[Risk Factors Associated with Thyroid Nodules in Patients with Acromegaly].

OBJECTIVE: To identify risk factors associated with thyroid nodular lesions in patients with acromegaly. METHODS: Clinical and thyroid ultrasonography data of patients with acromegaly diagnosed in the West China Hospital of Sichuan University from May 2009 to January 2018 were reviewed and analyzed. Multivariate linear regression models were established to identify factors associated with thyroid volumes and size of thyroid nodules. Multivariate binary logistic regression models were established to determine risk factors associated with thyroid nodules in patients with acromegaly. RESULTS: Of the 240 acromegaly patients, 70 received thyroid ultrasonography and 56 had thyroid nodules (56/70, 80%). The patients with thyroid nodules had a longer median duration of acromegaly than 14 patients who without thyroid nodules (8.0 years vs. 3.0 years, P＜0.05), but had a similar mean age and female to male ratio with the latter. The risk of thyroid nodules increased with the duration of acromegaly (odds ratio=1.306, 95% confidence interval (1.010, 1.688), P=0.042). The level of random growth hormone was linearly correlated with thyroid volumes. Gender, age, and serum growth hormone were not predictors of thyroid nodules in patients with acromegaly. CONCLUSION: Duration of acromegaly is an independent predictor of thyroid nodules.

Intracystic bleomycin for cystic craniopharyngiomas in children.

BACKGROUND: Craniopharyngiomas are the most common benign histological tumours to involve the hypothalamo-pituitary region in childhood. Cystic craniopharyngiomas account for more than 90% of the tumours. The optimal treatment of cystic craniopharyngioma remains controversial. Radical resection is the treatment of choice in patients with favourable tumour localisation. When the tumour localisation is unfavourable, a gross-total or partial resection followed by radiotherapy is the main treatment option in adults. However, it presents a risk of morbidity, especially for children. Intracystic bleomycin has been utilised potentially to delay the use of radiotherapy or radical resection, to decrease morbidity. This review is the second update of a previously published Cochrane review. OBJECTIVES: To assess the benefits and harmful effects of intracystic bleomycin in children from birth to 18 years with cystic craniopharyngioma when compared to placebo (no treatment), surgical treatment (with or without adjuvant radiotherapy) or other intracystic treatments. SEARCH METHODS: We searched the electronic databases CENTRAL (2016, Issue 1), MEDLINE/PubMed (from 1966 to February 2016) and EMBASE/Ovid (from 1980 to February 2016) with pre-specified terms. In addition, we searched the reference lists of relevant articles and reviews, conference proceedings (International Society for Paediatric Oncology 2005-2015) and ongoing trial databases (Register of the National Institute of Health and International Standard Randomised Controlled Trial Number (ISRCTN) register) in February 2016. SELECTION CRITERIA: Randomised controlled trials (RCTs), quasi-randomised trials or controlled clinical trials (CCTs) comparing intracystic bleomycin and other treatments for cystic craniopharyngiomas in children (from birth to 18 years). DATA COLLECTION AND ANALYSIS: Two review authors independently performed the study selection, data extraction and 'Risk of bias' assessment. We used risk ratio (RR) for binary data and mean difference (MD) for continuous data. If one of the treatment groups experienced no events and there was only one study available for the outcome, we used the Fischer's exact test. We performed analysis according to the guidelines in the Cochrane Handbook for Systematic reviews of Interventions. MAIN RESULTS: We could not identify any studies in which the only difference between the treatment groups was the use of intracystic bleomycin. We did identify a RCT comparing intracystic bleomycin with intracystic phosphorus(32) ((32)P) (seven children). In this update we identified no additional studies. The included study had a high risk of bias. Survival could not be evaluated. There was no clear evidence of a difference between the treatment groups in cyst reduction (MD -0.15, 95% confidence interval (CI) -0.69 to 0.39, P value = 0.59, very low quality of evidence), neurological status (Fisher's exact P value = 0.429, very low quality of evidence), third nerve paralysis (Fischer's exact P value = 1.00, very low quality of evidence), fever (RR 2.92, 95% CI 0.73 to 11.70, P value = 0.13, very low quality of evidence) or total adverse effects (RR 1.75, 95% CI 0.68 to 4.53, P value = 0.25, very low quality of evidence). There was a significant difference in favour of the (32)P group for the occurrence of headache and vomiting (Fischer's exact P value = 0.029, very low quality of evidence for both outcomes). AUTHORS' CONCLUSIONS: Since we identified no RCTs, quasi-randomised trials or CCTs of the treatment of cystic craniopharyngiomas in children in which only the use of intracystic bleomycin differed between the treatment groups, no definitive conclusions could be made about the effects of intracystic bleomycin in these patients. Only one low-power RCT comparing intracystic bleomycin with intracystic (32)P treatment was available, but no definitive conclusions can be made about the effectiveness of these agents in children with cystic craniopharyngiomas. Based on the currently available evidence, we are not able to give recommendations for the use of intracystic bleomycin in the treatment of cystic craniopharyngiomas in children. High-quality RCTs are needed.

