Solitary Langerhans cell histiocytosis of frontal lobe: a case report and literature review

The brain parenchymal Langerhans cell histiocytosis （LCH） without systemic disease or lytic skull lesions is extremely rare. We report a 23-year-old male presenting with new onset 1 hour seizure with loss of consciousness 20 days prior to admission, and recurrent seizure 2 weeks later. Brain magnetic resonance imaging （MRI） showed an irregularly mass with enhancement involving the right frontal lobe. Microscopically, the lesion was characterized by sheets of Langerhans cells in addition to reactive inflammatory elements. Immunohistochemically, Langerhans cells were positive for Langerin, CDla and S-100 protein. The patient received no chemotherapy or radiotherapy after surgery. After 24 months of follow-up, no recurrence or other systemic lesions were observed. Although there is no standard treatment for solitary cerebral LCH, the prognosis generally appears to be good.

Synaptic plasticity effects on FeCl_2-induced post-traumatic epilepsy onset in the rat

Studies have confirmed that iron induces epilepsy onset, and iron ion-induced epilepsy in anima models closely resembles the clinical situation. Models of post-traumatic epilepsy （PTE） were established by intracortical injection of FeCl2 using stereotactic techniques. Electron microscopy revealed neuronal degeneration, with shrinkage of the neuronal soma, hyperplasia of rough endoplasmic reticulum, ribosomal detachment from the endoplasmic reticulum, and vacuolar degeneration of glial cells in the right frontal lobe of FeCl2-induced PTE rats. With prolonged time injuries became more severe and neuronal apoptosis was observed. Synapses in the hippocampal neuropil significantly increased （primarily type I/excitatory synapses） at day 14 following injury. Type II synapses （inhibitory synapse） were observed in the rat hippocampus at day 30. Cortical neuronal degeneration, apoptosis, glial cell proliferation, and ultrastructural hippocampal changes, in particular changes in type of neuronal synapse, play an important role in PTE onset.

Sintilimab (anti-PD-1 antibody) combined with high-dose methotrexate, temozolomide, and rituximab (anti-CD20 antibody) in primary central nervous system lymphoma: a phase 2 study

Primary central nervous system lymphoma(PCNSL)is a rare and frequently fatal lymphoma subtype.The programmed death-1(PD-1)pathway has emerged as a potential therapeutic target,but the effectiveness of PD-1 antibody sintilimab in combination with immunochemotherapy as a frontline treatment for PCNSL remains to be determined.In this phase 2 trial(ChiCTR1900027433)with a safety run-in,we included patients aged 18–70 with newly diagnosed PCNSL.Participants underwent six 21-day cycles of a SMTR regimen,which includes sintilimab(200 mg,Day 0),rituximab(375 mg/m2,Day 0),methotrexate(3.0 g/m2,Day 1 or 1.0 g/m2 for patients aged≥65 years),and temozolomide(150 mg/m2/d,Days 1–5).Among 27 evaluable patients,the overall response rate(ORR)was 96.3%(95%confidence interval:81–99.9%),with 25 complete responses.At a median follow-up of 24.4 months,the medians for duration of response,progression-free survival(PFS),and overall survival were not reached.The most common grade 3–4 treatment-related toxicities were increased levels of alanine aminotransferase(17.9%)and aspartate aminotransferase(14.3%).Additionally,baseline levels of interferon-αand the IL10/IL6 ratio in cerebrospinal fluid emerged as potential predictors of PFS,achieving areas under the curve of 0.88 and 0.84,respectively,at 2 years.Whole-exome sequencing revealed a higher prevalence of RTK-RAS and PI3K pathway mutations in the durable clinical benefit group,while a greater frequency of Notch and Hippo pathway mutations in the no durable benefit group.These findings suggest the SMTR regimen is highly efficacious and tolerable for newly diagnosed PCNSL,warranting further investigation.

山西糜子核心种质分子身份证构建

为快速鉴定糜子(Panicum miliaceum)资源,建立分子标记检测平台,以272份山西糜子核心种质为研究材料,利用85对简单重复序列(SSR)引物,应用ID Analysis 4.0软件,构建DNA分子身份证。结果表明,对85对SSR引物进行筛选,发现20对引物组合(RYW67、RYW53、RYW37、RYW65、RYW62、RYW77、RYW5、RYW49、RYW84、RYW19、RYW11、RYW40、RYW54、RYW28、RYW31、RYW7、RYW16、RYW8、RYW9和RYW18)可区分272份材料。共检测到等位变异(Na)60个,平均每个位点检出3个;Shannon多样性指数(I)为0.9578(RYW16)–1.0967(RYW5),平均值为1.0552;多态性信息含量(PIC)为0.6044(RYW77)–0.7530(RYW37),平均值为0.6921。利用20对引物构建山西糜子核心种质的字符串、条形码和二维码DNA分子身份证,可为种质身份标识和溯源提供实践路径。

Glioblastoma vaccine tumor therapy research progress

Glioblastoma(GBM)is the most common primary malignancy of the central nervous system in adults.The prognosis for late-stage glioblastoma(World Health Organization grade IV astrocytic glioma)is very poor.Novel treatment options are sought after and evaluated by clinicians and researchers,and remarkable advances have been made in surgical techniques,radiotherapy,and chemotherapy.However,the treatment of glioblastoma remains extremely difficult and it can extend the lives of patients by only a few months.There has been notable progress in the field of immunotherapy,particularly with the use of tumor vaccines,for treating glioblastoma;especially peptide vaccines and cell-based vaccines such as dendritic cell vaccines and tumor cell vaccines.However,the results of the current clinical trials for vaccination are not satisfactory.This article reviews the progress in the development of vaccines for glioblastoma.

