Craniocerebral Surgery Research Articles

An active & passive dual-targeting platform for the precise treatment, process monitoring and effective protection of central nervous system infection

Precise antibacterial activity and effective inflammatory response reduction are critical for successful treatment of Intracranial infection after craniocerebral surgery, which remains an unmet clinical challenge. Herein, an intracranial drug delivery liposome (AFAA-lipo) that possesses dual active&passive targeting capability, direct antibacterial ability, favorable inflammation regulation, and excellent biocompatibility is developed as an antibiotics-free and hardly bacterial-resistance-induced platform for the management of intracranial infection. The surface-anchored specific peptide sequence HRERMS (the oligopeptide designed sourced from β-amyloid precursor protein) makes AFAA-lipo actively penetrate the blood–brain barrier and then perforated and lysed under the stimulation of α-toxin secreted by methicillin-resistant Staphylococcus aureus (MRSA, a severe and widespread intracranial infection type) in the infected site. Our results demonstrate that the AFAA-lipo can eliminate bacteria and biofilms, and reduce inflammatory response through mitochondrial function protection, DNA preservation from damage, TNFR1/NF-κB signaling pathway inhibition, and promotion of microglial polarization towards the anti-inflammatory subtype, ultimately improving post-infection prognosis and survival rate. More interestingly, the pre-intake of AFAA-lipo is capable to reduce MRSA infection risk and alleviate inflammatory response. Furthermore, the near-infrared (NIR) II region imaging fluorescence signal intensity variations of AFAA-lipo is proved the validation to monitor the course of the disease.

Prognostic value Analysis of Intraoperative Transcranial Electrical Stimulation motor evoked Potential Monitoring in Postoperative limb Function changes of Neurosurgical Patient

Objective: To explore the predictive value of intraoperative transcranial electrical stimulation motor evoked potential (TES-MEP) monitoring for postoperative muscle strength change in patients undergoing craniocerebral surgery. Methods: In this study, 166 patients who underwent intraoperative motor evoked potential (MEP) monitoring were retrospectively analyzed. Univariate analysis and binary Logistic regression were used to analyze the influencing factors of postoperative muscle strength changes. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of abnormal changes of MEP amplitude in postoperative muscle strength changes. Results: Binary Logistic regression analysis showed that the abnormal amplitude of MEP during operation was an independent risk factor for short-term and long-term muscle strength decline after operation (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for abnormal changes of MEP amplitude to predict short-term postoperative muscle strength decline was 0.754, with a sensitivity of 0.516, with a specificity of 0.993, and the AUC for long-term postoperative was 0.782, with a sensitivity of 0.591 and specificity of 0.972. Conclusions: The decrease of MEP amplitude more than 50% as a warning standard has a good predictive value for the change of limb function after operation, and the abnormal changes of MEP amplitude indicate that the muscle strength of patients after operation may be lower than that before operation.

Retracted: Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery.

[This retracts the article DOI: 10.1155/2021/4968300.].

Effects of Dexmedetomidine on Cognitive Function, Oxidative Stress and Brain Protection in Patients Undergoing Craniocerebral Surgery

