Pharmaceutical care for one case of levofloxacin-induced hypersensitivity reaction by the participation of clinical pharmacists and literature analysis / 中国药房

OBJECTIVE To analyze the characteristics of levofloxacin-induced hypersensitivity reaction. METHODS Clinical pharmacists participated in the treatment for a case of levofloxacin-induced hypersensitivity reaction， and adjudged the relationship of levofloxacin with hypersensitivity reaction according to relative standards. Retrieved from CNKI， VIP， Wanfang database， PubMed and Embase， relevant literature about levofloxacin-induced hypersensitivity reaction was collected and analyzed. RESULTS Clinical pharmacists suggested checking the patient’s previous medication and allergy history based on symptoms such as fever and systemic rash， and determined that the drug hypersensitivity was “likely” or “highly likely” to be associated with levofloxacin. Clinicians provided symptomatic treatment to the patient based on the judgment of clinical pharmacists， and the patient improved after treatment. Results of the literature analysis showed that among 31 involved patients， there were 23 males and 8 females； 18 patients aged 50 and above； the incubation period of 24 patients was within 4 days after medication. The main adverse drug reactions were drug hypersensitivity syndrome， fixed drug eruption， erythema multiforme， etc. Most patients were improved after withdrawal and symptomatic treatment. CONCLUSIONS Hypersensitivity reaction is the rare adverse drug reaction of levofloxacin， mostly occurring within 2.5 h to 4 days after administration， and it is more likely to occur in middle-aged and elderly patients. Before clinical use， patients should be asked about their drug allergy history in detail； when patients experience fever or rash without obvious causes， medication should be stopped promptly and symptomatic treatment should be taken to ensure the safety and effectiveness of the patients’ medication.

Epidemiological characteristics of pulmonary tuberculosis in the elderly people in Wuhan in 2016-2020 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in the elderly people in Wuhan during 2016-2020, and to provide a basis for formulating effective prevention and control strategies and measures. Methods Using the National Tuberculosis Information Management System, a descriptive statistical analysis was performed on the medical records of elderly (≥60 years old) pulmonary tuberculosis patients registered in Wuhan from 2016 to 2020. Results A total of 9 427 elderly pulmonary tuberculosis patients were registered in Wuhan during 2016-2020, accounting for 32.07% of the total number of registrations in the whole population. The reported incidence rate of tuberculosis in the elderly was significantly higher than that in the total population, and the reported incidence rates in both the elderly and the general population showed declining trends (whole population χ2trend=216.97, P2trend=153.57, P<0.05). The time distribution showed that more cases occurred from April to November (70.90%). The top three districts with the largest number of registered cases were far urban areas, namely Huangpi District (13.81%), Xinzhou District (11.55%), and Jiangxia District (9.82%). The ratio of male to female with pulmonary tuberculosis in elderly patients was 2.85:1. Among the elderly pulmonary tuberculosis, the most registered cases were in the age group of 60 ~ years old, followed by 65 ~ years old. The proportion of smear-positive in elderly patients with pulmonary tuberculosis retreatment was 16.83%. Conclusion From 2016 to 2020, the epidemic situation of elderly pulmonary tuberculosis showed a downward trend in Wuhan. However, the elderly population with tuberculosis registrations still accounted for a relatively high proportion of the total population. According to the epidemiological characteristics of pulmonary tuberculosis among the elderly, the city should carry out tuberculosis prevention and control work in a timely, appropriate and focused manner.

Study on the correlation between blood glucose fluctuation and body mass index in patients with type 2 diabetes mellitus / 医学研究生学报

