Objective To evaluate the follow-up diagnostic value of 3 T magnetic resonance angiography (MRA) after intracranial aneurysm coil embolization.Methods The databases such as PubMed,EMbase,Cochrane Library,CBM,CNKI and VIP were retrieved.According to the inclusion criteria of diagnostic tests,the diagnostic tests of the follow-up diagnostic value about MRA were screened after intracranial aneurysm coil embolization.The methodological quality included in the studies was evaluated using QUADAS items and the meta-analysis was conducted using Meta-Disc 1.4 software.The receiver operating characteristic curve was drawn and the area under the curve was calculated.The residual sensitivity and specificity diagnosed by MRA after intracranial aneurysm embolization were evaluated.Results A total of 6 studies were included,including 253 patients.The pooled sensitivity and specificity in 3 T MRA diagnosing residual intracranial aneurysms were 0.915 (95％ confidence interval [ CI]0.850 - 0.959) and 0.847 (95％ CI 0.787 - 0.896) respectively.The area under the receiver operating characteristic curve was 0.951,Q =0.892.Conclusions 3 T TOF MRA can be used as an effective and feasible imaging follow-up method after embolization of intracranial aneurysms,however,because of the methodological limitations,the high-quality research is needed to further validate the application value of the MRA during follow-up after intracranial aneurysm embolization.

Objective To investigate the clinical value of inflammation-related factors [white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein] in predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods The aneurysmal subarachnoid hemorrhage in 217 cases according to whether the occurrence of delayed cerebral ischemia were divided into 2 groups:delayed cerebral ischemia (DCI) group (n =69) and non DCI group (n =148).A retrospective analysis of 217 cases of patients was performed with inflammation-related factors,and its relationship with clinical prognosis of patients with DCI was also analyzed.Results The inflammation-related factors (WBC count,erythrocyte sedimentation rate,and C-reactive protein) in DCI group were significantly higher than those in non DCI group with a statistically significant difference (P ＜ 0.05).The follow-up results showed that there were 33 patients died,12 cases of plant survival,and 12 patients with severe disability in DCI group,which had a statistically significant difference relative to non DCI group (P ＜ 0.05).Spearman analysis showed that there was a significantly negative relationship between inflammation-related factors (white blood cell count,ESR,C-reactive protein) and glasgow prognostic score (GOS) in DCI group(r =-0.877,-0.683,-0.841,P ＜0.05).Conclusions The inflammation-related factors can be used as one of method to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Spontaneous complete thrombosis with parent artery occlusion of giant intracranial aneurysms is rare.We report a patient with a rare giant vertebral artery aneurysm with spontaneous complete thrombosis and parent artery occlusion,and review the related literature,discuss its incidence,clinical presentation,pathogenesis,diagnosis,and treatment.

Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P<0.05;4(18.2%) cases vs. 10(50.0%) cases, χ2=4.773, P<0.05;1 (4.5%) case vs. 7(35.0%) cases, χ2=4.481 P<0.05]. There were no significant differences in postoperative clipping results and GOS at 6 months after treatment between two approaches (P>0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.

Objective To investigate the clinicopathologic features of intestinal polypoid lymphoma (PL) in children. Methods The clinicopathologic data of 15 cases of pediatric intestinal PL in Jiangxi Provincial Children 's Hospital were retrospectively analyzed. Immuohistochemistry was used to detect the expressions of CD10, bcl-6, bcl-2, MUMl and ERCC1, then EB virus (EBV)-encoded RNA (EBER) status was tested by using in situ hybridization. Results Amongst 15 cases studied, 13 cases were Burkitt lymphoma (BL), 1 case was diffuse large B-cell lymphoma (DLBCL) and 1 case was between DLBCL and BL (DLBCL/BL). The positive rate of CD10, bcl-6, bcl-2, MUMl, ERCC1 and EBER were 100.0%(13/13), 92.3%(12/13), 0, 7.7 % (1/13), 15.4 % (2/13), 53.8 % (7/13), respectively in 13 BL cases. The clinical stage of 13 patients with BL: 11 cases (84.6 %) Ⅱ stage, 1 case (7.7 %) Ⅲ stage, 1 case (7.7 %) Ⅳstage. The clinical stage of DLBCL and BL/DLBCL: Ⅱstage. 14 cases of PL had survival time without tumors, 24-120 months follow-up, and 1 BL patient inⅣstage without chemotherapy died after 2 months. Conclusion BL is a major subtype of intestinal PL in children, which shows a low clinical stage and a good prognosis.

Objective To evaluate the expression and clinical significance of Periostin (POSTN) in craniopharyngi?oma. Methods Forty-two patients with pathologically diagnosed adamantinomatous craniopharyngioma involving the floor of 3rd ventricle were retrospectively analyzed. The correlation between expression of POSTN and outcome was studied. Results POSTN was expressed in stroma of craniopharyngioma tissues. The expression of POSTN was not associated with the postoperative recurrence (Z=-0.236,P=0.813) while was associated with the degree of the adhesion between tumor and floor of 3rd ventricle (r=0.685, P<0.001), postoperative Hypothalamic Status Scale (r=0.569, P<0.001) and Body Mass Index (r=0.594, P<0.001). Conclusions POSTN may predict the degree of the adhesion between craniopharyngioma and 3rd ventricle floor. The high expression of POSTN may indicate the worse hypothalamus function.

