Objective To investigate the effect of CXC chemokine ligand 5(CXCL5)on the growth of transplanted tumors of gastric cancer(GC)cells in mice via Wnt/β-catenin signaling path-way.Methods A total of 70 GC patients(GC group)and 70 healthy individuals(healthy group)were selected as study subjects.The serum CXCL5 levels in each group were detected,and the posi-tive rate of CXCL5 expression in GC tissues was determined using immunohistochemical staining.The relationship between CXCL5 expression and clinicopathological features was analyzed.Forty mice were divided into overexpressed CXCL5 group and control group,with 20 mice in each group.The mouse gastric cancer cell line MFC was used to establish a mouse transplanted tumor model by stable overexpression of CXCL5 and transfection with an empty vector.The growth of transplanted tumors and the survival conditions of mice in each group were recorded.The proportions of CD4+T lympho-cytes,CD8+T lymphocytes,and regulatory T cells(Treg cells)in the transplanted tumor tissues of mice were detected using flow cytometry.The expressions of CXCL5 and Wnt/β-catenin signaling pathway-related proteins in the transplanted tumor tissues of mice were detected using Western blot.The mRNA expressions of cyclin D1 and proto-oncogene c-Myc(c-Myc)in the transplanted tumor tissues of mice in each group were detected using reverse transcription-quantitative real time poly-merase chain reaction(RT-qPCR).Results The serum CXCL5 level in the GC group was higher than that in the healthy group,and the difference was statistically significant(P＜0.05).The posi-tive rate of CXCL5 expression in GC tissues was 67.14％(47/70),which was higher than 35.71％(25/70)in adjacent tissues,and the difference was statistically significant(P＜0.05).There were significant differences in tumor differentiation degree,TNM stage,and lymph node metastasis be-tween GC patients with positive and negative CXCL5 expressions(P＜0.05).The survival rate of mice in the overexpressed CXCL5 group was lower than that in the control group,and the difference was statistically significant(P=0.048).As time elapsed,the tumor volume of mice in the overex-pressed CXCL5 group was larger than that in the control group,and the difference was statistically significant(P＜0.05).The protein expressions of CXCL5,Wnt1,Wnt2,and β-catenin in the tumor tissues of mice in the overexpressed CXCL5 group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The proportions of CD4+T cells and CD8+T cells in the tumor tissues of mice in the overexpressed CXCL5 group were lower than those in the control group,while the proportion of Treg cells was higher than that in the control group,and the differences were statistically significant(P＜0.05).The mRNA expressions of Cyclin D1 and c-Myc in the tumor tissues of mice in the overexpressed CXCL5 group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion The ex-pression levels of CXCL5 in cancer tissues and serum of GC patients are upregulated.Abnormally high expression of CXCL5 may activate the Wnt/β-catenin signaling pathway,affect tumor immune activity,and promote the progression of GC.

