Protecting role of facial nerve motor evoked potential monitoring in facial nerves during resection of cerebellopontine angle lesions / 中华神经医学杂志

Objective:To analyze the protecting role of facial nerve motor evoked potential (FNMEP) monitoring in facial nerves during the resection of cerebellopontine angle lesions.Methods:The clinical data and monitoring data of 83 patients with cerebellopontine angle lesions, accepted intraoperative facial nerve motor evoked potential (FNMEP) monitoring in our hospital from January 2019 to December 2019, were retrospectively investigated. Pre-surgical (opening dural), intraoperative and post-surgical (closing dural) FNMEP amplitudes were recorded. Relation of end (closing dura) to start (opening dura) amplitude ratio with facial nerve function grading at early-term (3 d after surgery) by House-Brackmann (H-B) grading was analyzed.Results:In these 83 patients, 75 patients (90.4%) achieved total tumor resection, and 8 patients (9.6%) achieved subtotal resection. Integrated anatomical preservation of facial nerves was achieved in all patients (100%); one (1.2%) was died for postoperatively delayed hemorrhage. Three d after surgery, facial nerve H-B grading I-II was noted in 62 patients, and the end to start amplitude ratio was 85.3% (66.8%, 93.4%); facial nerve H-B grading III was noted in 11 patients, and the end to start amplitude ratio was 45.6% (38.7%, 43.8%); facial nerve H-B grading IV was noted in 7 patients, and the end to start amplitude ratio was 23.1% (16.4%, 25.6%); facial nerve H-B grading V-VI was noted in 3 patients, and the end to start amplitude ratio was 6.7% (3.5%, 7.7%). There was a negative correlation between end to start FNMEP amplitude ratio and post-surgical early HB grading ( r s=-0.895, P=0.000). Conclusion:FNMEP is highly reliable in predicting early postoperative facial function during resection of cerebellopontine angle lesions, which can be a valid protection technique for facial nerve.

The sodium fluorescein-guided microsurgical resection of glioblastoma / 中华外科杂志

Objective@#To investigate the clinic effect of the sodium fluorescein-guided microsurgical resection of glioblastoma.@*Methods@#In a retrospective clinical study, 82 patients with glioblastoma confirmed by post-operative pathologic inspection in the Department of Neurosurgery of Tianjin Huanhu Hospital from January 2016 to June 2017 were randomly divided into sodium fluorescein (FL) group (42 cases) and traditional microsurgical (TM) group (40 cases). The tumors were removed by the sodium fluorescein-guided surgical procedure in the FL group. The tissues which displayed different intensity of fluorescent staining were taken for the pathologic inspection. The resection of tumors were completed under common microscope in the TM group. The two groups of patients underwent MRI enhanced scan at 48 hours after operation to determine the degree of tumor resection. The rate of gross total resection, postoperative complication, recurrent rate of two groups were compared by χ2 test or Fisher exact test.@*Results@#Totally 135 fluorescent staining samples were obtained in the FL group. Forty-two samples were showed strong fluorescent staining, and all samples were proved to be tumor tissue by pathologic inspection, the sensitivity of FL was 100%. Thirty-seven gliomas were detected from 45 samples of faintly fluorescent staining, sensitivity of FL was 82.3%. Eight gliomas were found from 48 samples of non-fluorescent staining, the specificity of FL was 83.3%. The total resection rate of sodium fluorescein group was 85.7% (36/42), higher than that of traditional microsurgical group (62.5% (25/40)) (χ2=5.795, P=0.016). Two groups of patients were followed up to 6 months after the operation, and 6 cases (14.3%, 6/42) were recurred in the FL group. Among them, 1 case died and the average Karnofsky performance score was 82.2±15.2. There were 12 recurrent cases (33.3%, 12/36) in the TM group, of which 2 cases were died and the average Karnofsky performance score was 76.9±20.3. There was significantly statistical difference in recurrent rate (χ2=3.962, P=0.047).@*Conclusions@#The sensitivity and specificity of fluorescein staining in glioblastoma tissue are high. And the application of sodium fluorescein-guided microsurgical resection of glioblastoma is safe and simple. Therefore, it is helpful to improve the total resection rate of glioblastoma patients and reduce the recurrence rate.

