Objective To explore the effectiveness and significance of neuronavigation in transsphenoidal approach microneurosurgical treatment of pituitary adenoma.Methods A total of 12 patients with pituitary adenomas underwent transsphenoidal surgery.Before the surgery a continuous CT or MRI scanning was adopted,and then the data were inputted into the neuronavigation system for 3-D reconstruction and registration.During the surgery,real-time positioning of the anatomic midline,the anterior wall of the sphenoidal sinus,and the floor of the sella turcica was employed by using the neuronavigation system,as well as the identification of the cavernous sinus and the internal carotid artery to avoid unexpected injury.The extent of tumor resection was assessed postoperatively.Results The mean fiducial error was 2.13?0.94 mm,and the accuracy of targets was

Objective To study the relationship between the invasion of pituitary adenomas and expressions of MMP-9,Ki-67 and nm23. Methods The expressions of MMP-9,Ki-67 and nm23 were examined by immunohistochemical Elivision methods in 78 cases of pituitary adenomas. Of them,40 cases were invasive pituitary adenomas and, 38 cases were noninvasive pituitary adenomas. Results The expression levels of MMP-9 and Ki-67 in the invasive pituitary adenomas were significantly higher than those in the noninvasive ones (P

Objective:To investigate the quantitative expression of Melanoma-associated antigen MAGE-E1 mRNA in glioma, and explore its potential for immunotherapy in glioma.Methods:To establish a quantitative real-time polymerase chain reaction ( qRT-PCR) method to quantitatively determine MAGE-E1 mRNA in glioma.A total of 47 human glioma and 14 normal brain tissue specimens were analyzed.MAGE-E1 mRNA was normalized to HPRT1, a housekeeping gene.MAGE-E1/HPRT1 was used to evaluate the expression level of MAGE-E1 mRNA.Results:High-level expression of MAGE-E1 was observed in 7.1%of normal brain and 66.0%glioma tissues,which shown significant difference with P<0.05.There was irrelevant between the expression of MAGE-E1 mRNA and clinicopathogical parameters ,such as gender ,age,histological subtype and grade.Conclusion:With higher expression of MAGE-E1 in glioma tissues,it might be a potential target for immunotherapy of glioma.

Objective:To investigate the effects of Adp53 and F56 on the growth and lung metastasis of breast cancer.Methods:The BICR-H1 cells were inoculated into the mammary fatty pad of BALB/C nude mice and NOD/SCID mice to establish breast cancer model.Then the nude mice with xenograft tumor were randomized into group Adp53+F56,Adp53,F56 and control.The NOD/SCID mice with xenograft tumor were randomized into group Adp53+F56,Adp53,F56,Adlacz and control.They were theated for 3 weeks according to the plan,diversity of the volume and histopathology of xenograft tumor of nude mice was observed and the expressions of p53 and VEGF gene,and microvessel density(MVD)were detected by immunohistochemistry.Lung metastasis of breast cancer in NOD/SCID mice was observed.Results:(1)Intratumoral injections of Adp53,F56,and their combination resulted in an inhibition on the growth of xenograft tumor of BICR-H1 cells.The ultimate relative growth volumes of groups Adp53+F56,Adp53,F56 and control were 2.47,4.37,4.69 and 12.49 respectively.(2)After treatment,P53 positive rate of group Adp53+F56,Adp53 increased 9.4%,6.3% than before respectively,but compared with control group,the difference is not significant(P=0.693);VEGF protein of group Adp53+F56,Adp53 and F56 decreased 21.9%,9.4% and 3.1% than before respectively,but compared with control group,the difference was not significant(P=0.284).Necrosis and decrease of vessel in the tumor and morphological change of endothelium were observed under light microscope in the groups Adp53+F56,Adp53 and F56.MVD estimated by FⅧ-RA staining of group Adp53+F56,Adp53 and F56 were 14.50?2.54,16.28?3.44 and 18.06?7.66,compared with control group(24.93?6.53),the difference is significant(P=0.000).(3)The average number of lung metastasis of NOD/SCID mice in group Adp53+F56,Adp53 and F56 were 1.143?0.378,2.750?0.886 and 3.375?0.518 respectively,lower than Adlacz group(5.000?0.816)and control group(5.670?0.817)obviously(P=0.000).Conclusion:Adp53 combined with F56 can greatly inhibit growth and matastasis of breast cancer in vivo.The mechanism of anti-tumor effects of Adp53 and F56 may be related to the anti-angiogenesis effect on malignant tumor through inhibiting the expression and activity of VEGF.

