Objective To evaluate the clinical value of adriamycin injection via the foramen ovale and around peripheral trigeminal branches under the guidance of X-ray for treatment of primary trigeminal neuralgia by comparison with the three-dimensional computed tomography (CT).Methods A total of 91 patients with primary trigeminal neuralgia of both sexes,aged 33-76 yr,with the course of disease 6 months-24 yr,with visual analogue scale score of 6-9,were divided into 2 groups using a random number table:X-ray group (n =43) and CT group (n =48).Hartel anterior approach was used to puncture the foramen ovale in 2 groups.One point five percent adriamycin 0.2,0.3 and 0.5 ml were injected via the supraorbital foramen,infraorbital foramen and oval foramen.When pain relief was poor (visual analogue scalc scorc≥ 4) within 1 yr after treatment,oxcarbazepine and adjuncts (tramadol,flupentixol and melitracen tablets,etc.) were taken orally.The requirement for oxcarbazepine and adjuncts was recorded during 1 day-1 week,1 week-1 month,1-3 months,3-6 months and 6 months-1 yr after treatment periods.The operation time,the nuinber of puncture,and developinent and recurrence of complications during treatment and within 1 yr after treatment were recorded.Results Compared with CT group,the number of puncture and incidence of facial hematoma during treatment were significantly increased (P ＜ 0.05 or 0.01),and no significant change was found in the operation time,requirement for oxcarbazepine and adjuncts,incidence of dizziness,nausea and vomiting during treatment,or the incidence and recurrence rate of masticatory muscle weakness and facial numbness after treatment in X-ray group (P＞0.05).Conclusion Compared with the three dimensional CT,X-ray provides similar efficacy and safety when used to guide adriamycin injection via the foramen ovale and around peripheral trigeminal branches for treatment of primary trigeminal neuralgia,showing that X-ray guidance has significant clinical value.

Objective To investigate the effect of cyclooxygenase (COX)-2 inhibitor celecoxib on learning and memory capabilities of transgenic mice with five familial Alzheimer's disease (5×FAD) and its potential mechanism.Methods Totally 32 6-month male 5 ×FAD transgenic positive mice were selected and randomly divided into two equal groups (n=16):a model group (group AD) and a celecoxib treatment group (group S).The mice in group AD were fed with normal diet while those in group S took celecoxib in their diet.Another 16 wide-type (WT) gene mice,served as a normal control group (group WT),received normal diet.After treatment for 14 d,water maze test was arranged for the 3 groups to detect their learning capability.Thioflavin-S staining was conducted to detect the number and area of plaques in the cerebral cortex,hippocampus and thalamus of the mice,immunofluorescence staining was used to detect expressions of 4G8 and ion calcium junction protein molecule 1 (Iba-1) in the brain tissues,and quantitative real time-PCR (q-PCR) was used to detect expressions of markers of M1 and M2 microglia cells in the brain tissues.Results The latency periods in finding the platform in mice of group WT,group S and group AD successively increased on 24nd 3rd and 4th d of treatment,with significant differences among the 3 groups (P＜0.05).The ratio of time of staying in target quadrant to total time in mice from group AD was significantly lower than that in group WT and group S (P＜0.05).The average plaque number and volume per slice in group S were significantly reduced than those in group AD (P＜0.05).Immunofluorescence staining showed no plaque formation and a small number of activated microglia cells in group WT,but plaque formation and a large number of activated microglia cells in group AD and group S.The expression of M1 marker in brain tissues was significantly decreased and the expression of M2 marker was significantly increased in group S than those in group AD (P＜0.05).Conclusion COX-2 inhibitor celecoxib improves the learning and memory capabilities of 5×FAD mice,which is closely related to polarization of microglia cells.

OBJECTIVETo evaluate the laparoscopy combined with transperineal extralevator abdominoperineal excision (TP-ELAPE) for locally advanced low rectal caner.

METHODSClinical data of 12 patients with locally advanced low rectal cancer undergoing laparoscopy combined with TP-ELAPE in our department from May 2013 to March 2015 were retrospectively analyzed. There were 8 male and 4 female patients with median aged of 63 (46 to 72) years. The median distance from tumor lower margin to anal verge was 3.5(2.0 to 4.0) cm. A self-made transanal suit for minimally invasive operation was used to make a sealed lacuna outside the sphincter, thus laparoscope can be applied to perform transperineal operation.

RESULTSAll the patients underwent operations successfully without conversion to open abdominal operation. The median operating time was 206 (180 to 280) minutes with perineal operating time 95(80 to 120) minutes. The median intraoperative blood loss was 120(50 to 200) ml. The median postoperative hospital stay was 12(9 to 18 ) days. Postoperative pathology revealed that all circumferential margins (CRM) were negative. The area of sample horizontal section was (2 824±463) mm(2), and of outer muscularis propria was(2 190±476) mm(2). Postoperative complications included chronic sacrococcygeal region pain in 2 cases, urinary retention in 3 cases, perineal wound infection in 1 case. No perineal seroma, perineal hernia, wound dehiscence and sinus tract formation were observed. Among 8 patients with preoperative normal sexual function, sexual dysfunction occurred in 2 patients. There was no local recurrence and metastasis during a median follow-up of 21(12 to 34) months.

CONCLUSIONLaparoscopy combined with TP-ELAPE has the potential to simplify the operation procedure for low rectal cancer, can ensure the radical treatment and safety of operation, and may be carried out in experienced centers.

Abdomen ; Aged ; Anal Canal ; Blood Loss, Surgical ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Operative Time ; Perineum ; Postoperative Complications ; Postoperative Period ; Rectal Neoplasms ; surgery ; Rectum ; Retrospective Studies

Objective To investigate and study the relationship between abnormal monitoring and prognosis of long range video electroencephalogram(VEEG)in patients with intractable epilepsy. Methods 100 patients from March 2012 to May 2017 in our hospital whose diagnosis and treatment of refractory epilepsy were the research object,all patients were given VEEG monitoring records,epilepsy typing characteristics and antiepileptic drug(AEDs)use survey,prognosis of all patients and the correlation analysis. In 100 cases,GTCS 60 cases,CPS 30 cases,CPS-GTCS 10 cases;56 cases treated with sodium valproate,lamotrigine treatment in 44 cases. Results VEEG monitored 80 cases of epileptiform discharge in 100 patients and 20 cases without epileptiform discharge. There was no significant difference in the incidence of epileptiform discharges between different epileptic patients in VEEG monitoring(P > 0.05),and there was no significant difference in the incidence of epileptiform discharges between VEEG patients in different medication groups(P > 0.05). The total effective rate of treatment in the VEEG epileptiform discharge group was 91.3%,which was significantly lower than that of the VEEG non epileptic discharge group (100%,P < 0.05). The main adverse reactions during treatment were drowsiness , abnormal behavior, abnormal sensation and gastrointestinal reaction. There was no significant difference in monitoring epileptiform discharges between VEEG patients (P > 0.05). All adverse reactions were improved after symptomatic treatment. Conclusion The VEEG plays an important role in guiding the patients with refractory epilepsy for epilepsy typing characteristics and AEDs treatment ,so it has significant correlation to the prognosis , and it also has an important significance in assessing the prognosis.

Objective:To investigate the micro RNA (miR)-1182 expression in glioma, and explore the regulation role and mechanism of miR-1182 overexpression in malignant phenotype of glioma cells.Methods:(1) The data of miR-1182 expressions of 198 glioma samples and survival of these glioma patients were downloaded from the official website of Chinese Glioma Genome Atlas(CGGA), and the differences of miR-1182 expression levels among glioma tissues of different pathologic types and different WHO grades were compared. Kaplan-Meier survival curve was used to analyze the relation between miR-1182 expression level and patient survival. (2) Human glioma cell lines A172, LN229, T98G, U87, and U251, and human normal astrocyte cell line NHA were routinely cultured in vitro, and the miR-1182 expression levels in each group were detected by real-time quantitative PCR (qPCR). (3) U87 and U251 cells were divided into miR-1182 transfection group and negative control group; the miR-1182 mimics and miR-1182 negative control sequence were transfected, respectively. After 48 h of transfection, 5-ethynyl-2'-deoxyuridine (EdU) staining was used to detect the cell proliferation ability, flow cytometry was used to detect the cell apoptosis, Transwell assay was used to detect the cell migration ability, and Western blotting was used to detect the expression levels of cyclin (C-myC, C-Jun, CCND1, and P21), phosphatidylinositol 3 kinase/protein kinase B (PI3K/Akt), and epithelial-mesenchymal transformation (EMT) pathway related proteins (N-cadherin, β-catenin, and vimentin). Results:(1) The miR-1182 expressions in glioma tissues of WHO grading III and IV were significantly lower as compared with those in glioma tissues of WHO grading II ( P<0.05). The median survival time in patients from the low miR-1182 expression group ([701.00±11.14] d) was significantly shorter than that in the high miR-1182 expression group ([1812.00±23.21] d, P<0.05). (2) As compared with that in NHA cell group, the miR-1182 expression levels in A172, LN229, T98G, U87 and U251 cell groups were significantly decreased ( P<0.05), and the decrease was most significant in U87 and U251 cell groups. (3) As compared with the negative control group, the U87 and U251 cells in miR-1182 transfection group had significantly weaker proliferation ability, significantly higher apoptosis rate, significantly decreased number of transmembrane cells, significantly decreased protein expression levels of C-MyC, C-Jun and CCND1, significantly increased P21 protein expression level, significantly decreased expression levels of PI3K, phosphorylated (p)-PI3K, Akt and p-Akt, and significantly decreased expression levels of N-cadherin, β-catenin and vimentin ( P<0.05). Conclusions:Glioma patients with low miR-1182 expression have poor prognosis. Low miR-1182 expression is noted in glioma cells. Overexpression of miR-1182 can inhibit the malignant phenotype of glioma cells, which may be related to cell cycle-related proteins, PI3K/Akt, and EMT pathway ralated proteins.