Management of large medial sphenoid wing meningiomas: a series of 178 cases.

AIM: The aim of this study was to evaluate our treatment and outcome in patients with large medial sphenoid wing meningiomas (SWMs). MATERIAL AND METHODS: Data from 178 patients with large medial SWMs treated was collected and analyzed retrospectively. Most of patients underwent microsurgical resection under electrophysiological monitoring and Doppler probe. Radiation therapy was administered in 64 patients with residual tumor and malignant pathology. RESULTS: Total resection of the tumor was achieved in 118 of 178 cases (66.3%), subtotal in 60 of 178 (33.7%) at the time of initial surgery without serious surgical complications except 2 patients with ptosis. Postoperative vision improved in 84 patients (87.5%), remained unchanged in 8 (8.3%) and deteriorated in 4 (4.2%). The progress free survival (PFS) and Karnofsky performance score (KPS) between patients with gross total resection (GTR) and patients with subtotal resection (STR) followed by radiation therapy (RT) had no significant difference. CONCLUSION: Surgery still remains a principal treatment option for SWMs. Good craniotomy techniques, proper hemostasis and optimal surgery strategy are critical to improve resection rate and elevate prognosis. Likewise, it is expected that STR with adjuvant RT can provide satisfactory results in case of total removal impossible.

Intracystic bleomycin for cystic craniopharyngiomas in children.

BACKGROUND: Craniopharyngiomas are the commonest benign histological tumours to involve the hypothalamo-pituitary region in childhood. Cystic craniopharyngiomas comprise more than 90% of the tumours. The optimal treatment of cystic craniopharyngioma remains controversial. Radical resection is the treatment of choice in patients with favourable tumour localisation. When the tumour localisation is unfavourable, a gross-total or partial resection followed by radiotherapy is the main treatment option in adults. However, it presents a risk of morbidity, especially for children. Intracystic bleomycin has been utilised potentially to delay the use of radiotherapy or radical resection, to decrease morbidity. This review is an update of a previously published Cochrane review. OBJECTIVES: To assess the benefits and harmful effects of intracystic bleomycin in children from birth to 18 years with cystic craniopharyngioma when compared to placebo (no treatment), surgical treatment (with or without adjuvant radiotherapy) or some other intracyctic treatments. SEARCH METHODS: We searched the electronic databases CENTRAL (2014, Issue 1), MEDLINE/PubMed (from 1966 to March 2014) and EMBASE/Ovid (from 1980 to March 2014) with pre-specified terms. In addition, we searched the reference lists of relevant articles and reviews, conference proceedings (International Society for Paediatric Oncology 2005-2013) and ongoing trial databases (Register of the National Institute of Health and International Standard Randomised Controlled Trial Number (ISRCTN) register) in May 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs), quasi-randomised trials or controlled clinical trials (CCTs) comparing intracystic bleomycin and other treatments for cystic craniopharyngiomas in children (from birth to 18 years). DATA COLLECTION AND ANALYSIS: Two review authors independently performed the data extraction and 'Risk of bias' assessment. We used risk ratio (RR) for binary data and mean difference (MD) for continuous data. We planned that if one of the treatment groups experienced no events and there was only one study available for the outcome, we would use the Fischer's exact test. MAIN RESULTS: We could not identify any studies in which the only difference between the treatment groups was the use of intracystic bleomycin. We did identify a RCT comparing intracystic bleomycin with intracystic phosphorus(32) ((32)P) (n = 7 children). The trial had a high risk of bias. Survival could not be evaluated. There was no evidence of a significant difference between the treatment groups in cyst reduction (MD -0.15, 95% confidence interval (CI) -0.69 to 0.39, P value = 0.59), neurological status (Fisher's exact P value = 0.429), 3rd nerve paralysis (Fischer's exact P value = 1.00), fever (RR 2.92, 95% CI 0.73 to 11.70, P value = 0.13) or total adverse effects (RR 1.75, 95% CI 0.68 to 4.53, P value = 0.25). There was a significant difference in favour of the (32)P group for the occurrence of headache and vomiting (Fischer's exact P value = 0.029 for both outcomes). AUTHORS' CONCLUSIONS: Since we identified no RCTs, quasi-randomised trials or CCTs of the treatment of cystic craniopharyngiomas in children in which only the use of intracystic bleomycin differed between the treatment groups, no definitive conclusions could be made about the effects of intracystic bleomycin in these patients. Only one low-power RCT comparing intracystic bleomycin with intracystic (32)P treatment was available, but no definitive conclusions can be made about the effectiveness of these agents in children with cystic craniopharyngiomas. Based on the currently available evidence, we are not able to give recommendations for the use of intracystic bleomycin in the treatment of cystic craniopharyngiomas in children. High-quality RCTs are needed.

