1.Clinicopathological study of non-Langerhans cell histiocytosis in central nervous system
Tingting ZHANG ; Yongjuan FU ; Dehong LU ; Cunjiang LI ; Yueshan PIAO
Chinese Journal of Internal Medicine 2015;54(9):758-762
Objective To explore the clinicopathological features and imaging characteristics of non-Langerhans cell histiocytosis in central nerve system,thus to facilitate the diagnosis and differential diagnosis.Methods A total of ten cases were enrolled in the study,with seven cases of Rosai-Dorfman disease(RDD) and three cases of xanthoma disseminatum (XD).Data on the clinicopathological features,imaging,immunophenotype and prognosis were collected and analyzed.Results Seven patients with RDD,5 males and 2 females with the mean age of 46.7 years old,all presented as dural-based or intraparenchymal hypo-to isointense lesions on T1 and T2 with post-contrast enhancement.The polymorphous admixture of histiocytes,lymphocytes and plasma cells was observed in a fibrous stroma,with emperipolesis of some histiocytes.The immunohistostaining of CD11c,CD68,MAC387 and S-100 was positive in the histiocytes,while the staining of CD1α was negative.Five patients recovered after the operation,while one patient died of the disease.All the 3 XD patients were female,with the median age of 20.7 years old.All XD patients presented as multiple intraparenchymal hypointense lesions on T1 and hyperintense lesions on T2 with post-contrast enhancement.The infiltration of foam-like histiocytes,a few Touton giant cells,lymphocytes and eosnophils was observed in all XD patients.The immunohistostaining of CD68 and CD11c was positive in the histiocytes and that of MAC387 partly positive,while the staining of S-100 and CD1α was negative.One XD patient survived well,while another one died of the disease.Conclusions The diagnosis of RDD and XD should be based on their typical morphology and immunophenotype and should be differentiated from Langerhans cell histiocytosis and other non-Langerhans cell histiocytosis.Non-Langerhans cell histiocytosis in central nerve system often presents untypical clinical presentation and imaging features,thus the communication and cooperation between clinician and pathologist is needed.
2.Epidemiological status and risk factor analysis of female breast disease in Tongzhou district of Beijing
Xiaojun ZHANG ; Yueshan GU ; Hui DING ; Lihui SHI ; Li LIU
International Journal of Surgery 2011;38(12):819-821
Objective An epidemiological study was conducted to investigate the prevalence of female breast disease and risk factors in Tongzhou District of Beijing,providing objective data to prophylaxis of the disease in this area.Methods A questionnaire survey was done in 1 575 females aged 18-60 years in Tongzhou district of Beijing by a cluster random sampling method.Clinical breast examination,near- infrared scanning,colour ultrasound,X-ray and other adjunctive examinations were performed in these subjects for diagnosis of the disease.The subjects were divided into breast disease group and normal control group.And then a case-control study was conducted for risk factor analysis of female breast disease.Results Breast disease was found in 303 of 1 575 females,most in 30-50 years,the incidence being 19.2%.Breast hyperplasia was found in 270 females,breast fibroma in 5,other benign breast disease in 25,and breast cancer in 3,Breast disease was found related to education level,menopause time,history of breast hyperplasia and annoyance.Conclusions Female breast disease is related to age,education and menopause.History of breast hyperplasia and negative emotion are risk factora of the disease.Attention should be paid to breast health care and healthy life style,decreasing incidence of the disease.
3.A study on the correlation between electroencephalography characteristic and histopathological change in epilepsy patients due to focal cortical dysplasia
Lixin CAI ; Yueshan PIAO ; Lei LIU ; Dehong LU ; Yongjie LI
Chinese Journal of Neurology 2009;42(2):110-114
Objective To study the histopathological characteristics and the correlations between the cortical tissues from ictal discharge (ID) area and interictal epileptiform discharge (IED) area in epilepsy patients due to focal cortical dysplasia (FCD), in order to further discuss the mechanism of epileptogenicity. Methods Twenty-two subjects who underwent epilepsy surgeries consecutively in our institute since April 2005 to August 2006. All patients underwent intracranial electrode implantations and long-term video-EEG monitoring before the resective surgeries and the postoperative pathologies proved to be FCD. According the long-term EEG monitoring results, the cortex with intense IED and the cortex with ID onset were resected separatively in the operation for further histopathologic studies. Twenty cases were collected. Based on the Palimini' s pathologic subtype classification for FCD as well as quantificational scoring for immunocytochemistry for the calcium-binding protein parvalbumin (PV) which we designed by ourself, the specimens of IED and ID were studied and compared. Results The resected specimens from 20 cases were examed. ID specimens showed more severe abnormalities in the laminar cortical architecture, alterations in the morphology of neurons and in the appearance of abnormal balloon cells. With the PV quantificational scoring, we found significant difference between IED (6.4±2.1) and ID (4.4±1.8) from FCD Ⅱ specimens (P=0.042). No difference was found between ID subtypes (F=2.734, P=0.093 ). Conclusions ID cortical area showed more severe abnormalities in histopathologic changes than lED area. Our results suggested that the ID area of FCD had more severe damage in inhibitory synaptic circuits and neural networks, which meant it was more epileptogenic than IED. No difference was identified between each ID subtype in term of epileptogenicity, which meant all of them should be resected during the surgery.
