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Pesticides' overuse and misuse have been reported to induce ingredient variations in herbal medicine, which is now gaining attention in the medicinal field as a form of alternative medicine. To date, available studies on pesticide-induced ingredient variations of herbal medicine are limited only on a few compounds and remain most others unexamined. In this study, a plant metabolomics-based strategy was performed to systematically explore the effects of two frequently used insecticides on the comprehensive constituents of Lonicerae Japonicae Flos (LJF), the flower buds of Lonicera japonica Thunb. Field trials were designed on a cultivating plot of L. japonica with controls and treatments of imidacloprid (IMI) and compound flonicamid and acetamiprid (CFA). Unbiased metabolite profiling was conducted by ultra-high performance liquid chromatography/quadrupole-Orbitrap mass spectrometer. After data pretreatment by automatic extraction and screening, a data matrix of metabolite features was submitted for statistical analyses. Consequently, 29 metabolic markers, including chlorogenic acids, iridoids and organic acid-glucosides were obtained and characterized. The relative quantitative assay was subsequently performed to monitor their variations across flowering developments. This is the first study that systematically explored the insecticide-induced metabolite variations of LJF while taking into account the inherent variability of flowering development. The results were beneficial for holistic quality assessment of LJF and significant for guiding scientific use of pesticides in the large-scale cultivation.
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Objective: To observe the clinical efficacy of kidney tonifying and essence strengthening method in delaying physiological vascular aging. Method: Sixty-two subjects who completed the study were randomly divided into experimental group (31 cases) and control group (31 cases) with the matching research method. The experimental group was treated with kidney tonifying and essence strengthening recipe orally for 24 weeks, while the control group was not interfered with traditional Chinese medicine (TCM). Score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity, intima-media thickness, plasma homocysteine level and serum superoxide dismutase level were evaluated before and after treatment. Result: Compared with before treatment period, the score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity and plasma homocystenine level decreased, while the serum superoxide dismutase level increased in the experimental group after treatment (PPPPPConclusion: The kidney tonifying and essence strengthening method may delay the aging of physiological blood vessels caused by aging.
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Objective To investigate the relationships among resilience, perceived social support and acute stress reaction of naval soldiers. Methods Connor-Davidson resilience scale (CD RISC), perceived social support scale (PSSS) and the military acute stress scale (MASS) were used to investigate 1 348 naval soldiers. The relationships among the involved variables were analyzed by structural equation model. Results Perceived social support was positively correlated with resilience in the participants (P<0. 01). and both resilience and perceived social support were negatively correlated with the military acute stress reaction (P<0. 01); both of them could independently explain the variance of acute stress reaction of navy soldiers, in which strength (β = -0. 136, P<0. 01) and external family support (β = -0. 229. P< 0. 01) had significant negative predictive effects on military acute stress reaction. The mediating effect of resilience was significant between military acute stress reaction and perceived social support, accounting 16. 22% of the total effect. The model fitting was good: χ2/df = 27. 91/ 11 = 2. 537, P = 0.003; root mean square error of approximation (RMSEA) = 0. 032, comparative fit index (CFI) =0. 997 and goodness-of-fit index (GFI) = 0. 994. adjusted goodness of fit index (AGFI) =0.986, normed fit index (NFI) =0. 995, relative fit index (RFI) = 0. 986, incremental fitness index (IFI) = 0. 997 and Tucker-Lewis Index (TLI) = 0. 992. Conclusion Perceived social support has direct effect on acute stress reaction of navy soldiers, and it also has indirect influence on the acute stress reaction through the mediating effect of resilience.
