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第十四届中国医师协会神经外科医师年会

作者： pei-sen yao Department of Neurosurgery the First Affiliated Hospital of Fujian Medical University

Rationale: Intracranial ganglioneuroblastoma represents a rare subtype of primitive neuroectodermal tumor. Here, we report a hippocampal ganglioneuroblastoma and a literature review of cerebral anglioneuroblastoma is carried out. Methods: We report a 16-year-old male patient presenting with absence seizure and high-infiltration hippocampal ganglioneuroblastoma. Magnetic resonance imaging indicates a space-occupying lesion with a well-defined margin in the right temporal lobe and hippocampus. However, hyper-signal on flair and diffusion-weighted imaging with a low apparent diffusion coefficient value is detected, which prompts high tumoral invasiveness. A total resection of tumor and subsequent chemotherapy combing with radiotherapy is ***:For a follow-up period of 60 months, no evidence of recurrence and further seizures are detected. Conclusions: High-infiltration hippocampal ganglioneuroblastoma is a rare event. MRI examination often showed features of low-grade gliomas, while hyper-signal lesion on DWI with a low ADC value can be detected. Complete resection combined with fractionated radiotherapy and chemotherapy was the optimal treatment for cerebral ganglioneuroblastoma.

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Acetylation profiles in the metabolic process of glioma-associated seizures

Acetylation profiles in the metabolic process of glioma-asso...

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第十六届中国医师协会神经外科医师年会

作者： pei-sen yao

OBJECTIVE We test the hypothesis that lysine acetylation is involved in metabolic process of glioma-associated *** We used label-free based mass spectrometry-based quantitative proteomics to quantify dynamic changes of protein acetylation between gliomas with epilepsy(CA1 group) and gliomas without epilepsy(CA2 group).Furthermore,differences of acetyltransferase and deacetylase expression between CA1 and CA2 groups were performed by a quantitative proteomic *** further classified acetylated proteins into groups according to cell component,molecular function and biological *** addition,metabolic pathways and protein interaction networks were *** acetyltransferases and acetylated profiles were validated by parallel reaction monitoring(PRM) and western *** We detected 169 down-regulated lysine acetylation sites of 134 proteins and 39 upregulated lysine acetylation sites of 35 proteins in glioma with seizures based on *** detected 407 regulated proteins by proteomics,from which acetyl-CoA acetyltransferase 2(ACAT2) and 3-ketoacyl-CoA thiolase(ACAA2) were the differentially regulated enzymes in the acetylation of glioma-associated *** to the KEGG analysis,the up-regulated acetylated proteins within the PPIs were mainly mapped to pathways involved in the tricarboxylic acid cycle,oxidative phosphorylation,biosynthesis of amino acids,and carbon *** down-regulated acetylated proteins within the PPIs were mapped to pathways involved in the fatty acid metabolism,oxidative phosphorylation,TCA cycle,and *** ACAT2 expression and acetylated profiles were validated by parallel reaction monitoring(PRM) and western *** The data support the hypothesis that regulated protein acetylation is involved in the metabolic process of glioma-associated seizures,which may be induced by acetyl-CoA acetyltransferases.

关键词： Lysine acetylation metabolic process glioma-associated seizures

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Does Extended Lesionectomy Need to Cerebral Cavernous Malformations Presenting with Epilepsy?

Does Extended Lesionectomy Need to Cerebral Cavernous Malfor...

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第十四届中国医师协会神经外科医师年会

作者： pei-sen yao Department of neurosurgery the First Affiliated Hospital of Fujian Medical University

OBJECTIVE To confirm whether extended lesionectomy need to cerebral cavernous malformations presenting with epilepsy compare with lesionectomy. METHODS A literature search of PubMed, Embase, Web of science, Clinical trials and Cochrane Library online databases was performed to include pertinent English-language studies from 1967 to 2017. Then selected eligible study according to uniform inclusion and exclusion criteria. Meta-analyses and subgroup analyses were conducted to compare extended lesionectomy versus lesionectomy. RESULTS Seven studies including 245 patients（107 extended lesionectomy, 138 lesionectomy） were enrolled. Pooled analysis of them demonstrated that seizure outcome did not statistically significantly improve in patients who underwent extended lesionectomy（OR 0.77;95% CI [0.39–1.51];P=0.44;I2=15%）. In subgroup analyses, there were no significant difference in seizure duration time before surgery, average age, study quality, year of publication, follow-up time between the two groups. For location of lesion, when the rate of temporal lobe lesion≤50%, it appeared to have a more favorable outcome tendency in the lesionectomy group（OR 0.33;95% CI [0.12–0.88];P=0.03;I2=0%）. Moreover, no publication bias was found. CONCLUSIONS There is currently no robust evidence to prove extended lesionectomy can control seizure better than lesionectomy for CCMs. In combination with previous meta-analysis lesionectomy is the best surgical methods for CCMs presenting with epilepsy now.

关键词： cerebral cavernous malformations epilepsy surgery extended lesionectomy

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Is pterional keyhole approach suitable for anterior communicating artery aneurysms?

Is pterional keyhole approach suitable for anterior communic...

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第十四届中国医师协会神经外科医师年会

作者： pei-sen yao Department of Neurosurgery the First Affiliated Hospital of Fujian Medical University

Background: Pterional keyhole approaches are still frequently discussed for treatment of anterior communicating artery aneurysms（ACoAs） because of limited craniotomies and narrowing of the visual field, which may induce new damage to surrounding brain tissue. And the complications of postoperative ACoAs via pterional keyhole approaches remain unknown. Methods: A total of 181 patients with ruptured ACoAs underwent microsurgical clipping via pterional keyhole approaches. Complications related to the petrional keyhole approach were analyzed retrospectively, including brain contusion, intraoperative aneurysms rupture, postoperative intracerebral hemotoma, subdural hematoma and hygroma, pneumocrania, postoperative intracranial infection, pneumonia, hydrocephalus, cerebral vasospasm, cerebral infarction, and reoperation. Long-term neurological outcome was assessed at the 6-month follow-up and categorized according to the patient’s modified Rankin Scale（mRS） score. And a literature review of complications in craniotomy of ACoAs was performed. Results: 46 patients（22.1%） displayed no complications or approach-related morbidity. Long-term outcomes indicated that there were 158 patients presenting with mRS score 0-3, while 23 cases with mRS score 4-6. Cerebral vasospasm and infarction were observed in 82 cases（45.3%）, intraoperative aneurysms rupture in 5 patients（2.8%）, brain contusion in 39 patients（21.5%）, intracerebral hematoma in 18 patients（99.4%）, subdural hematoma in 9（5.0%）, intracerebral infection in 15（8.3%）, pneumonia in 40（22.1%）, and hydrocephalus in 34（18.8%）. Multivariable logistic regression model indicated that predictive factors of outcome included sex（OR 4.312, 95% CI 1.153–16.130, p = 0.030）, Hunt-hess grade（OR 11.392, 95% CI 2.040–63.606, p = 0.006）, postoperative intracerebral hematoma（OR 10.567, 95% CI 2.087-53.496, p = 0.004）, and pneumonia（OR 8.064, 95% CI 2.152-30.211, p = 0.002）. Conclusions: Low rate of intracerebral hematoma, subdural hematoma, i

关键词： Complication anterior communicating artery aneurysms pterional keyhole approaches

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Lower Iron Levels Predict Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

Lower Iron Levels Predict Acute Hydrocephalus Following Aneu...

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第十四届中国医师协会神经外科医师年会

作者： pei-sen yao Department of Neurosurgery the First Affiliated Hospital of Fujian Medical University

OBJECTIVE: We test the hypothesis that low serum iron levels are associated with acute hydrocephalus following aneurysmal subarachnoid hemorrhage（aSAH）. METHODS: Patients presenting with ruptured intracranial aneurysms were enrolled in the prospectively observational study. Age, sex, history of diabetes, hypertension and hyperlipidemia, symptom onset, Fisher grade, Hunt-Hess grade, aneurysm location, hemoglobin, and serum iron were collected. Acute hydrocephalus was determined within 72 hours after subarachnoid hemorrhage. A propensity-score matching（PSM） analysis was performed to correct imbalances in patient characteristics between hydrocephalus and nonhydrocephalus groups. RESULTS: A total of 535 patients were included. Incidence of acute hydrocephalus was 20.0%. In multivariate logistic regression analysis, lower serum iron was considered as a risk factor of acute hydrocephalus, as well as delayed ischemic neurological deficit（DIND） and lower hemoglobin（p = 0.000）. After PSM, lower serum iron was considered as independent risk factor for acute hydrocephalus, while hemoglobin and DIND not. The matched hydrocephalus group had lower serum iron comparing with the matched non-hydrocephalus group（10.26 ± 5.33 mmol/L vs 13.44 ± 5.18 mmol/L, p =0.000）. The optimal cutoff value for serum iron levels as a predictor for acute hydrocephalus in aSAH patients was determined as 13.1 mmol/L in the ROC curve. Furthermore, lower serum iron levels（OR 0.305, 95%CI 0.178-0.524, p=0.000） and acute hydrocephalus（OR 0.372, 95%CI 0.202-0.684, p=0.001） were predictors of poor outcome, as well as higher Hunt-Hess grade and Fisher grade. CONCLUSION: Lower serum iron level after aSAH was a predictor of acute hydrocephalus and unfavorable outcome.

