BACKGROUND: Nervousness, anxiety and depression are important inducing factors of migraine, while nervousness, anxiety and depression are closely correlated with the unreasonable belief and incorrect strategy. Medicine therapy is the principal method in the treatment of migraine at present, but it cannot change the unreasonable belief of the patients and thereby to reducethe occurrence of the inducing factors of headache.OBJECTIVE: To observe the near term and long term therapeutic effects of medicine therapy and rational emotional behavior therapy(REBT) to provide a safer and more effective intervention for the patients with migraine and thereby to improve their long term quality of life(QOL).DESIGN: An observatory comparative study based on patients with migraine as subjects and healthy population as controls.SETTING: A psychological consultation clinic of a municipal hospital(has been canceled now).PARTICIPANTS: Totally 86 cases of migraine including 34 males and 52females aged between 16 and 48 years old(means of 35 years old) with a course of disease between 2 and 11 years were selected from the Psychological Consultation Clinic of the 289 Hospital between March 1999 and October 2001. All 86 cases were randomly divided into REBT group and medicine group with 43 cases each. There was no significant difference of age, gender,course of the disease, situation of the disease, and education background between two groups. Another 30 healthy individuals including 12 males and 18 females with a mean age of 36 years old were selected in control group.METHODS: REBT was applied for patients in REBT group. Patients of medicine group received 50-100 mg/day of Amitriptyline and 60 mg/day of nimodipine through oral administration. Patients received 12 weeks of therapy followed by 24 weeks of observation.MAIN OUTCOME MEASURES: Therapeutic scale score on migraine (TSSM), before and after migraine-correlated potential(P300) and symptoms checklist 90 (SCL-90) scores were compared.RESULTS: SCL-90 total points of two groups of patients were significantly higher than that of control group( P ＜ 0.05); after 12 weeks of therapy,TSSM, SCL-90 total points and points of major factors of two groups of patients were significantly lower compared with the situations before therapy( P ＜ 0.05), but there was no significant difference between two therapy groups; on the 12th week after therapy, SCL-90 total points, points for major factors and TSSM, and P300 latency of REBT group were almost as the same as that after 12 weeks of therapy and the wave amplitude of P300 significantly elevated; owever, the differences in SCL-90 total points, points of major factors, and the TSSM in medicine group were significant compared with that after 12 weeks of therapy( P ＜ 0.05) . There was significant difference at the same period between two therapy groups ( P ＜ 0.05).CONCLUSION: REBT can reduce the attacks of migraine, decrease TSSM,and has similar therapeutic effects to medicine group. Simultaneously, it can ameliorate the cognitive disorder, change the unreasonable belief of the patients, and improve the strategy to cope with the disease; hence its long term therapeutic effect is better than medicine therapy.

Objective To summarize the experience of the simple neuroendoscopic endonasal transsphenoidal surgery for the large pituitary adenoma and discuss it's application value.Methods Seventy-eight cases of the large pituitary adenoma treated by simple neuroendoscopic endonasal transsphenoidal surgery from July,2011 to May,2014 were analyzed retrospectively.Tumors were resected using 0 and 30 degree endoscope after opening the same side of the anterior wall of the sphenoidal sinus and sellar bone using the abrasive drilling during operation.Results The tumor removal was total in 62 (79.49％),subtotal in 12 (15.38％),major in 3(3.85％) and part in 1 (1.28％).Seventy-one cases were followed up for 2 months to 2 years after operation and no recurrence was founded,the symptoms of headache disappeared in 49 cases;The vision of patients was improved in 47 cases,menstruation resumed in 12 cases;The acromegaly of patients reduced in 21 cases.Hormone level review of PRL returned to normal in 32 cases,GH returned to normal in 21 cases,ACTH returned to normal in 2 cases.Conclusion The endoscopic transsphenoidal surgery for large pituitary tumors is the safely,minimally invasive surgical techniques.With the development of endoscopic equipment constantly updated and the operational flexibility and comfort is improved ceaselessly,endoscopic transsphenoidal surgery for the sellar tumor will be carried out more widely.

Objective To observe and analyse the therapeutic effect of pentoxifylline in treating traumatic cerebral infarction.Methods Besides routine treatment received in control group,PTX 0.2～0.6 injection plus 500ml normal saline was intravenously dripped once a day,in the treatment group.Duration ten days as a treatment course in both groups and three courses were carried out.N-acetylaspartate(NAA),choline(Cho),Creatine(Cr) and lactate(Lac) in infarct part of brain were measured with proton magnetic resonance spectroscopy(1HMRS).Results Compared with control group,ability of daily life were better,N-acetyl aspartate(NAA) and creatine(Cr) were obvious higher.Lactate(Lac) were obvious lower,in the treatment group.Conclusion PTX has a better therapeutic effect in traumatic cerebral infarction.

