Impairment of Autophagic Flux After Hypobaric Hypoxia Potentiates Oxidative Stress and Cognitive Function Disturbances in Mice / 神经科学通报·英文版

Acute hypobaric hypoxic brain damage is a potentially fatal high-altitude sickness. Autophagy plays a critical role in ischemic brain injury, but its role in hypobaric hypoxia (HH) remains unknown. Here we used an HH chamber to demonstrate that acute HH exposure impairs autophagic activity in both the early and late stages of the mouse brain, and is partially responsible for HH-induced oxidative stress, neuronal loss, and brain damage. The autophagic agonist rapamycin only promotes the initiation of autophagy. By proteome analysis, a screen showed that protein dynamin2 (DNM2) potentially regulates autophagic flux. Overexpression of DNM2 significantly increased the formation of autolysosomes, thus maintaining autophagic flux in combination with rapamycin. Furthermore, the enhancement of autophagic activity attenuated oxidative stress and neurological deficits after HH exposure. These results contribute to evidence supporting the conclusion that DNM2-mediated autophagic flux represents a new therapeutic target in HH-induced brain damage.

Combination immunotherapy of glioblastoma with dendritic cell cancer vaccines,anti-PD-1 and poly I:C / 药物分析学报

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.

In-vitro cardiovascular protective activity of a new achillinoside from Achillea alpina

Abstract Achillinoside was isolated from methanol extract of Achillea alpina L., Asteraceae. The structure of the compound was characterized based on various spectrum data, including IR, HR-ESI-MS, 1D and 2D NMR. The cardiovascular protective effect of achillinoside was tested on H2O2-induced H9c2 cells. In our research, achillinoside could increase the cell viability dose-dependently in H2O2-induced H9c2 cells. In addition, the levels of caspase-3/9 cells were significantly decreased in H2O2 and achillinoside incubated H9c2 cells.

Effect of globular adiponectin on proliferation, migration and tube formation of ovarian microvascular endothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the effect of globular adiponectin on angiogenesis of ovarian microvascular endothelial cells (OMECs).</p><p><b>METHODS</b>Mouse OMECs were isolated and purified by density gradient centrifugation with Percoll and identified by immunofluorescence analysis of follicle-stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR), and endothelial cell marker von Willebrand factor (vWF). The capillary-like tube formation of OMECs was determined by vascular endothelial growth factor A (VEGFA) treatment in Matrigel matrix. OMECs treated with recombinant globular adiponectin protein were examined for cell proliferation with MTS assay and cell migration with scratch wound healing assay, and capillary-like tube formation was tested in Matrigel matrix. Western blotting was performed to detect the effect of globular adiponectin on AMPK phosphorylation.</p><p><b>RESULTS</b>The signals of LHR and vWF, but not that of FSHR, were detected in the isolated cells. VEGFA treatment of the cells induced capillary-like tube formation, indicating their properties of ovarian-specific endothelial cells. Treatment with 1 and 3 µg/mL of recombinant globular adiponectin significantly increased the number of OMECs by (158.72∓14.50) % and (186.50∓4.20)% (P<0.01) and resulted in scratch wound closure rates of (49.43∓3.43)% (P<0.05) and (69.67∓1.2) % (P<0.01) respectively. The cells treated with 3 µg/mL globular adiponectin formed a capillary-tube length 6.63∓0.66 folds greater than that formed by the control cells (P<0.01). Treatment of the cells with 3 µg/mL globular adiponectin for 15 and 30 min resulted in pAMPK/AMPK ratios of 0.86∓0.08 and 0.66∓0.13, respectively significantly higher than that in the control cells (0.13∓0.12, P<0.01). Compound C obviously suppressed the tube formation and AMPK phosphorylation induced by globular adiponectin.</p><p><b>CONCLUSION</b>Globular adiponectin promotes angiogenesis of OMECs through activation of the AMPK signal pathway.</p>

