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Objective To investigate the clinical effect of endovascular interventional treatment of intracranial peripheral aneurysms. Methods From January 2013 to December 2016,the clinical data of 31 patients with intracranial peripheral aneurysm admitted to the Department of Neurosurgery,Anhui Provincial Hospital were analyzed retrospectively.Among them,12 patients had saccular aneurysms,10 had narrow-neck aneurysms,and 2 lacked clear aneurysm necks;19 patients had fusiform aneurysms,they all lacked clear aneurysm necks.Ten patients with narrow-neck saccular aneurysm were treated with coil embolization, of the 2 lacked clear neck saccular aneurysms,1 was treated with stent-assisted coil embolization,1 was treated with coil occlusion of the aneurysm and parent artery;4 patients with fusiform aneurysm were treated with coil occlusion of the aneurysms and parent arteries,11 with fusiform aneurysm were treated with Onyx glue occlusion of the aneurysms and parent arteries,and 4 with fusiform aneurysm were treated with coils in combination with Onyx glue occlusion of the aneurysms and parent arteries.They were followed up for 6 to 36 months after procedure. Results All patients were successfully treated with endovascular intervention,no rebleeding cases were found.Immediate postoperative angiography showed that 11 patients with saccular aneurysm were totally occluded.The aneurysms and parent arteries in 1 patient with saccular aneurysm and 19 with fusiform aneurysm were totally occluded.The aneurysms and parent arteries of 8 patients were occluded with Onyx glue,cranial CT revealed different degrees of cerebral infarction (6 patients without new neurological deficits,2 new neurologic deficits).CT revealed cerebral infarction in 1 patient treated with coils in combination with Onyx glue for occlusion of the aneurysm and parent artery(no new neurologic deficit),other patients did not have cerebral infarction and new neurologic deficits.DSA follow-up revealed aneurysm neck recurrence in 1 patient with saccular aneurysm,no obvious aneurysm recurrence was observed in all other patients. Conclusions Endovascular treatment of intracranial peripheral aneurysms is safe and effective.Choose what specific intervention therapy base on the aneurysm morphology,location, tortuous degree of the parent artery,and the importance of the blood supply area.
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ObjectiveTo explore the changes of degree attribute values and its significance of post-concussion syndrome (PCS) patients with tinnitus by the brain network research method based on graph theory.Methods34 PCS patients were chosen,including 17 PCS patients with bilateral tinnitus (PCS tinnitus group) and 17 PCS patients without tinnitus (PCS non-tinnitus group).Meanwhile,17 healthy individuals with the matched age,gender and educational background were recruited as the control.Degree attribute values of PCS patients with tinnitus were figured out with the brain network research method based on graph theory.Results(1)The degree attribute values of PCS patients without tinnitus at left orbital middle frontal gyrus (3.13±1.07),left thalamus (2.51±1.03),left superior temporal gyrus (3.67±1.31),right anterior cingulate cortex (3.13±1.25),right posterior cingulate cortex (2.13±1.08) and right supramarginal gyrus (4.46±1.35) were reduced compared with the control group (4.41±1.47,3.71±1.08,5.27±2.13,5.51±0.67,5.63±2.16 and 5.64±1.30) (P<0.05).The degree attribute values of PCS patients without tinnitus at left posterior cingulate cortex (5.87±1.06) and left gyrus lingualis (4.67±1.48) increased compared with the control group (4.41±1.46,3.21±1.27) (P<0.05).(2) The degree attribute values of PCS patients with tinnitus at left posterior cingulate cortex (3.37±1.54),left parahippocampal gyrus (3.41±1.62),left amygdala (2.25±1.43),left angular gyrus (4.17±1.02),left superior temporal gyrus (3.25±1.02),right thalamus (2.35±1.34),right Heschl gyri (3.97±1.62),right superior temporal gyrus (3.26±1.22),right cuneus (3.18±1.32) and right lingular lobe (3.26±1.42) were decreased,compared with the control group (4.41±1.46,5.27±2.13,3.71±1.08,5.63±2.61,5.64±1.30,3.43±1.33,5.63±2.16,5.13±1.64,5.51±0.67,4.24±0.63) (P<0.05).The degree attribute values of PCS patients with tinnitus at right posterior cingulate cortex (5.76±1.83),left MPFC (6.08±1.62) and right precuneus (6.08±1.06) were increased,compared with the control group (4.47±1.26,4.41±1.47,4.81±0.62) (P<0.05).(3)The degree attribute values of PCS patients with tinnitus at left MPFC,left amygdale,left parahippocampal gyrus,right Heschl gyri,right superior temporal gyrus,right cuneus and right lingular lobe were decreased,compared with PCS patients without tinnitus (P<0.05).The degree attribute values of PCS patients with tinnitus at right posterior cingulate cortex and left insular lobe increased,compared with PCS patients without tinnitus (P<0.05).ConclusionsPCS patients with tinnitus present the alteration of degree attribute in related brain network structure.The alteration in degree attribute of relevant brain zones in auditory system,limbic system and default network system may be important factors which result in tinnitus of PCS patients.
