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Effects of ERAS-based intraoperative arousal anesthesia technique on the extent of tumor resection,postoperative language and motor function in patients with glioma
Guan Pei, Cao Yani
Abstract20)           
Objective To investigate the application of intraoperative wake-up anesthesia technique based on accelerated rehabilitation surgery (ERAS) in patients with glioma and its effects on the extent of tumor resection,postoperative language and motor function. Methods 159 patients with glioma in our hospital from January 2020 to January 2022 were selected and grouped differently according to the order of admission and establishment,with the observation group adopting intraoperative arousal anesthesia technique based on ERAS,the control A group adopting intraoperative arousal anesthesia technique,and the control B group receiving conventional anesthesia management.The surgery-related indexes,degree of tumor resection and pre- and post-operative speech function,motor function,quality of life and postoperative complications were compared among the three groups. Results When comparing the bleeding volume and operation time of the three groups,there was no significant difference ( P>0.05);the ICU supervision and postoperative hospitalization time of the observation group were shorter than those of the control A and B groups ( P<0.05);when comparing the degree of tumor resection of the three groups,the difference was not statistically significant ( P>0.05);the VFT,BNT,and ABC scores of the observation group were higher than those of the control A and B groups,and those of the control A group were higher than those of the control B group 1 month after surgery ( P<0.05);Fugl-Meye and ADL scores were higher in the observation group than in control groups A and B,and higher in control group A than in control group B at 1 month after surgery ( P<0.05);EORTCQLQ-C30 scores were higher in the observation group than in control groups A and B,and higher in control group A than in control group B at 1 month after surgery ( P<0.05).Complication rates in the three groups were not statistically significant compared with each other ( P>0.05). Conclusion In ERAS-based arousal anesthesia technique applied to patients with glioma can promote early postoperative recovery,improve language and motor function,and enhance the level of survival quality.
2022, 35 (3): 147-152. DOI: 10.19854/j.cnki.1008-2425.2022.03.0005
Effect of deep brain stimulation on quality of life in patients with medium-late stage Parkinson's disease
Wang Huanming, Hu Fei, Zhang Jianguo, et al
Abstract23)           
Objective To explore the effect of deep brain stimulation on quality of life in patients with medium-late stage Parkinson's disease. Methods There were 82 males and 85 females in this group.Their ages ranged from 41 to 77 years(mean 62.55 years).Their illness duration ranged from 3 to 22 years(mean 5.52 years).The clinical classification showed tremor-type in 35 cases,rigidity-type in 59 cases and tremor-rigidity-mixed-type in 73 cases.All the 167 cases were divided into three different groups according to different treatment methods:DBS group,lesioning group and medical treatment alone group.Activity of Daily Living(ADL) Scale and Parkinson's Disease Questionnaire (PDQ-39) were used to evaluate the patient's quality of life(QOL) before the therapy and 12 months after the therapy respectively. Results Bilateral STN-DBS was performed in 22 cases,deep nuclus lesioning was performed in 74 cases(including Gpi in 8 cases and Vim in 66 cases),and 71 cases received medical treatment alone.There was significant difference( P<0.05)in UPDRS of both surgical groups between 1 week before-operation and 1 year after-operation.12 months after the operation the ADL scores of both surgical groups were significantly higher than those before treatment( P<0.05),and PDQ-39 scores were significantly lower than those before treatment( P<0.05).Meanwhile the ADL scores of both surgical groups were significantly higher than those of medical treatment alone group( P<0.05),and PDQ-39 scores were significantly lower than those of medical treatment alone group( P<0.05).The ADL scores of DBS group were significantly higher than those of lesioning group( P<0.05),and PDQ-39 scores of DBS were significantly lower than those of lesioning group( P<0.05). Conclusion DBS not only can improve the motor symptoms of PD significantly,but also can ameliorate the non-motor symptoms (NMS),which can greatly improve the quality of life in patients with medium-late stage Parkinson's disease.
2022, 35 (3): 160-164. DOI: 10.19854/j.cnki.1008-2425.2022.03.0007
Abstract67)           
2022, 35 (3): 179-182. DOI: 10.19854/j.cnki.1008-2425.2022.03.0011
Abstract39)           
2022, 35 (3): 183-187. DOI: 10.19854/j.cnki.1008-2425.2022.03.0012
Abstract45)           
2022, 35 (3): 188-192. DOI: 10.19854/j.cnki.1008-2425.2022.03.0013
Effect of non - tractive translateral fissure insula approach microsurgical treatment for hypertensive basal ganglia hemorrhage in elderly patients
Liang Xi'an, Huang Yongwang, Wei Shuzhi, et al.
