胚胎发育不良性神经上皮肿瘤MRI诊断

目的探讨胚胎发育不良性神经上皮肿瘤（DNT）MRI影像学特征及诊断价值。方法回顾性分析经病理证实为DNT的3例患者平扫及强化MR资料。结果 2例表现为稍长T1,1例表现为等T1信号,2例为长T2信号,1例为等T2信号;3例压水像均呈稍高信号,无强化,无占位效应。结论 DNT具有一定特征性的MRI影像学表现,对早期诊断有一定的价值。     

皮层脑电监测在胚胎发育不良性神经上皮肿瘤术中的应用

目的探讨胚胎发育不良性神经上皮肿瘤（DNT）术中应用皮层脑电监测（ECoG）对术后癫痫控制率的影响。方法回顾5年来本院收治的10例DNT患者,全部患者以癫痫为主要表现并全部接受手术治疗,6例患者术中应用皮层脑电监测,全部患者术后长期随访。结果应用术中皮层脑电监测的6例患者,随访期内未出现癫痫复发的表现,4例未应用术中皮层脑电监测的患者,有3例术后出现不同程度的癫痫复发。结论术中应用皮层脑电监测对于控制DNT患者术后癫痫复发有积极作用。     

胚胎发育不良性神经上皮瘤诊断与治疗

目的探讨胚胎发育不良性神经上皮瘤(DNT)的临床特点、病理、治疗和预后。方法对我院收治的6例DNT就其诊断、影像学、病理、治疗等进行分析。结果4例行肿瘤切除,2例行颞叶切除。术后4例无癫痫发作,2例较术前癫痫发作减少。结论DNT是一种良性病变,手术切除效果良好,无需放疗。     

胚胎发育不良性神经上皮瘤的MRI表现

目的：分析胚胎发育不良性神经上皮瘤的MRI影像学特征,以提高对本病MRI征象的认识。方法对2007年1月-2013年12月15例经手术病理证实的胚胎发育不良性神经上皮瘤患者的临床和影像学资料进行回顾性分析。结果15例患者中,男11例,女4例,多数具有癫痫病史;病灶位于颞叶6例,额叶4例,顶叶3例,枕叶2例;和脑白质相比肿瘤T1WI呈低信号,T2WI呈高信号,DWI呈稍低信号,T2WI-FLAIR可见高信号环;增强扫描：病灶实性部分无强化或轻度强化;磁共振波谱（MRS）：符合良性肿瘤波谱特征,表现为NAA峰轻度降低,Cho峰正常。结论胚胎发育不良性神经上皮瘤的MRI表现具有一定的特征性,MRI多方位成像可对肿瘤明确定位,并有助于定性诊断。     

胚胎发育不良性神经上皮肿瘤2例影像分析

胚胎发育不良性神经上皮肿瘤(Dysembryoplastic neuro-epithelial tumor,DNET或DNT)是一种罕见的神经系统良性肿瘤,属于混合性神经元-神经胶质肿瘤.该病少见,国内外报道不多.现将2005～2008年经病理证实的2例DNET进行回顾分析,以加强并提高对该病的认识.     

侵入椎管的纵隔神经源性肿瘤的外科治疗

例 1,男 ,59岁。双下肢胀疼并乏力 2月。查体 :Ｔ8以下感觉减退 ,右下肢图形感、温度感差 ,右下肢肌力减退 ,病理征 ( - )。胸片、ＣＴ片、ＭＲＩ片显示 :Ｔ10～ 11右侧椎弓根模糊、椎体轻度楔形变 ,椎间孔增大 ,椎旁 5ｃｍ× 4ｃｍ软组织影 ,肿块延伸入椎管内为哑铃状 ,硬脊模囊被压向左侧 ,诊断为侵入椎管的神经源性肿瘤。采用椎旁正中切口完整切除肿瘤 ,病检为神经鞘瘤。术后 1周症状改善 ,3周消失 ,随访 2ａ情况良好。例 2 ,女 ,4 2岁。因乳房包块摄片发现椎旁肿块收住 ,无症状体征。胸片、ＣＴ片、ＭＲＩ片显示 :Ｔ8左侧 4ｃｍ× 3 5ｃ…     

69例纵隔神经源性肿瘤的外科治疗

我科1972年至今27年间收治纵隔神经源性肿瘤69例,经手术治疗取得良好效果,现报告于后。临床资料　本组69例中男42例、女27例,年龄以25～40岁者多。位于后上纵隔39例、其中胸腔顶部至颈部5例,后下纵隔24例,胸腔内4例,肋间神经干1例,前上纵隔1例。病理类型:神经纤维瘤28例,神经鞘瘤29例,神经节细胞瘤8例,恶性神经鞘瘤4例。临床上多无症状,常是体检或其它疾病摄片发现。本组19例有胸闷、胸背部不适,胸痛干咳3例,双上肢麻木1例,下肢麻木、肌力减退1例,上腔静脉压迫1例。胸片、ＣＴ片、ＭＲＩ片显示多为园形和类园形影像,3例可见病变侵入椎管,3例…     

