Objective To investigate the surgical technique and the curative effects of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 63 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively. Thirty-one of them were treated by neuroendoscopic surgery via superior frontal sulcus(neuroendoscopic surgery group), and 32 of them were treated by mini- invasive drainage (conventional therapy group). All of them were followed up for 6 months, and were assessed by the activity of daily living (ADL) scale. Results After treatment, all patients reviewed CT. The clear rate of hematoma in neuroendoscopic surgery group was 86.0%, in conventional therapy group was 23.3%, and there was significant difference (P<0.05). There were one death case in neuroendoscopic surgery group and 2 death cases in conventional therapy group. The survival patients were followed up for 6 months .The rate of better prognosis in neuroendoscopic surgery group was 83.3%(25/30), in conventional therapy group was 53.3%(16/30), and there was significant difference (P<0.05). Conclusions The surgical technique of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage is safe and effective.

Objective:To analyse the methord and effects of intermaxillary traction(IMT)screws used in the treatment of jaw frac-ture.Methods:In the treatment of 1 68 cases of jaw fracture IMT screws were used for the restoration of normal and stable occlusion. The screw number,position,traction effect and postoperative complications of the treatment were analysed.Results:705 screws were used in 168 patients,4 screws were used in each of 147 cased (88%),6 in 12(7%),5 in 9(5%).336(47.7%)screws were fixed between the roots of first and second premolar,292(41 .4%)between the roots of canine and first premolar,50 (7.1%)be-tween the roots of second premolar and first molar,27(3.8%)between the other tooth roots.Normal postoperative occlusion relation was achived by the use of screws in 92 cases without traction.Occlusion disharmony or deviation was found in 76 cases by the used of screws and was restored to normlal by 1 4-day traction in 71 cases.The total efficiency of the treatment was 97%.Pain of the mucosa surrounding the screws was observed in 23 cases (1 3.7%).Root damage,traction screw loosening and adjacent tooth dislocation were observed in 1 3(1 .8%),1 1 (1 .6%)and 2(0.3%)cases respectively.Conclusion:For the fixation of IMT screws,the posi-tions between tooth root from canine to first molar were most common and safe.The fixation point should be in 5 ~8mm below the gin-gival margin.Use of 4-6 screws can meet treatment need.

Objective To investigate the enhancing effect of microbubble contrast agent SonoVue of different dosage on high-intensity focused ultrasound (HIFU) ablation in goat livers in vivo. Methods Twenty goats were divided into 4 groups randomly. Animals in group 1,2 and 3 were bolus-injected of 0.01 ml/kg,0. 03 ml/kg and 0.05 ml/kg of SonoVue intravenously before HIFU exposure, respectively,and those in group 4 were not given injections as control. After injection 20s, the livers were ablated using HIFU performed in the manner of a single dot set by a computer system using a clinical device. The frequency of HIFU was 0.8 MHz,the intensity of HIFU was 19 100 W/cm2 ,the distance from skin to the target liver tissue was 30 mm,the exposure time was set at 15 s for all animals in the four groups. All animals were euthanized 7 days after HIFU, volumes of coagulated necrosis were measured. Pathological examinations were performed to analysis the exposure regions. Results Under the same parameters of exposure, coagulated volumes in group 1,2 and 3 were larger than those in group 4, the difference was significant (P < 0.05),and the coagulated volumes increased gradually with the dosage of SonoVue increasing from group 1 to group 3, the difference was significant (P<0.05). Pathological examinations confirmed that there were no residual unaffected tissues within the exposed volume. Two remarkable changes were observed in one goat in group 37 days after HIFU:the surrounding adjacent tissue outside the reactive zone necrotized and the skin were destroyed. Conclusions The enhancing effects of microbubble contrast agent in HIFU ablation is related with the dosage of the microbubble contrast agent SonoVue. The higher the SonoVue dosage,the larger the volume destroy in the target tissue.

Objective To explore the effect of oxytocin on uterine fibroids treated by ultrasound ablation. Methods Eighty-two single points in 29 uterine fibroids from 26 patients were sonicated with magnetic resonance imaging guided by high intensity focused ultrasound before and after using oxytocin. The required total energy, sonication time required to reach 60 ℃ and the acoustic energy for increasing 1 ℃ of temperature at the single point before and after using oxytocin were compared. Results Before intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (5320 ±910) J and it took (21 ±20) seconds for sonicating a single point, the energy required for increasing 1 ℃ was (255 ± 302) J. In contrast, after intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (2890 ±325) J, and it took (12 ±7) seconds for sonicating a single point, the energy required for increasing 1 ℃ was ( 126 ± 94 ) J. Those three index all reached statistical difference ( P = 0.002, P = 0.001, P= 0.002, respectively). Conclusion It seemed that Oxytocin could significantly decrease the energy required for ablating uterine fibroids, shorten treatment time and improve the treatment efficiency.