Abstract21)      PDF (597KB)(0)      
Objective To study the effect of non-tractive translateral cleft-insula approach (LFA) microsurgery (LFA) on the treatment of hypertensive basal ganglia hemorrhage (HBGH) in elderly patients. Methods A total of 100 HBGH in elderly patients treated in our hospital from January 2018 to December 2020 were selected and divided into LFA group ( n=50) and control group ( n=50) according to the surgical methods.The LFA group underwent LFA,and the control group underwent transtemporal cortical hematoma removal.The perioperative indexes such as operation time,hematoma residue,postoperative consciousness disturbance time and hematoma clearance rate were observed in both groups.Postoperative complications,Preoperative and postoperative intracranial pressure,serum levels of nerve injury factors such as vascular endothelial growth factor (VEGF),human chondoglycoprotein-39 (YKL-40),plus pentagprotein-3 (PTX3).Serum levels of stress factors such as β-endorphin( β-EP),Adrenocorticotropic hormone (ACTH),Cortisol (Cor).Prognosis at 6 months after surgery. Results The operation time,hematoma residue,postoperative consciousness disturbance time and hematoma clearance rate in LFA group were all lower than those in control group ( P<0.05).The incidence of postoperative complications in LFA group was lower than that in control group ( P<0.05).On 7d after operation,the levels of serum VEGF,YKL-40,PTX3 and intracranial pressure in experimental group were lower than those in control group ( P<0.05).On 7d after operation,the levels of serum β-EP,ACTH and Cor in experimental group were lower than those in control group( P<0.05).GOS score of LFA group was better than control group 3 months after surgery ( P<0.05). Conclusion LFA therapy for HBGH in elderly patients can effectively remove hematoma,repair hemorrhagic spots,reduce brain nerve injury and systemic stress response,and contribute to the rehabilitation of patients,and has the advantages of less trauma,less postoperative complications,and better prognosis of patients.
2022, 35 (4): 210-215. DOI: 10.19854/j.cnki.1008-2425.2022.04.0004
Meta-analysis of the effect of atorvastatin combined with dexamethasone on the recurrence of chronic subdural hematoma after drilling and drainage
Zhang Xu, Wang Yuhai, Xiang Dingchao, et al
Abstract48)           
Objective To study the effect of atorvastatin (ATO) combined with dexamethasone (DXM) on the recurrence of chronic subdural hematoma after drilling and drainage. Methods By using the method of systematic evaluation,the relevant literatures on Atorvastatin Combined with dexamethasone in the treatment of chronic subdural hematoma in PubMed,Cochrane,EMBASE,CNKI,Wanfang and other databases were retrieved,and the database was established until December 31,2021.The eligible literatures were included in the study.The extracted analysis index was the recurrence rate of hematoma.The quality of the included literatures was evaluated by the Newcastle Ottawa document quality rating scale (NOS).The revman5.3 statistical software was used for meta-analysis. Results A total of 5 articles were included in this study,including 338 patients.The NOS score of the included articles was 6~8.The recurrence rate of hematoma in ATO combined with DXM group (1.2%) was significantly lower than that in control group (single oral ATO) (13.6%),and the difference was statistically significant ( OR=0.12,95%CI:0.04~0.39, P<0.001, I 2=0%). Conclusion Compared with single oral ATO,oral ATO and DXM can reduce the recurrence rate of hematoma in CSDH patients after drilling and drainage.For CSDH patients with repeated recurrence or high risk of recurrence,oral ATO and DXM can be taken after drilling and drainage.
