Association between vitamin B2 intake and prostate-specific antigen in American men: 2003-2010 National Health and Nutrition Examination Survey.

BACKGROUND: Accumulating evidence suggests a pivotal role of vitamin B2 in the pathogenesis and progression of prostate cancer (PCa). Vitamin B2 intake has been postulated to modulate the screening rate for PCa by altering the concentration of prostate-specific antigen(PSA). However, the relationship between vitamin B2 and PSA remains indeterminate. Hence, we conducted a comprehensive evaluation of the association between vitamin B2 intake and PSA levels, utilizing data from the National Health and Nutrition Examination Survey (NHANES) database. METHODS: From a pool of 20,371 participants in the NHANES survey conducted between 2003 and 2010, a cohort of 2,323 participants was selected for the present study. The male participants were classified into four distinct groups based on their levels of vitamin B2 intake. We employed a multiple linear regression model and a non-parametric regression method to investigate the relationship between vitamin B2 and PSA levels. RESULTS: The study cohort comprised of 2,323 participants with a mean age of 54.95 years (± 11.73). Our findings revealed a statistically significant inverse correlation between vitamin B2 intake (mg) and PSA levels, with a reduction of 0.13 ng/ml PSA concentration for every unit increase in vitamin B2 intake. Furthermore, we employed a fully adjusted model to construct a smooth curve to explore the possible linear relationship between vitamin B2 intake and PSA concentration. CONCLUSIONS: Our study in American men has unveiled a notable inverse association between vitamin B2 intake and PSA levels, potentially posing a challenge for the identification of asymptomatic prostate cancer. Specifically, our findings suggest that individuals with higher vitamin B2 intake may be at a greater risk of being diagnosed with advanced prostate cancer in the future, possibly indicating a detection bias. These results may offer a novel explanation for the observed positive correlation between vitamin B2 intake and prostate cancer.

The down-regulation of GADD45B leads to a conversion of cellular oxidative phosphorylation to glycolysis and promotes the progression of bladder cancer.

Background: The predominant feature of cancer cells during the process of carcinogenesis is the inclination towards glycolytic metabolism rather than mitochondrial oxidative phosphorylation. Nevertheless, there is a scarcity of research investigating the correlation between bladder cancer and mitochondrial energy metabolism. Methods: A qPCR array comprising 90 genes associated with mitochondrial oxidative phosphorylation was employed to discern metabolic disparities between three sets of bladder cancer tissue and adjacent normal tissue. Wound healing and transwell assays were utilized to assess cell migration and invasion capabilities, respectively. Colony formation assays were conducted to ascertain the tumorigenic potential of the cells. The proliferative capacity of the cells was examined through in vitro CCK-8 assays. Additionally, nude mouse models were established to evaluate the impact of bladder tumor cells on in vivo proliferation. The Seahorse XFe96 Analyzer was utilized to quantify mitochondrial oxidative phosphorylation, while the levels of glucose-6-phosphate and pyruvate were assessed to evaluate glycolysis. Results: Examination of qPCR array data demonstrated a noteworthy inhibition of mitochondrial oxidative phosphorylation in bladder cancer tissue, as evidenced by the down-regulation of a majority of genes associated with mitochondrial energy metabolism. Notably, GADD45B may potentially exert a significant influence on bladder cancer development, warranting further investigation. The down-regulation of GADD45B in bladder cancer cells resulted in impaired mitochondrial respiration and elevated levels of glycolysis, thereby enhancing cell migration and invasion. Conversely, up-regulation of GADD45B had the opposite effect. Furthermore, over-expression of GADD45B inhibited tumor proliferation and tumorigenesis in both in vitro and in vivo settings. Conclusion: These findings from our study indicate that the down-regulation of GADD45B promotes the shift of cell mitochondrial oxidative phosphorylation towards glycolysis, thereby facilitating the progression of bladder cancer.

miRNA326-5p Targets DKC1 Gene to Regulate Apoptosis-Related Proteins and Intervene in the Development of Neuroblastoma.

