Applying the Full Endoscopic Keyhole Technique to CPA Lesions: A Single-Center Study.

In recent years, endoscopy has become an increasingly common tool used during neurosurgical procedures. However, its application in treating cerebellopontine angle (CPA) lesions has not progressed as rapidly. In this study, the authors present their initial experience with surgically treating CPA lesions using a fully endoscopic keyhole retrosigmoid approach. They conducted a retrospective analysis of clinical data from patients who underwent endoscopic keyhole CPA surgery at their center between May 2017 and April 2022. They provide a comprehensive explanation of this method and an overview of the strategies that have been developed to achieve better clinical outcomes. The study included 107 patients, consisting of 10 cases of vestibular schwannoma, 21 cases of epidermoid cyst, 32 cases of trigeminal neuralgia, and 44 cases of hemifacial spasm. The authors analyzed the clinicodemographic details of the patients. Among the 31 tumor cases, gross total resection was achieved in 25 patients (80.6%), while near-total resection was performed in 6 patients (19.4%). In patients with trigeminal neuralgia, facial pain resolved in 31 out of 32 patients (96.9%). Similarly, facial convulsions disappeared or were relieved in all 44 patients (100%) with hemifacial spasms after the operation. Postoperative complications included facial nerve paresis (n=9, 8.4%), with improvement observed in 6 cases during follow-up, transient facial hypoesthesia (n=3, 2.8%), cerebrospinal fluid rhinorrhea (n=3, 2.8%), transient abducens paresis (n=1, 0.9%), and postoperative hemorrhage (n=1, 0.9%). Endoscopy provides improved deep illumination and, combined with close-up observation, enhances the visualization of structures within the CPA region. The fully endoscopic keyhole technique is a safe and effective method for managing CPA lesions.

Macrophages Promote Subtype Conversion and Endocrine Resistance in Breast Cancer.

BACKGROUND: The progression of tumors from less aggressive subtypes to more aggressive states during metastasis poses challenges for treatment strategies. Previous studies have revealed the molecular subtype conversion between primary and metastatic tumors in breast cancer (BC). However, the subtype conversion during lymph node metastasis (LNM) and the underlying mechanism remains unclear. METHODS: We compared clinical subtypes in paired primary tumors and positive lymph nodes (PLNs) in BC patients and further validated them in the mouse model. Bioinformatics analysis and macrophage-conditioned medium treatment were performed to investigate the role of macrophages in subtype conversion. RESULTS: During LNM, hormone receptors (HRs) were down-regulated, while HER2 was up-regulated, leading to the transformation of luminal A tumors towards luminal B tumors and from luminal B subtype towards HER2-enriched (HER2-E) subtype. The mouse model demonstrated the elevated levels of HER2 in PLN while retaining luminal characteristics. Among the various cells in the tumor microenvironment (TME), macrophages were the most clinically relevant in terms of prognosis. The treatment of a macrophage-conditioned medium further confirmed the downregulation of HR expression and upregulation of HER2 expression, inducing tamoxifen resistance. Through bioinformatics analysis, MNX1 was identified as a potential transcription factor governing the expression of HR and HER2. CONCLUSION: Our study revealed the HER2-E subtype conversion during LNM in BC. Macrophages were the crucial cell type in TME, inducing the downregulation of HR and upregulation of HER2, probably via MNX1. Targeting macrophages or MNX1 may provide new avenues for endocrine therapy and targeted treatment of BC patients with LNM.

Study on the effect of different aldehyde modifiers on the fume suppression effect, mechanism and road performance of SBS modified asphalt.

In order to curb asphalt fume emissions during the heating process of styrene-butadiene-styrene (SBS) asphalt, three aldehyde modifiers [vanillin (X), citral (N) and amyl cinnamaldehyde (J)] were blended into SBS-modified asphalt to prepare aldehyde-modified asphalt in this paper. By collecting solid particles and volatile organic compounds (VOCs) in asphalt fumes to conduct relevant experiments, we have analyzed the fume suppression effect and suppression mechanism of aldehyde modified asphalt, and finally examined the road performance of aldehyde modifiers with the best fume suppression effect. It was found that the average VOCs concentration of aldehyde modified asphalt was reduced by about 78 % after 30 min. Aldehyde modifiers significantly reduce the compositional type and content of VOCs in SBS asphalt and reduce the risk of carcinogenicity by curbing the emission of substances such as benzene and phenol. J asphalt reduced solid particle emissions from SBS asphalt fume by 31.4 % and outperformed both X and N asphalt in inhibiting the escape of solid particulate matter and carcinogens from asphalt fume. Polymer networks and the cross-linking of chemical molecules are the main reasons for inhibiting the escape of asphalt fume molecules. In addition, the J modifier enhanced the high-temperature stabilization and water-stability properties of asphalt mixtures, but slightly reduced the low-temperature cracking resistance. The results showed that the three aldehyde modifiers were effective in inhibiting the volatilization of fumes from SBS modified asphalt. Among them, with the best effect of curbing fume emissions and a better road performance, J-modified asphalt is promising for the application in asphalt fume prevention and emissions reduction, and provides a new solution to reduce construction pollution and physical harm caused by asphalt fume in the construction process.

