Recent Advances in Biosensors for Nucleic Acid and Exosome Detection / 전남의대학술지

Biosensors are analytical devices for biomolecule detection that compromise three essential components: recognition moiety, transducer, and signal processor. The sensor converts biomolecule recognition to detectable signals, which has been applied in diverse fields such as clinical monitoring, in vitro diagnostics, food industry etc. Based on signal transduction mechanisms, biosensors can be categorized into three major types: optical biosensors, electrochemical biosensors, and mass-based biosensors. Recently, the need for faster, more sensitive detection of biomolecules has compeled researchers to develop various sensing techniques. In this review, the basic structure and sensing principles of biosensors are introduced. Additionally, the review discusses multiple recent works about nucleic acid and exosome sensing.

Does Early Postsurgical Temozolomide Plus Concomitant Radiochemotherapy Regimen Have Any Benefit in Newly-diagnosed Glioblastoma Patients? A Multi-center, Randomized, Parallel, Open-label, Phase II Clinical Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The radiochemotherapy regimen concomitantly employing temozolomide (TMZ) chemotherapy and radiotherapy (RT) 4 weeks after surgery, followed by 6 cycles of TMZ is a common treatment for glioblastoma (GBM). However, its median overall survival (OS) is only 14.6 months. This study was to explore the effectiveness and safety of early TMZ chemotherapy between surgery and chemoradiotherapy plus the standard concomitant radiochemotherapy regimen.</p><p><b>METHODS</b>A randomized, parallel group, open-label study of 99 newly diagnosed GBM patients was conducted at 10 independent Chinese neurosurgical departments from June 2008 to June 2012. Patients were treated with concomitant radiochemotherapy regimen plus early postsurgical temozolomide (early TMZ group) or standard concomitant radiochemotherapy regimen (control group). Overall response was assessed based on objective tumor assessments, administration of corticosteroid and neurological status test. Hematological, biochemical, laboratory, adverse event (AE), and neurological condition were measured for 24 months of follow-up. The primary efficacy endpoint of this study was overall survival (OS). The secondary endpoint was progression free survival (PFS).</p><p><b>RESULTS</b>The median OS time in the early TMZ group was 17.6 months, compared with 13.2 months in the control group (log-rank test P = 0.021). In addition, the OS rate in the early TMZ group was higher at 6, 12, and 18 months than in the control group, respectively (P < 0.05). The median PFS time was 8.7 months in the early TMZ group and 10.4 months in the control group (log-rank test P = 0.695). AEs occurred in 29 (55.8%) and 31(73.8%) patients respectively in early and control groups, including nausea (15.4% vs. 33.3%), vomiting (7.7% vs. 28.6%), fever (7.7% vs. 11.9%), and headache (3.8% vs. 23.8%). Only 30.8% and 33.3% were drug-related, respectively.</p><p><b>CONCLUSIONS</b>Addition of TMZ chemotherapy in the early break of the standard concomitant radiochemotherapy regimen was well tolerated and significantly improved the OS of the GBM patients, compared with standard concomitant radiochemotherapy regimen. However, a larger randomized trial is warranted to verify these results.</p>

Influence factors affecting insular gliomas prognosis / 中华神经医学杂志

Objective To investigate the factors affecting the prognosis of insular gliomas.Methods A series of 58 insular gliomas patients,admitted to and received microsurgical treatment in our hospital from April 2002 to April 2011,were chosen in our study; their clinical data were retrospectively reviewed and analyzed.The overall survival time (OS) and progression-free survival time (PFS) were calculated; univariate analysis (Log rank test) and multivariate analysis (Cox regression) were used to estimate the risk factors for patients' prognosis.Results The majority of 58 patients received aggressive treatment,with gross total resection in 33 (56.9％),sub-total resection in 12 (20.7％),partial resection in 12 (20.7％) and biopsy in only 1 (1.7％).In all,92.3％ high-grade gliomas patients (24/26)received adjuvant chemotherapy and radiotherapy.In 32 low-grade gliomas patients,21 (65.6％) received adjuvant chemotherapy and radiotherapy.The median OS was 29.0 months,and the median PFS was 25.0 months.Five years of survival rate was 46％,and till the follow-up deadline,the survival rate was 33％.KPS,grade of pathology and extent of resection were the independent prognostic factors for both OS and PFS.Conclusion In the protection of important structures and avoidance of complications,an aggressive management of optimal resection is associated with better outcome in patients with insular gliomas.

