Application of the "Hand as Foot" teaching method in liver Couinaud segmentation.

OBJECTIVE: We aim to provide a teaching method to better explain the liver Couinaud Segmentation teaching. METHOD: Through a deep understanding of the liver Couinaud Segmentation teaching, and after more than 20 years of teaching practice, our department teaching team pioneered "Hand as Foot ". RESULTS: The combined teaching method of "Hand as Foot" can clearly show the liver Couinaud Segmentation teaching. CONCLUSION: Compared with the traditional teaching method, "Hand as Foot" is favored by most teachers and students.

Effectiveness and Safety of Low-Dose Radiotherapy in Eosinophilic Lymphoid Granuloma.

Objective: To investigate the efficacy and safety of low-dose radiotherapy in treating eosinophilic lymphoid granuloma. Method: This study included a total of 20 patients diagnosed with eosinophilic lymphoid granuloma. All patients underwent low-dose three-dimensional conformal intensity-modulated radiotherapy for their lesions. We analyzed the control status of the lesions and any adverse reactions related to radiotherapy. Results: The overall effectiveness of low-dose radiotherapy in treating eosinophilic lymphoid granuloma was 90%. The incidence of grade I and grade II adverse reactions induced by radiotherapy was 70% and 30%, respectively. Over a median follow-up period of 23.6 months, all patients showed controlled lesions within the target delineation of radiotherapy. After radiotherapy, four patients experienced occasional pruritus, and one patient had a recurrence outside the target area three years later. No long-term severe adverse reactions related to radiotherapy were observed during the follow-up period. Conclusions: Low-dose radiotherapy demonstrates an apparent therapeutic effect on eosinophilic lymphoid granuloma with acceptable adverse reactions.

Evaluation of EZH2 expression, BRAF V600E mutation, and CDKN2A/B deletions in epithelioid glioblastoma and anaplastic pleomorphic xanthoastrocytoma.

INTRODUCTION: Epithelioid glioblastoma (EGBM) and anaplastic pleomorphic xanthoastrocytoma (APXA) are two rare entities with different prognoses. However, they share certain morphological and molecular features. MATERIALS AND METHODS: To better recognize EGBM and APXA and identify the prognostic factors associated with these tumors, EZH2 status, BRAF V600E mutations, and CDKN2A/B deletions were assessed in 15 APXA and 13 EGBM cases. RESULTS: The expression level of EZH2 was found to increase with tumor grade. Overexpression of EZH2 occurred in 69.2% (9/13) of EGBM cases and 20% (3/15) of APXA cases. In addition, 72.7% (8/11) of EGBM and 12.5% (1/8) of APXA cases harbored a CDKN2A homozygous deletion based on fluorescence in situ hybridization. BRAF V600E mutations were detected in 80% (8/10) of EGBM cases and 42.9% (3/7) of APXA cases. Furthermore, EGBM, which exhibited co-existing low-grade glioma-like lesions, was found to have strong EZH2 expression and high Ki-67 indexes only in epithelioid cells and not in low grade lesions. Univariate analysis demonstrated that abundant epithelioid cells, extensive necrosis, EZH2 overexpression and BRAF V600E mutations were significantly associated with decreased overall survival in EGBM and APXA patients (P < 0.05). CONCLUSIONS: The results suggested that testing for EZH2 expression and BRAF V600E mutations might be helpful to evaluate the prognoses of EGBM and APXA patients. The presence of heterogeneous EZH2 expression in biphasic EGBMs could also contribute to malignant progression.

Benign notochordal cell tumour: clinicopathology and molecular profiling of 13 cases.

AIMS: To study the clinicopathological and molecular features of benign notochordal cell tumours (BNCTs) and their differential diagnosis from chordoma. METHODS: 13 cases of BNCT were investigated. The genome-wide copy number imbalances were performed using Oncoscan CNV array in three cases and fluorescence in situ hybridisation (FISH) detection of epidermal growth factor receptor (EGFR)/chromosome 7 enumeration probe (CEP7), LSI1p36/1q21, LSI19p13/19q13, CEP3/CEP12 and Telvysion 6 P was performed in 13 cases. RESULTS: All 13 BNCTs were symptomatic and eight cases showed a close relationship with the bones of the skull base. The important histological character for differential diagnosis with chordoma was the absence of extracellular matrix and eosinophil cells and the presence of vacuoles in most tumour cells. Immunohistochemical staining of AE1/AE3, vimentin, epithelial membrane antigen, S-100 and brachyury (100% each) were positive in BNCTs. Gain of chromosome 7 occurred in 10 cases (76.9%), gain of 1p in four (30.8%), gain of 1q in five (38.5%), gain of 19p and 19q in five (38.5%), gain of chromosome 12 in 11 cases (84.6%), gain of 6p in eight (61.5%) and gain of chromosome 3 in four cases (30.8%). CONCLUSIONS: In contrast to chordoma, chromosome gain or normal copy number was more common while chromosome loss was infrequent in BNCTs. This may be a differential diagnosis clue for chordoma and may be an important characteristic in the progression of notochordal cell tumours.

