Delayed intracerebral hemorrhage after ventriculo-peritoneal shunt procedure: two case reports and a review of literature.

OBJECTIVE: Ventriculo-peritoneal shunt (VPS) is a commonly used procedure for treating hydrocephalus of various causes. Delayed intracerebral hemorrhage (DICH) is regarded as a very rare complication after VPS procedure, with mechanisms still indeterminate. We report two cases of this condition whereby we discuss the characteristics and potential explanations for it in a short review of literature. CASE REPORT: Two female patients, aged 49, 76 respectively, were admitted to our hospital for hydrocephalus in the year 2021 as ordinary participants among many other patients with the same diagnosis. Unforeseeably, what made them special was DICH situations occurred after regular VPS procedures. Luckily both of them responded well to subsequent conservative treatment with no deterioration and were discharged promisingly in the end. Surprisingly, both of the valve mechanisms in these two functioned properly so far even after the ominous DICH events. Quality of life also improved a lot for them, thus we could consider the VPS surgery successful as well as the later management of the unwanted hematomas, in other words, a full recovery from DICH. CONCLUSIONS: Only few cases or series of DICH were reported in the past decades and the mechanisms of it still lack a verdict. We intend to attribute physical vascular injury due to a closer contact between cerebral blood vessels and the VPS catheter for DICH in the younger patient, while degenerative changes of brain tissue might be the protagonist in the elder one. More discreetness should be expected in perioperative management of VPS patients, with still a long way to go to fully understand the mechanisms of DICH and prevent the complication in highest measure.

Downregulation of nuclear protein-1 induces cell cycle arrest in G0/G1 phase in glioma cells in vivo and in vitro via P27.

Nuclear protein-1 (NUPR1), also named as p8 or Com1, has been since found overexpressed in several human malignant tumor cells, such as glioma. NUPR1 also regulates cell cycle progression, however, the role of NUPR1 in regulating glioma cell cycle remains poorly understood. Knockdown efficiency of U87 and U251 cells infected with the lentiviral vector was detected by quantitative real-time PCR and western blot in vitro and in vivo. Flow cytometry and western blot were used to explore a mechanism by which NUPR1 modulates cell cycle in U87 and U251 cells. Immunohistochemistry was applied to detect expression levels of P27, CDK2, and cyclin E in human glioma tissues with NUPR1 positive expression and tumorigenesis in nude mice. We confirmed that the downregulation of NUPR1 arrested the cell cycle in the G0/G1 phase in U87 and U251 cells in vitro. Furthermore, the expression level of P27 was increased, and CDK2 and cyclin E were decreased upon silencing NUPR1 expression in vitro and in vivo. In conclusion, the knockdown of NUPR1 induces cell cycle arrest in the G0/G1 phase in glioma cells via P27.

Endothelial microparticles induce vascular endothelial cell injury in children with Kawasaki disease.

OBJECTIVE: To explore the role of microparticles produced by endothelial cells in the injury of vascular endothelial cells. MATERIALS AND METHODS: We stimulated human umbilical vein endothelial cells (HUVEC) with TNF-α in vitro, analyzed the change of cellular morphology, and measured EMP level in the supernatant with a flow cytometer. Then, we evaluated the corresponding clinical indicators and the role of EMP in endothelial injury. RESULTS: The endothelial cellular morphology underwent significant changes, and a large number of microparticles were secreted. In turn, these microparticles blocked cell cycle and induced apoptosis. CONCLUSIONS: The microparticles produced by endothelial cells play an important role in the injury of vascular endothelial cells.