Objective:To explore the clinical classifications and treatments of craniocerebral Langerhans cell histiocytosis (LCH).Methods:Patients with histopathologically conformed LCH in our hospital from January 2008 to January 2019 were classified into 7 types according to the International Histocell Association clinical typing: type I (single site of skull), type II (single site of skull and involvement of central nervous system [CNS]), type III (multiple sites of skull), type IV (single site of CNS), type V (multiple sites of CNS), type VI (low-risk multiple sites of multisystem), and type VII (high-risk multiple sites of multisystem). According to the classification, two treatment methods were adopted. Group A (patients with type I) was treated with local resection, and Group B (patients with type II, III, IV, VI, and VII) was treated with chemotherapy based on Japanese Langerhans Cell Histiocytosis Study Group (JLSG) protocol after local resection or biopsy; according to the efficacy standards of JLSG, the treatment efficacies were evaluated.Results:The study covered 17 patients from Group A (type I) and 29 patients from Group B, including 2 with type II, one with type III, one with type IV, 10 with type VI, and 15 with type VII. During the follow-up period of one-10 years, there was no recurrence in 17 patients from group A; 27 out of 29 patients from group B had effective induction in postoperative JLSG chemotherapy, enjoying induction efficiency of 93.1%; two patients were treated with other chemotherapy regimes, and one of them was followed up for one year and his condition was stable.Conclusion:For type I craniocerebral LCH patients, clinical cure can be obtained with local resection; for type II, III, IV, VI, and VII LCH patients, good curative effect can be obtained with JLSG chemotherapy after local resection or biopsy; for LCH patients who have no reaction or disease progress in the first 6 weeks of induction, the curative effect can be improved by changing the rescue plan in time.

Objective To investigate the experience of early diagnosis and surgical treatment of brain metastases to improve the therapy effect.Methods Retrospective analysis was performed on clinical data of 80 patients with brain metastases,received surgical treatment in our hospital from January 2003 to December 2013.The early diagnosis,treatment and survival of these patients were analyzed.Results Asymptomatic regularly head computerized tomography (CT) or enhanced magnetic resonance imaging (MRI) found 12 patients (15％).Two weeks after surgery,32 patients (40.0％) had totally disappeared neurological disorders,40 (50.0％) had obvious relief,6 (7.5％) were without relieved or even aggravated,and 2 (2.5％) were dead.Eight patients (10.0％) who combined with extracranial metastases died within 6 months of surgery.The one-year survival rate was 60.3％ (47/78),two-year survival rate was 34.6％ (27/78),three-year survival rate was 20.5％ (16/78) and five-year survival rate was 6.4％ (5/78);the median survival was 17 months.In 16 patients of survival more than 3 years,9 were the early-detection asymptomatic patients.Conclusion After resection of primary malignant tumor,the periodical enhanced head CT or MRI are effective measures for early diagnosis of brain metastases; surgical treatment can improve the survival quality and prolong survival time of patients with brain metastases.

Objective:To investigate the application value of 3D printing technology in precise surgery of complex skull base tumors.Methods:Thirty patients with complex skull base tumors who underwent surgical treatment in our hospital from May 2016 to May 2019 were chosen in our study; they were divided into 3D printing group and control group according to whether 3D printing technology was used or not. In the 14 patients from 3D printing group, patients accepted surgery with the guide of 3D printing technology before and during surgery. In the 16 patients from control group, surgery was performed with the guide of routine preoperative MR images. The surgical duration, intraoperative hemorrhage volume and tumor total resection rate were compared between the two groups.Results:The patients in the 3D printing group had significantly shortened average surgical duration, significantly decreased average intraoperative hemorrhage volume, and significantly higher proportion of patients with total resection as compared with those in the control group ([7.2±2.6] h vs. [9.4±2.2] h, [377.1±318.3] mL vs. [975.0±856.2] mL, 12/14 vs. 7/16, P<0.05). Conclusion:In surgical resection of complex skull base tumors, 3D printing technology can help to improve surgical efficiency and tumor total resection rate, and reduce intraoperative hemorrhage volume.