Early brainstem hemorrhage progression:multi-sequence magnetic resonance imaging and histopathology

According to clinical statistics,the mortality of patients with early brainstem hemorrhage is high.In this study,we established rat models of brainstem hemorrhage by injecting type Ⅶ collagenase into the right basotegmental pontine and investigated the pathological changes of early brainstem hemorrhage using multi-sequence magnetic resonance imaging and histopathological methods.We found that brainstem hematoma gradually formed in the injured rats over the first 3 days and then reduced after 7 days.The edema that occurred was mainly of the vasogenic type.No complete myelin sheath structure was found around the focus of the brainstem hemorrhage.The integrity and continuity of nerve fibers gradually deteriorated over the first 7 days.Neuronal degeneration was mild in the first 3 days and then obviously aggravated on the 7^(th)day.Inflammatory cytokines,interleukin-1β,and tumor necrosis factorαappeared on the 1st day after intracerebral hemorrhage,reached peak levels on the 3^(rd)day,and decreased from the 7^(th)day.Our findings show the characteristics of the progression of early brainstem hemorrhage.

Screening of differentially expressed genes related to differentiation and proliferation by gene expression profiling of different grade astrocytoma cell lines

BACKGROUND： The detection of differential gene expression in brain is possible by cDNA microarray technology, and the screening of differentially expressed genes might provide a biological basis for gene-targeted therapy for tumors. OBJECTIVE： To detect the differential expression of genes among astrocytoma SHG-44 （WHO grade Ⅳ）, CHG-5 （WHO grade Ⅱ）, and ATRA-treated SHG-44 cell lines by cDNA microarray. DESIGN： Laboratory experiments in vitro. SETTING： Department of Neurobiology, the Third Military Medical University. MATERIALS： The experiment was performed at the Department of Neurobiology in the Third Military Medical University of the Chinese PLA from January to October 2007. The SHG-44 cell line （WHO grade Ⅳ） was established by Prof. Ziwei Du, and the CHG-5 cell line （WHO grade Ⅱ） was set up by Prof. Xiuwu Bian from the Third Military Medical University of the Chinese PLA. The cDNA microarray containing 9182 known genes was prepared and provided by Dr. Yang Zhong at the City University of Hong Kong. METHODS： To screen differentially expressed genes from the gene expression profiles detected by cDNA microarray comparisons were made between CHG-5 and SHG-44 cells and between SHG-44 cells with or without treatment with 10 μmol/L ATRA. Some differentially expressed genes were selected randomly for Northern Blot analysis to confirm the results of the microarray. The determination criteria for differential gene expression were as follows. ① The ratio of Cy5 signal to Cy3 was greater than 2.0 or less than 0.5. ② The results of the triplicate microarray hybridizations showed the same trend in three experiments. ③ A gene appeared at least two times on the triplicate microarray hybridizations, and the 3^rd value did not show a contradictory trend. A normalized ratio of Cy5 intensity to Cy3 greater than 2.0 or less than 0.5 was considered to represent up-regulated or down-regulated gene expression, respectively. MAIN OUTCOME MEASURES： The identification of genes that were similarly regulated （overlapping） during tumor progression and differentiation, by comparison of gene expression profiles between CHG-5 and SHG-44 cells, and between SHG-44 cells with or without treatment with ATRA. RESULTS： Thirty-one overlapping genes were found to have similar regulatory effects on astrocytomas; among them, twenty genes were up-regulated and eleven were down-regulated in both comparisons between CHG-5 and SHG-44 cells, and between SHG-44 cells with or without treatment with ATRA. The four reported genes, SERPINFI, MAPKI 1, HIFIA and SOD2, were up-regulated in this study. CONCLUSION： The differentially expressed genes in different grade astrocytoma cell lines were revealed primarily by cDNA microarray; among them, five identified overlapping genes, SERPINF1, MAPK11, DCTN2, HIF1 A and SOD2, were related to the malignant progression of astrocytoma cells.

