Clinical features of 7 cases of pure spinal epidural cavernous hemangioma / 中国医师进修杂志

Objective:To study the clinical features of pure spinal epidural cavernous hemangioma in order to improve the diagnosis and treatment ability.Methods:The clinical data of 7 patients with pure spinal epidural cavernous hemangioma from January 2013 to November 2022 in Xiangyang Central Hospital were analyzed retrospectively.Results:Among the 7 patients, 2 males and 5 females, and the average age was 49.4 years old. Location of the lesion: cervical spine 1 case, thoracic spine 5 cases, and lumbar spine 1 case. One patient had pure radicular symptoms, 4 patients had pure spinal cord symptoms, and the other 2 patients had both myelopathy symptoms and radicular symptoms. T 1 and T 2 weighted images showed equal or slightly longer signals, and the enhanced scans showed uniform enhancement. Before operation, 1 case was misdiagnosed as meningioma, and the patient′s lesion was not carefully identified during operation, so the lesion was mistaken for oozing hemorrhage caused by operation; 2 cases were misdiagnosed as schwannoma. All patients underwent preoperative localization and microsurgical resection of epidural lesions through the posterior median approach. The lesions were completely removed and no significant complications were observed during hospitalization. Before operation, the neurological function Frankel grade C was in 1 case, grade D in 3 cases, grade E in 3 cases; the patients were followed up for 1 to 117 months, at the last follow-up, neurological function Frankel grade D was in 3 cases, grade E in 4 cases, no recurrence was found. Conclusions:The pure spinal epidural cavernous hemangioma is very likely to be misdiagnosed as the schwannoma and meningioma in imaging, the preoperative imaging should be carefully observed. It is recommended to inject methylene blue into the spinous process of the lesion segment before operation and locate the photos to help with precise intraoperative positioning. Once the disease is considered, special attention should be paid when opening the vertebral lamina to remove the epidural fat during the operation. The lesion is prone to bleeding, and is mistakenly believed to be absorbed by the aspirator or bitten together with the epidural fat. Total resection is an effective treatment for this disease, and it should be treated as soon as possible to avoid the influence of acute hemorrhage on the prognosis.

Diagnosis and treatment of primary intraspinal paraganglioma / 中国医师进修杂志

Objective:To provide a basis for its diagnosis and treatment for clinicians by analyzing the clinical manifestations, imaging features and surgical efficacy of primary intraspinal paraganglioma.Methods:The clinical data of 6 patients with intraspinal paraganglioma from April 2014 to January 2021 in Xiangyang Central Hospital were retrospectively analyzed, and all patients were treated with microsurgery via a posterior median approach.Results:All 6 patients achieved total tumor resection, and the postoperative pathological diagnosis was paraganglioma. Among them, 1 patient′s tumor located inside and outside the cervical spinal canal without destruction of the vertebral body; 1 patient′s tumor located lumbosacral canal with destruction of the vertebral body; the others 4 patients′ tumor located within the lumbar spinal canal. The patients were followed up for 12 to 120 months after surgery, with a median follow-up time of 61.5 months. MRI examination was performed at the last follow-up, and no recurrence was observed. The patients underwent MRI examination at the last follow-up, and none of the patients recurred.Conclusions:The intraspinal paraganglioma is a rare tumor, and nonfunctional benign tumors are predominant. Its clinical and imaging manifestations lack specificity and are often difficult to diagnose before surgery. Surgical resection, especially complete resection, has a better prognosis, and the effectiveness of adjuvant therapy is uncertain.

Regulation of Axon Initial Segment Diameter by COUP-TFI Fine-tunes Action Potential Generation / 神经科学通报·英文版

The axon initial segment (AIS) is a specialized structure that controls neuronal excitability via action potential (AP) generation. Currently, AIS plasticity with regard to changes in length and location in response to neural activity has been extensively investigated, but how AIS diameter is regulated remains elusive. Here we report that COUP-TFI (chicken ovalbumin upstream promotor-transcription factor 1) is an essential regulator of AIS diameter in both developing and adult mouse neocortex. Either embryonic or adult ablation of COUP-TFI results in reduced AIS diameter and impaired AP generation. Although COUP-TFI ablations in sparse single neurons and in populations of neurons have similar impacts on AIS diameter and AP generation, they strengthen and weaken, respectively, the receiving spontaneous network in mutant neurons. In contrast, overexpression of COUP-TFI in sparse single neurons increases the AIS diameter and facilitates AP generation, but decreases the receiving spontaneous network. Our findings demonstrate that COUP-TFI is indispensable for both the expansion and maintenance of AIS diameter and that AIS diameter fine-tunes action potential generation and synaptic inputs in mammalian cortical neurons.