4.The establishment of a multiple sclerosis model for clinical MRI study
Haiqin ZHANG ; Kuncheng LI ; Chunshui YU ; Jia MA ; Wen QIN ; Zhijuan JI ; Yueshan PIAO
Chinese Journal of Radiology 2009;43(8):882-886
at model is an ideal MS model for clinical MRI study.
5.The clinical and pathological features of 85 cases with positive cerebrospinal fluid cytology by thin-layer centrifugal cytological test
Wei GAO ; Zhuo LI ; Leiming WANG ; Fang LIAN ; Cuicui LIU ; Dehong LU ; Yueshan PIAO
Chinese Journal of Internal Medicine 2016;55(12):945-949
Objective To evaluate cytological test of cerebrospinal fluid in the diagnosis of meningeal dissemination of tumor cells.Methods The clinical and imaging features of 85 cases with tumor cells diagnosed by thin-layer centrifugal cytological test of cerebrospinal fluid were retrospectively reviewed.The characteristics of cellular morphology and immunocytochemical staining were analyzed.Results The main presentations of all the patinets was meningeal irritation and neurological dysfunction.The features of the brain MRI were meningeal thicking and enhancement,intracranial abnormal signals and intracranial space occupying lesion in part of the patients.Atypical cells were found in 84 cases (98.8%) with the first sample test and immunocytochemical staining was conducted in 48 cases to identify the tissue origin.Meningeal carcinomatosis was shown to be the majority with lung cancer as the dominated tissue type and adenocarcinoma as the most common histological type.Others were lymphatic hematopoietic system (13 cases),melanomas (5 cases),primitive neuroectodermal tumor (3 cases) and glioma (1 case).In addition,12 cases were only proved to be cancer by cytological test of cerebrospinal fluid.Conclusion The thin-layer centrifugal cytological test of cerebrospinal fluid has a relatively high accuracy for detecting disseminated tumor cells of meninges and could be of great help to identify the source and type of lesion with immunocytochemical staining.
6.A clinicopathologic analysis of specimens of hemispherectomy or multilobar resection from 46 cases of refractory epilepsy
Yuefeng WANG ; Yueshan PIAO ; Dehong LU ; Wei WANG ; Li CHEN ; Lifeng WEI ; Hong YANG
Chinese Journal of Neurology 2011;44(1):24-29
Objective To investigate the clinicopathologic features of the brain tissue from multilobar resection or hemispherectomy for refractory epilepsy. Methods The clinical and pathologic findings of 46 cases seen at Xuanwu hospital from 2005 to 2009 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 3.9 years and 10.2 years, respectively. There were 33 cases of hemispherectomy and 13 cases of multilobar resection. Temporal lobe abnormality was seen in all cases. The pathologic subgroups were as follows: ulegyria (31/46), malformation of cortical development (MCD, 7/46 ) and infection (8/46). Microscopic examination of ulegyria showed cortical architectural disturbances, neuronal loss, reactive gliosis and appearance of corpora amylacea. We also noted deposition of hemosiderin (13 cases), calcification (9 cases) and island-like neurons (5 cases). All ulegyria cases were accompanied by varying degree of cortical dysplasia, and hippocampus sclerosis were identified in 7 cases. MCD comprised of 5 cases of focal cortical dysplasia ( FCD), including 3 cases of FCDⅠB, 1 case of FCDⅡA and 1 case of FCDⅠA, 1 case of polymicrogyria and 1 case of porencephaly. Among 8 infection eases, there were 5 cases of Rasmussen encephalitis ( RE), l case of cysticercosis, 1 case of tuberculous meningitis and l case of Cytomegalovirus encephalitis. Conclusions The most common pathological category of specimens from hemispherectomy or multilobar resection is ulegyria with obvious temporal lobe abnormality. This is followed by MCD ( with FCDⅠB as the main type) and central nervous system infection (RE as the most frequent abnormality).
