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Objective To investigate the distance change of bilateral internal carotid artery in acromegalic patients. Methods Twenty patients with acromegaly were included in this study from August 2016 to March 2018 in Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University. There were 7 males and 13 females with an average age of 40.2±12.6 years (range from 21 to 62 years old). Forty sex and age matched patients with non-functional pituitary adenoma were selected as controls. The 3D printing software was used for reconstructing the internal carotid artery. Distances of the bilateral internal carotid arteries were measured on the reconstructed images. Results The maximum distance between bilateral siphon carotid ectasias (25.1±3.9 mm vs. 23.2±2.9 mm, P=0.041) and distance between bilateral lacerum segments (26.2 ±3.1 mm vs. 23.8 ±4.1 mm, P=0.022) were significantly longer in patients with acromegaly than in those without. Although the distance between bilateral cavernous segments (20.7 ±4.3 mm vs. 22.4 ±3.1 mm, P=0.076) tended to be shorter, the difference was not statistically significant. The distance between bilateral ophthalmic segments was not significantly different between the two groups (15.7±5.1 mm vs. 16.0±2.5 mm, P=0.783). Conclusion The distance of bilateral internal carotid artery of acromegalic patients is different from that of patients with non-functional pituitary adenomas. Patients with acromegaly have significantly longer distance between bilateral siphon carotid ectasias and distance between bilateral lacerum segments compared with the patients with non- functional pituitary adenomas.
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Objective The aim of our study was to establish an endoscopic endonasal transsphenoidal surgical training model, and to examine its application value. Methods The endoscopic endonasal transsphenoidal surgical training models were made.After assessments,the models was used for endoscopic operation training for 8 neurosurgeons with no experiences of endoscopic operation. Results The available operating space of this model is similar to the actual operating space in endoscopic endonasal transsphenoidal surgery. The egg fixed on the model has many layers of structure, such as eggshell, shell membrane, egg white and egg yolk, which constituted a good practice object. All students indicated that they could benefit from the training using this model. The skill in grinding the eggshell [(1.07 ± 0.221)cm2/min vs.(1.45±0.27)cm2/min, P<0.001]was significantly improved and the chance for shell membrane rupture (8 vs. 2, P=0.007) was significantly reduced in the last-time practice compared with the first-time practice (P<0.001). Conclusion The endoscopic endonasal transsphenoidal surgical training model is helpful for neurosurgeons to practice the basic operation of endoscopic surgery and to improve their surgical skills,and can be used repeatedly.It can be used in basic operation training before the training using cadaver cranium.
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Objective To study the risk factors of the biochemical remission of pituitary tumor patients with acromegaly treated by the endoscopic endonasal surgery. Methods A retrospective analysis of clinical data was conducted on 61 cases acromegaly patients underwent endoscopic endonasal surgery between August 2013- November 2016.Endocrinology tests were performed in all patients,including the fasting/random GH(growth hormone,GH)level, Nadir GH during OGTT(oral glucose tolerance test, OGTT), and IGF-1(insulin-like growth factor-1,IGF-1). The clinical data included gender, age, preoperative GH value, preoperative IGF-1 value, tumor invasion of the inferface space of internal carotid artery(ICA),tumor surrounding angle of internal carotid artery(≥/<135°),Knosp grade, Hardy grade, and tumor volume. Univariate analysis and multivariate Logistic retrospective analysis were used to analyze the association between above-mentioned factors and the occurrence of biochemical remission. Results There were 52.5% (32/61)patients achieving biochemical remission.Univariate analysis showed significant differences between patients with and without biochemical remission in preoperative GH value, tumor surrounding angle of internal carotid artery(</≥135°)and Knosp grade(P<0.05).The Logistic regression analysis showed that preoperative GH value,tumor surrounding angle of internal carotid artery(</≥135°)were risk factors concerning about the biochemical remission in patients underwent endoscopic endonasal surgery.(P<0.05). Conclusion Tumor surrounding angle of internal carotid artery(≥135°)is independent risk factors, while the preoperative GH value is a risk predictor of biochemical remission after endoscopic endonasal surgery in acromegaly.
