Surgical treatment of brain tumor coexisted with intracranial aneurysm—case series and review of the literature

Coexistence of brain tumor and intracranial aneurysm was previously considered as an uncommon phenomenon. Actually it is not rare in neurosurgical procedures, and its incidence rate may be underestimated. Furthermore, there remains a lack of consensus regarding numerous aspects of its clinical management. We performed a retrospective study of 12 cases of coexistent brain tumor and intracranial aneurysm in our database. Then a systematic PubMed search of English-language literature published between 1970 and 2012 was carried out using the keywords: “brain tumor” and “intracranial aneurysm” in combination with “associate” or “coexist.” A consensus panel of neurosurgeons, anesthetists, interventional neurologists, and intensivests reviewed this information and proposed a treatment strategy. In the majority of patients, clinical symptoms were caused by tumor growth, whereas aneurysm rupture was seen only in a few cases. Meningioma was the commonest tumor associated with aneurysm. In most patients, both lesions occurred within the adjacent area. Treatment of both pathologies in one session was performed in most patients. All of our patients were alive within the period of follow-up. Coexistence of brain tumor and intracranial aneurysm may be a coincidence. The treatment strategy should be designed according to the conditions of tumor and aneurysm, locations of both lesions, and pathologic nature of tumor.     

Impact of Adjuvant Radiotherapy on Survival after Pancreatic Cancer Resection: An Appraisal of Data from the National Cancer Data Base

Purpose

The impact of adjuvant radiotherapy for pancreatic adenocarcinoma (PAC) remains controversial. We examined effects of adjuvant therapy on overall survival (OS) in PAC, using the National Cancer Data Base (NCDB).

Methods

Patients with resected PAC from 1998 to 2002 were queried from the NCDB. Factors associated with receipt of adjuvant chemotherapy (ChemoOnly) versus adjuvant chemoradiotherapy (ChemoRad) versus no adjuvant treatment (NoAdjuvant) were assessed. Cox proportional hazard modeling was used to examine effect of adjuvant therapy type on OS. Propensity scores (PS) were developed for each treatment arm and used to produce matched samples for analysis to minimize selection bias.

Results

From 1998 to 2002, a total of 11,526 patients underwent resection of PAC. Of these, 1,029 (8.9 %) received ChemoOnly, 5,292 (45.9 %) received ChemoRad, and 5,205 (45.2 %) received NoAdjuvant. On univariate analysis, factors associated with improved OS included: younger age, higher income, higher facility volume, lower tumor stage and grade, negative margins and nodes, and absence of adjuvant therapy. On multivariate analysis with matched PS, factors independently associated with improved OS included: younger age, higher income, higher facility volume, later year of diagnosis, smaller tumor size, lower tumor stage, and negative tumor margins and nodes. ChemoRad had the best OS (hazard ratio 0.70, 95 % confidence interval 0.61–0.80) in a PS matched comparison with ChemoOnly (hazard ratio 1.04, 95 % confidence interval 0.93–1.18) and NoAdjuvant (index).

Conclusions

Adjuvant chemotherapy with radiotherapy is associated with improved OS after PAC resection in a large population from the NCDB. On the basis of these analyses, radiotherapy should be a part of adjuvant therapy for PAC.     

胶质瘤干细胞研究进展

随着对肿瘤干细胞（tumor stem cells）理论的深入认识和分离、培养肿瘤干细胞实验技术的不断进步,胶质瘤内肿瘤干细胞的存在已经有较多的证据和研究。这方面的研究不仅有助于深化人们对胶质瘤发生、复发和侵袭机制的认识,更重要的是可能改变以往胶质瘤的治疗策略,影响十分深远。新近,有学者将来自胶质瘤的肿瘤干细胞或具有干细胞特性的胶质瘤细胞称为“胶质瘤干细胞（glioma stem cells,GSC）”,较好地反映了这类细胞的特性。     

70岁以上住院老年慢性病病人抑郁和焦虑的调查

随着医学科学技术的飞速发展和人民物质精神生活水平的日益提高，我国人口的平均预期寿命不断增长，现已接近70岁。据统计：目前我国老年病人口（我国以60岁以上为老年病人）总数已近I．3亿，约占总人口数的10．09％，而75岁以上老年病人以每年平均3．62％的速度增长，预测到2025年将上升到20％，2050年将达到顶峰25．5％。老年人是慢性病的主要患病人群。因此，本研究针对70岁以上患慢性病的住院普通老年人和住院离休干部进行调查，采用Brink老年抑郁量表（GDS）、Zung焦虑自评量表（SAS），以了解住院老年人中存在的焦虑、抑郁情况以及分析两组病人的性别、年龄、文化程度、婚姻状况、个人习惯和经济收入情况。现将结果报道如下。[第一段]     

289 例特殊患者用药咨询调查分析

目的促进医院药房药师针对特殊人群的用药咨询工作质量。方法选择医院门诊289例特殊人员（孕妇、老人、未成年人监护人）用药咨询记录进行调查。结果与结论做好药房门诊的特殊患者用药咨询工作,可帮助患者提高合理、正确用药知识,从正确用药、减少误服和超量用药、不规范用药等方面起到辅助医疗作用。     

Clinical observation on hearing conditions of centenarians in northern district of China

Conclusion: The hearing conditions of the centenarians were quite poor as regards hearing thresholds and speech detection ability. Objective: To investigate hearing conditions of centenarians. Methods: A total of 54 centenarians in Rizhao and Linyi Districts in Shandong Province were investigated to assess hearing conditions of centenerians comprehensively by questionnaire investigation, pure-tone audiometry, acoustic immitance, intelligence evaluation, and speech detection scores. Also, 135 individuals were recruited as controls and divided into four groups according to their age: 45–59 years, 60–69 years, 70–79 years, and 80–89 years. Results: The hearing thresholds of the centenarians were dramatically higher than those of the control group (p < 0.05) and all centenarians suffered moderate to profound hearing loss according to the World Health Organization (WHO) criteria. Few centenarians had normal level of speech detection scores. All centenarians showed descending hearing curve, and the hearing threshold of the male centenarians at 8000 Hz was higher than that of the females (p = 0.047). There was a significant air–bone conduction gap in the centenarians (p < 0.05).     

18F-FDG PET/CT in lung adenosquamous carcinoma and its correlation with clinicopathological features and prognosis

Annals of Nuclear Medicine - Lung adenosquamous carcinoma (ASC) is a rare histological subtype of non-small cell lung cancer (NSCLC). Due to its rarity, the studies about 18F-FDG PET/CT in this...