Objective To compare the efficacy of stenting in the treatment of idiopathic intracranial hypertension(IIH)complicated by different types of venous sinus stenosis(VSS).Methods The clinical data of 48 patients with IIH complicated by VSS,who received stenting therapy at the First Affiliated Hospital of Zhengzhou University of China from January 2019 to September 2023,were retrospectively analyzed.According to the type of VSS,the patients were divided into intrinsic stenosis group(n=20)and the extrinsic stenosis group(n=28).The improvement of symptoms,Frisén grade of papilledema,lumbar puncture opening pressure(LPOP),trans-stenosis pressure gradient(△P)of VSS,and surgery-related complications were compared between the two groups.Results The mean age of the patients in the intrinsic stenosis group was greater than that of the patients in the extrinsic stenosis group(41.60 years vs.35.25 years,P=0.049).The length of the narrowed segment in the extrinsic stenosis group was 22.5 mm,which was significantly longer than 19.0 mm in the intrinsic stenosis group(P=0.007).The postoperative Frisén grade of papilledema in the extrinsic stenosis group was obviously lower than that in the intrinsic stenosis group(P=0.037).No statistically significant differences in the other clinical data existed between the two groups(all P＞0.05).After stenting,all of the median △P,mean LPOP,and median Frisén grade of papilledema were decreased significantly when compared with their preoperative values(all P＜0.001),and the postoperative 3-day median Frisén grade of papilledema in the extrinsic stenosis group was much lower(P=0.037).The patients were followed up for one year,the clinical symptoms of the patients in both groups were improved to varying degrees.At the time of discharge,the proportion of patients having no symptoms of papilledema in the extrinsic stenosis group was 57.1％,which was higher than 22.2％in the intrinsic stenosis group(P=0.049),and no statistically significant differences in the improvements of other symptoms existed between the two groups(all P＞0.05).There was no significant difference in the incidence of complications between the two groups(P=0.563).Conclusion Venous sinus stenting can effectively treat patients with IIH complicated by different types of VSS.

Objective To compare the clinical efficacy of medication and stenting in treating patients with idiopathic intracranial hypertension complicated by venous sinus stenosis.Methods The clinical data of 74 patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,who were admitted to the First Affiliated Hospital of Zhengzhou University of China from January 2020 to June 2023,were retrospectively analyzed.The patients were divided into medication group(n=35,receiving drug therapy)and stenting group(n=39,receiving stent implantation therapy).Before and after treatment,lumbar puncture and fundus examinations were performed,and the postoperative improvements in intracranial pressure and papillary oedema were evaluated.The changes in the median papillary oedema Frisén grade and the average opening pressure of lumbar puncture were compared between the two groups during hospitalization period.The improvement degrees of the clinical symptoms determined at discharge,as well as at the 6 months and 12 months after discharge were compared between the two groups.The incidence of complications during the follow-up period in the two groups was recorded.Results The time interval from onset to treatment in the stenting group was longer than that in the medication group(2 months vs.one month,P=0.021),and the differences in the other baseline data between the two groups were not statistically significant(all P＞0.05).After treatment,different degrees of improvement were obtained in both groups(all P＞0.05).At the time of discharge,the degree of median papillary oedema in the stenting group was Frisén grade I,which was lower than Frisén grade Ⅱ in the medication group(P=0.011);the average opening pressure of lumbar puncture in the stenting group was 205.26 mm H2O,which was lower than 248.14 mm H2O in the medication group(P=0.002).The proportions of patients having no symptom or showing symptom improvement in the stenting group and in the medication group at the time of discharge were 74.4％and 45.7％respectively(P=0.017),which at the time of 6 months after discharge were 84.6％and 48.6％respectively(P=0.001)and at the time of 12 months after discharge were 87.2％and 57.1％respectively(P=0.004).No statistically significant difference in the incidence of complications existed between the two groups(10.3％and 8.6％respectively,P=1.000).Conclusion For the treatment of patients with idiopathic intracranial hypertension complicated by venous sinus stenosis,stent implantation therapy is superior to medication therapy in quickly and effectively relieving papillary oedema,decreasing lumbar puncture opening pressure,and improving their corresponding symptoms and signs,with satisfactory patient's prognosis and clinical safety.