7.Paeoniflorin increases beta-defensin expression and attenuates lesion in the colonic mucosa from mice with oxazolone-induced colitis.
Yi ZHOU ; He WANG ; Yueshan LI ; Yiwen TAO ; Jianye ZHANG ; Zhiqiang ZHANG
Acta Pharmaceutica Sinica 2010;45(1):37-42
Previous studies have demonstrated that the Chinese medicine paeoniflorin, derived from the Ranunculaceae plant peony, peony, purple peony root, was able to have anti-inflammatory, anti-ulcer, anti-hypersusceptibility and anti-oxidation activity. In order to elucidate the pesticide effect and the mechanisms by which paeoniflorin exerts its effect of anti-inflammation and immunoregulation on oxazolone-induced colitic mice, disease activity index (DAI) and histological grading of colitis (HGC) were evaluated in animal model. Moreover, the expressions of HBD-2, IL-6 and IL-10 of mice with experimental colitis were observed with immunohistochemistry and RT-PCR in this study. Results showed that DAI and HGC of oxazolone control group was significantly higher than that of normal control group, and that paeoniflorin groups and 5-ASA group, compared with oxazolone control group, could alleviate the symptoms and histological damages of colitic mice (P < 0.05, P < 0.01). The expression of HBD-2 and IL-6 cytokine on the colon of colitic mice was higher than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01), but the expression of IL-10 is lower than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01). The positive correlations were demonstrated between the expression of (HBD-2 and IL-6) and DAI (Pearson r = 0.728, Pearson r = 0.758, P < 0.01, respectively), (HBD-2 and IL-6) and HGC (Pearson r = 0.819, Pearson r = 0.825, P < 0.01, respectively), whereas, the negative correlations were demonstrated between the expression of IL-10 and DAI (Pearson r = -0.789, P < 0.01), IL-10 and HGC (Pearson r = -0.725, P < 0.01). It can be concluded that to some extent paeoniflorin effectively alleviate the symptoms of oxazolone-induced colitis through regulating the expression of HBD-2, IL-6 and IL-10.
8.Effect of electroacupuncture on angiogenesis in rat ischemic hippocampus after focal cerebral ischemia/reperfusion and its mechanism
Chenchen XIE ; Yong LUO ; Xiang GAO ; Yueshan PANG ; Man LI ; Haiqi WEN ; Ruifang CHEN
Acta Laboratorium Animalis Scientia Sinica 2014;(4):41-46
Objective To explore the effect of electroacupuncture on CD 34 +VEGFR2 +endothelial progenitor cell (EPC)-derived vessels and stromal cell-derived factor-1α(SDF-1α)/CXCR4, and study its mechanism of promoting an-giogenesis in hippocampus after focal cerebral ischemia /reperfusion .Methods A total of 180 healthy male adult Sprague Dawley (SD) rats were randomly divided into sham operation (sham) group, model (I/R) group, electroacupuncture (I/RE) group, I/RE plus AMD3100 (A specific antagonist of CXCR4) group (I/REA) and AMD3100 (I/RA) group. The rats received filament occlusion of the right middle cerebral artery for 2 hours followed by reperfusion .Electroacupunc-ture was applied to “Baihui” (GV20)/“Siguan” (Hegu LI 4/Taichong LR 3) acupoints for 30 min, once a day.The mR-NA expression of SDF-1αand CXCR4 were detected by reverse transcription-polymerase chain reaction ( RT-PCR) .Double immunofluorescence was used to stain CD 34 +VEGFR2 +EPC-derived vessels.Results Compared with the sham group, the mRNA expressions of SDF-1αand CXCR4 were significantly upregulated in I/R and I/RE group ( P<0.05 ) , but that in I/RE group was more significantly increased than I/R group(P<0.05).In addition, the mRNA expression of SDF-1αand CXCR4 were highly increased on day 1 in the I/REA group than that of I/RE group, but decreased than that of I/RE group on day 7 after reperfusion (P<0.01).CD34 +VEGFR2 +EPCs-derived vessels were obviously increased on 3d and 7d in the I/RE group compared with that of the I/R group, and significantly decreased on 7d in the I/REA group compared with that of the I/RE group ( P<0.01) .Conclusions Electroacupuncture can effectively promote an-giogenesis through upregulating the expression of SDF-1αand CXCR4 in rat ischemic hippocampus after focal cerebral is-chemia/reperfusion.