2022, 35 (5): 312-315. DOI: 10.19854/j.cnki.1008-2425.2022.05.0011
Small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring in the treatment of hypertensive hemorrhage
Abstract22)           
Objective To investigate the effect of small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring in the treatment of hypertensive hemorrhage. Methods Sixty-eight patients with hypertensive hemorrhage admitted to our hospital from July 2021 to July 2022 were selected and divided into two groups: In the trial group,35 patients underwent small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring,and in the control group,33 patients only underwent small bone-window craniotomy under microscope.Postoperative complicationsand GOS score were compared between the two groups. Results The incidence of postoperative complications in the trial group were significantly lower than those in the control group ( P<0.05).The GOS score of trial group was significantly higher than that of control group 6 months after operation ( P<0.05). Conclusion Small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring can improve the prognosis of hypertensive hemorrhage patients,reduce postoperative complications,reduce hospital stay,and improve the quality of life of patients.
2023, 36 (2): 115-117. DOI: 10.19854/j.cnki.1008-2425.2023.02.0011
Research on the effect of carmustine combined with temozolomide in the treatment of glioma by regulating the levels of growth factors and their receptors
Du Bei, Gao Kai, Liu Changquan, Liu Yingyan
Abstract17)      PDF (831KB)(0)      
Objective To investigate theresearch on the effect of carmustine combined with temozolomide in the treatment of glioma by regulating the levels of growth factors and their receptors. Methods sA retrospective analysis was conducted to select 122 glioma patients admitted to our hospital from September 2018 to August 2020.All patients underwent surgical resection.According to the chemotherapy regimen, the patients were divided into the temozolomide group and the combination group.The neurological functions of the two groups were compared, ability to carry out activities of daily living, levels of growth factors and their receptors (VEGF, EGF and EGFR), quality of life, levels of T lymphocyte subpopulations, and adverse reactions.Follow-up was conducted until July 2023, and the overall survival and progression-free survival of the two groups of patients were compared. Results Six months post-surgery, patients in the combined therapy group manifested a significantly diminished CSS score (17.05±4.02 vs 26.95±5.30, t=11.742, P=0.000) in contrast to the temozolomide-only group, while their modified Barthel index (75.99±10.05 vs 62.15±9.12, t=7.957, P=0.000) markedly surpassed that of the temozolomide group.The KPS(84.28±8.41 vs 72.92±7.08, t=19.970, P=0.000) and QOL score (44.39±4.51 vs 35.81±3.50, t=11.498, P=0.000) of the combination group were significantly elevated compared to the temozolomide-only group.Further, patients under combined therapy exhibited significantly elevated levels of CD3+ (32.55±3.14 vs 28.67±3.71, t=6.135, P=0.000), CD4+ (56.49±5.03 vs 40.84±4.51, t=17.860, P=0.000), and CD4+/CD8+ ratio (2.41±0.25 vs 1.12±0.17, t=33.827, P=0.000) as opposed to those under temozolomide alone, whereas their CD8+ levels (23.48±2.87 vs 36.71±3.81, t=21.186, P=0.000) were significantly decreased in comparison.Additionally, combined group patients demonstrated significantly reduced levels of VEGF (158.33±19.05 vs 235.59±21.61, t=20.962, P=0.000), EGF (48.11±4.81 vs 80.78±6.54, t=30.702, P=0.000), EGFR (7.05±1.04 vs 11.32±3.09, t=9.727, P=0.000) and VEGFR (2.51±0.38 vs 3.10±0.23, t=10.591, P=0.000) compared to the temozolomide-only group.This denotes a profound augmentation in therapeutic efficacy with the implementation of combined therapy, highlighting the pivotal role of integrated treatment modalities in optimizing clinical outcomes.During treatment, patients in both groups experienced side effects such as nausea, vomiting, leukopenia, thrombocytopenia, anemia, and nephrotoxicity, and the incidence of grade I~ II side effects exceeded grade III~IV, there was no statistical difference between the two groups.significance ( P>0.05).After 3 years of follow-up, 2 cases in the temozolomide group and 3 cases in the combination group were lost to follow-up.The 3-year overall survival rate in the combination group was 63.96%, which was higher than 48.53% in the temozolomide group, but there was no significant difference ( χ 2=1.847, P=0.174);the 3-year progression-free survival rate of the combination group was 55.56%, which was significantly higher than the 30.88% of the temozolomide group ( χ 2=7.771, P=0.005). Conclusion The administration of Carmustine in conjunction with Temozolomide post-surgery has demonstrated efficacy in augmenting neurological function, bolstering capabilities for conducting daily activities, and enhancing quality of life for glioma patients.This combined treatment approach also aids in the restoration of T lymphocyte subpopulation levels, extends survival duration, and mitigates the proliferation of growth factors.The effectiveness and safety of this therapeutic combination are correlated with its receptor concentration, warranting further clinical investigation and control to validate its benefits and optimize its application in clinical settings.
