Changes of serum MMP-9, NSE, MPO levels and prognostic influencing factors in patients with intracranial aneurysm undergoing interventional embolization at different treatment timing.

Background: To analyzes the changes in serum levels of matrix metalloproteinase-9 (MMP-9), neuroenolase (NSE), myeloperoxidase (MPO) and prognostic factors in patients with intracranial aneurysm (IA) undergoing interventional embolization at different treatment times. Methods: A retrospective analysis was made of 200 IA patients admitted to our department from January 2018 to June 2021 was performed. All patients underwent interventional embolization. According to the timing of surgery, the patients were divided into an early group (n=120, onset to surgery ≤72 h) and a delayed group (n=80, onset to surgery >72 h). The effect of embolization, complications and neurological deficit scale (NDS) scores were compared between the two groups. Serum MMP-9, NSE and MPO levels were compared before and after surgery, and the prognosis of all patients within 2 years after surgery was assessed by the Glasgow outcome scale (GOS) and divided accordingly into the good prognosis group (n=147) and the poor prognosis group (n=53) accordingly, and the prognostic factors influencing the patients were analyzed univariately and multifactorially.

Identification of EMT-associated prognostic features among grade II/III gliomas.

Grade II/III gliomas have a highly heterogeneous clinical course. Identifying prognostic biomarkers in grade II/III gliomas is essential to guide clinical management. We explored epithelial-mesenchymal transition (EMT)-related genes to uncover prognostic features in grade II/III gliomas. Consensus cluster analysis of 200 EMT-related genes classified 512 grade II/III glioma samples into two molecular subtypes, C1 and C2. The C1 subtype had significantly worse overall survival compared to the C2 subtype. Pathway analysis revealed C1 tumors were highly associated with tumor progression pathways and demonstrated higher immune cell infiltration scores. Differential expression analysis identified four genes (ACTN1, AQP1, LAMC3, NRM) that discriminated the two subtypes. Validation in external datasets confirmed that high expression of this four-gene signature predicted poor prognosis in grade II/III gliomas. Cellular experiments showed ACTN1, AQP1 and NRM promoted glioma cell proliferation, migration and invasion. We examined correlations of the signature genes with T cell exhaustion markers and found ACTN1 expression had the strongest association. Immunohistochemistry analysis further demonstrated that ACTN1 protein expression in grade II/III gliomas was negatively correlated with patient overall survival. In summary, our study identified a concise four-gene signature that robustly predicts grade II/III gliomas prognosis across multiple datasets. The signature provides clinical relevance in distinguishing more aggressive grade II/III glioma tumors. Targeting the ACTN1, AQP1 and NRM genes may offer new therapeutic opportunities to improve grade II/III gliomas patient outcomes.

Protective mechanisms of tea polyphenols regulating the PI3K/Akt pathway on early brain injury after subarachnoid hemorrhage in rats.

In recent years, numerous studies have demonstrated that tea polyphenols (TPPs) can exert neuroprotective effects through the regulation of the PI3K/Akt pathway. The objective of this work was to verify whether TPPs could protect against early brain injury in rats after subarachnoid hemorrhage (SAH) by modulating the PI3K/Akt pathway. A total of 150 rats were randomly rolled into control (C), TPP, and SAH groups. The TPP and SAH groups underwent endovascular perforation to induce SAH, while C group received only endovascular needle puncture and saline injection. Brain water content, Evans Blue (EB) extravasation assay, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, Western blot, and RT-PCR analyses were performed. Relative to SAH group, TPP treatment considerably improved neurological function scores following SAH, reduced brain edema, cortical neuronal apoptosis, and blood-brain barrier damage. Levels of aquaporin-4 (AQP4) and apoptosis-related protein Bax were considerably lower in the TPP group than in SAH group. Conversely, levels of anti-apoptotic protein Bcl-2 and tight junction protein Zona occludens 1 (ZO-1) were considerably higher in the TPP group. Furthermore, TPP treatment was found to activate the PI3K/Akt signaling. TPPs can mitigate early brain injury caused by SAH in rats by reducing AQP4 levels, alleviating cortical damage, and attenuating neuronal apoptosis. These findings elucidate the protective mechanisms of TPPs against early brain injury following SAH through the regulation of the PI3K/Akt signaling.

