Acute cerebral venous outflow obstruction during convexity meningioma resection.

BACKGROUND: Cerebral venous outflow obstruction involves idiopathic intracranial hypertension, and the most common related condition is dural venous sinus stenosis or, in other words, an obstruction of the dural venous sinuses. In these cases, the pathological process is often chronic, displays only mild symptoms, and rarely requires urgent surgical intervention. In this study, we present a unique case involving an acute cerebral venous outflow obstruction that occurred during meningioma resection that ultimately had catastrophic consequences. MATERIALS AND METHODS: The patient's preoperative imaging only revealed an unremarkable frontal convexity meningioma with an average diameter exceeding 8 cm. She was admitted for a scheduled right frontoparietal craniotomy for lesion resection. RESULTS: The patient's unique congenital dural venous sinus structure along with a non-surgical epidural hematoma both contributed to a catastrophic outcome, causing a progressive hemispheric encephalocele, significant blood loss, and wound closure difficulties. CONCLUSION: Neurosurgeons should place an additional focus on cerebral venous outflow patency during tumor resection, even if the tumor does not involve the transverse or sigmoid sinuses. It is well known that the tacking sutures play an essential role in preventing an epidural hematoma, but the procedure to mitigate hematomas occurring outside the surgical field of view is not fully recognized by neurosurgeons. If dural tacking sutures are placed after complete tumor resection, the prophylactic effect for preventing EDH in the non-surgical areas may not be guaranteed. Therefore, we strongly advocate for the tacking sutures to be accurately placed before dural incisions are made.

Etomidate attenuates hyperoxia-induced acute lung injury in mice by modulating the Nrf2/HO-1 signaling pathway.

The present study aimed to investigate the protective effects of etomidate on hyperoxia-induced acute lung injury in mice, particularly on the nuclear factor-erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) pathway. Fifty specific pathogen-free mice were randomly divided into the blank control, model, high oxygen exposure + low etomidate dose (0.3 mg·kg-1), a high oxygen exposure + moderate etomidate dose (3 mg·kg-1), and a high oxygen exposure + high etomidate dose (10 mg·kg-1) groups, with ten mice allotted per group. After 72 h, the mice were sacrificed and the lung tissues were harvested, and the wet-to-dry (W/D) ratio of the tissues was calculated. Hematoxylin-eosin staining was performed to observe the pathological changes in the lung tissues, and the lung injury score (LIS) was calculated. The mRNA and protein expression levels of Nrf2 and HO-1 were measured. The malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and catalase (CAT) levels were also measured, and interleukin (IL)-1ß, IL-6, tumor necrosis factor alpha (TNF-α) and IL-10 concentrations in the bronchoalveolar lavage fluid were determined. At low and moderate doses, etomidate decreased pathological damage in the lung tissue, decreased the LIS and W/D ratio, upregulated Nrf2 and HO-1 mRNA and protein expression, decreased IL-1ß, IL-6, and TNF-α concentrations, increased MPO activity and IL-10 levels, suppressed the production of the oxidation product MDA, and enhanced the activities of the antioxidant enzymes CAT and SOD. Within a certain dose range, etomidate enhanced antioxidant and anti-inflammatory effects in mice, thereby decreasing lung injury induced by the chronic inhalation of oxygen at high concentrations. Furthermore, the underlying mechanism may be associate with the upregulation of the Nrf2/HO-1 signaling pathway.

Bioaccessiblity and exposure assessment of PM2.5- and PM10-bound rare earth elements in Oil City, Northeast China.

In this study, an in vitro method was used to simulate lung fluids [Artificial lysosomal fluid (ALF) and Gamble's solution (GS)] to assess how the bioaccessibility of rare earth elements (REEs) in airborne particulate matter (PM) affects human health. Airborne PM samples (PM10 and PM2.5) were collected in Daqing in Northeast China. The bioaccessible proportions determined for REEs in PM10 and PM2.5 had high variability, which can be attributable to the heterogenic feature of airborne PM and its components, as well as sampling time. Overall, the bioaccessiblity of the REEs in the airborne PM samples was time-dependent. The bioaccessiblity of the REEs varied in PM with different sizes, and it was an order of magnitude higher in ALF than in GS. During both heavy and light pollution, the bioaccessiblity of the REEs in PM2.5 was higher than in PM10 after 24 h of ALF extraction, whereas bioaccessiblity of the REEs in GS followed the opposite trend. The REEs associated with airborne PM had much greater bioaccessiblity as the exposure time increased. The results of this study emphasize the necessity of conducting bioaccessibility experiments with field samples for the proper evaluation of human health risks.