Screening and construction of MEK2-siRNA and its expression in human glioma / 中华神经医学杂志

Objective To construct a eukaryotic expression vector for MEK2-siRNA to explore the expression of this endogenous MEK2 in glioma U87 cell line. Methods Four single-stranded template DNAs encoding siRNA against MEK2, each consisting of 60 bp, were synthesized chemically;based on these 4 single-stranded template DNAs, 2 double-stranded DNAs were formed by annealing,then identified by restriction analysis and inserted into vector pSUPER.basic by T4 ligase. Positive recombinants were indentified by EcoRI and HindⅢ double digestion and transfected into the U87 cells.The protein expression level of MEK2 was determined by using Western blotting. Results Both restriction analysis and sequencing proved that the eukaryotic expression vector for MEK2-siRNA was constructed correctly. MEK2-siRNA plasmid screened out by Western blotting. The MEK2 expression level in negative control group was (0.105±0.023) and that in transfected group was (0.030±0.006).Conclusion The eukaryotic expression vector for MEK2-siRNA is successfully constructed, which down-regulates the transcription of MEK2 protein in U87 cells. It provides a certain experimental basis for gene therapy of glioma by RNAi technique.

Expressions of microtubule-associated protein 1 light chain 3B and autophagy-related gene Beclin 1 and their clinical significance in astrocytic tumors / 中华神经医学杂志

Objective To investigate the expressions of microtubule -associated protein 1 (MAP1) light chain 3B (LC3B) and autophagy-related gene Beclin1 in astrocytic tumors, and explore their correlations with the pathological features and clinical manifestations of astrocytic tumors to further reveal their roles in tumorigenesis and development of astrocytic tumors. Methods Sixty-two specimens with different-grade astrocytic tumors, including 4 with grade Ⅰ (pilocytic astrocytoma), 23 with grade Ⅱ (astrocytoma), 12 with grade Ⅲ (anaplastic astrocytoma) and 23 with grade Ⅳ (glioblastoma multiforme), were selected in our study. Immunohistochemistry was employed to detect the expression of Beclin1; the expressions of MAP 1-LC3B and Beclin1 were detected by Western blotting.The correlations between expressions of MAP 1-LC3B and Beclin 1 and both the pathological features and clinical manifestations of astrocytic tumors were analyzed. Results Immunohistochemistry showed decreased Beclin1 expression in the astrocytic tumors following the increase of tumor grades (P＜0.05).Western blotting indicated that the expressions of Beclin1 in tumors with different grades and these patients with different life cycles were significantly different (P＜0.05) and the average optical density ratio of Beclin1 in high-grade astrocytic tumors (grade Ⅲ/Ⅳ) was obviously lower than that in low-grade astrocytic tumors (grade Ⅰ/Ⅱ, P＜0.05). The expressions of LC3B-Ⅰ showed significant differences in different-grade astrocytic tumors, and the expression of LC3B-Ⅰ of grade Ⅳ tumor was statistically lower than that of grade Ⅰ, Ⅱ and Ⅲ tumors(P＜0.05). The expressions of LC3B-Ⅱ and Beclin 1 were negatively correlated to the pathological grade of the tumors (r=-0.334, P=0.007; r=-0.448, P=0.000), but positively correlated to the survival time(r=0.285, P=0.027; r=0.359, P=0.005). The expressions of LC3B-Ⅱ and Beclin 1 had a positive correlation (r=0.272, P=0.035). Conclusion Expressions of LC3B-Ⅱ and Beclin1 are down-regulated in glioblastoma multiforme; the decrease of autophagic capacity may relate to the tumorigenesis and development of astrocytic tumors.