Objective To investigate the relationship between expression levels of epidermal growth factor receptor(EGFR),proliferation marker protein Ki-67(Ki-67),P53 and circulating tumor cell(CTC)and the prognosis of triple negative breast cancer.Methods A total of 95 patients with triple negative breast cancer were selected.The expression levels of EGFR,Ki-67 and P53 in pathological tissue specimens were detected by immunohistochemistry.All patients underwent 8 cycles of chemotherapy,and the expression of CTC was detected before and after chemotherapy by isolation epithelial tumor cells(ISET).The relationship between CTC expression before and after chemotherapy and efficacy of chemotherapy was analyzed.The correlation between CTC and expression levels of EGFR,Ki-67 and P53 was analyzed.Patients were followed up for progression free survival(PFS).Risk factors of progression for triple negative breast cancer were analyzed by COX regression.Results The positive detection rates of EGFR,Ki-67 and P53 were 44.21%(42/95),63.16%(60/95)and 56.84%(54/95).The positive detection rate of CTC was lower in patients after chemotherapy than that before chemotherapy(14.74%vs.61.05%,P＜0.05).The efficacy of chemotherapy was negatively correlated with the positive expression of CTC after chemotherapy(P＜0.001).COX regression analysis found that clinical stage Ⅲ,positive EGFR and CTC after chemotherapy were independent risk factors of progression of triple negatively breast cancer(P＜0.05).PFS of patients at clinical stage Ⅰ,stage Ⅱ,and stage Ⅲ decreased in order(P＜0.05).PFS of EGFR positive patients was shorter than that of EGFR negative patients(P＜0.05).PFS of CTC positive patients after chemotherapy was shorter than that of CTC negative patients after chemotherapy(P＜0.05).Conclusion The positive expression of EGFR before chemotherapy and the positive expression of CTC after chemotherapy are related to the poor survival prognosis of patients with triple negative breast cancer.The lower the positive detection rate of CTC after chemotherapy,the better the efficacy of chemotherapy.

Objective To explore the application value of combined detection of serum neutrophil gelati-nase-associated lipocalin(NGAL)and calprotectin in patients with fracture in early infection after joint re-placement surgery.Methods A total of 206 fracture patients who underwent joint replacement surgery in a hospital from July 2021 to July 2022 were selected as the study objects,and divided into infection group(n=29)and non-infection group(n=177)according to whether infection occurred after joint replacement surgery.Serum NGAL and calprotectin levels were detected by enzyme-linked immunosorbent assay,and the influencing factors of infection after joint replacement surgery in fracture patients were analyzed by multivari-ate Logistic regression.The receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of serum NGAL and calprotectin combined detection in early infection after joint replacement surgery in frac-ture patients.Results The proportion of diabetes mellitus and erythrocyte sedimentation rate(ESR)in infec-tion group were significantly higher than those in non-infection group,while albumin was significantly lower than that in non-infection group,with statistical significance(P＜0.05).The levels of serum NGAL and cal-protectin in postoperative infection group were significantly higher than those in postoperative non-infection group,with statistical significance(P＜0.05).Serum NGAL,calprotectin,ESR and diabetes mellitus were risk factors for early infection after joint replacement surgery,while serum albumin was protective factor(P＜0.05).The area under the curve for the diagnosis of early infection after joint replacement surgery in patients with fracture was 0.838,0.813 and 0.934,respectively,and the combination of serum NGAL,calprotectin,and both were superior to the diagnosis of serum NG AL and calprotectin alone(Z=2.720,2.357,P=0.007,0.018).Conclusion The combined detection of serum NGAL and calprotectin has better diagnostic efficacy for early infection after joint replacement surgery in fracture patients,and has certain application value for clinical prognosis.

Objective To compare therapeutic efficacy of anticoagulation alone and combining with intervention for treating severe cerebral venous thrombosis(CVT).Methods Data of 65 severe CVT patients were retrospectively analyzed.The patients were divided into anticoagulation group(n=32)or combined group(n=33)according to therapeutic methods.The modified Rankin scale(mRS)score at admission and discharge,the prognosis of patients,vascular recanalization rate as well as incidence of complications during follow-up period were compared between groups.Results No significant difference of mRS scores at admission was found between groups(P＞0.05),while mRS scores of combined group were lower than of anticoagulation group at discharge(P＜0.05).The rate of good prognosis at discharge(84.85%vs.59.38%),6 months after discharge(87.88%vs.65.63%)and 12 months after discharge(93.94%vs.75.00%)in combined group were all higher than those in anticoagulation group(all P＜0.05).The vascular recanalization rate in combined group was higher than that in anticoagulant group(100%vs.75.00%,P＜0.05).At the end of follow-up,no significant difference of complication incidence was found between groups(15.15%vs.18.75%,P＞0.05).Conclusion For patients with severe CVT,anticoagulation combined with interventional therapy could significantly alleviate clinical symptoms and improve prognosis compared with anticoagulation alone.