ObjectiveThere are few reports on the correlation between blood glucose fluctuation and body mass index(BMI) in patients with type 2 diabetes mellitus (T2DM). This study aims to evaluate the correlation between the two by comparing the differences of glucose fluctuation in T2DM patients with different BMI.MethodsA total of 672 patients with T2DM admitted to the General Hospital of Eastern Theater Command from June 2017 to October 2018 were selected as subjects. They were divided into 4 groups according to the quartile of BMI. The age, height, weight, course of diabetes, hemoglobin, uric acid, glycosylated hemoglobin, HOMA-IR (insulin resistance index) and HOMA-β (islet β cell function index) were collected. The blood glucose of the patients was continuously monitored within 3 days by wearing a continuous glucose monitor (CGMS). The standard deviation of daily blood glucose (SBDG), the mean of daily differences (MODD) and the mean amplitude of glycemic excursion(MAGE) were calculated to analyze the effect of BMI on blood glucose fluctuation.ResultsThe index of blood glucose fluctuation was negatively correlated with BMI, HbA1c and HOMA-β, but positively with HOMA-IR. Compared with the 1st and 2nd quartiles of BMI, the fluctuation level of patients in the 3rd and 4th quartiles was lower. Multivariate logistic regression analysis showed that after adjustment of age, sex, cholesterol, triglyceride and hemoglobin, the risk of hyperglycemia fluctuation in the fourth quartile group was lower than that in the first quartile group (OR=0.594, 95%CI: 1.825~2.062).ConclusionThe fluctuation of blood glucose in patients with higher BMI is lower than that in patients with lower BMI.

Role of ERRα in regulating ATP synthesis in hiPSCs-derived cardiomyocytes / 解放军医学杂志

Objective: To investigate the role of estrogen-related receptor alpha (ERRα) in regulating the adenosine triphosphate (ATP) synthesis in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). Methods: Undifferentiated human induced pluripotent stem cells (hiPSCs) were induced to differentiate into cardiomyocytes by sequential transient activation/inhibition of Wnt signaling pathway. Immunofluorescence was used to detect the expression of pluripotency markers sex determining region Y-box 2 (SOX2), stage specific embryonic antigen 4 (SSEA4) and tumor resistance antigen 1-60 (TRA-1-60) in hiPSCs and the expression of cardiac specific markers cardiac troponin T (cTnT) and connexin 43 (Cx43) in hiPSCCMs, respectively; RT-qPCR was used to detect the mRNA expression levels of cardiac troponin T2 (TNNT2) and myosin heavy chain 6 (MYH6) in hiPSCs and hiPSCs-CMs; Western blotting was performed to detect the protein expression levels of ERRα, cytochrome C (CytC) and mitochondrial pyruvate carrier 1 (MPC1) in hiPSCs-CMs. Additionally, the ERRα-specific inhibitor XCT790 was used to treat the hiPSC-CMs, and then the protein expressions of ERRα, CytC and MPC1 were detected by Western blotting, and the changes of cell viability, intracellular ATP content and mitochondrial membrane potential were measured by assay kits. Results: Immunofluorescence results showed that hiPSCs expressed SOX2, SSEA4 and TRA-1-60, while hiPSC-CMs expressed cTnT and Cx43; compared with hiPSCs, the mRNA levels of TNNT2 and MYH6 in hiPSC-CMs increased significantly (82.820 ± 2.005 vs. 1.001 ± 0.029, 90982.000 ± 1968.000 vs. 1.003 ± 0.053, respectively, P<0.05), and intracellular ATP content and protein expression levels of ERRα, CytC and MPC1 also increased significantly [(9.905 ± 1.286) nmol/mg protein vs. (4.582 ± 0.141) nmol/mg protein, 5.392 ± 0.313 vs. 1.050 ± 0.076, 8.954 ± 0.293 vs. 1.071 ± 0.067, 2.605 ± 0.088 vs. 1.031 ± 0.091, respectively] with significant differences (P<0.05). Furthermore, compared with the control group, 10 μmol/L XCT790 could effectively inhibit the protein activity of ERRα in hiPSC-CMs without cytotoxicity, and reduced intracellular ATP content and mitochondrial membrane potential [(4.903 ± 1.158) nmol/mg protein vs. (9.310 ± 0.980) nmol/mg protein, 1.407 ± 0.022 vs. 1.977 ± 0.093, respectively], meanwhile down-regulated the protein expression levels of MPC1 and CytC in hiPSC-CMs (0.705 ± 0.019 vs. 0.897 ± 0.011, 0.594 ± 0.021 vs. 0.797 ± 0.025, respectively, P<0.05). Conclusions: The increase of ATP content after differentiation of hiPSCs into cardiomyocytes is related to the increase of ERRα expression. In hiPSC-CMs, ERRα may regulate the ATP synthesis though regulating the mitochondrial membrane potential and the protein expression of CytC and MPC1.

