Objective To explore the value of HRCT and contrast-enhanced MRI in diagosis of facial nerve injuries.Methods HRCT and contrast-enhanced MRI were performed in 18 cases of facial nerve injuries.CPR of the facial nerve and canal was performed on the Philips EBW workstation,and the temporal bone involved location,fracture type and involvement of facial nerve and canal and its course were observed.The involved location,size,signal variation of facial nerve were analyzed compared with contralateral side on the GE AW 4.5 workstation.Results Among 18 cases,8 cases of longitudinal fractures,5 cases of transverse fractures and 5 cases of mixed fractures were found.HRCT axial scan and CPR of facial canal revealed that 18 cases had temporal bone fractures,including 1 case of labyrinthine segment,2 cases of geniculate fossa,4 cases of tympanic segment,2 cases of geniculate fossa,tympanic segment and hematoma of middle ear cavity,3 cases of tympanic segment with adjacent hematoma of middle ear cavity and 6 cases without obvious fracture of facial canal.Contrast-enhanced MRI and CPR of facial nerve revealed facial nerve injuries in all 18 cases,including 12 cases of internal auditory meatus segment,14 cases of labyrinthine segment,18 cases of geniculate ganglion,16 cases of tympanic segment and 15 cases of mastoid segment.Signal intensity ratio of affected internal auditory meatus segment,labyrinthine segment,geniculate ganglion,tympanic segment and mastoid segment were higher than those of contralateral side (all P＜ 0.001).Conclusion HRCT and contrast-enhanced MRI can clearly reveal the involvement of different segment of traumatic facial nerve,HRCT CPR and MR CPR are helpful to visualiz the involvement of traumatic facial nerve and canal.

Objective To explore the application value of contrast-enhanced MRI and curved planar reformation (CPR) in diagnosis of facial neuritis.Methods Contrast-enhanced MRI scans were performed on 30 patients with facial neuritis.The involvement of intracranial facial nerve was observed,and the signal intensity of facial nerve and adjacent temporal lobe was measured with GE AW 4.5 workstation.While the signal intensity ratio (SIR) between facial nerve and adjacent temporal lobe was calculated.CPR of facial nerve was done with Philips EBW workstation,in order to observe the whole course and involvement of facial nerve.Results Among the 30 patients,SIR of affected geniculate ganglion,tympanic segment,labyrinthine segment,internal auditory meatus segment and mastoid segment was 1.59±0.28,1.16±0.16,1.38±0.20,1.30 ±0.19 and 0.96±0.14,respectively.While SIR of the relevant segment in contralateral side was 1.08±±0.19,0.74±0.13,0.81±0.13,0.83±0.08 and 0.69±0.12,respectively.There were significant differences of SIR between the affected and the contralateral segments (all P＜0.001).CPR could display the involved location and facilitate visualizing the whole course of facial nerve clearly.Conclusion Contrast-enhanced MRI and CPR are helpful to facilitate visualizing the whole course of facial nerve and clearly reveal the involvement.

Objective To summary the microsurgical strategies and techniques of petroclival meningiomas by trans-subtemporal combined with suboccipital retrosigrnoid keyhole approaches to raise the removal rate and improve the prognosis.Methods The clinical data of consecutive 26 patients with petroclival meningiomas,admitted to our hospital from January 2011 to December 2015 and accepted microsurgical treatment,were reviewed retrospectively;7 of them were guided by neuronavigation,8 were performed under neuroelectrophysiological monitoring,and 11 were guided by neuronavigation combined intraoperative MRI or neuroelectrophysiological monitoring.The operative methods and techniques,tumor resection rate and Kamofsky performance scale (KPS) scores before and after operation were analyzed.Results Of all patients who underwent surgical treatment by trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches,gross total tumor resection (Simpson Ⅰ-Ⅱ) was achieved in 23 patients (88.5％),subtotal (Simpson Ⅲ-Ⅳ) in 3 patients (1 1.5％).Six patients (23.1％) had cranial nerve deficit postoperatively.No mortality which related with operation was noted.Patients were followed up for 3-35 months,23 patients had KPS scores ≥70,and 3 patients had KPS ＜70;no tumor recurrence or progression was noted.Conclusion The trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches are safe,effective and minimally invasive for resection of petroclival meningiomas;mastering the operation strategies and intraoperative skills is conducive to improve the efficacy of surgery.