Endovascular treatment of ruptured aneurysms located at anterior communicating artery complex: a sixty-six cases report / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the endovascular treatments for the ruptured aneurysms located at anterior communicating artery complex (ACoAC).</p><p><b>METHODS</b>The data of patients with ruptured ACoAC aneurysms treated in Department of Neurosurgery, First Affiliated Hospital to Fourth Military Medical University from May 2013 to December 2014 was retrospectively analyzed. Sixty-six cases were recruited including 50 male and 16 female patients. The patients aged from 31 to 69 years old, averaging (51±8) years. The Hunt-Hess grade at admission were 13 cases with grade Ⅰ, 36 cases with grade Ⅱ, 11 cases with grade Ⅲ, and 6 cases with grade Ⅳ. The most diameter of aneurysms sac: 14 cases less than or equal to 3 mm, 36 cases more than 3 mm but less than or equal to 7 mm, and 16 cases more than 7 mm. The height diameter/neck width ratio: 8 cases with absolute wide neck, 50 cases with relatively wide neck, and 8 cases with narrow neck. There were 28 cases underwent single micro-catheter embolization, 18 cases underwent double micro-catheters embolization, 14 cases underwent stent-assisted embolization and 6 cases underwent balloon-assisted embolization. The patients were followed up for 6 to 12 months and evaluated by modified Rankin score (mRS) and digital subtraction angiography (DSA). The ratio of total embolization, recurrence rate, and time from operation to reexamination of four groups managed by different endovascular treatment were compared by χ(2) test or F test.</p><p><b>RESULTS</b>Sixty cases were totally embolized, 3 cases subtotally embolized, 3 cases incompletely embolized. Mild hemiparalysis and aphasia occurred in 2 cases, and 1 case died of infarction induced by subarachnoid haemorrhage. The mRS at six months after operation were 0 in 31 cases, 1 in 22 cases, 2 in 8 cases, 3 in 2 cases, 4 in 2 cases, 6 in 1 case. All the included cases reexamined the DSA at averaging (7.5±1.0) month post-operatively and 4 cases recurred. There were not significant differences of the ratio of total embolization, recurrence rate, time from operation to reexamination among four groups (all P>0.05).</p><p><b>CONCLUSION</b>The endovascular treatment maybe an ideal management for ruptured ACoAC aneurysms.</p>

Changes of serum Tau, GFAP, TNF-α and malonaldehyde after blast-related traumatic brain injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To determine the changes of serum Tau protein, glial fibrillary acidic protein (GFAP), tumor necrosis factor alpha (TNF-α), and malonaldehyde (MDA) in rats after blast-related traumatic brain injury (BTBI) and to provide relative information for further studies on BTBI mechanism and seek specific biomarkers for BTBI.</p><p><b>METHODS</b>Ninety male Sprague-Dawley rats were randomly assigned into three groups: control group, moderate blast injury group, and severe blast injury group (n=30 for each). Rats in the moderate and severe blast injury groups were respectively exposed to corresponding levels of BTBI. After explosion, serum levels of Tau, GFAP, TNF-α, and MDA in each group were determined by Elisa assay at different time points after injury (8 h, 24 h, 3 d, and 6 d). The extent of brain damage was detected by Nissl staining and TUNEL assay.</p><p><b>RESULTS</b>Serum levels of Tau and GFAP rapidly increased and reached the peak at 24 h after either moderate or severe blast injury. All the values were significantly higher than control group at all time points (P<0.05). Serum TNF-α level of both injury groups peaked at 8 h after BTBI and stayed significantly higher than control group at all time points (P<0.05). Serum MDA of two injury groups began to significantly increase at 3 d and the level stayed significantly higher than control group until 6 d (P<0.05). Moreover, unlike the other biomarkers, serum MDA of severe blast injury group was significantly higher than moderate blast injury group at 6 d (P<0.05).</p><p><b>CONCLUSION</b>The changes of serum Tau, GFAP, and TNF-α showed a good sensitivity at the acute phase after BTBI (within 24 h). However, their specificity and correlation with the extent of injury were limited in this experiment. Moreover, although the change of serum MDA showed a poor sensitivity and specificity to the diagnosis of BTBI during the first few days, it can reflect the injury degree at 6 d after injury. Therefore, further studies are needed to improve the methods of detecting more serum markers and investigate the significance of multiple markers in diagnosing BTBI.</p>

Relation of 11 C-MET uptake in PET with cell proliferation and angiogenesis in human brain gliomas / 重庆医学

