Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P ＞ 0.05);in the skin incision,there was statistically significant difference between two groups (P ＜ 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P ＜0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P ＜ 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P ＜ 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P ＜ 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P ＜ 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.

Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.

Objective To discuss the diagnosis and treatment of inflammatory granuloma in central nervous system(CNS)to provide reference for clinic.Methods Retrospective data included 8 patients with CNS inflammatory granuloma in Department of Neurosurgery,Shanxi People's Hospital,2012 -2015.We analyzed the imaging features, postoperative symptoms,blood and cerebrospinal fluid changes and prognosis.Results 8 cases all received surgical treatment.All the symptoms were improved,and the CT showed that the lesions were disappeared.All the patients had recovered to normal life and work.Conclusion The diagnosis of CNS inflammatory granuloma is difficult.Clinical manifestations are lack of specificity.The blood and cerebrospinal fluid laboratory examination have no abnormal changes.CT and MRI are the main diagnostic methods.Postoperative pathology is the gold standard for diagnosis.The large lesion,frequent episodes of epilepsy,severe neurological deficits and possibility of brain tumor all should be treated by surgery.

Objective To investigate the clinical effect of super selective embolization combined with opera-tion for treatment of meningiomas.Methods 82 cases treated by operation and pathology in return for meningioma were collected in the study,including 44 cases of preoperative superselective embolization for aneurysms as the treat-ment group,and the remaining 38 cases without preoperative embolization of patients as the control group.The opera-tion time,bleeding amount in the operation and the rate of total tumor removal were recorded and compared between the two groups.Results The average amount of bleeding of treatment group was (330.36 ±95.41)mL.The average amount of bleeding of control group was (460.82 ±114.64)mL.The data of the two groups was statistically significant (t =5.624,P <0.01).,The treatment group bleeding amount was less than that of the control group;,the mean oper-ation time of treatment group was (5.36 ±2.62)h,,the average operation time of control group was (6.63 ±2.25)h.The data of the two groups was statistically significant (t =2.355,P =0.021 ),the operation time of the treatment group was less than that of the control group.The total resection rate was 70.4% in treatment group and 36.8% in the control group,there was statistically significant (P <0.05),and the total resection rate in the treatment group was higher than that in the control group.Conclusion Compared with single operation treatment of meningiomas superse-lective embolization combined with operation for treatment of meningiomas can shorten operation time,reduce intraoperative hemorrhage,improve the rate of total tumor removal.It can reduce the operation risk and improve the treatment effect.

Objective To investigate the growth inhibition of β-elemene in ECV-304 cells,and study it's meaning to anti-angiogenesis in tumors.Methods The IC50 value of β-elemene in ECV-304 cells were got through MTT assay.Under treatment of β-elemene in ECV-304 cell,flow cytometry(FCM)was used to investigated the changing of cell cycle,electron microscope was used to show the morphological al-terations,agarose gel electrophoresis was used to detect effection on cells'DNA.Results The proliferation of ECV-304 cells was significantly inhibited by β-elemene,the IC50 value was (58.3 ±8.1)μg/ml.By FCM,we observed Cell cycle was significantly arrested in G0 /G1 phase under 60μg/ml treatment(P <0.05),apoptotic cells increased with the increase of drug concentrations.Typical apoptotic morphological alterations were found under electron microscope.Characteristic DNA-ladder standing for apoptosis was showed in agarose gel electrophoresis.Conclusions β-elemene can significantly inhibit ECV-304 cells'pro-liferation By inducing apoptosis.

Objective To detect the expression of the tryptase in the plasma,and study the meaning in brain traumatic patients.Methods There were two groups:the brain traumatic group(40 patients)and the control group (20 health people).The content of plasma tryptase was determined by fluorescence enzyme immunoassay..Results The level of plasma tryptase had no statistical significance in control group(2.97 ±1.05)μg/L compared with the brain traumatic group(3.03 ±1.39)μg/L,however there had statistical significance comparing with sever brain traumatic patients(3.84 ±0.52μg/L)(t =3.32,P <0.05).4 cases of death in patients with severe head injury group content of tryptase (5.85 ±1.05)μg/L,which was significantly higher than the group of 16 cases of injury in severe head injury after 2 months still alive with the content of serum tryptase (2.49 ±0.52)μg/L,the difference was statistically significant (t =8.13,P <0.01).Conclusion The plasma tryptase level in sever brain traumatic patients increased significantly,and might be of importance for treatment strategies and prognosis.

