Objective To compare the advantages of robot assisted and DSA guided PBC for the treatment of trigeminal neuralgia.Methods A retrospective clinical analysis was conducted on 85 patients(28 in robot group and 57 in DSA group)who underwent robot assisted and DSA guided PBC surgery in a same center from September 2021 to February 2024.The single puncture success rate,improvement rate of VAS score,clinical efficacy rate,incidence of complications,average surgical time and fluoroscopy time were compared between the two groups.Results There was no statistically significant difference between the two groups in terms of single puncture success rate(96.43% vs.84.21% ),VAS improvement rate[88.9% (77.78%,100.00% )vs.88.89% (55.56%,100.00% )],clinical effective rate(92.86% vs.94.74% ),and total incidence of complications(35.09% vs.42.11% )(P>0.05).The average surgical time was significantly higher in the robot group[38.50(35.00,48.00)min]than the DSA group[19.00(15.00,25.50)min],and the average fluoroscopy time in the robot group[13.00(12.00,15.75)s]was significantly lower than the DSA group[194.00(152.50,259.50)s].The difference in average surgical and fluoroscopy time between the two groups was statistically significant(P<0.05).Conclusion DSA guided surgery has more advantages in centers with a large number of patients and a pursuit of efficiency.The robot assisted surgical puncture process is safe and controllable and patient radiation exposure time is short,thereby having high clinical application and promotion value.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Objective To study the clinical efficacy of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy in treatment of locally advanced nasopharyngeal carcinoma (LA-NPC).Methods 115 patients with LA-NPC in Shanxi Cancer Hospital were randomly assigned to observation group (61 cases) and control group (54 cases) from February 2014 to April 2016.The patients in the observation group were treated with sodium cantharidate and vitamin B6 injection combined with concurrent chemoradiotherapy.The patients in the control group were treated with concurrent chemoradiotherapy.The differences between the two groups were compared in respect of recent curative effect,the quality of life (QOL) and the adverse reactions.Results The recent effective rate was 93.44 ％ (57/61) in the observation group and 79.63 ％ (43/54) in the control group,and there was significant difference between the two groups (x2 =4.818,P =0.049).The improvement rate of QOL was 73.77 ％ (45/61) in the observation group and 53.70 ％ (29/54) in the control group,and there was significant difference between the two groups (x2 =5.028,P =0.032).The incidence rates of oral cavity mucous membrane inflammation,hematology toxicity,pharynx and esophagus adverse reactions,the gastrointestinal tract adverse reactions and skin fibrosis in the observation group were lower than those in the control group,and there were significant differences between the two groups (all P ＜ 0.05).Conclusion The recent effect of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy on the patients with LA-NPC is obvious.The comprehensive treatment can also reduce adverse reactions and improve the QOL.

Objective To compare the effects of standard decompressive craniectomy (DC) vs.combined cisternostomy on severe traumatic brain injury (STBI).Methods Seventy-two patients with severe brain injury were divided into standard decompressive craniectomy group (control group,n=34) and DC combined cisternostomy group (treatment group,n=38).The clinical parameters from pre-and post-surgery were compared between the two groups.Results There was no statistical difference in clinical data including gander,age,injury causes,GSC score,Helsinki CT score and operative opportunity between two groups before surgery (P＞0.05).The treatment group was inferior in the duration of decompression (2.8±0.4 h vs.2.5±0.3 h,P＜0.05) relative to control treatment group.However,treatment group were superior to control group in the mean time of admission in neuro-intensive care unit (5.54±3.09 d vs.7.24±2.74 d,P＜0.01),the cumulative time of intracranial pressure (ICP) more than 20 nmHg within seven days after surgery(23.2±4.4 h vs.56.8±8.3 h,P＜0.01),Helsinki CT scores at postoperative day (3(2,5) vs.5(2,9),P＜ 0.01)and Glasgow Outcome Scores (GOS) at 3 month after surgery (P＜0.01).Conclusion DC combined with cisternostomy for STBI is significantly better than standard decompressive craniectomy,which is worth further study by multicenter clinical trials.

