Clinical features and management of intracranial subependymomas in children

Subependymoma is a rare low-grade glioma of the central nervous system that occurs most commonly in middle-aged and elderly men and rarely in children. Only a few paediatric patients with subependymomas have been reported. The authors retrospectively analysed five paediatric patients (4 males and 1 female; mean age 8.6 years; age range 5–13 years) at a single institute from July 1998 to April 2009 and summarised the clinical characteristics and management of paediatric intracranial subependymoma. The most common symptom in these five paediatric patients with subependymoma was intracranial hypertension. The tumours were located in the fourth ventricle in two patients, in the fourth ventricle with extension to the cerebellopontine angle (CPA) in one patient; in the right CPA exclusively in one patient, and intraparenchymally in the left parietal lobe in one patient, the latter two of which are rare locations for subependymoma. Surgery was performed on all five patients. The surgical approach was selected as appropriate for the tumor location. Total resection was achieved in three patients, and subtotal resection in two. All five patients had good outcomes without recurrence. We conclude that surgery is the optimal therapy for paediatric patients with intracranial subependymoma.     

无框架机器人引导立体定向核团毁损手术治疗帕金森病的疗效分析

目的应用无框架脑立体定向仪（CAS-R-2型）进行机器人引导立体定向毁损术治疗帕金森病（PD）,观察其临床疗效。方法对2001年11月至2006年10月间,海军总医院神经外科行机器人引导立体定向单侧核团毁损术治疗帕金森病56例患者的临床及随访资料进行分析,取得术前及术后6个月、1年、3年、5年的帕金森病国际统一评定量表（uPDRS）的评分,并比较它们之间的差异。结果手术结果与术前相比,均有显著性差异（￡检验,P〈0．05）;术后6个月、1年、3年,“开”、“关”期UPDRS评分的改善率明显比术后5年高。结论核团毁损术治疗PD术后疗效肯定,但呈逐渐减退趋势,术后5年的改善率明显降低。机器人系统具有减轻患者痛苦、方便术者操作、提高手术安全性的优势。     

Synergistic lignin construction of a long-chain branched polypropylene and its properties

In light of current environmental pressures (referring to its destruction) and the consumption of petrochemical resources, the substitution of chemicals products with renewable natural substances has attracted extensive interest. In this paper, a synergistically constructed lignin polypropylene matrix composite with long-chain branched characteristics was prepared by a pre-irradiation and melt blending method. The effects of lignin on the crystallization, rheological behavior, foaming and aging properties of polypropylene were studied. Differential scanning calorimetry and polarized light microscopy results show that lignin undergoes heterophasic nucleation in a polypropylene matrix; rheological studies show that lignin promotes the formation of a heterogeneous polypropylene network, and thus polypropylene exhibits long-chain branching features; nucleation and a network structure endow the polypropylene-based composites with uniform cell size, thin cell walls, and a foaming ratio of 5–44 times; at the same time, a large number of hindered phenols in lignin can capture free radicals to improve the aging properties of the polypropylene. This research will help to convert industrial waste into functional composite materials.

Polypropylene with long chain branching behavior was constructed by lignin, which foaming property and polarity were improved.     

MicroRNA-367-3p overexpression represses the proliferation and invasion of cervical cancer cells through downregulation of SPAG5-mediated Wnt/β-catenin signalling

MicroRNA-367-3p (miR-367-3p) has been previously reported as a cancer-related miRNA that is dysregulated in various cancer types and functions either as an oncogenic or as tumour suppressive miRNA. However, whether miR-367-3p is dysregulated in cervical cancer and, further, whether it contributes to the development and progression of the disease remains unknown. Here, our results demonstrated that miR-367-3p expression was markedly decreased in both cervical cancer tissues and cell lines compared with corresponding controls. In vitro experiments revealed that miR-367-3p overexpression repressed the proliferation and invasion of cervical cancer cells. Notably, sperm-associated antigen 5 (SPAG5) was identified as a target gene of miR-367-3p. Moreover, decreased expression of miR-367-3p was correlated with high expression of SPAG5 in cervical cancer tissue specimens. SPAG5 inhibition or miR-367-3p overexpression significantly downregulated Wnt/β-catenin signalling in cervical cancer cells. However, the antitumour effect mediated by miR-367-3p overexpression was partially reversed by SPAG5 overexpression. Overall, these findings demonstrate that miR-367-3p overexpression restricts the proliferation and invasion of cervical cancer cells through targeting SPAG5 to downregulate Wnt/β-catenin signalling, suggesting a mechanism for the tumour suppressive function of miR-367-3p in cervical cancer. Our study highlights the involvement of miR-367-3p/SPAG5/Wnt/β-catenin signalling axis in regulating the malignant progression of cervical cancer.     

Intraocular tumour necrosis factor ligand related molecule 1 A links disease progression of proliferative diabetic retinopathy after primary vitrectomy

Tumour necrosis factor ligand related molecule 1 A (TL1A), a member of tumour necrosis factor superfamily, has been identified as a crucial regulator for vascular homeostasis and inflammation. However, the function of TL1A in diabetic retinopathy (DR) is largely unknown. This study aims to examine levels of TL1A in serum and intraocular fluid in patients with proliferative diabetic retinopathy (PDR), and to explore the correlation of intraocular TL1A with the prognosis of PDR progression after primary vitrectomy. Seventy-five patients (75 eyes) with PDR who underwent pars plana vitrectomy (PPV) and 19 patients (19 eyes) who received vitrectomy for idiopathic macular holes (IMH) as non-diabetic control group were enrolled in this prospective study. Serum, aqueous and vitreous fluid samples were collected during cataract and PPV surgery. Protein expressions of TL1A as well as other angiogenic and inflammatory cytokines in serum and intraocular fluid were measured. Correlations of intraocular TL1A concentrations with inflammatory cytokines were analyzed. We found both aqueous and vitreous TL1A levels were significantly higher in the PDR group than in control group (P_aqueous = 0.026; P_vitreous <0.001). Angiogenic and inflammatory cytokines such as VEGF, IL-6, IL-8, MCP-1, MIP-1α, and MIP-1β were significantly higher in intraocular fluid in PDR group than in controls, which MCP-1 and MIP-1α showed positive correlation with intraocular TL1A levels. There is no significant difference in the levels of serum TL1A as well as other inflammatory cytokines between PDR patients and controls. Intraocular levels of TL1A were significantly lower in PDR progression group than in the stable group (P_aqueous <0.001; P_vitreous <0.001). Multivariate logistic regression analyses revealed that lower levels of intraocular TL1A was an important risk factor for predicting PDR progression after primary PPV (OR_aqueous = 0.717, P_aqueous = 0.001; OR_vitreous = 0.684; P_vitreous = 0.002). In conclusion, TL1A and multiple inflammatory cytokines were highly enriched in the intraocular fluid of PDR patients compared with the controls. Lower levels of intraocular TL1A were associated with development of PDR complications after primary PPV and might be used as prognostic factor in predicting the vitrectomy outcome in PDR patients.     

系统性肥大细胞增生症致继发性骨髓纤维化PET/CT显像一例

笔者报道了一例系统性肥大细胞增生症伴继发性骨髓纤维化的18F-FDG PET/CT显像病例。从临床症状、实验室检查、影像学检查以及骨髓穿刺等结果综合分析了该病的特点。并通过文献复习加深了对骨髓纤维化及肥大细胞增生症的认识。继发性骨髓纤维化的病因多种多样,肥大细胞增生症就是其病因之一。肥大细胞增生症是一种以肥大细胞多组织器官异常增生为特征的血液系统疾病,肥大细胞分泌的组胺会导致骨质密度弥漫性增高,肝脾淋巴结肿大一方面是因为肥大细胞的浸润,另一方面则是因为髓外造血所致。另外,此类患者出现的诸多临床症状也与肥大细胞分泌的化学介质密切相关。     

MRI-based treatment planning for brain stereotactic radiosurgery: Dosimetric validation of a learning-based pseudo-CT generation method

Magnetic resonance imaging (MRI)-only radiotherapy treatment planning is attractive since MRI provides superior soft tissue contrast without ionizing radiation compared with computed tomography (CT). However, it requires the generation of pseudo CT from MRI images for patient setup and dose calculation. Our machine-learning-based method to generate pseudo CT images has been shown to provide pseudo CT images with excellent image quality, while its dose calculation accuracy remains an open question. In this study, we aim to investigate the accuracy of dose calculation in brain frameless stereotactic radiosurgery (SRS) using pseudo CT images which are generated from MRI images using the machine learning-based method developed by our group. We retrospectively investigated a total of 19 treatment plans from 14 patients, each of whom has CT simulation and MRI images acquired during pretreatment. The dose distributions of the same treatment plans were calculated on original CT simulation images as ground truth, as well as on pseudo CT images generated from MRI images. Clinically-relevant DVH metrics and gamma analysis were extracted from both ground truth and pseudo CT results for comparison and evaluation. The side-by-side comparisons on image quality and dose distributions demonstrated very good agreement of image contrast and calculated dose between pseudo CT and original CT. The average differences in Dose-volume histogram (DVH) metrics for Planning target volume (PTVs) were less than 0.6%, and no differences in those for organs at risk at a significance level of 0.05. The average pass rate of gamma analysis was 99%. These quantitative results strongly indicate that the pseudo CT images created from MRI images using our proposed machine learning method are accurate enough to replace current CT simulation images for dose calculation in brain SRS treatment. This study also demonstrates the great potential for MRI to completely replace CT scans in the process of simulation and treatment planning.