Efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage / 国际外科学杂志

Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.

The problems and countermeasures of autoantibodies detection / 中华检验医学杂志

Autoantibodies are of great importance to diagnosis , differential diagnosis , curative effect observation and prognosis in autoimmune disease .Presently, there are many problems existing in detection of autoantibodies , such as non-standardized name , non-traceable reagent ,non-consistentdetection process , and results are not mutualrecognized .Administrative departments have attached importance to autoantibody testing, which will lead to the standardization , automation and intelligence of testing ,and will achieve mutual accreditation of laboratory results and better serve for clinics .

Application of twist drill craniostomy with urokinase in chronic subdual hematoma / 国际外科学杂志

Objective To evaluate the clinical effect of chronic subdual hematoma between surgical procedure twist drill craniostomy with injecting urokinase into hematoma space and only with twist drill craniostomy.Methods Two hundred and twenty-five patients with chronic subdual hematoma patients who were admitted in the Affiliated Hospital of Yangzhou University from January 2011 to April 2017 were retrospectively analyzed.They were divided into two groups according to the different surgical methods,group A for twist drill craniostomy with injecting urokinase into hematoma space (n =116),group B only for twist drill craniostomy (n =109).Then the postoperative drainage volume and residual hematoma was analyzed by repeated measures,while radiographic grading system and recurrence rates after operation were compared between groups with statistical analysis which was done by ANOVA analysis or non-parametric rank sum test.Results The drainage volume 48 hours after surgery was(52.41 ± 7.86) ml in group A,(28.42 ± 4.46) ml in group B as well.The residual volumes which were calculated at 1 month,3 months after surgery was (23.35 ±4.18) ml and (15.31 ±6.15) ml in group A,comparing the volumes of (46.07 ± 5.96) ml and (25.60 ± 5.03) ml in group B.The radiographic grading system was evaluated by grade 1-4.There were 75(64.7％) cases in grade 1,32(27.6％) cases in grade 2,8(6.9％) cases in grade 3,1 (0.9％) cases in grade 4 of group A,as well as 42(38.5％) cases in grade 1,55(50.5％) cases in grade 2,11 (10.1％) cases in grade 3,1 (0.9％) cases in grade 4 of group B.The rate of recurrence for chronic subdural hematoma was 6.0％ in group A,while it was 15.6％ in group B.These data all had significant statistical difference between the two groups (P ＜ 0.05).Conclusion Twist drill craniostomy might be a safe,effective and mini-massive method for treating chronic subdual hematoma,while injecting urokinase into the hematoma space could significantly reduce the rate of recurrence and decrease the volume of hematoma.

Effect of different electric coagulation method for cranioplasty / 中国医师进修杂志

Objective To compare the effect of the bipolar electric coagulation and unipolar electric coagulation on cranioplasty of scalp separation. Methods The clinical data of 67 patients who underwent unilateral frontotemporal cranioplasty from 2014 to 2017 were retrospectively analyzed. According to coagulation method during operation, these patients were divided into two groups, unipolar electric coagulation group (32 cases) and bipolar electric coagulation group (35 cases). The operation time, postoperative intracranial hemorrhage, infection, epilepsy and subcutaneous effusion were compared between two groups. Results The operation time of two groups had no significant difference (P > 0.05). The incidence of intracranial hemorrhage, infection and epilepsy of two groups had no significant differences (P > 0.05). But the incidence of subcutaneous effusion in unipolar electric coagulation group was significantly higher than that in bipolar electric coagulation group: 28.1%(9/32) vs. 5.7%(2/35), P<0.05. Conclusions The use of unipolar electric coagulation during the scalp separation in cranioplasty can reduce operation time in a certain extent, but significantly increase the incidence of postoperative subcutaneous effusion.

Curative effect and complication of neuronavigation guided puncture ventricle peritoneal shunt and traditional ventriculoperitoneal shunt for hydrocephalus / 国际外科学杂志

