Evacuation of spontaneous supratentorial intracerebral hematoma with double targets-single channel and multiaxial stereotaxis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of evacuation of spontaneous supratentorial hemorrhage with double targets-single channel and multiaxial stereotaxis.</p><p><b>METHODS</b>Thirty-four patients with supratentorial intracerebral hemorrhage, who underwent hematoma evacuation with the method of double targets-single channel between January 2014 and November 2014 in the Second Affiliated Hospital, Zhejiang University School of Medicine, were included in the study. We classified the hematoma into four types based on the principle of double targets-single channel calculation method (DTSC). And the appropriate stereotactic surgery path and operation opportunity were designed individually according to the hematoma volume and mass effect. Twenty-seven patients with supratentorial hemorrhage who underwent hematoma evacuation with the method of single targets-single channel between January 2013 and November 2014 were selected as single target group.</p><p><b>RESULTS</b>Volumes of initial hematoma in DTSC and single target groups were(38.6 ± 19.2)mL and(40.1 ± 18.1)mL, respectively. Initial Glasgow Coma Scale were 9.6 ± 3.2 (3~15) and 9.1 ± 2.9(3~13) (all P >0.05). Residual volume of hematoma and clearance ratio were (11.1 ± 4.2) mL and(73.1 ± 5.4)% in DTSC group and (18.5 ± 5.3) mL and(55.1 ± 5.1)% in single target group by CT scan 24 h after operation(all P <0.05). There was no significant difference in Glasgow Outcome Scale between two groups in one-month follow-up. Average length of postoperative stay of two groups were(12.6 ± 9.8)d and (14.2 ± 7.1)d, respectively.</p><p><b>CONCLUSION</b>Evacuation of spontaneous supratentorial intracerebral hematoma with DTSC and multi-axial stereotaxis can increase clearance ratio remarkably and decrease average length of stay.</p>

Effect of wt p53 gene transfection on sensitivity of hyperthermia in C6 glioma cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of wt p53 gene transfection on the sensitivity of hyperthermia in C6 glioma.</p><p><b>METHODS</b>The recombinant eukaryotic expressive vector pCMV-p53 plasmids were extracted, identified and transmitted to C6 glioma cells by stable transfection. The biological characteristics were compared among C6/p53 (+) cells, thermo-treated C6/p53 (+) cells, thermo-treated C6 cells, thermotolerance C6 cells and control C6 cells. Transplanted glioma was treated by laser interstitial thermotherapy (LITT) in tumor-bearing nude mice.</p><p><b>RESULT</b>The wt p53 gene segments were extracted and correctly identified by restriction enzyme (Hind and EcoR). The optimal transfection concentration of plasmid to liposome was 1:6, neo gene expressed stably in C6 cells transfected with positive and blank plasmid. Thermotolerance C6 cell growth was normal in vitro, growth of C6/p53 (+) cells was inhibited. Growth of hyperthermia treated C6 cells was inhibited significantly 12 h after thermal treatment, cell proliferation activity of C6/p53 (+) cells was suppressed significantly 6 h after hyperthermia treatment. Apoptosis was observed in C6/p53 (+), thermo-treat C6 and thermo-treat C6/p53 (+) cells. The apoptosis ratio of hyperthermia treated C6/p53(+) cells was increased by 30 folds compared with that of control groups. Study in nude mouse model demonstrated lower positive inoculation rate in groups of C6/p53 (+) cells (57 %), hyperthermia treated C6 cells (75 %) and hyperthermia treated C6/p53(+) cells (20 %). C6/p53(+) LITT group showed the highest antitumor effect, compared with C6 LITT group(P<0.05). However, thermotolerance C6 LITT group had the lowest effect.</p><p><b>CONCLUSION</b>Transfection of wt p53 gene can increase the sensitivity of hyperthermia in glioma cells.</p>

Diagnosis and micro-neurosurgery for the fourth cerebral ventricle tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic method and analyze the result of microneurosurgical treatment for tumors of the fourth cerebral ventricle.</p><p><b>METHODS</b>Tumor of the fourth ventricle was clinically diagnosed in 86 patients basing on the preliminary assessment of symptom and CT or MRI findings. Of these 86 patients treated with micro-neurosurgery, the tumors in 62 were totally removed, subtotally in 19, and partially in 5. Forty-two patients received postoperative radiotherapy.</p><p><b>RESULTS</b>Three patients died postoperatively within ten days, and symptoms in 83 were improved after treatment. The average survival period was over 3 years. The pathology included 32 medulloblastomas, 23 ependymoma, 15 astrocytoma, 10 hemangiblastomas, 2 choroid plexus papillomas, and 4 epidermoid cysts.</p><p><b>CONCLUSION</b>Medulloblastoma, astrocytoma and hemangiblastoma are suggested to be removed totally whenever technically possible according to the site, character and volume of the tumor. For ependymoma, if close to the brain stem, is recommended to be subtotally removed. Postoperative radiotherapy may be beneficial for malignant types.</p>

Correlation of cell apoptosis with brain edema and elevated intracranial pressure in traumatic brain injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the correlation between brain edema, elevated intracranial pressure (ICP) and cell apoptosis in traumatic brain injury (TBI).</p><p><b>METHODS</b>In this study, totally 42 rabbits in 7 groups were studied. Six of the animals were identified as a control group, and the remaining 36 animals were equally divided into 6 TBI groups. TBI models were produced by the modified method of Feeney. After the impact, ICP of each subject was recorded continuously by an ICP monitor until the animal was sacrificed at scheduled time. The apoptotic brain cells were detected by an terminal deoxynucleotide-transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) assay. Cerebral water content (CWC) was measured with a drying method and calculated according to the Elliott formula. Then, an analysis was conducted to determine the correlation between the count of apoptotic cells and the clinical pathological changes of the brain.</p><p><b>RESULTS</b>Apoptotic cell count began to increase 2 h after the impact, and reached its maximum about 3 days after the impact. The peak value of CWC and ICP appeared 1 day and 3 days after the impact, respectively. Apoptotic cell count had a positive correlation with CWC and ICP.</p><p><b>CONCLUSIONS</b>In TBI, occurrence of brain edema and ICP increase might lead to apoptosis of brain cells. Any therapy which can relieve brain edema and/or decrease ICP would be able to reduce neuron apoptosis, thereby to attenuate the secondary brain damage.</p>

Expression of PCNA and Bcl-2 in the traumatic brains implanted with embryonic brain tissue in rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the expression of PCNA and Bcl-2 in the traumatic brain area transplanted with embryonic brain tissue in rats.</p><p><b>METHODS</b>The cerebral contusion of rats was induced by dropping weight. The homogenates of embryonic brain tissue were transplanted into the traumatic brain area two weeks after injury. All rats were sacrificed 6 weeks after injury (4 weeks after transplantation), and their brains were examined histologically. The expressions of PCNA and Bcl-2 in the brains were analyzed by immunohistochemical methods.</p><p><b>RESULTS</b>The histology of brain presented the capillary and glia proliferation, especially in the transplantation group. No significant difference was found in the expression of PCNA between two groups. However, Bcl-2 was overexpressed in the transplantation group.</p><p><b>CONCLUSION</b>The transplantation of the embryonic brain tissue enhances the expression of Bcl-2, which may play a neuroprotective role following traumatic brain injury.</p>