Analysis of the lncRNA-miRNA-mRNA network to explore the regulation mechanism in human traumatic brain injury.

Traumatic brain injury (TBI) refers to brain dysfunction with or without traumatic structural injury induced by an external force. Nevertheless, the molecular mechanism of TBI remains undefined. Differentially expressed (DE) lncRNAs, DEmRNAs and DEmiRNAs were selected between human TBI tissues and the adjacent histologically normal tissue by high-throughput sequencing. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis of overlapping DEmRNAs between predicted mRNAs of DEmiRNAs and DEmRNAs. The competitive endogenous RNA (ceRNA) network of lncRNA-miRNA-mRNA was established in light of the ceRNA theory. In the ceRNA network, the key lncRNAs were screened out. Then key lncRNAs related ceRNA subnetwork was constructed. After that, qRT-PCR was applied to validate the expression levels of hub genes. 114 DElncRNAs, 1807 DEmRNAs and 6 DEmiRNAs were DE in TBI. The TBI-related ceRNA network was built with 73 lncRNA nodes, 81 mRNA nodes and 6 miRNAs. According to topological analysis, two hub lncRNAs (ENST00000562897 and ENST00000640877) were selected to construct the ceRNA subnetwork. Subsequently, key lncRNA-miRNA-mRNA regulatory axes constructed by two lncRNAs including ENST00000562897 and ENST00000640877, two miRNAs including miR-6721-5p and miR-129-1-3p, two mRNAs including ketohexokinase (KHK) and cyclic nucleotide-gated channel beta1 (CNGB1), were identified. Furthermore, qRT-PCR results displayed that the expression of ENST00000562897, KHK and CNGB1 were significantly decreased in TBI, while the miR-6721-5p expression levels were markedly increased in TBI. The results of our study reveal a new insight into understanding the ceRNA regulation mechanism in TBI and select key lncRNA-miRNA-mRNA axes for prevention and treatment of TBI.

Organized Chronic Subdural Hematoma Mimicking Acute Epidural Hematoma.

Background: Chronic subdural hematoma is a common disease in neurosurgery, but organized chronic subdural hematoma is rarely seen clinically. This article reports a case of misdiagnosis of organized chronic subdural hematoma as acute epidural hematoma. Through literature review, the causes of misdiagnosis and the treatment methods of organized chronic subdural hematoma are discussed. Case Description. A 70-year-old male patient was admitted to the hospital due to headache and dizziness after head trauma. Emergency head CT reported "left frontotemporal parietal epidural hematoma." Because the head CT showed that the hematoma occupying effect was obvious, an emergency "intracranial hematoma evacuation" was performed. After opening the skull during the operation, no epidural hematoma was seen. Upon incision of the dura mater, the outer membrane of organized chronic subdural hematoma was found. When the outer membrane was cut open, a large amount of reddish-brown silt-like materials was found in the capsule cavity. The inner membrane was not forcibly removed. Postoperative head CT showed that the organized chronic subdural hematoma was basically cleared. Conclusion: The early symptoms of organized chronic subdural hematoma are atypical, with insidious onset and easy misdiagnosis. By carefully inquiring about the medical history and carefully reading the head CT, such misdiagnosis can be avoided. Craniotomy is currently an important treatment option for organized chronic subdural hematoma.

Case report: a case of primary intracranial parasagittal meningeal angiosarcoma.

BACKGROUND: Angiosarcoma, also known as malignant hemangioendothelioma, is a rare vasogenic malignant tumor, commonly found on the skin of the head and neck, rarely occurring in the intracranial region. As for intracranial meningeal angiosarcoma, only 8 cases have been reported before and there is no clinical study with large sample size. We report here a case of parasagittal meningeal angiosarcoma. CASE DESCRIPTION: A 48-year-old Chinese male patient was admitted to our hospital due to headache accompanied by bilateral lower limb weakness. On admission, CT showed a high-density mass on both sides of the sagittal sinus at the top of the frontal lobe. We performed exploratory surgical resection of the tumor. During the operation, it was found that the tumor originated from the dura mater and extensively invaded the surrounding brain tissue and skull, and the surrounding hemosiderin deposition was observed. Postoperative pathology suggested angiosarcoma. CONCLUSIONS: Intracranial meningeal angiosarcoma is difficult to accurately diagnose before surgery, so radiologists and neurosurgeons need to strengthen their understanding of this disease. The presence of extensive superficial hemosiderin deposition during operation may contribute to the diagnosis, and immunohistochemistry is very important for the diagnosis of intracranial angiosarcoma.

Pterostilbene Attenuates Subarachnoid Hemorrhage-Induced Brain Injury through the SIRT1-Dependent Nrf2 Signaling Pathway.

