Objective:To explore the risk factors affecting death and functional recovery in patients with primary brainstem hemorrhage (PBH).Methods:A retrospective analysis of the patients with brain stem hemorrhage admitted by Neurosurgery Department of Beijing Chao-yang Hospital, Capital Medical University from January 2016 to November 2021 was made. The general data, neurological signs at admission, laboratory tests, hematoma volume and treatment methods of the patients were collected, and the patients were divided into survival group and death group according to their survival status 30 d after the onset of the disease. From follow up to 90 d after onset, patients were divided into good prognosis group (mRS score 0-2) and poor prognosis group (mRS score 3-5) based on the modified Rankin scale (mRS) score. Risk factors for 30 d death and 90 d inability to take care of themselves in patients with PBH were analyzed and screened.Results:A total of 36 patients with PBH were included, 30 patients (83.3%) received conservative treatment, and 6 cases (16.7%) underwent surgical treatment, including 23 patients in the survival group (63.9%) and 13 patients in the death group (36.1%). From follow up to 90 d after onset, there were 14 cases in good prognosis group and 9 cases in poor prognosis group. The results of univariate analysis showed that there was a statistically significant difference in heart rate, GCS score, and mechanical ventilation between the survival group and the death group (P<0.05); there were statistically significant differences in GCS scores, bilateral light reflex disappearance, mechanical ventilation, absolute values of white blood cell, hematoma volume >5 mL, and hematoma breaking into the ventricle between the good prognosis group and the poor prognosis group (P<0.05). Multivariate Logistic regression analysis showed that GCS score ≤8 (OR=15.893, 95%CI: 1.528-165.323, P=0.021) was a risk factor for death in patients with PBH.Conclusion:Deep coma upon admission is an important risk factor for death and poor prognosis in patients with PBH.

Objective:To evaluate the safty and effect of the treatment of middle meningeal artery (MMA) embolization combined with hematoma drainage on chronic subdural hematoma (CSDH).Methods:From July 2019 to Feburary 2021, forty CSDH patients received surgical treatment in Beijing Chaoyang Hospital, Capital Medical University. Thirty five of them recived hematoma drainage. Five patients recieved MMA embolization, and if necessary, extra hematoma drainage. Selective branches of MMA embolizations was performed by Onyx. After embolization, the hematoma drainage was perfomed immediately if obvious mass effect or midline shift was confirmed on computer tomography (CT) scan. Hematoma volume resorption, recurrence and complications associated with treatment was observed during follow up.Results:One hundred persent of the operations were successful. Hematoma volume reduced in all the patients and no recurrence and complication that related to the treatment was seen during the follow up. Thirty-five patients received hematoma drainage. The average follow up time was (8.1 ± 3.7) weeks, two recurrences (5.7%) were seen during follow up. Five CSDH patients received a total of 7 MMA embolizations. Four of the 5 patients were primary CSDH, one of the 5 patients was recurrent. A total of 3 patients underwent unilateral interventions and 2 of them underwent bilateral interventions. The median follow up time was (19.0 ± 7.0) weeks.Conclusions:Method of MMA embolization combined with hematoma drainage was safe and effective in treating CSDH, and futher result to be expected.

Infection remains the most significant complication of ventriculoperitoneal shunt (VPS) surgery. The objective of this study was to investigate intracranial infections complicating VPS surgery in adults with hydrocephalus. Patients who underwent VPS surgery for hydrocephalus between 2000 and 2016 were included. Clinical data and follow‐up evaluations were examined and analysed retrospectively. A total of 502 patients with hydrocephalus who underwent VPS surgery were included. They were followed up for at least 2 years. Twelve patients with incomplete data were excluded. Four hundred and ninety patients were included in the final analysis. Twenty‐five cases of intracranial infection occurred, accounting for 5.1% of patients with VPS surgery. The mean age of the patients was 57.1 ± 10.1 years (range, 39–72 years). The incidence of intracranial infection in patients over 60 years of age was higher than that in patients under 60 years of age (P = .007). Age (P = .007), diabetes (P = .026), skin infection (P = .028), bed‐ridden (P = .007), and modified operation (P = .011) were highly correlated with the incidence of intracranial infection. The findings of this retrospective study show that age, diabetes, skin infection, bed‐ridden, and modified operation of hydrocephalus significantly and independently correlated with the incidence of infection. Prospective studies are needed to assess the relationship between the incidence of infection and risk factors in patients with hydrocephalus after VPS.

Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.

OBJECTIVE:To assess the effect of intensive insulin therapy (IIT) for preventing postoperative infection in patients with traumatic brain injury (TBI).METHODS:In total, 88 patients with TBI were randomly divided into 2 groups, 44 in each group. One group (group ITT) received IIT and the other group (group CIT) received conventional insulin therapy (CIT). This study was conducted between February 2013 and January 2016. Outcomes included infection rate, mortality, and neurological outcome (measured by the Glasgow Outcome Scale [GOS]).RESULTS:A total of 81 patients completed the study. IIT showed greater efficacy than CIT, with a decreased infection rate in the IIT group compared to the CIT group (31.9% vs 52.3%, P = 0.03), and also a reduced duration of stay in intensive care unit (ICU) (IIT group, 4.5 ± 2.1 days vs CIT group, 5.7 ± 2.8 days, P = 0.02). In addition, a significant difference in scores on the GOS scale was observed between the 2 groups (P = 0.04). The mortality rates in hospital and at the 26-week follow-up were similar between the 2 groups.CONCLUSION:IIT leads to a reduced infection rate, shorter stays in ICU, and improved neurological outcome.

Previous studies have suggested that there is a disproportionally higher risk of infection following traumatic brain injury (TBI). This predisposition to infection may be driven by a poorly understood, brain-specific response in the immune system after TBI. However, there is a lack of studies that have fully characterized TBI patients to understand the relationship between TBI and peripheral immune function. In the present study, markers for humoral immunity and cellular immunity were measured for up to 2 weeks in the peripheral blood of 37 patients with TBI in order to elucidate the time course and the type of the peripheral immune response following TBI. 12 relatively healthy individuals without TBI and other neurological diseases were enrolled into the control group. Our data indicated that TBI could induce significant changes in humoral immunity characterized by a decrease in IgG and IgM levels and an increase in the complements C3 and C4 levels in comparison with the control group. Moreover, compared with the control group, a significant reduction in peripheral blood CD3+ and CD3+CD4+ lymphocyte counts occurred early (days 1-3) following the onset of trauma. These results provide evidence that TBI is associated with substantial changes in humoral immunity and cellular immunity, which may explain the high incidence of infection encountered in these patients.

Recently, several randomized controlled trials (RCT) investigating the effectiveness of decompressive craniectomy in the context of neurocritical illnesses have been completed. Thus, a meta-analysis to update the current evidence regarding the effects of decompressive craniectomy is necessary. We searched PUBMED, EMBASE and the Cochrane Central Register of Controlled Trials. Other sources, including internet-based clinical trial registries and grey literature, were also searched. After searching the literature, two investigators independently performed literature screening, assessing the quality of the included trials and extracting the data. The outcome measures included the composite outcome of death or dependence and the risk of death. Ten RCT were included: seven RCT were on malignant middle cerebral artery infarction (MCAI) and three were on severe traumatic brain injury (TBI). Decompressive craniectomy significantly reduced the risk of death for patients suffering malignant MCAI (risk ratio [RR] 0.46, 95% confidence interval [CI]: 0.36-0.59, P<0.00001) in comparison with no reduction in the risk of death for patients with severe TBI (RR: 0.83, 95% CI: 0.48-1.42, P=0.49). However, there was no significant difference in the composite risk of death or dependence at the final follow-up between the decompressive craniectomy group and the conservative treatment group for either malignant MCAI or severe TBI. The present meta-analysis indicates that decompressive craniectomy can significantly reduce the risk of death for patients with malignant MCAI, although no evidence demonstrates that decompressive craniectomy is associated with a reduced risk of death or dependence for TBI patients.

