Epilepsy is one of the most common neurological disorders, and surgical intervention is usually used for drug-resistant focal epilepsy. Cortical electrical stimulation is widely used in preoperative evaluation of epilepsy to explore the anatomical-clinical electrical correlations between epileptogenic and functional networks through electrical stimulation, and the functional brain maps produced by cortical electrical stimulation depict areas of the functional cortex at an individual level, identifying the functional cortex with greater precision, as well as helping to establish epilepsy network, enabling more precise localization of seizure zones and providing a more accurate localization for surgical resection. Electrical cortical stimulation has become a standard technique for the preoperative assessment of brain region function in brain surgery. It is an indispensable part of preoperative evaluation.The main types of functional mapping by electrical stimulation include stereoelectroencephalography (SEEG) and subdural electrode (SDE), SEEG-guided cortical electrical stimulation is gradually becoming more mainstream compared to subdural electrodes, and is increasingly valuable and important as a preoperative evaluation of epilepsy. It is increasingly demonstrating its value and importance because it avoids craniotomy, takes less time for surgery, has fewer associated complications and infections, and can explore deep lesions, increasing the understanding of human functional neuroanatomy and enabling more precise localization of seizure zones.This article reviews the history of the development of cortical electrical stimulation technology, the intrinsic mechanisms, the value of the application of SEEG, and also provides a comprehensive comparison between SEEG and SDE, despite the irreplaceable advantages of SEEG, attention should be paid to the unresolved clinical and scientific issues of SEEG, and the establishment of a consensus-based clinical guideline, as the application of this technology will be more widely used in both clinical and scientific work.
Objective To evaluate the safety and necessity of shortening the time of preoperative fasting and fluid limitation in lumber disc herniation patients undergoing minimally invasive surgery. Methods A total of 141 eligible patients were assigned into the control group (n=70) and the intervention group (n=71) between April and September 2015. The control group received traditional fasting method while the intervention group received new preoperative fasting method. The time of fasting food and fluid limitation, the incidences of hunger, thirsty, aspiration, postoperative nausea and vomiting, postoperative abdominal distension, and length of stay and the subjective feeling in hospital were compared between the two groups. Results The average time of preoperative fasting and fluid limitation were (13.09±2.30) and (7.84±2.10) hours in the control group and (6.88±0.96) and (4.68±1.08) hours in the intervention group. The incidence of thirsty in the intervention group was shorter than that in the control group, and the subjective feeling in hospital of the intervention group was better than that in the control group (P<0.05). There were no significant differences in the incidence of postoperative nausea and vomiting, the incidence of postoperative abdominal distension, and length of hospital stay between the two groups (P>0.05). Conclusions Shortening the time of preoperative fasting and fluid limitation can improve the subjective feeling in hospital of lumber disc herniation patients undergoing minimally invasive surgery, not increasing the incidences of complications. It can be applied gradually.
ObjectiveTo clarify the effectiveness of preoperative pulmonary rehabilitation (PPR) and provide evidence for the application of PPR on lung cancer patients by meta-analysis.MethodsAccording to inclusion and exclusion criteria, literatures related to PPR on lung cancer patients were retrieved from major databases between the date of establishment of each database and January 2019, and then data required were extracted from the selected literatures. Meta-analysis was conducted by RevMan 5.0.ResultsTwelve randomized controlled trials were involved in meta-analysis, including 658 patients who were well-diagnosed and prepared for surgery, with 307 patients in the PPR group and 351 patients in the control group. The results of the meta-analysis showed that in the PPR group, the pulmonary function including forced vital capacity [MD=0.31, 95%CI (0.21, 0.42), P<0.01], forced expiratory volume in one second [MD=0.27, 95%CI (0.20, 0.34), P<0.01] and activity tolerance including 6-minute walk distance [MD=50.55, 95%CI (35.98, 65.13), P<0.01] were significantly better than the control group, and the postoperative complication rate was lower ［MD=0.28, 95%CI (0.18, 0.43), P<0.01］, postoperative hospital stay was shorter [MD=–2.09, 95%CI (–2.41, –1.77), P<0.01].ConclusionsA period of PPR on lung cancer patients can improve postoperative pulmonary function and activity tolerance, and reduce postoperative complications and hospital stay, which is beneficial to postoperative recovery.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.
42 cases of hyperthyroidism had been operated from 1990-1993.In the preoperative treatment,antithyroid drugs were used togather with thyroxine.Some advantages have been observed,which are better than drugs were used togather with thyroxine.Some advantages have been observed,which are better than thoes of the usual preoperative preparaton.①Patient can be prepared to a complete euthyroid state.②The vascularity of the gland can be reduced to a least degree so that the operative risk of bleeding is will small.③The serum thyroid hormone will not be raised,therefore no thyroid crisis occurs.