Therapy of the neurosurgical postoperative culture negative meningitis by using external lumbar drainage combined with empirical antibiotics treatment / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the curative effect of external lumbar drainage combined with empirical antibiotics treatment on the postoperative culture negative meningitis.</p><p><b>METHODS</b>The clinical data of eighty post-operative meningitis patients with cerebrospinal fluid culture negative were retrospectively analyzed according to inclusive and exclusive criteria from January 2013 to December 2014 in Department of Neurosurgery, Tianjin Huanhu Hospital. All patients were composed of 45 male cases and 35 female cases, aging from 9 to 72 years. All patients were divided into two groups according to receiving the different treatment: one group only receiving a intravenously empirical antibiotics treatment (n=40), another group receiving a combined therapy of external lumbar drainage and intravenously empirical antibiotics treatment (n=40). The volume of drainage of cerebrospinal fluid (CSF) were set up from 200 to 300 ml per day. There was no difference in the dosage and interval of the same antibiotics between two groups. The antibiotics usage and therapeutic effect of two groups of patients were observed and analyzed by t-test, Wilcoxon rank test or χ(2) test.</p><p><b>RESULTS</b>The rate of CSF bacterial culture negative was 62.9% (88/140) in the same period. In group of empirical antibiotics treatment, the time of antibiotics treatment was (12.6±3.1) days, the rate of combined with other antibiotics treatment was 40.0% (16/40), the rate of mortality was 15.0% (6/40). However, in group of external lumbar drainage combined with empirical antibiotics treatment, the 3 data were (5.3±1.2) days, 10.0% (4/40), 7.5% (3/40), respectively. The time of antibiotics of the group of empirical antibiotics was longer (t=3.605, P=0.017), while the rate of combined antibiotics and the rate of mortality were lower (χ(2)=3.971, P=0.035; χ(2)=4.136, P=0.027, respectively). The average drainage time was (5.8±1.5) days, 32 patients gained a complete healing only by their first placement, 5 cases need replacement because of occlusion or drainage time more than 14 days. There were no recurrence cases after 3 months' follow-up.</p><p><b>CONCLUSIONS</b>The method of external lumbar drainage combined with empirical antibiotics treatment can significantly reduce the dosage and course of antibiotics treatment. It is a simple, safe, efficacious method for the treatment of neurosurgical postoperative bacterial culture negative meningitis.</p>

Relevant anatomy studies of subtemporal transtentorial and transpetrosal presigmoid approaches to petroclival region / 中华神经医学杂志

Objective To study the microscopic anatomy of the petroclival region through simulated subtemporal transtentorial and transpetrosal presigmoid approaches, and discuss their respective scope for clinical application and provide reference to petroclival region surgical approaches. Methods Ten wet adult head specimens (20 sides) were studied by subtemporal transtentorial and transpetrosal presigmoid approach under microscope, respectively; the features of vessels and nerves of the petroclival area, microanatomic relations of vessels and nerves with their surrounding structures were researched; the exposure scope of these two operative approaches to petroclival region was described. Results The trochlear nerve entered the edge of tentorium in post-lateral posterior clinoid process with a mean distance of (15.72±3.81) mm, and it sneaked (6.82±1.81) mm in the tentorium into the external wall of the cavernous sinus. When the tentorium was cut off, it could expose the posterior clinoid process and posterior communicating artery at upper bound, and petrous ridge at lower bound. The distance from petrous sigmoid sinus junction to the posterior semicircular canal was about (10.48 ±0.42) mm, Trautman's triangle could be exposed about (243.5±26.1) mm2. The rear of the cavernous sinus, Meckel's cavity and saddle back at upper bound, the contralateral slopes at the inside, and the bridge of groove and ventral medulla oblongata at lower bound could be reached via transpetrosal presigmoid approach. Conclusions Subtemporal transtentorial approach mainly applys to the upper, middle parts of slopes and petrous apex lesions;the temporal lobe needs to be lifted in the operation, which may damage Labbe vein. Transpetrosal presigmoid approach can be applied to superior, middle and inferior slope and petrous apex lesions, it has advantage of light pulling brain tissues and wide exposure than subtemporal transtentorial approach; however, intraoperative trauma and long operation time may cause hearing impairment and cerebrospinal fluid leakage.

