IDH mutations predict longer survival and response to temozolomide in secondary glioblastoma.

Recent studies have shown that isocitrate dehydrogenase 1/2 (IDH1/2) mutations occur frequently in secondary glioblastoma. This study aimed to investigate their impact on temozolomide chemosensitivity and relationship with O(6)-methylguanine DNA methyltransferase (MGMT) promoter methylation in secondary glioblastoma. Searches for IDH1 and IDH2 mutations, 1p19q codeletion, MGMT promoter methylation, and p53 expression were carried out in a series of 86 secondary glioblastomas and correlated with progression-free survival and overall survival. Response to temozolomide was evaluated by progression-free survival, as well as by tumor size on successive MRI scans, then correlated with molecular alterations. IDH (IDH1 or IDH2) mutations were found in 58/79 patients (73.4%). IDH mutation, MGMT promoter methylation, and 1p19q codeletion were associated with prolonged progression-free survival in univariate (P < 0.001, P < 0.001, P = 0.003, respectively) and multivariate analysis (P < 0.001, P < 0.001, P = 0.035, respectively). IDH mutation (P = 0.001) and MGMT promoter methylation (P = 0.011) were correlated with a higher rate of objective response to temozolomide. Further analysis of response to temozolomide showed that patients with both IDH mutation and MGMT promoter methylation had the best response rate to temozolomide. IDH mutation appears to be a significant marker of positive chemosensitivity in secondary glioblastoma. Use of IDH status combined with MGMT promoter status as a stratification factor seems appropriate in future clinical trials involving temozolomide for the treatment of patients with secondary glioblastoma.

Establishment of a mouse model bearing orthotopic temozolomide-resistant glioma / 南方医科大学学报

OBJECTIVE@#To establish a mouse model bearing orthotopic temozolomide (TMZ)-resistant glioma that mimics the development of drug resistance in gliomas @*METHODS@#Seventy-eight adult C57BL/6 mice were randomly divided into 6 groups (@*RESULTS@#The mouse models bearing TMZresistant glioma was successfully established. The cells from the high-dose induced group showed a significantly higher colony-forming rate than those from the high-dose control group (@*CONCLUSIONS@#Progressive increase of TMZ doses in mice bearing orthotopic gliomas can effectively induce TMZ resistance of the gliomas.

Preoperative radiologic characters to predict hemangiopericytoma from angiomatous meningioma.

BACKGROUND: Hemangiopericytoma is clinically difficult to be differentiated from angiomatous meningioma. We set out to determine if the preoperative MRI parameters can predict HPC from angiomatous meningioma. METHODS: A retrospective review of medical records was conducted for12 HPC patients and 17 angiomatous meningiomas. WHO-2007 grading was used for histopathological diagnosis. Preoperative radiologic parameters included tumor location, tumor size, tumor shape, T1-weighted signal, T2-weighted signal, T1-weighted Gd-enhanced image, ADC value, Flair signal, peritumoral edema (PTE), dural tail sign (DTS), vessel voids sign, arachnoid layer on T2-weighted MRI, tumor hemorrhage and necrosis were analyzed. Univariate analyses were conducted to examine the association between radiological or clinical and histopathological features. Binary logistic regression model was used to evaluate if the parameters predict the occurrence of HPC. RESULTS: Five parameters, included age, gender, ADC value, necrosis and T1 enhancement was found significantly different between two types after univariate analyses. Binary logistic regression model demonstrated ADC value was the sole independent predictor of HPC (p=0.039, OR: 14.5, CI-3.7-38.6). CONCLUSIONS: ADC value may be used as a simple and useful optional tool in differentiating primary intracranial HPC from angiomatous meningioma. The combination of ADC value with the data acquired from pre and post-contrast MR scans may further help improve the reliability in the differential diagnosis.

Establishment and evaluation of rat obesity model induced by electrical damage of ventromedial hypothalamic nucleus and arcuate nucleus / 中华行为医学与脑科学杂志

Objective:To construct a rat model of hypothalamic obesity by two point electrical damage to the ventromedial hypothalamus and arcuate nucleus.Methods:Twenty adult male SD rats of SPF grade were randomly divided into experimental group and sham operation group.A 25GA (0.45 mm) solid iron needle was used, the needle was coated with an insulating layer, and the tip exposed a 0.5 mm conductive area.With reference to The Rat Brain in Stereotaxic Coordinates and using the stereotactic instrument (AP: -2.6 mm, ML: ± 0.6 mm, DV: -9.6 mm) as the coordinate, 1.5 mA current was continuously applied for 25 s, the ventromedial nucleus (VMH) and arcuate nucleus (ARC) of bilateral brain in SD rats was damaged.During the experiment, the body weight(BW), food intake(FI) and water intake(WI) of the two groups were recorded regularly.The rats were sacrificed on the 28th day after the operation, and the changes of periprenal fat mass and body length were measured.The changes of liver and adipose tissue were detected by HE staining method, leptin by ELISA, leptin receptor(LEPR) by Western blot.Results:(1) The body weight of rats in the experimental group ((427.5±17.7)g) and weight gain ((208.5±14.8)g) were significantly increased compared with the rats in the control group((349.2±17.7)g), ((136.2±21.4)g)on the 28th day after operation ( t=7.661, 6.806, both P<0.001). (2) The daily food intake of rats in the experimental group ((44.2±6.6)g) on the 28th day after surgery was significantly higher than that in the control group ((23.0±3.6)g) ( t=6.918, P<0.001). There was no significant difference of the daily drinking water of rats between experimental group((37.5±12.1)ml) and the control group ((35.0±11.8)ml) ( t=0.361, P=0.726). (3) Perikidney fat mass of experimental group rats ((13.4±2.7)g) significantly increased 28 days after operation compared with control group rats((6.3±0.9)g)( t=4.250, P<0.05). The naso-anal length of experimental group((21.8±0.4)cm) was significantly decreased compared with the control group ((23.4±0.2)cm) ( t=-6.788, P<0.01). The Lee index of the experimental group (348.9±8.5) was significantly higher than that of the control group(305.5±4.3)( t=7.898, P<0.01). (4) The serum leptin content ((8 324.10±159.00)μg/L) of the experimental group rats at 28 days after surgery was significantly higher than that of the control group((2 705.31±407.10)μg/L) ( t=25.712, P<0.001). The lateral hypothalamus area (LHA) LEPR protein expression (1.3±0.1) in the experimental group was significantly higher than that in the control group (0.9±0.1) ( t=4.932, P<0.01). Conclusion:Two-point electrical damage to bilateral VMH and ARC of rats can establish hypothalamic obese rat model.

Discussion on prevention of external ventricular drainage-associated infection / 中华创伤杂志

External ventricular drainage ( EVD ) is a common treatment method in neurosurgery. EVD-associated infections are severe complications of EVD catheterization. How to optimize catheterization and postoperative management to reduce EVD-associated infections remains a difficult clinical issue. In this article, the pathogenesis of EVD-associated infection, preoperative preparation and surgical process of EVD, fixation and maintenance of drainage tubes, nursing, preventive use of antibiotics, and disease status of patients are expounded, so as to provide reference for better reducing EVD-associated infections.

JNK/c-Jun signaling pathway mediates arginine vasopressin neuron regeneration by promoting cytoskeleton reconstruction in rats with electrical lesions of the pituitary stalk / 南方医科大学学报