Hypoxiaisoneofthemostimportantfactorsinfluencingcancertherapyandclinicalprogno-sis.With positron emission tomography (PET)widely adopted in clinical practice,the development and appli-cation of PET hypoxia imaging agents has been much popular in the field currently.PET hypoxia imaging can detect tumor hypoxia region noninvasively,which has important significance for optimizing cancer treatment decisions and improving the prognosis of cancer.

Objective To investigate the role of large-diameter magnetic resonance imaging (MRI) simulation in target volume delineation in radiotherapy for nasopharyngeal carcinoma (NPC).Methods Eighteen patients with NPC underwent computed tomography (CT) simulation and MRI simulation scans and localization in the same body position,with SOMATOM Sensation Open 40-row 82-cm large-diameter CT simulator and Siemens 3T MRI MAGNETOM Skyra 70-cm large-diameter simulator,respectively.The gross tumor volume (GTV) and parotid glands were delineated on all images according to the ICRU Report 50/62,and MRI was applied to observe the changes in GTV and parotid volume during radiotherapy.Paired t-test was applied to analyze the differences between GTVCT and GTVMRI and between GTVnx-CT and GTVnx-MRI.Results GTVMRI decreased significantly compared with GTVCT,and the average volume decreased from (213.64±84.59) cm3 to (199.68±84.69) cm3(p=0.006).As for the volume of primary lesions in the nasopharynx,GTVnx-MRI was significantly smaller than GTVnx-CT,and the volume decreased from (95.75± 24.76) cm3 to (88.12±26.25) cm3 (P =0.001);as for the volume of cervical lymph nodes,GTVnd-MRI was significantly smaller than GTVnd-CT,and the volume decreased from (117.89± 72.69) cm3 to (111.56± 70.69) cm3 (P=0.018).The targets delineated by CT and MRI did not overlap completely,with major differences in skull base bone and cervical soft tissue.The volume of both parotid glands delineated on MRI image was higher than that delineated on CT image,with a major difference in the deep lobe.MRI showed that GTV was reduced by 82.64± 16.87％ during radiotherapy,and the volumes of the left and right parotid glands were reduced by (32.7± 23.95) ％ and (34.7± 21.72) ％,respectively.Conclusions The delineation of target volume based on MRI simulation is more accurate than that based on CT simulation and can achieve a smaller volume range,which helps to guide target volume delineation in radiotherapy for NPC accurately.

Objective To explore the changes of different brain regions of the human beings during completion of spatial working memory tasks under hyperthermia condition with functional magnetic yesonance.Methods Twenty-eight right-handed healthy young male volunteers were divided into control group and hyperthermia group randomly,and working memory task using block design was performed during behavioral test and fMRI scanning on both conditions.Activation intensity and location of different brain areas were compared in control and hyperthermia group.Results The activations of frontal,parietal,occipital and insular lobe were seen in both of the control group and the hyperthermia group.Right lateralization was shown in control group during spatial working memory (Li=0.05 1).While,in hyperthermia group the effect of the right lateralization significantly was enhanced (Li=0.103). Moreover,activation of bilateral middle frontal gyrus and right parietal lobe were significantly enhanced.Conclusion It is found for the first time that the hyperthermia could affect bilateral middle frontal gyrus and right parietal lobe,and enhance the effect of right lateralization in the spatial working memory task.

Objective To evaluate the efficacy and safety of recombinant adenovirus-p53(rAdp53) injection combined with radiotherapy and hyperthermia in the treatment of unresectable advanced soft tissue sarcoma.Methods In this retrospective study, we evaluated 76 patients with unresectable advanced primary or recurrent soft tissue sarcoma treated in our hospital from November 2005 to November 2012.These patients received radiotherapy and hyperthermia with rAdp53(p53 group, n=41) or without rAdp53(control group, n=35).rAdp53((1-2)×1012viral particles each time, once a week, 8 times on average) was injected into the tumor or infused into the pelvic cavity.Radiotherapy (2 Gy each time, 5 times a week) was performed for the planning target volume at 56.3±5.3 Gy in the p53 group and 58.1±4.2 Gy in the control group, with no significant difference between the two groups (P>0.05).Superficial or deep thermotherapy was employed 8 times on average (twice a week).Clinical features, response rate, time to progression (TTP), overall survival (OS), and adverse events were compared between the two groups (P>0.05).The Kaplan-Meier method was used to calculate OS;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparison of categorical data.Results At 2 months after treatment, the p53 group had significantly increased response rate (partial response+ complete response+ stable disease)(85% vs.54%, P=0.003) and local control rate (49% vs.23%, P=0.020) as well as prolonged TTP (12 months vs.5 months, P=0.010) and OS (48 months vs.31 months, P=0.049), as compared with the control group.No adverse events caused by radiotherapy and hyperthermia except transient fever were seen in the two groups.Conclusions Concurrent radiotherapy and hyperthermia combined with rAdp53 injection is effective and safe for patients with advanced soft tissue sarcoma.

