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1.
Neural Regen Res ; 17(3): 618-624, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34380902

ABSTRACT

Patients with type 2 diabetes mellitus (T2DM) often have cognitive impairment and structural brain abnormalities. The magnetic resonance imaging (MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function, and can therefore also be used to reflect whole-brain structural changes related to T2DM. A total of 136 participants (64 men and 72 women, aged 55-86 years) were recruited for our study between January 2014 and December 2016. All participants underwent MRI and Mini-Mental State Examination assessment (including 42 healthy control, 38 T2DM without cognitive impairment, 26 with cognitive impairment but without T2DM, and 30 T2DM with cognitive impairment participants). The total and sub-category brain atrophy and lesion index scores in patients with T2DM with cognitive impairment were higher than those in healthy controls. Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2DM patients with cognitive impairment and patients with T2DM and cognitive impairment. After adjusting for age, the brain atrophy and lesion index retained its capacity to identify patients with T2DM with cognitive impairment. These findings suggest that the brain atrophy and lesion index, based on T1-weighted and T2-weighted imaging, is of clinical value for identifying patients with T2DM and cognitive impairment. Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2DM that is complicated by cognitive impairment. This study was approved by the Medical Ethics Committee of University of South China (approval No. USC20131109003) on November 9, 2013, and was retrospectively registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900024150) on June 27, 2019.

3.
World Neurosurg ; 112: e407-e414, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29355809

ABSTRACT

BACKGROUND: Tumor location is a major prognostic factor in glioblastomas and may be associated with clinical properties. This study established and analyzed the correlation between tumor location and clinical properties of glioblastomas in frontal and temporal lobes. METHODS: This retrospective study determined the location of glioblastomas in the frontal lobe (FL) or temporal lobe (TL) based on preoperative magnetic resonance imaging. Clinical, radiologic, and molecular characteristics of FL and TL glioblastomas were compared to define their clinical properties, including sex, age, sides, relationship to ventricle, imaging subtypes, volume, isocitrate dehydrogenase mutation, promoter methylation of O6-methylguanine-DNA methyltransferase, progression-free survival, and overall survival. RESULTS: The study enrolled 406 patients (182 [44.83%] in FL group and 224 [55.17%] in TL group) with a mean age of 69.8 years. Compared with FL group, TL group had higher incidence of female patients (P = 0.024), tumor location distant to the ventricle (P = 0.006), isocitrate dehydrogenase mutations (P = 0.021), promoter methylation of O6-methylguanine-DNA methyltransferase (P = 0.012), and prolonged progression-free survival and overall survival (P < 0.05). No significant differences were observed between groups with respect to age ≥60 years at study entry (P = 0.668), sides (P = 0.879), imaging subtypes (P = 0.362), or volume (P = 0.709). CONCLUSIONS: This study demonstrated that different tumor locations are associated with diverse clinical properties of glioblastomas in FL and TL. This information will aid in increasing understanding of glioblastoma biology for application in baseline comparisons in future clinical trials.


Subject(s)
Brain Neoplasms/pathology , Frontal Lobe/pathology , Glioblastoma/pathology , Temporal Lobe/pathology , Aged , Biomarkers, Tumor/genetics , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/genetics , Brain Neoplasms/mortality , DNA Methylation , Female , Frontal Lobe/diagnostic imaging , Glioblastoma/diagnostic imaging , Glioblastoma/genetics , Glioblastoma/mortality , Humans , Isocitrate Dehydrogenase/genetics , Magnetic Resonance Imaging , Male , Middle Aged , Mutation , Prognosis , Promoter Regions, Genetic , Retrospective Studies , Survival Rate , Temporal Lobe/diagnostic imaging
4.
Chin J Traumatol ; 16(4): 221-4, 2013.
Article in English | MEDLINE | ID: mdl-23910674

ABSTRACT

OBJECTIVE: The management of secondary normal pressure hydrocephalus (sNPH) is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible factors influencing prognosis and provide theoretical basis for clinical treatment of sNPH. METHODS: A retrospective study was carried out to investigate the results of 31 patients with sNPH who underwent ventriculoperitoneal shunt surgery from January 2007 to December 2011. We processed the potential influencing factors by univariate analysis and the result further by multivariate logistic regression analysis. RESULTS: Factors including age, disease duration and Glasgow coma scale (GCS) score before surgery significantly influenced the prognosis of sNPH (P less than 0.05). Further logistic regression analysis showed that all the three factors are independent influencing factors. CONCLUSION: Age, disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH.