OBJECTIVE@#To investigate the mechanism by which doublecortin promotes the recovery of cytoskeleton in arginine vasopressin (AVP) neurons in rats with electrical lesions of the pituitary stalk (PEL).@*METHODS@#Thirty-two SD rats were randomized into PEL group with electrical lesions of the pituitary stalk through the floor of the skull base (=25) and sham operation group (=7), and the daily water consumption (DWC), daily urine volume (DUV) and urine specific gravity (USG) of the rats were recorded. Four rats on day 1 and 7 rats on each of days 3, 7 and 14 after PEL as well as the sham-operated rats were sacrificed for detection of the expressions of β-Tubulin (Tuj1), doublecortin and caspase- 3 in the AVP neurons of the supraoptic nucleus using immunofluorescence assay and Western blotting.@*RESULTS@#After PEL, the rats exhibited a typical triphasic pattern of diabetes insipidus, with the postoperative days 1-2 as the phase one, days 3-5 as the phase two, and days 6-14 as the phase three. Immunofluorescent results indicated the repair of the AVP neurons evidenced by significantly increased doublecortin expressions in the AVP neurons following PEL; similarly, the expression of Tuj1 also increased progressively after PEL, reaching the peak level on day 7 after PEL. The apoptotic rates of the AVP neurons exhibited a reverse pattern of variation, peaking on postoperative day 3 followed by progressive reduction till day 14. Western blotting showed that the expressions of c-Jun and p-c-Jun were up-regulated significantly on day 3 ( < 0.05) and 7 ( < 0.01) after PEL, while an upregulated p-JNK expression was detected only on day 3 ( < 0.05), as was consistent with the time-courses of neuronal recovery and apoptosis after PEL.@*CONCLUSIONS@#JNK/c-Jun pathway is activated after PEL to induce apoptosis of AVP neurons in the acute phase and to promote the repair of neuronal cytoskeleton by up-regulation of doublecortin and Tuj1 expressions.

Comparison of transparent effects of six different optical clearing methods on rat brain tissues / 中国比较医学杂志

Objective To compare the transparency efficiency of six different optical clearing method on the rat brain tissues. Methods Brain tissue blocks of 14 SD rats were processed with iDISCO, SeeDB, CUBIC, SCALEVIEW-A2,CLARITY-CUBIC, Passive-CLARITY clearing method, respectively. Results The gray value of PBS group was 13.031 ± 0.586,that of iDISCO,SeeDB,CUBIC,SCALEVIEW-A2,CLARITY-CUBIC,passive-CLARITY clearing were 6.447 ± 0.574,11.690 ± 0.909,2.318 ± 0.986,8.118 ± 1.026,8.591 ± 0.384,4.198 ± 0.182, respectively. Except the SeeDB group(P=0.185),the rest groups showed significant differences compared with the PBS group(P< 0.01), and there were significant differences between CUBIC and other groups(P < 0.01). After the clearing treatment, the changes of tissue area ratio in the iDISCO, SeeDB, CUBIC, SCALEVIEW-A2, CLARITY-CUBIC, Passive-CLARITY method were(-30.02 ± 2.39)%,(19.74 ± 4.09)%,(14.7 ± 3.92)%,(10.7 ± 5.55)%,(23.01 ± 4.19)%,(66.51 ± 5.68)%,respectively. Each group showed a significant difference compared with the groups iDISCO and the Passive-CLARITY,P< 0.01. Conclusions Except the SeeDB method,all the clearing methods can achieve a transparent effect, while CUBIC is better than the other groups applied for rat brain tissues. The tissue block volume is shrunken after iDISCO clearing,and expanded after Passive-CLARITY processing.

Effect analysis of hybrid operation for the treatment of intracranial complex ruptured aneurysms / 中国脑血管病杂志

