Differences of biological property between glioma stem cells and glioma non-stem cells / 中华神经医学杂志

Objective To observe the differences of biological property of glioma stem cells (GSCs) and glioma non-stem cells (nGSCs), and their related protein expressions. Methods The proliferations of GSCs1, GSCs2 and nGSCs1 and nGSCs2 were detected by CCK8 after two, 4, 6, 8, 10 and 12 d of culture in vitro. The sensitivities of the cells to temozolomide (TMZ) were detected by CCK8 after 2 d of culture. The adhesion abilities of cells were tested by adhesion assay. Transwell assay was used to detect the migration and invasion abilities of cells. The activity of matrix metalloproteinase-2 (MMP-2) was detected by gelatin zymography. Western blotting and immunofluorescence staining were used to detect the protein expressions of Notchl and epidermal growth factor receptor (EGFR). Results The survival rate of nGSCs1 was significantly higher than that of GSCs1 and the survival rate of nGSCs2 was significantly higher than that of GSCs2 after 4, 6, 8, 10 and 12 d of culture (P<0.05). The inhibitory concentration (IC)50 of TMZ for GSCs1, nGSCs1, GSCs2 and nGSCs2 was (1536.0±17.67) μmol/L, (514.5±13.44) μmol/L, (2543.0±39.87) μmol/L, (889.6±17.43) μmol/L, respectively (P<0.05). Number of GSCs1 adhering to extracellular matrix proteins Fibronectin and Collagen I was significantly larger than that of nGSCs1, and that of GSCs2 was significantly larger than that of nGSCs2 (P<0.05). The number of migrated GSCs112 and 24 h of cultivation was statistically larger than that of nGSCs1, and that of GSCs2 was statistically larger than that of nGSCs2 (P<0.05). The number of invaded GSCs124 and 36 h of cultivation was larger than that of nGSCs1, and that of invaded GSCs2 was larger than that of nGSCs2, with statistical differences (P<0.05). The activity of MMP2 secreted by GSCs1 was significantly higher than that by nGSCs1, and that of MMP2 secreted by GSCs2 was significantly higher than that by nGSCs2 (P<0.05). Western blotting showed that the relative protein expression level of EGFR/Notch1 in GSCs1 was significantly lower than that in nGSCs1, and that in GSCs2 was significantly lower than that in nGSCs2 (P<0.05). The results of immunofluorescence staining were consistent with those of Western blotting; EGFR protein strongly expressed in nGSCs and weakly expressed in GSCs; Notch1 protein strongly expressed in GSCs and weakly expressed in nGSCs. Conclusion As compared with the high-EGFR-expressing and proliferative primary glioma cells, the high-Notch1-expressing glioma stem cells have higher activity level of MMP-2,stronger abilities of adhesion, migration and invasion, which may be contributed to glioma treatment resistance and its occurrence.

Rapid dura-mater reticular incision in acute severe subdural hematoma evacuation / 中华神经医学杂志

Objective To research the application of rapid dura-mater reticular incision in the evacuation of acute severe subduml hematoma.Methods The clinical data of 30 patients performed evacuation of acute severe subdural hematoma in our hospital were retrospectively analyzed; the dumra maters was rapidly incised after the first bore hole being drilled,and then the dura mater was incised in reticular shape after the bone flap was formed.The subdural hematoma could effuse slowly and uniformly,and intmcranial hypertension would reduce effectively.Results The subdural hematoma of all patients was removed totally.Based on the Glasgow outcome scale (GOS) scores three months after surgery,8 patients got recovered,13 were referred to moderate maim,5 were severe disability and 4 died.By using this modified method,the acute cenencephalocele rate decreased to 23.3％,which was more effective as compared with that using traditional method (48.2％).Conclusion In acute severe subdural hematoma operation,reticular incision of dura mater may achieve rapid hematoma evacuation and controllable and balanceable decompression,increase curative rate and decrease mortality.

