Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Objective To discuss the experiences in successful treatment of hyperacute traumatic intracranial hematoma with percutaneous puncture and craniotomy.Methods Pereutaneous puncture and craniotomy was performed in 12 patients with hyperacute traumatic intracranial hematomas including seven with subdural hematoma,three with epidural hematoma and two with episubdural hematoma.Before operation,there found enlargement of bilateral pupil in six patients,enlargement of unilateral pupil in six and changed breathing rhythmicity in eight.Glasgow Coma Scale(GCS)was 3 points in four patients,4 points in six and 7 points in two.Results After pereutaneous puncture,enlarged pupil was retracted at different degrees in nine patients and spontaneous breathing conditions improved in seven.After crani otomy,two patients died within 24 hours,four died after 24 hours but six patients survived.The follow-up for 0.5-2 years showed four patients with sound Glasgow Outcome Score,two at vegetative state and six deaths.Conclusion Percutaneous puncture combined with craniotomy is an effective way for hyperacute intracranial hematoma.

Aim To investigate the change in neuropeptide Y(NPY) Y1 receptor level in infarcted myocardium tissues of (MI) rats. 　Method MI was induced by ligating the left descending anterior coronary artery (LAD) in the heart of rats. The techniques of reverse transcription polymerase chain reaction (RT-PCR) were used to identify the exist of NPY Y1 receptor mRNA in myocardial tissues. The technique of semi-quantitative PCR wa s used to observe the change of NPY Y1 receptor mRNA level. 　Results NPY Y1 receptor mRNA distributed in the heart tissues of rat. Compared with sham operated rats ,the NPY Y1 receptor mRNA level both in infarction area and non-infarction area was increased significantly after MI fo r 1d and 3d. The NPY Y1 receptor mRNA level in the heart tissues of sham-op erated rats was also significantly increased compared with that in control rats . 　Conclusion These results suggest that MI may result in increase NPY Y1 receptor level in the heart tissues of rats. Stre ss stimulation such as surgery may also increase the NPY Y1 receptor level in the heart.

Objective:To invetigate the value of a novel puncture and drainage of intracranial hematoma for the treatment of hypertensive intracerebral hemorrhage.Methods:In the group there were 27 patients with hypertensive intracerebral hemorrhage,with mean age of 61 years. Their hematomas located in thalamus(1 patient),basal ganglia(22 patients),and lobe(4 patients).The mean(SD)hematoma volume was 40(3.2)mL,the mean Glasgow Coma Scale (GCS)score was 10.15,and the mean National Institutes of Health Stroke Scale(NIHSS)score was 30.65 at admission.CT scan provided hematoma location.and the percutaneous puncture. grind and drainage were performed under the local anesthesia by using a novel puncture and drainage of intracranial hematoma.Results:No adverse events occurred during the punctures and after the procedures.One patiems died 20 days after procedure.Other patients were followed up for more than 6 months.Eight patients had a good outcome as assessed by Glasgow Outcome Scale(GOS)scores,15 had mild disability,2 had serious disability,and 1 was in a permanent vegetative state.Conclusions:This novel puncture and drainage of intracranial hematoma can be used in the treatment of hypertensive intracerebral hemorrhage,and it is simple and safe.

To investigate influence of butylphthalide injection on serum neuron specific enolase, C-reactive protein and fatty acid binding protein levels in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage.Methods Ninety patients with cerebral vasospasm were admitted to The First Affiliated Hospital of Fujian Medical University, then the patients were divided into two groups: The control group (45 patients) was treated with nimodipine and triple-H therapy after surgery;in addition to nimodipine and triple-H therapy, butylphthalide injection was administered to the experimental group(45 patients).Transcranial doppler(TCD)was used for the evaluating cerebral artery blood flow velocity, and the serum neuron specific enolase(NSE), C-reactive protein(CRP) and fatty acid binding protein(FABP) levels in patients with cerebral vasospasm were measured. Results The experimental group improved significantly more than the control group, a significant decrease in cerebral blood flow velocity of the middle cerebral artery in the experimental group as measured by TCD (P<0.05).The serum levels of NSE, CRP and FABP in the patients in the experimental group decreased more significantly (P<0.05).And the incidence of cerebral infarction in experimental group was lower than that in control group (P<0.05).Conclusion The serum levels of NSE, CRP and FABP in the patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage could be significantly reduced by administration of butylphthalide injection, which also could improve cerebral blood supply.Therefore, administration of butylphthalide injection is an effective treatment for cerebral vasospasm.

