Objective To observe the value of grey-level histogram analysis based on T2WI for differentiating consistency of meningioma.Methods Data of 109 patients with meningioma were retrospectively analyzed.The patients were ...Objective To observe the value of grey-level histogram analysis based on T2WI for differentiating consistency of meningioma.Methods Data of 109 patients with meningioma were retrospectively analyzed.The patients were divided into hard group(n=71)and soft group(n=38)according to the consistency of tumors.Tumor ROI was outlined on axial T2WI showing the largest tumor section,gray levels were extracted and histogram analysis was performed.The value of each histogram parameter were compared between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficiency for differentiating soft and hard meningioma.Results P 1,P 10,P 50,P 90,P 99 and the mean grey levels on T2WI in soft group were all higher than those in hard group(all P<0.05),while the variance,the kurtosis and the skewness were not significantly different between groups(all P>0.05).The differentiating efficiency of P 1,P 10,P 50,P 90,P 99 and the mean grey levels on T2WI were all fine,with AUC of 0.774 to 0.833,and no significant difference was found(all P>0.05).Conclusion Parameters of grey-level histogram analysis such as P 1,P 10,P 50,P 90,P 99 and the mean values based on T2WI were all valuable for differentiating soft and hard meningioma.展开更多
BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a pos...BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a posterior approach being the traditional preference.However,there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.The average age of the included 34 patients’(10 males and 24 females)age was 62.09 years.Mean follow-up duration was 22.65 months.The location of SM was the thoracic spine in 32 cases,with only 2 in the cervical spine.On average,intraoperative blood loss was 520.59 mL,and operating time was 176.76 minutes.Thirty three cases had successful outcomes while only 1 experienced an unexpe-cted outcome.The tumor recurrence rate was 2.9%.After surgery,there were 3 cases of cerebral spinal fluid leakage,1 case of pneumonia,and 1 case of urinary tract infection.Dural attachments were predominantly found dorsal or dorso-lateral(13 cases),followed by ventral or ventrolateral(14 cases),and lateral(7 cases).The outcomes among these subgroups were similar.CONCLUSION The posterior approach for SM resection is safe and effective,yielding comparable surgical and neurological outcomes regardless of the dural attachment location.展开更多
BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A ...BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus.Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign.Tumor resection was performed using a right retro sigmoid approach.A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid.The tumor was firmly adherent to the superior petrosal vein.The origin site was cauterized and resected with the preservation of the superior petrosal vein.A diagnosis of meningothelial meningioma was made.The patient’s headache and tinnitus gradually disappeared,and a recurrence was not observed five years after the surgery.CONCLUSION The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery.The absence of dural attachment makes it easy to completely resect such tumors.Vessels related to tumors should be removed carefully,considering the possible presence of tumor stem cells in the microvessels.展开更多
In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute ...In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.展开更多
This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on t...This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.展开更多
Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collis...Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collision tumors that are still not understood nor fully described. Patients and Method: We report a case of coexisting nonfunctioning pituitary adenoma and a left temporal lobe meningioma revealed by a 1-year history of progressive vision loss and occasional headaches in a 56-year-old woman. Her clinical condition worsened in the last 5 months with ptosis, cavernous sinus syndrome, and ophthalmoplegia of the right eye without papilledema. There was an improvement in the visual symptoms after subtotal resection of both lesions through a right frontotemporal craniotomy. Histology confirmed a collision tumor. The patient was referred for adjuvant treatment with gamma knife radiosurgery. He was doing well and back to his usual duties 6 months later. Conclusion: A gross total or subtotal resection with adjuvant therapy is the gold standard for the surgical management of collision tumors for a favorable patient outcome.展开更多
Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Nota...Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Notably, traditional chemotherapy was ineffective. Aim: I speculated if the exfoliation of graphene could disassemble the three-dimensional (3D) structures of the graphene because the tumor mass or the blood clots including the graphene consisted of inhomogeneous materials. Therefore, I aimed to explore another possible mechanism for the instant removal of inhomogeneous materials. Method: Herein, I report a case of anaplastic papillary meningioma. A 59- year-old man presented with partial complex seizures and recurrent headaches following craniotomy for the removal of a mass with a right frontotemporal convexity 10 years ago. Computed tomography (CT) and magnetic resonance imaging demonstrated a right frontotemporal mass with diffuse contrast enhancement and extensive surrounding edema. A right frontotemporal flap was performed. The