Acute paraplegia following embolization of spinal dural arteriovenous fistula / 中华医学杂志(英文版)

Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

Preliminary greening of specificity-associated genes of pituitary adenoma subtypes by whole genome oligonucleotide microarray / 中华神经医学杂志

Objective To explore the expression and function of correlative genes in the happening and developing of human pituitary adenoma-subtypes.Methods The whole genome oligonucleotide microarray (Affymetrix 133 plus 2.0) was used to examine the gene expressions of pituitary adenoma tissue in 8 patients with pituitary adenoma (2 with growth hormone adenomas,2 with prolactinomas,2 with gonadotroph adenomas and 2 with null cell adenomas) and normal pooled pituitary tissue.Differentially expressed genes were analyzed by Hierarchical method and bioinformatics.A candidate gene was selected to verify the microarray analyzed result by real-time quantitative PCR.Results Compared with associated genes with normal control,associated genes with pituitary adenoma mainly involved in the following biological processes analyzed from the view of function: binding,apoptosis-or-tumor correlation,metabolism,signal-transducer-activity,cell cycle,transcription-regulator-activity and transporter-activity.The specificity of expression in several differential genes was connected to the development of pituitary adenoma-subtypes.Conclusion The development of pituitary adenoma is a complex regulation process involving lots of genes,molecules and pathways.However,the molecular mechanism related to the individual pituitary adenoma-subtypes is different.

Expression of leptin in pituitary adenomas and its clinical significance / 中华神经医学杂志

Objective To detect the expression of leptin in pituitary adenomas and investigate the association of leptin expression with the invasiveness and proliferation of pituitary adenomas. Methods Sixty-one surgical specimens of pituitary adenomas and the clinical data of the cases were obtained from the Department of Nenrosurgery, Changzheng Hospital between February and October in 2007. Immunohistochemical staining was used to detect the expressions of leptin and Ki-67 in the pituitary adenomas to investigate the role of leptin in the occurrence and development of the tumor. Results The overall leptin positivity rate in these pituitary adenomas was 34.4%, significantly lower than that in normal pituitary tissues (P<0.05). The Ki-67 index and diameter of the leptin-positive pituitary adenomas were significantly lower than those of leptin-negative tumors (P<0.05). The leptin expression rate was significantly lower in invasive pituitary adenomas than in non-invasive adenomas (P<0.05). Conlusions Compared with normal pituitary tissues, pituitary adenomas have reduced leptin expression, which is significantly correlated to Ki-67 index, tumor invasiveness and diameter but not to the patients' age or gender.

Expression of ubiquitin conjugating enzyme UbcH10 in brain astrocytomas / 中华神经医学杂志

Objective To investigate the expression ofubiquitin conjugating enzyme UbcH10 gene at mRNA and protein levels in brain astrocytomas and its correlation to the pathological grades of astrocytomas. Methods Quantitative real-time RT-PCR analysis, immunohistochemistry and Western blot were performed to detect the expression of UbcH10 mRNA and protein in 32 astrocytomas of different pathological grades and 6 normal brain tissues. The correlation between UbcH10 and Ki-67 immunoreactivity was examined with the Spearman's correlation coefficient. Results Statistical analysis showed significantly increased expression levels of UbcH1O mRNA in high-grade astrocytornas (64.33±60.98) in comparison with those in low-grade astrocytomas (8.36±8.15) and normal brain tissues (1.00±1.57) (P<0.05). increased UbcH10 labeling index in immunohistochemistry was also noted in high-grade astrocytomas [(9.65±5.75)%] as compared with that in low-grade astrocytomas [(4.82± 3.30)%] (P<0.05) and normal brain tissues [0%, P<0.05). Western blot demonstrated significantly higher UbcH10 protein levels in high-grade astrocytomas (0.69±0.38) than in low-grade astrocytomas (0.10±0.08, P<0.05) and normal brain tissues (0.01±0.02, P<0.05). UbcH10 positivity rate was found to positively correlate to that of Ki-67 (r=0.67, P=0.000). Conclusion Overexpression of UbcH10 may play an important role in the development and progression of astrocytomas.

