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Objective To explore the clinical effect of direct posterior restoration and screw-rod (plate) internal fixation technique for the treatment of children with congenital atlantoaxial subluxation.Methods Seven children with congenital atlantoaxial subluxation,admitted to our hospital from April 2008 to March 2011, were chosen in our study; and 3 of them were combined with tonsil hernia of cerebellum and 3 with occipitalization. Japanese Orthopedic Association (JOA) scale was used to evaluate the patient's condition. Five patients were treated by internal fixation with occipital bone screw-axis (C2) pedicle screw and 2 were with atlas C1-C2.Articulatio atlantoepistrophica repositioning was performed during the operation. The post-operative improvement degree and therapeutic effect of these patients were assessed based on the JOA scores and imaging. Results All the patients were followed up for 1-15 months (average 3.2 months). The clinical symptoms of all patients improved significantly. The positions of all screws were fine 1 month after operation. Three-dimensional CT showed that occipital/interbody fusions were good in 3 patients.JOA scores after the surgery were 7-16 with an average scores of (12.03±3.58),which were significantly different as compared with those before the surgery ([7.56±3.16], P＜0.05). Conclusion Direct posterior restoration and internal fixation technique is a safe and effective method for the treatment of children with congenital atlantoaxial subluxation.

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<p><b>OBJECTIVE</b>There are a great number of modified models based on the four-vessel occlusion (4VO) model of Pulsinelli and Brierley which has been used worldwide for brain ischemia research. However, up to now the problems of collateral circulations of 4VO and the difficulty in arranging a surgery to occlude the basilar artery in other models are not satisfactorily solved yet. In this study, an improved 4-vessel occlusion (I4VO) rat model which is easy to handle and able to decrease the effect of collateral circulation is reported.</p><p><b>METHODS</b>The common carotid arteries and the beginning of the subclavical arteries of rats were occluded for different time by one-stage apertura thoracis superior approach. Neurological deficit scores defined by the modified Garcia scoring system and histopathological method were used to evaluate the effects of this model up to 7 days after reperfusion.</p><p><b>RESULTS</b>The neurological scores in the 15-min and 25-min groups decreased significantly at 24, 48 and 72 hours after reperfusion (P less than 0.05), and the histopathologic study showed that there were stable, symmetrical changes of lesions in bilateral hippocampus in all the ischemia samples from two ischemia groups compared with sham operated group (P less than 0.05).</p><p><b>CONCLUSION</b>This modified model is safe, easy, reliable, stable, mini-invasive as well as time-saving in making bilateral hemispheric ischemia, which can effectively decrease collateral circulations and meanwhile lead to stable lesions in hippocampus and cortex.</p>

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Objective o investigate the clinical characteristics of middle cranial fossa arachnoid cyst (MCFAC) and its therapeutic effects with different surgical methods. Methods Three hundred and fifty-two patients with MCFAC (about 2.58% of patients with intracranial space occupying lesion),admitted to our hospital from May 2001 to May 2008, were chosen in out study; their clinical data,surgical approach and prognosis were analyzed retrospectively. The gender ratio of patient with MCFAC adopted resection of arachnoid cyst and arachnoid cyst-peritoneal shunt was performed in 28 patients.Results Follow-up was performed for 3 months to 3 years. The headache completely disappeared in 75 patients (58.59%) and partial remission in 41 (32.03%) after the operation. The frequency and degree of seizures obviously decreased in 8 of the patients with MCFIAC. Eleven patients with dystropy,attention-deficit disorder or difficulty of learning got improvement. The head circumference and local skull eminentia was stable. The cyst disappeared completely in 46 patients (13.07%), partially in 257 (73.01%) and no changes in 49 (13.92%). Conclusion The clinical features of MCFAC is that it mainly occur in the left side of male. The younger the patient with MCFAC is, the better the treatment effect in the surgical intervention is. good outcome can be achieved by resection of the parietal layer of arachnoid cysts. The indication of shunt with meso-low pressure shunt system is for larger arachnoid cyst.

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Objective To establish the mouse models of acute epilepsy induced by kainic acid or penicillin, and explore the characteristics and condition of application of the 2 agents. Methods Ninety healthy male Kunming mice were selected and divided randomly into the normal saline group (n=10) and penicillin-induced group (n=40) and kainic acid-induced group (n=40). The kainic acid-induced group were treated with 10 mg/kg kainic acid by intraperitoneal injection, the penicillin-induced group were treated with 7× 106 U/kg penicillin by intraperitoneal injection, and the ones in the normal saline group were treated with 35 μL/g normal saline by intraperitoneal injection. After injection, seizure was observed continuously and graded in the following 5 h and monitored by electroencephalogram (EEG). Results Totally 80 mice of the penicillin- and kainic acid-induced groups entered the final analysis. It was noted that the latency of the appearance of the status epilepticus by kainic acid was shorter than that by penicillin (P＜0.05), and the mortality rate was lower as well (P＜0.05). Conclusions Acute epilepsy model reproduced by kainic acid might be superior to the one by penicillin because of the similar behavior and EEG features with human temporal epilepsy.