Glioma is the most common primary malignant brain tumor and its microenvironment exhibits immunosuppressive properties. Macrophages and T cells are the main immune cells of glioma, which engage in highly dynamic interactions. Cytokines such as interleukin-2 (IL-12), interleukin-10 (IL-10), interferon-γ (IFN-γ),and transforming growth factor-β (TGF-β) determine the direction and intensity of the anti-tumor immune response through finely regulating macrophage polarization and T cell subset differentiation. Co-stimulatory molecules on the surface of T cells are mostly members of the immunoglobulin superfamily (IgSF); in addition,co-stimulatory molecules including CD80/CD86, T cell inducible co-stimulatory molecule and its ligand (ICOS /ICOS-L),CD40L/CD40, OX40L/OX40 and glucocorticoid-induced tumor necrosis factor receptor related protein and its ligand (GITR /GITR-L) are involved in initiating,enhancing or inhibiting T cell activation,and collaboratively shape the overall tumor immune microenvironment. The in-depth understanding of these factors and molecular pathways can help optimize immunotherapeutic strategies for glioma and provide new therapeutic targets.

Glioma is the most common primary malignant brain tumor and its microenvironment exhibits immunosuppressive properties. Macrophages and T cells are the main immune cells of glioma, which engage in highly dynamic interactions. Cytokines such as interleukin-2 (IL-12), interleukin-10 (IL-10), interferon-γ (IFN-γ),and transforming growth factor-β (TGF-β) determine the direction and intensity of the anti-tumor immune response through finely regulating macrophage polarization and T cell subset differentiation. Co-stimulatory molecules on the surface of T cells are mostly members of the immunoglobulin superfamily (IgSF); in addition,co-stimulatory molecules including CD80/CD86, T cell inducible co-stimulatory molecule and its ligand (ICOS /ICOS-L),CD40L/CD40, OX40L/OX40 and glucocorticoid-induced tumor necrosis factor receptor related protein and its ligand (GITR /GITR-L) are involved in initiating,enhancing or inhibiting T cell activation,and collaboratively shape the overall tumor immune microenvironment. The in-depth understanding of these factors and molecular pathways can help optimize immunotherapeutic strategies for glioma and provide new therapeutic targets.

Glioma is the most common primary intracranial tumor. Despite surgical resection, radiation therapy, chemotherapy, and Tumor Treating Fields, the median survival period is still less than 21 months. In recent years, immunotherapy for glioma has become a research hotspot. The immune microenvironment of glioma plays an important role in immune escape, which is an important means of malignant progression. Exploring the immune escape mechanism of glioma, understanding the progress of immunotherapy, and extending the survival period of patients with glioma as much as possible are the major challenges facing glioma treatment. Therefore, this article reviews the new understanding of the immune system in the central nervous system, immune cells and immune escape in glioma, and immunotherapy for glioma, to help further understand the mechanism of glioma development and provide new ideas for immunotherapy.

Glioblastoma (GBM) is a clinically common type of glioma with a very poor prognosis and complex drug resistance mechanisms, high mortality, short survival time; invasiveness and recurrence are the main obstacles to treatment. Ferroptosis is an iron-dependent regulated cell death associated with massive lipid peroxidation that is related with the development and treatment response of various types of tumors. Cancer cells rely on their strong antioxidant capacity to avoid ferroptosis, therefore, exploring ferroptosis may be an effective strategy to prevent tumor proliferation and invasion. This article mainly reviews the mechanism of ferroptosis in GBM, as well as the research status and progress of ferroptosis as a potential therapeutic target.

The blood flow in the aortic arch and branch vessels in vitro is simulated,and the blood model is optimized with a non-Newtonian model.A numerical simulation analysis is conducted based on bidirectional fluid-solid coupling to analyze the hemodynamic characteristics(blood flow velocity,vascular wall pressure and vascular wall stress)in a cardiac cycle,and discuss their relationships with the formation of aortic dissection.It is concluded that the long-term existence of"chaotic"blood flow distribution in the blood vessel and the sudden changes of wall pressure and wall stress are liable to cause changes in the structure and function of the cells of the arterial wall,and ultimately induce the formation of aortic dissection.The study provides a more reliable basis for medical diagnosis,and further protects the life,health and safety of patients.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*

