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Objective:To analyze the clinic-pathological features and surgical outcomes of adult patients with hypothalamic gliomas.Methods:The adult cases pathologically confirmed as hypothalamic gliomas were analyzed from October, 2011 to January, 2022 in Beijing Tiantan Hospital.Results:There were 32 adult cases with hypothalamic gliomas, including 16 males and 16 females. Tumor was located in the hypothalamus in 6 cases, in the hypothalamus plus optic chiasma/nerve in 6 cases, in the hypothalamus plus thalamus in 9 cases, and in the hypothalamus plus the third ventricle in 11 cases. Pre-operative hydrocephalus was found in 20 cases. Five patents underwent stereotactic biopsy, 27 patients underwent craniotomy, and 11 patients underwent shunt surgery for hydrocephalus. Of 27 patients with craniotomy, trans-callosal approach was chosen for 9 patients, trans-cortical for 8 patients, via pterion approach for 4 patients, via lateral sub-frontal approach for 4 patients, via fissurae interhemisphaerica for 1 patient, and trans-sphenoidal approach for 1 patient. Twenty-two patients received gross-total or subtotal resection, 5 patients received partial resection. All the patients were pathologically confirmed, including 9 patients with high-grade and 23 patients with low-grade gliomas. Six patients died within 3 months after craniotomy, 8 patients suffered from endocrine dysfunction, 7 patients suffered from electrolyte disturbance, and 5 patients suffered from hydrocephalus. They were followed for 0.7-110.0 months, with 5-year progression-free survival rate of 63.8% and 5-year overall survival rate of 53.9% for all patients. The 5-year progression-free survival rate was 83.3% and the 5-year overall survival rate was 72.8% for low-grade gliomas.Conclusions:The peri-operative mortality is high for adult patients with hypothalamic gliomas, and protection of the hypothalamic function is important. Patients with low-grade hypothalamic gliomas have good prognoses.
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Objective:To compare the sedative and analgesic effect and safety of dexmedetomidine at different doses combined with lidocaine with intravenous administration after modified radical mastectomy for breast cancer. Methods:Sixty ASAⅠ-Ⅱpatients aged from 18 to 65 years with body weight index of 18-30 kg·m-2 were treated by modified radical mastectomy. The patients were randomly divided into 3 groups:lidocaine group (group L, n=20), low dosage dexmedetomidine and lidocaine group (group D1, n=20) and high dosage dexmedetomidine and lidocaine group (group D2, n=20). Group L was intravenously given lidocaine 1. 5 mg·kg-1 before the operation and intravenously infused lidocaine 1. 5 mg·kg-1 ·h-1 during the whole operation process. Group D1 was intravenously infused dexme-detomidine 0. 3μg·kg-1 in 10min before the operation, and intravenously infused lidocaine 1. 5 mg·kg-1 ·h-1 during the whole opera-tion process. Group D2 was intravenously infused dexmedetomidine 0. 6 μg·kg-1 in 10min before the operation, and intravenously in-fused lidocaine 1. 5 mg·kg-1 ·h-1 during the whole operation process. The propofol Ce was recorded when the modified OAA/S reached 3 (Ce3) and BIS reached 80 (Ce80) during the up period, the VAS in the 1st, 6th and 24th hour after the surgery (VAS1-24), and nausea and vomiting in the first postoperative day were also recorded and observed. Results:No difference was found in the demographic data among the 3 groups with modified OAA/S of 3 (Ce3) and BIS of 80 (Ce80). VAS of group D1 and D2 was significantly decreased when compared with group L in the 1st postoperative hour(P<0. 05). In the 6th and 24th postoperative hour, VAS of group D2 was much lower than that of group L and D1(P<0. 05), however, no difference was found between group L and D1. There was no significant difference in the propofol Ce during the up period and the adverse reactions in the 1st postoperative day among the 3 groups. Conclusion:Dexmedetomidine at the dosage of 0. 6 μg·kg-1 combined with lidocaine can significantly reduce the pain and optimize the short-term prognosis after modified radical mastectomy.
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Tissue engineering technology provides a new method to repair ill tissue and worn-out organs. In tissue engineering, scaffolds play an important role in supporting cell growth, inducing tissue regeneration, controlling tissue structure and releasing active factor. In the last decade, electrospinning technology developed rapidly and opened vast application fields for scaffolds. In this review, we summarized the technological conditions of electrospinning for scaffolds, the study of electrospun fiber scaffolds applied in tissue cell cultivation, and some new directions of electrospinning technology for scaffolds. We also addressed development directions of electrospinning research for scaffolds.