Objective To compare the accuracy of placement of ventricular shunt tube,the efficacy and complications of the neuronavigation-assisted ventriculoperitoneal shunt (group A) and traditional ventriculoperitoneal shunt (group B).Methods A retrospective study was made on 40 cases of hydrocephalus managed with neuronavigation-assisted ventriculoperitoneal shunt or ventriculoperitoneal shunt from January 2012 to June 2016.There were 18 cases [12 males,6 females;(47.5 ±8.5) years of age] in group A and 22 cases [14 males,8 females;(44.5 ± 7.5) years of age] in group B.Therapeutic effect and complications were analyzed postoperatively.The accuracy rate in ventricular end shunt placement that was free from the frontal horn of lateral ventricle and flush the Moro hole had also been studied.Results The position of ventricular shunt of all the patients were postoperative timely review of the CT view,and hospital outpatient follow-up periodical for 3-24 months after discharge from hospital.Patients with postoperative timely review of head CT and found that group A of ventricular end of the shunt tube position reach a set position in 16 cases,2 cases had not reached the set position,the accuracy rate was 88.89％.There were 8 cases in group B reach to the set position and 14 cases did not and the accuracy rate was 36.36％.After the statistical analysis there were significant differences (P ＜ 0.05).The total efficiency of A and B groups (excellent + effective) were 94.4％ and 86.4％ (P ＞ 0.05).Postoperative complications included bleeding,infection,obstruction of the shunt,excessive shunt,shunt insufficiency and so on.During follow-up,group A appeared excessive shunt in 1 case;group B incision infection in 1 case,4 cases of shunt obstruction,excessive shunt in 1 case,2 cases of deficiency of shunt.Two groups of patients were recovery well through the drainage tube pressure adjustment or set it once again.The incidence of complications in group A was 5.56％,group B was 36.36％.There was no significant difference between group A and group B (P ＞ 0.05).In group A,there was no obstruction of shunt tube,ventricular end of the shunt tube blockage occurred in 4 cases in group B,the incidence rate was 18.18％ (P ＞ 0.05).Conclusion Neuronavigation guided ventriculoperitoneal shunt placement to the accuracy of position setting has significant advantages over traditional ventriculoperitoneal shunt in the ventricular end of the shunt tube and it has some advantages in reducing postoperative complications.

Surgical treatment of ruptured middle cerebral artery aneurysms: clinical outcomes and prognostic factors / 国际脑血管病杂志

Objective To investigate the risk factors for clinical poor outcome after microsurgical treatment of ruptured middle cerebral artery aneurysms (MCAA).Methods The patients with ruptured MCAA treated with microsurgery were enrolled retrospectively.The data of demography,medical history,Hunt-Hess grade,imaging characteristics,surgery-related factors,and postoperative complications were collected.Glasgow Outcome Scale (GOS) was used to assess the outcomes.GOS 4-5 was defined as a good outcome and 1-3 was defined as a poor outcome.Results A total of 44 patients with ruptured MCAA were enrolled,including 26 (59.1％) females and 18 (40.9％) males,aged 36-75 years old (mean 58.5 years).The aneurysms were clipped in 42 cases (95.5％) and wrapped in 2 eases (4.5％).They were followed up for 3-6 months,33 (75.0％) had good outcome and 11 (25.0％) had poor outcome.Univariate analysis showed that there were significant differences in the proportions of Hunt-Hess grade,midline shift degree,hematoma volume,intraoperative rupture,decompressive craniectomy,and postoperative pulmonary infection between the good outcome group and the poor outcome group.Multivariatelogistic regression analysis showed that Hunt-Hess grade Ⅳ-Ⅴ (odds ratio [OR] 20.885,95％ confilence interval [CI] 1.342-38.696;P =0.001),intraoperative anenrysm rupture (OR 18.906,95％ CI 2.918-20.915;P=0.011),and complicated with pulmonary infection (OR 38.865,95％ CI 18.718-40.509;P =0.001) were the independent risk factors for poor outcomes.Conclusion The high Hunt-Hess grade,intraoperative aneurysm rupture,and complicated with pulmonary infection after surgery are the independent risk factors for poor outcomes after microsurgical treatment in patients with ruptured MCAA.

Roles of endoplasmic reticulum stress in early brain injury after subarachnoid hemorrhage / 国际脑血管病杂志

Spontaneous subarachnoid hemorrhage (SAH) is a common acute cerebrovascular disease with high morbidity and mortality in clinical practice.Recent studies have shown that early brain injury (EBI)would occur within 72 h after SAH,and is closely associated with the poor outcome in patients with SAH.There are many possible mechanisms resulting in EBI,such as inflammation,autophagy,apoptosis.These damage mechanisms are all associated with endoplasmic reticulum stress.This article reviews the roles of endoplasmic reticulum stress in EBI after SAH.

Roles of endoplasmic reticulum stress in early brain injury after subarachnoid hemorrhage / 国际脑血管病杂志

Spontaneous subarachnoid hemorrhage (SAH) is a common acute cerebrovascular disease with high morbidity and mortality in clinical practice.Recent studies have shown that early brain injury (EBI)would occur within 72 h after SAH,and is closely associated with the poor outcome in patients with SAH.There are many possible mechanisms resulting in EBI,such as inflammation,autophagy,apoptosis.These damage mechanisms are all associated with endoplasmic reticulum stress.This article reviews the roles of endoplasmic reticulum stress in EBI after SAH.