Comment on "An Injectable Hydrogel to Modulate T Cells for Cancer Immunotherapy".

Recent clinical successes of immune checkpoint blockade (ICB) therapies represents a milestone as a novel anti-tumor strategy beyond surgery, radiotherapy, chemotherapy, and targeted therapy in cancer therapy. T cells, especially CD8+ T cells, play crucial roles in anti-tumor immune responses. However, most T cells in the tumor microenvironment express high inhibitory receptors, such as PD-1, TIM-3, and LAG-3, and decreased T cell response in response to stimuli. Applying ICB therapies, such as anti-PD-1, promotes T cell activation and increases cytotoxic T lymphocyte (CTL) response, leading to the enhanced anti-tumor immune response in patients with malignancy. Therefore, studies aimed to define novel targets that can restrain T cell terminal exhaustion are urgently required to provide new strategies for patients resistant to immunotherapy. The previously published study by Zhang et al. (An Injectable Hydrogel to Modulate T Cells for Cancer Immunotherapy, https://doi.org/10.1002/smll.202202663) introduces a new type of injectable hydrogel that can regulate the function of T cells, thereby improving their effectiveness in cancer immunotherapy. However, it remains to be discussed for its conclusion, as the flow cell assay of this article may not be proper.

An unexpected case report of epidermoid cyst at the oculomotor nerve: mimicking a common cyst on MRI.

Intracranial epidermoid cysts are benign lesions and are rarely seen in clinical practice. Owing to similarities in imaging findings to those of common cystic lesions, the preoperative diagnosis is rendered challenging. Here, we present a case report of an epidermoid cyst at the right oculomotor nerve, which was initially misdiagnosed as a common cyst. A 14-year-old female child was admitted to our department due to a previous magnetic resonance imaging scan of a cystic lesion on the right side of the saddle that was suspected to be an oculomotor nerve cyst. In our department, this patient underwent a complete surgical resection of the tumor, and the pathology results revealed an epidermoid cyst. This is the first study that reported an epidermoid cyst at the right oculomotor nerve entering the orbit, mimicking a common cyst in imaging. We hope that this study would allow clinicians to consider this type of lesion as a differential diagnosis. Moreover, we suggest that specific diffusion-weighted imaging scan should be performed to aid in the diagnosis.

Development of a tumor microenvironment-related prognostic signature in glioma to predict immune landscape and potential therapeutic drugs.

The involvement of the tumor microenvironment (TME) in the biology of gliomas has expanded, while it is yet uncertain its potential of supporting diagnosis and therapy choices. According to immunological characteristics and overall survival, cohorts of glioma patients from public databases were separated into two TME-relevant clusters in this analysis. Based on differentially expressed genes between TME clusters and correlative regression analysis, a 21-gene molecular classifier of TME-related prognostic signature (TPS) was constructed. Afterward, the prognostic efficacy and effectiveness of TPS were assessed in the training and validation groups. The outcome demonstrated that TPS might be utilized alone or in conjunction with other clinical criteria to act as a superior prognostic predictor for glioma. Also, high-risk glioma patients classified by TPS were considered to associate with enhanced immune infiltration, greater tumor mutation, and worse general prognosis. Finally, possible treatment medicines specialized for different risk subgroups of TPS were evaluated in drug databases.

Deanxit and tandospirone relieved unexplained limb edema in a depressed pituitary adenoma survivor: A case report.

Our case report describes a 45-year-old woman who suffered from limb edema for 2 months. We focused on tumor recurrence and other common potential diseases based on the pituitary adenoma history. However, none of the examinations showed any abnormality. Later, her continuous complaints about the family relationship and depressed mood came into sight, and a psychiatry consultation was arranged. Following that, she was diagnosed with major depressive disorder. After several days of Deanxit and tandospirone treatment, the patient's limb edema dramatically subsided. This is the first case of limb edema associated with depression. This highlights the importance of awareness of mental illness for non-psychiatrists, especially in patients with severe somatic symptoms, but with negative results.

