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.

Objective To summarize the clinical features,treatment and prognosis of bullous systemic lupus erythematosus (BSLE).Methods Clinical data were collected from 6 cases of BSLE between May 2009 and September 2015,and were analyzed retrospectively.Results Among the 6 patients,2 were male and 4 were female.The mean age of onset was 34 years.All the 6 patients presented with tense blisters and bullae arising on an erythematous base or normal skin,which were arranged in an annular pattern in 3 patients.The SLE Disease Activity Index (SLEDAI) score was ＞ 4 in all the 6 patients.Histopathological examination showed subepidermal blisters or fissures in all the patients.Direct immunofluorescence (DIF) revealed continuous linear deposition of immunoglobulin G (IgG),IgM and IgA in all the patients,linear deposition of C3 in 4 patients,and linear deposition of Clq in 2 patients at the basement membrane zone (BMZ).All the 6 patients were treated with oral glucocorticoids and hydroxychloroquine,and 2 patients were additionally treated with cyclophosphamide.During the follow-up period,adverse reactions to different extents were observed in the 6 patients.Conclusions BSLE mainly occurs in young and middle-aged people.Histopathologically,subepidermal blisters or fissures can be observed with linear deposition of IgG,IgM,IgA,or C3 along the basement membrane zone on DIF.

Objective To investigate the association between HLA-DRB1 alleles and pemphigus vulgaris (PV) in a Han population in Sichuan.Methods Polymerase chain reaction with sequencespecific primer (PCR-SSP) method was used for low-resolution and high-resolution typing of HLA-DRB1 alleles in 19 patients of Han nationality with PV and 25 healthy controls in Sichuan.Allele frequencies were calculated,and differences in the allele frequency between the above two groups were compared by using chisquare test.Results Totally,9 kinds of DRB 1 low-resolution alleles and 19 kinds of DRB 1 high-resolution alleles were identified in the PV patients and healthy controls.Frequencies of the DRB1* 14 allele (39.47％[15/38] vs.8.00％[4/50],x2 =17.43,P ＜ 0.05) and DRB1*1405 allele (15.79％[6/38] vs.2.00％[1/50],x2 =4.25,P ＜ 0.05) were significantly higher in the PV patients than in the healthy controls.Conclusion The HLA-DRB1*14 allele may be a common susceptibility gene for PV in the Han population in Sichuan,and the HLA-DRB1* 1405 allele may be most closely associated with PV.

Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.

Objective Through comparision of HER2/neu status detected by immunohistoehemistry (IHC),fluorescence insitu hybridization(FISH)and chromogenic insitu hybridization(CISH),to explore the clinical significance of FISH and CISH on detecting gene status of HER2.Methods Sixty-four paraffinembedded breast samples whose pathological types were infiltrating ductal carcinomas were tested by IHC for HER2 protein overexpression and CISH,FISH for HER2 gene status.The rate of chromosome 17 polysomy was also analyzed.Results Among the cases of HER2 protein overexpression(+++)group,the concordant ratios of IHC and CISH.FISH detecting HER2/neu status were 100%.Among the cases of HER2 protein overexpression(++)group,the concordant ratios were 95.83%and 91.67%.Among the cases of HER2 protein overexpression(+/-)group,the concordant ratios were also 100%.One case in which FISH and CISH were performed yielded the different results.so the general coincident rate was 98.41%.The incidence of chromosome 17 polysomy Was 45.16%,45.83%and 11.11%in three IHC(+++,++,+/-)groups,and the total incidence was 40.62%.ConclusionIHC is a preliminary screening method;HER2 gene status detected by CISH and FISH have high concordant ratio,CISH is a more convenience and viable method to detect HER2/neu status,when doubling interference of fichromosome 17 polysomy,we need to select FISH further.