2024, 37 (2): 107-115. DOI: 10.19854/j.cnki.1008-2425.2024.02.0008
The value of Ingenia 1.5T MRI combined with GFAP level in predicting neonatal brain injury
Hao Shujuan, Zhao Ying, Ma Tonghui
Abstract22)           
Objective To evaluate the value of Ingenia 1.5T MRI combined with GFAP level in predicting neonatal brain injury. Methods A total of 120 neonates with neonatal brain injury admitted to our hospital from January 2019 to December 2020 were selected as the observation group,and 90 neonates born at term without brain injury during the same period were selected as the control group.Brain scans were performed using Ingenia 1.5T magnetic resonance imaging,and serum GFAP levels were determined by enzyma-linked immunosorbent assay.The serum GFAP levels of the two groups were compared,and the diagnostic analysis was conducted to explore the value of Ingenia 1.5T MRI combined with Serum glial fibrillary acidic protein(GFAP)level in predicting neonatal brain injury. Results The serum GFAP level of observation group (2.34±0.56) ng/ mL was significantly higher than that of control group (0.85±0.24) ng/ml,and the difference was statistically significant ( P<0.05).Ingenia 1.5T MRI diagnosis showed that 103 of the 120 children in the observation group were positive and 17 were negative.In the control group,there were 21 positive cases and 69 negative cases.The Ingenia 1.5T MRI positive rate in observation group was significantly higher than that in control group ( χ 2=67.818, P=0.000).In the observation group,90 cases were positive and 30 cases were negative for GFAP.In the control group,there were 13 positive cases and 77 negative cases.The positive rate of serum GFAP in observation group was significantly higher than that in control group ( χ 2=72.909, P=0.000).Moreover,the Ingenia 1.5T MRI detection rate was significantly higher than serum GFAP diagnosis (26.598, P=0.010).The sensitivity of combined diagnosis was significantly better than Ingenia 1.5t MRI ( χ 2=5.819, P=0.016),serum GFAP ( χ 2=18.824, P=0.000),and the accuracy of combined diagnosis was significantly better than Ingenia 1.5t MRI ( χ 2=6.821, P=0.000). P=0.009),single serum GFAP test ( χ 2=9.226, P=0.002),while there was no significant difference in specificity of combined diagnosis ( P>0.05).Ingenia 1.5T MRI showed that when the signal intensity value of bilateral globus pallidus and putamen was 1.26,the maximum area under ROC curve was 0.81,with sensitivity of 89.37%,specificity of 82.56%,and accuracy of 55.47%.The maximum area under ROC curve was 0.76 when serum GFAP level was 1.82 ng/mL,and the sensitivity,specificity and accuracy were 83.64%,91.35% and 78.39% respectively.The area under ROC curve of combined detection for the diagnosis of neonatal brain injury was 0.86,and the sensitivity,specificity and accuracy were 97.32%,89.34% and 93.61% respectively. Conclusion Ingenia 1.5T MRI combined with GFAP can improve the sensitivity of the diagnosis,and its good accuracy has good predictive value for neonatal brain injury,which can provide a basis for early clinical evaluation of brain injury.
2022, 35 (3): 170-174. DOI: 10.19854/j.cnki.1008-2425.2022.03.0009
The prognostic value of Notch3 and TIP30 expression in patients with glioma
Du Yun, Wang Weizhong, Liu Meng, et al
Abstract26)           
Objective To explore the prognostic value of Notch3 and TIP30 expression in glioma patients. Methods From December 2019 to December 2020,135 pathological tissue specimens from 135 patients with brain gliomas diagnosed by pathology after surgical resection in Baoding No.7 Hospital were collected,and 60 paratumor tissues were collected.The expression of Notch3 and Tat-interactive protein 30 (TIP30) in glioma tissue and paratumor tissue were detected by western blot and immunohistochemistry.The positive rates of Notch3 and TIP30 in different tissues and the relationship between the expression of Notch3 and TIP30 and the clinicopathological characteristics of glioma were compared.The survival of patients was followed up for 1 year after operation.The Kaplan-Meier method was used to analyze the relationship between the expression of Notch3 and TIP30 and the prognosis of patients with glioma,and the relationship between Notch3 and TIP30 expression was analyzed by Spearman rank correlation. Results The expression of Notch3 protein in glioma tissue (2.25±0.63) was higher than that in paratumor tissue (0.95±0.21),the positive rate of Notch3 was 57.78% higher than that in paratumor tissue(36.67%),and the expression of TIP30 protein (0.42±0.11) The positive rate of TIP30 was 48.15% lower than that of the adjacent tissue (0.71±0.23),which was significantly lower than that of the adjacent tissue (86.67%) ( P<0.05).The positive expression of Notch3 in glioma tissue was not related to the patient's gender,tumor location,and resection range( P>0.05),but was related to the patient's age,tumor diameter,pathological grade,and Ki-67 expression ( P<0.05).The positive expression of TIP30 was not related to the patient's gender,age,tumor location and extent of resection ( P>0.05),but was related to tumor diameter,pathological grade and Ki-67 expression ( P<0.05).Cox analysis showed that pathological grade (HR=2.401,95%CI:1.572-3.667),high expression of Ki-67 (2.492,95%CI:1.542-4.028),high expression of Notch3 (HR=2.221,95%CI: 1.138~4.333) and low expression of TIP30 (HR=8.457,95%CI:2.050-34.886) were important influencing factors for the prognosis of glioma patients ( P<0.05).Kaplan-Meier survival analysis showed that the one-year survival time of brain glioma patients in the high Notch3 expression (score < 2 points) group was lower than that in the low expression (score > 2 points) group ( P< 0.05);TIP30 high expression (score<2 points) The 1-year survival time of glioma patients in the group with glioma >3 points) was higher than that in the low expression (score <3 points) group ( P<0.05).Spearman rank correlation analysis showed that the expression of Notch3 and TIP30 in glioma tissue was negatively correlated ( r=-0.539, P<0.01). Conclusion The expression of Notch3 in the tissues of glioma patients is higher,and the expression of TIP30 is lower.With the increase of pathological grade,the expression of Notch3 is higher,the expression of TIP30 is lower,and the prognosis of patients is poor.Its expression has important reference value for early disease and prognosis evaluation.
2022, 35 (5): 273-279. DOI: 10.19854/j.cnki.1008-2425.2022.05.0004
supplementary motor area epilepsy surgery as demonstrated by SEEG:case report and review of the literature
Lan Zhengbo, Han Yanming, Zhang Xinding, et al
Abstract35)           
Objective To explore the epilepsy form,transmission network,diagnosis and treatment methods of supplementary motor area epilepsy. Methods The clinical data of a patient with epilepsy in the supplementary motor area diagnosed and treated with the aid of stereotaxic technology in our department were sorted out,and the clinical symptoms,EEG transmission network and treatment effect were analyzed in combination with domestic and foreign literature. Results After the first-stage evaluation of epilepsy,the patient was determined to undergo SEEG surgery assisted by stereotaxic technology,and entered the second-stage evaluation of epilepsy before epilepsy.After more than 2 months of observation,the patient's seizures increased.After the preoperative evaluation of epilepsy in the first two phases was reviewed again,the epilepsy foci resection was performed under the guidance of neuronavigator and cortical EEG,and the patient was seizure-free 18 months after operation. Conclusion The epileptic discharges from the supplementary motor area are rapidly transferred to the contralateral side through the corpus callosum,and the symptoms appear on both sides of the corpus callosum at the same time.Preoperative comprehensive evaluation cannotdetermine the location of epileptic focus,SEEG localization should be performed.Incomplete thermal coagulation can lead to aggravation of Epilepsy in the supplementary motor area.After excision of the epileptic foci in one SMA area,the patient's language and contralateral limb dysfunction did not appear.
