Combined External Ventricular Drainage and Endoscope-Assisted Microsurgery Using the Middle Frontal Gyrus Approach in Severe Ventricular Hemorrhage with Casting of the Fourth Ventricle.

OBJECTIVE: To investigate combined external ventricular drainage and endoscope-assisted microsurgery using the middle frontal gyrus approach in patients with severe ventricular hemorrhage with casting of the fourth ventricle and patients' recovery after this treatment. METHODS: Patients with severe ventricular hemorrhage with casting of the fourth ventricle (n = 41) were randomly assigned to intervention and control groups. Modified Graeb score was used to assess 3-day hematoma clearance rate before and after surgery, drainage tube extubation time for the 2 groups was compared, and time when blood clot in the fourth ventricle was not blocked with cerebrospinal fluid was compared. Glasgow Coma Scale was used to assess consciousness after surgery; Glasgow Coma Scale scores recorded 1 and 7 days after surgery were also compared. Modified Rankin Scale was used to evaluate patients' recovery 1 and 6 months after surgery. Hydrocephalus and intracranial infections in patients after surgery were recorded for 90 days. RESULTS: The 3-day hematoma clearance rate was dramatically higher in the intervention group. Modified Graeb score showed that more hemorrhage was delimited in 3 days in the intervention group. The intervention group exhibited significantly reduced length of block of the fourth ventricle and drainage tube extubation time. High Glasgow Coma Scale and modified Rankin Scale scores and significantly low incidence of complications (e.g., hydrocephalus and intracranial infection) were observed in patients in the intervention group. CONCLUSIONS: Combined external ventricular drainage and endoscope-assisted microsurgery using the middle frontal gyrus approach can effectively improve severe ventricular hemorrhage with casting of the fourth ventricle and enhance patients' neurological function and recovery.

HOXC6 Regulates the Epithelial-Mesenchymal Transition through the TGF-ß/Smad Signaling Pathway and Predicts a Poor Prognosis in Glioblastoma.

Background: The HOX gene family of transcription factors, characterized by conserved homeodomains, is positively correlated with the resistance to chemotherapy drugs and poor prognosis, as well as the initiating potential of gliomas. However, there are few studies regarding the HOXC6 gene in glioma cells. Therefore, in the present study, we explored the regulatory roles and detailed mechanisms underlying the relationship between HOXC6 and the progression of GBM. Methods: The expression levels and prognostic value of HOXC6 in GBM were evaluated using the data obtained from the GCCA, GEPIA, and ONCOMINE databases. The relationship between GBM prognosis and levels of HOXC6 was identified using Kaplan-Meier curves. The protein levels of HOXC6 in GBM and adjacent normal tissues were identified via Western blot and immunohistochemistry (IHC) staining methods. Lentiviruses containing full-length HOXC6 and HOXC6 specific siRNA sequences were used to overexpress and knock down, respectively, the expression of HOXC6 in U87 and U251 cells. The role of HOXC6 in the regulation of migration and proliferation of GBM cells was accessed using Transwell, wound healing, CCK-8, and colony formation assays. The activation of the TGF-ß/Smad signaling pathway was detected via Western blotting. Results: Compared to normal tissues and control cells, GBM tissues and cell lines showed higher expressions of HOXC6. The expression of HOXC6 was associated with disease-free and the overall survival of GBM patients. Additionally, positive correlations between the expression of HOXC6 and the migration and proliferation of GBM cells were observed in vitro. The mechanistic analyses indicated that HOXC6 exerts its promotive effect on the progression and invasion of glioma cells by promoting the activation of the EMT and TGF-ß/Smad signaling pathways. Conclusions: HOXC6 enhances the migration and proliferation of GBM by activating the EMT signaling pathway.

Research progress on tremors in patients with Parkinson′s disease / 中华全科医师杂志

Parkinson′s disease is a motion disorder mostly occurring in middle and old age with high disability and death rate. According to epidemiological studies, the incidence of Parkinson′s disease increases year by year worldwide. Tremor is one of the four major symptoms of Parkinson′s disease. However, due to the similarity of signs with other diseases, the diagnosis is mostly based on the clinical experience of neurologist, which makes accurate identification of Parkinson′s disease tremor a challenge. Understanding tremors in Parkinson′s disease can be of help to more accurately diagnose the disease. This article reviews the research progress of tremors presented in Parkinson′s disease and other diseases, and their differentiation, which is expected to be helpful for the diagnosis of Parkinson′s disease.

