Therapeutic efficiency of advanced stage liver cancer is insufficiency,which has become the hot spot of research.Clinical observation found that prognosis of liver cancer with integrity amicula was better.It is generally accepted that silicon dioxiode(SiO2) can induce pulmonary fibrosis,resulting in the formation of pneumosilicosis.Use of SiO2 as embolism material induces hepatic fibrosis and forms the fibrosis amicula around the liver carcinoma,and then restrains the recurrence and metabasis of liver cancer,which has been turned into one of the aspect of liver carcinoma therapy.The possible mechanisms of inducing hepatic fibrosis by SiO2 are peroxidative damage by free radical,releasing of active cytokines,or inducing cell apoptosis and the activation of HSC etc.

目的：探讨miRNA-490-3p调控Smad2/TGF-β对结直肠癌奥沙利铂化疗敏感性的影响。方法：选取100例结直肠癌（colorectal cancer，CRC）根治性手术后奥沙利铂（oxaliplatin，OXA）同种联合化疗患者作为研究对象，根据化疗情况分为耐药组（n=40）和非耐药组（n=60），用qPCR检测两组外周血miRNA-490-3p水平；选取人CRC细胞株SW480和CRC奥沙利铂（OXA）耐药型细胞株OXA-SW480进行研究，先用qPCR检测两种细胞株中miRNA-490-3p表达水平；后将miRNA-490-3p过表达载体转染OXA-SW480（过表达组），并设立空载体组（空载体转染OXA-SW480）和空白对照组（OXA-SW480未经任何处理）。用CCK-8检测各组细胞增殖能力，同时用不同浓度OXA处理各组细胞，计算其半数抑制浓度（IC50）；用Annexin-V-FITC/PI染色流式细胞术检测各组细胞凋亡率；用WB检测各组Smad2和TGF-β蛋白表达水平。结果：在CRC患者中，耐药组外周血miR-490-3p水平显著低于非耐药组，在CRC细胞株中，OXA-SW480耐药株细胞miR-490-3p水平显著低于正常株SW480细胞（P<0.05）。与空载体组和空白对照组相比，过表达组miR-490-3p水平显著降低（均P<0.05），增殖抑制率显著升高（均P<0.05），细胞凋亡率显著升高（均P<0.01），Smad2蛋白水平显著降低（均P<0.05），TGF-β蛋白水平显著升高（均P<0.05）。经OXA处理后，过表达组的IC50显著低于空载体组和空白对照组（均P<0.05）。经Pearson相关法分析，miR-490-3p与Smad2的表达呈负相关（r=–0.943，P<0.01），miR-490-3p与TGF-β的表达呈正相关（r=0.961，P<0.01）。结论：过表达miRNA-490-3p可增加CRC SW480细胞的OXA敏感性，此作用Smad2/TGF-β信号通路有关。

OBJECTIVETo investigate the microsurgical tchniques and effects for the resection of anterior clinoid meningioma (ACM).

METHODSBetween January 2003 and March 2013, a total of 46 ACM patients were operated on via the pterion approach or lateral subfrontal approach. There were 16 male patients and 30 female patients, their mean age was 48.5 (16-69) years. Symptoms lasted from 1 month to 9 years(average 24.7 months). Preoperative CT and MRI examination showed that the tumors were located in the anterior clinoid process (25 cases on the right side, 21 cases on the left side). The average maximal tumor diameter was 4.4 cm (1.9-7.4 cm). The patients were peroidly followed-up on outpatient on 3 months to 6 months, then every year postoperativelly. The clinical data, radiological findings, surgical records and outcome of patients were retrospectively analyzed, and the prognostic factors were ananlyzed by using of the unpaired data χ(2) test with continuity correction.

RESULTSOf fourty-six patients operated on, apparently complete removal was achieved in 36 patients (78.3%), 10 patients (21.7%) had minimal residual tumors, 5 of which had gamma knife radiosurgery. Preexisting visual deficit improved in 21 of 41 patients (51.2%), unchanged in 16(35.6%), and worsened in 9(20.0%). At 3-6 months after discharge, 37(80.4%) patients had a good recovery, 7(15.6%) patients were moderately disabled, 1(2.2%) presented with severe disability, and 1 (2.2%) patient died of surgery-related causes. The tumor wrapping blood vessels (χ(2) = 4.676, P = 0.031) and violating cavernous sinus(χ(2) = 4.973, P = 0.026) were causes of unfavorable prognosis. During the mean follow-up of 35.1 months (range, 4-107 months) for 40 patients, the average Karnofsky score was 83.2. Tumor recurred in 4 cases: 2 of which required reoperation, and 2 had gamma knife radiosurgery.

CONCLUSIONSTumor wrapped vessels and invasion of the cavernous sinus are important unfavorable prognostic factors for ACM resection. By using appropriate surgical strategies and techniques, ACM can be removed safely via the pterion approach or lateral subfrontal approach with relatively low morbidity and mortality.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Meningeal Neoplasms ; surgery ; Meningioma ; surgery ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult