Objective To investigate the routes and MR imaging manifestations of meningeal involvement by nasopharyngeal carcinoma (NPC) with pathological correlation. Methods Twenty five NPC patients with involvement of meninges were included into the study. All patients underwent both unenhanced and Gd DTPA enhanced MR imaging examinations. Surgical and pathological findings were correlated with MR imaging manifestations in 9 patients. Positive cytology was found in only 1 of the 25 patients. Results There were three main routes for meningeal involvement in NPC patients: (1).through the natural bony channels (foramens) of the skull base; (2).through direct bony erosion of the skull base; and (3).Through hematogenous spread. Dura mater was very frequently involved, being seen in 24 patients; pia mater was involved in only one patient. Irregular, patchy thickening in the form of “necklace”, nodules, or mass with obvious enhancement was the major MR feature of meningeal involvement by NPC. In one patient with choroid plexus involvement, dilatation of the lateral ventricles, subependymal nodules with patchy thickening were observed. Conclusion MR imaging with Gd DTPA enhancement was very useful to demonstrate the presence, location and extent of meningeal involvement in NPC patients.

Progressive brain injury after traumatic brain injury,including intracranial hemorrhage,cerebral ischemia and edema,is an important factor affecting the prognosis of patients with traumatic brain injury.On basis of reviewing literatures,the research progress on incidence,mechanism,methods for early diagnosis,treatment and prognosis of progressive brain injury after traumatic brain injury was reviewed.

Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.

Liver cirrhosis, characterized by diffuse hepatocytes necrosis, insufficient regeneration of hepatocytes, angiogenesis, severe fibrosis and the formation of pseudolobules, is a progressive chronic hepatic disease induced by a variety of causes. It is clinically characterized by liver function damage and portal hypertension, and many complications may occur in the late stage. Based on the update relevant guidelines, experts' consensus, and research advances on the diagnosis and treatment of cirrhosis, Chinese Society of Gastroenterology of Chinese Medical Association established a consensus aiming to standardize the clinical diagnosis and treatment of liver cirrhosis and guide clinical practice. This consensus contains 43 statements on the etiology, pathology and pathogenesis, clinical manifestations, major complications, diagnosis, treatment, prognosis and chronic disease management of liver cirrhosis. Since several guidelines and experts' consensus on the complications of liver cirrhosis have been published, this consensus focuses on the research progress of liver cirrhosis itself.

The vegetative state is a complex condition with unclear mechanisms and limited diagnostic, prognostic, and therapeutic methods. In this study, we aimed to explore the proteomic profile of tears from patients in a traumatic vegetative state and identify potential diagnostic markers using tears-a body fluid that can be collected non-invasively. Using iTRAQ quantitative proteomic technology, in the discovery phase, tear samples collected from 16 patients in a traumatic vegetative state and 16 normal individuals were analyzed. Among 1080 identified tear proteins, 57 were upregulated and 15 were downregulated in the patients compared to the controls. Bioinformatics analysis revealed that the differentially-expressed proteins were mainly involved in the wound response and immune response signaling pathways. Furthermore, we verified the levels of 7 differentially-expressed proteins in tears from 50 traumatic vegetative state patients and 50 normal controls (including the samples used in the discovery phase) using ELISA. The results showed that this 7-protein panel had a high discrimination ability for traumatic vegetative state (area under the curve = 0.999). In summary, the altered tear proteomic profile identified in this study provides a basis for potential tear protein markers for diagnosis and prognosis of the traumatic vegetative state and also provides novel insights into the mechanisms of traumatic vegetative state.
Adult ; Aged ; Aged, 80 and over ; Biomarkers ; metabolism ; Chromatography, Liquid ; Enzyme-Linked Immunosorbent Assay ; Eye Proteins ; metabolism ; Female ; Humans ; Male ; Mass Spectrometry ; Middle Aged ; Persistent Vegetative State ; metabolism ; Proteome ; Proteomics ; ROC Curve ; Tears ; metabolism ; Young Adult

Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography (aEEG) for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.
Brain ; physiopathology ; Brain Injuries ; complications ; diagnosis ; physiopathology ; Coma ; diagnosis ; etiology ; physiopathology ; Electroencephalography ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neurophysiological Monitoring ; methods ; Prognosis ; Prospective Studies ; Sensitivity and Specificity ; Severity of Illness Index