眼眶转移癌18例临床分析

目的 探讨眼眶转移癌临床表现、原发癌肿部位、治疗转归等特点.方法 回顾性分析2003年7月至2012年12月于我院神经外科住院,经手术和病理明确诊断的,肿瘤达眶尖或累及邻近颅内结构,需行开颅术式进行治疗的18例眼眶转移癌患者,总结其临床表现特点、原发肿瘤部位及治疗效果.结果 18例眼眶转移癌患者均接受外科手术治疗.其中原发癌来自肝癌者4例,肺癌者3例,乳腺癌者2例,肾癌者2例,胃癌者2例,结肠癌、鼻咽癌、甲状腺癌、黑色素瘤及多发性骨髓瘤者各1例.主要临床表现为视力下降、眼球突出、疼痛、眼动障碍等.手术治疗后患者疼痛、眼球突出症状有一定程度缓解.结论 眼眶转移癌发病率低,难以早期诊断;临床中需注意仔细查找原发病灶,并在病史、临床表现、影像学特点等方面与其他眼眶肿瘤进行鉴别,便于准确诊断及选择积极合理治疗方式;该病总体预后差,手术目的为明确诊断、减轻肿瘤负荷、缓解症状,延长患者生命、改善其生存质量.     

个性化血管内治疗椎动脉瘤分析

目的回顾性分析63例椎动脉瘤的个性化治疗经验。方法本组2000—2011年共收治63例患者(均已经DSA证实,共65个椎动脉瘤)为分析对象,其中41例伴瘤颈和载瘤血管闭塞的椎动脉瘤患者置入弹簧圈;12例未破裂的椎动脉瘤患者或对侧椎动脉发育不全的动脉瘤患者置入支架和弹簧圈;10例未破裂的VA-PICA动脉瘤患者或对侧椎动脉发育不全破裂的VA-PICA动脉瘤患者,单独行支架置入。运用改良Rankin量表(mRS)对临床结果进行评分。结果 63例中5例(7.9%)患者在30d的治疗过程中出现恶化,且导致其中3例患者死亡;57例(90.5%)患者,实现独立活动(mRS 0～2级);63例患者中44例(69.8%)进行血管造影随访,其中39例(88.6%)可确诊完全或基本完全的血栓形成,3例患者观察到病灶轻微减小,2例(4.5%)患者存在显著的残留病灶。结论椎动脉动脉瘤病人的个性化血管内治疗长期效果良好。     

脑白质疏松症相关危险因素分析

目的探讨LA发病的危险因素,为临床干预提供更多证据支持。方法根据磁共振检查结果,将128例患者分为无LA组和LA组,收集相关危险因素,通过单因素分析及多因素Logistic回归比较2组危险因素分布差异。结果单因素分析提示,2组年龄、吸烟史、饮酒史、高血压史、低密度脂蛋白(LDL)、血纤维蛋白原(FIB)、同型半胱氨酸(HCY)比较差异有统计学意义(P<0.05),FIB、HCY越高,LA分级程度越高(P值分别为0.006、0.000)。多因素Logistic回归表明,年龄、吸烟史、高血压、FIB与LA发病相关。结论年龄、吸烟史、高血压、高FIB血症为LA发病的危险因素。     

Pretreatment with scutellaria baicalensis stem-leaf total flavonoid prevents cerebral ischemia- reperfusion injury

Pretreatment with scutellaria baicalensis stem-leaf total flavonoid has protective effects against ischemia and attenuates myocardial ischemia-reperfusion injury. In this study, rats were given scutellaria baicalensis stem-leaf total flavonoid intragastrically at 50, 100, and 200 mg/kg per day for 7 days before focal cerebral ischemia-reperfusion injury models were established using the suture method. We then determined the protective effects of scutellaria baicalensis stem-leaf total flavon- oid pretreatment on focal cerebral ischemia-reperfusion injury. Results showed that neurological deficit scores increased, infarct volumes enlarged, apoptosis increased and Bcl-2 and Bax protein expression were upregulated at 24 hours after reperfusion. Pretreatment with scutellaria baicalensis stem-leaf total flavonoid at any dose lowered the neurological deficit scores, reduced the infarct volume, prevented apoptosis in hippocampal cells, attenuated neuronal and blood-brain barrier damage and upregulated Bcl-2 protein expression but inhibited Bax protein expression. Doses of 100 and 200 mg/kg were the most efficacious. Our findings indicate that pretreatment with scutel- laria baicalensis stem-leaf total flavonoid at 100 and 200 mg/kg can improve the neurological func- tions and have preventive and protective roles after focal cerebral ischemia-reperfusion injury.     

Systematic screen with kinases inhibitors reveals kinases play distinct roles in growth of osteoprogenitor cells

Cancer treatment-related bone loss has become growing problematic, especially in breast and prostate cancer treated with hormone/endocrine therapy, chemotherapy and radiotherapy. However, bone loss caused by targeted therapy in cancer patients is largely unknown yet. In present study, a kinase inhibitors screen was applied for MC3T3-E1, a murine osteoprogenitor cell line, and seven kinase inhibitors (GSK1838705A, PF-04691502, Dasatinib, Masitinib, GDC-0941, XL880 and Everolimus) were found to suppress the cell viability with dose- and time-dependent manner. The most interesting is that many kinase inhibitors (such as lapatinib, erlotinib and sunitinib) can promote MC3T3-E1 cell proliferation at 0.01 μM. 4 out of 7 inhibitors were selected to perform the functional study and found that they lead to cell cycle dysregulation, treatments of PF-04691502 (AKT inhibitor), Dasatinib (Src inhibitor) and Everolimus (mTOR inhibitor) lead to G1 arrest of MC3T3-E1 cells via downregulation of cyclin D1 and p-AKT, whereas XL880 (MET and VEGFR inhibitor) treatment results in increase of sub-G1 and G2/M phase by upregulation of p53 protein. Our work provides important indications for the comprehensive care of cancer patients treated with some targeted drugs.