Objective To investigate the rebleeding risk after cerebral hemorrhage surgery for oral administration of aspirin and the development of treatment decision.Methods A total of 306 patients with intracerebral hemorrhage surgery with a history of oral administration of aspirin at the Department of Neurosurgery,Beijing Chaoyang Hospital,Capital Medical University from January 2009 to December 2014 were analyzed retrospectively.The influencing factors of postoperative rebleeding were analyzed by using a case-control study.Preoperative thrombelastography (TEG) was used to examine the arachidonic acid (AA) pathway induced platelet inhibition rate,and the inhibition rate ≥ 75％ was used as the criterion of postponing emergency surgery.The postoperative rebleeding risk differences between the different treatment regimens and between the different surgical procedures were compared.Results The postoperative rebleeding rate of the inhibition rate ≥75％ group was 26.9％,the delayed surgery group was 4.1％ (OR,8.566,95％ CI 2.279-32.190;P =0.001).The rebleeding rate of the inhibition rate ＜ 75％ group was 7.6％ (OR,1.923,95％ CI 0.594-6.224;P =0.275);the inhibition rate ≥75％ group compared with the inhibition rate ＜75％ group (OR,4.455,95％ CI 1.539-12.891;P =0.006).The emergency craniotomy group compared with the delayed surgery group,the rebleeding rate was 15.9％ (OR,4.399,95％ CI 1.215-15.919;P=0.024).Conclusions The platelet inhibition rate ≥75％ induced by AA pathway can be used as a predictor for the high risk of postoperative rebleeding in patients with cerebral hemorrhage for oral administration of aspirin.The surgical methods and treatment choice can be chosen reasonably according to the own experiences and technological advantages of surgeons

Objectives: To investigate the risk factors, clinical presentation, neuroimaging features, treatment, and prognosis of patients with cerebral venous sinus thrombosis (CVST). Methods: We retrospectively analyzed the data of 19 patients with a diagnosis of CVST admitted to Beijing Chao-Yang Hospital affiliated to Capital Medical University, Beijing, China between January 2010 and December 2013. Results: There were 9 men and 10 women (age range: 27-75 years). Headache (84.2%) and focal signs (57.9%) were the 2 most common symptoms. Direct evidence of thrombosis was found on CT in 42.1%, and on MRI in 52.6%. Two or more sinuses were involved in 78.9% of cases, in which the transverse sinus plus sigmoid sinus were the most commonly involved combination. All patients received anticoagulant therapy. Most patients (84.2%) had no neurological sequelae at discharge, and only 3 patients (15.8%) recovered with sequelae. Conclusion: Our study provides detailed information on the clinical manifestations, neuroimages, management, outcome, and risk factors of the patients with CVST.

Objective: To explore the microsurgical treatment of tuberculum sellae meningioma operation.Methods:A retrospective analysis of the clinical data of 20 patients with tuberculum sellae meningioma, 20 cases of patients, 8 males and 12 females; aged 34 to 65 years old, with an average age of 47.1 years; the course of disease was 2 months to 3 years; the tumor diameter less than 4cm in 11 cases, pterional approach in 7 cases, unilateral subfrontal approach in 4 cases; the maximum tumor diameter greater than 4cm in 9 cases, double measurement subfrontal approach in 2 cases, pterional approach in 7 cases with fracture of composite.Results:Total resection (Simpson grade I and II) in 16 cases, pterional and (80%) the longitudinal composite approach in 7 cases were total resection of tumor, 4 cases of Simpson grade resection (20%). The visual acuity of the 18 eyes of 29 patients with 20 eyes, postoperative visual acuity improved (69%), no change in 7 eyes (24.1%), increased in 2 eyes (6.9%), preoperative monocular visual acuity decline after operation showed no recovery. Pterional approach in 7 cases with fracture of composite in the visual acuity improved in 6 cases, no change in 1 cases.Conclusion:The blood supply of optic nerve protection of perforating vessels, pay attention to tumor invasion of optic canal, is the key to the function of the optic nerve protection.