Objective To investigate the relation of 11C-methionine (11C-MET) uptake with cell proliferation and angiogenesis in human brain gliomas .Methods For 30 cases of newly diagnosed glioma patients ,positron emission tomography (PET ) examina-tion with 11C-MET was performed ,and the maximal standardized uptake value (SUVmax) of 11C-MET was measured .Expression of Ki-67 and CD34 antigens was examined by immunohistochemistry method in the same glioma samples ,both Ki-67 labeling index (Ki-67 LI) and microvessel density (MVD) were measured .Results Both 11C-MET SUVmax and Ki-67 LI increased significantly with glioma pathological grade ascending (P=0 .000 ,P=0 .000) ,and which in malignant glioma tissues were significantly higher than those in benign glioma tissues as well (P=0 .000 ,P=0 .000);however ,there were not significant differences in MVD among different grades of gliomas (P=0 .831) as well as between high and low malignant gliomas (P=0 .370) .11 C-MET SUVmax was significantly positively correlated with Ki-67 LI (P= 0 .000) ,however ,there were not significant correlations between 11C-MET SUVmax and MVD (P=0 .154) as well as between Ki-67 LI and MVD (P=0 .842) .Conclusion 11C-MET uptake and cell prolif-eration activity can better reflect the pathological grades and malignant degrees of gliomas .

Expression of aldehyde dehydrogenase 1 in human rectal carcinoma tissues and its prognostic significance / 肿瘤

Objective: To investigate the expression of CSC (cancer stem cell) and SC (stem cell) co-expressed marker ALDH1 (aldehyde dehydrogenase 1) in rectal carcinoma tissues and its clinical significance. Methods: The expressions of ALDH1 in rectal carcinoma tissues and the corresponding para-carcinoma tissues from 50 cases of rectal carcinoma were detected by indirect fluorescence antibody staining. The relationship between the expressions of ALDH1 and the clinicopathological features of patients with rectal carcinoma was analyzed. The five-year survival rate was estimated by Kaplan-Meier method. Results: The positive expression rate of ALDH1 in rectal carcinoma tissues was higher than that in the para-carcinoma tissues (P < 0.05). The expression level of ALDH1 was associated with tumor differentiation, Duke's stage, and TNM stage (P < 0.05). The five-year survival rate of patients with positive expression of ALDH1 was lower than that of patients without ALDH1 expression (P < 0.05). Conclusion: The expression of ALDH1 is associated with certain clinicopathological features and the five-year survival rate of patients with rectal cancer. Copyright © 2013 by TUMOR.

One-stage apertura thoracis superior approach for four-vessel occlusion in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>There are a great number of modified models based on the four-vessel occlusion (4VO) model of Pulsinelli and Brierley which has been used worldwide for brain ischemia research. However, up to now the problems of collateral circulations of 4VO and the difficulty in arranging a surgery to occlude the basilar artery in other models are not satisfactorily solved yet. In this study, an improved 4-vessel occlusion (I4VO) rat model which is easy to handle and able to decrease the effect of collateral circulation is reported.</p><p><b>METHODS</b>The common carotid arteries and the beginning of the subclavical arteries of rats were occluded for different time by one-stage apertura thoracis superior approach. Neurological deficit scores defined by the modified Garcia scoring system and histopathological method were used to evaluate the effects of this model up to 7 days after reperfusion.</p><p><b>RESULTS</b>The neurological scores in the 15-min and 25-min groups decreased significantly at 24, 48 and 72 hours after reperfusion (P less than 0.05), and the histopathologic study showed that there were stable, symmetrical changes of lesions in bilateral hippocampus in all the ischemia samples from two ischemia groups compared with sham operated group (P less than 0.05).</p><p><b>CONCLUSION</b>This modified model is safe, easy, reliable, stable, mini-invasive as well as time-saving in making bilateral hemispheric ischemia, which can effectively decrease collateral circulations and meanwhile lead to stable lesions in hippocampus and cortex.</p>

To enhance evidence-based medical study of secondary brain injury factors / 解放军医学杂志

Objective To analyze the progress in evidence-based medical study on secondary brain injury factors during the past 10 years and propose the direction and focal points for future research in this field. Methods The achievements and latest tendency in the study of secondary brain injury factors during the last 10 years were retrieved from the literatures, and duly arranged and analyzed. Results Remarkable progress has been made in the study of secondary brain injury during the last 10 years. Many factors in the pathophysiological process participating in the production of second brain damage, such as hyperpyrexia, hypoxemia, hypotension, increased intracranial hypertension, decreased cerebral perfusion pressure, arrhythmia, electrolyte disturbances, acid-base imbalance, etc., have been identified. However, for the opportune time of monitoring secondary brain damage and the significance of these findings, further evidence-based study is still necessary. Conclusion The prevention and treatment of secondary brain injury induced by various brain damage factors are the keys to improving the level of treatment of severe brain injury.

