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Metastatic encephaloma from lung carcinoma is one of the nost common intracranial tumors,which is paid to more and more attentions in Neurosurgery.Patients with metastatic neoplasm suffer great physiological and psychological pain for short survival time and survival of poor quality.In terms of treatment,surgery is the major method for metastatic encephaloma of lung cancer.But the subject range of surgery is limited to many factors,therefore many patients can not be treated with surgery.In order to solve the issue of applicability restriction,diversified adjuvant treatment strategies appear successively,such as chemotherapy,targeted therapy,immunotherapy.It has been verified by a number of clinical evidences that these therapies can prolong lifetime and improve living quality of patients.But at the present stage,there is no an uniform standard for the treatment of metastatic encephaloma from lung carcinoma.To give full play the role of each treatment,it is important to understand the advantages and disadvantages.Only in this way,can the patient's interests be optimized.
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Objective To investigate the hemostatic effect and influence on coagulation function of hemecongulase during neurosurgical operation.Methods Sixty patients with neurosurgical trauma at American statistical association(ASA) Ⅰ-Ⅱ were randomly divided into hemocoagnlase treatment group (n =30) and control group(n =30).Both two group were injected Baquting 2U at the day before the operation,30 min before the operation,every two day after the operation and end up 3 d.Treatment group were pedormed with Baqyting 4 U + physiological saline 10 ml topical spraying.The intelligibility of operating region,the volume of intraoperative,the volume of bleeding during the operation,transfusion of blood,postoperative drainage,and drainage tube exelcymosis time were recorded in all the patients.Prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen level(FIB),fibrinogen degradation product(FDP) and the two D-dimer and platelet count(PLT) before and after the surgery were also determined.All the patients were postoperatively followed up.Results The intelligibility of operating region was 70.0％ (21/30) in the hemocoagnlase treatment group,higher than that in control group (0％,P ＜0.05).The volume of bleeding during the operation in the hemecoagulase treatment group was (680.00 ± 95.22) ml,significantly fewer than that in the control group((790.00 ±47.00) ml,P =0.034).PLT significantly decreased after the surgery in both of the groups compare to that in preoperation (P ＜ 0.05 or P ＜ 0.01) and no significant difference was seen between two groups (P ＞ 0.05).No severe adverse events were found in both groups.Conclusion Hemocoagulase treatment during the operation can improve the intelligibility of operating region,reduce the volume of bleeding and transfusion of blood,and do not affect the coagulation function in the patients.Therefore,hemocoagulase is a safe and effective hemostatic and through local application during the operation it can improve curative effect.
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BACKGROUND:With the medical development, prognostic outcomes of spinal cord injuries have not been improved significantly, and most patients also suffer from severe complications. Nowadays, lots of laboratories and clinical researches have suggested that celltherapy has a great potential, especial y the application of umbilical cord blood stem cells in nervous system diseases. OBJECTIVE:To explore the feasibility and clinical effect of umbilical cord blood neural stem cells transplantation for patients with obsolete spinal cord injury. METHODS:Umbilical cord blood was harvested from newborns under aseptic condition, and differentiated into neural stem cells in vitro that were prepared into cellsuspension at a concentration of 109/L. The cellsuspension (3 mL) was injected via the L 3-4 or L 4-5 into the subarachnoid space. American Spinal Injury Association (ASIA) scores and the residual urine were assessed before and 3 months after transplantation. RESULTS AND CONCLUSION:After transplantation, al the patients showed a stable life indication. Three months later, ASIA scores were increased and the residual urine decreased, which significantly differed from those before transplantation (P<0.05). These findings indicate that umbilical cord blood neural stem cells transplantation is a new treatment that can improve the limb function and life quality of patients with obsolete spinal cord injury.
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Objective To explore the method and management of pre-hospital care and raise the level of traffic injuries in pre-hospital care by summarizing the clinical features of death patients with severe tragic accident trauma Methods The basic data of 62 death patients with severe traffic accident trauma was analyzed according to death report statistics of severe traffic accident trauma from January 1st,2005 to December 31th,2008 Results Brain injury death accounted for most of traffic accident trauma death.The mortality rate of brain injury in the wounded wag 8.28%(13/157),but of asphyxia and hemorrhagic shock was 2.55%(4/157),3.18%(5/157)respectively in 2005.With the development of treatment and rescued in time, the mortality rate reduced to 6.11%(11/180),0,0.56%(1/180)in 2008.Conclesions It should be trying to shorten the time of pre-hospital care for pafients with trsffic accident trauma,especially in patients combined with hemorrhagic shock,asphyxia,severe brain injury.It is concluded that rapid and effective pre-hospital care can significantly reduce death rate and self-help or each other rescue training would also be effective to reduce mortality.
