Alterations in gut microbiome associated with severity of atopic dermatitis in infants.

BACKGROUND: Atopic dermatitis (AD) often arises in infancy, and gut microbial dysbiosis is associated with the development of AD. However, less is known about specific changes in early-life gut microbiome associated with AD and AD severity. This study aims to reveal the gut microbial composition and function profiles associated with the severity of AD in infants. METHODS: Sixty-two infants (mean [SD] age, 4.7[1.9] months) with different severities of AD were enrolled and divided into three groups (mild, moderate and severe) according to the Scoring Atopic Dermatitis (SCORAD) index. The profiles of gut microbial composition and function were analysed by sequencing 16S ribosomal RNA amplicons. Quality of life on children and the family was evaluated using published questionnaires. RESULTS: Decreased levels of Clostridium sensu stricto, Collinsella and increased level of Parabacteroides presented in the severe AD group compared with the mild AD group after adjusting potential confounders (p < 0.05). There were strong positive correlations between the Scoring Atopic Dermatitis (SCORAD) index and the relative abundance (RA) of Bacteroides and functional pathways for metabolism of sphingolipids and glycosphingolipids (p < 0.05). The SCORAD index was negatively correlated with the RA of Clostridium sensu stricto (p < 0.05), and was also positively correlated with the index of quality of life on children and the family (p < 0.05). CONCLUSION: Discrepancies in gut microbial composition and functional pathways were observed in infants with mild-to-severe AD. Alterations in butyrate-producing bacteria (Clostridium sensu stricto), sphingolipid-producing bacteria (Parabacteroides, Bacteroides), and related functional pathways were associated with the severity of AD infants.

Structural Dynamics-Driven Discovery of Anticancer and Antimetastatic Effects of Diltiazem and Glibenclamide Targeting Urokinase Receptor.

Diltiazem and glibenclamide are commonly used hypotensive and antidiabetic drugs. This study reports the discovery of the potential antitumor and antimetastatic effects of these two drugs using a structural dynamics-driven virtual screening targeting urokinase receptor (uPAR). Owing to uPAR's high flexibility, currently resolved crystal structures of uPAR, all in ligand-bound states, provide limited representations of its physiological conformation. To improve the accuracy of screening, we performed a long-timescale molecular dynamics simulation and obtained the representative conformations of apo-uPAR as the targets for our screening. Experimentally, we demonstrated that diltiazem and glibenclamide bound uPAR with KD values in the micromolar range. In addition, both compounds effectively suppressed tumor growth and metastasis in a uPAR-dependent manner in vitro and in vivo. This work not only provides two potent uPAR inhibitors but also reports a proof-of-concept study on the potential off-label antitumor and antimetastatic uses of diltiazem and glibenclamide.

The natural occurring RRR-α-Tocopherol and synthetic α-Tocopherol stereoisomers in maternal plasma, cord plasma and breast milk among six regions of China.

The study aimed to investigate RRR-α-Tocopherol and synthetic α-Tocopherol stereoisomers in maternal plasma, cord plasma and breast milk from different regions of China, providing a reference for further guidance on maternal diet and the potential need to supplement mothers with vitamin E. Two hundred and twenty-one sample sets from maternal plasma, cord plasma and three stages of milk (colostrum: 1-5 d after delivery; transitional milk: 10-15 d; mature milk: 40-45 d) were collected longitudinally in six regions of Shanghai, Guangzhou, Tianjin, Chengdu, Lanzhou and Changchun. α-Tocopherol and the stereoisomers were determined by HPLC with a fluorescence detector. The RRR configuration accounted for more than 80 % of α-Tocopherol in maternal plasma, cord plasma and breast milk. Overall, there were regional differences both in α-Tocopherol and RRR. There were significant correlations between α-Tocopherol and RRR in maternal plasma, cord plasma and milk (P < 0.001). As well as negative correlations among α-Tocopherol, RRR and weight-related indicators, which refer to pre-gestation weight and BMI, pre-delivery weight and BMI and pregnancy weight gain, in almost all of samples. This study suggested that RRR-α-Tocopherol was the dominant configuration of α-Tocopherol and the main active form of vitamin E in the early life, guiding the rational supplement of pregnant women and the addition of α-Tocopherol in infant formula milk powder.