Subject(s)
Hydrocephalus, Normal Pressure/surgery , Ventriculoperitoneal Shunt , Adult , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Treatment Outcome
5.
Chin J Traumatol ; 16(3): 136-9, 2013.
Article in English | MEDLINE | ID: mdl-23735546

ABSTRACT

OBJECTIVE: To study the influence and mechanism of acute ethanol intoxication (AEI) on rat neuronal apoptosis after severe traumatic brain injury (TBI). METHODS: Ninety-six Sprague-Dawley rats were randomly divided into four groups: normal control, AEI-only, TBI-only and TBI+AEI (n equal to 24 for each). Severe TBI model was developed according to Feeney's method. Rats in TBI+AEI group were firstly subjected to AEI, and then suffered head trauma. In each group, animals were sacrificed at 6 h, 24 h, 72 h, and 168 h after TBI. The level of neuronal apoptosis and the expression of Bcl-2 protein were determined by TUNEL assay and immunohistochemical method, respectively. RESULTS: Apoptotic cells mainly distributed in the cortex and white matter around the damaged area. Neuronal apoptosis significantly increased at 6 h after trauma and peaked at 72 h. Both the level of neuronal apoptosis and expression of Bcl-2 protein in TBI-only group and TBI+AEI group were higher than those in control group (P less than 0.05). Compared with TBI-only group, the two indexes were much higher in TBI+AEI group at all time points (P less than 0.05). CONCLUSION: Our findings suggest that AEI can increase neuronal apoptosis after severe TBI.


Subject(s)
Apoptosis/drug effects , Ethanol/poisoning , Neurons/physiology , Prosencephalon/cytology , Proto-Oncogene Proteins c-bcl-2/metabolism , Animals , Brain Injuries , Cerebral Cortex/cytology , Disease Models, Animal , Immunohistochemistry , In Situ Nick-End Labeling , Male , Rats , Rats, Sprague-Dawley
6.
Chin J Traumatol ; 16(2): 99-102, 2013.
Article in English | MEDLINE | ID: mdl-23540898

ABSTRACT

OBJECTIVE: To assess zero drift of intraventricular and subdural intracranial pressure (ICP) monitoring systems. METHODS: A prospective study was conducted in patients who received Codman ICP monitoring in the neurosurgical department from January 2010 to December 2011. According to the location of sensors, the patients were categorized into two groups: intraventricular group and subdural group. Zero drift between the two groups and its association with the duration of ICP monitor were analyzed. RESULTS: Totally, 22 patients undergoing intraventricular ICP monitoring and 27 receiving subdural ICP monitoring were enrolled. There was no significant difference in duration of ICP monitoring, zero drift value and its absolute value between intraventricular and subdural groups (5.38 d+/-2.58 d vs 4.58 d+/-2.24 d, 0.77 mm Hg+/-2.18 mm Hg vs 1.03 mm Hg+/-2.06 mm Hg, 1.68 mm Hg+/-1.55 mm Hg vs 1.70 mm Hg+/-1.53 mm Hg, respectively; all P larger than 0.05). Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring (P less than 0.05) while zero drift value did not. Moreover, daily absolute value in the intraventricular group was significantly smaller than that in the subdural group (0.27 mm Hg+/-0.32 mm Hg vs 0.29 mm Hg+/-0.18 mm Hg, P less than 0.05). CONCLUSION: This study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring. Due to the smaller daily absolute value, ICP values recorded from intraventricular system may be more reliable than those from subdural system.


