Neutrophils,as an important member of the tumor microenvironment,are widely distributed in the circulatory system,and neutrophils in brain parenchyma may predominantly originate from the skull and adjacent vertebral bone marrow.Recent studies have shown that neutrophils undergo phenotypic changes after contact with glioma cells and exhibit various functions including involvement in the malignant progression of glioma,immunosuppression,and antitumor effect.In the early stage,neutrophils exert an inhibitory effect on tumor cells through the mechanism of antibody-dependent cytotoxicity.With the prolongation of contact time,the antitumor effect of neutrophils gradually weakens while their tumor promotion effect gradually strengthens.In addition,neutrophils interact with other immune cells through various factors and receptors and further promote the proliferation,invasion,angiogenesis,and immune suppression of glioma.Therefore,targeted therapy against neutrophils may become a new generation of immunotherapy and enhance the efficacy of cancer treatment,and these strategies mainly involve inhibiting neutrophil recruitment and promoting neutrophil reprogramming and depletion.This article summarizes the research on the origin,functional status,and immune effect of neutrophils,as well as their impact on glioma and the prospects of targeted therapy.
Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease in adults. Many CADASIL cases were reported after NOTCH3 was identified as the causative gene of CADASIL. However, there is still no specific and effective therapies for CADASIL. In this review, we summarize recent research progress on disease models, symptomatic treatments and potential therapies for CADASIL, thereby providing a reference for follow-up CADASIL treatment research.
目的 探讨细胞周期相关基因在胶质瘤患者中的表达及预后价值.方法 利用CGGA数据库筛选与胶质瘤患者预后相关的细胞周期基因,并基于CGGA与TCGA中胶质瘤患者的临床数据,通过LASSO回归分析,构建预测患者生存情况的预后模型.根据计算公式,区分高低风险组患者,组间进行GSEA富集分析与ssGSEA免疫微环境分析.结果 筛选到10个与患者预后密切相关的细胞周期基因,LASSO回归分析纳入4个基因[细胞周期蛋白依赖性激酶抑制剂2C(CDKN2C)、姐妹染色单体分离的PTTG1调控因子(PTTG1)、细胞周期蛋白依赖性激酶2(CDK2)、WEE1 G2检查点激酶(WEE1)]构建预后模型,计算公式为:风险值(risk socre)=(0.008)×CDKN2C表达量+(0.022)×PTTG1表达量+(0.031)×CDK2表达量+(0.127)×WEE1表达量.生存分析显示,高风险组患者生存率低于低风险组,ROC曲线表明,模型在CGGA与TCGA队列中,均具有较好的预测能力.GSEA富集分析显示,高风险组富集到多个细胞周期进程相关的信号通路,提示可能参与胶质瘤的恶性进程.免疫微环境分析表明,高风险组患者的免疫细胞浸润与免疫反应激活程度均高于低风险组.结论 基于细胞周期相关基因的预后模型可较好地应用于胶质瘤患者的预后预测,纳入的关键基因可能是胶质瘤治疗的可靠靶点.
重症监护病房获得性肌无力(intensive care unit acquired weakness,ICUAW)是重症监护病房患者出现的进行性全身肢体无力,且除危重病本身外无其他原因可解释的一组临床综合征,主要表现为神经肌肉功能障碍.ICUAW的发病机制涉及中枢、周围神经系统和肌纤维内复杂的功能、结构改变,但尚未完全明确.该文综述了目前关于ICUAW的潜在发病机制,以期对ICUAW的诊治提供新思路.
目的 探讨经纵裂-胼胝体-脉络膜裂入路显微手术切除松果体区病变的可行性、疗效及优缺点.方法 分析湘雅医院神经外科2010年7月—2018年12月收治的159例经纵裂-胼胝体-脉络膜裂入路行显微手术治疗松果体区病变患者的资料,统计患者一般情况、主要症状、病变切除程度、病变病理性质、术后并发症、术后生存时间等情况,分析患者的疗效.结果 159例患者中,143例病变得到全切,10例次全切,6例大部分切除.2例患者围手术期间分别因丘脑下部损伤、呼吸循环衰竭死亡.2例患者术后出现硬膜外血肿,清除血肿后缓解.4例患者出现慢性硬膜下积液,行钻孔引流术后无效,行硬膜下积液腹腔分流后缓解.16例患者术后出现脑积水,2例行内镜下三脑室底造瘘后缓解,14例行脑室腹腔分流术后缓解.患者随访6个月～9年,5年生存率81.3％.结论 患者总体疗效较好,经纵裂-胼胝体-脉络膜裂入路是一种安全有效切除松果体区肿瘤的手术路径.
