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1.
Clin Proteomics ; 21(1): 29, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594611

RESUMO

BACKGROUND: Adamantinomatous craniopharyngiomas (ACPs) are rare benign epithelial tumours with high recurrence and poor prognosis. Biological differences between recurrent and primary ACPs that may be associated with disease recurrence and treatment have yet to be evaluated at the proteomic level. In this study, we aimed to determine the proteomic profiles of paired recurrent and primary ACP, gain biological insight into ACP recurrence, and identify potential targets for ACP treatment. METHOD: Patients with ACP (n = 15) or Rathke's cleft cyst (RCC; n = 7) who underwent surgery at Sanbo Brain Hospital, Capital Medical University, Beijing, China and received pathological confirmation of ACP or RCC were enrolled in this study. We conducted a proteomic analysis to investigate the characteristics of primary ACP, paired recurrent ACP, and RCC. Western blotting was used to validate our proteomic results and assess the expression of key tumour-associated proteins in recurrent and primary ACPs. Flow cytometry was performed to evaluate the exhaustion of tumour-infiltrating lymphocytes (TILs) in primary and recurrent ACP tissue samples. Immunohistochemical staining for CD3 and PD-L1 was conducted to determine differences in T-cell infiltration and the expression of immunosuppressive molecules between paired primary and recurrent ACP samples. RESULTS: The bioinformatics analysis showed that proteins differentially expressed between recurrent and primary ACPs were significantly associated with extracellular matrix organisation and interleukin signalling. Cathepsin K, which was upregulated in recurrent ACP compared with that in primary ACP, may play a role in ACP recurrence. High infiltration of T cells and exhaustion of TILs were revealed by the flow cytometry analysis of ACP. CONCLUSIONS: This study provides a preliminary description of the proteomic differences between primary ACP, recurrent ACP, and RCC. Our findings serve as a resource for craniopharyngioma researchers and may ultimately expand existing knowledge of recurrent ACP and benefit clinical practice.

2.
Angew Chem Int Ed Engl ; 63(8): e202316029, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38168107

RESUMO

RuO2 is one of the benchmark electrocatalysts used as the anode material in proton exchange membrane water electrolyser. However, its long-term stability is compromised due to the participation of lattice oxygen and metal dissolution during oxygen evolution reaction (OER). In this work, weakened covalency of Ru-O bond was tailored by introducing tensile strain to RuO6 octahedrons in a binary Ru-Sn oxide matrix, prohibiting the participation of lattice oxygen and the dissolution of Ru, thereby significantly improving the long-term stability. Moreover, the tensile strain also optimized the adsorption energy of intermediates and boosted the OER activity. Remarkably, the RuSnOx electrocatalyst exhibited excellent OER activity in 0.1 M HClO4 and required merely 184 mV overpotential at a current density of 10 mA cm-2 . Moreover, it delivered a current density of 10 mA cm-2 for at least 150 h with negligible potential increase. This work exemplifies an effective strategy for engineering Ru-based catalysts with extraordinary performance toward water splitting.

3.
Neurosurg Rev ; 38(1): 101-7; discussion 107, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25139398

RESUMO

The purpose of this study is to summarize our experience in managing patients with an atypical or malignant meningioma at our institution, with a specific focus on determining the prognostic factors for treatment outcome. We reviewed the records of 126 patients with atypical or malignant meningiomas from January 2001 to August 2011. Data collected included gender, age, Karnofsky Performance Scale (KPS) score, pathology results, cleavability, and bone invasion. The symptoms and signs were recorded for further outcome analysis. There were 37 malignant meningiomas and 89 atypical meningiomas. Total resection (Simpson grade I-II) was achieved in 80.9% of atypical patients (n = 72) and 67.6% of malignant patients (n = 25). Forty patients (44.9%) in the atypical group underwent radiotherapy after surgery, while 26 (70.2%) patients underwent radiotherapy in the malignant group. The median follow-up duration was 25 months. Patients with a secondary tumor had a much shorter progression-free survival (PFS) than those with a primary tumor in the malignant group. The malignant meningioma group had lower overall survival. Progression-free survival for patients in the malignant group who received postoperative radiotherapy was longer than that for those who did not receive radiotherapy. In conclusion, total resection of the tumor was important because patients with a secondary tumor were much more likely to have recurrence than patients with a primary tumor in the atypical and malignant meningioma groups. Also, radiotherapy should be performed after surgery for a malignant meningioma.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Resultado do Tratamento
4.
J Neurosurg Case Lessons ; 7(10)2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38437680

