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Objective:To study the correlations of cerebrospinal fluid (CSF) routines and biochemical indexes before ventriculoperitoneal shunt with postoperative intracranial infection in adult patients with hydrocephalus.Methods:A retrospective case-control study was conducted on 347 adult patients who underwent ventriculoperitoneal shunt in Department of Functional Neurosurgery, Neurosurgery Center, Zhujiang Hospital of Southern Medical University from January 2016 to December 2021. According to the appearance of postoperative infection or not, these patients were divided into infection group ( n=27) and non-infection group ( n=320). General clinical data and CSF routines and biochemical indexes test results were analyzed and compared between the two groups. The correlations of postoperative intracranial infection with preoperative levels of white blood cells, chlorine, glucose, lactic acids and proteins in the CSF were analyzed by multivariate Logistic regression. Results:There was no significant difference in age, gender, or primary diseases between infection group and non-infection group ( P>0.05). As compared with the non-infection group, the infection group had significantly decreased glucose content and significantly increased lactic acid content in the CSF ( P<0.05). Multivariate Logistic regression analysis showed that glucose content ( OR=21.825, 95%CI: 4.994-95.394, P<0.001) and lactic acid content ( OR=18.430, 95%CI: 6.023-56.391, P<0.001) were independently correlated with infections after ventriculoperitoneal shunt. Risk of patients with glucose content<2.5 to develop intracranial infection after surgery was 21.825 times that of patients with preoperative glucose content≥2.5 mmol/L. Risk of patients with lactic acid content>2.5 mmol/L to develop intracranial infection after surgery was 18.430 times that of patients with preoperative lactic acid content≤2.5 mmol/L. Conclusion:For adult hydrocephalus patients without intracranial infection but only with abnormal CSF (glucose content<2.5 mmol/L or lactic acid content>2.5 mmol/L), ventriculoperitoneal shunt should only be performed after further improvement of CSF indexes to avoid increasing postoperative infection.
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Diffusion tensor imaging (DTI) is a neuroimaging technique which provides exquisite details on tissue microstructure. DTI also plays an important role in 3D reconstruction and visualization of white matter tracts and providing information about the relationship between these tracts and the tumor mass. DTI can not only guide neurosurgeons to optimize the actual surgical procedures and avoid injures to intact, functioning tracts, but also can improve the total rate resection of tumor. At the same time, it can also assist in preoperative risk assessment and postoperative functional assessment. This review is classified by different tractographies involved in brain tumors; it summarizes the advantages and disadvantages of DTI in the last decade. Therefore, this review provides new research methods and evidence for the future complex intracranial tumor treatment.
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Objective:To observe the clinical characteristics of pressure regulation frequency of shunt pump in patients with hydrocephalus after ventriculoperitoneal shunt, and explore the correlation between frequencies of shunt pump and prognoses of these patients.Methods:One hundred and one patients underwent ventriculoperitoneal shunt in our hospital from January 2018 to December 2018 were selected. According to the frequencies of postoperative pressure regulation of these patients, they were divided into non-pressure regulation group, low-frequency pressure regulation group (1-2 times) and high-frequency pressure regulation group (2 times or more). The relations of high-pressure hydrocephalus/normal pressure hydrocephalus with pressure regulation frequency, and relation between causes of pressure regulation and pressure regulation frequency were compared, and the prognoses of patients with different pressure regulation frequencies were analyzed.Results:Among the 101 patients with implanted adjustable pressure shunt, 34 had no pressure regulation after surgery, 52 had low-frequency pressure regulation, and 15 had high-frequency pressure regulation. The percentages of patients accepted low-frequency pressure regulation and high-frequency pressure regulation in patients with high-pressure hydrocephalus were significantly higher than those with normal pressure hydrocephalus ( P<0.05). The proportions of patients with insufficient shunt, excessive shunt or magnetic field interference in the low-frequency pressure regulation group were significantly higher than those in the high-frequency pressure regulation group ( P<0.05), while the proportions of patients with abnormal shunt (stagger of insufficient shunt, excessive shunt) in the low-frequency pressure regulation group were significantly lower than those in the high-frequency pressure regulation group ( P<0.05). There were 7 patients with poor curative effect, including 4 patients from the low-frequency pressure regulation group and 3 from the high-frequency pressure regulation group. The prognoses of patients with different pressure regulation frequencies were statistically different( P<0.05), the good prognosis rate of patients in the non-pressure regulation group, low-frequency pressure regulation group and high-frequency pressure regulation group decreased successively. Conclusion:About 66.3% patients need pressure regulation treatment again after hydrocephalus-ventriculoperitoneal shunt; the rate of poor efficacy in patients accepted high-frequency pressure regulation is obviously higher than that in patients accepted low-frequency pressure regulation, which needs clinical attention.