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Objective To analyze the influence factors for complete embolization of intracranial aneurysms. Methods The clinical data of 546 inpatients with single intracranial aneurysm underwent interventional embolization at the Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2013 to January 2017 were analyzed retrospectively. They were divided into either a complete embolization group (n=255) or a incomplete embolization group (n=291) according to the immediate embolism degree of aneurysms. Single factor,multiple factors logistic regression analyses were used to analyze the factors associated with complete embolization of intracranial aneurysms. Results Univariate analysis showed that there were significant differences in the rupture status,anatomical morphology,Hunt-Hess grade, aneurysm size and neck width, different treatment regimens, and aneurysm angle between the patients in the complete embolism group and the incomplete embolism group ( all P<0. 05). The results of multivariate regression analysis showed that aneurysm size ( OR,0. 344,95%CI 0. 204-0. 578,P<0. 01),aneurysm rupture status (OR,0. 568,95%CI 0. 314-0. 947,P=0. 030), embolism ways (OR,3. 699,95%CI 2. 223-6. 153,P<0. 01),neck width of aneurysm (OR,0. 326, 95%CI 0. 198-0. 539,P=0. 003),aneurysm angle (OR,0. 647,95%CI 0. 451-0. 928,P=0. 018),and aneurysm morphology (OR,1. 689,95%CI 1. 118-2. 552,P =0. 013) were the independent factors of affecting the complete embolization of intracranial aneurysms. Conclusion Tiny, unruptured, narrow-neck, small inclination angle,regular-shaped aneurysms,stent-assisted or balloon-assisted embolization of intracranial aneurysms are easier to embolize the aneurysms completely.
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Objective To analyze the influence factors for complete embolization of intracranial aneurysms. Methods The clinical data of 546 inpatients with single intracranial aneurysm underwent interventional embolization at the Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2013 to January 2017 were analyzed retrospectively. They were divided into either a complete embolization group (n=255) or a incomplete embolization group (n=291) according to the immediate embolism degree of aneurysms. Single factor,multiple factors logistic regression analyses were used to analyze the factors associated with complete embolization of intracranial aneurysms. Results Univariate analysis showed that there were significant differences in the rupture status,anatomical morphology,Hunt-Hess grade, aneurysm size and neck width, different treatment regimens, and aneurysm angle between the patients in the complete embolism group and the incomplete embolism group ( all P<0. 05). The results of multivariate regression analysis showed that aneurysm size ( OR,0. 344,95%CI 0. 204-0. 578,P<0. 01),aneurysm rupture status (OR,0. 568,95%CI 0. 314-0. 947,P=0. 030), embolism ways (OR,3. 699,95%CI 2. 223-6. 153,P<0. 01),neck width of aneurysm (OR,0. 326, 95%CI 0. 198-0. 539,P=0. 003),aneurysm angle (OR,0. 647,95%CI 0. 451-0. 928,P=0. 018),and aneurysm morphology (OR,1. 689,95%CI 1. 118-2. 552,P =0. 013) were the independent factors of affecting the complete embolization of intracranial aneurysms. Conclusion Tiny, unruptured, narrow-neck, small inclination angle,regular-shaped aneurysms,stent-assisted or balloon-assisted embolization of intracranial aneurysms are easier to embolize the aneurysms completely.
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Objective To investigate the influence of focal insular glioma on risky decision-making and to verify the causal relationship between insular and risky decision-making cognitive process.Methods 12 patients with focal insular glioma,15 healthy individuals and 15 lesion controls with brain glioma predominantly affecting non-insular lobes were tested with a risky decision-making task.The results were compared by statistical methods.Results The bet time (BT),report time (RT) and bet or report failure (F) of insular glioma patients were (1.61±0.06) s,(1.61±0.10) s and (2(2,3.75)) respectively.BT,RT and F of lesion controls were (0.70±0.11) s,(0.69±0.11s) and (0(0,0)) respectively and those of healthy group were (0.71 ±0.10) s,(0.68 ±0.11) s and (0(0,1)) respectively.Compared with normal subjects and lesion controls,BT and RT of insular glioma patients were significantly extended,and F was observably increased (P＜0.01).BT,RT and F of lesion controls had no significant difference compared with those of healthy group (P＞0.05).Conclusion The risky decision-making cognitive process may be influenced by insular glioma.The insular region plays a necessary role in decision-making under risk and insular causally is involved in risky decision making.
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Objective To explore the functional imaging alteration of dorsal attention network (DAN) between heroin addicts and heroin abstainers and probe into its influence on attentional function.Methods Attention-related neuropsychological assessments were applied to evaluate the difference of attentional function between heroin addicts and heroin abstainers.With the functional magnetic resonance imaging (fMRI) data obtained from 17 heroin addicts and 15 heroin abstainers at resting state,we extracted the DANs of heroin withdrawal group and heroin dependence group respectively by using independent component analysis (ICA) and analysed the differences of intra-group and inter-group,then correlation analysis was performed among brain areas which have significant difference between groups and Stroop interference effect test.Results Compared with the heroin dependence group,there was a better result of attentional function in the heroin withdrawal group (P＜0.05),especially at the digit span test(backward) (P=0.0363),digit symbol test (writing) (P =0.0195),Stroop test C (reaction) (P =0.0379),Stroop test C (error) (P=0.0014) and Stroop interference effect test (P=0.0002).Neuroimaging findings demonstrated that there was a similar DAN in the heroin withdrawal group and heroin dependence group which mainly included the bilateral intraparietal suleus,postcentral gyrus and frontal eye field.Compared with the DAN of heroin addicts,significantly enhanced functional connectivity within the DAN of heroin abstainers was observed in the left superior parietal lobule (MIN:-24,-75,48),right inferior parietal lobule (MIN:39,-54,45) and left inferior parietal lobule (MIN:-33,-51,57).Significant negative correlations were observed between these brain areas and Stroop interference effect test in the heroin dependence group (r=-0.79,-0.69,-0.64,P＜0.01),but not in the heroin withdrawal group.Conclusions Heroin addiction can impair attentional function,compared with the DAN of heroin addicts,significantly enhanced functional connectivity in the left superior parietal lobule as well as bilateral inferior parietal lobule are observed in the heroin abstainers at resting state,which may be one of the neural mechanisms of attentional function improvement.
