Objective To study the treatment effect of linear accelerator radiosurgery (X knife) on trigeminal neuralgia and the complications. Methods Follow-up was conducted in 42 cases of trigeminal neuralgia treated with linear accelerator radiosurgery in our department, and their complications and degree of pain relief were recorded. Results Outcomes were excellent in 14 (33.3%), good in 22 (52.4%), effective in 4 (9.5%) and poor in 2 (4.8%). The mean time of pain relief was 2.1 months. Seven (16.7%) cases experienced increased facial paresthesia. Conclusion Linear accelerator radiosurgery is a precise and effective treatment for trigeminal neuralgia.

Objective To explore the effects of the minimally invasive hematoma aspiration on the repair of the pyramidal tract and improvement of neurological function. Methods Forty-eight SD male rats were equally randomized into normal control group, sham-operated group, cerebral hemorrhage group (model), model + minimally invasive hematoma aspiration at the 6th, 12th, and 24th h groups (n=8).Intracerebral hemorrhage in the later 4 groups was induced by injection of type IV collagenase + heparin into the caudate nucleus of rats, and the same amount of normal saline was injected into the sham-operated group. And then, the hematoma was lysed by injection of urokinase into the hematoma center 6, 12 and 24 h after intracerebral hemorrhage in the later 3 groups, respectively. Animals were sacrificed after behavioral function evaluation 14 d after collagenase injection. Immunohistochemistry was performed to observe the expressions of neurofilament (NF) and growth associated protein-43(GAP-43) in the posterior limb of internal capsule. Results The snatch ability of left forelimb among all the groups showed no significant differences before the success of model making (P＞0.05). The snatch ability of left forelimb in each hematoma aspiration group was much higher than that in the model group on the 14th d of collagenase injection (P＜0.05). Within the hematoma aspiration groups, the snatch ability in the group performed hematoma aspiration at the 6th h was higher than those group at the 12th and 24th h (P＜0.05). The number of NF positive fibers and the expression of GAP-43 in the 3hematoma aspiration groups were much larger or higher than those in the model group (P＜0.05); the number of NF positive fibers in the group performed hematoma aspiration at the 6th h was larger than that in those group at the 12th and 24th h (P ＜0.05); The expression of GAP-43 in the group performed hematoma aspiration at the 6th and 12th h was higher than that in the group at the 24th h (P＜0.05).Conclusion The minimally invasive hematoma aspiration performed within 24 h of intracerebral hemorrhage, especially those within 6 h, would reduce the pyramidal tract's injury, promote the repair of pyramidal tract and improve the neurological function.

ObJective To summarize the microsurgieal techniques through direct Sylvian fissure approach. Methods A retrospective analysis was conducted in 62 patients undergoing microsurgeries through direct Sylvian fissure approach, including 4 with cavernous angioma in the Sylvian fissure, 5 with insular lobe tumors, 33 with middle cerebral artery aneurysms, 15 with glioma spanning or invading the Sylvian fissure, 1 with metastatic tumor, 2 with arteriovenous malformations, and 2 with temporal lobe epilepsy. Results All the vascular lesions were exposed satisfactorily and managed appropriately. Of the 19 cases ofgliomas and metastatic tumors, total resection was achieved in 13 cases, and subtotal resection in 6 cases. Transient aphasia or hemiparesis occurred postoperatively in a few patients but all recovered within 1 or two months. Conclusions The Sylvian fissure provides a good surgical route as a subarachnoid space between the frontal, parietal, temporal and insular lobes. The Sylvian fissure should be carefully separated under the operating microscope with high-power magnification, and tension-free retaction is critical in important language areas. In the management of tumors involving the Sylvian fissure, we recommend that extended resection be performed after exposure and appropriate preservation of important blood vessels in the fissure.

OBJECTIVETo investigate the association between long non-coding RNAs (lncRNAs) and brain injury in inflammation-induced preterm mice, and to provide a reference for the prevention and treatment of brain injury.

METHODSAn intraperitoneal injection of lipopolysaccharide in pregnant mice was performed to establish a model of inflammation-induced preterm mice with brain injury (preterm group). The full-term mice delivered by normal pregnant mice were used as controls (full-term group). The lncRNA chip assay was used to screen out the lncRNAs associated with brain injury in preterm mice. Quantitative real-time PCR was used to validate the lncRNAs identified by the above method.

RESULTSThe preterm and full-term groups showed significant differences in the expression of 1 978 lncRNAs (P<0.05), consisting of 786 up-regulated lncRNAs and 1 192 down-regulated lncRNAs, and 29 lncRNAs were 1.5 or more times differentially expressed between the two groups. A further analysis was performed for the 10 most differentially expressed lncRNAs, and the results showed that these lncRNAs were involved in the biological processes including transcription, signal transduction, apoptosis, cell cycle, and inflammatory response, as well as G protein-coupled receptor signaling pathway and neuropeptide signaling pathway. Real-time PCR was performed to validate the expression of two lncRNAs in brain tissue in the preterm and full-term groups, and the results were consistent with those of the chip assay.