Construction of recombinant lentivirus containing human mir-7-3 like sequence and its expression in gliomas / 肿瘤研究与临床

Objective To construct a lentiviral vector containing mir-7-3 gene and green fluorescent protein (GFP) gene,and to detect the expression of mir-7-3 gene in U251 cells.Methods The fragments containing all the mir-7-3 gene were amplified by RT-PCR and were cloned into the lentivirus vectors labeled with GFP,which was transfected together with the packaging plasmids into 293T cells by CaC12.The supernatant was collected,concentrated,identified,and was transfected to U251 cells of gliomas.Fluorescent microscopy was used to observe the fluorescence in the 293T cell,and real time RT-PCR was used to examine the relative contents of mir-7-3 in U251 cells.Results Electrophores was shown that the sequence of the RT-PCR product was consistent with the data of mir-7-3 by DNA sequence analysis,indicating that the mir-7-3 gene was successfully cloned,and strong green fluorescence was observed by fluorescent microscopy.The supernatant of lentivirus-transfected 293T cells effectively infected U251 cells and the relative content of mir-7-3 was observed in the transfected U251 cells.Conclusion It is concluded that the lentiviral vector containing mir-7-3 gene was constructed successfully,which provides a basis for further study of mir-7-3 function.

Microsurgical Treatment for Pituitary Adenoma via Single-nostril Transsphenoidal Approach / 中国肿瘤临床

Objective: To explore the effect of single-nostril transsphenoidal approach on pituitary adenoma. Methods: We retrospectively analyzed 46 cases of pituitary tumors treated with single-nostril transsphenoidal approach and the effects and complications of surgery.Dunng the surgery,a nasal speculum was inserted through right nostril slowly towards the anterior wall of sphenoid sinus.A nasal mucosa incision of about 1.5cm was made in the right nasal cavity at the level of the middle nasal turbinate.With a fracture of the bony septum,a space was developed between the bilateral nasal mucosa and bony septum to the sphenoid sinus.Then,the face of the sphenoid sinus was exposed.The remainder of the bony septum,the anterior sphenoid sinus wall,and the sphenoid mucosa were removed.The antenor sphenoidotomy should be less than 1.5cm wide.After confirming the tumor by dural puncture,a cross incision of dura was made and the tumor was removed.The saddle was usually Collapsed and visible after total tumor removal.When the tumor was resected,sevaral gelatin sponges were stuffed into the Surgical cavity to stop bleeding. Results: Thirty-four cases had total resection and 12 cases had subtotal resection.No deaths or disability occurred.Hormone levels in almost all patients were improved.Seventeen cases had a sign of diabetes insipidus.Electrolyte disturbance occuwed in 5 cases.NO postoperative cerebrospinal fluid rhinorrhea was observed. Conclusion: Single-nostril transsphenoidal approach has many advantages in treating pituitary adenomas such as simplified approach,brief technology and high security.

Diagnostic value of glucose-6-phosphate isomerase in rheumatoid arthritis patients: systematic review / 生物医学工程学杂志

In order to evaluate the diagnostic accuracy of glucose-6-phosphate isomerase in patients with rheumatoid arthritis, retrieval was performed using the data bases of Medline, Embase, Cochrane library, Cmcc and Cbmdisc (1990 to 2007). We included the articles which reported the studies of GPI measured by enzyme-linked immunosorbent assay in the diagnosis of RA patients. Then we reviewed 15 article and used RevMan Software for analysis; the heterogeneity among the articles was determined to be high (chi2 = 191.65, P < 0.00001). When we analyzed the 5 articles wherein serum was used as the standard, we noticed homogeneity (chi2 = 6.97, P = 0.14). The summary sensitivity was 25%; the summary specificity was 80%; the area under the curve was 0.6279. Our study demonstrated that GPI exhibited high specificity and low sensitivity in diagnosing RA cases. We suggest that GPI be used in conjunction with some assay or other that is characterized by high sensitivity.

Assessment on the application value of five auto-antibodies in rheumatoid arthritis diagnosis / 中华检验医学杂志