A multi-parameter study of the etiological diagnosis of hyponatremia after hypothalamic tumor surgery.

OBJECTIVES: This study aimed to analyze the difference between cerebral salt-wasting syndrome (CSWS) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in patients with hyponatremia after hypothalamic tumor surgery, and to explore a convenient and effective way to identify CSWS and SIADH. METHODS: Patients undergoing craniotomy of hypothalamic tumor admitted to the Department of The Affiliated Hospital of Qingdao University from December 2018 to May 2020 were enrolled in this study. Plasma brain natriuretic peptide (BNP), 24-h urine sodium, 24-h urine volume, and the diameter of the inferior vena cava (IVCD) were measured daily before operation and 1-7 days after operation, to analyze differences in plasma BNP, 24-h urinary sodium excretion, 24-h urine volume, and IVCD between the CSWS and SIADH. RESULTS: The medical data of 31 patients with hypothalamic tumors were collected. Fifteen of these patients (48%) had postoperative hyponatremia, nine patients (29%) had CSWS, and six patients (19%) had SIADH. Plasma BNP, 24-h urinary sodium excretion, and 24-h urine volume in the CSWS group were significantly higher than those in the SIADH group. IVCD decreased in the CSWS group and increased in the SIADH group. CONCLUSIONS: When hyponatremia occurs after hypothalamic tumor surgery, plasma BNP, 24-h urinary sodium excretion, 24-h urine volume, and IVCD are of great help in identifying CSWS and SIADH.

FUBP1 promotes colorectal cancer stemness and metastasis via DVL1-mediated activation of Wnt/ß-catenin signaling.

Distant metastasis is, unfortunately, the leading cause of death in colorectal cancer (CRC). Approximately 50% of CRC patients develop liver metastases, while 10-30% of patients develop pulmonary metastases. The occurrence of metastasis is considered to be almost exclusively driven by cancer stem cells (CSCs) formation. However, the key molecules that confer the transformation to stem cells in CRC, and subsequent metastasis, remain unclear. Far upstream element-binding protein 1 (FUBP1), a transcriptional regulator of c-Myc, was screened in CSCs of CRC by mass spectrometry and was examined by immunohistochemistry in a cohort of CRC tissues. FUBP1 was upregulated in 85% of KRAS-mutant and 25% of wild-type CRC patients. Further, whether in KRAS-mutant or wild-type patients, elevated FUBP1 was positively correlated with CRC lymph node metastasis and clinical stage, and negatively associated with overall survival. Overexpression of FUBP1 significantly enhanced CRC cell migration, invasion, tumor sphere formation, and CD133 and ALDH1 expression in vitro, and tumorigenicity in vivo. Mechanistically, FUBP1 promoted the initiation of CSCs by activating Wnt/ß-catenin signaling via directly binding to the promoter of DVL1, a potent activator of ß-catenin. Knockdown of DVL1 significantly inhibited the transformation to stem cells in, as well as the tumorigenicity of, CRC. Activation of Wnt/ß-catenin signaling by DVL1 increased pluripotent transcription factors, including c-Myc, NANOG, and SOX2. Moreover, FUBP1 was upregulated at the post-transcriptional level. Elevated FUBP1 levels in KRAS wild-type CRC patients is due to the decrease in Smurf2, which promotes ubiquitin-mediated degradation of FUBP1. In contrast, FUBP1 was upregulated in KRAS-mutant patients through both inhibition of caspase 3-dependent cleavage and decreased Smurf2. Our results demonstrate, for the first time, that FUBP1 is an oncogene, initiating the development of CSCs, as well as a new powerful endogenous Wnt-signaling agonist that could provide an important prognostic factor and therapeutic target for metastasis in both KRAS-mutant and wild-type CRC.

Juvenile Xanthogranuloma of the Sellar Region with a 5-Year Medical History: Case Report and Literature Review.