Analysis of Cerebrospinal Fluid Routine Biochemical Level, Pathogenic Bacteria Distribution, and Risk Factors in Patients with Secondary Intracranial Infection after Brain Tumor Surgery.

Purpose: Analysis of routine biochemical levels of cerebrospinal fluid (CSF), distribution of pathogenic bacteria, and risk factors in patients with intracranial infections secondary to brain tumour surgery. Methods: A total of 208 patients admitted to our hospital for brain tumour surgery from January 2020 to May 2022 were selected. Fully automated biochemical analyzer was employed for CSF routine and for measuring biochemical parameters such as white blood cell (WBC), micrototal protein (M-TP), glucose (GLU), and chlorine (CI). Double antibody sandwich assay for CSF procalcitonin (PCT), heparin-binding protein (HBP), and matrix metalloproteinase-9 (MMP-9) was performed. Fully automated microbiological analyzer for pathogen identification was utilized. Based on the above results, we determined whether the patients had secondary intracranial infections after surgery and analyzed the risk factors for secondary intracranial infections after brain tumour surgery by univariate and multifactorial logistic regression. Results: Among 208 patients with brain tumour surgery, 65 cases (31.25%) had secondary intracranial infection and 143 cases (68.75%) had no secondary intracranial infection. The levels of WBC, M-TP, CI, PCT, HBP, and MMP-9 in the CSF of intracranially infected patients were significantly higher than those of uninfected patients (P < 0.05), and GLU was significantly lower than that of uninfected patients (P < 0.05), and the levels of PCT, HBP, and MMP-9 in infected patients were significantly lower than those before treatment after 3, 7, and 10 d and tended to decrease over time (P < 0.05). A total of 62 pathogenic strains were isolated from 65 intracranial infections, of which 41 (66.13%) were Gram-negative bacteria, mainly resistant to amikacin and ciprofloxacin and sensitive to meropenem and imipenem; 19 (30.65%) were Gram-positive bacteria, mainly highly resistant to penicillin and erythromycin and sensitive to vancomycin. Univariate analysis showed that age, gender, tumour type, history of glucocorticoid application, and prophylactic application of antibiotics were not associated with secondary intracranial infection after brain tumour surgery (P > 0.05); tumour site, operation time, postoperative indwelling drainage time, postoperative cerebrospinal fluid leakage, and history of diabetics were all associated with secondary intracranial infection after brain tumour surgery (P < 0.05). Multivariate logistic regression analysis showed that infratentorial tumour, operation time ≥4 h, postoperative indwelling drainage time ≥24 h, and postoperative cerebrospinal fluid leakage were independent risk factors for secondary intracranial infection after brain tumour surgery (P < 0.05). Conclusion: Patients with intracranial infections secondary to brain tumour surgery have abnormal levels of CSF routine and biochemical parameters, and the detection rate of Gram-negative bacteria is higher than that of Gram-positive bacteria in patients. Treatment should be based on the characteristics of pathogenic bacteria and risk factors with targeted interventions to reduce intracranial infections.

Analysis of the Therapeutic Effect and Prognostic Factors of 126 Patients With Hypertensive Cerebral Hemorrhage Treated by Soft-Channel Minimally Invasive Puncture and Drainage.

