OBJECTIVE To discuss the preoperative locating diagnosis and transnasal endoscopic surgery for cerebrospinal fluid rhinorrhea in sella turcica region.METHODS All of the 22 patients with cerebrospinal fluid rhinorrhea had been located the position of leakage by means of high resolution computed tomography(HRCT),magnetic resonance imaging(MRI)and/or computed tomography cisternography(CTC)techniques,and then the skull base defects were repaired with fascia via transnasal endoscopic surgery.All the patients were followed up for 6 to 51 months.RESULTS Nineteen cases were successfully repaired by operation once and another patient was cured through reoperation.Two cases refused reoperation after failure of the operation and lost follow-up.No complications such as intra-cranial infection and hemorrhage were found during the perioperative period and follow-up.The main failure causes of operation were the necrosis of the repairing fascia,missing the real leakage,and the recurrence of malignant tumor.CONCLUSION It is a key step to locate leakage accurately before operation by means of CT and MRI.Transnasal endoscopic technique is the optimal choice for management of cerebrospinal fluid rhinorrhea in sella turcica region.

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Objective To investigate the influence of heparin pretreatment on serum and lung tissue level of neutrophil extracellular traps (NETs) in septic mice model and its molecular mechanism.Methods Ninety male C57BL/6J mice were randomly divided into control group (n = 30), lipopolysaccharides (LPS) group (n = 30, 30 mg/kg LPS in 100μL normal saline was intraperitoneally injected) and LPS+heparin group (n = 30, 8 U of heparin in 20μL normal saline was subcutaneously injected 30 minutes before the injection of LPS). Six hours later of LPS injection, blood was collected and lung tissue was harvested. Enzyme linked immunosorbent assay (ELISA) was used to assess the concentration of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and histones 2AX (H2AX), neutrophil elastase (NE), which reflected NETs concentration. PicoGreen fluorescent dyes was used to detect serum circulating free DNA (cf-DNA/NETs) concentration. The protein expression levels of H2AX and NE in lung tissue were examined by Western Blot.Results The serum concentrations of TNF-α, IL-6, H2AX, NE, cf-DNA/NETs, and the protein expression levels of H2AX and NE in lung tissue of septic mice were significantly higher than those of control group [TNF-α (ng/L): 133.0±14.1 vs. 2.7±1.0, IL-6 (ng/L): 3911.2±189.2 vs. 298.9±52.5, H2AX (ng/L): 545.5±40.0 vs. 21.9±8.3, NE (μg/L): 6.48±0.12 vs. 0.47±0.15, cf-DNA/NETs (μg/L): 846.3±137.5 vs. 152.7±36.4, H2AX protein (gray value): 1.14±0.09 vs. 0.68±0.04, NE protein (gray value): 0.56±0.03 vs. 0.32±0.04, allP < 0.05]. After heparin pretreatment, levels of serum TNF-α, H2AX, NE, cf-DNA/NETs, and protein expression levels of H2AX and NE in lung tissue were significantly reduced [TNF-α (ng/L): 83.2±7.6 vs. 133.0±14.1, H2AX (ng/L): 435.0±39.0 vs. 545.5±40.0, NE (μg/L): 4.26±0.17 vs. 6.48±0.12, cf-DNA/NETs (μg/L): 606.5±73.9 vs. 846.3±137.5, H2AX protein (gray value): 0.91±0.03 vs. 1.14±0.09, NE protein (gray value): 0.42±0.03 vs. 0.56±0.03, allP < 0.05], but no significant change was found in IL-6 (ng/L: 3919.9±166.6 vs. 3911.2±189.2,P > 0.05).Conclusion Heparin pretreatment could significantly decrease the level of NETs in serum and lung tissue, and can be the potential mechanism of its organ protection in sepsis.

