Stereotactic puncture surgery combined with early hyperbaric oxygen therapy may be better for long-term functional recovery in patients with moderate amounts of thalamic-inner capsule region haemorrhage.

BACKGROUND: The prognosis of patients with thalamic hemorrhage is poor, and their long-term neurological impairment is heavy, which seriously affects their work and life.To comparatively analyse the efficacy and prognosis of patients with moderate hemorrhage in the thalamic region who underwent conservative treatment, stereotactic puncture surgery and neuroendoscopic surgery. METHOD: This study retrospectively analyzed hospitalization data from 139 adult patients with moderate-volume cerebral hemorrhage in the thalamo-endocapsular region. They were categorized into a stereotactic group (39cases), a neuroendoscopic group (36cases), and a conventional conservative group (64cases). Logistic regression analysis was used to assess risk factors for severe neurological deficits in patients. Multivariate regression modeling was used to compare the correlation of severe neurological deficits among the three groups of patients. RESULTS: Patients with thalamic moderate-volume cerebral hemorrhage had statistically significantly higher Assessment of Daily Living (ADL) scores in the stereotactic surgery group than in the conservative treatment group and the neuroendoscopic surgery group after 6 months of treatment (p< 0.001).The amount of residual hematoma was significantly lower in the surgery groups than in the conservative treatment group at 3 days, 7 days, and 2 weeks after the onset of the disease (P< 0.001).In multivariate logistic regression analyses, after adjusting for all covariates, the odds ratios for severe neurologic dysfunction in the stereotactic group and the neuroendoscopy group were, respectively, OR: 0.37 (0.12-0.87), P< 0.001 and 0.42 (0.23-1.13), P=0.361). CONCLUSION: In patients with moderate volume cerebral hemorrhage in the thalamus-inner capsule region cerebral hemorrhage, patients treated with stereotactic surgery combined with early hyperbaric oxygen therapy may have better long-term neurological recovery compared with conservative and neuroendoscopic surgical treatments.

Stereotactic Puncture Surgery for the Treatment of Moderate Volume of Thalamus-Internal Capsule Area Hemorrhage: An Analysis of Real-World Data.

BACKGROUND: The efficacy of surgical intervention in ameliorating long-term prognosis for moderate volume of cerebral hemorrhage in the thalamus-internal capsule region remains unsubstantiated by clinical investigations. Consequently, the acquisition of credible evidence is imperative to authenticate the effectiveness of these methodologies. METHODS: One hundred and three eligible patients with moderate-volume thalamus-internal capsule region cerebral hemorrhage. Twenty-seven pairs of successful matches after using the 1:1 propensity score matching method, totaling 54 patients, were analyzed. The short- and long-term treatment outcomes of patients in the stereotactic surgery and conservative treatment groups were compared. The prognosis of the 2 groups of patients was analyzed by logistic regression analysis and model comparison. RESULTS: The primary outcome of this study was to assess the assessment of daily living scores after 6 months of treatment. Based on the analysis of this study, the assessment of daily living of the surgical group were significantly higher than those of the conservative treatment group after 6 months of treatment (P < 0.001), and the difference was statistically significant. The amount of residual hematoma was significantly lower in the stereotactic surgery group than in the conservative treatment group at 3 days, 7 days, and 2 weeks after the onset of the disease (P < 0.001), and the complication rate was lower than the conservative treatment group (P < 0.05). Univariate logistic regression showed that the risk of severe neurological dysfunction for patients in the surgery group was (odds ratio -0.27, 95% confidence interval: 0.08-0.86, P < 0.05). In multivariate logistic regression analysis, the odds ratio was 0.29 (95% confidence interval: 0.09-0.96, P < 0.05) after adjusting for all covariates. CONCLUSIONS: For moderate-volume thalamus-internal capsule region cerebral hemorrhage, stereotactic paracentesis has the advantage of a shorter hospital stay and a lower complication rate than conservative treatment. Moreover, it yields superior outcomes in terms of daily living assessment scores after six months of treatment and enhanced neurological recovery.

Association between high serum blood glucose lymphocyte ratio and all-cause mortality in non-traumatic cerebral hemorrhage: a retrospective analysis of the MIMIC-IV database.

