A new synonym of Rhododendronleishanicum (subg. Hymenanthes) from China (Ericaceae).

Based on a critical examination of type specimens, images of living plants, and the literature has shown Rhododendronoligocarpum to be conspecific with R.leishanicum. Although slight variations in corolla colour exist amongst different populations of R.oligocarpum, it does not serve as a key distinguishing trait. Therefore, we reduced R.oligocarpum to a synonym of R.leishanicum, and recommend placing it in Subsection Maculifera.

Microneurosurgery and subsequent gamma knife radiosurgery for functioning pituitary macroadenomas or giant adenomas: One institution's experience.

OBJECTIVE: Functioning pituitary macroadenoma and giant adenoma have large growth volumes and endocrinological abnormalities, requiring proper medical intervention. In this retrospective study, microneurosurgery and subsequent gamma knife radiosurgery (GKRS) is assessed for efficacy and safety for the treatment of functioning pituitary macroadenoma and giant adenoma. METHODS: Between January 2007 and December 2011, 59 patients with functioning pituitary macroadenoma (n=38) or giant adenoma (n=21) received microneurosurgical resection, and after three months, GKRS with average maximum radiation dose ∼42Gy (range 30-66.7Gy). The median follow-up time was 54.3 months (range 36-85 months). RESULTS: The combined treatment controlled tumor growth in 81.4% (48/59) of patients, and improved the endocrinological status in 64.4% (38/59). Complications included hypopituitarism and visual deterioration (22 and 7 patients, respectively). Large tumor size at presentation was a risk factor for tumor recurrence, but not age, gender, invasion, radiosurgical dose, pituitary hormone status or follow-up period. Better outcomes were achieved by patients with macroadenoma than giant adenoma. CONCLUSIONS: Combined microneurosurgery and GKRS are safe and effective for functioning pituitary macroadenomas or giant adenomas. Tumor control and endocrinological improvement were satisfactory, with minimal complications.

Bevacizumab treatment for newly diagnosed glioblastoma: Systematic review and meta-analysis of clinical trials.

High-grade glioma is a richly neovascularized brain solid tumor with a poor prognosis. Bevacizumab is a recombinant humanized monoclonal antibody that inhibits vascular endothelial cell proliferation and angiogenesis, which has shown clinical efficacy in recurrent glioblastoma. MEDLINE/PubMed, EMBASE and Web of Science databases were searched for relevant studies that compared bevacizumab plus combined radiotherapy/temozolomide (RT/TMZ) with RT/TMZ alone in newly diagnosed glioblastoma (GBM). Of all the studies identified, three comparative trials were included in the systematic review. All three enrolling trials, including a total of 1,738 patients, investigated bevacizumab or placebo plus combined RT/TMZ treatment in glioblastoma. The result showed no increased overall survival (OS) (pooled hazard ratio (HR), 1.04; 95% confidence interval (CI), 0.84-1.29; P=0.71) but increased progression-free survival (HR, 0.74; 95% CI, 0.62-0.88; P=0.0009). However, the two randomized double-blind placebo-control trials exemplified a high rate of adverse events of the bevacizumab compared with the placebo group while discrepant points were noted in term of quality-of-life outcome. Additionally, bevacizumab plus RT/TMZ did not increase the 6-month survival rate [odd ratios (ORs), 0.65; 95% CI, 0.37-1.13; P=0.13). Overall, addition of bevacizumab to radiotherapy-temozolomide treatment may be an effective therapy strategy for improving progression-free survival. OS and the 6-month survival rate was not prolonged and there was questionable efficacy of bevacizumab on the quality-of-life of glioblastoma patients, thus further clinical trials should be performed.

Osteogenic ability of bone marrow stem cells intraoperatively enriched by a novel matrix.