Background: The protective mechanism of dexmedetomidine on the brains of patients undergoing craniocerebral surgery remains unclear. The aim of this study was to examine the impact of dexmedetomidine on cognitive function, oxidative stress, and brain protection in such patients. Methods: Fifty-four patients who underwent craniocerebral surgery at our hospital from January 2020 to June 2023 were retrospectively selected as study subjects. They were divided into two groups: the control group (n = 27) and the study group (n = 27), based on different auxiliary anesthesia protocols. Patients in the study group received dexmedetomidine before anesthesia induction, using a midline intravenous pump to assist anesthesia, while the control group received an equivalent amount of normal saline. The remaining anesthesia induction and maintenance protocols were consistent for both groups. Cognitive function was assessed using the Mini Mental State Examination (MMSE) before and 1 day after surgery for both groups. Oxidative stress indicators, including malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels in the serum of both groups, were measured using enzyme-linked immunosorbent assay (ELISA). Additionally, changes in postoperative brain injury indicators, namely neuron-specific enolase (NSE) and central nervous system-specific protein (S100β), were detected and compared in the serum of both groups. Concurrently, postoperative adverse reactions were recorded for both groups. Results: The MMSE scale scores of both groups of patients 24 hours after surgery were significantly lower than those before surgery. However, the MMSE scale scores of the study group patients were notably higher than those in the control group, with a statistically significant difference (p < 0.05). One hour after surgery, the serum levels of MDA, GSH-Px, and SOD in both groups of patients were significantly elevated compared to pre-surgery levels. Yet, the study group exhibited significantly lower levels of MDA, GSH-Px, and SOD in comparison to the control group, and these differences were statistically significant (p < 0.05). The serum levels of NSE and S100β in both groups were markedly higher than preoperative levels 24 hours after surgery. However, the study group demonstrated significantly lower levels of serum NSE and S100β compared to the control group, with a statistically significant difference (p < 0.05). The incidence of postoperative complications in the study group was 7.41% (2/27), indicating a decreasing trend compared to 18.52% (5/27) in the control group. However, this difference did not reach statistical significance (χ2 = 1.477, p = 0.224). Conclusion: Dexmedetomidine-assisted anesthesia in craniocerebral surgery can effectively enhance postoperative cognitive function, mitigate oxidative stress, and facilitate overall postoperative recovery for patients. The intervention exhibits a favorable safety profile with no reported serious adverse reactions, establishing it as a relatively safe and reliable approach.

Application of lumbar drainage based on flow control in patients with intracranial infection after craniocerebral surgery

Application of lumbar drainage based on flow control in patients with intracranial infection after craniocerebral surgery

Actinobacillus ureae may be a critical pathogen in patients with predispositions: A case report and review of the literature.

Actinobacillus ureae (A. ureae) is an unusual commensal of human respiratory flora, rarely causing human infection. The predisposing factors, identification, clinical features, and antibiotic therapy of A. ureae are seldomly reported. Herein, we present a case of 64-year-old man affected by A. ureae pneumonia after intracranial surgery. A 64-year-old male was admitted with vomiting, drowsiness, and a severe disturbance of consciousness and was later diagnosed with cerebral hemorrhage by computed tomography images. After a craniocerebral surgery, the patient suffered from intractable pneumonia, experiencing treatment failure with multiple anti-bacterial agents. Sputum culture yield pure colonies of A. ureae, confirmed by matrix-assisted laser desorption/ionization time of flight and 16S rRNA gene sequencing. Minocycline (100 mg p.o. per 12 hours) with a course of 15 days was administrated for this patient. The respiratory symptoms, presenting as intermittent coughing with purulent and yellowish sputum, were gone. A 3-month follow-up examination showed a complete resolution of radiological findings. Clinically, the actual incidence of A. ureae pneumonia may be higher than that we generally recognized, and clinicians should consider A. ureae as a possible etiologic agent in patients with predispositions. Currently, A. ureae may be susceptible to penicillin, ampicillin, and third-generation cephalosporins. Other antibacterial agents, such as tetracycline, amoxicillin/clavulanic acid, and aminoglycosides also respond well and can be a choice in the treatment of A. ureae infections.

Ingestion of a row of artificial dentures in an adult: A case report and review of the literature.

