ObjectiveTo study the clinical features of the bilateral frontal brain contusion with cerebral hernia center and its treatment strategies. MethodsThe clinical data of 76 patients with cerebral central hernia were restropectively analyzed. ResultsIn 76 patients,there were 53 cases survive,23 cases died.The life and survival quality of these patients were evaluated according to the Karnofsky scale systerm :46 patients underwent surgery,including 35 cases with good recovery,8 cases with long-term coma or unable to look after themselves,3 cases with death;10 cases underwent a expectant treatment,of which,6 cases with good recovery,4 cases with long-term coma or unable to look after themselves.The other 20 cases died of central brain stem failure,with a central hernia when admissioned. ConclusionPatients with bilateral frontal brain contusion were extremely complicated with central hernia,and had a suddenly deteriored condition.Close observation of changes were critical importance.The surgery should be carried out before "diencephalon period",for most recovery well after surgery.Patients with diffuse brain swelling should go under the depressioning surgery as earlier as possible.

ObjectiveTo explore the relationship between glial growth factor (GGF), nerve growth factor (NGF) and growth characteristics of prolactinoma (PRL) and to evaluate pre and postoperative growth of PRL. MethodsImmunohistochemistry was used to analyze expression of GGF and NGF in 86 cases of PRL and to analyze the relationship between expression of GGF, NGF and PRL level, invasion, stroke, microvessel density. Cells were cultured with GGF and NGF to observe cell growth, cell cycle and angiogenesis. The relationship between proliferation, growth rate and GGF, NGF was evaluated by rank correlation and Chi-square test. Results GGF expression was significantly higher in invasive, stroke and recurrent pituitary adenomas ( P ＜ 0.05 ).Microvessel density increased significantly ( P ＜ 0.01 ). NGF expression was significantly lower in invasive, apoplexy and recurrent adenomas ( P ＜ 0. 05 ). Microvessel density decreased dramatically with NGF interruption ( P ＜ 0.05 ). GGF showed a positive correlation with growth rate of PRL. NGF showed a negative correlation with invasion and stroke. ConclusionsGGF is one of the factors facilitating growth and invasion of PRL while NGF can partly restrain proliferation of PRL cells. Expression of GGF and NGF indirectly reflects proliferation activity of PRL and can be used as markers to evaluate invasion, recurrence, treatment response and prognosis of PRL.

Free flaps have been successfully used in the repair of diabetic foot ulcers (DFUs), which can reduce amputation rate, maintain normal gait of patients, and improve life quality of patients. However, there are still many challenges in the repair of DFUs with free flaps, and many problems need to be solved. This paper summarizes the selection of patients, preoperative cautions, types of flaps, methods of vascular anastomosis, clinical effects, and existing problems in using free skin flaps for repairing DFUs.

Objective: To explore the value and disadvantage of micro-mirror in the intracranial aneurysm surgery. Methods: Micro-mirror was used to assist microsurgical clipping to 36 intracranial aneurysms in 31 cases, of which 3 were carotid-ophthalmic artery aneurysms, 3 anterior choroidal artery aneurysm, 11 were posterior communicating artery aneurysms, 7 were middle cerebral artery aneurysms, 10 anterior communicating artery or anterior cerebral artery aneurysms, and the others were a posterior cerebral artery aneurysm and a posterior inferior cerebellar artery aneurysm. The micro-mirror was used before and after clipping to observe the anatomic features of necks hidden behind and medial to aneurysms, to visualize surrounding neurovascular structures, and to verify the optimal clipping position. Intraoperative indocyanine green fluorescein angiography confirmed the success of sufficient clipping. Results: All aneurysms were clipped successfully. The parent arteries were occluded temporarily in 26 cases, and 9 aneurysms ruptured during the operation. Postoperative follow-up lasted from 2 weeks to 1 year. After operations digital subtraction angiography (DSA) were repeated in 10 cases, computed tomography angiography(CTA) in 21 cases, and no insufficient clipping or occlusion of parent arteries were revealed. Conclusions Micro-mirror assisting microsurgical clipping to the intracranial aneurysm is conducive to accurate clipping, and is a convenient and practical operation.