Ketogenic Diet Modulates Neuroinflammation via Metabolites from Lactobacillus reuteri After Repetitive Mild Traumatic Brain Injury in Adolescent Mice.

Repetitive mild traumatic brain injury (rmTBI) is associated with a range of neural changes which is characterized by axonal injury and neuroinflammation. Ketogenic diet (KD) is regarded as a potential therapy for facilitating recovery after moderate-severe traumatic brain injury (TBI). However, its effect on rmTBI has not been fully studied. In this study, we evaluated the anti-neuroinflammation effects of KD after rmTBI in adolescent mice and explored the potential mechanisms. Experimentally, specific pathogen-free (SPF) adolescent male C57BL/6 mice received a sham surgery or repetitive mild controlled cortical impacts consecutively for 7 days. The uninjured mice received the standard diet, and the mice with rmTBI were fed either the standard diet or KD for 7 days. One week later, all mice were subjected to behavioral tests and experimental analysis. Results suggest that KD significantly increased blood beta-hydroxybutyrate (ß-HB) levels and improved neurological function. KD also reduced white matter damage, microgliosis, and astrogliosis induced by rmTBI. Aryl hydrocarbon receptor (AHR) signaling pathway, which was mediated by indole-3-acetic acid (3-IAA) from Lactobacillus reuteri (L. reuteri) in gut and activated in microglia and astrocytes after rmTBI, was inhibited by KD. The expression level of the toll-like receptor 4 (TLR4)/myeloid differentiation primary response 88 (MyD88) in inflammatory cells, which mediates the NF-κB pathway, was also attenuated by KD. Taken together, our results indicated that KD can promote recovery following rmTBI in adolescent mice. KD may modulate neuroinflammation by altering L. reuteri in gut and its metabolites. The inhibition of indole/AHR pathway and the downregulation of TLR4/MyD88 may play a role in the beneficial effect of KD against neuroinflammation in rmTBI mice.

Plasmonic Silver-Nanoparticle-Catalysed Hydrogen Abstraction from the C(sp3 )-H Bond of the Benzylic Cα atom for Cleavage of Alkyl Aryl Ether Bonds.

Selective activation of the C(sp3 )-H bond is an important process in organic synthesis, where efficiently activating a specific C(sp3 )-H bond without causing side reactions remains one of chemistry's great challenges. Here we report that illuminated plasmonic silver metal nanoparticles (NPs) can abstract hydrogen from the C(sp3 )-H bond of the Cα atom of an alkyl aryl ether ß-O-4 linkage. The intense electromagnetic near-field generated at the illuminated plasmonic NPs promotes chemisorption of the ß-O-4 compound and the transfer of photo-generated hot electrons from the NPs to the adsorbed molecules leads to hydrogen abstraction and direct cleavage of the unreactive ether Cß -O bond under moderate reaction conditions (≈90 °C). The plasmon-driven process has certain exceptional features: enabling hydrogen abstraction from a specific C(sp3 )-H bond, along with precise scission of the targeted C-O bond to form aromatic compounds containing unsaturated, substituted groups in excellent yields.

Surface-Plasmon-Enhanced Transmetalation between Copper and Palladium Nanoparticle Catalyst.

Surface-plasmon-mediated phenylacetylide intermediate transfer from the Cu to the Pd surface affords a novel mechanism for transmetalation, enabling wavelength-tunable cross-coupling and homo-coupling reaction pathway control. C-C bond forming Sonogashira coupling and Glaser coupling reactions in O2 atmosphere are efficiently driven by visible light over heterogeneous Cu and Pd nanoparticles as a mixed catalyst without base or other additives. The reaction pathway can be controlled by switching the excitation wavelength. Shorter wavelengths (400-500 nm) give the Glaser homo-coupling diyne, whereas longer wavelength irradiation (500-940 nm) significantly increases the degree of cross-coupling Sonogashira coupling products. The ratio of the activated intermediates of alkyne to the iodobenzene is wavelength dependent and this regulates transmetalation. This wavelength-tunable reaction pathway is a novel way to optimize the product selectivity in important organic syntheses.