Intracystic bleomycin for cystic craniopharyngiomas in children.

BACKGROUND: Craniopharyngiomas are the commonest benign histological tumours to involve the hypothalamo-pituitary region in childhood. Cystic craniopharyngiomas occur in more than 90% of tumours. The optimal treatment of cystic craniopharyngioma remains controversial. Radical resection is the treatment of choice in patients with favourable tumour localization. When the tumour localization is unfavourable, a gross-total or partial resection followed by radiotherapy is the main treatment option in adults. However, it presents risk of morbidity especially for children. Intracystic bleomycin has been utilized to potentially delay the use of radiotherapy or radical resection to decrease morbidity. OBJECTIVES: To determine the benefits and harms of intracystic bleomycin versus other treatments for cystic craniopharyngiomas in children. SEARCH METHODS: We searched the electronic databases of CENTRAL (The Cochrane Library 2010, Issue 4), MEDLINE/PubMed (from 1966 to Oct 2010), and EMBASE/Ovid (from 1980 to Oct 2010) with pre-specified terms. In addition, we searched reference lists of relevant articles and reviews, conference proceedings and ongoing trial databases. SELECTION CRITERIA: Randomised controlled trials (RCTs) quasi-randomised trials or controlled clinical trials (CCTs) comparing intracystic bleomycin and other treatments for cystic craniopharyngiomas in children (from birth to 18 years). DATA COLLECTION AND ANALYSIS: Two review authors independently performed the data extraction and the 'Risk of bias' assessment. We used risk ratio (RR) for binary data and mean difference (MD) for continuous data. We planned that if one of the treatment groups experienced no events and there was only one study available for the outcome, we would use the Fischer's exact test. MAIN RESULTS: We could not identify any studies in which the only difference between the treatment groups was the use of intracystic bleomycin. We did identify a RCT comparing intracystic bleomycin with intracystic (32)P (n = 7 children). The trial had a high risk of bias. Survival could not be evaluated. There was no evidence of a significant difference in cyst reduction (MD = -0.15, 95% confidence interval (CI) -0.69 to 0.39, P= 0.59), neurological status (Fisher's exact P = 0.429), 3rd nerve paralysis (Fischer's exact P = 1.00), fever (RR = 2.92, 95% CI 0.73 to 11.70, P = 0.13) and total adverse effects (RR = 1.75, 95% CI 0.68 to 4.53, P = 0.25 ) between the treatment groups. There was a significant difference in favour of the (32)P group for the occurrence of headache and vomiting (Fischer's exact P = 0.029 for both outcomes). AUTHORS' CONCLUSIONS: Since no RCTs, quasi-randomised trials or CCTs in which only the use of intracystic bleomycin differed between the treatment groups in the treatment of cystic craniopharyngiomas in children, no definitive conclusions could be made about the effects of intracystic bleomycin in these patients. Only one low-power RCT comparing intracystic bleomycin with intracystic (32)P treatment was available, but no definitive conclusions can be made about the effectiveness of these agents in children with cystic craniopharyngiomas. Based on the currently available evidence, we are not able to give recommendations for the use of intracystic bleomycin in the treatment of cystic craniopharyngiomas in children. High quality RCTs are needed.

