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Glioma is the most common lethal tumor of the human brain. The median survival of patients with primary World Health Organization grade IV glioma is only 14.6 months. The World Health Organization classification of tumors of the central nervous system categorized gliomas into lower-grade gliomas and glioblastomas. Unlike primary glioblastoma that usually develop de novo in the elderly, secondary glioblastoma enriched with an isocitrate dehydrogenase mutant typically progresses from lower-grade glioma within 5-10 years from the time of diagnosis. Based on various evolutional trajectories brought on by clonal and subclonal alterations, the evolution patterns of glioma vary according to different theories. Some important features distinguish the normal brain from other tissues, e.g., the composition of the microenvironment around the tumor cells, the presence of the blood-brain barrier, and others. The underlying mechanism of glioma recurrence and evolution patterns of glioma are different from those of other types of cancer. Several studies correlated tumor recurrence with tumor heterogeneity and the immune microenvironment. However, the detailed reasons for the progression and recurrence of glioma remain controversial. In this review, we introduce the different mechanisms involved in glioma progression, including tumor heterogeneity, the tumor microenvironment and drug resistance, and their pre-clinical implements in clinical trials. This review aimed to provide new insights into further clinical strategies for the treatment of patients with recurrent and secondary glioma.
Subject(s)
Aged , Humans , Brain Neoplasms/genetics , Drug Resistance , Glioblastoma , Glioma/genetics , Mutation , Neoplasm Recurrence, Local/drug therapy , Tumor MicroenvironmentABSTRACT
Objective To study the effects of fat grafting on partial jaw deformity.Methods A total of 19 cases of partial jaw deformity.were used fat grafting in past 2.5 years,from January 2012 to June 2015.All analyses were to find suitable fat grafting method for partial jaw deformiw.Fat graft was obtained by low pressure suction and low speed centrifugation.Results A lot of 15 patients in this group had been followed up for 6 months to 2 years.9 patients was satisfied with once fat grafting and 6 with twice.Conclusions Fat grafting provides a useful alternative to partial jaw deformity with normal occlusion.But it also remains to be seen what the forward effects of fat grafting on partial jaw deformity are.
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Objective To investigate the relationship between isolated nocturnal hypertension and left ventricular hypertrophy. Methods In the inhabitants of 14 villages in Jingning County, Zhejiang Province, we performed 24-hour ambulatory blood pressure monitoring with SpaceLab monitors and measured 12-lead resting electrocardiogram using an electronic recording system of GE company, Left ventrieular hypertrophy was diagnosed with the criteria of Sokolow-Lyon voltage amplitude and Cornell product. Isolated nocturnal hypertension was defined as a nighttime ( from 22:00 to 4:00) blood pressure of ≥ 120/70 mm Hg( 1 mm Hg = 0. 133 kPa). Isolated daytime ( from 8:00 to 18:00) hypertension was a diurnal blood pressure of ≥ 135/85 nun Hg. When both conditions were present or absent, subjects were classified either as having combined day-night hypertension or as normotensive on ambulatory measurement. Analysis of variance and multiple regressions were used for statistical analysis. Results 647 participants (53.9% being female,average age 47. 8 years) included 72 patients with isolated nocturnal hypertension, 33 with isolated daytime hypertension and 248 with day-night sustained hypertension. Compared with normotensive subjects, patients with isolated nocturnal hypertension and day-night sustained hypertension had a higher Sokoiow-Lyon voltage amplitude and Comell product. However, after adjustment for sex, age, body mass index, drinking and smoking habits, serum total cholesterol, fasting blood glucose and the use of antihypertensive drugs, only day-night hypertensive patients had a significantly higher Sokolow-Lyon voltage (32. 8 mV, P =0. 0003 ) and Cornell product (1371 mV×ms, P =0.0004) than normotensive subjects (29.0 mV, 1114 mV×ms).Regardless of whether Sokolow-Lyon or Cornell criteria were used, both nighttime and daytime systolic and diastolic blood pressure were independent risk factors of left ventricular hypertrophy (P < 0. 01 ). However,the prevalence of left ventricular hypertrophy in patients with isolated nocturnal hypertension ( 23.6% ) study was not statistically different from that in normotensives ( 17.4%, P = 0. 24). Conclusion In our current cross-sectional study, isolated nocturnal hypertension was not independently related to left ventricular hypertrophy diagnosed with ECG criteria.
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Objective The Augmentation index(AI)is an indicator of pulse wave reflections.To under- stand the validity of AI in the elderly,we studied the determinants of AI in an elderly population.Methods All subjects older than 70 years living in Zhaoxiang Town,Qingpu District,Shanghai were recruited.Pulse wave a- nalysis at the left radial artery was performed by using Omron HEMg000AI device.The augmentation index (AI)adjusting for a heart rate of 75 beats/min was used for statistical analysis.Results One thousand two hun- dred eighty-six participants included 761(59 %)women,and 815(63 %)hypertensive patients with average age 76.3 years participate the study.Women had a significant higher AI than men(90.3% versus 85.8%,P
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In the PROFESS and TRANSCEND trials,telmisartan(80 mg daily),compared with placebo,reduced systolic blood pressure by about 4 mmHg,but did not influence the primary composite cardiovascular endpoint.The difference between the ACCOMPLISH and ALLHAT trials in the amlodipine-diuretic comparison might be attributed to the combination of amlodipine with an angiotensin converting enzyme inhibitor in the ACCOMPLISH trial,which provided further evidence that by smoothly controlling blood pressure over 24 hours amlodipine prevent vascular events better than other antihypertensive drugs.
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Distinction between the traditional Chinese medicine amber and its counterfeit was studied by polarizing microscope and electron microscope, and trace clements analyse d by plasma spectroscopy. Results showed that the counterfcit of amber is opal, which contains the same thirty-five kinds of trace elements as coal amber. The total amount of Ca, Mg, Al,and Fe contained in opal is 10 to 70 times more than that contained in coal amber, whichcau provide a basis for the appraisal of coal amber and opal.