Objective:To evaluate the classification of petroclival meningiomas(PCM), proposed selection of microsurgical approach and therapeutic outcomes.Methods:Retrospectively analyzed clinical data of 179 cases of PCM from Department of Neurosurgery, Xiangya Hospital, Central South University between January 2011 and November 2020. There were 28 males and 151 females with an age of(49.9±10.2) years(range: 22 to 75 years) and the tumor size of(44.8±10.3)mm(range: 15 to 80 mm). The mean duration of symptom ( M( Q R)) was 18.0(40.6)months(range:1 week to 320 months) and the mean preoperative Karnofsky performance scale(KPS) was 78.6±13.3(range: 40 to 100). The PCM were classified into 5 types according to the difference in the origin of dural attachment, involvement of adjacent structures and growth patterns through preoperative MRI. The surgical approaches were selected based on the proposed classification, and the clinical characteristics, surgical record, and follow-up data of each type were reviewed. Results:The PCM were divided into clivus type(CV, 4 cases), petroclival type(PC, 60 cases), petroclivosphenoidal type(PC-S, 62 cases), sphenopetroclival type with 2 subtypes(S-PC, 50 cases) and central skull base type(CSB, 3 cases). All of 176 cases were obtained microsurgical treatment except CSB type. The gross total resection reached in 124 cases(70.5%) with 112 cases of retrosigmoid approach(RSA), 27 cases of subtemporal transtentorial transpetrosal approach, 13 cases of pretemporal trancavernous anterior transpetrosal approach(PTCA), 12 cases of extended pterional transtentorial approach(EPTA) and presigmoid combined supra-infratentorial approach, respectively. The RSA could be adopted in both of CV type and PC type and most of PC-S type(71.0%). S-PC subtype Ⅰ and subtype Ⅱ were mainly underwent EPTA(40.8%) and PTCA(52.2%), respectively. Seventy-two cases(40.9%) gained new neurological dysfunctions mainly with the cranial nerve paralysis. The postoperative morbidity and complications were recovered or improved with conservative and positive symptomatic and supportive treatment. There was no intraoperative and postoperative death case. One hundred and sixty four cases(93.2%) of operative patients were followed with the duration of 24(48)months(range:3 to 108 months). Tumor recurrence and progress were identified in 14 cases(10.4%) and 14 cases(28.6%), respectively. Compared with postoperative neurological status, 89 patients(54.3%) had improved and 38 patients(23.2%) were still suffering various degrees of neurological dysfunctions during the follow-up. The recent KPS was 84.2±11.4(range: 50 to 100) without statistical difference from preoperative KPS ( t=-1.356, P=0.125). As for each type, there were statistically significant differences in brain stem edema (χ 2=3.482, P=0.038), gross total resection (χ 2=9.127, P=0.001), surgical duration( F=8.954, P=0.013), postoperative length of stay( F=3.652, P=0.025), postoperative complications (χ 2=1.550, P=0.024), postoperative KPS( F=2.856, P=0.042) and tumor recurrence/progress (χ 2=4.824, P=0.013). Conclusion:The precise and comprehensive classification of PCM and specific individual treatment strategy are benefit to evaluate the diverse clinical prognosis, choose optimal surgical approaches, elevate gross total resection, diminish neurological dysfunctions and restraint tumor recurrence, so as to improve the quality of life for patients.

Objective:To evaluate the classification of petroclival meningiomas(PCM), proposed selection of microsurgical approach and therapeutic outcomes.Methods:Retrospectively analyzed clinical data of 179 cases of PCM from Department of Neurosurgery, Xiangya Hospital, Central South University between January 2011 and November 2020. There were 28 males and 151 females with an age of(49.9±10.2) years(range: 22 to 75 years) and the tumor size of(44.8±10.3)mm(range: 15 to 80 mm). The mean duration of symptom ( M( Q R)) was 18.0(40.6)months(range:1 week to 320 months) and the mean preoperative Karnofsky performance scale(KPS) was 78.6±13.3(range: 40 to 100). The PCM were classified into 5 types according to the difference in the origin of dural attachment, involvement of adjacent structures and growth patterns through preoperative MRI. The surgical approaches were selected based on the proposed classification, and the clinical characteristics, surgical record, and follow-up data of each type were reviewed. Results:The PCM were divided into clivus type(CV, 4 cases), petroclival type(PC, 60 cases), petroclivosphenoidal type(PC-S, 62 cases), sphenopetroclival type with 2 subtypes(S-PC, 50 cases) and central skull base type(CSB, 3 cases). All of 176 cases were obtained microsurgical treatment except CSB type. The gross total resection reached in 124 cases(70.5%) with 112 cases of retrosigmoid approach(RSA), 27 cases of subtemporal transtentorial transpetrosal approach, 13 cases of pretemporal trancavernous anterior transpetrosal approach(PTCA), 12 cases of extended pterional transtentorial approach(EPTA) and presigmoid combined supra-infratentorial approach, respectively. The RSA could be adopted in both of CV type and PC type and most of PC-S type(71.0%). S-PC subtype Ⅰ and subtype Ⅱ were mainly underwent EPTA(40.8%) and PTCA(52.2%), respectively. Seventy-two cases(40.9%) gained new neurological dysfunctions mainly with the cranial nerve paralysis. The postoperative morbidity and complications were recovered or improved with conservative and positive symptomatic and supportive treatment. There was no intraoperative and postoperative death case. One hundred and sixty four cases(93.2%) of operative patients were followed with the duration of 24(48)months(range:3 to 108 months). Tumor recurrence and progress were identified in 14 cases(10.4%) and 14 cases(28.6%), respectively. Compared with postoperative neurological status, 89 patients(54.3%) had improved and 38 patients(23.2%) were still suffering various degrees of neurological dysfunctions during the follow-up. The recent KPS was 84.2±11.4(range: 50 to 100) without statistical difference from preoperative KPS ( t=-1.356, P=0.125). As for each type, there were statistically significant differences in brain stem edema (χ 2=3.482, P=0.038), gross total resection (χ 2=9.127, P=0.001), surgical duration( F=8.954, P=0.013), postoperative length of stay( F=3.652, P=0.025), postoperative complications (χ 2=1.550, P=0.024), postoperative KPS( F=2.856, P=0.042) and tumor recurrence/progress (χ 2=4.824, P=0.013). Conclusion:The precise and comprehensive classification of PCM and specific individual treatment strategy are benefit to evaluate the diverse clinical prognosis, choose optimal surgical approaches, elevate gross total resection, diminish neurological dysfunctions and restraint tumor recurrence, so as to improve the quality of life for patients.

