Objective:To investigate the effect of oxaliplatin inhibit the growth in glioma U 87 cells by regulating PI3K/Akt sig-nal pathway.Methods:The glioma U87 cells were cultivated in vitro ,using 0,20,40,80 μg/ml oxaliplatin treated U87 cells 24,36, 48,72 h respectively,MTT was used to detect cell proliferation.Using 40 μg/ml oxaliplatin treated U87 cells 48 h,flow cytometry was used to detect cell cycle and apoptosis .Cells apoptosis protein and PI 3K/Akt pathway protein expression after 40 μg/ml oxaliplatin treated U87 cells 48 h was detected by Western blot .Results:MTT assay showed that compared with the 0μg/ml treatment ,oxaliplatin treatment could significantly inhibited U 87 cell survival ( P<0.01 ) ,40μg/ml oxaliplatin treatment 48 h ,the survival inhibitory was the most obvious.U87 cell cycle was arrested in S phase after 40 μg/ml oxaliplatin treatment 48 h.After 40μg/ml oxaliplatin treatment 48 h,compared with the 0 μg/ml treatment,U87 cell apoptosis rate significantly increased (P<0.01).Western blot showed that after 40μg/ml oxaliplatin treatment , anti-apoptotic factor Bcl-2 expression had significant decreased , pro-apoptotic factors Bax , Cleaved-caspase3 protein expression had significantly increased (P<0.01).PI3K,p-Akt expression was significantly decreased (P<0.01),and Akt expression had no significant change in Akt pathway (P>0.05).Conclusion:Oxaliplatin may suppress U87 cell proliferation,ar-rest cell cycle,and promote apoptosis by inhibit PI3K/Akt signaling pathway.

目的：探讨神经内镜手术治疗老年女性颅底肿瘤的疗效及安全性。方法选取2013-09—2014-09我院收治的老年女性颅底肿瘤患者82例为研究对象，随机分为观察和对照组，分别予以神经内镜手术治疗和常规手术治疗，分析其手术成功率、疗效及安全性。结果观察组手术成功率为95.2％，对照组为97.5％，组间比较差异无统计学意义（P＞0.05）；2组总受益率分别为90.5％和92.5％，差异无统计学意义（P＞0.05）；观察组并发症发生率分为14.3％，对照组为32.5％，差异有统计学意义（P＜0.05）。结论神经内镜手术是治疗老年女性颅底肿瘤安全可行的方法，具有推广价值。

Objective To investigate the impact of temozolomide on differentiation,proliferation and apoptosis in glioma stem cell.Methods Incubated U251 cell and sorted stem cells using a magnetic cell sorter.Used 0μM,100μM,500μM,lmM temozolomide treating with U251 stem cells for 24h,48h,72h and 96h,MTT assay was used to detect the proliferation in various treatments on U251 cell.Used medium containing FBS inducing differentiation of stem cells U251,added 0μM or 500μM temozolomide treatment for 72h,extracted the protein in U251 stem cells before differentiation and temozolomide treatment groups,Western-blot was detected of stem cell markers CD133 and differentiation markers MAP2,GFAP,MBP protein expression.Used 0μM and 500μM temozolomide treating with U251 stem cells for 72h,flow cytometry was used to detect the cell apoptosis.Extracted the total protein in U251 stem cells treating with temozolomide in 0μM and 500μM,Western-blot detected the key protein expression in Notch1 signaling pathway.Results Compared with 0μM temozolomide treatment group,temozolomide treatment can significantly inhibited the U251 stem cell proliferation.500μM Temozolomide treatment for 72h has the most significant difference.After U251 cells differentiation,CD133 expression was significantly reduced,MAP2,GFAP,MBP protein expression was significantly increased.Compared with 0μM,CD133,MAP2,GFAP,MBP protein expression were significantly different after treating with 500μM temozolomide.U251 cell apoptosis was significantly increased after treating with 500μM temozolomide.Compared with 0μM temozolomide treatment,the key protein Notch1,CBF1,HES1 expression in Notch1 pathway was significantly decreased after 500μM Temozolomide treatment for 72h.Conclusion Temozolomide may inhibit U251 stem cell proliferation,promote stem cell differentiation and apoptosis by inhibit Notchl signaling pathway.

