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On the middle shelf a chipped eggcup containing pepper, a drum of table salt, four conglomerated black olives in oleaginous paper, an empty pot of Plumtree's potted meat, an oval wicker basket bedded with fibre and containing one Jersey pear, a halfempty bottle of William Gilbey and Co's white invalid port, half disrobed of its swathe of coralpink tissue paper, a packet of Epps's soluble cocoa, five ounces of Anne Lynch's choice tea at 2/- per lb in a crinkled leadpaper bag, a cylindrical canister containing the best crystallised lump sugar, two onions, one, the larger, Spanish, entire, the other, smaller, Irish, bisected with augmented surface and more redolent, a jar of Irish Model Dairy's cream, a jug of brown crockery containing a naggin and a quarter of soured adulterated milk, converted by heat into water, acidulous serum and semisolidified curds, which added to the quantity subtracted for Mr Bloom's and Mrs Fleming's breakfasts, made one imperial pint, the total quantity originally delivered, two cloves, a halfpenny and a small dish containing a slice of fresh ribsteak.

还有一个小玻璃瓶,里面装着加了芳香剂的糖果。中层放着一只盛了胡椒粉的有缺口的蛋杯,饭桌上还摆着那种鼓状食盐瓶,用油纸包着的四颗粘成一团的黑色橄榄,一听李树商标肉罐头的空罐儿,垫着纤丝的椭圆形柳条筐里是一只泽西梨,喝剩下的半瓶威廉。吉尔比公司釀造的药用白葡萄酒(裹在瓶子上的粉珊瑚色薄绘纸已剥掉了一半),一包埃普斯公司制造的速溶可可;一只绉锡纸袋里装着安妮。林奇公司出品的五英两特级茶叶,每磅二先令;一只圆筒形罐子,盛着优质结晶角沙糖;两颗葱头,较大的那颗西班牙种的是完整的,较小的那颗爱尔兰种的已经切成两瓣儿,面积扩大了,气味也更冲鼻了;一罐爱尔兰模范奶场的奶酪,一只褐色陶罐,盛着四分之一品脱零四分之一兑了水并变酸了的牛奶(由于炎热,它已化为水、酸性乳浆与半固体凝乳,再加上布卢姆先生和弗莱明大妈作为早餐消费掉的部分,就足够一英品脱了,相当于原先送来的总量);两朵丁香花蕾,一枚半便士硬币和盛有一片新鲜排骨肉的一个小碟子。

Results The main imaging of adult polycystic kidney disease signs: abdominal plain film (45 cases) showed renal shadow was lobulated increase; cystic wall calcification (14 cases); polycystic kidney disease and renal milk of calcium (8 cases); pelvis angiography (61 cases), the performance of the renal pelvis, renal calices separated, distorted, elongated; retroperitoneal inflatable angiography (6 cases): Performance increases of renal kidney shadow Shadow and the relationship between the neighboring organs, its boundaries clear and identified; CT scan (30 cases): the performance of the majority of the size of the renal low-density areas, ranging from thin-walled circular; B-mode ultrasonography (47 cases) showed a circular echo-free renal multiple classes of liquid dark area .

结果 成人多囊肾的主要影像学征象:腹部平片(45 例)显示肾影呈分叶状增大;囊壁钙化(14例);多囊肾合并肾钙乳(8例);肾盂造影(61例),表现为肾盂、肾盏相互分离、变形、拉长;腹膜后充气造影(6例):表现为肾影增大肾影与邻近器官之间的关系,其界限清晰可辨;CT扫描(30例):表现为肾内多数大小不等的薄壁圆形低密度区;B型超声(47例)表现为肾内多个类圆形无回声的液性暗区。结论影像学检查有助于提高多囊肾的诊断的准确性。

Comclusion: transpetrous presigmoid retrolabrinth approach was rational approach for surgery on petroclivus and -4- CPA; it抯 important for accomplish the surgery to study and master the anatomy and variance of this approach; there was relative anatomical relationship among those structure on posterior of petrous bone; AAMP was the extracranial mark of inflexion of TS and SS; LAM and PSC were obvious bone marks for operation; we can confirm the abraded range of petrous bone lean upon LAM and/or GSS beside abrading step by step as literature, and it抯 unnecessary and unrational to emphasize to show PSC if the surgical space was enough; preceding sigmoid sinus and high jugular bulb often appeared at right and would bring disadvantage effect; interspace ,between CN V and CNVII or CNVII and CNJXI, were available to reach clivus and manage the mass on the range.

经SS前迷路后入路是处理岩斜坡区、桥小脑角区病变理想的手术入路;研究和熟悉手术入路中的解剖结构及部分变异对指导手术十分必要;岩骨内测面的骨性结构之间有着相对稳定的空间关系;顶乳缝前角是SS和TS转接处在颅外的标志;IAM和PSC等结构可以作为手术中的重要骨性标志;以PSC确定岩骨的磨除范围是较安全和可靠的,但亦可以结合影像检查,以内耳道和乙状窦前缘为基点判定切除范围,如果操作空间足够,过分强调磨出半规管是不适当的;右侧GSS的宽度和深度较对侧大,SS前置和颈静脉球高位较对侧多见,这些都对右侧入路有不利的影响,但仍可以进行手术操作;三叉神经和面神经间隙及面l 神经和舌咽神经间隙方便到达斜坡并处理病变。l

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