Objective:To study the effects of the surgical treatment of nerve avulsion inside and outside the mandibular cannel.Methods:34 patients with trigeminal neuralgia of the third division,received neurotomy and avulsion of inferior alveolar nerve in the mandibular cannel above the lingual or through the mental foramen,concurrently with the avulsion of buccal nerve.Patients were fol-lowed up for 2-4 years.Results:All the operations were successfully completed,The wounds were well-healed.All patients felt that pain disappeared in the area innervated by inferior alveolar nerve.During the 2-4 years of follow-up,no recurrence was found.Conclusion:Inferior alveolar nerve neurotomy and avulsion in the mandibular cannel is simple,safe and effective in the treatment of trigeminal neuralgia of the third division.

Objective:To analyse the effects of mandibular swing approach in the treatment of the tumors in infratemporal fossa. Methods:11 patients with tumors in infratemporal fossa treated by the surgical operation with mandibular swing approach. The mandi-ble cut was at the front of foramina mentale in 5 cases, at the front of mandible angle in 4 cases and at the middle of chin in 2 cases re-spectively. Results:According to the nature, location, size and the relationship of the tumors with peripheral nerve and blood vessels, flexible selection of the position of mandibular cut could fully expose and completely remove the infratemporal fossa tumor. Conclusion:Surgical treatment of the tumors in infratemporal fossa by mandibular swing approach is safe and effective.

Objective The aim of this study is to establish a practical VX2 tumour model less than or equal to 10 mm from large blood vessel(as standard) for HIFU ablation .Methods 15 New Zealand rabbits were involved ,VX2 tumour blocks were inoculated near postcava through spine path ,and tumour rate was observed two weeks later by anatomy and MRI .Results Three experimental rabbits did not survive ,all the rest of the 12 into the tumour ,assembly tumour rate was 100% (12/12);The tumour rate reaching the standard accounted for 75% (9/12) ,the average distance between the tumour and the inferior vena cava was (5 .6 ± 3 .4)mm . Conclusion It is feasible to establish the VX2 tumor model less than or equal to 10 mm from large blood vessel through spine path .

Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.

Objective To investigate the changes of immunity in patients with hepatocellular carcinoma (HCC) treated by high intensity focused ultrasound (HIFU). Methods HIFU system was used to treat 21 patients with mid-advanced HCC. The blood tests of cellular and humoral immunity related indexes were made before and on the 3rd, 7th, 14th, 21st day following the sonication. The histological changes of the target lesions were observed by light and electron microscope for the cases undergoing second stage operation. Results Light and electron microscope all revealed that HIFU could lead to irreversible changes in the tumor cells of the target lesions. There were not significant differences between the values of CD 3, CD 4, CD 8, CD 16, IgG, IgA, IgM,etc. before and after the ablation. Conclusions HIFU could destroy the tissues of HCC effectively. HIFU could not change the immunity of the patients with mid-advanced HCC remarkably. It may be ideal to unite immunotherapy and the other methods to get a sound clinical prognosis for HCC patients.

Objective To observe the changes in proliferative capability of remnant tumors implanted in rabbit breast after ablation with high intensity focused ultrasound(HIFU). Methods Rabbit implanted models were established by implanting VX_2 tumor mass into the breast of New Zealand rabbits.HIFU was applied to the tumors,and the remnant tumors were harvested by controlling temperature around probe of tumors.Fifty-six rabbits were randomly divided into control group (n=10)and HIFU group(n=40).The expression of proliferating cell nuclear antigen(PCNA)was detected by immunohistochemistry at different time points after ablation,and the survival time and organ metastasis status were observed after ablation. Results After ablation in HIFU group,the positive expression of PCNA was decreased shortly in remnant tumors,and restored to the level before ablation 21 days after treatment.The survival time in HIFU group was much longer than that in control group,and the time of lung and abdominal viscera metastasis in HIFU group appeared significantly later than that in control group(P<0.05). Conclusion Though HIFU ablation can not completely eradicate tumor after one treatment,the growth and metastasis of remnant tumors can be effectively inhibited for a short time,and HIFU ablation can prolong the survival time.