2022, 35 (5): 280-283. DOI: 10.19854/j.cnki.1008-2425.2022.05.0005
Clinical efficacy analysis of conventionalcarotid endarterectomy without shunt in 68 casesof carotid stenosis
Wang Qiang, Xie Manyi, Wang Yan, et al
Abstract29)           
Objective To investigate the clinical efficacy of Conventional Carotid Endarterectomy (CEA) for patients with Carotid artery stenosis disease. Methods The clinical data of 68 patients with Carotid endarterectomy treated in neurosurgery department of Cerebrovascular Surgery,Affiliated Hospital of Xuzhou Medical University,from January 2019 to September 2020,were analyzed retrospectively,there were 59 cases of mild and moderate stenosis in contralateral carotid artery (Group A),8 cases of severe stenosis in contralateral carotid artery (Group B) and 1 case of contralateral internal carotid artery occlusion (Group C).Standard Longitudinal Carotid endarterectomy was performed in all patients and carotid bypass was not performed during the operation.All patients were followed up for 30 days after operation,and no patientshadnew stroke,myocardial infarction,hyperperfusion and other complications and mortality,to evaluate the safety of routine carotid endarterectomy without shunt. Results CEA was successfully performed in all 68 patients.The mean time of operation was 120 ± 20 minutes,the mean time of block was 25 ± 5 minutes.All patients were relieved of neck CTA Stenosis,and no new cerebral infarction or myocardial infarction occurred in 30 days,8 patients presented with Severe Headache (5in Group A,3 in Group B and 0 in Group C).No deaths.All surgical results met the AHA criteria [1]. Conclusion Routine Carotid endarterectomy is safe and effective,but the compensation of Willis Circle and the function of coronary artery should be evaluated strictly before operation,TCD and cerebral oxygen saturation should be monitored during operation,and blood pressure should be raised if necessary,and try to minimize the blocking time.
2022, 35 (5): 290-294. DOI: 10.19854/j.cnki.1008-2425.2022.05.0007
The application of neuroendoscopy combined with microscope in the resection of cerebellopontine angle epidermoid cyst
Wang Xuanzhi, Li Dongxue, Jiang Xiaofeng, et al
Abstract34)           
Objective To investigate the application value of neuroendoscopy combined with microscope in the resection of cerebellopontine angle epidermoid cyst. Methods he clinical data of 15 cases of cerebellopontine angle epidermoid cyst were retrospectively analyzed.The posterior suboccipital sigmoid sinus approach was adopted in all cases,and the lesions were resected by neuroendoscope combined with microscope. Results All of the 15 patients,12 (80.0%) were completely resected.Subtotal resection was performed in 2 cases (13.3%).The majority was resected in 1 case (6.7%).After 2-22 months follow-up,10 patients with clinical symptoms were relieved.One patient developed new abducens nerve palsy within 1 week after surgery,and one patient developed mild facial paralysis,which returned to normal within 6 months after surgery.One patient developed aseptic meningitis postoperation and was cured by external drainage of lumbar cisterna. Conclusion Microscopy and neuroendoscopy are surgical instruments,both of them have their own advantages and disadvantages.For the operation of complex cerebellopontine angle epidermoid cyst,the advantages of both surgical instruments should be utilized to remove the tumor as much as possible while protecting the patient's neurological function and reducing complications.
2023, 36 (6): 339-342. DOI: 10.19854/j.cnki.1008-2425.2023.06.0004
Pituicytoma:2 cases and literature review
Li Zheng, Niu Chaoshi, Mei Jiaming, Wang xuanzhi, ChenPeng
Abstract33)           
Objective To investigate the clinical and imaging manifestations,pathology and treatment of pituicytoma. Methods The clinical data,imaging findings,pathology and treatment of 2 patients who were diagnosed as pituicytoma in our hospital from January 2019 to October 2023 were retrospectively analyzed,and the relevant literature was reviewed. Results There were 2 patients of pituicytoma,1 male and 1 female.The main symptoms include headache and vision decreased,and the head magnetic resonance imaging showed iso-intense on T1 weighted imaging and hypo- or iso-intense on T2 weighted imaging in and above the sellar region,substantial lesions were increased signal intensity after enhancement.Transnasal sphenoid approach under microscope and neuroendoscope were performed respectively.The postoperative pathology was pituicytoma (WHO Grade I),which was not treated with radiotherapy.Two cases were followed up for 4 years and 3 months without recurrence. Conclusion Pituicytoma is rare and easily misdiagnosed,the blood supply of tumor tissue is affluent,total surgical resection is the main way of treatment.
