Objective:To investigate the expressions of krüppel-like factor 4 (KLF4) in human glioma tissues and its effect on the activity of tumor cells.Methods:The glioma tissues specimens of 74 patients with primary malignant gliomas who were admitted to Nanyang Second General Hospital of Henan Province from March 2018 to May 2019 were collected. During the same period, 50 cases of benign meningioma tissues and 31 cases of normal brain tissues receiving surgery because of head injury were also collected. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the expression of KLF4 mRNA in tissues. Glioma U-87MG cells were selected and the glioma cell models with low-expression of KLF4 were constructed and were divided into the blank control group, KLF4-NC group and KLF4-siRNA group. The proliferation ability of cells was detected by using MTS cell proliferation detection kit, and the expression levels of E-cadherin, vimentin and zonula occludens protein 1 (ZO-1) were detected by using Western blot.Results:The relative expression level of KLF4 mRNA in low-grade glioma, benign meningioma, and normal brain tissues was 0.26±0.04, 0.13±0.02, 0.11±0.02, respectively, which were lower than that in high-grade glioma(0.34±0.06), and the difference was statistically significant ( t = 8.381, 15.720, 15.984, all P<0.05). The relative expression level of KLF4 mRNA in benign meningiomas and normal brain tissues was lower than that in low-grade gliomas, and the difference was statistically significant ( t = 13.771, 14.239, all P<0.05). At each time point of cell culture, the proliferation ability of U-87MG cells in KLF4-siRNA group was lower than that of the blank control group and KLF4-NC group, and the difference was statistically significant (all P < 0.05). There was no significant difference in U-87MG cell proliferation ability between the blank control group and KLF4-NC group ( P > 0.05). The relative expression level of E-cadherin and ZO-1 protein in KLF4-siRNA group was 0.82±0.10, 0.79±0.11, respectively, which were higher than that in the blank control group (0.24±0.08, 0.39±0.05) and KLF4-NC group (0.26±0.05, 0.42±0.09), and the difference was statistically significant (all P < 0.01); and the relative expression level of vimentin in KLF4-siRNA group (0.31±0.08) was lower than that in the blank control group (0.90±0.08) and KLF4-NC group (0.92±0.05), and the difference was statistically significant (all P < 0.01). There was no statistically significant difference in the expression level of E-cadherin, vimentin and ZO-1 between the blank control group and KLF4-NC group (all P > 0.05). Conclusion:The expression level of KLF4 is increased in human glioma tissues, especially in high-grade glioma. Down-regulating the expression of KLF4 may inhibit glioma cell proliferation and epithelial-mesenchymal transition, and reduce cell activity.

Objective:To explore the risk factors of neurological complications after interventional treatment of ruptured intracranial aneurysms(RIAS), and to establish a predictive model of nomogram.Methods:The clinical data of 89 patients with RIAS who underwent endovascular treatment in Nanyang Second General Hospital Affiliated to Xingxiang Medical University from January 2016 to January 2019 were retrospectively studied.The clinical imaging data were collected and followed up for 6 months.The patients were divided into two groups: no neurological complications group (61 cases) and neurological complications group (28 cases). To analyze the clinical indicators and the possible related factors of neurological complications after RIAS interventional therapy.A nomogram was established to score the influencing factors, and a scoring prediction model was constructed; the clinical calibration of the model was evaluated by consistency index (C-index) and calibration curve, and the clinical differentiation of the model was evaluated by nomogram relying on ROC curve.Results:Multivariate logistic regression analysis showed that Hunt-Hess classification ( OR=4.927, 95% CI: 1.189-20.426, P=0.028), Fisher classification ( OR=4.633, 95% CI: 1.012-21.208, P=0.048 ), aneurysm cyst xiaofu ( OR=5.918, 95% CI: 1.104-24.948, P=0.015), wide carotid aneurysm ( OR=4.381, 95% CI: 1.029-18.645, P=0.046) and treatment Strategy ( OR=4.887, 95% CI: 1.235-19.329, P=0.024) is an independent risk factor for nerve-related complications after RIAs interventional therapy.The predictive model of nomogram showed that Hunt-Hess classification (grade IV, V) was 100, aneurysm bleb (with) 98, treatment strategy (stent implantation) 95, wide-necked aneurysm (yes) 92 and Fisher grade (grade III, IV) 81; the C-index of the predictive model was 0.871; the nomogram relied on ROC curve AUC 0.871, and the treatment strategy (stent implantation) was 95; the Fisher grade (grade III, IV) was 81; the C-index of the predictive model was 0.871.The sensitivity and specificity were 85.71%(24/28) and 77.05%(47/61) respectively. Conclusion:Hunt Hess classification, Fisher classification, aneurysmal sac caruncle, wide necked aneurysms and treatment strategies will affect the occurrence of neurological complications after RIAS interventional therapy.The nomogram established by this method can provide intuitive and reliable reference for clinical practice.