Background: This study aimed to evaluate the association between the glucose-to-lymphocyte ratio (GLR) and all-cause mortality in intensive care unit (ICU) patients with Non-traumatic cerebral hemorrhage. Methods: This is a retrospective cohort study. Baseline data and in-hospital prognosis from patients with non-traumatic cerebral hemorrhage admitted to the intensive care unit. Multivariate COX regression analysis was applied and adjusted hazard ratios (HR) and 95% predictive values with confidence intervals (CI) were calculated. Survival curves for the two groups of cases were plotted using K-M curves, and subgroup analyses were performed in one step. Using restricted cubic spline curves, we analyzed the potential linear relationship between GLR and outcome indicators. Results: In the Medical Information Mart for Intensive Care IV (MIMIC-IV database), we extracted 3,783 patients with nontraumatic intracerebral hemorrhage, and 1,806 patients were finally enrolled in the study after exclusion of missing values and patients with a short hospital stay. The overall ICU mortality rate was 8.2% (148/1806) and the in-hospital mortality rate was 12.5% (225/1806). The use of curve fitting yielded a significant linear relationship between GLR and both ICU mortality and in-hospital mortality. It also suggested a reference point at GLR=3.9. These patients were categorized into high and low subgroups based on the median value of their GLR (GLR = 3.9). Model comparisons based on multivariate COX regression analysis showed that in-hospital mortality was higher in the high GLR group after adjusting for all confounders (HR = 1.31, 95% CI: 1.04-1.47), while the ICU mortality in the high GLR group was (HR = 1.73, 95% CI: 1.18-2.52). Stratified analyses based on age, gender, race, GCS, BMI, and disease type showed stable correlations between the high GLR group and in-hospital and ICU mortality. Conclusion: Based on our retrospective analysis, it is known that as the GLR increased, the in-hospital mortality rate and ICU mortality rate of patients with nontraumatic cerebral hemorrhage also increased progressively in the United States in a clear linear relationship. However, further studies are needed to confirm these findings.

Strumal Carcinoid Tumor of the Ovary: Report of Rare Occurrence with Review of Literature.

The primary ovarian carcinoid tumor is a very rare ovarian tumor, which accounts for approximately 0.5% to 1.7% of all carcinoids and 1% of ovarian cancer. According to its histopathological features, it can be divided into four categories: insular, trabecular, strumal, and mucinous, among which insular carcinoid is common in Western countries. By comparison, the chain-typed and trabecular carcinoid seem to be common in Asian countries. To date, about 150 cases have been reported in the world, and 40% of them are strumal carcinoid tumor of the ovary (SCTO), which is a highly specialized teratoma differentiated from the monomer, and often characterized by the coexistence of thyroid follicular tissue and carcinoid tissue with the neuroendocrine function. Preoperative diagnosis may be difficult due to the very insidious nature of the disease and its multiple imaging manifestations. We reported the case of a 39-year-old woman with a 5-year clinical history. Gynecologic examination and ultrasonic testing revealed an enlarged ovary with a diameter of about 60 mm, accompanied by a hypoechoic area, which was suspected to be a benign teratoma. Ca-125, AFP, free T4, TSH, and other diagnostic indicators were normal. During the laparoscopic oophorocystectomy of the left ovary, a smooth and solid tumor with the size of 6 × 6 × 5 cm was found in the right ovary. During the operation, a mature cystic teratoma containing a struma was frozen, then the oophorocystectomy of the left ovary was performed. According to the Federation International of Gynecology and Obstetrics (FIGO) in 2014, histopathological examination showed a mature teratoma with thyroid carcinoid stage Ic, and Douglas's cystic hygroma cytopathology was negative. One year after the operation, the patient was tumor-free, with Ca-125, FT4, and TSH being within the normal range. Specific diagnostic tools and serological monitoring of malignant tumors of the ovary have low specificity and sensitivity in the diagnosis of this rare malignant tumor of the ovary. Female patients with habitual constipation, chronic abdominal colic, diarrhea, and endocrine dysfunction also need to be alert to this rare malignant tumor of the ovary.

Effects of the Tight Junction Protein CLDN6 on Cell Migration and Invasion in High-Grade Meningioma.

