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Objective:To explore the surgical method and clinical effect of craniopharyngioma resection through the cockscomb approach.Methods:A retrospective case-control study was conducted from December 2010 to May 2018.The clinical data, imaging data and follow-up data of 101 patients with craniopharyngioma confirmed by pathology by pathology after resection of the frontal floor longitudinal fissure through the crow′s comb approach were performed in Department of Neurosurgery, Sanbo Brain Hospital Capital Medical University.The total tumor resection rate, mortality and complications were analyzed by statistical methods.Results:Through this approach, the total resection rate of tumor was 90.1%(91/101), and the mortality was 1.9%(2/101). The most common postoperative complications were disturbance of sodium metabolism (54.5%(55/101)).Conclusion:Sub-frontal longitudinal fissure crista galli approach can safely and thoroughly remove the tumor and avoid the injury of the hypothalamus and its surrounding tissues as far as possible.
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OBJECTIVE:To explore the optimal steaming time of Carapax trionycis during cleansing period,and to optimize and improve production technology of Carapax trionycis recorded by current Chinese Pharmacopoeia. METHODS:The mechanical processing replaced the artificial processing method in Chinese Pharmacopoeia. The content of protein and the appearance of Cara-pax trionycis were investigated after steaming for 30,60,90,120,180,240 min during cleansing period. The extract,decoction, ash content,appearance and property of Carapax trionycis decoction piece processed with vinegar were also investigated after cleansed Carapax trionycis decoction piece was processed by sand scalding and vinegar quenching method. RESULTS:The differ-ent steaming time obtained different quality of cleansed Carapax trionycis decoction piece and Carapax trionycis decoction piece pro-cessed with vinegar. Compared with decoction piece steamed for other duration,when the steaming time was 90 min,the content of protein in cleansed Carapax trionycis decoction piece was higher(31.16%),and its appearance was up to the requirement. Cara-pax trionycis decoction piece processed with vinegar had higher contents of extract and decoction(9.13%,11.39%)and lower con-tent of ash(66.29%),and its appearance was up to the requirement. CONCLUSIONS:Different steaming time have certain effect on the quality of cleansed Carapax trionycis and Carapax trionycis processed with vinegar,the optimal steaming time of Carapax tri-onycis is about 90 min during cleansing. The mechanical processing method maybe replace the artificial processing on Carapax tri-onycis for improving its production efficiency.
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Objective To summarize the clinical characteristics of and the treatment efficacy of intracranial infections after ventriculoperitoneal shunt procedures.Methods Among the hydrocephalus patients who were treated by ventriculoperitoneal shunt from January 2013 to January 2016,there were seven cases that had an intracranial infection,but the patients and their families refused to remove shunt devices.Before the cerebrospinal fluid bacterial culture and drug sensitivity test results were available for the intracranial infection patients,their cerebrospinal fluid was drained through continuous lumbar drainage.After the bacterial culture and drug sensitivity test results had come out,they were treated with the intrathecal injection of sensitive antibiotics when necessary.Results Three patients were cured after lumbar drainage and intrathecal injection of antibiotics,showed by the follow-up six months later.One patient exhibited clinical symptoms of infection in a follow-up recheck two months later after removal of the lumbar shunt.Two patients implanted shunt devices again after the removal of the shunt devices during hospitalization.One patient died.Conclusion The lumbar drainage is an effective measure with clinical values for infections caused by not removing shunts after ventriculoperitoneal shunt procedures.
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Objective To discuss the strategies and efficacies of surgical treatment in medulla oblongata cavernous malformations.Methods The clinical and follow-up data of 9 patients with medulla oblongata cavernous malformations,admitted to our hospital from October 201 1 to February 2015,were retrospectively analyzed.Five patients underwent surgical treatment:posterior midline transcerebellomedullary fissure approach was used in 4,far-lateral transcondylar approach in one,and all cavernous malformations were excised completely.Conservative treatment and regular observation were done in 4 patients.Follow-up was performed for 10-40 months.Results Symptoms improved after surgery in 4 patients;postoperative hemiplegia appeared in one,and at the end of follow-up,the muscle strength of hemiplegic limbs recovered to level Ⅳ.Minor re-hemorrhage was noted in one of the 4 patients with conservative treatment at the end of the follow-up,and no changes were noted in the rest patients.Karnofsky Performance Scale scores were 82.2 ±6.7,which were significantly increased as compared with those before treatment (73.3±11.2,P＜0.05).Conclusion After strict preoperative evaluation,surgical treatment is a feasible way,enjoying good prognosis in medulla oblongata cavernous malformations;but,patients with deep site,small malformations or no obvious bleeding symptoms should not be operated.
