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ABSTRACT: Previous studies have shown that glioma patients have lower blood IgE levels than controls. To evaluate its potential as a surrogate biomarker for glioma, we measured plasma IgE levels in glioma patients and healthy controls, and correlated them with clinicopathological factors and the patients' outcome.
We used enzyme-linked immunosorbant assay (ELISA) to determine the plasma IgE levels of 25 normal subjects and 252 glioma patients (85 patients with grade II glioma, 46 patients with grade III glioma, and 121 patients with glioblastoma). We also collected longitudinal plasma samples from glioblastoma patients and compared the plasma IgE levels before operation, one week after operation, in the middle of radiotherapy, after two cycles of chemotherapy, and after recurrence. The correlations between plasma IgE levels and the outcomes of the patients were determined.
Plasma IgE levels were significantly lower in glioma patients (P = 0.004); patients with low-grade glioma have lower IgE levels than patients with high-grade glioma do (P = 0.029). In 24 patients with both preoperative plasma and two-cycle chemotherapy plasma samples, IgE levels increased after successful removal of the tumor (P = 0.021), and the increase correlated with the patients' survival (increase > 100 ng/ml vs. ≤ 100 ng/ml, 127.5 weeks vs. 62.3 weeks. P = 0.012, log-rank). Plasma IgE level increase of > 100 ng/ml has a specificity of 80% and a sensitivity of 78% to predict the patients' long survival (> 18 months).
Our results suggest that plasma IgE level correlates with clinical and pathological factors in glioma patients. It has the potential to be a biomarker for glioma patients.
Chinese medical journal 10/2011; 124(19):3042-8. · 0.86 Impact Factor
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ABSTRACT: Dumbbell C1 and C2 schwannomas are rare and have a distinctive presentation and anatomical features. To study the clinical characteristics of these tumors, we reviewed the microsurgical management of 18 patients with dumbbell C1 and C2 schwannomas by the far lateral approach. Data regarding clinical manifestations, radiological findings and surgical results were analyzed retrospectively. Total and subtotal resection of the tumor was achieved in 15 and three patients, respectively. At the time of discharge, 12 patients showed improvement while five patients remained the same. The average follow-up duration was 43 months (range = 3-110 months); six of seven patients had recovery from local pain or numbness. With the exception of one patient with hemiplegia or hemiparesthesia preoperatively, all patients recovered within 6 months postoperatively. The far lateral approach offers adequate exposure and access with minimal neural manipulation for treating dumbbell C1 and C2 schwannomas, and is considered the preferred surgical approach for resection of these tumors located ventrally or ventrolaterally to the first two cervical vertebrae.
Journal of Clinical Neuroscience 02/2011; 18(2):241-6. · 1.25 Impact Factor
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ABSTRACT: To investigate the treatment of chronic subdural hematoma (CSDH) with burr-hole craniotomy in our hospital.
From January 2004 to December 2009, 398 patients with CSDH, 338 males and 60 females (male/female equal to 5.63/1), received burr-hole craniotomy in our hospital. The median age was 60 years with the mean age of (58.1 ± 18.1) years, (65.0 ± 14.5) years for females and (57.0 ± 18.2) years for males. Trauma history was determined in 275 patients (69.1%). Burr-hole craniotomy was performed under local anesthesia in 368 patients and general anesthesia in 30 patients. CSDH was classified into 3 groups according to the density on CT scan. Clinical data concerning etiologies, symptoms and signs, concomitant diseases, diagnosis, therapies and outcomes were investigated retrospectively. Patients'neurological status on admission and at discharge was also classified to judge the outcomes.
Generally, trauma history showed few differences between those over 60 years old and under 60 years old, but showed obvious differences when gender was taken into account. Totally 123 male patients (60.0% of 204 cases) suffering from head injuries were under 60 years, whereas 35 female patients (85.4% of 41 cases) with trauma histories were over 60 years. The duration from trauma to appearance of clinical symptoms was (84.0 ± 61.7) days (range, 0-1493 days). Traumatic accident was the leading etiology, other accompanying diseases such as cerebral vascular disease, hypertension, etc, were also predisposing factors. Commonly, the elderly presented with hemiplegia/hemidysesthesia/hemiataxia and the young with headache. Most CSDH patients (95.6%) treated with burr-hole craniotomy successfully recovered. However, postoperative complications occurred in 17 cases, including recurrence of CSDH in 15 cases, subdural abscess in 1 case and pneumonia in 3 cases.
Burr-hole craniotomy is an easy, efficient and reliable way to treat CSDH.
Chinese Journal of Traumatology (English Edition) 10/2010; 13(5):265-9.
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ABSTRACT: To explore the surgical strategy of the tumors of petroclival region.
The surgical data of 55 cases presented with meningioma and trigeminal nerve sheath tumors from January 2002 to February 2009 was retrospectively analyzed. All the cases were divided into full-cut group, sub-total resection group, part of resection group or divided into full-cut group and no-total resection group, in terms of various surgical strategy. The incidence of postoperative neurological disorder and quality of life status were focused and statistical analysis was carried out.
There were 21 patients with complete cut, 22 patients with sub-total resection and 12 patients with part of resection. There were 12 patients with neurological deterioration in full-cut group and 10 patients in no-total resection group. There was significant difference between total resection group and no-total resection group (χ(2) = 4.16, P < 0.05). All the patients were assessed based on the criterion of KPS, 12 patients of full-cut whose KPS ≥ 80, 29 patients were the same in no-total resection group. There was significant difference between the two groups (χ(2) = 5.42, P < 0.05). The mean follow-up time was 3 years. No recurrence was found in full-cut group and 5 recurrence of no-total resection group.
The pursuit of full-cut for the tumors of petroclival region may result in serious neurological dysfunction and poor life quality after the operation. Non-full-cut combination of postoperative radiotherapy may receive a relative better results.
Zhonghua wai ke za zhi [Chinese journal of surgery] 08/2010; 48(16):1225-8.
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ABSTRACT: To explore the clinical manifestation, diagnosis and surgical treatment of cerebrospinal fluid rhinorrhea in sphenoidal sinus.
Nine cases of cerebrospinal fluid rhinorrhea in sphenoidal sinus from 2007 to 2009 were retrospectively analyzed consisting of their possible etiological factors, clinical manifestations, localization of the leakage site and treatment methods. Among them, there were 3 cases of traumatic rhinorrhea, 4 postoperative rhinorrhea and 2 spontaneous rhinorrhea. All 9 patients underwent 3-dimensional CT scan in sellar region including all para-nasal sinus. Leakage site was identified and repairing procedure was performed through trans-sphenoidal approach.
All cases were cured with the trans-sphenoidal microsurgical procedure. They were followed up for 9 months to 2 years. No recurrence, no infection and epilepsy complications were observed.
For the cerebrospinal fluid rhinorrhea at sphenoidal sinus, it is critical to identify the leakage site accurately and the trans-sphenoidal approach is a microinvasive and effective way to repair the leakage, which is worthy to be advocated.
Chinese Journal of Traumatology (English Edition) 06/2010; 13(3):178-81.
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Chinese medical journal 01/2008; 120(24):2341-3. · 0.86 Impact Factor
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ABSTRACT: To investigate the effects of tanshinone IIA (Tan IIA) on the regulation of the production of endothelin (ET)-1 (including large ET-1), mRNA levels of ET-1, endothelin-converting enzyme-1 (ECE-1), endothelin-A receptor (ETA) and endothelin-B receptor (ETB) induced by TNF-alpha in rat brain microvascular endothelial cells (BMVEC).
The ET-1 release (including large ET-1) into the culture medium was determined by enzyme immunoassay. The levels of ET-1, ECE-1, ETA, and ETB mRNA were measured by RT-PCR. Endothelin receptor binding was also tested.
The induction of ET-1 release by TNF-alpha from cultured BMVEC was dose-dependently reduced by Tan IIA, but large ET-1 levels progressively increased in response to Tan IIA; the mRNA expression of ET-1 was unaffected. Tan IIA also caused a decrease in ETA receptor mRNA and ECE-1 expression in a dose-dependent manner. Endothelin receptor binding was unaltered in BMVEC stimulated with TNF-alpha alone or a combination of TNF-alpha and Tan IIA.
These findings suggest that Tan IIA may inhibit ET-1 production in TNF-alpha-induced BMVEC through the suppression of ECE-1 synthesis.
Acta Pharmacologica Sinica 09/2007; 28(8):1116-22. · 1.95 Impact Factor
