以病例为基础的学习(Case Based Learning,CBL)模式是基于以问题为基础的学习(Problem-Based Learning,PBL)发展而来的全新教学模式,教学形式多样,其核心是以"临床病例为先导,以问题为基础"的小组讨论式教学法,适应临床医学...以病例为基础的学习(Case Based Learning,CBL)模式是基于以问题为基础的学习(Problem-Based Learning,PBL)发展而来的全新教学模式,教学形式多样,其核心是以"临床病例为先导,以问题为基础"的小组讨论式教学法,适应临床医学教学的要求,正逐渐成为临床教学中的重要方法。本文结合自身实践经验,探讨CBL教学模式在神经外科临床教学中的优势、意义、难点及局限性,以期对后续临床教学提供经验借鉴。展开更多
Objective: To observe the inhibition of intracranial glioma tumorigenesis by vascular endothelial growth factor (VEGF) antisense oligodeoxynucleotide (ODN) in rats. Methods: Totally 20 μ1 Hank's liquid containing...Objective: To observe the inhibition of intracranial glioma tumorigenesis by vascular endothelial growth factor (VEGF) antisense oligodeoxynucleotide (ODN) in rats. Methods: Totally 20 μ1 Hank's liquid containing 1×106 C6 glioma cells was seeded into rat right caudate putaraen in high-flow microinfusion with stereotactic technique. VEGF antisense ODN was simultaneously used with glioma cell. Each rat of the treated group Ⅰ and the treated group Ⅱ was treated with 1 000 μmol/L VEGF antisense ODN. Each rat of the treated group Ⅲ and the treated group Ⅳ was treated with 2 000 μmol/L VEGF antisense ODN. The experimental periods of the treated group Ⅰ , the treated group Ⅲ and the control group Ⅰ were 2 weeks, those of the treated group Ⅱ , the treated group Ⅳ and the control group Ⅱ were 3 weeks. Before sacrifice, MRI was performed on each rat. Tumor magnitude and pathologic examination were detected after samples were dissected. Results: The survival state of all treated rats was better, and that of the control rats was in severe danger. The tumor volumes of the treated group Ⅰ and the treated group Ⅱ were remarkably lessened. Tumor tissue could not be found macroscopically in the brain samples of the treated group Ⅲ and the treated group Ⅳ, but tumor nest could be found with microscopy. Tumors of the treated group I and the treated group Ⅱ had weak expressions of VEGF mRNA and VEGF, while normal brains and the samples of the treated group Ⅲ and the treated group Ⅳ had negative expressions, but tumors of the control groups had strong expressions. Conclusion: VEGF antisense ODN used early in situ can suppress angiogenesis and growth of rat intracranial glioma to retard tumorigenesis.展开更多
Objective: To construct the EGFR targeted non-viral vector GE7 system and explore the in vitro effect of p21WAF-1/CIPI gene on growth of human glioma cells mediated by the GE7 system. Methods: The EGFR targeted non-vi...Objective: To construct the EGFR targeted non-viral vector GE7 system and explore the in vitro effect of p21WAF-1/CIPI gene on growth of human glioma cells mediated by the GE7 system. Methods: The EGFR targeted non-viral vector GE7 gene delivery system was constructed. The malignant human glioma cell line U251MG was transfected in vitro with β-galactosidase gene ( reporter gene) and p21WAF-1/CIPI gee (therapeutic gene) using the GE7 system. By means of X-gal staining, MTS and FACS, the transfection efficiency of exogenous gene and apoptosis rate of tumor cells were examined. The expression of p21WAF-1/ CIPI gene in transfected U251MG cell was examined by immunohistochemis-try staining. Results: The highest transfer rate of exogenous gene was 70% . After transfection with p21WAF-1/CIPI gene, the expression of WAF-1 increased remarkably and steadily; the growth of U251MG cells were inhibited evidently. FACS examination showed G1 arrest. The average apoptosis rate was 25.2%. Conclusion: GE7 system has the ability to transfer exogenous gene to targeted cells efficiently, and expression of p21WAF-1/CIPI gene can induce apoptosis of glioma cell and inhibit its growth.展开更多
Objective：To evaluate the safety and efficiency of transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes. Methods： Twenty seven patients with dural arteriovenous fistu...Objective：To evaluate the safety and efficiency of transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes. Methods： Twenty seven patients with dural arteriovenous fistula of cavernous region were treated by transvenous embolization with micro-coils. The transvenous routes included inferior petrosal sinus, superior ophthalmic vein and facial vein. Results： Clinical cure was achieved in 23 cases and significant improvement of symptoms in 4 cases. Complete anglographic obliteration was documented in 22 patients （82%）. Residual shunting were left in 2 patients via pterygoid drainage and 1 case via inter-cavernous sinus, 2 cases via inferior petrosal sinus, disappeared one month later by manual compression carotid artery. Headache and vomiting were the most common symptoms after embolization. Three patients had diplopia and relieved within two months after embolization. There was no permanent procedure-related morbidity. The clinic follow up ranged from 5 months to 6 years, and there was not recurrence case. Conclusion： Transvenous embolization via different venous routes is a safe and efficient method for dural arteriovenous fistula of cavernous region treatment.展开更多
Objective: To clone the cDNA of human brevican secreting isoform and to investigate its mRNA expression in human glioma. Methods: The full-length cDNA of human brevican secreted isoform was cloned from a human anaplas...Objective: To clone the cDNA of human brevican secreting isoform and to investigate its mRNA expression in human glioma. Methods: The full-length cDNA of human brevican secreted isoform was cloned from a human anaplastic astrocytoma by RT-PCR, and the expression of human brevican mRNA in 22 cases of human glioma and 13 cases of non-glial brain tumors were investigated by in situ hybridization. Results: The cDNA which including the whole open reading frame of human brevican secreted isoform was obtained. In situ hybridization showed that brevican positive cells were present in all of the 22 cases of gliomas (100%), whereas none were found in the 13 cases of non-glial and metastasis brain tumors examined. Conclusion: The results suggest that brevican mRNA is highly and specifically expressed in human glioma.展开更多
Objective: To investigate the relationship between oxidative stress and apoptosis and bcl-2 expression following traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussi...Objective: To investigate the relationship between oxidative stress and apoptosis and bcl-2 expression following traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury (FPBI) of moderate severity. U-74389G (20 mg/kg) were administered intravenously before FPBI. The neurological functions were measured by beam-walk task (BWT) and beam-balance task (BBT). In addition to morphological evidence of apoptosis, TUNEL histochemistry was used to identify DNA fragmentation in situ with both light and electron microscopic levels. The internucleosomal fragments of DNA in apoptotic cells were examined using agarose gel electrophoresis. Bcl-2 protein expression was detected by immunohistochemistry. Results: The scores of BWT and BBT were significantly improved (P<0.01) in the treated animals. The treatment significantly reduced the number of apoptotic cells that was counted in the areas of the injured hemisphere at various time points following TBI. No DNA ladder was detected in the treated rats. Bcl-2 expression was observed in the cerebral cortex, subcortical white matter, dentate gyrus, hippocampal CA1 and CA3 region ipsilateral to injured hemisphere. Bcl-2 positive cells displayed normal nuclear morphology; Little Bcl-2 positive cells revealed morphological feature of apoptosis or necrosis. The immunoreactivity of Bcl-2 protein decreased significantly in the hippocampus ipsilateral impact site as early as 6 h post-injury. During 1-3 d after injury, the bcl-2 protein expression decreased relatively slow. In the U-74389G treated groups, the downregulation of bcl-2 expression was halted. Conclusion: In this model, apoptosis is associated with an activation of lipid peroxidation. U-74389G may block oxidative stress and halt the downregulation of bcl-2 expression. These may be one of the molecular mechanisms of the neuro-protective effects by U-74389G.展开更多
