Neuroprotective effect of acetoxypachydiol against oxidative stress through activation of the Keap1-Nrf2/HO-1 pathway.

BACKGROUND: Excessive oxidative stress in the brain is an important pathological factor in neurological diseases. Acetoxypachydiol (APHD) is a lipophilic germacrane-type diterpene extracted as a major component from different species of brown algae within the genus Dictyota. There have been no previous reports on the pharmacological activity of APHD. The present research aims to explore the potential neuroprotective properties of APHD and its underlying mechanisms. METHODS: The possible mechanism of APHD was predicted using a combination of molecular docking and network pharmacological analysis. PC12 cells were induced by H2O2 and oxygen-glucose deprivation/reoxygenation (OGD/R), respectively. Western blot, flow cytometry, immunofluorescence staining, and qRT-PCR were used to investigate the antioxidant activity of APHD. The HO-1 inhibitor ZnPP and Nrf2 gene silencing were employed to confirm the influence of APHD on the signaling cascade involving HO-1, Nrf2, and Keap1 in vitro. RESULTS: APHD exhibited antioxidant activity in both PC12 cells subjected to H2O2 and OGD/R conditions by downregulating the release of LDH, the concentrations of MDA, and ROS, and upregulating SOD, GSH-Px, and GSH concentrations. APHD could potentially initiate the Keap1-Nrf2/HO-1 signaling cascade, according to the findings from network pharmacology evaluation and molecular docking. Furthermore, APHD was observed to increase Nrf2 and HO-1 expression at both mRNA and protein levels, while downregulating the protein concentrations of Keap1. Both Nrf2 silencing and treatment with ZnPP reversed the neuroprotective effects of APHD. CONCLUSIONS: APHD activated antioxidant enzymes and downregulated the levels of LDH, MDA, and ROS in two cell models. The neuroprotective effect is presumably reliant on upregulation of the Keap1-Nrf2/HO-1 pathway. Taken together, APHD from brown algae of the genus Dictyota shows potential as a candidate for novel neuroprotective agents.

Association of immune checkpoint inhibitors therapy with arterial thromboembolic events in cancer patients: A retrospective cohort study.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have emerged as a standard treatment for various malignancies. However, research indicates blocking the immune checkpoint pathway may exacerbate atherosclerotic lesions. OBJECTIVES: We aimed to investigate whether ICI therapy increases the risk of arterial thromboembolic events (ATEs). METHODS: A retrospective cohort study was conducted on patients with histologically confirmed cancer at our institution between 2018 and 2021, using the propensity score matching method. The primary endpoint was ATEs occurrence, comprising acute coronary syndrome, stroke/transient ischemic attack, and peripheral arterial thromboembolism. Subgroup analyses assessed whether the ICI treatment effect on ATEs varied over time by limiting the maximum follow-up duration. Logistic regression analysis identified ATE risk factors in ICI-treated patients. RESULTS: Overall, the ICI group (n = 2877) demonstrated an ATEs risk 2.01 times higher than the non-ICI group (RR, 2.01 [95% CI (1.61-2.51)]; p < 0.001). Subgroup analysis revealed no significant increase in ATEs risk for ICI-treated patients within 1 year (Limited to a max 9-month follow-up, p = 0.075). However, ATEs risk in the ICI group rose by 41% at 1 year (p = 0.010) and 97% at 4 years (p ≤ 0.001). Age, diabetes, hypertension, peripheral atherosclerosis, atrial fibrillation, chronic ischemic heart disease, distant cancer metastasis, and ICI treatment cycles contributed to ATEs risk elevation in ICI-treated patients. CONCLUSION: ICI-treated patients may exhibit a higher risk of ATEs, especially after 1 year of treatment.

Optimal Timing of Cranioplasty and Predictors of Overall Complications After Cranioplasty: The Impact of Brain Collapse.