Foreign body (FB) ingestion is a common clinical emergency, although in most cases, the FB can pass safely through the entire gastrointestinal tract without causing any damage. However, ingestion of large dentures is very rare and alarming, as it can threaten the intestinal mucosa and cause perforation of the gastrointestinal tract, among other complications. A 64-year-old Chinese male was referred to our hospital for removal of a FB, which was a large denture. Clinical symptoms included chest and upper abdominal pain. He had no cough or dyspnea. Medical history included a recent cerebral infarction, craniocerebral surgery, and being bedridden for a long term. We initially suspected a single and smooth denture, complicated by pharyngeal and esophageal mucosal injury. Radiographic examination however showed a 70-mm long opaque object located in the middle and upper esophagus, close to the trachea and aorta. Multiple dentures and metal hooks were removed via endoscopy using a net, grasping forceps, and rubber jacket. The patient recovered well and experienced no postoperative complications. The patient was discharged 5 days after endoscopic therapy. Our case showed that endoscopy was effective for the retrieval of an esophageal FB. For sharp FBs, the use of a net and rubber jacket is a good choice. However, we advocate for appropriate surgery in patients in whom endoscopy is not possible after an accurate diagnosis or those with severe complications.

A prediction model of risk factors of poor wound healing after craniocerebral surgery.

To explore the independent risk factors of poor wound healing after craniocerebral surgery, and to generate a risk prediction model. A single-center retrospective observational analysis of 160 patients who underwent craniocerebral surgery in The 904th Hospital of the Joint Logistics Support Force of the PLA from February 2018 to February 2021 was carried out. Patients were divided into Group-A (n=70) and Group-B (n=90) according to postoperative wound healing outcome. Logistic regression was used to analyze the independent risk factors, and a nomogram prediction model was constructed using R software. The receiver operating characteristic (ROC) curve was used to test the predictive ability of the model, and the fitting effect was verified by Hosmer Lemeshow. The duration of operation, surgical site infection, diabetes mellitus, and the time of intubation in Group-B were significantly lower than Group-A (P<0.05). Serum albumin (ALB) and hemoglobin (HGB) in Group-B were significantly higher than those in Group-A (P<0.05). Logistic regression analysis showed that long operation duration, surgical site infection, duration of drainage tube, ALB <35g/L, and abnormal HGB were independent risk factors for poor wound healing (P<0.05). The area under the ROC curve (AUC) predicted by the model was 0.932, 95%CI (0.862~1.000). The Hosmer-Lemeshow goodness of fit test showed that the expected probability calculated by the model matched the actual probability (P>0.05). Long operation duration, surgical site infection, duration of drainage tube, ALB <35g/L, and abnormal HGB were risk factors for poor wound healing. The nomograph model based on these factors showed good discrimination, calibration, and clinical effectiveness in predicting poor wound healing.

Treatment and prognostic risk factors for intracranial infection after craniocerebral surgery.

The objective of this study was to determine risk factors of pejorative evolution course in patients suffering from postoperative cranial infection. The data of patients who developed an intracranial infection after craniocerebral surgery in the neurosurgical intensive care unit of the First Affiliated Hospital of Nanjing Medical University in Nanjing, Jiangsu, China, from February 2018 to August 2019 were retrospectively analyzed. Logistic regression was used to analyze the factors influencing the prognosis of intracranial infection treatment. Sixty-four patients developed an infection after craniocerebral surgery, and 48 of them with negative CSF cultures received experimental anti-infectives. In 16 patients, cerebrospinal fluid culture showed pandrug-resistant pathogens, including 11 Acinetobacter baumannii (11), Klebsiella pneumoniae (3), Escherichia coli (1), and Candida glabrata (1). Nine patients received intraventricular or intrathecal injections of polymyxin B. The mean duration of infection treatment was 22.2 ± 9.9 days, and the clinical cure rate was 85.9% (55/64). Logistic multivariate regression analysis showed that inadequate CSF drainage (OR, 6.839; 95% CI, 1.130-41.383; P = 0.036) and infection with drug-resistant bacteria (OR, 24.241; 95% CI, 2.032-289.150; P = 0.012) were independent risk factors for postoperative intracranial infection. Intracranial infection with positive CSF culture and inadequate CSF drainage are factors contributing to the poor prognosis of intracranial infection. Moreover, early anti-infection treatment and adequate CSF drainage may improve patient outcomes. In particular, intraventricular or intrathecal injection of polymyxin B may be a safe and effective treatment strategy for MDR/XDR gram-negative bacilli infection.