Expression and significance of calcyclin binding protein in rat brain tissues after traumatic brain injury / 中华创伤杂志

Objective To investigate the expression and significance of calcyclin binding protein (CacyBP)in the brain of rat model of traumatic brain injury(TBI).Methods Sixty 60 male SD rats were divided randomly into normal control group (n=10) and TBI group (n=50).The TBI model was created by using lateral head rotation device and subdivided into 6 h,24 h,72 h,7 d and 14 d group (10 rats per group).The expression and distribution of CacyBP in the rat brain was investigated immunohistochemically.The presence of the brown stained particles was considered aspositiveand lack of the stained particles agnegative. Results CacyBP was mainly distributed in the hippocampus,dentate gyrus and cortical neuron cytoplasm.Compared with the high level expression of CacyBP in the normal control group,the expression of CacyBP was decreased to the lowest in the rat brain at 6 h post TBI (P0.05). Conclusion The lowest level expression of CacyBP after TBI indicates that CacyBP may play an important role in development of brain injury under effect of difierent mechanisms.

Cognitive function changes in response to expression of glucocorticoid recepmr from rat hippocampus after traumatic brain injury / 中华创伤杂志

Objective To explore the effect of glucocorticoid receptor(GR)expression in rat hippocampus on cognitive function after traumatic brain injury(TBI). Methods The TBI model wag established in rats.Then,immunohistochemistry and Western blot were used to detect the GR expression and evaluate its relation with cognitire dysfunction by Morris water maze. Results Expression of hippocampal GR was down-regulated 4-10 days after TBI.Morris water maze test showed significant impairment of the cognitive function in rats. Conclusion There is correlation between expression change of hippocampal GR and cognitive dysfunction.

Diagnoses and treatment of severe traumatic brain injury in 4 462 cases: a retrospective study / 中华创伤杂志

Objective To analyze and summarize the experiences in diagnosis and treatment of patients with severe traumatic brain injury (sTBI) so as to increase the cure rate and survival rate. Methods A retrospective study was made on the diagnoses and treatment of 4 462 cases of sTBI inclu-ding 3 298 males (73.9%) and 1 164 females (26.1%). The most frequent cause for injury was traffic accident, accounting for 35.5% (1 583/4 462). Closed bead injury ocurred in 3 654 cases (81.9%) and open head injury in 808 (18.1%). The most commen clinical manifestations included unconscious-ness, changes of pupils and life signs. Of all, 1 158 cases (26.0%) were found with combined injury and 1 356 (30.4%) with complications. Treatment measures included first aid, surgery or conventional treatment. Emphasis was put on the treatment of secondary insults. Results Surgery was performed in 3 023 cases (67.7%) including craniotomy for hematoma clearance in 856 cases and hematoma clearance plus decompression in 2 167, with mortality rate of 17.9%. Conventional treatment was carried out in 1 439 cases (32.3%), with mortality rate of 23.7%. There were 2 462 eases (55.2%) with fair recov-ery, 508 (11.4%) with mild disability, 339 (7.6%) with severe disability, 272 (6.1%) under vege-tative state and 881 (19.7%) deaths on discharge according to the Glasgow Outcome Scale. Conelu-sions Active diagnoses and treatment, strict medication rules and prevention and treatment of secondary insults may be key to higher eure rate as well as lower morbidity and mortality of sTBI.