Toll-like receptor 4/nuclear factor-kappa B signaling detected in brain after early subarachnoid hemorrhage.

BACKGROUND: Inflammation and immunity play a vital role in the pathogenesis of early brain injury after subarachnoid hemorrhage (SAH). Nuclear factor-kappa B (NF-kappaB) regulates many genes essential for inflammation and immunity and is activated by toll-like receptor (TLR). This study aimed to detect the expression of the toll-like receptor 4/nuclear factor-kappa B (TLR4/NF-kappaB) signaling in the rat brain after early SAH. METHODS: The rats were decapitated and their brains were removed at 0, 2, 4, 6, 12, 24 and 48 hours after a single injection of blood into the prechiasmatic cistern. mRNA expression of TLR4 was measured by Taqman real-time RT-PCR, and protein expression by immunohistochemistry and Western blotting. NF-kappaB activity and concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: TaqMan real-time RT-PCR and Western blotting identified a biphasic change in TLR4 expression in both mRNA and protein: an initial peak (2 - 6 hours) and a sustained elevation (12 - 48 hours). Immunohistochemical staining showed the inducible expression of TLR4-like immunoreactions predominantly in glial cells and vascular endothelium. A similar biphasic change in the activation of NF-kappaB subunit p65 as well as the production of NF-kappaB-regulated proinflammatory cytokines (TNF-alpha, IL-1beta and IL-6) were detected by ELISA. CONCLUSIONS: These data suggest that experimental SAH induces significant up-regulation of TLR4 expression and the NF-kappaB signaling in early brain injury. Activation of the TLR4/NF-kappaB signaling may regulate the inflammatory responses after SAH.

WITHDRAWN: Activation of TLR4/NF-kappaB signaling pathway in early brain injury after subarachnoid hemorrhage.

Ahead of Print article withdrawn by publisher.

Experience of microsurgical treatment of brainstem cavernomas: report of 37 cases.

BACKGROUND: Cavernomas are rare in the brainstem and account for 18-35% of central nervous cavernomas and can cause recurrent hemorrhages, devastating neurological deficits and mortality. OBJECTIVES: To summarize the experience of microsurgical treatment of brainstem cavernomas and to investigate curative effect of microsurgical treatment of brainstem cavernomas. MATERIALS AND METHODS: A retrospective analysis clinical data of 37 patients with brainstem cavernomas seen between 2003 and 2007. The analysis included age distribution, hemorrhage rates, clinical presentation, location of the lesions, and preoperative and postoperative Karnofsky Performance Scale (KPS) scores. The surgical indications, the timing of surgery and the surgical techniques were also assessed. RESULTS: All the 37 patients received microsurgical resections, there was no surgery-related mortality. Histopathological examination confirmed the diagnosis of cavernoma. Postoperatively, 20 patients had functional improvement, 15 patients had no change in the neurological status, and two patients deteriorated. Early surgery was associated with better outcomes. Mean followed up period was 21.5 months (range 6-36 months). During the follow-up 20 patients had resumed activities of daily living (KPS scores of 90-100), 10 patients were able to self-care with some efforts (KPS scores of 70-80), five patients needed considerable assistance (KPS score of 50-60) and two patients suffered hemiparesis (KPS scores of 40). None of the patient had recurrent hemorrhage. CONCLUSIONS: Brainstem cavernomas can safely be resected. Successful resection of brainstem cavernomas can be achieved by optimal surgical approaches, feasible entry zone and meticulous microsurgical techniques. The goal of surgical intervention should be the total resection of the lesion without any deteriorative in the neurological deficits.

Microneurosurgical management of the clinoid and paraclinoid aneurysms.

OBJECTIVE: To evaluate the management of clinoid and paraclinoid aneurysms with modern microneurosurgical techniques and instruments. METHODS: The data of 38 patients with clinoid and paraclinoid aneurysms who underwent microsurgical clipping in the Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China, from 2000 to 2005, were analysed retrospectively. RESULTS: All 40 aneurysms were treated microneurosurgically, among which 97.5% were completely obliterated. The overall mortality is 5.2% and 76.3% patients had a good recovery (GOS 4-5) at discharge. CONCLUSION: For patients with clinoid and paraclinoid aneurysms, satisfying outcomes can be achieved by microneurosurgical management, using particular preoperative assessment and planning and careful maneuvering with refined microsurgical instruments. Microneurosurgical techniques are optimal for the management of clinoid and paralinoid aneurysms.