tumor and the infiltrated dura were removed, but massive intraoperative bleeding occurred and the right middle cerebral artery was clipped at the M2 territory. Postoperatively, the follow-up CT scan revealed hydrocephalus. Accordingly, a ventriculoperitoneal shunt was placed. The patient suffered from left hemiplegia as a sequela of intraoperative bleeding. Four months later, the follow-up CT scan showed chronic epidural hematoma in the right frontotemporoparietal region. The patient also had an altered level of consciousness. Results: The patient’s level of consciousness was restored after infusion of a NaCl + KCl solution with instant disappearance of the mass. Conclusion: There may be another mechanism for disassembling the inhomogeneous graphene-containing complex, such as quantum fluctuation of the graphene exfoliation with pair annihilation or relation to tissue engineering by the graphene.展开更多
BACKGROUND Adult-onset Still's disease(AOSD)is a rare autoinflammatory disease charac-terized by nonspecific symptoms such as fever,rash,sore throat and arthralgia.This paper reports a clinical case of AOSD succes...BACKGROUND Adult-onset Still's disease(AOSD)is a rare autoinflammatory disease charac-terized by nonspecific symptoms such as fever,rash,sore throat and arthralgia.This paper reports a clinical case of AOSD successfully treated with Bo’s abdo-minal acupuncture(BAA).CASE SUMMARY We report a 20-year-old man who suffered from cold exposure,presenting with high fever,rash,sore throat,arthralgia,and elevated erythrocyte sedimentation rate,leukocytosis with neutrophilic predominance,elevated ferritin,elevated C-reactive protein,and negative rheumatoid factors.He was diagnosed with AOSD based on the Yamaguchi criteria.After treatment with traditional Chinese medi-cine(TCM)decoction and prednisone acetate tablets,there was some alleviation of sore throat,joint and muscle pain,and fever,but he still had persistent low-grade fever,rash,sore throat and arthralgia.He went to the TCM acupuncture outpatient department to receive BAA.Abdominal acupoints Zhongwan(CV12),Xiawan(CV10),0.5 cm below Xiawan(CV10),Qihai(CV6),Guanyuan(CV4),bilateral Qixue(KI13),bilateral Huaroumen(ST24),bilateral Shangfengshidian(AB1)and bilateral Daheng(SP15)were selected.After 3 months treatment,all symptoms disappeared,and the laboratory examination returned to normal levels.He did not take glucocorticoids or nonsteroidal anti-inflammatory drugs afterwards,and no relapse was observed during the 3-year follow-up period.CONCLUSION BAA can be used as a complementary medical approach for treatment of AOSD.展开更多
With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent worldwide.Aging is considered the main risk factor for cognitive decline and acts through alterati...With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent worldwide.Aging is considered the main risk factor for cognitive decline and acts through alterations in the composition of the gut microbiota,microbial metabolites,and the functions of astrocytes.The microbiota–gut–brain axis has been the focus of multiple studies and is closely associated with cognitive function.This article provides a comprehensive review of the specific changes that occur in the composition of the gut microbiota and microbial metabolites in older individuals and discusses how the aging of astrocytes and reactive astrocytosis are closely related to age-related cognitive decline and neurodegenerative diseases.This article also summarizes the gut microbiota components that affect astrocyte function,mainly through the vagus nerve,immune responses,circadian rhythms,and microbial metabolites.Finally,this article summarizes the mechanism by which the gut microbiota–astrocyte axis plays a role in Alzheimer’s and Parkinson’s diseases.Our findings have revealed the critical role of the microbiota–astrocyte axis in age-related cognitive decline,aiding in a deeper understanding of potential gut microbiome-based adjuvant therapy strategies for this condition.展开更多
The interaction between metabolic dysfunction and inflammation is central to the development of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease.Obesity-related conditions like type 2 d...The interaction between metabolic dysfunction and inflammation is central to the development of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease.Obesity-related conditions like type 2 diabetes and non-alcoholic fatty liver disease exacerbate this relationship.Peripheral lipid accumulation,particularly in the liver,initiates a cascade of inflammatory processes that extend to the brain,influencing critical metabolic regulatory regions.Ceramide and palmitate,key lipid components,along with lipid transporters lipocalin-2 and apolipoprotein E,contribute to neuroinflammation by disrupting blood–brain barrier integrity and promoting gliosis.Peripheral insulin resistance further exacerbates brain insulin resistance and neuroinflammation.Preclinical interventions targeting peripheral lipid metabolism and insulin signaling pathways have shown promise in reducing neuroinflammation in animal models.However,translating these findings to clinical practice requires further investigation into human subjects.In conclusion,metabolic dysfunction,peripheral inflammation,and insulin resistance are integral to neuroinflammation and neurodegeneration.Understanding these complex mechanisms holds potential for identifying novel therapeutic targets and improving outcomes for neurodegenerative diseases.展开更多