关键词： Serum iron Hydrocephalus Aneurysmal subarachnoid hemorrhage

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GLAST was regulated by TGF-α via NF-κB signaling in U251 glioma cells

GLAST was regulated by TGF-α via NF-κB signaling in U251 g...

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第十六届中国医师协会神经外科医师年会

作者： pei-sen yao

Objective:GLAST,as a glutamate-aspartate transporter,is highly expressed on the gliomas,and correlates with elevated extracellular glutamate and shortened patient *** aim of this paper is to investigate the role of TGF-α and NF-κB signaling on the GLAST of U251 glioma ***:We investigated the role of TGF-α and NF-κB signaling in the GLAST expression,proliferation,glutaminase expression,and glutamate release of U251 glioma ***:We demonstrated that GLAST and NF-κB protein,as well as mRNA levels,significantly increased after treatment of TGF-α and decreased after treatment of NF-κB ***,overexpression of GLAST induced by TGF-α was inhibited by NF-κB *** release and glutaminase expression of U251 cells significantly decreased after treatment of NF-κB *** of U251 glioma cells decreased after intervention of NF-κB ***:These results indicate that GLAST expression was regulated by TGF-α via NF-κB signaling in U251 glioma *** addition,NF-κB signaling regulated glutaminase expression,glutamate release,and proliferation of U251 glioma cells.

关键词： TGF-α GLAST NF-κB glioma

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Serum creatine kinase and high grade glioma-associated seizures

Serum creatine kinase and high grade glioma-associated seizu...

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第十六届中国医师协会神经外科医师年会

作者： pei-sen yao

Objective---We tested the hypothesis that serum creatine kinase(CK) and abnormity of CK acetylation were associated with preoperative seizure(POS) for high-grade glioma(HGG) patients in frontal and temporal ***---A total of 105 patients were included in this prospective *** characteristics,preoperative routine blood tests(including CK) measured at admission and pathological reports were *** regression and receiver operating characteristic(ROC) were used for analyzing the association between POS and serum *** used label-free based mass spectrometry-based quantitative proteomics to quantify changes of CK acetylation(including CK M type,U type,B type,and S type) between 3 gliblastoma with seizures(GS group) and 3 gliomas without seizures(GWS group).Results---Incidence of POS for HGG patients in the frontal and temporal lobe was 22.86%(24/105).Significant differences were found in sex and serum CK between POS group and non-POS *** serum CK concentrations were 83(63.00,209.75) U/L in the POS group,which was significantly higher than that in the nonPOS group(66.00(45.50,85.50) U/L(p=0.002).In the multivariate logistic regression model,higher serum CK concentrations were considered as an independent risk factor of POS(OR 11.774,95% CI 3.125-44.358,p=0.000).The optimal cutoff value for serum CK level as a predictor for POS was determined as 128 U/L in the ROC curve(the area under the curve was 0.710,and the sensitivity was 45.83%,the specificity was 95.06%).Serum CK concentrations were not significantly different between the time of latest onset of POS ≤8d group and the time of latest onset of POS>*** detected down-regulated lysine acetylation of creatine kinase B-type in gliomas samples with seizures comparing with that in gliomas without seizures based on ***---For patients with HGG in frontal and temporal lobe,higher serum CK concentrations and lysine acetylation of glioma CK were associated with P

关键词： High-grade glioma Preoperative seizure Risk factors Creatine kinase

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Twist drill craniostomy for traumatic acute subdural hematoma in the elderly: case series and literature review

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Chinese Neurosurgical Journal 2019年第2期5卷 121-128页

作者： pei-kun Huang Yong-zhong Sun Xue-ling Xie De-zhi Kang Shu-fa Zheng pei-sen yao Fujian Medical University Fuzhou 350004China Department of Neurosurgery Hui'an County HospitalHui'an 362100China Department of Neurosurgery The First Affiliated Hospital of Fujian Medical UniversityNO.20 Chazhong RoadTaijiang DistrictFuzhou 350004China The First Clinical Medical College of Fujian Medical University NO.20 Chazhong RoadTaijiang DistrictFuzhou 350004China