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Objective To establish the xenotransplanted tumor model of Craniopharyngioma in chick chorioallan?toic membrane (CAM) and detect the angiogenesis ability, microvessel density (MVD) and cell proliferation of the xeno?graft. Method Craniopharyngioma tissues from surgical craniopharyngioma patients were transplanted on the CAM. An?giogenesis assay was performed and the MVD and PCNA were evaluated using immunohistochemistry following the trans?plantation. Results The tumor formation rate of adamantinomatous craniopharyngioma (ACP) and squamous papillary cra?niopharyngioma (SPCP) was 47.14% and 43.33%, respectively. There was no significant difference in tumor formation rate between ACP and SPCP(χ2=0.123,P=0.726). The CAM angiogenesis, MVD and expression of PCNA were higher in ACP than in SPCP. The expression of PCNA was positively correlated with MVD (Pearson r=0.639,P<0.001) and CAM assay score (Spearman r=0.490,P=0.001 ) in CP. Conclusion The model of human craniopharyngioma can be es?tablished in the CAM. The angiogenesis of the xenograft in the CAM can be evaluated and the craniopharyngioma xeno?graft of CAM possesses a new blood circulation and cell proliferation ability.
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Objective To explore effect of two methods for treating extravasation of venous indwelling needles.Methods A total of 96 patients with extravasation at transfusion were randomly divided into experiment and control groups with 48 cases in each group. Magnesium sulfate wet packing was used in the control group and external application of potato chips in the experiment group.The two groups were compared in terms of time for curative effect to occur and time for recovery.Result The time for curative effect to occur and time for recovery in the experiment group were both significantly shorter than those of the control group.Conclusion External application of potato chips is effective in reducing extravasation during venous transfusion.It is simple and free from side effects.
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Objective To summarize the perioperative nursing care of the elderly patients with hip fracture.Methods There were 95 elderly patients with hip fractures admitted to hospital and received the fixation of artificial joint replacement and preoperative and postoperative nursing care from June 2010 to September 2013.Results Ninety-five patients were recovered and discharged from the hospital. They had stayed the hospital for 11 to 28 days and the average time was(17.5±2.5)d.One patient had developed pneumonia after surgery and one patient had incision infection.After treatment both patients were cured.Conclusions When the elderly patients with hip fracture stayed in the hospital,the nurses should give them good care.The nurses should provide them with mental care based on their psychological and physiological characteristics,help the patients to prevent the complications,guide the patients through rehabilitation training,enhance daily living and promote the patients’health as soon as possible.
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Objective In order to investigate the role of Gap Junction (GJ) in the generation and development of epilepsy,we examined the expression of connexin43 (Cx43)and Cx32 in the epileptogenic lesions and surrounding brain tissues of the patients with refractory temporal epilepsy.Methods Thirty intractable epilepsy patients were performed the resection of epileptogenic lesions under the ECC monitor.The expression of Cx43 and Cx32 in the epileptogenic lesions and the surrounding brain tissues of the patients were examined by immunohistochemical staining(the two step method).The data were statistically analyzed.Results The results from the immunohistochemistry staining showed that Cx43 and Cx32 were expressed in the epileptogenic lesions and the surrounding brain tissues.The expression of Cx43 in the epileptogenic lesions was increased obviously in comparison with the surrounding brain tissues ( U =4.066,P ＜ 0.001 ).There was no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues ( U =1.866,P ＞ 0.05 )Conclusion The expression of Cx43 in the epileptogenic focus is increased in comparison with that in the surrounding brain tissues,indicating that GJ plays an important role in the generation and development of epilepsy.There is no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues,which may be related to the apoptosis of the neurons after multiple seizure attacks.