Objective To analyze the effect of clinical application of ultrasound in microsurgical treatment of intramedullary tumors in the superior cervical spinal cord.Methods Retrospective study the clinical data of 15 patients with intramedullary tumors in the superior cervical spinal cord,which were underwent a laminectomy for microsurgical tumor resection during January,2014 and January,2018.Intraoperative ultrasound and neuromonitoring was accompanied by the whole surgical procedure for each case.The follow-up data was collected by outpatient department visits and telephone interviews.Results All the described patients were performed with microscopic tumor resection by using intraoperative neurophysiological monitoring and ultrasound.The pathological diagnosis was ependymocytoma (n=8) and astrocytoma (n=7).Gross total resections comprised 86.7％ of cases (n=13),and subtotal resections 13.3％ (n=2).The neurological outcome was as follows:Mc-Cormick scale grade Ⅰ,10 patients;grade Ⅱ,3 patients;grade Ⅲ,1 patient;and grade Ⅳ 1 patient;Follow-up was applied for (19.2±7.6) months in 13 cases and 12.0 months in 2 cases.Compared to the preoperative period,66.6％ of patients recovered postoperatively,20.0％ improved,6.7％ remained without deficit and deterioration persisted in 6.7％.Conclusion The microscopic resection of tumors is the effective way to cure this disease.By using intraoperative neurophysiological monitoring and ultrasound,the complete tumor resection and the minimal spinal cord injury were certainly achieved.

Objective To study the mechanisms by which IL-4 inhibits formation of nod-like receptor protein 3 (NLRP3) inflammasome mediated by high mobility group box-1 (HMGB1) in microglia.Methods After the primary microglia were cultured at the gradient concentrations of HMGB1 (100,200 and 400 ng/mL) for 3 hours and extracted,the effects of HMGB1 on the NLRP3 inflammasome and on the expression of downstream transcription factor NF-κB were detected by immunofluorescence and Western Blotting.Meanwhile,BAY 11-7082,an NF-κB inhibitor,and IL-4 were added in HMGB1 to observe the changes in the NLRP3 inflammasome and NF-κB expression.Results HMGB1 significantly promoted the formation and expression of NLRP3 inflammasome components like NLRP3,ASC and Caspase-1 in microglia in a concentration-dependent manner (P＜0.05).This effect was inhibited by BAY 11-7082.The levels of relative protein expression of NLRP3,ASC and Caspase-1 in the group of 400 ng/mL HMGB1+BAY were significantly lower than in the group of 400 ng/mL HMGB1 (P＜0.05).At the same time,IL-4 significantly decreased the formation of NLRP3 inflammasome induced by HMGB1.The levels of relative protein expression of NLRP3,ASC and Caspase-1 in the group of 400 ng/mL HMGB1+IL-4 were significantly lower than in the group of 400 ng/mL HMGB1 (P＜0.05).Further finding demonstrated that IL-4 inhibited the activity of NF-κB in microglia.Conclusions HMGB1 may promote formation ofNLRP3 inflammasome via activating the NF-κB in microglia;IL-4 may inhibit formation ofNLRP3 inflammasome mediated by HMGB1 through negative regulation of NF-κB activity.

Objective To investigate the hemorrhagic factors affecting the prognosis of patients with intracranial arteriovenous malformations (AVM)treated by microsurgery. Methods From January 2012 to March 2017,62 consecutive patients with hemorrhagic AVM who met the inclusion criteria and treated with microsurgery in the same vascular group at the Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were enrolled retrospectively. The patients were divided into either a good prognosis group (n =48,mRS≤2)or a poor prognosis group (n =14,mRS >2)according to the modified Rankin scale (mRS)scores during the follow up at 6 months after the operation. The general information of the patients were collected,including gender,age,history of primary hypertension, history of previous cerebral hemorrhage,Glasgow Coma Scale (GCS)score on admission,AVM location,size of AVM,type of AVM venous drainage,Spetzler-Martin grade,combined aneurysm,combined intraventricular hemorrhage,site of hemorrhage,and volume of hemorrhage. Univariate analysis and multivariate logistic regression analysis were used to analyze the hemorrhage-related factors affecting the prognosis of hemorrhagic AVM operation. Results (1)There were no significant differences in gender,age,history of primary hypertension,history of cerebral hemorrhage between the two groups (all P > 0. 05),and there was significant difference in GCS on admission (P < 0. 05). (2)Compared with the the good prognosis group,there were significant differences in functional area AVM (33. 3% [16 /48]vs. 12 /14),Spetzler- Martin grade ≤Ⅱ (85. 4% [41 /48]vs. 6 /14),volume of hemorrhage ≥30 ml (10. 4% [5 /48]vs. 8 /14), and intraventricular hemorrhage (8. 3% [4 /48]vs. 7 /14)in the poor prognosis group (all P < 0. 05). There were no significant difference in the AVM volume,type of venous drainage,combined aneurysm,and bleeding site between the two groups (all P >0. 05). (3)Multivariate logistic regression analysis was used to analyze the independent variables related to bleeding in univariate analysis,the results showed that intraventricular hemorrhage (OR,11. 000,95% CI 1. 722 -46. 231,P =0. 009)and volume of hemorrhage ≥30 ml (OR,11. 467,95% CI 2. 029 -44. 894,P = 0. 004)were the independent risk factors for poor prognosis. Conclusion The intraventricular hemorrhage and volume of hemorrhage ≥30 ml may be the independent risk factors affecting prognosis of patients of hemorrhagic AVM surgery,however,further validation is needed.

