1.Clinical analysis of microelectrode guided stereotactic functional nucleus lesioning operation in treatment of Parkinson′s disease
Jinfeng LOU ; Keliang CHANG ; Xiaoteng GENG ; Guangming NIU ; Shengzhong TAO
Chongqing Medicine 2016;45(12):1645-1646,1649
Objective To study the application of microelectrode stereotactic functional nucleus lesioning operation in the treatment of Parkinson′s disease(PD) ,and to explore its clinical value .Methods The clinical data in 84 cases of PD treated with‐out using the microelectrode stereotactic functional nucleus lesioning operation(observation group) and 74 cases of PD treated by u‐sing microelectrode guided stereotactic functional nucleus lesioning in our hospital were retrospectively analyzed .At the same time the Unified Parkinson′s Disease Rating Scale (UPDRS) scores before the nucleus lesioning and at postoperative different medication states were obtained in the observation and the control group .Furthermore the difference of the UPDRS motor scores before and af‐ter operation were compared between the two groups .Results The UPDRS motor scores at postoperative 3 ,6 months and 1 year in the observation group were significantly improved compared with before operation(P<0 .05) ,meanwhile the postoperative anti‐PD drug dosage was significantly decreased compared with before operation(P<0 .05) .Among them ,70 cases(83 .3% ) in the control group were obviously effective ,14 cases(16 .7% ) were effective ,and the total effective rate was 100% ;while 62 cases(83 .7% ) in the observation group were obviously effective ,12 cases (16 .3% ) were effective ,and the total effective rate was 100% .The differ‐ence in improving the UPRDS motor scores before and after operation had no statistical difference between the two groups(P>0 .05) .Conclusion Stereotactic nucleus lesioning in treating PD has satisfactory effect and can significantly improve the UPRDS motor scores .Accurate positioning is the key to the operation success ,whether microelectrode recording can significantly improving the operation accuracy needs further discussion .
2.Clinical related factors for peritumoral brain edema in meningiomas
Ziang ZHONG ; Shengzhong TAO ; Zhan LIU ; Xiaoteng GENG
Chinese Journal of Neuromedicine 2021;20(12):1231-1236
Objective:To investigate the clinical related factors that affecting peritumoral brain edema (PTBE) and its severity in meningiomas.Methods:A total of 139 patients with meningiomas, admitted to and underwent surgery in our hospital from from January 2017 to October 2020 were chosen; their clinical data were analyzed retrospectively. Meningioma volume and edema volume were calculated from drawn regions of interest on preoperative MRI images by 3D-slicer software. Edema index (EI) was used to evaluate the severity of PTBE. The clinical factors affecting PTBE and EI were determined by statistical methods, and the value of meningioma volume in predicting PTBE was further analyzed.Results:(1) The PTBE incidence was 33.8% (47/139), and average EI was 2.47±0.73. (2) Univariate analysis showed that there was significant difference in percentage of patients with benign/malignant meningiomas, meningioma location, meningioma volume, and Ki-67 index between patients from PTBE group ( n=47) and non-PTBE group ( n=92, P<0.05). Multivariate binary Logistic regression analysis showed that benign/malignant meningiomas and meningioma volumes were independent risk factors for PTBE ( P<0.05). (3) There were significant differences in EI values among patients with different gender, WHO grading, KI-67 index and meningioma volumes ( P<0.05). Multivariate linear regression analysis showed meningioma malignant degrees and meningioma volume were independent risk factors for EI ( P<0.05). (4) Receiver operating characteristic curve showed that the area under curve of meningiomas of the cranial base and non-meningiomas of the cranial base in predicting PTBE was 0.824 and 0.825, respectively, with sensitivity of 0.800 and 0.784, and with specificity of 0.818 and 0.729. Conclusions:(1) Malignant degrees and meningioma volumes are the main factors affecting the incidence of PTBE, and are positively correlated with EI. (2) Meningioma volume has high predictive value in PTBE occurrence.