Sirtuin 5-Mediated Lysine Desuccinylation Protects Mitochondrial Metabolism Following Subarachnoid Hemorrhage in Mice.

BACKGROUND AND PURPOSE: Sirt5 (Sirtuin 5) desuccinylates multiple metabolic enzymes and plays an important role in maintaining energy homeostasis. The goal of this study was to determine whether Sirt5-mediated desuccinylation restores the energy metabolism and protects brain against subarachnoid hemorrhage (SAH). METHODS: Male C57BL/6 or Sirt5-/- mice were used. The endovascular perforation SAH model was applied. Protein lysine succinylation in the brain cortex was examined using liquid chromatography-tandem mass spectrometry analysis. The brain metabolism was evaluated by measurement of brain pH as well as ATP and reactive oxygen species level. Neuronal cell death and neurobehavioral deficits were assessed 24 hours after SAH. The expression and desuccinylation activity of Sirt5, lysine succinylation of citrate synthase and ATP synthase subunits were investigated by Western blot, immunohistochemistry, and ELISA in SAH mice and patients. Furthermore, the benefits of resveratrol-mediated Sirt5 activation were investigated. RESULTS: A total of 211 lysine succinylation sites were differentially expressed on 170 proteins in mice brain after SAH. Thirty-nine percent of these succinylated proteins were localized in mitochondria and they are related to energy metabolism. SAH caused a decrease of Sirt5 expression and succinylated citrate synthase as well as the subunits of ATP synthase, subsequently lowered brain pH, reduced ATP and increased reactive oxygen species production, leading to neuronal cell death, and neurological deficits. Knockdown of Sirt5 aggravated SAH-induced effects, mentioned above. Administration of resveratrol resulted in activation of Sirt5. The activation was accompanied both with restoration of the mitochondrial metabolism and alleviation of early brain injury as well as with desuccinylating citrate synthase and ATP synthase. CONCLUSIONS: Protein lysine succinylation is a biochemical hallmark of metabolic crisis after SAH, and disruption of lysine succinylation through activation of Sirt5 might be a promising therapeutic strategy for the treatment of SAH.

Management of Proximal Segment of the Anterior Cerebral Artery Aneurysms.

ABSTRACT: The authors reported 2 cases with proximal anterior cerebral artery (A1) aneurysms, and one was treated with aneurysm clipping, whereas another was treated with coil embolization. The authors suggest both endovascular surgery and aneurysm clipping are good options for A1 aneurysms.

Association between p73 gene G4C14-to-A4T14 polymorphism and risk of lung cancer: A meta-analysis.

OBJECTIVE: To explore the correlation between p73 G4C14-to-A4T14 polymorphism and lung cancer risk. METHODS: The meta analysis was conducted from October 2017 to March 2018, and comprised studies published till March 27, 2018, that addressed the relationship between the p73 G4C14-to-A4T14 polymorphism and risk of lung cancer, and were available on databases including PubMed, Web of Science, Embase, Cochrane Library and China National Knowledge Infrastructure. Pooled odds ratio with corresponding 95% confidence interval and subgroup analysis between ethnicities were carried out to assess the association between the two parameters using four different models. Stata 12 was used for data analysis. RESULTS: For overall population, there was no significant risk of lung cancer for the polymorphism under allele and dominant genetic models. However, reduced risks were found under homozygous (AT/AT vs GC/GC; p=0.02) and recessive (AT/AT vs GC/AT + GC/GC; p=0.02) comparison models. Subgroup analysis between ethnicities demonstrated reduced risk of lung cancer for the polymorphism under the four genetic comparison models for Asian population, but increased risk for the Caucasian group. CONCLUSIONS: AT/AT variant carriers possessed reduced susceptibility of lung cancer in the general population. Ethnic differences for the p73 gene polymorphism played an important role in lung cancer susceptibility.

Multiple organ benign metastasizing leiomyoma: A case report and literature review.