Objective To analyze factors influencing short-term effect of presurgical pharmacological thera-py and transsphenoidal microsurgery for somatotropinomas. Methods The clinical data of 53 patients underwent presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas were retrospectively analyzed in order to search for factors influencing effect of presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas. Results Serum GH inhibition rates decreased<50.00%from baseline in 62.26%of patients receiving presurgical pharmacological therapy. Statistical analysis concerning the influence of sex , neuropathological evaluation, tumor size and presence of invasion on presurgical pharmacological therapy effect were performed using a chi-squared test, no significant correlation was found among these factors and presurgical pharmacological therapy effect. Total remission rates were 43.40%, Statistical analysis concerning the influence of sex , neuropathological e valuation, tumor size, presence of invasion and presurgical pharmacological therapy effect on remission rate were performed using a chi-squared test, a significant correlation was found among tumor size, presence of invasion, presurgical pharmacological therapy effect and remission rate , while no significant correlation was found among the rest of the factors. Further Logistic regression analysis demonstrated a significant correlation among tumor size , presence of invasion and remission rate , while no significant correlation was found between presurgical pharmacolog-ical therapy effect and remission rate. Conclusions Presurgical pharmacological therapy effect revealed no signifi-cant correlation with sex, neuropathological evaluation, tumor size or presence of invasion. Total remission rate cor-related with tumor size and presence of invasion. A better presurgical pharmacological therapy effect may indicated a better outcome, while postoperative remission rate revealed no significant correlation with presurgical pharmacologi-cal therapy in our series.

Objective To evaluate quality of life in elderly patients treated with iodine-125 radioactive seed implantation for head and neck cancer.Methods From 2005 to 2011,40 elderly patients (≥ 65 years old)with head and neck cancer were treated with brachytherapy of 125I seed implantation alone (without radiation therapy history)and evaluated with QOL-RTI questionnaire for QOL.QOL of them were evaluated and relative factors were analyzed.Results QOL of these patients treated with 125 I-brachytherapy alone was satisfied.QOL in patients with the base tongue cancer was worse than that in others.Age had a significant effect on function/physical QOL and general QOL,but had no significant effect on emotional QOL and socioeconomic QOL.QOL of patients with early stage cancers were better than those with late stage cancers.Pathology,numbers of 125I seeds implanted,and time-period after brachytherapy had no significant effect on QOL.Conclusions QOL of elderly patients with head and neck cancer treated with125 I-BT is good.Tumor volume and clinical staging have significant effects on QOL.

Little is known about whether tamoxifen (TAM) can affect resting state microglia apoptosis and about the cellular mechanism that may account for this. To explore this question, we incubated the microglia cell line BV-2 cells with TAM at different concentrations. Cell viability was assessed by the MTT assay, and flow cytometric analysis was performed to detect the cell apoptosis rate. Furthermore, mitochondrial membrane potential (Δψm) was tested by flow cytometry, and Bax, Bcl-2, Fas, and Fas-L expression was detected by Western blot. The results demonstrated that TAM decreased cell viability and induced apoptosis of BV-2 cells in a concentration- and time-dependent manner. In addition, disruption of Δψm was followed by up-regulated expression of pro-apoptotic Bax, Fas and Fas-L, and down-regulated expression of anti-apoptotic Bcl-2. These results indicate that TAM may induce apoptosis of BV-2 cells through both mitochondria- and death receptor-mediated pathways.