Potassium Aspartate Attenuates Brain Injury Induced by Controlled Cortical Impact in Rats Through Increasing Adenosine Triphosphate (ATP) Levels, Na+/K+-ATPase Activity and Reducing Brain Edema.

BACKGROUND Potassium aspartate (PA), as an electrolyte supplement, is widely used in clinical practice. In our previous study, we found PA had neuroprotective effects against apoptosis after cerebral ischemia/reperfusion in rats. In this study, we examine whether PA has protective effects on traumatic brain injury (TBI). MATERIAL AND METHODS TBI was induced by controlled cortical impact (CCI) in rats. Vehicle treatment (control) or PA treatment was administered intraperitoneally at 30 minutes after CCI. The modified neurological severity score (mNSS) and cortical lesion volume were examined. Brain edema and blood-brain barrier (BBB) integrity were measured, as well as brain ATP contents, lactic acid levels, and Na+/K+-ATPase activities. RESULTS We found that CCI induced cortical injury in rats. Acute PA treatment at the dose of 62.5 mg/kg and 125 mg/kg significantly improved neurological deficits (p<0.05 and p<0.001, respectively) and decreased the cortical lesion volume (p<0.05 and p<0.001, respectively) compared with vehicle-only treatment. PA treatment at the dose of 125 mg/kg attenuated brain edema and ameliorated BBB integrity. In addition, PA treatment significantly reduced the loss of ATP (p<0.01), reduced lactic acid levels (p<0.001), and increased the activity of Na+/K+-ATPase (p<0.01). CONCLUSIONS Our results indicate PA has neuroprotective effects on TBI through increasing ATP levels, Na+/K+-ATPase activity, and reducing brain edema. It provides experimental evidence for the clinical application of PA.

[Clinicopathologic features of papillary tumors of the pineal region].

OBJECTIVE: To study the clinicopathologic features of papillary tumor of the pineal region (PTPR). METHOD: Three hundred and eighty six cases of pineal region and posterior third ventricle tumors, two newborn and two adult pineal glands were analyzed by HE, PAS and immunohistochemistry of 16 antibodies (EnVision method). RESULTS: Five cases of PTPR were diagnosed with mixed papillary features and densely cellular areas, and included one recurrent case. In the papillary areas, the vessels were lined by one or several layers of cuboidal/columnar cells; the vessel wall was hyalinized. In the densely cellular areas, sheets or nests of tumor cells were seen. The tumor cells of these five cases were immunoreactive to CK, CK8/18, synaptophysin, MAP2, nestin, S-100, and vimentin. Four cases were immunoreactive to NSE and CgA; and 2 cases were immunoreactive to NF. All five cases were negative for EMA, CK5/6, CEA, and NeuN. Ki-67 labeling index ranged from 1% to 6%.Three patients were alive, and the recurrent one died. CONCLUSIONS: PTPR occurs in patients with over a wide age range, from children to adults, and is more commonly found in male than female. PTPR is composed of both papillary and solid areas, characterized by epithelial cytology, and needs to be differentiated from ependymoma. PTPR may originate from the specialized ependymocytes of the subcommissural organ. The prognostic factors are early diagnosis, complete surgical resection and radiotherapy.

Role of Nurr1 and Ret in inducing rat embryonic neural precursors to dopaminergic neurons.