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Objective To investigate the relationship between impulsive behaviors and the errorrelated negativity (ERN) component of event-related potentials of error processing in heroin addicts.Methods Using the paradigms for psychological experiment,the Iowa gambling task (IGT) was performed both in heroin addiction group (HA group,20 cases) and healthy control group (HC group,20 cases),and the inspection of electroencephalography was underwent in all subjects concurrently.Following the collection of data,the amplitude and latency of ERN were compared between the two groups,and then the relationship between the amplitude of ERN and the scores of Barratt Impulsiveness Scale (BIS-11) was analyzed separately.Results Decision-making course had no effect on the net score remarkably in HA group (F =1.21,P ＞0.05).Compared with HC group(64.3 ±8.4,73.8 ± 16.4),BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group(75.2 ±7.6,105.5 ±22.2; t =-5.39,-9.24 ; P ＜ 0.05),while both the two groups had visible waveforms of ERN,and the amplitude was markedly lower in HA group(HA:(4.23 ±0.87) μV,HC:(6.11 ± 1.09) μV; t =5.96,P ＜0.05),but no statistical difference was found in latency of these two groups(HC:(102.1 ±28.2) ms,HA:(107.8 ±24.2) ms;t =-0.62,P =0.54),and the amplitude of the two groups was negatively associated with BIS score respectively in both two groups (HC:r =-0.66,HA:r =-0.78 ; both P ＜ 0.05).Conclusion The reduced capability of error processing maybe partly contribute to both addiction and relapse to heroin addict,and the ERN event-related potential could be regarded as an indicator of impulsive behaviors and the capability error processing.
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Objective To discuss the reoperation method for recurrent pituitary apoplexy after the successful initial transnasal-sphenoidal surgery.Methods Twenty-one patients with pituitary apoplexy were found recurrence after previous tumor resection via transsphenoidal surgery in 9 months to 5 years.In the reoperation,transsphenoidal approach would be still used.The anterior wall of sphenoid sinus and the sellar floor were located accurately,and then the remnants of them were removed as large as possible to expand the range of bone window.Next,the intrasellar hematoma was cleared away gently,and the residual tumor was removed progressively and thoroughly to make sure the sellar diaphragm subsiding fully and finally removed the whole tumor.Results Most of recurrent tumors were found to be of soft texture with rich blood supply,and 17 cases were still apoplexy.In 18 cases of the 21 patients,total resection was achieved.However,for the other 3 cases with tumor aggressive growth,only massive resection was achieved,and underwent stereotactic radiosurgery postoperatively.Postoperative clinical symptoms were alleviated in 15 cases,whose hormones were also decreased.Temporary diabetes insipidus and hypopituitarism appeared in 5 and 3 cases respectively,but all of these postoperative complications were relieved after symptomatic treatment.Two cases of intraoperative cerebrospinal fluid leakage were resolved by packing the cavity with muscle and fat flaps.All cases were followed up for 3 months- 5 years,residual tumor enlarged in only 1 case of massive resection,which umderwent transsphenoidal surgery for the third time,no other cases recurred.Conclusion Operation via the transsphenoidal approach of recurrent pituitary apoplexy after successful initial transsphenoidal surgery could achieve high total resection rate.While the accurate locating,full expansion of the saddle bone window,and repeatedly scraping the apoplexy tumor to get a full subsidence for the sellar diaphragm,are the key points to remove tumors totally as well as to improve the symptoms.
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Objective To investigate the characteristic of P30o event-related potentials(ERP) of impulsive behavior in heroin addicts.Methods The Iowa gambling task (IGT) were performed by using the paradigm for psychological experiment both in heroin addiction group (HA group) and health control group (HC group),the inspection of electroencephalography were underwent in all the subjects concurrently.Following the collection of data of ERP,amplitude and latency of P300 were compared between the two groups,and then the relationship betweenamplitude or latency of P300 and the results of Barratt impulsiveness scale were analyzed separately.Results Compared to HC group,BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group ( HA:75.12 ± 12.49,91.14 ± 21.35 ; HC:66.54 ± 8.61,73.71 ± 18.91 ; P ＜ 0.05 ),while the both two groups had visible waveforms of P30o,and the amplitude and latency were markedly lower ( HA:4.92 ± 1.14,293.43 ± 36.21 ; HC:7.65 ± 1.59,332.68 ± 40.15 ; P ＜ 0.05 ) and were negatively associated with BIS score in HA group( r =-0.76,-0.52,P＜ 0.05).Logistic regression results showed that the scores of BIS-11 were related to amplitude of P30o merely( P ＜ 0.05 ).Conclusion Impulsive behavior can be observed from the abnormal characteristic of the P300 event-related potential of impulsive behavior in heroin addicts,which may partly contribute to both addiction and relapse of heroin addict.
