Association between Lipoprotein Lipase Polymorphism and the Risk of Stroke: A Meta-analysis.

BACKGROUND: Several studies have studied the relationship between lipoprotein lipase (LPL) HindIII gene polymorphism and stroke susceptibility. However, the conclusions remain controversial. To clarify the association of LPL gene HindIII polymorphism and stroke susceptibility, we therefore conducted a comprehensive meta-analysis. MATERIALS AND METHODS: The PubMed, Web of Science, EMBASE, and Google Scholar databases were systemically searched to indentify available studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under the allelic, dominant, homozygous, heterozygous, and recessive models. The data were analyzed by using Stata 12.0 (StataCorp, College Station, TX). RESULTS: Ten studies were enrolled, including a total of 2122 cases and 2235 controls. The overall results showed that LPL HindIII variants were associated with a decreased risk of stroke (G versus T: OR = .78, 95% CI = .70-.87, P < .001; GG + TG versus TT: OR = .76, 95% CI = .67-.87, P < .001; GG versus TT: OR = .69, 95% CI = .53-.90, P = .006; TG versus TT: OR = .78, 95% CI = .68-.90, P <.001; GG versus TG + TT: OR = .74, 95% CI = .57-.95, P = .02). Stratified analysis by ethnicity (Asian and non-Asian) indicated that LPL HindIII variants were associated with a decreased risk of stroke in the Asian population, but not in the non-Asian population. In the subgroup analysis by stroke subtype, the results suggested that LPL HindIII variants contributed to a decrease in both ischemic stroke and hemorrhagic stroke risks. CONCLUSION: Our meta-analysis suggested that LPL HindIII variants were associated with a decreased risk of stroke in the Asian population, but not in the non-Asian population.

Association between the Matrix Metalloproteinase-9 rs3918242 Polymorphism and Ischemic Stroke Susceptibility: A Meta-Analysis.

BACKGROUND: In recent years, dozens of case-control studies showed that matrix metalloproteinase (MMP)-9 rs3918242 variants were associated with ischemic stroke (IS) susceptibility. However, the conclusions of case-control studies that evaluated the relationship between MMP-9 rs3918242 variants and the risk of IS were still equivocal. Herein, we conducted a comprehensive meta-analysis to investigate the association between MMP-9 rs3918242 variants and the risk of IS. METHODS: We searched 5 databases (PubMed, EMBASE, Google Scholar, Web of Science, and Chinese Biomedical Literature Database) to identify the eligible studies up to October of 2016. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the association of MMP-9 rs3918242 variants with IS susceptibility under the allelic model (T versus C) and the dominant model (TT + CT versus CC). RESULTS: A total of 14 studies with 3233 cases and 3123 controls were included in this meta-analysis. Our meta-analysis indicated that MMP-9 rs3918242 variants were associated with significantly increased risk of IS in overall populations (T versus C: OR = 1.43, 95% CI = 1.20-1.71, P < .001; TT + CT versus CC: OR = 1.39, 95% CI = 1.16-1.67, P < .001). Subgroup analysis based on ethnicity (Chinese and Caucasian) suggested that MMP-9 rs3918242 variants contributed to increase the risk of IS in Chinese population; However, no association was detected between MMP-9 rs3918242 variants and the risk of IS in Caucasian population. CONCLUSION: Therefore, our meta-analysis suggested that MMP-9 rs3918242 variants (T allele, TT and CT genotypes) contributed to significantly increase the risk of IS in the Chinese population.

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels regulate firing of globus pallidus neurons in vivo.