Role of dissection of secondary branches of splenic pedicle in portal hypertension cases undergoing splenectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is well known that conventional splenectomy, which requires careful handling and ligation of tissue of the splenic hilum, can easily cause complications such as splenic fever and pancreatic fistula. Here, we use the technique of dissection of the secondary branches of the splenic pedicle to handle the hilum in the portal hypertension patients who are subjected to splenectomy.</p><p><b>METHODS</b>We retrospectively compared and analyzed the complications, postoperative hospital stay, operative time, and occurrence of hemorrhage in 121 patients with portal hypertension undergoing splenectomy and devascularization of the gastric cardia from January 1999 to December 2007. The selected cases consisted of 51 patients undergoing conventional splenectomy and 70 patients undergoing dissection of secondary branches of the splenic pedicle. In addition, we analyzed the relationship between size of the spleen and occurrence of complications.</p><p><b>RESULTS</b>The incidence of pancreatic fistula and splenic fever (0/70 and 9/70) was lower in patients undergoing dissection of secondary branches of the splenic pedicle as compared with that of the conventional group (5/51 and 18/51 respectively). In addition, there was no significant difference in operative time and volume of blood loss between two groups. The spleen thickness of those patients who had pancreatic fistula and splenic fever was significantly greater than those without complications.</p><p><b>CONCLUSIONS</b>These results indicate that dissection of secondary branches of the splenic pedicle in portal hypertension patients undergoing splenectomy can decrease the incidence of splenic fever and pancreatic fistula, and shorten the postoperative hospital stay, especially in the patients with a large spleen. So dissection of secondary branches of the splenic pedicle is a valuable technique for splenectomy.</p>

Relationships between changes of kernel nutritive components and seed vigor during development stages of F1 seeds of sh2 sweet corn / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The changes of kernel nutritive components and seed vigor in F1 seeds of sh2 sweet corn during seed development stage were investigated and the relationships between them were analyzed by time series regression (TSR) analysis. The results show that total soluble sugar and reducing sugar contents gradually declined, while starch and soluble protein contents increased throughout the seed development stages. Germination percentage, energy of germination, germination index and vigor index gradually increased along with seed development and reached the highest levels at 38 d after pollination (DAP). The TSR showed that, during 14 to 42 DAP, total soluble sugar content was independent of the vigor parameters determined in present experiment, while the reducing sugar content had a significant effect on seed vigor. TSR equations between seed reducing sugar and seed vigor were also developed. There were negative correlations between the seed reducing sugar content and the germination percentage, energy of germination, germination index and vigor index, respectively. It is suggested that the seed germination, energy of germination, germination index and vigor index could be predicted by the content of reducing sugar in sweet corn seeds during seed development stages.

Endoscopic endonasal transsphenoidal approach for pituitary adenomas / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the clinical curative effect of the endonasal transsphenoidal approach for removing pituitary adenoma (PA) under neuroendoscope-assisted.</p><p><b>METHODS</b>There were 215 patients who had undergone neuroendoscopic transsphenoidal surgery. Each patient received CT or MRI examination which showed the size and surrounding structural of tumor.</p><p><b>RESULTS</b>Among the 215 patients, 190 cases (88.4%) had total removal, 17 cases (7.9%) achieved subtotal removal and the remaining 8 cases (3.7%) with fibrous tumor was carried out partial removal. Two patients (0.9%) died after operation. Postoperative follow-up period was 1 to 10 months (the average was 3.5 months). In 182 patients, 150 cases (90.9%) got vision recovered rapidly compared with their preoperative symptoms, such as diminished acuities and visual field defects, and 15 cases (9.1%) had gotten improvements to some extend among 165 who diagnosed as pituitary macroadenoma (PMaA); There were 17 patients who diagnosed as microadenoma (PMiA) showed that the pituitary dyshormonism recovered gradually.</p><p><b>CONCLUSIONS</b>The endonasal transsphenoidal surgery under the neuroendoscope-assisted appears to be a safe, effective and micro-invasive method for PA.</p>

Boron neutron capture inducing apoptosis in C6 glioma cells / 中华放射肿瘤学杂志

Objective To investigate the effect and mechanism of boron neutron capture therapy(BNCT) in C6 glioma cell line.Methods C6 cells in exponential phase were divided into 6 groups: untreated control,(~(60)Co?)(4 Gy),~(60)Co? 8 Gy,nuclear reactor exposure without boronophenylalanine(BPA) 3 Gy,BNCT(4 Gy) and BNCT 8 Gy.Cellular morphological change was observed by an inverted microscope,light microscope,fluorescence microscope and electronic microscope.Flow cytometry was used to determine the percentage of apoptosis,necrosis and normal cells 48h after irradiation.Colony forming assay was used to calculate cell surviving fraction.Results Typical morphological changes of apoptosis were observed early after irradiation in BNCT group,with a significant increase in apoptotic rates was observed 48 h after irradiation with 63.2% and 88.3% for BNCT(4 Gy) and 8 Gy group,respectively(P

