DNA methylation status of RARβ2 and p16(INK4α) in peripheral blood and tumor tissue in patients with esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the methylation status of retinoic acid receptor β2 (RARβ2) and p16(INK4α) genes in peripheral blood and tumor tissues and the perioperative dynamic changes of free RARβ2 and p16(INK4α) in the peripheral blood, and to investigate the relationship between RARβ2 and p16(INK4α) methylation in peripheral blood and clinicopathological characteristics of esophageal squamous cell carcinoma (ESCC) and their value in evaluating the completeness of surgical resection.</p><p><b>METHODS</b>Real-time methylation specific polymerase chain reaction (real-time MSP) technique was used to detect the methylation status of RARβ2 and p16(INK4α) in tumor tissue, adjacent normal tissue and peripheral blood perioperatively in 76 cases of ESCC. Sixty age-matched healthy volunteers were randomly selected as a control.</p><p><b>RESULTS</b>RARβ2 and p16(INK4α) hypermethylation presented in both tumor tissue [72.4% (55/76) and 86.8% (66/76)] and peripheral blood [63.2% (48/76) and 71.1% (54/76)] in the ESCC patients, showing a good agreement between them. RARβ2 and p16(INK4α) hypermethylation was significantly related with pathological stage, lymph node metastasis, and invasion of nerves and vessels (P < 0.05). The DNA methylation rate in peripheral blood was increasing first and then decreasing in the preoperative, intraoperative and postoperative periods. Moreover, the RARβ2 methylation in peripheral blood was shown to be significantly associated with family history of cancer (P = 0.023).</p><p><b>CONCLUSION</b>RARβ2 and p16(INK4α) methylation in the peripheral blood in ESCC patients may reflect the tumor-bearing status in the body, and may serve as a valuable marker in assessment of the degree of completeness of surgical resection in ESCC patients.</p>

Discussion on the control of treatment amount of acupuncture and moxibustion for peripheral facial paralysis / 中国针灸

To explore the control principles of treatment amount of acupuncture and moxibustion for peripheral facial paralysis. (1) Early stage: in this period, the selected acupoints should be few, therapy should be easy and simple, and the treatment amount should be small and basically constant, which is called constant acupoints and amount. (2) Middle stage: the treatment of this stage should be given with more acupoints and various therapies, the treatment amount should be gradually increasing and reach the peak within a certain time and keep it for an appropriate time, which is called increasing acuponts and amount. (3) Late stage: the treatment at this stage should be given with more acupoints, lesser therapies, and the treatment amount should be gradually decreasding and get the valley point within a certain time, which is called more acupoints and less amount. (4) Sequelae stage: the selection of acupoints at this stage should be focus on areas which there are the obvious symptoms, and solo type of therapy and little treatment amount is required, which is called changing acupoints and little amount. In a word, the best therapeutic effect could be achieved on condition that the control principles of treatment amount for peripheral facial paralysis are followed during the clinical practice.

Expression of DNA methylation of APC in peripheral blood and tumor tissue in patients with esophageal squamous cell carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between methylation status of APC gene in both peripheral blood and tumor tissues and clinical-pathology characteristics in patients with esophageal squamous cell carcinoma(ESCC), and to study the dynamic change of APC methylation in peripheral blood in the perioperative period.</p><p><b>METHODS</b>Real-time MSP technique was used to detect methylation status of APC in tumor tissues, adjacent normal tissues and peripheral blood on the day before the surgery, intraoperative, postoperative day 7 in 76 cases with ESCC. Sixty healthy volunteers matched by age and gender were randomly selected as controls.</p><p><b>RESULTS</b>The methylation rate of APC in tumor tissue and peripheral blood was 44.74%(34/76) and 42.11%(32/76), respectively, which were significantly higher than that in adjacent normal tissue and controls [6.58%(5/76) and 1.67%(1/60), P=0.000]. The methylation rates showed good agreement between tumor tissues and peripheral blood, which could be verified by ROC curve(A Zeta=0.849, P=0.000). APC methylation rate was significantly related to pathological staging, lymph node metastasis, depth of invasion, and invasion of nerve and vessel (P<0.05). The results demonstrated that family history of cancer was independently associated with APC methylation in peripheral blood(P<0.05). DNA methylation rates in peripheral blood showed an initial increase and then decreased in the preoperative period, intraoperative and postoperative.</p><p><b>CONCLUSION</b>The methylation rates of APC among free DNA in peripheral blood in patients with ESCC reflect tumor progression, and decrease with the solid tumour resection.</p>

Treatment of multisegmental intramedullary cervical spinal cord ependymomas / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the possibility of microneurosurgery techniques in the treatment of multisegmental intramedullary cervical spinal cord ependymomas.</p><p><b>METHODS</b>The clinical data of 26 cases of multisegmental intramedullary cervical spinal cord ependymomas patients was reviewed and analyzed.</p><p><b>RESULTS</b>There were 14 cases of cervical spinal cord ependymomas, 12 cases of cervical and thoracic spinal cord ependymomas. 4.5 spinal cord segments were involved in average. Incompletely inferior paraplegia was in 18 cases, incompletely high paraplegia in 8 cases, dyspnea in 6 cases, sphincter dysfunction in 10 cases. MRI detected syringomyelia formation in 24 cases. Vertebral lamina reposition were done in 20 cases. Muscle strength recovered in 21 cases, no change in 4 cases, aggravated in 1 case. All cases had total resection and 1 cases vertebral had instability in MRI.</p><p><b>CONCLUSIONS</b>Total resection of intramedullary cervical spinal cord ependymomas can be achieved by microneurosurgery. Most of the symptoms can be released after microsurgical treatment. After multisegmental laminotomy, the vertebral plate reposition should be done to ensure the stability.</p>

Experimental research of myogenic motor evoked potentials to transcranial magnetic stimulation for spinal cord monitoring / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the validity of intraoperative magnetic MEP (motor evoked potentials) monitoring in a spinal-cord-menaced surgery.</p><p><b>METHODS</b>32 rabbits were employed in weight-drop spinal cord contusion model. After anesthetized with a combination of Ketamine and Droperidol the spinal cords were surgically exposed with the dura intact, and the contusion injuries were delivered except the rabbits in control group. The MEPs were recorded and the relationship between the variation of the MEPs and the residual locomotor capacity after spinal cord injury was analyzed.</p><p><b>RESULTS</b>The 6 rabbits in mild-spinal-cord-injury group experienced transient attenuation of their TMS-MEPs, and the locomotor capacity remained intact (scores of 5) in almost all rabbits (5 of 6) when assessed 24 hours later; In the moderate-spinal-cord-injury group the 8 rabbits lost their TMS-MEP immediately after the weight-drop contusion, but they regained them partly in 1 hour one after another and scored 4 or 5 in the assessment of muscle power next day except for one score of 2; 8 rabbits had their spinal cords impaired severely in the contusion procedure and lost their TMS-MEP too but without recovery, their locomotor capacity outcomes were very poor, 5 of them had no response to transcranial magnetic stimulation next day, and in the other 3 rabbits we only found some polyphase waves with variant latency and lower amplitude which did not resemble common compound muscle action potential (CMAPs) evoked by TMS.</p><p><b>CONCLUSIONS</b>Myogenic TMS-MEPs was very sensitive to the spinal cord injury and should be a valid technique for intraoperative monitoring, and a slight change of them, even if a transient lose, should be unnecessarily related to a severe movement disorder. The warning threshold for a given patient should depend on the malady itself.</p>