INTRODUCTION: Xanthogranuloma of the sellar region is a rare benign lesion, and there are few cases reported in children. Its histogenesis is controversial, and it is difficult to strictly differentiate it from craniopharyngioma (CP), Rathke's cleft cyst, or pituitary adenoma. CASE PRESENTATION: A 16-year-old boy presented with a rare xanthogranuloma of the sellar region after complaining of retardation of growth 5 years previously. The ophthalmologic evaluation revealed no visual field disturbance. Endocrinological examination revealed hypopituitarism. Magnetic resonance imaging showed an intrasellar mass extending into the suprasellar region and compressing the optic chiasma, which appeared mixed signals on T1-weighted images. Endonasal transsphenoidal resection of the tumor was performed. Histological analysis of the tumor sections demonstrated granulomatous tissue with cholesterol clefts, hemosiderin deposits, fibrous tissues, multinucleated giant cells, and lymphocyte. Thus, the tumor was pathologically diagnosed as xanthogranuloma of the sellar region, which is different from adamantinomatous CP. There was no epithelial tissue in any part of the tumor including tumor capsule but have focal necrosis and calcification. His endocrinological dysfunction did not recover, so a hormonal replacement was continuously required. CONCLUSION: Xanthogranuloma of the sellar region is a rare entity but must be considered in the differential diagnosis of lesions of the sellar region, even in pediatric population. We should think about this disease when dealing with children with stunted growth accompanied by a long medical history. Our case demonstrates the natural progression of the disease, suggesting that xanthogranuloma of the sellar region without epithelial components may be an independent disease.

Multifactor Prognostic Evaluation of Postoperative Craniopharyngiomas.

PURPOSE: To evaluate various factors that could be associated with the postoperative prognosis of patients with craniopharyngiomas and provide evidence for the proper surgical course and optimal outcome assessments of craniopharyngiomas. METHODS: We performed a retrospective study and reviewed 68 patients with craniopharyngiomas who received surgery from May 2013 to October 2018. The relationships between the disease prognosis and age, gender, onset symptoms, size of tumor, degree of calcification, consistency, QST classification, adhesion strength, and pathological types were analyzed. RESULTS: There were no significant associations between the prognosis and age, gender, number of onset symptoms, and pathological types (P > 0.05). The severity of onset symptoms, tumor diameter, and degree of calcification was significantly associated with the prognosis (P < 0.05). There were significant different prognoses between patients with cystic and solid, mixed tumors (P < 0.05). The prognosis of patients with T type tumors was different from that of patients with either Q or S type tumors (P < 0.05). The prognoses of patients with either loose or tight type tumors were significantly different from those of patients with either invasive or fusion type tumors (P < 0.05). CONCLUSION: Clinical and pathological variables, such as onset symptoms, size of tumor, degree of calcification, consistency, QST classification, and the degree of adhesion strength, were important factors in evaluating the prognosis of patients with craniopharyngiomas.

Overexpression of HIF-1α protects PC12 cells against OGD/R-evoked injury by reducing miR-134 expression.

Nowadays, searching for new therapeutic targets for cerebral stroke treatment are still in urgent need. Our study explored the influences and mechanisms of HIF-1α on OGD/R-evoked injury. OGD/R treatment was conducted on PC12 cells to simulate ischemic injury. CCK-8, flow cytometry and qRT-PCR were conducted to determine the variations of cell viability, apoptosis and gene expression, respectively. Cell transfections were conducted to overexpress HIF-1α and miR-134. Variations of protein levels were evaluated by employing western blot. Results showed that OGD/R treatment induced cell injury through reducing viability, while enhancing apoptosis that was validated by the elevated ratios of C/P-PARP and C/P-caspase-3. HIF-1α expression was markedly increased by OGD/R treatment. HIF-1α overexpression attenuated OGD/R-evoked injury in PC12 cells and remarkably reversed OGD/R-triggered inhibitory effects on ERK1/2 and JAK1/STAT3 pathways. Besides, miR-134 was also down-regulated by HIF-1α overexpression in PC12 cells. Up-regulation of miR-134 notably counteracted HIF-1α overexpression-triggered neuro-protective impacts on OGD/R-evoked injury and ERK1/2 and JAK1/STAT3 pathways. Our present study reported that HIF-1α overexpression protected PC12 cells against OGD/R-evoked injury via down-regulation of miR-134, which making HIF-1α and miR-134 to be promising targets for cerebral stroke therapy.

A Rare Instance of Chordoid Glioma With Large Calcification Mimicking Craniopharyngioma.

