CT and CTA 3D-reconstruction of keyhole operation approaches in the saddle area / 中华神经医学杂志

Objective To comprehend the anatomical image data related to the keyhole microsurgery operation approaches in patients with saddle lesions.Methods Fifteen healthy volunteers and 10 patients with intracranial aneurysm were selected in the experiment and 16-slice spiral CT, CT angiography (CTA) and 3D-reconstruction were performed on them. The anatomitical distance and angle were measured through the ways from supraorbital keyhole approach, frontolateral keyhole approach, pterional keyhole approach, and subtemporal keyhole approach to the anterior/posterior clinoid process, the anterior communicating artery and the bifurcation of internal carotid. Results Of the distances between keyhole centre and anterior/posterior clinoid process, the shortest one was the way from subtemporal keyhole approach (4.98±0.54 em; 5.35±0.65 cm) and the longest one was the way from supraorbital keyhole approach (6.44±0.36 cm; 37.68±1.06 cm). Of the angles between the skull sagittal plane and the operation plane from keyhole centre to anterior/posterior clinoid process, the way from subtemporal keyhole approach was better than the way from frontolateral keyhole approach. Of the angles between skull transverse plane and the operation plane from keyhole centre to anterior/posterior clinoid process, that of subtemporal keyhole approach was better than pterional keyhole approach. Distances between keyhole centre and bifurcation of intemal carotid ordered as follows: the way from frontolateral keyhole approach, that from supraorbital keyhole approach, that from subtemporal keyhole approach and that from pterional keyhole approach. Of the angles between cranial sagittal plane and the operation plane from keyhole centre to the anterior communicating artery or the bifurcation of ipsilateral internal carotid,the way of frontolateral keyhole approach was better than that of supraorbital keyhole approach.Conclusion CT and CTA 3D-reconstruction, by demonstrating the distances and angles of each approach,play a significant role in choosing the right keyhole operation approach in different saddle lesions.

Report on childhood obesity in China (7). Comparison of NCHS and WGOC / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence.</p><p><b>METHODS</b>A total of 2020 adolescents (1007 boys and 1013 girls) aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index (BMI) categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics (NCHS).</p><p><b>RESULTS</b>Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity (especially for girls since the mid- adolescence), the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity (90.1% for boys and 89.2% for girls) and a relative high specificity (96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively) was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China.</p><p><b>CONCLUSION</b>High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosocial implications of stigmatization caused by misclassification.</p>

Study of the effects of mild hypothermia on cerebral PO2, PCO2 and pH and body temperature in patients with acute severe head injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the effects of mild hypothermia on cerebral oxygen partial pressure, carbon dioxide partial pressure, pH and body temperature (PbrO2, PbrCO2, pHbr and BT) in patients with acute severe head injury.</p><p><b>METHODS</b>Thirty-eight patients with acute severe head injury were treated with mild hypothermia, meantime PbrO2, PbrCO2, pHbr and BT were monitored in order to study the changes of PbrO2, PbrCO2, pHbr and BT.</p><p><b>RESULTS</b>In patients with acute head injury, mild hypothermia obviously increased PbrO2, decreased PbrCO2 and CO2 accumulation and acidosis in brain tissue. BT was 1-1.5 deg. higher than rectal temperature (RT) after injury. The BT and RT were decreased when the patients were treated with mild hypothermia, but at the same time the difference between BT and RT was increased.</p><p><b>CONCLUSIONS</b>In patients with acute severe head injury the direct monitoring of PbrO2, PbrCO2, pHbr and BT was safe and reliable, and is helpful in estimating prognosis and mild hypothermia therapy.</p>