Quantitative Proteomic Analysis Reveals Impaired Axonal Guidance Signaling in Human Postmortem Brain Tissues of Chronic Traumatic Encephalopathy

Chronic traumatic encephalopathy (CTE) is a distinct neurodegenerative disease that associated with repetitive head trauma. CTE is neuropathologically defined by the perivascular accumulation of abnormally phosphorylated tau protein in the depths of the sulci in the cerebral cortices. In advanced CTE, hyperphosphorylated tau protein deposits are found in widespread regions of brain, however the mechanisms of the progressive neurodegeneration in CTE are not fully understood. In order to identify which proteomic signatures are associated with CTE, we prepared RIPA-soluble fractions and performed quantitative proteomic analysis of postmortem brain tissue from individuals neuropathologically diagnosed with CTE. We found that axonal guidance signaling pathwayrelated proteins were most significantly decreased in CTE. Immunohistochemistry and Western blot analysis showed that axonal signaling pathway-related proteins were down regulated in neurons and oligodendrocytes and neuron-specific cytoskeletal proteins such as TUBB3 and CFL1 were reduced in the neuropils and cell body in CTE. Moreover, oligodendrocyte-specific proteins such as MAG and TUBB4 were decreased in the neuropils in both gray matter and white matter in CTE, which correlated with the degree of axonal injury and degeneration. Our findings indicate that deregulation of axonal guidance proteins in neurons and oligodendrocytes is associated with the neuropathology in CTE. Together, altered axonal guidance proteins may be potential pathological markers for CTE.

Ergosterol Alleviates Kidney Injury in Streptozotocin-Induced Diabetic Mice.

Ergosterol (ERG) has been widely used in the development of novel drugs due to its unique physiological function. However, little is known about the protective effects of ERG on diabetes. Hence, the current study was designed to evaluate the positive role of ergosterol on streptozotocin- (STZ-) induced diabetes in mice. Oral glucose tolerance test (OGTT) was carried out to assess blood glucose level. Biochemical parameters such as uric acid, creatinine, serum insulin, triglycerides (TG), and total cholesterol (TC) were also measured. Pathological condition of kidney was examined by hematoxylin-eosin (H&E) staining. The expressions of PI3K, p-PI3K, Akt, p-Akt, NF-κBp65, p-NF-κBp65, IκBα, and p-IκBα were analyzed by western blot. ERG significantly reduced the concentrations of blood glucose, uric acid, creatinine, TG, and TC. Serum insulin was elevated with ERG treatment. In addition, renal pathologic changes of diabetes mice were also alleviated by ERG. Obtained data revealed that ERG restored the levels of PI3K/Akt/NF-κB signaling-related proteins in comparison with diabetes mice. Above all, it could be assumed that ERG might play a positive role in regulating STZ-induced diabetes through suppressing PI3K/Akt/NF-κB pathway.

Correlation analysis on MN-RET from peripheral blood and MN-PCE from bone marrow in mice following exposure to irradiation / 中华放射医学与防护杂志

objective To study the changes of reticulocyte micronueleus(MN-RET)from peripherai blood and polychromatic erythrocyte mieronucleUS(MN-PCE)from bone marrow in mice following exposure to X-rays in order to provide an experimental basis for exploring possible hish-throughput radiation biodosimeter.Methods Male ICR mice were whole-body irradiated with 0,0.5,1,2,4 and 5 Gy at a dose rate of 0.488 Gy/min.MN-RET from peripheral blood wag scored with FCM and MN-PCE from bone marrow was scored with manual microscopy at 24,48 and 72 h post-irradiation.Results Both MN-RET and MN-PCE rates increaged with doses in the range of 0-5 Gy at 24,48 and 72 h after WBI.The dose-response relationship can be fit with linear equations(t=10.26-25.77,P<0.05).The correlation coeffcients between MN-RET from peripheral blood and MN-PCE from bone mallow were highly significant(r=0.986-0.996,P<0.05).Conclusions In view of its simplicity,accuracy and high throughput capacity,FCM scoring of peripheral blood MN-RET may be a candidate for radiation biodosimetry,More work should be carried out on human specimens to investigate this possibility.

Clinical research of stereotactic surgery in treatment of moderate hypertensive intracerebral hemorrhage / 中国基层医药

Objective To explore the near-term therapeutic effect and long-term result of stereotactie surgery in treatment of moderate hypertensive intraeerebral hemorrhage and discuss related problems of the surgery.Methods 60 cases of moderate hypertensive intracerebral hemorrhage were divided into two groups at random.30 cases treated by stereotactie surgery,the others treated by nonsurgical method, the near-term rebleeding rate, mortality rate and longterm living quality of the two groups were analyzed and compared.Results There were no statistical differences in rebleeding rate and mortality rate between the two groups( all P >0.05 ).The long-term result indicated that there was statistical difference in GOS grades between the two groups( P <0.05).The surgical group had better result than nonsurgical group.Conclusion The patients suffered for moderate hypertensive intracerebral hemorrhage treated by stereotsefic surgery had better long-term therapeutic effect than those treated by nonsurgical method.

