Microsurgical treatment of intra-auditory meningioma / 中华神经医学杂志

Objective:To summarize the surgical methods and experiences of intra-auditory meningioma, and discuss the techniques achieving complete resection of intra-auditory meningioma by retrosigmoid transmeatal approach on the basis of function reservation of the facial nerve and auditory nerve.Methods:The clinical data of 4 patients with intra-auditory meningioma confirmed by surgery and pathology in Xuanwu Hospital of Capital Medical University and Army General Hospital of People's Liberation Army from January 1998 to December 2018 were retrospectively analyzed. All these 4 patients accepted enlargment of the posterior wall of the internal auditory channel via retrosigmoid transmeatal approach to remove the tumors. The electro-audiogram, surgical records, discharge records and follow-up records were noted.Results:Total resection was achieved in all 4 patients; one was derived from the cerebral dura mater of the outside wall of the internal auditory canal, obtaining radical excision (Simpson grading I resection); the other three were derived from the cerebral dura mater of the internal auditory canal, and the epidural adhesion extended to the ventral internal auditory canal, only receiving Simpson grading II resection. The facial nerve and cochlear nerve in three patients were separated and protected by dissection; while the vestibular nerve and cochlear nerve in the left one patient were not found, and only the facial nerve was dissected and preserved. Two patients with preoperative hearing grading H2 and H3 were able to retain effective hearing after surgery, with postoperative hearing grading H3 and H4, respectively; and the other two patients had postoperative hearing grading H5. Postoperative Karnofsky Performance Scale (KPS) scores were 90 in 3 patients and 70 in one patient. There was no perioperative death.Conclusions:Retrosigmoid transmeatal approach is ideal approach for resection of the intra-auditory meningioma. Surgical excision of intra-auditory meningioma should accept the premise of protecting the facial auditory nerve and aim at extensive resection of tumors, including the dura and bone involved by tumors, so as to reduce the chance of recurrence; and it is necessary to open the width of intra-auditory.

Clinical comparative analysis of domestic 16-row and imported 8-row mobile CT head scans / 中华神经医学杂志

Objective:To compare the efficacy and safety of domestic 16-row and imported 8-row mobile CT in clinics.Methods:A total of 1469 patients accepted domestic 16-row mobile CT head scans (1604 times) from March 2017 to August 2018 in Bayi Brain Hospital Affiliated to 7 th Medical Center of General Hospital of People's Liberation Army and Langfang Aidebao Hospital; and 15510 patients accepted imported 8-row mobile CT head scans (24994 times) from January 2016 to August 2018 in Bayi Brain Hospital Affiliated to 7 th Medical Center of General Hospital of People's Liberation Army. All patients underwent horizontal plain and enhanced head scans, cerebral CT angiography (CTA), and helical 3D imaging; and the imaging quality, operating power consumption, computed tomography dose index volume (CTDIvol) and stability within scanning volume ranges under different scanning modes of the two CT scans were compared. Results:(1) Imaging quality: the horizontal scanning of domestic 16-row mobile CT could clearly display low-density tissues such as the eyeball, optic nerve, brain stem, sulcus and cerebral gyrus; the imaging quality of both CT scans in patients with traumatic subdural hematoma and ischemic stroke completely met the clinical diagnosis and treatment standards. (2) Operating power consumption: the per-hour operating power consumption of domestic 16-row mobile CT ([0.286±0.018] kW·h) was obviously lower than that of imported 8-row mobile CT ([0.485±0.028] kW·h). (3) Radiological hazard: the CTDIvol of the horizontal scanning volume range in domestic 16-row mobile CT ([36.270±0.281] mGy) was significantly lower than that in the imported 8-row mobile CT ([82.520±0.441] mGy, P<0.05); the CTDIvol of enhanced axis scan volume range in the domestic 16-row mobile CT ([36.270±0.335] mGy) was significantly lower than that in the imported 8-row mobile CT ([70.728±0.424] mGy, P<0.05); the CTDIvol in the volume of CTA imaging of domestic 16-row mobile CT ([20.600±0.087] mGy) was significantly lower than that in the imported 8-row mobile CT ([29.300±0.335] mGy, P<0.05). The domestic 16-row mobile CT was designed with shock absorbers and guides; domestic 16-row mobile CT had small load, a low center of gravity, and good stability as compared with imported 8-row mobile CT. Conclusion:In terms of head scanning applications, the imaging quality of domestic 16-row mobile CT and imported 8-row mobile CT is in full compliance with clinical diagnostic standards, but the energy consumption and radiation risk of domestic 16-row mobile CT is significantly lower than imported 8-row mobile CT, enjoying good stability as compared with imported 8-row mobile CT.