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<p><b>OBJECTIVE</b>To detect the expression of miR-124 in colorectal carcinoma (CRC) cells and tissue specimens and analyze its association with the radiosensitivity of the cells.</p><p><b>METHODS</b>The expression of miR-124 in CRC cell lines and tissues were detected using qRT-PCR. The effect of miR-124 in modulating cell radiosensitivity was assessed in CRC cells with miRNA-124 overexpression and miRNA-124 knockdown, and bioinformatics prediction and dual luciferase reporter system were employed to identify the direct target of miR-124.</p><p><b>RESULTS</b>s miR-124 expression was down-regulated in CRC cell lines and tissues. CRC cells over-expressing miR-124 showed an obviously enhanced radiosensitivity, whereas miR-124 knockdown resulted in a reduced radiosensitivity of the cells. Bioinformatics prediction and dual luciferase reporter system verified PRRX1 as a direct target of miR-124, which regulated the radiosensitivity of CRC cells by directly inhibiting PRRX1.</p><p><b>CONCLUSION</b>miR-124 can enhance the radiosensitivity of CRC cells by directly targeting PRRX1, which provides a target for improving the therapeutic effect of radiotherapy of CRC.</p>
Subject(s)
Humans , Cell Line, Tumor , Colorectal Neoplasms , Pathology , Radiotherapy , Down-Regulation , Gene Expression Regulation, Neoplastic , Homeodomain Proteins , Genetics , Metabolism , Luciferases , MicroRNAs , Genetics , Metabolism , Radiation ToleranceABSTRACT
This paper aims to establish a method for the determination of sulfur dioxide in sulfur fumigation Chinese herbs. Sample powder and hydrochloric acid solution were isolated by paraffin layer in order to avoid early reactions, with the generation of sulfur dioxide, headspace with airtight needle was used to transfer sulfur dioxide into gas chromatograph, and detected with thermal conductivity detector. The analytical performance was demonstrated by the analysis of 12 herbs, spiked at four concentration levels. In general, the recoveries ranging from 70% to 110%, with relative standard deviations (RSDs) within 15%, were obtained. The limit of detection (LOD) was below 10 mg x kg(-1). Standard addition can be used for low recovery samples. The method is simple, less time-consuming, specific and sensitive. Methods comparison revealed that gas chromatography is better than traditional titration in terms of method operability, accuracy and specificity, showing good application value.
Subject(s)
Chromatography, Gas , Methods , Fumigation , Limit of Detection , Plants, Medicinal , Chemistry , Sulfur , Chemistry , Sulfur DioxideABSTRACT
This paper aims to establish a method for the determination of sulfur dioxide in sulfur fumigation Chinese herbs. Sample powder and hydrochloric acid solution were isolated by paraffin layer in order to avoid early reactions, with the generation of sulfur dioxide, headspace with airtight needle was used to transfer sulfur dioxide into gas chromatograph, and detected with thermal conductivity detector. The analytical performance was demonstrated by the analysis of 12 herbs, spiked at four concentration levels. In general, the recoveries ranging from 70% to 110%, with relative standard deviations (RSDs) within 15%, were obtained. The limit of detection (LOD) was below 10 mg x kg(-1). Standard addition can be used for low recovery samples. The method is simple, less time-consuming, specific and sensitive. Methods comparison revealed that gas chromatography is better than traditional titration in terms of method operability, accuracy and specificity, showing good application value.
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OBJECTIVE: To study the multi-residues detection methods for Astrgalus membranaceus by GC-MS/MS. METHODS: The extraction was performed by modified QuEChERS method, and then cleaned by PSA solid phase extraction (SPE) cartridge. The residue detection was carried out by GC-MS/MS, which could identify and quantify pesticide simultaneously. RESULTS: The analytical performance was validated by recovery experiments that were fortified at three levels for each pesticide. In general, the recoveries ranged from 70% to 120% and the relative standard deviations (RSDs) were all less than 15%. The limits of detection (LODs) for most of the selected pesticides were below 0.01 mg · kg-1. CONCLUSION: The method shows high sensitivity, good repeatability and satisfactory cleaning-up excellence, which could be applied to the pesticide residue detection for Astrgalus Membranaceus. Copyright 2012 by the Chinese Pharmaceutical Association.
