Intraoperative awake combined with neuronavigation in surgery for eloquent area gliomas / 中华神经医学杂志

Objective:To explore the application value of intraoperative awake combined with neuronavigation in surgery for eloquent area gliomas.Methods:Twenty patients with eloquent area gliomas, admitted to our hospital from October 2017 to June 2019, were chosen in our study. Preoperative blood oxygenation level dependent-functional MR imaging (BOLT-fMRI) was used to display the functional cortex in all patients, and diffusion tensor imaging (DTI) was used to reconstruct the peripheral fibrous tracts of the gliomas; after imaging fusion of above function structures, the data were imported into the neuronavigation system; intraoperative microscope was used to determine the functional areas in the cortex and the fiber bundle, and intraoperative awake combined with cortical stimulus was employed to determine the functional areas in the cortex again before removal of the tumors. Changes in patients' quality of life (Karnofsky performance scale, [KPS] scores) before surgery, 2 weeks after surgery, and 3 months after surgery were compared, and surgical-related complications or death were recorded.Results:Intraoperative awake combined with neuronavigation were successfully applied with the addition of cortical electrical stimulation in all 20 patients; 16 (80%) accepted total resection and 4 (20%) accepted subtotal resection. Follow-up for 2 weeks after surgery and 3 months after surgery showed that only one patient with high-grade glioma had decreased KPS scores than those before surgery, and there were no postoperative deaths or severe disabilities. As compared with KPS scores before surgery(83.02±4.76), those at 2 weeks after surgery (90.15±6.72) and 3 months after surgery (96.86±6.18) were significantly higher ( P<0.05). Conclusion:Intraoperative awake combined with neuronavigation can locate the eloquent area and fibers accurately, help neurosurgeons to resect gliomas totally in the surgery and protect patients' neuro-function.

Clinical significance of vasculogenic mimicry and its correlation with extracellular matrix metalloproteinase inducer expression in gliomas / 中华神经医学杂志

Objective To investigate the expression of vasculogenic mimicry (VM) and its relations with extracellular matrix metalloproteinase inducer (EMMPRIN) expression and clinical data in gliomas.Methods Sixty-eight glioma specimens were collected in our hospital from January 2004 and April 2014, including 4 of grade I, 17 of grade Ⅱ, 23 of grade Ⅲ and 24 of grade Ⅳ.All specimens were preserved in paraffin embedded by standard procedures after surgery.Immunohistochemical staining of CD34 and PAS (dual staining) was employed to verify the existence of VM and EMMPRIN expression.The relations of VM with clinical data and EMMPRIN expression were analyzed.Results VM channels were found in 14 specimens of human gliomas (20.58％);higher incidence of VM in high-grade gliomas (WHO Ⅲ: 5.88％;WHO Ⅳ: 13.24％) was noted as compared with that in low-grade gliomas (WHO Ⅰ: 0.00％;WHO Ⅱ: 1.47％, Z=2.843, P=0.008).There were no significant differences of VM appearance between patients of different age, gender and tumor sizes (P＜0.05).EMMPRIN expression in glioma slices of VM appearance was significantly higher than that in glioma slices without VM appearance (Z=2.748, P=0.004).Conclusion VM exists in gliomas and VM is not only positively correlated with tumor grade, but also with EMMPRIN expression level;and it is not correlated with general clinicopathological features such as gender, age and tumor sizes.

Clinical analysis of 18 patients with chronic expanding intracerebral hematoma / 临床外科杂志

Objective To summarize the diagnostic and therapeutic experiences of 18 patients with chronic expanding intracerebral hematoma.Methods Clinical data of 18 patients with chronic expanding intracerebral hematoma was analyzed retrospectively.Results Most of the lesions were misdiagnosed preoperatively as cerebral neoplasms.Among 18 cases, 15 cases were cured, 2 cases had severe disability, and one case died after operation.Conclusions Chronic expanding intracerebral hematoma must be considered when encapsulated mass lesion is present in the brain. The ultimate diagnosis is confirmed at surgery and by histological analysis.

Sub-hypothermia Treatment on Patients With Diffusing Axonal Injury / 中国医师杂志

Objective To study the therapeutic effect of sub-hypothermia on 80 patients with diffusing axonal injury (DAI) and its prognosis.Methods All 80 patients with DAI were randomly divided into the sub-hypothermia group(40 cases)and the control group(40 cases). All patients'vital sign,intracranial pressure (ICP) and blood sugar were measured. 40 cases of the patients with DAI were treated by sub-hypothermia, the rectal temperate (RT) reached 32 0℃～35 0℃,sub-hypothermia lasted for 1～7 days; the control group was treated routine. According to Glasgow Outcome Scale (GOS), the prognosis of the patients was evaluated 3 months later.Results In comparison with the control group, increased ICP and raised blood sugar in sub-hypothermia group were significantly decreased (P

Neuroendoscopic neurosurgy for primary intraventricular hemorrhage / 临床外科杂志

Objective To investigate the new therapy for primary intraventricular hemorrhage (PIH).Methods 31 cases of PIH were treated by rigid neuroendoscopy.The cases were composed of 16 cases of single intraventricular hemorrhage,14 cases of double intraventricular hemorrhage and 1 case the third-fourth intraventricular hemorrhage.24 cases were accompanied with acute obstructive hydrocephalus.Results Duration of operation lasted from 30 minutes to 60 minutes, with an average time of 43.4 minutes.More than 90 percent of hemorrhage in 24 cases with single or double intraventricular hemorrhage were evacuated. 50 percent to 90 percent of hemorrhage were evacuated in other 7 cases. Neurological status was obviously improved and improved in 25 cases, no change in 4 cases and dead in 2 cases.Only one patient developed hydrocephalus.Conclusion Neuroendoscopic neurosurgy for PIH was characterized by visualized manipulation, shorten operative time,minimal invasion, effective hemorrhage evacuation and excellent post-operative outcomes.

Significance of NF-?B expression in human cerebral tumors / 中国癌症杂志

Purpose:To evaluate the significance of NF ?B P65 protein expression in various human cerebral tumors. Methods:The expression of NF ?B P65 protein in 106 cases of cerebral tumors was studied immunohistochemically. 106 cases included 64 cases of astrocytic tumors and 22 cases of medulloblastoma and 20 cases of meningioma. 10 cases of normal brain tissue were employed as a control group.Results:The positive rate of NF ?B P65 protein of 64 astrocytic tumor specimens was 54.7%; the positive rate of NF ?B P65 protein of 22 cases of medulloblastoma was 36.4% and 5.0% for 20 cases of meningioma. In contrast, none of the normal tissues exhibited NF ?B P65 protein staining. Significant difference were observed between astrocytic tumor group and meningioma, as well as between medulloblastoma and meningioma ( P