Observation on efficacy of tirofiban in patients with ischemic progressive stroke / 中华疾病控制杂志

Objective To observe the efficacy of tirofiban in the treatment of ischemic progressive stroke. Methods 300 patients who met the diagnostic criteria of ischemic progressive stroke were divided into the control group and tirofiban group. Patients in the control group received treatment of PA2S regiment, i.e., a combination of aspirin, clopidogrel, probucol and atorvastatin. Patients in the tirofiban group received extra tirofiban on the basis of PA2S therapy. National institute of health stroke scale (NIHSS) score was evaluated on patients in both group before the therapy and 3 days, 1 month, 6 months after the therapy respectively. Results For the control group, the average NIHSS score was 11.3±4.2,11.5±4.4,8.8±4.1,6.1±4.1 before therapy and at 3 days, 1 month, 6 months after the therapy. And for the tirofiban group, the average NIHSS score was 11.4±3.9, 10.8±3.6, 7.4±3.2, 4.4±3.0 at the corresponding period respectively. There were statistical differences between the two groups in the period of 1 month and 6 months after treatment with P<0.001. Conclusions Tirofiban hydrochloride can improve the degree of neurological deficit and outcome in patients with ischemic progressive stroke.

Microsurgical resection of tumors lateroventral and ventral to the high cervical spinal cord / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management.</p><p><b>METHODS</b>Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm x 2.5 cm x 2.0 cm to 12 cm x 3.0 cm x 2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium.</p><p><b>RESULTS</b>The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients.</p><p><b>CONCLUSION</b>Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.</p>

Cranioplasty and analysis of related problems after craniocerebral trauma / 中华创伤杂志

Objective To analyze the choice of implant materials,key points of operative proce- dures,prevention and management of postoperative complications in patients treated with cranioplasty. Methods Two hundred and twenty six patients with craniocerebral trauma underwent cranioplasty with different implant materials.Attention should be paid for the purpose of not tearing or injuring the dura ma- ter during operation.To take the dura mater up to the implant material and the edge of the bone flap,and put drainage under the scalp flap before closure of the incision.Results The clinical symptoms and neural function were improved in 146(64.6%)patients postoperatively.Postoperative complications mainly were infection,fluid collection and hematoma in the operative region.Follow-up showed the occur- rence of displacement or collapse of the implant materials in some patients.Conclusion Timely cra- nioplasty can not only resolve cosmetic problems but also improve clinical symptoms and neural function. The causes of postoperative complications are mainly related with the operative procedures and the materi- als used.