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The paper is to report the establishment of a method for the determination of multi-residue organochlorine and pyrethroid pesticides in traditional Chinese medicines (TCMs). Fifty-six pesticides were extracted by high-speed homogenization, and then purified through gel permeation chromatography (GPC) and solid phase extraction (SPE) cartridges. The residues were simultaneously identified and quantified by GC-ECD equipped with dual tower, dual column and two micro-ECD detectors. The analytical performance was demonstrated by the analysis of 3 TCMs samples' extracts, spiked at three concentration levels for each pesticide. In general, the recoveries ranging from 70% to 110%, with relative standard deviations (RSDs) better than 15%, were obtained. The limit of detection (LOD) for most of the targeted pesticides tested was below 0.01 mg kg(-1). The method had good extraction efficiency, purification effect and good reproducibility, which could be applied to the determination of organochlorine and pyrethroid pesticide residues in the routine analysis of TCMs.
Subject(s)
Chromatography, Gas , Methods , Chromatography, Gel , Drug Contamination , Drugs, Chinese Herbal , Chemistry , Hydrocarbons, Chlorinated , Limit of Detection , Pesticide Residues , Pyrethrins , Reproducibility of Results , Solid Phase ExtractionABSTRACT
AIM:To study a method for the determination of 13 N-methylcarbamate peticides in traditional Chinese herbal medicines(TCHMs).METHODS:Thirteen pesticides were extracted by acetonitrile,and purified through solid phase extraction(SPE)cartridges,then detected by HPLC with post-column derivatization and Fluorescense Detector excited wavelength was 330 nm,emissive wavelength was 465 nm.RESULTS:The analytical performance was demonstrated by the analysis of 6 TCHMs samples' extracts,spiked at three concentration levels for each pesticide.In general,the recoveries ranging from 74.1 to 108.8%,with relative standard deviations(RSDs)better than 15%,were obtained.The limit of quantification(LOD)of 13 pesticides from 0.000 3 to 0.06 mg/kg.CONCLUSION:The method has good extraction efficiency and purification effect,which could be standard of N-methylcarbamate peticides residues in the routine analysis of TCMs.
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The paper is to report the establishment of a method for the determination of multi-residue organochlorine and pyrethroid pesticides in traditional Chinese medicines (TCMs). Fifty-six pesticides were extracted by high-speed homogenization, and then purified through gel permeation chromatography (GPC) and solid phase extraction (SPE) cartridges. The residues were simultaneously identified and quantified by GC-ECD equipped with dual tower, dual column and two micro-ECD detectors. The analytical performance was demonstrated by the analysis of 3 TCMs samples' extracts, spiked at three concentration levels for each pesticide. In general, the recoveries ranging from 70% to 110%, with relative standard deviations (RSDs) better than 15%, were obtained. The limit of detection (LOD) for most of the targeted pesticides tested was below 0.01 mg kg(-1). The method had good extraction efficiency, purification effect and good reproducibility, which could be applied to the determination of organochlorine and pyrethroid pesticide residues in the routine analysis of TCMs.
