Clinical and imaging analysis on meningiomas initially manifesting as intracranial hemorrhage in 19 cases / 中国基层医药

Objective:To investigate the main clinical characteristics, imaging features, diagnosis, and treatment of meningiomas initially manifesting as spontaneous intracranial hemorrhage.Methods:The clinical characteristics, imaging features, treatment, and follow-up data of 19 patients with meningiomas initially manifesting as spontaneous intracranial hemorrhage who received treatment in The First Affiliated Hospital of Shantou University Medical College from January 2011 to December 2020 were retrospectively analyzed.Results:Among the 19 patients, there were 6 males and 13 females, with an average age of (53 ± 14) years. The onset manifestations were sudden and severe headache and vomiting in 6 cases, progressive coma in 4 cases, and hemiplegia in 9 cases. Among the 19 patients, 15 patients showed irregular tumor shape and mixed hyperintense signal in CT, and 4 patients showed a homogeneous hyperintense signal. Eighteen patients showed peritumoral edema. Three patients showed intratumoral calcification. One patient showed an intratumoral fluid level. Fourteen patients showed isointense to hypointense signals on T1WI images and isointense to hyperintense signals on T 2WI images. Five patients showed mixed isointense and hyperintense signals on T 1WI images and mixed hypointense and hyperintense signals on T 2WI images. Heterogeneous enhancement was found in 18 patients, intratumoral cystic necrosis was found in 15 patients, and the meningeal tail sign was found in 16 patients. Preoperative imaging misdiagnosis occurred in 4 patients. Before surgery, all patients underwent surgery to resect the tumor and remove the hematoma. No patients died because of surgery. After surgery, muscle strength was improved compared with that before surgery. The average follow-up time was (46.5 ± 28.4) months. Tumor recurrence occurred in two patients. The Karnofsky Performance Scale score at the last follow-up, at discharge, and before surgery was (73.7 ± 3.4) points, (61.1 ± 5.5) points, and (49.5 ± 5.6) points, respectively ( F = 21.06, P < 0.01). The Karnofsky Performance Scale score at the last follow-up was significantly increased compared with that at discharge and before surgery ( F = 13.13, P < 0.01). Conclusion:Spontaneous hemorrhagic meningioma is rare and has a sudden onset. It is easily misdiagnosed before surgery. Skull CT, skull CT angiography, and enhanced magnetic resonance imaging examination in combination can increase the preoperative diagnosis rate. Early surgical resection of tumors and removal of hematoma can acquire good clinical efficacy.

Parental origin of prenatally diagnosed pathogenic copy number variation in 56 pedigrees / 中华围产医学杂志

Objective:To investigate the prenatal management for pathogenic copy number variation (CNV) by analyzing the parental origin of CNV and pregnancy outcomes in 56 pedigrees.Methods:This study retrospectively analyzed the information of patients who received interventional prenatal diagnosis and chromosomal microarray analysis (CMA) at Guangzhou Women and Children's Medical Center from January 2015 to December 2020. The cases with pathogenic CNV indicated by CMA and receiving parental CMA for further verification were finally enrolled. Clinical data including prenatal diagnostic indications, chromosomal distribution of the pathogenic fragments and fragment sizes were collected and analyzed using t test. All cases were followed up by telephone and record review. Results:Fifty-six cases were included in this study. Pathogenic CNV in 13 (23.2%, 13/56) fetuses were inherited from one parent (eight from mothers and five from fathers), and mainly located in chromosomes 22 (3/13), 17 (3/11), 16 (2/7), 1 (2/4), and X (3/6) with fragment sizes all less than 3 Mb. The fragment size of inherited pathogenic CNV was significantly smaller than that of de novo CNV [1.69 (1.36-2.22) vs 7.54 (2.11-12.30) Mb, t=3.47, P=0.001]. Among the 43 cases with de novo pathogenic CNV, seven (16.3%) were lost to follow up and 35 (97.2%) terminated the pregnancy. The other one with a 0.58 Mb microruplication at 16p11.2 indicated at 37 gestational weeks gave birth to a baby weighting 2 900 g at 39 gestational weeks and no abnormalities were reported during an eight-month telephone follow-up. Two out of the 13 cases with inherited pathogenic CNV were lost to follow up and six pregnancies were terminated. The other five pregnancies were continued and babies were delivered with no abnormalities during a median follow-up period of 13 (4-15) months. Conclusion:Pathogenic CNV alone should not be the indication for pregnancy termination.

Retrospective analysis of clinics and the prognosis of 58 adult patients with hemophagocytic syndrome in a single center / 中国肿瘤临床