BACKGROUND:A wealth of evidence from animal experiments has indicated that hypertonic saline (HS) maybe a better choice for fluid resuscitation in traumatic hypovolemic shock in comparison with conventional isotonic saline. However, the results of several clinical trials raised controversies on the superiority of fluid resuscitation with HS. This meta-analysis was performed to better understand the efficacy of HS in patients with traumatic hypovolemic shock comparing with isotonic saline. MATERIALS AND METHODS:According to the search strategy, we searched the PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, which was completed on October 2013. After literature searching, two investigators independently performed the literature screening, assessment of quality of the included trials, and data extraction. Disagreements were resolved by consensus or by a third investigator if needed. The outcomes included mortality, blood pressure, fluid requirement, and serum sodium. RESULTS:Six randomized controlled trials were included in the meta-analysis. The pooled risk ratio for mortality at discharge was 0.96 (95% confidence interval [CI], 0.82-1.14), whereas the pooled mean difference for the change in systolic blood pressure from baseline and the level of serum sodium after infusion was 6.47 (95% CI, 1.31-11.63) and 7.94 (95% CI, 7.38-8.51), respectively. Current data were insufficient to evaluate the effect of HS on the fluid requirement for the resuscitation. CONCLUSIONS:The present meta-analysis was unable to demonstrate a clinically important improvement in mortality after the HS administration. Moreover, we observed HS administration maybe accompanied with significant increase in blood pressure and serum sodium.

Background: A wealth of evidence based on the randomized controlled trials (RCTs) has indicated that surgery may be a better choice in the management of primary intracerebral hemorrhage (ICH) compared to conservative treatment. However, there is considerable controversy over selecting appropriate surgical procedures for ICH. Thus, this meta-analysis was performed to assess the effects of stereotactic aspiration compared to craniotomy in patients with ICH.Methods: According to the study strategy, we searched PUBMED, EMBASE and Cochrane Central Register of Controlled Trials. Other sources such as the internet-based clinical trial registries, relevant journals and the lists of references were also searched. After literature searching, two investigators independently performed literature screening, assessment of quality of the included trials and data extraction. The outcome measures included death or dependence, total risk of complication, and the risk of rebleeding, gastrointestinal hemorrhage and systematic infection.Results: Four RCTs with 2996 participants were included. The quality of the included trials was acceptable. Stereotactic aspiration significantly decreased the odds of death or dependence at the final follow-up (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.69-0.93; P = 0.004) and the risk of intracerebral rebleeding (OR: 0.44, 95% CI: 0.26-0.74; P = 0.002) compared to craniotomy with no significant heterogeneity among the study results.Conclusions: The present meta-analysis provides evidence that the stereotactic aspiration may be associated with a reduction in the odds of being dead or dependent in primary ICH, which should be interpreted with caution. Further trials are needed to identify those patients most likely to benefit from the stereotactic aspiration.

Objective: To explore Discussion of intracranial metastases and efficacy of different treatment options.Methods:Retrospective analysis of 124 cases of hospitalized patients with intracranial metastases, 124 patients were selected surgical treatment alone (A group), surgery with postoperative whole brain radiation therapy (WBRT, group B) and FSRT with WBRT (group C). Assess the pros and cons of three treatment regimens in the treatment of brain metastases in neurosurgery. Results:Group B to Group A treatment of intracranial metastases in the above three areas were signiifcant statistical difference(P<0.05);under certain conditions set C for the treatment of intracranial metastases in group A in the above three areas also have signiifcant difference(P<0.05). Conclusions:For new development, diameter greater than 3cm, peripheral edema, intracranial mass effect evident metastatic lesion resection, postoperative WBRT good effect;less than 3cm in diameter solitary brain metastasis cancer lesions, minor or no mass effect obviously, you can line FSRT auxiliary WBRT.