Long non-coding RNA LINC01268 promotes cell growth and inhibits cell apoptosis by modulating miR-217/SOS1 axis in acute myeloid leukemia

The aim of this study was to evaluate the pathogenic role of newly identified long non-coding (lnc)-RNA LINCO1268 in acute myeloid leukemia (AML), and investigate its therapeutic potential. The expression level of LINC01268 in AML was measured by quantitative PCR (qPCR). The viability, cell cycle progression, and apoptosis of AML cells were measured by CCK-8 assay and flow cytometry, respectively. The interaction between LINC01268 and miR-217 were predicted by the miRDB website, and then verified by luciferase reporter assay and RNA immunoprecipitation (RIP) assay. The relationship between miR-217 and SOS1 was predicted by TargetScan website, and verified by luciferase reporter assay. LINC01268 was significantly upregulated by 1.6 fold in bone marrow samples of AML patients, which was associated with poor prognosis. LINC01268 was also significantly upregulated in AML cells. LINC01268 knockdown inhibited viability and cell cycle progression but promoted apoptosis of AML cells. Furthermore, LINC01268 functioned as a ceRNA via competitively binding to miR-217, and SOS1 was identified as a target of miR-217. Moreover, LINC01268 positively regulated SOS1 expression to promote AML cell viability and cell cycle progression but inhibited apoptosis via sponging miR-217. LINC01268 promoted cell growth and inhibited cell apoptosis through modulating miR-217/SOS1 axis in AML. This study offers a novel molecular mechanism for a better understanding of the pathology of AML. LINC01268 could be considered as a potential biomarker for the therapy and diagnosis of AML.

Research on the mechanism of gut microbiota in reducing blood glucose of db/db diabetic mice by broad-spectrum antibiotics / 医学研究生学报

Objective The alterations of gut microbiota is closely related to metabolic diseases. The aim of this study was to analyze the effects of antibiotics on glucose metabolism and gut microbiota in mice, and to further explore the mechanism of gut microbiota in reducing blood glucose in db/db diabetic mice by broad-spectrum antibiotics. Methods 16 C57BL/KsJ-db/db mice were randomly divided into antibiotic group and control group with 8 mice in each group. Antibiotic group: broad-spectrum antibiotics(vancomycin 10mg/(kg·d), carbenicillin 50mg/(kg·d), metronidazole 50mg/(kg·d), neomycin 30mg/(kg·d)); Control group: 1% cellulose sodium solution as placebo treatment. Fasting blood glucose and body weights were recorded once a week during the study. At the same time, feces were collected for 16S rDNA gene sequencing analysis. The changes of fasting blood glucose, body weight, the relative abundance of microbiota, Shannon index, Simpson index and GLP-1 were compared between the two groups. Results After 5 weeks of treatment with broad-spectrum antibiotics (Vancomycin , Carbenicillin , Metronidazole , and Neomycin ), fasting blood glucose levels in db/db diabetic mice were significantly decreased (9.59±4.49mmol/L vs 19.71±8.74mmol/L,P=0.016). At the same time, antibiotics can also affect the gut microbiota of mice. The relative abundance of Proteobacteria in mice treated with antibiotics was significantly higher than that in control group (0.471±0.12 vs 0.177±0.12, P<0.05), and the OTUs of Proteobacteria, Enterobacteriaceae, Gamma-proteobacteria, and Enterobacteriales increased in mice treated with antibiotics compared with controls. In addition, we also showed antibiotics could change the diversity of gut microbiota, and the diversity of gut microbiota in antibiotic treated mice decreased significantly (Shannon index 3.135 vs 5.359, P<0.01); Simpson index 0.794 vs 0.946, P<0.01). Conclusion Broad-spectrum antibiotics can significantly reduce the fasting blood glucose level and the diversity of gut microbiota of db / db diabetic mice, and the alterations of gut microbiota may play an essential role in the process of reducing blood glucose by broad-spectrum antibiotics.