Objective: To study the effect of congenital dyskeratosis 1 (DKC1) on neuroblastoma and its regulation mechanism. Methods: The expression of DKC1 in neuroblastoma was analyzed by TCGA database and molecular assay. NB cells were transfected with siDKC1 to observe the effects of DKC1 on proliferation, cloning, metastasis, and invasion, and apoptosis and apoptosis-related proteins. The tumor-bearing mouse model was constructed, shDKC1 was transfected to observe the tumor growth and tumor tissue changes, and the expression of DKC1 and Ki-67 was detected. Screening and identification of miRNA326-5p targeting DKC1. NB cells were treated with miRNA326-5p mimic or inhibitors to detect the expression of DKC1. NB cells were transfected with miRNA326-5p and DKC1 mimics to detect cell proliferation, apoptosis, and apoptotic protein expression. Results: DKC1 was highly expressed in NB cells and tissues. The activity, proliferation, invasion, and migration of NB cells were significantly decreased by DKC1 gene knockout, while apoptosis was significantly increased. The expression level of B-cell lymphoma-2 in shDKC1 group was significantly lower than that of the control group, while the expression level of BAK, BAX, and caspase-3 was significantly higher than that of the control group. The results of experiments on tumor-bearing mice were consistent with the above results. The results of miRNA assay showed that miRNA326-5p could bind DKC1 mRNA to inhibit the protein expression, thereby inhibiting the proliferation of NB cells, promoting their apoptosis, and regulating the expression of apoptotic proteins. Conclusion: miRNA326-5p targeting DKC1 mRNA regulates apoptosis-related proteins to inhibit neuroblastoma proliferation and promote the apoptotic process.

How to Improve the Effect of Microvascular Decompression for Hemifacial Spasm: A Retrospective Study of 32 Cases with Unsuccessful First Time MVD.

BACKGROUND: Microvascular decompression (MVD) has become accepted as an effective therapeutic option for hemifacial spasm (HFS); however, the curative rate of MVD for HFS varies widely (50-98%) in different medical centers. This study could contribute to the improvement of the MVD procedure. METHODS: We retrospectively analyzed 32 patients in whom initial MVD failed in other hospitals and who underwent a second MVD at our center. The clinical characteristics, operative findings, outcome of the second MVD, and complications were recorded. RESULTS: There were 18 women and 14 men (56.3 and 43.7%, respectively). The left-to-right ratio was 19:13. The mean age of the patients was 59.8 years. We found an undiscovered conflict site located in zone 4 in 10 patients and in the root entry zone in 8 patients. The initial MVD failed in nine patients because of ignorance of the arterioles that originate from the anterior inferior cerebellar artery. There were no special findings in four patients. No Teflon felts were found in the whole surgical field in one patient. CONCLUSION: Omission of the offending vessel is the most common cause of an unsuccessful MVD. Intraoperative abnormal muscle response associated with the Z-L response is a good measure to correctly identify the involved arterioles.

SOX17 inhibits proliferation and invasion of neuroblastoma through CXCL12/CXCR4 signaling axis.

SOX17 has been shown to be involved in the transcriptional regulation of CXCR4, and CXCL12 functions by binding to its receptor CXCR4. Here, we explored the expression of SOX17 in neuroblastoma (NB), its mutual regulation with CXCL12, and its effects on cancer cell proliferation, migration and invasion. Five human NB cell lines and 15 pairs of NB and adjacent tissue specimens were used, to conduct RT-qPCR, immunohistochemistry, western blot, ELISA, CCK-8, colony formation, Edu, transwell, chromatin immunoprecipitation (ChIP), and dual-luciferase assays, to study the role of SOX17 in NB. SOX17 levels were reduced in both NB tissues and cell lines. SOX17 inhibited NB tumor growth, migration and invasion in vivo and suppressed NB cell proliferation, migration, and invasion in vitro. SOX17 knockdown or overexpression revealed a negative correlation between SOX17 and CXCL12/CXCR4 pathway activation. ChIP and dual-luciferase assays in NB cells demonstrated that SOX17 significantly inhibited CXCL12 gene and protein levels by binding to CXCL12 promoter regions. In vivo and in vitro experiments using the CXCR4 antagonist, AMD3100, demonstrated that cell proliferation, migration and invasion were significantly abrogated by AMD3100 in NB cells with SOX17 knocked down. Further, AMD3100 impaired growth of NB tumors with SOX17 knocked down in mice. Importantly, SOX17 bound to the CXCL12 promoter, which then activated downstream targets to regulate cell viability, proliferation, and migration. In conclusion, our data demonstrate that SOX17 expression is repressed in NB tissues and cells, and that SOX17 suppresses NB tumor formation and proliferation through inhibition of CXCL12/CXCR4 signaling.

[Denitrification Process and N2O Production Characteristics of Heterotrophic Nitrifying Bacterium Pseudomonas aeruginosa YL].

Because of the massive discharge of nitrogenous wastewater, the eutrophication of a water body is becoming increasingly serious, and how to effectively remove nitrogen from this wastewater remains an urgent problem to be solved. In this study, due to disadvantages in the traditional biological nitrogen removal process, such as complex and long procedures, high energy consumption, weak impact resistance, and N2O release, the nitrogen removal theory by heterotrophic nitrification was further analyzed by discussing the physiological-biochemical, heterotrophic nitrification-aerobic denitrification, and N2O production characteristics of a high-efficiency heterotrophic nitrifying bacteria Pseudomonas aeruginosa YL. Results show that the strain YL had an eminent heterotrophic nitrification and aerobic denitrification ability, and NH4+-N, NO2--N, and NO3--N with concentration of 100 mg·L-1 could be completely removed during the 24-hour incubation period. There was almost no intermediate product in the process of heterotrophic nitrification, however when NO3--N was used as nitrogen source, the accumulation of NO2--N reached 25.55 mg·L-1. Meanwhile, the successful expression of denitrification genes napA, nirK, and nosZ further confirmed the aerobic denitrification ability of strain YL. Gaseous nitrogen products accounted for about 30%-40% of removed TN in the heterotrophic nitrification-aerobic denitrification process by strain YL, and N2 was the main denitrification product. When NH4+-N, NO2--N, and NO3--N were used as the sole nitrogen source, N2 production amounted to 3.46, 3.49, and 3.36 mg, respectively. In contrast, only small amounts of N2O were produced in the denitrification process by strain YL, and the total amount was 6.63 µg when NH4+-N was the nitrogen source, which was much lower than in the cases of NO2--N and NO3--N as the sole nitrogen source. In addition, high C/N, low pH, high temperature, high NH4+-N, and high NO2--N conditions could result in more N2O generation. Nevertheless, most environmental factors had little effect on N2O production of strain YL, and the maximum N2O production was significantly lower than that of short-cut nitrification system and autotrophic nitrification system. These results demonstrated that strain YL exhibited excellent abilities of nitrogen removal, N2O emission control, and tolerance to environmental conditions, and could be an effective candidate for treating wastewater without secondary air pollution.

Fully endoscopic microvascular decompression of the hemifacial spasm: our experience.

PURPOSE: Microvascular decompression (MVD) surgery has been accepted as a potentially curative method for hemifacial spasm (HFS). The primary cause of failure of MVD is incomplete decompression of the offending vessel due to inadequate visualization. This study is aimed at evaluating the benefit of endoscopic visualization and the value of fully endoscopic MVD. METHODS: From March 2016 to March 2018, 45 HFS patients underwent fully endoscopic MVD in our department. From opening the dura to preparing to close, the assistant held the endoscope and the surgeon operated. Abnormal muscle response (AMR) and brainstem auditory evoked potentials (BAEP) were monitored. For every patient, the offending vessel was transposed or interposed and achieved complete decompression. AMR was used to evaluate the adequacy of decompression at the end of the surgery. The intra-operative findings and postoperative outcomes and complications were analyzed. RESULTS: Immediately after surgeries, 39 patients (86.7%) achieved excellent result; 2 cases (4.4%) had good result. So the postoperative effective rate was 91.1% (41/45). During 12-36 month follow-up, the outcomes were excellent in 42 cases (93.3%) and good in 2 cases (4.4%), and the effective rate reached to 97.8% (44/45). No recurrence was noted. The postoperative complications were found in 2 patients (4.4%). One patient (2.2%) showed delayed facial palsy on the tenth day but was fully recovered 1 month later. Intracranial infection was noticed in 1 patient (2.2%) and was cured by using intravenous antibiotics for 2 weeks. There was no hearing impairment, hoarseness, or other complications. CONCLUSIONS: Fully endoscopic MVD is both safe and effective in the treatment of HFS. Electrophysiological monitoring is helpful to gain a good result and reduce hearing impairment.

[Simultaneous Nitrogen and Phosphorus Removal and Kinetics by the Heterotrophic Nitrifying Bacterium Acinetobacter junii NP1].

Due to the problems of traditional biological nitrogen and phosphorus removal, including long process duration and high infrastructural and operational costs, the simultaneous nitrogen and phosphorus removal capabilities, influencing factors and kinetic characteristics were systematically studied using the heterotrophic nitrifier Acinetobacter junii NP1 which possesses efficient simultaneous nitrogen and phosphorus removal ability. The results showed that strain NP1 exhibited efficient heterotrophic nitrification ability with a maximum ammonia removal rate of 99.12%. Furthermore, only small amounts of nitrification intermediates were accumulated during the reaction process. Strain NP1 also adapted well to higher ammonia nitrogen loading. In addition, strain NP1 had efficient aerobic denitrification characteristics, and could utilize nitrite and nitrate for growth and metabolism, achieving a maximum removal rate of 91.40% and 95.10%, respectively. The heterotrophic nitrification process of strain NP1 was accompanied by simultaneous phosphorus accumulation, and the appropriate ratio of nitrogen to phosphorus was beneficial for the simultaneous removal of nitrogen and phosphorus. When the ratio of nitrogen to phosphorus was 5:1, the maximum ammonia nitrogen and phosphate removal rates reached 99.21% and 88.35%, respectively. The bacterial growth process of stain NP1 matched the Logistic model (R2>0.99), and the nitrogen and phosphate degradation conformed to the Compertz model (R2>0.99). The maximum conversion rates of nitrogen and phosphate (Rm) obtained by model fitting were in the order ammonia>nitrate>nitrite, and lag time (t0) was in the order nitrate>nitrite>ammonia. According to the analysis of the degradation kinetics of the matrix and the removal rate of nitrogen and phosphorus, the optimal conditions were found to be sodium succinate, C/N=10, T=30℃, and r=160 r·min-1.

IGF1R facilitates epithelial-mesenchymal transition and cancer stem cell properties in neuroblastoma via the STAT3/AKT axis.

BACKGROUND: Neuroblastoma (NB) displays the most heterogeneity in clinical manifestation. The insulin-like growth factor 1 receptor (IGF1R) has long been recognized for its role in tumourigenesis and growth. The IGF/IGF1R pathway is important in maintaining cell survival. It is reported that IGF1R participates in the occurrence of NB, but the mechanism is still unclear. METHODS: Human NB cell lines IMR-32 and SH-SY5Y were recruited in this study. IGF1R was knocked down by transfection with short hairpin RNA. Signal transducer and activator of transcription 3 (STAT3) expression was inhibited by Cryptotanshinone treatment. Cell proliferation, migration, and invasion were determined by MTT assay, wound healing assay, and cell invasion assay, respectively. The cancer stem cell properties were characterized by tumour sphere formation assay and colony formation assay. The mRNA and protein expression levels of related proteins were detected by RT-PCR and Western blot, respectively. RESULTS: The knockdown of IGF1R inhibits NB cell tumourigenesis and the epithelial-mesenchymal transition (EMT) of NB cells. Additionally, IGF1R was found to stimulate cancer stem cell-like properties in NPC cells. The knockdown of IGF1R significantly reduced the phosphorylation of AKT, and STAT3, indicating that the activation of the AKT and STAT3 pathways was inhibited by IGF1R knockdown. Furthermore, IGF1R was demonstrated to stimulate cancer stem cell-like properties in NB cells via the regulation of the STAT3/AKT axis. CONCLUSION: IGF1R promotes cancer stem cell properties to facilitate EMT in neuroblastoma via the STAT3/AKT axis.

