Objective To investigate the expression of CD26 (dipeptidyl peptidase 4) in the kidney tissues of diabetic rats and the effects of mycophenolate mofetil (MMF) on the renal CD26 expression.Methods Wistar rats were randomly divided into three groups:normal control group (NC group,n=7),diabetic model group (DM group,n=7) and MMF-treated group (MMF group,n=7).Wistar rats were fed with high-sucrose-high-fat diet and injected with streptozotocin into abdominal cavity to induce diabetes.Sixteen weeks later,blood glucose (BG),blood urea nitrogen (BUN),serum creatinine (Scr),renal hypertrophy index (kidney weight]body weight) and 24 hour urinary protein (24Upro) were measured.The number of CD37CD4+ T cells in renal tissues were measured through flow cytometry.The expression of CD26 in kidney was examined by using Western blotting and immunohistochemistry.Results Compared with NC group,BG,BUN,Scr,kidney weight/body weight,24Upro were significantly increased in DM group (P ＜ 0.05).Except BG and kidney weight] body weight,the above-mentioned parameters were lower in MMF group compared with that in DM group (P ＜ 0.05).Intrarenal CD37CD4+ T cells were significantly up-regulated in DM group compared with that in NC group (P ＜ 0.01).CD26 in renal tissue was mainly expressed in T lymphocytes of renal interstitium.CD26 expression in DM group was significantly higher than that in NC group,and also higher than that in MMF group (P ＜ 0.05).In DM group,CD26+ T lymphocytes infiltration of renal interstitium was positively correlated with 24Upro (r2=0.770,P ＜ 0.05).Conclusions CD26 is related with diabetic nephropathy.MMF maybe inhibit T lymphocytes infiltration to reduce the expression of CD26 in renal interstitium,thus protecting the kidney function.

Objective To investigate the application of neurophysiological monitoring and microsurgi-eal technique in acoustic neurinoma resection, exploring the significance of neurophysiological monitoring in facial and auditory nerve reservation of acoustic neuronma microsurgery. Methods Accompanied with EMG and BAEP nerve monitoring, 113 patients harboring acoustic neuroma were treated surgically by the subocipi-tal retrosigmoid approach for reserving facial and auditory nerve. The facial nerve was stimulated to evaluate its function during late-operation. Postoperative facial and auditory nerve function were valuated in all the postop-erative following up. Results All of them were treated microsurgically via the suboccipitai retrosigmoid ap-proach. Total tumors resection was achieved in 102 cases (90.3%), subtotal resection in 6 cases(5.3%) and partial resection in 5 case (4.4%). The facial nerve was preserved anatomically in 98 cases (86.7%), the functional valuation of facial nerve according to the House-Brakman (H-B) postoperatively: 86 cases (76.1%) in class Ⅰ -Ⅱ , 12 cases(lO.6%) in class Ⅲ-Ⅳ and 15 cases (13.3%) in class Ⅴ-Ⅵ. The acoustic nerve was preserved anatomically in 40 cases (35.4%). It denoted the good function of facial nerve responsing sensi-tively to electrostimulation ≤ 4mA at the end of operation. Conclusion Assisted with the intraoperative electrophysiological monitoring techniques, it would be greatly facilitate the preservation of facial and auditory nerve in acoustic neuroma resection. Simultaneously, it would valuate the functional convalescence by late-op-erative electrostimulation in the postoperation.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.