Phoenixin-14 alleviates inflammatory smooth muscle cell-induced endothelial cell dysfunction in vitro.

BACKGROUND: Intracranial aneurysm (IA) is cerebrovascular disorder which refers to local vessel wall damage to intracranial arteries, forming abnormal bulge. Both endothelial cells (ECs) and vascular smooth muscle cells (VSMCs) are closely associated with IA formation and rupture. Inflammatory SMCs (iSMCs) were reported to induce EC dysfunction and result in IA progression. Phoenixin-14 (PNX-14) is a recently discovered brain peptide with pleiotropic roles, which participates in reproduction, cardio protection, lipid deposition and blood glucose metabolism. PNX-14 was previously reported to protect brain endothelial cells against oxygen-glucose deprivation/reoxygenation (OGD/R)-induced cell injury. Therefore, our study was designed to investigate the influence of PNX-14 on iSMCs-induced endothelial dysfunction. METHODS: Inflammation in SMCs was induced by cyclic mechanical stretch. Human umbilical vein endothelial cells (HUVECs) were exposed to SMC- or iSMC-conditioned medium and then treated with 100 nM PNX-14 for 24 h. The levels of proinflammatory cytokines (IL-1ß, IL-6 and TNF-α) in cell supernatants were analyzed by ELISA. Cell viability, apoptosis, angiogenesis and migration were subjected to CCK-8 assay, flow cytometry analysis, tube formation assay and Transwell migration assay. The protein levels of proinflammatory cytokines and apoptosis markers (Bcl-2 and Bax) were evaluated by western blotting. RESULTS: Cyclic mechanical stretch upregulated IL-1ß, IL-6 and TNF-α levels in SMCs. Treatment with SMC- or iSMC-conditioned medium HUVECs inhibited cell viability, angiogenesis and migration and induced apoptosis in HUVECs. iSMC-conditioned medium has more significant effects on cell functions. However, the influence of SMC- or iSMC-conditioned medium treatment on HUVEC biological functions were reversed by PNX-14 treatment. PNX-14 exerts no significant influence on the biological functions of HUVECs treated with SMC medium. CONCLUSION: PNX-14 alleviates iSMCs-induced endothelial cell dysfunction in vitro.

Comparison of nutritional effectiveness and complication rate between early nasojejunal and nasogastric tube feeding in patients with an intracerebral hemorrhage.

BACKGROUND: This study aimed to compare nutritional effectiveness and complication rate between early nasojejunal and nasogastric tube feeding in patients with an intracerebral hemorrhage. METHODS: This was a retrospective study. Eighty patients with an intracerebral hemorrhage were divided into a nasojejunal and a nasogastric tube feeding group. Feeding tubes were placed within 6 h after admission, and enteral feeding began within 2 h after tube placement. The nutritional status and complication rate of the 2 groups were compared before and 2 and 4 weeks after beginning feeding. RESULTS: Serum prealbumin, serum albumin, and hemoglobin levels were significantly higher in the nasojejunal tube feeding group than in the nasogastric tube feeding group at 2 and 4 weeks after beginning feeding (all, p < 0.05). The incidence of gastric retention, pulmonary aspiration, and pneumonia were lower in the early nasojejunal tube feeding group than in the early nasogastric tube feeding group (all, p < 0.05). There was no significant difference in the incidence of diarrhea between the 2 groups. CONCLUSION: Compared with early nasogastric feeding, early nasojejunal feeding provides better nutritional effectiveness and a lower incidence of gastric retention, pulmonary aspiration, and pneumonia in patients with an intracerebral hemorrhage.

Trans-eyebrow supraorbital keyhole approach for suprasellar and intra-suprasellar Rathke cleft cysts: the experience of 16 cases and a literature review.

