Toll-like receptor 4/nuclear factor-kappa B signaling detected in brain after early subarachnoid hemorrhage / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inflammation and immunity play a vital role in the pathogenesis of early brain injury after subarachnoid hemorrhage (SAH). Nuclear factor-kappa B (NF-kappaB) regulates many genes essential for inflammation and immunity and is activated by toll-like receptor (TLR). This study aimed to detect the expression of the toll-like receptor 4/nuclear factor-kappa B (TLR4/NF-kappaB) signaling in the rat brain after early SAH.</p><p><b>METHODS</b>The rats were decapitated and their brains were removed at 0, 2, 4, 6, 12, 24 and 48 hours after a single injection of blood into the prechiasmatic cistern. mRNA expression of TLR4 was measured by Taqman real-time RT-PCR, and protein expression by immunohistochemistry and Western blotting. NF-kappaB activity and concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>TaqMan real-time RT-PCR and Western blotting identified a biphasic change in TLR4 expression in both mRNA and protein: an initial peak (2 - 6 hours) and a sustained elevation (12 - 48 hours). Immunohistochemical staining showed the inducible expression of TLR4-like immunoreactions predominantly in glial cells and vascular endothelium. A similar biphasic change in the activation of NF-kappaB subunit p65 as well as the production of NF-kappaB-regulated proinflammatory cytokines (TNF-alpha, IL-1beta and IL-6) were detected by ELISA.</p><p><b>CONCLUSIONS</b>These data suggest that experimental SAH induces significant up-regulation of TLR4 expression and the NF-kappaB signaling in early brain injury. Activation of the TLR4/NF-kappaB signaling may regulate the inflammatory responses after SAH.</p>

Changes in P-selectin expression after brain injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relationship between expression thange of P-selectin after brain injury and secondary brain damage.</p><p><b>METHODS</b>Sixty SD rats were randomized into 3 equal groups, namely the control group, mild injury group and severe injury group and animal models of brain injury were established in SD rats according to the method of Feeney. P-selectin expression in the brain tissues were determined at 6 h and l, 3, and 7 days following brain injury (n=5 for each time point). Imaging analysis was performed using computerized imaging technique.</p><p><b>RESULTS</b>P-selectin expression and neutrophil infiltration in the brain tissues increased significantly 6 h after brain injury (P<0.05), reaching the peak level at postoperative 24 h and then gradually decreased.</p><p><b>CONCLUSION</b>P-selectin expression and neutrophil infiltration increase significantly following brain injury, and the time course and distribution of P-selectin expression are consistent with the secondary damage of the brain, strongly suggesting the involvement of P-selectin upregulation in the secondary insult after brain injury.</p>

Therapeutic effect of far lateral approach on the lesions located ventral to cranial-cervical junction / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the administration of far-lateral approach in lesions located anterior or anterolateral to brain stem and upper cervical spinal cord.</p><p><b>METHODS</b>Twenty-three patients underwent far lateral approach, including 12 retrocondylar approach, 5 partial transcondylar approach, 3 transfacetal and partial transcondylar approach, 2 transtubercular approach and 1 complete transcondylar approach.</p><p><b>RESULTS</b>Total tumor removal was achieved in 15 patients, subtotal removal in 5 patients, 3 vertibral artery aneurysms were clipped successfully, 3 patients were given occipitalcervical fusion. There was no operative mortality. The most frequent complications were lower cranial nerve deficit, CSF leakage, injury to vertibral artery, and ischemia of brain stem, cerebellum or spinal cord. No patient presented clinical instability of the occipitocervical junction after surgery.</p><p><b>CONCLUSIONS</b>The far-lateral approach is an ideal approach to structures located ventral to cranial-cervicle junction. But some of the surgical steps are technically difficult and carry some degree of risk. The choice of approach depends on the pathological feature and degree of exposure required for effective surgical treatment. Bone removal should be quantified for individual lesion. The approach may be limited to less aggressive steps, while still achieving significant exposure and surgical space.</p>

Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.</p><p><b>METHODS</b>Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen, the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed.</p><p><b>RESULTS</b>Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).</p><p><b>CONCLUSIONS</b>Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.</p>

Effect of compound Salvia injection on blood coagulation in patients with traumatic cerebral infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of compound Salvia injection (CSI) on blood coagulatory function in patients with traumatic cerebral infarction (TCI).</p><p><b>METHODS</b>Sixty-four patients with TCI were randomly divided into two groups, 32 in each group. The treated group were treated with CSI plus conventional treatment of western medicine, and the control group treated with conventional treatment alone. Changes of symptoms, levels of plasma P-selectin (P-S), von Willebrand's factor (vWf) and D-dimer were observed with ELISA.</p><p><b>RESULTS</b>The treated group was superior to the control group in Glasgow outcome scale (P < 0.01). Before treatment, the levels of plasma P-S, vWf and D-dimer in the TCI patients were higher than those in healthy people. After treatment, all the parameters lowered in both groups, but the effect of lowering was greater in the treated group than that in the control group.</p><p><b>CONCLUSION</b>Blood coagulation disorder exists in patients with TCI, CSI could improve it, and might alleviate the cerebral damage to a certain extent.</p>