Objective To analyze effect of balloon embolization therapy for traumatic carotid cavernous fistula (TCCF),so as to provide references for treatment of this disease.Methods A total of 21 patients with TCCF managed with balloon embolization from April 2006 to March 2012 were collected in the study.There were 17 males aged (32.3 ±5.4) years and 4 females aged (40.6 ±5.8)years.Perioperative clinical presentations and imageologic changes were observed as well as operative outcome was evaluated.Results After 3 months of follow-up,20 patients experienced successful detachable balloon embolization,but the other one patient had to have stent angioplasty due to the failure of the procedure.All patients had some improvements on clinical presentations after operation (P ＜ 0.05).Imageologic examination revealed that all patients had complete occlusion of TCCF following operation.In follow-up,one patient had a relapse,with total curative ratio of 95％.Conclusions Detachable balloon embolization is effective in treatment of TCCF.Presently,the technique is an optimal method for such kind of disease and is worthy of wide clinical use.

Objective To assess the clinical application value of single-source dual energy CT(SSDE),by measuring the multi-slice CT(MSCT) and single-source dual energy CT(SSDE) lower limb fractures image noise and contrast noise ratio(CNR),comparing the difference in the radiation dosage.Methods 39 cases of lower extremity fractures by clinical diagnosis were included in the study.Preoperation or postoperation the patients underwent MSCT scans,postoperation or postoperative follow-up SSDE CT scans were conducted,two sets of images were achieved.We measured and compared conventional CT group with 130 key energy spectrum group (prior studies showed the elimination of metal artifacts,images,subjective scoring the highest photon energy level) no significant artifacts cancellous bone area,compared the image background noise and contrast noise ratio (CNR),and radiation dosage,using paired sample t-test.Results Two sets of data for the same patient before and after surgery or after review of images,which body mass index (BMI) was negligible.The CTDIvol value of the conventional MSCT was (7.94 ± 1.69) mGy,the dual-energy CT was (7.04 ± 0.97) mGy,with significant difference (t =2.71,P ＜ 0.05) ; The image noise of the conventional MSCT was (44.36 ± 15.66) Hu,the dual-energy CT was (15.04 ± 8.23) Hu,with significant difference (t =15.26,P ＜ 0.05) ; The CNR of the conventional MSCT was (3.96 ± 1.78),the dual-energy CT was (4.62 ± 2.80),with significant difference (t =-2.14,P ＜ 0.05).Conclusion Compared with conventional MSCT,single source dual-energy CT imaging provides improved image CNR,obviously eliminate metal artifacts,to better show the complex structure for lower limb fracture surgery,and reduction in radiation dosage.

Objective To investigate the complications and outcomes of the treatments in the early time of posterior chamber phakic in-traocular contact lens ( ICL) implantation for the treatment of high myopia, and to analyze the causes. Methods Forty-six patients ( 92 eyes) who underwent ICL/TICL implantations were enrolled in this study. The intraoperative and the postoperative complications in 6 months were observed,at the same time also the treatments and the outcomes were observed. Results None of the patients had a pupillary block. Only 8 eyes in all the patients had an elevated IOP after peripheral iridectomy ( PI) ,and 7 eyes after the ICL implantation,the highest IOP in which was 28 mmHg. No medication was given for treatment. In the YAG PI group,the incidence rate of iris bleeding and pigment dispersion were all higher than that in the YAG PI group (P<0. 05);2 crystalline lens of different patient were damaged intraoperation. Rotation of TICL was observed in 2 eyes. Only 2 individuals of all the patients in this study had complained visual disturbances,which was shadows and glare. Visual psychological change occurred in 1 patient. Conclusion The complications in the early time after ICL implantation for treat-ment of high myopia can prevent and control,the satisfaction of the patients is high.

Objective To evaluate the advantage of single -source spectrum CT in differentiating of calcifi-cation and tophus.Methods 146 cases of clinical suspected patients with gout pain were scaned by single -source spectrum CT,observed the adjacent to the bone and joint hyperplasia and showing characteristics of gout stone,coun-ted quantity,size and position of the sedimentary tophus.Diagnosed by American rheumatism association standard as the gold standard,computed the sensitivity,specific degrees and accuracy of showing tophus of single -source spec-trum CT and conventional CT,and evaluated the advantage of differentiating adjacent to the bone and joint hyperplasia and gout stone of single -source spectrum CT.Results Diagnosis of gout in 105 cases.Scaned 349 joints,positive in 341 of them,The first plantar toe joint involvement was obvious[118,34.60%(118/341)];The result showed that the sensitivities of the tophus,specific and accurate rate of the conventional CT were 63.80%(67 /105),65.85%(27 /41),64.38%(94 /146),which of single -source spectrum CT were 96.19%(101 /105),87.80%(36 /41), 93.84%(137/146),the differences of sensitivity,specificity and accuracy between the two methods were statistical significance(χ2 =34.42,555,38.34,all P <0.05).Conclusion Single -source spectrum CT in gout stone adjacent to the bone and joint has higher sensitivity and accuracy,specific degree,it is higher than conventional CT and provide a new noninvasive imaging technique for the identification of the peripheral bone and joint of the bone.