Endovascular intervention in treating acute cerebral stroke: a report of 32 cases / 中华神经医学杂志

Objective To evaluate the effectiveness of endovascular intervention in treating acute cerebral stroke.Methods Thirty-two patients with acute cerebral stroke (22 with middle cerebral artery occlusion and 10 with internal carotid artery occlusion),admitted to and treated with endovascular intervention in our hospital from January 2010 to October 2013,were chosen in our study;14 were performed arterial thrombolysis+mechanical fragrnengation and 18 were performed mechanical fragrnengation+ solitaireAB stent thrombectomy.Retrospective analysis was performed on the clinical data and treatment efficacy,and the prevention experience of complications was concluded.Results CTA showed that complete recanalization was noted in 18 patients and partial recanalization in 5,with a recanalization rate reaching 7 1％.Postoperative symptomatic intracerebral hemorrhage was noted in 2 patients (6％) and 1 (3.1％) had large area of cerebral infarction.One month after the treatment,MRI indicated decreased areas of infarction in all patients.NIHSS scores were 4-6 points of all patients;favorable prognosis was noted in 23 patients (72％).Nine patients had heavy neurological dysfunction,with limb muscle strength less than grade Ⅲ.Conclusion Endovascular intervention in treating acute cerebral stroke can get high recanalization rate,and achieve good clinical outcome.

Analysis of cause of Secondary intracranial hemorrhage during craniotomy for intracranial tumor / 中国基层医药

Objective To explore the reasons and the treatment counter-measures for secondary intracranial hemorrhage happens in the intracranial tumor craniotomy. Methods Retrospectively analyzed the clinical data of 15 patients with intracranial tumor who suffered secondary intracranial hemorrhage intraoperation. Summarized the tumor characteristics and the situation of corresponding vessels confined by second operation. Results In these 15 cases,the rank of course of disease was 6.5 months to 2 years, mean 1.2 years. The size of the tumor was big with diameter 4.62 ～5. 82cm,mean 5. 12cm,and the tumor was deep surrounding by large range edema,which led to intracranial hypertension. The emissary vein,bridging vein and cortical draining vein were considered as the corresponding vessels for ' secondary intracranial hemorrhage during the second operation carried out for all 15 cases. There wsa no death cases in this research and all patients recovered the nomal ability for self-caring after 3 months following up. Conclusion Sudden drawdown of intracranial pressure and perfusion pressure breakthrough of local vessels had relationship with secondary intracranial hemorrhage during craniotomy for intracranial tumor. Accurate judgement for the occurrence of secondary intracranial hemorrhage intra-operation and quickly taking the effective corresponding measures was the important strategy for prognosis improving for these patients.

Clinical diagnosis and treatment for superior sagittal sinus thrombosis / 中国基层医药

Objective To discuss the diagnosis and treatment of superior sagittal sinus thrombosis.Methods The early diagnosis and treatment of superior sagittal sinus thrombosis was induced and summarizd,7 cases in our hospital treated from 2005.6 to 2008.9.were analyzed.Results In this investigation,3 cases were puerperal women,and the other 4 had no special medical history.Brain edema of difference degree was found in all cases on CT scans,including sulcus (7 cases),compression of cistern(5 cases) or even disappeared of cistern(2 cases).CT scanning also revealed dense triangle in 2 cases,multiple small encephalomalacia focus of frontal lobe lesions in 3 cases,and sub-arachnoid hemorrhage(SAH) in 2 cases.The digital subtraction angio-grapby(DSA) also was underwent,of 2 superior sagittal sinus not seen,of 4 appear unevenness,of 7 Arterio-venous circulation delayed and of 5 collateral circulation vasodilatation.After treatment,the clinical symptoms and signs of all patients were improved.All of them could be self-supporting.Followed up for 3 years,the mortality was 0,and no one cerebral hemorrhage again.Conclusion The early diagnosis and treatment of superior sagittal sinus thrombosis could reduce the morbidity and mortality, also could improve prognosis.Especially for the one without cerebral hemorrhage,using heparin at the beginning was an effective and safe way.

Early hematoma piercing attract combining with hematoma clearance to bone valves decompression technique to treat high blood pressure brain hemorrhage / 中国基层医药

Objective To explore hematoma piercing attract joint hematoma clearance to bone valves decompression technique in hematoma volume,skull,pressure high blood pressure brain hemorrhage treatment,and to further explore hypertension brain hemorrhage of reasonable surgery. Methods Hematoma in relatively large quantities of high intracranial pressure in hypertensive cerebral hemorrhage patients were randomly divided into experimental group and control group,and patients in the experimental group were implemented early hematoma puncture to attract a joint hematoma decompressive craniectomy treatment,and the control group were implemented the traditional hematoma de-compressive craniectomy treatment. The prognosis of the two groups were compared. Results The two groups were followed up for 6 months,and evaluated by ADL grade,between the two groups was statistically significant difference in ADL classification( P<0.01). Conclusion In the hematoma volume larger, high intracranial pressure in hypertensive cerebral hemorrhage in the surgical treatment of patients,the early line to attract a joint hematoma puncture decompressive craniectomy was a reasonable and feasible surgical method which can improve these patients prognosis.

Combined treatment and prognosis of ependymoma in fourth ventricle of the brain / 中国基层医药

Objective To summarize experience of the combined treatment of ependymoma in fourth ventricle of the brain of child and to study improvement of effect of the operation plus radiotherapy.Methods 35 cases with ependymoma in fourth cerebral ventricle were treated with microneuro-surgical resection.Among the 35 cases,25 were treated with total brain and spinal cord plus local focus radiotherapy within 2 to 3 weeks after operation;8 only with local focus radiotherapy,2 cases were not done with radiotherapy.Results Total removal of tumors was done in 20 cases,subtotal removal in 15 cases,and no patient died from operation.After operation,20 patients had a good recovery,10 had a light disability,and 5 needed assistance.The 5-year survival rate were 90.0%(18/20),6.6%(1/15),88.0(22/25),62.5%(5/8) and 0%,in different group respectively.Conclusion Surgical treatment is obviously effective to ependymoma in fourth ventricle of the brain and total removal of tumors combined with radiotherapy is aid to extend the patient's survival time.

Diagnosis and treatment of microneurosurgery for meningiomas of the lateral ventricle / 中国基层医药

Objective To discuss the diagnosis and treatment of microneuro-surgery for meningiomas of the lateral ventricle.Methods A retrospe CT analysis was performed on 20 patients with meningomas of the lateral ventricle during a 7-year period.Results 20 cases had total tumor removal.among them 6 cases were completed removal,14 cases were cent piece removal.There were no postoperative deaths.The follow-up period ranged from 0.5 to 7 years.All followed patients went well.Conclusion Lateral ventricular meningiomas can be diagnosed by CT or MRI and fedding vascular of tom or revealed by cerebral vascular angiography.By using the ideal approach,the tumors could be totally removed under microscope.

Use of neuroendoscope in intracranial tumor microneurosurgery through a keyhole approach / 中国基层医药

Objective To study the techniques for treating the intracranial tumor.Methods Through a keyhole approach with endoscope-assisted micro-neurosurgery,30 patients with intracranial tumor were treated.With microneurosurgery,larger part of tumor was resected,then under neuroendo-scope remains of tumors were found out and removed.Results Tumors were totally removed in 22 patients,subtotally removed in 5.In three patients cerebral aneurysm was clipped successfully.Two patients with pituitary adenoma had temporay diuresis and one patient non-bacteria meningitis,and after two weeks treatment all recovered.There was no-mortality in 41 patients,no cerebral hemorrhage,optic nerve injury,internal carotid injury,and other complications occurred.Conclusion Endoscope-assisted microneurosurgery through a keyhole approach can increase the total-resection rate for tumors,reduce the trauma of operation and postoperative reaction.