Breast Neoplasms ; diagnosis ; therapy ; Early Detection of Cancer ; Female ; Humans ; Practice Guidelines as Topic ; Receptor, ErbB-2 ; analysis

Objective To analyze retrospectively the clinical characteristics, pathogeny and therapy of traumatic interhemispheric subdural hematoma (ISH). Methods 31 ISH cases admitted since 1996 were reviewed and analyzed retrospectively concerning the clinical characteristics and therapies. Typically,ISH manifested itself with hemiplegia or monoplegia in the contralateral lower limb, called the falx syndrome, and unconsciousness was infrequent at the initial stage of the head injury. The pathogeny of ISH involved cracks of the bridging vein, hematomas in the interhemispheric small arteries and veins and probably coagulation dysfunction or anticoagulant therapy. Results In all 31 patients, 29 were cured and 2 died ofmultisystem organ failure (MSOF) and cerebral hernia respectively. The follow-up revealed that 6 cured patients developed interhemispheric subdural effusion. Conclusion CT scanning showing the interhemispheric hematoma exceeds 20 mL, or the interhemispheric hematoma is thicker than 1 cm can be referential to the diagnosis of ISH. For the ISH treatment, surgery and conservative management are suggested based on the functional disturbance or the stability of the disease. Patients with progressive neurologic deterioration should be operated without delay.

Objective To investigate the clinical efficacy of Gamma knife treatment on patients with functional pituitary prolactinoma(PRL)and its endocrine response.Method We retrospectively analyzed the clinical data of 135 cases of functional pituitary prolactinoma treated with Gamma knife in our hospital from Oct 1994 to Jan 2008.All patients were divided into 3 groups:group A(a central dose of 50 to 60 Gy,a marginal dose of 20 to 30 Gy);group B(a central dose of 40 to 50 Gy,a marginal dose of 15 to 25 Gy)and group C(a central dose of 30 to 40 Gy,amarginal dose of 12 to 20 Gy).The dose in the optic nerves of the 3 groups was under 9 Gy. Results After treated with Gamma knife,partial remission(PR)of the clinical symptoms appeared in 90 patients(66.7%);complete remission(CR)of those was showed in 35(25.9%)and no change of those appeared in 10(7.4%).No significant difference was found between age and both sex and tumor sizes in the 3 group(P<0.05).Different normal PRL rates was concluded by using different doses of Gamma knife(F=8.604,P=0.000).Pairwise comparison indicated that high dose of Gamma knife resulted in high PRL normal rates with statistical significance (P<0.05). Conclusion Gamma knife treatment used in patients with functional pituitary adenoma can not only control the growth of tumor,but also improve the dysfunction of endocrine,which should be adopted as the first choice for clinical treatment of functional pituitary prolactinoma.

Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)

Objective To analyze the gene expression profiles in relation to the migration ability of adult human bone marrow-derived neural stem cells (Md-NSCs), and identify the genetic basis of the high migration potential of Md-NSCs in the central nervous system (CNS). Methods Adult human bone marrow stromal celIs(BMSCs) obtained from adult healthy volunteers were induced to differentiate into Md-NSCs in vitro, and the expressions of the genes related to cell invasiveness and metastasis were investigated by microarray analysis. Quantitative real-time PCR (RT-PCR) was used to verify the microarray results. Results The results of microarray analysis revealed significant overexpressions of the genes MMP1, MMP2, MMP17, ITGA3, RhoB, RhoC and RhoD in the Md-NSCs as compared with the expressions in fresh normal human adult bone marrow cells depleted of red blood cells. Quantitative RT-PCR verified the overexpression ofMMP2 gene by 2.84×100 folds, ITGA3 gene by 2.22×102folds, and RhoC gene by 4.92×100 folds. Conclusion The high migration potential of the Md-NSCs in the CNS is probably associated with the overexpression of the genes that promote cell invasiveness and metastasis. These overexpressed genes are also important oncogenes, and therefore the tumorigenicity of the Md-NSCs warrants further investigation.

Objective To explore the role of forskolin, a reagent elevating the cellular content of cAMP, in blood-brain barrier (BBB) damage in rats after cerebral injury damage. Methods Sixty male SD rats were equally randomized into normal control group, sham-operated group, injured group and forskolin treatment group. Rat models of cerebral injury in the later 2 groups were induced by the improved device of Feeney weight-dropping. Foskolin treatment group was peritoneally administered forskolin 5 mg/kg 0.5 h after the brain injury. Twenty g/L Evens blue was given through intravenous injection 23 h after the injury; all the rats were sacrificed 24 h after the injury. The permeation of Evens blue was observed qualitatively with a fluorescence microscope and measured quantitatively with a spectrophotometer. Results No obvious permeation of Evens blue was noted in the surrounding areas of the damaged tissue of normal controls and sham-operated group; Evans blue significantly permeated in the injured group; as compared with that in the injured group, the permeation of Evens blue was significantly decreased in the forskolin treatment group (P＜0.05). The level of Evens blue in the cortex and hippocampus of both side of the brain in the injured group was significantly higher that that in the normal controls and sham-operated group (P＜0.05); the level of Evens blue in the cortex of the left side of the brain in the forskolin treatment group was significantly lower that that in the injured group, but obviously higher than that in the normal controls and sham-operated group (P＜0.05).Conclusion Forskolin, the reagent elevating the cellular content of cAMP, can significantly prevent BBB opening.

