Objective:To investigate the role of long-chain non-coding RNA MEG3 and DNA demethylase TET2 in the invasive growth of pituitary growth hormone (GH) adenomas, and provide research directions for the subsequent exploration of molecular biological mechanisms.Methods:All of 60 patients with GH pituitary adenomas diagnosed in Dalian Central Hospital from January 2016 to November 2019 were collected, and the normal anterior pituitary tissue samples of 10 patients with traumatic brain injury without neurological or endocrine system diseases were collected as control group. Real-time reverse transcription-polymerase chain reaction (qPCR) was used to detect the expression of lnc RNA MEG3 and TET2 in normal pituitary tissue as well as invasive and non-invasive pituitary growth hormone adenomas, and the differences between each groups were analyzed. At the same time, age and gender were included in the research, and the effects of age and gender on the invasive growth of pituitary GH adenomas were analyzed.Results:The aggressive growth of MEG3 and TET2 was independent of patients′ age and gender. The expression of lncRNA MEG3 in invasive pituitary GH adenoma and non-invasive pituitary GH adenoma was significantly lower than that in normal control brain tissue. Analysis of the differences between the groups found that the expression level of lncRNA MEG3 in normal trauma control pituitary tissues, non-invasive GH adenomas, and invasive GH adenomas were sequentially decreased, and MEG3 expression level was related to the aggressive growth behavior of pituitary GH adenomas ( P<0.05). The expression levels of DNA demethylase TET2 in invasive pituitary GH adenomas and non-invasive pituitary GH adenomas were significantly lower than those in the normal control brain tissue, and the expression levels in the three groups of samples gradually decreased ( P<0.05). It suggested that the expression of lncRNA MEG3 was positively correlated with the expression of DNA demethylase TET2. Conclusions:The low expression of lncRNA MEG3 and DNA demethylase TET2 is closely related to the aggressiveness of pituitary growth hormone adenoma.

Objective: To explore the therapeutic effect of modified pedicled nasal septum mucosa flap on cerebrospinal fluid leakage in transsphenoidal pituitary surgery. Methods: The clinical data of 28 patients treated with modified pedicled nasal septal mucosa flap during endoscopic transsphenoidal resection of pituitary adenoma in Dalian Central Hospital from August 2017 to December 2018 were analyzed retrospectively. Seven cases of high-flow cerebrospinal fluid leakage occurred during the operation. Skull base reconstruction was performed with modified pedicled nasal septum mucosal flap. Modified pedicled nasal septum mucosal flap was repositioned in 21 cases. Results: Seven cases of modified pedicled nasal septum mucosal flap for skull base reconstruction had no postoperative cerebrospinal fluid leakage and 1 case had hypoolusia. Postoperative cerebrospinal fluid leakage occurred in One of the 21 patients with mucosal flap replacement, and stopped after 8 d of continuous lumbar drainage. One case had hypoolusia. Conclusions Modified pedicled nasal septum mucosal flap is a safe and reliable technique. It can not only achieve the effect of pedicled nasal septum mucosal flap in skull base reconstruction, but also avoid nasal complications caused by excessive application of mucosal flap.

Objective To evaluate the monitoring effect of microvascular Doppler blood flow detector in intracranial aneurysm surgery. Methods One hundred and twenty patients with intracranial aneurysms from July 2015 to July 2017 who received craniotomy and used microvascular Doppler ultrasound 1 mm microprobe to detect the hemodynamics of the parent artery and related perforating artery change were retrospectively analyzed . According to the blood flow signal, aneurysm clip was not adjusted in 55 cases; when the tumor artery or perforator artery blood flow signal decreased or disappeared after treatment, aneurysm clip clamping position was changed in 65 cases, so that the blood flow of tumor artery or perforator artery returned to normal. The blood flow velocity and pulsation index (PI) of the artery was measured before and after adjustment of the aneurysm clip. The patients underwent CT angiography (CTA) or DSA examination 1 week after surgery. Angiography was performed to evaluate the postoperative results in one month, three months, and six months' follow-up. The data obtained were statistically analyzed. Results Vascular obstruction or neck residual rate of 120 cases was lower than 5％vascular obstruction or residual neck residual rate in large cases. Conclusions The microvascular Doppler blood flow detector is safe, reliable and easy to operate. This technique is useful for finding the clips in the craniotomy of the intracranial aneurysm or the incomplete clamping of the tumor-bearing artery, so as to adjust the position of the aneurysm clip in time and improve the curative effect.

Objective To explore the therapeutic effect of pedicled nasal septum mucosal flap on high-flow cerebrospinal fluid leakage in transsphenoidal approach. Methods The clinical data of 31 patients with high-flow cerebrospinal fluid leakage during neuroendoscope transsphenoidal approach from January 2012 to April 2018 were analyzed retrospectively. Among them, skull base of 18 patients was reconstructed with pedicled nasal septum mucosal flap technique (observation group), and skull base of 13 patients was reconstructed with the'sandwich'method (control group). The postoperative cerebrospinal fluid leakage and complications were compared between 2 groups. Results Postoperative cerebrospinal fluid leakage occurred in 6 cases in control group, and 1 case in observation group, and there was statistical difference between 2 groups (P<0.05). Postoperative olfactory loss occurred in 2 cases in control group, and 3 cases in observation group, and there was no statistical difference between 2 groups (P>0.05). Conclusions Multilayer skull base reconstruction with pedicled nasal septum mucosal flap can significantly reduce the incidence of cerebrospinal fluid leakage after transsphenoidal tumor resection, and is a safe and reliable method to treat the high flow cerebrospinal fluid leakage in operation.

Objective To evaluate the prognostic significance of extent of resection (EOR) in patients with gradeⅢglioma, and the MRI sequence best related with tumor volume. Methods Ninety-six cases were studied retrospectively who were diagnosed as glioma of grade Ⅲ gliomas at Dalian Medical University Affiliated Hospital of Dalian Municipal Central Hospital during the period from 2010 to 2015. EOR was calculated using preoperative and postoperative contrast-enhanced T1-weighted and T2-weightedfluid attenuated inversion recovery (T2Flair) MR images. Univariate and multivariate analyses were performed to evaluate the correlation between EOR and overall survival (OS). Results The results of univariate analysis showed that patients with age<50 years(P=0.032), preoperative KPS>80 scores (P<0.01), no edema (P=0.005), postoperative chemotherapy (P<0.01) and T2Flair EOR≥68% (P<0.01) had better prognosis. Cox multivariate regression analysis showed that age(P=0.008), edema (P＝0.003), postoperative chemotherapy(P=0.000) and T2Flair EOR (P=0.004) were independent factors of prognosis for grade Ⅲ glioma patients. Conclusions T2Flair-EOR is one of the most significant prognostic predictors in patients with grade Ⅲ gliomas. An important survival advantage is associated with T2Flair-EOR≥68% for patients with gradeⅢgliomas.