Objective:To detect the functional role of Fascin1 and its related molecular mechanisms in migration and invasion capacity of glioma cells,we utilized gene specific small interference RNA of Fascin1 in cell line U87 MG. Methods:Fascin1-siRNA or negative siRNA was transfected into U87 MG cells of control group or experiment group. Transwell method was employed to assess the migration and invasion capacity of glioma cells. Western blot analysis was used to detect the protein expression of Fascin1,pAKT and pSTAT3. The impact of PI3K/AKT pathway and STAT3 pathway on migration and invasion of U87 MG cells was verified,via applying LY294002 and LY294002,which was inhibitor of the two pathways respectively. Results:As compared to control groups,the migration and invasion capacity of transfected glioma cells were attenuated about 52% or 43%(P<0. 05),accompanied with the decreased phos-phorylation of AKT and STAT3. As utilizing the inhibitors of AKT and STAT3,attenuated migration and invasion capacity of U87 MG cells were observed. Conclusion:Down-regulated expression of Fascin1 could suppress the migration and invasion capacity of U87 MG cells by inhibiting the phosphorylation of PI3K/AKT pathway and STAT3 pathway.

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 investigate the expressions and significance of erythropoietin producing hepatocellular cell line receptor A2 (EphA2) in pediatric brain glioma.Methods Seventy-eight fresh pediatric glioma specimens with a defined histological grade were collected in the Fifth Affiliated Hospital of Zhengzhou University from Jan.2009to Mar.2013,which included 36 of low grade glioma(Ⅰ-Ⅱ grade),42 of high grade glioma(Ⅲ-grade),another 33 cases with brain trauma line pressure to remove children brain tissues were collected as control group.The expressions of EphA2 mRNA and protein were detected by reverse transcription-polymerase chain reaction (RT-PCR),Western blot and immunohistochemistry.Results 1.RT-PCR and Western blot showed that EphA2 did not express in control brain tissue,but the expression levels of EphA2 mRNA were over-expressed in pediatric brain glioma,and the difference was statistically significant(F =36.271,P ＜ 0.05) ;the expression levels of EphA2 protein were significantly higher in high-grade pediatric glioma group than in low-grade pediatric glioma group,and the difference was statistically significant(F =42.839,P ＜ 0.05).2.Immunohistochemistry showed that EphA2 expression was negative in control group,the positive expression in low-grade glioma group was 88.57％,and the positive expression in high-grade glioma group was 100.00％.Moreover,the higher the grade glioma,distribution of EphA2 expression was stronger,and the difference was statistically significant(Z =4.962,P ＜ 0.05).Conclusions The mRNA and protein expression levels of EphA2 were significantly high in pediatric brain glioma which were associated with the grade of glioma.Therefore,EphA2 may participate in the development and progression of pediatric brain glioma.

Objective To explore expression of HMGB1 in glioma tissue of glioma-related epilepsy patients. Methods Immunohistochemistry was used to detect the expression of HMGB1 in the tissues from 82 glioma-related epi?lepsy patients (glioma-related epilepsy group), 80 glioma patients (glioma without epilepsy group), 80 intractable epilepsy patients (epilepsy control group) epileptogenic foci tissue and 20 normal controls (negative control group). Results HMGB1 in glioma tissue of glioma-related epilepsy group was significantly higher than that in glioma tissue of glioma without epilepsy grou p (χ2=16.944, P<0.001), especially in low pathological grade glioma tissue. HMGB1 was higher in glioma tissue of glioma-related epilepsy group than in epileptogenic foci tissue of epilepsy control group (χ2=26.094, P<0.001). Expression of HMGB1 in glioma tissue of glioma without epilepsy group (χ2=32.273, P<0.001) and epileptogenic foci tissue of epilepsy control group ( χ2=22.236,P<0.001) was higher than in normal brain tissue of negative control group. In glioma-related epilepsy group, HMGB1 was positively correlated with seizures duration(r=0.365,P=0.001), sei? zures frequency (r=0.531,P=0.000) and pathological grade of glioma tissue (r=0.265,P=0.016). Conclusions HMGB1 is highly expressed in glioma tissues of glioma-related epilepsy; HMGB1 expression is closely related with seizures; and HMGB1 in glioma tissue may contribute to the formation of glioma-related epilepsy.

