Search

Objective: To investigate the effect and mechanism of Polyphyllin Ⅱ on the proliferation, invasion and chemosensitivity of glioma cells. Method: CCK-8 cell proliferation assays and Transwell assays were employed to determine the effect of Polyphyllin Ⅱ on the proliferation and invasion of glioma cells (T98G and LN18), respectively. The expression of E-cadherin, Snail and O6-methylguanine DNA methyltranferase (MGMT) were quantified by Western blot analysis. Results: Polyphyllin Ⅱ could inhibit the proliferation of glioma cells in a time- and does-dependent manner. The half maximal inhibitory concentration (IC(50)) of T98G at 24 h, 48 h and 72 h were (5.82±0.32), (3.57±0.07) and (1.48±0.35) µmol/L, respectively. The IC(50) of LN18 at 24 h, 48 h and 72 h were (6.83±0.11), (4.28±0.29), (2.66±0.22) µmol/L, respectively. After being treated with 2 µmol/L, 4 µmol/L and 6 µmol/L Polyphyllin Ⅱ for 24 h, the percentage of invasive cell area in the chamber area was lower than those in T98G and LN18 control groups ( P <0.05). Western blot analysis showed that compared with glioma cells without Polyphyllin Ⅱ treatment, the expression of E-cadherin in T98G and LN18 was higher ( F =85.56, P <0.05; F =60.80, P <0.05), but the expression of snail was lower ( F =25.34, P <0.05; F =48.28, P <0.05). When temozolomide was used in combination with Polyphyllin Ⅱ at different concentrations, the coefficient of drug interaction (CDI) was less than 1. Western blot showed that MGMT expressions in T98G and LN18 were inhibited compared with glioma cells without Polyphyllin Ⅱ treatment ( F =40.38, P <0.05; F =48.44, P <0.05). Conclusion: Polyphyllin Ⅱ can inhibit the proliferation and invasion of glioma cells, and improve its sensitivity to Temozolomide.

Objective: This study was designed to investigate prognostic factors and the potential relationship between the expression of Ki67 and IDH of glioblastoma in the elderly (≥ 65 years old) and the clinical factors such as gender, the KPS score and treatments including surgical resection, radiotherapy and chemotherapy and the prognosis of such patients. Methods: Fifty-four elderly patients (≥ 65 years old) with glioblastoma admitted to the First Affiliated Hospital of Zhengzhou University from 2013 to 2018 were enrolled in this study. The expression of Ki67 was detected by immunohistochemical SP method and the mutation of IDH was detected by Sanger sequencing. Finally, statistical analysis was performed to determine whether Ki67, the mutation of IDH, gender, the KPS score and the extent of resection, radiotherapy and chemotherapy were associated with the clinical prognosis of the patients. Results: Of the 54 elderly patients with glioblastoma, none was detected with IDH mutation. Univariate analysis showed that Ki67( P= 0.033), the KPS score ( P= 0.008), the extent of resection ( P< 0.001) were factors influencing the prognosis of elderly patients with glioblastoma. Patients receiving postoperative adjuvant radiotherapy ( P= 0.002) and chemotherapy ( P= 0.034) had longer survival time. There was no significant correlation between gender ( P= 0.467) and prognosis. Multivariate analysis demonstrated that radiotherapy ( OR 2.446, P= 0.009) and the extent of resection ( OR 6.976, P< 0.001) were independent prognostic factors. Conclusions: No IDH mutation was detected in all the patients in this study, indicating that IDH mutation is indeed rare in elderly glioblastoma, which suggests that geriatric population often harbor a molecular phenotype with poor prognosis. Ki67, KPS score, the extent of resection, radiotherapy and chemotherapy were the factors influencing the prognosis of patients.

