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Objective To evaluate the effect of activating adenosine A2A receptors on myocardial is-chemia-reperfusion ( I∕R) injury in diabetic rats and the relationship with autophagy. Methods Clean-grade healthy male Sprague-Dawley rats, aged 6 weeks, weighing 200-250 g, were studied. The diabetic rat model was established by intraperitoneal injection of 1％ streptozotocin 60 mg∕kg. Forty diabetic rats were divided into 4 groups ( n=10 each ) using a random number table method: sham operation group ( group Sham) , I∕R group ( group I∕R) , I∕R plus adenosine A2A receptor agonist CGS21680 group ( group CGS) , and I∕R plus CGS21680 plus adenosine A2A receptor antagonist ZM241385 group ( group CGS+ZM) . Myocardial I∕R was produced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120-min reperfusion. Adenosine A2A receptor agonist CGS2168010μg∕100g was in-travenously injected at 10 min before reperfusion in group CGS. CGS2168010 ug∕100g and ZM2413850. 2 mg∕kg were intravenously injected sequentially at 10 min before reperfusion in group CGS+ZM. Blood sam-ples were obtained at the end of reperfusion for determination of concentrations of creatine kinase-MB ( CK-MB), lactate dehydrogenase (LDH) and cardiac troponin I (cTnI) in serum (by enzyme-linked immu-nosorbent assay). The animals were sacrificed, and myocardial tissues were obtained for measurement of the percentage of myocardial infarct volume ( by TTC staining) and for determination of the expression of mi-crotubule-associated protein 1 light chain 3 Ⅰ ( LC3Ⅰ) , LC3 Ⅱ, p62 and Beclin-1 ( by Western blot) . LC3 Ⅱ∕LC3 Ⅰ ratio was calculated. Results Compared with group Sham, the serum CK-MB, LDH and cTnI concentrations and percentage of myocardial infarct volume were significantly increased, the expression of p62 and Beclin-1 was up-regulated, and the LC3Ⅱ∕LC3Ⅰratio was increased in group I∕R ( P<0. 05) . Compared with group I∕R, the concentrations of serum CK-MB, LDH and cTnI and percentage of myocardial infarct volume were significantly decreased, the expression of p62 and Beclin-1 was down-regulated, and the ratio of LC3Ⅱ∕LC3Ⅰwas increased in group CGS ( P<0. 05) , and no significant change was found in the pa-rameters mentioned above in group CGS+ZM (P>0. 05). Compared with group CGS, the concentrations of serum CK-MB, LDH and cTnI and percentage of myocardial infarct volume were significantly increased, the expression of p62 and Beclin-1 was down-regulated, and the ratio of LC3Ⅱ∕LC3Ⅰwas decreased in group CGS+ZM ( P<0. 05) . Conclusion Activating adenosine A2A receptors can mitigate myocardial I∕R injury, and the mechanism may be related to enhancing autophagy in diabetic rats.
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Objective To summarize the experience of pterional craniotomy microsurgical resection of giant tuberculum sellae meningiomas. Methods A total of 18 patients with giant tuberculum sellae meningiomas were treated microsurgically in this hospital from February 2000 to November 2004. The patients were operated on by use of pterional craniotomy on the side of worse vision. The basal part of the tumor was firstly dissected to control the blood supply of the lesion. Through the cerebral cisterns at the sellar region and the interfaces between the tumor and the adjacent structures, the tumor was removed to the greatest possible extent with minimal invasion to the neighbouring structures. Results[WTBZ] A total resection was conducted in 16 patients (88.9%), and a subtotal resection, in 2 patients (11.1%). No surgery related death was observed. Follow-up examinations in 14 patients for 3 months ~ 4 years (mean, 2.5 years) found no recurrence of meningiomas. Conclusions[WTBZ] The pterional approach provides excellent exposure of the middle fossa and the parasellar area. Pterional approach microsurgical technique can improve the rate of total resection of giant tuberculum sellae meningiomas.
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Objective To explore the outcomes of endoscopic minimally invasive surgery as a new technique for the treatment of glossopharyngeal neuralgia.Methods From January 2000 to May 2008,16 cases of primary glossopharyngeal neuralgia were treated by endoscopic minimally invasive surgery through suboccipital retrosigmoid approach in our hospital.We made a 6-to 8-cm vertical incision within the inner hairline to drain the cerebrospinal fluid from the cerebellopotine angle cistern(CPA) so that to form an operational path.And then,the adherent arachnoid membrane was freed and the structure of the glossopharyngeal nerve and local arteries were detected.Results After the endoscopic surgery,pharyngeal pain disappeared in all of the 16 cases.Follow-up was available for 3 months to 8 years in the patients(1-3 years in 4 cases,and 3-8 years in 2 cases).Two patients had hoarse voice after the operation.No one had dysphagia or recurrence during the follow-up.Conclusion Endoscopic surgery through suboccipital retrosigmoid approach is a minimally invasive method for primary glossopharyngeal neuralgia with good outcomes,mild surgery-related complications,and quick post-operative recovery.
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Objective To evaluate the safety and efficacy of microsurgical resection of large acoustic neurinoma via the suboccipital retrosigmoid approach.Methods Forty-nine patients with large acoustic neurinoma(≥4 cm) underwent microsurgical resection through suboccipital retrosigmoid approach.The craniotomy was performed by way of an unilateral S-shaped suboccipital incision.With microsurgical techniques the outmost layer of the arachnoid membrane was preserved in order to avoid damaging to the surrounding vital structures.The tumor was resected intracapsularly from the superior pole and the internal auditory meatus was finally opened.The last pieces of tumor were removed by sharp dissection from the facial nerve bidirectionally,and were resected cautiously in a piecemeal fashion.Results Of the 49 patients,45 patients(92%) received a total resection of the tumors,and 4 patients(8%) subtotal resection.No patients died.The facial nerve was preserved anatomically in 42 patients(86%) and functionally in 36 patients(73%).The acoustic nerve was preserved anatomically in 7 patients(14%) and functionally in 3 patients(6%).One patient experienced a postoperative haematoma,and a re-operation was required.No recurrence was seen in 37 patients during a follow-up for 6 months ～ 5 years(mean,2.8 years).These patients had recovered for normal work and daily activities.Conclusions Microsurgical operation through suboccipital retrosigmoid approach is a favorable treatment for large acoustic neurinomas.The procedure can improve the rate of total resection,decrease the morbidity and mortality,and effectively protect the function of the acoustic and facial nerves.
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Objective To To evaluate the efficacy of Guglielmidetachable coil (GDC)F embolization in treatment of intracranial aneurysms and summarize the main points of GDC manipulation.Methods Thirty two patients were examined with digital substraction angiography (DSA) and 34 intracranial aneurysms were found, including 15 aneurysms in the anterior communication artery, 13 in the posterior communi cation artery, 2 in the middle cerebral a rtery, 1 in the anterior cerebral artery and 1 Ophthalmic artery. After wards GDC was used for embolization therapy. Results Thirty two patients with 34 aneurysms were successfully embolized with GDCs. Complete embolization achieved in 20 patients and incomplete in 12 patients; while one aneurysm ruptured during the performance, but all curedafter treatment. Vas cular spasm occurred in 2 patients, one of them had slight hemiplegia. Sixpatients with 7 aneurysms were followed up by DSA examinationl year after operation. No obvious change was observed.Conclusions Treatment of intracranial aneurysms with GDC embolization is a safe, reliable, and effective measure. Skillful techniques of the operator and correct management of complications are important factors affecting the outcome of operation. A period follow up is essential to patients with partial embolism.