amount of bleeding to different degrees. It is believed that with the wide use of tranexamic acid during and after total knee arthroplasty, there wil be more optimal mode that can better control blood loss after total knee arthroplasty.

Objective To explore the origin of chronic subdural heamatoma.Methods Follow-up 92 patients of acute subdural haematoma(ASDH)and 207 patients of traumatic subdural effusion(TSE)S by CT or MRI.Results None of ASDHs developed into CSDHs directly,but ASDHs could become to CSDHs via TSEs;67 cases of TSE was proved becoming to CSDHs by CT scanning or operation.Conclusions Origin of CSDH is TSE.

Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.

Objective Discuss the active mechanism of dural border layer cells in the process of subdural fluid collection developing into chronic subdural hematoma.Methods Review and analyse literature combined with one special return case whom with subdural fluid collection.Results At the same case,subdural fluid collection at left side did no change during 49 months,and that at right side developed into chronic subdural hematoma in 23rd week,and the latter was absorbed at 62rd week.Conclusion In the process of subdural fluid collection developing into chronic subdural hematoma,dural border layer cells roll on important functions.

Objective: To investigate the role of oxygen free radicals in renal dysfunction of rats with obstructive jaundice and the protective effect of reduced glutathione on renal mitochondria. Methods: Fifty-four Wistar rats were randomly divided into three groups: sham-operation control group (group A), obstructive jaundice group (group B), reduced glutathione treated group (group C). The model of obstructive jaundice in rats was established by common bile duct ligation (CBDL). In group C, reduced glutathione (150mg/kg.d) was given through abdominal cavity for 21 days. The rats were executed at 7th, 14th, and 21st day after operation respectively. The contents of serum BIL, Cr, BUN and the contents of renal mitochondria MDA and cholesterol were detected respectively, and the changes of renal histopathology were observed. Results: The contents of renal mitochondria MDA and cholesterol in group B and group C were markedly higher than group A (P

BACKGROUND: As a kind of unwounded biomagnetism technique, magnetoencephalography (MEG) relfects immediate information of cerebral function by using magnetic source imaging through recording changes of magnetic field of neurocytes under different functional status.OBJECTIVE: To investigate the practicability of magnetoencephalography (MEG) imaging in localizing sensory-motor cortex for brain tumour surgery in 36 patients.DESIGN: Observational study.SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICTPANTS: From Janury 2003 to April 2006, 36 patients (17 male and 19 female) with brain tumors selected from Deparment of Neurosurgery, Guangdong 999 Brain Hospital underwent surgery with MEG-guided neuronavigation in the region of the sensory and motor cortex. Ages of the patients ranged from 13 to 70 years. Among the 36 patients, 14 with gliomas (including 5 highly malignant gliomas), 19 with meningomas, 1 with spongy angioma and 2 with adenocarcinoma (due to the metastasis of brain tumor). All patients and relatives provided the confirmed consent and the experiment provided by the local ethics committee.METHODS: A 148-channel biomagnetometer (4-D Neuroimaging, USA) was used to determine motor and/or senory cortex with sampling rate 678.17 Hz, high-pass filter 1.0 Hz and bandwith 200 Hz. MRI images were acquired using a Philips Gyroscan Intera 1.5T MR tomography. And then, the functional maps were transfered to the neuronavigation system for the treatment of brain tumor. All patietns followed up by further consultation and telephone call in 2-26 months after operation.MAIN OUTCOME MEASURES : Operative outcome and prognosis.RESULTS: MEG demonstrated that the tumor lesion changed the sensory-motor cortex in various degrees for the 36 patients. Brain tumors were resected completely in 34 cases. At 2-26 months after surgery, neurological deficits fully recovered in 19 cases, unchanged in 15 cases and deteriorated in 2 cases.CONCLUSION: MEG was found to be practical and useful in localizing sensory-motor cortex and brain tumor. It is a valuable non-invasive method for presurgical planning in the treatment of brain tumors.