9.The effect of electroacupuncture on urodynamic changes soon after complete T10 spinal cord transection
Jie CHENG ; Yi ZHU ; Wenyi ZHANG ; Jun YUN ; Yueshan YU ; Zhonghan LI ; Liting ZHU
Chinese Journal of Physical Medicine and Rehabilitation 2012;34(6):411-414
Objective To observe the effect of electroacupuncture on urodynamic alteration in rats after complete T10 spinal cord transection.Methods Thirty-one female Sprague-Dawley rats were divided randomly into a sham operation group (n=10),a model group (n=11) and an electroacupuncture (EA) group (n=10).The spinal cords of the rats in the latter two groups were completely transected at the T10 level.Pressure was applied to the rats'lower abdomens every day while in the EA group electroacupuncture with continuous wave electricity was applied to the guanyuan (RN4) and sanyinjiao (SP6) acupoints for 15 min.The treatment was carried out daily for consecutive 7 days.Urodynamic examinations were carried out after the treatment course had finished.Results At the 9th day after the operation,average residual urine volume and bladder capacity in the EA group were both significantly lower than in the model group.Residual urine volume and bladder capacity were lowest in the sham operation group.Average voided volume and voiding rate in the EA group were significantly higher than in the model group.The average voiding rate was highest in the sham operation group.The average vesical pressure of the urine leak point and bladder compliance of the EA group rats were significantly lower than those of the model group The average vesical pressure of the urine leak point and bladder compliance of the sham operation group were lowest of all.All of these differences were statistically significant at the 1% level of confidence.Conclusion EA can improve the lower bladder's detrusor reflex state and urinary tract function soon after complete T10 spinal cord transaction,at least in rats.
10.The relationship between expression of drug resistance proteins and antiepileptic drug concentrations in brain tissue of patients with refractory epilepsy
Jing LIU ; Yueshan PIAO ; Dehong LU ; Wei WANG ; Li CHEN ; Lifeng WEI ; Hong YANG
Chinese Journal of Neurology 2012;(11):796-800
Objective To compare the expression and distribution of drug resistance proteins Pglycoprotein (P-gp) and lung resistance protein (LRP) in brain tissues of patients with refractory epilepsy and to investigate the relationship between expression of drug resistance proteins and concentration of antiepileptic drug carbamazepine (CBZ).Methods We included the brain tissues of 26 cases with refractory epilepsy who had in the experiment.They had following pathologic diagnosis: focal cortical dysplasia (FCD) Ⅰb (n =10),FCD Ⅱ a (n =4),FCD Ⅱb (n =2) and brain tumorsincluding ganglioglioma (n =6) and dysembryoplastic neuroepithelial tumor(n =4).Immunohistochemistry staining using EnVision system was used to reveal the expression location of P-gp and LRP,and Western blot in SDS-polyacrylamide gel was used to quantitatively analyze the expression of P-gp and LRP.Fluorescence polarization immunoassay was used to determine concentration of CBZ.Results Both P-gp and LRP performed(μg/ml) prominent overexpression in brain tissues of patients with refractory epilepsy,especially in the lesions of both FCD type Ⅱ (P-gp: 2.593 ±0.829 vs 1.711 ±0.292,t =-2.201,P=0.028;LRP:1.352 ±0.445 vs 1.179 ±0.593, t =-2.516,P =0.028, respectively)and tumor(P-gp:1.567 ±0.092 vs 0.775 ± 0.101, t =2.698, P =0.024; LRP: 1.091 ± 0.239 vs 0.825 ± 0.297, t =3.997, P =0.003respectively).The concentration of CBZ in lesions of brain tumors were lower than which in surrounding regions(0.848 ±0.726 vs 0.948 ±0.785, t =-3.056,P =0.014), while P-gp and LRP were higher than which in surrounding regions in 80% cases.There was no relationship between expression of drug resistance proteins and concentration of CBZ.Conclusions In processing of drug resistance, P-gp and LRP play important roles.However, there is no correlation between expression of drug resistance proteins and concentration of CBZ, suggesting epilepsy drug resistance to be a complicated mechanism.