[Nitrogen Removal by Heterotrophic Nitrifying Bacterium Pseudomonas putida YH and Its Kinetic Characteristics].

Due to the low nitrogen removal efficiency, lengthy procedure, and vulnerability to high loads of ammonium of the traditional sewage treatment process, the physiological characteristics, nitrogen removal characteristics, influencing factors, and kinetic analysis were systematically studied for the heterotrophic nitrifier Pseudomonas putida YH, which has efficient nitrogen removal ability. The results showed that strain YH exhibited efficient heterotrophic nitrification ability with a low accumulation of nitrification products. The maximum ammonium removal rate was 99.1%, and nearly 53% of the removed TN was converted to intracellular nitrogen. In addition, nitrite and nitrate could also be metabolized by strain YH under aerobic conditions, with a maximum removal rate of 99.8% and 99.5%, respectively. Additionally, the successful PCR amplification of the napA and nirK genes further improved the aerobic denitrification characteristics of strain YH. The bacterial growth process of strain YH matched the Logistic model (R2>0.99), and the nitrogen degradation conformed to the Compertz model (R2>0.99). The order of the maximum conversion rates of nitrogen (Rm) was ammonia > nitrate > nitrite, and that of the lag time (t0) was nitrate > nitrite > ammonia. The optimal conditions for heterotrophic ammonium oxidation with strain YH were succinate as the carbon source, C/N=10, T=30℃, r=160-200 r·min-1, and pH=7.0. Under the optimal conditions, the average ammonia oxidation rate and Rm were 8.35 and 16.71 mg·(L·h)-1, respectively. Strain YH could adapt to a broad range of ammonium loads. A high ammonium removal rate was observed under high ammonium concentrations (1000 mg·L-1), indicating the high potential of strain YH for application in high-strength ammonium wastewater treatment.

Simultaneous removal of nitrogen and phosphorous by heterotrophic nitrification-aerobic denitrification of a metal resistant bacterium Pseudomonas putida strain NP5.

A novel strain NP5 with efficient heterotrophic nitrification, aerobic denitrification and phosphorus accumulation ability was isolated and identified as Pseudomonas putida strain NP5. The removed ammonium and phosphate were mainly converted into intracellular components by assimilation, and negligible nitrification intermediates and N2O were accumulated during heterotrophic nitrification. In addition, the optimal conditions for nutrient removal were: succinate as carbon source, C/N 10, P/N 0.2, temperature 30 °C, salinity 0% and shaking speed 160 rpm. Besides, strain NP5 possessed an exceptional heavy metal and nanoparticles resistance. Cr6+ was found to be the most toxic among the tested metals, and it could be removed simultaneously. Moreover, an obvious phosphorus release was observed under anaerobic condition, and repeated exposure to the anaerobic/aerobic conditions could significantly improve the nutrient removal. Furthermore, the successful expression of key enzymes for nitrogen and phosphorous removal provided additional evidence for possibility of simultaneous nitrification, denitrification and phosphorus removal.

Sortilin promotes glioblastoma invasion and mesenchymal transition through GSK-3ß/ß-catenin/twist pathway.

High aggressiveness is a hallmark of glioblastoma and predicts poor prognosis of patients with glioblastoma. The expression level of sortilin has been preliminarily reported to be elevated in high-grade glioma; however, the potential significance of sortilin in glioblastoma progression has not been elucidated. In this study, we investigated the oncogenic effect of sortilin in glioblastoma. Increased levels of sortilin were noted in the mesenchymal subtype of glioblastoma and highly aggressive subtypes of glioblastoma tissues and cell lines. In addition, high levels of sortilin predicted poor prognoses in patients with glioblastoma. Sortilin knockdown or inhibition with AF38469 (an orally bioavailable inhibitor of sortilin) significantly suppressed migration and invasion by inhibiting EMT-like mesenchymal transition in glioblastoma cells. Furthermore, we proved that sortilin promoted cell invasion mainly via Glycogen synthase kinase 3 beta (GSK-3ß)/ß-catenin/Twist-induced EMT-like mesenchymal transition in glioblastoma. Taken together, our results demonstrate a critical role of sortilin in glioblastoma invasion and EMT-like mesenchymal transition, indicating that sortilin contributes to glioblastoma progression. These data also highlight the dramatic antitumor effects of AF38469 in glioblastoma, suggesting that AF38469 is a potentially powerful antitumor agent for sortilin-overexpressing human glioblastoma.

