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OBJECTIVE The island sign of non-contrast computed tomography (NCCT) is a risk factor for hematoma expansion (HE) after spontaneous intracerebral hemorrhage (sICH), but has inconsistent conclusions. A meta-analysis was performed to investigate the predictive accuracy of island sign for HE. METHODS A systematic review of published literature on island sign and hematoma expansion was conducted. The pooled sensitivity, specificity and summary receiver operating characteristics curve (SROC) were generated. The publication bias was assessed by Deeks’ funnel plot asymmetry test. RESULTS Nine studies with a total of 2,939 patients were included in the present study. The pooled sensitivity and specificity of island sign for predicting hematoma expansion was 0.50 and 0.89, respectively. The area under the curve (AUC) was 0.73 in the SROC curve. There was no significant publication bias. CONCLUSION This meta-analysis suggests that island sign of non-contrast CT has a good predictive accuracy for hematoma enlargement in intracerebral hemorrhage.

To discuss the techniques and methods in respective operation of brain gliomas located in eloquent brain region under awake anesthesia state METHODS: 21 patients admitted into Department of Neurosurgery of the First Affiliated Hospital of Xiamen University were chosen as subject. Diagnosed with brain gliomas, they received operation with neuronavigation, intraoperative ultrasonography for locating the lesion and intraoperative direct electric stimulation for functional mapping of the eloquent brain region after receiving awake anesthesia. All patients were followed up from post-surgical 3 months to 18 months.Applied with MRI scanning during post-surgical 60-90d, resection results shows that 5 cases (23.8%) received total resection of lesions, 10 cases (47.6%) received subtotal resection while 6 cases (28.6%) received partial resection. Post-surgical performance shows 8 cases (38.1%) of transitory postoperative aphasia, 5 cases(23.8%) of transitory postoperative dyskinesia and 1 case(4.8%) of permanent dyskinesia. Recovery was achieved in the patients except for the 1 case of permanent dyskinesia.Comprehensive application of awake anesthesia, neuronavigation, intraoperative ultrasonography and intraoperative direct electrical stimulation facilitates recognition of clear position relationship between gliomas and eloquent brain region, and maximum safe resection of gliomas in eloquent brain region with maximal protection of brain function.

Objective To address the feasibility and predictive value of multimodal image-based 3D reconstruction in assessing features of neurovascular relationship particularly regarding the detection of offending vessels, degree of compression exerted on the nerve root, in patients who underwent microvascular decompression for primary trigeminal neuralgia. Methods This study includes 58 patients who underwent microvascular decompression for primary trigeminal neuralgia. All patients underwent preoperative 3.0-T magnetic resonance imaging (MRI) scan of 3D-TOF MRA and 3D-FIESTA sequences in combination. Multimodal MRIs were then registered with open-source software 3D Slicer, followed by 3D image reconstruction to get 3D models for detection of possible neurovascular relationship in the cerebellopontine angle (CPA). Evaluations were performed by 2 doctors and compared with the intraoperative findings and surgery video. Results For detection of offending vessels, multimodal image-based 3D reconstruction sensitivity was 93.1% (54/58). Compared with the intraoperative findings, the k coefficients for evaluating the offending vessel and the degree of compression were >0.70 (P Conclusions Multimodal image-based 3D reconstruction proved to be reliable and practical in detecting offending vessel and in predicting the degree of nerve compression. The 3D anatomical model is consistent with the structural position found during surgery, which means that the method is valuable in the formulation of preoperative plans.