[Micro-neurosurgical treatment of cranionasal tumors in combination with transnasal endoscopy].

OBJECTIVE: To explore an effective microsurgical approach to the treatment of cranionasal tumors. METHODS: A retrospective review of 18 micro-neurosurgical patients with cranionasal tumors (June 2005 to June 2007) was undertaken. RESULTS: All of the 18 patients were treated with subfrontal approaches in combination with transnasal endoscopy. Tumors were resected in the stage-one operations (14 were totally resected and 4 were subtotally resected). The anterior skull bases were reconstructed. Transient CSF rhinorrhea was found in two cases. All of the patients experienced good recoveries, with no operative death. The follow up after 5 to 29 months revealed that only four patients had tumor recurrence. Three patients lost in the follow up. CONCLUSION: Subfrontal microsurgical operation combined with transnasal endoscopy is an effective approach to the treatment of cranionasal tumors. It enables high total resection rate and has low complications.

[Expression of CD147 and MMP-2 in human gliomas and its correlations with prognosis].

OBJECTIVE: To investigate the expressions of CD147 and MMP-2 in human gliomas and to study the relationship between their expression and prognosis. METHODS: Immunohistochemistry SP methods were applied to detect the expression of CD147 and MMP-2 in 50 cases of gliomas and RT-PCR also applied to analyze the expression level of CD147 mRNA. The relationship between the expression level and the glioma prognosis were analyzed statistically depends on the follow-up investigation of the disease development. RESULTS: The positive rates of CD147 and MMP-2 in human gliomas were 72. 0% and 78. 0%, and coexpression of CD147 and MMP-2 in gliomas was 70. 0%. CD147 protein was positively correlated with the expression of MMP-2 protein (r =0. 737, P<0. 01). CD147 mRNA expression was also detected in low and high grade gliomas by RT-PCR, but their expression levels were obviously enhanced in high grade gliomas. There was a significant difference in each grade gliomas. The higher expression of CD147, the shorter survival time of the patients. The variations were significant statistically. CONCLUSION: There was positive correlation between the expressions of CD147, MMP-2 in human gliomas and the degree of malignancy and prognosis. CD147 and MMP-2 may be a prognostic factor of human gliomas and targets for chemotherapeutical strategies.

[An experimental research on tumor metastasis treated by chicken homologous matrix metalloproteinase-2 vaccine combined with low-dose cisplatin].

OBJECTIVE: To evaluate the cooperating effect on whether the chicken homologous matrix metalloproteinase-2 (c-MMP-2) vaccine combined with low-dose cisplatin (DDP) can enhance the treatment efficacy of tumor metastasis. METHODS: The eukaryotic expression plasmid encoding chicken homologous MMP-2 was constructed by recombinant DNA technique. In this experiment, the lung metastasis model of murine colon adenocarcinoma (C26) was established in 6- to 8- weeks of age female BALB/c mice, and then treated with 0.9% NaCl solution (NS), DDP, c-MMP-2, or c-MMP-2 combined DDP. The number of tumor metastasis nodules on murine lung surface was counted and the lungs were weighed after the completion of above treatments. The tumor microvessel density (MVD) and cell apoptosis were evaluated by immunohistochemical and TUNEL methods. The titer and type of autoantibodies against MMP-2 in serum of mice were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared with three other control groups, the combined treatment group significantly decreased the number of tumor metastasis nodules on lung surface and markedly the weight of murine lungs. The immunohistochemical analysis of tumor demonstrated a decreased MVD and a higher apoptosis cell rate happening to the combined treatment group. Autoantibodies against MMP-2 in serum of mice were, by ELISA, found in c-MMP-2 group and c-MMP-2 combined DDP group. CONCLUSION: The antitumor effect of DDP can be potentiated by c-MMP-2. Thus the combination of c-MMP-2 and DDP results in an additive effect on the treatment of tumor metastasis.

[Changes in P-selectin expression after brain injury in rats].