To study the immunogenicity of EsxA protein of Staphylococcus aureus, the EsxA-pET-28a recombinant plasmid was constructed and the expression product was analyzed by SDS-PAGE and Western blotting after the positive recombinant plasmid was induced by IPTG. Mice were immunized with purified EsxA protein and then the IgG, IgG1 and IgG2a antibody were detected with indirect ELISA. Then the histopathological examination, bacteria loading and immune protection of immunized mice were studied after challenge with S. aureus. The recombinant protein EsxA was successfully induced and expressed. After immunization the EsxA specific antibody titer could reach 1:900. Bacteria loading and pathological damage of liver, spleen and kidney were reduced after immunization with EsxA in the immunized mice. The protection rate of immunized mice was 75%. In conclusion, EsxA protein has good immunogenicity.

Objective: To explore the effects of paracondylar-lateral cervical approach for resection of the jugular foramen schwannoma(JFS). Methods: A total of 15 patients with JFS operated via the paracondylar-lateral cervical approach between December 2011 and March 2016 at Department of Neurosurgery in Xiangya Hospital of Central South University were retrospectively analyzed. There were 7 males and 8 females, aging from 22 to 77 years with a mean age of (41.9±15.8) years.There were 12 patients who accepted primary surgery, 3 patients who accepted secondary surgery. There were 10 patients with tinnitus or hearing loss, 8 patients with dysphagia, 9 patients with hoarseness, 7 patients with tongue hemiparesis, 8 patients with ataxia, 1 patient with Pyramidal signs, 2 patients with facial hypesthesia or pain, 1 patient with facial paresis. According to Samii JFS grading system, 2 patients were type B, 4 were type C and 9 were type D. All patients were followed-up through outpatient and telephone by MRI in 3, 9, 12 months postoperation. Results: Gross total removal of tumors were achieved in 14 patients and subtotal removal in 1 patient. Two patients had new hoarseness, 2 had new dysphagia and 3 had more serious dysphagia, 1 patient had more serious facial paresis after the operation. There were 2 patients with intracranial infection, 2 with pneumonia, 1 with subcutaneous effusion, 1 with cerebrospinal fluid rhinorrhea, 5 with gastric intubation during perioperative period. There were no death, intracranial hematoma and decreased hearing patients. All patients were followed up, the follow-up time were 3 to 33 months with a mean of (26.9±11.2) months. Till to the latest follow up, dysphagia improved in 2 cases, hoarseness and tongue hemiparesis improved in 3 cases, hearing loss and tinnitus improved in 9 cases, balance function improved in 7 cases, facial hypesthesia and pain improved in 2 cases, pyramidal signs disappeared in 1 case, facial nerve function improved to normal in 1 case. There was no recurrence and progressed case. Conclusion Paracondylar-lateral cervical approach is an alternative approach for both intracranial and extracranial JFS.

Objective To explore the effect of psychological intervention on compliance and tolerance for the primary liver cancer patients who first performed TACE in the perioperative. Methods A total of 100 were randomly divided into control group and intervention group,which were respectively used routine nursing and psychological intervention.The anxiety and depression scores of patients in the perioperative period trough Self-Rating Depression scale (SDS)and Self-Rating Anxiety Scale (SAS)were assessed,and patients’nausea and vomiting symptoms,blood pressure and heart rate changes in operative period were recorded.Results SAS was lower in the intervention group,and nausea and vomiting symptoms alleviated significantly compared with the control group after operation.Intraoperative blood pressure and?heart rate was significantly lower than that of the control group(P <0.05).SDS was no significant difference between the two groups(P >0.05).Conclusion Psychological intervention and routine nursing can improve the treatment compliance and tolerance of patients with primary liver cancer.

