Objective To study the surgical skills for parasagittal meningioma at the central cortex. Methods A total of 32 patients with parasagittal meningiomas at the central cortex were treated with microsurgery. Through the arachnoid interfaces between the tumor and the brain tissue, the tumor was removed piece by piece. The vein of central sulcus, other draining veins, and normal brain tissues were protected, and the involved sagittal sinus was appropriately treated. Results Simpson Ⅰ, Ⅱ, and Ⅲ grades resection was achieved in 17 (53.1%), 11(34.4%), and 4 (12.5%) of the 32 patients respectively. None of the patients died. Two patients developed cerebral edema and infarction and were cured by surgical decompression. Hemiparalysis was deteriorated in 10 patients, 8 of them recovered spontaneously in 1 to 6 weeks, and the other 2 developed hemiparesis. Among the patients, 21 patients were followed up for 3 months to 5 years. 4 patients had recurrent meningioma in 1 to 3 years after the operation (Ⅱ grade resection in 2 and Ⅲ grade resection in 2). Conclusions For parasagittal meningiomas at the central cortex, preoperation imaging evaluation and microsurgical techniques are key factors for complete resection and surgical outcomes. The vein of central sulcus, other draining veins, and normal brain tissues should be protected during the procedure.

Objective To observe the short-term and long-term effect of microvascular decompression in patients with trigeminal neuralgia (TN).Methods The chnical data of 180 patients with TN treated with microvascular decompression were retrospectively analyzed.The pain improvement of patients in 2 years was observed,combined with age and course of disease,as well as the type of pressure vessels,whether obvious impression and so on,to analysis the recurrence factors of TN.Results All patients were found with vascular compression,including 93 cases with apparent pressure pressing mark,85 cases with arterial compression,15 cases with venous compression,and 8 cases with arteriovenous compression,among of them 74 patients with artery compression had pressure pressing mark,and 11 patients with vascular compression had pressure pressing mark,all of 8 patients with arteriovenous compression had pressure pressing mark.One week postoperatively,the patients with vascular compression gained significant improvement,of which 79 cases achieved optimal,6 cases achieved good;9 patients with vascular compression achieved optimal,6 cases achieved good,and 5 patients with arteriovenous compression achieved optimal,3 cases achieved good.Follow-up for 1 year after surgery,artery compression recurred in 5 cases,of which 3 cases of part recurrence,2 cases of recurrence completely ;vascular compression recurred in 6 cases;arteriovenous compression recurred in 2 cases.Univariate analysis showed that the vascular compression type,bascular compression notch and duration were the risk factors of postoperative recurrence (P ＜ 0.01).Multiple analysis showed that the vascular compression type,bascular compression degree and duration were the independent risk factors of postoperative recurrence (P ＜ 0.05).Conclusions TN patients treatd with microvascular decompression have effective improvement.History of diease,vascular compression type and compression degree are the important influence factors of postoperative recurrence.

Objective To observe the expression of interleukin-1β (IL-1β) in blood serum after axonal injury in rats and investigate the effects of ciclosporin A (CsA) on it so as to discuss mechanism of CsA protecting neural function. Methods A total of 75 adult male SD rats were randomly divided into control group (Group A with 5 rats), only optic nerve stretch group (Group B with 35 rats) and stretch plus CsA treatment group (Group C with 35 rats). Stretch injury was induced in the right optic nerves of the rats in Group B and C. CsA at 20 mg/L was intraperitonealy injected in Group C immediately after stretch injury. Five animals from both Group B and Group C were killed at 1,3, 6, 12 hours and at days 1,3 and 7 after stretch injury or injection of CsA respectively. Morphological changes of optic nerves and retinal ganglion cells (RGCs) after stretch injury were examined under light microscope. In the mean- time, expression of IL-1β in the blood serum was observed by means of radioimmunoassay. Results (1) Histopathological observation showed lose of R GCs at day 3 and disarranged nerve fiber at day 7 after stretch injury of optic nerve in Group B, but significant amelioration of corresponding changes in Group C. (2) The expression of IL-1β in blood serum in Group B was significantly higher than that in Group A 3, 6, 12 hours and 1 day after injury. The expression of IL-1β reached peak at the 6th hour, then de- creased gradually and returned to the similar level of Group A after 3 days. The expression pattem of IL- 1 β in blood serum of Group C decreased more significantly at 3, 6, 12 hours and 1 day compared with that in Group B but was still higher than that of Group A at 6, 12 hours and 1 day. Conclusions The long-term and excessive expression of IL-1β may be involved in the secondary pathological changes after axonal injury. CsA exerts neuroprotective effect on injured axons mostly by attenuation of inflammation re- action after axonal injury.