Poly-L-lysine (PLL) is commonly used as an adhibiting agent due to its good viscosity, and demineralized bone matrix (DBM) is a common enriched matrix for selective cell retention technology. Therefore, the aim of this study was to use PLL to coat the surface and interspaces of DBM to form a novel type of enriched matrix [DBM coated with PLL (PLL-DBM)], in order to effectively improve the enrichment effects of bone marrow stem cells and enhance their osteogenic ability. Electron microscope scanning and the infrared spectrum were used to observe the structure of PLL-DBM and the optimal conditions for the combination of PLL and DBM. Enriching effects on bone marrow nucleated cells (NCs) and platelets (PLTs) were detected with an automated hematology analyzer. The osteogenesis of the following four groups was assessed with a grafting bone model in a goat spinal transverse process: IA, tissue engineered bone (TEB) fabricated following enrichment of bone marrow with PLL-DBM; IB, autogenous iliac bone; IIC, TEB fabricated following enrichment of bone marrow with DBM; IID, blank DBM. The goats were sacrificed in one batch at week 16 after the surgery and the fusion specimens were examined using X-ray and three-dimensional computed tomography (CT). In addition, the CT value was determined and the histology and biomechanics were analyzed in order to evaluate the osteogenic ability. The results showed that PLL and DBM combined well and that PLL-DBM exhibited a natural mesh pore structure. The fold enrichment of NCs and PLTs with PLL-DBM was significantly higher than that with DBM. The fusion effects of the IA and IB groups were similar and significantly enhanced compared with those of the IIC and IID groups. The results confirmed that PLL-DBM is an ideal enriched matrix for bone marrow stem cells, and TEB rapidly fabricated by PLL-DBM intraoperatively enriched bone marrow stem cells exhibits an improved osteogenic ability.

[Application of posterior spinal canal reconstruction in surgery of intraspinal tumor].

OBJECTIVE: To apply H-shaped allogeneic bone graft combined with spinous process replantation for posterior spinal canal reconstruction after removal of intraspinal tumors, and observe its effectiveness. METHODS: A total of 48 cases of thoracic and lumbar intraspinal tumors were recruited between February 2006 and May 2012, including 35 males and 13 females with a mean age of 29.5 years (range, 17-48 years). The disease duration was 3-16 months (mean, 10.5 months). Intraspinal tumors located at T5,6 in 3 cases, at T10 in 7 cases, at T12, L1 in 13 cases, at L3 in 10 cases, and at L4-S1 in 15 cases. There were 18 cases of epidural meningioma, 2 cases of epidural lipoma, 3 cases of extramedullary neurological tumors, 10 cases of extramedullary meningioma, 6 cases of extramedullary schwannoma, 6 cases of intramedullary ependymoma, and 3 cases of intramedullary astrocytoma. All patients underwent H-shaped allogeneic bone graft combined with spinous process replantation for posterior spinal canal reconstruction after removal of intraspinal tumor by posterior laminectomy. The Oswestry disability index (ODI) was used to assess postoperative symptom improvement, and the Frankel grade of spinal cord injury to evaluate the extent of nerve damage and recovery. RESULTS: After operation, 8 cases had cerebrospinal fluid leakage, and 4 cases had yellowish exudate, and they were all cured after appropriate treatment; primary healing of wound was obtained in the other cases, without postoperative complication. Forty-eight patients were followed up 18-72 months (mean, 38 months). CT showed all the graft bones healed and posterior spinal canal was well reconstructed without iatrogenic spinal stenosis formation. X-ray film showed no vertebral instability or spondylolisthesis, and no shifting of reconstructed vertebrae. MRI showed no recurrence except 1 case. The symptoms were improved significantly after operation; the ODI score at last follow-up (16.69 ± 2.53) was significantly lower (t = 0.89, P = 0.00) than that at preoperation (47.83 ± 7.25). The results of symptom improvement were excellent in 36 cases, good in 10 cases, fair in 1 case, and poor in 1 case; the excellent and good rate was 95.83%. At last follow-up, Frankel grade was improved significantly (Z = 13.32, P = 0.00) when compared with preoperative grade except 1 recurrent patient. CONCLUSION: The application of the H-shaped allogeneic bone graft combined with spinous process replantation can well reconstruct the posterior spinal canal, and also can effectively avoid iatrogenic spinal stenosis, so it is worthy of promoting in the clinical treatment of intraspinal tumor surgery.

Identification of type II inhibitors targeting BRAF using privileged pharmacophores.

V-RAF murine sarcoma viral oncogene homologue B1 (BRAF) is the most frequently mutated protein kinase in human cancers. The most common mutant BRAF V600E constitutively activates the RAS/RAF/MEK/ERK signaling pathway. BRAF has been validated as an important therapeutic target in human cancers. Phenylaminopyrimidine and unsymmetrical diaryl urea are two privileged pharmacophores in kinase inhibitor drug discovery. Herein, we describe the design of a novel hybrid pharmacophore, 4-phenylaminopyrimidine urea, using the above two pharmacophores. A new series of compounds were in turn synthesized and evaluated to successfully identify selective inhibitors of BRAF and oncogenic BRAF V600E. Once daily oral dosing of lead compound 3 demonstrated sustained antitumor efficacy in A549 human non-small-cell lung cancer xenograft model. Molecular docking suggested that compound 3 might be a type II kinase inhibitor binding to the DFG-out conformation of BRAF.