Objective To investigate the clinical efficacy and safety of criteria to large craniectomy in treatment of severe brain injury.Methods From January 2013 to December 2015, 100 cases of patients with severe brain injury in our hospital were selected as the study object, according to the choice of surgical treatment, 100 cases were divided into observation group and control group, 50 cases of control group were treated with bone craniotomy, 50 cases of observation group were treated with the standard to hemicraniectomy, to survey the postoperative GOS scores and to compare the postoperative recovery of two groups.Results The intracranial pressure monitoring of the postoperative day 1,3,7were lower than those of control group, the difference was statistically signiifcant (P<0.05). The postoperative group GOS scores increased to ( 11.3±3.2) points, higher than that of control group (P<0.05); postoperative recovery criteria group is more ideal, the 1 level accounted for 56.0%, higher than that of the normal group (P<.0.05), the 5 levels accounted for 6.0%, lower than that of the atmospheric pressure group (P<0.05).Conclusion The application of criteria to hemicraniectomy in the treatment of traumatic Brain injury has good effect, compared with the craniotomy, which can make patients a quick recovery, decrease the death rate and so on.

1 临床资料<br>　　1.1 一般资料 急性蛛网膜下腔出血56例患者，男23例，女33例；年龄28～84岁；一次出血者49例，二次出血者5例，三次出血者2例；有高血压史10例。按 Hunt‐Hess 分级，Ⅰ级13例，Ⅱ级19例，Ⅲ级15例，Ⅳ级7例，Ⅴ级2例。

我科成功地进行了2例完全腹腔镜下胰十二指肠切除术[1]",现报道如下. 临床资料 1.一般资料:例1,女,48岁.因2型糖尿病收住内分泌科.查体:巩膜轻度黄染,腹平软,未触及包块.B超检查发现主胰管轻度扩张,肝外胆管轻度扩张;ERCP活检:十二指肠降段腺癌;腹部增强CT考虑十二指肠降部占位,腹膜后淋巴结肿大.

1999年12月至2006年8月,作者对30例低位直肠癌患者行腹腔镜下改良Bacon's手术保肛治疗(严格遵循TME原则),取得满意的临床效果,现报道如下.

[Objective] To discuss the feasibility of the laparoscopic resection of insulinoma. [Method] The data of 3 insulinoma patients who had laparoscopic resections of insulinoma during Mar. 2005 and Jun. 2006 was reviewed. The three laparoscopic resections of insulinoma consisted of 2 cases by gouging out the insulinoma and the 1 case of pancreas body and afterbody and lienectomy. And analysis of these operations was done by reading domestic and overseas papers. [Result] The operations were all successful, the tumors were cut off completely. The three operations were all accomplished by laparoscopy. The hemorrhages during operations were 15, 70, and 500 mL respectively. 2 patients ate and walked after the operations in 2 days. And 1 patient transuded a little. The 3 patients were all healed. [Conclusion] The laparoscopic resection of insulinoma is tiny-wound, safe, and feasible approach. It has the merits such as a little while hemorrhage, slight wound, quick recovery and few complications and so on. So it worth extending.

目的 探讨腹腔镜胰岛细胞瘤切除的可行性.方法 回顾2005年3月至2006年6月我科对3例胰岛细胞瘤病人实施的腹腔镜胰岛细胞瘤切除术,手术种类包括:胰岛细胞瘤剜除术(2例)和胰体尾加脾切除术(1例).并结合国内外有关文献报道进行诊治分析.结果 手术过程顺利,肿瘤完整切除,3例均在全腹腔镜下完成,术中出血分别为15、70、500 ml,2例术后第2天进食、下床活动,1例少量渗出.3例病人均痊愈出院.结论 腹腔镜对于胰岛细瘤切除是微创、安全可行的,具有术中出血少、创伤轻、术后恢复快、并发症少等优点,值得进一步推广.

目的探讨腹腔镜下胰十二指肠切除术的可行性、适应证及手术难点。方法分析该院1例腹腔镜胰十二指肠切除术患者的临床资料,包括该患者病例摘要、术前准备、手术过程中难点及术后康复情况。结果该例手术成功完成。手术历时15h,术中出血150mL。患者术后3周痊愈出院。结论腹腔镜下胰十二指肠切除术被认为是腹腔镜手术问世以来难度最高的手术,要求有丰富的临床经验、高超的腹腔镜下操作技术和先进的腹腔镜设备。具备这些条件并掌握好适应证,该手术是安全的可行的。