Effects of butylphthalide injection on cerebral blood flow perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder / 中华神经医学杂志

Objective To investigate the effects of butylphthalide injection on cerebral blood flow (CBF) perfusion and cognitive function in patients with acute cerebral infarction accompanied by cognitive disorder.Methods From September 2016 to September 2017,80 patients with acute cerebral infarction and cognitive impairment were admitted to the Department of Neurology,Yan'an Hospital of Kunming Medical University.They were assigned to an observation group (n=40) and a control group (n=40).The control group received conventional treatment while the observation group received butylphthalide injection in addition to conventional treatment.The treatment lasted for 14 days for both groups.Before and after treatment,dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) was used to measure the CBF parameters in the cerebral ischemic region,and Montreal Cognitive Assessment (MoCA) was used to evaluate the changes in cognitive function.Results After treatment,rCBF and rCBV increased significantly and rMTT and rTTP decreased significantly in the observation group (P＜0.05).After treatment,there were significant improvements in MoCA subscores and total score in the observation group (P＜0.05).In the observation group,the post-treatment increases in rCBV and rCBF were positively correlated with increased MoCA total score (r=0.474,P=0.013;r=0.282,P=0.027),and the post-treatment decreases in rMTT and rTTP were negatively correlated with increased MoCA total score (r=-0.294,P=0.021;r=0.382,P=0.019).Conclusion Butylphthalide injection can safely improve CBF perfusion in the focal region and cognitive function in patients with acute cerebral infarction,with no obvious adverse reactions.

Infantile Sandhoff disease:a case report and literature review / 临床儿科杂志

Objective To summarize the clinical manifestations, diagnosis, and treatment of infantile Sandhoff disease. Methods The clinical data of one case with infantile Sandhoff disease were reviewed retrospectively. The related literatures were reviewed. Results The girl aged 1 year and 2 months suffered from psychomotor regression and intractable convulsions. The parents were consanguineous marriage. The fundus microscopy showed fundus erythema. Brain magnetic resonance imaging showed an abnormal signal of long T2WI and identical T1WI at left pons, white matter edema, and diffuse demyelination. No abnormal karyotype was observed. A chromosome microarray suggested multiple large homozygous chromosomes segments. The second generation gene sequencing showed deletion of c.1263_1268delTGAAGT:P. (Glu422_Val423del) deletion in exon 11 and a shear mutation of c.1614_2A>G:P? in intron 13 of HEXB gene which were carried by her parents respectively . The activity of HexA, HexA & HexB were 84 and 112 nmol?mg?1?h?1, respectively. Finally, this girl was diagnosed of infantile Sandhoff's disease. After treatment with valproate, levetiracetam combined with antiepileptic and glucocorticoids, episodes of convulsions were decreased gradually, and the reaction was better than before. In 5 months of follow up, the condition was stable, and no progression and no seizures exist. Her mother got pregnant again and received an amniocentesis on her 21+6 weeks of pregnancy, and results suggest that the fetus had the same mutation as this girl. Conclusions Sandhoff's disease is a type of rare hereditary lysosomal disease, characterized by progressive neurological impairment. Currently there are no effective treatments. Genetic testing is helpful in the diagnosis and prenatal diagnosis.

EGFR inhibitor enhances cisplatin sensitivity of human glioma cells / 华中科技大学学报（医学）（英德文版）

Epidermal growth factor receptor (EGFR) is found to express at high levels in a variety of solid tumors including gliomas. This study was to examine the effect of an EGFR-tyrosine kinase inhibitor (AG1478) alone or in combination with cisplatin (CDDP) on the growth of glioma cells (U87). U87 glioma cells were treated with AG1478 (10 μmol/L) or CDDP (25 μmol/L) as a single agent or in combination for 24 or 48 h. The expression of EGFR and the components in its downstream signaling pathway [extracellular signal-regulated kinase (ERK), protein kinase B (AKT)] in U87 glioma cells was detected by Western blotting. Cell growth, cell cycle distribution and cell apoptosis were determined by MTT method and flow cytometry, respectively. The results showed that CDDP could induce the activation of EGFR and the components in its downstream signaling pathways in a concentration-dependent manner. The combined treatment of AG1478 with CDDP could inhibit the proliferation of U87 glioma cells, arrest the cell cycle and promote cell apoptosis. In the EGFR signaling pathway, AG1478 decreased the phosphorylation of ERK, AKT and EGFR in U87 glioma cells. It was concluded that the combined treatment of AG1478 and CDDP may exert synergistic inhibitory effects on the growth of glioma cells by suppressing the activities of EGFR, AKT and ERK.

Iodine-125 implants on operation for Intracavitary radiotherapy to neuroglioma / 中国医师进修杂志

Objective To evaluate the efficacy of surgical excision combined with iodine-125 implants intmcavitary radiotherapy for neumglioma Method After excision,27 patients with nenroglioma were implanted with the iodine-125 into the tumor bed or the residual tumor tissues.Results Of all cases,there were no operative mortality and no serious complication.The survival time of 25 cases exceeded 6 months and 1 glioblastoma recurrence,22 cases exceeded 12 months,3 glioblastoma and 1 astrocytoma Ⅲgrade recurrence.There were 19 cases exceeding 24 months,15 cases no recurrence,3 cases died for cere bral hernia because of giving.up further tremment,1 case surviving.Conclusions Surgical excision Combined with iodine-125 implants intracavitary radiotherapy can improve partial control rate,prolonged the survival time of patients with neuroglioma,and complications is rare.It is an efficient therapy for neu roglioma