卵巢上皮性肿瘤临床病理表现

目的探讨卵巢上皮性肿瘤的临床病理分析。方法选取临床40例卵巢上皮性肿瘤临床资料进行分析。结果Ⅰ期32例,Ⅱ期6例,Ⅲ期2例。结论卵巢上皮性肿瘤是最常见的卵巢肿瘤,大致上分为良性、交界性和恶性。     

E-cadherin在消化道上皮性肿瘤的检测及意义

上皮型钙粘蛋白（E-cadherin）是钙粘附蛋白分子家族中跨膜蛋白亚型一种，是钙依赖性同种上皮亲和粘附分子，在维持正常上皮完整性和极性中发挥重要作用。     

神经上皮肿瘤端粒酶活性及其相关基因的表达

目的研究神经上皮肿瘤的端粒酶活性及其相关基因TRF1、TRF2、TP1、hTERT的表达。方法改良TRAP法检测65例神经上皮肿瘤的端粒酶活性,免疫组化法检测TRF1、TRF2、TP1、hTERT的表达。结果神经上皮肿瘤端粒酶阳性率为61．54％,Ⅰ、Ⅱ、Ⅲ及Ⅳ级肿瘤的端粒酶活性分别为39．0TPG、74．0TPG、171．1TPG和255．2TPG。TP1、hTERT和肿瘤恶性度呈正相关;TRF1、TRF2和肿瘤恶性度呈负相关。结论端粒酶活性及hTERT和神经上皮肿瘤恶性度密切相关;hTERT是端粒酶活性水平调节的关键。     

直肠胃肠道间质瘤的外科治疗

目的：探讨直肠胃肠道间质瘤（gastrointestinal stromal tumor,GIST）外科治疗的疗效及安全性。方法回顾性分析本院2006年1月~2011年1月收治的44例直肠GIST患者的临床资料,观察治疗效果及预后。结果根治手术组的手术时间、住院时间长于姑息手术组,术中出血量多于姑息手术组,住院费用、并发症发生率率高于姑息手术组（P＜0.05）;两组的复发转移率、生存率差异无统计学意义（P＞0.05）。结论根治性、姑息性手术的转归相似,而姑息性手术具有更好的安全性,是保证患者预后及生存质量的较佳选择。     

纵隔肿瘤51例外科治疗分析

目的总结纵隔肿瘤的诊断及外科治疗经验。方法回顾性分析我院2003年1月-2008年1月51例纵隔肿瘤患者的临床资料及外科治疗方法。结果51例患者中,手术完整切除47例,其中2例连同肺叶切除,开胸探查活检4例。手术切除率92．2％（47／51）。49例痊愈出院,1例并发脊液胸腔漏经治疗好转出院,1例术后死于呼吸衰竭。死亡率1．96％。结论根据病史及影像学检查结合肿瘤好发部位是诊断纵隔肿瘤的主要方法。对于纵隔肿瘤一旦诊断,有手术指征者应尽早手术,选择合适的手术切口,尽量完整的切除瘤体,根据病理选择合适的术后治疗,可以提高治愈率。     

脑干肿瘤的显微手术治疗

目的探讨脑干肿瘤手术治疗的适应证、手术技巧及临床疗效。方法回顾性分析2007年3月至2010年3月期间在我院行显微手术治疗的17例脑干肿瘤患者的临床资料。结果 17例患者显微镜下全切除11例,次全切除4例,部分切除2例,均为星形胶质细胞瘤。术后症状明显改善13例,变化不明显2例,加重1例,死亡1例,死亡原因为术后1d脑干水肿致呼吸循环衰竭死亡。结论 MRI为脑干肿瘤诊断的首选检查方法。手术适应证和手术入路的正确选择,精准的术中操作,积极预防和处理术后并发症是提高脑干肿瘤治疗效果的关键。     

膀胱肿瘤二次电切术的手术配合

目的 探讨手术室护士在高危浅表性膀胱肿瘤患者行二次电切术中的配合技巧.方法 收集我院2010年2月至2012年4月中首次经尿道膀胱肿瘤电切术后病理诊断为非肌层侵润性膀胱尿路上皮癌的33例高危浅表膀胱肿瘤患者在首次电切术后第4周进行的二次电切术的资料,对患者进行术前访视,术中正确的配合.结果 所有患者手术顺利,情绪稳定,无并发症.结论 有效的术前访视能减轻患者再手术顾虑,术中熟练配合是手术成功的保证.     