Objective To explore the effect of psychological intervention on compliance and tolerance for the primary liver cancer patients who first performed TACE in the perioperative. Methods A total of 100 were randomly divided into control group and intervention group,which were respectively used routine nursing and psychological intervention.The anxiety and depression scores of patients in the perioperative period trough Self-Rating Depression scale (SDS)and Self-Rating Anxiety Scale (SAS)were assessed,and patients’nausea and vomiting symptoms,blood pressure and heart rate changes in operative period were recorded.Results SAS was lower in the intervention group,and nausea and vomiting symptoms alleviated significantly compared with the control group after operation.Intraoperative blood pressure and?heart rate was significantly lower than that of the control group(P <0.05).SDS was no significant difference between the two groups(P >0.05).Conclusion Psychological intervention and routine nursing can improve the treatment compliance and tolerance of patients with primary liver cancer.

Objective To explore the impact of 2009 International Federation of Gynecology and Obstetrics(FIGO)staging system alteration for stage Ⅰ endometrioid adenocarcinoma on its' prognosis assessing.Methods A retrospective study was carried out on 244 cases with endometrial carcinoma admitted in Peking University People's Hospital from Jan.1995 to Feb.2008.Results(1)All 244 patients were divided into FIGO 2009 Ⅰ a group(n =200)and FIGO 2009 Ⅰ b group(n =44)according to FIGO 2009 staging system,while they were divided into FIGO 1988 Ⅰ a group(n =34),FIGO 1988 Ⅰ b group(n =156)and FIGO 1988 Ⅰ c group(n =29).The others 25 cases were stage Ⅱ a(n =16)and stage Ⅲa with merely positive abdominal cytology(n =9)according to FIGO 1988 staging system.(2)The higher percentage of low-grade in FIGO 1988 Ⅰ a group than that in FIGO 2009 Ⅰ a group(P =0.003).Compared with FIGO 2009 Ⅰ a group,the age of the patients,surgery extent,the percentage of lymph node excision and received chemotherapy and radiotherapy,there were no difference in FIGO 1988 Ⅰ a and Ⅰ b group,respectively(P ＞ 0.05).There were 5.9％(2/34)and 6.7％(10/150)found relapse among FIGO 1988 Ⅰ a group and FIGO 1988 Ⅰ b group,and there were 2.9％(1/34)and 2.7％(4/150)for the two groups died of carcinoma.Compared with FIGO 2009 Ⅰ a group,there were not significant difference[7.5％(13/200)vs.3.0％(6/200);P ＞0.05].The 5 years and 10 years progression-free survival(PFS)of FIGO 1988 Ⅰ a group and Ⅰ b group were(97.0 ±3.0)％,(90.9 ±6.5)％ and(95.3 ±2.1)％,(90.2 ± 3.6)％,respectively,in which there were not significant difference compared with that in FIGO 2009 Ⅰ a group[(96.1 ±1.6)％,(89.6±3.2)％ ; P＞0.05].The 5 years and 10 years overall survival(OS)in FIGO 1988 Ⅰ a group and Ⅰ b group were 100％,(93.8 ±6.0)％ and(96.9 ± 1.8)％,(95.2 ±2.5)％,respectively,in which there were did not significant difference with that in FIGO 2009 Ⅰ a group [(97.9 ± 1.2)％,(93.4 ± 2.8)％ ; P ＞ 0.05].(3)There were not significant difference between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group(P ＞0.05)for the age of the patients,grade,surgery extent,lymph node excision,the percentage of received chemotherapy and radiotherapy.Between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group,there were 3.4％(1/29)and 6.8％(3/44)cases found relapse,respectively.And there were 0 and 2.3％(1/44)cases died of carcinoma in the two groups,in which there were not differ much either(P ＞ O.05).The 5 years and 10 years PFS in FIGO 1988 Ⅰ c group were all 100％,while they were 100％ and(90.9 ±6.2)％ in FIGO 2009 Ⅰ b group.The 5 years and 10 years OS in FIGO 1988 Ⅰ c group were all 100％,but were 100％ and(95.0 ±4.9)％ in FIGO 2009 Ⅰ b group,in which they all did not significantly differ much(P ＞ 0.05).(4)The patients in FIGO 2009 Ⅰ a group were younger than those in FIGO 2009 Ⅰ b group(P ＜ 0.01).The percentage of low grade in FIGO 2009 Ⅰ a group were higher than that in FIGO 2009 Ⅰ b group(P =0.029).The percentages of received chemotherapy and radiotherapy in FIGO 2009 Ⅰ a group were lower than that in FIGO 2009 Ⅰ b group remarkably(P ＜ 0.01).But there were not significant difference in the uterine excision extent and the percentage of lymph node excision between the two groups(P ＞ 0.05).There were not significantly differ in the relapse rates and the death rates between the FIGO 2009 Ⅰ a group and FIGO 2009 Ⅰ b group(P ＞0.05).There were also not significant difference in PFS and OS between the two groups(P ＞0.05).Conclusions There were not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 1988 stage Ⅰ a and Ⅰ b.There were also not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 2009 stage Ⅰ b,which may be due to received more chemotherapy and radiotherapy in FIGO 2009 stage Ⅰ b patients.