BACKGROUND: The optimal timing of cranioplasty (CP) and predictors of overall postoperative complications are still controversial. OBJECTIVE: To determine the optimal timing of CP. METHODS: Patients were divided into collapsed group and noncollapsed group based on brain collapse or not, respectively. Brain collapse volume was calculated in a 3-dimensional way. The primary outcomes were overall complications and outcomes at the 12-month follow-up after CP. RESULTS: Of the 102 patients in this retrospective observation cohort study, 56 were in the collapsed group, and 46 were in the noncollapsed group. Complications were noted in 30.4% (n = 31), 24 (42.9%) patients in the collapsed group and 7 (15.2%) patients in the noncollapsed group, with a significant difference ( P = .003). Thirty-three (58.9%) patients had good outcomes (modified Rankin Scale 0-3) in the collapsed group, and 34 (73.9%) patients had good outcomes in the noncollapsed group without a statistically significant difference ( P = .113). Brain collapse ( P = .005) and Karnofsky Performance Status score at the time of CP ( P = .025) were significantly associated with overall postoperative complications. The cut-off value for brain collapse volume was determined as 11.26 cm 3 in the receiver operating characteristic curve. The DC-CP interval was not related to brain collapse volume or postoperative complications. CONCLUSION: Brain collapse and lower Karnofsky Performance Status score at the time of CP were independent predictors of overall complications after CP. The optimal timing of CP may be determined by tissue window based on brain collapse volume instead of time window based on the decompressive craniectomy-CP interval.

Significance of Preoperative Nerve Reconstruction Using Diffusion Tensor Imaging Tractography for Facial Nerve Protection in Vestibular Schwannoma.

OBJECTIVE: The facial nerve trace on the ipsilateral side of the vestibular schwannoma was reconstructed by diffusion tensor imaging tractography to identify the adjacent relationship between the facial nerve and the tumor, and to improve the level of intraoperative facial nerve protection. METHODS: The clinical data of 30 cases of unilateral vestibular schwannoma who underwent tumor resection via retrosigmoid approach were collected between January 2019 and December 2020. All cases underwent magnetic resonance imaging examination before operation. Diffusion tensor imaging and anatomical images were used to reconstruct the facial nerve track of the affected side, so as to predict the course of the nerve and its adjacent relationship with the tumor, to compare the actual trace of the facial nerve during operation, verify the degree of coincidence, and evaluate the nerve function (House-Brackmann grade) after surgery. RESULTS: The facial nerve of 27 out of 30 cases could be displayed by diffusion tensor imaging tractography, and the tracking rate was 90% (27/30). The intraoperative locations of facial nerve shown in 25 cases were consistent with the preoperative reconstruction results. The coincidence rate was 92.6% (25/27). The facial nerves were located on the anterior middle part of the tumor in 14 cases, anterior upper part in eight cases, anterior lower part in seven cases, and superior polar in one case. Intraoperative facial nerve anatomy was preserved in 30 cases. Among the 30 patients, total resection was performed in 28 cases and subtotal resection in two cases. The facial nerve function was evaluated 2 weeks after operation, and the results showed grade I in 12 cases, grade II in 16 cases and grade III in two cases. CONCLUSION: Preoperative diffusion tensor imaging tractography can clearly show the trajectory and adjacent position of the facial nerve on the side of vestibular schwannoma, which is beneficial to accurately identify and effectively protect the facial nerve during the operation, and is worthy of clinical application and promotion.

Risk assessment of asbestos containing materials in a deteriorated dwelling area using four different methods.

The release of asbestos fibers in old buildings, during demolition, or remodeling is associated with severe public health risks to building occupants and workers. In Korea, asbestos was used in several building materials during the 20th century. Although the use of asbestos is currently banned, its widespread earlier use and the current government initiatives to revitalize dilapidated areas make it essential to accurately evaluate the location and status of asbestos-containing materials (ACMs). This study surveyed buildings in an area of deteriorated dwellings targeted for renewal and determined the status and distribution of ACMs in that area. Asbestos distribution maps were generated and asbestos characteristics were analyzed. In addition, the risk posed by the identified ACMs was assessed using four international methods (the Korean Ministry of Environment, US Environmental Protection Agency, American Society for Testing and Materials, and UK Health and Safety Executive methods), and the results were compared. Notable differences between the assessment results were identified and were found to reflect the specific characteristics of buildings in the study area. These findings suggest ACM risk assessments should be specifically tailored to the regions in which they are applied, thereby improving ACM management and promoting both worker and occupant health.