Objective:To investigate the influence of clinical outcomes and the risk factors of poor prognosis for preoperative nutritional risk in gastric cancer patients.Methods:A prospective study was performed in 140 patients with gastric cancer and the nutritional risk screening 2002 (NRS 2002) was done.The influence of preoperative nutritional risk on postoperative complications,hospital stay,ICU stay,hospital expenses,60 days readmission and mortality was analyzed,and the risk factors of perioperative complication were identified by univariate and multivariate analysis.Results:The significant difference (NRS 2002 ≥ 3 group vs.NRS 2002 ＜ 3 group) was observed in the rates of overall postoperative complications,pulmonary infection,overall hospital stay and postoperative hospital stay (P ＜ 0.05).The rates of anastomotic fistula,pleural effusion,60 days readmission,60 days mortality and hospitalization expenses in NRS 2002 ≥ 3 group were higher than that of NRS 2002 ＜ 3 group,but there were no differences between the two groups (P ＞ 0.05).By univariate and multivariate analysis,preoperative high cholesterol levels and preoperative nutritional risk are the risk factors of poor prognosis and postoperative complications.Conclusion:Preoperative high cholesterol levels and preoperative nutritional risk are independent risk factors of postoperative complications.

Objective To investigate the medical cost of 72 patients with panic disorder and efficacy of paroxetine(SSRIs)in the treatment.Methods The course,medical cost,types and times of main examination of all 72 patients were reviewed and analyzed.The effect of paroxetine on the patients was studied in terms of anxiety and depression scale.Results The 72 patients had long course,high medical cost and received many unnecessary medical examinations.Paroxerine was effective on patients with panic disorder in light of anxiety and depression scale.Con- clusion Patients with panic disorder had long course and spent much unnecessany money before final diagnosis. Paroxetine was useful and safe in the treatment of panic disorder.

Cold-stimulus headache is a primary headache syndrome which is provoked by an external application or ingestion or inhalation of cold stimulus. It has not been reported to occur secondary to another focal structural brain lesion, or as a reversible illness. This is a report of two women who developed cold-stimulus headache on taking ice cold food after the onset of thalamic hemorrhage. The headache was typical of cold-stimulus headache except a relatively long duration of pain lasting half an hour. There was spontaneous remission after a few months. Our patients suggest that cold-stimulus headache can be secondary to thalamic hemorrhage..

To investigate the expression of vascular endothelial cell growth factor (VEGF) and its receptors in vitreous of patients with diabetic retinopathy ( DR), and to discuss its role in the development of DR.
●METHODS: Selected 13 patients (16 eyes) with DR and 15 healthy people (15 eyes), the expression of VEGF and its receptors (fms-like tyrosine kinase-1, Flt-1 and kinase insert domain containing receptor, KDR) were evaluated by immunohistochemistry in vitreous. The levels of VEGF, the Flt-1 and KDR in vitreous of patients with DR were examined with enzyme linked immunosorbent assay (ELlSA).
● RESULTS: lmmunohistochemical staining showed that the expression of VEGF, Flt-1 and KDR in vitreous vessel membrane of patients with DR was increased significantly. And the levels of VEGF, Flt - 1 and KDR in vitreous of patients with DR were obviously higher than that in the control group (P<0. 05 or P<0. 01).
● CONCLUSlON: VEGF, Flt - 1 and KDR were widely expressed in vitreous of patients with DR, and were positively related to micro-angiogenesis of DR patients. lt proved that VEGF and its receptors played important roles in the occurrence and development of DR.

AIM: To investigate the effects of external counterpulsation combined with laser photocoagulation for treatment of non-proliferative diabetic retinopathy.
METHODS: A prospective study method were used from Aug. 2013 to Feb. 2016. A total of 104 cases in our hospital for treatment of non - proliferative stage of diabetic retinopathy patients were selected as the research object, and all the patients were equally divided into observation group and control group, 52 cases in each group according to the order of admission. Patients in control group were treated with panretinal laser photocoagulation treatment. The observation group were given external counterpulsation combined with laser photocoagulation for treatment, observed the prognosis in the two groups.
RESULTS: The total efficiency in the observation group and the control group were 98. 1% and 84. 6%, the observation group was significantly higher than the control group (P<0. 05). The eye artery EDV and PSV values in the observation group and the control group after treatment were significantly higher than those before treatment (P<0. 05), while the observation group after treatment of eye artery EDV and PSV value were significantly higher than those in control group (P<0. 05). The CMT values in the observation group before and after treatment were 198. 13±45. 32μm and 200. 46±31. 94μm, while the control group were 203. 14±51. 94μm and 202. 90±42. 95μm that compared between the two groups were not statistically significant (P>0. 05).
CONCLUSION: External counterpulsation combined with laser photocoagulation treatment has good safety in the treatment of non-proliferative diabetic retinopathy, it can promote eye artery blood flow speed, thereby improve the therapeutic effect.