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The pineal tumor was once considered as a restricted area for surgery. Such cases are rare, with many different opinions on surgical treatment.This study aimed to review our experience of tumor treatment in the pineal region and explore the optimal treatment strategy.The clinical data of 72 patients with pineal tumors from January 1997 to May 2015 (18 years) were retrospectively analyzed. Preoperative preparation, pathology types, tumor resection rate, surgical approach, and follow-up outcomes were used as the indicators to evaluate the treatment efficacy.The Krause approach was used in 46 cases, the Poppen approach in 10 cases, and the transcallosal-lateral ventricle-choroid fissure approach in 16 cases. The postoperative pathological results were as follows: 24 cases of germinoma, 11 of teratoma, 15 of glioma, 6 of meningioma, 11 of Pineocytoma, 2 of cholesteatoma, 2 of cavernous hemangioma, and 1 of choriocarcinoma. Further, the study included 64 cases of total surgical resections, 8 of subtotal resections, and 2 deaths. The follow-up period was from 7 months to 10 years. Further, 51 (70.8%) patients were followed up. The multivariate regression model showed that the surgical method and the pathological type contributed significantly to predicting outcomes.The type of pathology, extent of excision, and surgical approach had a significant impact on the prognosis of patients. The transcallosal-lateral ventricle-choroid fissure approach for large and medium-sized pineal tumors near the posterior part of the third ventricle had good efficacy.

Additional file 2. ClinGen database shown 5.29 Mb deletion in chromosome Xq22.1–q22.3 affect 98 genes from DRP2 to NAP1L4P2.

Additional file 6: ROC curve for peripheral blood B subset patients with sCAP on the first day of admission to predict prognosis at day 28.

PURPOSEWe aimed to explored the influence of preoperative gamma knife treatment on the clinical effect of microsurgical resection of vestibular schwannoma.METHODSThe patients who underwent vestibular schwannoma resection in our hospital between November 2010 and December 2019 were retrospectively collected. According to retrospectively collected data, the patients who met the inclusion and exclusion criteria were defined as group A. The 1:3 ratio design was adopted in this study to select the group B that was not subjected to gamma knife treatment in the same period. The pre/postoperative clinical manifestations, neurological function grade, postoperative complications, tumor recurrence and increase were collected and compared between the two groups.RESULTSThere were 40 patients in group A and 120 patients in group B. At the last follow-up, the number of patients with poor facial nerve function was 15 (39.5%) in group A and 25 (21.2%) in group B (P = 0.025). In group A and group B, disequilibrium occurred in 14 patients and 17 patients respectively after operation (P=0.003). 7 patients caught the pulmonary infection in group A and 3 patients had a pulmonary infection in group B (P=0.03) after operation. CONCLUSIONSwhen a patient with vestibular schwannoma undergoes microsurgical surgery, the preoperative history of gamma knife treatment will make a recovery from postoperative facial paralysis difficult for the patients, making them more prone to suffer from postoperative disequilibrium and postoperative pulmonary infection.

Background: Human papillomavirus (HPV) vaccine has been licensed in mainland China since 2016; however, the acceptability of HPV vaccination is unclear. This study aimed to evaluates women’s knowledge and attitudes toward cervical cancer, HPV infection and its vaccination in Taizhou area, southeast of China. Methods: A cross-sectional survey was conducted among women who visited the gynaecological clinic of Taizhou Hospital using a questionnaire-based interview. The process was divided into two periods, period I was May to August 2017, and period II was January to March 2019. Results: A total of 819 women were conducted, and 736 were included in the final analysis. Most women (92.4%) had ever heard of cervical cancer. Almost half of women had ever heard of HPV (57.5%) and HPV vaccines (53.1%). Knowledge level of cervical cancer, HPV infection and its vaccines was inadequate; only 12.2% achieved 21-30 scores (at a 30-point scale). Logistic regression analysis showed that marital status, education, occupation, and family annual income were statistically significantly related to the knowledge level ( P