Objective To investigate the micro-anatomical approach to resect both intracranial and extracranial jugular foramen tumors in one-stage. Methods With the aid of surgical microscope, fifteen cadaver heads were used to study the microsurgical anatomy of high cervical part and jugular foramen, measure relative data. Results Detailed dissection was performed on high cervical part between the 1st cervical vertebra and the 4th cervical vertebra, resect foramen processus transversi of the 1st cervical vertebra, free vertebral artery 2nd and 1st cervical vertebra segment and horizontal segment. The jugular tubercle, jugular tunisia and part of the occipital condylus was drilled away as much as possible, total exposure of lateral semicircular canal was completed after the removal of the mastoid revealed labyrinthinem. Then the sigmoid sinus and jugular bulb were skeletonized. The vertical of segment of facial nerve was fully skeletonized to study the necessity of the facial nerve translocation. Full exposure to the sigmoid sinus, open jugular foramen. JF areas expanded, and the measured parameters revealed. The distance was (29.65 ± 3.24)mm from mastoidalec to oncentrated focus of condyle (10.18 ± 0.81)mm from hinder margin of condyle to endostoma of hypoglossal canal. The left distance was (6.8 ± 0.35)mm from jugular foramen to perpendicular part of facial nerve, right was (4.6 ± 0.33)mm. Conclusions Total exposure of JF can be achieved through the approach we described, and will enable the facial nerve, cochlea, and the structure of the vertebral artery to be performed. Both intracranial and extracranial tumors can be removed in a one-stage procedure related to anatomical parameters. Improve the cure, reduce complication and lower mortality.

OBJECTIVE: To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. METHODS: Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. RESULTS: Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann: excellent facial nerve function (House-Brackmann I–II level) cases accounted for 75.2% (79/105), facial nerve function III–IV level cases accounted for 22.9% (24/105), and V–VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I–II level) was 74.4% (58/78). CONCLUSION: Acoustic neuroma patients after surgery, the long-term (≥1 year) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient’s age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.
Acoustics* ; Colon, Sigmoid ; Facial Nerve* ; Humans ; Hydrocephalus ; Microsurgery ; Mortality ; Neuroanatomy ; Neuroma, Acoustic* ; Outpatients ; Recurrence ; Retrospective Studies ; Telephone

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

ObjectiveTo assess the feasibility and clinical efficacy of minimally invasive esophagectomy for esophageal cancer.MethodsFrom July 2007 to December 2009,eighty-one patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.ResultsThe median operative time was 270.5 min (range 196-315 min).The median time of gastric mobilization and abdominal lymph node dissection was 64.5 min,and the median time of esophageal dissection and mediastinall lymph node dissection was 81.2 min.The median blood loss was 121.5 ml for the thoracic phase and 42.4 ml for abdomen phase.The mean number of disected lymph nodes was 20.4 (range 5-41) with metastastic rate of 30.9% (25/81).The mean harvest lymph node was 12.5 in chest and 7.3 in abdomen.Perioperative complications rate was 27.2%,including respiratory failure in 1 case,pulmonary infection in 10,anastomotic leak in 3,chylothorax in 2,gastric tube dilatation in 1,gastric tube leak in 1.And recurrent laryneal nerve injury in 5 .Seventy-nine patients were followed up withmMean follow up time of 14.2 months( range 2-31 months).The overall one-year survival rate was 91.1%.Postoperative complications included anastomotic stenosis in 5 cases (6.3%),reflux esophagitis in 12 (15.2%) and recurrence or metastasis in 6 (7.6%).ConclusionMinimally invasive esophagectomy for esophageal cancer can mimimus trauma,reduce post-operative complications,improve the quality of life,which is feasible and effective from the point of the clinical efficacy and the purpose of tumor therapy.

This study was aimed to establish an HPLC method for simultaneous content determination of valtrate, acevaltrate, and their degradation products, which were baldrinal and 11-ethoxyviburtinal, in Valeriana jatamansi Jones. The separation and quantification of 4 constituents mentioned above were performed on an Agilent ZORBAX SB-C18 (4.6 mm×250 mm, 5 μm). The mobile phase consisted of water (A) - acetonitrile (B) with an optimized gradient program. The flow rate was 1 mL·min-1. The column temperature was set at 25℃. The wavelength was set at 241 nm. And the injection volume was 10μL. The results showed that among 14 different places of V. jatamansi, the 4 contents determined were different. The contents of valtrate, acevaltrate, and baldrinal in the Yunnan Baoshan Mount were the highest. And the content of 11-ethoxyviburtinal was the highest in Yunnan Dali. It was concluded that the method was with good precision, reproducibility and stability. And it was suitable for the determination of 4 valepotriates ingredients in V. jatamansi. It also provided references for the quality control and exploitation of V. jatamansi.

