Andrographolide promoted ferroptosis to repress the development of non-small cell lung cancer through activation of the mitochondrial dysfunction.

BACKGROUND: Ferroptosis, a form of regulated cell death by lipid peroxidation, was currently considered as a key factor affecting the occurrence and progression in various cancers. Andrographolide (ADE), a major effective ingredient of Andrographis paniculate, has proven to have a substantial anti-tumor effect on multiple cancer types. However, the function and underlying mechanism of ADE in Non-Small Cell Lung Cancer remain unclear. METHODS: CCK8 assay, colony-formation assay, flow cytometry, scratch test, transwell assay, western blotting, ferroptosis analysis and mitochondria analysis were performed to reveal the role and underlying mechanisms of ADE in NSCLC cell lines (H460 and H1650). In vivo, xenograft model and lung metastatic model were performed to verify the effect of ADE on the growth and metastasis of NSCLC. RESULTS: In this present study, we demonstrated that treatment with ADE could inhibit cell growth and metastases through eliciting ferroptosis in vitro an in vivo. The IC50 of ADE in H460 and H1650 cells were 33.16 µM and 32.45 µM respectively. In Lewis xenografted animals, i.p. ADE repressed relative tumor growth (p < 0.01) and inhibited metastases (p < 0.01). Notably, the ferroptosis inhibitor Fer-1 abrogated the anti-tumor capacity of ADE. Induction of ferroptosis by ADE was confirmed by elevated levels of reactive oxygen sepsis (ROS), glutathione (GSH), malondialdehyde (MDA), intracellular iron content and lipid ROS reduced glutathione (GSH) accumulation (p < 0.01). Furthermore, ADE inhibited the expression of ferroptosis-related protein GPX4 and SLC7A11. Simultaneously, it also disclosed that ADE enhanced mitochondrial dysfunction, as evidenced by increased mitochondrial ROS release, mitochondrial membrane potential (MMP) depolarization, and decreased mitochondrial ATP. Most interestingly, Mito-TEMPO, a mitochondria-targeted antioxidant, rescued ADE-induced ferroptosis. CONCLUSION: Our data validated that ADE treatment could restrain proliferation and metastases of NSCLC cells through induction of ferroptosis via potentiating mitochondrial dysfunction.

Rare Cervical Intramedullary Cavernous Angioma with Trigeminal Neuralgia and Cervical Itch: Case Report and Review of the Literature.

INTRODUCTION: Intramedullary cavernous angioma (ICA) is a rare lesion of the spinal cord, representing only 3% - 5% of central nervous system lesions. The coexistence of trigeminal neuralgia and refractory itch is very rarely encountered in clinical practice. To our knowledge, a report of an ICA with trigeminal neuralgia and local neuropathic itch has never been published to date. Thus, we present a very interesting case of a C2 ICA. CASE PRESENTATION: A 61-year-old female presented with right facial pain for three years, which was exacerbated by accompanying cervical pain and itch for one month. The patient's symptoms were relieved after surgery, and there was no recurrence of lesions one year later. CONCLUSIONS: ICA with trigeminal neuralgia and local neuropathic itch is very rarely encountered in clinical practice. As it is not always diagnosed at first, some patients miss the best treatment period. Therefore, we call for emphasis to be placed on early diagnosis and timely surgical treatment.

Sacral canal myeloid sarcoma as initial manifestation of granulocytic leukemia: MRI features and differential diagnosis (with a case report).

Myeloid sarcoma initially occurring in the sacral canal is often misdiagnosed as other pathological tumors on MRI due to the lack of a definite history or clinical evidence of granulocytic leukemia. Here, we report a case of 24-year-old male patient with myeloid sarcoma misdiagnosed radiologically. On MRI, sacral myeloid sarcoma is characterized by homogeneous signal intensity, marked enhancement, and the lack of cystic degeneration, calcification and necrosis. Based on our study of this patient and review of the relevant literature, we believe that these MRI features in the sacral region may help us differentiate it from other pathological tumors, which could prompt further clinical examinations to confirm the diagnosis of granulocytic leukemia.

Traumatic brain injury in Ya'an earthquake: a report of 69 cases / 中华创伤杂志

Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61％) were injured from falling objects.Fifty-eight patients (84％) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32％) sustained associated injuries.Twenty-nine patients (42％) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.

A posterolateral approach to occipitoatlantoaxial ventral lesions: a report of the long-term follow-up of 23 cases.