Objective To explore the microsurgical method in treating ruptured aneurysms treatment and evaluating the treatment of the complication during or after the operation.Methods 36 cases of patients with intracranial aneurysm were analyzed retrospectively.All of the patients were subarachnoid hemorrhage (SAH) by CT scan on admission.The intracranial aneurysms were confirmed in 35 cases by DSA examination and A2 aneurysm was confirmed by explorative operation in 1 case.The microsurgical treatment was performed in 36 cases at the early or intermediate stage,22 cases were treated in the early stage,the other 14 cases were treated in the intermediate stage (early stage means within 3 days post SAH;intermediate stage means from 4 days to 10 days post SAH).Results After the operation,21 cases were GOS grade Ⅰ,4 cases were COS grade Ⅱ,4 cases were COS grade Ⅲ,4 cases were GOS grade Ⅳ.Of all the patients,CT scan was done after the operation,finding no intracranial bemorrhage,and cerebral infarction was disclosed in 5 cases.3 cases were dead,one suffered occipital lobe infaret after the PCoA aneurysm clipped,brain hernia occurred at last,one's Hunt Hess grade was Ⅴ,ACoA aneurysm was disclosed by DSA examination,severe brain edema occurred after the operation,the other suffered tonsillar hernia one week after the aneurysm clipping,which ruptured after endovascular treatment of ACoA aneurysm 2 years later.DSA examinations were done in 26 cases after operation,declaring 1 ACoA aneurysm was unclipped,1 PCoA aneurysm was incompletely clipped,and 1 PCoA was sacrificed.Conclusions It is a valuable method to clip the ruptured intracranial aneurysms in early and intermediate stage.The cerebral ischemia is the severe complication after clipping.Especially for the PCoA aneurysms,it is very important to protect the PCoA.Further research should be done for the treatment in the case with mother artery arteriosclerosis and thrombosis within the aneurysms.

Objective To discuss the errors and dangers of the YL-1 type encephalic puncture needle in intracranial hematoma treatment. Methods The in-depth re-analysis and re-test of the principles in the YL-1 puncture needle use for treating intracranial hematoma were carried out by means of clinical symptoms and CT images. Results Thirty-nine (3.3%) out of 1 176 patients received grinding of the intracranial hematoma using the puncture needle, 16 (41%) of the 39 patients were re-examined by CT 12 h after the grinding, among whom 5 (31%) presented with radial low density image of the brain tissue around the needle on the CT slice. Thirteen (33%) of 39 patients had exacerbation of clinical symptoms. Conclusion The principle of turbulent flow is a fundamental principle of evacuating the shattered hematoma. But present processing technique can not meet the design requirements, so the water columns can not form turbulent flow, while vertically and directly shoot into the hematoma and brain tissue under high pressure, thus destroying the brain tissue again and even more times. For the safety and efficacy, the puncture needle should be used very carefully or forbidden, except for the chronic subdural or extradural hematoma.

