Objective To evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method.Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy,treated with resection of pituitary tumor,in PLA General Hospital,from 2005 to 2011,were collected and analyzed.Comparative analysis of cardiac function were made in these patients before and after the surgery,also with the postoperative recovery status,using echocardiography and other noninvasive detection means to detect the growth hormone ( GH),left ventricular end-diastolic diameter (LVEDD),septal thickness (ST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF) values.Results After the resection of pituitary tumor,the LVEDD,ST,LVPWT,LVEF levels were all significantly better than that before the surgery.Before the surgery the GH,ST,LVPWT,LVEF levels were 93.89 μg/L,11.13 mm,43.92％ and 10.53 mm,while those after the surgery were 5.16 μg/L,10.64 mm,49.28％ and 8.87 mm.The difference of the GH level before and after the surgery was correlated with the difference of ST,LVEDD and LVEF in a linear manner.Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy,and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.

Objective To evaluate the value of the StealthStation neuronavigation in the operation of intracranial lesions. Methods 22 patients with different intracranial lesions, including 14 cases of glioma, 2 cases of meningioma,4 cases of cavernous angioma,1 case of lymphoma and 1 case of metastatic cancer, were operated on with the aid of StealthStation neuronavigational system. The neuronavigational accuracy and surgical effect were analysed. Results All intracranial lesions were found accurately with StealthStation neuronavigational system, the predicted accuracy (PA) value was 2.53?0.73mm, accuracy sphere of intracranial lesions in the neuronavigational system was within 2mm in all patients. 13 cases out of 14 gliomas were totally removed under microscope, in 1 case removal was subtotal. In 2 patients, neurological symptoms became worse immediately after the operation but improved within 3 months after the operation. The other 12 patients recovered very well. In another 8 cases total removal under microscopy was successful, but one lymphoma patient showed exacerbation of neurological symptoms immediately after operation, but improved within 1 week after operation. The other 7 cases recovered very well. Conclusion The StealthStation neuronavigational system is reliable and accurate in neurosurgical operation, thus it is helpful to facilitate total resection of intracranial lesions with less operative complications.

Objecive To reproduce an experimental model of aneurysm more which is simulating intracranial aneurysm pathomorphologically to serve further research on aneurysm. Methods Saccular aneurysms of the carotid artery were reproduced by corrosion of initial segment of the external carotid artery (1mm long) with elastase in 10 SD rats. After 4 weeks, the size of the aneurysms was measured. Then the aneurysms were fixed by intra-arterial perfusion of formalin and were resected. The pathological characteristics were evaluated with hematoxylin-eosin and Van Gieson staining. Results The pathological features of the experimental aneurysms showed that the tunica intima was interrupted, the elastic and muscular layers were disrupted or disappeared, replaced by proliferative collagen fiber, simulating natural aneurysms. After 4 weeks, the size of aneurysms was larger compared with that in the beginning (P

Objective to study the effect of blood pressure on the enlargement of saccular aneurysm and its mechanism. Methods Forty-eight SD rats were divided into 3 groups randomly(A, B and C; n=16 in each group). Saccular aneurysms of the carotid artery were induced by corrosion of the initial segment of the external carotid artery (1mm long) with elastase. In group A, the posterior branches of both renal arteries were ligated in order to produce a marlced blood pressure elevation. In group B, only unilateral renal artery was ligated, and a moderate hypertension was produced. In group C high blood pressure was not produced to serve as the control group. After 2 and 8 weeks, the blood pressure and the size of the aneurysms were measured. Then the aneurysms were fixed by intraarterial perfusion of formalin and were harvested for examinations. The expression of basic fibroblast growth factor (bFGF) in aneurismal wall was determined by immunohistochemical analysis. Results Two weeks after the beginning of the experiment, there was no difference in size of aneurysm among the 3 groups. But after 8 weeks, significant difference in aneurysmal size was found between group A and the other two groups. The expression of bFGF in group A was stronger than that in group B and C. Conclusion The elevation of blood pressure and enhancement of bFGF expression in aneurismal wall play an important role in enlargement of the aneurysm.

s Objective To observe the changes in neurochemical metabolites at early stage of DAI in rats with MRS technique. Methods DAI was induced by a self-made rotating injury device in Sprague-Dawley (SD) rats (n=16). MRS was used to evaluate the changes in neurochemical metabolites before-trauma, 2 hours and 3 hours after the trauma. The data were analyzed by statistical analysis system. Results MRS demonstrated that contents of both NAA/Cr and Cho/Cr of corpus callosum were decreased obviously 3 hours posttrauma, and differences between those before trauma and those after trauma were statistically significant. The content of NAA/Cr of the brain stem was declined at 2 hours also with significant difference compared with that before trauma. There was no significant difference in values between 2 and 3 hours. The content of Cho/Cr of the brain stem was significantly decreased 3 hours after the trauma. Conclusions MRS technique has a high sensitivity in diagnosing microscopic pathology following DAI and functional defect of neuron and axon, as shown by significant decrease in NAA/Cr and Cho/Cr at early stage (i.e. 2-3 hours) after trauma.

