Objective To introduce the microsurgical experience of total removal in large and middle sized recurrent sphenoid ridge meningiomas and discuss the recurrent reasons Methods A series of 24 cases large and middle sized recurrent sphenoid ridge meningiomas operated microsurgically by combined frontotemporal orbitozygomatic approach were analysed retrospectively Result Totol removal(Grade Ⅱ of Simpson system)were achieved in 14 of the 24 patients,and subtotal in 6,partial in 4 There were isolative tumor nodi near main tumor in 5 cases Conclusion Combined frontotemporal orbitozygomatic approach and microsurgical technique are helpful to totally remove the tumor Resection uncompletely and tumor implantation within operation were recurrent reasons of sphenoid ridge meningiomas

Objective To evaluate the clinical effect of cerebellomedullary fissure approach to resect the fourth ventricle tumors. Methods Eightten cases of the fourth ventricle tumors that have been operated on through the posterior fossa craniotomy and cerebellomedullary fissure approach were analyzed retrospectively. Results Total turmor resection was achieved in 13 patients and subtotal in 5 patients. All patients were conscious after surgery. None of them presented mutism. Three cases suffered from postoperative hydrocephalus, ventriculoperi-toneal hunts were applied in 2 cases, another case died of acute obstructive hydrocephalus. Conclusion The cerebellomedullary fissure approach can provide a sufficent exposure to resect the fourth ventricle tumor without incision of the inferior vermis.

Objective To construct a eukaryotic expression plasmid of pcDNA 3.1-Ag85A-CD226, and to use it as DNA vaccine then further evaluate its immunogenicity through oral administration in a mouse model.Methods The CD226-PCR2.1-ToPo plasmid was used as the template to clone CD 226 gene by PCR.The CD226 gene was then inserted into pcDNA 3.1-Ag85A plasmid to construct the recombinant plas-mid of pcDNA3.1-Ag85A-CD226.After identified by restriction enzyme analysis and sequencing , the re-combinant plasmid was transfected into HEK 293 cells by using lipofection .The expression of Ag85A-CD226 gene in HEK293 cells was detected by RT-PCR, Western blot and indirect immunofluorescence assay .The purified recombinant plasmid was used to prepare the Ag 85A-CD226 DNA vaccine by liposomal encapsula-tion.The vaccine was administered intragastrically to mice .The activities of NK cells , the cytokine levels in the supernatants of spleen cell cultures and the mRNA level of cytokines in the intestines were evaluated to analyze the immunogenicity of Ag85A-CD226 DNA vaccine.Results The Ag85A-CD226 DNA vaccine was prepared successfully .The expression of Ag85A-CD226 fusion protein was detected in HEK293 cells.The activities of NK cells from mice vaccinated with Ag 85A-CD226 DNA vaccine were higher than those from other control groups (P<0.01).The level of TNF-α, IFN-γand IL-2 in the supernatants of spleen cell cul-tures and in the intestines were significantly up-regulated in comparison with other control groups ( P <0.01).The level of IL-4 in the supernatants of spleen cell cultures was down-regulated in the experimental group (P<0.01), but the level of IL-4 in intestines showed no significant difference among the five groups (P>0.05).Conclusion The Ag85A-CD226 DNA vaccine could significantly enhance Th1 type immune responses systemically and in the intestine as in comparison with those vaccinated with single dose of Ag 85A DNA vaccine or CD226 DNA vaccine.

Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.

目的探讨康复患者使用经外周置入中心静脉导管(PICC)的可行性。方法对康复组16例住院患者行PICC,并与非康复组行PICC的12例患者进行对照观察,分别观察留管时间、局部症状、全身症状等。结果康复组与非康复组的留管时间、局部症状、全身症状无显著性差异。结论康复治疗活动对PICC的留管时间等无影响,PICC对康复治疗也无影响,进行康复治疗的患者可行PICC。

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

To evaluate the value of prenatal ultrasound in the diagnosis of single umbilical artery( SUA ) and fetal malformation . Methods T he characteristics of the prenatal ultrasound findings of 143 fetuses with SU A in different gestational weeks were retrospectively analyzed ,and the missing side of SU A were checked . Different types of SUA combined with fetal malformation were analyzed as well as chromosomal abnormalities and so on . Results For 143 fetuses with SU A ,there were 83 cases ( 58 .0% ) with absent left umbilical artery and 60 cases ( 42 .0% ) with absent right umbilical artery ,there was no statistical difference between the two groups ( P ＞0 .05 ) . Six cases ( 4 .2% ,6/143 ) were detected at and before 20 weeks of gestation ,and the rest 137 cases were detected after 20 weeks( 95 .8% ,137/143) . T here were 121 cases ( 84 .6% ) of isolated SUA ,22 cases ( 15 .4% ) were complicated with other malformations , including 10 cases ( 45 .5% ) with absent left umbilical artery and 12 cases ( 54 .5% ) with absent right umbilical artery . T here was no statistical difference between left and right umbilical artery deletion combined with fetal malformation( χ2 ＝1 .692 ,ν＝1 , P ＞0 .05) . T here were 11 cases( 7 .7% ,11/143) with cardiovascular malformation and nine cases ( 6 .3% , 9/143 ) with digestive system malformation . Chromosome examination was performed in 23 cases . One case of trisomy 18‐trisomy and 1 case of trisomy 13‐trisomy were found to be with missing right umbilical artery and all of them were complicated with multiple deformities . Conclusions The absence of left and right umbilical artery can be combined with abnormal fetal malformation . Prenatal ultrasonography can accurately diagnose SU A and fetal malformation .