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Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years (6.5 ± 1.5 months). MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal invasion are critical for the operation safety.
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BACKGROUND: Cell cycle has proved that about 90% stem cells were in resting state in the G0 phase; therefore, serum deprivation method which did not contain any growth factors and related nutrition additive was beneficial for separating glioma stem cells.OBJECTIVE: To explore the method of serum deprivation to culture glioma cell lines U87, and to isolate and identify the cancer stem cells which are in the U87 cell lines. METHODS: U87 cells were cultured in the medium containing both DMEM and L-glutamine for six days; cancer stem cells would be screened out; then the medium was changed for the neural stem cell culturing medium. The formation of tumor spheres and their differentiation characteristics were observed when they were inoculated onto serum-containing medium. The immunofluorescence staining of cells was employed to identify the surviving cells cultured in serum deprivation medium, tumor spheres and differentiated cells. RESULTS AND CONCLUSION: The serum deprivation method was used to select tumor stem cells successfully which expressed CD133 and could form tumor spheres. The tumor spheres had an ability of multi-differentiations, and the daughter cells expressed glial fibrillary acidic protein and neuron specific enolase. The U87 cell lines exist glioma stem cells which have the capacities of self-renewal and multi-differentiation.
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BACKGROUND: PEX gene can interfere with the invasion acts of malignant glioma. Bone marrow mesenchymal stem cells (MSCs) are a new type of targeted cell vector on cancer therapy. OBJECTIVE: To construct MSCs stably expressing PEX gene.METHODS: PEX eukaryotic expression vector was constructed by molecular cloning, and identified the recombinant plasmid pcDNA3.1(+)-PEX by restriction endonuclease digestion and sequencing. After transfected with MSCs, the eukaryotic expression vector expression in MSCs was verified by immunocytochemical method. The MSCs stably expressing PEX was established by G418 selection, and then was detected by using reverse transcriptase-polymerase chain reaction.RESULTS AND CONCLUSION: The MSCs stably expressing PEX gene is successfully established, in which PEX gene is highly expressed at both gene level and protein level.
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BACKGROUND:Bone marrow mesenchymal stem cells(MSCs)are a kind of adult stem cells with multi-potential differentiation property.At present,it has served as cell carrier for the treatment of Parkinson's disease.OBJECTIVE:To construct pDsRed-C1-CDNF eukaryotic expression vector and induce its expression in rat MSCs.METHODS:CDNF gene was amplified from mouse tissues using RT-PCR,and sequence with Xho I,BamHI restriction enzyme cutting site.The CDNF gene was inserted into the eukaryotic expression vector pDsRed-C1 encoding red fluorescent protein gene.The plasmid pDsRed-C1-CDNF was constructed and transfected into rat bone marrow MSCs.RESULES AND CONCLUSION:The pDsRed-C1-CDNF recombinant plasmid was confirmed by double digestion of Xho I and BamHI restriction enzyme or single digestion of BamHI,and PCR sequence.Results show that the recombinant pDsRed-C1-CDNF eukaryotic expression vector was successfully constructed.