Neuroinflammatory injury, oxidative insults, and neuronal apoptosis are major causes of poor outcomes after subarachnoid hemorrhage (SAH). Pterostilbene (PTE), an analog of resveratrol, has been verified as a potent sirtuin 1 (SIRT1) activator. However, the beneficial actions of PTE on SAH-induced brain injury and whether PTE regulates SIRT1 signaling after SAH remain unknown. We first evaluated the dose-response influence of PTE on early brain impairment after SAH. In addition, EX527 was administered to suppress SIRT1 signaling. The results revealed that PTE significantly attenuated microglia activation, oxidative insults, neuronal damage, and early neurological deterioration. Mechanistically, PTE effectively enhanced SIRT1 expression and promoted nuclear factor-erythroid 2-related factor 2 (Nrf2) accumulation in nuclei. Furthermore, EX527 pretreatment distinctly repressed PTE-induced SIRT1 and Nrf2 activation and deteriorated these beneficial outcomes. In all, our study provides the evidence that PTE protects against SAH insults by activating SIRT1-dependent Nrf2 signaling pathway. PTE might be a therapeutic alternative for SAH.

Case Report: A case of cervical spinal epidural abscess combined with cervical paravertebral soft tissue abscess.

Background: Spinal epidural abscess (SEA) is a rare purulent infection of the central nervous system. Abscesses confined to the spinal canal can compress the spinal cord, causing nerve damage and even death in severe cases (1). Prompt diagnosis and treatment can relieve symptoms and prevent complications. To increase awareness of this rare disease, we report a case of a 58-year-old man with a cervical spinal epidural abscess combined with a soft tissue abscess in the neck and describe its clinical course, imaging feature, pathology, treatment, and patient prognosis. Case description: A 58-year-old male Chinese patient was admitted to our hospital because of neck pain for 2 months, which worsened for 4 days. On the third day of admission, the muscle strength of the limbs decreased, and MRI of the spinal cord showed abnormal signal shadows in the spinal canal at the C1-C7 level and in the surrounding soft tissue on the right side of spine, suggesting the possibility of inflammatory lesions with local abscess formation. We immediately performed decompression of the spinal canal on the patient and performed incision and drainage of the cervical abscess. During the operation, we found a large amount of pus in the epidural space of the spinal canal, and there was a fistula between the cervical abscess and the epidural abscess of the spinal canal. The patient underwent continuous drainage and anti-infective treatment with sensitive antibiotics after operation. No recurrence of the abscess was observed and the patient recovered well. Conclusion: Early diagnosis is the key to the treatment of SEA, so radiologists and neurosurgeons need to strengthen their understanding of this rare disease to avoid misdiagnosis. For SEA with definite diagnosis, decompression surgery should be performed in a timely manner when symptoms of nerve compression occur, continuous drainage should be performed after surgery, and sensitive antibiotics should be used for anti-infective treatment.

Identification of an epithelial-mesenchymal transition-related lncRNA prognostic signature for patients with glioblastoma.

Glioblastoma (GBM) is a strikingly heterogeneous and lethal brain tumor with very poor prognosis. LncRNAs play critical roles in the tumorigenesis of GBM through regulation of various cancer-related genes and signaling pathways. Here, we focused on the essential role of EMT and identified 78 upregulated EMT-related genes in GBM through differential expression analysis and Gene set enrichment analysis (GSEA). A total of 301 EMT-related lncRNAs were confirmed in GBM through Spearman correlation analysis and a prognostic signature consisting of seven EMT-related lncRNAs (AC012615.1, H19, LINC00609, LINC00634, POM121L9P, SNHG11, and USP32P3) was established by univariate and multivariate Cox regression analyses. Significantly, Kaplan-Meier analysis and receiver-operating-characteristic (ROC) curve validated the accuracy and efficiency of the signature to be satisfactory. Quantitative real-time (qRT)-PCR assay demonstrated the expression alterations of the seven lncRNAs between normal glial and glioma cell lines. Functional enrichment analysis revealed multiple EMT and metastasis-related pathways were associated with the EMT-related lncRNA prognostic signature. In addition, we observed the degree of immune cell infiltration and immune responses were significantly increased in high-risk subgroup compared with low-risk subgroup. In conclusion, we established an effective and robust EMT-related lncRNA signature which was expected to predict the prognosis and immunotherapy response for GBM patients.

Intracranial solitary fibrous tumor/hemangiopericytomas: a clinical analysis of a series of 17 patients.

OBJECTIVE: Solitary fibrous tumors (SFTs) and haemangiopericytomas (HPCs) are rare mesenchymal tumors in central nervous system (CNS). Although progressed recognition to the diagnosis and treatment of SFT/HPCs, it still remains many confusions regarding on its occurrence, aggressive evolution, malignant transformation, dedifferentiation phenomenon, distant metastasis and unpredictable propensity. PATIENTS AND METHODS: Seventeen cases of CNS SFT/HPCs who underwent surgical treatment from January 2010 to December 2020 were collected in the authors' institute. Clinical, radiological, pathological data and followup details were reviewed in all cases. RESULTS: The age of this series was 41-73 years old. Seven cases located subtentorially, five cases originated from middle skull base and four in supratentorial. MRI shows iso-signal intensity on T1WI, and heterogeneous slightly long/short signal on T2WI. There is significant contrast after gadolinium-enhancement. It is easy to be misdiagnosed before surgery. The positive rate of nuclear STAT6 is 94.12%, higher than CD34 (87.5%). Eight patients were grade I, eight grade II and one in grade III. Five cases developed tumor relapse, in which two cases had local intracranial recurrence combined with dissemination and metastasis of cerebrospinal fluid in the spinal canal, accompanied by pathological malignant transformation, and another one occurred blood metastasis. CONCLUSIONS: CNS SFT/HPCs are rare intracranial tumors with unpredictable propensity. Gross total resection is critical to its overall clinical prognosis. Given its potential recurrence and malignant transition, adjuvant radiotherapies are recommended when necessary, and long-term follow-up is indispensable. The underlying molecular biological mechanisms are still needed to be further exploration.

