Microsurgery for sellar region lesions via frontolateral approach / 中华神经医学杂志

Objective To investigate the feasibility and effect of frontolateral approach in microsurgical treatment of sellar region lesions. Methods Twenty-eighty patients with sellar region lesions,admitted to our hospital from January 2009 to December 2011,were treated with microsurgery via frontolateral approach; a retrospective analysis of their clinical data was conducted. In these 28 patients,8 had meningiomas ofsellar tuberculum and anterior clinoidal process,5 pituitary tumors,3 craniopharyngiomas, 1 cholesteatoma, 6 anterior communicafing artery aneurysms and 5 posterior communicating artery aneurysms. Results The total removal was achieved in 12 of the 17 patients with sellar region tumors,and subtotal removal in 5.Six patients with anterior communicating artery aneurysm and 5 with posterior communicating artery aneurysm were successfully clipped.No death or severely disabled case were noted. Conclusion The microsurgery via frontolateral approach can fully expose the sellar region lesions and proper treatment can be given, which is minimally invasive and enjoys satisfactory result.

Analysis of the factors contributing to diabetes insipidus after surgeries for craniopharyngiomas / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the factors contributing to the occurrence of diabetes insipidus after operations for craniopharyngiomas.</p><p><b>METHODS</b>A total of 121 cases of diabetes insipidus following surgeries for craniopharyngiomas were retrospectively analyzed and the factors associated with postoperative diabetes insipidus were analyzed.</p><p><b>RESULTS</b>The incidence of diabetes insipidus was 27.3% (33/121 cases) before the operation, 89.9% (107/1119) early after the operation and 39.8%(37/93) in later stages after the operation. The occurrence of early postoperative diabetes insipidus showed a significant relation to the classification and calcification of the craniopharyngioma. Patients with supradiaphragmatic and extraventricular tumors had the lowest incidence of postoperative diabetes insipidus. Late postoperative diabetes insipidus was closely correlated to such factors as age, classification of craniopharyngioma, and intraoperative treatment of the pituitary stalk, but not to the scope of tumor resection or tumor calcification. Late diabetes insipidus was more frequent in children and patients with severed pituitary stalk. The incidence of late postoperative diabetes insipidus was significantly higher in patients with supradiaphragmatic and extra-intraventricular tumors than in those with tumors beneath the diaphragma sellae and extraventricular tumors.</p><p><b>CONCLUSIONS</b>Postoperative diabetes insipidus following surgeries for craniopharyngiomas is closely related to the tumor classification, calcification and pituitary stalk protection.</p>

Effects of comprehensive preventive measures on incidence and prognosis of post-traumatic cerebral infarction in adults / 中华神经医学杂志

Objective To retrospectively analyze the effect of combined preventive measures on the incidence and prognosis of post-traumatic cerebral infarction (PTCI) in adults. Methods All the adult patients admitted with moderate or severe head injury since the May 2003 were treated by comprehensive preventive methods such as using less hemostatics, ensuring cerebral perfusion, taking surgical procedure timely to relieve cerebral herniation, scavenging the blood clots in subarachnoid space, improving cerebral circulation, et al. Comparative analysis was conducted on the incidence and prognosis of PTCI occurred in patients with moderate or severe head injury between 1999-2007 in our department. All the patients were divided into two groups: traditional group (1999-2003) and preventive group (2003-2007). Results PTCI occurred in 29 cases of traditional group and the incidence rate was 6.90%. 7 cases died. In the 15 follow-up cases: 4 in vegetative state, 5 severe neurological deficit, 4 moderate neurological deficit, and 2 good recovery. PTCI occurred in 17 cases of preventive group and the incidence rate was 3.02%. 2 cases died. In the 14 follow-up cases: 1 in vegetative state, 4 severe neurological deficit, 3 moderate neurological deficit, and 6 good recovery. Statistical analysis showed significant difference in both the incidence rate and the long-term prognosis of PTCI between the two groups. Conclusion The occurrence of PTCI have multi-influential factors and often results in worse consequence. Taking preventive measures at the very beginning after head injury will help reduce the incidence of PTCI and improve the prognosis.

Growth of craniopharyngioma involving the third ventricular floor in relation to the hypothalamus / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the growth of craniopharyngioma involving the third ventricular floor with regard to the hypothalamus by detecting expressions of leukocyte common antigen (CD45) and intercellular adhesion molecule (ICAM-1) in the tumor tissue.</p><p><b>METHODS</b>The expressions of CD45 and ICAM-1 proteins in 30 craniopharyngioma samples with third ventricular floor involvement were detected by SP immunohistochemistry.</p><p><b>RESULTS</b>The inflammations labeled by CD45 were identified commonly in the craniopharyngioma tissues involving the third ventricular floor. The expression of ICAM-1 was mainly in the inner tumor cells and interstitial cells, but not detected in the basilar tumor cells growing toward the third ventricular floor. Adamantinomatous craniopharyngiomas showed markedly higher CD45 and ICAM-1 expressions than squamous papillary tumors (P<0.05).</p><p><b>CONCLUSION</b>Inflammatory adhesion largely characterizes the growth of the craniopharyngioma tissues involving the third ventricular floor toward the hypothalamus without the tendency of invasion. The difference in the inflammation between the two types of craniopharyngioma may affect the prognosis of the patients.</p>

Effects of jingui shenqi pill combined prednisone on expression of glucocorticoid receptor and its clinical effect in treating bullous pemphigoid patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Jingui Shenqi Pill (JSP) on the expression of glucocorticoid receptor (GR) in the skin lesion and its clinical effect in treating bullous pemphigoid (BP) patients.</p><p><b>METHODS</b>Thirty BP patients were randomly divided into the treatment group (n=15) treated with JSP plus prednisone and the prednisone group (n=15) with prednisone alone both for 4 weeks. And a normal control group was set up also. Expressions of GR-alpha and GR-beta in the skin lesion of BP patients and the normal skin of the normal control were detected by immunohistochemical assay. Results The total effective rate was 93.33% in the treatment group, significantly higher than that in the prednisone group which was 73.33% (P < 0.05); GR-alpha expression was higher in the treatment group than that in other two groups (P < 0.01), while GR-beta expression in the treatment group was lower than that in the prednisone group (P < 0.01).</p><p><b>CONCLUSION</b>JSP could increase GR-alpha expression and decrease GR-beta expression in the skin lesion of BP patients, so as to improve sensitivity of skin to glucocorticoid.</p>

Surgical treatment of the tumors of posterior part of third ventricle and pineal region / 军事医学科学院院刊

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.