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Objective To investigate the effect of chlorhexidine gluconate in prevention of surgical site infection ( SSI ) . Methods Randomized controlled clinical trial method was used in the study. Comparison was made in the rates of SSI between the experiment group using 2% chlorhexidine gluconate and the control group. Results The rate of SSI in experiment group was significantly lower than that in control group (0.83% vs.5.83%, χ2 =3.23,P =0.035).Differences of hospital stay, total cost, infection in other sites and mortality rate of SSI were not statistically significant between the two groups ( P>0 .05 ) . Conclusion Preoperative head disinfection by chlorhexidine gluconate has remarkable effect in prevention of cerebral surgical site infection.
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Objective To summarize the surgery skills of removing the insular lobe glioma and explore the curative effect of lateral cleft microsurgery in treating the hypertensive cerebral hemorrhage (HCH) via pterional approach. Methods The clinic data of 46 patients with gravis type HCH in the basal nuclei that accepted the lateral cleft microsurgery via pterional approach, were retrospectively analyzed. Results In all of these patients, 2 patients died and 44 survived (survival rate 95.7%);according to the ADL test, grade Ⅰ, grade Ⅱ, grade Ⅲ, grade Ⅳ and grade Ⅴ were found in 14, 16, 8, 6 and 2 patients, respectively. Conclusion This operation approach is an effective one, helping relieve the sharply high intracranial pressure and improving the patients' prognosis.
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Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.
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Objective To investigate the effects of different medium and rat age on optic nerve tissue culture of rats.Methods Theoptic nerves from newborn rats(4dpostbirth)or adult rats(3-month old)were cultured on the rat-tailed collagen slide,pely-L-Lycine(PEL)slide,and Biocoat culture inserts,respectively.Their growth status was dynamically observed under a phase contrast microscope every day.The adherence rate of explant was recorded 48 h after culture.The maximum migration distance Was measured by an image analysis system on the 5th day after culture.The activity of lactic dehydrogenase (LDH)in the tissue culture medium Was measured dynamically.Morphological observance Was carried out by routine HE staining and the ultrastmcture of the tissue explants Were observed by a transmission electronmicroscope. Results The tissue adherence rate was higher in the Bioeoat insert group than in the rat-tailed collagen slide group or PLL slide group.The magnum migration distance of the tissue explants cultured in the Bioeoat insert group was longer than that in the rat-tailed collagen slide group or the PLL slidegroup.The maximum migration distance of the newborn rats Was longer than that of the adult rats under same culture condition(P<0.05).The LDH activity in the tissue culture medium began to descend 3 d after culture.The LDH activity in the adult rat group increased again on the 9th day since culturewhile it remained low level in the newborn rat group even on 12th day since culture.The cell processes showed up from the edge of explants and neuralgia cell migration was observed at the early stage,especially in newborn rats.The optic nerve structure gradually died out with the increase of culture time.The survival timeofopticnerve explant from newborn rats was longer than that of adult rats. Conclusion The optic nerve tissue can be cultured for a long time under suitable culture conditions.
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Objective To observe dynamically the response of the retinal ganglion cells (RGCs) following chronic optic nerve compression in cats. Methods Thirty adult cats were randomly divided into 6 groups (n=5): normal control group, sham operation group, 1-week compression group, 2-week compression group, 4-week compression group and 8-week compression group. The chronic optic nerve injury was produced by an inflatable balloon implanted under the optic chiasm. RGCs of all animals were labeled with Dil by retrograde tracing 2 weeks before operation. After each group animals were killed by perfusion, the retina were harvested to observe the pathological changes using the light microscope and electron microscope and the number of RGCs was counted under fluorescence microscope. Results There were three cell layers in normal HE stained retinas of cats with clear limits, named ganglion cell layer, bipolar cell layer and photoreceptor cell layer in sequence from vitreous body to selera. By 4 weeks after optic nerve compression, there were no obvious pathological changes in the retinas, however, at 8 weeks the nuclei of the RGCs became markedly thin, with the larger almost disappearing, and the total thickness of the retinas reduced with the glial cells proliferating. Under electron microscopy, the RGCs of the normal eats had large ovate nuclei with homogeneous karyoplasms. The cytoplasm occupied only small space of the cells, but contained a great of cellular organelle. At 4 and 8 weeks after compression, it was found in the retinal ganglion cells that the components of cytoplasm reduced, the endoplasmic reticulum expanded, the mitochondria was swollen, the vacuole occurred under the plasma membrane, the membrane of nuclei was shrunk and the chromatin was marginated and condensed. The density of the DiI labeled RGCs in the normal group animals ranged from 406 to 527 cells/mm2, with an average of (465±38) cells/mm2 and higher density in the central area than in the peripheral one. The number of the RC, Cs was unchanged by 4 weeks after optic nerve compression, but 8 weeks later, the number declined significantly to (293±32) cells/mm2 by about 37%. Conclusion The RGCs present delayed and secondary degeneration following chronic optic nerve compression, which gives an opportunity to protect the RGCs.
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<p><b>OBJECTIVE</b>To investigate the clinical applied anatomy in the region of anterior clinoid process, and to improve the therapeutic efficacy of clinoidal tumors.</p><p><b>METHODS</b>Twelve patients with large meningiomas located in clinoid were surgically treated via the extended anterior and middle fossa combined with epidural approach between January 1998 and August 2004. The surgical outcome and follow-up results were reviewed retrospectively. Supraorbital-posterional approach and cranioorbital zygomatic approach were used when tumors involved cavernous sinus. Anterior clinoid process was grinded with high-speed drilling. Supply of tumors were blocked extradurally. Tumors were resected intradurally.</p><p><b>RESULTS</b>Of the 12 cases in large meningiomas located in clinoid, 8 cases had total removal of tumors, 3 patients had subtotal removal. Of the 10 patients with pre-operative severe visual deterioration, 6 patients was markedly improved, one patient unchanged and one patient worsened post-operatively. No death was found in this group.</p><p><b>CONCLUSIONS</b>Using epidural approach for clinoidal meningiomas and grinding anterior clinoid process was advantageous to block tumors base blood supply and detach infraclinoidal tumors from internal carotid artery. Supraorbital-pterional approach could minimize brain retraction and was advantageous to expose superior pole of giant tumors.</p>