Objective To explore the methods for diagnosis and treatment of malignant meningioma.Methods The clinical data of twenty-nine patients with malignant meningioma were retrospectively analyzed.Results Among the 29 patients,15 underwent Simpson Ⅰ resection,8 underwent Simpson Ⅱ resection and 6 had Simpson Ⅲ resection.Among these patients,Twenty-five cases were successfully followed up for 20-100 months.There are 11 cases who occurred relapse (44％),of whom 2 received Simpson Ⅰ resection,3 received Simpson Ⅱ resection and all the 6 cases receiving Simpson Ⅲ cases.Conclusion Head CT and MRI examination is helpful to diagnose malignant meningioma.The treatment mainly involved surgical resection combined with radiation and chemotherapy,with high postoperative recurrence rate and short survival time depending on the differentiation of the tumor.

Objective: To analyze the characteristics of changes in serum cholesterol level in sepsis patients, and to explore its correlation with prognosis. Methods: A retrospective analysis was conducted. Two hundred and six patients with sepsis admitted in the Third People′s Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group), and 206 patients without sepsis hospitalized in the same period were served as control group. The basic clinical data of the two groups were collected, and the results of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis. Results: Compared with control group, the levels of serum TC [(2.49 ± 1.14) mmol/L vs. (3.40 ± 1.26) mmol/L, t=6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs. (2.49 ± 0.81) mmol/L, t=5.532] in observation group were significantly lower (P<0.05), and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs. (2.10 ± 0.72) mmo/L, t=0.940, P>0.05]. In observation group, the patients in death group (85 cases) were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs. (62.5 ± 6.0) years, t=4.565], serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs. (165.4 ± 35.6) μmol/L, t=5.420], and the levels of serum TC [(2.15 ± 0.59) mmol/L vs. (2.89 ± 1.02) mmol/L, t= 5.475], HDL-C [(1.40 ± 0.42) mmol/L vs. (1.94 ± 0.52) mmol/L, t=4.856] and LDL-C [(1.73 ± 0.56) mmol/L vs. (1.97 ± 0.72) mmol/L, t=4.261] were significantly lower than those of survival group (P<0.05). Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.256, 95% CI 1.006 -1.056, P=0.012), and TC was the protective factor for the prognosis of sepsispatients (OR=-0.758, 95%CI 0.579-0.867, P=0.014). Conclusions The levels of TC, HDL-C in sepsis patients are significantly lowered, and the levels of TC, HDL-C, LDL-C in death group are significantly lower than those in survival group. TC may be used as a clinical indicator to assess the outcome of sepsis patients.

Objective:To explore the effectiveness and safety of tirofiban in patients with reocclusive ischemic stroke after intravenous thrombolysis with alteplase.Methods:Eighty-four patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase, admitted to our hospital from January 2018 to May 2020, were prospectively chosen; these patients were divided into tirofiban group and routine (non-tirofiban) group ( n=42). In addition to thrombolysis, patients in the routine group received intensive lipid-lowering, collateral circulation improvement, blood glucose control, and early rehabilitation therapy; after thrombolysis for 24 h, patients without intracranial hemorrhage were given oral aspirin, 0.1 g/d, for 90 d. After thrombolysis and re-occlusion, patients in the tirofiban group were intravenously pumped with 0.4 μg/(kg·min), which was changed to 0.1 μg/(kg·min) after 30 min for 24 h; at 24 h after thrombolysis, brain CT was reexamined: tirofiban was discontinued for patients with intracranial hemorrhage, and intravenous pumping of tirofiban was continued for patients without intracranial hemorrhage for 24 h. Effectiveness was evaluated by comparing the general clinical data, National Institutes of Health Stroke Scale (NIHSS) scores 7 d after treatment, and modified Rankin Scale (mRS) scores 90 d after treatment between the two groups. Safety was assessed by comparing the intracranial hemorrhage, symptomatic intracranial hemorrhage, and mortality within 90 d of treatment between the two groups. Results:There were no significant differences in age, gender, underlying diseases, risk factors, baseline NIHSS scores, time from onset to start of treatment, infarction sites, and TOAST classification between the 2 groups ( P>0.05). NIHSS scores 7 d after treatment ([10.05±4.73] min vs. [7.93±4.68] min), mRS scores 90 d after treatment (3.48±1.48 vs.2.55±1.93), and good prognosis rate 90 d after treatment (21.4% vs. 42.9%) showed significant differences between the routine group and tirofiban group ( P<0.05). In terms of safety, there were no significant differences in intracranial hemorrhage rate (4.76% vs. 7.14%), symptomatic intracranial hemorrhage incidence (2.38% vs. 2.38%) and mortality (2.38% vs. 2.38%) between the 2 groups ( P>0.05). Conclusion:It is safe and effective for tirofiban in patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase.