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Objective To investigate the application of 1H-MR spectroscopy in predicting the value of each grade range and grading of glioma invasion. Methods A restrospective analysis was conducted on the preoperative biopsy or posoperative pathology confirmed glioma in 33 cases. Cerebral gliomas were graded into four categories based on the stan?dard of WHO(2007):grade I, II, III andⅣ. All patients underwent MRI and 1H-MR spectroscopy before operation. The 1H-MR spectroscopy analysis was used to analysis metabolite NAA,Cho,Cr and NAA/Cho, NAA/Cr, Cho/Cr in the tu?mor area, peritumoral region and normal area. Results 1H-MRS revealed that there were no significantly differences in Cho, Cho/Cr, NAA/Cho between the peritumoral region and tumor area of grade I glioma (P<0.025). However, there were significantly differences in Cho, Cr, NAA/Cho, Cho/Cr ratio between peritumoral region and the normal brain tissue of grade I glioma (P<0.025). There were significantly differences in NAA, NAA/Cho, NAA/Cr ratio between peritumoral re? gion and the tumor area of grade II glioma (P<0.025). There were statistically significantly differences in Cho, NAA, Cr, NAA/Cho, NAA/Cr, Cho/Cr ratio between the peritumoral region and normal brain tissue of Grade III orⅣglioma (P<0.025). The ratio of Cho/Cr and NAA/Cho were correlated with the pathological grade(F values were 403.9 and 159.46, P<0.05), and the ratio of NAA/Cr and NAA/Cho were decreased gradually whereas the ratio of Cho/Cr was gradually in?creased(F=119.91,P<0.05). Conclusion The 1H-MR spectroscopy analysis has a predictive value in evaluating the lev?el of glioma invasion and determining the grading of glioma before surgery, which is very helpful for the surgical plan and the scope of resection, thereby reducing the recurrence and prognosis of the patients after surgery.
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Objective To investigate the diagnosis and the causes of misdiagnosis of skull base chondrosarcoma.Methods The clinical data of 7 cases of skull base chondrosarcoma confirmed by pathology from April 2009 to February 2014 were analyzed retrospectively.Results Only 1 case of preoperative diagnosis was correct in 7 cases of skull base chondrosarcoma, other 6 cases were misdiagnosed, of which 2 cases were misdiagnosed as trigeminal schwannoma, 3 cases were misdiagnosed as chordoma, 1 case was misdiagnosed as meningioma,the misdiagnosis rate was 85.7％.Conclusion Chondrosarcoma of the skull base is rare, so clinicians are lack of knowledge, and non-characteristic clinical features and non-characteristic radiographic manifestations contribute to misdiagnosis.Strip calcification on CT and honeycomb reinforced on enhanced MRI existing at the same time,which prompts to diagnosis chondrosarcoma of the skull base.
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BACKGROUND:Matrix protein is an essential component of the vascular wal , provides a necessary frame for the integrity of the vessel wal and physiological function of vascular wal cel s, and regulates cel s and smooth muscle. OBJECTIVE:To construct rat model of early aneurysm, and to evaluate differences in the expression of matrix structural proteins during cerebral aneurysm formation. METHODS:Twenty-eight healthy male Sprague-Dawley rats were randomized into control group (n=8) and model group (n=20). Aneurysm model was established by ligation of the left common carotid artery and right renal artery-induced hypertension in the model group. In the control group, only the left carotid artery bifurcation and bilateral carotid were exposed in rats. Rats in the model group were sacrificed at 15 and 30 days after model establishment. Right anterior cerebral artery in rats and olfactory artery bifurcation received immunohistochemical staining. The expressions of fibronectin,α-smooth muscle actin and col agen III were analyzed. RESULTS AND CONCLUSION:Compared with the control group, no significant difference in fibronectin expression was detected in right anterior cerebral artery and olfactory artery bifurcation in rats of the model group at 30 days after model establishment (P>0.05). However,α-smooth muscle actin and col agen III expressions were significantly reduced (P<0.05). These data confirmed that expression of structural proteins had differences and dynamic changes during early aneurysm formation in rats. Degradation of matrix structural protein in cerebral artery may be one of the key mechanism of aneurysm formation.
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BACKGROUND:Vascular endothelial growth factor and transforming growth factor play a crucial role in embryonic development, wound healing, inflammation, cancer, ischemic hypoxia and other physiological and pathological processes, and participate in the development and progression of brain damage. OBJECTIVE: To evaluate the differences in the expression of vascular endothelial growth factor and transforming growth factor-α during the early phase of cerebral aneurysm formation in rats. METHODS:Twenty-eight healthy Sprague-Dawley rats were randomized into three groups. Sham operation group (n=8): the left carotid artery bifurcation and bilateral renal artery were only exposed, without ligation, and rats were kiled that day. 15 days group (n=10) and 30 days group (n=10): the left common carotid artery, internal carotid artery, external carotid artery and bilateral renal artery were ligated, to establish aneurysm model, and rats were kiled at 15 and 30 days, respectively. The bilateral sides of the anterior cerebral artery/olfactory artery bifurcations were harvested and observed under light microscopy for pathological changes. Immunohistological staining was performed to detect the expression of vascular endothelial growth factor and transforming growth factor-α. RESULTS AND CONCLUSION:The results showed that, no aneurysm formed in the sham operation group and 15 days group. In the 30 days group, one saccular aneurysm and five early aneurysm-like changes were found in the right anterior cerebral artery/olfactory artery bifurcations. In the sham operation group and 15 days group, no vascular endothelial growth factor was expressed. In the 30 days group, the positive rate of vascular endothelial growth factor was up to 80%, indicating that vascular endothelial growth factor is possibly involved in the formation of aneurysm. Transforming growth factor-α expression in the sham operation group and 15 days group was more apparent than that in the 30 days group, indicating that transforming growth factor-α is damaged or secretion is reduced in this process, which was possibly related to the formation of aneurysm.
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ObjectiveTo compare the effects of cardiovascular reaction after laryngeal mask and endotracheal intubation in patients of epidural anesthesia combined with surgery and a comparative analysis of the oral secretions volume.MethodsChoose elevcitce general anesthesia associated with epidurdl opuo cases.Randomly divided into 2 groups:laryngeal mask airway group and endotracheal intubation set,each group 20 coses.Records before each group of patients with laryngeal mask airway or endotracheal intubation( T1 ),after induction( T2 ),1 minute( T3 ),3minute ( T4 ),intraoperative ( T5 ),remove cover(pipes) ( T6 ),to pull over and over 1 minute ( T7 ) and remove cover ( pipes )after 3minute(T8) SBP,DBP,HR,SpO2.ResultsLaryngeal mask or tracheal intubation prior to SBP,DBP,HR was not very different.Prior to extubation T6,T7,T8 of the SBP,DBP,HR between the two groups had significant differences The tracheal intubation group showed that the group with more than the larYngeal mask group.Particularly T6 endotracheal intubation group SBP ( 138 ± 35 ) mm Hg,DBP ( 92 ± 16) mm Hg,HR ( 96 ± 19 )/min showed higher LMA T6 group.ConclusionLaryngeal mask airway affects slightly effect on cardiovascular system in patients.LMA intubation could be achieved with satisfactory ventilation of the same tracheal intubation.LMA with hemodynamic stable,easy to operate,simple,throat discomfort,hoarseness of low.Laryngeal mask airway group was less than the amount of oral secretions endotracheal intubatior group and so on.