BACKGROUND: Purely suprasellar and some complex intra-suprasellar Rathke cleft cysts (RCCs) are commonly treated via extended endonasal endoscopic approach or traditional transcranial approach. The feasibility of the trans-eyebrow supraorbital keyhole approach (TSKA) for RCCs was evaluated in this retrospective study. METHODS: A cohort of 16 patients (11 females and 5 males) with RCC was surgically treated via TSKA between January 2013 and November 2021. The medical data and follow-up results were analyzed. RESULTS: Eight patients had a purely suprasellar RCC, and 8 patients had an intra-suprasellar RCC with most of pituitary gland occupying the sellar floor. The mean maximal size of the cysts was 15.4 (range 7-29) mm. Postoperatively, complete cyst drainage was achieved in 15 (93.7%) patients. Preoperative headache, visual dysfunction, and hypopituitarism improved in 12 (100.0%), 3 (75.0%) and 3 (75.0%) patients, respectively, and hyperprolactinemia normalized in all patients. Except 2 (12.5%) cases of transient diabetes insipidus (TDI), no other complications were observed. During the mean follow-up period of 41.0 (range 4-102) months, 1 (6.3%) radiological recurrence was found. CONCLUSIONS: For the treatment of purely suprasellar and some intra-suprasellar RCCs with most of the pituitary occupying the sellar floor, the endoscopic TSKA has the advantage of the minimal invasiveness, excellent visualization of the intrasellar compartment, no additional damage to the underlying pituitary gland, and no risk of CSF leakage. TDI or DI is relative commonly found in treatment of these RCCs. During surgery, care should be taken to avoid damage to the surrounding structures, including the pituitary stalk.

Identification of Antithrombotic Natural Products Targeting the Major Substrate Binding Pocket of Protein Disulfide Isomerase.

Protein disulfide isomerase (PDI) is a vital oxidoreductase. Extracellular PDI promotes thrombus formation but does not affect physiological blood hemostasis. Inhibition of extracellular PDI has been demonstrated as a promising strategy for antithrombotic treatment. Herein, we focused on the major substrate binding site, a unique pocket in the PDI b' domain, and identified four natural products binding to PDI by combining virtual screening with tryptophan fluorescence-based assays against a customized natural product library. These hits all directly bound to the PDI-b' domain and inhibited the reductase activity of PDI. Among them, galangin showed the most prominent potency (5.9 µM) against PDI and as a broad-spectrum inhibitor for vascular thiol isomerases. In vivo studies manifested that galangin delayed the time of blood vessel occlusion in an electricity-induced mouse thrombosis model. Molecular docking and dynamics simulation further revealed that the hydroxyl-substituted benzopyrone moiety of galangin deeply inserted into the interface between the PDI-b' substrate-binding pocket and the a' domain. Together, these findings provide a potential antithrombotic drug candidate and demonstrate that the PDI b' domain is a critical domain for inhibitor development. Besides, we also report an innovative high-throughput screening method for the rapid discovery of PDI b' targeted inhibitors.

[Contents and isomers distribution of vitamin E in human mature breast milk from six regions of China in 2018-2019].

OBJECTIVE: The study aimed to investigate the contents and isomer composition of vitamin E in mature milk in different regions of China. METHODS: Simultaneously recruited 604 lactating mothers aged(29.58±3.43) from Shanghai, Guangzhou, Tianjin, Chengdu, Lanzhou and Changchun cities. They were mainly primiparas with good education background. A total number of 604 mature milk samples was collected. The contents of α-, γ-, δ-tocopherols and the stereoisomers of α-tocopherol were determined by high performance liquid chromatography(HPLC). RESULTS: The M(P25, P75) concentrations of α-tocopherol, RRR-α-tocopherol, γ-tocopherol and δ-tocopherol in Chinese mature milk were 3.16(2.29, 4.16)mg/L, 2.57(1.77, 3.48)mg/L, 0.89(0.58, 1.27)mg/L and 0.17(0.09, 0.27)mg/L, respectively. The total α-TE level was 3.09(2.22, 4.10)mg/L with statistically regional differences(P<0.001). RRR-α-tocopherol was the predominated stereoisomers of α-tocopherol, accounting for 83.17%(76.36%, 88.43%). The proportion of RRR in Tianjin mature milk was significantly lower than that in Lanzhou(77.11% vs. 86.16%, P<0.001) while breast milk samples from other regions had similar RRR-α-tocopherol proportions(82.82%-85.39%). CONCLUSION: Vitamin E content in mature milk was mainly composed of α-tocopherol. Even though the contents of tocopherols have large regional differences, RRR-α-tocopherol was predominated form in all breast milk samples. It is suggested that RRR-α-tocopherol was the main active form of vitamin E in the early stage of life.

LINC01116 boosts the progression of pituitary adenoma via regulating miR-744-5p/HOXB8 pathway.

