Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P <0.01). The patients were followed up for 6 months. The poor prognosis rates were 17.0%and 25.7%in clipping group and coiling group, respectively (P>0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.

Objective: To compare the diagnosis and treatment experience of brain abscesses and improve prognosis. Methods: The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment. There were 196 cases received operation, including 95 cases of excision, 89 cases of ventriculopuncture, 12 cases of excision after ventriculopuncture, 106 cases received drug conservative therapy. Two groups of information including clinical manifestation, abscess location, therapeutic effect and prognosis were compared by χ² test. Results: Compared to 1980-2001 group, adjacent infection incidence declined(χ²=8.000, P=0.005). The ratio of single abscess declined and multiple abscess increased(χ²=11.060, P=0.001), the infection proportion of frontal lobe and temporal lobe decreased(χ²=9.080, P=0.003; χ²=15.440, P=0.000). The ratio of headache and vomit and papilledema declined significantly(χ²=23.290, P=0.000; χ²=21.020, P=0.000; χ²=2.290, P=0.001). Total mortality of 302 patients were 23 cases and 5 cases of 1980-2001 group and 2002-2014 group (10.4% vs. 6.3%, χ²=1.180, P=0.277). However, there were statistical difference in postoperative mortality between both groups (14.4% vs. 4.0%, χ² =3.880, P=0.049). Conclusion With the application of antibiotics and the development of neurosurgical techniques, the prognosis of brain abscess has been improved.

Objective To longitudinally analyze the perioperative serum levels of inflammatory fac-tors in patients with hypertensive intracerebral hemorrhage(HICH),and to explore their correla-tion with prognosis.Methods A total of 173 HICH patients admitted to our hospital from Febru-ary 2021 to January 2023 were consecutively enrolled.Their serum levels of inflammatory factors were measured before operation,and in 6,12,24,48 and 72 h after operation.All of them were fol-lowed up for 6 months,and according to their prognosis,they were divided into good prognosis group(116 patients)and poor prognosis group(57 patients).Multivariate logistic regression anal-ysis was applied to analyze the correlation of the perioperative serum inflammatory factors with HICH prognosis.Results In these HICH patients,IL-6 and IL-1β were increased continuously within 72 h after operation,and the TNF-α level reached its peak at 48 h after operation.The poor prognosis group had significantly longer time from bleeding to admission(6.32±1.50 h vs 5.14±2.00 h),larger hematoma[35.50(24.50,46.00)ml vs 30.00(21.00,41.50)ml],and higher ratio of hematoma breaking into ventricles(28.07％vs 2.59％),and lower GCS score at admission(10.07±1.32 vs 11.00±0.85)when compared with the good prognosis group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that the levels of IL-6,IL-1β and TNF-α at different postoperative time points were independent influencing factors for poor prognosis of HICH patients(P＜0.05,P＜0.01).Conclusion Serum levels of inflammatory factors IL-6,IL-1βand TNF-α are all elevated in HIGH patients during perioperative period,and their increments at different time points are correlated with the increased risk of adverse prognosis in the patients within 6 months after operation.

Objective To observe the effectiveness of ultrasound wide beam(WB)-based harmonic motion imaging(HMI)(WB-HMI)for locating irradiation focus of high intensity focused ultrasound(HIFU)for in vitro tissue.Methods WB-HMI technology was developed with acoustic radiation force and ultrasound imaging as the key technology.For in vitro porcine tenderloin and bovine liver tissue,different amplitude modulation(AM)frequencies(25-100 Hz)and excitation acoustic power(0.7-28 W)were used to achieve WB-HMI localization of HIFU irradiation focus,and the differences of WB-HMI localization of HIFU irradiation focus under different parameter combinations were observed.Taken the actual focus position on ultrasonic image after HIFU as the standard and the focus positioning error＜1 mm as the effective standard of WB-HMI locating irradiation focus,the locating success rate was calculated.Results The larger the acoustic power,the larger the displacement amplitude of irradiation focus by WB-HMI at the same AM frequency,while the smaller the AM frequency,the larger the displacement amplitude of irradiation focus located by WB-HMI under the same acoustic power.Under different AM frequencies,for in vitro porcine tenderloin,the success rate of WB-HMI for locating HIFU radiation focus was higher than 90.00％when acoustic power was 15 W or 22 W,whereas the success rate showed a decreasing trend when the acoustic power was 28 W.For in vitro bovine liver tissue,the success rate of WB-HMI localization was 100％when acoustic power was ≥7.0 W.Conclusion WB-HMI could be used to effectively locate HIFU irradiation focus for isolated tissue.