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Purpose To clarify the effect of adenosine on brain metastasis of lung cancer and the possible mechanism of adenosine promoting brain metastasis of lung cancer. Methods Western blot was used to dynamically detect the expression level of hypoxia inducible factor-1 (HIF-1) in lung cancer cells and tight junction protein ZO-1 in brain microvascular endothelial cells on blood-brain barrier. The content of adenosine in lung cancer cell culture was determined by ELISA. Fluorescence analysis was used to detect the changes of permeability of the blood-brain barrier model in vitro. Hemocytometer counts the number of A549 lung cancer cells in Transwell's lower chamber. Results The expression level of HIF-1 in lung cancer cells and the content of adenosine in lung cancer cell culture reached the highest level when lung cancer cells were deprived of oxygen for 12 hours. At the same time, the expression level of ZO-1 protein in the blood-brain barrier was the lowest, the blood-brain barrier permeability was the highest (7.11), and the number of lung cancer cells passing through the blood-brain barrier model was the highest (84.6). The permeability of the blood-brain barrier model increased after the action of adenosine, and its change trend was consistent with the effect of hypoxic lung cancer cell culture solution. Conclusion Hypoxia can induce the lung cancer cell to release adenosine, the increased adenosine can reduce the expression of tight junction protein ZO-1 in blood brain barrier, which leads to the increase of permeability of blood-brain barrier and eventually lead to brain metastasis of lung cancer.
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<p><b>OBJECTIVE</b>To explore clinical presentations and the operational opportunity of traumatic cervical disc herniation.</p><p><b>METHODS</b>From June 2002 to June 2009,40 patients with traumatic cervical disc herniation were treated. There were 24 males and 16 females, with an average age of 43.2 years old ranging from 30 to 56 years. There were 36 patients with single intervertebral disc herniation and 4 patients with double. The injury level of those patients were at C3,4 in 16 cases, C4,5 in 10 cases, C5,6 in 12 cases and C6,7 in 6 cases. Among them, 18 patients showed spinal cord signal changes by MRI, 5 patients suffered from nothing but neck and shoulder pain, 8 patients with nerve root stimulation; 10 patients with spinal cord compression, and 17 patients had both nerve root stimulation and spinal cord compression symptoms. Conservative treatment were applied to 13 patients with neck and shoulder pain and nerve root stimulation, 5 cases of which were transferred to operation in case of poor effects, and Odom criteria were used to assess operational effects. Twenty-seven patients with spinal cord compression accepted operation from 1 to 27days after their trauma, 16 of which were operated in 5 days (early operational group with an JOA score of 11.3 +/- 2.8), other 11 cases were operated from 5 to 27 days (delayed operational group with an JOA score of 11.4 +/- 2.9 ), then functional assessment of spinal cord were assessed according to JOA criteria.</p><p><b>RESULTS</b>Three patients who were transferred from conservative treatment recovered excellently according to Odom criteria and the other 2 were good at final followed-up. JOA score of early operational group increased from (11.3 +/- 2.8) to (15.3 +/- 1.8) one week after operation (P < 0.01), and (15.9 +/- 1.4) at final followed-up (P < 0.01). JOA score of delayed operational group increased from (11.4 +/- 2.9) to (14.0 +/- 2.6) one week after operation (P < 0.01), and (15.3 +/- 1.5) at final followed-up (P < 0.01). The recovery ratio of JOA score of early operational group were (74.6 +/- 16.8)% 1 week after operation,and increased to (85.6 +/- 13.6)% at final followed-up; while that of delayed operational group were (50.9 +/- 17.5)% and (68.2 +/- 21.5)%, and there were significant difference between early operational group and delayed operational group both at 1 week postoperation and final followup (P < 0.05).</p><p><b>CONCLUSION</b>There are some difference in pathological segment and imaging manifestation between traumatic cervical disc herniation and cervical spondylosis. Early operation is favorable to the recovery of neurological function in patients with spinal cord compression.</p>
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Adult , Female , Humans , Male , Middle Aged , Cervical Vertebrae , Wounds and Injuries , General Surgery , Intervertebral Disc Displacement , General SurgeryABSTRACT
OBJECTIVE@#To evaluate the feasibility of endoscopic paravertebral approach surgery in the far lateral lumbar disc herniation.@*METHODS@#Fifty sets of integral lumbar vertebral specimens were selected, and the anatomical data of lumbar intervertebral foramina and its adjacent structures were measured. Twenty specimens are randomly divided into a traditional group and an endoscopic group, then the traditional and endoscopic operations by paravertebral approach were used to dissect every strata of soft tissues in order to expose the intervertebral foramen. At last,the relationship between the intervertebral foramen and its adjacent structures was observed, and the 2 procedures were compared.@*RESULTS@#The sagittal diameter of lumbar intervertebral foramina became shorter from the top to bottom,while the diameter of cross section of relative nerve roots became longer. The depth of the line which connected the middle point of the 2 adjacent transverse process roots and the anterior branch of lumber nerve root in L1,L3 and L5 was (1.03+/-0.30), (1.71+/-0.29), and (1.99+/-0.34) mm respectively, with the increasing tendency; the depth of L3 to L5 was mostly less than 2 cm. The distance of the middle points of the 2 adjacent transverse process roots from L1 to L5 was long enough, but the distance between L5 and S1 was only (10.14+/-1.71) mm. The surgery by paravertebral approach had a relative safe operation area,which was similar to a triangle.@*CONCLUSION@#The technique of endoscopic surgery by paravertebral approach is feasible in the treatment of far lateral lumbar disc herniation. However, it is difficult to perform this surgery in the treatment of L5/S1 far lateral lumbar disc herniation, which is often conducted with endoscopy, after 18 to approximately 20 mm of the partial sacrum is eliminated by conventional method.