Pituitary adenoma (PA) is one of the common intracranial tumors. In order to optimize status quo, seeking out potential biomarkers for pituitary adenoma diagnosis and treatment is urgent and important. Long non-coding RNAs (lncRNAs) have been related with progression of various cancers. Based on this reason and unknown role of long intergenic non-protein coding RNA 1116 (LINC01116) in pituitary adenoma, we aimed to explore the function and molecular mechanism of LINC01116 in pituitary adenoma. The RT-qPCR analysis showed that LINC01116 was abnormally overexpressed in pituitary adenoma cells. Down-regulated LINC01116 effectively suppressed cell proliferation and migration as well as epithelial-mesenchymal transition (EMT) progression in pituitary adenoma. Additionally, LINC01116 could competitively sponge miR-744-5p as shown by RIP, RNA pull down and luciferase reporter assays. Similarly, we also proved that homeobox B8 (HOXB8) was the target gene of miR-744-5p in pituitary adenoma cells. In the end, the rescue assays unmasked that HOXB8 could effectually reverse inhibition effect of LINC016 knockdown on pituitary adenoma cells proliferation, migration and EMT, further suggesting that LINC01116 expedited the pituitary adenoma progression by up-regulating HOXB8. Taken together, LINC01116 boosted the progression of pituitary adenoma cells via regulating miR-744-5p/HOXB8 pathway.

The development of a Chinese Healthy Eating Index for School-age Children and its Application in children from China Health and Nutrition Survey.

This study aimed to develop a Chinese Healthy Eating Index for School-age Children (CHEI-SC), apply it in the 2011 China Health and Nutrition Survey (CHNS) to assess dietary quality, and compared it with our former developed index named CHEI. Data of 3-day 24-hour diet recalls and household food inventory survey from 1600 school-age children in CHNS-2011 were used to develop the CHEI-SC, using the methods of standard portion size, energy-density-based approach, and least restrictive approach. The CHEI-SC included 19 components with a total score (T-score) ranging from 0 to 100. The investigated children had a median score of 49.6. Children with a higher T-score were more likely to have higher social economic status (SES), higher level of urbanisation, fewer family size, and regularly attending school. The CHEI-SC was able to assess dietary quality of Chinese school-age children, was sensitive to demographics, and more comprehensive and accurate than the CHEI.

Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions.

Objectives Cranioorbital lesions present a great challenge for neurosurgeons and ophthalmologists. There is no consensus on the choice of surgical approach. The aims of this study were to investigate 49 cases of cranioorbital lesions and evaluate surgical approaches and outcomes. Patients and Methods A retrospective study was done on 49 patients (51 operations) from 2009 to 2018. Information about the lesion was used to decide whether the supraorbital eyebrow approach (SEA) or pterional approach (PA) was performed. Results Twenty-eight patients had surgical resection using SEA, 21 patients received PA, each group included one case of recurrence, who underwent reoperation via the same approach. SEA provided better cosmetic satisfaction, and a shorter incision than PA ( p < 0.05). There was no significant difference in total resection rates, visual outcomes, recovery of ptosis, and other new surgical-related complications between SEA group and PA group ( p > 0.05). Forty-nine cases of proptosis (94.1%, 49/51) were improved. Thirty-three patients (33/37, 89.2%) who underwent follow-up for longer than 12 weeks had a modified Rankin Scale (mRS) score ≤ 3. Conclusion Surgery is the preferred treatment for cranioorbital lesions, but total resection is difficult. SEA may be a more minimally invasive option for some more limited lesions superior to optic nerve. PA may be more reasonable for the lesion with obvious hyperostosis and more extensive lesions.

Silencing of Long Non-Coding RNA (LncRNA) Non-Coding RNA Activated by DNA Damage (NORAD) Inhibits Proliferation, Invasion, Migration, and Promotes Apoptosis of Glioma Cells via Downregulating the Expression of AKR1B1.

