2016年 · 第32卷第08期

Neuroendoscopic surgical technique for ventriculocisternal system diseases refers to the use of neuroendoscopic equipment to observe and operate the lesions during the operation of ventriculocisternal system diseases. This technique can be divided into^[1]: (1) Endoscopic surgery: or endoscopic neurosurgery. The surgical instruments are completed through the working channel of the endoscope, and dual instruments can be operated through dual channels at the same time. The disadvantage is that the operation is not flexible. Endoscopic surgery is mainly used for hydrocephalus, arachnoid cysts, intraparenchymal cystic lesions and some intraventricular solid tumors. (2) Extraendoscopic surgery: or endoscopic controlled surgery. The endoscope plays the role of illumination and image acquisition, and the device operates in the working channel outside the endoscope. After the endoscope is fixed with the support arm, it can be operated with both hands to avoid tumor spread and blood entering the cerebrospinal fluid circulation. (3) Combined endoscopic and external surgery: simultaneous endoscopic and external endoscopic operation channels are used for surgery. (4) Endoscopic combined microsurgery: or endoscopic assisted surgery. Major surgical procedures are performed under the microscope, and areas invisible under the microscope are observed and processed endoscopically, discovering important and hidden structures and residual tumors.

Traumatic skull defects in adults (hereinafter referred to as skull defects) are caused by depressed comminuted skull fracture, open craniocerebral injury, severe closed craniocerebral trauma combined with refractory intracranial hypertension and decompressive craniocraniectomy. In patients with large-scale skull defects, local scalp subsidence due to atmospheric pressure may lead to imbalance of intracranial pressure, brain tissue displacement, decreased blood flow in the cerebral hemisphere and disorder of cerebrospinal fluid circulation, resulting in a series of clinical manifestations, mainly including: headache, dizziness, irritability, epilepsy, unexplainable discomfort and various mental disorders^[1,2,3,4]。 Cranioplasty can not only repair skull defects, restore skull appearance and protective function of patients, but also effectively restore normal cerebrospinal fluid dynamics and cerebral cortical blood perfusion, which is beneficial to reduce intracranial complications and help patients to recover neurological function.

Intracranial arteriovenous malformation (AVM) is a common congenital vascular disease in the cranium. Treatment methods include surgical resection, endovascular embolization and stereotactic radiotherapy. In recent years, with the advancement of embolization materials and technology, embolization with intravascular ethylene-vinyl alcohol copolymer (Onyx) embolization system has become an important treatment for brain AVM^[1]。 Onyx glue is a non-adhesive embolic material, but during cerebral AVM embolization, because the blood supply arteries are mostly slender and tortuous blood vessels, early severe reflux may occur when injected with Onyx glue, resulting in embolization failure, and may lead to difficulty in extracting microcatheter^[2,3,4,5]。 To solve these two problems encountered in brain AVM embolization with Onyx glue, a variety of solutions have been proposed, such as "pressure cooker technique" (PCT)^[6]"reverse plug and push" technology^[7]"over-the-catheter" technique^[8]"Monorail capture technology "(monorail snare technique)^[9]"pull-push-pull" technology^[10]And using a tip-detachable microcatheter^[11]Etc. The "extubation-injection" technology in this study makes full use of the characteristics of Onyx glue casting mass gradually solidifying from outside to inside with the precipitation of solvent dimethyl sulfoxide when entering the blood. When the casting mass is solidified outside and the core is still in liquid state, the whole casting mass can be compressed, and the polymerization force generated during the solidification process slowly "grasps" the microcatheter, thus ensuring that the casting mass and the microcatheter move synchronously. At this time, the microcatheter is slowly pulled back, resulting in the proximal end of the casting mass being compressed into a dense "plug". While ensuring that the tip of the microcatheter does not move, the Onyx glue is slowly injected with maintaining tension, and the injection is stopped when the embolization is satisfactory or the catheter tip is moved out of the Onyx glue casting mold. The application of "extubation-injection" technique can not only control excessive reflux during intracranial AVM embolization with Onyx glue, increase the success rate of single embolization, but also solve the problem of difficult microcatheter extraction. This technique is reported as follows.

The insula lobe is an important structure of the paralimbic system of the brain^[1]。 Insular cortex is an intermediate cortical structure in which old cortex and neocortex are connected. Its formation process undergoes the transition from heterotypic cortex to homotypic cortex^[2,3]。 The insula lobe has abundant neural connections with the whole cerebral cortex and subcortical nucleus, and is a pool area of multiple functions^[4,5]。 The functions of insula mainly include visceral sensory, auxiliary motor, somatosensory, auditory and complex language functions, and coordinate internal and external information from one's own emotional consciousness^[6], plays a balancing role in experiential, emotional, and behavioral activities^[7]。

traumatic brain injury (TBI) is the leading cause of death and disability among young adults worldwide. There are more than 1.7 million new cases of TBI in the United States every year, of which 275,000 require hospitalization and more than 52 000 die^[1]。 China's TBI database shows that the mortality rate of severe TBI patients is 21.8%, and the severe disability rate is 49.9%^[2]。 At present, the diagnosis and prognostic evaluation of TBI mainly rely on the clinical manifestations and imaging examinations of patients. However, the mechanism of TBI injury is intricate, and it is called "the most complex disease of the most complex organ in the human body"^[3]。 Obviously, it is not enough to rely solely on clinical manifestations and imaging examinations. Scholars are dedicated to finding highly specific and sensitive TBI molecular markers, in order to reflect the severity of craniocerebral injury, thus guiding treatment and evaluating prognosis. In this paper, the research progress of TBI-related plasma markers in recent years is reviewed.

Glioma is the most common primary intracranial tumor with the highest fatality rate. Although various comprehensive treatment methods are adopted at present, the prognosis of its patients is still very poor, and the median survival time is only 12~15 months^[1]。 retinoic acid signaling is an important regulatory pathway for cell proliferation, differentiation and apoptosis. The "dual effect" of this pathway in regulating the interchange between division and differentiation of nerve cells is closely related to neural tumors^[2]。 In-depth research on the mechanism of retinoic acid signaling pathway in glioma will be beneficial to the understanding of the molecular mechanism of glioma occurrence, and can also provide new ideas for the treatment of glioma. This article reviews the research progress of retinoic acid signaling pathway in glioma.

Professor Song Jiaren, one of the pioneers of neurosurgery in China, the founder of neurosurgery in Ningxia, the academic leader, and the former president of the Affiliated Hospital of Ningxia Medical College, died at 9: 15 pm on June 20, 2016 in the General Hospital of Ningxia Medical University at the age of 87 due to ineffective treatment.