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Objective To investigate the application of neurophysiological monitoring and microsurgi-eal technique in acoustic neurinoma resection, exploring the significance of neurophysiological monitoring in facial and auditory nerve reservation of acoustic neuronma microsurgery. Methods Accompanied with EMG and BAEP nerve monitoring, 113 patients harboring acoustic neuroma were treated surgically by the subocipi-tal retrosigmoid approach for reserving facial and auditory nerve. The facial nerve was stimulated to evaluate its function during late-operation. Postoperative facial and auditory nerve function were valuated in all the postop-erative following up. Results All of them were treated microsurgically via the suboccipitai retrosigmoid ap-proach. Total tumors resection was achieved in 102 cases (90.3%), subtotal resection in 6 cases(5.3%) and partial resection in 5 case (4.4%). The facial nerve was preserved anatomically in 98 cases (86.7%), the functional valuation of facial nerve according to the House-Brakman (H-B) postoperatively: 86 cases (76.1%) in class Ⅰ -Ⅱ , 12 cases(lO.6%) in class Ⅲ-Ⅳ and 15 cases (13.3%) in class Ⅴ-Ⅵ. The acoustic nerve was preserved anatomically in 40 cases (35.4%). It denoted the good function of facial nerve responsing sensi-tively to electrostimulation ≤ 4mA at the end of operation. Conclusion Assisted with the intraoperative electrophysiological monitoring techniques, it would be greatly facilitate the preservation of facial and auditory nerve in acoustic neuroma resection. Simultaneously, it would valuate the functional convalescence by late-op-erative electrostimulation in the postoperation.
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Objective To explore further the abilities of cerebellar lesions in skills of time estimation, and to test the hypothesis that cerebellum is involved in the special network of time perception. Methods Time reproduction was required for 3 time intervals of 600-milliseconds, 3 and 5 seconds with visual discrimination for control. Participants reproduce those time intervals after 1-second or 5-seconds of delay. Twenty-six patients with cerebellar lesions were compared to 26 healthy controls, matched for age, handedness, education. Results 600-milliseconds was overestimated by both cerebellar lesions and healthy controls, however, both 3-seconds and 5-seconds were underestimated. Patients with cerebellar lesions were significantly impaired on 600-milliseconds reproduction task ( delaying 1 s or 5 s, 1.37 ± 0.24, 1.26 ± 0.29 respectively, Z=-5.347, -4.230, both P<0.01). No group differences were found for the 3-seconds and 5-seconds time reproduction (delaying 1 s or 5 s, Z=-1.200,-0.092,-1.519, -0.723, all P>0.05). Conclusion The findings suggest that patients with cerebellar lesions perform poorly during measurement of the shorter interval, but show no impairment of longer intervals perception, supporting the hypotheses that cerebellum is specifically involved in the perception of sub-second intervals.
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Objective To investigate the relationship between the grade of gliomas and the status of adjacent fiber tract with DTL Methods MRI and DTI were performed in 24 patients with histologically confirmed brain gliomas.Regions of interest were placed in the white matter adjacent to the tumor with the lowest FA(Faa) and in the white matter of the contralateral hemisphere(Fac).The values of Faa and Fac were measured.In the regions of the same slice, the values of ADCa and ADCc were measured. Relative fractional anisotropy ratios (rFA) and relative apparent diffusion coefficient ratios (rADC) were also calculated.The status of fiber tracts adjacent to the gliomas were characterized as displacement, infiltration or disruption.Fiber tracking using the Fiber Assignment by Continuous Tracking (FACT) method was performed to investigate the integrity of white matter tracts in the surrounding border zone of the gliomas.The correlation of rFA, rADC, the state of adjacent fiber tracts, and the grade of gliomas were analyzed statistically by using independent sample t test and tendency X2 test.Results Eleven of the 24 tumors were demonstrated as low grade gliomas (WHO grade Ⅰ-Ⅱ) and 13 were high grade giiomas (WHO grade Ⅲ-Ⅳ).The average rFA and rADC of the low grade gliomas were 0.65±0.19 and 1.43 ± 0.50 respectively.Most of fiber tracts in the periphery of the low grade gliomas were displaced or infiltrated.The average rFA and rADC of the high grade gliomas were 1.51 ± 0.39 and 1.70 ±0.27 respectively.Most of fiber tracts in the periphery of the high grade gliomas were infiltrated or disrupted.Significant difference was found for rFA (t =8.504,P =0.000) and but not for rADC(t = - 1.435 ,P =0.165) between low grade and high grade gliomas.Significant difference existed between the state of fiber tracts adjacent to ghomas and low and high-grade(X2 =5.882 ,P =0.015).Conclusions The malignancy of gliomas influences the state of fiber tracts in the vicinity of tumors, rFA can serve as a reference for distinguishment of high-grade and low-grade gliomas.DTI can depict the localization of gliomas and the adjacent fiber tracts.The state of fiber tracts can also be identified by DTI.It is helpful for the therapeutic plan of the tumors.