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<p><b>OBJECTIVE</b>To observe the therapeutic effect of Shenyin Oral Liquid (SOL) in relieving mild cognitive impairment (MCI) and decreasing the Alzheimer's disease (AD) transformation rate.</p><p><b>METHODS</b>One hundred and seventeen MCI patients were randomly assigned to the Chinese medicine group (42 cases), the vitamin E group (38 cases) and the placebo group (37 cases). The treatment course was 12 months and a 6-month follow-up was conducted after ending the treatment course.</p><p><b>RESULTS</b>After treatment, the scores of clock drawing test (CDT), nonsensical figure recognition and mini-mental state examination (MMSE) raised significantly in the Chinese medicine group (P < 0.05 or P < 0.01), the activity of acetylcholine esterase in erythrocytic membrane was lower in the Chinese medicine group than that in the placebo group and the Vitamin E group (P < 0.05 or P < 0.01). Six months after the treatment, there were 2 and 5 cases in the placebo group and the vitamin E group which were diagnosed as AD, respectively, and none in the Chinese medicine group.</p><p><b>CONCLUSION</b>SOL has an effect similar to cholinesterase inhibitor, it could improve cognitive function in MCI patients and reduce the AD transformation rate in them.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease , Cognition Disorders , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Memory , Mental Status Schedule , Nootropic Agents , Therapeutic Uses , Phytotherapy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To research the mechanism of TX0201 abstracted from heart-regulating formula in the treatment of rat with Alzheimer's disease (AD).</p><p><b>METHOD</b>The rat models of AD were induced by A beta(1-40) injected into the bilateral amygdale. All rats were divided into five groups at random, namely control group, model group, heart-regulating formula group, TX0201 group and aricept group. The rats were intragastrically treated with different solution respectively for 20 days. The effect of TX0201 on spatial learning and memory ability of these rat models was investigated with the method of Morris water maze. By using the method of RT-PCR, the expression of apoptosis associated genes (such as Bcl-2 and Bax) in cerebral cortex and hippocampus of rats were examined.</p><p><b>RESULT</b>Heart-regulating formula, TX0201 and aricept could significantly improve the spatial learning and memory ability of rats. Heart-regulating formula could comprehensively redress the abnormal expression of Bax mRNA and Bcl-2 mRNA in cerebral cortex and hippocampus. TX0201 could rectify the abnormal expression of Bax mRNA in cerebral cortex and hippocampus. Aricept could regulate the abnormal expression of Bax mRNA in cerebral cortex.</p><p><b>CONCLUSION</b>TX0201 could ameliorate the learning and memory ability of these model rats by alleviating neuron apoptosis by means of regulating the abnormal expression of Bax mRNA in brain.</p>
Subject(s)
Animals , Male , Rats , Alzheimer Disease , Genetics , Amyloid beta-Peptides , Apoptosis , Cerebral Cortex , Metabolism , Drug Combinations , Drugs, Chinese Herbal , Pharmacology , Hippocampus , Metabolism , Maze Learning , Plants, Medicinal , Chemistry , Proto-Oncogene Proteins c-bcl-2 , Genetics , RNA, Messenger , Genetics , Metabolism , Random Allocation , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , bcl-2-Associated X Protein , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To study the display of different types injuries of recurrent laryngeal nerve (RLN) in laryngeal electromyography (LEMG).</p><p><b>METHODS</b>LEMGs of one hundred and forty-seven patients (147 sides) with traumatic unilateral vocal cord paralysis (UVCP) were studied. After LEMGs, the RLNs exploration operations were performed. The condition of RLNs injury and laryngeal muscles was observed and recorded during the operation.</p><p><b>RESULTS</b>The severe injuries of RLNs were found during operation. The types of injuries were listed as ligation (58 cases), adhesion (28 cases) and cut (61 cases). The waveform morphology of LEMG was recorded less in the patients with the RLNs cut than that in the patients with the RLN ligation or adhesion, respectively. 75.4% RLNs cut showed spontaneous waveform while 96.4% RLNs adhesion and 94.8% RLNs ligation. When the RLN was cut off, single pattern was showed oftener. When the RLN was adhered or ligated, mixed pattern was showed oftener. 