Background:A large craniotomy is usually the first choice for removal of traumatic acute subdural hematoma (TASDH).To date,few studies have reported that TASDH could be successfully treated by twist drill craniostomy (TDC) alone or combined with instillation of *** aimed to define the TDC for the elderly with TASDH and performed literature *** presentation:A total of 7 TASDH patients,who were presented and treated by TDC in this retrospective study between January 2009 and May 2017,consisted of 5 men and 2 women,ranging in age from 65 to 89 (average,78.9) *** patients' baseline characteristics,including age,sex,medical history,received ventriculoperitoneal shunt for hydrocephalus or not,reason for avoiding or refusing large craniotomy,preoperative Glasgow Coma Scale (GCS),suffered from cerebral herniation or not,the location of TASDH,imaging characteristics of TASDH in CT scan,injury/surgery time interval,midline shift,preoperative neurologic deficit,operation time,and infusions of urokinase or not,were *** postoperative GCS,postoperative neurologic deficit,rebleeding or not,intracranial infection,and modified Rankin Scale (mRS) at 6 months after surgery were analyzed to access the safety and efficacy of evacuation with *** results showed that the mean time interval from injury to TDC was 68.6 min (30-120 min).The mean distance of midline shift was 14.6 mm (10-20 mm).The preoperative GCS in all patients ranged from 4 to 13(median,9).The mean duration of the operation was 14.4 min (6-19 min).Postoperative CT scan showed that hematoma evacuation rate was more than 70% in all *** were no cases of acute rebleeding and intracranial infection after *** cases presented with chronic SDH at the ipsilateral side within 6 months after being treated by TDC alone or combined with instillation of *** outcomes were shown in all cases (mRS scores 0-2) at 6 months after ***:TASDH in the elderly could be

关键词： Traumatic acute subdural hematoma Cerebral herniation Twist drill craniostomy Pre-injury antiplatelet therapy The elderly

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蛛网膜下腔出血后血清铁与急性癫痫发作的关系(英文)

蛛网膜下腔出血后血清铁与急性癫痫发作的关系(英文)

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第十四届中国医师协会神经外科医师年会

作者： pei-sen yao From Department of Neurosurgery the First Affiliated Hospital of Fujian Medical University

Background and Purpose---The aim of the study is to investigate the value of serum iron and hemoglobin levels for predicting acute seizures following aneurysmal subarachnoid hemorrhage（aSAH）. Methods---Clinical and laboratorial data from patients with ruptured intracranial aneurysms were collected. Propensity-score matching（PSM） analyses were performed to correct imbalances in patient characteristics between seizure and non-seizure groups. Results---After PSM, the matched seizure group had lower serum iron and hemoglobin levels compared with the matched non-seizure group（p ＜ 0.05）. The optimal cutoff value for serum iron and hemoglobin levels as a predictor for acute seizure after aSAH was determined as 9.9 mmol/L（sensitivity was 81.63%, and the specificity was 65.40%） and 119 g/L（sensitivity was 63.27%, and the specificity was 70.18%）. Conclusions---Serum iron and hemoglobin levels were inversely associated with high risk of acute seizures following aSAH.

关键词： Hemoglobin iron epilepsy subarachnoid hemorrhage

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The classification of intracranial aneurysm neck: a single center research experience

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Chinese Neurosurgical Journal 2019年第3期5卷 129-136页

作者： Cai-Qiang Huang De-Zhi Kang Liang-Hong Yu Shu-Fa Zheng pei-sen yao Yuan-Xiang Lin Zhang-Ya Lin Department of Neurosurgery The First Affiliated HospitalFujian Medical UniversityNo.20 Changzhou RoadTaijiang DistrictFuzhou 350004Fujian ProvinceChina

There is associating with incidence of unfavorable outcomes compared to microsurgical clippings. We are in order to investigate the outcomes of microsurgical clipping for intracranial aneurysms and determine the ideal clipping methods for different aneurysm subtypes. Method: Retrospectively analyzed the clinical characteristics and follow-up data (completely recorded) of 123 patients with 128 aneurysms were treated. 20 cases were treated as control group from October 2013 to December 2013. Since January 2014, aneurysms were classified base on the 20 cases of aneurysm imaging data. 103 patients were treated as experimental group, the classification of aneurysms previously proposed was used to estimate the way of surgery, and the guiding value of the genotype was verified according to the intraoperative findings. The proposed aneurysm classification is based on the virtual surface of the aneurysm and the parent artery, the aneurysm neck was classified as follows: subtype I, the curved surface of the neck is a single curved surface;subtype II, the neck is hyperboloid;subtype III, neck is a three-curved surface. Aneurysms were divided into further subtypes according to the ratio of the width of the aneurysm neck surface and the length of the artery circumference: subtype A, the ratio of the aneurysm neck surface to the parent artery was not more than 0.5;subtype B, more than 0.5. There are some clamping methods include simple, sliding, interlocking and hybrid. Results: In the control group, patients did not undergo a suitable clipping scheme without classification of aneurysm neck (unclassed clipping). While causing the occurrence of occlusion adverse events, including neck residual, Tumor artery stenosis, electrophysiological changes, the lack of blood supply and so on. The experimental[page1image12073600]group was analyzed by using a predetermined clipping scheme (classed clipping), and the use of aneurysms clamps was approximately the same as expected. Compared the p

关键词： Intracranial aneurysms Microsurgery clipping Aneurysm neck classification Aneurysm neck curved surface

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