Objective:To investigate the relations of serum hypoxia inducible factor 2α (HIF-2α) and miR-21 expressions with cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH) after interventional embolization.Methods:One hundred and seventy-four patients with aSAH underwent interventional embolization in our hospital from October 2017 to June 2019 were prospectively selected. DSA examination was performed 4 d after surgery, and severity of cerebral vasospasm was evaluated. Enzyme-linked immunosorbent assay was used to detect the level of serum HIF-2α and reverse transcription-PCR was employed to detect the serum miR-21 expression before and 3 and 7 d after interventional embolization. The clinical data and changes of serum HIF-2α and miR-21 expressions in patients with different degrees of cerebral vasospasm were compared. Correlation analysis was performed to analyze the relation of HIF-2α expression with miR-21 expression 3 and 7 d after interventional embolization. Receiver operating characteristics curve was used to analyze the diagnostic values of serum HIF-2α and miR-21 levels in cerebral vasospasm 3 d after interventional embolization.Results:There were 100 patients without vasospasm, and 20, 38 and 16 patients with mild, moderate and severe cerebral vasospasm, respectively. The serum levels of HIF-2α and miR-21 in patients with mild, moderate and severe cerebral vasospasm increased successively 3 and 7 d after interventional embolization, with significant differences ( P<0.05). Positive correlation was noted between expressions of HIF-2α and miR-21 in serum 3 and 7 d after interventional embolization ( P<0.05). Area under the curve (AUC) of HIF-2α in diagnosis of cerebral vasospasm was 0.748 ( 95%CI: 0.615-0.883, P=0.000) 3 d after interventional embolization. AUC of serum miR-21 level in diagnosis of cerebral vasospasm was 0.715 ( 95%CI: 0.590-0.842, P=0.000). AUC of serum HIF-2α combined with miR-21 in diagnosis of cerebral vasospasm was 0.893 ( 95%CI: 0.792-0.985, P=0.000). When diagnostic critical points of HIF-2α and miR-21 were 82.75 pg/mL and 1.15, the sensitivity, accuracy and negative predictive value of HIF-2α combined with miR-21 in the diagnosis of cerebral vasospasm were higher than those of HIF-2α or miR-21 alone. Conclusion:The expressions of serum HIF-2α and miR-21 in patients with aSAH after interventional embolization can effectively predict the occurrence of cerebral vasospasm, and may be involved in the occurrence and development of cerebral vasospasm.

Objective:To investigate the expression of octamer-binding transcription factor 4(OCT4) in glioma tissues and its relationship with prognosis of patients.Methods:From March 2015 to June 2016, 168 patients with glioma and 72 normal brain tissues in the Second People's Hospital of Nanyang were collected.The expression levels of OCT4A and OCT4B were detected by reverse transcription-polymerase chain reaction(RT-PCR), and the relationship between clinicopathological characteristics and prognosis of glioma patients was analyzed.Results:The relative expressions of OCT4A(2.28±0.85) and OCT4B(2.84±1.29) in 168 glioma tissues were significantly higher than those in normal tissues [(1.05±0.41), (1.18±0.46)] ( t=11.649, 14.798, all P<0.01), and there was a positive correlation between OCT4A and OCT4B in glioma tissues( r=0.682, P=0.001). The expression levels of OCT4A and OCT4B in glioma patients with different pathological stages, pathological types, degree of differentiation and depth of invasion had statistically significant differences( t=14.695, 11.309, 16.038, 13.721, 17.216, 15.083, 14.871, 15.417, all P<0.01). Taking the median value of OCT4A and OCT4B mRNA expression as the cutoff value, the patients were divided into low expression group and high expression group.The overall survival of patients with low expression of OCT4A and OCT4B was (24.17±3.41)months and (25.30±4.16)months, which were significantly longer than (15.80±2.93)months and (15.94±3.07)months of high expression patients, the differences were statistically significant( t=15.639, 16.143, all P=0.000). Cox regression model analysis showed that the expression levels of OCT4A and OCT4B were independent factors affecting the prognosis of glioma patients.The hazard ratio (95% CI) was 1.731(0.804-3.181) and 1.605(0.795-2.942), respectively. Conclusion:The expression levels of OCT4A and OCT4B in glioma tissues are abnormally elevated, which is closely related to the severity of the disease.The patients with high expression of OCT4A and OCT4B have a shorter overall survival period, which has a certain predictive value for the treatment effect and prognosis of glioma.