Feasibility of free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in supratentorial intracerebral hemorrhage and accuracy of catheter placement / 中华神经医学杂志

Objective:To assess the feasibility of free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in patients with supratentorial intracerebral hemorrhage (sICH), and to evaluate the accuracy of catheter placement.Methods:Fifty-two sICH patients received free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in our hospital from January 2018 to December 2019 were chosen (free-handed conical craniotomy group); 30 sICH patients received frameless stereotactic puncture and drainage at the same time period were selected (stereotactic puncture group). The clinical data of these patients were retrospectively analyzed. The CT results were analyzed, and differences of relative error (RE) as the indicator of catheter placement accuracy were compared between the two groups.Results:Mobile CT was successfully performed in all patients from free-handed conical craniotomy group, and sufficient information was provided for surface projection in all patients. The percentages of patients with satisfactory results of catheter placement (RE<1) in the free-handed conical craniotomy group and stereotactic puncture group were 92.3% and 90.0%; one patients from the free-handed conical craniotomy group had repeated puncture. There was no significant difference in postoperative RE between the two groups (0.52±0.33 vs. 0.53±0.29, P>0.05). Subgroup analysis of different hematoma locations and volumes also showed no statistically significant difference in postoperative RE ( P>0.05). Conclusion:Free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection is feasible in sICH patients, and the accuracy of catheter placement is similar with frameless stereotactic puncture and drainage.

Minimally invasive surgical strategy for acoustic neuromas: an analysis of 415 cases / 中华神经医学杂志

Objective To explore the surgical strategy of minimally invasive treatment for acoustic neuroma and to improve the tumor removal rate and facial nerve function preservation rate. Methods Four hundred and fifteen patients suffering from acoustic neuromas, admitted to and treated by minimally invasive surgery via trans-suboccipital retrosigmoid transmeatus approach in our hospital from January 2008 to December 2016, were chosen in our study. Their clinical data were analyzed retrospectively. Postoperative Karnofsky behavioral status scale (KPS) was used to evaluate the prognoses of the patients. Postoperative routine enhanced MR imaging was performed to determine the degrees of tumor resection. Three months after surgery, House-Brackmann facial function grading (H-B) was used to evaluate the facial function of all patients. Results KPS indicated that excellent prognosis was noted in 399 patients (96.10％), good prognosis in 14 (3.37％), and poor prognosis in 2 (0.48％); the larger the tumor diameter, the smaller the proportion of patients with good prognosis. Total resection of the tumors was achieved in 387 patients (93.25％), sub-total resection in 24 (5.78％), and partial resection in 4 (0.96％); the larger the tumor diameter, the smaller the proportion of patients with total resection. There were 398 patients with facial nerve preservation in anatomy, and the anatomic preservation rate of facial nerve was 95.9％; there were 17 without anatomic preservation, and 12 received end to end anastomosis of facial nerve. Three months after operation, H-B grading I-II was noted in 334 patients (80.5％), grading III-IV in 76 patients (18.3％), grading V-VI in 5 patients (1.2％); the larger the tumor diameter, the smaller the proportion of patients with H-B grading I-II. No surgically related deaths occurred. Conclusion Early diagnosis and early microsurgical treatment of acoustic neuroma is helpful in improving the safety and efficacy of tumor resection.

Research status and progress on treatment of chronic consciousness disorder in children / 中华神经医学杂志

With the development of first aid and severe medical technology,more and more patients are turning from severe coma to chronic disorder of consciousness (DOC),and the incidence rate of children is high.The treatments and prognoses of DOC in children are important issues related to family and society.This article reviews the diagnoses and scales,the research status of clinical drug therapy and non-invasive,invasive nerve stimulation therapies and hyperbaric oxygen therapy of DOC in childem.