BACKGROUND: Meningioma is a common tumor of the central nervous system, and malignant meningioma is highly aggressive and frequently recurs after surgical resection. Claudin 6 (CLDN6) is involved in cell proliferation, migration, and invasion and plays a role in maintaining tight junctions between cells and obstructing the movement of cells to neighboring tissues. METHODS: In the present study, we evaluated the effect of tight junction protein CLDN6 expression levels on meningioma invasiveness using silencing and overexpression constructs in both in vitro and in vivo models. The expression of CLDN6 at the mRNA and protein levels was measured using quantitative reverse transcription polymerase chain reaction and Western blot assays. RESULTS: We found that CLDN6 was expressed at higher levels in normal meningeal tissue and cell samples. Next, vectors with silenced and overexpressed CLDN6 were successfully established, and the expression of CLDN6 mRNA and protein in the IOMM-Lee and CH157-MN cell lines was downregulated after transfection with siRNA-CLDN6 and upregulated by transfection of the entire CLDN6 sequence vector. An in vitro assay revealed that abrogation of CLDN6 expression added to the capacity for tumor migration and invasion relative to the overexpression of CLDN6. In addition to the in vitro evidence, we observed a significant increase in tumor growth and invasion-associated gene expression, including matrix metalloproteinase-2, matrix metalloproteinase-9, vimentin, and N-cadherin, after silencing CLDN6 expression in vivo. CONCLUSIONS: CLDN6 might play an important role in meningioma migration and invasion and, thus, might serve as a novel diagnostic and/or prognostic biomarker and as a potential therapeutic target.

Primary Cervical Malignant Melanoma: 2 Cases and a Literature Review.

Primary cervical malignant melanoma (MM) is an extremely rare tumor, and we are only aware of 44 reported cases. Further information is needed with regard to this disease's clinicopathologic features. Two patients (55 and 81 yr old) with postmenopausal vaginal bleeding were diagnosed with primary cervical MM on the basis of hematoxylin-eosin staining and immunohistochemistry findings. Our literature review revealed that the average age in cases of primary cervical MM was 59 yr (range, 34-81 yr); 93% of patients presented with vaginal bleeding, and 82% of patients were diagnosed at an early clinical stage (International Federation of Gynecology and Obstetrics stages I-II). Primary cervical MM is an extremely rare cervical tumor and is associated with a poor prognosis. Histologic morphology and immunohistochemistry are very important considerations for diagnosing this disease, which must be differentiated from cervical undifferentiated carcinoma, leiomyosarcoma, and malignant peripheral schwannoma.

Long non-coding RNA PVT1 indicates a poor prognosis of glioma and promotes cell proliferation and invasion via target EZH2.

Human glioma is one of the malignant tumors of the central nervous system (CNS). Its prognosis is poor, which is due to its genetic heterogeneity and our poor understanding of its underlying molecular mechanisms. The present study aimed to assess the relationship between plasmacytoma variant translocation 1 (PVT1) and enhancer of zeste homolog 2 (EZH2), and their effects on the proliferation and invasion of glioma cells. The expression levels of PVT1 and EZH2 in human glioma tissues and cell lines were measured using quantitative RT-PCR (qRT-PCR). Then, after siRNA-PVT1 and entire PVT1 sequence vector transfection, we determined the regulation roles of PVT1 in the proliferation, apoptosis, migration, and invasion of glioma cells. We found that the expression levels of both PVT1 and EZH2 were up-regulated in human glioma tissues and cell lines, and positively correlated with glioma malignancy. And, silencing of PVT1 expression resulted in decreased proliferation, increased apoptosis, and decreased migration and invasion. In addition, exogenous PVT1 led to increased EZH2 expression and increased proliferation and induced proliferation and invasion. These data inferred that long non-coding RNA PVT1 could be served as an indicator of glioma prognosis, and PVT1-EZH2 regulatory pathway may be a novel therapeutic target for treating glioma.

The relationship between iron level and thyroid function during the first trimester of pregnancy: A cross-sectional study in Wuxi, China.

