Objective To investigate the therapeutic effect and safety of microneurosurgery associated with Gamma Knife radiosurgery on the large meningiomas in sellar region, and to clarify its clinical curative effect. Methods The clinical data of 34 patients with large meningiomas in sellar region underwent microsurgery were retrospectively analyzed.All of them underwent microsurgery,and then treated with Gamma Knife radiosurgery in one month after operation if there were residual tumors.The tumor removal of situation,complication,rate of symptom remission,and recurrence rate were analyzed.Results Among the 34 patients,total resection (7 cases of Simpson grade Ⅰ and 12 cases of Simpson grade Ⅱ)was achieved in 19 cases (55.9%),subtotal resection (Simpson grade Ⅲ )in 14 cases (41.2%), and partial resection (Simpson grade Ⅳ )was achieved in 1 case (2.9%).The major complications were cranial nerve injuries (such as oculomotor nerve, trochlear nerve and abducens nerve,n=6),the contralateral limb paresis (n = 2),postoperative bleeding (n = 1),CSF leak with infection (n=3),and secondary epilepsy (n = 3 ); no death occurred postoperatively. All these patients were followed up for about 3 to 48 months.Postoperative headache disappeared in 24 cases (80%),and 6 cases were alleviated (20%);postoperative vision improved in 12 cases (80%),remained unchanged in 2 cases (13.3%)and deteriorated in 1 case (6.7%); postoperative olfactory function improved in 5 cases (62.5%) and 3 cases unchanged (37.5%); 5 cases recoverd from the ocular motility disorder (71.4%), and 2 cases unchanged (28.6%);7 cases recoverd from thehemiplegia (100%).One of the total resection cases (5.2%)and two of the non-total resection (13.3%)suffered from tumor recurrence.All of the non-total resection cases were treated with Gamma Knife radiosurgery.Conclusion The clinical effect of microneurosurgery associated with Gamma Knife radiosurgery in treatment of large meningiomas in sellar region is satisfactory.

OBJECTIVE: To identify the subtype of transient receptor potential (TRPs) channel involved in stretch-induced injury of human brain microvascular endothelial cells (HBMEC) and to explore the mechanism responsible for eNOS expression.
 METHODS: TRPs expression was examined by Western blot and immunocytofluoresence in the cultured HBMEC. Mechanical stretch was performed by mini-type multi-functional bio-impact machine. The levels of free calcium ion in cells were examined by the flow cytometry. The eNOS expression was detected by Western blot.
 RESULTS: The mRNA and protein expression of TRPV4 was detected in HBMEC by qRT-PCR, Western blot and immunocytofluoresence. The levels of free calcium ion in the stretch-treated HBMEC was significantly decreased in the presence of TRPV4 specific inhibitor (P<0.001), but there was no difference in calcium levels between the stretch and the control or unspecific inhibitor group (P=0.072 or 0.308). The levels of eNOS protein in the stretch-treated HBMEC were reduced in the presence of TRPV4 specific inhibitor or NOS inhibitor (P<0.05), but it was not changed compared with that in the control group (P>0.05).
 CONCLUSION The eNOS expression is up-regulated under the condition of mechanic stretch, which is related to the activation of TRPV4, resulting in the influx of calcium.
Brain ; cytology ; Calcium ; metabolism ; Cells, Cultured ; Endothelial Cells ; physiology ; Humans ; Nitric Oxide Synthase Type III ; metabolism ; Stress, Mechanical ; TRPV Cation Channels ; physiology