Objective: To observe the process of tumor response to interstitial brachytherapy of intracranial germinomas during and immediately after the therapy. Methods: Fractionated brachytherapy using 192 Ir was used in 13 pa...Objective: To observe the process of tumor response to interstitial brachytherapy of intracranial germinomas during and immediately after the therapy. Methods: Fractionated brachytherapy using 192 Ir was used in 13 patients with intracranial germinomas. The average age at diagnosis was 14.3 years (range 5-27 years). The frequency of fractionation had been increased stepwise from 3 fractionations within 5 d in the past to 26-30 fractionations in 15-20 d at present. Results: Of 9 pineal tumors, the average reduction of tumor volume was 73.2% at a cumulated radiation dose of 20 Gy and 85.3% at 30 Gy, respectively. In 4 cases of basal ganglia and thalamus areas tumors, the reduction of tumor volume was from an average 56.1% at a cumulated radiation dose of 30 Gy to 75.2% at the end of therapy. That intratumoral hemorrhage was absorbed quickly accompanying tumor regression was demonstrated in all but one patient; 6 patients died; 7 patients were still in follow-up without any evidence of tumor recurrence. Conclusion: Interstitial brachytherapy could be given as the first optional therapy for intracranial germinomas. The histological diagnosis of germinomas can be verified by stereotactic biopsy simultaneously. Germinoma is one of the sensitive tumors to interstitial brachytherapy. The radiation injury to surrounding brain tissue could be reduced by using a conformal dynamic brachytherapy.展开更多
文摘以病例为基础的学习(Case Based Learning,CBL)模式是基于以问题为基础的学习(Problem-Based Learning,PBL)发展而来的全新教学模式,教学形式多样,其核心是以"临床病例为先导,以问题为基础"的小组讨论式教学法,适应临床医学教学的要求,正逐渐成为临床教学中的重要方法。本文结合自身实践经验,探讨CBL教学模式在神经外科临床教学中的优势、意义、难点及局限性,以期对后续临床教学提供经验借鉴。
文摘Objective: To observe the inhibition of intracranial glioma tumorigenesis by vascular endothelial growth factor (VEGF) antisense oligodeoxynucleotide (ODN) in rats. Methods: Totally 20 μ1 Hank's liquid containing 1×106 C6 glioma cells was seeded into rat right caudate putaraen in high-flow microinfusion with stereotactic technique. VEGF antisense ODN was simultaneously used with glioma cell. Each rat of the treated group Ⅰ and the treated group Ⅱ was treated with 1 000 μmol/L VEGF antisense ODN. Each rat of the treated group Ⅲ and the treated group Ⅳ was treated with 2 000 μmol/L VEGF antisense ODN. The experimental periods of the treated group Ⅰ , the treated group Ⅲ and the control group Ⅰ were 2 weeks, those of the treated group Ⅱ , the treated group Ⅳ and the control group Ⅱ were 3 weeks. Before sacrifice, MRI was performed on each rat. Tumor magnitude and pathologic examination were detected after samples were dissected. Results: The survival state of all treated rats was better, and that of the control rats was in severe danger. The tumor volumes of the treated group Ⅰ and the treated group Ⅱ were remarkably lessened. Tumor tissue could not be found macroscopically in the brain samples of the treated group Ⅲ and the treated group Ⅳ, but tumor nest could be found with microscopy. Tumors of the treated group I and the treated group Ⅱ had weak expressions of VEGF mRNA and VEGF, while normal brains and the samples of the treated group Ⅲ and the treated group Ⅳ had negative expressions, but tumors of the control groups had strong expressions. Conclusion: VEGF antisense ODN used early in situ can suppress angiogenesis and growth of rat intracranial glioma to retard tumorigenesis.
基金Supported by the National High Science and Technical Foundation of China(No. 102-12-02-05)
文摘Objective: To construct the EGFR targeted non-viral vector GE7 system and explore the in vitro effect of p21WAF-1/CIPI gene on growth of human glioma cells mediated by the GE7 system. Methods: The EGFR targeted non-viral vector GE7 gene delivery system was constructed. The malignant human glioma cell line U251MG was transfected in vitro with β-galactosidase gene ( reporter gene) and p21WAF-1/CIPI gee (therapeutic gene) using the GE7 system. By means of X-gal staining, MTS and FACS, the transfection efficiency of exogenous gene and apoptosis rate of tumor cells were examined. The expression of p21WAF-1/ CIPI gene in transfected U251MG cell was examined by immunohistochemis-try staining. Results: The highest transfer rate of exogenous gene was 70% . After transfection with p21WAF-1/CIPI gene, the expression of WAF-1 increased remarkably and steadily; the growth of U251MG cells were inhibited evidently. FACS examination showed G1 arrest. The average apoptosis rate was 25.2%. Conclusion: GE7 system has the ability to transfer exogenous gene to targeted cells efficiently, and expression of p21WAF-1/CIPI gene can induce apoptosis of glioma cell and inhibit its growth.
文摘Objective：To evaluate the safety and efficiency of transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes. Methods： Twenty seven patients with dural arteriovenous fistula of cavernous region were treated by transvenous embolization with micro-coils. The transvenous routes included inferior petrosal sinus, superior ophthalmic vein and facial vein. Results： Clinical cure was achieved in 23 cases and significant improvement of symptoms in 4 cases. Complete anglographic obliteration was documented in 22 patients （82%）. Residual shunting were left in 2 patients via pterygoid drainage and 1 case via inter-cavernous sinus, 2 cases via inferior petrosal sinus, disappeared one month later by manual compression carotid artery. Headache and vomiting were the most common symptoms after embolization. Three patients had diplopia and relieved within two months after embolization. There was no permanent procedure-related morbidity. The clinic follow up ranged from 5 months to 6 years, and there was not recurrence case. Conclusion： Transvenous embolization via different venous routes is a safe and efficient method for dural arteriovenous fistula of cavernous region treatment.
文摘Objective: To clone the cDNA of human brevican secreting isoform and to investigate its mRNA expression in human glioma. Methods: The full-length cDNA of human brevican secreted isoform was cloned from a human anaplastic astrocytoma by RT-PCR, and the expression of human brevican mRNA in 22 cases of human glioma and 13 cases of non-glial brain tumors were investigated by in situ hybridization. Results: The cDNA which including the whole open reading frame of human brevican secreted isoform was obtained. In situ hybridization showed that brevican positive cells were present in all of the 22 cases of gliomas (100%), whereas none were found in the 13 cases of non-glial and metastasis brain tumors examined. Conclusion: The results suggest that brevican mRNA is highly and specifically expressed in human glioma.
基金Supported by Directive Subject of Chinese PLA(No.96L036)
文摘Objective: To investigate the relationship between oxidative stress and apoptosis and bcl-2 expression following traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury (FPBI) of moderate severity. U-74389G (20 mg/kg) were administered intravenously before FPBI. The neurological functions were measured by beam-walk task (BWT) and beam-balance task (BBT). In addition to morphological evidence of apoptosis, TUNEL histochemistry was used to identify DNA fragmentation in situ with both light and electron microscopic levels. The internucleosomal fragments of DNA in apoptotic cells were examined using agarose gel electrophoresis. Bcl-2 protein expression was detected by immunohistochemistry. Results: The scores of BWT and BBT were significantly improved (P<0.01) in the treated animals. The treatment significantly reduced the number of apoptotic cells that was counted in the areas of the injured hemisphere at various time points following TBI. No DNA ladder was detected in the treated rats. Bcl-2 expression was observed in the cerebral cortex, subcortical white matter, dentate gyrus, hippocampal CA1 and CA3 region ipsilateral to injured hemisphere. Bcl-2 positive cells displayed normal nuclear morphology; Little Bcl-2 positive cells revealed morphological feature of apoptosis or necrosis. The immunoreactivity of Bcl-2 protein decreased significantly in the hippocampus ipsilateral impact site as early as 6 h post-injury. During 1-3 d after injury, the bcl-2 protein expression decreased relatively slow. In the U-74389G treated groups, the downregulation of bcl-2 expression was halted. Conclusion: In this model, apoptosis is associated with an activation of lipid peroxidation. U-74389G may block oxidative stress and halt the downregulation of bcl-2 expression. These may be one of the molecular mechanisms of the neuro-protective effects by U-74389G.
文摘Objective: To observe the process of tumor response to interstitial brachytherapy of intracranial germinomas during and immediately after the therapy. Methods: Fractionated brachytherapy using 192 Ir was used in 13 patients with intracranial germinomas. The average age at diagnosis was 14.3 years (range 5-27 years). The frequency of fractionation had been increased stepwise from 3 fractionations within 5 d in the past to 26-30 fractionations in 15-20 d at present. Results: Of 9 pineal tumors, the average reduction of tumor volume was 73.2% at a cumulated radiation dose of 20 Gy and 85.3% at 30 Gy, respectively. In 4 cases of basal ganglia and thalamus areas tumors, the reduction of tumor volume was from an average 56.1% at a cumulated radiation dose of 30 Gy to 75.2% at the end of therapy. That intratumoral hemorrhage was absorbed quickly accompanying tumor regression was demonstrated in all but one patient; 6 patients died; 7 patients were still in follow-up without any evidence of tumor recurrence. Conclusion: Interstitial brachytherapy could be given as the first optional therapy for intracranial germinomas. The histological diagnosis of germinomas can be verified by stereotactic biopsy simultaneously. Germinoma is one of the sensitive tumors to interstitial brachytherapy. The radiation injury to surrounding brain tissue could be reduced by using a conformal dynamic brachytherapy.