Objective To study the value and effectiveness of surgical management and mapping in supratentorial tumoral complicated with epilepsy and to study the correlations between tumor and the epileptogenic focus.Methods The clinical data of 121 patients with supratentorial cerebral tumor but epilepsy as initial symptom were retrospectively analyzed for the incidence of pre-and postoperative epileptic seizures,including grade Ⅰ glioma in 1 5 cases and grade Ⅱ glioma in 35 cases,grade Ⅲ-Ⅳglioma in 12 cases,menigoma in 32 cases,metastases in 10 cases,cavernous angiomas in 15 cases,and ependymomas in 2 cases.Results Surgery based on CT/MRI,seizure type and EEG changes was conducted.There was no death in operation.The highest incidence was in frontal lobe and the lowest in occipital lobe.Correlations between localization of tumor and the epileptogenic focus:there were 50 cases in the same location,near or beside tumors in 28 cases,far separate apart(＞2 cm)from tumors in 25 cases,no relationship was found in 18 cases.103 patients were followed up for one to nine years.31 patients had a few seizures in the early postoperative period.Epileptic seizures were cured without anti-epilepsy drugs in 83 cases.Conclusion There are some differences between tumors'location and epileptogenic focus in supratentorial tumoral epilepsy.The location and size of epileptogenic zone should be detected before and during operation.The resection of the tumor combined with the resection of the epileptogenic zone"epilepsy surgery"can provide good results.

Objective:To explore the characteristics of Siewert classification and microsatellite instability(MSI) and HER2 expression in adenocarcinoma of esophagogastric junction (AEG).Methods:The clinicopathological data of gastric adenocarcinoma from May 2019 to November 2020 were retrospectively analyzed. The patients were divided into two groups: AEG group and non AEG group. The composition ratio of Siewert type of AEG was counted, and the relationship between tumor size and Siewert type was analyzed. The MSI status and HER2 expression status of AEG and non AEG were statistically compared. The measurement data of normal distribution were expressed as mean ± standard deviation( Mean± SD), the comparison between groups were by t test, the comparison of count data between groups were by Chi-square test. Results:A total of 328 consecutive cases of gastric adenocarcinoma were collected, including 242 cases of AEG and 86 cases of non AEG. The Siewert classification of AEG was mainly type Ⅱ (151 cases, 62.40%), followed by type Ⅲ (86 cases, 35.54%) and type Ⅰ (5 cases, 2.07%). The analysis of the relationship between the size of the tumor length and the number of Siewert type showed that the number of Siewert type Ⅱ cases decreased and the number of Siewert type Ⅲ cases increased with the increase of the tumor size. MSI status was detected non selectively in 192 cases of gastric adenocarcinoma (140 cases of AEG and 52 cases of non AEG). There were 12 cases of MSI (6.25%), 2 cases of MSI-H (1.04%) and 10 cases of MSI-L (5.21%). There was no significant difference in MSI ratio between AEG group and non AEG group ( P>0.05). All MSI cases were negative or weakly positive for PMS2. The expression of HER2 was detected by immunohistochemistry in 313 cases of gastric adenocarcinoma, except 15 cases of PTIS/T1a. There were 30 cases (9.58%) with HER2 expression 3+ . Thirty-two cases (10.22%) expressed HER2 (2+ ), of which 7 cases were detected by fluorescence in situ hybridization (FISH), and 3 cases were positive. The proportion of HER2 (3+ ) in AEG was significantly higher than that in non AEG group ( P<0.05). Conclusions:The main type of AEG was Siewert type Ⅱ. AEG may mostly occur between 1 cm above the esophagogastric junction and 2 cm below the esophagogastric junction; For endoscopic screening of early AEG, more attention should be paid to this area of stomach. Siewert type Ⅲ may be derived from the development of Siewert type Ⅱ. The incidence of microsatellite instability in gastric cancer is low. Compared with other gastric adenocarcinoma, AEG has no specificity in MSI. The MSI of AEG was mainly the expression defect of PMS2. Compared with other gastric adenocarcinoma, there are more HER2 overexpression in AEG.