Objective To investigate the iNOS expression in cerebral aneurysm tissue, and the effect of selective iNOS inhibitor aminoguanidine on experimental cerebral aneurysm formation and serum NO production. Methods Fifty SD rats were divided into 3 groups randomly. To reproduce the aneurysm model, 40 adult male rats (weight, 250-300g) were subjected to ligation of the left common carotid artery and the posterior branches of both renal arteries. One week after the operation, 1% saline was given for drinking to substitute plain water. Each rat received an intraperitoneal injection of aminoguanidine (100mg/kg)(group A, n=20) or normal saline (group B, n=20) beginning in the morning of postoperative day(POD) 1 through POD 150. Group C rats received no operation to serve as the control group (n=10). Arterial wall at the bifurcation of the right anterior cerebral artery and olfactory artery as well, as serum were harvested after 5 months. Blood pressure was measured before the experiment and 5 months after the experiment procedure. NO levels were indirectly quantified by measuring nitrate levels. The incidence of formation of aneurysm, pathological findings and expression of iNOS in aneurysmal wall were evaluated with HE staining and immunohistochemical analysis. Results Selective iNOS inhibitor aminoguanidine could significantly inhibit the formation of aneurysms and lower serum levels of nitrate. The pathological features of the experimental aneurysms were similar to that in human, including discontinuation or disappearance of tunica intima, thinning or disappearance of the elastic and muscular layers, and substitution of artery wall by a layer of fibrous connective tissue. iNOS immunoreactivity could be seen in the smooth muscle cells of the intimal pad and distal portion of the newly formed aneurysm. Conclusion Cerebral aneurysm can be induced in rats by alteration in hemodynamics, and it is related to formation of local expression of iNOS and high NO level.

Objective To study the advantages and procedure of telovelar approach for resection of the lesion in the fourth ventricle. Methods Telovelar approach to the fourth ventricle was executed in 17 cases. Among these patients, seven were females and 10 were males. The age ranged from 5 years to 49 years with mean age of 26.6 years. Pathologically, there were 5 medulloblastomas, 5 ependymomas, 2 epidermoids, 2 brain cysticercosis, and 3 choroid plexus papillomas. During the operation, the medullotonsillar space of the cerebellomedullary fissure and the urulotonsillar space were sharply dissected to release the tonsils from uvula and medullar oblongata bilaterally. According to the size of the neoplasm, the tela or both tela and velum were incised. The fourth ventricle was exposed adequately and the lesion was removed. All operations were performed with the help of microscope. The dura was sutured securely. Results The space occupying lesions were removed totally in all cases and all patients recovered very well, and threre was no mortality or serious disability. With 3 to 21-month follow-up in 11 cases, no death or serious disability was found, and the CT or MRI in 8 patients showed no recurrence. Conclusion The telovelar approach can provide adequate exposure to remove the lesion in the fourth venticle. The inferior vermis need not be incised, so a minimum amount of brain tissue was injured, and postoperative complication is decreased.

Objective To study the role of VEGF on the growth of hypertensional saccular aneurysm and its mechanism. Methods Twenty-four SD rats were divided into 2 groups randomly (A and B, each with 12 rats). Saccular aneurysms of the carotid artery were reproduced by treatment of initial segment of the external carotid artery (1mm long) with elastase. In group A, the posterior branches of both renal arteries were ligated in order to produce marked elevation of blood pressure. In Group B hypertension was not produced to serve as the control group. After 8 weeks, the blood pressure and the size of the aneurysms were measured. Then formalin was infused into the arteries for fixation, and aneurysms were resected. The expression of vascular endothelial growth factors (VEGF) in aneurysmal wall was assessed with immunohistochemical analysis. Results The size of aneurysms: after 8W, significant difference was found between A and B group (P

s Objective To observe the changes in the expression of ?-amyloid precursor protein (?-APP) in selected brain areas in early stage of diffuse axonal injury (DAI) in rats. Methods DAI was induced in SD rats by a self-made rotating injury device. 16 rats in injury group were sacrificed by decapitation at 3 hours and 6 hours post-trauma, while the other 8 rats in sham injury group were put to death after 24 hours. The samples of the rat brain were stained with ?-APP for immunohistochemistry in order to detect the early stage pathological changes in subcortex white matter, hippocampus, corpus callosum and brain stem at different time points. Results The ?-APP expression was positive at 3 hours and was particularly strong at 6 hours after injury. The results of semi-quantitative analysis showed a significant differentiation of 3 hours and 6 hours in the immuno-positive expression of brain stem, corpus callosum and hippocampus. Histological results demonstrated that DAI occurred in all rats of injury group. Conclusion ?-APP is a kind of sensitive and useful immunochemical marker for early DAI diagnosis, and it indicates axonal lesion or breakage.

Objective To explore the formation of intravascular microthrombosis in the brain after traumatic brain injury in rat in order to study the potentially causal linkage between thrombosis and post-traumatic cerebral ischemia. Methods Lateral fluid percussion injury (FPI) model was reproduced in the present study to prodace acute brain injury in rats. The rats were sacrificed at 12, 24, 72 hours and 7days after traumatic brain injury. Sham-injured animals received identical craniotomy without FPI. Pathological studies were performed to study the distribution and severity of intravascular microthrombosis in the brain. The difference in the severity of intracerebral thrombosis between groups was evaluated. Results Abundant fibin thrombi were found in all injured rats as compared with the controls (P