Recurrent central nervous system Rosai-Dorfman disease with KRAS mutation: a case report.

BACKGROUND: Rosai-Dorfman disease (RDD) is a rare, non-Langerhans cell histiocytosis of unknown etiology. we report a very rare case of recurrent central nervous system RDD with KRAS gene mutation and review the literature to improve our understanding of this disease. CASE PRESENTATION: A 19-year-old male patient was admitted to our hospital for headache. Cranial magnetic resonance imaging revealed a mass of abnormal signal shadows in the prepontine cistern. The mass was surgically removed and the patient was consequently diagnosed with intracranial Rosai-Dorfman disease. Seven months later, pathological examination confirmed that the RDD had recurred. Next-generation sequencing found KRAS mutation in exon 4 (C.351A > C. P. K117n). CONCLUSION: RDD of the CNS has no distinct clinical manifestations and imaging characteristics, and the final diagnosis should be based on the results of the pathological examination. Although RDD is not currently classified as a neoplastic disorder, some evidence of clonality has changed our understanding of it. Follow up examinations over a long period are necessary to determine the efficacy of treatment.

Staged Surgery for Intra-Extracranial Communicating Jugular Foramen Paraganglioma: A Case Report and Systematic Review.

Staged surgery strategy was preferred for patients with intra-extracranial communicating jugular foramen paraganglioma (IECJFP). A female patient who presented mild tinnitus, headache, and dizziness, together with preoperative related imaging, was diagnosed with a left intra-extracranial communicating jugular foramen lesion in November 2015 and accepted an initial operation for the intracranial tumor by retrosigmoid approach. The pathologic report was paraganglioma. In November 2021, a subtotal resection of the extracranial tumor was conducted for prominent lower cranial nerves (LCNs) deficit and middle ear involvement by infratemporal approach. In patients with IECJFP accompanied by LCNs deficit and middle ear involvement, an initial surgery for extracranial lesion and a second procedure for intracranial tumor were appropriate. However, the first operation for the intracranial lesion was preferred in IECJFP cases without LCNs deficit and middle ear involvement, as it could remove compression to the neurovascular structure and brain stem, clarify a pathological diagnosis, avoid a CSF leak, and prevent a severe neurological disorder from extracranial lesion excision. Subtotal resection of the extracranial tumor would be performed when lesion became larger combined with obvious LCNs disorder and tympanic cavity involvement. Consideration of specific staged surgical strategy for IECJFP in accordance with preoperative LCNs deficit and tympanic cavity involvement could prevent critical postoperative neurological deficit and improve quality of life in the long term.

Research on smoke simulation with vortex shedding.

The Lagrangian vortex method has the advantage of producing highly detailed simulations of fluids such as turbulent smoke. However, this method has two problems: the construction of the velocity field from the vorticity field is inefficient, and handling the boundary condition is difficult. We present a pure Lagrangian vortex method, including a nested grid to accelerate the construction of the velocity field, and a novel boundary treatment method for the vorticity field. Based on a tree structure, the nested grid algorithm considerably improves the efficiency of the velocity computation while producing visual results that are comparable with the original flow. Based on the vortex-generating method, the least square method is used to compute the vorticity strength of the new vortex elements. Further, we consider the mutual influence between the generated vortex particles. We demonstrate our method's benefits by using a vortex ring and various examples of interaction between the smoke and obstacles.

Towards an uncertainty evaluation model for marine track considering local sampling cloud and sample information.

To evaluate the practical ability of crews during the navigation of an inward-port single ship, a track evaluation model was developed on a planar forward normal cloud chart under sample information based on the forward normal and the backward normal cloud generator. Since the track sampling cloud may be too divergent, a track belt division method based on the contributions of normal cloud drops was proposed. Combining the track evaluation model with the track belt division method, a comprehensive track evaluation scheme of the local sampling cloud based on sampling information was established. The results of an example of M.V. DAQING 257 unloaded into Dalian Port demonstrated the effectiveness of the model and showed its consistency with expert evaluation results based on subjective information. The proposed uncertainty evaluation model provides a new approach for intelligent evaluation under sample information.