OBJECTIVE:To determine whether transplanting olfactory ensheathing cells (OECs) is effective in controlling or reversing the deterioration caused by amyotrophic lateral sclerosis (ALS). METHODS:Between February 2003 and April 2006, 327 patients (241 males and 86 females) with probable or definite ALS (diagnosed according to the El Escorial criteria) received the OECs transplantation. Their ages ranged from 20 to 84 years (51.6 +/- 11.1 years). The duration of symptoms before surgical treatment was 4.8 months to 13 years (2.9 +/- 2.0 years). OECs were cultured and injected into pathological regions of the spinal cord and/or bilateral corona radiata of the brain; the patients were divided into three groups, group A (cord only, n = 29), group B (cord and brain, n = 6), and group C (brain only, n = 292) based on the transplant sites. RESULTS:The patient's neurological function was assessed both before and at 4 weeks after transplantation by using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) of the ALS CNTF Treatment Study (ACLS). The scores were increased from 17.2 +/- 8.6 pre-operation to 20.1 +/- 9.7 post-operation in group A (P < 0.05), from 24.2 +/- 6.8 to 25.7 +/- 6.6 (P > 0.05) in group B, and from 20.3 +/- 8.6 to 22.0 +/- 9.4 (P < 0.001) in group C. There were no significant difference in increased ALSFRS scores among the three groups (P > 0.05). The total improvement rate of neurological function was 77.1% (252/327). The result of electromyographic examination showed that spontaneous potential diminished and/or disappeared, the amplitude of the motor unit action potential decreased remarkably and the numbers of motor unit action potential greatly increased in 261 cases (79.8%). Sixteen patients (4.9%) experienced the various complications including headache, short-term fever, seizure attack, central nerve system infection, pneumonia, respiratory failure, urinary tract infection, heart failure, and possible pulmonary embolism; of them, there were 4 deaths (1.2%). CONCLUSION:These preliminary results suggest that the OECs transplantation is effective in controlling or reversing the physiological deterioration caused by ALS.

OBJECTIVE:To explore the influence factors for the functional improvement after the fetal olfactory ensheathing cell (OEC) transplantation for chronic spinal cord injury(SCI).METHODS:The olfactory bulbs were harvested and trypsinized down to single fetal OEC. They were cultured for 12-17 days prepared for use. From November 2001 to December 2003, a total of 300 patients volunteered for the fetal OEC transplantation, among whom 222 suffered from complete chronic SCI and 78 suffered from incomplete chronic SCI. The procedures were performed on the patients with a disease course ranging from 6 months to 31 years (average 3.1 years) after their injuries. The fetal OEC was transplanted by the form of injections into the spinal cord at the upper and lower ends of the injury site. All the patients were assessed by the ASIA standard before the transplantation and 2-8 weeks after the transplantation. The influence factors including age, sex, duration after the injury, and injury degrees and levels were compared with those in the functional improvement after fetal OEC transplantation.RESULTS:The partially-improved neurological functions assessed by the ASIA standard were indicated by the motor scores increasing from 39.1 +/- 20.6 to 45.9 +/- 20.3 (P < 0.001), the light touch scores from 51.7 +/- 24.9 to 63.4 +/- 23.0 (P < 0.001), and the pin prick scores from 53.0 +/- 24.2 to 65.3 +/- 22.7 (P < 0.001). There was no significant difference in the functional improvement of the motor, light touch, and pin brick when compared with the age, sex, duration after the injury, and the injury degrees and levels. The motor scores and light touch scores at the cervical level were higher than the scores at the thoracic level.CONCLUSION:The fetal OEC transplantation can partially improve the neurological functions quickly in treatment of the chronic spinal cord injury. All the influence factors except the motor scores and light touch scores, which were higher at the cervical level than at thoracic level, have no impact on the functional improvement after the fetal OEC transplantation.

AIM:To probe into the reliability and effectiveness of olfactory ensheathing cell transplantation in the treatment of amyotrophic lateral sclerosis ALS.METHODS: Eighty-eight patients with ALS treated in the Neurological Research and Treatment Center of Beijing Xishan Hospital and Second department of Neurology, Affiliated Beijing Chaoyang Hospital, Beijing Medical University between January 2003 and March 2005 were selected. 50 μl olfactory ensheathing cell suspension, containing 1×106 cells, was injected into two sites of the pathological spinal cord, then bilateral cerebral corona radiata was injected with 50 μl olfactory ensheathing cell suspension, containing 2×106 cells. Neurological function was evaluated and inspected with electromyography EMG before operation and 2-4 weeks after operation. The neurological functional evaluation was done with international united amyotrophic lateral sclerosis functional rating scale ALSFRS.RESULTS: A total of 88 patients were involved in the analysis of results. Comparison of ALSFRS score between pre-operation 20.69±9.32 and 2-4 weeks after operation 23.96±9.06: Peurological function of 72 patients 81.8% were stable and ameliorated P < 0.001. Post-operation examination of 63 patients with EMG showed that spontaneous electric potential diminished or disappeared, the amplitude of wave in EMG was significantly decreased in contraction than that before operation, while the density of electric potential increased obviously.CONCLUSION: Olfactory ensheathing cell transplantation is safe and feasible, which can prevent or reverse the deterioration of ALS 2-4 weeks after operation.