Current Status of Neuromodulatory Therapies for Disorders of Consciousness / 神经科学通报·英文版

Treatment for disorders of consciousness (DOCs) is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. This article reviews the most relevant studies in the literature in order to describe a clear picture of the current state of neuromodulation therapies that could be used to treat DOC patients. Both invasive and non-invasive brain stimulation is discussed. Significant behavioral improvements in prolonged DOCs under neuromodulation therapies are rare. The efficacy of various such therapies remains a matter of debate. Further clinical investigations of existing techniques in larger samples properly controlling for spontaneous recovery are needed, and new approaches are awaited.

Novel 16-slice mobile CT head scan in 391 patients / 中华神经医学杂志

Objective To discuss the application of self-developed novel 16-slice mobile CT head scan.Methods A total of 391 patients were performed 16-slice mobile CT scan:145 were scanned in the emergency department,156 in the neurosurgical ICU,55 in the operated room,and 35 in the ambulance vehicle.Sixty-eight patients were with brain injury,122 were with cerebral hemorrhage,120 were with cerebral infarction,59 were with brain tumors,and 22 were with hemifacial spasm.Thirty-five patients were randomly selected from 391 patients and 8-slice mobile CT head scan was performed on them,which included 12 with brain injury,6 with cerebral hemorrhage,12 with cerebral infarction,3 with brain tumors and 2 with hemifacial spasm.The resolution,imaging quality,radiation doses,power consumption and performance stability of novel 16-slice mobile CT and 8-slice mobile CT head scan were compared.Results The resolution line pairs of brain tissues were 91 p/cm by 16-slice mobile CT and 71 p/cm by 8-slice mobile CT,respectively.The imaging quality of the two kinds of mobile CT head scans was high level to the clinic diagnostic criteria.The radiation dose of 16-slice mobile CT were 40.43 mGy,which decreased by 51.01％ as compared with that of 8-slice mobile CT (82.52 mGy).The personal power consumption of 16-silce mobile CT (0.29 kW· h) decreased by 38.30％ as compared with those of 8-layer mobile CT (0.47 kW· h).The 16-slice mobile CT kept regularly,while 8-slicer mobile CT stopped to work twice during clinical trial.Conclusion The 16-slice mobile CT scan has high resolution,fine imaging quality,low radiation dose,small power consumption and stable working performance.

The effect of R-spondin3 on proliferation of neural stem cells and Wnt/β-catenin signals in mice / 中华神经医学杂志

Objective To explore the effect of R-spondin3 on the proliferation of neural stem cells (NSCs) and its mechanism in mice.Methods The mouse NSCs derived from the subventricular zone of E 14-15d CD 1 mice were confirmed by immunofluorescence assay.The NSCs after 3 passages of culture were chosen and randomly divided into 2 groups (V=1 mL).In the experimental group,0.8 μL of R-spondin3 with an initial concentration of 50 μg/mL was added (final concentration:40 ng/mL) while in the control group an equal amount of culture fluid was added.The proliferation of the cells in the 2 groups was detected by 5-Bromo-2-deoxy Uridine (BrdU) kits after the cells were treated by R-spondin3 for 6 hours.The protein expression of [β-catenin was measured by western blotting after the cells were treated by R-spondin3 for 4 and 8 hours.Results Under optical microscopy,the round and bright cells grew in culture medium and easily accumulated to become neurospheres.Immunofluorescence assay showed that over 90％ of the cells expressed Nestin and SOX2 and that some of them expressed NeuN or GFAP after induced differentiation.Brdu proliferation test showed that the proliferation rate of Brdu+/DAPI+ for the experimental group (1.56±0.03) was significantly higher than that for the control group (1.04±0.04) (P＜0.05).Western blotting showed that the expression levels of [β-catenin were increased at both 4h and 8h after treatment for the experimental group (1.09±0.10 and 1.20±0.13),significantly higher than those for the control group (0.56±0.05 and 0.83±0.04) (P＜0.05).Conclusions R-spondin3 can promote in vitro proliferation of NSCs in mice,which may be associated with activated Wnt/β-catenin signal pathways.