Analysis of the factors affecting the clinical outcomes of corpus callosal gliomas / 中华神经医学杂志

Objective To identify the factors that influence the prognosis and particularly the survival of patients with corpus callosal gliomas. Methods A retrospective analysis of the clinical data was conducted involving 60 patients with corpus callosal gliomas treated between January, 1995 and December, 2007. All the patients underwent surgical tumor resection with postoperative radiotherapy and chemotherapy. Kaplan-Meier and Cox regression model were used to evaluate the possible prognostic factors including the patients' gender, age, preoperative Karnofsky performance status (KPS), tumor locations, preoperative epilepsy, histological grade, enhancement pattern on magnetic resonance imaging (MRI), extent of surgical resection, and tumor size. Results Kaplan-Meier analysis revealed that age, preoperative KPS score, and histological grade had significant influences on progression-free survival (PFS) and overall survival time of the patients. The tumor location had a significant impact on the overall survival time of the patients, but did not obviously affect the PFS. Multivariate analysis with the Cox regression model indicated that age, histological grade, and extent of surgical tumor resection significantly influenced the overall survival time of the patients, and age and histological grade of the tumor significantly affected the PFS. Conclusion A younger age, lower pathological grade and radical surgical resection of the tumor are the protective prognostic factors in patients with corpus callosal gliomas, while gender, tumor size, tumor location, and KPS score before operation have no prognostic significance.

Craniotomy for posterior fossa and deep muscles incision and suture technique in suboccipital retrosigmoidal approach / 中华神经医学杂志

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.

Construction and characterization of mutants in the neurofibromatosis type 2 tumor suppressor gene / 中华神经医学杂志

Objective To construct the eukaryotic expression vector of mutants in the neurofibromatosis type 2 (NF2) tumor suppressor gene and observe its expression in rat schwannoma cell line RT4. Methods Site-directed mutagenesis was performed to induce the mutation of the codons for the residue Ile 546 in pEGFP-N1-NF2 into Met to construct the muton of pEGFP-N1-NF2~(△Ⅱe546Met). After lipofectin-mediated transient transformation of RT4 with the plasmids containing the mutation and the one without mutation, respectively, the mRNA and protein expression levels of NF2 were determined using fluorescence imaging and Western blotting. The cell proliferation was determined by the MTT assay. Results DNA sequence analysis confirmed the success of site-directed mutagenesis and Western blotting showed that pEGFP-NF2 protein could be expressed in the RT4 cells. The RT4 cell inhibition rate in the pEGFP-N1-NF2~(△Ⅱe546Met) transfection group was statistically lower than that in the pEGFP-N1-NF2 transfected group (P<0.05).Conclusion The recombinant plasmids pEGFP-N1-NF2~(△Ⅱe546Met) has been successfully constructed with efficient expressions in RT4.

Introduction of plasmid-mediated exogenous microRNA to silence PTTG1 gene expression and inhibit proliferation and invasiveness of glioma cells HUANG Qing-feng, LU Yi-eheng, BAI / 中华神经医学杂志

Objective To investigate the role of pituitary tumor transforming gene 1 (PTTG1) in the growth and invasion of human glioma cell line by introduction of exogenous microRNA to silence PTTG 1 gene expression. Methods Two double-stranded DNA pcDNA6.2-GW/EmGFP-miR vectors (MIR-1, MIR-2) targeting human PTTG1 mRNA and a negative control plasmid (Neg) were constructed, and were transfected into human U251 cells with high metastatic potentials. Real-time PCR and Western blotting were used to quantify the mRNA and protein levels of PTTG1, respectively. Proliferation and invasiveness of transfected U251 cells were analyzed by MTT assay and Matrigel invasion assay. Results After transfection, Expression of PTTG1 mR.NA was inbibited significantly with inhibitory rates of 87.6% in MIR-2 group, and the protein levels were significantly lower than those of the other groups. There was significant difference in cellular growth rate among the 3 groups. The growth inhibiting rates in the MIR-2 group are 10.7%-34.7%. The migrating number of U251 cells transfected with MIR-2 with relative percentage (12.3±1.0)% was also significantly decreased as compared the Neg group (24.7±1.4)% and Mock group (24.0±2.0)%. Conclusion Introduction of exogenous miRNA to U251 cell line by transfection of MIR-2 can effectively reduce the PTTG1 expression, which can significantly inhibit the proliferation and decrease the invasiveness of glioma cells.