A case of multiple occurrences of benign metastasizing leiomyoma in the lung, left thigh, left ilium and pelvis in a 43-year-old woman who underwent twice myomectomy in 1999 and 2004 and had hysterectomy in 2009 was reported. She was complained of chest distress as well as the pain of left hip and back of thigh. Computed tomography, X-ray and positron emission tomography-computed tomography (PET-CT) demonstrated multiple nodules in lung, masses of left thigh and pelvis. Biopsy of these nodules indicated benign metastasizing leiomyomas according to pathologic and immunohistochemical results. The patient received gonadotropin-releasing hormone agonist injection and regular follow-up. Up to now, all the symptoms have been alleviated.

Moderate hypothermia inhibits microglial activation after traumatic brain injury by modulating autophagy/apoptosis and the MyD88-dependent TLR4 signaling pathway.

BACKGROUND: Complex mechanisms participate in microglial activation after a traumatic brain injury (TBI). TBI can induce autophagy and apoptosis in neurons and glial cells, and moderate hypothermia plays a protective role in the acute phase of TBI. In the present study, we evaluated the effect of TBI and moderate hypothermia on microglial activation and investigated the possible roles of autophagy/apoptosis and toll-like receptor 4 (TLR4). METHODS: The TBI model was induced with a fluid percussion TBI device. Moderate hypothermia was achieved under general anesthesia by partial immersion in a water bath for 4 h. All rats were killed 24 h after the TBI. RESULTS: Our results showed downregulation of the microglial activation and autophagy, but upregulation of microglial apoptosis, upon post-TBI hypothermia treatment. The expression of TLR4 and downstream myeloid differentiation primary response 88 (MyD88) was attenuated. Moderate hypothermia reduced neural cell death post-TBI. CONCLUSIONS: Moderate hypothermia can reduce the number of activated microglia by inhibiting autophagy and promoting apoptosis, probably through a negative modulation between autophagy and apoptosis. Moderate hypothermia may attenuate the pro-inflammatory function of microglia by inhibiting the MyD88-dependent TLR4 signaling pathway.

Ethyl Pyruvate Attenuates Early Brain Injury Following Subarachnoid Hemorrhage in the Endovascular Perforation Rabbit Model Possibly Via Anti-inflammation and Inhibition of JNK Signaling Pathway.

Early brain injury (EBI) following subarachnoid hemorrhage (SAH) is the main cause to poor outcomes of SAH patients, and early inflammation plays an important role in the acute pathophysiological events. It has been demonstrated that ethyl pyruvate (EP) has anti-inflammatory and neuroprotective effects in various critical diseases, however, the role of EP on EBI following SAH remains to be elucidated. Our study aimed to evaluate the effects of EP on EBI following SAH in the endovascular perforation rabbit model. All rabbits were randomly divided into three groups: sham, SAH + Vehicle (equal volume) and SAH + EP (30 mg/kg/day). MRI was performed to estimate the reliability of the EBI at 24 and 72 h after SAH. Neurological scores were recorded to evaluate the neurological deficit, ELISA kit was used to measure the level of tumor necrosis factor-α (TNF-α), and western blot was used to detect the expression of TNF-α, tJNK, pJNK, bax and bcl-2 at 24 and 72 h after SAH. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and Fluoro-jade B (FJB) staining were used to detect neuronal apoptosis and neurodegeneration respectively, meanwhile hematoxylin and eosin (H&E) staining was used to assess the degree of vasospasm. Our results demonstrated that EP alleviated brain tissue injury (characterized by diffusion weighted imaging and T2 sequence in MRI scan), and significantly improved neurological scores at 72 h after SAH. EP decreased the level of TNF-α and downregulated pJNK/tJNK and bax/bcl-2 in cerebral cortex and hippocampus effectively both at 24 and 72 h after SAH. Furthermore, EP reduced TUNEL and FJB positive cells significantly. In conclusion, the present study supported that EP afforded neuroprotective effects possibly via reducing TNF-α expression and inhibition of the JNK signaling pathway. Therefore, EP may be a potent therapeutic agent to attenuate EBI following SAH.

Effect of Reflection of Temporalis Muscle During Cranioplasty With Titanium Mesh After Standard Trauma Craniectomy.