Changes in metabotropic glutamate receptor 4 expression and the effects of L-2-amino-4-phosphonobutyrate in a rodent model of diffuse brain injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To examine the changes in the expression of mGluR4 after diffuse brain injury (DBI) and to determine the role of its specific agonist L-2-amino-4-phosphonobutyrate (L-AP4) in vivo.</p><p><b>METHODS</b>A total of 161 male SD rats were randomized into the following groups. Group A included normal control, sham-operated control and DBI group. DBI was produced according to Marmarou's diffuse head injury model. mRNA expression of mGluR4 was detected by hybridization in situ. Group B included DBI alone, DBI treated with normal saline and DBI treated with L-AP4. All DBI rats were trained in a series of performance tests, following which they were subjected to DBI. At 1 and 12 hours, animals were injected intraventricularly with L-AP4 (100 mmol/L, 10 microl) or normal saline. Motor and cognitive performances were tested at 1, 3, 7, 14 days after injury and the damaged neurons were also detected.</p><p><b>RESULTS</b>There was no significant difference between normal control group and sham-operated group in the expression of mGluR4 (P>0.05). The animals exposed to DBI showed significantly increased expression of mRNA of mGluR4 compared with the sham-operated animals 1 h after injury (P<0.05). At 6 hours, the evolution of neuronal expression of mGluR4 in the trauma alone group was relatively static. Compared with saline-treated control animals, rats treated with L-AP4 showed an effective result of decreased number of damaged neurons and better motor and cognitive performances.</p><p><b>CONCLUSIONS</b>Increased expression of mGluR4 is important in the pathophysiological process of DBI and its specific agonist L-AP4 can provide remarkable neuroprotection against DBI not only at the histopathological level but also in the motor and cognitive performance.</p>

Cranioplasty of skull vault defect and skull base reconstruction: diagnosis and management / 中华创伤杂志

Objective To discuss and analyze the diagnosis,management and surgical techniques for cranioplasty of skull vault defects and skull base reconstruction in order to raise the therapeutic effect. Methods The clinical data of 169 cases of skull vault and skull base defects treated with cranioplasty of skull vault defect and skull base reconstruction were retrospectively analyzed.Results Overlay tech- nique or inlay technique with imported titanium alloy mesh was used in 160 cases,and homologous bone was used in 9 cases.The surgical time ranged from 3 months to 8 years after injury.Eight cases presented with complications such as hematoma,subcutaneous effusion,infection and epilepsy postoperatively,but no operative death occurred.Conclusion For patients with skull vault defect with the diameter≥3 cm the best operative time is 3 months after injury,and for patients with intracranial and extracranial communica- ting tumors,skull base reconstruction can be performed when tumors are removed.Much attention should be paid to perioperative management and surgical skills.

Changes of metabotropic glutamate receptor subtype 1a in diffuse brain injury with secondary brain insults and the effects of 2-methyl-4-carboxyphenylglycine / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To observe the changes of metabotropic glutamate receptor 1a in rat brain in a rodent model of diffuse head injury with secondary insults and the effects of 2-methyl-4-carboxyphenylglycine (MCPG).</p><p><b>METHODS</b>Based on Marmarous rodent model of diffuse brain injury (DBI), hypotension was made by blood withdrawal as secondary brain insults (SBI). 105 male SD rats were randomized into A and B groups. The changes of mGluR(1a) in cerebral cortex were studied by immunohistochemistry and the effect of MCPG by HE. Each group was divided into different subgroups at different time after injury.</p><p><b>RESULTS</b>Compared with that of sham group, the number of mGluR(1a) positive neuron increased by 12.9+/-3.2 (P<0.05) 1 day after injury in the injured cerebral cortex in DBI group. However, in DBI and SBI group there was a more significant increase in the number of mGluR(1a) positive neuron at 4 hours after injury (15.6+/-3.0, P<0.05) and then the number of mGluR(1a) positive neuron gradually decreased. Administration of MCPG reduced total cortical necrotic neurons counts on the 7th day after injury (5.21+/-2.52, P<0.05).</p><p><b>CONCLUSIONS</b>Brain injury can increase the gene expression of mGluR(1a) and the role of mGluR(1a) may be a key factor in the aggravation of head injury with SBI, and that MCPG may have therapeutic potential in head injury.</p>