Objective:This study aimed to achieve the early diagnosis and active treatment of adult hemophagocytic syndrome (HPS) and investigate the clinical characteristics and prognostic factors of this syndrome. Methods:A single-center retrospective analysis was performed to analyze clinical characteristics, laboratory findings, and survival data. Results:In 58 patients, the most common clinical manifestations were fever (100%) and splenomegaly (89.7%). The most common laboratory parameters were serum ferritin 500 g/L (100%) and peripheral cytopenia in two or more lineages (96.6%). platelet count, fibrinogen, and lactate dehydrogenase in the death group were significantly lower than in the survival group (P=0.000, 0.001, and 0.000). Survival analysis results showed that infections in the rheu-matological group exhibited good prognosis [the overall survival (OS) time was not reached in 190 d]. Patients with unexplained causes had moderate prognosis (OS time was 60 d);tumor-associated HPS patients had poor prognosis (the OS time was only 30 d). Univariate analysis results showed that patients with Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2000 U/L also exhibited poor prognosis (P=0.000). Multivariate analysis results showed that PLT<40 × 109/L was an independent adverse factor (HR=6.472, 95%CI:1.526-26.065, P=0.011). Conclusion:HPS exhibits complex clinical manifestations and varied etiology. Patients with infection and rheumatism-related HPS had good prognosiss compared with those manifesting tumor-associated HPS. Fbg<1.5 g/L, PLT<40×109/L, and LDH≥2 000 U/L were the univariate factors that affected the survival time of patients. PLT<40×109/L is an independent adverse factor. These patients need systemic treatments as early as possible.

Chronergy of umbilical cord blood-mesenchymal stem cell transplantation for treatment of hypoxic-ischemic brain damage / 中国组织工程研究

BACKGROUND: Mesenchymal stem cell transplantation for treatment of hypoxic-ischemic brain damage (HIBD) has obtained some outcomes in adult animals, but studies are few in neonatal animal models. Mesenchymal stem cells are commonly harvested from bone marrow. A few studies are on umbilical cord blood-mesenchymal stem cells (UCB-MSCs). OBJECTIVE: To investigate the feasibility and timeliness of UCB-MSC transplantation after injecting UCB-MSCs into neonatal rat models of HIBD. DESIGN, TIME AND SETTING: The complete randomized controlled animal experiment was performed at the Laboratory of Department of Neurology of First Hospital Affiliated to Nanchang University from October 2004 to July 2005. MATERIALS: A total of 38 healthy neonatal SD rats aged 7 days old were used to create rat models of HIBD. Three rats died. METHODS: Cord blood samples were collected after normal full-term delivery of 23-35 healthy pregnant women for culturing UCB-MSCs. MSCs were labeled with 4',6-diamidino-2-phenylindole 2hci (DAPI) in vitro before transplantation. Thirty-five rat models were divided into three groups. UCB-MSCs were injected into tail vein of twelve rat models in the early transplantation group two days after modeling. UCB-MSCs were injected into tail vein of twelve rat models in the late transplantation group one week after modeling. Same volume of saline was injected into eleven rats of the control group. Six rats from early transplantation and late transplantation groups each were respectively obtained at day 2 after transplantation and at week 2 after modeling. Three, four and four rats from control group were obtained respectively 2 days, 1 and 2 weeks after modeling, and sacrificed after anaesthesia. Ischemic brain tissues from the brain and hippocampal gyrum were sliced into frozen sections. MAIN OUTCOME MEASURES: Brain tissue pathomorphology was measured by Haematoxylin and Eosin Staining. Brain tissue DAPI-positive cells were detected with a fluorescence microscope. RESULTS: Brain edema at ischemic region, neural cell swelling and a decrease in cell number were tested in the control group. DAPI-positive UCB-MSCs were few in focal brain tissues, and swelling degree,extracellular space improvement and increased cell number were insignificant in the early transplantation group. One week after modeling, brain tissue extracellular space became small, cell number increased, and brain swelling reduced; A mass of DAPI-positive cells in rat focal brain migrated and diffused, without significant boundary in the late transplantation group. CONCLUSION: UCB-MSCs effectively traverse blood-brain barrier, and migrate, disperse and conform around focal brain tissues. A good outcome of transplantation is obtained at week 1 after HIBD.

Study on prokaryotic expression and partial biological activities for tissue factor pathway inhibitor-2 / 中华检验医学杂志

Objectives To express human TFPI-2 gene in E.coli and get the recombinant protein;to investigate the recombinant activities of antiplasmin and antitumor.Methods (1) Encoding region of mature protein of human TFPI-2 was amplified by PCR.The 645 bp PCR product was cloned into expression vector pET28a and transformed into BL21 strain to get expression.(2)Identifying the DNA segment of TFPI-2 with enzyme digestion and colony PCR and the TFPI-2 fusion protein with western blot respectively.(3)To establish the kinetics assay for detecting the TFPI-2 and test it′s inhibiting plasmin activities.(4)To assess ovarian tumor cell migratory and invasive behaviors with the Boyden chamber in vitro.Results (1)Expression plasmid of recombinant TFPI-2 was constructed and high-level expression of TFPI-2 was produced as fusion protein. (2) The TFPI-2 fusion protein was identified by western blot. (3) Antiplasmin activity of the TFPI-2 was confirmed in the fluid and on the cell surface. (4) In invasion assay, the number of the A2780 and A2780-TFPI-2 groups transferred the Matriged matrix-coated PVPF membrane was obvious decreased compared with that of A2780 group(P0.05).Conclusion (1) Prokaryotic expression of TFPI-2 gene was got, which can provide the rich experimental material for investigating the role of TFPI-2 in relative fields; (2)Recombinant TFPI-2 has antiplasmin activity, which provides the experiment basis for investigating the role of recombinant TFPI-2 in human ovarian tumor migration and invasion in vitro; (3) The recombinant TFPI-2 inhibits the invasive ability of human ovarian tumor cells in vitro, but has no effect on the migration, which may provide a target basis for treating human ovarian tumor with TFPI-2 protein therapy.