Objective To discuss the utility of lean management in the informationalization of health check-up.Methods A total of 2125 matched adults who received health check-up from April to July 2008 (n =1001) or 2012 (n =1124) were enrolled by using random sampling.Time of health check-up registration and laboratory sheet filling,preparation of final report,consumption of labor force,and integrity of data collection were compared before and after the conduction of lean management.Results Since lean management startup,time of registration was decreased from (250.0 ± 7.7) to (7.8 ± 0.9) min/100persons,time of sheet filling was reduced from (137.0 ± 10.6) to (26.0 ± 2.9) min/100 persons,preparation of final report was less time-consuming ((702.0 ± 11.7) vs.(300.0 ± 12.6) min/100persons).The integrity and accuracy of health check-up reports were significantly improved (67.0％ vs.99.2％).Newer health check-up receivers were increased from 17.8％ to 29.4％ (x2 =461.944,P ＜0.05).Conclusion Lean management may be feasible and effective in the informationalization of health check-up.

Objective To investigate the clinical characteristics and treatments of patients with long-term oral aspirin treatment combined with craniocerebral injury.Methods A retrospective analysis was made on 24 cases admitted for long-term oral aspirin treatment combined with craniocerebral injury from January 2010 to June 2012.There were 15 males and 9 females at age of 52-78 years (mean,63.5years).Injuries were caused by a traffic accident in 18 cases,a high fall in four and a blow in two.GCS on admission was 13-15 points in six cases,10-12 points in 10 cases and ＜ 8 points in eight cases.Six cases had conventional treatment,nine puncture drainage,six intracerebral hematoma evacuation by small craniotomy and three hematoma evacuation by large craniotomy.Results The patients were followed up for three months.Glasgow outcome score (GOS) was used to assess the prognosis in five categories,i.e.,grade Ⅴ (good recovery),grade Ⅳ (low disability),grade Ⅲ (severe disability),grade Ⅱ (vegetative state) and grade Ⅰ (death).Besides,grades Ⅴ and Ⅳ GOS represented a good outcome.Of these patients 15 (62.5％) had good results and nine (37.5 ％) undesirable results.Conclusions Patients with long-term oral aspirin administration combined with craniocerebral injury are characterized by high incidence of delayed and progressive cerebral hemorrhage,multi-focus intracerebral hemorrhage and postoperative rehemorrhagia.Therefore,aspirin therapy should be discontinued.Instead,enough blood coagulation accelerator,platelet and fresh plasma should be given.An operation is necessary for the patients with critically severe conditions but is not advisable for the patients with milder conditions.

BACKGROUND: More recently,repair of skull defect with computer-designed prosthesis contributes to the revolutionary development of skull reconstruction technique. OBJECTIVE: To individually molded titanium mesh by computer-aided design (CAD) technique,and to observe the clinical application value of the titanium mesh in the repair of large-area skull defects in the fronto- temporo-parietal lobes. DESIGN,TIME AND SETTING: A retrospective case analysis was performed at the Department of Neurosurgery,Liuzhou People's Hospital between January 2006 and August 2007.PARTICIPANTS: A total of 16 patients comprising 12 males and 4 females,aged 16-52 years,suffered from skull defects in the fronto-temporo-parietai lobes following standard large trauma craniotomy and were recruited into this stud Two of these patients were complicated by hydrocephalus and received ventriculoperitoneal shunt. Skull defect area ranged between 9. 2 cm ×11.2 cm and 12.2 cm×14.6 cm. Skull defect neoplasty was performed in all patients 3-8months following standard large trauma craniotomy. METHODS: Titanium mesh patches were individually modeled by CAD,computer-aided manufacturing (CAM) and rapid shaping techniques and implanted into skull defect region. In addition,defect edge was fastened with titanium nails. MAIN OUTCOME MEASURES: Moulding effects and complications following skull defect neoplasty. RESULTS: A small amount of subcutaneous effusion was found in one patient and disappeared after liquid extraction and pressure dressing. Titanium mesh was firmly fixed with no loosening. Patients exhibited left-right symmetry,appropriate lateral curvature,no irregular umbilication or chewing dysfunction. All patients were followed for 3-18 months postoperatively and were satisfied with good resuRs,Le.,no complications,infection,material exposure,loosening,or collapse. CONCLUSION: CAD technique used for repair of skull defects is convenient,effective,and safe. This method can. reduce postoperative complications and improve repair effects.