Background Although chronic periodontitis has previously been reported to be linked with Alzheimer's disease (AD), the pathogenesis between the two is unclear. The purpose of this study is to analyze and screen the relevant and promising molecular markers between chronic periodontitis and Alzheimer's disease (AD). Methods In this paper, we analyzed three AD expression datasets and extracted differentially expressed genes (DEGs), then intersected them with chronic periodontitis genes obtained from text mining, and finally obtained integrated DEGs. We followed that by enriching the matching the matching cell signal cascade through DAVID analysis. Moreover, the MCODE of Cytoscape software was employed to uncover the protein–protein interaction (PPI) network and the matching hub gene. Finally, we verified our data using a different independent AD cohort. Results The chronic periodontitis gene set acquired from text abstracting was intersected with the previously obtained three AD groups, and 12 common genes were obtained. Functional enrichment assessment uncovered 12 cross-genes, which were mainly linked to cell morphogenesis involved in neuron differentiation, leading edge membrane, and receptor ligand activity. After PPI network creation, the ten hub genes linked to AD were retrieved, consisting of SPP1, THY1, CD44, ITGB1, HSPB3, CREB1, SST, UCHL1, CCL5 and BMP7. Finally, the function terms in the new independent dataset were used to verify the previous dataset, and we found 22 GO terms and one pathway, "ECM-receptor interaction pathways", in the overlapping functional terms. Conclusions The establishment of the above-mentioned candidate key genes, as well as the enriched signaling cascades, provides promising molecular markers for chronic periodontitis-related AD, which may help the diagnosis and treatment of AD patients in the future.

Background: To analyze risk factors affecting the long-term facial nerve functional outcomes in patients receiving vestibular schwannoma surgery. Method: A total of 89 cases receiving vestibular schwannoma surgery via retrosigmoid sinus approach were analyzed retrospectively. The facial nerve functional outcomes of all enrolled patients were evaluated 6 months after the operation according to House-Brackmann grading scale. The relationships between facial nerve injury and its potential risk factors were analyzed. Results: Postoperative facial nerve injury was found in 53 patients (59.6%) 6 months after the operation. The results of univariate logistic regression analysis indicated that the tumor volume, the maximum tumor diameter, the facial nerve elongation, the enlargement of internal auditory canal (IAC), the IAC size on the affected side, and the facial nerve adhesion to tumor were significantly correlated with the occurrence of facial nerve injury. The multivariate logistic regression analysis revealed that the facial nerve elongation, the facial nerve adhesion to tumor, the tumor volume, and the enlargement of IAC were the independent risk factors of facial nerve injury 6 months after vestibular schwannoma surgery. The ROC curve showed that the cut-off points of the facial nerve elongation, tumor volume and enlargement of IAC were 2.925cm,10.965 cm³ and 1.818 respectively. When the cut-off points were exceeded, the possibility of facial nerve injury would largely increase. Conclusion: With the growth of the facial nerve elongation, the tumor volume, the facial nerve adhesion to tumor, and the enlargement of IAC, the possibility of facial nerve injury after the vestibular schwannoma surgery would accordingly increase.

Background: Alzheimer disease (AD) is a progressive neurodegenerative disease caused by many factors. The essential genes and signaling pathways involved in the pathogenesis of AD are still unknown. The purpose of our research is to analyze and screen out potential molecular biomarkers and related signaling pathways.Methods: We obtained the gene expression profile of GSE18309 from the gene expression Omnibus website. Then, we used the Limma package in Rstudio to screen out differentially expressed genes (DEGs), followed by the corresponding cell signal pathway enrichment using DAVID analysis. Finally, STRING used to obtain the protein-protein interaction (PPI) network and the corresponding hub gene obtained through MCODE of Cytoscape software.Results: The results showed that a total of 119 upregulated genes and 160 downregulated genes were identified, which met the criteria of |log2 changes| ≥2, adjusted P value Conclusions: In summary, the above-obtained hub gene and the identified signaling pathway will help explore the pathogenesis of AD; and provide new therapeutic targets and prognostic assessment for AD.

Objective To investigate risk factors for aneurysm rupture in intracranial aneurysm clipping (IAC). Methods Patients admitted for IAC from April 2010 to December 2017 in the Fujita Health University Hospital or the First Affiliated Hospital of Xiamen University were retrospectively reviewed. Clinical parameters were recorded and analyzed using univariate and multivariate analysis. The Hunt-Hess grade was used to assess the preoperative clinical status of patients. Modified Rankin Scale was applied to evaluate the prognosis of patients 6 months after surgery. Results Univariate analysis showed that the preoperative clinical status ( p = 0.015) and the preoperative aneurysm rupture ( p = 0.005) were significantly associated with intraoperative aneurysm rupture (IAR) during clipping. Multivariate logistic regression analysis showed that the preoperative aneurysm rupture was an independent risk factor of IAR ( p < 0.001, OR = 10.518). There was no significant difference in the prognosis between patients with and without IAR ( p > 0.05). No significant differences existed on aspects of incidences and time points of rupture in the operations conducted by experienced surgeons compared with that conducted by less-experienced surgeons ( p > 0.05). Conclusion Preoperative aneurysm rupture is the independent risk factor for aneurysm rupture during IAC. Intraoperative rupture, if treated properly in time, has no influence on the prognosis of patients receiving IAC. Less-experienced surgeons can also reduce the incidence rate of IAR by strictly controlling surgical indications.

Oncolytic viruses represent a promising therapeutic modality, but they have yet to live up to their therapeutic potential. Safety and efficacy concerns impel us to identify least toxic oncolytic agents that would generate durable and multifaceted anti-tumor immune responses to disrupt the tumors. Here we describe a rational engineered oncolytic herpes virus (OVH) that is a selective killer for targeting tumors, has strong safety records, induces complete regression of tumors in multiple tumor models, and elicits potent antitumor immunity. By far, the potential of OVs in promoting the tumor antigen-specific humoral immune responses remains obscure. In this study, we found that effective treatment by OVH induced immunogenic cell death, which facilitates to elicit humoral immune responses. Depletion experiments revealed that B cells were required for maximal antitumor efficacy of oncolytic immunotherapy. Both serum transfer and antibody treatment experiments revealed that endogenous oncolysis-induced antigen-targeting therapeutic antibodies can lead to systemic tumor regression. Our data demonstrate that tumor-targeting immune modulatory properties confer oncolytic OVH virotherapy as potent immunotherapeutic cancer vaccines that can generate specific and efficacious antitumor humoral responses by eliciting endogenous tumor antigen-targeting therapeutic antibodies in situ, resulting in an efficacious and tumor-specific therapeutic effect.

Object The occurrence of hydrocephalic macrocephaly is uncommon. When the condition does occur, it is usually seen in infants and young children. Patients with this disorder have an excessively enlarged head and weak physical conditions. Various surgical techniques of reduction cranioplasty for the treatment of these patients have been reported. In this study, a revised surgical procedure with the aid of simulated computer imaging for the treatment of hydrocephalic macrocephaly is presented. Methods Five cases of hydrocephalic macrocephaly in children ranging in age from 16 to 97 months were reviewed. These patients underwent surgical treatment at The First Affiliated Hospital of Xiamen University over a period of 4 years from January 2007 to January 2011. After physical examination, a 3D computer imaging system to simulate the patient's postoperative head appearance and bone reconstruction was established. Afterward, for each case an appropriate surgical plan was designed to select the best remodeling method and cranial shape. Then, prior to performing reduction remodeling surgery in the patient according to the computer-simulated procedures, the surgeon practiced the bone reconstruction technique on a plaster head model made in proportion to the patient's head. In addition, a sagittal bandeau was used to achieve stability and bilateral symmetry of the remodeled cranial vault. Each patient underwent follow-up for 6–32 months. Results Medium-pressure ventriculoperitoneal shunt surgery or shunt revision procedures were performed in each patient for treating hydrocephalus, and all patients underwent total cranial vault remodeling to reduce the cranial cavity space. Three of the 5 patients underwent a single-stage surgery, while the other 2 patients underwent total cranial vault remodeling in the first stage and the ventriculoperitoneal shunt operation 2 weeks later because of unrecovered hydrocephalus. All patients had good outcome with regard to hydrocephalus and macrocephaly. Conclusions There are still no standard surgical strategies for the treatment of hydrocephalic macrocephaly. Based on their experience, the authors suggest using a computer imaging system to simulate a patient's postoperative head appearance and bone reconstruction together with total cranial vault remodeling with shunt surgery in a single-stage or 2-stage procedure for the successful treatment of hydrocephalic macrocephaly.

Supplemental Digital Content is available in the text, Background: Accumulating evidence in the last decade has pointed to the effectiveness of oncolytic virus in the treatment of a variety of cancer types in preclinical or clinical studies, showing high potency and low toxicity compared to conventional treatments. To track this research trend and highlight future directions, we conducted a bibliometric analysis of oncolytic virus research to date. Methods: Relevant studies were obtained from the Web of Science Core Collection between January 2000 and December 2018. Data were collected in terms of the number of publications, country, journal of publication, journal scope, author, and keywords or topics. Analysis and visual representation of the data were performed with CiteSpace V. Results: The trend in publications related to oncolytic virus showed a dramatic increase, from 10 publications in 2000 to 199 publications in 2018. The United States clearly dominates this field (981 publications, 52.770%), followed by Canada (244, 13.125%) and China (205, 11.027%). The top 15 academic journals account for over one third of the total publications on oncolytic virus research (724, 38.95%). Most of the related papers were published in journals with a focus on biology, medicine, immunology, medicine, molecular biology, and clinical perspectives, as represented by the dual-map overlay. The most highly cited papers were published in journals in the fields of nursing, molecular biology, general biology, genetics, health, and medicine. Over 1300 institutions have focused their attention on oncolytic virus research to date, and cooperation among mainstream institutions is common. Conclusion: The global field of oncolytic virus research has expanded at a rapid pace from 2000 to 2018. There is no doubt that North America currently has the most powerful impact on the field with respect to both productivity and contribution. However, European and some East Asian institutions are also prominent in this field. Overall, this bibliometric study identifies the top 4 hotspots in oncolytic virus research: T-cells, vaccinia virus, dendritic cells, and apoptosis. Thus, further research focuses on these topics may be more helpful to promote the clinical translation of this treatment strategy to bring a benefit to cancer patients in the near future.

Object Fibrosis along the route of CSF flow is indicated by the development of hydrocephalus. The changes of fibrosis index might reflect the level of hydrocephalus and even become a diagnostic index of hydrocephalus. The object of this study was to analyze the levels of procollagen Type I C-terminal propeptide (PICP), procollagen Type III N-terminal propeptide (PIIINP), hyaluronic acid (HA), and laminin (LN) and their significance in the CSF of communicating hydrocephalus rat models. Methods Thirty adult Sprague-Dawley rats were randomly divided into 3 groups: hydrocephalus group (20 rats) with intraventricular kaolin injections, sham control group (5 rats) with saline injections, and normal group (5 rats) without any processing. The levels of PICP, PIIINP, HA, and LN in the CSF were detected using ELISA. Results Levels of PICP, PIIINP, HA, and LN in the hydrocephalus group were significantly higher than those in the saline control group (p < 0.05). It was revealed by correlation analysis that the increase was positively correlated with the severity of ventricular dilation. Conclusions Results indicated that PICP, PIIINP, HA, and LN continue to rise dramatically in experimental hydrocephalus and may serve as the diagnostic index of hydrocephalus.

The purpose of this study was to determine the difference in discrimination between high- and low-grade supratentorial nonenhancing gliomas (HGGs and LGGs, respectively) when using apparent diffusion coefficient (ADC) values with high or standard b-value. Thirty-nine patients underwent conventional magnetic resonance imaging and diffusion-weighted imaging (DWI) with standard and high b-values (b = 1000 and 3000 s/mm2, respectively). Minimum, maximum, and mean ADC values (ADCMIN, ADCMAX, and ADCMEAN, respectively) were measured from ADC maps with both b-values. Receiver operating curve analysis was used to determine the cutoff ADC values for distinguishing between nonenhancing HGGs and LGGs. ADCMIN, ADCMAX, and ADCMEAN values for the nonenhancing HGGs were lower than those for LGGs. These differences were much larger when a high b-value was used (all P < 0.0001) than when a standard b-value was used (P = 0.0001

Background: Glioma is the most devastating brain tumor worldwide. Previous studies showed that UTRN (utrophin) was related to cancers, but its role in glioma cells remains uncovered. Materials and Methods: RNAi was used to knockdown UTRN in U251 cells using lentivirus system. The knockdown efficiency was validated by real-time quantitative PCR. Cell proliferation, cell cycle, and apoptosis progression were determined by MTT, colony formation analysis, and flow cytometry analysis. Furthermore, some apoptotic markers were examined by Western blot assay. Results: Most cells were infected. Cell proliferation and colony formation ability were suppressed in U251 cells lacking UTRN. Moreover, there was an obvious increase in cell percentage in the G2/M phases and a significant apoptosis in U251 cells after UTRN silencing. Further investigation demonstrated that UTRN knockdown activated caspase and PARP pathways. Conclusions: Knockdown of UTRN expression by shRNA evidently inhibited cell proliferation an...

