1.Clinical efficacy and safety of neuro-endoscopic evacuation and microsurgery via keyhole approach in early spontaneous supertentorial intracerebral hemorrhage: a prospective multi-center randomized controlled trial
Lenian LU ; Xiaobing XU ; Famu LIN ; Yilong PENG ; Xian HUANG ; Liyi MA ; Erning QIU ; Yibo XIN ; Shengcong QIU ; Yajie CHI ; Dahai ZHENG
Chinese Journal of Neuromedicine 2023;22(3):248-254
Objective:To evaluate the clinical efficacy and safety of neuro-endoscopic evacuation and microsurgery via keyhole approach in early spontaneous supertentorial intracerebral hemorrhage (ICH). Methods:A prospective multi-center randomized controlled trial was performed; 114 patients with spontaneous supertentorial ICH (time from onset to surgery<6 h) admitted to Departments of Neurosurgery, Shunde Hospital of Southern Medical University, Jiangmen Central Hospital, Affiliated Hospital of School of Medicine of Yanbian University from January 2019 to December 2021 and met the surgical indications were selected. They were divided into endoscopic group (evacuation of intracerebral hematoma under neuroendoscope, n=71) and microscopic group (microsurgery of intracerebral hematoma via keyhole approach, n=43) according to different surgical methods. After 1:1 propensity score matching of the general data, surgical time, hematoma clearance rate, early postoperative re-bleeding rate, Glasgow coma scale (GCS) scores 7 d after surgery, activity of daily living (ADL) scores 6 months after surgery, mortality, and surgery-related complications of 66 patients (33 from each group after matching) were compared. Results:The difference of surgical time between endoscopic group and microscopic group was statistically significant (125[102, 157] mins vs. 175[125, 260] mins, P<0.05). However, hematoma clearance rate (93.00%[80.88%, 96.52%] vs. 93.31%[88.15%, 96.03%]), early postoperative re-bleeding rate (15.2% vs. 9.1%), GCS scores 7 d after surgery (13[10, 15] vs. 12[8, 14]), ADL scores 6 months after surgery (65[45, 85] vs. 55[0, 85]), mortality rate (18.2% vs. 21.2%) and incidences of postoperative intracranial infection and acquired pulmonary infection were not statistically significant between the two groups ( P>0.05). Conclusion:Comparing with microsurgery via keyhole approach, neuro-endoscopy could shorten the surgical time, but not improve the prognosis or safety in early spontaneous supertentorial ICH patients.
2.Influence of fibroblast growth factor receptor antagonist BGJ398 in biological characteristics of gliomas
Xiao LI ; Yun WANG ; Taoliang CHEN ; Jiansheng CHEN ; Min HUANG ; Yajie CHI ; Yuantao YANG ; Yiquan KE
Chinese Journal of Neuromedicine 2017;16(6):541-546
Objective To explore the effect of fibroblast growth factor receptor (FGFR) receptor antagonist BGJ398 in growth, migration and invasiveness of gliomas. Methods (1) Glioma cells U87 and U251 were routinely cultured in vitro and divided into BGJ398 treatment group (10 μmol/L BGJ398 complete medium) and control group; the proliferation of U87 and U251 cells was detected by CCK-8 and colony formation; 2 d after cultivation, the migration and invasion of U87 and U251 cells were measured by wound-healing assay and Transwell assay. The phosphor-FGFR (pFGFR) level and vimentin expressions were detected by Western blotting. (2) Eight BALB/c nude mice were performed abdominal subcutaneous injection of 200 μL U87 cells (1×107 cells) and randomly divided into BGJ398 treatment group (giving physiological saline solution containing 20 mg/kg BGJ398) and control group (giving physiological saline solution); 15 d after cultivation, the quality of the subcutaneously implanted tumors was compared between the two groups, and the vimentin expression was detected by Western blotting. Results (1) Three, 4 and 5 d after cultivation, the optical density in the U87 cells of BGJ398 treatment group was significantly lower than that in the control group (3 d: t=4.059, P=0.015; 4 d: t=9.892, P=0.001; 5 d: t=10.259, P=0.001); 2, 3, 4 and 5 d after cultivation, the optical density in the U251 cells of BGJ398 treatment group was significantly lower than that in the control group (2 d: t=3.780, P=0.019; 3 d: t=4.515, P=0.011; 4 d: t=16.205, P=0.000; 5 d: t=17.613, P=0.000); 10 d after cultivation, the cloning number of U87 and U251 cells in the BGJ398 treatment group was significantly smaller than that in the control group (P<0.05); the results of wound-healing assay showed that the migration of U87MG cells in the BGJ398 treatment group was significantly slower than that in the control group (P<0.05); 24 h after cultivation, the number of U87 cells migration in the BGJ398 treatment group was significantly smaller as compared with that in the control group (P<0.05); 48 h after cultivation, the number of U87 and U251 cells passed the pore membrane in the BGJ398 treatment group was significantly smaller as compared with that in the control group (P<0.05). Western blotting showed that the content of pFGFR and vimentin in U87 and U251 cells of the BGJ398 treatment group decreased significantly as compared with that in the control group (P<0.05). (2) The subcutaneous tumor tissues in the BGJ398 treatment group[(0.186± 0.064) g] were significantly smaller than those in the control group[(0.450±0.106) g] (P<0.05); Vimentin expression in the BGJ398 treatment group (2.503±0.359) was significantly decreased than that in the control group (4.125±1.155, P<0.05). Conclusion Experiments in vivo and in vitro confirm that BGJ398 can inhibit the activation of FGFR and the growth, migration, and invasion of glioma cells, indicating that FGFR is one of effective targets for the treatment of gliomas.
