Objective To evaluate the clinical efficacy of radical cystectomy with orthotopic ileal neobled-der. Methods 28 cases of bladder tumor treated with radical cystectomy with ileal orthotopic neobladder were studiedretrospectively. Results All patients achieved excellent continence,whereas possessory patients needed time-lapse e-mietion at nighttime. The mean bladder capacity for the entire group was 330 ml. Residual urine was less than 70 ml.All of these patients have been followed up for 4～58 months with a mean of 18 months. They were survival with no re-currences except 1 case. Good urinary stream was reported. A little operative complications occurred. ConclusionThe operation of radical cystectomy with orthotopic ileal neobladder might be an ideal way of bladder replacement,characterized by large capacity,low pressure, orthotopie continent urination.

Brain tuberculosis is difficult to diagnose with low incident and high mortality and mobidity.Early diagnosis and timely treatment are the keys to prognosis.In recent years,reports of brain stem tuberculosis gradually increased with the improvement of diagnosing techniques.To further understand brain stem tuberculosis,the pathogenesis,clinical manifestation,feasibility of diagnosis,treatment,prognosis and vaccination are reviewed.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.

Objective:To analyze the efficacy of neuronavigation‐guided pure endoscopic endonasal transsphenoidal approach for the surgical removal of complex pituitary adenomas .Methods :The clinical data of 60 patients who received pure endoscopic endonasal transsphenoidal surgery for complex pituitary adenomas from Apr 2010 to Sep 2012 was retrospectively analyzed . These patients had one or more characteristics which including tumors more than 4 cm in size(34 patients) ,Knosp grade 3‐4(41 patients) ,recurrent or residual tumor(17 patients) .All patients received pure endoscopic endonasal transsphenoidal surgery and neuronavigation was used . Neuro‐ophthalmological , neuroimaging and endocrinological examination were performed postoperatively .Results:There were 33 nonfunctional adenomas and 27 functional adenomas .Overall ,the tumors were gross totally removed in 42 patients ,subtotal removed in 11 patients and partially removed in 7 patients .Postoperative visual acuity was improved in 32 patients ,endocrine remission was achieved in 8 patients .The gross total removal was achieved in 18 ,23 and 12 patients for tumors more than 4 cm in size ,Knosp grade 3‐4 adenomas ,recurrent or residual adenomas ,respectively .The postoperative complications included electrolyte disturbances in 4 patients ,cerebral spinal fluid leakage in 3 patients ,insipidus in 1 patient .And 1 patient had visual impairment ,hypopituitarism and hypersomnia caused by postoperative hemorrhage .And 5 patients had reoperation .Conclusions :Neuronavigation‐guided pure endoscopic endonasal transsphenoidal surgery is safe and effective for complex pituitary adenoma .The effectiveness of that approach for invasive pituitary adenomas (Knosp grade 4) and complex functional adenomas still need to be promoted .