Objective To investigate the approaches,techniques and efficacies ofmicrosurgical resection ofpetroclival meningiomas.Methods A total of 59 patients with petroclival meningiomas,admitted to our hospital from January 2003 to January 2016,were chosen in our study;single microscopic resection was performed in 55 patients (93.2％) and re-operation was performed in 4 patients (6.8％);29 times (46.0％) via retrosigmoid approach,17 times (27.0％) via tranpetrosal approach,and 17 time via subtemporal approach (27.0％) were chosen.The clinical data,radiological findings,surgical records and outcomes of patients were retrospectively analyzed,and the prognostic factors was analyzed.Results Complete resection was achieved in 31 patients (52.5％),subtotal resection in 19 (21.7％) and partial resection in 9 (15.3％).There was no death in perioperative period.Follow-up were obtained in 55 patients,and median follow-up was 42.6 months (ranged 3-131 months).Permanent neurological damage occurred in 16 patients (27％).Tumor recurred in 11 patients:6 had gamma knife radiosurgery,one had routine radiotherapy,and 4 required re-operation.Two patients died of tumor recurrence/progression reoperation.In these 55 patients,42 enjoyed good prognosis and 13 had poor prognosis.The tumor sizes,brainstem edema and preoperative Kamofsky performance scale scores were unfavorable prognostic factors.Conclusion By using appropriate approaches,surgical strategies and techniques,the petroclival meningiomas can be removed with relatively favorable outcome.

OBJECTIVETo investigate the microsurgical tchniques and effects for the resection of anterior clinoid meningioma (ACM).

METHODSBetween January 2003 and March 2013, a total of 46 ACM patients were operated on via the pterion approach or lateral subfrontal approach. There were 16 male patients and 30 female patients, their mean age was 48.5 (16-69) years. Symptoms lasted from 1 month to 9 years(average 24.7 months). Preoperative CT and MRI examination showed that the tumors were located in the anterior clinoid process (25 cases on the right side, 21 cases on the left side). The average maximal tumor diameter was 4.4 cm (1.9-7.4 cm). The patients were peroidly followed-up on outpatient on 3 months to 6 months, then every year postoperativelly. The clinical data, radiological findings, surgical records and outcome of patients were retrospectively analyzed, and the prognostic factors were ananlyzed by using of the unpaired data χ(2) test with continuity correction.

RESULTSOf fourty-six patients operated on, apparently complete removal was achieved in 36 patients (78.3%), 10 patients (21.7%) had minimal residual tumors, 5 of which had gamma knife radiosurgery. Preexisting visual deficit improved in 21 of 41 patients (51.2%), unchanged in 16(35.6%), and worsened in 9(20.0%). At 3-6 months after discharge, 37(80.4%) patients had a good recovery, 7(15.6%) patients were moderately disabled, 1(2.2%) presented with severe disability, and 1 (2.2%) patient died of surgery-related causes. The tumor wrapping blood vessels (χ(2) = 4.676, P = 0.031) and violating cavernous sinus(χ(2) = 4.973, P = 0.026) were causes of unfavorable prognosis. During the mean follow-up of 35.1 months (range, 4-107 months) for 40 patients, the average Karnofsky score was 83.2. Tumor recurred in 4 cases: 2 of which required reoperation, and 2 had gamma knife radiosurgery.

CONCLUSIONSTumor wrapped vessels and invasion of the cavernous sinus are important unfavorable prognostic factors for ACM resection. By using appropriate surgical strategies and techniques, ACM can be removed safely via the pterion approach or lateral subfrontal approach with relatively low morbidity and mortality.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Meningeal Neoplasms ; surgery ; Meningioma ; surgery ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult