OI To research the new interhemispheric approach treatments of removing different large or huge sellar region tumor. Methods To remove 36 cases of different infiltrated-growth large or huge sellar region tumors by interhemisphefic approach microsurgery. Results In the 36 cases, total removal was achieved in 29, subtotal in 5 and most-partly in 2, and without any severe complications or death occured. 12 in 18 functional pituitary adcnoma were followed up, 10 cases got recovery on hormone level, and the level in 2 cases reduced ob ously. 2 cases recurred, both received γ-knife treatment. Conclusion The new interhemispheric approach surgery is important for large or huge invasive sellar region tumor.

Objective To investigate the correlation between Dishevelled protein expression and the proliferation and invasion of glioma cells.Methods 67 cases of brain glioma specimens were collected.The expression of Dishevelled protein was detected with immunohistochemical method.The immunoreactivity score (IRS) of Dishevelled protein,and proliferation index (PⅠ) and invasion index (Ⅱ) were measured and their correlations were analyzed.Results The positive rate of Dishevelled protein in glioma was 65.7 ％ (44/67).IRS,PⅠ and Ⅱ were 4.15±3.13,(30.93±17.92) ％,(20.38±13.36) ％,respectively.Both PⅠ and Ⅱ significantly increased with an increase in the pathological grade of brain glioma (P ＜ 0.001).Furthermore,PⅠ and Ⅱ were significantly higher in the Dishevelled protein-positive group than those in the Dishevelled protein-negative group [(38.27±17.60) ％ vs (16.02±8.92) ％ of PⅠ and (30.03±13.81) ％ vs (10.63±4.41) ％ of Ⅱ,respectively,P ＜ 0.001].PⅠ and Ⅱ of glioma cells were positively correlated with IRS of Dishevelled protein (r =0.940 between PⅠ and IRS,and r =0.953 between Ⅱ and IRS,respectively).Conclusion Dishevelled protein plays an important role in the proliferation and invasion of brain malignant glioma.

Objective To explore the expression of CD133 and nestin in human glioma cell of patients with neuroglioeytoma and to see whether CD133 and nestin expression associate with the differentiation and pathologic grading.Methods The expression of CD133 and nesfin was detected by immunohistochemistry staining in 65 cases of human glioma and 19 specimens of normal brain tissues.Results The rate of the CD133 positive ceUs was 18.46%in human glioma and 0 in the control group(P＜0.01),and that of nesfin was 23.79%and 5.16%respectively.The positive cell rates of CD133 or nestin varied accordingly to different pathological grades.There were significant difference between grade Ⅰ and grade Ⅲ or grade Ⅳ (P＜0.01).There were difference between grade Ⅱ and grade Ⅲor grade Ⅳ (P＜0.01).The same significance were also found between grade Ⅲ and grade Ⅳ(P＜0.01).The higher pathological grades had higher positive cell rates.There was a significant corl~lation between the rate of CD133 positive cells and that of nestin in experimental group (r=0.408,P＜0.01).Conclusion Detecting CD133 and nestin in the human glioma can be used in diagnosing,judging the malignancy degree and the prognosis.

Objective To explore the value of F wave recording in evaluating facial nerve function and its pathological changes in the pressure-induced rat models of acoustic neurinoma. Methods 58 rats in different groups were conducted F wave recording and biotinylated dextran amine(BDA) retrograde tracing for their right facial nerve one week after establishing models. Their latencies, amplitudes and F/M rates were analyzed first. 72 hours after BDA was injected into right whisker muscle, the rats were infused with 4% polyoxymethylene, then pontines and facial nerves in the CPA cistern were obtained. Pontiues were cut into frozen sections for histochemical staining with avidin-horseradish peroxidase (HRP)-DAB and Nissl 's counterstaining, calculating the positive BDA neurons ratio(BDA+-N%)in facial nuclear. Facial nerves were cut and stained with toluidine blue for light-micrescope inspection, and/or stained for transmission electron microscope observation. Correlating F/M with BDA+-N% and the facial nerve pathological findings. Results F/M are 97.66 % and 97.48 % in normal and pseudo-operation group, respectively, when stimulus are 1.4 mA; while 77.13 %, 48.91% and 11.54 % in from small to large tumor model groups because F waves were delayed in latencies or increasinglylost (P <0.001). Similarly, BDA+-N% are 98.37 % and 97.96 % in the above two control groups, while 77.28 %, 48.28 % and 11.55 % in from small to large tumor model groups (P < 0.001). Thus F/M are positively correlated with their BDA+-N% in all groups (r =0.996,P <0.001). Facial nerve examinations under light and electron microscope show increasing pathological changes along with increasing "tumor" size. Conclusion The findings of F wave recording in facial nerve may reflect its functional status and pathological changes. Therefore, F wave detection may help electrophysiological monitoring during acoustic neurinoma resection and facial nerve function evaluation after surgery.

ObjectiveTo explore the function of intraoperative monitoring by brainstem auditory evoked potential and free electromyography during the operation of large acoustic neuroma for improving the operation more accurately and safely. MethodsThe intraoperative monitoring of affected cranial nerve and brainstem function respectively by brainstem auditory evoked potential and free electromyography was performed in 26 patients with large acoustic neuroma. According to the monitoring result the strategy and method of surgery was adjusted. Facial nerve function was assessed using the House-Brackmann facial nerve grading system immediately after two weeks of surgery.Results23 cases (88 ％) achieved total resection,3 cases(12 ％)achieved subtotal resection. The facial nerve was preserved anatomically in 25 patients.According to the House-Brackmann facial nerve grading system,21 cases (80 ％) got preserve of facial nerve function in grade Ⅰ - Ⅱ, 3 cases(12 ％)got preserve of facial nerve function in grade ]Ⅲ-Ⅳ and 1 cases (4 ％) got preserve of facial nerve function in grade Ⅴ after two weeks of surgery.ConclusionIntraoperative physiological monitoring may increase the anatomical and functional preservation rate of affected cranial nerve and also may improve the operation more accurately and safely.

Objective To investigate the inhibitive effects of Ad-PUMA combined with temozolomide on human glioblastoma cells growth in vivo experiments. Methods The nude mouse model with human glioblastoma cells subcutaneous transplantation was established. The mice were randomly divided into 4 groups to receive subcutaneous injection at the 14th day separately with: Normal saline 100 μl (control, n=8), Ad-PUMA 2×108 pfu/100 μl (PUMA group, n=8), 10 mg/kg TMZ (TMZ group, n=8) and 2×108 pfu/100 μl Ad-PUMA + 10 mg/kg TMZ (combined group, n=8). Mice were killed after 20 days treatment.Tumor volume, inhibition rates and apoptotic index (AI) were measured, meanwhile, apoptotic tumor cells were detected by TUNEL technology respectively. The expression of MGMT mRNA and MGMT protein were revealed by the methods of RT-PCR and Western blot. Results According to the order: control group, AdPUMA group, TMZ group, combined group, tumor volumes were (3.68±0.09), (2.63±0.13), (2.13±0.07),(0.97±0.02) cm3 respectively (P＜0.05); the inhibitive rates were 0, 28.5 %, 42.1%, 73.6 % respectively and AI were (2.0±1.2) %, (11.4±2.6) %, (7.6±3.2) %, (20.6±8.6) % (P＜0.05). The results of Western blot and RT-PCR showed that MGMT mRNA and MGMT protein levels in TMZ group were higher than other groups (all P＜0.01). Conclusion Ad-PUMA combined with TMZ greatly enhances the sensitivity of human glioblastoma cells to TMZ and could effectively inhibit the proliferation and promote the apeptosis of glioblastoma cells, its mechanism was probably related Ad-PUMA promote apoptosis and inhibit MGMT expression.

Objective To investigate the expression of FRAT1 and β-catenin in human brain glioma,analyze the correlation between the expression and clinical pathological grades and the correlation of the two genes.Methods FRAT1 and β-catenin were detected by immunohistochemistry in 84 human brain glioma tissues and 6 human normal brain tissues.Results 66.7 ％ (56/84) and 77.4 ％ (65/84) of human brain glioma tissues expressed FRAT1 and β-catenin protein,whereas no FRAT1 and β-catenin protein expression was detected in human normal brain tissues.The expression levels of FRAT1 and ββ-catenin increased markedly with the ascending of pathologic grade of tumor specimens (r =0.55,P ＜ 0.01,r =0.70,P ＜ 0.01),there was a positive correlation between FRAT1 and β-catenin (r =0.77,P ＜ 0.01).Conclusion FRAT1 and β-catenin over-expression maybe closely related with occurrence and development of human brain gliomas.The results provide important supplements for the research of Wnt/β-catenin pathway.Meanwhile,FRAT1 may act as a valuable biomarker for molecular diagnosis of glioma and a potential target for gene therapy of glioma.