The globus pallidus plays a significant role in motor control under both health and pathological states. Recent studies have revealed that hyperpolarization-activated cyclic nucleotide-gated (HCN) channels occupy a critical position in globus pallidus pacemaking activity. Morphological studies have shown the expression of HCN channels in the globus pallidus. To investigate the in vivo effects of HCN channels in the globus pallidus, extracellular recordings and behavioral tests were performed in the present study. In normal rats, micro-pressure ejection of 0.05mM ZD7288, the selective HCN channel blocker, decreased the frequency of spontaneous firing in 21 out of the 40 pallidal neurons. The average decrease was 50.4±5.4%. Interestingly, in another 18 out of the 40 pallidal neurons, ZD7288 increased the firing rate by 137.1±27.6%. Similar bidirectional modulation on the firing rate was observed by a higher concentration of ZD7288 (0.5mM) as well as another HCN channel blocker, CsCl. Furthermore, activation of HCN channels by 8-Br-cAMP increased the firing rate by 63.0±9.3% in 15 out of the 25 pallidal neurons and decreased the firing rate by 46.9±9.4% in another 8 out of the 25 pallidal neurons. Further experiments revealed that modulation of glutamatergic but not GABAergic transmission may be involved in ZD7288-induced increase in firing rate. Consistent with electrophysiological results, further studies revealed that modulation of HCN channels also had bidirectional effects on behavior. Taken together, the present studies suggest that HCN channels may modulate the activity of pallidal neurons by different pathways in vivo.

Microsurgical treatment for central gyrus region meningioma with epilepsy as primary symptom.

BACKGROUND: The objective of this article was to investigate the operation outcome, complications, and the patient's quality of life after surgical therapy for central gyrus region meningioma with epilepsy as the primary symptom. METHODS: All patients get at least 6 months of follow-up (range, 6-34 mo) after surgery. They underwent preoperative magnetic resonance imaging and video electroencephalography, and their clinical manifestations, imaging characteristics, microsurgical methods, and prognosis were retrospectively analyzed. RESULTS: The meningioma was located in the front and back of the central sulcus vein in 3 and 2 patients, respectively; in the compressed precentral gyrus and central sulcus vein in 3 patients; and in the precentral gyrus and postcentral gyrus each in 1 patient; beside the right sagittal sinus and invaded a thick draining vein on the brain surface in 1 patient and beside the right sagittal sinus and close to the precentral gyrus in 2 patients; invaded the superior sagittal sinus in 8 patients; crossed the cerebral falx and compressed cortex gyrus veins in 1 patient; invaded duramater and irritated skull hyperplasia in 3 patients; invaded duramater and its midline infiltrated into the superior sagittal sinus, was located behind the precentral gyrus, and enveloped the central sulcus vein. They were resected and classified by Simpson standards: 17 of the 26 patients had grade I, 6 patients had in grade II, and 3 patients had in grade III. CONCLUSIONS: Resection of central gyrus region meningioma by microsurgical technique avoids injury to the cerebral cortex, central sulcus vein, and other draining veins. Microsurgery improves the total resection rate, reduces recurrence rate, and lowers disability or death rate.

Cross-linked gelatin microsphere-based scaffolds as a delivery vehicle of MC3T3-E1 cells: in vitro and in vivo evaluation.

Scaffolding plays a crucial role in bone tissue engineering by not only providing interfaces for cell adhesion, proliferation, and differentiation but also guiding neotissue formation. For this purpose, microspheres (MSs) are being increasingly used alone or in combination with other scaffolds. However, few researchers have used MSs to prepare 3D scaffolds by culture with delivered cells. In this study, we have developed covalent cross-linked gelatin MSs (ccG-MSs) (average diameter = 100-300 µm) to load mouse osteoblast MC3T3-E1 cells, which exhibit attachment and spreading on surfaces of ccG-MSs after co-culture. Significantly, the ccG-MSs can be integrated into a macroscopic construct with MC3T3-E1 cells after 5 days of cultivation. The MC3T3-E1 cells within ccG-MSs constructs show a higher viability and proliferation activity than those in the micro-cavitary gelatin gel (MCG) constructs. Calcium deposition, alkaline phosphatase activity as well as osteocalcin secretion within both ccG-MSs and MCG constructs have been evaluated in vitro and in vivo, respectively. Compared to MCG scaffolds, ccG-MS-based scaffolds can provide better cellular microenvironments for cell proliferation and osteogenic differentiation. Our findings will lay the foundation for understanding cellular behaviors in MS-based 3D constructs and help in designing MS-based bone tissue engineering scaffolds.

Cryopreservation of Autologous Cranial Bone Flaps for Cranioplasty: A Large Sample Retrospective Study.