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Objective To observe the trend of temperature changes after ventriculoperitoneal shunt and its relation with postoperative infection.Methods A retrospective cohort study was conducted on 272 patients underwent ventriculoperitoneal shunt in our hospital from January 2015 to December 2018.Patients were divided into infected group and non-infected group according to whether intracranial infection occurred after surgery.According to the occurring time of postoperative intracranial infection,patients were divided into early infection group and delayed infection group.Temperature levels of all patients were monitored on the surgery day,and on the first,yd,5th and 7th d of surgery,and the temperature changes and fever rate of the two groups were compared.Results Among 272 patients,intracranial infection occurred in 25 (9.19％),including 21 with early infection and 4 with delayed infection,and un-infection in 247 (90.81％).As compared with those in the non-infected group,the fever rate and body temperature of the infected group were significantly higher on the 3rd,5th and 7th d after surgery (P＜0.05).There was no significant difference in fever rate and body temperature changes between the early infection group and the delayed infection group on the surgery day and on the first,3rd,5th and 7th d of surgery (P＞0.05).Conclusions The fever rate is higher and the body temperature decreases faster after ventriculoperitoneal shunt.The fever since the third d of surgery is closely related to postoperative intracranial infection,which has a certain predictive significance for postoperative infection,so we should consider anti-infection treatment in time.
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Objective To investigate the effects of long non-coding RNA (SNHG1) on the autophagy and growth of human neuroblastoma cell line SH-SY5Y and their specific mechanism using a cell model of Parkinson's disease.Methods (1) After SH-SY5Y cells were cultured in vitro,the expression levels of autophagy-related proteins LC3-Ⅱ/LC3-Ⅰ and p62 were detected by Western Blotting at different time points and subjected to treatment with different dosages of 1-methyl-4-phenyl-pyridine (MPP+).The survival rate of SH-SY5Y was detected by MTT assay.(2) The expression of SNHG1 was detected by real-time quantitative PCR after SH-SY5Y treated with different concentrations of MPP+ for different time durations.(3) The expression of endogenous SNHG1 in SHSY5Y was down-regulated by specific siRNA;the expression levels ofautophagy-related proteins LC3-Ⅱ/LC3-Ⅰ and p62 were detected by Western Blotting after MPP+ treatment while the survival rate of SH-SY5Y was detected by MTT.Moreover,SH-SY5Y cells were treated with autophagy late inhibitor bafilomycin A1 (BafA1) and autophagy inducer to further clarify the role of SNHG1.(4) The expression of p27 was detected by Western blotting after treated with different concentrations of MPP+ for different time durations.In addition,after the expression of SNHG1 in SHSY5Y was down-regulated,the expression of p27 was detected by Western blotting.Results (1) The expression of LC3-Ⅱ in SH-SY5Y was significantly increased in a dose-and time-dependent manner and the expression of p62 was significantly decreased (P＜0.05).MTT results showed that MPP+ (2.5 mmol/L) significantly reduced the survival rate of SH-SY5Y (P＜0.05).(2) Compared with the control group,the expression of SNHG1 was significantly increased in SH-SY5Y cells treated with MPP+ in a dose-and time-dependent manner (P＜0.5).(3) When SNHG1 down-regulated,the expression of LC3-Ⅱ induced by MPP+ was inhibited while the expression of p62 increased (P＜0.05).In addition,when treated with Baf A 1 at the same time,the expression of LC3-Ⅱ was increased,suggesting that SNHG1 might mainly affect the autophagosome formation of SH-SY5Y.The survival rate of SH-SY5Y cells was significantly increased after SNHG1 was down-regulated,and the cell viability was further inhibited by SH-SY5Y treated with rapamycin,suggesting that SNHG1 inhibited the growth of SH-SY5Y cells through promoting the autophagy formation.(4) The expression of p27 was significantly increased in SH-SY5Y cells treated with MPP+ in a dose-and time-dependent manner (P＜0.05).Down-regulation of SNHG1 expression inhibited the expression of p27,suggesting that SNHG1 might promote the autophagy and growth of SH-SY5Y cells through the p27 signal pathway.Conclusions SNHG1 can induce the autophagy of SH-SY5Y cells and promote death of the cells,which may be related to the regulation of p27 expression.