Objective:With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques,it is necessary to re-examine the therapeutic strategy for the treat-ment of petroclival meningiomas.To sum up the operative experience and methods in microsurgical resec-tion of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach.To explore the minimally invasive operation approach of petroclival meningiomas,to raise the removal degree and to improve the postoperative result using this approach.Methods:The clinical data of the consecutive 21 patients with the petroclival meningiomas were reviewed retrospectively.The meth-od,degree of tumor resection,techniques of the combining keyhole approach,Karnofsky performance score (KPS)before and after operation were also analyzed.The neuronavigation guided operation was performed in 9 cases,and 12 cases were operated in the neuroelectrophysiological monitoring.Results:Total excision of the tumor resection (Simpson,Ⅰ -Ⅱlevels)was conducted in 18 cases (85.7%,18 /21),and 3 patients underwent close resection (Simpson Ⅲ level,14.3%,3 /21).Postoperative three-dimensional CT showed good lock bone flap restoration;Postoperative pathology confirmed meningioma. Postoperative cranial nerve dysfunction or new original nerve dysfunction were aggravated in 5 cases (23.8%),including transient trochlear nerve (3 cases),abducent nerve (1 case),and the motor branch of trigeminal nerve paralysis (1 case).Abducent nerve paralysis (1 case)appeared,with hearing impairment.After the 3-month follow-up,11 cases had the same KPS aspreoperation,7 cases improved,and 3 cases not improved.The KPS score was 77.14 ±23.12 on average,and there was no statistically significant difference compared with that before operation (P >0.05 ).The postoperative follow-up for half a year showed fluent speaking and writing in 19 cases (KPS 70 or higher),and general recovery in 2 cases (KPS <70).The postoperative follow-up for 3 -29 months showed no tumor recur-rence or progress.Conclusion:The combining trans-subtemporal and suboccipital retrosigmoid keyhole approach is simple,safe,and minimally invasive,and an ideal operation approach of petroclival menin-gioma.To master the operation skills and the intraoperative matters needing attention in the operation,is favorable to improve the resection rate and curative effect.

Aim To investigate the effect of DHA on NGF-induced neuronal differentiation of PC12 cells and explore the possible mechanism via regulating BMP pathway. Methods PC12 cells were treated with 100μg·L-1 NGF and 100 μg·L-1 NGF + 10 μmol· L-1 DHA for 3, 6 and 9 days respectively. The length and number of neurite were detected by immunofluores-cenc. DHA content was analyzed by gas chromatogra-phy in all groups. The protein expression of BMP4, BMP7 , BMPR-II and p-Smad 1/5/8 was determined by Western blot. Results The length of total primary neurite in NGF+DHA groups was obviously increased, longer than that in NGF group; DHA content in 10μmol · L-1 DHA group was higher than that in the control group;NGF+DHA groups also unregulated the protein expression of BMP4 , BMP7 , BMPR-II and p-Smad 1/5/8 . Conclusion DHA promotes NGF-in-duced neuronal differentiation in PC12 cells, which may be associated with the upregulation of BMP path-way protein.

Objective To study the initial application of 3.0T high field intensity intraoperative magnetic resonance(iMR)for cranial tumors.Methods Forty-three patients with cranial tumors including 23 glioma cases,12 pituitary tumor cases,3 brain stem cavernous hemangioma cases,2 meningioma cases,2metastatic tumor cases,1 neurilemmoma case,received operation examined with GE Signa HDX 3.0T iMR system.The operation process and influence of iMR were reviewed.Results In 43 patients,average iMR examination was 1.3(1-3)times.In 16 patients the first iMR examination revealed tumor remnants,and in 13 of them continued surgical interventions and complete resection.The rate of complete resection was increased from 63％(27/43)to 93％(40/43).No complications related to iMR occurred.Conclusion 3.0T high field intensity iMR can provide accurate positioning and real-time navigation for the surgery,increase the rate of complete resection,improve the accuracy and safety of cranial tumor resection,and decrease complications.