Green tea and black tea inhibit proliferation and migration of HepG2 cells via the PI3K/Akt and MMPs signalling pathway.

BACKGROUND AND AIMS: Black tea and green tea were produced via different processing techniques from the same tea leave variety. Then, biochemical components of the two water extracts were analysed to study cell apoptosis, migration and invasion of HepG2 cells induced by black tea and green tea. METHOD: The monomer components of the black tea and green tea extracts were analysed by colorimetry and HPLC, with MTT assay and colony formation assays used to assess cell proliferation and viability. The effects of black tea and green tea on apoptosis of HepG2 cells were verified by flow cytometry, with wound healing and Transwell experiments used to detect cell invasion and metastasis. The expression of PI3K/Akt signalling and apoptosis-related proteins as well as epithelial-mesenchymal transition (EMT) regulatory factor in HepG2 cells were determined by western blotting after black tea and green tea treatment. RESULTS AND CONCLUSIONS: Black tea and green tea extracts demonstrated different degrees of inhibition of cell migration and invasion, with green tea inducing more HepG2 cell apoptosis. In addition, green tea and black tea extracts inhibited the growth of HepG2 cells and induced apoptosis via PI3K/Akt, and inhibited cell migration and invasion through the MMPs signalling pathway. This study revealed the effects of fermented (black tea) and non-fermented tea (green tea) on liver cancer cells, providing a basis for the investigation of tea extracts for their anti-tumour potential.

An Extended Endoscopic Endonasal Approach for Sellar Area Chondrosarcoma: A Case Report and Literature Review.

BACKGROUND: Chondrosarcoma is a malignant tumor that originates from mesenchymal cells that have differentiated into chondrocytes, often growing laterally, rarely seen in the cranium, and seldom seen in the saddle area. We believe that only a few cases have been reported in the literature. We report a case of pituitary fossa chondrosarcoma, which was completely resected by an extended endoscopic endonasal approach, and a literature review. CASE DESCRIPTION: A 20-year-old man was admitted to hospital with bilateral temporal headache and blurred vision, without any history of sexual dysfunction or diabetes insipidus. Endocrine function was normal. Computed tomography of the head showed calcified sellar lesions and sellar bone destruction, which were closely associated with the right cavernous sinus. Magnetic resonance imaging showed saddle area space-occupying lesions, with low signal on the T1-weighted image and high signal on the T2-weighted image, uneven enhancement by enhanced scanning, and unclear pituitary display. The tumor was completely resected by an extended endoscopic endonasal approach and confirmed by magnetic resonance imaging. Postoperative pathology revealed conventional chondrosarcoma (World Health Organization grade II). Postsurgical visual acuity also improved. The patient did not receive radiotherapy or chemotherapy. No recurrence was found at 10-month follow-up. CONCLUSIONS: Sellar region chondrosarcoma is rare. For space-occupying lesions in this area, chondrosarcoma should be considered and not necessarily pituitary adenoma, craniopharyngioma, meningioma, and chordoma. The extended endoscopic endonasal approach represents a good treatment option for sellar area chondrosarcoma.

Development and validation of a multi-color model using 3-dimensional printing technology for endoscopic endonasal surgical training.

BACKGROUND: The teaching of endoscopic endonasal surgery has always been difficult because of the complex structure of the nasal cavity, and the unique endoscopic view angle and endoscopic surgical tools. In this study, we have designed a 3D printed multi-color model for training of endoscopic endonasal surgery, and obtained preliminary application results. METHODS: The 3D printed model contained facial skin, bony skeleton, internal carotid artery, turbinate, optic chiasm, and a special sellar base with appropriate colors. After it was printed, six otolaryngologists and neurosurgeons assessed the model. Twenty graduate students and residents from otolaryngology or neurosurgery, without prior experience in endoscopic endonasal surgery were recruited and consented for the training. The training results were recorded. The subjective feeling of participants in terms of using 3D printed model in surgical training was investigated after training. RESULTS: All experts strongly agreed or agreed that the 3D printed model has realistic anatomical structure of nasal passage and appropriate colors for different parts, and is a good teaching tool. As the trainees practiced more, the rate and quality of endoscopic operation increased gradually. Compared to the first practice, all recorded training parameters were improved significantly (all P < 0.05). All participants strongly agreed or agreed that they benefited from the training and the 3D printed model can inspire interest and enthusiasm of endoscopic endonasal surgical training. CONCLUSION: This 3D printed model has realistic anatomical structure of nasal passage and appropriate colors for different parts, and could be a good teaching tool of endoscopic endonasal surgery.