Efficacy and Safety of Risperidone versus Haloperidol in the Treatment of Behavioral and Psychological Symptoms of De- mentia：a Meta-analysis / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of risperidone versus haloperidol in the treatment of behavioral and psychological symptoms of dementia （BPSD）， and to provide evidence-based reference for clinical drug use. METHODS： Cochrane library， PubMed， EMbase， CNKI， CBM， Wanfang and VIP database were searched for the randomized controlled trials （RCT） on risperidone （trial group） versus haloperidol （control group） in the treatment of BPSD. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 26 studies were included， involving 2 219 patients. The results of Meta-analysis showed that the total response rate [RR＝1.11， 95％CI（1.05， 1.18）， P＝0.000 3] and CMAI score [SMD＝0.19， 95％CI（0.04， 0.34）， P＝0.01] in trial group were significantly higher than control group. MMSE score [SMD＝－0.32， 95％CI（－0.63， －0.01）， P＝0.04]， and the incidence of extrapyramidal reaction [RR＝0.39， 95％CI（0.31， 0.49）， P＜0.000 1]， gastrointestinal reaction [RR＝0.51， 95％CI（0.38， 0.68）， P＜0.000 1]， somnolence [RR＝0.47， 95％CI （0.25， 0.88）， P＝0.02]， thirst [RR＝0.50， 95％CI（0.33， 0.74）， P＝0.000 5] and constipation [RR＝0.33， 95％CI（0.20， 0.54）， P＜0.000 1] in trial group were significantly lower than control group. There were no statistical significance in BEHAVE-AD score [SMD＝0.03， 95％CI（－0.09，0.16）， P＝0.62] and the incidence of insomnia [RR＝1.26， 95％CI（0.76， 2.11）， P＝0.37]， headache/dizziness [RR＝0.65， 95％CI（0.38， 1.12）， P＝0.12] and tachycardia[RR＝0.40， 95％CI（0.12， 1.31）， P＝0.13] between two groups. CONCLUSIONS： The efficacy and safety of risperidone in the treatment of BPSD are signi- ficantly better than haloperidol， and risperidone can improve agitation behavior and general cognitive state of patients.

Correlation of the thyroid hormone level with glycemic fluctuation in patients with euthyroid type 2 diabetes mellitus / 医学研究生学报

Objective Diabetes mellitus (DM) is often complicated by thyroid hormone abnormality. The aim of this study was to investigate the relationship between the thyroid hormone level and glycemic fluctuation in patients with euthyroid type 2 DM (T2DM).Methods A total of 143 euthyroid T2DM patients were treated in the Department of Endocrinology of Nanjing General Hospital from January 2014 to December 2015. The continuous blood glucose monitoring system was used for 72-hour continuous monitoring of blood glucose fluctuation indexes, including the standard deviation (SD) of the glucose level, the mean amplitude of glycemic excursions (MAGE), and the absolute mean of daily differences (MODD). According to the percentile of the MAGE level, the patients were divided into groups Q1 (MAGE<4.1864, n=35), Q2 (4.1864≤MAGE<5.3764, n=37), Q3 (5.3764≤MAGE<6.8484, n=35), and Q4 (MAGE≥6.8484, n=36), compared the thyroid hormone level and such thyroid function parameters as serum free triiodothyronine (FT3), triiodothyronine (T3), free thyroxine (FT4) and FT3/FT4 among the four groups, and analyzed the correlation between the thyroid hormone level and glycemic indexes.Results The levels of serum FT3, T3 and FT3/FT4 were decreased with the increase of MAGE (P<0.05), and those of FT3 and FT3/FT4 were 4.11±0.77 and 0.38±0.37 in group Q1, 4.06±0.55 and 0.34±0.37 in Q2, 3.49±0.57 and 0.33±0.06 in Q3, and 3.68±0.65 and 0.31±0.09 in Q4, with statistically significant differences between any two groups (P<0.05). There were also statistically significant differences among the four groups (P<0.05) in the T3 and FT4 levels (P<0.05). The levels of FT3 and T3 were correlated negatively with SD, MODD and MAGE (P<0.05), and so was that of FT3/FT4 with MAGE (r=-0.243, P<0.05).Conclusion MAGE reduces the levels of FT3 and FT3/FT4 in patients with euthyroid T2DM probably by inhibiting the conversion of T4 to T3.

