Objective To investigate the expression and clinical significance of connective tissue growth factor (CTGF) in colorectal cancer. Methods The expressions of CTGF in 62 patients’ colorectal cancer tissues and their corresponding adjacent tissues were detected by SP immunohistochemical method. The results were statistically analyzed. Results The positive rates of CTGF in colorectal cancer and adjacent tissues were 61.3% and 19.4% respectively， and the difference between them was significant (P＜0.05). The expression of CTGF was related to degree of differentiation, depth of infiltration and lymph node metastasis or not (P＜0.05）, namely the lower degree of differentiation, the deeper depth of infiltration and the more lymph node metastasis, the corresponding positive expression rates were lower (P=0.030, P=0.032 and P=0.017 respectively), but correlation with gender was not significant (Pgt;0.05）. Conclusion CTGF may play an important role in the occurrence of colorectal cancer， which contributes a lot to guide clinical treatment and prognosis.
Driven by advances in intelligent technology, artificial intelligence (AI) is emerging as the cornerstone of neurosurgical education. By providing personalized learning experiences and enhancing learning outcomes, AI has enriched the avenues and depth of knowledge acquisition for medical students. The integration of AI not only helps medical students master the basic theories and practical skills of neurosurgery more thoroughly, but also lays a solid foundation for them to provide high-quality and efficient medical services in the future. At the same time, the ability of educators to use intelligent technologies further enhances the interactivity and effectiveness of teaching. In order to further ensure the application of AI in neurosurgery teaching, this article explores the strategic integration of AI in neurosurgical education, emphasizing its critical importance in ensuring that teaching methods evolve with the times.
Objective To observe and explore the effects of adipose-derived stem cells (ADSCs)-hyaluronic acid (HA) composite on heal ing of wound combined with radiation injury. Methods The ADSCs were harvested from the fat tissue in groin of 10 inbred Sprague Dawley (SD) rats and were isolated and cultured by enzyme digestion. The ADSCs-HA composite wasprepared with ADSCs (5 × 106 cells/mL) at passage 6 and HA (10 mg/mL). Thirty inbred SD rats, 15 males and 15 females, were randomly divided into groups A (n=10), B (n=10), and C (n=10). A 2 cm × 2 cm full-thickness skin defect was made on the rat back before 20 Gy 60Co radiation exposure. One week after debridement, wounds were treated by petrolatum gauze in group A as the control group, by HA (0.4 mL) and petrolatum gauze in group B, and by ADSCs-HA composite (0.4 mL) and petrolatum gauze in group C. The microvessel density (MVD) and the distribution of CD90 positive cells were observed at 1st, 2nd, 3rd, and 4th weeks. Results The wound heal ing was slower, and wound did not heal at 4th week and still filled with granulation tissue in group A; the wound heal ing of group B was faster than that of group A, and the wound did not heal completely with depression in the center at 4th week; the wound healed completely with epidermil izated surface and no obvious depression at 4th week in group C. The histological observation showed that MVD was significantly higher in group C than in groups A and B at the 1st, 2nd, and 3rd weeks (P lt; 0.05), and in group B than in group A at the 3rd week (P lt; 0.05); MVD was significantly higher in groups B and C than in group A (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05) at 4th week. No CD90 positive cell was found in groups A and B; CD 90 positive cells were observed in group C and gradually decreased with time. Conclusion ADSCs-HA composite can accelerate heal ing of wound combined with radiation injury by promoting and controll ing wound angiogenesis.
ObjectiveTo investigate the effect of microsurgical therapy and the key techniques in resection of large bilateral olfactory groove meningiomas via unilateral subfrontal approach.MethodsThe clinical data and follow-up results of 181 patients with large bilateral olfactory groove meningiomas who underwent microsurgical removal between June 2007 and May 2014 were retrospectively analyzed. The initial symptom was headache or (and) dizzy in 95 cases, hyposmia or anosmia in 53, impairment of visual function or (and) visual field deficits in 26, cognitive deficits in 3, epilepsy in 2, and accidentally discovered in 2. Unilateral subfrontal approach was applied in all patients (neuroendoscopy was applied in some cases in the later period); incision of falxcerebri, and when necessary, ligation of superior sagittal sinus to resect contralateral tumor were performed. Simultaneous or staged period resection of tumors invading skull base such as ethmoid sinus and superior meatus and reconstruction of the skull base were performed.ResultsThere was no perioperative mortality. Simpson grade Ⅰ resection was obtained in 33 cases, grade Ⅱ resection was in 141, grade Ⅲ resection was in 4, and grade Ⅳ resection was in 3. Among the 229 eyes with preoperative visual impairment, postoperative visual improvement was found in 215 eyes, unimproved was in 12, and aggravation was in 2. The 59 sides which lost their function of olfactory nerve before surgery obtained no recoveries after surgery, while olfactory nerve with residual function preoperative still kept sensing after surgery in 149 lateral sides (149/303). The patients were followed up for (76.9±43.8) months, and postoperative recurrence or residual tumor growth were found in 21 cases.ConclusionsBecause of the contralateral ocular and (or) nasal compensation, early discovery is very difficult for patients with olfactory groove meningioma. The unilateral subfrontal approach can provide sufficient exposure for resection of large bilateral olfactory groove meningiomas and improve the visual acuity and visual field deficits. But it is poor at the preservation of olfactory function. The approach, better with the aid of neuroendoscopy, can improve the total cutting rate, with the advantages of minimally invasion and fewer complications. It is a worthy priority for these tumors.