Comprehensive Analysis of REST/NRSF Gene in Glioma and Its ceRNA Network Identification.

We sought to clarify the clinical relationship between REST/NRSF expression and the prognosis of glioma and explore the REST-associated competitive endogenous RNA (ceRNA) network in glioma. We downloaded RNA-seq, miRNA-seq and correlated clinical data of 670 glioma patients from The Cancer Genome Atlas and analyzed the correlation between REST expression, clinical characteristics and prognosis. Differentially expressed genes (DEGs) were identified with DESeq2 and analyzed with Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) using the Profiler package. Starbase was used to explore the regulatory interaction between REST and miRNAs or LncRNAs. The lncRNA-miRNA-REST ceRNA network was constructed with Cytoscape. RT-qPCR, WB, CCK8, wound-healing, and luciferase assays were performed to validate the ceRNA network. Results showed that REST expression was significantly higher in glioma patients than normal samples. Higher REST expression was significantly associated with worse overall survival, progression-free interval, and worse disease-specific survival in glioma patients. The DEGs of mRNA, miRNA, and lncRNA were identified, and GO and KEGG enrichment analyses were performed. Finally, REST-associated ceRNA networks, including NR2F2-AS1-miR129-REST and HOTAIRM1-miR137-REST, were experimentally validated. Thus, REST may be a prognostic biomarker and therapeutic target in glioma, and its regulatory network validated in this study may provide insights into glioma's molecular regulatory mechanisms.

Clinicopathological characteristics of multiple intracranial Rosai-Dorfman disease with increased IgG4-positive plasma cells: a report of two cases.

Rosai-Dorfman disease (RDD) is an uncommon condition characterized by the proliferation of histiocytes and multiple intracranial involvements and it is extremely rare. Here, we present two cases of multiple intracranial RDD mimicking meningioma. These patients underwent surgery for tumour resection and pathological findings revealed an increased number of IgG4-positive plasma cells in RDD. The radiographic appearance and histology may contribute to a diagnostic dilemma, and immunohistochemical and serological examinations are a necessary complement for definitive diagnosis. Treatment protocols pertaining to such types of RDD cases are reviewed. Currently, surgical resection is the most effective therapy, and steroid therapy, radiotherapy, or chemotherapy may be provided as adjuvant treatments in some selected patients.

MicroRNA-1269a Promotes Proliferation and Arrest of Apoptosis of Glioma Cells by Directly Targeting ATRX.

Glioma is one of the deadliest malignant brain tumors in adults worldwide. MicroRNA (miR) has been reported to be a pivotal regulator in human tumors. The aim of this study was to determine the expression, function, and mechanism of action of miR-1269a in glioma progression. The expression of miR-1269a was higher in both glioma cases reported in databases and glioma cell lines, and it was highly associated with poorer prognosis. Next, it was shown in vitro that mimic of miR-1269a could promote glioma progression and arrest apoptosis, whereas the inhibition of miR-1269a exhibited the opposite effects. In addition, miR-1269a was found to directly target ATRX chromatin remodeler by a dual-luciferase reporter assay. Moreover, ATRX overexpression could reverse the suppressive effects of miR-1269a on proliferation and apoptosis in vitro. In vivo subcutaneous xenograft tumor assay was also performed to confirm the phenotypes and molecular mechanism involved. Taking the findings together, our study implies that the miR-1269a/ATRX axis is a novel therapeutic target of glioma.

Research on anchor chain visualization for a ship anchoring simulation training system.

