Objective To discuss the operation effect and the role of neuroendoscope which was used to assist the keyhole approach in treatment of intracranial aneurysms Methods The keyhole surgery with the assistant of neuroendoscope was used to treat 14 cases of aneurysm After initial exposure of pterional or superciliary arch keyhole approach with the aid of microscope,the rigis endoscpe was introduced to confirm regional anatomy,including the aneurismal neck and adjacent structure After clipping,introduced again to inspect the positions of the clip and nearby structures. Results After operation,all the 14 cases were recovered without any severe complication. Conclusions There was a sufficient exposure in the visualization of the anatomy of the aneurysm and surrouding structures,the injuries of operation were relieved,the time in operation and hospital can be shortern,as well as reliable operation effect.

Objective To prepare RGD and TAT co-modified paclitaxel loaded liposome(RGD/TAT-LP-PTX)for A 549 cells targeting.Method The co-modified liposome was prepared by film-ultrasonic method. The appearance,particle size,Zeta potential were evaluated. The cellular uptake by A 549 cells in vitro was used to evaluate the targeting efficiency. The anti-proliferation efficiency of RGD/TAT-LP-PTX was evaluated by MTT assay. Results The particle diameter of the co-modified liposome was (118.5±11.4) nm with the Zeta potential of (21.58±2.42 )mV. The entrapment efficiency of PTX was 86.5%. The result demonstrated that the co-modified liposome uptaken by A 549 were 2.1, 2.8 times higher than that of TAT-LP and RGD-LP, respectively. The RGD/TAT-LP-PTX shows the highest anti-proliferation efficiency. Conclusion The co-modified liposome might serve as a promising tumor delivery system of antitumor drugs.

Objective To compare the outcome and early patency rate of revascularization treatment for patients with iliac artery occlusion or stenosis.Methods Retrospective analysis was made on 105 cases of iliac artery occlusion or stenosis from January 2009 to April 2014.49 were with iliac artery occlusion and 56 with iliac artery stenosis.Results The demographics,and comorbidities were not statistically different between the 2 groups.The occlusion group had more critical limb ischemia and the ankle-brachial index was lower than the stenosis group.The occlusion group underwent more hybrid surgery and used more covered stents in the operation.The peri-operative complication was higher in the occlusion group,but the difference was not statistically different.The ABI improved significantly for all patients after surgery.The early patency rate was similar in the 2 groups.Conclusions Revascularization treatment for patients with iliac artery occlusion and stenosis was safe and effective,with similar early patency rate and peri-operative complications between the two groups.

Objective To investigate the efficacy of treatment on malignant intracranial gliomas with the chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with radiotherapy of interstitial implantation of 125Ⅰ after microsurgery resection. Methods Sixty-five patients with malignant intracranial gliomas who had underwent craniotomy microsurgical resection were intraoperatively implanted in the tumor bed around with 5-Fu biodegradable polymers and 125Ⅰ seeds. After first implantation (3 months to 1 year), stereotactic guided implantation was carried out 1 or 2 times again. The patients were followed up for 6-36 months to observe the efficacy, edema and adverse reactions, compared with follow-up of 40 patients with malignant intracranial gliomas treated by conventional radiotherapy and chemotherapy after microsurgical total resection. Results Within 1 week after the implantation the patients had headache significantly, WBC of cerebrospinal fluid was increased to some degrees, and edema was obvious compared with surgery alone. All patients were treated and discharged. Forty-four patients were completely followed-up and the survival period was significantly longer. Within 6 months, 1 year, 2 years and 3 years, there were 4 cases (9.1 %) of recurrence and no case of death, 14 cases (31.8 %) of recurrence and no case of death, 20 cases (45.5 %) of recurrence and 12 cases (27.6 %) of death and 29 cases (65.9 %) of recurrence and 20 cases(45.5 %) of death, respectively. No obviously adverse reactions were found and the quality of life was significantly improved. Conclusion Microsurgical total resection is the key of the treatment. It is an alternative treatment of human malignant gliomas in the safe and effective way that the local chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with local sensitivity radiotherapy of interstitial implantation of 125Ⅰ after microsurgical resection.

