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Objective:To explore the relation between extended resection and prognosis of primary glioblastoma.Methods:A prospective study was performed. The subjects were from the colony of patients with primary glioblastoma who underwent surgical resection in our hospital from January 2014 from January 2017. Tumor volume and tumor residual volume showed by MR imaging T1 enhanced sequences (Group A and Group B), and tumor volume and tumor residual volume showed by fluid-attenuated inversion recovery (FLAIR) sequences (Group A1 and Group A2) were obtained within one week before surgery and 24 h after surgery, respectively; and the degrees of tumor resection were calculated. Cox proportional hazards regression model was used to determine factors influencing overall survival (OS) in glioblastoma patients. Kaplan-Meier method was used to plot the survival curves of these patients. Log-rank test was used to compare the survival rates of patients from Group A and Group B, and patients from Group A1 and Group A2.Results:A total of 128 patients were included; 71(55.5%) were into Group A, and 17 (13.3%) were into Group A1. Multivariate analysis showed that preoperative Karnofsky performance scale (KPS) scores, promoter methylation status of O-6-methylguanine-DNA methyltransferase (MGMT), tumor residual volume by T1 enhanced sequences, tumor residual volume by FLAIR sequences, and tumor resection degree by FLAIR sequences were independent influencing factors for OS ( P<0.05). Survival rate of patients from Group A was significantly higher than that in Group B( P<0.05); and survival rate of patients from Group A1 was significantly higher than that in Group A2 ( P<0.05). Conclusion:Residual of primary glioblastoma showed by FLAIR sequences is an important factor affecting the prognoses, and extended resection is necessary.
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Objective To explore the clinical manifestations and treatment of pediatric pituitary adenoma.Methods Between January 2001 to January 2015,24 pediatric patients diagnosed with pituitary.adenoma were treated in People's Hospital of Henan Province.The clinical data were retrospectively analyzed,including age,gender,clinical manifestation,therapy and prognosis.Endocrinological levels including all pituitrin and magnetic resonance imaging were analyzed by the follow-up survey.Results The median age was 16.2 years old,ranged from 6.0 to 17.8 years old.Common clinical manifestations were comprised of endocrine-related symptoms (18 cases) and visual deficit (8 cases),and so on.The ratio of male to female was 1.∶ 3.There were 12 cases of prolactin (PRL)-secreting adenoma (50.0％),4 cases of adrenocorticotropic hormone-secreting adenoma (16.7％),3 cases of growth hormone-secreting adenoma (12.5％),3 cases of plurihorminal adenomas (12.5％),and 2 cases of non-functioningadenomas (8.4％).The ratio of micro-adenoma versus macro-adenoma was 15.∶ 9,and there was no invasive macro-adenoma.Transsphenoidal surgery was applied in 14 cases (58.3 ％) with respect to 2 cases (8.3 ％) in transorbital keyhole approach,5 cases (20.8％) through pterional approach,and still 1 case (4.2％) through transsubfrontal approach.Two cases(8.3％) were cured with medications.Eighteen cases were totally resected,while 4 cases were subtotal resected.Six of 18 gross total resection patients recurred within 2 years,while tumors of subtotal resection grew differently.Hypotrophy in patients who received Gamma knife therapy (4/7 cases) was statistically different than that in the patients who did not (7/17 cases) (P =0.002).Conclusion Pediatric pituitary adenomas are usually common in female with endocrine related symptoms,and PRL-secreting adenoma is the most common subtype,and recurrence rate was higher.Individualized therapy is needed for the invalid cases.But any radiotherapy including Gamma knife therapy might induce hypotrophy,which requires special attention.
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Objective To explore the clinical manifestations and treatment of pediatric pituitary adenoma.Methods Between January 2001 to January 2015,24 pediatric patients diagnosed with pituitary.adenoma were treated in People's Hospital of Henan Province.The clinical data were retrospectively analyzed,including age,gender,clinical manifestation,therapy and prognosis.Endocrinological levels including all pituitrin and magnetic resonance imaging were analyzed by the follow-up survey.Results The median age was 16.2 years old,ranged from 6.0 to 17.8 years old.Common clinical manifestations were comprised of endocrine-related symptoms (18 cases) and visual deficit (8 cases),and so on.The ratio of male to female was 1.∶ 3.There were 12 cases of prolactin (PRL)-secreting adenoma (50.0％),4 cases of adrenocorticotropic hormone-secreting adenoma (16.7％),3 cases of growth hormone-secreting adenoma (12.5％),3 cases of plurihorminal adenomas (12.5％),and 2 cases of non-functioningadenomas (8.4％).The ratio of micro-adenoma versus macro-adenoma was 15.∶ 9,and there was no invasive macro-adenoma.Transsphenoidal surgery was applied in 14 cases (58.3 ％) with respect to 2 cases (8.3 ％) in transorbital keyhole approach,5 cases (20.8％) through pterional approach,and still 1 case (4.2％) through transsubfrontal approach.Two cases(8.3％) were cured with medications.Eighteen cases were totally resected,while 4 cases were subtotal resected.Six of 18 gross total resection patients recurred within 2 years,while tumors of subtotal resection grew differently.Hypotrophy in patients who received Gamma knife therapy (4/7 cases) was statistically different than that in the patients who did not (7/17 cases) (P =0.002).Conclusion Pediatric pituitary adenomas are usually common in female with endocrine related symptoms,and PRL-secreting adenoma is the most common subtype,and recurrence rate was higher.Individualized therapy is needed for the invalid cases.But any radiotherapy including Gamma knife therapy might induce hypotrophy,which requires special attention.
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Objective To explore the efficacy of difficult decompression and its influence factors in microvascular decompression for hemifacial spasm.Methods A retrospective analysis of clinical data and follow-up results of 458 patients who underwent microvascular decompression for hemifacial spasm in our hospital from October 2012 to December 2015 was performed.Aecording to whether there was narrow posterior fossa,compression of vertebral artery with perforating branch of brain stem or long vertebral artery,or vessel passing through cranial nerves,all patients were divided into difficult and general decompression groups (n=50,n=408);the effective rate,delayed remission rate and their influencing factors were compared between the two groups.Results All patients were followed up for one to 3 years,averaging 1.6±0.6 years.Among them,46 patients from difficult decompression group were effective (effective rate=92％ [46/50]);and 390 patients from general decompression group were effective (effective rate=95.6％ [390/408]);no statistical difference was noted between the two groups (x2=0.592,P=0.442).But there was statistical difference in delayed remission rate between the two groups (47.8％ vs.25.1％,x2=10.627,P=0.001).Logistic regression analysis was performed among gender,age,course of disease,offending vessels,location,indentation of facial nerve,complex condition of microvacular decompression,efficacy rate and delayed relief rate,and it showed that indentation of facial nerve was related to delayed relief(OR=7.681,P=0.004,95％CI:10.235-31.223).Conclusion The hemifacial spasm patients with difficult decompression are able to achieve as good effect as general decompression if measures are used properly,but the delayed relief rate might be high.