Application of 3D slicer plus Sina software for performing hematoma puncture and drainage after local anesthesia in elderly patients with intracerebral hemorrhage / 中华老年医学杂志

Objective:To explore the effect of minimally invasive hematoma puncture and drainage in the treatment of elderly patients with cerebral hemorrhage by using 3D slicer and Sina software to conduct 3D reconstruction and preoperative localization of intracerebral hematoma.Methods:A total of 74 elderly patients with a first-onset intracerebral hematoma aged ≥75 years, having surgical indications and stable vital signs were grouped into 3D slicer plus Sina software localization group(as group A, n=40)or CT localization group(as group B, n=34). Based on the localization, hematoma puncture and drainage were performed after local anesthesia.Preoperative preparation time, hematoma location, puncture success rate, postoperative hematoma clearance rate, postoperative re-bleeding rate and GCS score were statistically analyzed.Glasgow coma scale(GCS)scores were used in predicting the mortality.Results:The preoperative preparation time was significantly shorter in group A than in group B[(5.5±3.4)min vs.(8.5±2.7)min, t=3.337, P=0.001]. The success rate of hematoma puncture and drainage(90.0% and 70.6%, χ2=4.51, P=0.034)and postoperative hematoma clearance rate[(87.5±3.4)% and(80.3±2.7)%, t=10.10, P=0.000]were higher in group A than in group B. There were no significant differences in operative time, the accuracy of hematoma localization, re-bleeding rate and GCS score between the two groups( P>0.05). Conclusions:3D slicer plus Sina software can precisely locate the intracerebral hematoma, and minimally invasive hematoma puncture and drainage of intracerebral hematoma under local anesthesia were safe and effective in the treatment of elderly patients with intracerebral hemorrhage.

Target identification of a novel unsymmetrical 1,3,4-oxadiazole derivative with antiproliferative properties.

1,3,4-Oxadiazole derivatives are widely used in research on antineoplastic drugs. Recently, we discovered a novel unsymmetrical 1,3,4-oxadiazole compound with antiproliferative properties called 2j. To further investigate its possible targets and molecular mechanisms, RNA-seq was performed and the differentially expressed genes (DEGs) were obtained after treatment. Data were analyzed using functional (Gene Ontology term) and pathway (Kyoto Encyclopedia of Genes and Genomes) enrichment of the DEGs. The hub genes were determined by the analysis of protein-protein interaction networks. The connectivity map (CMap) information provided insight into the model action of antitumor small molecule drugs. Hub genes have been identified through function gene networks using STRING analysis. The small molecular targets obtained by CMap comparison showed that 2j is a tubulin inhibitor and it acts mainly affecting tumor cells through the cell cycle, FoxO signaling pathway, apoptotic, and p53 signaling pathways. The possible targets of 2j could be TUBA1A and TUBA4A. Molecular docking results indicated that 2j interacts at the colchicine-binding site on tubulin.

Comparative study of pyramidal tract magnetic resonance diffusion tensor imaging and prognosis of hypertensive putaminal hemorrhage treated via transsylvian-transinsular and transcortical transtemporal approaches / 中国脑血管病杂志

Objectives To conduct grading comparison for the damage degree of pyramidal tracts after procedure in patients with unilateral hypertensive putamen hemorrhage via transsylvian-transinsular (TS-TI) approach and transcortical transtemporal (TC-TF) approach using magnetic resonance diffusion tensor imaging (DTI) and to evaluate the postoperative recovery of the patients according to the quality criteria of the activities of daily living (ADL),and to identify the advantages and disadvantages of both surgical approaches.Methods Sixty-three consecutive patients with first onset of unilateral hypertensive basal ganglia putamen hemorrhage admitted to Department of Neumlsurgery in Affiliated Hospital of Southwest Medical University of Traditional Chinese Medicine were enrolled prospectively.The volume of hematoma at admission was 26-45 ml.They were randomly divided into group A and group B by random number table.The patients in group A (n =31) were treated via the TS-TI approach,and those of group B (n =32) were treated via the TC-TT approach.The operator was the same surgeon.The patients of rebleeding were excluded (4 in group A,7 in group B),and 52 patients were actually included,including 27 in group A and 25 in group B.The DTI examinations were perforrned 5 to 8 d after procedure.The image data were processed by PHILIPS Extended MR Workspace 2.6.3.4 (EMW 2.6.3.4) software.The bilateral pyramidal tracts were reconstructed,the damage degree of pyramidal tract and its relationship with hematoma and surgical approach were observe respectively.The ADL quality criteria were used to evaluate the recovery at 3 months after procedure.The SPSS 17.0 software was used to conduct rank sum test for the pyramidal tract injury grade after procedure in both groups.The number of rebleeding in the operation areas and the ADL quality criteria evaluation were tested by Chi-squared test.Results There was no significant difference in the postoperative rebleeding rate between group A (12.9％,4/31) and group B (21.9％,7/32) (x2 =0.367,P =0.545).The postoperative pyramidal tract damage degree of group A was better than that of group B.There was significant difference (U =180.00,P =0.004).The comparison of ADL quality evaluation in both groups after procedure showed that the good prognosis rate (81.5％,22/27) of group A after procedure was better than that of group B (56.0％,14/25).There was significant difference (x2 =3.957,P =0.047).Conclusions The three-dimensional relationship between the hematoma lesions and the pyramidal tracts was observed by DTI,the damage degree of the pyramidal tracts were identified.The TS-TI approach was superior to the TC-TF approach in the postoperative damage degree of pyramidal tract and the quality of ADL for the treatment of hypertensive putamen hemorrhage.

The application of magnetic resonance diffusion tensor imaging for evaluation of optic radiation injury in patients with hypertensive putaminal hemorrhage / 中国神经精神疾病杂志

Objective We attempted to investigate optic radiation (OR) injury and visual field mean defect (MD) in patients with hypertensive putaminal hemorrhage by using diffusion tensor imaging (DTI). Methods Thirty-three first onset of patients with hypertensive putaminal hemorrhage and 30 normal healthy control subjects were recruited. DTI data were acquired between 3 and 5 days as well as 3 months after onset. DTI-Studio software was used to reconstruct the OR and examine the degree of OR injury (typeⅠ, Ⅱ, and type Ⅲ). Fractional anisotropies (FA) and apparent diffusion coefficient (ADC)values of the ORs were measured. Statistical analysis was performed to calculate hematoma volume, MD,OR-FA and ADC values by using SPSS 17.0 software. Results FA and ADC values of ORs were not significantly different between the two hemispheres in normal control groups (student t-test, P>0.05). Compared with MD values in control group, the visual field was significantly impaired in patients group (P<0.01). FA and ADC values of ORs were significantly different between two hemispheres in patient group (student t-test, P<0.01). There was no correlation of hematoma volume with OR-FA nor with ADC values nor with MD values (P>0.05). The MD values were correlated with OR-FA and ADC values after onset(P<0.05). MD, FA and ADC values of ORs in the affected hemisphere of the patient group were significantly different for the three OR types between 3 and 5 days as well as 3 months after onset (P<0.01). Conclusion DTI can examine the three-dimensional relationship between hematoma and OR, reflect the changes of OR morphology and predict the degree of visual-field defects.