Current strategies for targeted delivery of bio-active drug molecules in the treatment of brain tumor

Brain tumor is one of the most challenging diseases to treat. The major obstacle in the specific drug delivery to brain is blood–brain barrier (BBB). Mostly available anti-cancer drugs are large hydrophobic molecules which have limited permeability via BBB. Therefore, it is clear that the protective barriers confining the passage of the foreign particles into the brain are the main impediment for the brain drug delivery. Hence, the major challenge in drug development and delivery for the neurological diseases is to design non-invasive nanocarrier systems that can assist controlled and targeted drug delivery to the specific regions of the brain. In this review article, our major focus to treat brain tumor by study numerous strategies includes intracerebral implants, BBB disruption, intraventricular infusion, convection-enhanced delivery, intra-arterial drug delivery, intrathecal drug delivery, injection, catheters, pumps, microdialysis, RNA interference, antisense therapy, gene therapy, monoclonal/cationic antibodies conjugate, endogenous transporters, lipophilic analogues, prodrugs, efflux transporters, direct conjugation of antitumor drugs, direct targeting of liposomes, nanoparticles, solid–lipid nanoparticles, polymeric micelles, dendrimers and albumin-based drug carriers.     

Cell cycle inhibition by sodium arsenite in primary embryonic rat midbrain neuroepithelial cells.

Arsenite (As3+) exposure during development has been associated with neural tube defects and other structural malformations, and with behavioral alterations including altered locomotor activity and operant learning. The molecular mechanisms underlying these effects are uncertain. Because arsenic can cross the placenta and accumulate in the developing neuroepithelium, we examined cell cycling effects of sodium arsenite (As3+ 0, 0.5, 1, 2, and 4 microM) on embryonic primary rat midbrain (gestational day [GD] 12) neuroepithelial cells over 48 h. There was a concentration- and time-dependent As3+-induced reduction in cell viability assessed by neutral red dye uptake assay but minimal apoptosis at concentrations below 4 microM. Morphologically, apoptosis was not apparent until 4 microM at 24 h, which was demonstrated by a marginal but statistically significant increase in cleaved caspase-3/7 activity. Cell cycling effects over several rounds of replication were determined by continuous 5-bromo-2'-deoxyuridine (BrdU) labeling and bivariate flow cytometric Hoechst-Propidium Iodide analysis. We observed a time- and concentration-dependent inhibition of cell cycle progression as early as 12 h after exposure (> or =0.5 microM). In addition, data demonstrated a concentration-dependent increase in cytostasis within all cell cycle phases, a decreased proportion of cells able to reach the second cell cycle, and a reduced cell cycle entry from gap 1 phase (G1). The proportion of affected cells and the severity of the cell cycle perturbation, which ranged from a decreased transition probability to complete cytostasis in all cell cycle phases, were also found to be concentration-dependent. Together, these data support a role for perturbed cell cycle progression in As3+ mediated neurodevelopmental toxicity.     

Monitoring radiographic brain tumor progression

Determining radiographic progression in primary malignant brain tumors has posed a significant challenge to the neuroncology community. Glioblastoma multiforme (GBM, WHO Grade IV) through its inherent heterogeneous enhancement, growth patterns, and irregular nature has been difficult to assess for progression. Our ability to detect tumor progression radiographically remains inadequate. Despite the advanced imaging techniques, detecting tumor progression continues to be a clinical challenge. Here we review the different criteria used to detect tumor progression, and highlight the inherent challenges with detection of progression.     

脑转移瘤的CT诊断

目的　通过CT增强扫描研究脑转移瘤的CT表现特征 ,为临床提供治疗依据。方法　 136例脑转移瘤患者 ,扫描采用层厚、层距各 10mm ,必要时加薄用 3mm或 5mm。单纯平扫 8例 ,平扫加增强 2 4例 ,直接增强10 4例。增强扫描用 6 0 %泛影葡胺 6 0～ 80ml或优维显 5 0ml,静脉推注。结果　共检出病灶 4 11个。脑转移瘤典型CT表现为 :好发于灰白质交界大脑中动脉供血区 ;多发或单发圆形、类圆形强化结节 ;壁厚薄不均之环形病灶 ;病灶周多有不同程度的水肿带。原发瘤中以腺癌多见占 5 8 2 % ,脑转移瘤中一般无钙化。结论　CT增强扫描能清晰显示转移瘤的部位、数目、大小、形态、边缘状况和密度变化 ,是脑转移瘤首选的检查方法