CONCLUSIONSThe expression profiles of lncRNAs in brain tissue change significantly in inflammation-induced preterm mice, and the G protein-coupled receptor signaling pathway may be involved in the pathogenesis of preterm brain injury.

Animals ; Brain ; metabolism ; Female ; Inflammation ; complications ; metabolism ; Mice ; Mice, Inbred BALB C ; RNA, Long Noncoding ; analysis ; Receptors, G-Protein-Coupled ; physiology ; Signal Transduction ; physiology

OBJECTIVETo investigate the possibility and the limit in increasing the survival area of the random skin flap by extremely increasing the ratio of its length and width within 24 hours.

METHODSSD rats (n = 20) were chosen for this study. The rats were randomly divided into: subject group and control one. Pre-made skin flap was prepared as design. The subject group was carried out rapid pre-fabricated skin flap formation training. No training was performed in control group. The changes in perfusion value of micro-circulation inside skin flap were monitored during the whole process, and micro-circulation parameters of the skin flap were used to evaluate whether its blood circulation network was mature or not.

RESULTSTraining of pre-made skin flap at 18th hour, the perfusion value of its micro-circulation was basically stable, Skin flap formation was finished at 24th hour. Survival area in control group was (68.25 +/- 0.18)% and in subject group was (97.25 +/- 0.24)% (P < 0.01). There was a significant difference between the two groups.

CONCLUSIONSWithin short time, it is possible to establish micro-circulation in skin flap which exceeds the limit set by traditional theory. Digitalized judgment can be used to monitor the fast formation of super-big skin flap. This method is reliable and can increase the survival rate of random skin flap.

Animals ; Female ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin ; blood supply ; metabolism ; Skin Transplantation ; Surgical Flaps ; Time Factors

Objective To explore the surgical skills, therapeutic effects and complications of selective amygdalohippocampectomy via the inferior temporal gyrus approach for treatment of mesial temporal lobe epilepsy (MTLE). Methods Sixty-two patients with medically intractable MTLE underwent selective amygdalohippocampectomy. Temporal keyhole craniotomy was performed, and the mid-anterior segment of the inferior temporal gyrus was resected to access the anterolateral floor of the temporal horn. The mesial temporal structures such as the amygdale and the parahippocampal gyrus were selectively resected. Results All the patients were followed up for at least 2 years (range 24-80 months) after the surgery. Obvious improvement of the neuropsychological function was achieved in these patients after the operation, without serious surgical complications. Forty-five patients (72.6%) had Engel's Class Ⅰ, 12 (19.4%) had class Ⅱ, and 5 (8.0%) had class Ⅲ outcomes after the operation. Conclusion The inferior temporal gyms approach allows minimally invasive amygdalohippocampectomy that preserves both the optic radiation and the language area, and can be especially effective in patients with epileptic lesions limited to the mid-anterior temporal lobe.

Objective To explore the effect of olfactory ensheathing cells (OECs) on the proliferation and differentiation of neural stem cells (NSCs). Methods The cells from the embryonic rat brain were primarily cultured and identified by immunofluorescence and immunocytochemistry. NSCs in the experimental group shared medium with OECs were cultured and induced to differentiate. Simultaneously, NSCs in the control group were cultured alone. The effect of OECs on the proliferation and differentiation of NSCs was observed by immunocytochemistry. Results Nerve growth factor receptor (P75NGFR) was observed in the primarily cultured OECs; nestin was expressed in the primarily cultured neurosphere and the cells differentiated from the neurosphere expressed neurofilament 200 (NF200) and glial fibrillary acidic protein (GFAP). Compared with that in the control group, the number of NSCs in the experimental group was significantly increased (P<0.05). On the 4~(th) and 7~(th) day of differentiation, the percentage of NF200-positive cell was higher in the experimental group than that in the control group (P<0.05), indicating that the appearance of OECs increased the differentiation of NSCs into NF200-positive cells. Conclusion OECs can promote the proliferation of NSCs and induce the differentiation of NSCs into neurons.

Objective: To investigate the application values of immunophenotypic analysis and molecular genetics in the diagnosis of acute promyelocytic leukemia (APL) . Methods: The retrospective analyses of flow cytometric (FCM) immunophenotypic anyalysis, chromosome karyotype and chromosome fluorescence in situ hybridization (FISH) of 798 outpatient or hospitalization APL patients referred to our hospital between May 2012 and December 2017 were performed to further study the application values of FCM and molecular genetics in the diagnosis of APL. Results: The sensitivity and specificity of FCM were 91.9% and 98.7% respectively. The typical characteristic immunophenotype for APL was as of follows: a high SSC, absence of expression of cluster differntiation (CD) CD34 and HLA-DR, and expression or stronger expression of CD33, consistent expression of CD13, CD9, CD123, expression of CD56, CD7, CD2 (sometimes) . The rest 10% of the cases harbored atypical APL phenotypes, generally accompanied by CD34 and/or HLA-DR expression, decreased SSC and often accompanied by CD2 expression, it was difficult to definitively diagnose APL by this FCM phenotype, and their diagnoses depended on the results of genetics or molecular biology tests. Compared with normal individuals, complex karyotypes APL with t (15;17) translocation, other variant translocations and variant t (11;17) , t (5;17) had no significant differences in terms of their FCM phenotypes. Conclusions FCM could rapidly and effectively diagnose APL. Despite the fact that complex karyotypes with various additional chromosomal abnormalities were detected in approximately one third of APL cases in addition to the pathognomonic t (15;17) (q22;q21) , they had no observable impact on the overall immunophenotype. Molecular and genetic criteria were the golden criteria for the diagnosis of APL. About 10% of immunophenotyping cases relied on molecular genetics for diagnosis.