Three-dimensional printing technology for treatment of intracranial aneurysm

Background:The development of three-dimensional (3D) printing technology provides a new method for surgical treatment,but currently there are few reports on its application in the treatment of aneurysm.The aim of the present study was to explore the materials and methods of fabricating 3D printed individual aneurysm model and its value in the treatment of intracranial aneurysm.Methods:Twenty-four patients with intracranial aneurysm diagnosed by CTA who had undergone operation in our hospital were analyzed retrospectively.CTA Data collected at the time of surgery was used for reconstruction.Soft Mimics 17.0 was used to reconstruct the thin layer CTA scan data into 3D image and the final data was sent to the 3D printer for fabricating the model.We compared the proposed 3D printed model-based preoperative plan and the actual approach used in the surgery based on CTA data to evaluate the value of the 3D printed model in preoperative planning,and picked out the materials which were more suitable for the clinic.Results:Twenty-four aneurysm models with high degree of reality were fabricated successfully with 3D-printing technology.The patients' blood vessels,skulls and aneurysms were printed into the reality model at a ratio of 1:1.It is reported that the soft material-based,3D printed vascular and aneurysm model more closely resembled the characteristics of the real blood vessels,thus provides a better simulation compared to the plaster-based model.Compared with the original operation plan,3D printed model could be used for pre-operative aneurysm clip selection,and provide more intuitive information in selection of operational approach.Conclusions:3D printed model can be used as an operational physical model to design operative schemes,choose the best operative paths and select suitable aneurysm clips by its high simulation degree and individualized characteristics.The model is helpful for surgical planning,especially for the preoperative plan of treating refractory multiple aneurysms and giant aneurysms.

Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors:an operative technique and short-term outcomes of 20 consecutive cases

Background:To present a surgical technique for the treatment of intradural extramedullary(IDEM)tumors by using endoscopically controlled surgery with open hemilaminectomy technique.Methods:In this study,20 patients with 22 IDEM tumors were enrolled.An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors.Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis.Results:All the tumors in 20 patients were well removed.The clinical symptoms were significantly reduced in all the patients as well.The short-term follow-up data showed that there was no tumor recurrence or spinal deformity.Conclusion:The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors.It may be an effective surgical method for treating IDEM tumors.Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

Anatomy and surgery of pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor

Background: The pineal region tumors are surrounded by important structures. Neuroendoscopy has been increasingly used at home and abroad. This study is to simulate pure neuroendoscopic infratentorial supracerebellar approach for resection of pineal region tumor from the cadaveric head, and discuss the advantages and safety through this corridor. Methods: The anatomical structure for resection of pineal region tumor was visualized through pure neuroendoscopic infratentorial supracerebellar approach in three cadaveric heads. Three cases with pineal region tumors were retrospectively analyzed and summarized between June 2017 and December 2017. All cases were operated through pure neuroendoscopic infratentorial supracerebellar approach in the first affiliated hospital of Fujian medical university. Results: The anatomical structures of pineal region can be completely visualized by pure neuroendoscopic infratentorial supracerebellar corridor in the cadaveric head. Among the three cases, the first case was total resection, the second case was subtotal resection and the last case was partial resection. The postoperative pathology revealed cavernous hemangioma, germinoma and yolk sac tumor, respectively. The patients were followed-up for 1-6 months and had normal life.The KPS (karnofsky performance status) score was 100. Conclusion: The anatomical structure of the pineal region can be completely visualized and the tumor can be safely removed through pure neuroendoscopic infratentorial supracerebellar approach.

Exosomal circular RNAs inglioma:coexistenceof opportunitiesand challenges forapplication

Glioma is the most common primary tumor in the central nervous system.With the help of intercellular communication,glioma cells have the ability to survive in the tumor microenvironment(TME)and make it more suitable.

Safety and feasibility of curved lead simultaneously implanted into pedunculopontine nucleus and subthalamic nucleus

To the Editor:Combined nuclei stimulation may have a synergistic effect on controlling the symptoms of nervous system diseases and improving quality of life.[1]However,increasing of leads may increase costs and complications.[2]Therefore,our study aims to investigate the safety and feasibility of the single curved lead,which can simultaneously reach both subthalamic nucleus(STN)and pedunculopontine nucleus(PPN).

Altered regional homogeneity of prefrontal cortex in Parkinson's disease with mild cognitive impairment

Background:Mild cognitive impairment (MCI) is a common non-motor symptom of early Parkinson's disease (PD),but the neural mechanisms underlying it remain poorly understood.The aim of the present study was to investigate the characteristics of cognition-related brain activities in the PD patients with MCI.Methods:The brain fMRIs and cognition tests were acquired in 39 PD patients and 22 healthy controls (HC) from September 2013 to January 2015.The patients were divided into two groups:PD-MCI (n--18) and PD with normal cognition (PDNC,n =19).we used resting state fMRI and a regional homogeneity (ReHo) method to explore patterns of intrinsic brain activity in patients with PD-MCI as compared with PDNC subjects and HC.Results:Compared with the PDNC group,the PD-MCI group exhibited significantly increased ReHo in parts of the prefrontal cortex regions (e.g.right superior frontal gyrus,right middle frontal gyrus and orbitofrontal cortex).Compared to the HC group,a decrease of ReHo value in left thalamus was found in PD-MCI.However,this reduction was not found in the left thalamus of PDNC group,but in the above prefrontal regions (p ＜ 0.05,with Bonferroni correction).Conclusions:These results demonstrate that the ReHo of prefrontal cortex in resting state is changed in PD patients with MCI.The presence of MCI in PD may be attributed to abnormal regional activity in prefrontal cortex regions.