Objective To investigate the level of five auto-antibodies including MCV and GPI in the serum of RA patients and assess the application value of five auto-antibodies in RA diagnosis.Methods The five auto-antibodies were detected by ELISA in serum samples of 150 patients with RA and 40 healthy controls,32 patients of SLE,30 patients of OA,20 patients of AS,20 patients of SS,20 patients of CTD.Results The positive rates of these five auto-antibodies in RA patients were significantly higher than in other group(X2=88.5,76.0,279.2,88.2,94.8,P＜0.05).Except anti-AKA,there was no the differences in the level of other antibodies among groups(X2=21.9,9.4,20.2,43.2,41.6,P＞0.05).Anti-MCV and anti-GPI has the highest sensitivity(78.0% and 83.3%),while anti-CCP has the highest specificity(97.1%)and anti-AKA has good specificity(96.1%)and lowest sensitivity(49.4%).When two antibodies were detected together,the sensitivity and specificity of MCV/CCP were highest(92.7% and 96.9%).When RF/GPI/CCP were detected together,the sensitivity and specificity were 90.7% and 96.9%,respectively.When RF/MCv/CCP were detected together,the sensitivity and specificity were 94.0% and 96.9%.Conclusions Anti-MCV and anti-GPI has the hishest sensitivity in laboratory diagnosis of RA,while anti-CCP has the highest specificity and anti-AKA have good specificity and lowest sensitivity.The combination detection can decrease the amount of missed diagnosis caused by single test. The combination detection of RF/GPI/CCP and RF/MCV/CCP will improve sensitivity and specificity for diagnosis to the RA patients.

Clinical application of keyhole craniotomy microsurgery / 中国微创外科杂志

Objective To explore the clinical application of keyhole craniotomy microsurgery in neurosurgery. Methods Corresponding keyhole approach operation was employed in 13 cases of sellar region tumor, 6 cases of meningoma, 5 cases of hypertensive cerebral hemorrhage, 2 cases of glioma of corpus callosum, 2 cases of acoustic neuroma, 1 case of metastatic cerebral tumor, 1 case of epidural hematoma and 1 case of C 2 intravertebral tumor. Results Among the 25 cases, total resection was accomplished in 19 cases and subtotal resection, 6 cases. Lesions were all thoroughly cleared away in 5 cases of cerebral hemorrhage and 1 case of epidural hematoma. One case of acoustic neuroma died of re-bleeding in the lesion on the 3rd postoperative day. Subcutaneous dropsy took place in 2 cases and transient diabetes insipidus occurred in 3 cases. Conclusions Keyhole craniotomy microsurgery has the advantages of minimal exposure, micro-invasion, fewer complications and faster recovery.

Study on the positive standard of anti-ribosomal antibodies / 中国免疫学杂志

Objective:Analysis the relationship between antiribosomal antibodies with molecular weight 38 kD and/or 15/16.5 kD protein and SLE,then to discuss the positive standard of anti ribosomal antibodies and its prevalent rate in SLE patients.Methods:262 sera from 115 SLE, 57 RA,20 SSc,39 MCTD and 31 other immune diseases were detected anti ENA antibodies by Western blot method.Results:Respectively, use 38 kD and 15/16.5 kD protein bands appear simultaneously and 38 kD protein bands appear as anti ribosomal antibodies’ positive standard, the sensitivity and specificity of anti ribosomal antibodies to SLE were 17.4%,97.3% and 28.7%,96.6% respectively.The sensitivity had significant difference (P0 05).SLE patients were dramatically dominated in 14 anti ribosomal 38 kD antibody positive patients(71.4% vs. 28.6%,P0 05).Conclusion:Anti ribosomal 38 kD antibody was closely associated with SLE but not with anti Sm antibody. Use 38 kD protein as the primary standard to verdict anti ribosomal antibody,not only can improve the positive rate of anti ribosomal antibody, but also do not depress its diagnostic specificity for SLE.So it’s worthy to spread this method. [

The Role of CT in Thalamotomy and Posteroventral Pallidotomy Localization / 实用放射学杂志

Objective:To probe the role of CT in guided thalamotomy and posteroventral pallidotomy for Parknson's disease.Methods:With the help of microelectrode guided technique,ipsilateral thalamotomy and pallidotomy were used for 150 Parkinsonian disease.To fix position with CT in operation,the three dimension for target was measured.Results:80 percent of targets orientated by CT tallyed with that recorded by microelectrode electrophysiology.The error of the rest 20% was less than 2 mm on the average.Conclusions:By CT the targets can be accurately located in 3 dimension during operation.The cost of this kind of orientation is 50 percent less than that of SPCT or MRI

The Role of CT in Thalamotomy and Posteroventral Pallidotomy Localization / 实用放射学杂志

Objective:To probe the role of CT in guided thalamotomy and posteroventral pallidotomy for Parknson's disease.Methods:With the help of microelectrode guided technique,ipsilateral thalamotomy and pallidotomy were used for 150 Parkinsonian disease.To fix position with CT in operation,the three dimension for target was measured.Results:80 percent of targets orientated by CT tallyed with that recorded by microelectrode electrophysiology.The error of the rest 20% was less than 2 mm on the average.Conclusions:By CT the targets can be accurately located in 3 dimension during operation.The cost of this kind of orientation is 50 percent less than that of SPCT or MRI.