OBJECTIVES: To explore the effect of resveratrol (Res) on Kawasaki disease (KD)-induced myocardial injury and to evaluate its effect on apoptosis and autophagy. METHODS: Forty-eight juvenile male Sprague Dawley rats were randomly divided into a control group, a Res group, a lactobacillus casei cell wall extract (LCWE)-induced Kawasaki disease group (KD group), and a LCWE-induced Kawasaki disease + Res treatment group (Res+KD group). The control group was intraperitoneally injected with saline. The Res group was intraperitoneally injected with resveratrol (100 mg/kg). The KD group was intraperitoneally injected with 0.5 mL LCWE (1 mg/mL). The Res+KD group was intraperitoneally injected with 0.5 mL LCWE (1 mg/mL) and resveratrol (100 mg/kg). After 4 weeks, the left ventricular ejection fraction (LVEF) and short axis shortening rate (LVFS) were detected by echocardiography. The apoptotic rate was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) staining. The levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), microtubule-associated protein 1 light chain 3β (LC3B), Beclin-1, autophagy related 5 (Atg5) and sequestosome-1 (p62) were detected by Western blotting. The formation of autophagosome was observed under transmission electron microscope. RESULTS: There was no significant difference in the above-mentioned indexes between the control group and the Res group (all CONCLUSIONS Res can attenuate the KD-induced myocardial injury via inhibiting the apoptosis and autophagy.
Animals ; Apoptosis ; Autophagy ; Male ; Mucocutaneous Lymph Node Syndrome/drug therapy* ; Rats ; Rats, Sprague-Dawley ; Resveratrol/therapeutic use* ; Stroke Volume ; Ventricular Function, Left

Objective:To study the strategies in the diagnosis and treatment of pancreatic tumors in children.Methods:The clinical data of 18 children with pancreatic tumor managed at the Children's Hospital Affiliated to Chongqing Medical University from March 2015 to September 2020 were retrospectively studied. There were 8 males and 10 females, age ranged from 3 months to 14 years and 11 months, with a median age of 8 years and 2 months. Clinical data including age, gender, pathological data, surgical methods, chemotherapy, tumor location and treatment outcomes were collected. Follow-up was conducted by outpatient visits and by telephone.Results:Abdominal ultrasound, enhanced CT and/or MRI examinations were performed on all these patients, with findings of either a cystic or solid lesion of pancreas. All patients were treated by laparotomy under endotracheal intubation and general anesthesia. The operations were all completed successfully. Among the 18 patients, there were 11 patients with solid pseudopapillary tumors and 7 patients with pancreatoblastoma (PBL). The tumors were located in the head of the pancreas in 13 patients (including 3 patients who underwent pancreaticoduodenectomy, 1 patient who underwent resection of the head of the pancreas with preservation of the duodenum, and 9 patients who underwent resection of the tumors). The tumors were located in the body and tail of the pancrease in 5 patients (including 3 patients who underwent resection of the body and tail of the pancreas with preservation of spleen, and 2 patients who underwent resection of tumors). Because of huge tumors, 1 patient had bilateral lung, left supraclavicular fossa lymph node and retroperitoneal lymph node metastasis, 3 patients were confirmed to have PBL by biopsy, and these tumors were resected completely after neoadjuvant chemotherapy. Postoperative pathology showed that all the 3 patients had PBL and were given systematic chemotherapy. Postoperative pancreatic fistula occurred in 1 patient and chylous fistula in another patient, both were discharged home successfully after conservative treatments. All patients were followed-up for 2-7 years, and all children were tumor-free.Conclusion:It is not difficult to diagnose pediatric pancreatic tumors by ultrasound, CT and MRI before operation, and postoperative pathology was needed to confirm the diagnosis. Function-preserving surgical resection was the treatment of choice for pancreatic tumors in children.