Objective:To study the correlation between liver imaging reporting and data system (LI-RADS) category with tumor differentiation, Ki67 index, microvascular infiltration, and predictive prognosis in hepatocellular carcinoma (HCC).Methods:We retrospectively analyzed the clinical and radiological data of 178 patients with HCC who were confirmed by histopathological studies after liver resection between January 2015 and September 2020 at Lishui Central Hospital and Lishui People’s Hospital. There were 156 males and 22 females, with age of (57±10) years old. These patients were assessed for LI-RADS categories according to the 2018 version of LI-RADS, and they were divided into 4 groups according to the assessment results: 12 patients with LI-RADS-3 (the LI-RADS-3 group); 26 patients with LI-RADS-4 (the LI-RADS-4 group); 102 patients with LI-RADS-5 (the LI-RADS-5 group); and 38 patients with LI-RADS-M (the LI-RADS-M group). The patients' general information, tumor markers, pathology and other clinical data were recorded. Correlation analysis between the LI-RADS category with pathology was performed by the Kendall's tau-b test. Survival analysis between groups was performed by the Kaplan-Meier analysis. The Cox regression risk model was used to analyze the relationship between these variables with the risk of death.Results:The Kendall's tau-b test showed that LI-RADS category was positively correlated with the degree of tumor differentiation ( t=0.204, P=0.002), but not with microvascular infiltration and Ki 67 index ( P>0.05). All patients were followed up for 4.2 to 84.2 months (median follow-up 36.3 months). By the end of follow-up, 31 patients had died and 147 patients were alive. The cumulative 1-year and 3-year survival rates of the LI-RADS-5 group were 97% and 90% respectively, which were significantly higher than those in the LI-RADS-M group (81% and 63%), and the LI-RADS-4 group (96% and 81%), ( P<0.05). The cumulative 1-year and 3-year survival rates of patients in the LI-RADS-3 group were 100% and 67% respectively, and there was no statistically significant difference with the LI-RADS-5 group ( P>0.05). The Cox multivariate regression analysis showed that tumor glycoantigen 199 (>50 μl/ml) to be an independent influencing factor in survival of HCC patients ( HR=0.43, 95% CI: 0.24-0.76, P=0.004). Conclusion:The LI-RADS category of HCC was positively correlated with the degree of tumor differentiation, and patients with HCC meeting the LI-RADS-5 criteria had relatively better prognosis.

Objective To explore the clinical value of resistance index(RI)of prostatic capsular artery in predicting or screening of prostate cancer(PCa)by comparing prostatic capsular artery RI with the serum total prostatic specific antigen(TPSA),fPSA/tPSA ratio and prostatic specific antigen dernsity(PSAD).Methods RI of prostate capsular artery,serum TPSA,of fPSA/tPSA ratio and PSAD were measured with colour Doppler ultrasonography in this subset of 203 patients who had undergone transrectal ultrasound guided prostate puncture biopsy.The patients were divided into two groups [PCa and benign prostatic hyperplasia(BPH)group] for comparative study.Results Of them,the level of TPSA were between 4 and 10 ng/ml(grey area)in 34 cases,accounts for 16.75%of the total subjects.All the others were outside the grey area.ROC curve analysis showed that the area under the curve(AUC)of RI of the capsular artery was 0.77,which was close to 0.84 and 0.86 of TPSA and PSAD.It indicated a similar value in predicting or screening PCa; while the AUC of fPSA/tPSA ratio was only 0.49,which had little clinical value.The fPSA/tPSA ratio and the mean value of PSAD in the grey area had significant differences(t=2.78,3.94,P＜0.02)between the two groups.However,the fPSA/tPSA ratio had no statistical significance in the high value area outside the grey area(t=0.873,P ＞ 0.05).And the mean value of RI of prostatic capsular artery had significant differences between the two groups both in the grey area and in the high value area outside the grey area(t=4.56,5.10,P ＜ 0.001).Conclusions RI of prostatic capsular artery can be steadily used to predict or screen PCa.It is not affected by the gray area of TPSA and is of great value in clinical practice.

Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.

Objective To detect the expression of the tryptase in the plasma,and study the meaning in brain traumatic patients.Methods There were two groups:the brain traumatic group(40 patients)and the control group (20 health people).The content of plasma tryptase was determined by fluorescence enzyme immunoassay..Results The level of plasma tryptase had no statistical significance in control group(2.97 ±1.05)μg/L compared with the brain traumatic group(3.03 ±1.39)μg/L,however there had statistical significance comparing with sever brain traumatic patients(3.84 ±0.52μg/L)(t =3.32,P <0.05).4 cases of death in patients with severe head injury group content of tryptase (5.85 ±1.05)μg/L,which was significantly higher than the group of 16 cases of injury in severe head injury after 2 months still alive with the content of serum tryptase (2.49 ±0.52)μg/L,the difference was statistically significant (t =8.13,P <0.01).Conclusion The plasma tryptase level in sever brain traumatic patients increased significantly,and might be of importance for treatment strategies and prognosis.