Objective To explore the lymph nodes (LN) metastasis characters of the endometrial carcinoma and its relation with the patients' prognosis. Methods A retrospective study was carried out on 227 cases of endometrial carcinoma who admitted to our department and underwent LN excision from Jul. 2000 to Feb. 2008. Results Among 227 cases who underwent pelvic LN excision, there were 22 cases (9.7%) presented LN metastasis. There were 12 cases with positive external iliac LN from 20 cases of patients with data in LN grouping. Para-aortic LN excision was carried out on 138 patients. There were 6 cases with positive para-aortic LN, 5 cases of them together with pelvic LN metastasis. Those patients with cervix involvement, annex metastasis, deep myometrium infiltration, grade 2-3 and negative estrogen receptor occurred pelvic LN metastasis more frequently than the others ( P ＜ 0. 05 ). Among the 6 cases with positive para-aortic LN, there were 3 cases ( 3/6) with deep myometrium infiltration. For those whose paraaortic LN was negative, it was only 16. 7% (22 cases). But there were no difference statistically between them ( P＞ 0. 05 ). There were significant difference in 3 years disease-free survival rate between patients with positive pelvic LN or negative pelvic LN [(81. 8 ± 8. 2)% vs ( 97. 4 ± 1. 2 ) % , P = 0. 004]. While there were not significant difference in 3 years disease-free survival rate between patients with positive para-aortic LN or negative para-aortic LN [100% vs ( 96. 7 ± 1. 6) % , P ＞ 0. 05]. Single factor analysis showed that the age more than 50 years, annex metastasis and pelvic LN metastasis related with the recurrence (P ＜0. 01). But cervix involvement, deep myometrium infiltration, para-aortic LN metastasis, pathology type, tumor grade and estrogen receptor did not relate with the recurrence ( P ＞ 0. 05 ). Cox regression analysis showed that annex metastasis and the age of patients were independent risk factors affecting the recurrence ( P = 0. 011, P = 0. 025 ). Conclusions The most common site of pelvic LN metastasis is the external iliac LN for endometrial carcinoma patients. The patients with positive para-aortic LN always accompanied pelvic LN metastasis. Those patients with cervical involvement, annex metastasis, deep myometrium infiltration, poor differentiation and negative estrogen receptor be more likely exist pelvic LN metastasis. Pelvic LN metastasis may affect the prognosis of endometrial carcinoma patients.

ObjectiveTo explore the effects of hyperbaric oxygen (HBO) on severe brain injury. Methods60 patients with severe brain injury were divided into control group and treatment group. They were treated with neurosurgical conventional therapy, and HBO for treatment group in addition. They were assessed with Glasgow Coma Scale (GCS) before and after treatment, and Glasgow Outcome Scale (GOS) 3 and 6 months after treatment. ResultsCompared with control group, there is significant improvement in GCS (P<0.05) and GOS (P<0.05) in treatment group. ConclusionHBO has immediate and long-term efficiency on severe brain injury.