Intraoperative cerebral perfusion monitoring by evoked potential and transcranial doppler ultrasonography in carotid endarterectomy: a comparative study / 中华神经医学杂志

Objective To investigate the effectiveness of evoked potential in monitoring cerebral perfusion during carotid endarterectomy by a retrospective cohort study.Methods A retrospective cohort survey of clinical data of 59 patients,who underwent carotid endarterectomy in our hospital from September 2013 to December 2016,was performed.All patients were monitored by transcranial doppler ultrasonography (TCD) and somatosensory evoked potential (SEP),motor evoked potential (MEP) for changes of cerebral blood flow;the monitoring of TCD was defaulted as "gold standard",recording monitoring results at different time points.By drawing the four table,the sensitivity,specificity,positive predictive value,negative predictive value of SEP and MEP during cerebral hypoperfusion were calculated,and correlation analyses between SEP and TCD,and between MEP and TCD were performed.Through receiver operating characteristic (ROC) curve,SEP monitoring threshold of cerebral hypoperfusion was predicted.Results The sensitivity,specificity,positive predictive value,and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 60.00％,91.84％,60.00％,and 91.84％ when SEP amplitude declined beyond 50％;the sensitivity,specificity,positive predictive value and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 70.00％,93.88％,70.00％ and 93.88％ when SEP latency extended beyond 10％.The sensitivity,specificity,positive predictive value,and negative predictive value of MEP in predicting intra-operative cerebral hypoperfusion were 30.00％,97.96％,75.00％,and 87.27％ when MEP amplitude declined beyond 50％.Decline of SEP and MEP amplitudes and extension of SEP latency have positive correlations with TCD.ROC indicated that the amplitude of somatosensory evoked potentials could predict intraoperative hypoperfusion when it decreased by 51.0％ than the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 89.8％ and area under the curve of 0.918 (95％CI:0.846～0.990,P=0.024).ROC also showed that the latent phase of somatosensory evoked potentials could predict intraoperative hypoperfusion when it was prolonged ＞9.8％ compared to the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 92.9％and area under the curve of 0.941 (95％CI 0.878～0.995,P=0.014).Conclusion Evoked potentials can real-time monitor intra-operative cerebral hypoperfusion continuously in carotid endarterectomy,enjoying high sensitivity and specificity;in addition,decline of SEP amplitude and extension of SEP latency have higher sensitivity than MEP.

Thromboelastography and conventional coagulation tests in detecting coagulation function of antiplatelet after endovascular treatments in acute ischemic stroke: an association study / 中华神经医学杂志

Objective To explore the association,consistency and complications prognostic value of thromboelastography and conventional coagulation tests in detecting coagulation function of antiplatelet after endovascular treatments in patients with acute ischemic stroke.Methods A retrospective cohort survey of 240 patients,admitted to our hospital from September 2012 to December 2017,was performed.All acute ischemic stroke patients accepted coagulation function monitoring 5 d after aspirin and clopidogrel and endovascular treatments by thromboelastography (R time,K time,α angle,maximum amplitude [MA]) and routine coagulation tests (prothrombin time [PT],activated partial thromboplastin time [APTT],fibrinogen [FIB],international normalized ratio [INR],blood platelet count).The association,consistency,and sensitivity,specificity,positive predictive value,negative predictive value of complications prognostic value of thromboelastography and conventional coagulation tests were analyzed.Results (1) R time and APTT,K time and APTT,α angle and FIB,and α angle and PLT were positively correlated;K time and FIB,R time and PLT,and α angle and APTT were negatively correlated.(2) R time and APTT (κ=0.266,P=0.000),K time and APTT (κ=0.134,P=0.024),and α angle and FIB (κ=0.162,P=0.007) had agreement in identifying hypercoagulability;R time and APTT (κ=0.211,P=0.001),K time and APTT (κ=0.198,P=0.002),and blood platelet count and K (κ=0.388,P=0.000),and α angle and PLT (κ=0.099,P=0.041) had agreement in identifying hypocoagulability.(3) The sensitivity of thromboelastography and routine coagulation tests in identifying early neurological deterioration was 17.65％ and 58.82％,and the sensitivity in identifying symptomatic hemorrhages by thromboelastography and routine coagulation tests was 73.68％ and 47.39％.Conclusions Some parameters has correlations in peroperative period,and has agreement in identifying hypercoagulability and hypocoagulability.Accordingly,routine coagulation tests might be superior in evaluating early neurological deterioration,and thromboelastography might be superior in evaluating symptomatic hemorrhages in patients with acute ischemic stroke.