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Objective For decreasing the infected rate,the prevention and cure methods of intracranial infections following posterior fossa craniotomy were study. Methods Twenty-eight patients with the intracranial infections following posterior fossa craniotomy were examined by lumbar puncture,and analyzed cerebrospinal fluid with routine examination and reference to the bacteriological data and drug sensitive tests. All the patients were treated with high dosage sensitive antibiotics, and draining continually the infected cerebrospinal fluid by lumbar puncture catheterization and injected small dosages of antibiotics into intraspinal for most cases. Results Twenty-eight patients had intracranial hypertension by lumbar puncture examination, outcome of cerebrospinal fluid culture indicated that 17 cases had bacteria growth and 11 cases had no bacteria. The intracranial infection was controlled effectively,and 96.4%(27 cases) were cured, 1 case dead of systemic failure. Conclusions Strict aseptic techniques,reduce operative time,decrease intracranial place of foreign matters, such as gelfoam, hemostatic gauze and artificial implants, could reduce the possibilities of intracranial infections. Appropriate antibiotics selection,lumbar puncture catheterization and intraspinal administration of antibiotics can cure intracranial infections effectively.
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BACKGROUND: Vascular restenosis alter carotid endarteractomy (CEA) is an important factor affecting curative affect ofoperation.OBJECTIVE: To explore the role of matrix metalloproteinase-9 (MMP-9) mRNA dynamic expression in the development of early vascular restenosis after carotid endarterectomy.DESIGN, TIME AND SETTING: A random grouping contrast observation was completed in the General Hospital of Beijing Military Area Command of Chinese PLA from February 2006 to December 2007. MATERIALS: Forty-one healthy male New Zealand rabbit, weighing about 3.0 kg, with 36 ones used for preparing carotid atherosclerotic stenosis (CASS) models. experimental group, each 6 of the CASS rabbit models (n =36) were selected at the time points of hour 4, day 1, 3, 7, 30, and 90 following CEA respectively. Then they were fixed with 40 g/L polyoxymethylene perfusion and stained with hematoxylin-eosin to observe their morphologic changes.MAIN OUTCOME MEASURES: The expression changes of MMP-9 mRNA were observed dudng the development of early vascular restenosis by the quantitative real-time polymerase chain reaction technique preoperatively as well as at day 1, 3 and 7 following CEA.RESULTS: Several stages could be seen in the reparative process of neointima after CEA, including the thrombosis, the inflammatory reaction, the repair of endothelium, the proliferation of vascular smooth muscle call, the formation and accumulation of extracellular matrix. MMP-9 mRNA was expressed since day 1, reached a peak at day 3 and then decreased significantly at day 7 postoperatively.CONCLUSION: MMP-9 plays an important role in the proliferation, migration and reconstruction of vascular smooth muscle calls, the mediated reconstruction of local blood vessels, as well as the development of vascular restenosis.
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To investigate the feasibility of in vitro inducing differentiation of bone marrow stromal cells (BMSCs) into neural stem cells and mature neural cells, and to offer reference for the application of BMSCs in the field of neuroscience, BMSCs were acquired from the marrow of dogs. Basic fibroblast growth factor (bFGF), all trans retinoic acid (RA) and glial cell line derived neurotrophic factor (GDNF) etc were used as proliferation or differentiation factors. Immunocytochemistry was employed to identify the cells at every culture stage. When BMSCs were proliferatively cultured for 24～72h, cleavage phase and cluster like clones appeared. On the 3rd day, some of the BMSCs derived cells started to express neuron specific enolase (NSE) or glial fibrillary acidic protein (GFAP). The same stage cells could be cloned, that is one of the characters of stem cells, when they were cultured in the proliferation medium. The neural cell modality like cells appeared on the 10th day after adding inducing factors into culture medium, which were proved by testing the express of NSE and GFAP. BMSCs can differentiate into neural stem cells and mature neural cells in vitro, and can be used as "seed cells" in the field of neuroscience.