RESUMO

BACKGROUND: Marfan syndrome, a connective tissue disorder, poses unique challenges in neurosurgery, given the fragility of vascular structures. Superior cerebellar artery (SCA) aneurysms in patients with the syndrome are rare and present distinct surgical difficulties, necessitating innovative approaches. OBSERVATIONS: A 29-year-old male with Marfan syndrome presented with a subarachnoid hemorrhage from a ruptured SCA aneurysm. Given the lack of a defined aneurysm neck and the small diameter of the SCA, standard clipping and endovascular therapies were unsuitable. A microsurgical approach using microsutures was successfully employed, effectively managing the aneurysm while preserving the parent artery. LESSONS: This case underscores the efficacy of the microsuture technique in complex neurosurgical scenarios, particularly in patients with connective tissue disorders such as Marfan syndrome. The adaptability of surgical strategies, as demonstrated in this case, is crucial for achieving successful outcomes in patients with unique anatomical challenges.

5.
J Ethnopharmacol ; 310: 116342, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-36889419

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Dendrobium huoshanense C. Z. Tang et S. J. Cheng is an important edible medicinal plant that thickens the stomach and intestines, and its active ingredient, polysaccharide, can have anti-inflammatory, immunoregulatory, and antitumor effects. However, the gastroprotective effects and potential mechanisms of Dendrobium huoshanense polysaccharides (DHP) remain unclear. AIM OF THE STUDY: An N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) induced human gastric mucosal epithelial cells (GES-1) damage model was used in this research, aiming to investigate whether DHP has a protective effect on MNNG-induced GES-1 cell injury and its underlying mechanism based on the combination of multiple methods. MATERIALS AND METHODS: DHP was extracted using water extraction and alcohol precipitation methods, and the proteins were removed using the Sevag method. The morphology was observed using scanning electron microscopy. A MNNG-induced GES-1 cell damage model was developed. Cell viability and proliferation of the experimental cells were investigated using a cell counting kit-8 (CCK-8). Cell nuclear morphology was detected using the fluorescent dye Hoechst 33342. Cell scratch wounds and migration were detected using a Transwell chamber. The expression levels of apoptosis proteins (Bcl-2, Bax, Caspase-3) in the experimental cells were detected by Western blotting. Ultra-high performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) was performed to investigate the potential mechanism of action of DHP. RESULTS: The CCK-8 kit analysis showed that DHP increased GES-1 cell viability and ameliorated GES-1 cell injury by MNNG. In addition, scratch assay and Transwell chambers results suggested that DHP improved the MNNG-induced motility and migration ability of GES-1 cells. Likewise, the results of the apoptotic protein assay indicated that DHP had a protective effect against gastric mucosal epithelial cell injury. To further investigate the potential mechanism of action of DHP, we analyzed the metabolite differences between GES-1 cells, GES-1 cells with MNNG-induced injury, and DHP + MMNG-treated cells using UHPLC-HRMS. The results indicated that DHP upregulated 1-methylnicotinamide, famotidine, N4-acetylsulfamethoxazole, acetyl-L-carnitine, choline and cer (d18:1/19:0) metabolites and significantly down-regulated 6-O-desmethyldonepezil, valet hamate, L-cystine, propoxur, and oleic acid. CONCLUSIONS: DHP may protect against gastric mucosal cell injury through nicotinamide and energy metabolism-related pathways. This research may provide a useful reference for further in-depth studies on the treatment of gastric cancer, precancerous lesions, and other gastric diseases.


Assuntos
Dendrobium , Neoplasias Gástricas , Humanos , Metilnitronitrosoguanidina/toxicidade , Dendrobium/química , Neoplasias Gástricas/patologia , Polissacarídeos/farmacologia , Espectrometria de Massas
6.
Food Chem ; 387: 132872, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35390604

RESUMO

This study aimed to investigate the effects of standing curing (SC), tumbling curing (TC), vacuum tumbling curing (VTC) and ultrasonic-assisted curing (UAC) on the edible quality of black pork and property of myofibrillar proteins (MPs) extracted from black pork. The results showed that all curing methods could improve the marinating absorptivity and the gel water retention of black pork, the solubility and surface hydrophobicity of myofibrillar proteins, and reduce the cooking loss and shear force of black pork, the hydrogen bond content of myofibrillar proteins and the gel whiteness compared with the control group (SC). The result of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed that the concentration of protein bands by VTC treatment was decreased obviously. In addition, the result of the scanning electron microscope (SEM) presented that tumbling and ultrasound treatment would destroy the structure of muscle fibers and make them loose and disordered.