OBJECTIVE: To explore the relationships between the sphenoid-sinus-o-tumoropathy and local anatomy, as well as the characteristics of invasive damages of nerve system in sphenoid-sinus-o-tumoropathy, and emphasize that it is crucial of early diagnosis and surgery for sphenoid-sinus-o-tumoropathy. METHOD: Retrospective analysis of the characteristics of invasive damages of nerve system in 13 patients with sphenoid-sinus-o-tumoropathy, and follow-up the outcomes of nerve system after transnasal endoscopic surgery. RESULT: 1) The majority clinical manifestations of invasive damages in nerve system are cranial nerves, there are 9 cases optic nerve, 7 cases oculomotorius nerve, 4 cases trochlear nerve, 4 cases abducent nerve and 1 cases trigeminal nerve have been found damage at different levels in this group, and the secondly are 3 cases dysfunction of pituitary and 2 cases central nerve damage. 2) The improvement of invasive damages in nerve system after transnasal endoscopic surgery are as follow: at the day of operation or the next day, there are 4 cases to be reported that the symptoms of headache and eyes relieve very well; during 3 to 7 days after operation there are 9 cases to be reported that the symptoms of headache and eyes relieve or disappear significantly; 2 weeks after operation, there are 8 cases to be reported that the optical sights recovery at different levels, and there are many symptoms such as headache (9 cases), visual diplopia (1 cases), ptosis (2 cases), fixation of eyeball (1 cases), exophthalmoptosis (2 cases), face pain (2 cases), orbital paralysis (2 cases) disappeared completely. No complications of cerebrospinal fluid rhinorrhea, brain edema and hemorrhage to be found during the period of operation and follow-up. CONCLUSION The majority clinical characteristics of invasive damage in nerve system with sphenoid-sinus-o-tumoropathy are cranial nerve manifestations, and the second manifestation is dysfunction of pituitary. Transnasal endoscopic surgery could inhibit the invasive damages in cranial nerves of sphenoid-sinus-o-tumoropathic patients effectively.
Adolescent ; Adult ; Aged ; Child ; Cranial Nerves ; pathology ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; pathology ; surgery ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Young Adult

Objective To observe the effect of 3D-Slicer combined with sina software assisted minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage,and investigate the application value of 3D-Slicer combined with sina software in the preoperative localization of minimally invasive neuroendoscopic surgery.Methods From July 2015 to October 2017,38 consecutive patients with supratentorial hypertensive intracerebral hemorrhage admitted to Shunde Hospital,Guangzhou University of Chinese Medicine were enrolled retrospectively.According to the different treatment methods,they were divided into an endoscopic group and a puncture group (n =19 in each group).The endoscopic group was treated with 3D-Slicer combined with sina software for neuroendoscopic hematoma removal,and the puncture group was treated with the hematoma minimally invasive soft-channel puncture and drainage under the CT localization.The effect of 3D-Slicer combined with sina software in the preoperative localization of hypertensive intracerebral hemorrhage by the minimally invasive surgery was evaluated by comparing the hematoma clearance of the first and third day of the two groups of patients after procedure,puncture to the preset position success,postoperative rebleeding,postoperative complications,and good prognosis at 3 months after procedure.Results The clearance rate of hematoma at the first day after operation in the endoscopic group was significantly higher than that in the puncture group ([90 ± 10]％ vs.[46 ± 16]％;t =2.348,P ＜ 0.05).The success of the puncture to the preset position was better than that in the puncture group (19/19 vs.14/19;x2 =5.758,P =0.016),and postoperative rebleeding rate was lower than that in the puncture group (0 vs.4/19;x2 =4.471,P =0.034).There were significant differences.There was no significant difference in postoperative infection complications between the two groups (all P ＞ 0.05).The prognosis of the endoscopic group was good in 17 patients within 3 months after procedure,and the prognosis was good in 11 patients in the puncture group.The good prognosis in the endoscopic group was better than that in the puncture group (x2 =4.866,P =0.027).Conclusion The effect of 3D-Slicer combined with sina software assisted minimally invasive neuroendoscopic surgery for hypertensive intracerebral hemorrhage was better than the hematoma minimally invasive soft-channel puncture and drainage under the CT localization,and the 3D-slicer combined with sina software can provide rapid and accurate preoperative localization for minimally invasive neuroendoscopic surgery of hypertensive intracerebral hemorrhage.