Objective To investigate the effect of the peritoneal lymphatic stomata on intra-abdominal infection and the regulatory mechanism of angiotensin Ⅱ receptor specific inhibitor PD123319 on peritoneal lymphatic stomata.Methods The experimental study was adopted.Forty rats were divided into the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group by the random number table,every group had 10 rats.The classic appendix perforation (CLP) intraabdominal infection model was established in the abdominal infection group.After establishing the model of abdominal infection,PD123319 solution was injected intraperitoneally immediately (0.2 g/kg) in the abdominal infection drug intervention group.Abdominal cavity of the rats in the sham operation group was opened,and then was shut after flipping the intestine.The rats in the control group,sham operation group and intra-abdominal infection group were treated with intraperitoneal injection of 1ml stroke-physiological saline solution.After 2 hours,the rats were sacrificed,and peritoneal tissue was taken for the following tests.(1) The aperture size and distribution density of peritoneal lymphatic stomata were observed by scanning electron microscope (SEM).(2) The nitric oxide (NO) concentration in the peritoneal tissues was detected using nitric oxide nitric acid reduction method.(3) The expressions of endothelial nitric oxide synthase (eNOS) and Phospho-eNOS (P-eNOS) were detected by the Western blot.(4) The intracellular Ca2+ concentration were detect by flow cytometry.Measurement data with normal distribution were presented as-x ± s.The comparison among groups was analyzed using the ANOVA and pairwise comparison was analyzed by the LSD test.Results (1) The aperture size and distribution density of the peritoneal lymphatic stomata in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (2.3 ± 0.4) μm,(2.5 ± 0.5)μm,(4.7 ±0.5)pm,(3.8 ±0.5)pm and (2.0 ±0.8) × 108/m2,(2.1 ±0.7) × 108/m2,(6.2 ± 1.3) × 108/m2,(4.6 ± 1.4) × 108/m2,with statistically significant differences among the 4 groups (F =98.130,56.780,P ＜ 0.05).There were statistically significant differences in the aperture size and distribution density of the peritoneal lymphatic stomata between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =11.586,8.573,3.854,3.098,P ＜ 0.05) and no statistically significant differences between the control group and sham operation group (t =1.281,0.514,P ＞0.05).(2) The concentrations of NO in the peritoneal tissues in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.380 ± 0.024) μmol/gprot,(0.450 ±0.020) μmol/gprot,(1.253 ±0.033) μmol/gprot and (0.579 ±0.035) μmol/gprot,with a statistically significant difference among the 4 groups (F =52.725,P ＜ 0.05).There were statistically significant differences in the concentration of NO between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =10.536,67.798,P ＜ 0.05) and no statistically significant difference in the concentration of NO between the control group and sham operation group (t =2.007,P ＞ 0.05).(3) The results of Western blot showed that the expressions of eNOS and P-eNOS in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.591 ± 0.028)U/mg,(0.603 ± 0.007) U/mg,(0.615 ± 0.027) U/mg,(0.626 ±0.026) U/mg and (0.578 ±0.003)U/mg,(0.603 ± 0.071) U/mg,(0.773 ± 0.033) U/mg,(0.710 ± 0.012) U/mg,with no statistically significant difference in the expression of eNOS among the 4 groups (F =0.902,P ＞ 0.05) and with a statistically significant difference in the expression of P-eNOS among the 4 groups (F =205.062,P ＜ 0.05).There were statistically significant differences in the expression of P-eNOS between the control group and sham operation group or intra-abdominal infection group (t =7.678,13.322,P ＜ 0.05) and between the intra-abdominal infection group and intraabdominal infection drug intervention group (t =4.035,P ＜0.05).(4) The results of flow cytometry showed that Ca2+ concentration in the control group,sham operation group,intra-abdominal infection group and intraabdominal infection drug intervention group were respectively 82.200％ ± 0.060％,81.730％ ± 0.052％,21.980％ ± 0.010％,29.500％ ± 0.004％,showing a statistically significant difference between the 4 groups (F =21 271.030,P ＜ 0.05).There were statistically significant differences in the Ca2+ concentration between the intra-abdominal infection group and control group (t =164.750,P ＜ 0.05) and between the intra-abdominal infection group and intra-abdominal infection drug intervention group (t =21.338,P ＜ 0.05),and no statistically significant difference between the control group and sham operation group (t =1.861,P ＞ 0.05).Conclusion The intra-abdominal infection could increase aperture size and distribution density of peritoneal lymphatic stomata,and PD123319 may be through inhibiting the activation of NO synthase to decrease the concentration of NO,enhance the concentration of Ca2+ in peritoneal mesothelial cells and reduce the opening of peritoneal lymphatic stomata.

