The distance between the medial border of the two articular processes was measured by CT and MRI. At the level of C5-6-7 it was 23-25 mm(24mm on average). If the distance is 24 mm at C5-6 a tuohy needle is inserted 10 mm(24?2-2) lateral to the midline. When the needle touches vertebral lamina, withdraw the needle 2mm and redirect it cephalad at 45-60, Resistance is encountered when the needle touches ligament flavum. When the resistance disappears, the tip of the needle has entered the lateral recess via tuohy needle. This approach was used in 45 patients with satisfactory results. In ten patients the position of the cathter was confirmed with contrast medium by CT and MRI.

Objective To study the angiogenic effects of adenovirus mediated human vascular endothelial growth factor 165 and human angiopoietin-1 (Ad 5-VEGF 165 , Ad 5-Ang-1) in rat models of hindlimb ischemia. Methods Rat models of hindlimb ischemia were established by ligation and peeling off rat′s femoral arteries. Ad-VEGF 165 and Ad-Ang-1 were intramuscularly transferred into the rat ischemic hindlimbs. The expression of VEGF 165 and Ang-1 were examined by Western blotting. Immunohistochemistry was performed to illustrate the effects on rat ischemic muscles after gene transferring. Results (1) Western blotting showed a high expression of VEGF 165 and Ang-1 in the ischemic hindlimb muscle transferred with Ad 5-VEGF 165 and Ad 5-Ang-1 VEGF 165 respectively. (2) There was no significant difference between groups on 7 days after the transfer. The capillary to muscle fiber ratio was significantly higher in the treating groups than that in control groups and were significantly higher in VEGF 165 +Ang-1 group than in VEGF 165 or in Ang-1 groups on day 14th and day 21th. (3) Many structured vessels surrounded by a layer of smooth muscle cells were found in Ad-VEGF 165 and Ad-VEGF 165 +Ad-Ang-1 groups, the number of SMA + vessel per muscle fiber was obviously higher than those in control groups. (4) Enormous cells positive for BrdU appeared in treated muscles in Ang-1, VEGF 165 , VEGF 165 +Ang-1 groups and many of them were positive for C-Kit, an antigen expressed by pluripotent marrow stem cells. Some C-Kit+ cells were incorporated in sites of neovascularization. Conclusion (1) Vascular endothelial growth factor 165 and angiopoietin-1 can promote neovascularization in rat models of hindlimb ischemia and the angiogenic effect is much more significant in Ad-VEGF+Ad-Ang-1 group. (2) VEGF 165 can increase the number of vessles that are coated with smooth muscle cells which shapes are similar to arterioles. (3) Not only angiogenic effect but perhaps vasculogenic effct also contribute to the neovascularization.

Objective: To study the application of CT and MRI fusion technique in the diagnosis and treatment of intraocular and orbital tumors. Methods: 2D-images of 13 patients with intraocular and orbital tumors were fused by special-point registration and Iterative Local Closest Point(ILCP) method; 3D-fusion images were reconstructed by Ray Tracing method. Results: A 3D-CT-MRI fusion images of intraocular and orbital tumors were reconstructed and displayed. The CT and MRI data of intraocular and orbital tumors were displayed on the same image as a comprehensive whole,which provided a stereogram of 3D-structure of the normal and abnormal orbital tissues. Anatomical structure of the orbit was clearly visualized by 3D-CT-MRI image. Conclusion: The multi-modality fusion technique can provide more accurate and comprehensive information for clinical diagnosis of intraocular and orbital tumors, which is helpful for doctors' planning of surgical operations,clinical education and doctor-patient communication.

Objective To observe the effects of propofol or thiopental on the changes of blood brain barrier (BBB) permeability in focal cerebral ischemia Methods Focal cerebral ischemia model was induced with occluding the middle cerebral artery (MCA) Sixty adult male SD rats were divided randomly into 5 groups: control group(group MC): without any anesthetics; propofol pretreated group (group MP1) or thiopental pretreated group (group MT1): intravenous bolus of propofol 20mg/kg or thiopental 40mg/kg, followed by intravenous infusion of propofol or thiopental at rate of 50 60 mg?kg 1 ?h 1 or 100 120 mg?kg 1 ?h 1 ,respectively ,to achieve and maintain the EEG burst suppression 30 min before MCA occlusion until the beginning of reperfusion; propofol therapy group (group MP2) or thiopental therapy group (group MT2): from the beginning to the end of the reperfusion , propofol or thiopental was administered at the same dose as group MP1 or group MT1; Blood pressure, P ET CO 2, ECG and EEG were monitored throughout the experiment Rectal temperature was maintained between 37 5℃ and 38 5℃ At the end of the experiment, after intravenous bolus of 2% evans blue dye(EB) 3ml/kg, the brain was taken out to check out the extends and areas of EB staining on the surface and standardized serial coronal sections of the brain ,under the optical microscope and electromicroscope Results 1 Both propofol groups did not alleviate BBB permeability changes and cerebral damage 2 Cerebral injury was most slightly in group MT1 3 BBB permeability and brain injury in group MT2 were slighter than those in group MC and MP1, MP2 Conclusions Thiopental at the dose maintaining EEG burst suppressioncan can reduce the brain injury induced with ischemia and reperfusion, with the better protective effects following the prophylactic administration Propofol at that dose can not improve the cerebral ischemic reperfusion injury