Development and Validation of a Nomograph Model for Post-Operative Central Nervous System Infection after Craniocerebral Surgery.

A nomograph model of predicting the risk of post-operative central nervous system infection (PCNSI) after craniocerebral surgery was established and validated. The clinical medical records of patients after cranial surgery in Renmin Hospital of Wuhan University from January 2020 to September 2022 were collected, of whom 998 patients admitted to Shouyi Hospital District were used as the training set and 866 patients admitted to Guanggu Hospital District were used as the validation set. Lasso regression was applied to screen the independent variables in the training set, and the model was externally validated in the validation set. A total of 1864 patients after craniocerebral surgery were included in this study, of whom 219 (11.75%) had PCNSI. Multivariate logistic regression analysis showed that age > 70 years, a previous history of diabetes, emergency operation, an operation time ≥ 4 h, insertion of a lumbar cistern drainage tube ≥ 72 h, insertion of an intracranial drainage tube ≥ 72 h, intraoperative blood loss ≥ 400 mL, complicated with shock, postoperative albumin ≤ 30 g/L, and an ICU length of stay ≥ 3 days were independent risk factors for PCNSI. The area under the curve (AUC) of the training set was 0.816 (95% confidence interval (95%CI), 0.773-0.859, and the AUC of the validation set was 0.760 (95%CI, 0.715-0.805). The calibration curves of the training set and the validation set showed p-values of 0.439 and 0.561, respectively, with the Hosmer-Lemeshow test. The analysis of the clinical decision curve showed that the nomograph model had high clinical application value. The nomograph model constructed in this study to predict the risk of PCNSI after craniocerebral surgery has a good predictive ability.

Serum levels of p-tau181 in patients with Parkinson’s disease

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disease. Evidence has shown that phosphorylated tau-181 (p-tau181) is involved in the pathological process of PD. The goal of this study was to investigate the changes of serum phosphorylated Microtubule-associated protein tau at threonine-181 in patients with Parkinson's disease and it's correlation with disease severity, cognitive impairment and prognosis. Methods: A total of 40 patients with primary Parkinson's disease who were hospitalized or outpatient in the First Affiliated Hospital of Chongqing Medical University from July 2021 to February 2022 were selected as the study subjects. Patients with secondary Parkinson's disease, Parkinson's syndrome, stroke, Alzheimer's disease, craniocerebral surgery or trauma, severe systemic or infectious diseases, local or systemic infectious diseases, motor neurone disease or other central nervous system diseases were excluded. In addition, 35 healthy subjects with similar age and gender matching were selected as the healthy control group. Age, gender, course of disease, Hoehn-Yahr (H-Y) scale, Unified Parkinson's Disease Scale (UPDRS), and MoCA score were recorded in the Parkinson's disease group. According to the H-Y scale, PD group was divided into PD patients in the advanced stage (H-Y≤2.5, n=16) and PD patients in the advanced stage (H-Y&gt;2.5, n=24). Six months after blood sample collection, we assessed the H-Y rating and UPDRS score in the Parkinson's group again by telephone follow-up. Those with decreased or unchanged H-Y rating or total UPDRS score were divided into good prognosis group (n=25), and those with increased H-Y rating or total UPDRS score were divided into poor prognosis group (n=14). The serum p-tau181 concentration of all subjects was detected and compared by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA), and the correlation between serum p-tau181 level and UPDRS score, MoCA score and prognosis of Parkinson's disease patients was analyzed. Results: Compared with HC, serum p-tau181 concentration in PD patients were higher, but not statistically significant (1.01[0.28-2.63]vs 0.53[0.04-3.72]ug/mL, P=0.55, P&gt;0.05). There was no significant difference in p-tau181 concentration between PD patients in early stage and PD patients in advanced stage (P=0.80 P&gt;0.05), and no significant difference in p-tau181 level between PD patients with cognitive impairment, PD patients with normal cognition and HC patients (P=0.63, p&gt;0.05). P-tau181 was not significantly correlated with disease duration (r=-0.14, P=0.37, P&gt;0.05), UPDRS score (r=0.02, P=0.89, P&gt;0.05), and MoCA score (r= 0.16, P=0.32, P &gt; 0.05). There was no significant difference in serum P-tau181 expression between good prognosis group and poor prognosis group (P=0.74, P &gt; 0.05). Conclusions: Serum expression of p-tau181 increased in PD patients, but no statistical difference was observed, and no clear correlation was found between p-tau181 and disease severity and cognitive impairment. Serum p-tau181 level in PD patients has no significant prognostic significance.