Cranioplasty (CP) with titanium mesh after standard trauma craniectomy (STC) has been proven to be a favorable technology. According to reflection of temporalis muscle or not, the CP was divided into 2 operation ways. Effect of reflection of temporalis muscle has not been systematically researched. Thirty-nine patients were enrolled to assess the effect of reflection of temporalis muscle during CP after STC. Cranial index of symmetry was adopted to evaluate the aesthetic results, transcranial Doppler was used to assess change of cerebral blood flow (CBF), functional independence measurements were performed to monitor the improvement of neuronal function, and complications associated with CP were also recorded. The results displayed that reflection of temporalis muscle or not had no effect on the anesthetic results. Both operation ways could improve CBF and neuronal function. Cranioplasty with reflection of temporalis muscle could improve CBF and neuronal function more significantly. Furthermore, reflection of temporalis muscle would not increase complications associated with CP. Reflection of temporalis muscle during CP with titanium mesh after STC proves to be an effective and safe operation way.

Glial fibrillary acidic protein as a biomarker in severe traumatic brain injury patients: a prospective cohort study.

INTRODUCTION: Glial fibrillary acidic protein (GFAP) may serve as a serum marker of traumatic brain injury (TBI) that can be used to monitor biochemical changes in patients and gauge the response to treatment. However, the temporal profile of serum GFAP in the acute period of brain injury and the associated utility for outcome prediction has not been elucidated. METHODS: We conducted a prospective longitudinal cohort study of consecutive severe TBI patients in a local tertiary neurotrauma center in Shanghai, China, between March 2011 and September 2014. All patients were monitored and managed with a standardized protocol with inclusion of hypothermia and other intensive care treatments. Serum specimens were collected on admission and then daily for the first 5 days. GFAP levels were measured using enzyme-linked immunosorbent assay techniques. Patient outcome was assessed at 6 months post injury with the Glasgow Outcome Scale and further grouped into death versus survival and unfavorable versus favorable. RESULTS: A total of 67 patients were enrolled in the study. The mean time from injury to admission was 2.6 hours, and the median admission Glasgow Coma Scale score was 6. Compared with healthy subjects, patients with severe TBI had increased GFAP levels on admission and over the subsequent 5 days post injury. Serum GFAP levels showed a gradual reduction from admission to day 3, and then rebounded on day 4 when hypothermia was discontinued with slow rewarming. GFAP levels were significantly higher in patients who died or had an unfavorable outcome across all time points than in those who were alive or had a favorable outcome. Results of receiver operating characteristic curve analysis indicated that serum GFAP at each time point could predict neurological outcome at 6 months. The areas under the curve for GFAP on admission were 0.761 for death and 0.823 for unfavorable outcome, which were higher than those for clinical variables such as age, Glasgow Coma Scale score, and pupil reactions. CONCLUSIONS: Serum GFAP levels on admission and during the first 5 days of injury were increased in patients with severe TBI and were predictive of neurological outcome at 6 months.

Residual hemifacial spasm after microvascular decompression: prognostic factors with emphasis on preoperative psychological state.

Residual hemifacial spasm (HFS) after microvascular decompression (MVD) is common, and the factors associated with residual HFS are still controversial. In the present study, we analyzed the outcome of 212 patients with hemifacial spasm after a single microvascular decompression and evaluated the prognostic factors involved in residual hemifacial spasm. Based on our study, possible prognostic factors included indentation of the root exit zone (REZ), preoperative illness duration, and preoperative psychological state. We suggest that MVD should be performed as early as possible for it may decrease the rate of residual HFS. Preoperative assessment of psychological state in HFS patients is a timely intervention that should be implemented to minimize the residual HFS.

Spontaneous resolution of nontraumatic chronic subdural hematoma associated with anti-aggregation therapy.

Spontaneous resolution of chronic subdural hematoma (CSDH) is rare, especially for the nontraumatic cases. Here, we present 1 case of a 70-year-old female patient with spontaneous resolution of CSDH. She was chronically anticoagulated after percutaneous coronary intervention. Moreover, she denied previous mild head trauma and bleeding episodes. For personal reasons, she declined surgery. Treatment just included mannitol, which was used to alleviate the symptoms. Intermittent computed tomography showed gradually resolution of CSDH. Spontaneous resolution of nontraumatic CSDH is rare, with different mechanisms and computed tomography characteristics compared with that of traumatic CSDH. Dimerized plasmin fragment D in venous blood may be more sensitive in the judgment of types of CSDH.