Clinical analysis of 32 patients with symptomatic carotid stenosis treated by eversion carotid endarterectomy / 中国医师进修杂志

Objective To review the experience and early clinical results of eversion carotid endartotectomy (eCEA) in treatment of patients with symptomatic carotid stenosis. Methods eCEA were performed on 32 patients who suffered from the extracranial carotid stonosis. The treatment results were retrospectively reviewed. Results Thirty-two patients were successfully treated with eCEA. The symptom in 17 patients with transient ischemia attach (TIA) admitted to hospital did not recurrence, the other original symptoms of the patients had different degrees of improvement or disappeared. Two patients had TIA during 72 h after surgery, but 24 h repeatedly CTA examination without infarcts oecurring, and recovered after the treatment of small doses of urokinase. Two cases of severe swelling appeared tracheal shift incision, and went smoothly through edema by treatment of tracheal intubatian. In 4 patients headache reliefed in 2-3 d after medical treatment of the dehydration. Seven patients appeared different degree of hoarseness, and got recovery through neurotrophic medication for 1 month. No other serious complication occurred. Follow-up by 6 months, no CTA carotid artery stenosis appeared again. Conclusion eCEA is an effective method to treat symptomatic carotid stenosis.

Intraventricular epidermoids.

To study the clinical characteristics of intraventricular epidermoids, we analysed retrospectively 12 patients treated in our hospital and reviewed the literature with regard to clinical manifestations, imaging features, diagnosis, surgical procedures and prognosis. Four patients with lateral ventricle epidermoid and eight in the fourth ventricle were included in this group. Intraventricular epidermoids are characteristically hypodense non-enhancing lesions on CT scans. MRI reveals them to have long T1 and T2 relaxation times with slight mass effect. Total removal is ideal, but special attention should be paid to preservation of important neurovascular structures. Close proximity of tumours to cranial nerves and the brain stem pose technical difficulties in total removal. Cranial nerve dysfunction and aseptic meningitis are the main postoperative complications. Long-term prognosis for patients with intraventricular epidermoids and well-preserved neurological conditions is good, even in the case of subtotal excision. Clinical follow-up and MRI allow earlier diagnosis of recurrence.

Cerebellopontine angle epidermoids presenting with trigeminal neuralgia.

We studied the clinical characteristics of cerebellopontine angle (CPA) epidermoids presenting with trigeminal neuralgia (TN). Twenty-four patients were analyzed retrospectively and the literature reviewed with regard to clinical manifestation, imaging features, surgical procedures and prognosis. TN may be the initial symptom of CPA epidermoid, particularly in young patients. Epidermoids are characteristically hypodense nonenhancing lesions on CT scans, while on MRI they exhibit long T1 and T2 relaxation times. Although complete removal is ideal in the surgical management of CPA epidermoid, proximity to cranial nerves and the brain stem may pose technical difficulties in complete resection. In addition to complete resection of the tumour, arterial compression at the root entry zone (REZ) of the trigeminal nerve should be sought, and if found, a microvascular decompression (MVD) should be performed. Cranial nerve dysfunction and aseptic meningitis are the most common operative complications.

Cystic acoustic neuroma.

To define the clinical characteristics of cystic acoustic neuroma, we retrospectively analyzed 22 patients with cystic acoustic neuroma and reviewed the literature with regard to clinical manifestation, imaging features, diagnosis, surgical procedures and prognosis. An acoustic neuroma was defined as cystic according to the following criteria: the presence of hypodense/hypointense areas on CT or MRI, the identification of cystic elements at operation and histological verification. At the end of surgery, the facial nerve was anatomically intact in 86.4% of cystic acoustic neuromas. Complete removal of the tumor was achieved in 18 cases (81.8%). We conclude that patients with cystic acoustic neuroma need prompt surgery with special attention paid to the preservation of the facial nerve.

Neuroendoscopic anatomy and surgery of the cerebellopontine angle.