ObjectiveTo study the methods of how to protect facial nerve function following complete resection of acoustic neurinomas and the value of the techniques of F wave assisted electrophysiological monitoring intraoperatively.Methods Retrospectivelysummarizing theresultsof combining three electrophysiological monitoring techniques such as nasal muscle F wave recording,online EMG and triggered EMG to monitor 46 cases of microoperations for acoustic neurinomas intraoperatively during the period of Feb.2004 to Dec. 2008. Correlating every intraoperative monitoring index with their follow-up results of facial nerve function 1 day and 6 months after their operations.The tendency of the two continuous monitoring techniques between nasal F wave recording and online EMG of facial muscles has also been studied in this paper. Results Among 46 cases of acoustic neurinomas, 45(97.83 %) tumors have been totally resected, and 1 (2.17 %) tumor subtotally resected,lcase (2.17 %)died after operation,and 2ases occurred the leakage of cerebrospinal fluid(CSF) which have been cured through conservative treatment. The whole anatomic protection rate of facial nerve is 97.83 %,and their functional protection rates 6 months after operation are:HB Ⅰ - Ⅱ,75.56 %;Ⅲ-Ⅳ,22.22 % and Ⅴ-Ⅵ,2.22 %.The completely accordant rate between the intraoperative findings of nasal F wave recording and online EMG is 52.17 %, partially accordant rate is 45.65 %, and totally opposite rate is 2.17 % (x2 趋势= 6.113, P ＜0.05). The intraoperative monitoring indexes in nasal muscle F wave recording are correlated well with the facial nerve function in the 6th month' s follow-up (κ=0.429, P ＜0.001).In triggered EMG monitoring after tumors being resected,the stimulus threshold ratio and maximum amplitude ratio of facial nerve between leaving brain stem part and inner acoustic porus part are also correlated well with the facial nerve function 6 months after operation(κ=0.576, P ＜0.001; κ=0.595, P ＜0.001). ConclusionNasal muscle F wa recording cooperated well with online EMG and triggered EMG intraoperatively and correlates well with the postoperative facial nerve function, so they should be routinely applied together intraoperatively.

PURPOSE: Endothelial progenitor cells (EPCs) play a key role in tissue repair and regeneration. Previous studies have shown that infusion of human umbilical cord blood-derived endothelial colony-forming cells improves outcomes in mice subjected to experimental traumatic brain injury (TBI). However, the efficiency of cell transplantation is not satisfactory. Oxidative stress plays a significant role in the survival of transplanted cells following ischemic reperfusion injury. This observational clinical study investigated the correlation between the number of circulating EPCs and plasma levels of superoxide dismutase (SOD) and malonyldialdehyde (MDA). MATERIALS AND METHODS: Peripheral blood samples were collected from 20 patients with mild TBI at day-1, day-2, day-3, day-4, and day-7 post TBI. The number of circulating EPCs and the plasma levels of SOD and MDA were measured. RESULTS: The average of circulating EPCs in TBI patients decreased initially, but increased thereafter, compared with healthy controls. Plasma levels of SOD in TBI patients were significantly lower than those in healthy controls at day-4 post-TBI. MDA levels showed no difference between the two groups. Furthermore, when assessed on day-7 post-TBI, the circulating EPC number were correlated with the plasma levels of SOD and MDA. CONCLUSION: These results suggest that the number of circulating EPCs is weakly to moderately correlated with plasma levels of SOD and MDA at day-7 post-TBI, which may offer a novel antioxidant strategy for EPCs transplantation after TBI.
Animals ; Brain Injuries* ; Cell Transplantation ; Clinical Study ; Endothelial Progenitor Cells* ; Humans ; Malondialdehyde ; Mice ; Oxidative Stress* ; Plasma ; Regeneration ; Reperfusion Injury ; Superoxide Dismutase ; Transplants ; Umbilical Cord