The effects of RNAi-mediated gene silencing of LRlG1 on proliferation and invasion of the human glioma cell line U251-MG and the possible mechanisms were explored in this study. The plasmids pGenesil2-LRIG1-shRNA1 and pGenesil2-LRIG1-shRNA2 were transfected into U251-MG glioma cells respectively by using Lipofectamine 2000 and the transfected cells in which the LRIG1 expression was stably suppressed were selected by G418. The cells transfected with negative shRNA served as control. The expression levels of LRIG1 mRNA and protein were measured by qRT-PCR and Western blotting, respectively. The cell cycle was analyzed by flow cytometry. The results showed that LRIG1 mRNA expression was reduced by 70% and 58% and LRIG1 protein expression by 58% and 26% in U251-MG cells transfected with pGenesil2-LRIG1-shRNAl and pGenesil2-LRIG1-shRNA2 relative to the negative shRNA-transfected U251-MG cells. The proliferative capacity of the LRIG1 specific siRNA-transfected cells was stronger than that of control cells. Cell cycle analysis showed that silencing LRIG1 significantly increased the percentage of S phase cells and the proliferation index (P<0.01). Moreover, silencing LRIG1 could promote the invasion of U251-MG cells (P<0.05). These findings suggested that LRIG1-targeting siRNA can exert a dramatically inhibitory effect on RNA transcription and protein expression of LRIG1, and LRIG1 down-regulation could promote the proliferation of U251-MG cells, arrest U251-MG cells in S phase, and enhance the invasion of U251-MG cells.

Little is known about whether tamoxifen (TAM) can affect resting state microglia apoptosis and about the cellular mechanism that may account for this.To explore this question,we incubated the microglia cell line BV-2 cells with TAM at different concentrations.Cell viability was assessed by the MTT assay,and flow cytometric analysis was performed to detect the cell apoptosis rate.Furthermore,mitochondrial membrane potential (△ψm) was tested by flow cytometry,and Bax,Bcl-2,Fas,and Fas-L expression was detected by Western blot.The results demonstrated that TAM decreased cell viability and induced apoptosis of BV-2 cells in a concentration- and time-dependent manner.In addition,disruption of Δψm was followed by up-regulated expression of pro-apoptotic Bax,Fas and Fas-L,and down-regulated expression of anti-apoptotic Bcl-2.These results indicate that TAM may induce apoptosis of BV-2 cells through both mitochondria- and death receptor-mediated pathways.

The effects of RNAi-mediated gene silencing of LRIG1 on proliferation and invasion of the human glioma cell line U251-MG and the possible mechanisms were explored in this study.The plasmids pGenesi12-LRIG1-shRNA1 and pGenesi12-LRIGl-shRNA2 were transfected into U251-MG glioma cells respectively by using Lipofectamine 2000 and the transfected cells in which the LRIGI expression was stably suppressed were selected by G418.The cells transfected with negative shRNA served as control.The expression levels of LRIG1 mRNA and protein were measured by qRT-PCR and Western blotting,respectively.The cell cycle was analyzed by flow cytometry.The results showed that LRIG1 mRNA expression was reduced by 70％ and 58％ and LRIG1 protein expression by 58％ and 26％ in U251-MG cells transfected with pGenesil2-LRIGl-shRNAl and pGenesil2-LRIG1-shRNA2 relative to the negative shRNA-transfected U251-MG cells.The proliferative capacity of the LRIG1 specific siRNA-transfected cells was stronger than that of control cells.Cell cycle analysis showed that silencing LRIG 1 significantly increased the percentage of S phase cells and the proliferation index (P＜0.01).Moreover,silencing LRIG1 could promote the invasion of U251-MG cells (P＜0.05).These findings suggested that LRIG1-targeting siRNA can exert a dramatically inhibitory effect on RNA transcription and protein expression of LRIG1,and LRIG1down-regulation could promote the proliferation of U251-MG cells,arrest U251-MG cells in S phase,and enhance the invasion of U251-MG cells.

The Leucine-rich repeats and immunoglobulin-like domains-2 (LRIG2) gene expression in pituitary adenoma and its correlation with tumor invasiveness were studied. The expression of LRIG2 mRNA and protein in human pituitary adenoma obtained surgically was detected by RT-PCR (39 cases) and immunohistochemical staining (30 cases). It was found that LRIG2 was mostly localized at the nucleus of the pituitary adenoma cells. Its expression was significantly higher in the invasive cases than in the non-invasive cases. LRIG2 protein was positive in 14 cases out of 21 cases of invasive adenoma, but only 2 cases were positive in 9 cases of non-invasive adenoma. The positive expression rate of LRIG2 mRNA was 91.3% in invasive cases (total 23 cases) and 62.5% in non-invasive cases (total 16 cases), respectively. LRIG2 gene is overexpressed in invasive pituitary adenoma. It may play an important role in pituitary adenoma invasiveness and further studies are necessary to elucidate the mechanism under this phenomenon.