92.9% RLN adhesion showed misdirect-regeneration-potentials while 70.7% RLN ligation and 24.6% RLN cut. There were significant difference between two types, but the compound muscular active potential (CMAP) amplitude wasn't significantly different. Evoked amplitude could be recorded in 91.4% patients with ligation and its amplitude was (23.6 +/- 8.1)%, in 85.7% patients with adhesion and its amplitude (16.3 +/- 5.2)%, in 29.5% patients with cut and its amplitude (2.6 +/- 4.2)%.</p><p><b>CONCLUSIONS</b>The display of different injuries of RLN in LEMG presents significant difference. If RLN was cut off, the CMAP might be recorded in most cases. The clinical injury of RLN often is followed by sub-clinic reinnervation.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Electromyography , Laryngeal Muscles , Wounds and Injuries , Recurrent Laryngeal Nerve , Recurrent Laryngeal Nerve Injuries , Vocal Cord Paralysis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate postoperative glottic area and vocal quality of three various surgical techniques for treating bilateral vocal cord paralysis, including laser arytenoidectomy (Group A, 24 cases), reinnervation of the posterior cricoarytenoid muscle by phrenic nerve (Group B, 9 cases) and arytenoidectomy accompanying lateral cordopexy by extralaryngeal approach (Woodman's procedure, Group C, 13 cases).</p><p><b>METHODS</b>46 cases suffered from bilateral recurrent laryngeal nerve injury were included in our study. The pre-postoperative glottic measurement and vocal acoustic parameters were analyzed.</p><p><b>RESULTS</b>The decannulated cases in group A and group B and group C were 22, 8, 13 respectively. The post-operative mean maximal glottic area was (47.2 +/- 7.4) mm2, (78.3 +/- 16.0) mm2, (48.1 +/- 6.5) mm2 respectively. Group B cases glottic area was larger than that of group A and group C (t value were 4.46 and 3.85, P value were 0.000 and 0.001). No significant difference was found between group A and group C (t = 1.68, P = 0.101). After surgery, in group A, 17 cases voice quality was the same compared with that of before surgery, and 7 cases voice quality had become worse; In group B, the voice quality had become better in 5 cases, completely recovered in 1 case, and had not change in 3 cases; In group C, the voice quality had become deteriorated in 10 cases and no change in 3 cases. And in group B, ipsilateral diaphragm paralysis in 9 cases after surgery, whose vital capacity and forced vital capacity had decreased to 72%-84%, 76%-84% of that before the surgery respectively; and the diaphragm mobility had recovered by 35%-76% respectively, while vital capacity and forced vital capacity had become 93%-97%, 91%-98% of that before the surgery. In Group B, all cases' pulmonary function was normal half a year postoperatively.</p><p><b>CONCLUSIONS</b>Reinnervation of the posterior cricoarytenoid muscle by phrenic nerve seems to be best procedure with better post-operative voice and larger glottic area. Although the sufficient airway for decannulation can be acquired in Group A and Group C, but most of patients in Group A had pre-operative vocal level and badly abnormal in Group C.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Arytenoid Cartilage , General Surgery , Glottis , Laser Therapy , Phrenic Nerve , General Surgery , Treatment Outcome , Vocal Cord Paralysis , General Surgery , Voice QualityABSTRACT
<p><b>OBJECTIVE</b>To study the mechanism of TX0201, an effective fraction extracted from Tiaoxin recipe in regulating apoptosis associated genes in brain tissue of rat analogue model of Alzheimer's disease (AD) induced by beta-amyloid protein 25-35 (Abeta 25-35).</p><p><b>METHODS</b>The model of AD was induced by bilateral amygdala injection of Abeta 25-35 to study the spatial memory capacity using Morris water maze test, and by means of RT-PCR and immunohistochemistry assay, the expressions of beta-amyloid precursor protein (APP), apoptosis correlative genes (bcl-2, bax), and apoptosis signal transduction molecule (Caspase-3) in the brain, and the effect of TX0201 on expressions of these genes were examined.</p><p><b>RESULTS</b>In AD model group, the spatial capacity was damaged significantly. Caspase-3 and the expression of APP mRNA and bax/bcl-2 mRNA were increased in the cortex and hippocampus; TX0201 ameliorated all the pathologic changes mentioned above.</p><p><b>CONCLUSION</b>TX0201 could improve the oriented learning and memory capacity in AD rats by decreasing bax/bcl-2 and down-regulating Caspase-3 to reduce neurocyte apoptosis, suggesting that effective regulation of neuron apoptosis associated genes may be one of the mechanisms of TX0201.</p>