Objective To evaluate the analgesic effect and safety of subarachnoid chromaffin cell allograft for terminal cancer pain Methods Ten patients with intractable cancer pain despite traditional treatments were randomly divided into two groups In test group(n=4), 2ml of the suspension chromaffin cells cultured in vitro for 3 days was injected into the subarachnoid space through lumber puncture The same amount of cell free culture solution was injected intrathecally in control group(n=6) Opioids were administered continuously after transplantation The intensity of pain was assessed by VAS, the dose of opioids taken was recored,and the catecholamine and enkephalin concentrations in cerebrospinal fluid and immune function were measured before and after transplantation Results The VAS scores declined markedly in both groups after transplantation (P

Objective To reconstruct caudate nucleus,lentiform nucleus and thalamus three-dimensionally,fuse these neural structures with (patient's) radiological images and provide anatomical data for diagnosis and treatment of neurosurgical diseases. Methods Chinese Virtual Human dataset was segmented using image-transparency method at first and each image was smoothed by eroding and dilating, then fused neural structures with MRI,the neural structures and brain in MRI were reconstructed and displayed using surface rendering and volume rendering lastly. Results The reconstructed neural structures were smooth,natural and realistic.Their shapes and positions was clearly displayed and could be rotated, observed in any direction.On the fused images,the neural structures and tumor could be seen at the same time.Conclusion The reconstructed structures and fused images have great reference value to teaching and learning and diagnosis and treatment of neurosurgical diseases.

Objective To reconstruct the three-dimensional(3D) image and to study on the virtual anatomy of the thigh part based on computed tomography(CT) data source. Methods Ten patients' contrast-enhanced light-speed CT images of the thigh part were chosen, “3D medical studio” was applied to read CT data, then to reconstruct and anatomize the thigh part. Results The reconstructed 3D images of the thigh part were realistically pseudocolored displayed, it was composed of four kinds of tissues(skin, muscle, skeleton and artery) and could be freely rotated and incised and restored for many times at any shape and depth on real time. Its' layers were distinct among tissues. Conclusion This research realizd partial function of virtual anatomy, it may play a definite role on regional anatomy and sectional image anatomy teaching and clinical radiology diagnosis.

The new approaches were designed to have anti-inflammatory analgetics act concentratively on the surrounding of pathological nerve roots or to inject collagenase directly to the protruding lumbar intervertebral disc for more simple and effective treatment of the low back pain. Method: The approaches to epidural lateral recess via incisura margo lateralis of lamina arcus vertebrae or margo medialis of joint processus artieularis were supposed and applied in clinic after study of anatomy and analysis of lumbar vertebra X-ray and CT photographes. The safety and feasibility of the approaches were evaluated according to the test of block region, measurement of therapeutic effect and monitoring of CT during the whole procedures in some cases. Result: A total of 170 cases via the incisura margo lateralis of lamina areus vertebrae were tested, 168 cases turned out to be successful and 2 cases failing. Another 15 cases via margo medialis of joint proeessus articularis, all punctures were successful. Conclusion: The approaches can lead to epidural lateral recess precisely to obtain a better treatment. When the technique is applied to discolysis, no X-ray machine will be needed and therefore no injury of X-ray occurs to both doctors and patients.

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Objective To reconstruct three-dimensional (3D) image of heart and coronary artery on internet and explore the reliability. Methods After the contrast medium was injected into coronary artery of 2 heart specimens, hearts were scanned by UFCT with enhancement volume. One patient's UFCT images of coronary artery angiography were also chosen.Then the primitive images were transposed format, removed noise, specified interesting areas. 3D software on server was applied to reconstruct heart and coronary artery. Results The reconstructed 3D images of the heart and coronary artery were realistically displayed, freely rotated and transected.Main parts and branches of coronary artery were similar to those in the images of the UFCT. Conclusion Heart and coronary artery can be reconstructed on internet,which offers a new approach for reconstructing organs and tissues of human being.;