Effects ofdifferent medium and age on optic nerve tissue culture of rats / 中华神经医学杂志

Objective To investigate the effects of different medium and rat age on optic nerve tissue culture of rats.Methods Theoptic nerves from newborn rats(4dpostbirth)or adult rats(3-month old)were cultured on the rat-tailed collagen slide,pely-L-Lycine(PEL)slide,and Biocoat culture inserts,respectively.Their growth status was dynamically observed under a phase contrast microscope every day.The adherence rate of explant was recorded 48 h after culture.The maximum migration distance Was measured by an image analysis system on the 5th day after culture.The activity of lactic dehydrogenase (LDH)in the tissue culture medium Was measured dynamically.Morphological observance Was carried out by routine HE staining and the ultrastmcture of the tissue explants Were observed by a transmission electronmicroscope. Results The tissue adherence rate was higher in the Bioeoat insert group than in the rat-tailed collagen slide group or PLL slide group.The magnum migration distance of the tissue explants cultured in the Bioeoat insert group was longer than that in the rat-tailed collagen slide group or the PLL slidegroup.The maximum migration distance of the newborn rats Was longer than that of the adult rats under same culture condition(P<0.05).The LDH activity in the tissue culture medium began to descend 3 d after culture.The LDH activity in the adult rat group increased again on the 9th day since culturewhile it remained low level in the newborn rat group even on 12th day since culture.The cell processes showed up from the edge of explants and neuralgia cell migration was observed at the early stage,especially in newborn rats.The optic nerve structure gradually died out with the increase of culture time.The survival timeofopticnerve explant from newborn rats was longer than that of adult rats. Conclusion The optic nerve tissue can be cultured for a long time under suitable culture conditions.

Dynamic observation on retinal ganglion cells following chronic optic nerve compression in cats / 中华神经医学杂志

Objective To observe dynamically the response of the retinal ganglion cells (RGCs) following chronic optic nerve compression in cats. Methods Thirty adult cats were randomly divided into 6 groups (n=5): normal control group, sham operation group, 1-week compression group, 2-week compression group, 4-week compression group and 8-week compression group. The chronic optic nerve injury was produced by an inflatable balloon implanted under the optic chiasm. RGCs of all animals were labeled with Dil by retrograde tracing 2 weeks before operation. After each group animals were killed by perfusion, the retina were harvested to observe the pathological changes using the light microscope and electron microscope and the number of RGCs was counted under fluorescence microscope. Results There were three cell layers in normal HE stained retinas of cats with clear limits, named ganglion cell layer, bipolar cell layer and photoreceptor cell layer in sequence from vitreous body to selera. By 4 weeks after optic nerve compression, there were no obvious pathological changes in the retinas, however, at 8 weeks the nuclei of the RGCs became markedly thin, with the larger almost disappearing, and the total thickness of the retinas reduced with the glial cells proliferating. Under electron microscopy, the RGCs of the normal eats had large ovate nuclei with homogeneous karyoplasms. The cytoplasm occupied only small space of the cells, but contained a great of cellular organelle. At 4 and 8 weeks after compression, it was found in the retinal ganglion cells that the components of cytoplasm reduced, the endoplasmic reticulum expanded, the mitochondria was swollen, the vacuole occurred under the plasma membrane, the membrane of nuclei was shrunk and the chromatin was marginated and condensed. The density of the DiI labeled RGCs in the normal group animals ranged from 406 to 527 cells/mm2, with an average of (465±38) cells/mm2 and higher density in the central area than in the peripheral one. The number of the RC, Cs was unchanged by 4 weeks after optic nerve compression, but 8 weeks later, the number declined significantly to (293±32) cells/mm2 by about 37%. Conclusion The RGCs present delayed and secondary degeneration following chronic optic nerve compression, which gives an opportunity to protect the RGCs.

Tissue microarray-based high-throughput screening of differentially expressed proteins as biomarkers in meningioma / 中华神经医学杂志