Bioaccessible trace metals in lip cosmetics and their health risks to female consumers.

Females can be exposed to toxic elements in lip cosmetics following ingestion. The bioaccessibility of Cr, Mn, Co, Ni, Cu, Cd, Sb and Pb in lip cosmetics (n = 32) were assessed via the dilute HCl extraction method, In Vitro Gastrointestinal protocol (IVG) and the United States Pharmacopeia Methodology (USPM), and then health risks were characterized. The total concentrations of trace metals (TMs) in lip cosmetics were in the range of 15.55-111.97 mg/kg (Mean: 60.99 mg/kg). Cu, Pb and Cr were the three major TMs and accounting for >75% of the total concentrations. Except Sb and Pb in 4/32 and 4/32 samples were higher than the US FDA (Food and Drug Administration of the United States) limits, the other TMs were lower than that limits. Only bioaccessible Pb in all samples significantly exceeded the FDA limit 0.1 mg/kg in candy. Using IVG or USPM might be preferable for evaluating the TMs exposure over HCl since they better represent gastrointestinal physiology. The estimated average daily intake (ADI) of bioaccessible ∑TMs through lip cosmetics ingestion of career women and female college students were under safety level. The long-term exposure of bioaccessible TMs by lip cosmetics using would inevitably cause non-carcinogenic health risk. This is the first report on the in vitro tests used for evaluating bioaccessible TMs in lip cosmetics.

Exposure and health risk assessment of PM2.5-bound trace metals during winter in university campus in Northeast China.

In order to better understand the risk to students' health caused by pollution derived from fine particulate matter with an aerodynamic diameter <2.5mm (PM2.5), this study collected 189 samples in one outdoor and four different functional indoor environments of a research center in a university campus. Trace metals (TMs) bound to PM2.5 in outdoor and indoor environments were measured using X-ray fluorescence spectrometry. The TMs measured were: As, Co, Cd, Cr, Ni, Cu, Zn, Mn, Hg, and Pb. The measurements of PM2.5-bound TMs before and during the 2015 Spring Festival held in Northeast China were compared. Results showed that pollution due to PM2.5-bound TMs in outdoor and indoor environments was higher before than during the Spring Festival. Cu (in three indoor environments) and Zn (in an outdoor environment) showed the highest concentrations among the ten TMs that were measured. Hg showed the lowest concentrations in all the environments analyzed. The concentrations of PM2.5-bound TMs declined among four indoor environments in the following order: the atrium, the students' office (sampled just nine days before the Spring Festival), the laboratory, and an empty room. The potential carcinogenic and non-carcinogenic health risks derived from PM2.5-bound TMs were within safe limits for graduate and undergraduate students, according to the standards established by the United States Environmental Protection Agency (USEPA).

Oral Exposure to Atrazine Induces Oxidative Stress and Calcium Homeostasis Disruption in Spleen of Mice.

The widely used herbicide atrazine (ATR) can cause many adverse effects including immunotoxicity, but the underlying mechanisms are not fully understood. The current study investigated the role of oxidative stress and calcium homeostasis in ATR-induced immunotoxicity in mice. ATR at doses of 0, 100, 200, or 400 mg/kg body weight was administered to Balb/c mice daily for 21 days by oral gavage. The studies performed 24 hr after the final exposure showed that ATR could induce the generation of reactive oxygen species in the spleen of the mice, increase the level of advanced oxidation protein product (AOPP) in the host serum, and cause the depletion of reduced glutathione in the serum, each in a dose-related manner. In addition, DNA damage was observed in isolated splenocytes as evidenced by increase in DNA comet tail formation. ATR exposure also caused increases in intracellular Ca2+ within splenocytes. Moreover, ATR treatment led to increased expression of genes for some antioxidant enzymes, such as HO-1 and Gpx1, as well as increased expression of NF-κB and Ref-1 proteins in the spleen. In conclusion, it appears that oxidative stress and disruptions in calcium homeostasis might play an important role in the induction of immunotoxicity in mice by ATR.

Trace metals in resuspended fraction of settled bus dust and assessment of non-occupational exposure.

Trace metals (TMs) within urban public transportation systems have rarely been studied and information on related health risks is scant. This study measured TM (arsenic, chromium, cadmium, nickel, zinc, copper and lead) concentrations in resuspended fractions of settled bus dust in Harbin, China, and estimated the exposure and health risks. The incremental lifetime cancer risk (ILCR) for commuters was estimated for TM exposures. The average concentration of total TMs was 559µg/g (ranges from 312 to 787) among 45 bus routes in Harbin. The hazard quotient of three selected commuter groups increased in the following order: teenagersdermal contact>inhalation.

Dibromoacetic Acid Induces Thymocyte Apoptosis by Blocking Cell Cycle Progression, Increasing Intracellular Calcium, and the Fas/FasL Pathway in Vitro.

Dibromoacetic acid (DBAA), a haloacetic acid found in drinking water as a disinfection by-product, can cause many adverse effects, including immunotoxicity. In a previous study, we confirmed that DBAA can induce obvious immunotoxicity in mice but that the underlying mechanisms are not clearly understood. In our current study, we confirmed that DBAA induced cytotoxicity and apoptosis in thymocytes isolated from mice by a range of DBAA concentrations (0, 5, 10, 20, or 40 µM). The data showed that DBAA exposure led to a significant decrease in proliferative responses to T-cell mitogens and obvious inhibition in the production of cytokines interleukin-2 and interleukin-4. We found obvious morphological changes of apoptosis in thymocytes and observed the percentage of apoptotic thymocytes to increase significantly as the DBAA concentration increased. Further investigation showed that DBAA can cause G0/G1 arrest in cell cycle analysis, increase intracellular calcium ([Ca(2+)]i) levels, increase the expression of Fas/FasL proteins, and decrease the expression of Bcl-2 protein. It is concluded that in vitro exposure to DBAA can lead to marked cytotoxicity and apoptosis among thymocytes, and the mechanism involved is strongly related to blocking cell cycle progression, increasing intracellular calcium, and increasing Fas/FasL expressions.

Effects of basic drugs on prognosis of acute lung injury in mice.

The aim of this study was to investigate the effects of basic drugs that alkalizes blood, on prognosis of acute lung injury in mice. Mice were randomized into three groups: Group normal saline, Group THAM, injected with 3.64% tri-(hydroxymethyl) methylamine (THAM), and Group NaHCO3, injected with 5% NaHCO3 (n=26, each group). The acute lung injury model was established by intraperitoneal injection of lipopolysaccharide (LPS; 50 mg/kg), followed by infusion of varying concentrations of the above solution into tail vein at the rate of 0.5 ml/h (controlled by micro pump) for over 2 h. Thirty minutes later, 6 mice from each group were randomly selected for blood gas analysis; then, the mice were killed and their lung tissues were sampled for detection of relative indicators, and the remaining mice were observed for signs of mortality for 72 h. Arterial pH, bicarbonate (HCO3 (-)), and BE and mortality of group THAM and NaHCO3 increased significantly compared to the corresponding parameters of the group normal saline (P<0.05); compared to the group normal saline, group NaHCO3 had increased blood [Na(+)] and decreased [K(+)] and [Ca(2+)] (P<0.05). Blood [Na(+)] of group THAM decreased while the lactic acid concentration increased (P<0.05) compared to the corresponding values of the group normal saline. Malondialdehyde (MDA) and myeloperoxidase (MPO) activity and wet-to-dry lung weight ratio (W/D) of group THAM and NaHCO3 increased significantly relative to group normal saline (P<0.05). Compared with the biopsy results of (A), pathological biopsy of (B) and (C) clearly revealed alveolar wall thickening, edema of alveolar epithelial cells, and infiltration of large neutrophils. Alkalizing blood could neither inhibit inflammatory reactions in LPS mouse model nor reduce the mortality rate of mice with acute lung injury, while excessive alkalization of blood could increase mice mortality.

[Importance of colonoscopy combined with biopsy in the diagnosis of colonic Crohn's disease].

