Objective To perform facial nerve monitoring in patients under the low level of neuromuscular blockade during resection of acoustic neurinomas.Methods Twenty-eight patients with large,or medium acoustic neuroma underwent the surgery of acoustic neurinomas resection. During the operation,TOF and EEG monitoring were performed in order to detect the degree of muscle relaxation and the depth of anesthesia. Neuromuscular relaxation was maintained at T_4/T_1=25%～50% by adjusting doses of muscle relaxant and aneasthetic. Free-run EMG and Triggered EMG of orbicularis oris, orbicularis oculi, masseter and trapezius were recordered to monitor the function of the facial, trigeminal and accessory nerves, respectively. The function of the facial nerve was evaluated at first week and half year postoperatively according to House-brackmann classification.Results The facial never was successfully identified and mapped by neurominitoring in all 28 patients. successfully, tThe electrical stimulation was 0.1 mA-0.3 mA and no any involuntary body movement was observed in all patients ne of patients have moved during operation. The preservation of the facial nerve function following surgery was good. Five patients had a HB grade I, 13 a HB grade II, 8 a grade III and 2 a HB grade IV The facial nerve function was HB Grade Ⅰin 5 of 28 patients, HB GradeⅡ in 13, HB Grade Ⅲ in 8 and HB Grade Ⅳ in 2 immediately after operation. Six months after surgery, 10 casespatents showed demonstrated a HB GradeⅠof facial never function, 12 cases exhibited a slight palsy (HB Grade II) , and 5 cases exhibited a HB Grade III palsy and . Another 1 cases a exhibited severe palsy (HB Grade IV).Conclusions Facial nerve monitoring in patients under the low level of neuromuscular blockade can ensure the surgical safety and preserve the facial never function.

Objective To explore the expression of Speckle-type POZ protein-like(SPOPL)in human glioma tis?sues and its relationship with clinical pathological parameters and prognosis. Methods Immunohistochemical and west?ern blotting method were used to detect SPOPL expression in glioma tissues and tumor peripheral tissues in 68 cases of glioma patients including 32 cases of low grade gliomas (WHO I- II), and 36 cases of high grade gliomas (WHO III-IV). T test,χ2 test, Kaplan-Meier method and the Cox regression model were used to analyze the relationship between the expression and clinical indicators. Results The expression of SPOPL was significantly lower in gliomas than in tumor pe?ripheral tissues (t=-8.754, P<0.05), the expression of SPOPL was lower in high pathological grade tissues than in low grade of glioma tissues (t=-13.552, P<0.05). SPOPL expression was associated with pathological grade ( χ2=4.023, P<0.05). Cox regression model showed that the tumor pathological grade and different SPOPL protein expression were inde?pendent risk factors for the prognosis of patients with glioma. Conclusions SPOPL may be a biomarkers of human brain gliomas and can help to evaluate the prognosis of brain glioma.

Objective To determine the impact of PEE with different ethanol concentration extract on the activity of tyrosinase in B16 melanoma and to explore the feasibility of PEE used as skin whitening agent make use of a model organism .Methods 30%, 50%, 70%, 95%, different concentration of ethanol reflux got four kinds of PEE alcohol extract, respectively.And selected the most active inhibition to mushroom tyrosinase ( PEE30、PEE50、PEE70、PEE95).The effect of extracts from the selected on B16 cell model was determined by MTS, NaOH splitting decomposition, L-DOPA oxidation progress.The change in protein expression level after ethanol extract of PEE was determined by Western bolt.Results The capacity of inhibition to mushroom tyrosinase in each concentration of PEE extraction, but PEE70 had the most active inhibition.When challenged with B16 cell model, PEE70 showed the capacity of decrease in tyrosinase activities and melanin synthesis (P<0.01) and had a does dependence ;it also decreased Tyrosinase and TRP-1 expression compared with control B16 cells.Conclusion These data support the idea that PEE can restrain melanogenesis, through its inhibitory effect on the activity of tyrosinase.

Objective To determine the effects and dosage of N?acetylcysteine( NAC) in the im?provement of the visibility in esophagogastroduodenoscopy( EGD) . Methods A prospective randomized con?trolled study was performed on 193 patients scheduled for EGD from November 2014 to July 2015 were ran?domized into five groups using digital table. In group A, 100 mg dimethicone and 2 g NaHCO3 were given. In group B,100 mg dimethicone, 2 g NaHCO3 and 20 000 U pronase were given. Group C received 100 mg dimethicone, 2 g NaHCO3 and 200 mg NAC. Group D received 100 mg dimethicone, 2 g NaHCO3 and 400 mg NAC and group E 100 mg dimethicone, 2 g NaHCO3 and 600 mg NAC.The agents were dissolved in 100 ml water for each patient.Endoscopy was completed by one endoscopist and the score of image visibility assessment was completed by 2 other endoscopists. The 3 endoscopists were unaware of grouping. The total scores, the time of washing, the time of examination and complications were compared and analysed. The total image scores of group A, B, C,D and E were 30?83±3?78, 35?69±2?88, 33?16±3?90, 34?95±3?46 and 36?76±2?91, respectively. Group A was the lowest(P<0?05),followed by group C(P<0?05). There were no differences among group B,D, and E(P>0?05).Images that were scored 3 were the most in group E.The washing times of each group were 38?00±19?10, 17?03±11?44, 15?92±10?81, 15?78 ±10?24 and 15?55±9?69, and the examination times of each group were 13?49±2?49, 9?41±1?86, 9?08± 1?80, 8?73±1?91 and 8?78±1?79 minutes.Group A was the longest in these two indices(P<0?05). There were no significant differences among group B, C, D and E ( P<0?05) . There were no significant differences in adverse effects among groups after EGD( P>0?05) . Conclusion The preoperative NAC can improve the visibility in EGD. The best dose is 600 mg, whose effects and safety were similar to those of 20 000 U, but yield to less washing time and the examination time in EGD.