Subject(s)
Animals , Male , Rats , Alzheimer Disease , Drug Therapy , Metabolism , Amyloid beta-Peptides , Apoptosis , Caspase 3 , Genetics , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Phytotherapy , Proto-Oncogene Proteins c-bcl-2 , Genetics , RNA, Messenger , Genetics , Rats, Sprague-Dawley , Signal Transduction , bcl-2-Associated X Protein , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To explore the therapeutic mechanism of Tiaoxin Recipe (TXR) and Bushen Recipe (BSR) in treating Alzheimer's disease (AD).</p><p><b>METHODS</b>Sixty patients with AD were divided into 3 groups according to their MMSE and ADL scores before treatment, using randomized block design. They were treated separately with TXR, BSR and Donepezil (Dp) for 12 weeks. The changes of MMSE score, ADL score, neuro-psychology amount table score, including FOM, RVR, DS and BD, as well as the overall operational evaluation before and after treatment were analyzed.</p><p><b>RESULTS</b>The recognition and daily life capacity of patients in the 3 groups were improved after treatment. MMSE score in the TXR group increased from 16.10 +/- 1.94 scores before treatment to 17.90 +/- 2.59 scores after treatment, in the BSR group, from 16.15 +/- 2.16 to 17.50 +/- 2.59, and in the Dp group, from 17.35 +/- 1.90 to 19.60 +/- 3.39, all showed significant difference (all P < 0.01). Change of ADL score showed that in TXR from 43.10 +/- 3.86 to 41.50 +/- 4.40, in the BSR group from 43.30 +/- 4.53 to 41.60 +/- 4.12 and in the Dp group, from 42.95 +/- 3.58 to 40.60 +/- 5.23, which also showed significant difference (P < 0.05 or P < 0.01). Moreover, increase of FOM, RVR and DS score was shown in the TXR and the Dp group, and increase of RVR and BD score was shown in the BSR group with significant difference in comparison of corresponding score before and after treatment, inter-groups comparison showed significant difference of FOM score between the BSR and the Dp group (P < 0.01). Overall operational evaluation (total effective rate) in the TXR group was 70%, in the BSR group 65% and in Dp group 75%, with no significant difference among them.</p><p><b>CONCLUSION</b>TXR and BSR are effective TCM drugs in treating AD.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease , Drug Therapy , Diagnosis, Differential , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , PhytotherapyABSTRACT
Objective： To study the application of DSA in the diagnosis and treatment of ENT diseases. Methods： The diagnostic and therapeutic roles of DSA in ENT patients admitted from November 1995 to December 1999 were retrospectively studied. Results： Therapeutic vascular embolization using DSA was performed in 9/10 patients with severe epistaxis. The treatment was successful in 8/9 patients with a successful rate of 88.89%; embolization of tumor supplying vessels using DSA as a preoperative measure for reducing operative blood loss in 3 patients with nasopharyngeal fibrohemangioma obtained a total success; diagnosis was clarified in 2 patients using DSA. No patients were with severe complications. Conclusion： DSA is not only a safe and effective measure for diagnosis and therapy, but also effective in differential diagnosis of space occupying lesions. Preoperative selective embolization of tumor supplying arteries can reduce operative blood loss.
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Objective： To study the application of DSA in the diagnosis and treatment of ENT diseases. Methods： The diagnostic and therapeutic roles of DSA in ENT patients admitted from November 1995 to December 1999 were retrospectively studied. Results： Therapeutic vascular embolization using DSA was performed in 9/10 patients with severe epistaxis. The treatment was successful in 8/9 patients with a successful rate of 88.89%; embolization of tumor supplying vessels using DSA as a preoperative measure for reducing operative blood loss in 3 patients with nasopharyngeal fibrohemangioma obtained a total success; diagnosis was clarified in 2 patients using DSA. No patients were with severe complications. Conclusion： DSA is not only a safe and effective measure for diagnosis and therapy, but also effective in differential diagnosis of space occupying lesions. Preoperative selective embolization of tumor supplying arteries can reduce operative blood loss.
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Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.
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Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.