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Objective By combined application of endoscopic and microscopic vivisection-pronged approach,forms a three-dimensional morphological observation through focusing on an observation of structure of various signs, imaging features, morphology and measuring in vivo data, which are concerned with expansion of transsphenoidal approach. This will provide expansion of transsphenoidal approach with an intuitive morphological imagines,detailed anatomical parameters,accurate imaging data,viviperception and data measurement. Methods 80 patients were recruited for investigation, preoperative measurement of the size of the patient' s nose,height of nasal columella,the plane angle among bridge of nose,inner canthal of eyes and nose columella,and the length of bridge of nose.in the operation,measure the distance from nasal columella to aperture of sphenoidal sinus; observe the shape of aperture of sphenoidal sinus; measure the longest and the shortest distance between aperture of sphenoidal sinus; observe the shape of septum of sphenoidal sinus,three uplift and the relationship among them,as well as the color and texture of the tumor.Measure sphenoid sinus wall,screening room,sellar floor,extent of slope resection,operating space,as well as observation & study of selection and repairing of skull base reconstruction materials. Results The shape according to the discretion of the column is divided into butterfly saddle nose, normal nose, eagle nose and acromegaly hypertrophy nose.The nostrils shape is kidney form,ball form,snow humanoid formand triangle form.The butterfly saddle biggest digging distance:between the cavernous sinus is( 18.9±2.51 ) mm,from saddle nodules to slope is(19.2 ±2.67) mm.After tumor resection,the transsphenoidal observation space is forward to former group of ethmoid sinus,back to the slope. Conclusion The measurement data might be benefit for selecting of speculum, evalution of placing depth on speculum and operation position and sellar floor opening range. It would also make it possible for a safer, minimally invasive and effective surgery by avoid damage to the internal carotid artery,cavernous sinus or cranial nerve.

Objective To observe the application of the mini-mental status examination (MMSE)cognitive assessment in the patients with brain glioma before and after surgery. Methods Using MMSE,36 pastients with primary brain glioma were subjected to the cognitive assessment before surgery, after surgery,and 3 monthsr after surgery. Results The quantitative cognitive assessments with MMSE before surgery revealed the hidden cognitive dysfunction patients.The quantitative cognitive assessments after surgery showed that surgeons might need to protect the non-function area and to form the idea of cognitive function in patients with glioma.Conclusion MMSE assessment is a simple,understandably,and convenient method having good compliance of patient. It may be effectively used to assess cognitive impairment for patients with glioma and worth being studied continuously and used widely in the clinic practice.

Objective To explore the clinical value of resistance index(RI)of prostatic capsular artery in predicting or screening of prostate cancer(PCa)by comparing prostatic capsular artery RI with the serum total prostatic specific antigen(TPSA),fPSA/tPSA ratio and prostatic specific antigen dernsity(PSAD).Methods RI of prostate capsular artery,serum TPSA,of fPSA/tPSA ratio and PSAD were measured with colour Doppler ultrasonography in this subset of 203 patients who had undergone transrectal ultrasound guided prostate puncture biopsy.The patients were divided into two groups [PCa and benign prostatic hyperplasia(BPH)group] for comparative study.Results Of them,the level of TPSA were between 4 and 10 ng/ml(grey area)in 34 cases,accounts for 16.75%of the total subjects.All the others were outside the grey area.ROC curve analysis showed that the area under the curve(AUC)of RI of the capsular artery was 0.77,which was close to 0.84 and 0.86 of TPSA and PSAD.It indicated a similar value in predicting or screening PCa; while the AUC of fPSA/tPSA ratio was only 0.49,which had little clinical value.The fPSA/tPSA ratio and the mean value of PSAD in the grey area had significant differences(t=2.78,3.94,P＜0.02)between the two groups.However,the fPSA/tPSA ratio had no statistical significance in the high value area outside the grey area(t=0.873,P ＞ 0.05).And the mean value of RI of prostatic capsular artery had significant differences between the two groups both in the grey area and in the high value area outside the grey area(t=4.56,5.10,P ＜ 0.001).Conclusions RI of prostatic capsular artery can be steadily used to predict or screen PCa.It is not affected by the gray area of TPSA and is of great value in clinical practice.