Objective To investigate the safety and short-term effectiveness of the hybrid operation for the treatment of intracranial complex ruptured aneurysms.Methods From December 2014 to March 2017,14 consecutive patients with complex ruptured aneurysm treated with hybrid operation at the Department of Neurosurgery,Nanfang Hospital,Southern Medical University were enrolled retrospectively,including 13 with acute spontaneous aneurismal subarachnoid hemorrhage and 1 with hemorrhage in the recurrent aneurysm embolization.Twelve aneurysms were treated with shape clipping.Digital subtraction angiography (DSA) was used to evaluate the clipping effect of aneurysms.Two patients with aneurysm were treated with extracranial-intracranial (EC-IC) bypass and aneurysm trapping.Endovascular balloon occlusion for trapping aneurysms was performed after DSA evaluation of the patency of bridge vessel.Results Of the 14 patients,11 were treated with emergency hybrid operation after angiography,2 were treated with elective surgery,and 1 with emergency surgery for rescue because of bleeding during embolization.DSA revealed that the aneurysm clips in 3 of 12 patients needed to be adjusted,including 2 parent artery stenosis and 1 with incomplete clipping.After adjustment,the clipping was satisfactory.In intracranial and extracranial bypass surgery,angiography revealed that the blood vessels were patent.Trapping of the aneurysms was performed in the one-stage operation.One patient discharged voluntarily after procedure because of serious vasospasm.Onepatient had perfusion pressure breakthrough after surgery and received hematoma evacuation and decompression.The Glasgow outcome scale (GOS) score was 3 at discharge.Other patients had no new neurological dysfunction after operation.Thirteen patients were followed up for 3-24 months after operation.There were no new neurological dysfunction,including GOS 5 in 8 cases and 4 in 5 cases.Six patients underwent DSA examination,in 4 of them the aneurysm clipping did not show aneurysm recurrence,and the parent arteries were patent.Two patients treated with vascular bypass.There were no recurrence of aneurysms,and the parent arteries and anastomotic vessels were patent.Conclusion After preliminary observation,using hybrid operation for the treatment of complicated intracranial ruptured aneurysms was safe and effective.

Combined intravenous and intrathecal vancomycin in treatment of patients with intracranial infections after craniotomy / 中华危重病急救医学

Objective To explore the efficacy and safety of combined intravenous and intrathecal vancomycin in treatment of patients with intracranial infection after craniotomy. Methods Clinical data of a total of 60 consecutive patients with intracranial infections after cranial operation admitted to Department of Neurosurgery of Nanfang Hospital of Southern Medical University from June 1st 2013 to June 1st 2015 were retrospectively analyzed. The patients were divided into two groups: intravenous injection only (n = 25) and combined intravenous and intrathecal injection (n = 35). In both groups of patients intravenously given vancomycin hydrochloride 500 kU every 6 hours as well as third or fourth generation of cephalosporins or meropenem. In combined intravenous and intrathecal injection group, in addition to 20 mg vancomycin was slowly injected via lumbar puncture after release of cerebrospinal fluid (CSF) once a day. The clinical efficacy and complications of the two groups were compared. Results The recovery rate in the combined intravenous and intrathecal injection group was significantly higher than that in the intravenous injection only group (94.3% vs. 76.0%, χ2 = 4.220, P = 0.040). Lowering of white blood cell count in combined intravenous and intrathecal injection group was significantly earlier than that of the intravenous injection only group (time to become normal: 8 days vs. 13 days). The time of recovery in combined intravenous and intrathecal injection group was significantly shorter than that of the intravenous injection only group (days: 9.9±0.7 vs. 13.4±1.1, t = -2.716, P = 0.009). There were 3 patients who experienced nerve root irritation symptoms in combined intravenous and intrathecal injection group. Symptomatic treatment was given and injection speed was slowed down for these patients. There were no severe complications, such as coma, epilepsy or death in both groups. Conclusion Combined intravenous and intrathecal injection of vancomycin could be a safe and effective therapy for intracranial infection after craniotomy.

Improved primary culture and primary identification of human pituitary adenoma cells / 中华神经医学杂志

Objective To explore an improving primary culture method of human pituitary adenoma cells.Methods Thirty-six pituitary adenoma specimens,collected from excision and conformed by pathology in our hospital from November 2014 to June 2015,were used.Based on the former experience from papers and ourselves,our primary culture methods of several different kinds of human pituitary adenomas were improved.Purification and passage culture of cells were performed in the following experiments.CCK-8 assay was used to detect the multiplication capacity of pituitary adenoma cells;immunofluorescent staining and Western blotting were used to observe the cytokeratin and vimentin protein expressions.Results By using the improve culture methods,tumor cells proliferated in suspension with good status and had the tendency of aggregation in culture medium.The proliferation test showed that the tumor cells enjoyed proliferation ability in vitro;tumor cells could pass over five generations.The growth curve of pituitary adenoma cells showed S pattern.Immunofluorescent staining and Western blotting indicated negative cytokeratin and vimentin protein expressions,showing that the cells were from epithelium.Conclusion Each type of pituitary adenoma cells has characteristics of suspended growth and tendency of gathering by using this improved method.

