Objective To investigate the therapeutic effect of the hemilaminectomy approach in intraspinal tumor with the help of intraoperative ultrasound,high-speed drill and ultrasound knife.Methods Clinical data of 35 cases with the intraspinal tumor were analyzed retrospectively.All the patients were treated by hemilaminectomy approach,the position of the lesions were fixed by preoperative X-ray and intraoperative ultrasound,root of the spinous process were removed in order to achieve adequate visual field by high-speed drill and ultrasound knife.Electrophysiologic monitoring were used if the lesions were in the spinal cord.Results Total surgical resection was achieved in 32 cases,gross total resection was in 3 cases.Twenty-eight of the 35 cases were followed up.The symptom alteration of the first period ( 1 - 3 months postoperative):improved in 25 cases,no changed in 2 cases,aggravated in 1 case.The symptom alteration of the second period (6-24 months postoperative):no changed in all cases,no stability change of the vertebral column had been found.Conclusions Followed with the development of the electrophysiologic monitoring,high-speed drill,intraoperative ultrasound,the indication of the hemilaminectomy and have no influence of the spinal stability.However,to spinal meningioma which have a wide base,the hemilaminectomy approach may not adapt.

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.

Objective To study the feasibility and safety of individual laparoscopic pancreatectomy for patients with pancreatic neuroendocrine neoplasm(pNEN).Methods 16 patients with pNEN admitted from Jan.2007 to Nov.2016 undergoing individual laparoscopic pancreatectomy were retrospectively analyzed.Results The operations were successfully accomplished in all the 16 patients,including 2 cases of local excision,2 cases of bundling method excision,2 cases of central pancreatectomy and pancreaticojejunostomy,4 cases of spleen-preserving distal pancreatectomy and 6 cases of distal pancreatectomy combined with splenectomy.The operation time was ranging from 60 to 260 mins,and the blood loss was from 50 to 300 ml.Three cases suffered from level A postoperative pancreatic leakage.The cases of grade G1,G2,G3 were 10,5,1,respectively.The follow-up period was from 3 to 121 months.One case of grade G2 died 46 months postoperatively and 1 case of grade G3 died 36 months postoperatively.Conclusion Individual laparoscopic pancreatectomy is safe and feasible for early pNEN.

Acute kidney injury (AKI) is one of the most common and severe nephropathy syndromes in clinical practice and also one of the most common serious complications after organ transplantation, with high incidence and fatality. Iron is an essential trace element in the body. Ferroptosis is a form of programmed cell death induced by the accumulation of iron-mediated lipid peroxidation, and its occurrence is closely related to iron metabolism, lipid metabolism, amino acid metabolism and multiple signaling pathways. Recent studies have shown that ferroptosis plays a key role in the occurrence and development of AKI and provides therapeutic targets for AKI. This article summarizes the regulatory mechanism of ferroptosis and its role in AKI, as well as the compounds that play an important role in the prevention and treatment of AKI by inhibiting ferroptosis, providing new ideas for the future treatment and research of AKI.

Objective: To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). Methods: A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. Results: The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance (P>0.05). Conclusions Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.