Objective To explore the therapeutic efficacy and complications of endoscope-assisted lateral skull base surgery. Methods Assisted by hard-tube ear endoscope, 11 patients with acoustic neuroma were operated via labyrinthine approach and retrosigmoid approach, and 5 patients with petrous apex cholesteatoma were operated via middle cranial fossa approach and mastoid-middle cranial fessa approach. Results Among 11 patients with acoustic neuroma, total removal was achieved in 9 cases (81.8%), subtotal in 2 cases (18.2%). Facial nerves and cochlear nerves were preserved completely during operation. After operation there was no facial paralysis in 9 cases (81.8%), mild peripheral facial paralysis in 2 cases (18.2%), the same hearing level as that of preoperation in 2 patients (18.2%), hearing impairment in different degrees in 9 cases (81.8%), among which moderate sensorinural hearing loss in 1 patient (9.1%), moderate to severe in 2 patients (18.2%), severe in 3 patients (27.3%), profound in 3 patients (27.3%). Among 5 patients with petrous apex cholesteatoma, total removal was achieved in all cases. After operation, preoperative facial paralysis in 3 patients disappeared within 9 months, and moderate to severe conduction deafness appeared in 2 patients. Conclusions The application of ear endoscope in lateral skull base surgery can improve the total removal of lesions and the salvage rate of vessels and nerves. However, its disadvantages make it only be an assistant method for micresurgery.

Objective To explore the micresurgical techniques and outcome of tumors in jugular foramen and its around. Methods Eleven patients with jugular foramen tumors were operated through suboccipital-retrosigmoid approach (2 cases), jugular foramen approach (2 cases), temporal fossa approach (4 cases) and mastoid-cervical combined approach (3 cases). Results Nine tumors were totally removed and 2 were subtotally removed. Of those cases, there were 4 neurinoma, 4 paragangliome, I meningioma, 1 mucochondrosarcoma, and 1 low-differentiated carcinoma. Postoperative complications included transient cerebrespinal fluid leak(1 case) and new lower cranial nerve injury (2 cases). All cases were followed up for mere than 8 months. The postoperative hearing was improved in 1 case, stable in 6 cases, deteriorated in 4 cases. Postoperative facial paralysis of grade Ⅱ- Ⅲ occurred in 3 of 9 patients without facial paralysis, which recovered in half a year. Of 2 patients with facial paralysis before surgery, facial function was improved in 1 case and stable in 1 case. Conclusion Proper surgical approaches and micrceurgical techniques, which were adopted according to the types, the location, and the expansion of tumors, the function of facial nerve and lower cranial nerves, and hearing level, are good for reducing complications, exposing and removing jugular foramen tumors.

OBJECTIVETo study ingredients penetrable through placental barrier by administering pregnant rats with Scutellaria Radix extract using HPLC-MS.

METHODRats in early, middle and late pregnancy were intragastrically administered with Scutellaria Radix extract for 5 days. Maternal plasma and embryonic tissues were obtained at 1.5, 12 h after the final administration of Scutellaria Radix extract to determine ingredients of biological specimens.

RESULTUnder the optimum experimental conditions, seven compounds were detected in all pregnant rat plasma, specifically including baicalin, wogonoside, baicalein, wogonin and oroxylin A. The seven compounds were also discovered in embryonic tissues of rats in early pregnancy, including the five detected compounds. But they were not detected in embryonic tissues of rats in middle pregnancy, and six compounds except baicalein were detected embryonic tissues of rats in late pregnancy.

CONCLUSIONIngredients contained in Scutellaria Radix are detected in pregnant rats at different stages, except those in middle pregnancy, indicating a potential in utero exposure in case of oral administration of Scutellaria Radix pregnancy. Therefore, a study of embryotoxicity shall be continued to evaluate the safety of Scutellaria Radix extract.

Animals ; Drugs, Chinese Herbal ; adverse effects ; chemistry ; pharmacokinetics ; Female ; Placenta ; metabolism ; Plant Extracts ; adverse effects ; chemistry ; pharmacokinetics ; Pregnancy ; Rats ; Scutellaria baicalensis ; chemistry

OBJECTIVE: To explore the therapeutic efficacy and complications of endoscope-assisted surgical resection of acoustic neuroma. METHOD: Assisted by hard-tube ear endoscope, 11 patients with acoustic neuroma were operated via labyrinthine approach and retrosigmoid approach. RESULT: Total removal was achieved in 9 (81.8%) cases, while subtotal removal was achieved in 2 (18.2%) cases. Facial nerves and cochlear nerves were preserved completely during operation in all cases. After operation 9 (81.8%) cases had no facial paralysis, while the other 2 cases (18.2%) had mild peripheral facial paralysis. The same hearing level as that of preoperation in 2 patients (18.2%), hearing impairment in different degrees in 9 patients (81.8%), among which moderate sensorineural hearing loss in 1 patient, moderate to severe in 2 patients, severe in 3 patients, profound in 3 patients. CONCLUSION The application of ear endoscope in acoustic neuroma surgery can improve the total removal rate of tumors and the salvage rate of vessels and nerves. However, its disadvantages make it an assistant method for microsurgery.
Adult ; Ear, Inner ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods ; Young Adult