BACKGROUND: It was thought that there was no regeneration capacity in central nerves. Recent research shows that regeneration capacity of injured neural axons and recovery of some neurological functions can be achieved by changing local surroundings after spinal cord injury (SCI).OBJECTIVE: To probe into whether the transplantation of fetal olfactory ensheathing cells (OECs) in recovering the neurological functions of patients with chronic SCI is safe, feasible, and effective.DESIGN: Auto-control observation before and after surgery.SETTING: Neurological Research and Treatment Center of Beijing Xishan Hospital; Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences; Second Department of Neurosurgery in Naval General Hospital.PARTICIPANTS: A total of 171 patients with chronic spinal cord injury were selected from the Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences and the Second Department of Neurosurgery in Naval General Hospital betweenNovember 2001 and February 2003, of which there are 147 patients with complete injury and 24 ones with incomplete injury. Post-injury period ranged from 0.5 to 18 years. Process of treatment is discussed and permitted by relevant Medical Ethics Committees. Cells were obtained from voluntary donors and patients agreed to receive the treatment.METHODS: ① Fetal olfactory bulbs were cultured for 12-17 days after being digested into single cells. ② Fetal OECs were transplanted into sites rostral and caudal to the epienter. ③ Neurological functions of all patients 2-8 weeks before and after operation were evaluated according to the scoring standard of ASIA.MAIN OUTCOME MEASURES: ① Status of functional recovery in spinal cord of patients after transplantation of OECs. ② Harmful events and side effects.RESULTS: A total of 171 patients were involved in the analysis of results.①Status of functional recovery in spinal cord of patients with OECs transplantation: Partial neurological functions of 171 patients rapidly recovered,whose motor function score increased from (34.5±20.3) points before operation to (42.0±20.0) points (P ＜ 0.001) after operation, score of light touch increased from (47.2±24.0) points to (61.8±23.0) points (P ＜ 0.001) after operation,score of pain sense increased from (48.6±23.5) points to (64.0±22.8) points (P ＜ 0.001). ②Harmful events and side-effects: Early manifestations of spinal cord injury induced by infection in surgical area of one patient aggravated; two patients suffered from serious pulmonary infection,one patient from thalamic hemorrhage. Three patients mentioned above died of serious respiration and circulatory failures.CONCLUSION: OEC transplantation can rapidly promote partial neurological function of patients with chronic SCI, while the mechanism needs further observing.

Objective:To investigate the effect of the degree and the duration of chronic cervical cord injury on pulmonary function.Method:To test the VCMAX?FVC?FEV1?PEF and ASIA score in 40 patients with chronic cervical cord injury.Result:The level of pulmonary function showed lower than normal in 40 patients with chronic cervical cord injury,ASIA score was positively correlated with VCMAX?FVC?FEV1 and PEF;There were significant differences of VCMAX?FVC?FEV1 and PEF between complete lesions group and incomplete lesions group.In complete or incomplete lesions group,there were no significant differences among VCMAX?FVC?FEV1 and PEF in different levels.The duration of chronic cervical cord injury was no correlated with VCMAX,but it was positively correlated with FVC?FEV1 and PEF.Conclusion:Pulmonary function in chronic spinal cord injured patients is lower than normal,the change accord with the degree and the duration.