Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage.

The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventricular hemorrhage (IVH) were explored and compared. From Jan. 2015 to Dec. 2016, the clinical data of 42 cases of IVH were retrospectively analyzed, including 18 patients undergoing endoscopic hematoma evacuation (group A), and 24 patients receiving EVD (group B). The hematoma clearance rate was calculated by 3D Slicer software, and complications and outcomes were compared between the two groups. There were no significant differences in age, sex and Graeb score between groups A and B (P>0.05). The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05). The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27 min, respectively (P<0.05). The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A, and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05). The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05). The GOS scores at 6 months after surgery were 3.83±1.12 in group A, and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate, fewer complications and better outcomes in the treatment of severe IVH, indicating it is a safe, effective and promising approach for severe IVH.

[Comparison of four surgical procedures for the treatment of varicocele].

Objective: To compare the clinical effects of inguinal varicocelectomy, Palomo varicocelectomy,laparoscopic varicocelectomy, and microscopic varicocelectomy in the treatment of varicocele. Methods: We retrospectively analyzed the pre- and post-operative clinical data about 318 cases of varicocele,108 treated by inguinal varicocelectomy,84 by Palomo varicocelectomy,68 by laparoscopic varicocelectomy, and 58 by microscopic varicocelectomy. We compared the operation time, hospital stay, pre- and post-operative sperm concentration and progressive motility, incidence of complications, rate of recurrence, and rate of sperm quality improvement among the four groups. Results: The operation times for the inguinal, Palomo, laparoscopic, and microscopic varicocelectomy procedures were(50. 3 ± 13. 9),(70. 4 ± 14. 3),(35. 1 ± 11. 1),and(65. 3 ± 13. 2) min, respectively, significantly shorter for the laparoscopic strategy than for the other three( P < 0. 05). The lengths of hospital stay of the four groups of patients were(6. 3 ± 1. 6),(5. 7 ± 1. 5),(4. 3 ± 1. 4),and(3. 4 ± 1. 3) d, respectively, remarkably shorter in the microscopic group than in the other three( P < 0. 05). The microscopic group also showed a significantly lower rate of postoperative complications, incidence of spermatic vein reflux, and recurrence( P < 0. 05) and higher rates of improvement in postoperative sperm concentration and progressive motility than the other three groups( P < 0. 05). Conclusion: Microscopic varicocelectomy is superior to inguinal,Palomo and laparoscopic varicocelectomy procedures in the treatment of varicocele for its lower incidence of complications, higher rate of sperm quality improvement,and shorter length of hospital stay. It is therefore more suitable to be applied in community hospitals.

Negative correlation of Nogo-A with the malignancy of oligodendroglial tumor.

OBJECTIVE: Nogo-A is an axon regeneration inhibitor, and its function in central nervous system (CNS) is still unknown. The present study is to explore the relationship between the expression of Nogo-A and the malignancy of oligodendroglial tumors in patients. METHODS: Tumor tissue samples with different malignancy grade were obtained from the hospitals. The samples used for detection had been diagnosed as oligodendroglial tumors (oligodendroglioma or anaplastic oligodendroglioma). The expression of Nogo-A was detected by immunohistochemistry and western-blot analysis. The correlation test between the Nogo-A expression and the morphological changes (the percentages of atypical cells and mitotic cells in the tumors) related to the malignancy of tumor tissues was performed. RESULTS: There was significant negative correlation between the Nogo-A expression and the morphological change of tumor tissues according to immunohistochemistry. Western-blot analysis also indicated that the gray value of Nogo-A protein band in the oligodendroglioma group was significantly higher than that in the anaplastic oligodendroglioma group. CONCLUSION: Nogo-A expression was negatively correlated with the malignancy grade of oligodendroglial tumors.