STUDY DESIGN: A retrospective study of consecutive patient series. OBJECTIVES: To report a technique of odontoidectomy using a transoccipitocervical posterolateral approach for occipitoatlantoaxial ventral lesions in a long-term follow-up study. SUMMARY OF BACKGROUND DATA: Occipitoatlantoaxial malformation and old traumatic dislocation usually cause compression of the high cervical spinal cord from a variety of different directions and angles, leading to high morbidity. The main objective of treatment is to relieve the anteroposterior compression and to restore the stability of the occipitocervical region. Currently, there are 2 approaches to perform the surgical procedure: (1) posterior decompression by suboccipital and occipitocervical fusion and internal fixation; and (2) decompression by a transoral approach to an odontoid resection. However, there are some short points, which need to be changed, such as the incomplete decompression (the former), narrow view, cerebrospinal fluid leakage, and the high infection rates. METHODS: From 1999 to 2006, 23 patients with occipitoatlantoaxial ventral lesions were treated using a transoccipitocervical posterolateral approach for decompression. The procedure included an expansion of the foramen magnum, a resection of the posterior arch of atlas, a lateral occipitocervical epidural exposure to the odontoid and the C2 vertebra, and an excision of the odontoid. Thus, an anteroposterior decompression and occipitocervical spinal fusion was achieved. Neurological function, daily living ability, and the work ability of patients were assessed in a follow-up study. RESULTS: A 28-year-old woman died of respiratory and circulatory failure 10 hours after operation. The remaining patients survived without postoperative infection. The neurological injury in 17 patients did not deteriorate, whereas 5 patients had decreased sensation in the upper limbs, and the elbow flexor muscle strength in 2 patients declined by 1 grade on the operation side. Short-term follow-up (3-6 mo, 22 cases) indicated that 19 patients recovered normal sensation with decreased limb muscle tension. Motor function was improved by >1 grade (5 patients with postoperative nerve injury recovered to preoperative levels or better). Long-term follow-up (>4 y) of 15 patients (10 patients by clinic visit and 5 patients by correspondence) indicated that the occipitoatlantoaxial regions were stable without local discomfort or loss of nerve function. Fourteen patients were able to care for themselves and some patients regained their ability to work. One patient felt no significant improvement after surgery and had no improvement in the quality of life. CONCLUSIONS: Transoccipitocervical posterolateral approach to occipitoatlantoaxial ventral lesions provides a broad and sterile operating field to perform anteroposterior decompression and occipitocervical spinal fusion simultaneously. Neurological improvement is significant, and the long-term follow-up results are satisfactory.

Executive function in patients with mild traumatic brain injury / 中国神经精神疾病杂志

Background Patients often suffer from a few complications of neurological and psychiatric problems after traumatic brain injury including damage of cognition, mental disorders and behavior problems. Damage of cognition is a common sequela in traumatic brain injury. Numerous researchers were focus on the cognition changes of patients with mild brain injury. But their conclusions are debatable. Executive function is one of the important components of cognition. In this study,we tried to find out the executive functional alterations of the patients with mild brain injury.Methods 159 patients with brain injury caused by transportation events and 68 normal controls were assessed executive function. The executive function tests included the block design in WAIS, the Stroop test, the verbal fluency and the modified version of Wisconsin card sorting test (M-WCST). These tests were applied to compare the scores of traumatic brain injury patients with various severities including mild, moderate, and severe and with different CT/MRI results.Results Patients with mild head injury got significantly lower scores on all tests than normal controls ( P＜0.01 ). But there was no significant difference between mild and moderate brain injury group. Except Stroop test and WCST categories, patients with mild brain injury got significantly lower scores on all other tests than those with severe brain injury ( P ＜0.05). In the brain injury cases with damage signs on CT/MRI, there was no significant difference on scores of all tests except block design tests among brain injury patients with various severities. Among the brain injury cases without any damage signs on CT/MRI, there was no significant difference on scores of all tests among brain injury patients with various severities. The correlation analysis showed that scores of block design and verbal fluency test were negatively related to the severity of brain injury( P＜0.05). The age and the education level of the patients had negative and positive correlation, respectively, to executive function.Conclusions The executive function of patients with mild brain injury was impaired when the medication was terminated. We should pay more attention to patients with mild brain injury by performing various tests for assessment of disability.

Craniocerebral Shotgun Injury: A Report of 14 Cases / 中华创伤杂志

Fourteen cases of craniocerebral shotgun injury were repoted, including 10 males and 4 females. Eleven patients were treated non—operatively and 3 operatively. Two of the 3 patients died after operation. The clinical manifestation, wound judgment and management are discussed detailly in the paper. The complications of the injury such as intracranial hematoma, brain abcess, epilepsy and morality were significantly lower than those of other missile craniocerebral injury. Although the matal pills remained in the patient brains for a long time, the final outcome of shotgun injured patients is good.