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BACKGROUND:Co-culture withembryonic stem cels or embryonic tissues can induce differentiation of carcinoma cels into normal epithelial cels or decreasemalignancyof carcinoma cels.Acelular embryoid bodies retain the structure and important cytokines of embryonic tissues. OBJECTIVE:To prepare acelular embryoid bodies from mouse embryonic stem cels and to investigate their effects on differentiation of mouse Lewis lung carcinoma cels at three-dimensional culturein vitro. METHODS:Mouse embryonic stem cels(D3)were dynamicaly cultured for 7 days to produce embryoid bodiesfolowedbydecelularization with 0.1% sodium dodecyl sulfate. Mouse Lewis lung carcinoma cels were co-cultured with acelular embryoid bodiesas test group or culturedinthree-dimensionalmatrigel mediumfor 7 days as control group, respectively. Cel proliferation and expression of E-cadherin were detected by immunohistochemical staining and western blot assay, respectively. In addition, mRNA expressions ofSlug and E-cadherin were observed using RT-PCR technology. RESULTSAND CONCLUSION:Uniform mouse embryoid bodieswere successfuly prepared, andwere completely decelularized with sodium dodecyl sulfate. After 7-day three-dimensionalmatrigelculture, in the control group,multicelular tumor spheroidswere formed,accompanied byahigherKi67positive rate;Lewis lung carcinoma cels in the test group were repopulated in the acelular embryoid bodies showing significantly lowerKi67positive rate. Compared with the control group, the absorbance ofPaxilin in the test group was significantly smaler, and the absorbance of E-cadherin was significantly higher (P< 0.05). Besides, mRNA expressions of Slug and E-cadherin were significantly decreased and increasedin the test group compared with the control group, respectively(P< 0.05). These findings indicate that the acelular embryoid bodies can promote differentiation of mouse Lewis lung carcinoma celsinthree-dimensional culturein vitro.
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Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) in neurosurgery. Methods One hundred fifteen patients who underwent neurosurgery surgery in Henan Province People's Hospital from June 2012 to March 2014 were enrolled in this study. All the patients were divided into FTS group (62 cases) and the tra?ditional operation group (53 cases). The clinical index, postoperative hospital stay and hospitalization cost were compared between the two groups. Results The clinical index were significantly lower in FTS group than in traditional operation group (P<0.05). Length of hospital stay (days) and hospitalization cost of FTS group were significantly shorter and lower in FTS group compared with traditonal operation group (8±1 vs. 11±2 days and RMB 4.58 ±0.75 vs. 5.78 ±0.64 ten thou?sand, respectively) (P<0.05). Conclusion FTS in neurosurgery operation is an all-new concept for surgery which can ef?fectively reduce postoperative complications, shorten length of hospital stay, decrease hospitalization cost and promote postoperative recovery.
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Objective To explore the risk factors of recurrent cerebral infarction and the preventive meas-ures. Methods The risk factors were compared between recurrent group (246 cases with recurrent cerebral infarc-tion) and unrecurrent group( 100 cases with unreeurront cerebral infarction) by means of multiple logistic regression analysis. Results The recurrent cerebral infarction is correlated closely with hypertension, diabetes, heart diseases and excessive drinking, and the OR values arc 2.206, 2.232, 2.252, 2.842, 2.366 respectively (P<0.05), prophy-lactic treatment had the protective effects against the recurrent cerebral infarction,and the OR value was 0.249. Con-dusions The main risk factors of recurrent cerebral infarction were hypertension,heart diseases,excessive drinking. Prophylactic treatment hed great significance in preventing the recurrence of cerebral infarction.
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Objective To observe the influence of intravenous anesthesia with ketamine or propofol on intraocular pressure (IOP) in pediatric patients. Methods 27 pediatric patients, ASA grade Ⅰ～Ⅱ, were divided into ketamine and propofol groups. Basic anesthesia was conducted with ketamine 4～6 mg*kg-1 combined droperidol 0.04～0.1 mg*kg-1 intramuscularly. Anesthesia maintained with continous infusion of 0.04% ketamine or 0.04% propofol following intravenous bolus of ketamine 1 mg*kg-1 or propofol 1 mg*kg-1 in ketamine group and propofol group respectively. IOP, systemic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and pulse oxygen saturation(SpO2) were measured at 10 minutes after basic anesthesia, 3 minutes after intravenous bolus of ketamine or propofol and end of surgery. Results There were no differences in IOP between two groups after basic anesthesia. IOP increased or decreased significantly after intravenous bolus of ketamine or propofol respectively. IOP in ketamine group decreased near to the level in propofol group at end of surgery. There were no statistic differences in SBP, DBP and HR between two groups priopration. SpO2 did not change (but in one patient decreasing to below 95% ) and significantly decreased within 5 minutes of intravenous bolus of ketamine and propofol respectively. Conclusion Ketamine increases IOP propofol decreases IOP. Ketamine combined propofol can keep from increase of IOP but strength respiration inhibition.
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31 patients with cysticercosis of cerebral ventricles verified by operation or pathological investigation were reported. All patients were between 7 and 64 years of age and 14 were females. All had a single cyst. Since 29 patients (94%) were without a history of intestinal taeniasis, it was proposed that most patients of cysticercosis of cerebral ventricles were caused by hetero-infection and the entrance of Cysticercus into brain ventricle was through choroid plexus along the cerebro-spinal fluid. This is probably the reason why it occurs mostly in the 4th ventricle. The clinical manifestation of cysticercosis of cerebral ventricles were paroxysmal headache and vomiting caused by increased intracranial pressure. Ventricu-lography and CT scanning have considerable diagnostic value. Removal of Cysticercus by surgical operation is successful (Figs. 1 - 8).