Glioma as an aggressive type tumor is rapidly growing and has become one of the leading cause of cancer-related death worldwide. γ-Glutamylcyclotransferase (GGCT) has been shown as a diagnostic marker in various cancers. To reveal whether there is a correlation between GGCT and human glioma, GGCT expression in human glioma tissues and cell lines was first determined. We found that GGCT expression was up-regulated in human glioma tissues and cell lines. Further, we demonstrate that GGCT knockdown inhibits glioma cell T98G and U251 proliferation and colony formation, whereas GGCT overexpression leads to oppose effects. GGCT overexpression promotes the expression of Notch receptors and activates Akt signaling in glioma cells, and Notch-Akt signaling is activated in glioma tissues with high expression of GGCT. Finally, we show that inhibition of Notch-Akt signaling with Notch inhibitor MK-0752 blocks the effects of GGCT on glioma proliferation and colony formation. In conclusion, GGCT plays a critical role in glioma cell proliferation and may be a potential cancer therapeutic target.

Reactive gliosis has been implicated in injury and recovery patterns associated with hydrocephalus. The roles that these mechanisms play in the pathophysiology of hydrocephalus are still not clear in terms of cytopathology and gene expression. In this paper, we investigated the relationship between reactive gliosis and neuroinflammation of hydrocephalic rats of different severity at both cellular and molecular levels. Therefore 35 adult SD (standard deviation) rats were randomly divided into the normal group (n=5), the sham operation group (n=5) and the model group (n=25). Hydrocephalic rat models were induced by intraventricular injections of 3% kaolin, and the ventricular dilatation was examined by MRI (magnetic resonance imaging) at 2-week postoperation. Then the model group was subdivided into the mild group (n=5), the moderate group (n=7) and the severe group (n=9) according to the degree of ventricular dilatation. While IL-18 (interlukin 18), GFAP (glial fibrillary acidic protein), and Iba-1 (ionized calcium binding adaptor molecule-1) were detected by ELISA (enzyme-linked immunosorbent assay), RT-PCR, immunohistochemistry, Western blot and correlation analysis were conducted at the same time. According to the result comparison between the normal group and the sham operation group, the ventricle of model group was obviously enlarged (P0.01). The expression of GFAP and Iba-1 was increased (P0.05) in brain tissue of the model group and IL-18 was also increased in CSF (cerebrosinal fluid) sample of model group. It was revealed by correlation analysis that the increase was positively correlated with the severity of ventricular dilatation.These results indicate that gliosis and inflammation continue to rise dramatically in experimental hydrocephalus and can be regarded as the main factors of hydrocephalus. Regulating the level of gliosis and alleviating inflammation may provide new therapeutic methods of hydrocephalus.

Reactive gliosis has been implicated in the pathogenesis of communicating hydrocephalus. Because the activation of Wnt/β-catenin signaling pathway is considered as a significant factor to contribute to brain development, neurodegenerative process, and reactive gliosis, we target this pathway for intervention by using sFRP-l and investigated the expression of β-catenin, cyclin D-1, and glial fibrillary acidic protein (GFAP) in the brain of experimental hydrocephalic rats in terms of protein and gene expression. Therefore, 30 adult SD rats were randomly divided into the normal group (n = 5), the sham operation group (n = 5), the hydrocephalus group (n = 10), and the sFRP-l group (n = 10). Hydrocephalic rat models were induced by intraventricular injections of 3 % kaolin while sFRP-l group was treated by sFRP-l with kaolin injections. The ventricular dilatation was examinated by MRI at 2-week post-operation. After that, β-catenin, cyclin D-1, and GFAP were qualified by Western blot and immunohistochemistry. According to the result, the expression of β-catenin and cyclin D-1 increased (P