We report the case of a 46-year-old man with von Hippel-Lindau (VHL) disease, manifesting disseminated leptomeningeal hemangioblastomatosis. The patient initially presented with a solitary hemangioblastoma in the right cerebellum. Later, he was diagnosed with VHL disease and underwent several surgical procedures in the following 14 years. But the prognosis was poor. Recently, the hemangioblastomatosis disseminated along leptomeninges involving both brain and spine. We aim to analyze the possible reason for the leptomeninges dissemination, discuss the imaging characteristics of this rare disease with ominous manifestation and propose the optimal strategy for treatment. We think the optimal treatment strategy should be surgical biopsy and surgical decompression. A long-term follow-up is inevitable. Antiangiogenic medication might be the hope for remission of this disease.

To evaluate the relationships of CXCR4 (chemokine stromal cell-drived factor-1 receptor) and VEGF (vaseular endothelial growth factor) expression to tumor angiogenesis in hemangioblastomas of the central nervous system.The protein expressions of CXCR4 and VEGF were detected by SP immunohistochemical staining in 40 hemangioblastomas. The endothelial cells of blood vessels within the tumor were labeled by CD34, then the microvessel density (MVD) was calculated.Total positive expression rates of CXCR4 and VEGF were 95% (38/40) and 85% (34/40) respectively. The expression rates of CXCR4 and VEGF were found positive obviously in hemangioblastomas compared with the normal cerebellar tissues (P0.01). CXCR4 expression was located in the nucleus of tumor stromal cells. VEGF expression was located in the cytoplasm and membrane of tumor stromal cells and some endothelial cells. VEGF has significant positive correlation with the expression level of CXCR4 (r = 0.704, P0.001). MVD also has significant positive correlation with the expression level of CXCR4 and VEGF (P0.001). But there is no significant difference between the cystic and solid tumors, VHL disease and sporadic disease on the expression level of CXCR4, VEGF and MVD (P0.05).CXCR4 and VEGF may collaborate to induce angiogenesis in hemangioblastomas.

Background and objective During the resection of jugular foramen tumors via the basic far lateral approach, the jugular foramen tumor area as well as its adjacent structures, especially the intracranial part, can be better exposed, which avoids stripping of the petrous part of temporal bone and displacement of facial nerve, and protects the patient's hearing from damage. However, when applied in tumors developed from ventral to the brain stem and middle fossa, with extracranial tumors, this surgical approach seems to be inadequate and limited. This study was to explore the microsurgical technique and clinical value for treating giant dumbbell-shaped tumors at jugular foramen (JF) via a modified far lateral approach. Methods A retrospective analysis was performed in 16 patients with huge dumbbell-shaped tumors at JF which were removed through the modified far lateral approach (suboccipital transjugular-jugular tubercle-jugular process) between January 2001 and December 2008. The process of operation, and pre-and postoperative clinical data were included in the analysis. Results Gross total tumor removal was achieved in 14 cases, subtotal removal in 1 case, and partial removal in 1 case. Follow-up examinations in most patients demonstrated that the patient with an obvious preoperative deficit had a good recovery. During the follow-up from three months to seven years, 10 (76.9%) cases with lower cranial nerve involvement showed obvious improvement of symptom after operation, 8 (80.0%) cases with facial palsy obtained various degrees of alleviation, and 7 (77.8%) cases with hearing impairment at different levels restored hearing. Two patients developed new lower cranial nerve palsies after operation, and underwent functional rehabilitation in the three-month follow-up. Conclusions Modified far lateral approach is helpful for removing the huge tumors at JF, especially for tumors extending to the petroclival region ventral part of pontomedullary junction. It has a higher rate of total resection, preoperative cranial nerve function impairment is expected to restore, and also has the advantage of protecting the facial nerve, labyrinth and vertebral artery structure from unnecessary damage.