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Objective To investigate the displacement characteristics of intraoperative and postoperative positions of electrodes on CT imaging for bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) in Parkinson's disease (PD).Methods A retrospective analysis on preoperative MR imaging,intraoperative and postoperative CT images of 35 patients with PD treated with STN-DBS in our hospital from January 2014 to June 2018 was performed.A three-dimensional coordinate system was established based on preoperative MR imaging.MR imaging/CT fusion technique was used to fuse intraoperative and postoperative CT images with preoperative MR imaging to locate intraoperative and postoperative electrode positions.The displacement characteristics of intraoperative and postoperative electrodes were analyzed.Results The spatial distance between intraoperative and postoperative positions of bilateral electrodes was about 1 mm,and the depth displacement was minimal.The postoperative position of the first side electrode on lateral axis was shifted outwardly from intraopemtive position,and the second side electrode was shifted internally with a small degree;on anterior-posterior axis,the first side electrode obviously shifted backward,and the second side electrode slightly shifted backward.For bilateral electrodes,corresponding coordinate deviation of three axis between intraoperative electrode-preoperative target and postoperative electrode-preoperative target,showed a significant positive linear correlation,therefore,leading out the coordinate deviation regression function model.Conclusions The displacement of electrodes between intraoperative and postoperative positions has obvious rules after STN-DBS in PD,which can guide the adjustment of intraoperative electrode position and predict the postoperative position of electrode.
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Objective To investigate the role of micro RNA-124 (miR-124) in regulating activation of microglias and secretion of pro-inflammation cytokines and its potential mechanism.Methods (1) BV-2 cells were exposed to different concentration oflipopolysaccharide (LPS) for different durations;relative expression level of miR-124 was detected by real time-quantitative PCR (RT-qPCR).(2) The BV-2 cells were divided into four groups:PBS group,LPS group,LPS+ctrl-simulant group and LPS+miR-124 simulant group.Protein and mRNA expressions of inflammatory factors (tumor necrosis factor [TNF]-α and interleukin [IL] 1-β) were evaluated by RT-qPCR and ELISA.Expressions of p38α,phosphorylated (p)-p38α,ERK and p-ERK were detected by Western blotting.(3) Besides the above groups,four groups were added:LPS+VX702 group,LPS+miR-124 inhibitor group,LPS+VX702+miR-124 simulant group and LPS+VX702+miR-124 inhibitor group;pretreatment with p38α specific inhibitor VX702 was given to the BV-2 cells,the latter two groups were given miR-124 simulant or miR-124 inhibitor,and LPS was used to activate the cells;the expressions of TNF-α and IL-1β were evaluated by ELISA.Results (1) As compared with control group,miR-124 was significantly down-regulated in LPS-stimulated BV-2 cells (P＜0.05),in a dose-and time-dependent manner.(2) As compared with cells in the LPS+ctrl-simulant group,cells in the LPS+miR-124 simulant group had significantly decreased TNF-α and IL-lβ mRNA and protein expressions,and p38α and p-p38α levels (P＜0.05);the ERK and p-ERK levels showed no significant difference between the two groups (P＞0.05).(3) The TNF-α and IL-1β levels between LPS+VX702 group and LPS+VX702+miR-124 simulant group were not significantly different (P＞0.05);those between the LPS+VX702+miR-124 inhibitor group and the LPS+VX702 group were not significantly different (P＞0.05).Conclusion The miR-124 is down-regulated in LPS-activated BV-2 cells and miR-124 could suppress the secretion of pro-inflammatory mediators by targeting to p38α.
