Objective:To investigate the difference in intracranial infection rate between long-tunneled external ventricular drainage(LTEVD)and conventional external ventricular drainage(EVD),as well as the risk factors for intracranial infection.Methods:A retro-spective analysis was performed for the clinical data of 45 patients who were admitted to Department of Neurology Center,The Third Affiliated Hospital of Chongqing Medical University,from January 2020 to December 2022 and underwent EVD,among whom 13 patients underwent LTEVD(LTEVD group)and 32 patients underwent conventional EVD(EVD group).Related data were recorded for both groups,including general information,postoperative catheter-related complications,and postoperative management,to investi-gate the effect on reducing the rate of intracranial infection.According to the presence or absence of intracranial infection after surgery,the patients were divided into the infection group with 10 patients and non-infection group with 35 patients,and related clini-cal data were analyzed to investigate the risk factors for intracranial infection.Results:The LTEVD group had a significantly lower secondary infection rate of catheterization days than the EVD group[2.40‰(1/417)vs.27.19‰(9/331),P=0.009].The duration of catheterization was 14-85 days[27.00(22.50,36.50)days]in the LTEVD group and 8-22 days[9.00(8.00,11.50)days]in the EVD group,suggesting that the LTEVD group had a significantly longer duration of catheterization than the EVD group(P=0.000).The multivariate logistic regression analysis showed that the times of cerebrospinal fluid sampling was an independent risk factor for post-operative intracranial infection in patients undergoing EVD,and the use of LTEVD was a protective factor against intracranial infection after EVD.Conclusion:Compared with conventional EVD,LTEVD can safely prolong the duration of catheterization and reduce the rate of postoperative intracranial infection in patients undergoing EVD.The use of LTEVD procedure and the reduction in the times of cerebrospinal fluid sampling can reduce the risk of postoperative in-tracranial infection.

Objective To investigate the clinical effect of using uninterrupted vacuum sealing drainage combined with routine debridement and pedicled periosteal flap sealing frontal sinusitis in treating frontal sinusitis after craniotomy.Methods The clinical data in 31 cases of frontal sinusitis after craniotomy in our hospital from January 2006 to December 2014 were retrospectively analyzed.Seventeen cases adopted simple debridement and drainage treatment and 14 cases were treated with continuous vacuum sealing drainage combined with routine debridement treatment.Postoperative follow up lasted over 1 year.Results In simple debridement and drainage,12 cases were cured,the other 5 cases recurred after operation,and the cure rate was 70.6 ％.But in the continuous vacuum sealing drainage combined with routine debridement treatment,14 cases were cured,no case recurred after operation,and the cure rate was 100％.Therefore,the cure rate of continuous vacuum sealing drainage treatment combined with routine debridement was higher than that of simple debridement and drainage treatment(P＜0.05).Conclusion Adopting vacuum sealing drainage combined with routine debridement and pedicled periosteal flap sealing frontal sinusitis can promote the infection focus clearance and wound healing,and increases the cure rate.

Objective To explore the relationship of phosphatase and tensin homology deleted on chromosome ten ( PTEN ) expression with the positioning of AMPA recepter subunit GluR2 in hippocampal neuron after stretch injury. Methods The primary rat hippocampal neuron from neonate rats were cultured and the model of stretch injury established. Western blot and TUNEL staining were used to detect PTEN expression and the positioning of AMPA receptor subunit GluR2 in rat hippocampal neuron at different time intervals after stretch injury. Results The PTEN expression was increased obviously after stretch injury, while the expressions of AMPA receptors GluR1, GluR2 and GluR3 showed no evident differences at every time point. However, AMPA receptor subunit GluR2 located at cytomembrane was down-regulated obviously after stretch injury. Conclusion The intracellular PTEN expression and the expression of AMPA receptor subunit GluR2 located at cytomembrane are on the contrary, indicating that PTEN phosphatase may participate in the transport and reintegration process of AMPA receptor subunit GluR2 located at cytomembrane.

Objective To analyse the therapeutic outcome of cavernous sinus meningiomas by gamma knife radiosurgery. Methods Retrospective analysis was conducted of 37 patients with cavernous sinus meningiomas. The median maximum diameter was 2.6 cm (1.4～3.2 cm) with the median dose to the tumor margin of 15.7Gy(8～22 Gy), the isodose curve to the tumor margin of 40%～60% and the target numbers of 1～9. The radiosurgical dose to the optic nerve and brain stem was not more than 10 Gy and 15 Gy, respectively. Results After an average follow up of 22.6 months(ranging 4～43 months), unchanged symptoms were found in 22 cases(59.5%), alleviated in 12 cases(32.4%) and complications of optic and trigeminal nerve in 3 cases(8.1%). By MR image analysis, unchanged size was found in 18 cases(48.6%), smaller size in 15 cases(40.5%) and larger size in 4 cases(10 8%). One factor analysis of variance revealed that tumor recurrence was associated with marginal dosage(

Objective To investigate the treatment effect of gamma knife radiosurgery for hypothalamic hamartomas. Methods Gamma knife radiosurgery was performed in 9 patients with gelastic seizures. Collimator helmets (4 and 8 mm) were used and a radiosurgery plan was designed to cover 90% of the hamartoma at the 40%~55% isodose curve with the center dose of 28~40 Gy and the margin dose of 12~18 Gy. The clinical outcome was evaluated with the Tan’s scale. Results No complications due to gamma knife radiosurgery occurred. A follow-up from 24 to 54 months showed effectiveness in 7 patients, disappearance of seizure in 1 patient, rare occurrence in 3 patients, significantly reduced occurrence in 2 patients, improvement in seizure control in 1 patient, but ineffectiveness in 2 patients. Conclusion As an approach to the treatment of hypothalamic hamartomas, gamma knife is a safe and cost-effective therapy with rare side effects for hypothalamic harmatomas.

Objective　To compare the predictive value of Glasgow coma scale (GCS), revised trauma score (RTS) and acute phsiology and chronic health evaluation (APACHEⅡ) system on head injury prognosis, and selectscoring systems apt to predicting prognosis of the head injury. 　Methods　The data of 116 case of head injury were reviewed. The correlation between the score of GCS, RTS, or APACHEⅡ and the patients' prognosis was determined by Spearman rank relation test on admission. Then, the logistic regression analysis was administered, in which GOS I～Ⅲ in half year were regarded as risk event. The independent predictive varieties were determined from following varieties: GCS, systolic pressure, respiratory rate, age, and chronic health condition. 　Results　GCS, RTS and APACHEⅡ were significantly related with the prognosis (r=0.660,0.676 and -0.578, respectively). GCS and age were independent predictive indexes. 　Conclusions　RTS system doesn't show the superiority to GCS system. The predictive accuracy may improve if GCS system is appropriately combined with APACHEⅡ system.

Objective:　To investigate the effects of nimodipine on changes of endothelin after head injury. 　　Methods:　Sixty-five adult rabbits were randomized into an injury group (IG, n=30), a nimodipine-treatment group (NTG, n=30) and a control group (CG, n=5). With their heads unfixed, the animals in IG and NTG were injured in the frontal-parietal zone with BIM-II bioimpact. Blood samples and brain tissue were collected before and after injury. The endothelin level was measured with RIA. 　　Results:　The endothelin level in plasma and brain tissue was significantly increased 24 hours after injury. At the 8th or/and 24th hours postinjury, the endothelin level was significantly lower in NTG than that in IG. 　　Conclusions:　Nimodipine can prevent endothelin from elevation and act as a practical endothelin antagonist after head injury clinically.