Objective: To evaluate the efficacy and safety of resection of lumbar nerve sheath tumors via muscle-pedicle open-door laminoplasty approach. Methods: From March 2016 to June 2018, 6 patients (4 males and 2 females, average age (45±14) years) with lumbar spinal nerve sheath tumors received surgical treatment via muscle-pedicleopen-door laminoplasty approach in the Department of Spinal Surgery, the Affiliated Hospital of Qingdao University. The operation time, blood loss, cerebral spinal fluid (CSF) leakage, and pre- and post-operative Oswestry Disability Index (ODI) and low back and leg pain visual analogue scale (VAS) were recorded for all patients. Cobb angle of lumbar lordosis was measured on the standing lateral X-ray before and 6 months after surgery. Bone fusion was observed in computed tomography at six months after surgery. Results: Total tumor resection was achieved in all the 6 patients. The operation time was from 76 to 117 minutes (average, (102±15) minutes). The blood loss was from 160 to 280 ml (average, (256±24) ml). No CSF leakage was observed in this cohort.All patients were followed up for more than 6 months. ODI and VAS for low back and leg pain were much better at one month after operation than those before the operation( t= 7.70, 8.63,11.31, all P< 0.05). The Cobb angle of lumbar lordosis before operation and at six months after the operation were comparable in all six patients( t= 0.70, P> 0.05). Bone fusion was observed in computed tomography at six months after surgery. No bone necrosis or absorption, no lamina dislodgement or spinal stenosis was occurred. Conclusions: The muscle-pedicle open-door laminoplasty approach is proved effective and safe to incise nerve sheath tumors in the lumbar spine. Some blood supply of lamina can be kept intact to accelerate bone fusion.

Objective: To investigate the prognostic values of IDH, TERT and 1p/19q in patients with anaplastic oligodendroglioma. Methods: In the study, 66 patients with pathological diagnosis of anaplastic oligodendroglioma were enrolled (The First Affiliated Hospital of Zhengzhou University 2011 to 2016 years). Kaplan-Meier method was used to calculate the survival rates. Log-rank was used to calculate the differences in group. Chi-square testwas used tocalculate the differences in common factor group. Cox regression model was used to conduct multivariate analysis. Results: The median survival time of IDH-wt and IDH-mt subgroups were 16.10 and 42.00 months with statistical significance ( P= 0.001). The median survival time of 1p/19q codeleted and 1p/19q noncodeleted subgroups were 42.00 and 22.40 months with statistical significance ( P= 0.012). IDH-mt and 1p/19q codeleted predicted better survivals compared with IDH-wt and 1p/19q noncodeleted ( P= 0.001). And IDH-mt and 1p/19q noncodeleted predicted better survivals compared with IDH-wt and 1p/19q noncodeleted ( P= 0.041), too. Multivariate survival analysis demonstrated that Molecular groups was an independent factor to evaluate the prognosis of anaplastic oligodendroglioma ( P= 0.008). Conclusion: IDH-mtand (or) 1p/19q codeletedpredicted better survivals in patients with anaplastic oligodendroglioma. IDH and 1p/19q deleted might be a biomarker for predicting prognosis of patients with anaplastic oligodendroglioma.

Objective: To investigate the prognostic values of preoperative prognostic nutritional index (PNI) in patients with lower-grade gliomas. Methods: In the study, 379 patients with pathological diagnosis of lower-grade gliomas were enrolledwhich were confirmed in The First Affiliated Hospital of Zhengzhou University (2011-02 to 2016-05). Kaplan-Meier method was used to calculate the survival rates. log-rank was used to calculate the differences in group. Cox regression model was used to conduct multivariate analysis. Results: The cutoff value of PNI was 46.70. The median survival time of PNI≤47.80 and PNI>47.80 subgroups were 46.76 and 67.37 months with statistical significance ( P< 0.001). High PNI predicted a better survival rate. Multivariate survival analysis demonstrated that low PNI was an independent risk factor to evaluate the prognosis of glioma patients. In lower-grade gliomas, high PNI predicted better survivals in TERT mutation only ( P= 0.003) and triple-negative group ( P= 0.007). Conclusion: In lower-grade gliomas, low PNI predicts worse survivals and PNI have differential prognostic significances in molecular groups of lower-grade gliomas.