3.Establishment of a rhesus monkey model of chronic temporal lobe epilepsy
Yajie CHI ; Shan XUE ; Haitao SUN ; Yuting XU ; Bolin WU ; Jianwei GUAN ; Jin'e YUAN ; Zhiming LIANG ; Zhaohui WU ; Qiang XU ; Zhaoming LIU ; Liangxue LAI ; Yanwu GUO
Chinese Journal of Neuromedicine 2017;16(6):564-569
Objective To describe a rhesus monkey model of temporal lobe epilepsy (TLE) established via repetitive unilateral intra-amygdala kainic acid (KA) injection and provide experimental basis for epileptogenic network and related research. Methods Eight male adult rhesus monkeys were randomly divided into KA injection group (n=6) and saline injection group (n=2). Brain stereotaxic technique, micro catheter implantation into the right amygdaloid nucleus, subcutaneous bladder connection, and continuous video-EEG monitoring were performed, and KA or saline injection into their right amygdala was achieved. Interictal epileptic discharges (IEDs), ictal discharges and behavioural performance between the two groups were compared right after injection and within 6 months of first discharge. Results Typical IEDs were recorded in the 6 monkeys from KA injection group after 2-4 times of KA injection, with focal spike waves discharges at the right temple area as manifestation; ictal discharges were recorded in 4 monkeys, with discharge patterns of discharges from the right temple area to the whole brain as manifestation, and during epileptic attack, these 4 monkeys suddenly stopped and dumbfounded without obvious limb seizures. Monkeys from the saline injection group showed no obvious abnormal behaviors. Conclusion Through a modified protocol of unilateral repetitive intra-amygdala KA injection, a rhesus monkey model with high similarity of behavioral and brain electrical features to TLE is developed.
4.Stable Angina Pectoris with Sleep Disorders Treated by Modified Tongmai Anshen Formula (通脉安神方加减): An Clinical Observation of 74 Cases
Xinbiao FAN ; Xiaofei GENG ; Zhipeng YAN ; Tingting LI ; Yajie FAN ; Aolin LI ; Wenyu SHANG ; Chi ZHANG ; Junping ZHANG
Journal of Traditional Chinese Medicine 2023;64(17):1777-1785
ObjectiveTo observe the clinical efficacy of the Modified Tongmai Anshen Formula (通脉安神方加减, MTAF) in the treatment of stable angina pectoris (SAP) with sleep disorders. MethodsA total of 148 patients suffering from SAP with sleep disorder were included and randomly divided into control group and treatment group, with 74 patients in each group. The control group received conventional western medicine, and the treatment group additionally received MTAF (1 dose per day), both for 4 weeks. The changes in angina pectoris symptoms, traditional Chinese medicine (TCM) syndromes, sleep quality, quality of life, serological indicators including serum intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), brain-derived nerve growth factor (BDNF) and tyrosine kinase receptor B (TrkB) were compared between groups before and after treatment, and the safety was evaluated. ResultsIn the treatment group and the control group, the total effective rates of TCM syndromes(82.43% vs 52.70%), angina pectoris (79.73% vs 64.86%) and sleep (89.19% vs 68.92%) showing significant difference (P<0.001). After treatment, the total TCM syndrome score, primary symptom score, secondary symptom score, and secondary symptoms sleeplessness, restlessness, tiredness and fatigue individual score, angina pectoris score, PSQI total score and each item score were all significantly reduced in both groups, while the SF-36 single item score significantly increased (P<0.05). The total TCM syndromes and primary symptom scores, secon-dary symptoms sleeplessness, restlessness, tiredness and fatigue individual score, angina pectoris score, time to fall asleep, sleep quality, hypnotic medication, sleep disturbance, daytime dysfunction score and PSQI total score were significantly lower in the treatment group than those in the control group after treatment (P<0.05), while the somatic pain, general health status, social functioning, emotional functioning, mental health, and health change were significantly higher in the treatment group (P<0.05). After treatment, ICAM-1 and VCAM-1 level significantly decreased (P<0.05), and BDNF and TrkB levels increased (P<0.05) in the treatment group, while BDNF level significantly decreased in the control group (P<0.05). The TrkB level was significantly higher in the treatment group compared to the control group after treatment (P<0.05). A total of four adverse events occurred during the treatment, none of which were considered to be related to this study. ConclusionMTAF can significantly improve angina pectoris symptoms, TCM syndromes, sleep quality and quality of life in patients suffering from SAP with sleep disorders, the mechanism of which may be related to the protection of vascular endothelial function and central neurons.