ObjectiveTo assess the efficacy and safety of Xuebijing injection for the treatment of severe acute pancreatitis (SAP).Methods An extensive search of related literatures from the Cochrane Library, EMBASE, China Biology Medicine (CBM), CNKI, VIP and Wanfang data up to March 2014 was performed. Randomized controlled trials (RCTs) regarding Xuebijing injection for the treatment of SAP were collected regardless of languages. Jadad scale was taken for quality evaluation of the included studies by two researchers. The patients in control group were given conventional treatment, and those of the Xuebijing group were given Xuebijing injection on the top of conventional treatment. The Cochrane Collaboration RevMan 5.2 software was used for data analysis regarding the effect of Xuebijing injection on the mortality, incidence of complication, effective rate, the length of stay in hospital, and the safety of the drug in patients with SAP.Results A total of 15 published reports meeting the inclusion criteria were enrolled. The methodological quality of the trials was low. Meta analysis showed that the mortality in Xuebijing group was significantly lower [odds ratio (OR) = 0.37, 95% confidence interval (95%CI) =0.17 - 0.77,P = 0.008], and the incidence of complication was also significantly decreased (OR = 0.26, 95%CI =0.14 - 0.45,P< 0.000 01) as compared with those of control group. The effective rate in Xuebijing group was significantly higher than that of the control group [relative risk (RR) = 0.85, 95%CI = 0.80-0.91,P< 0.000 01]. The length of stay in hospital in Xuebijing group was significantly shorter than that of the control group [mean difference (MD) = -5.28, 95%CI = -6.69 to -3.86,P< 0.000 01]. Adverse reactions of Xuebijing injection were reported in 2 studies. The adverse reaction in one study was headache and nausea, which were relieved by adjusting the speed of intravenous infusion, and mild rash was reported in another case, and it disappeared after the withdrawal of Xuebijing. Conclusions The currently available evidence shows that Xuebijing injection may have some therapeutic effect on SAP. Because of the low methodological quality of the included trials, multi-center and high-quality RCTs with large sample sizes are needed to provide stronger evidence.

Objective To investigate the safety and short-term effectiveness of the hybrid operation for the treatment of intracranial complex ruptured aneurysms.Methods From December 2014 to March 2017,14 consecutive patients with complex ruptured aneurysm treated with hybrid operation at the Department of Neurosurgery,Nanfang Hospital,Southern Medical University were enrolled retrospectively,including 13 with acute spontaneous aneurismal subarachnoid hemorrhage and 1 with hemorrhage in the recurrent aneurysm embolization.Twelve aneurysms were treated with shape clipping.Digital subtraction angiography (DSA) was used to evaluate the clipping effect of aneurysms.Two patients with aneurysm were treated with extracranial-intracranial (EC-IC) bypass and aneurysm trapping.Endovascular balloon occlusion for trapping aneurysms was performed after DSA evaluation of the patency of bridge vessel.Results Of the 14 patients,11 were treated with emergency hybrid operation after angiography,2 were treated with elective surgery,and 1 with emergency surgery for rescue because of bleeding during embolization.DSA revealed that the aneurysm clips in 3 of 12 patients needed to be adjusted,including 2 parent artery stenosis and 1 with incomplete clipping.After adjustment,the clipping was satisfactory.In intracranial and extracranial bypass surgery,angiography revealed that the blood vessels were patent.Trapping of the aneurysms was performed in the one-stage operation.One patient discharged voluntarily after procedure because of serious vasospasm.Onepatient had perfusion pressure breakthrough after surgery and received hematoma evacuation and decompression.The Glasgow outcome scale (GOS) score was 3 at discharge.Other patients had no new neurological dysfunction after operation.Thirteen patients were followed up for 3-24 months after operation.There were no new neurological dysfunction,including GOS 5 in 8 cases and 4 in 5 cases.Six patients underwent DSA examination,in 4 of them the aneurysm clipping did not show aneurysm recurrence,and the parent arteries were patent.Two patients treated with vascular bypass.There were no recurrence of aneurysms,and the parent arteries and anastomotic vessels were patent.Conclusion After preliminary observation,using hybrid operation for the treatment of complicated intracranial ruptured aneurysms was safe and effective.

Chromosomal Proteins, Non-Histone ; metabolism ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Keratins ; metabolism ; Male ; Mucin-1 ; metabolism ; Phosphopyruvate Hydratase ; metabolism ; Rhabdoid Tumor ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma ; metabolism ; pathology ; S100 Proteins ; metabolism ; SMARCB1 Protein ; Sarcoma ; metabolism ; pathology ; Sarcoma, Clear Cell ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; surgery ; Transcription Factors ; metabolism ; Vimentin ; metabolism

Displacement of distal ventriculo-atrial (VA) shunt is not uncommon. However, misplacement of the distal catheter of VA shunt in the internal jugular vein is a possibility, especially when conducted without intraoperative monitoring. We describe a patient in whom a VA shunt was performed due to failure of ventriculo-peritoneal shunt and the distal catheter of the shunt was found to be misplaced in the left internal jugular vein. Endovascular intervention via femoral vein was used to retrieve the distal catheter.
Catheters ; Displacement (Psychology) ; Femoral Vein ; Humans ; Hydrocephalus ; Jugular Veins ; Monitoring, Intraoperative ; Ventriculoperitoneal Shunt