OBJECTIVETo investigate the incidence, molecular features and clinical significance of CCAAT/enhancer binding protein alpha (CEBPA) gene mutation in patients with acute myeloid leukemia (AML).

METHODSMutation analysis of the entire coding region of CEBPA gene in 206 de novo AML patients was performed by using polymerase chain reaction (PCR) followed by sequence analysis and fragment length analysis.

RESULTSOf 206 AML patients, 31 (15%) had CEBPA gene mutations, including 23 with double mutations (duCEBPA) and 8 with single mutation (siCEBPA). CEBPA gene mutations presented mainly in M2 subtype or intermediate risk patients. As compared with those with wild type CEBPA gene, patients with mutated CEBPA gene were of higher white blood cell counts [20.92(0.86-351.43)× 10(9)//L vs 8.17(0.47-295.2) × 10(9)/L, P=0.003], higher hemoglobin levels [97.5(51-128) g/L vs 80.5(13-153) g/L, P=0.015] and lower platelet counts [27.5(5-81)× 10(9)//L vs 44(3-548)× 10(9)/L, P=0.004]. Patients with CEBPA gene mutation had higher complete remission (CR) rate than those with wild type (P=0.009). While co-existing of NPM1 and siCEBPA mutations was observed in M5 subtype (2/8, 25%), NPM1 gene mutation was not present in any patients with duCEBPA mutation (0/23, 0%). Dynamic tracking analysis showed that CEBPA mutations disappeared at CR, and the same mutations re-appeared at relapse. When compared to sequence analysis, the coincidence rate of CEBPA mutations detected by fragment length analysis was 100% (54/54).

CONCLUSIONCEBPA gene mutation is a recurring genetic change in AML patients and has a certain correlation with clinical and laboratory features. It could be reliably used as a potential marker for minimal residual disease follow up. The prognostic significance of co-existing of siCEBPA with NPM1 mutations in patients with AML-M5 subtype needs further investigation.

Adolescent ; Adult ; Aged ; CCAAT-Enhancer-Binding Proteins ; genetics ; DNA Mutational Analysis ; Female ; Gene Expression Regulation, Leukemic ; Genotype ; Humans ; Leukemia, Myeloid, Acute ; genetics ; therapy ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; Prognosis ; Young Adult

OBJECTIVETo analyze the ultra microstructures and the expression of platelet peroxidase (PPO) of megakaryocytes from bone marrow, their clinical manifestations and laboratory characteristics in patients with acute megakaryoblastic leukemia (AMKL).

METHODSKaryocytes from bone marrow of 22 AMKL patients were divided into two parts by lymphocyte separation liquid, one part was used to prepare the ordinary transmission electron microscope specimens to observe the morphological structures of megakaryocytes, the other was used to prepare the histochemical specimens of platelet peroxidase to analyze the positive reaction of PPO in AMKL, which were coupled with the patients' data of with bone marrow morphology, cell chemistry, and chromosome karyotype examination.

RESULTSMegakaryocytes from 17 of 22 patients were in the first stage, less than 20 µm in diameter, the nucleis were round, the cytoplasm contained microtubules, membranous vesicles and minute dense granules, no demarcation membrane system and surface-connected canalicular system, less dense granules and α-granules; Megakaryocytes in 5 cases were mainly in the first stage, while containing second and third stage megakaryocytes; the positive rate of PPO in megakaryocytes of 22 patients was 0-80%. The primitive and naive megakaryocytes were found in bone marrow smears of 22 cases, CD41 staining of the megakaryocytes was detected in the primitive and naive megakaryocytes, and more complex chromosome karyotype anomalies were observed.

CONCLUSIONThe majority of megakaryocytes in AMKL patients were the first stage ones, the rest were second and third stage ones, and the positive PPO reaction was significantly different. CD41 staining of the megakaryocytes was specific with complex chromosome karyotypeswere.

Blood Platelets ; enzymology ; Bone Marrow ; pathology ; Cell Count ; Chromosome Aberrations ; Chromosome Disorders ; Humans ; Karyotyping ; Leukemia, Megakaryoblastic, Acute ; diagnosis ; pathology ; Megakaryocytes ; pathology ; Peroxidase ; metabolism ; Staining and Labeling