Analysis of clinical factors influencing mid-long term pituitary hormone levels in patients after severe traumatic brain injury / 中华神经医学杂志

Objective To investigate the characteristics of mid-long term pituitary hormone abnormalities in patients after severe traumatic brain injury (TBI) and its influencing clinical factors.Methods A total of 79 patients with severe TBI,admitted to our hospital from January 2011 to December 2013,were chosen in our research.Their basal levels of pituitary hormones,cortisol,testosterone,estradiol and free thyroxine 4 were detected in 6 months to 2 years after injury;and their clinical data were retrospectively analyzed by Chi-square test and multivariate Logistic regression analysis was employed to explore the incidence and types of pituitary hormone abnormalities,and the possible influencing factors.Results There were 35 patients with pituitary hormone abnormalities in 79 patients,with an incidence of 44.30％;the types of pituitary hormone abnormalities included prolactin in 18 patients (26.87％),thyroid stimulating hormone in 16 patients (23.88％),adrenocorticotropic hormone in 9 (13.43％),growth hormone in 8 (11.94％),and follicle stimulating hormone in 10 (14.93％) and luteinizing hormone in 6 (8.96％).Multivariate Logistic regression analysis showed that factors associated with pituitary hormone abnormalities following severe TBI in the mid-long term were diffused injury (OR=5.252,95％CI:1.176-23.465,P=0.030),brain hernia (OR=4.119,95％CI:1.261-13.452,P=0.019),subarachnoid hemorrhage (OR=3.966,95％CI:1.179-13.337,P=-0.026) and skull fracture (OR=4.222,95％CI:1.087-16.396,P=0.037).Conclusion Pituitary hormones following severe TBI are likely to be abnormal,and diffused injury,brain hernia,subarachnoid hemorrhage and skull fracture are the risk factors.

Development of transparent sheath and its application in neuroendoscopic intra-axial surgery / 中华神经医学杂志

Objective To develop a newly transparent sheath and explore the application value of the sheath in neuroendoscopic intra-axial surgery Methods Sixty-eight patients,admitted to our hospital from August 2010 to February 2013,underwent endoscopic surgery with the help of new sheath.Pre-operated CT or MRI were performed to locate the puncture direction;the transparent sheath was used to provide a trajectory in the brain parenchyma,and offer the clear vision surround the sheath tube and the puncture direction.Results Forty-eight patients adopted lateral ventricle anterior horn approach and 46 (95.83％) achieved lesions in the first puncture.Three patients with septum pellucidum cyst and one with Monro obstruction were successfully received the cystic wall fenestration or recanalization with the sheath directly.After the entry point were determined with CT in 10 intracerebral hematoma,the sheath was inserted into the hemorrhage cavity simply and easily;and a smash-suction tube was inserted to evacuate the hematoma safely.Conclusion The transparent sheath can be inserted into lateral ventricle,hemorrhage cavity or cyst efficiently,and provide perfect surgical vision around the sheath and the puncture direction to estimate the brain parenchyma,hemorrhage cavity or the hemorrhage remains;therefore,this transparent sheath,as a safely neuroendoscopic intra-axial surgical instrument,is deserved to be spread.

Complete spontaneous thrombosis and parent artery occlusion of a giant vertebral artery aneurysm: a case report and literature review / 国际脑血管病杂志

Spontaneous complete thrombosis with parent artery occlusion of giant intracranial aneurysms is rare.We report a patient with a rare giant vertebral artery aneurysm with spontaneous complete thrombosis and parent artery occlusion,and review the related literature,discuss its incidence,clinical presentation,pathogenesis,diagnosis,and treatment.

Side selection of the pterional approach for anterosuperior-pointing anterior communicating artery aneu-rysms / 中国神经精神疾病杂志

Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.