BACKGROUND: Nurr1, a member of the nuclear receptor superfamily of transcription factors, is highly expressed in midbrain dopaminergic (DA) neurons. Ret is a member of the receptor tyrosine kinase (RTK) superfamily and a critical signal transducing subunit of receptors for glial cell line-derived neurotrophic factor (GDNF). Both Nurr1 and Ret play important roles in the development of DA neurons. PURPOSE: To investigate possible correlation between Nurr1 and Ret on inducing expression of tyrosine hydroxylase (TH) in neural precursor cells. METHODS: Neural precursors isolated from rat embryonic mesencephalon (E13.5d) were transfected with vectors containing Nurr1 or Ret and treated with 9-cis-retinoic acid (RA) and/or GDNF for 3 days. RT-PCR and immunocytochemistry was used to test the expression of Nurr1 and Ret and the TH positive cells. RESULTS: The number of TH positive cells was increased from 1.53 +/- 0.12 to 3.83 +/- 0.56% after the cells were transfected with Nurr1. Increased endogenous Nurr1 by RA lead to 1.8 times (2.86 +/- 0.32% versus 1.53 +/- 0.12% in the controls) increase in TH positive cells. A double inducing effect by both endogenous and exogenous Nurr1 on the expression of TH was observed by 3.3 times increase in the positive cells (from 5.03 +/- 0.76 to 1.53 +/- 0.12% in control). Ret expression was induced by overexpression of Nurr1. Overexpressed Ret had no inducing effect on the expression of Nurr1 and the number of TH positive cells. The gene of dopamine transporter (DAT) was clearly induced in the cells transfected with Ret. CONCLUSION: Nurr1, required for the expression of Ret, had inducing effect on TH positive cells, and Ret may promote maturation of DA neuron by up-regulating DAT expression through its ligand. As a cooperator, Ret seems to work together with Nurr1 in the development of DA neurons.

[Gene therapy of tyrosine hydroxylase, aromatic L-amino acid decarboxylase, and GTP cyclohydrolase genes in rat model of Parkinson's disease].

OBJECTIVE: To detect the expression and function of enzyme genes involved in biosynthetic pathway for dopamine in vitro and assess their effect in rat model of Parkinson's disease. METHODS: Cos7 cells were transfected with separate adeno-associated virus (AAV) expressing tyrosine hydroxylase (TH) gene, aromatic L-amino acid decarboxylase (AADC) gene and GTP cyclohydrolase I (GCH-I) gene. The expression and function of the three genes were detected by methods of immunohistochemistry, in situ hybridization and high performance liquid chromatograph and electrochemical detection (HPLC-ECD). Gene engineered cells were sequentially transplanted into the striatum of 6-hydroxy-dopamine-leisioned Parkinsonian rat by stereotaxic instrastriatal injection. The asymmetric rotations of these rats after apomorphine administration were detected every week after transplantation. 10 weeks after grafting, the animals were sacrificed and the dopamine produced in the striatum was detected by HPLC-ECD. RESULTS: In vitro experiments showed that the three genes were high expressed in Cos7 cells. When Cos7 cells expressing TH, AADC and GCH-I were cocultured, they produced large amount of dopamine in the condition of existance of L-tyrosine. Furthermore, triple genes therapy resulted in greater dopamine production in the striatum of Parkinsonian rats and improved the rotational behavior of the rats more efficiently than did single gene therapy. However, the production of dopamine in the rats with triple genes therapy is no more than double genes therapy. CONCLUSION: For gene therapy in Parkinson's disease, the amount of target genes to be used should be determined by the level of doperminergic neurons damaged. In the present study, the efficiency of multiple genes therapy is significantly better than that of single gene therapy.

[Identification of bone marrow stromal cells and expression of tyrosine hydroxylase gene in them].

The study is to establish the method of isolation and identification of bone marrow stromal cells and to investigate the ability of bone marrow stromal cells to accept and express TH gene. Cells were isolated by a density gradient (lymphocytes separation) and identified by BrdU labeling and fluorescence-activated cell sorting (FACS) technology using CD11b, CD45 and CD90 antibodies. TH and lacZ gene were transfected to rBMSCs with an adeno-associated virus vector. The results showed that most tightly adherent cells in the primary culture were fibroblast-like and formed foci of two to four cells. The cells in the foci remained dormant for 2 to 4 days and then began to multiply rapidly. After several passages, the adherent cells became more uniformly spindle-shaped in appearance. BrdU, indicating that BMSCs replicate actively, labeled about 74.9% of cultured cells. Data from FACS showed that about 75% of isolated cells were CD90(+)/CD45(-)/CD11b(-), which is the marker of bone marrow stromal cells. The efficiency of TH gene transfection was about 75%. BMSCs could readily be genetically engineered and could be useful delivery targets of gene therapy for Parkinson's disease.