The vast majority of in vitro studies have demonstrated that PINK1 phosphorylates Parkin to work together in mitophagy to protect against neuronal degeneration.However,it remains largely unclear how PINK1 and Parkin a...The vast majority of in vitro studies have demonstrated that PINK1 phosphorylates Parkin to work together in mitophagy to protect against neuronal degeneration.However,it remains largely unclear how PINK1 and Parkin are expressed in mammalian brains.This has been difficult to address because of the intrinsically low levels of PINK1 and undetectable levels of phosphorylated Parkin in small animals.Understanding this issue is critical for elucidating the in vivo roles of PINK1 and Parkin.Recently,we showed that the PINK1 kinase is selectively expressed as a truncated form(PINK1–55)in the primate brain.In the present study,we used multiple antibodies,including our recently developed monoclonal anti-PINK1,to validate the selective expression of PINK1 in the primate brain.We found that PINK1 was stably expressed in the monkey brain at postnatal and adulthood stages,which is consistent with the findings that depleting PINK1 can cause neuronal loss in developing and adult monkey brains.PINK1 was enriched in the membrane-bound fractionations,whereas Parkin was soluble with a distinguishable distribution.Immunofluorescent double staining experiments showed that PINK1 and Parkin did not colocalize under physiological conditions in cultured monkey astrocytes,though they did colocalize on mitochondria when the cells were exposed to mitochondrial stress.These findings suggest that PINK1 and Parkin may have distinct roles beyond their well-known function in mitophagy during mitochondrial damage.展开更多
Parkinson’s disease is the second most common progressive neurodegenerative disorder,and few reliable biomarkers are available to track disease progression.The proteins,DNA,mRNA,and lipids carried by exosomes reflect...Parkinson’s disease is the second most common progressive neurodegenerative disorder,and few reliable biomarkers are available to track disease progression.The proteins,DNA,mRNA,and lipids carried by exosomes reflect intracellular changes,and thus can serve as biomarkers for a variety of conditions.In this study,we investigated alterations in the protein content of plasma exosomes derived from patients with Parkinson’s disease and the potential therapeutic roles of these proteins in Parkinson’s disease.Using a tandem mass tag-based quantitative proteomics approach,we characterized the proteomes of plasma exosomes derived from individual patients,identified exosomal protein signatures specific to patients with Parkinson’s disease,and identified N-acetyl-alpha-glucosaminidase as a differentially expressed protein.N-acetyl-alpha-glucosaminidase expression levels in exosomes from the plasma of patients and healthy controls were validated by enzyme-linked immunosorbent assay and western blot.The results demonstrated that the exosomal N-acetyl-alpha-glucosaminidase concentration was not only lower in Parkinson’s disease,but also decreased with increasing Hoehn-Yahr stage,suggesting that N-acetyl-alpha-glucosaminidase could be used to rapidly evaluate Parkinson’s disease severity.Furthermore,western blot and immunohistochemistry analysis showed that N-acetyl-alpha-glucosaminidase levels were markedly reduced both in cells treated with 1-methyl-4-phenylpyridinium and cells overexpressingα-synuclein compared with control cells.Additionally,N-acetyl-alpha-glucosaminidase overexpression significantly increased cell viability and inhibitedα-synuclein expression in 1-methyl-4-phenylpyridinium-treated cells.Taken together,our findings demonstrate for the first time that exosomal N-acetyl-alpha-glucosaminidase may serve as a biomarker for Parkinson’s disease diagnosis,and that N-acetyl-alpha-glucosaminidase may reduceα-synuclein expression and 1-methyl-4-phenylpyridinium-induced neurotoxicity,thus providing a new therapeutic target for Parkinson’s disease.展开更多
Netrin-1 and its receptors play crucial roles in inducing axonal growth and neuronal migration during neuronal development.Their profound impacts then extend into adulthood to encompass the maintenance of neuronal sur...Netrin-1 and its receptors play crucial roles in inducing axonal growth and neuronal migration during neuronal development.Their profound impacts then extend into adulthood to encompass the maintenance of neuronal survival and synaptic function.Increasing amounts of evidence highlight several key points:(1)Diminished Netrin-1 levels exacerbate pathological progression in animal models of Alzheimer’s disease and Parkinson’s disease,and potentially,similar alterations occur in humans.(2)Genetic mutations of Netrin-1 receptors increase an individuals’susceptibility to neurodegenerative disorders.(3)Therapeutic approaches targeting Netrin-1 and its receptors offer the benefits of enhancing memory and motor function.(4)Netrin-1 and its receptors show genetic and epigenetic alterations in a variety of cancers.These findings provide compelling evidence that Netrin-1 and its receptors are crucial targets in neurodegenerative diseases.Through a comprehensive review of Netrin-1 signaling pathways,our objective is to uncover potential therapeutic avenues for neurodegenerative disorders.展开更多