Background: Surgery is the main method for the clinical treatment of hypertensive cerebral hemorrhage. Traditional craniotomy faces the disadvantages of the long operation time, easy to cause secondary injury to patients during the operation, and prone to infection after the operation, which is not conducive to the rehabilitation of patients. At present, it is urgent to find a surgical scheme, which can clear hematoma in time, protect brain tissue, and effectively reduce surgical trauma in the clinic. Materials and Methods: The case database of our hospital was consulted, and the clinical data of patients with hypertensive intracerebral hemorrhage (HICH) treated with soft channel minimally invasive puncture and drainage from February 2018 to October 2021 were retrospectively analyzed. Patients were evaluated for efficacy, and the changes in serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), homocysteine (Hcy), endothelin (ET), and vasopressin (AVP) levels before surgery, 3 days after surgery, and 7 days after surgery were analyzed. Clinical data were collected and Logistic regression was used to analyze the prognostic factors. Results: Finally, according to the inclusion and exclusion criteria, 126 patients were selected as the research object. Among them, there were 24 cases (19.05%) of recovery, 47 cases (37.30%) of markedly effective, 34 cases (26.98%) of effective, 11 cases (8.73%) of ineffective, and 10 cases (7.94%) of death. The total effective rate was 83.33%. The hematoma was basically removed in 116 cases (92.06%). The average evacuation time of hematoma was (7.82 ± 1.63) days. Post-operative intracranial infection occurred in 2 cases (1.59%) and post-operative rebleeding occurred in 5 cases (3.97%). The average hospital stay was (34.16 ± 16.59) days. Serum CRP, TNF-α, IL-6, Hcy, ET, and AVP levels of all patients on the third and seventh days after surgery were lower than those before surgery, and those on the seventh day after surgery were lower than those on the third day after surgery (p < 0.05). The differences in pre-operative Glasgow Coma Scale (GCS) score, bleeding volume, ventricular rupture, complicated cerebral hernia, and attack time to surgery between the good prognosis group and the bad prognosis group were statistically significant (p < 0.05). Pre-operative GCS score, bleeding volume, ventricular rupture, complicated cerebral hernia, and onset time to surgery were all independent factors that affect the prognosis of patients (p < 0.05). Conclusion: Soft-channel minimally invasive puncture and drainage treatment of HICH has a significant effect, which is conducive to the complete removal of hematoma, reducing hospitalization time, while adjusting the balance and stability of various cytokines, and improving patient prognosis. Pre-operative GCS score, bleeding volume, rupture into the ventricle, complicated cerebral hernia, and time from onset to operation are all independent factors that affect the prognosis of patients.

Quantitative liver surface nodularity score based on imaging for assessment of early cirrhosis in patients with chronic liver disease: A protocol for systematic review and meta-analysis.

BACKGROUND: Early stage of cirrhosis is of great value in the diagnosis and management in patients with chronic liver disease (CLD). Recent studies have shown that quantitative liver surface nodularity (LSN) score based on imaging techniques can be used to predict the early cirrhosis stage noninvasively, with varied diagnostic accuracy and limited sample size. Hence, this study will evaluate the diagnostic accuracy of LSN in the prediction of early cirrhosis. METHODS: We will conduct a comprehensive search in PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases to identify eligible studies. The literature screening, data extraction, data analysis, and quality assessment will then be carried out. The summary receiver-operating-characteristic (ROC) and pooled sensitivity, specificity will be calculated to summarize the diagnostic performance of LSN using a random-effect model. A meta-regression analysis will be performed to investigate the underlying cause of the heterogeneity. RESULTS: This study will evaluate the diagnostic accuracy of LSN score in the identification of early cirrhosis, which may further determine whether this method can be used as an alternative in the assessment of CLD patients. CONCLUSIONS: This study will help to determine the diagnostic accuracy and summarize the recent evidence on this issue. STUDY REGISTRATION: INPLASY2020100096.

Increased LGALS3 expression independently predicts shorter overall survival in patients with the proneural subtype of glioblastoma.