In the development of ship anchorage training systems, the problems of low efficiency and poor fidelity exist in the simulation of flexible anchor chains, and a position-based dynamics (PBD) method is proposed to express the chain movement. To satisfy the requirements of simulating anchoring manipulation, the PBD method modifies the position of anchor chain particles by controlling constraints. Using the original distance constraint and bending constraint of the PBD approach, two novel constraints, namely, the long-range attachment (LRA) constraint and pin constraint, are developed to simulate the bending and stretching of the anchor chain. Simulation of ordinary ropes can be achieved using distance and bending constraints. The developed LRA constraint is capable of preventing anchor chain particles from being overstretched. Adoption of the pin constraint is proposed to integrate two particles into one to be calculated as an attempt to simulate the connection between the chain and the anchor. The continuous collision detection (CCD) constraint method considering friction and viscosity is used to detect collisions in the ship anchoring training system. Collision detection covers chain collisions with other objects and chains. Finally, the PBD method is more efficient and robust than the Newton method. Since it has sufficient visual plausibility and can realize real-time visualization, the simulation system developed by the PBD method effective for training crew members.

Predictive values of maximum changes of brainstem auditory evoked potentials during microvascular decompression for hemifacial spasm.

BACKGROUND: Brainstem auditory evoked potentials (BAEPs) have been widely monitored to prevent hearing loss (HL) during microvascular decompression (MVD) for hemifacial spasm (HFS); however, their predictive value is still unclear. The aim of this study is to investigate the predictive values of the maximum changes in BAEPs and define the best warning indicator and a cutoff value (CV) during HFS-MVD. METHODS: The clinical data of 93 HFS-MVD patients were retrospectively analysed. The maximum change rates of the latency and amplitude of waves I, III, and V and the interpeak latencies (IPLs) I-III, I-V, and III-V, when BAEPs change most during MVD, were defined. Pure tone audiometry was performed to evaluate hearing loss (HL). Logistic regression, propensity score, receiver operating curve (ROC), and area under the curve (AUC) were used to identify the predictive value of relevant indexes and to determine the CV (with the largest Youden index) of the best index at different levels of HL. RESULTS: The AUCs of BAEPs for predicting HL were 0.98, 0.92, and 0.84 for 50 dB, 30 dB, and 10 dB, respectively. The amplitude of wave V (AwV) was the best single predictive index at all three HL levels. The CV of AwV was 55% (50 dB), 46% (30 dB), and 34% (10 dB). At 50 dB HL, the predictive value of IPLs I-V (AUC 0.89 with CV 0.6 ms) was better than that of LwV (AUC 0.82 with CV 1 ms). CONCLUSION: BAEPs can predict HL well. AwV is the best single predictive index of all BAEPs. The reduction of AwV by 34% (watching), 46% (reporting), and 55% (warning) can be used as a sliding-scale warning sign. In addition, IPLs I-V (> 0.6 ms) and LwV (> 1 ms) should also be observed and reported during MVD.

Association between IL-13 Gene rs20541 Polymorphism and Glioma Susceptibility: A Meta-Analysis.

OBJECTIVE: We performed a meta-analysis to estimate the association between IL-13 gene rs20541 (R130Q) polymorphism and the susceptibility of glioma. PATIENTS AND METHODS: Potentially eligible studies published before February 1, 2016 were searched in 4 databases including PubMed, EMBASE, EBSCO, and Ovid. Odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were used to estimate the strength of relationship between the IL-13 gene rs20541 polymorphism and glioma susceptibility. Stata 11.0 software was used to perform the present meta-analysis. RESULTS: In total, 10 case-control studies with 13 datasets including 3,123 cases and 5,390 controls were identified. A significant increase in glioma susceptibility was found in the dominant model (AA + AG vs. GG: OR = 1.14, 95% CI 1.01-1.29; P = 0.031). Significantly decreasing glioma susceptibility was found for Asians in the heterozygote comparison (AG vs. GG: OR = 0.74, 95% CI 0.55-0.99; P = 0.042) and the allele contrast genetic model (A vs. G: OR = 0.67, 95% CI 0.47-0.96; P = 0.028). By contrast, in Caucasians, a significant increase in glioma susceptibility was found in the dominant model (AA + AG vs. GG: OR = 1.25, 95% CI 1.11-1.41; P = 0.000). CONCLUSION: There may be a weak association between the IL-13 gene rs20541 polymorphism and glioma susceptibility, and the associations may be different between ethnicities.

What range of stimulus intensities should we apply to elicit abnormal muscle response in microvascular decompression for hemifacial spasm?