0.05).The values and ages were positive correlation before age 25(r=0.71～0.91,?0.05).Four main patterns of marrow distribution were identified in the proximal femur.Our data implied that there was progressive marrow fat distribution with age.The diaphyseal red marrow began to convert to yellow marrow after 5 years old and the conversion completed at age of 10.Foci of longer T 1 signals were found in the diaphysis in some of the subjects and the percentage increased with age.The femoral head and the greater trochanter showed yellow marrow signals after ossification.Conclusion Measurement of MRI signal intensity values could be used in evaluating the conversion of red to yellow marrow of the femur.Red and yellow marrow of femur may be distinguished by MRI.We should notice the different MRI feafure in different ages.

Objective To study the findings of CT and MRI in tongue cancer.Methods 21 cases of tongue cancer were examined by CT or MRI,CT examined 7 cases,MRI examined 14 cases.Results MRI could display the tongue cancer in all the cases,but CT only display 5 of 7 cases of the tumour.The value of CT and MRI was same in displaying soft tissue direct invasion.MRI and contrast enhanced CT could display cervical lymph node metastases.CT was superior to MRI in the diagnosis of mandible invasion.Conclusion MRI is superior to CT in the display soft tissue of tongue cancer and the metastases.CT is optimal in detection of cortical bone invasion.

5) receiving cardiopulmonary coronary artery bypass grafting(CCAB) during the same period was reviewed as control group(CCAB Group).The preoperative risk factors,operation parameters,and postoperative outcomes between the two groups were compared for statistical analysis.Results The EuroSCORE value of the OPCAB Group and the CCAB Group was 9.0?2.6 and 8.3?2.1,respectively(t=2.016,P=0.045). The number of grafts in the OPCAB Group was less than that in the CCAB Group(3.2?0.9 vs 3.8?0.9;t=-4.267,P=0.000).The postoperative levels of creatine kinase(CK) and creatine kinase myocardial band(CK-MB) were significantly lower in the OPCAB Group [570(61～8246) U/L and 20(1～282) U/L] than the CCAB Group [870(246～8155) U/L and 55(12～300) U/L](Z=-3.648 and-5.767,P=0.000).The blood transfusion in the OPCAB Group was significantly less than that in the CCAB Group(775?693 ml vs 1088?712 ml;t=-2.887,P=0.004).There was no statistical difference in postoperative complications between the two groups.The mortality is 3.5%(4/113) in the OPCAB Group and 6.6%(5/76) in the CCAB Group,without statistical difference(?2=0.925,P=0.336).Conclusions OPCAB is safe and effective in high risk patients.Different operation methods should be used for patients with different risks.

Objective To study the methods of delineating the whole length of bilateral facial nerve canals in one image. Methods High resolution computed tomography of the temporal bone was performed in 60 cases (120 ears) by Philips Mx8000 multislice spiral CT. Parameters: 120 kV, 200～250 mAs, Collimation: 0.5 mm, Pitch: 0.875, Scan time: 0.75 s/ring, Matrix: 512?512, Reformation interval: 0 1～0.2 mm, Reformation matrix: 1 024?1 024. Curved planar reformation(CPR)images were prepared along the facial nerve canal in the axial plane, and in the coronal and sagittal plane of multiplanar reconstruction(MPR). In the axial plane, a reference line was traced following the facial nerve canal from the internal auditory meatus, through the labyrinthine segment, the tympanic segment up to the second genu and mastoid segment. Another two protocols of curved reformatting were adopted: (a) a curved line was delineated along the facial nerve canal on the coronal reformatted image; (b) a curved line was drawn along the facial nerve canal on the sagittal reformatted image. The reference lines were carefully revised and moved exactly to the center of each segment of the facial nerve canal. For displaying bilateral facial nerve canals in one image, one reference line should be drawn along bilateral facial nerve canals. Results In 56 cases of 60 CPR, images in the axial plane, and coronal plane of MPR could show the unilateral or bilateral facial nerve canals clearly. The result of CPR of bilateral facial nerve canals in sagittal plane of MPR was unsatisfactory. The image on one side was often clear, but just part of it could be showed on the other. So the left and right facial nerve canals should be reformed separately. In 4 cases, CPR was unsatisfactory. In 1 of them the labyrinthine and tympanic segment had breaks because the patient′s head shook during the scanning. In 3 of them the facial nerve canals were showed unsatisfactorily because of the inexact position of head during the scanning. Conclusion The unilateral or bilateral facial nerve canals could be showed in one image by CPR. Combining the images of the high resolution CT in axial scan and MPR of the temporal bone, it would be helpful in the diagnosis of the lesions of facial nerve canal.