Objective To investigate the experience of early diagnosis and surgical treatment of brain metastases to improve the therapy effect.Methods Retrospective analysis was performed on clinical data of 80 patients with brain metastases,received surgical treatment in our hospital from January 2003 to December 2013.The early diagnosis,treatment and survival of these patients were analyzed.Results Asymptomatic regularly head computerized tomography (CT) or enhanced magnetic resonance imaging (MRI) found 12 patients (15％).Two weeks after surgery,32 patients (40.0％) had totally disappeared neurological disorders,40 (50.0％) had obvious relief,6 (7.5％) were without relieved or even aggravated,and 2 (2.5％) were dead.Eight patients (10.0％) who combined with extracranial metastases died within 6 months of surgery.The one-year survival rate was 60.3％ (47/78),two-year survival rate was 34.6％ (27/78),three-year survival rate was 20.5％ (16/78) and five-year survival rate was 6.4％ (5/78);the median survival was 17 months.In 16 patients of survival more than 3 years,9 were the early-detection asymptomatic patients.Conclusion After resection of primary malignant tumor,the periodical enhanced head CT or MRI are effective measures for early diagnosis of brain metastases; surgical treatment can improve the survival quality and prolong survival time of patients with brain metastases.

Objective:To explore the clinical classifications and treatments of craniocerebral Langerhans cell histiocytosis (LCH).Methods:Patients with histopathologically conformed LCH in our hospital from January 2008 to January 2019 were classified into 7 types according to the International Histocell Association clinical typing: type I (single site of skull), type II (single site of skull and involvement of central nervous system [CNS]), type III (multiple sites of skull), type IV (single site of CNS), type V (multiple sites of CNS), type VI (low-risk multiple sites of multisystem), and type VII (high-risk multiple sites of multisystem). According to the classification, two treatment methods were adopted. Group A (patients with type I) was treated with local resection, and Group B (patients with type II, III, IV, VI, and VII) was treated with chemotherapy based on Japanese Langerhans Cell Histiocytosis Study Group (JLSG) protocol after local resection or biopsy; according to the efficacy standards of JLSG, the treatment efficacies were evaluated.Results:The study covered 17 patients from Group A (type I) and 29 patients from Group B, including 2 with type II, one with type III, one with type IV, 10 with type VI, and 15 with type VII. During the follow-up period of one-10 years, there was no recurrence in 17 patients from group A; 27 out of 29 patients from group B had effective induction in postoperative JLSG chemotherapy, enjoying induction efficiency of 93.1%; two patients were treated with other chemotherapy regimes, and one of them was followed up for one year and his condition was stable.Conclusion:For type I craniocerebral LCH patients, clinical cure can be obtained with local resection; for type II, III, IV, VI, and VII LCH patients, good curative effect can be obtained with JLSG chemotherapy after local resection or biopsy; for LCH patients who have no reaction or disease progress in the first 6 weeks of induction, the curative effect can be improved by changing the rescue plan in time.

Objective:To investigate the application value of 3D printing technology in precise surgery of complex skull base tumors.Methods:Thirty patients with complex skull base tumors who underwent surgical treatment in our hospital from May 2016 to May 2019 were chosen in our study; they were divided into 3D printing group and control group according to whether 3D printing technology was used or not. In the 14 patients from 3D printing group, patients accepted surgery with the guide of 3D printing technology before and during surgery. In the 16 patients from control group, surgery was performed with the guide of routine preoperative MR images. The surgical duration, intraoperative hemorrhage volume and tumor total resection rate were compared between the two groups.Results:The patients in the 3D printing group had significantly shortened average surgical duration, significantly decreased average intraoperative hemorrhage volume, and significantly higher proportion of patients with total resection as compared with those in the control group ([7.2±2.6] h vs. [9.4±2.2] h, [377.1±318.3] mL vs. [975.0±856.2] mL, 12/14 vs. 7/16, P<0.05). Conclusion:In surgical resection of complex skull base tumors, 3D printing technology can help to improve surgical efficiency and tumor total resection rate, and reduce intraoperative hemorrhage volume.

Objective To investigate the expression and biological value of heme oxygenase I (HO-1) in gliomas. Methods Fifty-six patients with gliomas, admitted to and accepted surgery in our hospital from January 2010 to January 2015, were chosen in our study; WHO grade I was noted in 4 patients, grade Ⅱ in 16, grade Ⅲ in 10, and grade IV in 26 patients; patients with grade I and Ⅱ were as low-grade glioma group and patients with grade Ⅲ and IV were as high-grade glioma group. The HO-1 expression in the two groups was detected by immunohistochemistry. R-langrage survival tool was used to analyze the relation between HO-1 expression and prognosis of 1107 patients with gliomas selected from The Cancer Genome Atlas (TCGA) database. Results Significant differences of HO-1 expression were observed in different grades of gliomas (P<0.05), and HO-1 high-expression rate in the high-grade gliomas (75%) was significantly higher than that in the low-grade group (30%, P<0.05). HO-1 protein expression level in the high-grade gliomas was significantly higher than that in the low-grade group (P<0.05). Moreover, area under the curve (AUC) of the receiver operating characteristic curve was suggested that the HO-1 could be an ideal determine factor (AUC=0.747, P=0.002). Log rank analysis indicated that the accumulate survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). TCGA database analysis showed that simultaneous survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). Conclusion Expression of HO-1 is correlated with the malignant degrees and prognoses of gliomas, and it has potential to be a novel biological marker for the diagnosis and treatment of gliomas; furthermore, HO-1 could also be a target for the study and treatment of gliomas.