Anatomy and surgery of pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor.

BACKGROUND: The pineal region tumors are surrounded by important structures. Neuroendoscopy has been increasingly used at home and abroad. This study is to simulate pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor from the cadaveric head, and discuss the advantages and safety through this corridor. METHODS: The anatomical structure for resection of pineal region tumor was visualized through pure neuroendoscopic infratentorial supracerebellar approach in three cadaveric heads. Three cases with pineal region tumors were retrospectively analyzed and summarized between June 2017 and December 2017. All cases were operated through pure neuroendoscopic infratentorial supracerebellar approach in the first affiliated hospital of Fujian medical university. RESULTS: The anatomical structures of pineal region can be completely visualized by pure neuroendoscopic infratentorial supracerebellar corridor in the cadaveric head. Among the three cases, the first case was total resection, the second case was subtotal resection and the last case was partial resection. The postoperative pathology revealed cavernous hemangioma, germinoma and yolk sac tumor, respectively. The patients were followed-up for 1-6 months and had normal life.The KPS (karnofsky performance status) score was 100. CONCLUSION: The anatomical structure of the pineal region can be completely visualized and the tumor can be safely removed through pure neuroendoscopic infratentorial supracerebellar approach.

Estimating the Additional Greenhouse Gas Emissions in Korea: Focused on Demolition of Asbestos Containing Materials in Building.

When asbestos containing materials (ACM) must be removed from the building before demolition, additional greenhouse gas (GHG) emissions are generated. However, precedent studies have not considered the removal of ACM from the building. The present study aimed to develop a model for estimating GHG emissions created by the ACM removal processes, specifically the removal of asbestos cement slates (ACS). The second objective was to use the new model to predict the total GHG emission produced by ACM removal in the entire country of Korea. First, an input-equipment inventory was established for each step of the ACS removal process. Second, an energy consumption database for each equipment type was established. Third, the total GHG emission contributed by each step of the process was calculated. The GHG emissions generated from the 1,142,688 ACS-containing buildings in Korea was estimated to total 23,778 tonCO2eq to 132,141 tonCO2eq. This study was meaningful in that the emissions generated by ACS removal have not been studied before. Furthermore, the study deals with additional problems that can be triggered by the presence of asbestos in building materials. The method provided in this study is expected to contribute greatly to the calculation of GHG emissions caused by ACM worldwide.

Effect of targeted ovarian cancer therapy using amniotic fluid mesenchymal stem cells transfected with enhanced green fluorescent protein-human interleukin-2 in vivo.

The aim of the present study was to investigate the effect of using amniotic fluid mesenchymal stem cells (AF-MSCs) in targeted ovarian cancer therapy in vivo. AF-MSCs were isolated from human second trimester AF and a plasmid, enhanced green fluorescent protein­human interleukin­2 (pEGFP­hIL­2) was formed. The plasmid was stably transfected into the AF­MSCs and the cells were intravenously injected into ovarian cancer nude mice models. Following stable transfection of the vector, tumor formation, and the expression and activity of hIL­2 were investigated, and microscopic pathological examinations of the tumor were performed. It was found that AF­MSCs exhibited high motility during migration in vivo, and the vector, pEGFP­hIL­2 can be stably transfected into AF­MSCs. Following stable transfection, this type of stem cell is able to successfully transport the therapeutic gene, IL-2, migrate to the ovarian cancer tumor site to secrete the functional IL-2 and treat the tumor. Thus, AF-MSCs may serve as transporters for therapeutic genes targeting ovarian tumor sites and, therefore, be involved in the treatment of tumors.

Late hematoma, seroma, and galactocele in breasts injected with polyacrylamide gel.