Intracranial ependymal tumour: a clinical study of 83 cases / 中国医师进修杂志

Objective To study the clinical features of patients with intracranial ependymal tumour, and explore the prognostic factors which have.a significant association with the outcome. Methods Eighty-three patients with histologically proven ependymal tumour were retrospectively reviewed. The tumour location, the patients' age, the histological features, imaging characteristics, surgical management and adjuvant therapy were studied. Results In 83 cases of intracranial ependymal tumour,41 cases were infratentorial and 42 cases were supratentorial ependymal tumour, 37 patients age ≤15 years, while 46patients age ＞ 15 years. Fifty-eight patients ( 69.9% ) and 25 patients (30.1% ) had low (WHO Ⅰ - Ⅱ ) and high-grade (WHOⅢ) tumors respectively. Sixty-reven (80.7%) patients had gross total resection and 16patients ( 19.3% ) had subtotal resection. The 5-year survival rate was 81.9%( 68/83 ). The factors that were found to have a statistical significance association with the outcome were the extent of the resection and the pathologic characteristics. Conclusions Gross total resection of these tumors results in a good long-term outcome. Reoperation should be considered, if feasible, to remove residual malignant tissue. Anaplastic ependymomas carries a much poorer prognosis. Radiotherapy may play an important role in their treatment.The role of chemotherapy appears limited but can be attempted, especially in the very young, in order to avoid the deleterious effect of radiotherapy.

Interaction of Rabbit Skeletal Muscle Lactate Dehydrogenase with Asolectin Liposome / 第二军医大学学报

In this paper, the effect of asolectin liposome on the activity of rabbit skeletal muscle lactate dehydrogenase (LDH) is reported. The results suggested that asolectin liposome could inhibit LDH activity, KC1 could restore the enzyme activity, and NAD+ and NADH could protect the enzyme from being inhibited by asolectin liposome.

COMPARATIVE STUDIES OF THE ZYMOGRAMS OF ESTERASE AND LACTIC DEHYDROGENASE ISOZYMES FROM TWO SPECIES OF AEDES / 第二军医大学学报

The zymograms of esterase(Est)and lactic dehydrogenase (LDH) isozymes fromtwo species of Aedes were studied by polyacrylamide gel electrophoresis.The zy-mograms were divided into two groups of bands, Est Ⅰ and Ⅱ, and LDH ⅠandⅡ, respectively.They exhibited some similar characteristics of sibling species,On the basis of differences of Est Ⅱ phenotypes, the two species could be distinguished from each other

Analysis of EST Zymograms in Six Species of Anopheline Mosquitoes / 第二军医大学学报

The zymograms of EST in six species of anopheline mosquitoes (Female) were studied with polyacrylamide gel electrophoresis.The zymograms of EST were divided into three groups,EST Ⅰ, EST Ⅱ and EST Ⅲ, respectively.The Rm of subgenus Anopheles (including An sinensis,An.anthropophagus and An.kunmigensis) was larger than that of subgenus Cellia (including An.dirus, An.mmmus and An.kochi) in main bands of EST Ⅲ. The results showed specific characteristics at the taxonomic level of subgenus. The six species of anopheline mosquitoes could be differentiated from each other by the particular band pattern and Rm in EST n groups.

METHOD FOR ULTRASTRUCTURAL LOCALIZATION OF N ACETYLCHOLINE RECEPTOR / 第二军医大学学报

A method by using ?-BT-HRP conjugate to localize N-acetylcholinc receptor of neuromuscular junction was described.Thin strips of fresh muscle were incubated with ?-BT-HRP conjugate at a concentration of 1?10-7 M in Tyroid's solution and then reacted with Karnovsky's DAB medium.There were obviously brownish red positive deposits to constitute various vesicular forms seen under a light microscope. Under an electron microscope we can see positive deposits that were localized both on the presynaptic and postsynaptic membra-nes. The binding activity and reliability of a-BT-HRP were discussed.

A STUDY OF SOME PROPERTIES OF ?-BT-HRP CONJUGATES AND THE PERIODATE METHOD OF PREPARATION / 第二军医大学学报

Some properties of ?-BT-HRP conjugates and its periodate method of preparaton were investigated.The results of SDS-PAGE, absorption spectrum, and the observations proved that the conjugates were heterogeneous, but stable ; the good conjugates had an O.D.403nm : O.D.280nm ratio(RZ) of approximately 1.0.The periodate method used in this study was reproducible. The conjugating effect between ?-BT and HRP was high.

Comparative Studies on Kinetics of Mitochondrial LDH and Solubilized Mitochondrial LDH in Rat Liver / 第二军医大学学报

In this paper, we studied the kinetics of nitochondrial lactate dehydrogenase (LDH) and solubilized mitochondrial LDH in the rat liver. The apparent Km values of mitochondrial LDH and solubilized mitochondrial LDH for substrate pyruvate were 50.0 ?mol/L and 33.8 ?mol/L, and those for NADH were 35.3?mol/L and 21.4 ?mol/L, respectively. The apparent Km values of mitochondrial LDH were greater than those of solubilized nitochondrial LDH. The mitochondrial LDH in the rat liver was mainly LDH-5, which could be solubilized by 0.15 mol/L NaQ solution.