BACKGROUND We aimed to investigate the functions of long non-coding RNA (lncRNA) non-coding RNA activated by DNA damage (NORAD) in glioma and identify the potential mechanisms. MATERIAL AND METHODS The expression of NORAD and AKR1B1 in human glioma cell lines were examined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Then, cell proliferation, invasion, and migration were tested by Cell Counting Kit-8 (CCK-8), colony formation assay, Transwell, and scratch wound healing assay after NORAD silencing. Meanwhile, western blotting was utilized to measure the expression of migration-related proteins. Apoptosis of glioma cells was detected using flow cytometry and apoptosis-related proteins expression was determined. Moreover, the correlation between NORAD and AKR1B1 was verified by RNA-binding protein immunoprecipitation (RIP assay). After co-transfection with AKR1B1 overexpressed plasmid and NORAD siRNA, cell proliferation, invasion, migration, and apoptosis were examined again. Furthermore, the expression of proteins in extracellular signal-regulated kinase (ERK) signaling was tested using western blotting. RESULTS The results revealed that NORAD and AKR1B1 were highly expressed in glioma cells. NORAD silencing inhibited proliferation, invasion and migration but promoted apoptosis of glioma cells, accompanied by the expression changes of migration- and apoptosis-related proteins. However, after co-transfection with AKR1B1 pcDNA3.1 in NORAD silencing cells, the effects of NORAD silencing on proliferation, invasion, migration, and apoptosis were attenuated. Consistently, the expression of phosphorylated ERK (p-ERK) was decreased after NORAD silencing, which were reversed following AKR1B1 overexpression. CONCLUSIONS These findings demonstrated that NORAD silencing suppressed proliferation, invasion, and migration and boosted apoptosis of glioma cells via downregulating the AKR1B1 expression, which may provide a potential therapeutic target for glioma treatment.

LncRNA FEZF1-AS1 Sponges miR-34a to Upregulate Notch-1 in Glioblastoma.

INTRODUCTION: LncRNA FEZF1-AS1 has been reported to be an oncogene in many types of cancer, while its role in glioblastoma (GBM) is unknown. This study aimed to investigate the potential involvement of FEZF1-AS1 in GBM. METHODS: FEZF1-AS1 expression in paired GBM and non-tumor tissues from GBM patients was determined by RT-qPCR. A 2-year follow-up was performed to analyze the prognostic value of FEZF1-AS1 for GBM. Cell transfections were performed to analyze the interactions between FEZF1-AS1, miR-34a and Notch-1. Transwell assay was performed to analyze the role of FEZF1-AS1, miR-34a and Notch-1 in regulating GBM cell invasion and migration. RESULTS: In this study, analysis of TCGA dataset revealed the upregulation of FEZF1-AS1 in GBM, and the overexpression of FEZF1-AS1 in GBM was further confirmed using GBM tissues from GBM patients included in this study. High levels of FEZF1-AS1 were correlated with poor survival. FEZF1-AS1 was predicted to form base pairing with miR-34a. However, overexpression of FEZF1-AS1 and miR-34a failed to affect the expression of each other. However, upregulation of Notch-1, a target of miR-34a, was observed after FEZF1-AS1 in GBM cells. Moreover, increased invasion and migration rates of GBM cells were observed after FEZF1-AS1 and Notch-1 overexpression. MiR-34a played an opposite role and reduced the effects of FEZF1-AS1 and Notch-1 overexpression. CONCLUSION: FEZF1-AS1 may sponge miR-34a to upregulate Notch-1 in GBM, thereby promoting cancer cell invasion and migration.

Investigation of the effects of laminin present in the basal lamina of the peripheral nervous system on axon regeneration and remyelination using the nerve acellular scaffold.

This study aimed to investigate the effects of laminin (LN) located in the basal lamina, which are important components of the peripheral nervous system-extracellular matrix, on axon regeneration and remyelination. Nerve acellular scaffolds (NASs) (S-untreated) were prepared using the acellular technique. The active component LN in the NASs was blocked (S-LN- ) or upregulated (S-LN+ ); S-LN+ contained seven times more LN than did the S-untreated group. The adhesion capacity of Schwann cells (SCs) to the three types of NAS (S-untreated, S-LN- , and S-LN+ ) was assessed in vitro. Our results showed that the adhesion of SCs to the NASs was significantly reduced in the S-LN- group, whereas no difference was observed between the S-LN+ and S-untreated groups. The pretreated NASs were used to repair nerves in a nerve injury mouse model with the animals divided into four groups (S-LN- group, S-untreated group, S-LN+ group, and autograft group). Two weeks after surgery, although there was no difference in the S-LN- group, S-untreated group and S-LN+ group, the newly formed basal lamina in the S-LN- group were significantly lower than those in the other two groups. Four weeks after surgery, the S-LN+ group had higher numbers of newly generated axons and their calibers, more myelinated fibers, thicker myelin sheaths, increased myelin basic protein expression, and improved recovery of neural function compared to those of the S-LN- and S-untreated groups, but all of these parameters were significantly worse than those of the autograft group. Downregulation of the LN level in the NAS leads to a reduction in all of the above parameters.

