Objective To investigate the application value of minimally-invasive surgical treatment in patients with traumatic epidural hematoma(EDH)straddling transverse sinus.Methods Forty-eight patients with traumatic EDH straddling transverse sinus were chosen and preoperative Glasgow Coma Scale (GCS)score ≥8 scores were managed with minimally-invasive drainage under CT location.CT scanning was performed 1 h,3 d after operation and hematoma volume was calculated,and Glasgow Outcome Scale(GOS)score was evaluated 3 months after operation.Results CT scanning showed that the hematoma volume preoperative was(46 ± 14)ml,postoperative of 1 h was(21 ± 4)ml,and 3 d was(16 ± 3)ml,decreased more obviously than preoperative,and there was significant difference(P ＜ 0.05).The GCS score preoperative was(8 ± 4)scores,postoperative of 3 d was(12 ± 2)scores,increased more obviously than preoperative,and there was significant difference(P ＜ 0.05).Three months after operation in 48 patients,GOS score 5 points 37 cases(77.1％,37/48),4 points 7 cases(14.6％,7/48),2 points 2 cases(4.2％,2/48),1 point two cases(4.2％,2/48).Conclusion Minimally-invasive drainage is effective in the treatment of traumatic EDH straddling transverse sinus with GCS score ≥ 8 scores.

Objective To observe the variations and distribution of the pulmonary fissures of normal subjects in China on multi-planar recontruction (MPR) images of 64- slice helical CT.Methods A total of 1235 subiects underwent 64- slice helical CT scan with a slice thickness of 0.6 mm.The MPR images were observed to find normal interlobar fissures and the variations including the accessory fissures occurred in lobar or segmental lungs.Results Of the all cases,no variation was seen in 80.08%(989/1235),and pulmonary fissure variations occurred in the remaining 19.92%(246/1235).Among pulmonary fissure variations,20.33% (50 cases) occurred bilaterally,with the other 79.67%(196 cases) unilaterally.Of the unilateral pulmonary fissure variations,63.01%(155 cases) was seen in right lungs,and 16.66% (41 cases)was found in left lungs.There was neither oblique nor horizontal fissure in 1.22%(3 cases) of right lungs.Absence of oblique fissure happened more frequently in left lungs (6.91%,17 cases) than right lungs(3.65%,9 cases).Incomplete oblique fissure happened more frequently in left lungs (8.53%,21 cases)than in right lungs(4.06%,10 cases).Totally,absence of the horizontal fissures were found in 27.24%(67 cases) of the subjects,and incomplete horizontal fissures were found in 9.76% (24 cases).Accessory fissure were found in 83.33%(205 cases) of the subjects,and they happened more frequently in right lungs than in left lungs(53.66%,132 cases on the right,while 29.67%,73 cases on the left).Accessory fissures on right lower lobe and segments happened much more than on the left(40.65%,100 cases on the right,while 7.72%.19 cases on the left).Lingular fissures in the lungs were found in 15.85%(39 cases).The changes in shape and location of the oblique and horizontal fissures were found in 41.06%(101 cases),and happened more frequently in right lungs than left lungs (35.37%,87 cases on the right,5.69%,14 cases on the left).Conclusions Sixty-four-slice helical CT with MPR can clearly display pulmonary fissures and their variations,and it can distinguished small lesions from small vessels.

Objective To study diagnostic significance of spinal tuberculosis with PA and lateral view of X-ray film and CT.Methods X-ray and CT findings of 207 cases with spinal tuberculosis proved by pathology were respectively analysed.Results (1)The diagnostic rates by X-ray and CT was 93.7% and 98% respectively;(2)The diagnostic sensetivity in showing destruction of vertebral body and narrowing of interveterbral space was 74.4% and 89.9% respectively by radiography and CT;(3)The diagnostic rate only according to the destruction of vertebral body and narrowing of interveterbral space was nearly 90%;(4)Computer tomograph display of sequester formation,phamatosis in paraveterbral soft tissue,swelling of psoas muscle,involvement of bony veterbral canal,destruction of adnexa is better than the spinogram display.There is difference between two methods(?

Basic research and clinical research on multiple myeloma (MM) have extensively progressed, as proven by the change in the definition of complete response (CR). With improvements in laboratory technology and introduction of novel agents, CR particu-larly emphasized both micro-and macro-models. The development of CR yielded therapeutic advances in MM and vice versa. The defi-nitions of response and treatment strategies were closely connected and improved. A need exists for further detailed studies on long-term disease control, such as optimal combination of agents. Given the shortage of new drugs and the distinctiveness of health in-surance, Chinese doctors should select the best treatment projects based on real-life situation in China.