2024, 37 (1): 48-53. DOI: 10.19854/j.cnki.1008-2425.2024.01.0010
Abstract27)           
2024, 37 (1): 54-62. DOI: 10.19854/j.cnki.1008-2425.2024.01.00011
The application of 3D printed nasal skull base tumor model in neurosurgery clinical and teaching
Wang Xuanzhi, Li Zhang, Zhang Weiwen, Li Jianji, Jiang Xiaofeng, Niu Chaoshi
Abstract28)           
Objective To explore the application value of 3D printed nasal skull base tumor model in the clinical and teaching of neurosurgery. Methods Total of 13 patients with skull base tumor were selected,the virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed according to the image data before surgery.40 students who participated in the standardized training of residents in the neurosurgery department were selected as teaching objects,and they were randomly divided into the traditional teaching group and the 3D printing model teaching group.The teaching effect of the two teaching modes was evaluated from the examination of theoretical knowledge and clinical skills,the satisfaction of teaching methods,the increase of understanding of neuroanatomical structure,the improvement of three-dimensional space imagination and the stimulation of active learning interest.Before surgery,the surgeon evaluated the spatial location of the tumor,preoperative talk,preoperative planning,intraoperative reference and postoperative anastomosis according to the 3D printed tumor model and traditional image data. Results The virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed before operation in all the 13 patients with skull base tumor.The 3D model clearly showed the tumor and its adjacent skull,blood vessels and nerves.We found that students in the 3D printed model teaching group had better scores in the assessment of theoretical knowledge and clinical skills than those in the traditional teaching group,and the difference between the two groups was statistically significant ( P<0.05).Moreover,the 3D printed model teaching group was higher than the traditional teaching group in terms of satisfaction with teaching methods,increasing understanding of neuroanatomical structure,improving three-dimensional space imagination and stimulating active learning interest.We also found that,in addition to preoperative planning,the 3D printed model group scored higher than the traditional image group on tumor spatial display,preoperative talk,intraoperative reference,and postoperative anastomosis.The difference between the two groups was statistically significant ( P<0.05). Conclusion Compared with the traditional surgical planning and clinical teaching based on two-dimensional image data,3D printed tumor model has better surgical planning and clinical teaching value.
2024, 37 (1): 17-21. DOI: 10.19854/j.cnki.1008-2425.2024.01.0004
The value of plasma Lp-PLA2 combined with GOS score in evaluating the prognosis of aneurysm subarachnoid hemorrhage interventional therapy
Abstract15)           
Objective To investigate the prognostic value of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) combined with Glasgow Outcome Scale (GOS) score in assessing the prognostic value of interventional therapy for aneurysmal subarachnoid hemorrhage (aSAH). Methods From June 2018 to December 2020,86 patients with aSAH who received endovascular interventional aneurysm embolization were selected.GOS score was performed at discharge;modified Rankin Scale (mRS) score was performed at 6 months after discharge,with 0 2 being a good prognosis ( n=63);3 6 being a poor prognosis ( n=23).Plasma Lp-PLA2 levels were detected by enzyme-linked immunosorbent assay kit.Logistic multivariate analysis was used to analyze the influencing factors of poor prognosis in patients with aSAH;receiver operating characteristic curve (ROC) was used to analyze the value of Lp-PLA2 and GOS score to evaluate the prognosis. Results Logistic multivariate analysis showed that age (OR=1.834),preoperative Hunt-Hess grade (OR=4.123),aneurysm diameter (OR=5.002),number of aneurysms (OR=2.567),Lp-PLA2 expression level (OR=4.671) and GOS score at discharge (OR=2.678) were independent influencing factors of poor prognosis of aSAH patients ( P<0.05).The AUCs of Lp-PLA2 and GOS scores for predicting poor prognosis were 0.793 and 0.725,respectively,and the combined AUC was 0.891.The combined prediction had a sensitivity of 87.23% and a specificity of 76.12%. Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients. Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients.