Chordoid glioma (CG) is a world health organization classified grade II tumor whose typical localization is in the anterior part of the third ventricle. It's clinical, neuroimaging, and pathologic features may vary and furthermore mimic other types of benign lesions usually associated with a better outcome, thus representing a potential radiological and diagnostic pitfall. In this article, the authors present a novel case of a 51-year-old male who underwent gross total removal of the tumor of the third ventricle with high calcification. The imaging studies and the intraoperative examination led at first to a hypothesis of craniopharyngioma. In this case, the patient underwent successful operative management and has remained well throughout follow-up.

Tannic Acid Accelerates Cutaneous Wound Healing in Rats Via Activation of the ERK 1/2 Signaling Pathways.

Objective: This study was aimed to evaluate the effect of tannic acid (TA), a natural plant polyphenol astringent, on wound healing in vitro and in vivo, and to elucidate the underlying molecular signaling pathway in the wound healing. Approach: Cutaneous skin wounds were created in rats and then treated until closure with purified TA, serum or tissue samples were collected to test the concentration of factors by enzyme-linked immunosorbent assay (ELISA), and the expression in gene or protein was measured by quantitative real-time polymerase chain reaction or Western blot. We explored the cell-/dose-specific responses of TA (0.1-0.4 µg/mL) on proliferation and gene and protein expression of fibroblast NIH 3T3 cells. Results: The wounds on rats treated by TA got healed faster than those in the untreated group. The histopathology study showed that TA accelerated re-epithelialization and increase in hair follicles could be detected. The levels of growth factors including basic fibroblast growth factor (bFGF), transforming growth factor-beta, and vascular endothelial growth factor in TA-treated groups were all increased, and the content of interleukin-1 (IL-1) and IL-6 was decreased significantly when compared with that of the untreated group. The NIH 3T3 cells grow faster in 6 h at concentration of 0.1 µg/mL, and the expression of bFGF in gene and protein was increased significantly in the 0.1 µg/mL TA group. Further study revealed that the protein levels of bFGF, extracellular signal regulated kinase (Erk) 1/2, and P-Erk 1/2 in Erk 1/2 pathway were increased after TA treatment. Innovation: The role of TA in wound healing efficacy is unclear; this study, therefore, assesses the effects of TA on wound healing in different periods and the underlying molecular mechanisms. Conclusion: These results suggested that TA could accelerate wound healing through modulation of inflammatory cytokines and growth factors and activate Erk 1/2 pathway. In conclusion, TA may be a potential agent in promoting wound healing.

Review of the role of cigarette smoking in diabetic foot.

Diabetic foot ulceration has been a serious issue over the past decades in Asia, causing economic and social problems. Therefore, it is important to identify and reduce the risk factors of diabetic foot. Cigarette smoking has been reported to be associated with diabetes and its macrovascular complications, but the relationship between smoking and diabetic foot ulcers is still unclear. In the present review, we summarize the effects of cigarette smoking on diabetic foot ulcers with respect to peripheral neuropathy, vascular alterations and wound healing. One underlying mechanism of these impacts might be the smoking-induced oxidative stress inside the cells. At the end of this review, the current mainstream therapies for smoking cessation are also outlined. We believe that it is urgent for all diabetic patients to quit smoking so as to reduce their chances of developing foot ulcers and to improve the prognosis of diabetic foot ulcers.

Body mass index (BMI) as a major factor in the incidence of the metabolic syndrome and its constituents in unaffected Taiwanese from 1998 to 2002.

A large health screening program in Taiwan with members who have periodic checks provides an opportunity to track individuals who are healthy at baseline for the emergence of the metabolic syndrome (MS) and its component disorders. The syndrome comprised abdominal obesity assessed by waist circumference, high fasting serum glucose (FSG), high triglyceride (TG), low high density lipoprotein-cholesterol (HDL-C) and high blood pressure. A cohort of 9,785 adults (4,707 men and 5,078 women), aged 19 to 84 years, who were free from the MS at baseline were followed for 4 years from 1998 to 2002. Using Asian criteria for abdominal obesity and reducing the threshold for FSG from >or=110 mg/dL to >or=100 mg/dL, the incidence of MS during the 4-year follow up in the MJ Health Screening Center Study in Taiwan was 12.7% (17.5% for men and 8.3% for women). The incidence of the MS in men exceeded that for women up until 50-59 years and then this gender was reversed in the older age groups pointing to pre-menopausal protection in women. The most evident manifestations of the incident of metabolic abnormalities were high FSG, high blood pressure and high TG, particularly in post-menopausal women. Baseline body mass index and age were the most significant predictors of MS for both men and women, with cigarette smoking significantly predictive in men. Incident information should inform preventive and intervention strategies in Taiwanese, both Chinese and Indigenous, more effectively than MS and its component disorder prevalences.