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Objective The inadvertent lateral ventricle puncture is still a problem in subthalamic nucleus deep brain stimulation (STN-DBS) surgery,to which a solution is found in this study with a better choice of electrode angle in STN-DBS by reconstruction of the lateral ventricle and STN.Methods Forty patients with Parkinson's disease,admitted to our hospital from January 2009 to December 2015,were chosen in our study.According to the MRI data of the patients,the lateral ventricle and STN were reconstructed with mimics software;Evans indexes were measured,and the volume of lateral ventricle was reconstructed.Different lateral ventricle and STN planes were captured by using different Ring angles (50-60°,n=11),and the Slide angles of these planes were measured.The patients were divided into two groups according to their age:Group A (60-79-year-old) and Group B (40-59-year-old);their volume of lateral ventricle was measured and compared between the two groups;the correlation between age and volume of lateral ventricle was analyzed;the difference of electrode angle was compared between the two groups and the right and left side of the same group;according to the Evans indexes,these patients were then divided into three groups,the Slide angle and Ring angles were measured and the different angles between left and right brain and among the Evans groups were analyzed so as to give a recommended angle in the STN-DBS.Results Age was positively related to the volume of lateral ventricle,and left one and right volume of lateral ventricle (Pearson correlation index:0.364,0.384 and 0.362),which had statistical significance (P＜0.05).No significant difference on electrode angle was noted between group A and B of different Ring angles (P＞0.05),while significant difference was noted on right and left electrode angle between the two groups (P＜0.05).Positive correlations were noted between volume of lateral ventricle and both Evans indexes and electrode angle,and difference was noted on electrode angle in different Evans indexes groups (P＜0.05).The recommended angle was listed according to the difference of side and Evans' index.Conclusions Age is positively related to volume of lateral ventricle,however,the correlation between age and angle is not clear.Considering the difference of sides and Evans' index,we make a list of Ring and Slide angles as recommendation for deep brain stimulation.
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OBJECTIVE@#To explore the impact of upper airway expansion surgery on the blood pressure of hypertension patients with upper airway obstruction.@*METHOD@#Clinical data of 45 cases of hypertension patients with nasal obstruction who were underwent upper airway expansion surgery. The morning sitting blood pressure of patients were recorded. All of the patients were underwent nasal expansion surgery and 11 cases with obstructive sleep apnea hypopnea syndrome were combined with H-uvulopalatopharyngoplasty.@*RESULT@#Blood pressure of all 45 cases were apparently reduced in 12 months after the operations [systolic blood pressure (157.38 +/- 15.15) mmHg to (132.18 +/- 8.43) mmHg, diastolic blood pressure (95.42 +/- 9.28) mmHg to (82.31 +/- 5.88)mmHg], in which 9 cases with type I hypertension were lowered to normal pressure. Results had statistical difference between pre-operation and post-operation (P < 0.01).@*CONCLUSION@#Upper airway expansion surgery (including nasal and pharynx cav ity) can help lower blood pressure of hypertensive patients with nasal obstruction. Post-operative results were better than H-uvulopalatopharyngoplasty only.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Blood Pressure , Physiology , Hypertension , Otorhinolaryngologic Surgical Procedures , Sleep Apnea, Obstructive , General SurgeryРеферат
OBJECTIVE@#To explore the influence of hypoxemia on the hearing of children with childhood obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#Auditory brainstem response (ABR) and distortion-product otoacoustic emission (DPOAE) was recorded in 68 ears and 60 ears respectively of children suffering from OSAHS with "A" tympanogram. Meanwhile, ABR and DPOAE was also recorded in 30 controls of children with "A" tympanogram.@*RESULT@#There was no statistical difference between the mild OSAHS group and the control group in the latency of wave I, III and V, the interval between wave I and III, III and V, I and V. There was significant difference between the moderate and severe OSAHS group and the control group in the delayed latency of wave I. There was significant difference between the mild OSAHS group and the control group in the amplitudes of DPOAE at 8 kHz. There was significant difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz.@*CONCLUSION@#Cochlear function was affected when AHI > or = 10/h. ABR and DPOAE could be used to detect the early damagement of auditory function in childhood OSAHS.
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Evoked Potentials, Auditory, Brain Stem , Otoacoustic Emissions, Spontaneous , Sleep Apnea, ObstructiveРеферат
OBJECTIVE@#To explore the correlation between childhood obstructive sleep apnea-hypopnea syndrome and tympanogram.@*METHOD@#A prospective clinical study was carried out. Polysomnography and tympanogram were analyzed in 72 cases.@*RESULT@#Among the 144 ears 37 ears had type C or B tympanogram. There was no correlation between tympanogram and LSaO2. It was found correlation between tympanogram and AHI (P < 0.05).@*CONCLUSION@#Hypoxemia may affect middle-ear function. It was necessary to do the examination of acoustic impedance routinely in children with moderate and severe OSAHS.