To probe the feasibility and utility of neuroendoscopic inspection of the anatomy of the cerebellopontine angle (CPA) and of neuroendoscopic assisted microneurosurgery (NEAMN) for CPA lesions via a retrosigmoid approach, we used retrosigmoid NEAMN in 28 patients with CPA lesions. Prior to this, we undertook anatomical observation of bilateral CPA in two adult cadaver heads using the neuroendoscope. NEAMN tumour resection was performed in eight acoustic neuromas, one meningioma and 14 cholesteatomas and NEAMN vascular decompression was performed in five patients with trigeminal neuralgia. Both the neurovascular structures of the CPA and the ventral surface of the pons, as well as the clivus, can be inspected using the neuroendoscope through a retrosigmoid approach with a 2-3 cm diameter bony opening. Complete excision of the tumour with preservation of the facial nerve was achieved in all eight acoustic neuromas. Likewise, total resection of the tumour was possible in the 14 cholesteatomas and one meningioma. Paroxysmal facial pain resolved after NEAMN vascular decompression in the five patients with trigeminal neuralgia. There were no postoperative complications or deaths in this series. The CPA can be divided into three levels - the cranial, medial, and caudal, and each level contains specific neurovascular structures as seen through the neuroendoscope. Knowledge of these divisions is useful to master the common NEAMN procedures of the CPA. NEAMN for CPA lesions via a retrosigmoid approach is a useful adjunct to standard microneurosurgical techniques effect and may decrease the operative risk.

Rerupture of intracranial aneurysms during cerebral angiography.

Three cases of re-rupture of intracranial aneurysms during cerebral angiography (RIADCA) between June and September, 2001 are reported. All cases underwent emergency craniotomy and aneurysm clipping. The subarachnoid blood and the extravasating contrast medium were removed intraoperatively as completely as possible. There was no mortality in this series. The incidence, timing, sex, age, inducing factors, risk factors, prevention measures and prognosis are discussed and reviewed in conjunction with the literature.

Chronic expanding intracerebral hematoma.

In order to study the clinical characteristics of chronic expanding intracerebral hematoma (CEICH), we analyzed retrospectively 21 patients with CEICH and reviewed the literature with regard to clinical manifestations, medical imaging features, surgical findings, pathological examinations, diagnoses, treatments and prognoses, etc. All patients recovered well and did not recur 1-2 months after operation, except one, who died of contralateral intracerebral hemorrhage three months later. Patients were followed-up by computerized tomographic (CT) scanning. MRI was useful for the preoperative diagnosis.

Intracranial tumoural haemorrhage--a report of 58 cases.

In order to study the computerized tomographic (CT) appearances and clinical characteristics of intracranial tumoural haemorrhage (ITH), we analyzed retrospectively fifty-eight patients with ITH and reviewed the literature. As a result, 91% patients had acute or subacute onset and 26% manifested haemorrhage as their first symptoms. CT scanning indicated that intratumoural bleeding occurred in 23 cases, bleeding into parenchyma 18 cases, subarachnoid space 6 cases, ventricle 3 cases and subdural space 8 cases. Thirty-eight patients had emergency operations and the others had selective operations. Both tumours and haematomas were removed all together in all patients. Fifty-five patients were cured or improved and three died during the perioperative stage in our series. Among the patients with ITH, there were 21 metastatic tumours, 19 gliomas, 10 meningiomas, 6 pituitary adenomas, 1 melanoma and 1 acoustic neurilemoma. The onset of most ITH resembled that of cerebrovascular diseases. The location of ITH and the CT appearances of ITH varied in different cerebral tumours. Radical removal of brain tumours with haemorrhage is an effective treatment for ITH, which can greatly decrease the perioperative mortality rate and improve the prognoses of patients.

Clinical characteristics of chronic subdural hematoma evolving from traumatic subdural effusion / 中华外科杂志

<p><b>OBJECTIVE</b>To probe into the incidence, mechanism and clinical characteristics of chronic subdural hematoma (CSDH) evolving from traumatic subdural effusion (TSE).</p><p><b>METHODS</b>The clinical materials of 32 patients with CSDH evolving from TSH were analyzed retrospectively and the correlative literature was reviewed.</p><p><b>RESULTS</b>16.7% of the patients with TSH evolved into CSDH. The time of evolution was 22 - 100 days after head injury. All patients were cured with hematoma drainage.</p><p><b>CONCLUSIONS</b>TSE is one of the origins of CSDH. The clinical characteristics of TSE evolving into CSDH include polarization of patient age, and chronic small effusion. The patients are usually injured deceleratedly and accompanied with mild cerebral damage.</p>

Pituitary apoplexy (a report of five cases) / 临床神经病学杂志

Five cases of pituitary apoplexy were reported and the literature was reviewed in clinical aspects. Our diagnosis criteria consisted of 1. sudden onset of maked visual impairment, bitemporal hemianopsia ,severe headache, yore-Ring, etc; 2. with or without a history of pituitary adenoma, but radiological examinations suggest evidences of pituitary apoplexy; 3. exeluding cases with asymptomatic hemorrhage verified at operation. CT scan, treatment with corticosteroids and craniotomy or transsphenoidal decompression will lead a successful outcome in most cases of pituitary apoplexy. One case in this series died of herniation, the prognosis of other four patients was satisfactory.