Lactational changes of fatty acids and fat-soluble antioxidants in human milk from healthy Chinese mothers.

Human milk fat is specially tailored to supply the developing infant with adequate and balanced nutrients. The present study aimed to quantify the composition of fatty acids, tocopherols and carotenoids in human milk, with special emphasis on the lactational changes. Colostrum, transitional and mature milk samples were collected longitudinally from the same forty-two healthy, well-nourished Chinese mothers. Fatty acids were quantified by GC with carotenoids (carotenes and xanthophylls) and tocopherols (α-, γ-tocopherol) determined by HPLC. Total fatty acid (TFA) content increased from 15·09 g/l in colostrum to 32·57 g/l in mature milk with the percentages of DHA and arachidonic acid (ARA) decreased. The ratio of n-6:n-3 PUFA and ARA:DHA remained constant during lactation at about 11:1 and 1·3:1, respectively. Both α-tocopherol and γ-tocopherol decreased over lactation with the ratio of α-:γ-tocopherol declined significantly from 7·21:1 to 4·21:1 (P < 0·001). Carotenoids all dropped from colostrum to mature milk as the less polar carotenes dropped by 88·67 %, while xanthophylls only dropped by 35·92 %. Lutein was predominated in both transitional and mature milk carotenoids (51·64-52·49 %), while colostrum carotenoids were mainly composed of lycopene (32·83 %) and ß-carotene (30·78 %). The concentrations of tocopherols and xanthophylls but not carotenes were positively associated with TFA content in milk. These results suggested that colostrum and mature milk contained divergent lipid profiles and selective transfer mechanisms related to polarity might be involved. The present outcomes provide new insights for future breast-feeding studies, which also add in scientific evidences for the design of both initial and follow-on infant formulas.

Outcomes After Pterional and Supraorbital Eyebrow Approach for Cranio-Orbital Lesions Communicated via the Supraorbital Fissure-A Retrospective Comparison.

OBJECTIVE: The pterional approach (PA) has been used to remove cranio-orbital lesions that have communicated via the supraorbital fissure (SOF). The supraorbital eyebrow approach (SEA) has become increasingly popular as a minimally invasive approach. However, few reports have examined the SEA for cranio-orbital lesions. We assessed the relative advantages, disadvantages, and selection criteria for these 2 approaches. METHODS: The data from all consecutive patients who had undergone removal of a cranio-orbital lesion that communicated via the SOF using the PA or SEA were analyzed. RESULTS: Of the 25 patients, 13 had undergone surgical resection using the SEA and 12 had undergone resection using the PA. The SEA provided better cosmetic satisfaction, resulted in a shorter surgical time, and required a shorter incision (P < 0.05). Proptosis had improved significantly in all the patients. No significant differences were found in the total resection rates, visual outcomes, recovery of ptosis, or other new surgically related complications between the 2 groups (P > 0.05). All the patients were followed up for an average of 21.9 months. One patient in each group had developed recurrence or progression that required radiotherapy. The disease of the other patients with subtotal resection was stable or atrophic. CONCLUSION: The SEA provided better cosmetic satisfaction, resulted in a shorter surgical time, and required a shorter incision. The SEA might be a more minimally invasive option for lesions communicating via the SOF without obvious hyperostosis. The PA might be more reasonable for lesions with obvious hyperostosis and more extensive lesions in the cavernous sinus.

An Ectopic Recurrent Craniopharyngioma of the Temporal Lobe: Case Report and Review of the Literature.