OBJECTIVE: To clarify the clinical outcomes of cranioplasty with cryopreserved bone flaps and identify risk factors related to bone flap infection and resorption after cranioplasty with cryopreserved bone flaps. METHODS: A total of 946 patients (989 bone flaps) underwent decompressive craniectomy and delayed cranioplasty via the use of cryopreserved autogenous cranial bone flaps. Cranial bone flaps were removed during the initial craniectomy and reserved in liquid nitrogen (-196°C) with dimethyl sulfoxide as a cryoprotectant. Cranioplasty subsequently was performed once the brain injury had healed. Data regarding complications and clinical outcomes were recorded and the potential risk factors were analyzed. RESULTS: Data from 960 flaps were available for analysis. The overall complication rate was 15.83% (152 of 960). Bone resorption occurred in 42 flaps in 37 patients (4.38%). The bone flaps resorption rate was greater in patients ≤18 years than in patients >18 years (9.38% vs. 3.61%, P < 0.05). Cryopreservation for more than 365 days tended to result in a greater bone resorption rate (6.88% vs. 2.92%, P < 0.01). Skull bone grafts infection occurred in 39 flaps in 34 patients (4.06%). The bone graft infection rate was greater in emergency craniectomy cases (8.81% vs. 2.59%, P < 0.01) and in patients with diabetes (10.53% vs. 3.07%, P < 0.01). CONCLUSIONS: Cryopreservation of autologous cranial bone flaps is safe and effective for cranioplasty. Cranioplasty with cryopreserved autologous cranial bone flaps should be performed no more than 1 year after craniectomy. Emergency craniectomy and patients with diabetes require special attention.

HCN channels modulate the activity of the subthalamic nucleus in vivo.

The subthalamic nucleus is a key component in the indirect pathway of the basal ganglia, which mediates a variety of motor functions. The subthalamic nucleus neurons have intrinsic pacemaking properties. Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels are expressed in the central nervous system, including the subthalamic nucleus. However, the in vivo modulation of HCN channels in the subthalamic nucleus remains relatively obscure. To investigate the direct effects of HCN channels in the subthalamic nucleus, multi-barrel extracellular recordings and behavioral tests were performed in the present study. In 42 out of the 89 subthalamic nucleus neurons, micropressure ejection of HCN channel inhibitor, ZD7288 (0.05 mM), decreased the spontaneous firing rate from 11.6 ± 1.8 to 5.7 ± 1.3 Hz (P < 0.001). The average decrease was 56.7 ± 5.3 %. In another 47 out of the 89 subthalamic nucleus neurons, micropressure ejection of ZD7288 increased the spontaneous firing rate from 9.5 ± 1.6 to 16.3 ± 2.4 Hz (P < 0.001), with the average increase of 142.2 ± 29.8 %. Activation of HCN channels by 8-Br-cAMP also produced bidirectional modulation on the firing rate of the subthalamic nucleus neurons. Furthermore, unilateral microinjection of ZD7288 or 8-Br-cAMP produced postural behavior in awake rats. The present electrophysiological and behavioral findings demonstrated that the pharmacological blockade or activation of HCN channels produces bidirectional modulation on the excitability of the subthalamic nucleus.

Surgical treatment of symptomatic Rathke's cleft cysts: clinical features, therapy considerations and outcomes.

BACKGROUND: Rathke's cleft cyst (RCC) is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs. METHODS: Totally 42 patients (19 males and 23 females) were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010. RESULTS: Patients' age ranged from 6 to 67 years (mean of 41.6 years). The duration of symptoms ranged from 4 days to 10 years. Headache (69%), visual impairment (36%), and pituitary dysfunction (10%) were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm (mean of 20.07 mm). Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients (80%) with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 (31%) patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months (range 12 - 60 months). CONCLUSIONS: Surgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.

Primary anaplastic solitary fibrous tumor of the tentorium cerebelli.

Meningeal solitary fibrous tumors (MSFT) have been described in about 80 patients as benign spindle-cell neoplasms, with few anaplastic variants. We report a 57-year-old male patient with a 4-month history of progressive headache caused by a primary anaplastic MSFT arising from the tentorium cerebelli. MRI revealed a tentorium-based tumor that extended into the occipital lobe superiorly and into the cerebellum inferiorly on the left. Following gross total resection of the tumor and postoperative radiotherapy, the patient experienced symptomatic improvement with no recurrence at the 12-month follow-up. The final tumor pathology was consistent with an anaplastic MSFT, with a Ki-67 proliferative index of 25%.