Dislocations-induced precipitates and their effect on mechanical properties of Mg-Gd-Y-Zr alloy

Optical microscope(OM),scanning electron microscope(SEM),transmission electron microscope(TEM)and tensile machine were used to characterize the microstructures and mechanical properties of as-forged and aged Mg-9.5Gd-3.8Y-0.6Zr alloys.The results show that a novel kind of dislocation arrays,comprising parallel arranged dislocations,were obtained in the forged alloy.The arrays tend to extend parallel and are heterogeneously distributed with adjacent distances varying from 0.3μm to 1.4μm.After aging the alloy at 265°C,a large number of preferential-oriented phases were precipitated on the dislocation arrays,forming a structure of"precipitation chains"(PCs),which results in simultaneous increments of strength and ductility.

Cell cycle-related genes p57kip2, Cdk5 and Spin in the pathogenesis of neural tube defects

In the field of developmental neurobiology, accurate and ordered regulation of the cell cycle and apoptosis are crucial factors contributing to the normal formation of the neural tube. Preliminary studies identified several genes involved in the development of neural tube defects. In this study, we established a model of developmental neural tube defects by administration of retinoic acid to pregnant rats. Gene chip hybridization analysis showed that genes related to the cell cycle and apoptosis, signal transduction, transcription and translation regulation, energy and metabolism, heat shock, and matrix and cytoskeletal proteins were all involved in the formation of developmental neural tube defects. Among these, cell cycle-related genes were predominant. Retinoic acid treat-ment caused differential expression of three cell cycle-related genes p57kip2, Cdk5 and Spin, the expression levels of which were downregulated by retinoic acid and upregulated during normal neural tube formation. The results of this study indicate that cell cycle-related genes play an im-portant role in the formation of neural tube defects. P57kip2, Cdk5 and Spin may be critical genes in the pathogenesis of neural tube defects.

Electrocorticography-Guided Surgical Treatment of Solitary Supratentorial Cavernous Malformations with Secondary Epilepsy

Objective To evaluate the efficacy of electrocorticographic(ECoG) monitoring and the application of different surgical approaches in the surgical treatment of solitary supretentorial cavernous malformations with secondary epilepsy. Methods This study enrolled a consecutive series of 36 patients with solitary supratentorial cavernous malformations and secondary epilepsy who underwent surgery with intraoperative ECoG monitoring in the Department of Neurosurgery between January 2004 and January 2008. The patients were composed of 15 males and 21 females, aged between 8 and 52 years(mean age 27.3±2.8 years) at the time of surgery. Epilepsy history, the type of epilepsy at the presentation, lesion location, the incidence of residual epileptiform discharges, and postoperative outcomes were evaluated. Results Histopathological examination indicated cavernous malformations and hippocampal sclerosis in 36 and 5 cases, respectively. Neuronal degeneration, glial cell proliferation, and neurofibrillary tangles were found in all the resected cerebral tissues of extended lesionectomy of residual epileptic foci. Lesionectomy, anterior temporal lobectomy, anterior temporal lobectomy plus cortical thermocoagulation, extended lesionectomy, extended lesionectomy plus cortical thermocoagulation were performed in 4, 4, 1, 14, and 13 cases, respectively. Residual epileptiform discharges were captured in 9 out of the 14 patients who had additional cortical thermocoagulation. According to Engle class for postoperative outcomes, 27 cases were class I(75.00%), 5 were class II(13.89%), 2 were class III(5.56%), and 2 were class IV(5.56%), thus the total effective rate(class I+class II) was 88.89%. Neither of epilepsy history, the type of epilepsy, and the location of cavernous malformation was significantly related to outcomes(P>0.05). A significant relationship was found between the incidence of residual epileptiform discharges and outcomes(P=0.041). Conclusions Intraoperative ECoG monitoring, the application of different surgical approaches, and the resection of residual epileptic foci could produce good result in the surgical treatment of supratentorial cavernous malformation with secondary epilepsy. Postoperative residual epileptiform discharges could be a useful predictor for evaluating the outcomes.