Our objective was to evaluate the relationship between iron level and thyroid function during the first trimester of pregnancy in Eastern China. This was a hospital-based, cross-sectional observational study. A total of 1764 pregnant women were enrolled during their first trimester of gestation in Wuxi city. Serum ferritin (SF), hemoglobin (Hb), urinary iodine concentrations (UIC), thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured and evaluated in pregnant women. The median of TSH,FT4 and FT3 were 1.53mIU/L,10.43pmol/L and 4.50pmol/L respectively. The median UIC was 200µg/L and the median Hb was 126g/L. Of all the women, 1.76% of the subjects had iron deficiency anaemia (IDA) (SF<20µg/L and Hb<105g/L), and 39.06% of the population had iron deficiency (ID) (SF<15µg/L). Compared with SF>100µg/L group, the FT4 level was significantly lower in SF<20µg/L group (P=0.031) and in SF 20-100µg/L group (P=0.048). The TSH value of SF>20µg/L group was significantly higher than that in SF 20-100µg/L group (P=0.038) and SF>100µg/L group(P=0.034). There was an inverse linear relationship between TSH and FT4 after log transformation (r=0.245,P=0.000). Moreover, spearman's correlation analysis showed that UIC were correlated with SF and FT3 (all P<0.001) and iodine status more than adequate was associated with reduced serum ferritin concentration and FT3 levels. Thus, it is recommended that iron deficiency and iron deficiency anaemia shoud be evaluated and treated to combat thyroid dysfunction during the first trimester of pregnancy, Meanwhile, an increased attention should be paid on iodine nutritional status among this pregnant women simultaneous iron deficiency and thyroid dysfunction.

Expression of Hepcidin and Ferroportin in the Placenta, and Ferritin and Transferrin Receptor 1 Levels in Maternal and Umbilical Cord Blood in Pregnant Women with and without Gestational Diabetes.

BACKGROUND: Regulation of iron transfer from mother to fetus via the placenta is not fully understood and the relationship between stored iron status in the mothers' serum and gestational diabetes (GDM) in case-control studies is controversial. The present study aimed to detect circulating soluble transferrin receptor (sTfR) and ferritin levels in maternal and umbilical cord blood. We also examined the expression of hepcidin (Hep), transferrin receptor (TfR1), and ferroportin (FPN) in the placenta in pregnant women with and without GDM at full term. METHODS: Eighty-two women participated (42 with GDM and 40 without GDM [controls]). Maternal samples were collected at 37-39 weeks' gestation. Umbilical cord blood was collected at birth. Ferritin and sTfR levels in maternal serum and umbilical cord blood, and Hep, TfR1, and FPN protein expression in plac enta were compared between the GDM and non-GDM groups. Serum ferritin (SF) was measured by electrochemiluminescence assay and sTfR was measured by ELISA. Hep, TfR1, and FPN expression was measured by immunohistochemistry. RESULTS: Maternal serum sTfR levels were significantly elevated in the GDM group compared with the non-GDM group (p = 0.003). SF levels in cord blood in the GDM group were significantly higher than those in the non-GDM group (p = 0.003). However, maternal hemoglobin and SF, and umbilical cord sTfR levels were not different between the groups. In placental tissue, FPN expression was higher and hepcidin expression was lower in the GDM group compared with the non-GDM group (p = 0.000 and p = 0.044, respectively). There was no significant difference in TfR1 between the groups (p = 0.898). CONCLUSIONS: Women with GDM transport iron more actively than those without GDM at term pregnancy. Maternal iron metabolism in GDM may play a role in fetal/placental iron demand and in the overall outcome of pregnancy.

The effect of fetal and early postnatal iron deficiency on iron metabolism in adult rats.

Undernutrition during pregnancy and/or lactation plays an important role on the overall health of offspring later in life. Using a rodent model, the present study was conducted to examine the effect of fetal and early postnatal iron deficiency on iron metabolism in adult animals. Rats were treated with three stages of low or normal iron diets from gestation until the end of the study. During the first stage (4 weeks prior to 3 weeks after pregnancy, total 7 weeks), two groups of adult females (dams) were fed with either a low-iron (7.4 mg iron/kg, group LD) or control-iron (274 mg/kg, group CD) diet. During the second stage (from 3 to 13 weeks of age, total 10 weeks), all pups from stage 1 (both the LD and CD groups) were placed on a control-iron diet for 10 weeks (groups LD-CD and CD-CD, respectively). During the third stage (from 13 to 29 weeks of age, total 16 weeks), both LD-CD and CD-CD groups from stage 2 were fed with a low-iron (named LD-CD-LD and CD-CD-LD groups, respectively). We found that the live birth rate of the offspring of the LD dams (84.7 %) was significantly lower than that of the CD dams (95.4 %). During stage 2, the mean body weight of the LD-CD male or LD-CD female rats exceeded the CD-CD male rats (p < 0.05). Compared with the CD-CD-LD rats, the LD-CD-LD rats had significantly increased total iron binding capacity, and higher levels of transferrin, serum erythropoietin (EPO), renal EPO mRNA, duodenal divalent metal transporter-1, and renal transferrin receptors. These findings indicate that rats with an early-life experience of iron deficiency (during pregnancy and the nursing period) can develop stronger iron absorption capabilities in adulthood.