OBJECTIVE: An attempt was made to provide a better insight into endoscopic and histological features and/or problems encountered when establishing a diagnosis of colonic Crohn's disease (Crohn's colitis). METHODS: As presented in our 27 cases with Crohn's colitis, the endoscopic findings and histological changes of biopsy specimens were summarized. As collated with correspondent results of biopsy and surgical specimens, the diagnostic accuracy of endoscopy was evaluated. RESULTS: twenty-six involvements of the large intestine (combined with other sites of the intestine) was found (96.3%). However, involvement limited to the colon alone was seen in only 4 cases (14.8%). Endoscopically, overlapped lesions with multistaged-segmental distributed and multi-sited diverse patterns (destructive and proliferative/regenerative) of inflammatory changes were observed. Endoscopic accuracy was 66.7%. The characteristic features of mucosal biopsy include focal distribution of the lesions, a thickened and edematous submucosa, deep fissuring ulcers, lymphoid aggregate, and hyperplasia, fibrosis and granulomas (detected in 30% of the group), etc. CONCLUSIONS: Colonic involvement of Crohn's disease is common. Colonoscopy may be valuable in establishing the diagnosis and in assessing the extent and severity of colonic involvement, and CDEIS was value in the follow up of patients. Colonoscopic biopsies are helpful for verification of the diagnosis in difficult cases. Colonoscopy has replaced radiology as the initial test of choice in many clinical situations.

[A rapid and simple method for extracting mitochondrial DNA from human lung cancer tissue].

BACKGROUND: The relationship between mitochondrial DNA (mtDNA) mutation and tumor is the hot point in cancer research field by now. The existent methods for extracting mtDNA are time-consuming and complicated. In order to further research the relationship of the mutation of mtDNA and development of lung cancer, it is necessary to establish a rapid and simple method for extracting mtDNA from lung cancer tissue. METHODS: Lung cancer tissues were lysed in base-denaturalization liquid and mtDNA was directly extracted from them by chloroform:isoamyl alcohol (24:1). The mtDNA was confirmed by PCR. RESULTS: The extracted mtDNA samples were not combinated with protein and 1528bp PCR products of (mtDNA) were detected from 40 samples of analyzing patients. About (7.97±0.12)µg of mtDNA could be extracted from 1 gram of cancer tissue. CONCLUSIONS: The method is simple, rapid and efficient to extract (mtDNA) from human lung cancer tissues and it could be used to handle small amount tissues or large number of samples in clinical and scientific research.

Clinical features and management of Crohn's disease in Chinese patients.

BACKGROUND: An increasing incidence of Crohn's disease has been found in China in recent years. Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn's disease in order to improve early diagnostic accuracy and therapeutic efficacy. METHODS: Thirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease. RESULTS: Most patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract (from the mouth to the anus). In this study, the colon and small bowel were the major sites involved. Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host's nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported. CONCLUSION: Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.

[Clinical features of Crohn's disease: its diagnosis and treatment].

OBJECTIVE: To enhance our understanding of Crohn's disease and improve its early diagnostic accuracy and therapeutic efficacy. METHODS: Thirty-one patients with active Crohn's disease were studied. All their diagnostic and therapeutic results were analyzed. RESULTS: Most patients were young adults, with a 1.14:1 female predominance in prevalence. The disease affects any segment or a combination of segments of the alimentary tract from the mouth to the anus. However, the colon and the small bowel were the major sites involved. Recurrent episodes of abdominal pain and watery diarrhea were the most common symptoms. In addition, low grade fever, emaciation, anemia, and symptoms with skin, joints or perianal complications could be discovered if attention was paid. An endoscopy combined with histologic examination in biopsy specimens provided characteristic features with a diagnostic accuracy of 62.9%. Granulomas were identifiable in 30.8% of all biopsy specimens. Transabdominal bowel sonography (TABS) accurately detected intestinal complications. Factors causing misdiagnosis were: insufficient attention of the disease, diverse clinical presentations, or over emphasis of the diagnostic value of granulomas. Oral prednisone therapy for mild to moderate disease was more rapid to receive clinical remission when compared to oral aminosalicylates (SASP or 5-ASA). Nutrition support therapy was given in 20 cases with active disease and received beneficial effects on host nutritional status. Immunosuppressives were used on an individual basis, and showed variable effects with limited experience. Sixteen patients had operations due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after operations was achieved. CONCLUSIONS: Crohn's diseases not uncommon in China. Abdominal pain and watery diarrhea are two hallmark symptoms. Endoscopy (with biopsy), and TABS were both valuable procedures for diagnosis. Prednisone and SASP/5-ASA were effective as inductive therapies. Surgery, as an alternative and effective treatment, provided another choice in well selected patients.