Objective:To observe the effect of self-designed Buqi Huoxue Decoction on the rehabilitation of patients with stroke sequelae and qi deficiency and blood stasis syndrome.Methods:A total of 116 patients with stroke sequelae treated from October 2019 to October 2020 were selected and divided into observation group and the control group by randomized digital tables, 58 patients in each group. The control group was given the conventional treatment, and the observation group combined self-designed Buqi Huoxue Decoction and conventional treatment. Both groups were treated for 3 months. The soluble vascular cell adhesion molecule-1 (sVCAM-1), nito-oxide (NO), endothelin (ET-1), endothelial-derived hyperpolarization factor (EDHF), insulin-like growth factor (IGF-II), interleukin-1β (IL-1β), interleukin-6 (IL-6) levels were detected by ELISA. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit, motor function was evaluated by the Fugl-Meyer motor function scale (FMA), patients' daily living ability was assessed by daily living ability assessment table (ADL), the QLQ-C30 was used to evaluate the QoL of patients. The TCM syndrome scores were evaluated. The clinical response was compared between the two groups.Results:The total response rate was 94.8%(55/58) in the observation group and 81.0%(47/58) in the control group. There was significant difference between the two groups ( χ2=3.98, P=0.046). After treatment, the scores of TCM syndrome and NIHSS of pruritus in the observation group were significantly lower than those in the control group ( t values were 5.61, 5.21, respectively, all Ps<0.01). After treatment, the scores of FMA, ADL QLQ-C30 of pruritus in the observation group were significantly higher than those in the control group ( t values were 3.61, 3.13, 9.38, respectively, all Ps<0.01). After treatment, the NO[(87.61±19.18) μmol/L vs. (77.93±17.26) μmol/L, t=2.81], EDHF [(21.14±6.14) μmol/L vs. (16.61±4.52) μmol/L, t=4.45] levels in the observation group were significantly higher than those in the control group ( P<0.01). After treatment, the sVCAM-1[(309.58±30.11) μg/L vs. (354.16±33.04) μg/L, t=7.46], ET-1 [(50.07±18.23)ng/L vs. (66.31±17.89)ng/L, t=4.76] levels in the observation group were significantly lower than those in the control group ( P<0.01). After treatment, IL-1β, IGF-Ⅱ, IL-6 levels in the observation group were significantly lower than those in the control group ( t values were 4.66, 8.14 7.43, respectively, all Ps<0.01). Conclusion:The treatment of self-designed Buqi Huoxue Decoction can improve the vascular endothelial function, inhibit the inflammation, reduce the nerve function damage, improve the limb movement function, daily life ability, quality of life and the clinical symptoms.

Objective To investigate the influence of drug refractory temporal lobe epilepsy relapse shortly after surgery in its long-term efficacy.Methods The clinical data of 57 patients with medically intractable temporal lobe epilepsy,underwent surgery from August 2010 to August 2011 in our hospital,were retrospectively analyzed; all the patients were performed surgery,and postoperative treatment of epilepsy (adjustment antiepileptic drugs) in our hospital and rehabilitation center was chosen;the parallel regular follow-up clinic or telephone was also performed.According to the relapse situation one year after surgery,these patients were divided into control group (no epilepsy,n=18) and experimental group (relapse,n=39).Follow-up data,long-term efficacy and overall efficacy between the two groups were analyzed.Results (1) Postoperative medial temporal lobe sclerosis,neoplastic lesions,mixed lesions and normal patients were 27,7,10 and 13,respectively,counting for 47.37％,12.28％,17.54％ and 22.81％ of the patients; (2) on the second year of surgery,patients in the experimental group had 44.44％ satisfactory seizure control,which was significantly lower than those in the control group (74.36％,x2=4.839,P=0.028); (3) Kapan-Meier survival curve indicated that epilepsy remission rate in the control group was significantly higher than that in the experimental group on the second year of surgery (x2=5.928,P=0.017); (4) multivariate Logistic regression analysis showed that risk factors affecting the long-term efficacy included incentives recurrence (OR=4.511,95％CI:3.195-7.569),relapse frequency≥ 3 times (OR=4.281,95％CI:0.040-0.712) and recurrence of epilepsy type to complex partial seizure/generalized tonic-clonic seizures (OR=3.344,95％CI:3.186-8.400).Conclusion Drug refractory temporal lobe epilepsy relapse shortly after surgery will affect its long-term efficacy,and the determinate factors included incentives recurrence,relapse frequency≥ 3 times and recurrence of epilepsy type.

