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Objective To explore the effect of neuroendoscopic techniques on treating cerebrospinal fluid (CSF) leakage.Methods Five patient with CSF leakage,admitted to our hospital from November 2012 to April 2013 and treated with surgery under neuroendoscope,were chosen in our study; their clinical data were retrospectively analyzed; the diagnostic methods,surgical methods and clinical effects were summarized.Results Two had traumatic CSF leakage and 3 had iatrogenic CSF leak.In patients with traumatic CSF leakage,brain MR,thin CT scan,skull base reconstruction and cistermography CT were used to determine the location of ventages,while the ventages in patients with iatrogenic CSF leakage can be determined according to clinical experience; the ventages located in the frontal sinus,the ethmoid sinus,the bottom of the saddle,the recessus sphenoethmoidalis,and the border area of middle skull base and parasellar.Direct observation of the ventages was achieved and repair was finished successfully.Follow up for at least three months showed no recurrence or complications.Conclusions Preoperative localization of the ventage of CSF leakage is every important; combination of brain MR,thin CT scan and skull base reconstruction and cistermography CT can accurately locate the ventage in patients with traumatic CSF leakage; for patients with iatrogenic CSF leakage,location of the ventage can be achieved according to clinical experiences.Neuroendoscopy is minimally invasive and having direct view and high success rate,which can be used as the preferred choice for CSF leakage.
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Objective To explore the clinical effect of burr-hole and hemolysis with urokinase on patents with epidural hematomas. Methods We retrospectively analyzed the clinical data of 31patients with epidural hematomas,admitted to our hospital from June 2005 to September 2011 and treated by burr-hole and hemolysis with urokinase; and the characteristics and indications of this operation,prevention of its complications were summarized. Results All the 31 patients got satisfied results;their mean GOS scores were 5,and no clinical mortality and mobility was noted.Most of hematoms were discharged within 3 days in 24 patients; the rests of the hematomas were removed in 4-5 days in another 7patients. Conclusion Burr-hole and hemolysis with urokinase is a simple,effective and minimally invasive operation in the treatment of epidural hematomas, but the operative indications should be carefully selected.
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Objective To explore the relevant factors of prognosis of intracranial aneurysms after microsurgical treatment and risk factors of cerebral vasospasm (CVS). Methods Three hundred and twenty-two patients with intracranial aneurysms, admitted to and received surgical treatment in our hospital from June 2006 to May 2009, were chosen in our study; their clinical data were retrospectively analyzed. Logistic regression analysis was employed to analyze the influences of age, gender, blood pressure level, blood sugar level, operation time, Fisher's grade, Hunt Hess grade and infection on the prognosis of patients with intracranial aneurysms and the risk of CVS. Results Multivariate logistic analysis indicated that age, Hunt Hess grade, Fisher's grade, CVS, infection and lumber puncture times were the independent risk factors influencing the prognosis of patients with intracranial aneurysms (P< 0.05). Hunt Hess grade, Fisher's grade, number of aneurysms, endplate colostomy, lumber puncture times and infection were the independent risk factors of CVS (P<0.05). Conclusion Age, Hunt Hess grade, Fisher' s grade, CVS, lumber puncture times and infection are the independent risk factors affecting the prognosis of patients with intracranial aneurysms, among which, CVS is the most important factor. CVS is mainly affected by Hunt Hess grade, Fisher's grade, number of aneurysms, endplate colostomy, lumber puncture times and infection.
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Objective To compare the effects and complications between neuroendoscope-assisted and conventional shunt methods in patients with hydrocephalus,Methods The data of 299 patients with hydrocephalus admitted to our hospital from June 2002 and June 2009 were analyzed.Among these patients,98 adopted neuroendscope:78 were performed ventriculoperitoneal shunt(EVPS)combined with endoscopic third ventriculostomy(ETV)and the other 20 with obstructive hydrocephalus were performed ETV only.The other 201 patients adopt conventional operation:VPS was employed in 196 and ventriculoatrial shunt was performed in 5.We compared shunt effectiveness by calculating the pre-and post-operative ventricular indexes,shunt failure rates and complication rates during the follow-up between the 2 groups.Results No difference in etiology of hydrocephalus or clinical characteristics between the 2 groups was found.Compared with the conventional shunt group,neuroendscope-assisted group enjoyed a longer operative time,a higher surgery cost,a lower clogging incidence rote and a higher precision rote of putting the tube(P<0.05).Conclusion Applying of neuroendoscope is a very good option in treating patients with various kinds of hydrocephalus with good long-term follow-up results.
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Objective To investigate the effects of Rac1 gene silencing on cell cycle and apoptosis of Daoy cell line in medulloblastoma. Methods Daoy cells were divided into Rac1-shRNA group and empty plasmid control group; Daoy cells in the former group were transfected by using Rac1-shRNA plasmid (Rac1-shRNA). RT-PCR, Western blotting and flow cytometry were used to observe the changes of cycle and apoptosis of Daoy cells after Rac1 gene silencing. Results Rac1 mRNA and protein in medulloblastoma Daoy cell lines were highly expressed; cell cycle of Daoy cells with Rac1 gene silencing were blocked at G0-G1 phases and cell percentage of G0-G1 phases significantly increased to 80.9%±4.9%; however, the proportion of cells in the S phase reduced to 11.8%± 2.3%. The apoptosis rate of Rac1-shRNA plasmid group (36.7%±3.9%) was significantly different as compared with that of empty plasmid control group (8.5% ±0.9%) (P<0.05). Conclusion RNA-interfered Rac1 gene silencing can inhibit the proliferation of Daoy cells and promote their apoptosis, indicating that Rac1 may become a new target being able to inhibit the cell proliferation and promote the apoptosis of Daoy cells in medulloblastoma.
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Objective To investigate the expressions of interleukin-8 (IL-8) mRNA and proliferating cell nuclear antigen (PCNA) protein in astrocytic tumors and their correlation with the tumor cell apoptosis. Methods The expressions of IL-8 mRNA in 64 cases of astrocytic tumor and 10 normal brain tissues were detected using RT-PCR. The expression of PCNA protein in the tumors was assayed with immunohistochemistry, and the apoptosis index (AI) of the tumor cells determined using TUNEL assay. Results The expression ofIL-8 mRNA in the astrocytic tumors was strongly correlated to the malignancy of the tumors, and both the PCNA expression and the apoptosis index increased in tumors of greater malignancies. IL-8 mRNA expression was positively correlated to the expression of PCNA (r=0.938, P<0.01) and AI (r=0.907, P<0.01) in these tumors. Conclusion IL-8 mRNA expression is positively correlated to the histological grade of the astrocytic tumors, whose proliferation is mediated by inhibition of cell apoptosis and upregulation of IL-8 transcription.