Assuntos
Carne de Porco , Carne Vermelha , Animais , Culinária , Eletroforese em Gel de Poliacrilamida , Proteínas , Solubilidade , Suínos
7.
Artigo em Inglês | MEDLINE | ID: mdl-35104200

RESUMO

Chlorfenapyr has been widely used in recent years to control a variety of pests on fruit and vegetables. Cabbage, leek, asparagus, and chive are four of the most common green foods consumed word wide; their pesticide residue issues have also received more attention. Therefore, studies on the residue analysis, degradation evaluation and dietary risk assessment based on the complete residue definition of chlorfenapyr on these four vegetables were essential and urgently needed. A reliable analytical method was developed and applied to simultaneously determine the content of chlorfenapyr and its metabolite tralopyril residues on the four vegetables. Recoveries were satisfactory (84%-110% for chlorfenapyr; 83%-106% for tralopyril) at a spiked level of 0.01-1 mg/kg, with intraday precision (n = 5) and interday precision (n = 15) ranging from 1.6% to 8.9% and from 2.4% to 9.1%, respectively. The limits of quantification (LOQs) were all 0.01 mg/kg. On the basis of supervised field trials, the degradation half-lives of chlorfenapyr were 1.2-9.8 days. Chlorfenapyr rapidly degraded on asparagus, but persisted much longer on chive. The terminal concentration of chlorfenapyr residues varied from <0.01 to 0.84 mg/kg. Additionally, the risk quotients (RQs) ranged from 4.7% to 13.8%, suggesting that chlorfenapyr had a negligible risk for chronic dietary intake of these crops. This study was thus significant in evaluating the degradation rate and quality safety of chlorfenapyr on various vegetables and promoted the development of maximum residue limits.


Assuntos
Resíduos de Praguicidas , Piretrinas , China , Resíduos de Praguicidas/análise , Piretrinas/análise , Verduras/química
8.
Front Plant Sci ; 13: 997778, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36212317

RESUMO

Trichomes, which develop from epidermal cells, are considered one of the important characteristics of the tea plant [Camellia sinensis (L.) O. Kuntze]. Many nutritional and metabolomic studies have indicated the important contributions of trichomes to tea products quality. However, understanding the regulation of trichome formation at the molecular level remains elusive in tea plants. Herein, we present a genome-wide comparative transcriptome analysis between the hairless Chuyeqi (CYQ) with fewer trichomes and the hairy Budiaomao (BDM) with more trichomes tea plant genotypes, toward the identification of biological processes and functional gene activities that occur during trichome development. In the present study, trichomes in both cultivars CYQ and BDM were unicellular, unbranched, straight, and soft-structured. The density of trichomes was the highest in the bud and tender leaf periods. Further, using the high-throughput sequencing method, we identified 48,856 unigenes, of which 31,574 were differentially expressed. In an analysis of 208 differentially expressed genes (DEGs) encoding transcription factors (TFs), five may involve in trichome development. In addition, on the basis of the Gene Ontology (GO) annotation and the weighted gene co-expression network analysis (WGCNA) results, we screened several DEGs that may contribute to trichome growth, including 66 DEGs related to plant resistance genes (PRGs), 172 DEGs related to cell wall biosynthesis pathway, 29 DEGs related to cell cycle pathway, and 45 DEGs related to cytoskeleton biosynthesis. Collectively, this study provided high-quality RNA-seq information to improve our understanding of the molecular regulatory mechanism of trichome development and lay a foundation for additional trichome studies in tea plants.

9.
Artigo em Inglês | MEDLINE | ID: mdl-34407740

RESUMO

Strawberries are widely cultivated and highly consumed globally, but pests and diseases can severely affect yields. Phenamacril and difenoconazole are high-efficacy pesticides and the mixture of these two pesticides offers a satisfactory option for disease control. In this study, an optimised QuEChERS method combined with dispersive solid-phase extraction purification before injection for simultaneously determining the residues of phenamacril-difenoconazole mixture on strawberries was developed and validated using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Average recoveries of phenamacril and difenoconazole in the strawberry matrices ranged from 100% to 104% and 99% to 104%, with relative standard deviations of 2.6%-5.3% and 2.2%-5.5%, respectively. The degradation half-lives of phenamacril and difenoconazole were 3.5-6.6 days and 2.2-3.4 days on strawberries, respectively. Final residues of phenamacril and difenoconazole on strawberries at eight different cultivation regions were 0.033-0.66 mg kg-1 and <0.02-0.089 mg kg-1 after spraying at the maximum dosage recommended by the company of 300 mg a.i. kg-1 twice, respectively. Overall, this study is the first report of phenamacril and difenoconazole residue analysis in strawberries. Therefore, it could provide the reference data for safe management and proper use of phenamacril and difenoconazole in China.