FGF represses metastasis of neuroblastoma regulated by MYCN and TGF-ß1 induced LMO1 via control of let-7 expression.

BACKGROUND: MYCN and LMO1 amplification are commonly observed in neuroblastoma (NB), which was often accompanied by genetic loss of let-7 microRNA (miRNA). Fibroblast growth factor (FGF) was found to regulate let-7 miRNA expression via FGF receptor substrate 2 (FRS2), which then activates transforming growth factor beta (TGF-ß) signaling. METHODS: Expression of MYCN, LMO1, FRS2, let-7, and TGF-ß receptor I (TGFßRI) was selectively knocked-down or enhanced in NB cells. Proliferation, invasion, migration, metastasis and tumorigenesis of NB, expression of downstream signaling factors and metastasis-associated protein were evaluated. RESULTS: Knock-down on either MYCN or LMO1 has led to inhibition on proliferation, invasion, migration, and metastasis of NB cells, and knock-down of FRS2 resulted in increases in MYCN and LMO1 expression and enhanced invasion, migration and metastasis of NB cells. Decreased expression of TGF-ß1 or TGFßRI led to decrease expression in LMO1 and proliferation, invasion, migration and metastasis markers, except MYCN expression which appeared not to be regulated by TGF-ß1 or TGFßRI. Furthermore, let-7 miRNA was shown to decrease the expression levels of TGF-ßRI, LMO1 and MYCN. CONCLUSIONS: FGF regulates MYCN and TGF-ß1-induced LMO1 and metastasis of NB cells via let-7 miRNA.

Surgical Treatment of Secondary Hemifacial Spasm: Long-Term Follow-Up.

BACKGROUND: Hemifacial spasm (HFS) is generally caused by the root exit zone of the facial nerve compressed by an overlying arterial loop. HFS can also be caused by various types of tumor, aneurysm, or arteriovenous malformation. We retrospectively analyzed patients to evaluate possible differences in the demographic and clinical features between primary and secondary HFS. METHODS: A retrospective study of 3140 cases of HFS treated in our department between January 2009 and June 2016. Among the 3140 total cases, 26 patients had secondary HFS. RESULTS: The 26 tumors of secondary HFS included 11 meningiomas, 8 epidermoid cysts, and 7 vestibular schwannomas. Compared to those with idiopathic HFS, those patients with tumor-induced HFS were significantly younger (P < 0.05). Secondary HFS tended to have responsible vessels, and were observed in 20 (76.92%) of these 26 patients. The long-term effective rate of operation was 84% in the secondary HFS group and was 96.45% in the primary HFS group (P < 0.05); the incidence rate of complication was 12% in the secondary HFS group and was 3.06% in the primary HFS group (P < 0.05). CONCLUSIONS: In cases of secondary HFS, facial nerves of most patients were compressed by blood vessels, so microvascular decompression after tumor resection plays an important role. We should examine the entire nerve root for possible vascular compression.

Satisfaction about Patient-centeredness and Healthcare System among Patients with Chronic Multimorbidity.