Objective To study the feasibility and morphological characteristics of wide caliber of local biliary tract constructed by increasing pressure of local bile duct in a short period of time.Methods Twelve mongrel dogs were randomized into 2 groups.In group A,only inlaid bile duct dilator(IBDD)was placed for biliary drainage in common bile duct.In group B,IBDD was placed in tommort bile duct for biliary drainage and dilated it through affusing 0.1 ml,0.1 5 ml,0.2 ml and 0.25 ml water on postoperative day 1,8,15 and 22,respectively.The expandable ballbladders were kept on being dilated with increasing pressure for a month.Total bilirubin(TB),alanine aminotransferase (ALT),aspartate aminotransferase;aspartate transaminase(AST)of serum,bile duct diameter (BDD),histologic changes of biliary duct wall and hepatic tissue,and postoperative biliary tract contrast were determined before and after operation in both groups.Results There was no significant difference in TB,ALT,AST and histologic changes of hepatic tissue in bilary predilation and postdilation of each group and between group A and group B.There was great difference in BDD in bilary predilation and postdilation of each group and between group A and group B.In group B,the biliary wall was thickened and the lumina of bile duct widened,favorable tenacity of broaden biliary tract was shown.The specific staining of the broadened biliary wall showed that collagen and elastic fibers compacted fine and close and there was no breakage.Conclusion Dilated local bile duct constructed by increasing internal pressure of local bile duct has thick wall,wide caliber and its collagen and elastic fibers compact fine and close.This provides condition to supply early-stage cholangio-jejunostomotic reconstruction of bile duct iniury and create wide stoma for cholangio-jejunostomy in dogs.

we examined the serum copper level in 125 pregnant women (83) normal pregnant women of 28～40 weeks of pregnancy; 12 patients with se-vere edema-proteinurine-hyperterision syndromeduring 37～40 weeks of pregnancy; 30 patientswith prolonged pregnancy) and compared it withurine E/C value and Apgar score in order to deter-mine the reliability of serum copper value in diag-nosing placental insufficiency. The results con-firmed that the serum copper value was increasingwith the growth of weeks of pregnancy, but it wasdecreasing after the fortieth week of pregnancy.Comparison of the serum copper value with theurine E/C value showed that when the E/C or = 10. And when the Apgar score7. These results indicatethat the serum copper value can serve as an indexof placental function in the third trimester of preg-nancy.

Objective To study the curative effect of posterior diskoscope discectomy for adolescent lumbar disc herniation.Methods Eleven adolescent patients with lumbar disc herniation were treated with posterior diskoseope discectomy,the Japanese orthopaedic association (JOA) lower back pain score was observed and compared before operation and after operation 3,6,12 months.Results The JOA lower back pain score were (15.45 ± 2.73),(27.18 ± 2.08),(28.18 ± 1.25),(28.54 ± 1.21) scores before operation and after operation 3,6,12 months,there was statistical difference in JOA lower back pain score between before operation and after operation 3,6,12 months (P ＜ 0.01).The patients were followed up for 1-10 years,mean 7.9 years,excellent was in 8 cases,good was in 2 cases,general was in 1 case.Recurrence and iatrogenic lumbar instability were not found.Conclusions The posterior diskoscope discectomy with less trauma,less bleeding,faster recovery,and can achieve the same decompression objective with the traditional open surgical.So posterior diskoscope discectomy can be used as adolescent treatment of lumbar disc herniation.

PBL teaching module is the developing trend of medical education reform in China.By studying the advanced foreign experiences and modern methods,teachers and students should change the perceptions and roles to adapt to the PBL teaching style in order to propel the reform of the medical education.

To improve the quality of clinical teaching in burn surgery,79 students of Grade 2005 were randomly divided to problem-based learning(PBL)group and lecture-based learning(LBL) group.The teaching quality of two teaching methods were compared.The results showed that the average score,the score of teaching effectiveness appraisal targets in PBL group were sig-nificant higher than that in LBL group.This indicated that the teaching effectiveness of PBL was better than that of LBL,PBL should be applied in clinical teaching in burn surgery.

In order to elucidate the ultrastructural changes of human spermatozoa afteradministration of gossypol acetate 40 mg/day for 50 days,freeze-replica techniqueswere employed.In addition to the ordinary changes of spermatozoa,such as swelling,wasting,atrophy,tortuosity,nodulation in the head and/or tail region and fracture betweenhead and tail,the internal structure,biomembrane and intramembranous particles ofsperm also showed relatively more sensitive changes.The changes of biomembranerevealed certain shift in regard to the firmness of reciprocating attachment of inner-and outer-leaflets of the unit membrane.On the other hand,the changes of intra-membranous particles revealed a specialized arrangement,this is,on the plasmamembrane of head and tail they were concentrated into lattice work,whereas,in thehind-head region they accumulated as clusters.In the hind-acrosomal membranetwo types of particles,large and small,may be distinguished,the smaller ones werearranged orderly in lines of all directions.As for the nuclear pores,no changewas found in this study.It is considered that the influences of gossypol upon human spermatozoa,firstof all,were shown in the biomembrane and intramembranous particles,and theordinary changes in appearance were the secondary result.In the discussion,it'ssuggested that a special agent,gossypol receptor,responsible for the gossypol effectsto the sperm,may be present in the plasma membrane of the spermatozoa.