BACKGROUND: Abnormal muscle response (AMR) has been considered as a predictor of the prognosis after microvascular decompression (MVD) for hemifacial spasm (HFS). However, its predictive value has not always been satisfactory. The objective of this work was to confirm an optimal range of stimulus intensities to elicit AMR in surgery. METHODS: Seventy-two consecutive patients with primary HFS treated by MVD were retrospectively included in this study. A wide range of stimulus intensities from 1 to 100 mA was applied in AMR monitoring. The AMR-elicited threshold value was quantitatively traced throughout all surgical procedures. The relationship between clinical outcomes and electrophysiological findings was analyzed. RESULTS: Of the 72 patients, 44 were immediately cured and 24 were delayed cured; the remaining 4 were proved not to be cured in their follow-up periods. The patterns of AMR-elicited threshold changes were categorized into five types, which could only be discriminated with a wide range of stimulus intensities. The constituent ratio of the patterns was significantly different (P < 0.001) among the clinical outcomes. CONCLUSIONS: Some patterns of AMR changes might have been ignored if we had only applied a narrow range of stimulus intensities (1-30 mA) to judge whether AMR disappeared or not. Thus, a wide range of stimulus intensities (1-100 mA) to trace the AMR-elicited threshold values was proposed for a more precise prediction.

[Effect of Tongmai Jiangtang Capsule on Experimental Diabetic Peripheral Neuropathy Rats].

OBJECTIVE: To observe the effect of Tongmai Jiangtang Capsule (TJC) on experimental diabetic peripheral neuropathy (DPN) rats. METHODS: Forty Wistar rats were divided into the TJC group, the mecobalamin treatment group, the model group, and the normal group according to random digit table, 10 in each group. Except rats in the normal group, DPN rat model was prepared using intraperitoneally in- jecting streptozotocin (STZ) in the rest rats. One rat in the model group died during the modeling. Different drugs were administered by gastrogavage to rats in corresponding groups from the 8th week after successful modeling. TJC (0.23 g crude drugs/mL, 10 mL/kg) was administered to rats in the TJC group by gastrogavage. Suspension of mecobalamin and normal saline (10 mL/kg, 0.05 mg/mL) was administered by gastrogavage to rats in the mecobalamin treatment group to the end of the 12th week. Meanwhile, equal volume of distilled water was administered by gastrogavage to rats in the model group and the normal group. Peripheral nerve conduction velocity was detected in each group. Gait analysis was performed. Changes of intraepidermal nerve fiber were observed by immunohistochemical assay. Pathological changes of tibial nerve tissue were observed using HE staining. RESULTS: (1) Compared with the normal group, the nerve conduction velocity was slowed down; print length (PL), intermediary toe spread (ITS), and toe spread (TS) were added in the model group, with statistical difference (P <0. 01). Compared with the mod- el group, nerve conduction velocity was speeded; PL and ITS decreased in the TJC group and the mecobal- amin treatment group, with statistical difference (P <0. 01). Besides, the nerve conduction velocity was superior in the TJC group than in the mecobalamin treatment group, with statistical difference (P <0. 05). (2) Immunohistochemical results showed, the staining of intraepidermal nerve fiber was not clear and dispersedly distributed in the model group, with no nerve fiber staining in local regions. Nerve fibers were not regular in lesser amount and shallow stained in the mecobalamin treatment group, with no nerve fiber staining in local regions. Nerve fibers were not regular in lesser amount and dispersedly distributed in the TJC group. (3) HE staining showed that tibial nerve tissue was severely swollen with swollen myelin sheath in the mod- el group. It was difficult to identity myelin sheath. Vaculole degenerated in local regions. Swollen axon could be seen. Partial axons were separated and degenerated. In the mecobalamin treatment group tibial nerve tissue was edematous with swollen myelin sheath. It was difficult to identity myelin sheath. Axons were locally separated. In the JMC group tibial nerve tissue was swollen with unclear myelin sheath and swollen axons. CONCLUSION: TJC could improve peripheral neuropathy of diabetic rats.