Assuntos
Cianoacrilatos/análise , Dioxolanos/análise , Análise de Alimentos , Fragaria/química , Fungicidas Industriais/análise , Resíduos de Praguicidas/análise , Triazóis/análise , Cromatografia Líquida de Alta Pressão , Extração em Fase Sólida , Espectrometria de Massas em Tandem
10.
J Clin Neurosci ; 83: 13-20, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33328148

RESUMO

OBJECTIVE: The frontal basal interhemispheric approach (FBIA) is preferable for resection of craniopharyngioma (CP), achieving desirable total resection rates in early reports of lesions located in the suprasellar region to the third ventricle. For tumours that have created a larger obstruction of the tuberculum sellae and planum sphenoidale, aggressive resection in the intrasellar region and medial wall of the cavernous sinus is not feasible compared to improving tumour visualization by drilling the tuberculum sellae and planum sphenoidale. In a report of drilling the sellar tuberculum and sphenoid planum, drilling allowed the direct visualization of tumours invading the intrasellar region and medial wall of the cavernous sinus. Reconstructing the opening of the sellar-sphenoid cavity is achieved by microsuturing a piece of the pericranium/dura around the dural edge of the defective dura of the open sphenoid sinus and sellar cavity to prevent cerebrospinal fluid (CSF) leakage. PATIENTS AND METHODS: The FBIA with drilling of the tuberculum sellae and planum sphenoidale was performed to remove the tumours that invaded the intrasellar region and cavernous sinus in 55 patients from January 2014 to October 2019 at our institution. The pre- and postoperative pituitary hormone levels and vision were evaluated as effective standards after surgery and compared using paired t-tests. The different rates of CSF leakage between the packing and microsuture groups were compared by χ2 test, p < 0.05. RESULTS: In all patients with a mean 37-month follow-up (range, 3-2 months), 43 (78.2%) patients returned to their normal life or school independently, 7 (12.7%) patients were able to perform normal activities with minor complaints or effort, and 4 (7.3%) patients could care for themselves or only required occasional assistance. One (1.8%) death occurred, attributed to CSF leak-related meningitis at 5 months after surgery. Postoperative CSF leakage occurred in eight (19.0%) of 42 patients with packed bone wax or pieces of muscle to the sphenoid sinus. Of 13 patients with a piece of the periosteum/dura microsutured around the defective dura of the sellar region and open sphenoid sinus, one (7.7%) of 13 patients experienced CSF leakage in the perioperative period. With statistical analysis, there was a potential risk for postoperative CSF leakage in the bone wax and muscle piece in the open sphenoid sinus, whereas microsuture manoeuvres were effective for avoiding the risk of postoperative CSF leakage (χ2 = 8.865, p < 0.005). The microsutures closed the open sphenoid sinus such that it was water-tight. Postoperative visual acuity and the visual field were not affected by the increased intrasellar exposure or the open sphenoid sinus achieved by drilling the tuberculum sellae and planum sphenoidale. CONCLUSION: Tuberculum sellae/planum sphenoidale drilling via FBIA is feasible to enhance the direct visualization of CP resection, which expands the intrasellar region with a direct resection of recurrent tumours in the sellar cavity and adhering to the medial wall of the cavernous sinus. The potential risk of a CSF leakage seemed to be mitigated when using water-tight microsutures on a piece of the pericranium/dura around the edge of the defective dura in the sellar region and the open sphenoid sinus cavity.


Assuntos
Craniofaringioma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Sela Túrcica/cirurgia , Osso Esfenoide/cirurgia , Adolescente , Adulto , Seio Cavernoso/patologia , Seio Cavernoso/cirurgia , Vazamento de Líquido Cefalorraquidiano , Criança , Pré-Escolar , Craniofaringioma/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Estudos Retrospectivos , Sela Túrcica/patologia , Osso Esfenoide/patologia , Seio Esfenoidal/patologia , Seio Esfenoidal/cirurgia
11.
J Colloid Interface Sci ; 510: 111-117, 2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-28942161

RESUMO

Due to its high isoelectric point, relative safety and low environmental toxicity, magnesium oxide has attracted much attention for its role in the removal of toxic dyes from wastewater. Herein, MgO-SiO2 composites with rough surfaces were synthesized by a one-step method. The as-prepared composites were characterized for the adsorption of Congo red from water using adsorption kinetics and isotherms. The adsorption capacity of the 20% MgO-SiO2 sample could be as high as ∼4000mg/g at 25°C, which is the highest value reported to date. The adsorption process of Congo red on the as-synthesized samples obeyed the Langmuir adsorption model. The MgO-SiO2 composite sample could be regenerated by calcination, and the regeneration efficiency remained for up to 5 cycles of the regeneration.