Alzheimer Disease ; therapy ; Animals ; Cell Differentiation ; Embryo, Mammalian ; cytology ; Male ; Maze Learning ; Mice ; Mice, Inbred C57BL ; Parasympathetic Nervous System ; cytology ; Stem Cell Transplantation

Objective To investigate the changes in mitoehondrial membrane potential of the rat neurons after acute brain contusion and laceration injuries. Methods Seventy Sprague-Dawley (SD)rats were randomized into the sham injury group(n=10)and brain injury group.The brain injury group was divided into 6 subgroups(n=10)for observation at 1,6,and 24 h and 2,3,and 7 days after acutebrain contusion and laceration injury,which was induced by impact of the brain with a flee-falling object.In the brain slices labeled with fluorescent JC-l staining,the changes in the mitoehondrial membrane potential of the neurons were observed under confocal laser scanning microscopy at the indicated time points.The neuronal apoptosis Was detected using Hoehesd3342 staining and TUNEL assay,and the number of apoptotic neurons was determined under optical microscope.The ultrastructural alterations of the neurons were observed with transmission electron microscopy. Results Compared with that of the sham injury group,the mitoehondrial membrane potential of the neurons decreased significantly 1 h alterthe brain injury(P<0.01),reachingthe lowestlevel at 24 h,and maintained the low level aRerwards.Apoptotie neurons were identified in the brain slices with Hochest33342 staining.One hour after the brain injury,TUNEL assay revealed a small number of positive neurons,which increased significantly at 6 h(P<0.01)and reached the highest level at 48 h.The alteration pattern of the number of the positive neurons showed a 24-h delay in compariSOIl witll that of the mitochondrial membrane potential aRer the brain trauma.Under electronmicroscope.the mitocbondria of the neurons exhibited only slight swelling at l h. and obvious morphological changes of the mitochondria occurred 6 h after the brain trauma,accompanied by chromatin fragmentation,presence of marginal nuclei and broadened nuclear membrane;nuclear condensation and chromatolysis were observed in the neurons 24 h after the brain trauma.Conclusion In rats with acute brain contusion and laceration injuries,the mitochondrial membrane potential of the neurons decreases early(<1h)after the brain injury,which induces apoptosis of the neurons.

Objective To observe the therapeutic effect of cholinergic neural stem cell (NSC) transplantation in a mouse model of Alzheimer's disease (AD). Methods Ibotenic acid was injected into the nucleus basalis ofMeynert (NBM) of C57BL/6 mice to establish a mouse model of AD. Four weeks after the injection, mouse embryonic stem cell (ES)-derived cholinergic NSCs were transplanted into the frontal and the barrel field of the S1 cortex. Behavioral tests using eight-arm radial maze were conducted 8 weeks after the transplantation, and the survival and differentiation of the transplanted NSCs were evaluated with double staining of choline acetyltransferase (CHAT), serotonin, amyloid-a protein (Aa) and green fluorecent protein (GFP) 12 weeks after transplantation. Results The cholinergic NSCs transplanted into mouse cortices survived and produced a large number of adult ChAT-positive neurons and a small amount of serononin-positive neurons in and around the grafts. The expression of Aain the surrounding cortex was significantly reduced, and the working memory error significantly decreased in mice grafted with cholinergic NSCs. Conclusion Transplantation of cholinergic NSCs into the prefrontal and parietal cortices can partially reconstruct the cholinergic innervation and significantly improve recent memory disruption in mice with NBM damage.

Objective To investigate the value of diffusion tensor imaging (DTI) in evaluating the injury of corticospinal tract (CST), including the motor dysfunction and the integrity of CST, in patients with hypertensive intracerebral hemorrhage (HICH), and explore the relation between DTI results and the recovery of myodynamia. Methods Clinical data of 10 healthy volunteers and 35 patients with HICH, admitted to our hospital and performed evacuation of hematoma from November 2006 to May 2009, were retrospectively analyzed; DTI by using a 3.0T MR canner were chosen on them and the imaging was analyzed by Functool software. The changes of directionality and integrity of SCT were analyzed on fractional anisorropic (FA) map, color-coded directional map, and three-dimensional white matter tractography. Myodynamic examination at Brunnstrom standard 2 months after rehabilitation nursing was performed in these patients. The correlation between the injured degree of CST and the recovery of myodynamia was analyzed. Results Fiber tractography derived from DTI was consistent with known white matter fiber anatomy in 10 healthy volunteers. Three patterns of corticospinal tract involvement were identified in 35 patients: the intact one in 11 patients (the ipsilateral corticospinal tract was almost the same as contralateral corticospinal tract), the partially damaged one in 18 patients (the ipsilateral corticospinal tract was less than 2/3 but larger than 1/3 contralateral corticospinal tract) and the almost completely damaged one in 6 patients (the ipsilateral corticospinal tract was less than 1/3 contralateral corticospinal tract). Different pattern had totally different clinical outcome and the intact one had a full recovery. The ipsilateral corticospinal tract showed significantly lower Brunnstrom scores of the upper extremities than the ipsilateral one (P<0.05); the Brunnstorm scores and the value of myodynamia among the 3 patterns were statistically different (P<0.05). The recovery of motor function was negatively correlated to the injured degree of CST (r=-0.931, P=0.000). Conclusion The DTI, offering the optimal visualization of white matter tracts can detect the injured degree of the corticospinal tracts and predicate the prognosis to some extent, thus, early evaluation of corticospinal tract injury based on DTI can provide predictive value for motor functional outcome in patients with HICH.