Objective To explore the value of low-dose CT in the diagnosis of congenital heart disease(CHD)with tracheal stenosis (CTS)in infants.Methods Data of low-dose CT and echocardiography in 18 cases of CHD with CTS were analyzed retrospectively, and compared with surgical findings.Results 18 cases of CST were comfirmed by surgical operation.The diagnostic accuracy of low-dose CT was 100%,and there was no statistical difference in the assessment of the range and degree in tracheal stenosis(P=0.76>0.05, P=0.767>0.05).42 cardiac anomalies were comfirmed by operation.The diagnostic accuracies of low-dose CT and echocardiography were 88.1% and 90.5% respectively,which was no statistical difference(P=0.825>0.05).15 cases of CTS(15/18,83.33%)were caused by the compression of the vessels,in which there were 9 cases by pulmonary artery sling,3 cases by vascular ring,3 cases by double aortic arches.Conclusion Low-dose CT can accurately diagnose CHD with CTS and provide important information for clinical practice.

Objective:To investigate the correlation between the expression of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immunoinflammatory index (SII) in patients with radical hepatectomy.Methods:A total of 78 patients with radical hepatectomy from March 2016 to January 2018 were enrolled in the observation group. All patients were treated with radical hepatectomy. 58 patients with liver benign disease treated at the same time were selected as the control group. The patient′s neutrophil, lymphocyte and platelet levels were calculated by automatic biochemical analyzer, and the NLR and PLR values were calculated. The SII was calculated using the formula platelet × neutrophil/lymphocyte; The patients′ gender, age, preoperative alanine aminotransferase (ALT), tumor diameter, preoperative alpha-fetoprotein (AFP), liver function classification and other indicators were recorded, and univariate and multivariate logistic analysis was performed; the patients were followed up for 18 months after treatment, and were divided into death group and survival group according to the prognosis. The levels of NLR, PLR and SII in the two groups were recorded and analyzed. Pearson correlation analysis was used to analyze the correlation between NLR, PLR, SII and prognosis.Results:The levels of NLR (7.48±1.21), PLR (25.31±4.23) and SII (452.98±43.69) in the observation group were higher than those in the control group [NLR(2.35±0.96), PLR (10.49±2.44) and SII (253.23±25.31)] ( t=6.391, 5.328, 8.562, P<0.05). The results of univariate and multivariate logistic analysis showed that the levels of NLR, PLR and SII in the observation group were related to preoperative ALT, tumor diameter, preoperative AFP and liver function classification ( P<0.05); 55 patients survived and 23 died in 18 months follow-up. The levels of NLR (4.39±1.46), PLR (15.93±4.39) and SII (275.69±21.53) in survival group were lower than those in death group [NLR (13.59±2.49), PLR (53.29±6.41), SII (574.67±46.39)] ( t=7.398, 4.395, 6.781, P<0.05). The results of Pearson correlation analysis showed that the levels of NLR, PLR and SII were negatively correlated with the prognosis of patients ( r=-0.693, -0.771, -0.709, P<0.05). Conclusions:NLR, PLR and SII are highly expressed in patients with radical hepatectomy. The expression level of NLR, PLR and SII is correlated with the prognosis of patients, monitoring their expression level can evaluate the prognosis and guide clinical treatment.

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.
Animals ; Erectile Dysfunction* ; Hemodynamics ; Lithotripsy ; Male ; Models, Animal ; Penis ; Peripheral Nervous System Diseases ; Phosphodiesterase 5 Inhibitors ; Shock*