In the current study, we tried to study the expression of LGALS3 and LGALS3BP, their potential as prognostic markers and the possible genetic/epigenetic mechanisms underlying their dysregulation in different subtypes of glioblastoma (GBM). An in silico retrospective study was performed using large online databases. Results showed that LGALS3 and LGALS3BP were upregulated at both RNA and protein levels in GBM tissue and were generally associated with shorter overall survival (OS) in GBM patients. However, in subgroup analysis, we only found the association in proneural subtype. The copy number alterations did not necessarily lead to LGALS3/LGALS3BP dysregulation. In the proneural subtype of GBM patients, hypermethylation of the two CpG sites (cg19099850 and cg17403875) was associated with significantly lower expression of LGALS3. In univariate and multivariate analysis, LGALS3 expression independently predicted shorter OS in the proneural subtype of GBM (HR: 1.487, 95% CI: 1.229-1.798, P < 0.001), after adjustment of age, gender, IDH1 mutations, temozolomide chemotherapy, radiotherapy and LGALS3BP expression. In comparison, LGALS3BP lost the prognostic value in multivariate analysis. Based on these findings, we infer that LGALS3 expression serves as an independent biomarker of shorter OS in the proneural subtype of GBM, the expression of which might be regulated in an epigenetic manner.

Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula with Acute Worsening After Steroid Administration.

Intracranial dural arteriovenous fistulas (DAVFs) draining into the perimedullary venous system are rare and potentially life-threatening lesions often presenting as a myelopathy. The early and proper diagnosis of this rare disease is challenging because the symptoms are nonspecific. Acute clinical deterioration in patients with spinal DAVFs treated with steroid administration has been described. Here we report a case of cervical myelopathy caused by intracranial DAVF with acute worsening after steroid administration. The lesion was successfully treated with endovascular Onyx embolization.

Successful Management of Angiographically Occult Spinal Dural Arteriovenous Fistula with Multiple Draining Veins.

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformation and frequently cause progressive myelopathy. Early detection and surgical or endovascular intervention are important to preventing permanent neurologic impairment. Selective spinal angiography is still the gold standard for the diagnosis and localization of the SDAVF. Occasionally, these lesions may be angiographically occult. Here we report a case of an angiographically occult SDAVF, which was localized using magnetic resonance angiography. The lesion was successfully treated by direct surgery.

Prognostic role of survivin in patients with glioma.

BACKGROUND: The aim of this study was to systematically evaluate the prognostic role of survivin in patients with glioma through performing a meta-analysis. METHODS: PubMed, Web of Science, Cochrane Library, and EMBASE were searched for potentially eligible literature. The study characteristics and relevant data were extracted. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to estimate the prognostic role of survivin in patients with glioma. RESULTS: Sixteen studies with 1260 patients were included. The pooled HR of higher survivin expression for overall survival was 1.96 (95% CI, 1.57-2.45). The pooled HRs of higher survivin expression for progression- and disease-free survival were 1.62 (95% CI, 0.91-2.90) and 2.41 (95% CI, 0.98-5.90), respectively. Subgroup analyses were also performed. CONCLUSION: Our results suggested that higher survivin expression was associated with worse overall survival in patients with glioma. The findings may assist future exploration on pathogenesis, diagnosis, anti-survivin therapy, and prognosis in glioma. However, due to the limited study number, more studies are warranted to verify our results.

Predictive value of preoperative retinal nerve fiber layer thickness for postoperative visual recovery in patients with chiasmal compression.

The aim of this study was to evaluate the predictive role of preoperative retinal nerve fiber layer (RNFL) thickness for postoperative visual recovery in patients with chiasmal compression through performing a meta-analysis. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant studies. The study and patient characteristics were extracted. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to estimate the predictive value of RNFL thickness. Subgroup analyses were also performed. Four studies with 202 patients and 395 eyes were included. The pooled results showed that patients with normal RNFL thickness could achieve better visual recovery compared with those with thin RNFL with the OR of 15.61 (95% CI, 4.09-59.61). Significant heterogeneity was observed (I2 = 54.5%, P=0.086). Publication bias was not present. Normal preoperative RNFL thickness could predict better postoperative visual recovery than thin RNFL in patients with chiasmal compression.

Prognostic role of neutrophil lymphocyte ratio in patients with glioma.