Late hematoma or seroma and galactocele caused by augmentation mammaplasty have been reported in patients with silicon breast prostheses but are extremely rare in patients injected with polyacrylamide gel (PAAG). In a retrospective survey, the incidence, clinical manifestations, and management of late hematoma, seroma, and galactocele in 28 of 2,610 patients who underwent breast augmentation with PAAG injection were investigated, and 5 typical cases are presented. The diagnostic and managing methods for this complication have been assessed. The incidence of late hematoma or seroma was 0.65% and that of galactocele was 0.35% among patients with PAAG-injected breast augmentations. The clinical onsets of such late PAAG complications were of two types: rapid enlargement in 17 patients and progressive expansion in another 11 patients. Aspiration, ultrasound, and magnetic resonance imaging (MRI) are useful and sensitive tools for diagnosis. Foreign body reaction, PAAG-related tissue necrosis and fibrosis, and granuloma were shown, and the bacterial cultures in all 12 cases were negative. Needle aspiration with pressure dressing has been advocated as a reliable method for small diseases, and surgical exploration with irrigation-vacuum drainage and evacuation with capsulectomy have been considered more effective for recurrent, large, and long-term cases. In conclusion, these late complications rarely present after large-volume injections of PAAG for breast augmentation. The PAAG-related pathologic inflammatory tissue changes are suggested as the pathogenesis for the complication. Trauma and breastfeeding are considered to be stimulating factors.

Vitamin B6 points PC6 injection during acupuncture can relieve nausea and vomiting in patients with ovarian cancer.

The impact of chemotherapy-induced nausea and vomiting on the quality of life of ovarian cancer patients is well known. The purpose of this study was to compare the effectiveness of acupuncture plus vitamin B6 PC6 points injection with acupuncture or vitamin B6 alone in controlling emesis of 142 patients undergoing a highly emetogenic chemotherapy regimen between March 1, 2006, and June 30, 2008. The patients were divided into 3 groups randomly and were given different antiemesis treatments accordingly. All patients received the same concurrent antiemetic pharmacotherapy and high-dose chemotherapy. We compared the total number of emesis episodes and the proportion of emesis-free days among the 3 groups during the study period. The acupuncture plus vitamin B6 PC6 points injection group had significantly fewer emesis episodes and a greater proportion of emesis-free days than the acupuncture group or the vitamin B6 alone group. We conclude that acupuncture plus vitamin B6 PC6 point injection is a quite useful method against emesis in cancer patients undergoing chemotherapy.

Anti-tumor effect and influence of Gekko gecko Linnaeus on the immune system of sarcoma 180-bearing mice.

Gekko gecko Linnaeus (GgL) is an extract used in traditional Chinese medicine. In the present study, we examined the anti-tumor activity of GgL and its effect on the immune system of mice. Sarcoma 180-bearing mice were used as the animal model, and cisplatin was applied as the positive control drug. The mice were randomly divided into six groups, and each group was treated with a different drug or drug concentration. The effects of GgL were evaluated based on its anti-tumor activity and prolongation of the lifespan, the lymphocyte transformation rate and pathological changes observed in the tumors. The results suggest that GgL has anti-tumor activities and up-regulates the immune system in a dose-dependent manner. This study provides original data related to the anti-tumor and immune up-regulating function of GgL.

Isolation of human mesenchymal stem cells from third-trimester amniotic fluid.

OBJECTIVE: To determine whether mesenchymal stem cells (MSCs) can be isolated in third-trimester amniotic fluid (AF) and their differentiation induced. METHOD: Sufficient numbers of MSCs were isolated from the AF of 15 healthy women undergoing cesarean delivery in the third trimester to be cultured and induced to differentiate into osteocytes. RESULTS: Reverse-transcriptase polymerase chain reaction showed the MSCs to express the pluripotency marker gene OCT4, and flow cytometry showed these cells to be positive for CD29, CD73, CD90, and CD105 and negative for CD31, CD45, and CD61. The MSCs were also determined to be nontumorigenic. CONCLUSION: Multipotent MSCs can be obtained from AF in the third trimester, which may be less dangerous than the second trimester to women and their fetuses.