Parkinson’s disease is a common neurodegenerative disease with movement disorders associated with the intracytoplasmic deposition of aggregate proteins such asα-synuclein in neurons.As one of the major intracellular...Parkinson’s disease is a common neurodegenerative disease with movement disorders associated with the intracytoplasmic deposition of aggregate proteins such asα-synuclein in neurons.As one of the major intracellular degradation pathways,the autophagy-lysosome pathway plays an important role in eliminating these proteins.Accumulating evidence has shown that upregulation of the autophagy-lysosome pathway may contribute to the clearance ofα-synuclein aggregates and protect against degeneration of dopaminergic neurons in Parkinson’s disease.Moreover,multiple genes associated with the pathogenesis of Parkinson’s disease are intimately linked to alterations in the autophagy-lysosome pathway.Thus,this pathway appears to be a promising therapeutic target for treatment of Parkinson’s disease.In this review,we briefly introduce the machinery of autophagy.Then,we provide a description of the effects of Parkinson’s disease–related genes on the autophagy-lysosome pathway.Finally,we highlight the potential chemical and genetic therapeutic strategies targeting the autophagy–lysosome pathway and their applications in Parkinson’s disease.展开更多
BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significan...BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.展开更多
Alzheimer’s disease is a debilitating,progressive neurodegenerative disorder characterized by the progressive accumulation of abnormal proteins,including amyloid plaques and intracellular tau tangles,primarily within...Alzheimer’s disease is a debilitating,progressive neurodegenerative disorder characterized by the progressive accumulation of abnormal proteins,including amyloid plaques and intracellular tau tangles,primarily within the brain.Lysosomes,crucial intracellular organelles responsible for protein degradation,play a key role in maintaining cellular homeostasis.Some studies have suggested a link between the dysregulation of the lysosomal system and pathogenesis of neurodegenerative diseases,including Alzheimer’s disease.Restoring the normal physiological function of lysosomes hold the potential to reduce the pathological burden and improve the symptoms of Alzheimer’s disease.Currently,the efficacy of drugs in treating Alzheimer’s disease is limited,with major challenges in drug delivery efficiency and targeting.Recently,nanomaterials have gained widespread use in Alzheimer’s disease drug research owing to their favorable physical and chemical properties.This review aims to provide a comprehensive overview of recent advances in using nanomaterials(polymeric nanomaterials,nanoemulsions,and carbon-based nanomaterials)to enhance lysosomal function in treating Alzheimer’s disease.This review also explores new concepts and potential therapeutic strategies for Alzheimer’s disease through the integration of nanomaterials and modulation of lysosomal function.In conclusion,this review emphasizes the potential of nanomaterials in modulating lysosomal function to improve the pathological features of Alzheimer’s disease.The application of nanotechnology to the development of Alzheimer’s disease drugs brings new ideas and approaches for future treatment of this disease.展开更多
Alzheimer's disease poses a significant global health challenge owing to the progressive cognitive decline of patients and absence of curative treatments.The current therapeutic strategies,primarily based on choli...Alzheimer's disease poses a significant global health challenge owing to the progressive cognitive decline of patients and absence of curative treatments.The current therapeutic strategies,primarily based on cholinesterase inhibitors and N-methyl-Daspartate receptor antagonists,offer limited symptomatic relief without halting disease progression,highlighting an urgent need for novel research directions that address the key mechanisms underlying Alzheimer's disease.Recent studies have provided insights into the critical role of glycolysis,a fundamental energy metabolism pathway in the brain,in the pathogenesis of Alzheimer's disease.Alterations in glycolytic processes within neurons and glial cells,including microglia,astrocytes,and oligodendrocytes,have been identified as significant contributors to the pathological landscape of Alzheimer's disease.Glycolytic changes impact neuronal health and function,thus offering promising targets for therapeutic intervention.The purpose of this review is to consolidate current knowledge on the modifications in glycolysis associated with Alzheimer's disease and explore the mechanisms by which these abnormalities contribute to disease onset and progression.Comprehensive focus on the pathways through which glycolytic dysfunction influences Alzheimer's disease pathology should provide insights into potential therapeutic targets and strategies that pave the way for groundbreaking treatments,emphasizing the importance of understanding metabolic processes in the quest for clarification and management of Alzheimer's disease.展开更多
文摘Objective To observe the value of grey-level histogram analysis based on T2WI for differentiating consistency of meningioma.Methods Data of 109 patients with meningioma were retrospectively analyzed.The patients were divided into hard group(n=71)and soft group(n=38)according to the consistency of tumors.Tumor ROI was outlined on axial T2WI showing the largest tumor section,gray levels were extracted and histogram analysis was performed.The value of each histogram parameter were compared between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficiency for differentiating soft and hard meningioma.Results P 1,P 10,P 50,P 90,P 99 and the mean grey levels on T2WI in soft group were all higher than those in hard group(all P<0.05),while the variance,the kurtosis and the skewness were not significantly different between groups(all P>0.05).The differentiating efficiency of P 1,P 10,P 50,P 90,P 99 and the mean grey levels on T2WI were all fine,with AUC of 0.774 to 0.833,and no significant difference was found(all P>0.05).Conclusion Parameters of grey-level histogram analysis such as P 1,P 10,P 50,P 90,P 99 and the mean values based on T2WI were all valuable for differentiating soft and hard meningioma.