Objective To explore multi-causes and therapy of massive hemothorax after thoracic operation.Methods Sixty-six patients suffered from massive hemothorax after thoracic operation.All of them were executed conservative treatments for postoperative hemothorax.The noneffeetive cases were executed re-exploration.The relationship of area of residual cavity,fluctuation of intrapleural pressure and volume of hemothorax were analyzed between lobectomy in 30 eases and wedge,segmental or no excision of lung in 24 cases in 24 h postoperation.Results Thirty-two of 66 cases being executed conservative treatments were suteessful,2 cases were dead,while 32 cases were executed re-exploration,and 29 of them were cured.but 1 case of them dead,and 2 cases suffered from bronchial fistula,who were cured by thoracoplasty.The operations of wedge,segmental or no excision of lung in 24 cases were compared with lobectomy in 30 cases.It Was proved that the former had the smaller area of residual cavity,the lower intrapleural pressure.and the less volume of hemothorax(P＜0.05).Conclusions The multiplicity analysis of massive hemothorax after thoracic operation are flucmafion of intrapleural pressure after operation,intracavitary suction with negative pressure,rise of pressure in microcirculation at wound,abnormality of blood coagulation function and so on.It can reduce complications that proper therapy is timely performed,and even avoid of re-exploration.

AIM: To observe the change of insulin receptor in rabbit kidney with acute ischemic-reperfusion injury. METHODS: 15 Japanese white rabbits were allocated randomly into control group, ischemic-reperfusion group(IR group). IR group received clamping for 1 h followed by 2 h or 48 h of reperfusion. At 2 h or 48 h after reperfusion, glucose and insulin in serum were determined. Insulin receptor in renal tissue was analyzed by radioligand binging assay(BAD). RESULTS: The level of serum glucose increased after 2 h reperfusion in 2 groups, but in IR group the value increased much more higher than those in control groups(P

Objective To evaluate different treatment modaltities for limited (local) hepatic metastasis in patients of colonic carcinoma Methods We conducted a retrospective analysis on 81 cases of colonic cancer suffering from hepatic local metastasis from 1987 to 2000 Results The 1、3、5 year survival rate was 85%、 46% and 32% respectively for patients underwent resection of metastatic liver cancer, and 26%、 0 and 0, respectively for those not having the metastatic liver cancer resected ( P 0 05) Conclusion Resection or ablation therapy promises a much longer long term survival than do nothing in colonic cancer patients with local liver metastatic tumor

BACKGROUND:Artificial knee joint replacement in older patients often combines with basic diseases, such as hypertension and diabetes. Perioperative blood loss is an important factor affecting the safety of replacement. OBJECTIVE: To explore the effect of the early closure of drainage tube on blood loss after primary total knee arthroplasty. METHODS: We randomly selected 90 patients with osteoarthritis of the knee who underwent primary total knee arthroplasty in the Affiliated Hospital of Qingdao University from January 2014 to July 2015. The patients were randomly divided into three groups (n=30). In the 4-hour occlusion group, the drainage tube was closed for 4 hours in early stage of replacement. In the 2-hour occlusion group, the drainage tube was closed for 2 hours in early stage of replacement. In the control group, the drainage tube was not closed. Because of the use of tourniquet during surgery, the amount of intraoperative blood loss was considered as 0 mL. Drainage blood loss after surgery was recorded. Total blood loss was calculated according to Gross formula through patient height, weight and preoperative and postoperative hematocrit. Hidden blood loss was gotten by subtracting the visible blood loss from total loss. Under the observation of postoperative joint sweling and subcutaneous ecchymosis, knee Hospital for Special Surgery score was recorded at 6 weeks after replacement, and compared among groups. RESULTS AND CONCLUSION:Statistical analysis indicated that significant differences in total blood loss and dominant blood loss were detected among the three groups (P < 0.05), indicating that both occlusion for 2 hours and 4 hours could reduce total blood loss and dominant blood loss, but the range of reduction was greater in occlusion for 4 hours. At 6 months after replacement, no significant difference in knee Hospital for Special Surgery score and hidden blood loss was detectable among three groups (P > 0.05). The incidence of joint sweling and subcutaneous ecchymosis was increased in the 4-hour occlusion group (P < 0.05). Above results confirmed that drainage tube occlusion can decrease total blood loss and dominant blood loss after total knee arthroplasty, but cannot reduce hidden blood loss. 2-hour occlusion after total knee arthroplasty is an ideal choice, but the amount of hidden blood loss should be carefuly considered.