Fibrosis along the route of CSF flow is indicated by the development of hydrocephalus. The changes of fibrosis index might reflect the level of hydrocephalus and even become a diagnostic index of hydrocephalus. The object of this study was to analyze the levels of procollagen Type I C-terminal propeptide (PICP), procollagen Type III N-terminal propeptide (PIIINP), hyaluronic acid (HA), and laminin (LN) and their significance in the CSF of communicating hydrocephalus rat models.Thirty adult Sprague-Dawley rats were randomly divided into 3 groups: hydrocephalus group (20 rats) with intraventricular kaolin injections, sham control group (5 rats) with saline injections, and normal group (5 rats) without any processing. The levels of PICP, PIIINP, HA, and LN in the CSF were detected using ELISA.Levels of PICP, PIIINP, HA, and LN in the hydrocephalus group were significantly higher than those in the saline control group (p0.05). It was revealed by correlation analysis that the increase was positively correlated with the severity of ventricular dilation.Results indicated that PICP, PIIINP, HA, and LN continue to rise dramatically in experimental hydrocephalus and may serve as the diagnostic index of hydrocephalus.

To evaluate the clinical effectiveness of programmable valves compared with non-programmable valves of hydrocephalus.In this paper, the authors report a systematic review and meta-analysis of complications and revision rate for programmable valves and non-programmable implantation. Randomized or non-randomized controlled trials of hydrocephalus treated by programmable and non-programmable valves were considered for inclusion.Seven published reports of eligible studies involving 1702 participants meet the inclusion criteria. Compared with non-programmable, programmable valves had no significant difference in catheter-related complications [RR = 0.88, 95%CI (0.66,1.19), p = 0.10] and infection rate [RR = 1.25, 95%CI (0.92,1.69), p = 1.00]. There were significant differences in overall complications [RR = 0.80, 95%CI (0.67,0.96), p0.01], over-drainage or under-drainage complications [RR = 0.44, 95%CI (0.31,0.63), p0.01] and revision rate [RR = 0.56, 95%CI (0.45,0.69), p0.01] in favor of programmable valves.Although the studies seem to demonstrate a small advantage for the programmable shunts, the probable bias and the difficulties in patient selection are too important to make a general conclusion.

Magnetic nano-size solid acid catalysts were prepared, characterized, and examined, for the first time, for the esterification of free fatty acid (FFA) to develop a green and efficient pretreatment step for producing biodiesel (fatty acid methyl ester, FAME) from waste grease containing FFA. PGMA-cat 4, consisting of a core of iron oxide magnetic nanoparticles (MNPs), a poly(glycidyl methacrylate) (PGMA) shell, and sulfonic acid groups on the surface, was synthesized in 98% yield from the corresponding core–shell structured PGMA–MNPs containing epoxy surface groups by gentle sulfonation with Na2SO3, possessing a mean size of 90 nm, high acid capacity of 2.3 mmol H+ g−1, and excellent superparamagnetic properties. Esterification of FFA (16 wt%) in grease with methanol using this catalyst (4 wt%) gave 96% conversion of FFA to FAME within 2 h. PGMA-cat 4 was easily separated under a magnetic field and showed no loss of productivity during 10 cycles. In comparison, PS-cat 12, consisting of a core of iron oxide MNPs, a polystyrene shell, and benzenesulfonic acids on the surface, was active but possessed no recyclability; Si-cat 14, consisting of a core of iron oxide MNPs, a silica shell, and sulfonic acids as surface groups, showed lower activity and poor recycling performance. The catalytic performance of PGMA-cat 4 was also better than those of the micro-size counterpart such as PGMA-cat (m) 15 and large-size solid acid catalysts such as Amberlyst 15. Thus, a novel, active, stable, and recyclable magnetic nano-size solid acid catalyst was successfully developed for the green and efficient esterification of FFA in grease as a pretreatment step to produce biodiesel from waste grease.