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Objective To analysis the therapeutic effect of microsurgery through single-nostril transsphenoidal approach on pituitary adenomas and to study the surgical skill and postoperative complications about microsurgery for pituitary adenomas.Methods The clinical manifestations,pathological type, removal percentage,postoperative complications and follow-up data of 241 cases with pituitary ademoma by microsurgery through single-nostril transsphenoidal approach were analysed retrospectively.Results 171(7 1%)cases were achieved total tumor removal,28(11.6%)cases were achieved subtotal tumor removal,26(10.7%)cases were achieved most tumor removal and 16(6.6%)cases were achieved partial tumor removal.Most of patients achieved better results,however there were 38(15.8%)eases with diabetes insipidus,12(4.9%)cases with transient worse sight,4(1.6%)cases with cerebrospinal fluid leakage,2(0.8%)cases with oculomotor paralysis,and no death.The postoperative complications were cured and outcome was considered as good.The follow-up period was 1-36 months in 241 patients and the clinical symptoms were improved by different degrees.Conclusion Pituitary adenomas can be treated by microsurgery through single-nostril transsphenoidal approach due to the time of operation shorten,the postoperative complications.
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Objective To provide microanatomic basis for direct microsurgical operation on the region of Dorello's canal. Methods The structures of the region of Dorellos canal were observed and measured on 30 sides of adult cadaverical heads under microscope. Results ①Dorello's canal was an osteofibrous canal composed of Gruber ligament, petrous apex and the lateral border of the upper part of clivus. The roof of Dorello's canal was mainly composed of Gruber ligament. The maximal distance from roof to bottom of Dorello's canal was 2.14 mm±0.70 mm. ②Abducens nerves passed through the lateral 1/3(56.7%) or intermedial 1/3(43.3%) of Dorello's canal to the cavernous sinus. The nutrient arteries of abducens nerves were originated from the dorsal meningeal arteries, and 83.3% of them traversed Dorello's canal by one stem, medially to abducens nerves. ③The point of abducens nerves entering cavernous sinus was 3.97 mm±1.83 mm posterior to the ascending portion of intracavernous carotid artery, 3.11 mm±0.95 mm medial to the Meckel's cave. Conclusion In the region of Dorello's canal, the positions of abducens nerves and their nutrient arteries are steady, and they should be protected during operation.
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0.05). The rFA2 values were higher and rFA3 were lower in high grade gliomas than that in low grade and had significant difference (respectively t=2.453, P
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The microangioarchitecture of human thalamus was studied by the ink-gelatin injection, thick section transparency, histochemical staining and methacrylate cast under the stereoscope and scanning electron microscopy. There were some impressions of smooth muscular cells on the arteriole, precapillary arteriole, origin of capillary, larger venule, and converging region of each venula. Some circular impressions presented at the course of capillary regularly and discontinuously, which might be caused by contraction of pericytes of capillary. The microvascular anastomoses were rich and complex. Besides capillary anastomoses of different shape, there were many anastomoses occurred between two arterioles, or between several arterioles. The form of venular anastomoses was similar to arterioles. The anastomosis between arteriole and venule was observed occasionally. The relationship of characteristic of vertical branches of arterioles to thalamic hemorrhage was discussed.