Objective:To investigate the clinical efficacy of microsurgical resection in primary jugular foramen schwannomas (JFSs).Methods:A retrospective analysis was performed; the clinical data of 58 patients with JFSs treated by microsurgery in Department of Neurosurgery, First Affiliated Hospital of Sun Yat-sen University from May 2012 to June 2021 were collected. Seven patients accepted microsurgery via suboccipital retrosigmoid approach, and 51 patients accepted microsurgery via jugular foramen approach. Fifty-three patients were followed up for 4.5 years (ranged from 0.5-8.5 years); follow-ups included Karnofsky performance status (KPS) scores, postoperative complications, and imaging reexaminations. Results:Fifty patients (86.2%) achieved total tumor resection and 8 (13.8%) subtotal resection. The KPS scores at discharge were 68.6±14.9, which were significantly lower than the preoperative KPS scores (77.6±13.5, t=2.452, P=0.017). During the follow-up, 5 patients(9.4%) had tumor recurrence, and 39 patients (73.6%) had improved symptoms after surgery. One patient (1.9%, modified Samii D type) died of cerebellar hemorrhage and swelling after surgery. The main complications included new/aggravated hoarseness (11/53), cerebrospinal fluid leakage (7/53), new/aggravated dysphagia (5/53), and new facial paralysis (4/53). Conclusion:In microsurgical resection of JFSs, short-term symptoms of the lower cranial nerves may be exacerbated, but long-term results are good.

Objective:To investigate the clinical value of neuroendoscopic resection in recurrent or residual sellar and clivus tumors and the prevention and treatment of operative complications.Methods:A retrospective study was performed. Clinical data of 49 patients with residual or recurrent sellar and clivus tumors after neuroendoscopic resection in Department of Neurosurgery, First Affiliated Hospital of Sun Yat-sen University from November 2021 to October 2023 were collected; 45 patients were with pituitary adenoma, 3 were with craniopharyngioma, and 1 patient was with clivus chordoma; their surgical efficacy and complications were summarized and analyzed.Results:Total resection was achieved in 29 patients (59.2%), subtotal resection in 12 (24.5%), and partial resection in 8 (16.3%). Two patients (4.1%) had intraoperative internal carotid artery rupture and were given emergency laminar stenting, discharging with good recovery, but one of them left with unilateral motor nerve palsy. During 1-24 months of follow-up, 97.2% patients (35/36) had headache relief and visual acuity improvement, and no patient had permanent diabetes insipidus or cerebrospinal fluid rhinorrhea. Residual tumors increased in 3 patients (6.1%); no tumor recurrence after total resection was noted.Conclusion:Endoscopic resection of recurrent or residual sellar and clivus tumors is safe and effective; attention should be paid to the internal carotid artery during the operation.

OBJECTIVETo observe the expression of asporin, bone morphogenetic protein-2 (BMP-2) and alkaline phosphatase (ALP) in cultured human periodontal ligament cells in vitro under relative centrifugal force.

METHODSHuman periodontal ligament cell was cultured in vitro and applied 30 ×g centrifugal force for 0, 1, 2, 6, 10 hours. The expression of asporin, BMP-2 and ALP was observed with real time-PCR.

RESULTSAll the cells showed normal figuration. The expression of asporin, BMP-2, ALP in no force loading group did not have any statistical significance change (P > 0.05). In 1 hour force loading group, the expressions of asporin and BMP-2 were 0.50 ± 0.05 and 0.40 ± 0.13. In 2 hour force loading group, the expressions of asporin and BMP-2 were 0.42 ± 0.09 and 0.58 ± 0.19, which decreased significantly from no force loading group (P < 0.05). The expression of asporin and BMP-2 increased significantly in 6 hour force loading group than in 1 and 2 hour force loading groups (P < 0.05). Then the expression of asporin decreased to no force loading group level (P > 0.05) and the expression of BMP-2 decreased rapidly lower than no force loading group level (P < 0.05). During the 10 hour interval of stress loading, the expression of asporin and BMP-2 showed a positive correlation (r = 0.995, P < 0.05).

CONCLUSIONSThe expression of asporin in human periodontal ligament cell was stable. Short and light centrifugal force could up-regulate the expression of asporin rapidly, and suppress the abnormal BMP-2 expression back to baseline level.

Alkaline Phosphatase ; biosynthesis ; Bone Morphogenetic Protein 2 ; biosynthesis ; Cell Line ; Centrifugation ; Gene Expression ; Humans ; Periodontal Ligament ; metabolism ; Up-Regulation