Advanced technologies applied to physiopathological analysis of central nervous system aneurysms and vascular malformations

While depiction and definition of morphological and architectural characteristics of CNS vascular disorders remains the first step of an MR analysis, emerging imaging techniques offer new functional information that might help to characterize rupture risk of CNS vascular disorders. Two main orientations are suggested by recent studies: inflammation of the vessel wall and analysis of physical constraints of blood flow using 4D flow imaging (shear parietal). This paper will focus on radiological application of 4D flow imaging and inflammation imaging, in the characterization of potential prognostic markers of CNS vascular disorders. We will review the basic technical considerations of 4D flow MRA, inflammation imaging and discuss their applications in CNS vascular disorders: aneurysms, arteriovenous malformation, dural arteriovenous fistulas. We will illustrate their potential in the development of individual rupture risk criteria in brain vascular disorders.     

Growth hormone treatment and risk of recurrence or development of secondary neoplasms in survivors of pediatric brain tumors

Growth hormone (GH) is increasingly used for treatment of pediatric brain tumors. However, controversy remains over its safety. This meta-analysis assessed whether GH treatment was associated with risk of recurrence or development of secondary neoplasm for brain tumors in children. Systematic computerized searches of PubMed and Web of Knowledge were performed. Pooled relative risks (RR) with 95% confidence interval (CI) for recurrence and/or secondary neoplasm in children who were treated with GH versus those who did not receive GH were calculated. Ten studies were included. The pooled recurrence rates were 21.0% and 44.3% in the GH-treated group and non-GH-treated group, respectively. The pooled RR for recurrence was 0.470 (95% CI 0.372–0.593; z = 6.33, p = 0.000). Begg’s test (p = 0.060) and Egger’s test (p = 0.089) suggested there was no significant publication bias. The pooled RR in sensitivity analysis was 0.54 (95% CI 0.37–0.77; z = 3.32, p = 0.001), which showed the result was robust. The pooled RR for secondary neoplasm was 1.838 (95% CI 1.053–3.209; z = 2.14, p = 0.032). Begg’s test (p = 1.000) and Egger’s test (p = 0.553) suggested there was no significant publication bias. We found no evidence that GH therapy is associated with an increased risk of recurrence for pediatric brain tumors. However, because of our small sample size, the association of GH therapy with an increased risk of secondary neoplasm is uncertain. Further prospective cohorts are needed.     

康莱特注射液＋胸腺法新＋分子靶向药物联合立体定向放疗治疗脑转移瘤23例

目的评价康莱特注射液＋胸腺法新＋分子靶向药物联合立体定向放疗治疗脑转移瘤的临床疗效。方法将已有明确病理诊断的原发灶癌，经复查头颅CT或磁共振或PET／CT确诊为脑转移瘤的46例患者随机分为治疗组和对照组各23例，其中原发灶癌手术切除术后32例，不能手术或患者拒绝手术14例，每组手术切除术后和没有手术的患者分别为16例、7例。对照组采用全脑放射治疗，治疗组采用立体定向放疗，同时给予康莱特注射液＋胸腺法新（基泰）＋吉非替尼（gefitinib）。结果治疗组总有效率82．61％，对照组为26．09％，二组比较，差异有统计学意义（P〈0．05）。治疗组放疗后头痛症状明显改善，恶心、呕吐反应较轻，KPS评分增加，较对照组比较，差异均有统计学意义（P〈0．05）。结论康莱特注射液＋胸腺法新＋吉非替尼联合立体定向放疗治疗脑转移瘤能明显改善患者的临床症状，降低副作用，提高肿瘤患者的生活质量。     

龈沟液瘦素与牙齿移动的相关性研究

目的:探讨龈沟液瘦素在牙齿移动过程中的作用.方法:随机选择需拔除上颌第一前磨牙的正畸患者16名作为实验组,10名非正畸患者作为对照组,采集实验组在放置矫治器前、加力后第1小时、第3、7、14、21和28天时,对照组在首次采集、首次采集后第1小时、第3、7、14、21及28天时,上颌尖牙远中侧的龈沟液,测量尖牙与第2前磨牙距离,采用ELISA法检测龈沟液中瘦素的含量.结果:2组患者龈沟液量在实验前后的差异无统计学意义(P＞0.05);实验组尖牙与第2前磨牙的间距减小(第3、7、14、21、28天),与对照组比较差异具有统计学意义(P＜0.05);2组龈沟液的瘦素含量比较,差异无统计学意义(P＞0.05),但实验组瘦素含量具有先降低后回升的变化趋势.结论:龈沟液瘦素含量在牙齿移动时波动,提示瘦素可能是牙齿移动的调节因子之一.     

类风湿关节炎患者肺泡灌洗液检测结果分析

目的通过对类风湿关节炎（RA）患者进行高分辨CT（HRCT）和肺泡灌洗液检测（BLAF）,探讨诊断类风湿肺间质病变的有效方法。方法选择RA患者31例,进行高分辨CT、肺泡灌洗液检测。结果 31例患者中,HRCT检测发现肺间质病变1例（阳性率为3.2%）,BLAF检测发现肺间质病变4例（阳性率为12.9%）;BLAF的肺间质病变阳性检出率高于HRCT,但差异无统计学意义（χ2=1.957 9,P〉0.05）。结论 BLAF是探询早期发现及明确类风湿性关节炎引发呼吸系统损害的更为有效的检查方法,比HRCT能更好地明确肺间质病变病变的病理类型,有助于治疗方案的制定。     

Effects of lithium and aripiprazole on brain stimulation reward and neuroplasticity markers in the limbic forebrain

Bipolar disorder (BD) is a severe pathological condition with impaired reward-related processing. The present study was designed to assess the effects of two commonly used BD medications, the mood stabilizer lithium chloride (LiCl) and the atypical antipsychotic and antimanic agent aripiprazole, in an animal model of reward and motivation and on markers of neuroplasticity in the limbic forebrain in rats. We utilized intracranial self-simulation (ICSS) to assess the effects of acute and chronic administration of LiCl and aripiprazole on brain stimulation reward, and phosphorylation studies to determine their effects on specific cellular neuroplasticity markers, i.e., the phosphorylation of CREB and crucial phosphorylation sites on the GluA1 subunit of AMPA receptors and the NA1 and NA2B subunits of NMDA receptors, in the limbic forebrain. Chronic LiCl induced tolerance to the anhedonic effect of the drug observed after acute administration, while chronic aripiprazole induced a sustained anhedonic effect. These distinct behavioral responses might be related to differences in molecular markers of neuroplasticity. Accordingly, we demonstrated that chronic LiCl, but not aripiprazole, decreased phosphorylation of CREB at the Ser133 site and NA1 at the Ser896 site in the prefrontal cortex and GluA1 at the Ser831 site and NA2B at the Ser1303 site in the ventral striatum. The present study provides evidence for BD medication-evoked changes in reward and motivation processes and in specific markers of neuronal plasticity in the limbic forebrain, promoting the notion that these drugs may blunt dysregulated reward processes in BD by counteracting neuronal plasticity deficits.