Objective: To explore the clinical characteristics and microsurgical strategies of intracranial posterior circulation aneurysms. Methods: The clinical manifestations, imaging data, surgical approaches and follow-up results of 35 patients with circulating aneurysms (37 aneurysms) treated by microsurgery in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2018 were analyzed retrospectively. Results: A total of 22 aneurysms were clipped, 13 were clipped and resected, 1 case was clipped and together with AVM resection and 1 case was isolated. Of 37 aneurysms in 35 patients, 11 aneurysms were at the basilar artery apexes, 10 at the posterior cerebral arteries, 6 at the posterior inferior cerebellar arteries, 3 at the basilar arteries, 3 at the vertebral arteries (including 1 case of vertebral arterial dissecting aneurysm), 2 at the anterior inferior cerebellar arteries and 2 at the superior cerebellar arteries. The surgical approaches included pterional approach, extensive pterional approach, infratemporal fossa approach, retrosigmoid approach and far-lateral approach. The Glasgow Outcome Scale (GOS) scores showed good recovery in 24 cases, moderate neurological dysfunction in 6 cases, severe neurological dysfunction in 2 cases, persistent vegetative state in 1 case and 2 cases of death 6 months after their discharge from hospital. Conclusions: Posterior circulation aneurysms are adjacent to important structures. They are deep in position, with small operation space and difficult to operate. Full preoperative evaluation of the condition, selection of appropriate surgical methods are the key factors to benefit the patients.

Objective: To investigate if Dishevelled 2 (DVL2) regulates the apoptosis of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) via the JAK-STAT pathway. Methods: DVL2 overexpressed lentivirus was transfected into RA-FLS and the apoptosis rate was detected by flow cytometry. The effect of DVL2 on RA-FLS signaling pathway was detected by RNA-seq, and then the key genes were verified by RT-PCR. Results: Compared with the control group, DVL2 significantly increased the apoptosis rate of MH7A (3.2%±2.2% vs 25.7%±4.5%). RNA-seq results showed that DVL2 down-regulated the JAK-STAT pathway.The results of RT-PCR showed that DVL2 inhibited the gene expression of JAK2, Stat1, and Stat2; DVL2 still inhibited the gene expression of JAK2 and Stat2 but not Stat1 after TNF-α stimulation.DVL2 inhibited the gene expression of Bcl-xL, and the gene expression of Bcl-2 and Bcl-xL after TNF-α stimulation. Conclusion: DVL2 can increase the apoptosis rate of RA-FLS through inhibiting the JAK-STAT pathway and its downstream anti-apoptotic gene.

Objective: To evaluate the safety and efficacy of diagnosis and treatment of pleuroperitoneal communication in patients on peritoneal dialysis by computerized tomography (CT) peritoneography and thoracoscopic surgery. Methods: The records of 8 pleuroperitoneal communication patients treated by thoracoscopic surgery in Peking University First Hospital from January 2012 to March 2017 were retrospectively reviewed.CT peritoneography was performed before surgical treatment. Iopamiro (50 ml∶15 g) was mixed with 2 L of peritoneal dialysate solution, and then was instilled into the peritoneal cavity through the Tenckhoff catheter. After dwelling for 1 hour, CT scan was taken from thorax to upper abdomen.The thoracic cavity was filled with sterile saline, and then carbon dioxide was inflated to the peritoneal cavity via Tenckhoff catheter.Air bubbles leaking from the diaphragmatic defect were identified during thoracoscopic operation.Then defect was repaired and pleurodesis was performed. Results: The CT value of pleural effusion increased to (155±57) HU.Pleuroperitoneal communication was clearly diagnosed.The diaphragmatic defects in 5 cases were detected and repaired.However, defects in the other 3 cases were not found.The mean operative time was (152±50) minutes. All patients had uneventful recovery and reinstated normal peritoneal dialysis 3 weeks after the operation.The median follow-up time was 14.5 months (1-68 months) and no recurrence occurred. Conclusions: CT peritoneography could identify pleuroperitoneal communication clearly. Thoracoscopic surgery is a safe and reliable method for pleuroperitoneal communication and could restore patients to peritoneal dialysis.