Objective To investigate the expressions of DEAD-box (DDX) 5 and hepatoma-derived growth factor (HDGF) in glioma samples and their relations with prognoses of the patients.Methods Seventy-eight samples from the lesions and 78 samples from the adjacent tissues of glioma patients,admitted to hospital from February 2013 to June 2017,were selected.The protein expressions of DDX5 and HDGF were detected by immunohistochemistry.The positive expression rates of DDX5 and HDGF in the glioma tissues of patients with different clinical characteristics were compared.Kaplan-Meier method was used to plot the survival curves of patients with DDX5 positive expression and DDX5 negative expression;Log-rank test was used to compare the survival rates of these patients.Results Among 78 patients,the positive expression rates of DDX5 and HDGF in the lesion group were 85.9％ and 80.8％,which were significantly higher than those in the paracancerous group (24.4％ and 28.2％,P＜0.05).There were no significant differences in the positive expression rates of DDX5 and HDGF in patients of different genders,ages,or body mass indexes (P＞0.05);patients with tumor size ＞ 3 cm had significantly higher positive expression rates of DDX5 and HDGF as compared with those with tumor size＜3 cm (P＜0.05);patients with WHO grading Ⅲ-Ⅳ had significantly higher positive expression rates of DDX5 and HDGF as compared with those with WHO grading Ⅰ-Ⅱ (P＜0.05);patients with intracranial cerebrospinal fluid metastasis had significantly higher positive expression rates of DDX5 and HDGF as compared with those without intracranial cerebrospinal fluid metastasis (P＜0.05).Log-rank analysis showed that the overall survival of patients from the DDX5 positive expression group was significantly lower than that of patients from the DDX5 negative expression group (P＜0.05).Conclusion DDX5 and HDGF are highly expressed in glioma tissues,and their expressions are related to tumor sizes,WHO grading and intracranial metastasis;patients with positive DDX5 expression have poor prognosis.

Objective To investigate the application value of biological mesh in the pelvic floor reconstruction of extralevator abdominoperineal excision (ELAPE) for advanced low rectal cancer (RC).Methods The retrospective cohort study was conducted.The clinicopathological data of 228 patients with advanced low RC who underwent ELAPE in the Beijing Chaoyang Hospital of Capital Medical University between August 2008 and December 2016 were collected.Of 228 patients,174 using biological mesh closure and 54 using primary closure were respectively allocated into the biological mesh group and primary closure group.Observation indicators:(1)intra-and post-operative situations;(2) postoperative complications (including short-term and long-term complications);(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications,tumor recurrence or metastasis and overall survival up to December,2017.Measurement data with normal distribution were represented as（ x） ±s,and comparison between groups was analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was analyzed using the nonparametric test.Comparisons of count data were evaluated by the chi-square test or Fisher exact probability.Results (1)Intra-and post-operative situations:all the patients underwent successful ELAPE.The perineal operation time,time of indwelling perineal drainage-tube and hospital expenses were respectively (60 ± 50)minutes,(11.6 ± 2.4) days,(57 781± 11 337) yuan in the biological mesh group and (50±21) minutes,(8.9± 1.7) days,(53 714± 13 395)yuan in the primary closure group,with statistically significant differences between groups (t =3.327,7.691,-2.203,P＜0.05).The total operation time and duration of postoperative hospital stay were respectively (242±53) minutes,(13.0±5.0) days in the biological mesh group and (228±51) minutes,(12.0±5.0) days in the primary closure group,with no statistically significant difference between groups (t =1.701,1.309,P＞0.05).(2) Postoperative complications:26 and 19 patients in the biological mesh group and primary closure group had respectively perineal wound complications (1 patient combined with multiple complications),showing a statistically significant difference between groups (x2 =10.660,P＜0.05).The perineal wound infection,perineal hernia and disruption of perineal wound were respectively detected in 20,6,1 patients in the biological mesh group and 12,7,3 patients in the primary closure group,showing statistically significant differences between groups (x2 =3.931,5.282,P＜0.05).(3) Follow-up and survival situations:174 patients in the biological mesh group were followed up for 64 months (range,13-112 months),and 54 patients in the primary closure group were followed up for 51 months (range,23-76 months).The local recurrence rate,distal metastasis rate and overall survival rate were respectively 5.17％ (9/174),20.11％ (35/174),77.59％ (135/174) in the biological mesh group and 7.41％(4/54),24.07％(13/54),79.63％(43/54) in the primary closure group,with no statistically significant difference between groups (x2 =0.080,0.389,0.101,P＞0.05).Conclusions The biological mesh in the pelvic floor reconstruction of ELAPE for advanced low RC is safe and feasible.Compared with primary closure,biological mesh closure will extend perineal operation time and time of indwelling perineal drainage-tube,and increase hospital expenses,but doesn't affect total operation time and duration of postoperative hospital stay,meanwhile,it can also reduce the overall perineal wound complications,especially in perineal wound infection,perineal hernia and disruption of perineal wound.