The purpose of this study was to evaluate the prognostic role of neutrophil lymphocyte ratio (NLR) in patients with glioma. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant literature. The study and patient characteristics were extracted. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to estimate the prognostic role of NLR in patients with glioma. Subgroup analysis and sensitivity analysis were also performed. Six studies with 1,021 patients were included. The pooled HR of elevated NLR for OS in patients with glioma was 1.48 (95% CI, 1.25-1.76). Among the included studies, five studies used 4 as the cut-off value of NLR. The pooled HR for OS of the five studies was 1.67 (95% CI, 1.37-2.03). No significant heterogeneity was observed (I2 = 42.4%, P=0. 122). Publication bias was not present. Elevated NLR was associated with poorer overall survival in patients with glioma.

miR-181a involves in the hippocampus-dependent memory formation via targeting PRKAA1.

Post-transcriptional gene regulation by microRNAs (miRNAs) is involved in memory formation. However, the roles of individual miRNAs in these processes remain largely unknown. In this study, we want to clarify the role of miR-181a in hippocampus-dependent memory formation. A transient increase in miR-181a expression was observed after conditioned fear conditioning (CFC) and object location task (OLT) training. Selective overexpression or inhibition of miR-181a in the dorsal hippocampus (DH) via the injection of a miR-181a agomir or antagomir enhanced or impaired the CFC- and OLT-dependent memory formation, respectively. Using bioinformatics and luciferase assays, we identified PRKAA1 as a potential target gene of miR-181a. After CFC or OLT training, the expression and activity of PRKAA1 decreased as miR-181a expression increased and was effectively blocked by the miR-181a antagomir. Moreover, microinjection of the PRKAA1 agonist AICAR or inhibitor compound C in the DH reversed the roles of the miR-181a agomir or antagomir in CFC- and OLT-dependent memory formation. In conclusion, this work provides novel evidence describing the role and mechanism of miR-181a in hippocampus-dependent memory formation, which sheds light on the potential regulation of cognition and future treatments for cognitive disorders.

Frontal intradiploic meningioma with progressive intracranial invasion: A rare case report.

RATIONALE: Intradiploic meningiomas are a subset of extradural meningiomas that arise in the skull. They are mostly localized in the frontoparietal and orbital regions, and they are often mistaken for primary bone tumors. PATIENT CONCERNS: The patient was a 48-year-old man with headache and a 12-year history of frontal cranium occupation, which was first discovered in 2005 and enlarged in 2009. The patient had a history of fracture in his frontal cranium 12 years ago. The computed tomography and magnetic resonance imaging revealed an occupation and intracranial invasion in frontal cranium. And the angiography showed an occlusion at the anterior part of sagittal sinus. INTERVENTIONS: Bilateral frontal craniotomy, intracranial tumor resection, and cranioplasty were performed. DIAGNOSIS: Histologic examination confirmed an intradiploic ectopic meningioma (World Health Organization Grade I). OUTCOMES: He was discharged with no neurological deficits 3 days after surgery. At the 6-month clinical follow-up, there was no tumor recurrence or other complaints. LESSONS: In this study, we present the case of a frontal intradiploic meningioma with progressive intracranial invasion and review the radiographic and clinical findings of patients with primary intraosseous meningioma.

Facial flushing after alcohol consumption and the risk of cancer: A meta-analysis.

BACKGROUND: The association between facial flushing after alcohol consumption and the risk of cancer remains controversial. The aim of this study was to evaluate the relation between facial flushing and cancer risk. METHODS: PubMed, EMBASE, and Cochrane Library were searched for relevant literature. The patients' baseline characteristics and estimated risks were extracted. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to estimate the risk of facial flushing in cancer, and subgroup analysis was performed. RESULTS: Ten studies with 89,376 participants from East Asia were included. The pooled OR of facial flushing in all cancers was 1.43 (95% CI, 1.08-1.91), with the pooled ORs of 1.94 (95% CI, 1.33-2.83) and 0.95 (95% CI, 0.80-1.12) in men and women, respectively. The pooled ORs were also estimated in different cancer types. CONCLUSION: Our results showed that facial flushing response to alcohol was associated with higher cancer risk in men in East Asia, especially in esophageal squamous cell carcinoma, yet facial flushing was not significantly associated with cancer risk among women.