OBJECTIVE: To explore the relationship between expression thange of P-selectin after brain injury and secondary brain damage. METHODS: Sixty SD rats were randomized into 3 equal groups, namely the control group, mild injury group and severe injury group and animal models of brain injury were established in SD rats according to the method of Feeney. P-selectin expression in the brain tissues were determined at 6 h and l, 3, and 7 days following brain injury (n=5 for each time point). Imaging analysis was performed using computerized imaging technique. RESULTS: P-selectin expression and neutrophil infiltration in the brain tissues increased significantly 6 h after brain injury (P<0.05), reaching the peak level at postoperative 24 h and then gradually decreased. CONCLUSION: P-selectin expression and neutrophil infiltration increase significantly following brain injury, and the time course and distribution of P-selectin expression are consistent with the secondary damage of the brain, strongly suggesting the involvement of P-selectin upregulation in the secondary insult after brain injury.

Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach.

BACKGROUND: Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications. METHODS: Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen, the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed. RESULTS: Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%). CONCLUSIONS: Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.

[Therapeutic effect of far lateral approach on the lesions located ventral to cranial-cervical junction].

OBJECTIVE: To investigate the administration of far-lateral approach in lesions located anterior or anterolateral to brain stem and upper cervical spinal cord. METHODS: Twenty-three patients underwent far lateral approach, including 12 retrocondylar approach, 5 partial transcondylar approach, 3 transfacetal and partial transcondylar approach, 2 transtubercular approach and 1 complete transcondylar approach. RESULTS: Total tumor removal was achieved in 15 patients, subtotal removal in 5 patients, 3 vertibral artery aneurysms were clipped successfully, 3 patients were given occipitalcervical fusion. There was no operative mortality. The most frequent complications were lower cranial nerve deficit, CSF leakage, injury to vertibral artery, and ischemia of brain stem, cerebellum or spinal cord. No patient presented clinical instability of the occipitocervical junction after surgery. CONCLUSIONS: The far-lateral approach is an ideal approach to structures located ventral to cranial-cervicle junction. But some of the surgical steps are technically difficult and carry some degree of risk. The choice of approach depends on the pathological feature and degree of exposure required for effective surgical treatment. Bone removal should be quantified for individual lesion. The approach may be limited to less aggressive steps, while still achieving significant exposure and surgical space.

[Effect of compound Salvia injection on blood coagulation in patients with traumatic cerebral infarction].

OBJECTIVE: To investigate the effect of compound Salvia injection (CSI) on blood coagulatory function in patients with traumatic cerebral infarction (TCI). METHODS: Sixty-four patients with TCI were randomly divided into two groups, 32 in each group. The treated group were treated with CSI plus conventional treatment of western medicine, and the control group treated with conventional treatment alone. Changes of symptoms, levels of plasma P-selectin (P-S), von Willebrand's factor (vWf) and D-dimer were observed with ELISA. RESULTS: The treated group was superior to the control group in Glasgow outcome scale (P < 0.01). Before treatment, the levels of plasma P-S, vWf and D-dimer in the TCI patients were higher than those in healthy people. After treatment, all the parameters lowered in both groups, but the effect of lowering was greater in the treated group than that in the control group. CONCLUSION: Blood coagulation disorder exists in patients with TCI, CSI could improve it, and might alleviate the cerebral damage to a certain extent.

[Therapeutic effect of 125IUdR on the glioma cell line C6 in vitro and in vivo].

OBJECTIVE: To investigate the therapeutic effect of 125IUdR on gliomas. METHODS: By means of growth-curve, clonogenic formation experiment and MTT assay, the inhibitive effect of 125IUdR on the proliferation of C6 cells was studied in vitro. Wistar rats with intracerebral C6 gliomas were used to verify the therapeutic efficacy of 125IUdR in vivo. RESULTS: C6 monolayer cells were efficiently inhibited by 125IUdR in a time-and-dose-dependent manner. In the MTT assay, after treament with 150 kBq/ml 125IUdR for 5 days, the inhibition rate reached 93.06%. In murine transplantable tumor, 125IUdR had significant therapeutic effect on rats bearing solid tumor glioma C6. After treatment with 125IUdR for 5 days, the tumor weight of experiment group was lower than that of blank group and control group (P<0.01). The median survival of animals treated with 125IUdR (27 days) was markedly longer than that of control group (9 days) (P<0.01). Na 125I and 127IUdR showed little inhibitive effect on the proliferation of C6 cells in vitro and in vivo. CONCLUSION: 125IUdR can markedly inhibit the growth of Glioma cell line C6. 125IUdR has potential for the treatment of malignant brain tumor.