A Novel Frameless Laser Stereotaxis System for Neurosurgical Interventions

The aim of the article is to introduce a novel laser-based frameless stereotactic device that can locate intracranial lesions quickly and with computed tomograph (CT)/magnetic resonance imaging (MRI) films. Preliminary experiences of application in 416 cases are also summarized. From August in 2020 to October in 2022, a total of 416 cases of new minimalist laser stereotactic surgery have been performed on 415 patients. Of the 415 patients, 377 had intracranial hematomas, while the remaining cases were brain tumors or brain abscesses. Postoperative CT was used to evaluate the accuracy of catheterization of 405 patients according to the MISTIE study. The duration time of locating was recorded. Rebleeding refers to the definition: Compared with preoperative CT, the relative volume of postoperative hematoma increases by >33% or absolute volume increase >12.5 mL. According to postoperative CT, the accuracy of 405 stereotactic catheterization cases was good in 346 cases (85.4%) and suboptimal in 59 cases (14.6%), with no poor results. Postoperative rebleeding occurred in 4 spontaneous cerebral hemorrhage cases and 1 brain biopsy case. The average localization time of supratentorial lesions was 13.2 minutes in the supine position, 21.5 minutes in the lateral position, and 27.6 minutes in the prone position. The new laser-based frameless stereotactic device is simple in principle and convenient in positioning operation of brain hematoma and abscess puncture, brain biopsy and tumor surgery, and appropriate to the precision requirements in most craniocerebral surgery.

Ceftazidime-avibactam-based combination therapy for hospital-acquired central nervous system infections caused by carbapenem-resistant Klebsiella pneumoniae

Klebsiella pneumoniae is one of the most common bacteria in the hospital-acquired central nervous system (CNS) infections. CNS infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are associated with significant mortality rates and high hospital costs due to limited antibiotic treatment options. This retrospective study aimed to evaluate the clinical efficacy of ceftazidime-avibactam (CZA) for the treatment of CNS infections caused by CRKP. In total, 21 patients with hospital-acquired CNS infections caused by CRKP who received treatment of CZA ≥ 72 hours were enrolled. A high burden of comorbidity was discovered among 95.2% (20/21) of the patients. The majority of patients had a history of craniocerebral surgery and 81.0% (17/21) of the patients were residing in the intensive care unit with a median APACHE II score of 16 (IQR 9-20) and SOFA score of 6 (IQR 3-7). A total of 18 cases were treated by CZA-based combination therapies, while the remaining three cases were treated with CZA alone. At the end of the treatment, the overall clinical efficacy was 76.2% (16/21) with a bacterial clearance rate of 81.0% (17/21) and all-cause mortality of 23.8% (5/21). This study shows that CZA-based combination therapy is an effective treatment option for CNS infections caused by CRKP.

Analysis of risk factors and treatment strategies for lumbar cistern blockage after craniocerebral surgery.

