Objective To analyze the expression changes of transforming growth factor-β (TGF-β) and vascular endothelial growth factor (VEGF) in malignant brain gliomas and their values in tumor resectability evaluation.Methods One hundred and eighty-eight patients with malignant brain gliomas received surgery in our hospital from January 2010 to January 2017 were chosen in our study as patient group;during the surgery,the glioma tissues and peritumoral tissues were collected;Westem blotting was employed to detect the VEGF and TGF-β expressions.Fifty healthy controls accepted healthy examinations at the same time-period were enrolled.Peripheral blood 24 h before surgery of the two groups was collected.ELISA was used to test the serum VEGF and TGF-β levels.The values of serum VEGF and TGF-β levels in tumor resectability were analyzed by receiver operating characteristic (ROC) curve.Results In the patient group,significantly higher levels of VEGF and TGF-β in the tumor tissues were noted as compared with those in the para-tumor tissues (P＜0.05).Significantly higher levels of VEGF and TGF-β in the patient group were noted as compared with those in the control group (P＜0.05).There were 126 patients received total tumor resection,while 62 just had partial tumor resection;one year after surgery,22 patients with total tumor resection (17.46％) died,and 20 patients with partial tumor resection (32.26％) died,which indicated that the cumulative mortality rate one year after surgery in patients with total tumor resection was significantly lower than that in patients with partial tumor resection (P＜0.05).With cut-off point value of 588.0 pg/mL,ROC analysis showed that the sensitivity of VEGF in prediction of total tumor resection was 80.65％,and specificity 80.16％,and area under curve 0.82,which were better than those of TGF-β.Conclusion For malignant brain glioma patients,the levels of VEGF and TGF-β increase,and VEGF shows an ideal value in tumor resectability evaluation.

OBJECTIVE:To explore clinical efficacy and safety of Ulinastatin injection combined with Xingnaojing injec-tion in the treament of severe craniocerebral injury(CCI). METHODS:A total of 120 severe CCI patients selected from our hospital during Sept. 2014-Nov. 2015 were divided into ulinastatin group,Xingnaojing group and combination group according to therapy plan,with 40 cases in each group. Three groups were given routine treatment timely after admission. On the basis of routine treatment,Ulinastatin group additionally received Ulinastatin injection 200 000 U,ivgtt,bid;Xingnaojing group addi-tionally received Xingnaojing injection 20 mL,ivgtt,qd;combination group additionally received Ulinastatin injection com-bined with Xingnaojing injection,same usage as above(with 1 h intervals). Three groups received therapy for consecutive 14 d. Serum inflammatory factors(CRP,IL-1,IL-6,TNF-α),serologic indexes of craniocerebral injury [neuron specific enolase (NSE),myelin basic protein(MBP),S100B protein(S100B)] and GCS scores before and after treatment as well as GOS scores after treatment were all observed in 3 groups. The occurrence of ADR was recorded during treatment. RESULTS:Before treatment,there was no statistical significance in serum inflammatory factors,serologic indexes of craniocerebral injury or GCS scores among 3 groups(P>0.05). Compared to before treatment,inflammatory factors of 3 groups were decreased signifi-cantly after treatment,the ulinastatin group was significantly lower than the Xingnaojing group,combination group was signifi-cantly lower than two single drug groups,with statistical significance(P<0.05). Levels of serologic indexes of craniocerebral injury and GCS scores of 3 groups were improved significantly,and the combination group was significantly better than the two single drug groups,with statistical significance(P<0.05). There was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). Six months after treatment,GOS score of combination group(4.17±0.81)was significantly better than those of ulinastatin group(3.05±0.97)and Xing-naojing group(2.97 ± 0.89),with statistical significance (P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). During treatment,the incidence of ADR in combination group(27.50%)was significantly lower than ulinastatin group(50.00%)and Xingnaojing group(42.50%),with statistical significance(P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). CONCLUSIONS:Ulinastatin injection combined with Xingnaojing injection can sig-nificantly decrease serum inflammatory factor levels,relieve craniocerebral injury,protect cerebral tissue and improve short-term prognosis with good safety.

The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- xisting intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.
Tomography, X-Ray Computed ; Postoperative Complications/ultrasonography ; Male ; Liver Diseases/complications/*radiography/surgery ; Infant, Newborn ; Infant ; Humans ; Female ; Choledochal Cyst/complications/*radiography/surgery ; Cholangiography ; Child, Preschool ; Child ; Bile Ducts/*abnormalities/pathology/surgery

The purpose of this study was to investigate and discuss imaging methods and management strategies for congenital choledochal cyst with co-existing intrahepatic dilation and aberrant bile duct as well as other complicated biliary anomalies. In this study we reviewed and analyzed 72 patients with congenital choledochal cyst, ranging in age from 15 days to 12 years old and who were seen at our hospital during the past 12 years, from January 1993 to October 2005. The image manifestation and clinical significance of patients with co- xisting intrahepatic biliary dilation and aberrant bile duct were carefully examined during operation via MRCP, cholangiography and choledochoscope. Twenty-two cases (30.1%) presented with intrahepatic bile duct dilation and 12 of these were of the cystic type. That is, the orifice of the dilated intrahepatic tract that converged into the common hepatic duct showed membrane or septum-like stenosis. In 10 cases the dilation tapered off from the porta hepatis to the initiating terminals of the intra-hepatic bile ducts and was not accompanied by stenosis. An aberrant bile duct was observed in 2 of the cases. In 3 cases, the right and left hepatic ducts converged at the choledochal cyst. In conclusion, the imaging methods for intrahepatic bile duct dilation possess important clinical significance. Further, for hepatojejunostomy with radical excision of a choledochal cyst, additional operative procedures for intrahepatic stenosis, possible bile duct malformation and pancreaticobiliary common duct calculi can potentially reduce postoperative complications.
Tomography, X-Ray Computed ; Postoperative Complications/ultrasonography ; Male ; Liver Diseases/complications/*radiography/surgery ; Infant, Newborn ; Infant ; Humans ; Female ; Choledochal Cyst/complications/*radiography/surgery ; Cholangiography ; Child, Preschool ; Child ; Bile Ducts/*abnormalities/pathology/surgery