Subject(s)
Intracranial Pressure , Monitoring, Physiologic , Aged , Cerebral Ventricles , Female , Humans , Male , Middle Aged , Prospective Studies , Subdural Space
7.
J Surg Res ; 183(2): 720-5, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23535113

ABSTRACT

BACKGROUND: We attempted to investigate the effect of external ventricular drainage (EVD) plus intraventricular fibrinolysis from ipsilateral or contralateral ventricle on clinical outcomes in patients with intraventricular hemorrhage. METHODS: We undertook a prospective controlled study. Patients with acute obstructive hydrocephalus after intraventricular hemorrhage were randomized to receive EVD from ipsilateral ventricle (ipsilateral group [IG]) or contralateral ventricle (contralateral group [CG]). They received intracranial pressure (ICP) monitoring and intraventricular injection of urokinase after surgery. We compared clinical outcomes and complications between groups. RESULTS: A total of 45 patients were enrolled, with a mean age of 55.4 years. We assigned 28 patients assigned to the IG and 17 patients to the CG. Patients in the IG showed significantly faster clot clearance in the third and fourth ventricles on computed tomography than those in the CG (3.3 ± 1.0 d versus 3.9 ± 0.8 d; P = 0.042). Analysis of ICP data showed that initial ICP in the IG was significantly higher than in the CG (20.4 ± 7.2 mm Hg versus 16.5 ± 4.4 mm Hg; P = 0.039), as was the average daily ICP on the following 3 d. The percentage of ICP readings over 20 mm Hg in the IG was also significantly larger than that in the CG (18.0% versus 10.9%; P < 0.001). There was no significant difference in the incidence of complications regarding rebleeding, infection, epilepsy, or communicating hydrocephalus. Neither 30-d mortality rate nor Glasgow Outcome Scale score revealed significant differences between the two groups. CONCLUSIONS: External ventricular drainage plus EVT from the ipsilateral or contralateral ventricle has similar short-term outcomes and complications in patients with intraventricular hemorrhage. Faster clot clearance in the third and fourth ventricles but higher ICP levels at the early stage may be expected in patients with EVD from the ipsilateral ventricle, compared with those from with EVD from the contralateral ventricle.


Subject(s)
Cerebral Hemorrhage/pathology , Cerebral Hemorrhage/therapy , Drainage/methods , Lateral Ventricles/pathology , Thrombolytic Therapy , Acute Disease , Cerebral Hemorrhage/diagnostic imaging , Drainage/adverse effects , Female , Fibrinolytic Agents/administration & dosage , Fibrinolytic Agents/therapeutic use , Humans , Hydrocephalus/etiology , Injections, Intraventricular , Lateral Ventricles/diagnostic imaging , Male , Middle Aged , Prospective Studies , Tomography, X-Ray Computed , Treatment Outcome , Urokinase-Type Plasminogen Activator/administration & dosage , Urokinase-Type Plasminogen Activator/therapeutic use
8.
Chin J Traumatol ; 8(4): 236-9, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16042871

ABSTRACT

OBJECTIVE: To assess the therapeutic effect of ulinastatin on severe craniocerebral injuries and to explore its mechanism. METHODS: There were 87 cases of severe brain injury in this series and they were either treated by ulinastatin (treatment group, 41 cases) or not (control group, 46 cases) besides routine managements. We estimated C-reactive protein, interleukin-6, superoxide dismutase, and endothelin from plasmas of all the cases on the 1st, 3rd, 5th, and 7th day after injury. RESULTS: C-reactive protein level rose on the 1st and 3rd day after injury in the two groups, but descended in treatment group on the 5th and 7th day and was significantly lower than that in control group (P < 0.01). No significant difference was found for interleukin-6 in two groups during 1-5 days after injury, but on the 7th day, it decreased significantly in treatment group than control one (P < 0.01). Superoxide dismutase was higher in treatment group than control one in 5-7 days after injury (P < 0.01). Endothelin elevated on the 1st day after injury but dropped afterwards in the two groups, in which the level in treatment group was lower than that in control one. The incidence of gastrointestinal hemorrhage was lower in treatment group than control one (P < 0.01). CONCLUSIONS: Ulinastatin has the function of protecting cerebral tissue, reducing the incidence of gastrointestinal hemorrhage, improving hepatic and renal function and prognosis.


Subject(s)
Craniocerebral Trauma/drug therapy , Glycoproteins/therapeutic use , Trypsin Inhibitors/therapeutic use , Adolescent , Adult , Aged , C-Reactive Protein/analysis , Craniocerebral Trauma/blood , Endothelins/blood , Female , Glycoproteins/adverse effects , Humans , Interleukin-6/blood , Male , Middle Aged , Superoxide Dismutase/blood
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