Advances in the clinical diagnosis and treatment of intracranial venous sinus thrombosis / 中国医师进修杂志

Intracranial venous sinus thrombosis is a special type of cerebral vascular disease. It usually originates from the later period of wasting disease, brain trauma, puerperium, blood disease, heart disease, eye/nasal/facial infection, meningitis and septicemia. It occurs in different age and sex. Infants, young children, frail elderly people, postpartum women, chronic disease patients are prone to be affected.Because of lacking of typical clinical manifestations, the clinical diagnosis and treatment of this disease is difficult and easily leading to misdiagnosis and mistreatment, which affects the prognosis of the patients.Because of lacking of standardized diagnosis and treatment strategy, different methods are needed. According to the proceeding reports, we reviewed the current progress of the diagnosis and treatment of intracranial venous sinus thrombosis.

Effect of miR-184 on proliferation of neural stem cells and its underlying mechanism / 中华神经医学杂志

Objective To investigate the effect ofmiR-184 on proliferation of neural stem cells (NSCs) and its mechanisms in mice.Methods The pHBLV-U6-GFP-miR-184 over-expression plasmid and pHBLV-U6-GFP-miR-184 inhibitor plasmid were used to construct recombinant lentivirus.And the NSCs derived fiom subventricular zone of E14d CD1 mouse were confirmed by immunofluorescence assay.There were four groups that contain a miR-184 overexpression group,a miR-184 inhibitor group and two control groups.The NSCs which infected with lentiviral vectors were selected for puromycin resistance for 5-7 days,and then surviving cells were cultivated to three generations.The expression level ofmiR-184 was detected by real time-quantitative PCR (RT-qPCR).And the target genes ofmiR-184 were predicted through TargetScan,IRTarBase and MiRanda,and were confirmed by Western blotting and RT-qPCR.The cells in the four groups were culttared under proliferating conditions incorporated bromodeoxyuridine (BrdU) in cell proliferation analyses.The protein expressions of Hesl and Hes5,the target proteins of Notch signaling pathways,and their mRNA expressions were detected by Western blotting and RT-qPCR.Results There were 90％ of cells in each group expressing both Nestin and Sox2.The miR-184 level in the miR-184 overexpression group was 67.63±7.53 times of that of the control group,with significant difference (P＜0.05).The percent of BrdU+/DAPI+ of the miR-184 overexpression group was 1.47±0.05 times of that in the control group,with significant difference (P＜0.05);and the percent of BrdU+/DAPI+ of the miR-184 inhibitor group was 0.84±0.03 times of that in the inhibitor control group,with significant difference (P＜0.05).Numbl was a target gene ofmiR-184 indicated by IRTarBase and MiRanda.The miR-184 could inhibit Numbl protein expression;the Numbl protein expression level in the miR-184 overexpression group was 0.73±0.07times of that in the control group,and the Numbl protein expression level in the miR-184 inhibitor group was 1.30±0.05 times of that in the control group,with significant difference (P＜0.05);but miR-184 did not change the Numbl mRNA level.The miR-184 could activate Notch signaling pathway through inhibiting the Numbl protein expression,and increase the Hes1 and Hes5 protein and mRNA expression levels (P＜0.05).Conclusion The miR-184 promotes the NSCs proliferation through inhibiting the Numbl protein translation and further activating the Notch signaling pathway.

Surgical strategies and techniques of petroclival meningiomas by trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches / 中华神经医学杂志

Objective To summary the microsurgical strategies and techniques of petroclival meningiomas by trans-subtemporal combined with suboccipital retrosigrnoid keyhole approaches to raise the removal rate and improve the prognosis.Methods The clinical data of consecutive 26 patients with petroclival meningiomas,admitted to our hospital from January 2011 to December 2015 and accepted microsurgical treatment,were reviewed retrospectively;7 of them were guided by neuronavigation,8 were performed under neuroelectrophysiological monitoring,and 11 were guided by neuronavigation combined intraoperative MRI or neuroelectrophysiological monitoring.The operative methods and techniques,tumor resection rate and Kamofsky performance scale (KPS) scores before and after operation were analyzed.Results Of all patients who underwent surgical treatment by trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches,gross total tumor resection (Simpson Ⅰ-Ⅱ) was achieved in 23 patients (88.5％),subtotal (Simpson Ⅲ-Ⅳ) in 3 patients (1 1.5％).Six patients (23.1％) had cranial nerve deficit postoperatively.No mortality which related with operation was noted.Patients were followed up for 3-35 months,23 patients had KPS scores ≥70,and 3 patients had KPS ＜70;no tumor recurrence or progression was noted.Conclusion The trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches are safe,effective and minimally invasive for resection of petroclival meningiomas;mastering the operation strategies and intraoperative skills is conducive to improve the efficacy of surgery.