Cost-effectiveness Analysis of SOX Regimen versus CapeOX Regimen for Metastatic Colorectal Cancer / 中国药房

OBJECTIVE:To evaluate the cost-effectiveness of SOX regimen(tegafur+oxaliplatin)vs. CapeOX regimen (capecitabine+oxaliplatin)in the treatment of metastatic colorectal cancer,and to provide reference for exploring more economical first-line regimen of metastatic colorectal cancer. METHODS:Based on published high-quality Ⅲ-phase randomized controlled trial,Markov model was established according to the process of disease development in patients with metastatic colorectal cancer. The model was divided into progression-free survival state,progressive disease state and death state. Combined with relevant data of our hospital,pharmacoeconomic cost-effectiveness analysis was conducted for SOX regimen and CapeOX regimen. Sensitivity analysis validation model was used to analyze the stability of the model. RESULTS:According to the results of Markov model operation,compared to standard CapeOX regimen,SOX regimen could increase 0.14 QALYs,and cost increased by 35 493.45 yuan;incremental cost-effectiveness ratio was 253 524.64 yuan/QALYs,which was higher than willingness-to-pay(WTP) threshold(168 201.201 yuan/QALYs). Single factor sensitivity analysis showed that cost of oxaliplatin had the most important impact on the result of cost-effectiveness analysis. Probabilistic sensitivity analysis depicted that with the increase of GDP per capita,the probability of SOX regimen with cost-effectiveness would increase. CONCLUSIONS:At present,compared with standard CapeOX regimen,SOX regimen has no cost-effectiveness for metastatic colorectal cancer,which is not recommended as the first choice for first-line treatment of metastatic colorectal cancer.

Comparative transcriptome profile of the leaf elongation zone of wild barley (Hordeum spontaneum) eibi1 mutant and its isogenic wild type

Abstract The naturally occurring wild barley mutant eibi1/hvabcg31 suffers from severe water loss due to the permeable leaf cuticle. Eibi1/HvABCG31 encodes a full ATP-binding cassette (ABC) transporter, HvABCG31, playing a role in cutin deposition in the elongation zone of growing barley leaves. The eibi1 allele has pleiotropic effects on the appearance of leaves, plant stature, fertility, spike and grain size, and rate of germination. Comparative transcriptome profile of the leaf elongation zone of the eibi1 mutant as well as its isogenic wild type showed that various pathogenesis-related genes were up-regulated in the eibi1 mutant. The known cuticle-related genes that we analyzed did not show significant expression difference between the mutant and wild type. These results suggest that the pleiotropic effects may be a compensatory consequence of the activation of defense genes in the eibi1 mutation. Furthermore, we were able to find the mutation of the eibi1/hvabcg31 allele by comparing transcript sequences, which indicated that the RNA-Seq is useful not only for researches on general molecular mechanism but also for the identification of possible mutant genes.

Exogenous neuregulin-1 attenuates STZ-induced diabetic peripheral neuropathic pain in rats

Abstract Purpose: To investigate whether modulating NRG1 could attenuate diabetic neuropathic pain and analyze the underlying mechanism. Methods: Male SD rats were randomly divided into control group, diabetic group, NRG1 intervention group. After STZ-induced 2 weeks, NRG1 intervention daily for consecutive 7 days. 4 weeks after NRG1 intervention, both the mechanical withdrawal threshold and the morphological changes of the dorsal root ganglion and sural nerve were observed. Meanwhile, the expression of NGF, IL-1β, TNF-α in spinal cord were determined. Results: Compared with the diabetic group, NRG1 treatment improved the mechanical withdrawal threshold in diabetic rats, pathological changes of dorsal root ganglion and sural nerve were alleviated by NRG1 treatment with electron microscopy imagine. Moreover, compared with the control group, the expression of NGF was significantly decreased and the production of IL-1β, TNF-α were markedly induced in diabetic group. Furthermore, NRG1 treatment could normalized the above effect as compared to diabetic group. Conclusion: NRG1 exerted positive effects on the behavioral and pathological changes of rats with STZ-induced diabetic neuropathic pain, the underlying mechanism might be related to the promotion of NGF excretion and the inhibition of inflammatory cytokines excretion.

