ObjectiveTo investigate the pattern of the relationship of craniopharyngiomas with pituitary stalks and hypothalamus. Furthermore, based on different patterns affirmed during the operations, surgical strategies were designed for radical excision. MethodsA series of 66 patients with primary suprasellar craniopharyngiomas were treated with microsurgical techniques and the relationships of the craniopharyngiomas with pituitary stalk and hypothalamus were analyzed prospectively. Appropriate surgical approaches were selected preoperatively according to the lesion's sizes and expanding directions. The relationships of the lesions to the pituitary stalks and hypothalamus were identified in detail and dissected carefully with protection of perforating vessels. ResultsThe patterns that pituitary stalks were involved by craniopharyngiomas were identified in 36 cases and divided into four types: no relation (5 cases), adhesion (10 cases), partial invasion (8 cases) and total invasion (13 cases). The anterior floor of the third ventricle was involved in 42 cases, in which it disappeared totally in 10 cases. Total resection was achieved in 58 case, subtotal resection in 8 cases. Diabetes insipidus (DI) was identified in 44 cases postoperatively. No surgical mortality, no recurrence was found during follow-up of mean 35 months. ConclusionThe appropriate selection of surgical approaches preoperatively, careful identification and according treatment of the relationships of the tumors with pituitary stalks and hypothalamus are the keys to protect the pituitary stalk; hypothalamus in craniopharyngiomas resection in adults.

Combined Modality Therapy ; High-Frequency Ventilation ; Humans ; Liquid Ventilation ; Nitric Oxide ; therapeutic use ; Pulmonary Surfactants ; therapeutic use ; Respiration, Artificial ; Respiratory Insufficiency ; therapy

Objective To observe the clinical efficacy and adverse reactions of high-dose methylprednisolone pulse treatment on peritumoral edema induced by supratentorial brain tumors.Methods Thirty-five patients with supratentorial brain tumors and peritumoral edema were treated with methylprednisolone pulse therapy before surgery and the edema index of every patient was calculated by MRI examinations before and after methylprednisolone treatment.Results After methylprednisolone pulse therapy, the edema indexes of the light, medium and severe edema patients reduced by 1.79%, 8.81% and 12.02% respectively. The edema indexes of the medium and serious patients were significantly lower than that before treatment ( P<0.01). But the edema index of the light edema patients was not significantly different with that before treatment ( P>0.05).Conclusion High-dose methylprednisolone pulse therapy has an obvious effect on medium and serious peritumoral edema induced by supratentorial brain tumors and has no serious adverse reactions.

ObjectiveTo investigate the role of intraoperative ultrasound (IOUS) in the surgical treatment of cerebral gliomas.MethodsThirty patients with primary supratentorial gliomas underwent microsurgery guided by intraoperative real-time ultrasound, IOUS was utilized for localization and delineation of the tumor as well as determination of the extent of resection.ResultsAll of 30 lesions were accurately defined by IOUS due to the distinct echogenicity compared with the normal brain. Solid low grade gliomas tended to be well circumscribed with regular sulcus, while central necrosis was most commonly present with malignant gliomas. Complete tumor extirpation was achieved by IOUS guidance in this group. Two patients exhibited mild neurological deficit following the surgery.ConclusionIOUS may provide valuable real-time information and facilitate effectual surgery with accuracy for the cerebral gliomas.

Objective To investigate the characteristics,treatment and prognosis of supratentorial parenchymal ependymomas(SPEs).Methods 16 cases with SPEs determined with pathology were reported.Results and Conclusion SPEs appears some figures different from other cerebral tumors.Surgery and radiotherapy can result in satisfied outcome.

Objective To analyze and explore the clinical characterizations, treatment and prognosis of central neurocytoma (CNC).Methods The data of 62 cases of CNC from Jan 1995 to Jan 2008 confirmed by pathological examinations and underwent surgical treatment were analyzed retrospectively.Results CNC appeared some radiological figures.Conclusion Surgical resection with the help of post-operative radiotherapy can result in satisfied outcomes.

Objective To discuss the clinical characteristics, treatment and prognosis of pseudotumor forms of demyelinating diseases. Methods 21 patients with pseudotumor forms of demyelinating diseases diagnosed pathologically were analyzed retrospectively. Results 16 cases were operated on. The lesions were established through biopsy in other 5 patients. All the patients improved significantly after corticosteroid therapy. 4 patients relapsed after treatment, and 1 patient died. Conclusion The feature of pseudotumor forms of demyelinating disease is similar to some kinds of intracranial tumors, however it presents some radiological characteristics. Diagnostic corticoid therapy may be helpful to draw a diagnosis.

Objective To explore the risk factors of no reflow phenomenon on post-percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods The clinical data of 268 patients with AMI who performed emergency PCI were collected and divided into normal group(normal flow) and no-reflow group (no flow).The risk factors of predicting the occurrence of no reflow phenomenon were screened by univariate and multivariate analysis.Results Thirty-two cases (11.9％) of 268 patients had flow occurrence and 236 cases(88.1％) were with no flow occurrence.There were significantly statistical differences between the two groups in terms of angina pectoris history before infarction,white blood cell count (WBC),history of oral of stains,administration of 600 mg of plavix before the operation,creatinine kinase,MB isoenzyme (CK-MB),C-reactive protein (CRP),Low density lipoprotein(LDL),time of coronary artery perfusion,numbers of balloons used during PCI and Killip ≥ grade 2 (all P ＜ 0.05).The multivariate logistic regression model analysis displayed that Killip ≥ grade 2 (odds ratio (OR) =1.237,95％ confidence interval (95％ CI) 1.049 -2.264,P=0.021),history of oral of stains(OR=2.355,95％CI 1.547-3.438,P＜0.001),WBC ≥ 12× 109/L (OR =4.139,95％ CI 2.273-8.451,P＜0.001),no administration of 600 mg of plavix before the procedure (OR =2.645,95％CI 1.628-5.246,P＞0.005) and no angina pectoris history before infarction(OR=1.413,95％CI 1.150-2.426,P＜0.001) were independent risk factors regarding of causing no reflow phenomenon.Conclusion The factors including Killip ≥ grade 2,history of oral of stains,WBC ≥ 12× 109/L,no administration of 600 mg of plavix before theoperation and no angina pectoris history before infarction were independent risk factors in terms of causing no reflow phenomenon.

Insulin-like growth factor-Ⅰ can promote the breast cancer formation, development and metastasis. According to the characteristic of insulin-like growth factor pathway, the inhibition of insulin-like growth factor pathway signaling can inhibit the growth and metastasis of breast cancer, which is of great significance for breast cancer prevention and treatment.