Development of a novel score to predict probability of growth without growth hormone after resection of paediatric craniopharyngiomas: relative to tumour growth pattern.

OBJECTIVE: Some patients with paediatric craniopharyngiomas (PCs) showed normal growth despite growth hormone deficiency, which is known as growth without GH (GWGH); however, its mechanism remains unclear. We aimed to develop a novel clinical score to predict the probability of GWGH in PCs. METHODS: A total of 708 PC patients were prospectively enrolled from six hospitals, among which 431 patients were finally included. Data from four of the six hospitals (n = 325) were used to develop the innovative clinical score (ICS), which was further validated using the data from the other two hospitals (n = 106). To establish and validate the ICS, sequential logistic regression was used to analyse the clinical characteristics including tumour growth pattern and tumour size and so on. Furthermore, C-statistic was employed to calibrate the discriminatory ability of the established clinical score, while a calibration plot was adopted for further assessment. RESULTS: The overall incidence of GWGH was 16.9% (73/431). The ICS ranged from 2 to 23, with an optimism-corrected C-statistic of 0.820, Furthermore, the optimism-corrected C-statistic of external validation was 0.835, indicating good discriminatory power and robustness of the clinical score. Additionally, no apparent overestimation or underestimation was observed in the calibration plots, which showed excellent calibration power of the clinical score. CONCLUSIONS: Based on tumour growth patterns and PC patients' clinical characteristics, individualized surgical strategies were promising to achieve long-term effective management of PC patients. The ICS is valuable for the evaluation of probability of developing postoperative GWGH. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT00949156.

[Hypopituitarism mode in patients with craniopharyngioma in relation to tumor growth pattern].

Objective: To investigate the pituitary hormone changes of patients with craniopharyngioma of different growth patterns during perioperative period and follow up time. Methods: Retrospective studies were performed on 212 cases of primary craniopharyngioma patient who received total tumor excision surgery in our hospital from January 2001 to May 2012. The characteristics of pituitary hormone and associated clinical manifestation during preoperative, perioperative and postoperative periods were analyzed according to the QST surgical classification. Results: One hundred and seventy-seven (83.5%) of patients present preoperative hypopituitarism, 36 of them were panhypopituitarism. The hypopituitarism condition was exacerbated during the early stage of post-operation period. The abnormal rates of HPA and HPT during the follow up were 60.1% and 58.3% respectively and hormone replacement treatment was needed for these patients. Craniopharyngioma of different growth patterns showed diversities in the characteristics of hypopituitarism. Conclusion: QST surgical classification was closely associated with the pattern of hypopituitarism, it can help to optimize treatment and prognosis estimation, and could be important criterion for improving the clinical practice of neuroendocrine monitoring, treatment and health education of patients with craniopharyngioma.

[Effect of recombinant human growth hormone therapy on metabolic parameters in patients with craniopharyngioma].

Objective: To investigate the effects of recombinant human growth hormone (rhGH) on metabolic parameters in patients with craniopharyngioma surgeries. Methods: Totallys 30 patients with craniopharyngioma were included in this retrospective study. They were divided into growth hormone (GH) group and control group according to whether they received rhGH therapy or not. The following parameters, including body mass index (BMI), weight, waist circumstance, transaminase, fasting blood glucose, lipid profile and high-sensitivity C-reactive protein (hsCRP) were compared after rhGH therapy for 4-6 months. Results: In GH group, patients were 18-46 (30.0±8.8) years old. The duration after craniopharyngioma surgery was (12.9±5.4) years. Before rhGH therapy, they had got sufficient thyroid and glucocorticoid hormone replacement. After rhGH therapy, the body weight decreased from (92.3±20.1) to (87.6 ±14.6) kg (P=0.190), with a reduction of BMI from (30.1±5.9) to (28.2±3.7) kg/m(2) (P=0.120). The waist circumference decreased from (104.4±9.4) cm to (98.8±10.6) cm (P=0.002). Alanine aminotransferase (ALT) decreased from (52±34) to (28±19) U/L (P=0.029), with a reduction of aspartate transaminase (AST) from (46±21) to (33±18) U/L (P=0.035) and γ-glutamyl transpeptadase (GGT) from (59±42) to (29±15) U/L (P=0.02). hsCRP decreased from (5.3±4.9) to (2.3±2.8) mg/L (P=0.006) and triglyceride (TG) decreased from (1.8±0.7) to (1.5±0.6) mmol/L (P=0.028). Fasting blood glucose, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and free fat acid (FFA) were not significantly changed(all P>0.05). In the control group, the above mentioned parameters did not changed significantly during 4-6 months of observational period(all P>0.05). Conclusion: rhGH therapy improves metabolic parameters in patients after craniopharyngioma surgery by decreasing body weight, waist circumstance and fat deposit in liver, as well as lowering TG and hsCRP levels.

Role of IL-8 gene polymorphisms in glioma development in a Chinese population.