Investigation and Analysis of Patients’Satisfaction and Related Influential Factors to Outpatient Pharmacy in a Third Grade Class-A Hospital in Chengdu / 中国药房

OBJECTIVE:To provide reference for improving the service quality of outpatient pharmacy in hospital. METH-ODS:A questionnaire survey was conducted to investigate and analyze the patients’satisfaction and related influential factors to outpatient pharmacy in a third grade class-A hospital in Chengdu. RESULTS:Totally 165 questionnaires were sent out,and 150 were effectively received with effective recovery of 90.91%. The total score for patients’satisfaction was (44.67 ± 7.81) scores, and the rate of satisfaction was(81.22±14.19)%. The top three entries were“the will you choose to come to our hospital again if necessary”,“the notices about time and place for taking the medicine”and“the overall evaluation of the professional ethics of med-ical staff”,scored 4.38,4.25 and 4.25,respectively;the last three entries were“waiting time for taking medicine”,“the notices about how long it takes to take the medicine”and“service facilities and environmental facilities for drug taking”,scored 3.55, 3.63 and 3.95,respectively. The top three suggestions were“long waiting time for taking medicine and inconvenient”,“noisy envi-ronment,bad order”and“expensive drugs charges but less reimburse”. The univariate analysis and multivariate analysis showed that gender,age,marital status,education,occupation,family income per month,resident,drug taking times and payment etc. factors showed no significant effects on patients’satisfaction scores(P>0.05). CONCLUSIONS:The degree of patients’satisfac-tion in outpatient pharmacy have no obvious specificity and preference,the key to improve the degree of satisfaction lies on strengthening the service of the hospital and the perception of the patients. While the next research will focus on how to find the breakthrough points and key points to improve the experience of waiting,standardize process management and logistics manage-ment,and make patients aware of the service development.

The miR-17-92 cluster regulates FOG-2 expression and inhibits proliferation of mouse embryonic cardiomyocytes

MicroRNAs (miRNAs) have gradually been recognized as regulators of embryonic development; however, relatively few miRNAs have been identified that regulate cardiac development. A series of recent papers have established an essential role for the miRNA-17-92 (miR-17-92) cluster of miRNAs in the development of the heart. Previous research has shown that the Friend of Gata-2 (FOG-2) is critical for cardiac development. To investigate the possibility that the miR-17-92 cluster regulates FOG-2 expression and inhibits proliferation in mouse embryonic cardiomyocytes we initially used bioinformatics to analyze 3’ untranslated regions (3’UTR) of FOG-2 to predict the potential of miR-17-92 to target it. We used luciferase assays to demonstrate that miR-17-5p and miR-20a of miR-17-92 interact with the predicted target sites in the 3’UTR of FOG-2. Furthermore, RT-PCR and Western blot were used to demonstrate the post-transcriptional regulation of FOG-2 by miR-17-92 in embryonic cardiomyocytes from E12.5-day pregnant C57BL/6J mice. Finally, EdU cell assays together with the FOG-2 rescue strategy were employed to evaluate the effect of proliferation on embryonic cardiomyocytes. We first found that the miR-17-5p and miR-20a of miR-17-92 directly target the 3’UTR of FOG-2 and post-transcriptionally repress the expression of FOG-2. Moreover, our findings demonstrated that over-expression of miR-17-92 may inhibit cell proliferation via post-transcriptional repression of FOG-2 in embryonic cardiomyocytes. These results indicate that the miR-17-92 cluster regulates the expression of FOG-2 protein and suggest that the miR-17-92 cluster might play an important role in heart development.

Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

OBJECTIVE: We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. MATERIALS AND METHODS: Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. RESULTS: All the lesions were located in the cortex and their mean size was 1.3 +/- 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. CONCLUSION: Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.