Risk factors for intracranial infection after external ventricular drainage by Logistic regression / 中国神经精神疾病杂志

Objective To investigate the risk factors for intracranial infection after external ventricular drainage and provide basis for preventing and controlling the drainage-associated intracranial infection. Metheds the clinical data from three hundred sixty-seven cases of ventricular hemorrhage patients were retrospectively analyzed, using Logis?tic regression to screen risk factors of intracranial infection after external ventricular drainage. Results There were 29 cases with intracranial infection and infection rate was 8.19%, 8.04% and 7.32% at ventricle drainage tube indwelling 1-week group, 2-week group and 3 week-group, respectively. Glasgow coma score (GCS) [OR= 2. 569 CI (1.792 3.378) %, P< 0.05), urokinase perfusion (OR= 2.897, 95%CI (1.297 5.061), P< 0.05), cerebrospinal fluid sampling (OR= 3.399, 95%CI (2.705 4.175), P< 0.01] and comorbidities [OR= 3.751, 95%CI (2.032 5.371), P< 0.01] were risk factors for ventricle drainage operation. Conclusion Ventricle drainage tube indwelling 3 weeks is safe. Less use of urokinase perfusion and cerebrospinal fluid sampling and active treatment of comorbidities diseases can reduce the intra?cranial infection incidence of external ventricular drainage after Intraventricular hemorrhage .

The establisment of human craniopharyngioma xenografts in chick chorioallantoic membrane / 中国神经精神疾病杂志

Objective To establish the xenotransplanted tumor model of Craniopharyngioma in chick chorioallan?toic membrane (CAM) and detect the angiogenesis ability, microvessel density (MVD) and cell proliferation of the xeno?graft. Method Craniopharyngioma tissues from surgical craniopharyngioma patients were transplanted on the CAM. An?giogenesis assay was performed and the MVD and PCNA were evaluated using immunohistochemistry following the trans?plantation. Results The tumor formation rate of adamantinomatous craniopharyngioma (ACP) and squamous papillary cra?niopharyngioma (SPCP) was 47.14% and 43.33%, respectively. There was no significant difference in tumor formation rate between ACP and SPCP(χ2=0.123,P=0.726). The CAM angiogenesis, MVD and expression of PCNA were higher in ACP than in SPCP. The expression of PCNA was positively correlated with MVD (Pearson r=0.639,P<0.001) and CAM assay score (Spearman r=0.490,P=0.001 ) in CP. Conclusion The model of human craniopharyngioma can be es?tablished in the CAM. The angiogenesis of the xenograft in the CAM can be evaluated and the craniopharyngioma xeno?graft of CAM possesses a new blood circulation and cell proliferation ability.

Membranous layers of the pituitary gland: histological anatomic study and related clinical issues.

OBJECTIVE: The purpose of this study was to examine the membranous layers of the human pituitary gland and their relationships with invasive adenomas. METHODS: Histological and microdissection techniques were used to study 8 fetal and 10 adult human cadavers, respectively. The distribution of the membranous layers was observed, and their thickness was measured. The results were analyzed histologically and anatomically. RESULTS: In all specimens, the pituitary glands were found to be coated by 2 membranous layers, the inner layer being referred to here as the lamina propria and the outer as the pituitary capsule. In all specimens, the 2 membranes were intact with no histological defects. An interstice or cavity between the 2 layers was found on the surface of the adenohypophysis. However, as these 2 layers got closer and closer to each other, they began to adhere on the surface of the neurohypophysis. The thickness of the pituitary capsule was not constant like that of the lamina propria: the inferolateral part of the capsule was thicker than the other parts. The medial wall of the cavernous sinus (CS) was also a bilayered membrane just like the other CS walls: the 2 layers of the medial CS wall were composed of the lateral part of the pituitary capsule and the fibrous layer. Many fibrous trabeculae arising from this fibrous layer divided the CS into several small venous spaces and connected the internal carotid arteries with the medial wall. CONCLUSION: The terminology for the 2 membranous layers, the lamina propria and the pituitary capsule, seemed to be more appropriate and representative of the histological features of the pituitary layers. The lateral part of the capsule and the fibrous layer constituted the medial wall of the CS, which has a superior part that is weaker than the thicker inferior part. It is still difficult to postulate the criteria needed to predict CS invasion. However, the distance between the 2 sides of the internal carotid artery might be another predictive criterion to preoperatively diagnose CS invasion by adenomas. Enhanced knowledge of these membranes may be of assistance in finding a useful criterion.