Establishment of primary cultures of craniopharyngioma cells

Craniopharynigoma samples were collected from 36 patients. Out of the 36 samples, 29 achieved successful sub-culturing, with a success rate of 80.6%. Immunohistochemistry staining showed that cytokeratin-7 was positively expressed in the cytomembrane and cytoplasm of craniopharyngioma cells at 6-8 passages, confirming that all cultured cells were squamous epithelial cells. The doubling time of craniopharyngioma cells was 3 days, as confirmed by the 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide assay. In this study, craniopharyngioma cells cultured in vitro were established; however, establishment of immortalized craniopharyngioma cell lines requires further research.

Hippocampal and cortical expression of gamma-aminobutyric acid transporter 1 and glial fibrillary acidic protein in pentylenetetrazol-induced chronic epileptic rats

BACKGROUND： Gamma-aminobutyric acid transporter plays an important role in gamma-aminobutyric acid metabolism, and is highly associated with epilepsy seizures. Pathologically, astrocytes release active substances that alter neuronal excitability, and it has been demonstrated that astrocytes play a role in epileptic seizures. OBJECTIVE： To observe changes in gamma-aminobutyric acid transporter 1 and glial fibrillary acidic protein expression in the hippocampus and cortex of the temporal lobe in rats with pentylenetetrazol-induced chronic epilepsy. DESIGN, TIME AND SETTING： Randomized, controlled, animal experiment was performed at the Department of Neurobiology, Third Military University of Chinese PLA between January 2006 and December 2007. MATERIALS： Pentylenetetrazol was purchased from Sigma, USA; rabbit anti-rat gammaaminobutyric acid transporter 1 and glial fibrillary acidic protein were from Chemicon, USA. METHODS： A total of 40 Sprague Dawley rats were divided into model and control groups. Rat models of chronic epilepsy were created by pentylenetetrazol kindling, and were subdivided into 3-, 7-, and 14-day kindling subgroups. MAIN OUTCOME MEASURES： Gamma-aminobutyric acid transporter 1 and glial fibrillary acidic protein expression, as well as the number of positive cells in the hippocampus and cortex of temporal lobe of rats, were determined by immunohistochemistry and Western blot analyses. RESULTS： Compared with the control group, the number of gamma-aminobutyric acid transporter 1 and glial fibrillary acidic protein -positive cells in the hippocampus and cortex of rats with pentylenetetrazol-induced epilepsy significantly increased, gamma-aminobutyric acid transporter 1 and glial fibrillary acidic protein expression increased after 3 days of kindling, reached a peak on day 7, and remained at elevated levels at day 14 （P〈 0.05）. CONCLUSION： Astrocytic activation and gamma-aminobutyric acid transporter 1 overexpression may contribute to pentylenetetrazol-induced epilepsy.

Identification of tumor invasion-related differentially expressed genes in different grades and all-trans retinoic acid-treated astrocytoma cell lines