文摘BACKGROUND Spinal meningiomas(SMs)are common benign tumors that are typically treated with surgical resection.The choice of surgical approach may vary depending on the location of dural attachment of the SM,with a posterior approach being the traditional preference.However,there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.The average age of the included 34 patients’(10 males and 24 females)age was 62.09 years.Mean follow-up duration was 22.65 months.The location of SM was the thoracic spine in 32 cases,with only 2 in the cervical spine.On average,intraoperative blood loss was 520.59 mL,and operating time was 176.76 minutes.Thirty three cases had successful outcomes while only 1 experienced an unexpe-cted outcome.The tumor recurrence rate was 2.9%.After surgery,there were 3 cases of cerebral spinal fluid leakage,1 case of pneumonia,and 1 case of urinary tract infection.Dural attachments were predominantly found dorsal or dorso-lateral(13 cases),followed by ventral or ventrolateral(14 cases),and lateral(7 cases).The outcomes among these subgroups were similar.CONCLUSION The posterior approach for SM resection is safe and effective,yielding comparable surgical and neurological outcomes regardless of the dural attachment location.
文摘BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus.Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign.Tumor resection was performed using a right retro sigmoid approach.A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid.The tumor was firmly adherent to the superior petrosal vein.The origin site was cauterized and resected with the preservation of the superior petrosal vein.A diagnosis of meningothelial meningioma was made.The patient’s headache and tinnitus gradually disappeared,and a recurrence was not observed five years after the surgery.CONCLUSION The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery.The absence of dural attachment makes it easy to completely resect such tumors.Vessels related to tumors should be removed carefully,considering the possible presence of tumor stem cells in the microvessels.
文摘In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.
文摘This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.
文摘Background: The simultaneous presence of a pituitary adenoma and a meningioma is a rare and underreported condition. The randomly encountered cases need to be reported to further allow our understanding of this collision tumors that are still not understood nor fully described. Patients and Method: We report a case of coexisting nonfunctioning pituitary adenoma and a left temporal lobe meningioma revealed by a 1-year history of progressive vision loss and occasional headaches in a 56-year-old woman. Her clinical condition worsened in the last 5 months with ptosis, cavernous sinus syndrome, and ophthalmoplegia of the right eye without papilledema. There was an improvement in the visual symptoms after subtotal resection of both lesions through a right frontotemporal craniotomy. Histology confirmed a collision tumor. The patient was referred for adjuvant treatment with gamma knife radiosurgery. He was doing well and back to his usual duties 6 months later. Conclusion: A gross total or subtotal resection with adjuvant therapy is the gold standard for the surgical management of collision tumors for a favorable patient outcome.
文摘Background: There is limited information regarding adjuvant treatment for malignant meningiomas. Although external whole-brain irradiation is recommended, the patient’s family in our case rejected this modality. Notably, traditional chemotherapy was ineffective. Aim: I speculated if the exfoliation of graphene could disassemble the three-dimensional (3D) structures of the graphene because the tumor mass or the blood clots including the graphene consisted of inhomogeneous materials. Therefore, I aimed to explore another possible mechanism for the instant removal of inhomogeneous materials. Method: Herein, I report a case of anaplastic papillary meningioma. A 59- year-old man presented with partial complex seizures and recurrent headaches following craniotomy for the removal of a mass with a right frontotemporal convexity 10 years ago. Computed tomography (CT) and magnetic resonance imaging demonstrated a right frontotemporal mass with diffuse contrast enhancement and extensive surrounding edema. A right frontotemporal flap was performed. The tumor and the infiltrated dura were removed, but massive intraoperative bleeding occurred and the right middle cerebral artery was clipped at the M2 territory. Postoperatively, the follow-up CT scan revealed hydrocephalus. Accordingly, a ventriculoperitoneal shunt was placed. The patient suffered from left hemiplegia as a sequela of intraoperative bleeding. Four months later, the follow-up CT scan showed chronic epidural hematoma in the right frontotemporoparietal region. The patient also had an altered level of consciousness. Results: The patient’s level of consciousness was restored after infusion of a NaCl + KCl solution with instant disappearance of the mass. Conclusion: There may be another mechanism for disassembling the inhomogeneous graphene-containing complex, such as quantum fluctuation of the graphene exfoliation with pair annihilation or relation to tissue engineering by the graphene.