Effects of PSIP1 gene silencing on migration and invasion of oral squamous cell carcinoma cells / 国际肿瘤学杂志

Objective:To investigate the expression of PC4 and SFRS1 interacting protein 1 (PSIP1) in oral squamous cell carcinoma cells and the effects of PSIP1 silencing on the migration and invasion of oral squamous cell carcinoma cells, and to preliminarily explore its mechanism.Methods:The PSIP1 gene of oral squamous cell carcinoma cell line HN30 was silenced by RNA interference technique. HN30 cells were divided into si-NC group (transfected with siRNA-NC) and si-PSIP1 group (transfected with siRNA-PSIP1). Quantitative real-time PCR was used to detect the expression of PSIP1 mRNA. Scratch test and Transwell invasion test were used to detect the migration and invasion abilities of HN30 cells, and Western blotting was used to detect the expression levels of epithelial-mesenchymal transformation (EMT) related proteins in HN30 cells of the two groups.Results:The relative expression levels of PSIP1 of HN30 cells in the si-NC group and si-PSIP1 group were 1.00±0.00 and 0.21±0.06 respectively, with a statistically significant difference ( t=22.30, P=0.002). The scratch healing rates of the si-NC group and si-PSIP1 were (48.21±4.66)% and (42.05±11.74)% at 12 h respectively, with no statistically significant difference ( t=1.46, P=0.173), and the scratch healing rates of the two groups were (86.61±6.06)% and (67.76±3.62)% at 24 h respectively, with a statistically significant difference ( t=8.01, P<0.001). The invasion numbers of HN30 cells in the si-NC group and si-PSIP1 group were 91.00±7.05 and 23.34±4.98, and there was a statistically significantly difference ( t=19.20, P<0.001). Compared with the si-NC group, the migration and invasion abilities of HN30 cells in the si-PSIP1 group decreased significantly (all P<0.001). The expression levels of E-cadherin of the si-NC group and si-PSIP1 group were 1.06±0.02 and 1.43±0.13 respectively, with a statistically significant difference ( t=-4.94, P=0.036), and the expression levels of N-cadherin were 1.00±0.04 and 0.57±0.14 respectively, with a statistically significant difference ( t=5.03, P=0.007). Compared with the si-NC group, the expression level of E-cadherin in the si-PSIP1 group increased, while the expression level of N-cadherin decreased. Conclusion:Silencing the expression of PSIP1 can significantly inhibit the migration and invasion of HN30 cells, and the mechanism may be related to the effect of PSIP1 on the EMT pathway of oral squamous cell carcinoma.

Meta-analysis of the prognosis of medullary thyroid carcinoma patients with biochemical recurrence and the determination of optimal cut-off value of calcitonin for predicting postoperative structural recurrence / 肿瘤研究与临床

Objective:To summarize the prognosis of medullary thyroid carcinoma (MTC) patients with biochemical recurrence (the increase of postoperative calcitonin and no abnormal imaging) and to investigate the optimal cut-off value of calcitonin for postoperative structural recurrence (with imaging abnormality).Methods:Literature retrieval was conducted for PubMed, CNKI, EMbase, Web of Science, Cochrane and other databases, and literatures related to the increase of calcitonin after MTC surgery were included. Review Manager 5.4 software was used for Meta-analysis of the recurrence and death. SPSS 23.0 software was used and receiving operating characteristic (ROC) curve was used to analyze the rising folds of postoperative calcitonin level in comparison with the maximum value of experiment detection, and to predict the outcome of biochemical recurrence transforming to structural recurrence, and then the optimal cut-off value could be worked out.Results:A total of 7 studies including 1 005 MTC patients (276 cases of biochemical recurrence and 542 cases of biochemical cure). Meta-analysis showed that structural recurrence rate in postoperative biochemical recurrence group [40.6% (112/276) vs. 2.2% (12/542); OR = 27.99, 95% CI 14.57-53.78, P < 0.001] and mortality [10.0% (19/190) vs. 0.96% (3/312); OR = 7.26, 95% CI 2.42-21.84, P < 0.001] were higher than those in the biochemical cure group (normal postoperative calcitonin level and no disease state). The data of 89 MTC patients with biochemical recurrence were collected in another 4 studies. ROC curve analysis showed that area under the curve of the rising folds of postoperative calcitonin level in predicting structural recurrence was 0.825; according to the cut-off value at all sections, the optimal cut-off value of the increased postoperative calcitonin was 50 times, the sensitivity was 66. 7%, the specificity was 88.6%. Conclusions:MTC patients with postoperative biochemical recurrence have higher structural recurrence rate and mortality compared with patients with normal postoperative calcitonin. The postoperative elevation of calcitonin more than 50 times the maximum value of the laboratory detection can be taken as the critical diagnostic value, when more than 50 times is prone to structural recurrence.