Objective To investigate the accuracy of preoperative three-dimensional reconstruction of tumor in craniotomy for supratentorial convex brain tumors, and to provide an accurate and safe auxiliary method for craniotomy. Methods Patients with supratentorial convexity brain tumors who were admitted to the Department of Neurosurgery, West China Hospital, Yibin Hospital, Sichuan University between April 2018 and November 2020 were prospectively enrolled and randomly divided into reconstruction group and control group. In the reconstruction group, preoperative three-dimensional reconstruction of the tumor was used for craniotomy positioning, while in the control group, traditional two-dimensional tomographic imaging was used. The basic conditions, intraoperative localization and tumor exposure satisfaction rate, maximum diameter of bone window, operation time, cerebral draining vein injury, and postoperative subcutaneous effusion or intracranial infection were compared between the two groups. Results A total of 43 patients were included, 22 in the reconstruction group and 21 in the control group. There was no significant differences in age, gender composition, incidence of midline shift, tumor growth site and tumor size between the two groups (P>0.05). There was no significant difference in the incidence of cerebral drainage vein injury and postoperative subcutaneous effusion or intracranial infection between the two groups (P>0.05). The satisfaction rate of intraoperative positioning and tumor exposure in the reconstruction group (95.5% vs. 66.7%) was higher than that in the control group, the maximum diameter of the bone window [(6.26±1.32) vs. (7.31±1.13) cm] and the operation time [(194.00±22.76) vs. (214.57±26.53) min] were lower than the control group, and the differences were statistically significant (P<0.05). Conclusions Preoperative three-dimensional reconstruction helps to locate the tumor more accurately, improves the satisfaction rate of tumor exposure, reduces the diameter of the craniotomy window, and shortens the operation time. Compared with traditional two-dimensional tomographic positioning, it has more advantages.
ObjectiveTo explore the effectiveness of keystone flap in repairing skin and soft tissue defects around joint.MethodsBetween March 2013 and December 2017, 10 patients of skin and soft tissue defects around the joint were repaired with keystone flaps. There were 6 males and 4 females. The age ranged from 17 to 72 years, with an average age of 57.5 years. The skin and soft tissue defects located around the joints, including 2 cases of hip joints, 4 cases of knee joints, 3 cases of elbow joints, and 1 case of wrist joint. The cause of skin and soft tissue defects included scar contracture in 3 cases, basal cell carcinoma in 3 cases, squamous-cell carcinoma in 3 cases, and dermatofibrosarcoma protuberant in 1 case. The area of defects ranged from 4 cm×3 cm to 11 cm×11 cm. The keystone flap was designed beside the wound, and the V-shaped flap was designed at the longer side of the fan-shaped flap. The area of flap ranged from 7 cm×3 cm to 35 cm×10 cm. The flap was constantly compressed by vacuum assisted closure after operation for 3-6 days.ResultsPrimary wound healing was achieved and the flaps survived. All patients were followed up 6-24 months (mean, 15 months). The texture and color of flap was similar to the adjacent area. The appearance and function of joint were satisfactory.ConclusionThe keystone flap is a feasible and efficient way to repair the wound around joint. Furthermore, the skin color and texture is similar to the surrounding tissue after healing.
ObjectiveTo explore the clinical features and prognostic factors of diffuse brain stem glioma in children. MethodsA retrospective analysis was conducted on pediatric diffuse brain stem glioma diagnosed by pathology in West China Hospital of Sichuan University between January 2016 and May 2019. The demographic data, clinical manifestations, MRI findings, pathological results, and treatment were included in the prognosis study.ResultsA total of 39 cases of pediatric diffuse brain stem glioma confirmed by pathology were enrolled, including 21 males and 18 females aged between 3 and 14 years with an average of (8.1±2.8) years and mostly between 5 and 10 years (29 cases). The mean maximum diameter of gliomas was (4.46±0.81) cm. Among the 39 cases, there were 15 cases complicated with hydrocephalus and 16 cases whose tumors completely surrounded the basilar artery. The median survival time was 6 months. The one-year survival rate was 15.4%, and the two-year survival rate was 5.1%. Univariate analyses showed that the tumor enhancement and completely enclosed basilar artery had significant impact on the prognosis (P<0.05). Multiple Cox regression analysis showed that whether the basilar artery was completely wrapped was related to the prognosis [hazard ratio=4.596, 95% confidence interval (1.839, 11.488), P=0.001]. ConclusionsPediatric diffuse brain stem gliomas are common in children aged 5-10 years with poor prognosis. Whether the tumor completely surrounds the basilar artery is closely related to the short overall survival time.