Intraventricular Shunt as a Treatment for Entrapped Temporal Horn After Removal of Ventricular Meningioma: A Report of Two Cases.

Entrapped temporal horn (ETH) is a complication following resection of ventricular trigone tumors. It is a special localized hydrocephalus. Obstruction of cerebrospinal fluid outflow following resection of ventricular trigone tumors leads to dilation of the temporal horn and the production of the local space-occupying effect. This article presents two cases of ETH following the resection of ventricular trigone tumors. Our Intraventricular shunt is an effective treatment that uses a T-connector to connect a reservoir with two catheters. We presented temporal-frontal horn shunt and trigone-front horn shunt. A patient presented with ETH shunt dependency. Our intraventricular shunt surgery achieved a good prognosis.

Predictive role of shock index in the early formation of cerebral infarction in patients with TBI and cerebral herniation.

Background and purpose: Traumatic brain injury (TBI) with brain herniation predisposes to posttraumatic cerebral infarction (PTCI), which in turn seriously affects the prognosis of patients. At present, there is a lack of effective indicators that can accurately predict the occurrence of PTCI. We aimed to find possible risk factors for the development of PTCI by comparing the preoperative and postoperative clinical data of TBI patients with brain herniation. Methods: The clinical data of 120 patients with craniocerebral trauma and brain herniation were retrospectively analyzed. Among them, 54 patients had cerebral infarction within 3-7 days after injury. The two groups of patients were compared through univariate and multivariate logistic regression analysis, and a classification tree model and a nomogram model were constructed. Finally, receiver operating characteristic curve analysis and decision curve analysis were conducted to analyze the clinical utility of the prediction model. Results: Logistic regression analysis showed that factors like the Glasgow Coma Scale (GCS) score (P = 0.002), subarachnoid hemorrhage (SAH) (P = 0.005), aspiration pneumonia (P < 0.001), decompressive craniectomy (P < 0.05), intracranial pressure (ICP) monitoring (P = 0.006), the shock index (SI) (P < 0.001), the mean arterial pressure (MAP) (P = 0.005), and blood glucose (GLU) (P < 0.011) appeared to show a significant statistical correlation with the occurrence of infarction (P < 0.05), while age, sex, body temperature (T), D-dimer levels, and coagulation tests were not significantly correlated with PTCI after cerebral herniation. Combined with the above factors, Classification and Regression Tree was established, and the recognition accuracy rate reached 76.67%. Conclusions: GCS score at admission, no decompressive craniectomy, no ICP monitoring, combined SAH, combined aspiration pneumonia, SI, MAP, and high GLU were risk factors for infarction, of which SI was the primary predictor of PTCI in TBI with an area under the curve of 0.775 (95% CI = 0.689-0.861). Further large-scale studies are needed to confirm these results.

Analysis of quality of life and risk factors in 122 patients with persistent hemodialysis.

Objectives: To summarize existing evidence on the quality of life and influencing factors in maintenance hemodialysis (MHD) patients. Methods: Total 122 MHD patients treated in the department of hemodialysis, Liyang branch of Jiangsu Provincial People's Hospital from January 2018 to June 2020 were selected as the patient group. and 98 healthy persons in the same period were selected as the control group. The quality of life of the two groups was investigated by SF-36 score scale. At the same time, the clinical data of the patient group were investigated. Influencing factors of patients' quality of life were analyzed by univariate test, and independent risk factors were analyzed by logistic multiple regression. Results: Univariate analysis showed that age, education, marital status, dialysis time, urea clearance index (Kt/V), income level, diabetic nephropathy, nutritional status, medical insurance type, depression and anxiety were single factors influencing the quality of life of MHD patients (P<0.05). Logistic multiple regression analysis showed that age ≥ 60 years, dialysis time ≥ one year, income less than 3000 yuan/month, primary disease is diabetic nephropathy., low medical insurance reimbursement, depression and anxiety were independent risk factors affecting the quality of life of MHD patients (P < 0.05). Conclusions: There was a relatively high proportion of patients with age ≥ 60 years, dialysis time ≥ one year, income less than 3000 yuan/month, primary disease is diabetic nephropathy, low medical insurance reimbursement, depression and anxiety. Timely nursing interventions such as reasonable nutritional support, comprehensive monitoring and psychological counseling for patients with the above situation may be helpful in improving quality of life of MHD patients.

Expression of immune checkpoints in T cells of esophageal cancer patients.

Inhibition of immune checkpoint proteins (checkpoints) has become a promising anti-esophageal cancer strategy. We here tested expressions of immune checkpoints in human esophageal cancers. Our results showed the expressions of many immune checkpoints, including CD28, CD27, CD137L, programmed death 1 (PD-1), T cell immunoglobulin mucin-3 (TIM-3), T cell Ig and ITIM domain (TIGIT), CD160, cytotoxic T lymphocyte antigen 4 (CTLA-4), CD200, CD137 and CD158, were dysregulated in peripheral T cells of esophageal cancer patients. Further, the expressions of PD-1, TIM-3 and TIGIT were upregulated in tumor infiltrating lymphocytes (TILs), which might be associated with TILs exhaustion. Meanwhile, the expressions of PD-1 and TIM-3 on CD4+ T cells were closely associated with clinic pathological features of esophageal cancer patients. These results indicate that co-inhibitory receptors PD-1, TIM-3 and TIGIT may be potential therapeutic oncotargets for esophageal cancer.

Clinical-psychological characteristics of refractory globus patients in China.

BACKGROUND: Refractory globus is not rare in clinical practice, but little research about it. AIMS: To investigate the clinical-psychological characteristics of patients with refractory globus. METHODS: Six hundred and nineteen globus patients were divided into the refractory globus group (n=149) and the non-refractory globus group (n=470). All subjects completed the following questionnaires: demographic characteristics, medical information, Hamilton Rating Scale of Anxiety/Depression, Pittsburgh Sleep Quality Index, Glasgow Edinburgh Throat Scale, and 36-item Short Form Health Survey. RESULTS: No significantly differences were found in demographic characteristics between the two groups, but the refractory globus group had longer disease duration and more serious symptoms. Sought healthcare more frequently but still had poorer quality of life than did the non-refractory globus group. Compared with the non-refractory globus group, the refractory globus group also had higher percentages of anxiety, depression, and sleep disorders. Positive correlations were observed between the severity of globus symptoms and HAMA, HAMD, and PSQI scores. CONCLUSIONS: Refractory globus is not rare in clinical practice and should receive more attention from patients and doctors because of its severe symptoms, long disease duration, poor quality of life, and accompanied by psychological disorders and sleep disorders.