Intraparenchymal hematoma caused by rupture of the traumatic pseudoaneurysm of middle meningeal artery.

Rupture of traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually causes extradural hematoma. In rare cases, it may be a possible cause of intraparenchymal hematoma. We present 2 cases of intraparenchymal hematoma caused by rupture of traumatic pseudoaneurysms of MMA. Both patients had definite medical history of head trauma. Imaging examinations indicated temporal hematoma or frontal hematoma caused by rupture of pseudoaneurysm of MMA. After surgical management, both the patients had a favorable prognosis. The formation of the traumatic pseudoaneurysms, imaging findings, and the management were discussed, and we conclude that in the management of traumatic intraparenchymal hematoma, possibility of traumatic pseudoaneurysms must be considered. Surgery may be the prior choice for the treatment of traumatic pseudoaneurysms.

Intracerebral arachnoid cyst treated with ommaya reservoir implantation in a patient younger than two years.

Intracranial arachnoid cysts are rare cystic-appearing intracranial masses. In rarer cases, the arachnoid cysts originate from brain parenchyma, which is defined as intracerebral arachnoid cyst. Here, we present a patient younger than 2 years with massive intracranial arachnoid cysts (one of which was intracerebral arachnoid cyst), whose clinical symptoms included megacephaly and limb weakness. Ommaya reservoir implantation and repeated aspiration of the intracerebral cyst fluid were performed. The symptoms gradually improved, and the intracerebral arachnoid cyst gradually disappeared during 13 months of follow-up. The case highlights the potential of Ommaya reservoir implantation in the treatment of intracerebral arachnoid cyst, especially for young patients. We also reviewed the published literatures concerning the rare condition, including the mechanisms for its pathogenesis and enlargement.

Nonaneurysmal subarachnoid hemorrhage and cerebral infarction associated with moyamoya disease.

Moyamoya disease patients with subarachnoid hemorrhage and cerebral infarction are rare, especially when the subarachnoid hemorrhage is nonaneurysmal. Here, we present one 48-year-old male patient with moyamoya disease identified with digital subtraction angiography. His initial symptoms are associated with increased intracranial pressure. Subsequent computed tomography demonstrated subarachnoid hemorrhage and cerebral infarction. Digital subtraction angiography showed no obvious aneurysms. We assume that subarachnoid hemorrhage is associated with the rupture of the moyamoya vessels and transdural anastomotic vessels. The cerebral infarction can be also explained by hemodynamic mechanisms. We should pay more attention to the recurrent hemorrhagic stroke.

Citrate synthase lysine K215 hypoacetylation contributes to microglial citrate accumulation and pro-inflammatory functions after traumatic brain injury.

AIMS: This study aimed to investigate the relationship between microglial metabolism and neuroinflammation by examining the impact of citrate accumulation in microglia and its potential regulation through Cs K215 hypoacetylation. METHODS: Experimental approaches included assessing Cs enzyme activity through Cs K215Q mutation and investigating the inhibitory effects of hesperidin, a natural flavanone glycoside, on citrate synthase. Microglial phagocytosis and expression of pro-inflammatory cytokines were also examined in relation to Cs K215Q mutation and hesperidin treatment. RESULTS: Cs K215Q mutation and hesperidin exhibited significant inhibitory effects on Cs enzyme activity, microglial citrate accumulation, phagocytosis, and pro-inflammatory cytokine expression. Interestingly, Sirt3 knockdown aggravated microglial pro-inflammatory functions during neuroinflammation, despite its proven role in Cs deacetylation. CONCLUSION: Cs K215Q mutation and hesperidin effectively inhibited microglial pro-inflammatory functions without reversing the metabolic reprogramming. These findings suggest that targeting Cs K215 hypoacetylation and utilizing hesperidin may hold promise for modulating neuroinflammation in microglia.