The aim of the present study was to measure the prevalence of multimorbidity in Bangladesh, India and China, and to assess the relationship between multimorbidity and patient's opinion regarding their involvement in healthcare decision-making and overall satisfaction of healthcare system. Cross-sectional data on 18 696 men and women aged 18 and above were collected from the World Health Survey of World Health Organization (WHO). Outcome variables were subjective rating of (1) healthcare system's ability to involve patients in decision-making, and (2) satisfaction with the way healthcare system runs in the country. Self-reported chronic conditions were used to measure the prevalence of multimorbidity. Out of 9 chronic conditions, back pain, arthritis, and chronic cough appeared to be the most prevalent ones among majority of the participants. About one-third of the participants in China (30.7%) and two-thirds in Bangladesh (66.1%) and India (66.6%) reported having at least one chronic illness. Prevalence of multimorbidity was highest in India (34.3%) followed by Bangladesh (28.8%) and China (14.3%). In Bangladesh, India and China, respectively 70.5%, 41.7%, 61.3% women and 54.5%, 42.8% and 58.8 % men expressed dissatisfaction regarding the way healthcare system runs in their country. In Bangladesh and India, men who were living with multimorbidity were more likely to rate the patient-centeredness as "bad" than those who had no disease illness. This study suggests that the prevalence of multimorbidity was remarkably high especially in Bangladesh and India. Higher likelihood of dissatisfaction about healthcare system among multimorbid patients might be indicative of inadequacy in the provision of care in qualitative and quantitative terms.

Involved Small Arteries in Patients Who Underwent Microvascular Decompression for Hemifacial Spasm.

BACKGROUND: Microvascular decompression (MVD) has become widely accepted as first-line therapy for hemifacial spasm. However, not all patients are candidates for the procedure, and some surgeons ignore arterioles that represent the actual underlying cause of the condition. The aim of this study was to address the role of involved arterioles in management of MVD in patients with hemifacial spasm. METHODS: Data were collected from 765 consecutive patients who underwent MVD from January 2009 to August 2010 in our hospital. Electromyographic abnormal muscle response and Z-L response were used to identify the involved arterioles. All patients were followed for 25-35 months. RESULTS: Compression by the involved arterioles was identified in 20 patients. The most commonly involved arteriole was a branch of the anterior inferior cerebellar artery, followed by the posterior inferior cerebellar artery. During follow-up, effective outcomes were achieved in 93.6% of patients with involved arterioles. There was no MVD-related mortality. CONCLUSIONS: The main reason for failed MVD is that the involved offending vessel is not correctly identified. Intraoperative abnormal muscle response and Z-L response are good supplementary measures to identify involved arterioles. In addition, not isolating or coagulating the involved arterioles increases the risk associated with the operation.

Evaluation of Microvascular Decompression as Rescue Therapy for Trigeminal Neuralgia in Patients with Failed Gamma Knife Surgery.

OBJECTIVE: Owing to increasing use of Gamma Knife surgery (GKS) for trigeminal neuralgia (TN), physicians are challenged over the problem of choosing an appropriate treatment if GKS fails. The aim of this study was to determine whether microvascular decompression (MVD) is a safe and effective alternative therapy for trigeminal neuralgia in patients with failed GKS. METHODS: Between January 1, 2010, and January 1, 2012, data of 32 patients with trigeminal neuralgia who presented with persistent or recurrent pain after GKS and elected to undergo MVD were collected. Clinical characteristics, operative findings, outcomes of MVD, and complications were reviewed. RESULTS: Mean interval time between GKS and MVD was 16 ± 5.64 months (range, 6-27 months). During MVD, the most common offending vessel was the superior cerebellar artery, followed by the anterior inferior cerebellar artery and vertebral artery. Immediately after MVD, 29 patients (90.63%) experienced complete pain relief without medication. At the end of the follow-up period, 25 patients were pain-free without medication. CONCLUSIONS: Our data confirm that MVD is an effective and safe alternative therapy after GKS, although the risk of facial numbness seems higher in patients with a history of GKS than in patients without a history of GKS.

Posterior Fossa Re-Exploration for Recurrent Trigeminal Neuralgia: Operative Findings and Surgical Techniques.