Objective To observe the value of stent implantation for treating idiopathic intracranial hypertension(IIH)complicated with venous sinus stenosis(VSS).Methods Data of 54 patients with IIH complicated with VSS who underwent stent implantation were retrospectively analyzed.The papillary edema grade,lumbar puncture-opening pressure(LP-OP)and trans-stenotic pressure gradient of venous sinus(ΔP)before and after stent implantation were compared,and the symptom improvement and treatment-related complications during the follow-up period were recorded.Results Totally 60 stents were successfully implanted in 54 patients.Before stent implantation,the papillary edema grade was 3(3,3),LP-OP was(391.39±92.62)mmH2O and the ΔP was 18.50(15.00,25.00)mmHg,which decreased to 1(0,1),(208.80±62.31)mmH2O and 1.25(0.88,2.55)mmHg after stent implantation,respectively,all with significant differences(all P＜0.001).Clinical symptoms improved after stent implantation in all 54 patients.At the end of follow-up,disappearance of headache,papillary edema,visual disorder,abducent nerve paralysis and tinnitus were noticed in 30(30/37,81.08%),38(38/45,84.44%),41(41/45,91.11%),8(8/10,80.00%)and 9 cases(9/10,90.00%),respectively.Treatment-related complications occurred in 4 cases(4/54,7.41%),all improved after intervention.Conclusion Stent implantation was effective and safe for treating IIH complicated with VSS.

Objective To observe the therapeutic effect of endovascular embolization for perimedullary arteriovenous fistula(PMAVF).Methods Data of 8 PMAVF patients who underwent endovascular embolization were retrospectively analyzed.Findings of digital subtraction angiography(DSA)immediately and 6 months after treatment were reviewed,and the modified Aminoff-Logue score(mALS)was compared before and 6 months after treatment.Results Among 8 cases of PMAVF,there were 2 cases of type Ⅰ,5 cases of type Ⅱand 1 case of type Ⅲ,among them 3 were treated with Onyx glue while 5 with Glubrane glue.The immediate DSA results after treatment showed complete embolization of the fistula in all 8 cases,while those 6 months after treatment showed no recurrence.One case recovered and the other 7 cases improved,and mALS(2.25±2.12)6 months after treatment was lower than that(5.50±2.39)before treatment(P＜0.05).Conclusion Endovascular embolization could safely and effectively treat PMAVF.

OBJECTIVEThe aim of this study was to explore whether estradiol induces the expression of VEGF and bFGF in the endometrial cancer Ishikawa cells by activation of NF-κB via AKT pathway, and its effect on cell proliferation.

METHODSWestern blot was used to detect the AKT protein expression in Ishikawa cells after stimulation with estradiol, and the effect of AKT inhibitor or ER inhibitor on the activation of AKT. TransAM kit was used to detect the NF-κB p65 activity. qPCR and Western blot were used to detect the expression of VEGF and bFGF mRNA and proteins in the Ishikawa cells after estradiol treatment (E2 group), and pretreated with AKT inhibitor (AKT group) or ER inhibitor (ER group) or NF-κB inhibitor (NF-κB group), following the estradiol treatment. Flow cytometry and CFSE (carboxyfluorescein diacetate, succinimidyl ester) staining were used to examine the cell proliferation. Transwell was used to detect the migration ability of Ishikawa cells.

RESULTSExpression of p-AKT protein in the Ishikawa cells was markedly higher than that in the control group (P < 0.05). Expressions of p-AKT protein in the AKT and ER groups were significantly decreased than that in the E2 group (P < 0.05). The NF-κB activity was highest after stimulation with 1×10(-6) mol/L estradiol for 30 min to 1 h. AKT inhibitor significantly reduced the NF-κB activity (P < 0.05). The expressions of VEGF and bFGF mRNA and proteins in the E2 group were significantly increased than that in the control group (P < 0.05), and their expression in the AKT, ER and NF-κB groups were significantly decreased than that in the E2 group (P < 0.05). The proliferation and migration abilities of the Ishikawa cells were significantly increased after estradiol stimulation.

CONCLUSIONSEstradiol induces the production of VEGF and bFGF through activating NF-κB via AKT pathway, and enhances the proliferation and migration ability of cancer cells.

Cell Line, Tumor ; Cell Proliferation ; Endometrial Neoplasms ; Estradiol ; metabolism ; Female ; Humans ; NF-kappa B ; metabolism ; Neovascularization, Pathologic ; metabolism ; RNA, Messenger ; Signal Transduction

Objective To identify the effect of glucose regulating protein 75 expression in PC12 cells under glucose deprivation.Methods MTT method was used to monitor the cell viability.The leakage of LDH was represented as the index of cell injury.Flow cytometry was applied for cell cycle analysis,apoptosis and necrosis.Using RT-PCR detected and quantified mRNA.Western blot to measure relative amounts of the protein.Results Cell viability decreased and the LDH leakage increased.While the treated PC12 cells had two main forms of apoptosis and necrosis.GRP75 mRNA and protein levels were upregulated.Conclusion GRP75 has protective function during glucose deprivation.