hypertensive cerebral hemorrhage after borehole drainage treated in our hospital were selected . According to analgesic drugs taken after operation ,they were divided into dexmedetomidine group (n=48) and mid‐azolam group (n= 48) .Riker SAS score ,Ramsay sedation score and adverse reactions after operation were com‐pared between two groups . Results:Compared with midazolam group ,there were significant rise in Ramsay seda‐tion score [6h :(1.59 ± 0.52) scores vs .(2.13 ± 0.15) scores] and significant reduction in Riker SAS score [6h :(4.09 ± 0.82) scores vs .(3.73 ± 0.76) scores] on 6h ,12h and 24h after operation ,P<0.05 or <0.01 ;and signifi‐cant reduction in incidence rate of adverse reactions (37.5% vs .10.4% , P< 0.05 ) in dexmedetomidine group . Conclusion:Dexmedetomidine possesses definite analgesic and sedative effects on patients with hypertensive cerebral hemorrhage after borehole drainage ,it's safe andreliable ,which is worth extending .

Objective To explore the interactive effect of acupuncture and exercise on severe traumatic brain injury (TBI). Methods 120 comatose patients following TBI after routine surgery were equally divided into combined group (acupuncture and exercise), acupuncture group, exercise group, and control group (neither acupuncture, nor exercise). They were assessed with Glasgow coma scale (GCS),Fugl-Meyer assessment (FMA), modified Brathel index (MBI) and neurological deficit scores (modified Edinburgh-Scandinavia stroke scale, MESSS) before and after the treatment. Results The scores of GCS, FMA, MESSS and MBI improved more in the combined group than in the control group (P<0.05). The scores of GCS and MESSS improved more in the acupuncture group and the exercise group than in the control group (P<0.05). The scores of MESSS improved more in the combined group than in the exercise group (P<0.01). Conclusion Both acupuncture and exercise can synergetically reduce the disability and coma of comatose patients following TBI.

Objective To estimate the predictive value of neutrophil gelatinase-associated lipocalin in urine (uNGAL) for detection of acute kidney injury (AKI) in the intensive care unit (ICU) critically ill patients.Methods A total of 110 patients from the ICU of three general hospitals were enrolled in the study.The patients were adults more than 18 years of age.After admitted to ICU,the patients were continuously observed for 72 hours.According to the RIFLE criteria for diagnosis of AKI,the patients were classified as AKI group (33 cases) or non-AKI (77 cases).According to the sepsis diagnostic criteria,the patients were classified as sepsis (79 cases) or non-sepsis (31 cases).Exclusion criteria of patients were chronic renal insufficiency,malignant tumor,death after admitted to ICU 24 hours.Serum creatinine and uNGAL of the patients were analyzed daily.The difference of uNGAL between sepsis and non-sepsis patients,AKI and non-AKI patients,sepsis non-AKI and sepsis AKI patients was compared.Moreover,the difference of serum creatinine and uNGAL between AKI and non-AKI patients into ICU 24 h was compared,and the sensitivity and specificity of uNGAL and serum creatinine for diagnosis of AKI in the ICU patients were evaluated using ROC curve.Results The uNGAL levels were all significantly different between sepsis and non-septis patients,AKI and non-AKI patients,sepsis concomitant AKI and sepsis without AKI patients.The uNGAL levels were significantly different between AKI and non-AKI patients in ICU for the first 24 h,while the difference of serum creatinine were not significant.The area under receiver operating characteristic (ROC) curve of uNGAL and serum creatinine of patients in ICU for the first 24 h were 0.828 (95％ CI:O.742-0.914) and 0.583 (95％ CI:0.471-0.695),respectively.The cutoff value of uNGAL was 170 ng/ml,and the sensitivity and specificity were 0.778 and 0.784,respectively.The sensitivity was superior to serum creatinine.Conclusions uNGAL was superior to serum creatinine in the diagnosis of AKI,and could be used as a marker of the early diagnosis of AKI.

Objective To investigate the effect of combined application of cervical perivascular sympathectomy (CPVS) and selective posterior rhizotomy (SPR) on spasticity of cerebral palsy. Methods The data on 11 children with cerebral palsy following spasm who were treated by CPVS and SPR were retrospectively analyzed. Results Spasm of most children relieved significantly 1 month after surgery and limb movement function got notable improvement. The effect was confirmed stable and durable 4 months after surgery. Conclusion CPVS and SPR are effective surgical methods for treating spasticity of cerebral palsy.