基金Supported by Beijing Municipal Commission of Education,No.SM202214075001。
文摘BACKGROUND Adult-onset Still's disease(AOSD)is a rare autoinflammatory disease charac-terized by nonspecific symptoms such as fever,rash,sore throat and arthralgia.This paper reports a clinical case of AOSD successfully treated with Bo’s abdo-minal acupuncture(BAA).CASE SUMMARY We report a 20-year-old man who suffered from cold exposure,presenting with high fever,rash,sore throat,arthralgia,and elevated erythrocyte sedimentation rate,leukocytosis with neutrophilic predominance,elevated ferritin,elevated C-reactive protein,and negative rheumatoid factors.He was diagnosed with AOSD based on the Yamaguchi criteria.After treatment with traditional Chinese medi-cine(TCM)decoction and prednisone acetate tablets,there was some alleviation of sore throat,joint and muscle pain,and fever,but he still had persistent low-grade fever,rash,sore throat and arthralgia.He went to the TCM acupuncture outpatient department to receive BAA.Abdominal acupoints Zhongwan(CV12),Xiawan(CV10),0.5 cm below Xiawan(CV10),Qihai(CV6),Guanyuan(CV4),bilateral Qixue(KI13),bilateral Huaroumen(ST24),bilateral Shangfengshidian(AB1)and bilateral Daheng(SP15)were selected.After 3 months treatment,all symptoms disappeared,and the laboratory examination returned to normal levels.He did not take glucocorticoids or nonsteroidal anti-inflammatory drugs afterwards,and no relapse was observed during the 3-year follow-up period.CONCLUSION BAA can be used as a complementary medical approach for treatment of AOSD.
基金supported by the Haihe Laboratory of Cell Ecosystem Innovation Foundation,No.22HHXBSS00047(to PL)Graduate Science and Technology Innovation Project of Tianjin,No.2022BKY173(to LZ)Tianjin Municipal Science and Technology Bureau Foundation,No.20201194(to PL).
文摘With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent worldwide.Aging is considered the main risk factor for cognitive decline and acts through alterations in the composition of the gut microbiota,microbial metabolites,and the functions of astrocytes.The microbiota–gut–brain axis has been the focus of multiple studies and is closely associated with cognitive function.This article provides a comprehensive review of the specific changes that occur in the composition of the gut microbiota and microbial metabolites in older individuals and discusses how the aging of astrocytes and reactive astrocytosis are closely related to age-related cognitive decline and neurodegenerative diseases.This article also summarizes the gut microbiota components that affect astrocyte function,mainly through the vagus nerve,immune responses,circadian rhythms,and microbial metabolites.Finally,this article summarizes the mechanism by which the gut microbiota–astrocyte axis plays a role in Alzheimer’s and Parkinson’s diseases.Our findings have revealed the critical role of the microbiota–astrocyte axis in age-related cognitive decline,aiding in a deeper understanding of potential gut microbiome-based adjuvant therapy strategies for this condition.
基金supported by a Presidential Postdoctoral Fellowship (021229-00001) from Nanyang Technological University,Singapore (to JZ)a Lee Kong Chian School of Medicine Dean’s Postdoctoral Fellowship (021207-00001) from NTU Singaporea Mistletoe Research Fellowship (022522-00001) from the Momental Foundaton,USA (to CHL)
文摘The interaction between metabolic dysfunction and inflammation is central to the development of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease.Obesity-related conditions like type 2 diabetes and non-alcoholic fatty liver disease exacerbate this relationship.Peripheral lipid accumulation,particularly in the liver,initiates a cascade of inflammatory processes that extend to the brain,influencing critical metabolic regulatory regions.Ceramide and palmitate,key lipid components,along with lipid transporters lipocalin-2 and apolipoprotein E,contribute to neuroinflammation by disrupting blood–brain barrier integrity and promoting gliosis.Peripheral insulin resistance further exacerbates brain insulin resistance and neuroinflammation.Preclinical interventions targeting peripheral lipid metabolism and insulin signaling pathways have shown promise in reducing neuroinflammation in animal models.However,translating these findings to clinical practice requires further investigation into human subjects.In conclusion,metabolic dysfunction,peripheral inflammation,and insulin resistance are integral to neuroinflammation and neurodegeneration.Understanding these complex mechanisms holds potential for identifying novel therapeutic targets and improving outcomes for neurodegenerative diseases.