Objective To assess roles of vascular endothelial growth factor(VEGF)and plateletderived growth factor(PDGF)in the mechanisms of lymphangiogenesis in epithelial ovarian carcinoma.Methods (1)Expression of Proxl,a newly described lymphatic endothelial cell nucleus marker,VEGF-A,VEGF-C,VEGF-D and PDGF-A,PDGF-B,PDGF-C,PDGF-D were detected bv RT-PCR in SKOV3 cell line and in 90 ovarian tissue samples,included 15 benigh tumors 10 borderline tumors, 45 malignant tumors and 20 normal ovarian samples.(2)Expression levels of Proxl,VEGF-A,-C,-D and PDGF-A,-B,-C,-D were detected in 90 ovarian tissue sample mentioned above by real-time quantitative PCR(RTQPCR).Resuls (1)Proxl was expressed in ovarian samples mentioned above,while not detected in SKOV3 cell. VEGF-A,-C,-D and PDGF-A,-B,-C,-D were found in SKOV3 cell and various ovarian tissues.(2)Expression levels of Proxl(2.2±1.3,P＜0.01),VEGF-A(3.5±1.5,P＜0.01),VEGF-C(19±14.P＜0.01),VEGF-D(3.0±1.8,P＜0.01)and PDGF-A(3.3±3.3,P＜0.05),PDGF-C(6.9±4.6,P＜0.01)in malignant group were found to be significantly higher than those in borderline group and benign group.(3)The expression levels of Proxl,VEGF-A and PDGF-A were significantly greater in samples from the patients with lymph node metastasis(Proxl:3.0±1.4,VEGF-A:4.1± 1.7,PDGF-A:4.9±4.1),peritoneum metastasis(Proxl:2.8±0.9,VEGF-A:4.0±1. 8,PDGF-A:4.5±4.0)and in stage Ⅲ-Ⅳ(Proxl:2.6±1.3,VEGF-A:4.0±1.4,PDGF-A:4.1±3.7)than those without lymph node metastasis,without peritoneum metastasis and in stage Ⅰ-Ⅱ.There was a significant increased in the degree of VEGF-C and VEGF-D expression in positive lymph node metastasis group(VEGF-C:24±13,VEGF-D:3.9±2.0)compared with negative group(P＜0.05).(4)There were significant positive correlations between the expression levels of Proxl and VEGF-D(r=0.62,P＜0.01),PDGF-C(r=0.91,P＜0.01)or PDGF-D(r=0.61.P＜0.01).Conclusions VEGF-A,VEGF-C and PDGF-A may promote lymphatic metastasis in epithelial ovarian carcinoma though else mechanisms other than lymphangiogenesis.VEGF-D may facilitate lymphangiogenesis and lymph node metastasis in epithelial ovarian cancer.There is no significant correlation between the expression of PDGF-B and lymphangiogenesis and lymph node metastasis.PCGF-C and PDGF-D may motivate lymphangiogenesis,but could not participate in lymph node metastasis in ovarian carcinoma.

ObjectiveTo investigate the characteristic parameters and variation of acoustic startle reflex (ASR) and conditioning response (CR)during the acquisition of delay-trace eyeblink conditioning.Methods15healthy Kunming mice were randomly divided into 3 groups:single-task DEBC group ( n =5 ) ; single-task TEBC group ( n =5) ; dual delay/trace group ( n =5).Three groups received paired training of tone conditioned stimulus(CS)in different audio frequency (TEBC groups:2KHz; DEBC group:1KHz) and a 100 ms comeal oxygenpuff unconditioned stimulus(US).Then observed the characteristic parameters of ASR and CR.ResultsAfter pairing training for 10 days,ASR rate( ASR％ ) of single-task groups ( 10th day (38.00 ± 8.64) ％ and (38.55 ±12.41 ) ％ respectively,time effect:F =4.574,P =0.008 ; group effect:F =2.021,P =0.193 ) and dual delaytrace group ( 10th day (47.95 ± 14.23 ) ％ and (62.01 ± 9.03 ) ％ respectively,time effect:F =5,547 P =0.013 ;group effect:F =0.738,P =0.415) changed significantly with the following training but between single-task groups or dual delay-trace group.CR rate ( CR％ ) of single-task groups ( 10th day were (45.4 ± 5.39) ％ and (65.6 ± 6.77) ％ respectively,time effect:F =9.558,P =0.000 ; group effect:F =5.117,P =0.054 ) and dual delay/trace group ( 10th day (57.66 ± 4.34) ％ and (77.35 ± 7.36) ％ respectively,time effect:F =7.750,P =0.002 ;group effect:F=1.449,P=0.263 ) showed obvious change with the following training but between singletask groups or dual delay-trace group.Peak amplitude of single-task DEBC group ( time effect F =2.679,P =0.017 ) and dual delay-trace group ( F=3.452,P=0.034 ) had increased significantly with the following training.Peak latency showed no obvious change.ConclusionDual delay-trace conditioning procedure of classical eyeblink conditioning and single-task can be successfully established in Kunming mice.Although there are some variations,those can be controled and be weaken effect of them by taking targeted measures.