The clinical value of inflammation-related factors in prediction of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage / 中国医师杂志

Objective To investigate the clinical value of inflammation-related factors [white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein] in predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods The aneurysmal subarachnoid hemorrhage in 217 cases according to whether the occurrence of delayed cerebral ischemia were divided into 2 groups:delayed cerebral ischemia (DCI) group (n =69) and non DCI group (n =148).A retrospective analysis of 217 cases of patients was performed with inflammation-related factors,and its relationship with clinical prognosis of patients with DCI was also analyzed.Results The inflammation-related factors (WBC count,erythrocyte sedimentation rate,and C-reactive protein) in DCI group were significantly higher than those in non DCI group with a statistically significant difference (P ＜ 0.05).The follow-up results showed that there were 33 patients died,12 cases of plant survival,and 12 patients with severe disability in DCI group,which had a statistically significant difference relative to non DCI group (P ＜ 0.05).Spearman analysis showed that there was a significantly negative relationship between inflammation-related factors (white blood cell count,ESR,C-reactive protein) and glasgow prognostic score (GOS) in DCI group(r =-0.877,-0.683,-0.841,P ＜0.05).Conclusions The inflammation-related factors can be used as one of method to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Expression and roles of the epithelial mesenchymal transition markers Vimentin and E-cadherin in craniopharyngioma / 重庆医学

Objective To assess the different protein expressions of epithelial mesenchymal transition (EM T ) markers Vimentin and E‐cadherin in craniopharyngioma ,especially at the tumour invasive front ,and correlate the findings with clinicopathological fea‐tures and patient outcomes .Methods Forty‐two craniopharyngiomas were subjected to the detection of Vimentin and E‐cadherin by immunohistochemistry and double immunofluorescence staining .The relationships between expression of these markers and various clinico pathological indicators and clinical outcomes of these tumors were analyzed .Results There was statistically significant difference in the expression of Vimentin and E‐cadherin between adamantinomatous and papillary variants in whole tumor and at the tumor invasive front .The expression of Vimentin and E‐cadherin in whole tumor sections were associated with tumor recurrence , postoperative weight and hypothalamic disturbances ,and the expression of vimentin and E‐cadherin at the tumor invasive front were colligated with tumor recurrence ,postoperative weight and hypothalamic disturbances .Conclusion Our study exemplifies the po‐tential prognostic implications of Vimentin and E‐cadherin expression in craniopharyngioma .EM T may represent a crucial mecha‐nism in the progression of adamantinomatous craniopharyngioma .

Comprehensive analysis of teaching methods in experimental animal surgery for students with different majors and languages / 中华医学教育探索杂志

Objective To systematically evaluate the study of animal surgery course among medical students with different majors and languages so as to provide evidences for further improve-ment education quality. Methods Ten majors and two kinds of international medical students (in total of 1 105 students;2009 grade)of Southern Medical University were subdivided into five groups ac-cording to the relationship with clinical operative manipulation. Quality of experimental animal surgery education was tested respectively. Then SPSS 13.0 was used to statistically evaluate and analyze the data. Measurement data between two groups were compared by t-test,multi-group analysis of variance between groups was conducted using one-way ANOVA. Ranked data between groups were compared using non-parametric Mann-Whitney U rank sum test. Merits and demerits of the curriculum were dis-cussed by combing statistical results with in-class condition to provide evidences for further improve-ment. Results There was no significant difference between clinical group and clinical professional group in aseptic technique and operation skills (P=0.739),but scores of the two groups were signifi-cant higher than that of associate group (P=0.004). Moreover,scores of international students who passed Chinese TOEFL were significant higher than the others (P=0.001). Differences between groups existed predominantly in the animal surgical practice rather than in basic theory or knot and sterilized methods. Conclusions For students with different majors and languages,different teaching key points should be paid attention to. Basic surgery techniques might be emphasized on for students with associ-ate clinical major and foreign students with poor Chinese language.