Growth differentiation factor 11 promotes proliferation of mouse neural stem cells and activates both transforming growth factor-β/Smads and Wnt/β-Catenin signal pathways / 中华神经医学杂志

Objective To investigate the effects of growth differentiation factor 11 (GDF11) on proliferation of mouse neural stem cells (NSCs) and expression levels of transforming growth factor (TGF)-β/Smads and Wnt/β-Catenin signal key proteins.Methods NSCs,derived from the subventricular zone of E14 d CD1 mice,were cultured and induced differentiation;specific proteins nestin and SOX2 were confirmed by immunofluorescence assay.Neuron marker nucleus antigen (NeuN)and astrocyte marker glial fibrillary acidic protein (GFAP) were identified by immunofluorescent staining.The cells of third generation in their exponential phase were chosen and randomly divided into experimental group (adding GDF11 to make the final concentration as 40 ng/mL) and control group (adding equal amount of culture fluid).The proliferation of the cells in the two groups was detected by 5-ethynyl-2'-deoxyuridine (EdU) kits and protein expressions of Smad2/3,phosphorylated (p)-Smad2/3,Smad4 and β-Catenin were measured by Western blotting one and 6 h after treatment.Results Round and bright cells suspended in culture medium were observed through optical microscope.Immunofluorescence assay showed that over 90％ cells expressed both nestin and SOX2,and some of them expressed NeuN or GFAP.EdU proliferation test showed that the percentage of EdU positive cells in the experimental group (0.34±0.08) was significantly higher than that in the control group (0.24±0.03,P＜0.05).Western blotting showed that the expression levels ofp-Smad2/3,Smad4 and β-Catenin were significantly increased one and 6 h after treatment as compared with those in the control group (P＜0.05).Conclusion GDF11 can promote the proliferation of NSCs in vitro and probably is on account of activating TGF-β/Smads and Wnt/β-Catenin signal pathways.

Cultivation and identification of neural GABAergic precursor cells derived from medial ganglionic eminence of embryonic mice / 中华神经医学杂志

Objective To explore a method for isolation,cultivation and identification of GABAergic precursor cells derived from medial ganglionic eminence (MGE-NPCs) of embryonic mice.Methods The MGE brain tissues of pregnant mice of 14.5 d were isolated under stereomicroscope;and the cells from these tissues were cultured to third passage or above in serum-free medium with SHH signal path stimulator.(1) Fluorescence immunocytochemistry was used to detect the expressions of neural stem cells (NSCs) markers nestin,sex determining region Y-box protein 2 (SOX2),MGE transcription factor NK2 homeobox 1 (NKX2-1) and intemeuron progenitor marker LIM homeobox 6 (LHX6) to identify the NSCs maintenance ability.(2) Proliferation potential of MGE-NPCs was detected by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay and bromodeoxyuridine (BrdU) labeling one and 3 d after culture in vitro.(3) The expressions of neuronal marker neuronal nuclear antigen (NeuN),and interneuron markers gamma-aminobutyric acid (GABA),glutamic acid decarboxylase(GAD67),and parvalbumin (PV) were examined by immunocytofluorescent 5 d after induced culture with GABAergic induced medium.(4) The differentiations of MGE-NPCs into GABA-,GAD67-and PV-positive cells in vivo one month after transplantation into the mice were detected by frozen section immunofluorescence staining.Results The neurospheres with self-renewal and proliferation capacity were obtained from the MGE of embryonic mice.Immunofluorescent staining showed that nestin,SOX2,Nkx2.1 and LHX6 positively expressed in the MGE-NPCs.The results of MTT assay revealed that the optical density (OD) one d after culture was significantly less than that 3 d after culture (0.392±0.032 vs.0.811±0.017,P＜0.05).BrdU labeling indicated that the ratio of proliferated MGE-NPCs one d after culture was significantly less than that 3 d after culture (45.086±7.122 vs.61.786±10.540,P＜0.05).The MGE-NPCs could differentiate into NeuN-,GABA-,GAD67-and PV-positive inhibitory interneurons 5 d after differentiation culture and one month after transplantion into mice.Conclusion The MGE-NPCs cultured in vitro still have NSCs characteristics of neuronal precursors and remain the capacity of differentiated intemeuron.