OBJECTIVETo investigate telomerase activity and expression of hTR and hTERT in human neuroepithelial tumors for exploring new strategy for clinical diagnosis and treatment.

METHODSTelomerase activity was detected by modified TRAP method and the expression of hTR and hTERT was measured by RT-PCR method in 65 human neuroepithelial tumors, respectively.

RESULTSThe positive rates of telomerase and hTERT were 61.54% and 70.77% respectively in human neuroepithelial tumors, and the positive rate and their level of expression were correlated with the degree of malignancy of tumors positively.

CONCLUSIONSTelomerase activity and hTERT are significantly correlated with the degree of malignancyin human neuroepithelial tumors. hTERT may play a key role in the regulation of telomerase activity.

DNA-Binding Proteins ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Neoplastic ; Humans ; Neoplasms, Neuroepithelial ; enzymology ; genetics ; Telomerase ; biosynthesis ; genetics ; metabolism

Objective To investigate the advantage of neuronavigation assisted microsurgical resection of gliomas in eloquent areas of brain. Methods The clinical data of 99 patients with gliomas in eloquent areas of brain and underwent microsurgery in the First Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2017 were analyzed retrospectively. All patients were divided into two groups: neuronavigator-guided microsurgery group (neuronavigation group,46 cases) and non-neuronavigator-guided microsurgery group (non-neuronavigation group,53 cases). The neuronavigation group received neuronavigation assisted microsurgery, while the non-neuronavigation group received general microsurgery. MRI examination, Karnofsky performance scale (KPS) score and symptomatic improvement rate were used to analyze the extent of resection and postoperative function. Results The total resection rate of neuronavigation group was 91.3% (42/46). Comparing with 73.6% (39/53) total resection rate in non-neuronavigation group,the difference of total resection rate was statistically significant (Z=-2.343,P＜0.05). The postoperative symptoms improved both in neuronavigation group and non-neuronavigation group,and the KPS score at discharge were higher than that before operation (P＜0.05). No aggravation of symptoms and signs or new complications occurred in all patients except one case of postoperative muscle strength decline in non-neuronavigation group after the surgery. According to tumor size,the total resection rate of neuronavigation group and non-neuronavigation group among patients whose maximum size of tumor≥3cm were 89.5%(34/38) and 72.5%(37/51) respectively. The difference of total resection rate was statistically significant between these two groups (Z=-2.040,P＜0.05). Conclusion Neuronavigation assisted microsurgical resection of gliomas in brain eloquent areas can improve the rate of total resection and postoperative quality of life without increase in postoperative complications.

Objective To explore the relationship between carbohydrate sulfotransferase 6(CHST6)expression level and prognosis in glioma patients and construct prognosis model by using bioinformatics method.Methods To analyze the difference of CHST6 expression in glioma.The median CHST6 expression was divided into high and low expression groups.The prognostic differences between the groups were analyzed.The expression level of CHST6 and different clinical features were analyzed by Cox regression,and the prediction and improvement model was established,and the validity improvement was compared with the control model.Results A total of 1204 medical records were included in TCGA and CGGA databases.CHST6 was significantly up-regulated in glioma samples(TCGA vs.GTEx,Z= 2.457,P＜0.001;CGGA vs.GTEx,Z=4.800,P＜0.001),and was an independent prognostic factor for glioma together with age,WHO grade,IDH mutation status,and 1p19q co-deletion(Cox analysis β=0.02,SE=0.01,HR=1.02,95%CI:1.01～1.04,P=0.01;C-Index 0.885,95%CI:0.862～0.908),has higher predictive validity than the control model(Improved model vs.Control model:TCGA d=0.036±0.004,SE=0.002,P=0.007;CGGA d=0.087±0.004,SE=0.002,P=0.001).Conclusion The high expression of CHST6 may be a predictor of poor prognosis and abnormal immune function in glioma patients.

Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective method for the treatment of portal hypertension complications in patients with decompensated liver cirrhosis. At present, there are many prognostic scoring tools for risk stratification of poor prognosis after TIPS. This article briefly introduces seven prognostic scoring tools commonly used for TIPS and summarizes the clinical research evidence of each scoring tool. The literature review shows that there is currently no sufficient research evidence to determine the optimal prognostic scoring tool after TIPS. Future clinical studies should comprehensively explore the advantages and disadvantages of different scoring tools in predicting short- and long-term adverse prognostic events after TIPS and develop new prognostic scoring tools in combination with new prognostic markers.

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*