BACKGROUND: Ectopic recurrent craniopharyngioma is rare. We present a case of a temporal ectopic recurrent tumor after a trans-eyebrow supraorbital keyhole approach and provide a review of the reported data with basic statistics. METHODS: We retrospectively reviewed 57 cases of craniopharyngiomas surgically treated at our institution. A temporal ectopic recurrent tumor with 10% high Ki-67 proliferation index expression was identified. The lesion underwent gross total resection without any complications. We also reviewed the related data and performed a basic statistical analysis. RESULTS: Our review found 64 cases of ectopic recurrent craniopharyngioma that had been reported (including the present case). The median interval until ectopic recurrence was 4.0 years (interquartile range, 2.0-10.0). Of the 64 lesions, 48 (75%) were adamantinous, 6 (9%) were papillary, and 10 (16%) were unknown. Also, 34 tumors (53%) were located in the previous surgical tract, and 30 (47%) had disseminated along the cerebrospinal fluid pathway. Of the 64 ectopic tumors, 50 (78%) could be resected in total without complications. CONCLUSIONS: Ectopic recurrent craniopharyngioma is a rare phenomenon. Meticulous protection of the entire surgical field and careful manipulation of the tumor during resection are required to prevent possible ectopic recurrence. Regular follow-up examinations are strongly recommended to detect any further recurrences. Gross total resection is the treatment of choice for ectopic recurrence.

Trans-eyebrow supraorbital keyhole approach to tuberculum sellae meningiomas: a series of 30 cases with long-term visual outcomes and recurrence rates.

BACKGROUND: Approach selection paradigm for tuberculum sellae meningiomas (TSMs) is still a point of discussion. The trans-eyebrow supraorbital keyhole approach (TSKA) is a minimally invasive transcranial approach and has been used for the treatment of TSMs during recent years. In this study, we presented a series of 30 cases of TSMs treated via TSKA with a long-term follow-up. METHOD: Thirty patients with TSMs underwent surgery via TSKA between December 2006 and August 2018. The medical data and follow-up results were retrospectively analyzed. RESULTS: A total of 5 males and 25 females were included in this study. Three patients presented with recurrent TSMs. The mean tumor size was 25.3 ± 7.3 mm (range, 10-48 mm). The mean follow-up period was 58.0 months (interquartile range, 33.5-86.3 months). Gross total resection (GTR) was achieved in 27 patients (90.0%). One recurrence (3.3%) occurred 9 years after surgery. Out of 29 patients with preoperative visual impairment, 17 (58.6%) improved, eight (27.6%) remained stable, and four (13.8%) deteriorated. No peri-operative death, CSF rhinorrhea, or permanent endocrine dysfunction occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the glasgow outcome scale score was five in 27 patients (90.0%). CONCLUSION: The TSKA is characterized by minimal invasion with a satisfactory cosmetic outcome. Based on the tumor characteristics and surgeon's experience, this approach can be employed as an alternative minimally invasive approach for the treatment of TSMs.

Trans-eyebrow supraorbital keyhole approach in suprasellar and third ventricular craniopharyngioma surgery: the experience of 27 cases and a literature review.

BACKGROUND: The trans-eyebrow supraorbital keyhole approach, a minimal transcranial approach, has been widely used in different types of surgery for sellar and parasellar lesions. In this study, we investigated the outcome of this approach in the surgical treatment of suprasellar and third ventricular craniopharyngioma. METHODS: Twenty-seven patients with suprasellar and third ventricular craniopharyngioma underwent surgery via a supraorbital approach between June 2007 and June 2018. The medical data and follow-up results were retrospectively analyzed. RESULTS: All tumors were located in the suprasellar region and the third ventricle. The mean tumor size was 29.1 mm. The mean follow-up period was 49.6 months. Gross total resection (GTR) was achieved in 23 patients (85.2%). Of 17 patients with preoperative visual impairment, 12 patients (70.6%) showed improvement. Following surgery, 11 patients exhibited new-onset anterior hypopituitarism, ten developed diabetes insipidus, and two became overweight. One residual tumor relapsed 1 year after surgery. No perioperative death, cerebrospinal fluid (CSF) rhinorrhea, or meningitis occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the Extended Glasgow Outcome Scale Score was 8 in 25 patients (92.6%). CONCLUSION: The supraorbital trans-eyebrow keyhole approach is characterized by minimal invasion and a satisfactory cosmetic outcome. According to our experience, craniopharyngiomas located in the suprasellar region and the third ventricle can be safely resected via a trans-eyebrow supraorbital keyhole approach.