Galangin induces apoptosis of glioma cells through Wnt/β-Catenin signal pathway / 中华神经医学杂志

Objective To investigate the effect of galangin on proliferation and apoptosis of glioma cells in vitro.Methods (1) The glioma cells U87 and U25 1were divided into blank control group,DMSO group,100,200,300 and 400 μmol/L galangin treatment groups.MTT was used to study the effects of drugs on the proliferation of U251 and U87 cells.(2) Hoechest staining was used to observe cell apoptosis in the presence of different concentrations of galangin (0,100 and 200 μmol/L).(3) Flow cytometry was employed to detect the apoptosis of U251 and U87 cells in the presence of different concentrations of galangin (1 00 and 200 μmol/L).(4) Western blotting was employed to detect the expressions of apoptosis-related protein 3-Catenin,B-cell lymphoma-2 (Bcl-2),Bcl-2 related protein gene (Bax),cleaved-caspase-3,cleaved-caspase-9 and poly (ADP-ribose) polymerase (PARP) in the presence of different concentrations of galangin.Results (1) The proliferation of U251 and U87 cells was obviously inhibited atter 100,200,300 and 400 μmol/L galangin treatments,and dose-effect relation was noted.The concentrations of galangin at half rate of inhibition (IC50) were 281,321,276 and 229 μmol/L in U251 cells,and 289.4,261.1,247.4 and 225.3 μ mol/L in the U87 cells after 100,200,300 and 400μmol/L galangin treatments for 24 h.(2) Under the action of galangin,corresponding increase in apoptosis rates of U251 and U87 cells was noted following the increase of galangin concentrations (0,100 and 200 μmol/L),with significant differences (P＜0.05).(3) The detection of cell apoptosis by flow cytometry found similar changes.(4) Western blotting results indicated that galangin at the concentration of 0,100 and 200 μmol/L could significantly decrease the expressions of apoptosis-related protein 3-Catenin and Bcl-2,and increase the Bax,cleaved-caspase-3 and cleaved-caspase-9,and cleaved-PARP expressions;significant differences were noted between each two concentrations (P＜0.05).Conclusion Galangin can inhibit proliferation of glioma cells U251 and U87,and induce mitochondrial pathway of apoptosis via Wnt/β-Catenin signaling.

Selection of operative approach for brainstem cavernous malformations / 中华神经医学杂志

There are many important nerve nuclei,ascending and descending conduction bundles,as well as the vital center in the brainstem.How to select the safe,minimally invasive andefficient surgical approach to the intemal brain stem lesions is a problem that must be considered before brain stem cavernous hemangioma surgery.Individual choice of the best surgical approach is very important for total resection of brain stem cavernous hemangioma.The surgical approach to brainstem lesions is divided into grade Ⅰ access and grade Ⅱ approach,which is easy to understand how to select the operative approach and correct the choice of surgical approach.Based on the selection principle of surgical approach,how to select grade Ⅰ and grade Ⅱ approaches,as well as the common approach of brainstem cavernous hemangioma in different regions are expounded in detail.

Mechanical thrombectomy with the Solitaire AB device in acute ischemic stroke of posterior circulation: a series of 17 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB device in recanalization of patients with acute ischemic stroke of posterior circulation.</p><p><b>METHODS</b>The clinical data of 17 consecutive patients with acute ischemic stroke of posterior circulation, treated with the Solitaire AB device from August 2011 to August 2015 in Department of Neurosurgery, the Military General Hospital of Beijing People's Liberation Army, were extracted and then retrospectively analyzed. There were 12 male and 5 female patients with a median age of 60 years (ranging from 44 to 75 years). Among them, 8 cases occluded in basilar artery, 4 cases occluded in vertebral artery and 5 cases occluded in vertebral plus basilar artery. Recanalization rate as well as complications after treatment were analysized. Also, neurological functions of the patients before and after treatment, measured by National Institute of Health stroke scale (NIHSS) score, were compared via t test and the clinical outcomes were assessed by modified Rankin score (mRS) at 90 days after treatment.</p><p><b>RESULTS</b>Fifteen patients resulted in successfully recanalization, and 2 cases failed both of whose onset to sheath time were above 7.5 hours. The NIHSS score at 7 days was 11±10, which was significantly decreased compared to the admission NIHSS score 17±5 (t=2.949, P=0.009). No symptomatic intracranial hemorrhage case was found after thrombectomy. At 90 days, one patient died(mRS 6), one patient seriously disabled (mRS 5), two patients moderately seriously disabled (mRS 4), four patients resulted in moderate outcome (mRS 3) and the other 9 patients achieved good outcome (mRS 0 to 2). The dead and seriously disabled cases were both due to failure in recanalization. Two moderately seriously disabled cases were probably attributed to their severe admission condition (NIHSS >20) and prolonged time (onset to sheath time >6 hours).</p><p><b>CONCLUSION</b>Mechanical thrombectomy with the Solitaire AB device contributes to a high rate of recanalization with a low probability of complication and improves functional outcome in patients with acute ischemic stroke of posterior circulation.</p>