Regulatory effect of CCN3 on proliferation of mouse embryonic fibroblasts and its mechanism / 南方医科大学学报

OBJECTIVE@#To investigate the role of NOV/CCN3 in regulating the proliferation of mesenchymal stem cells (MSCs) and its regulatory mechanism and assess the value of CCN3 as a proliferative factor in bone tissue engineering.@*METHODS@#Mouse embryonic fibroblasts (MEFs) were used as the MSC model, in which CCN3 expression was up-regulated and downregulated by transfection with the recombinant adenovirus vectors Ad-CCN3 and Ad-siCCN3, respectively. Flow cytometry was used to analyze the changes in cell cycle and apoptosis of the transfected cells. Western blotting was used to detect the expression levels of the proliferation indicators (PCNA, cyclin E, and cyclin B1) and the apoptosis indicators (Bax and Bcl-2) to assess the effect of modulation of CCN3 expression on MEF proliferation and apoptosis. CCN3 protein secretion by the cells was detected using ELISA. RT-qPCR and Western blotting were employed to analyze the changes in the expressions of Notch1, ligand DLL1, the downstream key proteins or genes (Hey1, P300, H3K9) and MAPK pathway-related proteins ERK1+2 and p-ERK1+2.@*RESULTS@#Flow cytometry showed that compared with the control cells, MEFs transfected with Ad-CCN3 exhibited significantly increased cell proliferation index (@*CONCLUSIONS@#CCN3 over-expression promotes the proliferation and inhibits apoptosis of MEFs possibly by inhibiting the classical Notch signaling pathway and activating the MAPK pathway

Pneumocephalus caused by congenital mastoid dysplasia:A case report and literature review / 吉林大学学报(医学版)

Objective:To investigate the diagnosis and treatment of one patient with pneumocephalus caused by congenital mastoid dysplasia,and to clarify the clinical features,diagnostic methods and treatment strategies of intracranial accumulation of pneumocephalus.Methods:The patient with ineffective right upper limb activity accompanied stupid speech for 12 h was admitted to hospital.After admission,the head CT and MRI examination were performed again,and the patient was diagnosed as pneumocephalus.The paitent scheduled for stoma repair,neurotrophic treatment,infection prevention and other symptomatic treatments were performed after operation;the patient was instructed avoid cough forcefully,blowing nose,defecating and sneezing to increase the intracranial pressure.Results:Due to congenital dysplasia of mastoid wall,local thinning bones and intense swimming choking cough of the patient destroyed the intracranial pressure balance to form pneumocephalus,the patient scheduled for stoma and damaged dura repair;when discharged from hospital,the patient's right upper limb muscle strength and language function returned to normal;the head CT results showed that pneumocephalus disappeared completely.Conclusion;Pneumocephalus is common in clinic,and its reason is diversiform;it should be combined with the patient's history and imaging findings to explore the causes,the most reasonable treatment measures should be performed in order to relieve the patient's symptoms of increased intracranial pressure,and promote the recovery of neural function.

Serum levels of β2-microglobulin and lactic dehydrogenase in patients with multiple myeloma and their clinical significance / 中国医师进修杂志

Objective To evaluate the clinical significance of the serum β2-microglobulin (β 2-MG) and lactic dehydrogenase (LDH) in multiple myeloma (MM) patients.Methods The serum levels of β2-MG and LDH in 63 MM patients (MM group) and 20 healthy person (control group) were measured by biochemical assay.Results The serum levels of β 2-MG and LDH in MM group were higher than those in control group[(3.81 ± 0.62) mg/L vs.(2.43 ± 0.91) mg/L and (296.4 ± 34.7) U/L vs.(145.5 ±17.8) U/L,P ＜ 0.05].Furthermore,the serum levels of β 2-MG and LDH increased gradually with MM clinical staging (P ＜0.05).After VAD chemotherapy,the serum levels of β 2-MG and LDH in clinical response MM patients(54 cases) were significantly decreased [(2.51 ± 1.36) mg/L vs.(3.57 ± 0.82) mg/L and (159.1 ± 35.2) U/L vs.(285.3 ± 87.6) U/L,P ＜ 0.05],while those in no response patients (9 cases)were unchanged (P＞ 0.05).Conclusion The serum levels of β 2-MG and LDH can be taken as a clinical index to classify the clinical phase,prognosis and effectiveness of chemotherapy in MM patients.