Lumbar cistern blockage is a common complication of continuous lumbar cistern drainage. This paper analyzes the risk factors for lumbar cistern blockage drainage due to various causes and proposes a series of prevention and intervention measures to reduce blockage or improve recanalization after blockage. The clinical data of 637 patients with various lesions who underwent lumbar cistern drainage in our hospital were retrospectively collected and analyzed. Perioperative clinical and imaging data were assessed. Variates were analyzed using univariate and multivariate logistic regression analyses. A total of 13.7% (87/637) of patients had lumbar cistern blockage. Multivariate analysis revealed that drainage time (≥7 days), CSF volume <200 (mL/d), CSF leakage, and abnormal CSF properties were predictors of lumbar cistern blockage. Reducing the probability of lumbar cistern blockage can be achieved by repeatedly flushing, increasing the drainage flow and shortening the drainage time. The recanalization rate after blockage was 67.8% (59/87). After the drainage tube was removed, no complications related to the drainage tube occurred during the 1-week follow-up. Lumbar cistern blockage is the main reason for poor drainage. Prevention or early intervention can effectively reduce the probability of blockage and achieve the purpose of drainage of cerebrospinal fluid.

颅脑术后颅内感染的诊治研究进展

颅脑术后颅内感染的诊治研究进展

Clinical application of 3D-Slicer + 3D printing guide combined with transcranial neuroendoscopic in minimally invasive neurosurgery

To explore the clinical advantages of 3D-Slicer + 3D printing guide combined with transcranial neuroendoscopic in minimally invasive neurosurgery. By collecting the datum of patients who underwent craniotomy under 3D-Slicer + 3D printing guide plate positioning combined with transcranial neuroendoscopic in our hospital from October 2021 to February 2022, this paper introduces the accurate planning and positioning lesions of patients before operation and the minimally invasive operation of intraoperative neuroendoscopic and analyses clinical data such as lesion size and surgical bone window size. We collected the case datum of 16 patients who underwent craniocerebral surgery with 3D-Slicer + 3D printing guide combined with transcranial neuroendoscopic, including 5 males and 11 females, aged 46–76 years, including 6 brain tumors (3 meningiomas, 1 glioblastoma, 2 lung cancer brain metastases), 2 cavernous hemangioma, 7 hydrocephalus and 1 chronic subdural hematoma. The lesions of the 16 patients were located accurately before operation and the target areas were reached quickly during operation. Postoperative imaging datum confirmed that the lesions was removed fully, and the ventricular end of shunt tube was in good position. The technology of 3D-Slicer + 3D printing guide plate combined with transcranial neuroendoscopic is not difficult, which has many advantages such as inexpensive equipment, simple operation, easy learning, accurate positioning, and minimally invasive surgery. It is considered to be a practical technology that is feasible, reliable, convenient for diagnosis, preoperative planning and minimally invasive surgery. It is suitable for promotion in neurosurgery and other surgical departments of all medical institutions.

The Value of CD64 in the Early Diagnosis for Intracranial Infection After Craniocerebral Surgery

To investigate the value of CD64 in the early diagnosis of intracranial infection after craniocerebral surgery. A total of 93 patients who met the inclusion and exclusion criteria after neurosurgery in Lianyungang First People's Hospital and Lianyungang Second People's Hospital were admitted and divided into experimental group with intracranial infection (n= 32) and uninfected control group (n= 61) according to the results of cerebrospinal fluid culture. We performed relevant statistical analysis, drew the receiver operating characteristic curve and calculated area under the curve (AUC). The sensitivity and specificity of the CD64, c-reactive protein (CRP), and white blood cell (WBC) counts were 84.38% and 86.89%, 78.13% and 75.41%, and 75.00% and 67.21%, respectively; the AUCs were 0.912, 0.858, and 0.851, respectively. Accuracy was the highest when the 3 diagnosis were combined, reaching 93.75%; the AUC could reach 0.948. Serum CD64, CRP, and WBC count in the diagnosis of intracranial infection after craniocerebral surgery were significant. CD64 was more valuable than the others. The diagnostic efficiency could be improved when CD64, CRP, and WBC count were combined.

The Investigation on Nosocomial Infection of Acinetobacter baumannii and the Clinical Analysis of Sequential Therapy of Cefoperazone/Sulbactam Sodium for Intracranial Infection.

Background Intracranial infection is a serious complication after neurosurgery. According to a survey, the incidence of intracranial infection is about 2.2%-2.6%, and patients with severe symptoms may even pose a threat to their life safety. Objective To explore the risk factors for intracranial infection caused by Acinetobacter baumannii after surgery and the clinical effect of sequential therapy of cefoperazone/sulbactam sodium. Methods In this study, a retrospective study was used. In this case-control study, 48 cases of intracranial Acinetobacter baumannii infection after neurosurgery in our hospital from January 2016 to December 2021 were selected as the infection group, and 96 patients without intracranial infection after surgery during the same period were selected as the control group to study all kinds of related factors and analyze the risk factors for intracranial Acinetobacter baumannii infection; in addition, in accordance with the therapeutic regimen for anti-infection, the infection group was divided into the tigecycline group (patients with tigecycline therapy in this group) and the combined group (patients with tigecycline combined with cefoperazone/sulbactam sequential therapy), with 24 cases in each group in order to compare the therapeutic effects of the two groups. Results Logistic regression factor model results show that increasing age of patients, surgical treatment for intracranial tumor or craniocerebral trauma, postoperative drainage time (≥3 days), and postoperative hospital stay (≥10 days) were the risk factors for postoperative intracranial infection of Acinetobacter baumannii in neurosurgical patients (P < 0.05), and postoperative prophylactic antibiotic treatment can reduce the incidence of intracranial infection (P < 0.05). The cerebrospinal fluid nucleated cell count, serum CRP, and serum PCT in the combined group 72 h after treatment were lower than those in the tigecycline group, and the difference was statistically significant (P < 0.05). Compared with the clinical efficacy after 72-hour treatment, the cure rate and effective rate in the combined treatment group were 83.33% and 16.67%, respectively, and those in the tigecycline group were 54.17% and 33.33%, respectively. The invalid interest rate was 12.50%, and the combined treatment group was superior to the tigecycline group (P < 0.05). Conclusion For patients with craniocerebral surgery, targeted preventive interventions should be carried out for the risk factors that may lead to intracranial Acinetobacter baumannii infection. The clinical effect of tigecycline combined with cefoperazone and sulbactam sodium sequentially in the treatment of intracranial Acinetobacter baumannii infection is better.

Analysis of perioperative negative emotion risk factors in patients with pituitary adenoma and its impact on prognosis: a retrospective study.

BackgroundPituitary adenoma (PA) is the third most common tumor in craniocerebral surgery. Most patients will experience varying degrees of negative emotions before and after surgery, which may affect the prognosis of surgery. This study analyzed the perioperative negative emotional risk factors of patients with different characteristics of PA and their impact on prognosis, so as to provide a reference for improving the prognosis of patients with PA.MethodsA total of 234 patients who underwent PA surgery in the Affiliated Hospital of Nantong University from January 2017 to January 2022 were selected as the observation population. The general characteristics of the subjects were collated using a general information questionnaire designed by the researchers. The negative emotions of the patients were evaluated using a Self-rating Anxiety Scale (SAS) and a Self-rating Depression Scale (SDS). The prognosis of patients was determined by assessing the hypophyseal hormone levels. Multiple regression analysis and logistic regression were used to analyze the risk factors of perioperative negative emotions and the effects of negative emotions on patient prognosis.ResultsMultiple regression analysis showed that with and without children, education, income, PA type, PA size, and surgical approach were independent factors influencing negative emotions in patients after PA surgery (P<0.05). Logistic regression analysis showed that negative emotion was an independent prognostic factor (P<0.05).ConclusionsThere are many factors that affect the anxiety and depression of patients after PA surgery. The family members and medical staff of the patients should take effective measures to relieve the anxiety and depression of the patients so as to improve the prognosis of patients according to the influencing factors.

Application of Etomidate Combined with Different Doses of Analgesics in Anesthesia Induction of Senile Craniocerebral Surgery

Application of Etomidate Combined with Different Doses of Analgesics in Anesthesia Induction of Senile Craniocerebral Surgery