Objective:To explore the relationship between microsatellite instability (MSI) and Ki-67 expression level and the clinicopathological features of colorectal cancer, and investigate their impact for prognosis, so as to provide reference for prognostic judgment of colorectal cancer.Methods:The data of 183 patients who underwent radical colorectal cancer surgery and were diagnosed pathologically in the Department of General Surgery, the First Affiliated Hospital of Xinxiang Medical University from January 2017 to December 2019 were retrospectively analysed, including 101 males (55.2%)and 82 females(44.8%), ranged from 20 to 86 years and the mean age was(60.27±13.13)years. According to the results of mismatch repair protein immunohistochemical staining, the patients were divided into MSI-H group ( n=32) and MSI-L/MSS group ( n=151). According to the results of Ki-67 antigen immunohistochemical staining, the patients were divided into low Ki-67 expression group (<82.5%, n=136) and high Ki-67 expression group (≥82.5%, n=47) , among which 62 cases (78.5%) with low Ki-67 expression and 17 cases (21.5%) with high Ki-67 expression were in patients with Ⅲ+ Ⅳ stage colorectal cancer. The data of clinicopathological features, disease-free survival, and overall survival were collected and analyzed. The cotegorical variables were presented as n(%), and the comparisons between groups were performed using Chi-square test or Fisher′s exact test. The multivariate Logistic regression model was used to estimate the correlation between microsatellite instability and Ki-67 expression level and clinicopathologic characteristics of colorectal cancer. Kaplan-Meier survival curve and COX proportional hazards regression model were used to analyze the correlation between microsatellite instability and Ki-67 expression level and disease-free survival and overall survival. Results:Single factor analysis showed that the differences in gender ( χ2=4.37, P=0.037), tumor site ( χ2=26.40, P<0.001), tumor maximum diameter ( χ2=11.12, P=0.001) and nerve invasion ( χ2=5.53, P=0.019) between MSI-H group and MSI-L/MSS group were statistically significant. Multivariate Logistic regression model analysis showed that only gender ( OR=3.013, 95% CI: 1.183-7.672, P=0.021), tumor location ( OR=0.167, 95% CI: 0.067-0.419, P<0.001) and nerve invasion ( OR=0.202, 95% CI: 0.042-0.968, P=0.045) were independently correlative factors for MSI status. In Ⅲ+ Ⅳ stage colorectal cancers, the difference in tumor site between low Ki-67 expression group and high Ki-67 expression group was statistically significant( χ2=3.91, P=0.048). Multivariate Cox proportional hazards regression model analysis revealed that high Ki-67 expression ( HR=0.301, 95% CI: 0.118-0.768, P=0.012; HR=0.275, 95% CI: 0.083-0.912, P=0.035) and MSI-H ( HR=0.072, 95% CI: 0.010-0.525, P=0.009; HR=0.122, 95% CI: 0.017-0.900, P=0.039) were independently protective factors for disease-free survival and overall survival. Conclusions:MSI-H colorectal cancer is common in males, right-sided colonic cancers and non-neuroinvasive patients. In stage Ⅲ+ Ⅳ colorectal cancer, the expression level of Ki-67 in right-sided colonic cancer was lower than in left-sided colorectal cancer. Patients with MSI-H and high Ki-67 expressive colorectal cancer had longer disease-free survival, longer overall survival and better prognosis.

Objective:To summarize the clinical characteristics of patients with epilepsy caused by focal cortical dysplasia (FCD), and identify the influencing factors for postoperative seizure controls.Methods:Fifty-seven patients with epilepsy caused by FCD admitted to Department of Neurosurgery, Third Affiliated Hospital of Zhengzhou University from July 2019 to November 2023 were chosen; standard preoperative evaluation, surgery, postoperative management and follow-up were performed. A retrospective study of clinical data, imaging and video electroencephalogram (VEEG) data, surgical approaches, pathological findings, and follow-up data was performed; influencing factors for postoperative seizure controls were analyzed.Results:In these 57 patients with epilepsy caused by FCD, 29 were males (50.88%) and 28 were females (49.12%). Onset age was 30.00 (8.00, 74.50) months, and surgery age was 95.00 (50.00, 138.50) months. Focal to bilateral tonic-clonic seizures (42/57; 73.68%) and epileptic spasms (13/57; 22.81%) were common seizure types. Cranial MRI was positive in 34 patients (59.65%), mainly manifested as abnormal cortical gyri/sulci morphology (17/57; 29.82%). In 43 patients accepted PET-CT, hypometabolic sites were detected in 40 (93.02%), and complete agreement between PET/MRI fusion results and actual lesion sites was noted in 40 (93.02%). FCD type I was noted in 16 patients (28.07%), type II in 39 (68.42%), and type III in 2 (3.51%). By December 2023, 44 (77.19%) had Engel grading I, 4 (7.02%) had grading II, 4 (7.02%) had grading III, and 5 (8.77%) had grading IV. Children with good prognosis (Engel grading I+II) and those with poor prognosis (Engel grading III+IV) showed significant differences in terms of time from first seizure to surgery, positive/negative MRI, and regularity of postoperative ASMs ( P<0.05). Conclusions:Focal to bilateral tonic-clonic seizure is the most common seizure type in patients with epilepsy caused by FCD, and abnormal cortical gyri/sulci morphology is the most common MRI manifestation; PET/MRI fusion imaging is superior to PET-CT or MRI in identifying epileptogenic foci. Poor seizure control can be noted in patients with long onset time to surgery, with negative cranial MRI results, or with irregular postoperative ASMs.