OBJECTIVETo investigate the prevalence of esophageal and gastric cardia cancer and various precancerous lesions in high-risk rural areas.

METHODSRandom cluster sampling method was used to select people aged 40-69 years of some natural villages as screening objects in Feicheng, Shangdong province, from 2006 to 2012. The screening program was conducted by endoscopy with iodine staining and indicative biopsy followed by pathological examination.

RESULTSA total of 24 759 subjects were screened during 2006-2012 years. The positive detection rates of esophagus and gastric cardia cancers were 1.37% and 0.42%, respectively, the early diagnosis rates were 84.71% and 65.05%, and the treatment rates were 92.65% and 92.23%, respectively. The detection rates of all lesions in males were significantly higher than those in females (P < 0.05), and were gradually increased with age (P < 0.05). The time trend analysis showed that detection rates of all lesions in the two sites showed no significant changes during this period, and the detection rates of esophageal lesions were higher than those of gastric cardia.

CONCLUSIONSThere are considerable numbers of patients with precancerous lesions in the general population from the high risk areas. Men and the elderly are the key populations calling for cancer control programs. Endoscopy using iodine staining is an effective method to increase the detection rate of precancerous lesions and cancers. The root of mucosal fold in gastric cardia must be carefully observed so as to increase the detection rate of early gastric cardia lesions.

Adult ; Aged ; Biopsy ; Carcinoma, Squamous Cell ; Cardia ; Coloring Agents ; Early Detection of Cancer ; statistics & numerical data ; Esophageal Neoplasms ; diagnosis ; epidemiology ; Esophagoscopy ; Female ; Gastroscopy ; Humans ; Iodine ; Male ; Middle Aged ; Precancerous Conditions ; diagnosis ; epidemiology ; Prevalence ; Rural Population ; statistics & numerical data ; Sex Distribution ; Stomach Neoplasms ; diagnosis ; epidemiology

Objective To investigate the prevalence of esophageal and gastric cardia cancer and various precancerous lesions in high?risk rural areas. Methods Random cluster sampling method was used to select people aged 40?69 years of some natural villages as screening objects in Feicheng, Shangdong province, from 2006 to 2012. The screening program was conducted by endoscopy with iodine staining and indicative biopsy followed by pathological examination. Results A total of 24 759 subjects were screened during 2006?2012 years. The positive detection rates of esophagus and gastric cardia cancers were 1.37% and 0.42% , respectively, the early diagnosis rates were 84. 71% and 65. 05%, and the treatment rates were 92.65% and 92.23%, respectively. The detection rates of all lesions in males were significantly higher than those in females (P<0.05), and were gradually increased with age(P<0.05). The time trend analysis showed that detection rates of all lesions in the two sites showed no significant changes during this period, and the detection rates of esophageal lesions were higher than those of gastric cardia. Conclusions There are considerable numbers of patients with precancerous lesions in the general population from the high risk areas. Men and the elderly are the key populations calling for cancer control programs.Endoscopy using iodine staining is an effective method to increase the detection rate of precancerous lesions and cancers. The root of mucosal fold in gastric cardia must be carefully observed so as to increase the detection rate of early gastric cardia lesions.

Objective To investigate the prevalence of esophageal and gastric cardia cancer and various precancerous lesions in high?risk rural areas. Methods Random cluster sampling method was used to select people aged 40?69 years of some natural villages as screening objects in Feicheng, Shangdong province, from 2006 to 2012. The screening program was conducted by endoscopy with iodine staining and indicative biopsy followed by pathological examination. Results A total of 24 759 subjects were screened during 2006?2012 years. The positive detection rates of esophagus and gastric cardia cancers were 1.37% and 0.42% , respectively, the early diagnosis rates were 84. 71% and 65. 05%, and the treatment rates were 92.65% and 92.23%, respectively. The detection rates of all lesions in males were significantly higher than those in females (P<0.05), and were gradually increased with age(P<0.05). The time trend analysis showed that detection rates of all lesions in the two sites showed no significant changes during this period, and the detection rates of esophageal lesions were higher than those of gastric cardia. Conclusions There are considerable numbers of patients with precancerous lesions in the general population from the high risk areas. Men and the elderly are the key populations calling for cancer control programs.Endoscopy using iodine staining is an effective method to increase the detection rate of precancerous lesions and cancers. The root of mucosal fold in gastric cardia must be carefully observed so as to increase the detection rate of early gastric cardia lesions.

