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Objective:To investigate the effect of treatment of spinal meningioma with microsurgical procedures.Methods:From January 2003 to March 2022, there were 120 patients who had spinal meningioma and treated in the Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University. Their clinical data were retrospectively analysed. Of the 120 patients, there were 90 females and 30 males, aged from 14 to 85 (average, 54) years old. According to McCormick Classification, 29 cases were in grade I, 59 cases were in grade II, 25 cases were in grade III, and 7 cases were in grade IV. They were all underwent microsurgery. Patients were followed up by outpatient service within 3 months after surgery, then reviewed by outpatient visits and telephone interviews. McCormick's classification method and MRI examination were used to analyse the neurological and imaging changes of the patients before and after the surgery.Results:A total of 113 patients had complete resection and 7 had the resection of most part of the spinal meningioma. No infection, cerebrospinal fluid leakage, other complications and death occurred. Three months after surgery, 95 patients achieved the improvement or even completely disappearance of symptoms (such as numbness, pain, limited movement, etc.). There were 23 patients who had the symptoms unchanged as what before the surgery. Two patients had the symptoms worsened after the surgery. At 3 months after surgery, 95 cases (79.2%) improved, 23 cases (19.2%) were stable, and 2 cases (1.6%) aggravated. According to McCormick classification method, 92 cases were in grade Ⅰ, 15 cases were in gradeⅡ, 10 cases were in grade Ⅲ, and 3 cases were in grade Ⅳ. MRI scans showed that the dural sac were well refluxed, and no recurrence was found.Conclusion:Microsurgery is safe and effective for removal of spinal meningioma, with significant improvement in symptoms with fewer complications.
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<p><b>BACKGROUND</b>Aberrant epithelial repair has been observed in chronic rhinosinusitis (CRS) patients; however, the mechanism of epithelial cell repair regulation is unclear. Epidermal growth factor (EGF) plays an important role in regulating epithelial cell repair in lower airway and may be a critical factor in the remodeling processes of CRS. The objective of our research is to evaluate the differences between CRS and normal subjects and between chronic rhinosinusitis without nasal polys (CRSsNP) and chronic rhinosinusitis with nasal polys (CRSwNP) in the regulation of EGF pathways and the regulating proliferative position of classic Ras/Raf/MEK/ERK pathways.</p><p><b>METHODS</b>We evaluated the proliferation rates of ethmoidal mucosal cells before and after stimulation with EGF, epidermal growth factor receptor (EGFR) kinase inhibitor AG1478, and extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 using MTT assays. We also analyzed the sinonasal epithelial cells collected from control subjects and patients with CRS subtypes CRSsNP and CRSwNP for the expression of ERK1/2, phosphorylated ERK1/2, P21, P15, and P27 using western blotting analyses.</p><p><b>RESULTS</b>The proliferation rates of sinonasal epithelial cells before and after EGF stimulation were lower in CRS patients than in the controls. AG1478 or PD98059 inhibitor treatment of control epithelial cells did not result in a significant difference in proliferation. Although, AG1478 and PD98059 inhibited the proliferation of CRS cells, the degree of proliferation inhibition was markedly different in CRSsNP. AG1478 suppressed the proliferation of CRSwNP epithelial cells, whereas PD98059 had no effect. The ratio of ERK1/2 phosphorylation in CRS cells was lower than that of the control cells. Cyclin-dependent kinase inhibitors were highly expressed in CRS cells compared with that of control cells. ERK1/2 and P27 showed differential expression in CRSsNP and CRSwNP.</p><p><b>CONCLUSIONS</b>Differences existed in EGF pathways in CRS patients and normal subjects as well as in CRSsNP and CRSwNP. Classical Ras/Raf/MEK/ERK pathway may assume absolute superiority in control cells. Ras/Raf/MEK/ERK classical pathway and other pathways might be active at the same time to stimulate epithelial cell proliferation in CRSsNP. The function of Ras/Raf/MEK/ERK classical pathway was weaker in CRSwNP than in CRSsNP and when the classical pathway was blocked in CRSwNP, some other pathway could have completely compensated the proliferation induced by the Ras/Raf/MEK/ERK pathway.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cell Proliferation , Cells, Cultured , Epidermal Growth Factor , Pharmacology , Epithelial Cells , Cell Biology , Nasal Mucosa , Cell Biology , Sinusitis , MetabolismABSTRACT
Objective To evaluate the efficacy of cyclosporine A plus prednisone in the treatment of refractory nephrotic syndrome in children.Methods The 26 refractory nephrotic syndrome children were treated with CsA plus prednisone,3 ～6 mg/(kg d),Po.The duration of treatment was 3 to 27 months (12.69 ± 6.44) mos.The 24 h quantitative urinary proteins,serum cholesterol,urea nitrogen,plasma creatinine,N-acetyl beta amino glycosidase enzymes cystatin C were detected before and after treatment,and the adverse drug reactions were accessed.Results Among 26 cases,12 cases of steroid-resistant NS,6 cases of steroid-dependent NS,and 8 cases of frequent relapse NS were included.16 patients (61.54％) were complete remission,8 patients (30.77％) partial remission,2 cases (7.69％) were non-remission,The total remission rate was 92.31％.The 24 hours urine protein was 3.01 g and 0.63 g before treatment and after treatment,respectively,with a statistically significant difference (P ＜0.01); serum cholesterol was (7.72 ± 3.86) mmol/L and (7.15 ± 3.23) mmol/L; nitrogen urea was (3.93 ± 1.44) mmol/L and (4.04 ± 1.27) mmol/L,creatinine (33.38 ± 13.16) μmol/L and (35.64 ± 3.53) μmol/L serum N-acetyl beta amino glycosidase enzymes was (18.96 ±4.86) u/L and (20.45 ±5.85)u/L before treatment and after treatment,respectively,without a statistically significant difference (P ＞ 0.05).The response to CsA was no significant difference in SRNS,SDNS and FRNS.Children complete remission,follow-up to 6 months,9 months,12 months and 18 months of the recurrence rate was 37.5％,31.25％,18.75％ and 12.5％.Eight cases ended treatment 3 ～ 6 months,all cases were not recurrence.The main adverse effects of CsA included hirsutism,tremble,gastrointestinal reaction and so on,and liver kidney toxicity was not obvious during the therapy course.Conclusions The treatment of CsA in combination with prednisone to children refractory nephrotic syndrome had a significant curative effect,which could obviously minimize the dosage of glucocorticoids and reduce the recurrence after at least one year of maintenance treatment of CsA.
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Vitamin D is an important hormone.Its biological effect is mediated by intracellular vitamin D receptor-specific.In recent years,studies have shown that active vitamin D and its receptor can reduce the degree of the pathological changes of the glomerular and tubular interstitial fibrosis,decrease 24 hour urinary protein,reduce the mortality rate of cardiovascular diseases,and have protective effect on chronic kidney disease.This paper reviews progress of the vitamin D and its receptor in kidney disease.