Objective To investigate the mechanism responsible for the malignant progressionof meningiomas at the protein level using tissue microarray technique. Methods Twenty-twointracranial meningioma tissue microarrays were constructed, each containing the tissues of 42 benign, 18atypical, and 19 anaplastic meningiomas. Immunohistochcmistry of the microarrays was performed induplicate with the antibodies of MYC, ARNT2, MDM2, AR, ER, PR, Ki-67, P53, survivin, CD34 andVEGF, respectively. Negative control microarrays were used throughout the experiment and breast cancertissue microarrays were used as the positive controls for ER and PR staining. SAS9.0 solfware was usedfor grading of the expression levels of the biomarkers according to the WHO grades of meningiomas.Results For each antibody, the duplicate tissue microarrays yielded uniform staining results invisualization of the protein distributions in the cytoplasm and nuclei, and the negative controls displayedno positive staining. The p53, AR, ER, PR and Ki-67 proteins were found only in the cell nuclei, MDM2in both the cytoplasm and nuclei, and ARNT2, CD34 and VEGF in the cytoplasm only. The c-MYC andsurvivin proteins were found mainly in the cytoplasm, and in some instances in both the cytoplasm andcell nuclei. Immunohistochemical staining for p53, AR, CD34, Ki-67 and MYC proteins showed strongcorrelations to the degree of malignancy of the meningioma (P<0.05). Conclusions Tissue microarrayand immunohistochemical techniques provide an efficient means for screening the specific biomatkers ofmeningiomas. The expressions of p53, AR, CD34, Ki-67 and MYC proteins are involved in the malignantprogression of meningioma, and these proteins may serve as important biomarkers for meningiomagrading at the protein level.

Experience of resection large clinoidal meningiomas / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical applied anatomy in the region of anterior clinoid process, and to improve the therapeutic efficacy of clinoidal tumors.</p><p><b>METHODS</b>Twelve patients with large meningiomas located in clinoid were surgically treated via the extended anterior and middle fossa combined with epidural approach between January 1998 and August 2004. The surgical outcome and follow-up results were reviewed retrospectively. Supraorbital-posterional approach and cranioorbital zygomatic approach were used when tumors involved cavernous sinus. Anterior clinoid process was grinded with high-speed drilling. Supply of tumors were blocked extradurally. Tumors were resected intradurally.</p><p><b>RESULTS</b>Of the 12 cases in large meningiomas located in clinoid, 8 cases had total removal of tumors, 3 patients had subtotal removal. Of the 10 patients with pre-operative severe visual deterioration, 6 patients was markedly improved, one patient unchanged and one patient worsened post-operatively. No death was found in this group.</p><p><b>CONCLUSIONS</b>Using epidural approach for clinoidal meningiomas and grinding anterior clinoid process was advantageous to block tumors base blood supply and detach infraclinoidal tumors from internal carotid artery. Supraorbital-pterional approach could minimize brain retraction and was advantageous to expose superior pole of giant tumors.</p>

Effects of magnesium sulfate on traumatic brain edema in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of magnesium sulfate on traumatic brain edema and explore its possible mechanism.</p><p><b>METHODS</b>Forty-eight Sprague-Dawley (SD) rats were randomly divided into three groups: Control, Trauma and Treatment groups. In Treatment group, magnesium sulfate was intraperitoneally administered immediately after the induction of brain trauma. At 24 h after trauma, total tissue water content and Na(+), K(+), Ca(2+), Mg(2+) contents were measured. Permeability of blood-brain barrier (BBB) was assessed quantitatively by Evans Blue (EB) dye technique. The pathological changes were also studied.</p><p><b>RESULTS</b>Water, Na(+), Ca(2+) and EB contents in Treatment group were significantly lower than those in Trauma group (P<0.05). Results of light microscopy and electron microscopy confirmed that magnesium sulfate can attenuate traumatic brain injury and relieve BBB injury.</p><p><b>CONCLUSIONS</b>Treatment with MgSO4 in the early stage can attenuate traumatic brain edema and prevent BBB injury.</p>

Hemiparesis in carotid cavernous fistulas (CCFs): a case report and review of the literature / 中华创伤杂志(英文版)

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low), or pathogenesis (direct or indirect). The most commonly adopted classification is that described by Barrow based on arterial supply. Traumatic CCFs are almost always direct shunts between the internal carotid artery (ICA) and the cavernous sinus. General features of CCFs, which may be apparent with any lesion, including bruit, headache, loss of vision, altered mental status and neurological deficits. Some fistulae may present primarily with hemorrhage before any evaluation can be performed. However, hemiparesis has been rarely observed. Only a literature review of Murata et al reported a case of hemiparesis caused by posttraumatic CCF, in which the fistula resulted in venous hypertension and subsequent brainstem congestion. While in our case, cerebral infarction was caused by total steal of the blood flow. The patient recovered after occlusion of the fistula with a detachable balloon.