Objective To explore the significance of surgical resection for the pineal region tumor,the extent of tumor resection,the surgical approaches and treatment measures of hydrocephalus.Methods Twentythree patients diagnosed of pineal region cancer were recruited for this study.Thirteen patients received ventriculo-peritoneal shunt(V-P),during which 7 cases received intraoperative end-plate colostomy.Two of the 13 cases received a second V-P procedure.Another 13 cases received operation by corpus callosum- septum-Dome Room-the third ventricle approach to remove the tumor; Eight cases underwent the tumor resection by suboccipital supratentorial approach (Poppen approach )and 2 cases underwent the tumor resection by the infratentorial cerebellar approach( Krause approach).Results Total tumor resection was performed in 11 cases,subtotal or major total resection in 8 cases and partial resection in 4 cases.Nine cases underwent postoperative radiotherapy alone,8 receiving radiotherapy plus chemotherapy,and 6 cases receiving neither radiotherapy nor chemotherapy.Two cases died during treatment.Conclusion Though it is not practicable to completely remove the germ cell tumor in patients with relatively large tumors,cerebrospinal fluid circulation pathways should be reestablished,including ventriculo-peritoneal shunt,colostomy from the end of the third ventricle to the end plate.If tumors are not too large,they would be easy to be removed.The effects on the surrounding brain tissue would not be much significant.If the connection of Ⅲ,V ventricles were normal,the patient may not need shunt or colostomy.Radiotherapy and chemotherapy can be given to this kind of patients after the surgery.To improve the efficacy,other types of tumors,expecially the benign tumors,should be totally removed.

ObjectiveTo investigate the situation of mother to child transmission of HIV after mothers acquired HIV prenatally or before pregnancy and the related factors. Methods Two hundred and seventy-seven mothers who acquired HIV prenatally or before pregnancy and their 322children from Yi-ning city of Xinjiang Uygur autonomous region and some counties of central China were enrolled in this study from January 2000 to December 2009.Subtypes of HIV were determined by detection of Gag sequence,the rate of HIV transmission from mother to child was calculated and its related factors were analyzed by Chi-square test and Logistic regression analysis.ResultsThe HIV subtype of all mothers who were infected through blood (n=174) was B'.The major subtype of mothers who were infected via sexuality (n =58) was recombined subtype CRF01-BC (n=35) and CRF-AE (n=20),accounting for 60.3％ and 34.5％,respectively,and only 3 mothers with B'subtype (5.2％).Twelve infants died before HIV detection,and 108 infants out of the rest 310infants were found to be HIV positive, giving the HIV mother-to-child transmission rate of 34.8％ (95％ CI:29.5％-40.1％).The infection rate of bottle feeding infants was lower than that of breastfeeding infants [12.5％ (6/48) vs 38.9％ (102/262),x2 =12.484,P=0.000].The infection rate of the infants whose mothers' HIV infection ＜7 years was lower than that of the infants whose mothers' HIV infection ≥7 years [28.8％ (46/160) vs 54.2％ (32/59),x2 =12.211,P=0.000].Multi-factor Logistic analysis showed that the duration of maternal HIV infection (OR =1.342,95％ CI:1.189-1.515,P=0.000) and duration of breastfeeding (OR =1.137,95％ CI:1.053-1.227,P=0.001) were risk factors of HIV vertical transmission.ConclusionsThe HIV subtypes might be associated with transmission route.Formula feeding could decrease the vertical transmission rate of HIV,while long duration of maternal HIV infection and breastfeeding might increase the vertical transmission rate of HIV.