SOCS3 conditional ablation induces differentiation of M2-type macrophages after spinal cord injury in mice / 中华神经医学杂志

Objective To evaluate the influence of SOCS3 conditional ablation in macrophage polarization and functional recovery after spinal cord injury in mice.Methods The Socs3fVfl Nes cre mice were used to obtain nervous-system-restricted SOCS3 deletion models as experimental group (n=40),and littermate Socs3fl as control group (n=40).Mice (n=35) in each group were underwent T10 spinal cord compressing injury (the left 5 were as sham-operated controls);on the third,7th and 14th d of injury,injured tissues from 15 mice of each group were harvested;immunofluorescence was performed to detect the changes of M2a and M2c phenotypic marker Arginase1 and M1 and M2b phenotypic marker CD86;on the first,third,7th and 14th d of injury,injured tissues from the left 20 mice from each group were harvested;fluorescent quantitative real time-PCR was used to detect the macrophage phenotypic markers (Arginasel,CD206,iNOS and CD32),SOCS3 and STAT3 gene expressions;the above data from the sham-operated controls were used as base data.BMS scale was used to evaluate the motor functions of posterior limbs and bodies on the first,third,7th and 14th d of injury.Results The behavioral assessments of the experimental group were superior on the third,7th and 14th d of injury as compared with those of control group (P＜0.05).Immunofluorescence showed that as compared with the controls,the Socs3fVfl Nes cre mice had a predominance in distribution and population of Arginasel-positive macrophages in spinal cords on the third,7th and 14th d of injury;in contrast,the control group showed superiority of CD86 expression on the 7th and 14th d,with significant differences (P＜0.05).Similarly,fluorescent quantitative real time-PCR analysis demonstrated that gene expression of A rginase I on the 7th d of injury,that of CD206 on the 7th and 14th d of injury,and that of STAT3 on the third,7th,and 14th d of injury were significantly increased,whereas that of CD32 on the 14th d of injury and SOCS3 on the first and third d of injury were significantly reduced in the experimental group,as compared with those in the control group (P＜0.05).Conclusion SOCS3 conditional knockout can promote the formation of M2 macrophage,as well as good functional recovery after spinal cord injury in mice.

Application value of arcuate fasciculus diffusion tensor imaging technology combined with neuronavigation in epilepsy surgery / 中华神经医学杂志

Objective To evaluate the application value of arcuate fasciculus diffusion tensor imaging (DTI) combined with neuronavigation in epilepsy surgery. Methods A retrospective analysis of 24 patients with refractory epilepsy, admitted to our hospital from March 2011 to March 2014, was performed; the epileptic foci of these patients were adjacent to the language functional areas conformed by imaging before operation. Surgical resection was performed with the help of arcuate fasciculus of DTI, diffusion tensor fiber tracking (DT-FT) combined with neuronavigation. The surgical efficacy and language function of the patients were evaluated by Engel classification and Verbal Behavior Assessment Scale (VerBAS) at postoperative follow-up. Results During the follow-up from 12 to 47 months, according to Engel classification, in 7 patients with foci adjacent to Broca area, Engel grade I was achieved in 3, Engel grade II in 3 and Engel grade Ⅲ in one; and in 17 patients with foci adjacent to Wernicke area, seizure control was as follows: Engel grade I was noted in 13, Engel grade II in 2 and Engel grade III in 2. No perpetual language dysfunction after operation was noted in all the patients. Conclusion Arcuate fasciculus DTI combined with intraoperative neuronavigation has very high application value in the epilepsy surgery.