Postoperative complications of central neurocytoma.

Six patients with central neurocytoma were retrospectively examined, including diagnosis and treatment process as well as postoperative complications. Clinical follow-ups were performed through telephone calls or outpatient service. Of the 6 patients, a total of 5 patients had 1 or more postoperative complications. The postoperative complications included hydrocephalus, basal ganglia edema, epidural hematoma of the operated region and the remote region, and intracranial infection; 5 patients underwent the cortical fistulization approach and 1 underwent the longitudinal fissure-corpus callosum approach. The neoplasms of 3 patients were totally resected and those of the other 3 patients were subtotally resected. Preoperative accurate diagnosis of central neurocytoma is of great importance for the drawing up of the operation strategy; in addition to magnetic resonance imaging and computed tomography, digital subtraction angiography and magnetic resonance spectroscopy could be helpful for the preoperative diagnosis of central neurocytoma. Subtotal resection of the lesion and the longitudinal fissure-corpus callosum approach may be useful for the reduction of postoperative complications.

Dynamic task allocation in multi-hop multimedia wireless sensor networks with low mobility.

This paper presents a task allocation-oriented framework to enable efficient in-network processing and cost-effective multi-hop resource sharing for dynamic multi-hop multimedia wireless sensor networks with low node mobility, e.g., pedestrian speeds. The proposed system incorporates a fast task reallocation algorithm to quickly recover from possible network service disruptions, such as node or link failures. An evolutional self-learning mechanism based on a genetic algorithm continuously adapts the system parameters in order to meet the desired application delay requirements, while also achieving a sufficiently long network lifetime. Since the algorithm runtime incurs considerable time delay while updating task assignments, we introduce an adaptive window size to limit the delay periods and ensure an up-to-date solution based on node mobility patterns and device processing capabilities. To the best of our knowledge, this is the first study that yields multi-objective task allocation in a mobile multi-hop wireless environment under dynamic conditions. Simulations are performed in various settings, and the results show considerable performance improvement in extending network lifetime compared to heuristic mechanisms. Furthermore, the proposed framework provides noticeable reduction in the frequency of missing application deadlines.

A novel epithelial-mesenchymal transition-related lncRNA signature predicts prognosis and immune status in endometrioid endometrial cancer.

The pathogenesis and progression of endometrial cancer (EC) are associated with epithelial-mesenchymal transition (EMT) and long noncoding RNAs (lncRNAs). In the present study, we aimed to identify an EMT-related lncRNA signature and evaluate its prognostic value in EC. We obtained the expression profile of lncRNAs and clinical information of patients with endometrioid EC from The Cancer Genome Atlas database (N = 401). We identified a signature of 5 EMT-related lncRNAs and calculated the risk score of each patient. Next, we validated the independence of the prognostic value of the EMT-related lncRNA signature. Furthermore, we performed Gene Set Enrichment Analysis to identify potential molecular function and Kyoto Encyclopedia of Genes and Genomes pathways related to the EMT-related lncRNA signature. Tumor microenvironment analysis and immune checkpoint blockade (ICB) response prediction were also assessed. Survival analysis revealed that the high-risk group, based on the EMT-related lncRNA signature, had a poorer prognosis than the low-risk group in the training, testing, and entire sets. The predictive value of the EMT-related lncRNA signature was independent of age, The International Federation of Gynecology and Obstetrics stage, tumor grade, and body mass index. Time-dependent receiver operating characteristic curves also demonstrate the prognostic accuracy of this risk model. Gene Set Enrichment Analysis showed that cytokine-cytokine receptor interaction, glycolysis/gluconeogenesis, and IL-17 signaling pathway were significantly enriched. Furthermore, tumor microenvironment analysis indicated a significant negative correlation between the immune score and EMT-related lncRNA signature risks core, while the low-risk group was more likely to respond to ICB therapy than the high-risk group. A reliable EMT-related lncRNA signature of endometrioid EC was identified that could be utilized as an independent prognostic biomarker to predict patient survival outcomes and provide references for the option of ICB therapy.