Patients with neurofibromatosis 1 (NF1) are predisposed to develop central nervous system tumors, due to the loss of neurofibromin, an inactivator of proto-oncogene Ras. However, to our knowledge, only three cases of ependymomas with NF1 have been reported in the literature. The authors present a case of NF1 patient with a spinal cord ependymoma. She was referred for about half a year history of increasing numbness that progressed from her fingers to her entire body above the bellybutton. Magnetic resonance imaging revealed a relative-demarcated, heterogeneously enhanced mass lesion accompanied by perifocal edema in C5-7 level, a left-sided T11 spinous process heterogeneously enhanced mass in soft tissue, intervertebral disk hernia in L2-5 level, and widespread punctum enhancing lesion in her scalp and in T11-L5 level. The patient underwent C5-7 laminectomies and total excision of the tumor under operative microscope, and intraoperative ultrasonography and physiological monitoring were used during the surgery. Histopathologically, her tumor was found to be a ependymoma without malignant features (grade II in the World Health Organization classification). Therefore, no adjuvant therapy was applied. Following the operation, the patient showed an uneventful clinical recovery with no evidence of tumor recurrence after one year of follow-up.
Central Nervous System Neoplasms ; Edema ; Ependymoma* ; Fingers ; Follow-Up Studies ; Hernia ; Humans ; Hypesthesia ; Intervertebral Disc ; Laminectomy ; Magnetic Resonance Imaging ; Monitoring, Physiologic ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Proto-Oncogenes ; Recurrence ; Scalp ; Spinal Cord* ; Ultrasonography ; World Health Organization

ObjectiveTo observe the microbial changes in Wistar rats with liver injury caused by the Dictamni Cortex-Flavescens Sophora by high-throughput sequencing technology and investigate the potential mechanism of liver injury caused by the Dictamni Cortex-Flavescens Sophora. MethodFemale Wistar rats were randomly divided into four groups： normal group， as well as low-dose， medium-dose， and high-dose groups of traditional Chinese medicine （TCM）. The rats were gavaged with the Dictamni Cortex-Flavescens Sophora in different doses （4.125， 8.25， 16.5 g·kg^-1 of raw drug respectively） for 28 days， and the general condition was recorded. The liver-body weight ratio was calculated， and the biochemical indexes of serum were observed. The Hematoxylin-eosin （HE） staining was used to observe pathological changes in the liver， and 16S rDNA high-throughput sequencing was utilized to detect fecal microbial changes in rats. ResultCompared with the normal group， Dictamni Cortex-Flavescens Sophora increased the liver weights and liver-body weight ratios of Wistar rats. The difference in liver weight between the medium-dose and high-dose groups of TCM was statistically significant （P<0.05）， and the liver-body weight ratios of the low-dose， medium-dose， and high-dose groups of TCM were all statistically significant （P<0.05）. Compared with the normal group， serum albumin and cholesterol levels increased in the medium-dose and high-dose groups of TCM （P<0.05）. The histopathology of the liver in the medium-dose and high-dose groups of TCM showed tiny vacuole-like changes. Compared with the normal group， there were obvious intestinal flora disorders after administration of Dictamni Cortex-Flavescens Sophora， and alpha diversity increased in the medium-dose and high-dose groups of TCM. The principal coordinates analysis showed that species increasingly deviated from the normal group as the administered dose increased. Compared with the normal group， the proportion of Firmicutes and Bacteroidota decreased after the drug administration， and the genus level of Parasutterella， Romboutsia， Turicibacter， Allobaculum， and Dubosiella increased. The genus level of Lachnospiraceae_NK4A136_group， Blautia， Erysipelatoclostridium， Muribaculum， and Ruminococcus_gnavus_group decreased. The correlation analysis showed that Parasutterella， Romboutsia， Turicibacter， Allobaculum， and Dubosiella were positively correlated with serum cholesterol and liver-body weight ratio， and lanchnospiraceae_NK4A136_group， Blautia， Muribaculum， Erysipelatoclostridium， and Ruminococcus_gnavus_group were negatively associated with serum cholesterol and liver-body weight ratio. ConclusionThe liver injury caused by Dictamni Cortex-Flavescens Sophora is manifested as a lipid metabolism disorder， and the mechanism is related to the increase in lipid metabolism-related microorganisms.