12.
World Neurosurg ; 90: 511-517, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27012837

RESUMO

OBJECTIVE: To determine risk factors for the occurrence of postoperative entrapped temporal horn (ETH), a specific form of isolated hydrocephalus that is a severe complication after resection of lateral ventricular trigone tumors, following trigone meningioma surgery. METHODS: A retrospective review was performed of 121 cases of trigone meningiomas surgically treated between November 2011 and March 2015 in Beijing Tiantan Hospital. Patient demographics, imaging features, surgical procedures, and postoperative complications were evaluated by statistical analysis. RESULTS: The median follow-up time was 24.1 months. Postoperative ETH developed in 23 patients (19.0%). Primary univariate analysis showed that young age, a longer clinical history, development of postoperative meningitis, and a longer duration of ventricular drainage were significantly associated with an increased risk of postoperative ETH. Subsequent multiple logistic regression analysis indicated that a clinical history of >3 months (odds ratio [OR], 4.8; P = 0.008), postoperative neurologic deficits (OR, 4.2; P = 0.014), duration of ventricular drainage >3 days (OR, 4.8; P = 0.012), and postoperative meningitis (OR, 9.9; P = 0.001) were independently associated with a risk of postoperative ETH. CONCLUSIONS: Postoperative ETH frequently occurs in patients with trigone meningiomas. The severity of surgical injury of the surrounding brain tissue partly accounts for the risk of postoperative ETH. Clinical management of ventricular drainage and postoperative meningitis are of utmost importance. Ventricular drainage should be performed on an individual basis, and drainage tubes should be removed as early as possible.


Assuntos
Hidrocefalia/epidemiologia , Neoplasias Meníngeas/epidemiologia , Neoplasias Meníngeas/cirurgia , Meningioma/epidemiologia , Meningioma/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Causalidade , Neoplasias do Ventrículo Cerebral/mortalidade , Neoplasias do Ventrículo Cerebral/prevenção & controle , Criança , China/epidemiologia , Feminino , Humanos , Hidrocefalia/prevenção & controle , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
13.
J Neurosurg ; 119(3): 695-708, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23829815

RESUMO

OBJECT: Intracranial and intraspinal malignant peripheral nerve sheath tumors (MPNSTs) are rarely reported because of their extremely low incidence. Knowledge about these tumors is poor. In this study the authors aimed to analyze the incidence and clinical, radiological, and pathological features of intracranial and intraspinal MPNSTs. METHODS: Among 4000 cases of intracranial and intraspinal PNSTs surgically treated between 2004 and 2011 at Beijing Tiantan Hospital, cases of MPNST were chosen for analysis and were retrospectively reviewed. To determine which parameters were associated with longer progression-free survival (PFS) and overall survival (OS), statistical analysis was performed. RESULTS: Malignant PNSTs accounted for 0.65% of the entire series of intracranial and intraspinal PNSTs. Twenty-four (92.3%) of these 26 MPNSTs were primary. Radiologically, 26.9% (7 of 26) of the MPNSTs were misdiagnosed as nonschwannoma diseases. Twenty-one patients were followed up for 1.5 to 102 months after surgery. Twelve patients experienced tumor recurrence, and median PFS was 15.0 months. The 2- and 3-year PFS rates were 47.7% and 32.7%, respectively. Five patients died of tumor recurrence, and median OS was not available. The 2- and 3-year OS rates were 74.7% and 64.0%, respectively. Univariate analysis revealed that female sex, total tumor removal, and primary MPNSTs were significantly associated with a better prognosis. Multivariate analysis revealed that only total removal was an independent prognostic factor for both PFS and OS. CONCLUSIONS: Malignant PNST within the skull or spinal canal is a rare neoplasm and is seldom caused by benign schwannomas. Radiologically, intracranial or intraspinal MPNST should be differentiated from meningioma, chordoma, fibrous dysplasia of bone, and ear cancer. Total resection whenever possible is necessary for the prolonged survival of patients, especially males.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Neoplasias de Bainha Neural/diagnóstico por imagem , Neoplasias de Bainha Neural/patologia , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/patologia , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/mortalidade , Criança , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Neoplasias de Bainha Neural/mortalidade , Radiografia , Estudos Retrospectivos , Fatores Sexuais , Neoplasias da Medula Espinal/mortalidade , Taxa de Sobrevida , Resultado do Tratamento , Adulto Jovem
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