Objective To assess the clinical effect of lumboperitoneal shunting (LPS) on communicating hydrocephalus.Methods An retrospectively study was conducted on communicating hydrocephalus patients who were hospitalized from Sep.2009 and Dec.2013 at the No.174th Hospital of Chinese People's Liberation Army.All patients were underwent the LPS.All patients were with difference degrees of coma,and lumbar punctured for continued cerebrospinal fluid extended drainage before LPS.The change of disturbance of consciousness and the complications of LPS were assessed.Results There were 12 patients with communicating hydrocephalus.Of them,7 cases were underwent routine lumboperitoneal shunts,and 5 cases were experienced adjustment valve.After the LPS operation,3 patients were awakened from the coma,and 8 patients were improved in terms of consciousness and the decompression pressure of skull window as well as decreased enlarged lateral ventricles in pre-operation by CT.As for another 1 patient,the lumboperitoneal catheter had been slipped into the peritoneal cavity after 2 months of operation.There were no complications of infection,intracranial hemorrhages,obstruction of catheter and epilepsy.Conclusion The LPS should be the first selection of those patients who suffered from communicating hydrocephalus without trouble in spine and abdomen.A positive response to pre-operative continuing cerebrospinal fluid extend drainage is good prediction factor for surgical results of LPS.

We reported a case of microcephaly-capillary malformation(MIC-CAP)caused by STAMBP gene variant,in order to improve the clinical diagnosis and treatment.The patient is a 3-month-old male with recurrent convulsions and the main clinical manifestations are multiple forms of seizures,microcephaly,multiple small capillary malformations in the skin,and generalized hypotonia.The genetic test showed that a heterozygous variant in the STAMBP gene was present in the child.Both parents were heterozygous carriers.He was administrated various anti-seizure medications and ketogenic diet,but still had frequent seizures.He then underwent corpus callosotomy,and was followed up until he was 4 years and 10 months old.The post operational outcome was grade IV on Engel's classification.Based on the clinical data of 22 patients in literature,in addition to severe psychomotor retardation,microcephaly,and cutaneous capillary malformations,early-onset drug-refractory epilepsy is also a major feature of MIC-CAP syndrome,which is clinically rare and has a poor prognosis;Callosotomy may help to reduce seizures in the short term.However,the long-term outcome is poor.STAMBP gene is the main responsible gene for this syndrome.

Objective:To explore the surgical outcomes of focal cortical dysplasia (FCD) patients with "difficult to locate" intractable epilepsy and their influencing factors.Methods:Thirty-five FCD patients with "difficult to locate" intractable epilepsy, underwent surgical treatment after intracranial electroencephalogram (iEEG) evaluation in our hospital from January 2011 to December 2018, were chosen in our study. Engel grading was used to evaluate the surgical efficacies of these patients, and they were divided into a satisfied efficacy group (Engel grading I) and an incomplete satisfied efficacy group (Engel grading II-IV). The clinical data of patients from the 2 groups were compared. Multivariate Logistic regression analysis was performed to explore the influencing factors for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy.Results:Of these 35 patients, 26 patients (74.3%) achieved satisfied efficacy, and 4 had incomplete satisfied efficacy. As compared with those in the satisfied efficacy group, patients in the incomplete satisfied efficacy group had significantly lower total resection rate of epileptogenic foci ( P<0.05). Multivariate Logistic regression analysis showed that incomplete resection of epileptogenic foci was the influencing factor for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy ( P=0.014, OR=0.050, 95%CI: 0.005-0.547). Conclusion:The FCD patients with "difficult to locate" intractable epilepsy can achieve satisfactory results by surgical resection of epileptogenic zones after iEEG monitoring; these FCD patients with "difficult to locate" intractable epilepsy with incomplete resection of epileptogenic foci often have poor surgical outcomes.

Objective To analyze the effect of body mass index (BMI) on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for the diagnosis and treatment of COPD. Methods A total of 1 278 patients who visited the respiratory department of our hospital from January 2019 to June 2022 were selected as the research objects, including 368 COPD patients, 225 of whom were in stable stage and 143 of whom were in acute exacerbation stage. According to BMI, they were divided into low group (n=31, BMI<18.5kg/m²), normal group (n=198,18.5kg/m2≤BMI<24 kg/m²), overweight group (n=106, 24kg/m²≤BMI<28 kg/m²) and obese group (n=33,BMI≥28 kg/m²). Health-related quality of life (HRQOL) was used to evaluate the quality of life of patients. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by pulmonary function instrument to evaluate the pulmonary function grade of patients. Logistic regression was used to analyze the risk factors of pulmonary function and quality of life in COPD patients. Results There were significant differences in age, smoking, BMI and hyperlipidemia between stable COPD patients and acute exacerbation COPD patients with different BMI groups (P<0.05). There were significant differences in the proportion of pulmonary function Ⅲ/Ⅳ, FEV1/FVC, FEV1pred and HRQOL scores among different BMI groups (P<0.05) . The FEV1/FVC and FEV1pred in patients with acute exacerbation and stable COPD from high to low were obese group, overrecombination group, normal group and too low group, and the differences were statistically significant (P<0.05). The HRQOL scores of COPD patients in acute exacerbation and stable stage from high to low were obese group, overweight group, normal group and too low group, and the difference was statistically significant (P<0.05). Low body mass index was a risk factor for pulmonary function in COPD patients at stable stage (OR=2.52) and acute exacerbation stage (OR=2.83) (P<0.05). High body mass index was a risk factor for quality of life in patients with stable COPD (OR=2.43) and acute exacerbation (OR=2.65) (P<0.05). Conclusion BMI can affect pulmonary function and quality of life in COPD patients. Patients should maintain normal BMI, which can improve pulmonary function and quality of life.