The Surgical Strategy Cerebrospinal Fluid Decompression Facilitates Outcomes of Adults with Chiari Malformation Type I: An Observational, Real-World, Single-Center Study of 528 Patients.

OBJECTIVE: We designed this study to introduce the surgical strategy cerebrospinal fluid (CSF) decompression in treatment of Chiari malformation type I and compared CSF decompression with other surgical strategies to provide a solid basis for patient counseling. METHODS: The study enrolled 528 consecutive patients with CMI who underwent surgical interventions from 2012 to 2022. The surgical strategy for these patients was bony and dural decompression, anatomical reduction of herniated tonsils, or CSF decompression. Short-term results were determined after 3 months; long-term outcomes were evaluated at last follow-up (at least 18 months). RESULTS: CSF decompression was independently associated with better long- or short-term primary outcomes than anatomical reduction of herniated tonsils or bony and dural decompression (P < 0.001). Compared with short-term, the long-term outcomes were better in patients who underwent CSF decompression (P = 0.035), but were worse in patients with bony and dural decompression (P = 0.03). Specific surgical techniques cannot affect the long- and short-term outcomes of patients with Chiari malformation type I. CSF decompression provided better long-term syringomyelia improvement than short-term (181/218, 83% vs. 169/218, 77.5%; P < 0.001). CONCLUSIONS: CSF decompression, but not a specific surgical technique or operative method, was associated with favorable neurological outcomes in ADULT patients with Chiari malformation type I. The surgical technique and operative method should be selected according to the characteristics of each patient and the intraoperative condition to normalize CSF circulation at the craniovertebral junction area. The intraoperative target, smooth CSF flow out from the fourth ventricle and in to the bilateral Luschka foramina, could be observed.

Photodynamic Therapy Combined with Dermabrasion in Cutaneous Squamous Cell Carcinoma Concomitant with Psoriasis.

Objective: Photodynamic therapy (PDT) is an effective method of treating skin tumors such as Bowen disease. Dermabrasion surgery removes the visible carcinoma, and PDT diminishes suspected malignant lesions. Combining the two methods can treat and prevent the recurrence of carcinoma. In this study, we describe a case of highly differentiated squamous cell carcinoma (SCC) located within a psoriatic lesion on the leg of a patient. Methods: Skin dermabrasion combined with four applications of PDT was used to successfully treat SCC. Topical tazarotene and calcipotriol ointments were used to treat the psoriasis, significantly improving the symptoms. Results: The SCC in the left leg disappeared without recurrence for 4 years of follow-up. Conclusions: PDT combined with skin dermabrasion is an effective method to treat SCC lesions with unclear boundaries.

Determination of freely dissolved polycyclic aromatic hydrocarbons in human serum using core-shell Fe3O4@polyacrylate magnetic microspheres by exclusive volume effect.

Freely dissolved concentration is an important parameter for evaluating the bioavailability of compounds. Negligible-depletion solid-phase microextraction (nd-SPME) has been widely used for the determination of freely dissolved compounds but suffered from long equilibrium time. Multifunctional mesoporous composite microspheres have large specific surface area and therefore extraction equilibrium could be reached in a short time. In this study, a novel method was developed for quick determination of freely dissolved polycyclic aromatic hydrocarbons (PAHs) in human serum using core-shell polyacrylate-ferriferous oxide magnetic microspheres (Fe3O4@PA). Mass transfer of PAHs from sample solution to Fe3O4@PA was greatly increased owing to unique properties including large surface area (58.5 m2 g-1), high pore volume (0.10 cm3 g-1) and thin coating layer (50 nm). Freely dissolved PAHs can be selectively extracted because of the mesoporous structure of PA coating layer with uniform pore size of 7.08 nm. However, bound forms of PAHs would not be able to access into pore channels due to size exclusion. In comparison with long equilibration time (139 h) by nd-SPME, equilibrium can be reached within 29 min (t90%) using Fe3O4@PA as novel sorbents. The sorption coefficients (log KBSA) of PAHs to bull serum albumin (BSA) ranged from 3.36 to 4.87, which are consistent with the values measured by nd-SPME (log KBSA = 3.64-5.12). Finally, the freely dissolved PAHs (Cfree) measured by the proposed method (0.69-1.92 µg L-1) have a good agreement with that by nd-SPME (0.56-2.11 µg L-1), indicating that it is feasible for rapid determination of free forms of compounds in real samples by Fe3O4@PA.

Mycobacterium tuberculosis found at both skin lesions and Mantoux testing site in a patient with erythema induratum of Bazin.

Mycobacterium tuberculosis is very rarely found in erythema induratum of Bazin; recently, we found an unusual case with positive acid-fast bacilli and polymerase chain reaction for detecting M. tuberculosis in both skin lesions of the extremities and the site of Mantoux test.

Pathway and network analysis in glioma with the partial least squares method.

Gene expression profiling facilitates the understanding of biological characteristics of gliomas. Previous studies mainly used regression/variance analysis without considering various background biological and environmental factors. The aim of this study was to investigate gene expression differences between grade III and IV gliomas through partial least squares (PLS) based analysis. The expression data set was from the Gene Expression Omnibus database. PLS based analysis was performed with the R statistical software. A total of 1,378 differentially expressed genes were identified. Survival analysis identified four pathways, including Prion diseases, colorectal cancer, CAMs, and PI3K-Akt signaling, which may be related with the prognosis of the patients. Network analysis identified two hub genes, ELAVL1 and FN1, which have been reported to be related with glioma previously. Our results provide new understanding of glioma pathogenesis and prognosis with the hope to offer theoretical support for future therapeutic studies.