2023, 36 (2): 100-104. DOI: 10.19854/j.cnki.1008-2425.2023.02.0008
Association between soluble lectin-like oxidized low-density lipop rotein receptor 1 and the prognosis of aneurysmal subarachnoid hemorrhage
Abstract14)           
Objective To investigate the effect of serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) on aneurysmal subarachnoid hemorrhage (aSAH) ) value of patient prognosis assessment. Methods A total of 232 aSAH patients who visited our hospital's neurosurgery department from March 2020 to March 2022 were selected as the analysis group,and 114 healthy subjects were selected as the control group.The general clinical data of the research subjects were collected,and the Hunt-Hess grade,modified Fisher grade,and aneurysm rupture size were evaluated and recorded.The venous blood of the patients admitted to the hospital within 24 hours was collected to detect the level of sLOX-1,and the mRS score was used to analyze and compare the good prognosis group and the poor group.For various clinical indicators,Spearman correlation test was used to analyze the correlation between sLOX-1 and the severity of aSAH;multivariate logistic regression was used to analyze the risk factors for the prognosis of patients with aSAH;receiver operating characteristic curve (ROC curve) was used to analyze the relationship between sLOX-1 Evaluation value in the prognosis of aSAH patients. Results The level of serum sLOX-1 in the aSAH group was significantly higher than that in the healthy control group ( P<0.05),and the level of sLOX-1 in the poor prognosis group was significantly higher than that in the good prognosis group ( P<0.05).Serum sLOX-1 level was positively correlated with Hunt-Hess classification and modified Fisher classification ( P<0.001)Logistic regression analysis showed that Hunt-Hess grade (grade 3-5),aneurysm size (≥5 mm),serum sLOX-1 concentration and modified Fisher grade (grade 3-4) were associated with poor postoperative prognosis in patients with aSAH Influencing factors ( P<0.05),The AUC of serum sLOX-1 for evaluating the prognosis of aSAH patients was 0.739,the cutoff value was 1.68 ng/ml,the sensitivity was 67.82%,the specificity was 76.37%,(Youden index=0.659;95% CI 0.741-0.902). Conclusion The level of serum sLOX-1 is related to the severity of aSAH patients,and is an independent influencing factor for patients with poor prognosis.
2023, 36 (2): 105-109. DOI: 10.19854/j.cnki.1008-2425.2023.02.0009
Protective effect of protectin D1 on cerebral ischemia reperfusion injury in mice
Abstract17)           
Objective To investigate the role ofprotectin D1 on cerebral ischemia reperfusion injury (CIRI) in mice. Methods Ninety C57BL/6 male mice were randomly divided into control group,model group and protectin D1 group.The CIRI model in mice was established by thread embolism method.The mice in the protectin D1 group were injected with 5 mg/kg protectin D1 through the tail vein 30 minutes before ischemia,and the mice in the control group and the model group were given the same amount of normal saline.After 24 hours of reperfusion,the infarct volume,brain water content and blood-brain barrier permeability of mice were measured.The neural function of mice was evaluated by Bederson scoring.The content of interleukin-1β (IL-1β),cyclooxygenase-2 (COX-2),tumor necrosis factor- α (TNF-α),superoxide dismutase (SOD),glutathione (CAT) and malondialdehyde (MDA) in the brain tissue of mice were detected.TUNEL staining was used to evaluate the apoptosis of brain tissue of mice. Results Compared with the control group,the volume of cerebral infarction,brain water content,blood brain barrier permeability,Bederson scoreand adhesion removal time in the model group were significantly increased,and the rotational drop time was significantly decreased ( P<0.05);Compared with the model group,the volume of cerebral infarction,brain water content,blood brain barrier permeability,Bederson score and adhesion removal time in the protectin D1 group were significantly decreased,and the rotational drop time was significantly decreased ( P<0.05).Compared with the control group,the level of IL-1β,COX-2 and TNF-α in the model group were increased significantly ( P<0.05);Compared with model group,the level of IL-1β,COX-2 and TNF-α were significantly decreased ( P<0.05).Compared with the control group,the contents of SOD and CAT in the model group were decreased significantly,while the content of MDA were increased ( P<0.05);Compared with the model group,the contents of SOD and CAT in the protectin D1 group were significantly increased,while the contents of MDA was significantly decreased ( P<0.05).Compared with the control group,the apoptosis index in the model group was increased significantly( P<0.05);Compared with the model group,the apoptosis index in the protectin D1 group was significantly lower ( P<0.05). Conclusion Protectin D1 alleviates cerebral ischemia reperfusion injury in mice,and its mechanism is related to reducing inflammatory reaction,oxidative stress and apoptosis.
2023, 36 (2): 110-114. DOI: 10.19854/j.cnki.1008-2425.2023.02.0010