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

OBJECTIVE:To investigate clinical efficacy and safety of goserelin in the treatment of adenomyosis complicated with severe dysmenorrheal before placing levonorgestrel intrauterine system (LIS). METHODS:A total of 140 adenomyosis pa-tients with severe dysmenorrheal were selected from Sanya Family Planning Technology Service Center during Jan. 2014-Jan. 2016, and then divided into control group and observation group according to lottery method,with 70 cases in each group. Both groups re-ceived LIS within first 7 d of menstruation,and observation group was given Goserelin acetate sustained-release implant 10.8 mg subcutaneously via anterior abdominal wall one week before placing. Therapeutic efficacy was evaluated 6 months later. The im-provement of dysmenorrhea was compared between 2 groups. The uterine volume,COX dysmenorrhea score (CMSS),menstrual volume,hemoglobin (Hb) and CA125 content were compared between 2 groups before and after treatment. The occurrence of ADR was also compared. RESULTS:The rate of dysmenorrheal improvement in observation group was 95.71％,which was signifi-cantly higher than 81.43％of control group,with statistical significance(P<0.05). Before treatment,there was no statistical signif-icance in above indexes between 2 groups (P>0.05). Compare to before treatment,CMSS score,menstrual volume and CA125 content of 2 groups were decreased significantly after treatment,while Hb content was increased significantly;the observation group was significantly better than the control group,with statistical significance(P<0.05). There was no statistical significance in uterine volume between 2 groups before and after treatment (P>0.05). There was no statistical significance in the incidence of ADR(10.00％ vs. 14.29％)between 2 groups(P>0.05). CONCLUSIONS:Goserelin in the treatment of adenomyosis complicated with severe dysmenorrheal before placing LIS can effectively relieve dysmenorrheal,reduce menstrual volume and improve Hb and CA125 levels,but do not increase the risk of ADR.

Objective To assess the feasibility of low voltage with CARE dose 4D computed tomography pul-monary angiography(CTPA)by using image quality and radiation dosage.Methods 92 patients with clinically sus-pected pulmonary embolism(BMI:20 ~30kg/m2)were randomly divided into two groups(group A:n =46,80kV;groups B:n =46,100kV),the male and female of group A were equal to the number.Image quality score(given blind-ly by two senior radiologists ranged from 1 to 5 points).The CT value and standard deviation(SD)were measured and recorded in common pulmonary artery trunk,the main right pulmonary arteries,right low lobar arteries,and erector muscle of spine,calculated the SNR of ROI.Average CT value,signal noise ratio(SNR),CTDIvol,DLP were com-pared between the two groups.Used the CT dose index(CTDIvol)to compare radiation dosage between group A female and male.Results The agent average CT value and SD in arteries in group A [(510.27 ±115.45)HU,(50.06 ± 11.67)HU respectively]were higher than those in group B[(413.32 ±100.38)HU,(35.12 ±11.94)HU respective-ly],there were significant differences between the two groups(t =10.367,8.892,all P =0.000),but the SNR of ROI was (12.36 ±3.90),which was lower than (14.03 ±4.46)in group B,there was significant difference between the two groups(t =-5.238,P =0.001 ).Image quality score of transverse ection(1mm)in group A was (4.20 ± 0.29),which was lower than (4.91 ±0.36)in group B,there was significant difference(t =-20.23,P =0.000), but there was no significant difference in coronal section(5mm),coronal maximum intensity project(MIP)image and the capability of displaying the pulmonary artery branches(all P >0.05 ).The CTDIvol in group A was (2.03 ± 0.39)mGy,which was greatly lower than (5.04 ±1.02)mGy in group B,there was significant difference (P <0.05);but there was no significant difference between female and male in group A[male:(2.05 ±0.39)mGy;female:(2.01 ±0.38)mGy,t =-0.300,P >0.05].Conclusion Radiation dose can be decreased greatly(above 50%)in 80kV CTPA compared 100kV without compressing obviously the image quality for patients BMI 20 -30kg/m2 ,and no significant difference between the group A(80kV)different gender radiation dosage.

Objective To investigate the effect of triiodothyronine on the expression of alpha subunit of C protein Co (Coa) gene in cultured rat cerebral cortex neurons. Methods Primary cultured neurons of rat were prepared from the cerebral cortex at embryonic day 19. The neurons were cultured in DMEM supplemented with 15% fetal calf serum. After 7 days, the neurons were cultured in different media; DMEM supplemented with 15% fetal calf serum (group A), DMEM supplemented with 15% fetal calf serum stripped of thyroid hormone (group B), 0.5nmol/L T3-containing DMEM supplemented with 15% fetal calf serum stripped of thyroid hormone (group C) , 5nmol/L T3-containing DMEM supplemented with 15% fetal calf serum stripped of thyroid hormone (group D) and 50nmol/L T3-containing DMEM supplemented with 15% fetal calf serum stripped of thyroid hormone (group E). The neurons were cultured for another 7 days and total RNA was extracted. Goa mRNA leves were measured by competitive RT-PCR. Results As compared with group A, Coa mRNA leves in group B, D and E were low (P 0.05). Conclusion T, has dual effects on the expression of Coa gene in cultured rat cerebral cortex neurons. T3 down-regulated Coa mRNA in cultured neuron. However, in the absence of T3, Goa mRNA was also very low. Thyroid hormone may exert their action on brain development by regulating the the expression of Goa gene.

Objective To observe the effect of meridian balancing on speech disorder in children with cerebral palsy. Methods 130 childrenaged 1.5~7 years old were divided into the control group (n=62) and treatment group (n=68). The control group received routine rehabilitationwhile the treatment group received meridian balancing in addition. Results The rate of improvement was 89.7% in treatmentgroup and 79% in control group (P<0.05). The rate was more for those with language retardation than with anarthria in the treatment group(P<0.01). Conclusion The meridian balancing is effective on speech disorder in children with cerebral palsy, especially for those with languageretardation.