BACKGROUND： Although several genetic aberrations and gene expressional changes have been shown to exist in tumors and different grades of astrocytomas, as well as in normal tissues, the gene profiling and genetic pathways associated with malignant transformation and progression remain unclear. OBJECTIVE： To identify differentially expressed genes related to tumor invasion from various grades and all-trans retinoic acid （ATRA）-treated astrocytoma cell lines by cDNA microarray. DESIGN, TIME AND SETTING： In vitro gene experiment was performed at the Department of Neurobiology, Third Military Medical University of Chinese PLA from January to October 2007. MATERIALS： Two different grades of astrocytoma cell lines CHG-5 （WHO grade II ） and SHG-44 （WHO grade IV） were developed by our laboratory; a cell differentiation-inducing agent ATRA and a human cDNA microarray technology were used to determine differentially expressed genes （City University of Hong Kong）. METHODS： Total RNA was extracted using the Trizol test kit. Reverse transcription was performed using Superscript 11 reverse transcriptase. The cDNA product （target DNA） was marked with fluorochromes Cy3 （normal SHG-44） and Cy5 （CHG-5 or ATRA-treated SHG-44）, followed by chip hybridization. MAIN OUTCOME MEASURES： Gene expression profiles of CHG-5 vs. SHG-44 and ATRA-treated vs. normal SHG-44 were performed to identify differentially expressed genes. Several of these genes were randomly selected for Northern Blot analysis. The identification of genes that were similarly regulated （overlapping） was performed by comparing gene expression profiles between CHG-5 and SHG-44 cells, and between SHG-44 cells with or without treatment with ATRA. RESULTS： No significant differences were observed between CHG5 and SHG-44 cell line morphology. Under confocal microscopy, GFAP staining intensity of CHG5 cells was greater than SHG-44 cells （t = 6.078 P = 0.004）. Growth curve analysis demonstrated that the speed of SHG-44 cell growth was greater than CHG5 cells. Flow cytometry analysis showed that the number of ATRA-treated SHG-44 cells at G0/G1 stage increased by 15%, compared with normal SHG-44 cells （P 〈 0.05）. A total of 31 known genes with altered expression were identified in this study. Among them, 20 genes were upregulated and 11 were downregulated in CHG-5 compared with SHG-44 cells, and ATRA-treated SHG-44 compared with untreated SHG-44 ceils. Four of these reported genes （CD151, G3BP, UGB, and CSTB） were shown to be involved in tumor invasion. Validation of a selection of differentially expressed genes was perfonlaed by Northern blot. CONCLUSION： A total of 31 known genes were demonstrated by cDNA microarray to relate to the malignant progression of astrocytomas, and four differentially expressed genes （CD151, G3BP, UGB, and CSTB） were shown to relate to tumor invasion.

Changes in platelet parameters and secondary brain injury in acute craniocerebral trauma

Changes in platelet parameters are important in secondary brain injury in acute craniocerebral trauma We selected 163 patients with craniocerebral trauma who were admitted within 24 hours with nonoperative therapy. Platelet parameters of 40 healthy subjects served as controls. Platelet number was decreased, while mean platelet volume and platelet distribution width values were increased, at 1 and 3 days after injury. Platelet number was lower and mean platelet volume and platelet distribution width were larger in patients with traumatic cerebral infarction and those in Glasgow Coma Scale score 〈 8 group. Platelet number was negatively correlated to volume of cerebral edema, but positively correlated to Glasgow Outcome Scale score. These data indicate that changes in platelet parameters may be utilized to indicate the state of central nervous system injury and patient prognosis .

Effects of all-trans retinoic acid on metabolic gene expression in the glioma cell line SHG-44

BACKGROUND： Genetic abnormalities and changes in gene expression have been shown in various grades of glioma. However, the relationship between gene expression patterns and pathways related to malignant transformation of glioma remains poorly understood. OBJECTIVE： To screen differentially expressed genes between normal and all-trans retinoic acid-treated glioma cell line SHG-44 cells with a complementary DNA （cDNA） microarray. DESIGN, TIME AND SETTING： The genomics, in vitro study was performed at the Laboratory of Neurobiology, Third Military Medical University of Chinese PLA, China from January to October 2007. MATERIALS： The glioma cell line SHG-44 was provided by the Third Military Medical University of Chinese PLA. AII-trans retinoic acid was purchased from Sigma, USA. cDNA microarray was purchased from City University of Hong Kong. METHODS： The glioma cell line SHG-44 was treated with 10 μmol/L all-trans retinoic acid for 3 days Differentiation-related genes were determined using cDNA microarray. MAIN OUTCOME MEASURES： Gene expression patterns were compared between normal and all-trans retinoic acid-treated SHG-44 cells. Differentially expressed genes were randomly selected and determined by Northern blot analysis. RESULTS： Northern blot analysis revealed downregulated RPL 13 gene expression and upregulated SOD2 gene expression, which was identical to cDNA microarray results. Five differentially expressed genes （TPI1, BPGM, ALDOA, LDHA, and RRM1） were shown to be involved in cell metabolism, in six metabolic pathways. Four differentially expressed genes （TPI1, BPGM, ALDOA, and LDHA） were associated with carbohydrate metabolism, such as fructose metabolism, pyruvic acid metabolism, pentose phosphate pathway, glycolysis, and gluconeogenesis. One differentially expressed gene （RRM1） was correlated with purine and pyrimidine metabolism. CONCLUSION： Five metabolic genes （TPI1, BPGM, ALDOA, LDHA, and RRM1）, which participate in cell carbohydrate and nucleotide metabolism, were shown to closely correlate with glioma development.

Pristine atmospheric condition over the Third Pole:An insight from levoglucosan records

Expanding urbanization and agricultural intensification across neighboring South Asia and East Asia have substantially threatened atmospheric condition over the Third Pole(TP)during the past few decades.Whether the atmospheric condition over the TP is still as clean as a representative of the regional background draws great concern.In this work,great differences in levoglucosan concentration within/above the atmospheric boundary layer height are revealed.Levoglucosan results support the hypothesis that atmospheric pollutants in the mid-troposphere over the TP are mainly affected by long-range transport,although there are some local biomass burning emissions in residential areas.In addition,levoglucosan concentration in the midtroposphere over the TP is at the same magnitude as marine and polar regions,but about 2–3 magnitudes lower than neighboring densely-populated Asian regions.With insights of levoglucosan records,this work therefore proves that the high-altitude TP still has largely pristine atmospheric conditions,and is one of the cleanest remote regions on the Earth.

Gene expression in retinoic acid-induced neural tube defects A cDNA microarray analysis

BACKGROUND： Neural tube defects can be induced by abnormal factors in vivo or in vitro during development. However, the molecular mechanisms of neural tube defect induction, and the related gene expression and regulation are still unknown. OBJECTIVE： To compare the differences in gene expression between normal embryos and those with neural tube defects. DESIGN, TIME AND SETTING： A neural development study was performed at the Department of Neurobiology, Third Military Medical University of Chinese PLA between January 2006 and October 2007. MATERIALS： Among 120 adult Kunming mice, 60 pregnant mice were randomly and evenly divided into a retinoic acid group （n = 30） and a normal control group （n =30）. The retinoic acid was produced by Sigma, USA, the gene microarray by the Amersham Pharmacia Company, Hong Kong, and the gene sequence was provided by the Incyte database, USA. METHODS： Retinoic acid was administered to prepare models of neural tube defects, and corn oil was similarly administered to the normal control group. Total RNA was extracted from embryonic tissue of the two groups using a Trizol kit, and a cDNA microarray containing 1 100 known genes was used to compare differences in gene expression between the normal control group and the retinoic acid group on embryonic （E） day 10.5 and 11.5. Several differentially expressed genes were randomly selected from the two groups for Northern blotting, to verify the results of the cDNA microarray. MAIN OUTCOME MEASURES： Morphological changes and differential gene expression between the normal control group and the retinoic acid group. RESULTS： Anatomical microscopy demonstrated that an intact closure of the brain was formed in the normal mouse embryos by days E10.5 and E11.5. The cerebral appearance was full and smooth, and the surface of the spine was intact. However, in the retinoic acid group on days E10.5 and E11.5, there were more dead embryos. Morphological malformations typically included non-closure at the top of the cranium and abnormal changes of the metencephalon and face. cDNA microarray analysis suggested that the changes in expression of seven different genes were similar on both days E10.5 and E11.5. These were downregulation of NekT, Igfbp5, Zw10, Csf3r, Psmc6 and Rb 1, and upregulation of Apoa-4. This study also indicated that Cdk5 expression was downregulated in the retinoic acid group on day E11.5. The results of the cDNA microarray analysis were partly confirmed by Northern blotting. CONCLUSION： Cdk5, Nek7, Igfbp5, Zw10, Csf3r, Psmc6, Rb1 and Apoa-4 may be key factors in retinoic acid-induced neural tube defects.

Multiple different remote epidural hematomas after craniotomy:A case report

BACKGROUND Epidural hematoma is one of the common postoperative complications after craniotomy.However,multiple remote epidural hematomas in different sites,including supratentorial and infratentorial regions,are exceedingly rare.CASE SUMMARY We present a rare case in which three remote epidural hematomas occurred after craniotomy.A 21-year-old woman was admitted with a headache for 1 mo,vomiting,and rapid vision loss for 1 wk.Brian magnetic resonance imaging indicated a right thalamic tumor.The intraoperative diagnosis was a cystic tumor,posterior cerebral artery aneurysm,and vascular malformation.The operation was successful.Unfortunately,the patient developed three extradural hematomas within 48 h.Family members consented to the first two hematoma evacuations but refused the third.CONCLUSION More attention should be paid to this kind of rare complication.Adequate preoperative evaluation is important,especially for acute patients.Monitoring neural function and early computed tomography scanning of the brain after surgery should be highlighted.

Prolonged stay of spontaneous intracranial hemorrhage patients in the emergency department is correlated with worse outcomes

Spontaneous intracerebral hemorrhage(ICH)represents the second most common type of stroke,with high mortality and disability rates.^([1,2])In 2010,there were approximately 5.3 million ICH cases,with 3 million deaths worldwide.^([1])However,there is still no validated medical treatment for ICH,with the role of surgery remaining controversial.^([2,3])Cusack et al^([4])demonstrated that lowering blood pressure rapidly in hypertensive ICH patients may be safe and at least partially effective in inhibiting hematoma expansion.

Identification of Tumor Progression-Related Genes in Astrocytoma Cell Lines

OBJECTIVE To identify progression-related genes that lead toastrocytoma progression from a low to a high grade by analyzingthe gene expression profiles from different tumor grades,and all-trans retinoic acid-treated astrocytoma cell lines.METHODS In this study,all-trans retinoic acid (ATRA) wasused to induce differentiation of SHG-44 cells.Then,by usinga cDNA microarray,we compared gene expression profilingin different grades of astrocytoma cell lines (CHG-5,WHOGrade Ⅱ and SHG-44,WHO Grade Ⅳ) and in ATRA-induceddifferentiation in SHG-44 cells.A panel of overlapped genes thatmight be related to tumor progression was identified,and the cellline individual variation was avoided as well.RESULTS In the 31 overlapped genes,the stable over-expressionof MDM2 and UGB as well as the repression of SOD2,G3BP,andCSTB in parental SHG-44 cells was observed and their possibleroles in tumor progression were discussed.Moreover,validationof some differentially expressed genes was confirmed by Northernblots.CONCLUSION The overlapped genes reported in this studymight relate to progression of astrocytoma.Further study ofprogression-related genes may be helpful to explore the geneticpathways that are involved in astrocytoma progress from a low toa high grade.

Accessory Nerve Schwannoma Extending to the Foramen Magnum and Mimicking Glossopharyngeal Nerve Tumor—A Case and Review of Surgical Techniques

Background: Intracranial schwannomas of the accessory nerve are very rare lesions. They are categorised according to their locations into either intrajugular or intracistemal schwannomas although most of them are intrajugular. The intrajugular type constitutes about 2% to 4% of all intracranial schwannomas described in literature. Aim: It’s very unusual for an accessory nerve to mimic glossopharyngeal nerve looking at the anatomical location of the accessory nerve. Although many authors have written on accessory nerve, none have described this unusual presentation. We present a case, management as well as review on the classification and appropriate surgical techniques we could have use to access the tumor in our patient since the choice of a particular surgical approach is based on the nature of tumor, location as well as it extension into other adjacent structures. Case Presentation: We present a case of 52-year-old woman with very unusual accessory nerve schwannoma which mimics the clinical presentation of glossopharyngeal nerve tumor. The main symptom in our case is six (6) months history of deviation of the tongue to right side with dizziness and change of voice. Conclusion: The unusual presentation in our case could be due to massive compression of glossopharyngeal nerve by the growing accessory nerve schwannoma since most lower cranial nerve schwannomas at this location will almost always course compressive symptoms.