Ossified Chronic Subdural Hematoma in Children: Case Report and Review of Literature.

BACKGROUND: Chronic subdural hematoma is a frequently clinical common problem encountered in neurosurgery practice. Nevertheless, ossified chronic subdural hematoma is extremely rare, especially in children. CASE DESCRIPTION: Here we report a case of ossified chronic subdural hematoma in a 7-year-old female child, with a literature review. CONCLUSIONS: Because of its infrequency and variable clinical manifestation, ossified chronic subdural hematoma should be considered and included in the differential diagnosis when we encounter an intracranial placeholder.

Postoperative Complications of Endoscopic Versus Microscopic Transsphenoidal Pituitary Surgery: A Meta-Analysis.

Transsphenoidal microscopic pituitary surgery is an effective way of treating pituitary tumors. However, minimal invasive approach endoscopic transsphenoidal pituitary surgery has become much more prevalent these days. Endoscopic surgery resects the maximum tumour with less complications. As endoscopic surgery is much safer and less invasive as compared to the microscopic transsphenoidal surgery, selection of technology for the treatment of pituitary adenoma is becoming increasingly equivocal. The main aim of this systematic review was to assess the safety of endoscopic and microscopic transsphenoidal pituitary surgery in terms of postoperative complications. Relevant studies between January 1992 and January 2017 were searched in the Cochrane Library electronic databases, EMBASE and MEDLINE, through a systematic literature search. A total of 1,463 patients reviewed (microscopic group=684, endoscopic group=779), the proportion of diabetes insipidus, septal perforation and other complications related to surgery (include lip anesthesia, nasal anesthesia, deviated septum, saddle nose, sinusitis, synechiae, anosmia) in those patients who had endoscopic surgery were significantly lower (p<0.05). No significant difference emerged between the two approaches in the incidence rates of cerebrospinal fluid leak, meningitis, epistaxis or hypopituitarism (p>0.05). These results support the safety of endoscopic transsphenoidal pituitary adenoma surgery.

[In-depth interviews on late stage schistosomiasis patients about factors related to prevention and treatment in the rural areas].

OBJECTIVE: To explore factors related to current prevention and treatment of Advanced cases on schistosomiasis. METHODS: In-depth interviews were introduced to the qualitative study on 61 Advenced cases of schistosomiasis in Dongting Lake regions. Sampling was accidentally and judgmentally performed. RESULTS: Related factors on prevention and treatment of Advenced cases of schistosomiasis would include: higher degree of social support for patients (61/61), excessive dependence on the past pattern of schistosomiasis control, lack of the idea that one should be responsible for his/her own health, lack of knowledge about prevention and treatment of schistosomiasis (28/61), older age (57.40 +/- 10.80), lower education (4.70 years), less family income, lack of effective medical insurance system and efficient close-to-client system. CONCLUSION: Active participation from patients, medical institutions and society was needed to control Late Stage Schistosomiasis. Health education campaign should be intensified to improve the health awareness for schistosomiasis among residents in the heavy endemic areas. Medical insurance system should be set up in epidemic areas, while public health and cure systems for important diseases should be intensified in rural areas. The ability of public health system to be responsive and the accessibility of residents to health service system should be improved in rural areas as well.

[Study on the strategy of interrupting schistosomiasis transmission in a hilly new endemic area of Taoyuan County].

OBJECTIVE: To develop a strategy for interrupting the transmission of schistosomiasis japonica in a hilly new endemic area. METHODS: Since 1996, chemotherapy with praziquantel (adult 40 mg/kg, child 50 mg/kg, cattle 30 mg/kg, once a year) on human beings in Taoyuan County who had ever contacted with infectious water and cattle which were herded in endemic situation was the major intervention, with focal control of Oncomelania snails in susceptible areas as supplementary one. RESULTS: The positive rate of stool examination for schistosomiasis in human and cattle reduced from 5.69% and 6.76% in 1996 to 0.04% and 0 in 2005 respectively. The positive rate of indirect hemagglutination test (IHA) in human dropped from 7.45% in 1996 to 1.61% in 2004. Though living snails were still found in most habitats, the density of infected snails decreased from 0.0036/0.11m2 in 1997 to 0 in 2005 and no infected snails were found since 2000. CONCLUSION: Due to less movement of human and cattle populations and the hilly area relatively isolated, chemotherapy combined with focal mollusciciding have been highly effective in eliminating the infection sources and interrupting transmission of schistosomiasis.