[Effects of low-iron intervention in pregnant rat on hematology parameters of adulthood offspring].

OBJECTIVE: To explore the effect of low-iron intervene in pregnant rat on hematologic parameters of its offspring in adulthood. METHODS: Wistar female rats at the age of six weeks were divided into two groups randomly: experimental group were feeded with low-iron diet, control group were feeded with iron-sufficient diet. They were mated with healthy male rats after four weeks and the iron intervention were carried out until the lactation period end. Iron-sufficient diet were then given to all rats for ten weeks and this period were called iron balancing period. After that control group and experimental group were divided into two groups respectively and all the rats were killed to detect Hb, RET, RDW, FEP, SI, SF, TIBC et al after sixteen weeks. RESULTS: Iron intervention in pregnant rats resulted in the iron deficiency of their offspring. In comparison with control group, Hb and RET of the offspring whose mother feeded with low-level iron diet in pregnancy were significantly elevated after four and six weeks in intervention again. While TIBC were also higher than those of control when intervention period was ended. CONCLUSION: Iron deficiency during pregnant rats produce long-dated affect on iron intake of their offspring in growth phase and adulthood, but it did not show stronger capability of anti-anemia than control rats.

Ethnicity determines association of p53Arg72Pro alleles with cervical cancer in China.

Minority Uigur women residing in Xinjiang, in the northwest of China, have a high incidence of cervical carcinoma (CC; 527/100 000) and are often diagnosed young. We favor the hypothesis that Uigur women may carry different genetic factor(s) making them more susceptible to CC than majority Han (Chinese) women living in the same region. Using PCR-restriction fragment length polymorphism, we investigated associations of a p53Arg72Pro polymorphism with CC in Uigur women compared with those in Han women. The study included 152 Uigur patients with CC and 110 controls, and 120 Han patients with CC and 122 controls. In Uigur women, CC was associated with p5372Arg/Arg homozygosity (chi=7.196, P<0.05) and with human papillomavirus-16 (chi=7.177, P<0.05). In Han women, however, CC was associated with p5372Pro/Pro homozygosity (chi=8.231, P<0.05). These observations suggest that individuals with different genetic backgrounds carry different susceptibilities to CC, at least in the Uigur and Han ethnic women studied in China.

[Relationship between p53 Arg72Pro polymorphism and cervical carcinoma in Uigur and Han women in Xinjiang].

OBJECTIVE: To investigate the association between p53 Arg72Pro polymorphism and cervical carcinomas HPV-associated cervical carcinoma in Uigur and Han women. METHODS: The distribution and frequencies of p53 Arg72Pro genotypes were determined by PCR-RFLP in 152 cases of cervical carcinoma in ethnic Uigur women with 110 cases of normal control and 120 cases of cervical carcinoma in Han women with 122 cases of normal control. RESULTS: The omni-constituent ratio of p53 genotype was statistically different between cervical carcinoma and normal control groups in the Uigur (chi(2) = 7.196, P < 0.05) group. The proportion of Arg/Arg was higher in cervical carcinomas than that in control. The omni-constituent ratio of p53 genotype was statistically different between cervical carcinoma and normal control groups in Han (chi(2) = 8.231, P < 0.025). The proportion of Pro/Pro was higher in cervical carcinoma than that in normal control. The omni-constituent ratio was statistically different between HPV 16 positive and negative groups of cervical carcinoma in the Uigur group (chi(2) = 7.177, P < 0.05). The proportion of Arg/Arg was higher in HPV 16 positive group than that in HPV 16 negative group. CONCLUSIONS: p53 Arg72Pro polymorphism may be associated with the development of cervical carcinoma in Uigur and Han women in Xinjiang. p53 Arg/Arg genotype may be a genetically susceptible factor to HPV-associated cervical carcinoma in Uigur. p53 Pro/Pro genotype may be a genetically susceptible factor to cervical carcinoma in Han. There may be different susceptibilities to cervical cancer between Uigur and Han women in Xinjiang.