This case-control study aimed to investigate the role of -251 T>A (rs4073) and -781 C>T (rs2227306) polymorphisms in the interleukin-8 (IL-8) gene in the development of glioma in a Chinese population. One hundred and twenty-seven glioma patients and 284 healthy control subjects were recruited to this study between February 2013 and December 2014. The IL-8 -251 T>A (rs4073) and -781 C>T (rs2227306) polymorphisms were genotyped by polymerase chain reaction coupled with restriction fragment length polymorphism. The patients and control subjects were comparable by gender (X2 = 1.24, P = 0.27), tobacco smoking status (X2 = 0.80, P = 0.37), alcohol consumption status (X2 = 0.97, P = 0.32), and family history of cancer (X2 = 1.54, P = 0.22). The age of glioma patients was statistically lower than that of control subjects (t = 2.87, P = 0.002). The chi-square test revealed the lack of any statistically significant differences in the genotype distributions of IL-8 rs4073 (X2 = 0.89, P = 0.64) and rs2227306 (X2 = 2.58, P = 0.28) between the glioma patients and control subjects. Unconditional logistic regression analysis revealed that the IL-8 rs4073 and rs2227306 gene polymorphisms did not contribute to the development of glioma. In conclusion, we determined that there is a lack of evidence suggesting a significant association between the IL-8 rs4073 and rs2227306 gene polymorphisms and the development of glioma in a Chinese population.

ERCC2 rs13181 polymorphism association with glioma susceptibility in a Chinese population.

We conducted a case-control study to investigate the role of ERCC2 rs13181 polymorphism in glioma development. A total of 165 patients who were histopathologically diagnosed to have gliomas and 330 controls were collected at Jiujiang First People's Hospital between July 2012 and June 2014. The ERCC2 rs13181 polymorphism was analyzed using a polymerase chain reaction -restriction fragment length polymorphism assay. By conditional regression analysis, we found that the GG genotype of the ERCC2 rs13181 polymorphism is associated with susceptibility to gliomas when compared to the TT genotype (OR = 2.05, 95%CI = 1.11-3.79). In the recessive model, the GG genotype is associated with an increased risk of gliomas when compared with the TT+TG genotype (OR = 1.87, 95%CI = 1.03-3.37). In conclusion, the ERCC2 rs13181 polymorphism is correlated with an increased risk of gliomas in codominant and recessive models, which suggests that this polymorphism could influence the etiology of gliomas.

Effects of DNA damage and short-term spindle disruption on oocyte meiotic maturation.

DNA damage has recently been shown to inhibit or delay germinal vesicle breakdown (GVBD) in mouse oocytes, but once meiosis resumes, DNA-damaged oocytes are able to extrude the first polar body. In this study, using porcine oocytes, we showed that DNA damage did not affect GVBD, but inhibited the final stages of maturation, as indicated by failure of polar body emission. Unlike mitotic cells in which chromosome mis-segregation causes DNA double-strand breaks, meiotic mouse oocytes did not show increased DNA damage after disruption of chromosome attachment to spindle microtubules. Nocodazole-treated oocytes did not display increased DNA damage signals that were marked by γH2A.X signal strength, but reformed spindles and underwent maturation, although aneuploidy increased after extended nocodazole treatment. By using the mouse for parthenogenetic activation studies, we showed that early cleavage stage embryos derived from parthenogenetic activation of nocodazole-treated oocytes displayed normal activation rate and normal γH2A.X signal strength, indicating that no additional DNA damage occured. Our results suggest that DNA damage inhibits porcine oocyte maturation, while nocodazole-induced dissociation between chromosomes and microtubules does not lead to increased DNA damage either in mouse meiotic oocytes or in porcine oocytes.

[Nerve threshold value detector].

This paper describes the design, the composition and the method of clinical application of the nerve threshold value detector, which offers a new way of surgical diagnosis and treatment for paralytics.

[The study and manufacture of multifunctional brain microsurgery operation dilator].

The dilator consists of fixative clasp-handle, fixative platform, support arm, spatula and handle. The dilator may be fixed on the edge of bone window easily in the brain operation. The functions of the dilator include localization, dilation, expose, washing, lighting and suction. The spatula of the dilator may be prepared according to the different depth and width of the operation field.

Survivin is essential for fertile egg production and female fertility in mice.

Survivin is the smallest member of the inhibitor of apoptosis protein (IAP) family and acts as a bifunctional protein involved in mitosis regulation and apoptosis inhibition. To identify the physiological role of Survivin in female reproduction, we selectively disrupted Survivin expression in oocytes and granulosa cells (GCs), two major cell types in the ovary, by two different Cre-Loxp conditional knockout systems, and found that both led to defective female fertility. Survivin deletion in oocytes did not affect oocyte growth, viability and ovulation, but caused tetraploid egg production and thus female infertility. Further exploration revealed that Survivin was essential for regulating proper meiotic spindle organization, spindle assembly checkpoint activity, timely metaphase-to-anaphase transition and cytokinesis. Mutant mice with Survivin depleted in GCs showed reduced ovulation and subfertility, caused by defective follicular growth, increased follicular atresia and impaired luteinization. These findings suggest that Survivin has an important role in regulating folliculogenesis and oogenesis in the adult mouse ovary.