Objective: To assess the efficacy and safety of transbronchial cryobiopsy (TBCB) for the etiologic evaluation of diffuse lung disease (DLD). Methods: Between December 2015 to April 2017, a total of 38 patients with DLD met the inclusion criteria for TBCB in the First Affiliated Hospital of Chongqing Medical University, and 35 of them consented to undergo the procedure under rigid or flexible bronchoscopy. On the tissues obtained from the 35 patients, histopathologic and microbiological evaluations were performed, and together with clinical and radiological manifestations, diagnoses were made and the efficacy of TBCB in the diagnosis of DLD was confirmed, and then therapies were planned accordingly. Complications of the biopsy procedures were recorded. Results: Of the 35 patients who were enrolled, 24 underwent TBCB under rigid bronchoscopy and 11 under flexible bronchoscopy. Another 3 patients refused the procedure due to disinclination to invasive examinations. One single procedure of TBCB took (51.8±19.2) min on average, the median number of tissues obtained was 6 (5, 8), and the median area of tissues was 15 (9, 20) mm(2).Definite diagnoses were reached in 33 patients, including idiopathic nonspecific interstitial pneumonia ( n =8), connective tissue disease-interstitial lung disease ( n =8), occupational lung disease ( n =4), idiopathic pulmonary fibrosis ( n =3), interstitial pneumonia with autoimmune features ( n =3), tuberculosis ( n =2), cryptogenic organization pneumonia ( n =1), acute interstitial pneumonia ( n =1), pulmonary infection ( n =1), hypersensitivity pneumonia ( n =1) and sarcoidosis ( n =1). Diagnostic yield was 94.3% (33 out of 35 cases diagnosed). Pneumothorax occurred in 3 patients (1 patients with mild pneumothorax , 1 moderate and 1 severe), and were resolved with thoracic puncture or pleural drainage. Bleeding occurred in all 24 patients who received TBCB under rigid bronchoscopy (11 patients with mild bleeding, 12 moderate and 1 severe) and was controlled after coagulation measures. After one month of treatment according to the diagnoses acquired with cryobiopsy, the condition was cured in 1 patient (3.0%), alleviated in 17 (51.5%), stable in 11 (33.3%), and deteriorated in 4 (12.1%). Conclusion: TBCB yields reliable diagnoses with a good safety profile.

Objective: To reduce the stemness maintenance ability of endometrial cancer stem cell and increase its sensitivity to chemotherapy by inducing hypoxia inducible factor 1α (HIF-1α) protein deSUMOylation. Methods: Lentiviral plasmid mediated ubiquitin carrier protein 9 (Ubc9) gene silencing was transgened into KLE endometrial carcinoma cells. The expression of Ubc9, small ubiquitin-related modifier 1(SUMO1) and HIF-1α protein was detected by Western blotting. Then tumor stem cells clones were cultured in 96 well plates, and these clone balls diameter were calculated. Cell cycles were determined by flow cytometry. MTT cytotoxicity assay and flow cytometry method were used to test sensitivity of cisplatin to endometrial cancer stem cell. Results: The results of Western blotting showed that Ubc9 gene was silenced well, and the covalent binding state of SUMO-1 and HIF-1α protein levels were significantly decreased ( P <0.05). Ubc9 gene silencing in endometrial cancer cells reduced clone formation rate by (31.61±5.29)% down to (11.42±3.07)%, while the cell cycle shift from G1 to G2. IC50 of cisplatin decreased from 44.37 mg/L to 7.39 mg/L, and the rate of cell apoptosis by (41.59±5.37)% down to (26.22±4.03)%. Conclusion: The stemness maintenance ability of endometrial cancer stem cell can be reduced through deSUMOylation of HIF-1α protein by silencing Ubc9 gene expression, and their sensitivity to chemotherapy be enhanced, which provides a new reference for future gene therapy of endometrial carcinoma.

Objective: To evaluate the efficacy of tracheobronchial segmental resection and reconstruction applied to surgical treatment in the patients with esophageal cancer with airway invasion. Methods: From January 2004 to April 2014, 13 patients in our center underwent radical esophagectomy combined with tracheobronchial segmental resection and reconstruction. Patient characteristics, operative procedures, postoperative complications and long-term survival were retrospectively reviewed. Results: All patients received complete resection (R0) with an average length of resected airway 2.77±0.73 cm. In addition, carinal resection plus lobar resection (including carinal pneumonectomy) was accomplished in 2 patients; 1 patient underwent aortic replacement. Complications were noted in 5 patients (39%) and 2 patients (15.38%) died within 30 days after operation. 4 patients (30.76%) suffered from airway anastomosis stenosis and all 3 of them died within 2 years after operation due to refusing bronchoscopy interventions. The overall 1-, 2-, and 5-year survival rates were 72.7%, 45.5%, and 24.2%, respectively, with a median survival time of 2 years (0.5-10 years). Conclusion: Tracheobronchial segmental resection and reconstruction can provide an opportunity of complete resection and a survival benefit for patients with esophageal cancer invading airway with acceptable morbidity and mortality. Postoperative airway anastomosis stenosis needs active treatment.