基金supported by the National Natural Science Foundation of China,Nos.32070534(to WY),32370567(to WY),82371874(to XL),81830032(to XL),82071421(to SL)Key Field Research and Development Program of Guangdong Province,No.2018B030337001(to XL)+2 种基金Guangzhou Key Research Program on Brain Science,No.202007030008(to XL)Department of Science and Technology of Guangdong Province,Nos.2021ZT09Y007,2020B121201006(to XL)Guangdong Basic and Applied Basic Research Foundation,Nos.2022A1515012301(to WY),2023B1515020031(to WY).
文摘The vast majority of in vitro studies have demonstrated that PINK1 phosphorylates Parkin to work together in mitophagy to protect against neuronal degeneration.However,it remains largely unclear how PINK1 and Parkin are expressed in mammalian brains.This has been difficult to address because of the intrinsically low levels of PINK1 and undetectable levels of phosphorylated Parkin in small animals.Understanding this issue is critical for elucidating the in vivo roles of PINK1 and Parkin.Recently,we showed that the PINK1 kinase is selectively expressed as a truncated form(PINK1–55)in the primate brain.In the present study,we used multiple antibodies,including our recently developed monoclonal anti-PINK1,to validate the selective expression of PINK1 in the primate brain.We found that PINK1 was stably expressed in the monkey brain at postnatal and adulthood stages,which is consistent with the findings that depleting PINK1 can cause neuronal loss in developing and adult monkey brains.PINK1 was enriched in the membrane-bound fractionations,whereas Parkin was soluble with a distinguishable distribution.Immunofluorescent double staining experiments showed that PINK1 and Parkin did not colocalize under physiological conditions in cultured monkey astrocytes,though they did colocalize on mitochondria when the cells were exposed to mitochondrial stress.These findings suggest that PINK1 and Parkin may have distinct roles beyond their well-known function in mitophagy during mitochondrial damage.
基金supported by the Science and Technology(S&T)Program of Hebei Province,No.22377798D(to YZ).
文摘Parkinson’s disease is the second most common progressive neurodegenerative disorder,and few reliable biomarkers are available to track disease progression.The proteins,DNA,mRNA,and lipids carried by exosomes reflect intracellular changes,and thus can serve as biomarkers for a variety of conditions.In this study,we investigated alterations in the protein content of plasma exosomes derived from patients with Parkinson’s disease and the potential therapeutic roles of these proteins in Parkinson’s disease.Using a tandem mass tag-based quantitative proteomics approach,we characterized the proteomes of plasma exosomes derived from individual patients,identified exosomal protein signatures specific to patients with Parkinson’s disease,and identified N-acetyl-alpha-glucosaminidase as a differentially expressed protein.N-acetyl-alpha-glucosaminidase expression levels in exosomes from the plasma of patients and healthy controls were validated by enzyme-linked immunosorbent assay and western blot.The results demonstrated that the exosomal N-acetyl-alpha-glucosaminidase concentration was not only lower in Parkinson’s disease,but also decreased with increasing Hoehn-Yahr stage,suggesting that N-acetyl-alpha-glucosaminidase could be used to rapidly evaluate Parkinson’s disease severity.Furthermore,western blot and immunohistochemistry analysis showed that N-acetyl-alpha-glucosaminidase levels were markedly reduced both in cells treated with 1-methyl-4-phenylpyridinium and cells overexpressingα-synuclein compared with control cells.Additionally,N-acetyl-alpha-glucosaminidase overexpression significantly increased cell viability and inhibitedα-synuclein expression in 1-methyl-4-phenylpyridinium-treated cells.Taken together,our findings demonstrate for the first time that exosomal N-acetyl-alpha-glucosaminidase may serve as a biomarker for Parkinson’s disease diagnosis,and that N-acetyl-alpha-glucosaminidase may reduceα-synuclein expression and 1-methyl-4-phenylpyridinium-induced neurotoxicity,thus providing a new therapeutic target for Parkinson’s disease.
基金supported by the National Natural Science Foundation of China(Youth Science Fund Project),No.81901292(to GC)the National Key Research and Development Program of China,No.2021YFC2502100(to GC)the National Natural Science Foundation of China,No.82071183(to ZZ).
文摘Netrin-1 and its receptors play crucial roles in inducing axonal growth and neuronal migration during neuronal development.Their profound impacts then extend into adulthood to encompass the maintenance of neuronal survival and synaptic function.Increasing amounts of evidence highlight several key points:(1)Diminished Netrin-1 levels exacerbate pathological progression in animal models of Alzheimer’s disease and Parkinson’s disease,and potentially,similar alterations occur in humans.(2)Genetic mutations of Netrin-1 receptors increase an individuals’susceptibility to neurodegenerative disorders.(3)Therapeutic approaches targeting Netrin-1 and its receptors offer the benefits of enhancing memory and motor function.(4)Netrin-1 and its receptors show genetic and epigenetic alterations in a variety of cancers.These findings provide compelling evidence that Netrin-1 and its receptors are crucial targets in neurodegenerative diseases.Through a comprehensive review of Netrin-1 signaling pathways,our objective is to uncover potential therapeutic avenues for neurodegenerative disorders.