OBJECTIVE: Microvascular decompression (MVD) is considered the first choice for the surgical treatment of trigeminal neuralgia (TN). However, recurrence after MVD is still a problem and a challenge for neurosurgeons. In this study, we share our experience in the posterior fossa re-exploration of the recurrent cases. METHODS: From January 2014 to January 2015, 15 recurrent TN patients who received fossa re-exploration were retrospectively studied. Surgeries were performed by retrosigmoid suboccipital approach. Brainstem auditory evoked potentials (BAEP) were monitored throughout the operation. Intraoperative findings and surgical techniques were recorded. Postoperative outcomes and complications were analyzed. RESULTS: Among the 15 patients, Teflon adhesion was found in 14. Teflon felt displacement was found in 4 patients, and additional Teflon felt was used to interpose. New offending vessels were found in 5 patients. Three of them were small arteries and the other 2 were petrosal veins. After dissected, small pieces of wet gelatin sponge and Teflon felt were implanted respectively to ensure complete decompression. The remaining 6 patients had no vascular compression except severe adhesion, and nerve combing was performed. After surgery, 12 achieved complete pain relief, 2 gained partial pain relief, and 1 failed. Six patients experienced facial numbness postoperatively. There was no hearing impairment or other complications. During the mean 26-month follow-up, no recurrence occurred and all of 6 cases with facial numbness after surgery improved. CONCLUSIONS: Teflon adhesion is a significant cause of recurrent TN. Wet gelatin-assisted method is good for Teflon interposition. If no vascular compression is found during re-exploration, trigeminal nerve combing can be used. Intraoperative BAEP monitoring is helpful to reduce the incidence of hearing loss.

Organic loading rate shock impact on extracellular polymeric substances and physicochemical characteristics of nitrifying sludge treating high-strength ammonia wastewater under unsteady-state conditions.

Laboratory experimentation was used to investigate the impact of the organic loading rate shock on extracellular polymeric substances (EPSs) and the physicochemical characteristics of nitrifying sludge (NS) treating high-strength ammonia wastewater. The increased organic loading rates (OLRs) strongly influenced the stability of the NS with regard to nutrient removal, biomass-liquid separation, and surface properties, leading to the sludge system collapse at the OLR of 0.75 kg COD per kg MLVSS d. However, an incomplete recovery of the NS after the high OLRs shock was observed when decreasing the OLRs. In addition, the variations of OLRs resulted in relatively stable amounts of tightly bound EPS (TB-EPS), but a significant change in loosely bound EPS (LB-EPS). Both in LB-EPS and TB-EPS, the proteins (PN) contents and proteins to polysaccharides (PN/PS) ratios decreased with the increase in OLRs. Results from the excitation emission matrix spectra implied that the tryptophan PN-like substances were the major components in EPS at low OLRs, while the humic acid-like and fulvic acid-like substrates increased markedly at high OLRs. Furthermore, correlation analysis demonstrated that PN and the PN/PS ratio were the most important factors in determining the physicochemical properties of the NS. It was indicated that the PN could accurately reflect the sludge properties of the NS, and thus effectively change the surface properties of the sludge, contributing to the cohesion between the aggregates to maintain a stable structure.

Management of Primary Bilateral Trigeminal Neuralgia with Microvascular Decompression: 13-Case Series.

BACKGROUND: Bilateral trigeminal neuralgia is a relatively rare disease. Microvascular decompression (MVD) is a safe and effective treatment for unilateral trigeminal neuralgia; however, its utility in bilateral trigeminal neuralgia is unclear. Here, we report our experience with MVD in 13 cases of primary bilateral trigeminal neuralgia. METHODS: We retrospectively analyzed 13 cases of bilateral trigeminal neuralgia that were treated with MVD between January 2013 and January 2015. Surgical outcomes and complications were explored in each case. RESULTS: Postoperatively, 11 patients had excellent outcomes and 2 patients had good outcomes on the operative side. Three patients also reported the amelioration of contralateral symptoms after MVD. Of 10 cases indicating no contralateral improvement, 1 refused to undergo a second MVD procedure on the opposite side and 9 underwent a second MVD procedure and experienced symptom relief. The superior cerebellar artery was the most common offending vessel. There were no severe MVD-related complications. CONCLUSION: Vascular compression plays a causative role in bilateral and unilateral trigeminal neuralgia. MVD appears to be a safe and effective treatment option in patients who are refractory to pharmacotherapy.