Objective To evaluate carotid endarterectomy (CEA) for bilateral moderate to severe carotid stenosis.Methods The clinical data of 59 patients with bilateral moderate to severe carotid stenosis who were treated with CEA in our hospital from October 2010 to August 2014 were retrospectively analyzed.There were 50 males and 9 females age ranging 42-80 years (mean:65 ± 9 years).48 patientsunderwent ipsilateral CEA and 11 underwent staged bilateral CEA.In patients who were confirmed to have coronary artery disease or peripheral vascular disease by preoperative angiography,6 received coronary artery bypass graft (CABG)simultaneously,1 received iliac artery balloon angioplasty and stent implantation simultaneously,and 1 received renal artery stenting simultaneously.Results A total of 70 endarterectomies were performed,shunt and patching were used in all patients,the surgical success rate was 100％.2 patients suffered from vagus nerve injury,4 patients suffered from hypoglossal nerve injury,and 3 patients presented with hyperperfusion syndrome.Follow-up period was 2-36 months (mean:19 ± 10 months).1 patient died of heart attack during the follow-up,the other patients were relatively stable with no restenosis.Conclusion CEA should be performed in patients with bilateral moderate to severe carotid stenosis,and the prognosis is good.

Objective To explore the risk factors of pulmonary infection in patients with basal ganglia hemorrhage . Methods A total of 152 patients with basal ganglia hemorrhage who received conservative treatment from March 2013 to Septem‐ber 2014 were enroled in the study ,while the incidence of pulmonary infections and and risk factors were retrospectively analyzed , and recorded the distribution of pathogenic bacteria .Results The pulmonary infections occured in 106 of 152 patients with the in‐fection rate of 69 .7% .The way of treatment ,history of smoke and consciousness were the independent risk factors for pulmonary infection(P<0 .05) .A total of 153 strains of pathogens were isolated from the patients of infection group ,in which there were 132 strains of gram negative bacteria ,10 strains of gram positive bacteria and 12 strains of fungi .Conclusion Basal ganglia hemorrhage associated with a greater incidence of pulmonary infection ,it should be noted the risk factors of pulmonary infection in basal ganglia hemorrhage patients to reduce the incidence of pulmonary infection .

The clinical data of 21 patients with carotid body tumor (CBT) were analyzed retrospectively.The lesions were unilateral (n =20) and bilateral (n =1).Among 20 surgical cases, the procedures included tumor resection alone (n =11) , tumor resection along with external carotid artery (n =6) and vascular reconstruction of carotid artery after resection of tumor body (n =3).No mortality occurred during perioperative period.CBT was confirmed by pathologic examination in all cases and 1 case was malignant.Follow-up period ranged from 3 months to 7 years and the follow-up rate was 85％.Five cases of cranial nerve impairment recovered completely over 3 months.One case of bilateral CBT underwent contralateral tumor resection at another hospital 1 year later and 1 case with malignant tumor died from metastases 3 years later.The remainder survived recurrence-free.CBT tends to be misdiagnosed.Therefore ultrasonography, digital subtraction angiography (DSA), CT angiography (CTA) or magnetic resonance angiography (MRA) are important for preoperative diagnosis and evaluation.Surgical resection is a first choice for CBT.

Objective To explore the mechanism and clinical value of320-slice CT perfusion (CTP) and CT angiography (CTA) in peritumoral brain edema of parasagittal meningiomas.Methods Sixty-six patients diagnosed as having benign parasagittal meningioma by imaging in our hospital from May 2010 to January 2015 were divided into non-peritumoral edema group (n=22) and peritumoral edema group (n=42) according to the cerebral MR T2 phase imaging.All patients were given 320-row CTP and CTA scan before surgery,and cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT) and time to peak (TTP) were obtained;and then,generated perfusion images and CTA images and fusion image were created.Results TTP ofperitumoral tissues from the tumor margin 0.5 cm and 1.5 cm was [(28.1±3.3) s and (24.5±2.8) s,respectively in the peritumoral edema group,which was significantly longer than that in the non-peritumoral edema group ([14.8±1.3] s,P＜0.05).Via comparison of the fused image,the lumen diameter of tumor-draining venous widened and shaped in appearance,and became relatively thin and straight in appearance in lumen diameter before entering the sinus,which suggested that the drainage was not free.Conclusion The TTP extension of tumor tissues and peritumoral brain tissues is the important characteristic for CTP scanning of peritumoral edema in meningiomas;poor blood return of tumor tissues may be the mechanism of peritumoral edema in meningiomas;fusion image has an important guiding significance for clinical surgery.