基金supported by the National Natural Science Foundation of China,No.82101340(to FJ).
文摘Parkinson’s disease is a common neurodegenerative disease with movement disorders associated with the intracytoplasmic deposition of aggregate proteins such asα-synuclein in neurons.As one of the major intracellular degradation pathways,the autophagy-lysosome pathway plays an important role in eliminating these proteins.Accumulating evidence has shown that upregulation of the autophagy-lysosome pathway may contribute to the clearance ofα-synuclein aggregates and protect against degeneration of dopaminergic neurons in Parkinson’s disease.Moreover,multiple genes associated with the pathogenesis of Parkinson’s disease are intimately linked to alterations in the autophagy-lysosome pathway.Thus,this pathway appears to be a promising therapeutic target for treatment of Parkinson’s disease.In this review,we briefly introduce the machinery of autophagy.Then,we provide a description of the effects of Parkinson’s disease–related genes on the autophagy-lysosome pathway.Finally,we highlight the potential chemical and genetic therapeutic strategies targeting the autophagy–lysosome pathway and their applications in Parkinson’s disease.
基金Supported by Natural Science Foundation of Anhui Medical University,No.2023xkj130.
文摘BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
基金supported by the Natural Science Foundation of Shanghai,No.22ZR147750Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission,No.23Y11906600Shanghai Changzheng Hospital Innovative Clinical Research Project,No.2020YLCYJ-Y02(all to YY).
文摘Alzheimer’s disease is a debilitating,progressive neurodegenerative disorder characterized by the progressive accumulation of abnormal proteins,including amyloid plaques and intracellular tau tangles,primarily within the brain.Lysosomes,crucial intracellular organelles responsible for protein degradation,play a key role in maintaining cellular homeostasis.Some studies have suggested a link between the dysregulation of the lysosomal system and pathogenesis of neurodegenerative diseases,including Alzheimer’s disease.Restoring the normal physiological function of lysosomes hold the potential to reduce the pathological burden and improve the symptoms of Alzheimer’s disease.Currently,the efficacy of drugs in treating Alzheimer’s disease is limited,with major challenges in drug delivery efficiency and targeting.Recently,nanomaterials have gained widespread use in Alzheimer’s disease drug research owing to their favorable physical and chemical properties.This review aims to provide a comprehensive overview of recent advances in using nanomaterials(polymeric nanomaterials,nanoemulsions,and carbon-based nanomaterials)to enhance lysosomal function in treating Alzheimer’s disease.This review also explores new concepts and potential therapeutic strategies for Alzheimer’s disease through the integration of nanomaterials and modulation of lysosomal function.In conclusion,this review emphasizes the potential of nanomaterials in modulating lysosomal function to improve the pathological features of Alzheimer’s disease.The application of nanotechnology to the development of Alzheimer’s disease drugs brings new ideas and approaches for future treatment of this disease.
基金supported by the National Natural Science Foundation of China,No.82271214(to ZY)the Natural Science Foundation of Hubei Province of China,No.2022CFB109(to ZY)。
文摘Alzheimer's disease poses a significant global health challenge owing to the progressive cognitive decline of patients and absence of curative treatments.The current therapeutic strategies,primarily based on cholinesterase inhibitors and N-methyl-Daspartate receptor antagonists,offer limited symptomatic relief without halting disease progression,highlighting an urgent need for novel research directions that address the key mechanisms underlying Alzheimer's disease.Recent studies have provided insights into the critical role of glycolysis,a fundamental energy metabolism pathway in the brain,in the pathogenesis of Alzheimer's disease.Alterations in glycolytic processes within neurons and glial cells,including microglia,astrocytes,and oligodendrocytes,have been identified as significant contributors to the pathological landscape of Alzheimer's disease.Glycolytic changes impact neuronal health and function,thus offering promising targets for therapeutic intervention.The purpose of this review is to consolidate current knowledge on the modifications in glycolysis associated with Alzheimer's disease and explore the mechanisms by which these abnormalities contribute to disease onset and progression.Comprehensive focus on the pathways through which glycolytic dysfunction influences Alzheimer's disease pathology should provide insights into potential therapeutic targets and strategies that pave the way for groundbreaking treatments,emphasizing the importance of understanding metabolic processes in the quest for clarification and management of Alzheimer's disease.