Objective Few studies are reported on the clinical characteristics of glioma-related epilepsy (GRE).Postoperative recurrence of epilepsy in some patients seriously affects their recovery.We aimed to explore the duration, frequency and type of the epileptic seizure as well as possible factors for postoperative recurrence of epilepsy.Methods We recorded the frequency and duration of epileptic seizures, analyzed the recurrence-related factors using the Cox regression model, and investigated the risk factors of recurrent epilepsy.Results The postoperative recurrence of epilepsy was found in 24 (26.97%) of the 89 cases, which, compared with the 65 non-recurrence cases, had a significantly longer seizure duration (7[3-10] vs 5[2-9] min, P<0.05) and higher onset frequency (6.5[4-9] vs 5[3-9] times/mo, P<0.05) preoperatively.After surgery, the 24 recurrence cases showed a remarkably reduced seizure duration (1[0.5-2.0] min, P<0.05) and onset frequency (1.5[1-3] times/mo, P<0.05).The main risk factors for epileptic recurrence included the level of the glioma-involved site (HR=6.728, 95% CI: 2.994-15.116), peritumoral edema (>2 cm) (HR=2.867, 95% CI: 1.210-6.795), brain wave type (HR=2.501, 95% CI: 1.058-5.914), and preoperative frequency of epileptic seizure (>6 times/mo) (HR=5.100, 95% CI: 2.437-10.677).Conclusion Postoperative recurrence of epilepsy is associated with the clinical pathological parameters, and the changes of the frequency and duration of epileptic seizures before and after surgery may provide some new theoretical reference for the treatment and prognosis of the disease.

Objective To build a supervision mechanism for independent clinical labs (ICL),surveyed the current situation of such novel institutions in China.Methods By way of the nationwide network of clinical labs,ICL in China were surveyed by written questionnaires and spot inspection.Results In the surveyed 38 ICLs,the maximum registered capital was 44 900 thousands,the minimum was 2 000 thousands.The maximum number of employee was 1 105,the minimum was 19.6 labs passed ISO15189 ratification,4 labs passed CAP ratification.17 labs participated in local external quality control,29 labs par-ticipated in national external quality control.Conclusion Although ICL in our country have developed well in the past dec-ade,such vulnerabilities as unbalanced staff ratio,full-range quality control bugs,cutthroat competition,asymmetrical infor-mation disclosure and bio-safety have loomed in the meantime.It is time to formulate a stricter industry access system and appropriate regulatory modes.

Objective The present study aimed to explore the effects of CC-chemokine receptor 5 antagonism on tumor growth and immune microenvironment.Methods Cell Counting Kit-8 was used to detect in vitro anti-proliferation activity of maraviroc,a selective CC-chemokine receptor 5 inhibitor,on Lewis cells,a mouse lung adenocarcinoma cell strain.Flow cytometry and real-time quantitative PCR were respectively used to detect cell apop-tosis and Caspase 8 gene expression.In a congenic mouse lung cancer model,the mice were intraperitoneally admin-istered with maraviroc or vehicle.Tumor sizes were measured and tumor infiltrating CD4+,CD8+ and Foxp3+ cells were determined by immunofluorescent staining.Results Our results showed that maraviroc could inhibit the growth of Lewis cancer cells not only in vitro but also in vivo.This in-vitro inhibition was presumably attributable to apoptosis induction by the enhancement of Caspase 8 gene expression after maraviroc blockade.Additionally,more CD4+ and CD8+ cells but less Foxp3+ cells were detected in tumor mass from the mice administered with maraviroc.Conclusions Taken together,it can be speculated that CCR5 blockade may inhibit the growth of Lewis cells by inducing cell apoptosis and impairing the immunosuppressive tumor microenvironment.It is worthy of further investi-gation as a candidate for cancer therapy.

Objective:To investigate the clinical and imaging characteristics of isolated cortical vein thrombosis (ICVT) in order to improve the understanding of this rare disease.Methods:From December 2013 to September 2019, patients with ICVT admitted to Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were collected retrospectively. Their clinical manifestations, imaging examination, treatment and prognosis were analyzed.Results:A total of 6 patients with ICVT were enrolled in the study, including 3 males and 3 females, with an average age of 37 years. The main clinical manifestations were acute seizures (5/6, 83.3%), focal neurological deficits (3/6, 50.0%), and headache (3/6, 50.0%). In the imaging examination, the direct signs of ICVT were spot sign and cord sign, and the indirect signs were cerebral lobe hemorrhage, infarction, or edema.Conclusions:Seizures, focal neurological deficits and headaches are common manifestations of ICVT. Multimodality imaging examinations are helpful for early diagnosis of the disease.

Objective:To investigate the clinical and imaging characteristics of deep cerebral vein thrombosis (DCVT).Methods:From December 2006 to December 2019, patients with DCVT admitted to Nanjing Drum Tower Hospital were enrolled retrospectively. The clinical manifestations, imaging examinations, treatment and prognosis of the patients were analyzed.Results:A total of 11 patients with DCVT were enrolled in the study, including 4 females and 7 males. Their average age of onset was 41.6 years. Their most common clinical manifestations were acute or subacute onset headache (11/11, 100%), disturbance of consciousness (5/11, 45.5%), and seizures (4/11, 36.4%). All 11 patients involved straight sinus, 9 involved the great cerebral vein, 5 involved the internal cerebral vein, and 1 involved the basilar vein. All patients were complicated with other venous sinus thrombosis, and 3 were complicated with superficial cortical venous thrombosis. Early CT plain scan (within 1 week of onset) of 8 patients (72.3%) showed high-density point sign of great cerebral vein or cord sign of straight sinus. Head MRI showed that 90.9% (10/11) of patients had brain parenchymal damage, thalamic involvement (5/11, 45.5%) was the most common, followed by deep white matter (4/11, 36.4%). One patient received urokinase interventional thrombolysis and died on the 6 th day of onset. The remaining 10 patients improved after receiving anticoagulant therapy. Follow up of 4 months to 13 years showed that 4 patients left with mild to moderate disability (the modified Rankin scale score 1-3), and 6 returned to normal. Conclusions:Headache, disturbance of consciousness and seizures are common clinical manifestations of DCVT. Imaging examination shows that the possibility of DCVT should be warned when the thalamus or deep white matter is involved. It is necessary to pay attention to the high-density thrombus spot sign and cord sign on early CT plain scan. DCVT patients with cortical venous thrombosis progressed rapidly in the acute phase, and the outcomes were poor.