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Objective To introduce a membrane retraction technique that can provide good exposure of deep-seated recipient arteries in cortical sulci and simplify the anastomosis procedure. Methods Only those adult patients with moyamoya disease who underwent superficial temporal artery to middle cerebral artery bypass surgery during which the suitable recipient arteries were located deep in cortical sulci were included in this retrospective study. By placing 10–0 prolene sutures to the arachnoid membrane of the 2 banks of sulcus, arachnoid retraction was applied to pull the sulcus apart and then the deep-seated recipient arteries were exposed. Standard end-to-side anastomosis was completed. The mean occlusion time and successful rate were recorded and compared with those of the normal procedure. Results From June to November 2019, 124 superficial temporal artery to middle cerebral artery bypass surgeries for the treatment of moyamoya disease were performed in Nanfang Hospital. The membrane retraction technique was used in 5 patients (5/110, 4.5%) and the success rates were 100%. The mean temporary occlusion time was 27.2 minutes. No procedure-related complications were observed. All patients recovered uneventfully. The postoperative angiograms confirmed good patency of bypass grafts in all 5 cases. Conclusions The membrane retraction technique is an effective and safe method for the treatment of adult patients with moyamoya disease with deep-seated recipient arteries within the sulci.

To explore the clinical efficacies of bevacizumab (BEV) for high-grade glioma (HGG) in Chinese patients and evaluate its profiles of adverse events and usage safety.A total of 15 HGG cases, including glioblastoma multiform (GBM) (n = 12) and anaplastic astrocytoma (AA) (n = 3), were selected to receive the treatments of BEV (10 mg/kg, q2w) and temozolomide (TMZ, 150 mg/m(2), 5 d/28 d). Their radiological responses, clinical status, progression-free survival (PFS) and overall survival (OS) were evaluated. Also their adverse events and severity were recorded and analyzed.According to the RANO criteria, during the short period (3 months), 11 cases had significant radiological and clinical responses. However, only 4 cases responded during a follow-up period of beyond 3 months. Three cases had retrogression after BEV chemotherapy. At 6 months post-treatment, 8 cases (53.3%) survived without lesion progression and the median PFS was 8 ± 5 months. During a longer follow-up (6 months), 8 patients had tumor retrogression, including 5 deaths. The median overall survival period was 24 ± 10 months. The adverse events included hypertension (n = 2), wound-healing complication (n = 1), vomiting (n = 2) and cerebro-spinal fluid leakage (n = 1). All complications were cured by activate supportive measures.After BEV treatment, most patients obtain more significant short-term responses with good toleration. For re-operative cases, the usage of BEV should be deferred to one month post-operation so as to avoid the occurrence of wound-healing complications.