ObjectiveTo discuss the role of imatinib preoperative chemotherapy in treatment of advanced gastrointestinal stromal tumor(GIST). MethodThe related literatures about imatinib preoperative chemotherapy for GIST were reviewed. ResultsImatinib preoperative chemotherapy is an effective treatment for advanced GIST, which significantly improve the resection rate and prolong the overall survival time for patients with advanced GIST. ConclusionsPreoperative imatinib treatment has good effect for metastatic or locally advanced GIST. It should be individualized by gene type of the GIST, which is deserved to be further studied.
ObjectiveTo study the preoperative evaluation value of serum tumor markers (CA72-4, CEA, CA199 and CA125) in patients with gastric cancer. MethodsSerum levels of tumor markers (CA72-4, CEA, CA199 and CA125) and clinical pathological data of 70 patients with gastric cancer before operation who underwent surgical treatment in the Gastrointestinal Surgery Department of Second Affiliated Hospital of Kunming Medical University in June 2013 to 2014 June were retrospectively analyzed. ResultsThere were some connection between the concentration of the serum CA72-4 and the tumor diameter, TNM staging, invasion depth, and the number of lymph node metastasis (P < 0.05), between CA199 and tumor size, TNM staging, and invasion depth (P < 0.05), between CEA, CA125 and tumor diameter, TNM staging and distant metastasis (P < 0.05), but the CA72-4, CA72-4, CEA and CA125 had nothing to do with patient' age and gender. ConclusionThe serum tumor markers of CA724, CEA, CA199, and CA125 have clinical application value in preoperative evaluation of gastric cancer.
ObjectiveTo investigate the negative emotions of patients before cardiac surgery in West China Hospital in order to analyze the related factors.MethodsThe Huaxi emotional-distress index (HEI), a screening tool for mood disorders developed by the Mental Health Center of West China Hospital, was used for preoperative psychological evaluation of 1 968 adult patients hospitalized in cardiac surgery from March 2016 to July 2014. There were 835 males and 1 133 females at age of 49±13 years.Results Fifty-one patients (2.6%) had negative emotions, among whom 6 patients were screened for suicide risk. After intervention, none of them had serious consequences caused by adverse emotions, such as automatic discharge from hospital, avoidance of surgery and suicide.ConclusionThis study found that most of the cardiac surgery patients in West China Hospital have good psychological status before surgery, and a few suffered from negative emotions. “Huaxi emotional-distress index” is simple, effective and worth promoting.
The effects of preoperative selective arterial perfusion chemotherapy (PSAPC) in the treatment of 20 cases of histologically confirmed gastric cancers is reported in which 12 patients were operated on, and a comparison with that of general chemotherapy in 10 cases of gastric cancers (as controls) was made. In the PSAPC group, besides the improvement of clinical symptoms and singns, the cancer cells of lesions in situ and metastatic lymph nodes have different degrees of degeneration and necrosis. This result show significant differences in two group comparison (Plt;O.01). We conclude that the PSAPC has good short-term effect and little side-effect. It can improve the resection rate and radical resection rate, and prevent the iatrogenic metastasis and implantation during operation, and decrease the postoperative recurrence of the patients with gastric cancer.
ObjectiveTo evaluate the possible role of the expression of insulin-like growth factor-1 receptor (IGF-1R) in determining rectal cancer radiosensitivity. MethodsThe paired preradiation biopsy specimens and postoperative specimens were obtained from 87 patients with rectal cancer in the department of digestive tumor surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2009 to December 2010. The IGF-1R expression was examined by immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR). The tumor radiosensitivity was defined according to Rectal Cancer Regression Grade, then the relation between the IGF-1R expression and tumor radiosensitivity was evaluated. ResultsCompared with the preradiation biopsy specimens, IGF-1R expression significantly increased in the paired postoperative specimens of the residual cancer cells (Plt;0.001). The IHC result demonstrated IGF-1R overexpression was significantly associated with a poor response to radiotherapy (rs=0.401, Plt;0.001); RT-PCR detection of IGF-1R expression on preradiation biopsy specimens also showed that IGF-1R mRNA negative patients had a higher radiation sensitivity (rs=0.497, Plt;0.001). ConclusionDetection of IGF-1R expression may predict radiosensitivity of preoperative irradiation for rectal cancer.