A Domain Extension Algorithm for Digital Error Correction of Pipeline ADCs

A domain extension algorithm to correct the comparator offsets of pipeline analog-to-digital converters (ADCs) is presented, in which the 1.5-bit/stage ADC quantify domain is extended from a three-domain to a five-domain. This algorithm is designed for high speed and low comparator accuracy application. The comparator offset correction ability is improved. This new approach also promises significant improvements to the spurious-free dynamic range (SFDR), the total harmonic distortion (THD), the signal-to-noise ratio (SNR) and the minor analog and digital circuit modifications. Behavioral simulation results are presented to demonstrate the effectiveness of the algorithm, in which all absolute values of comparator offsets are set to |3Vref/8|. SFDR, THD and SNR are improved, from 34.62-dB, 34.63-dB and 30.33-dB to 60.23-dB, 61.14-dB and 59.35-dB, respectively, for a 10-bit pipeline ADC.

Comparison of the Improvement Effect of MVD and Gamma Knife on Pain,Anxiety and Depression of Patients after Treatment of Primary Trigeminal Neuralgia

Objective:To explore the effects of microsurgical vascular decompression(MVD)and gamma knife respectively on the treatment of pain,anxiety and depression in patients with primary trigeminal neuralgia.Methods:From February 2011 to June 2017,we treated 108 patients with primary trigeminal neuralgia.According to the treatment plan of the patients,they were divided into an observation group and a control group,54 cases each.The observation group underwent microsurgical vascular decompression(MVD)for the treatment of primary trigeminal neuralgia,while the control group received gamma knife treatment.The effects of pain,improvement of anxiety and depression were compared between two groups at 1 week,3 months,and 6 months after treatment.Results:The pain,anxiety and depression scores of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:MVD can relieve patients'pain,anxiety and depression symptoms,as well as improve quality of life and restore self-confidence in life.

The Clinical Effect Two Approaches of Microsurgery the Treatment for Pituitary Tumor

Objective:To analyze the effect of two approaches of microsurgery in the treatment of pituitary tumor.Methods:The main body of this study was 69 patients with pituitary tumor who came to the hospital between December 2016 and December 2019.Taking the coin method as the standard,group A underwent nasal-sphenoid sinus approach with 36 cases;group B underwent transcranial approach with 33 cases.The treatment effects were compared.Results:The total effective rate of group A was 94.44%,and that of group B was 72.73%;the therapeutic index of group A was better than that of group B;the complication rate of group A was 8.33%,and that of group B was 30.30%(P<0.05).After treatment,the tumor volume of both groups decreased,and group A was smaller than group B(P<0.05).Conclusion:Nasal-sphenoid sinus approach for patients with pituitary tumors can improve the treatment index,enhance the curative effect,reduce the size of the tumor,and have better safety.

Bidirectional crosstalk between therapeutic cancer vaccines and the tumor microenvironment:Beyond tumor antigens

Immunotherapy has rejuvenated cancer therapy,especially after anti-PD-(L)1 came onto the scene.Among the many therapeutic options,therapeutic cancer vaccines are one of the most essential players.Although great progress has been made in research on tumor antigen vaccines,few phase III trials have shown clinical benefits.One of the reasons lies in obstruction from the tumor microenvironment(TME).Meanwhile,the therapeutic cancer vaccine reshapes the TME in an ambivalent way,leading to immune stimulation or immune escape.In this review,we summarize recent progress on the interaction between therapeutic cancer vaccines and the TME.With respect to vaccine resistance,innate immunosuppressive TME components and acquired resistance caused by vaccination are both involved.Understanding the underlying mechanism of this crosstalk provides insight into the treatment of cancer by directly targeting the TME or synergizing with other therapeutics.