Objective To study the surgical skills for parasagittal meningioma at the central cortex. Methods A total of 32 patients with parasagittal meningiomas at the central cortex were treated with microsurgery. Through the arachnoid interfaces between the tumor and the brain tissue, the tumor was removed piece by piece. The vein of central sulcus, other draining veins, and normal brain tissues were protected, and the involved sagittal sinus was appropriately treated. Results Simpson Ⅰ, Ⅱ, and Ⅲ grades resection was achieved in 17 (53.1%), 11(34.4%), and 4 (12.5%) of the 32 patients respectively. None of the patients died. Two patients developed cerebral edema and infarction and were cured by surgical decompression. Hemiparalysis was deteriorated in 10 patients, 8 of them recovered spontaneously in 1 to 6 weeks, and the other 2 developed hemiparesis. Among the patients, 21 patients were followed up for 3 months to 5 years. 4 patients had recurrent meningioma in 1 to 3 years after the operation (Ⅱ grade resection in 2 and Ⅲ grade resection in 2). Conclusions For parasagittal meningiomas at the central cortex, preoperation imaging evaluation and microsurgical techniques are key factors for complete resection and surgical outcomes. The vein of central sulcus, other draining veins, and normal brain tissues should be protected during the procedure.

BACKGROUND: More recently,repair of skull defect with computer-designed prosthesis contributes to the revolutionary development of skull reconstruction technique. OBJECTIVE: To individually molded titanium mesh by computer-aided design (CAD) technique,and to observe the clinical application value of the titanium mesh in the repair of large-area skull defects in the fronto- temporo-parietal lobes. DESIGN,TIME AND SETTING: A retrospective case analysis was performed at the Department of Neurosurgery,Liuzhou People's Hospital between January 2006 and August 2007.PARTICIPANTS: A total of 16 patients comprising 12 males and 4 females,aged 16-52 years,suffered from skull defects in the fronto-temporo-parietai lobes following standard large trauma craniotomy and were recruited into this stud Two of these patients were complicated by hydrocephalus and received ventriculoperitoneal shunt. Skull defect area ranged between 9. 2 cm ×11.2 cm and 12.2 cm×14.6 cm. Skull defect neoplasty was performed in all patients 3-8months following standard large trauma craniotomy. METHODS: Titanium mesh patches were individually modeled by CAD,computer-aided manufacturing (CAM) and rapid shaping techniques and implanted into skull defect region. In addition,defect edge was fastened with titanium nails. MAIN OUTCOME MEASURES: Moulding effects and complications following skull defect neoplasty. RESULTS: A small amount of subcutaneous effusion was found in one patient and disappeared after liquid extraction and pressure dressing. Titanium mesh was firmly fixed with no loosening. Patients exhibited left-right symmetry,appropriate lateral curvature,no irregular umbilication or chewing dysfunction. All patients were followed for 3-18 months postoperatively and were satisfied with good resuRs,Le.,no complications,infection,material exposure,loosening,or collapse. CONCLUSION: CAD technique used for repair of skull defects is convenient,effective,and safe. This method can. reduce postoperative complications and improve repair effects.

Objective:To explore the expression and clinical significance of ASB6 in colorectal cancer tissue.Methods:The cancer tissues and para-carcinoma tissues were selected from 106 patients with colorectal cancer admitted to the Department of Gastrointestinal Surgery, Third Affiliated Hospital of Shandong First Medical University from January 2015 to January 2018. Immunohistochemical method was used to detect the expression level of ASB6 protein in tissues, and the correlation between its expression and clinical pathological characteristics of patients was analyzed. At the same time, the expression of ASB6 mRNA in colorectal cancer tissues and para-carcinoma tissues was detected by quantitative real-time PCR (qRT-PCR). The Kaplan-Meier survival analysis method was used to explore the relationship between the expression of ASB6 and prognosis in colorectal cancer patients. The Cox regression model was used to analyze the independent prognostic factors of colorectal cancer patients.Results:The high expression rate of ASB6 in colorectal cancer tissues (67.9%, 72/106) was significantly higher than that in para-carcinoma tissues (10.4%, 11/106, χ2=73.67, P<0.001). Further analysis showed that the expression of ASB6 protein was significantly correlated with lymph node metastasis ( χ2=7.34, P=0.007) and TNM stage ( χ2=16.85, P<0.001). There was no significant correlation between the expression of ASB6 protein and age ( χ2=0.42, P=0.516), sex ( χ2=0.76, P=0.385), tumor size ( χ2=0.91, P=0.341), tumor location ( χ2=2.29, P=0.130), histological classification ( χ2<0.01, P>0.999), differentiation degree ( χ2=2.54, P=0.111) and distant metastasis ( χ2=3.38, P=0.066). qRT-PCR results showed that the expression level of ASB6 mRNA in colorectal cancer tissues was significantly higher than that in para-carcinoma tissues (5.37±0.13 vs. 3.39±0.09, t=-12.48, P<0.001). Kaplan-Meier survival analysis showed that the overall 5-year survival rates of patients in the ASB6 high expression group (72 cases) and the ASB6 low expression group (34 cases) were 45.8% and 73.5%, respectively ( χ2=6.82, P=0.009). Univariate survival analysis found that ASB6 protein expression ( HR=3.09, 95% CI: 1.25-7.65, P=0.015), lymph node metastasis ( HR=0.41, 95% CI: 0.21-0.82, P=0.011), distant metastasis ( HR=0.20, 95% CI: 0.10-0.42, P<0.001), and TNM stage ( HR=0.10, 95% CI: 0.03-0.32, P<0.001) were prognostic factors, while multivariate Cox survival analysis found that distant metastasis ( HR=0.22, 95% CI: 0.09-0.50, P<0.001) and TNM stage ( HR=0.25, 95% CI: 0.11-0.58, P<0.001) were independent prognostic factors. Conclusion:The expression of ASB6 in colorectal cancer tissues is significantly higher than that in para-carcinoma tissues, and the prognosis of patients with high expression of ASB6 is significantly worse than that of patients with low expression of ASB6. ASB6 can be used as an important indicator for early monitoring and postoperative survival assessment of colorectal cancer patients in the future.