OBJECTIVE:To evaluate the efficacy and prognosis of intraventricular medication (IVM) administered via the reservoir of Ommaya or ventricular shunt (VS) system to control leptomeningeal metastases, with or without VS based on intracranial pressure, in combination with postoperative systemic therapy. METHODS:Between April 2021 and December 2022, 125 patients with leptomeningeal metastases were managed in our department who underwent Ommaya reservoir placement and/or VS and subsequently received IVM postoperatively. The extent of symptom amelioration and survival, as well as the determinants influencing prognosis, were evaluated. The 3-, 6-month, and 1-year survival rates and mOS of the patients were calculated by the Kaplan‒Meier method, and survival and prognostic analyses were performed using the log-rank test, one-way analysis of variance, and the Cox proportional hazards model. RESULTS:Symptoms were significantly alleviated among the 113 leptomeningeal metastases with intracranial hypertension who underwent VS placement. The median survival time of 112（89.6%）cases who received medication regularly was 9.0 months, and significantly prolonged by 2-4 months compared with that of other studies not involving IVM in the literature. Cox multifactorial analysis revealed that postoperative administration of IVM and the number of IVM times independently influenced the efficacy of leptomeningeal metastases treatment. CONCLUSIONS:For leptomeningeal metastases, VS not only significantly alleviates symptoms caused by intracranial hypertension but also avoids sudden death for those with severe intracranial hypertension. However, VS placement only does not improve overall survival. IVMs controls effectively leptomeningeal metastases, significantly prolongs survival, enhances quality of life.

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Objective: The secondary injury caused by RBC autolysis after intracerebral hemorrhage (ICH) can be reduced by increasing the efficiency of microglia (MG)/macrophages (Mo) phagocytizing red blood cells (RBCs). CD47 is an important regulator of MG/Mo phagocytosis. This study aims to clarify whether anti-CD47 antibody administrated into the cisterna magna after ICH can transfer to the hematoma site, promote MG/Mo gathering to phagocytize RBCs and ultimately reduce cell death. Methods: Forty male Wistar rats were divided into sham, ICH, low-dosage (group A, 0.3 mu g), medium-dosage (group B, 0.9 mu g) and high-dosage (group C, 1.8 mu g) anti-CD47 antibody groups. For the rats in group A, B and C, anti-CD47 antibody solution was administrated into the cisterna magna at 10 min after ICH. Brain tissue was harvested 3 days after the operation. Western blotting was performed to detect the expression of Caspase-3 and Bcl-2. Immunofluorescence was performed to detect the CD68 expression. TUNEL was performed to detect the cell death. Results: The hematoma of the ICH rats was located in the basal ganglia, with a good homogeneity of hematoma volume. Low-dosage anti-CD47 antibody in group A had no effects on the perihematomal CD68 (P = 0.338), Caspase-3 (P = 0.769), Bcl-2 (P = 0.176) expression and cell death (P = 0.698), compared with the ICH group. CD68 and Bcl-2 expression increased and Caspase-3 expression decreased significantly in group B (P < 0.001 for all) and group C (P < 0.001 for all). The increase of CD68 expression in group C was greater than that in group B (P < 0.01) by a large margin, while there was no difference for Bcl-2 (P = 0.908) and Caspase-3 (P = 0.913) expression between the 2 groups. Compared with the ICH group, medium-dosage of anti-CD47 antibody in group B significantly reduced the number of TUNEL-positive cells (P < 0.005), but not for group C (P = 0.311). Conclusion: The results suggested that anti-CD47 antibody administration into the cisterna magna in proper dosage (0.9 mu g) can effectively reach the hematoma, induce more MG/Mos to gather around the hematoma, and reduce cell death in perihematomal brain tissue. The results of this study has provided a basic theory for improving the efficiency of MG/Mo phagocytizing RBCs and hematoma clearance after ICH by administrating anti-CD47 antibody via the cisterna magna.

Background: Non-motor symptoms in PD usually arise at very early stage and vary during the whole disease progression. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD's motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown. Objective: The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with or without constipation and find potential factors which might influence the efficacy. Methods: A retrospective analysis of 65 PD patients accepted STN-DBS operation in Qilu Hospital during 2019–2020 were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses about the relationship between hyposmia and constipation were carried out. Analysis of flora in nasal mucosa was also conducted to evaluate the abundance and variety in different PD groups. Results: Our study showed that DBS had clearly improved olfactory function in Parkinson patients (P = 0.012) and subgroup analysis found that PD patients with constipation have lower olfactory function scores (25.27 ± 3.44 vs. 33.90 ± 6.633, p = 0.014) and worse improvement after DBS operation (ΔTDI 12.11 ± 3.2 vs. 8.78 ± 2.91, p = 0.0072). Analysis of flora indicated the obvious discrepancy on olfactory function scores and degree of improvement might be related to the abundance and dysbiosis of microbiota. Conclusion: In summary, this article presents a study on PD with hyposmia and constipation after DBS operation, explored the relationship between different NMS and offer a potential explanation on why PD patients with constipation usually have worse olfactory function for the less abundance and variety of microbiota.

Secreted protein acidic and rich in cysteine (SPARC) has a close association with inflammatory response and oxidative stress in tissues and is widely expressed in intracranial aneurysms (IAs), especially in smooth muscle cells. Therefore, it is inferred that SPARC might be involved in the formation and development of IAs through the inflammatory response pathway or oxidative stress pathway. The aim of this study is to investigate the pathological mechanism of SPARC in oxidative stress, inflammation, and apoptosis during the formation of IAs, as well as the involvement of TGF-β1 and NOX4 molecules. Human brain vascular smooth muscle cells (HBVSMCs) were selected as experimental objects. After the cells were stimulated by recombinant human SPARC protein in vitro, the ROS level in the cells was measured using an ID/ROS fluorescence analysis kit combined with fluorescence microscope and flow cytometry. The related protein expression in HBVSMCs was measured using western blotting. The mitochondrial membrane potential change was detected using a mitochondrial membrane potential kit and laser confocal microscope. The mechanism was explored by intervention with reactive oxygen scavengers N-acetylcysteine (NAC), TGF-β1 inhibitor (SD-208), and siRNA knockout. The results showed that SPARC upregulated the expression of NOX4 through the TGF-β1-dependent signaling pathway, leading to oxidative stress and pro-inflammatory matrix behavior and apoptosis in HBVSMCs. These findings demonstrated that SPARC may promote the progression of IAs.

Secreted protein acidic and rich in cysteine (SPARC) was widely expressed in VSMCs of human IAs and could reduce the capability of self-repair. This indicates that SPARC may play a role in the promotion of IAs formation and progression, but the mechanism remains unclear. In this study, we further investigated whether SPARC could induce phenotypic modulation of Human Brain Vascular Smooth Muscle Cells (HBVSMCs) and sought to elucidate the role of SPARC-mediated autophagy involved in it. The results demonstrated that SPARC inhibited the expression of contractile genes in HBVSMCs and induced a synthetic phenotype. More importantly, SPARC significantly up-regulated multiple proteins including autophagy marker microtubule-associated protein light chain 3-II (LC3-II), Beclin-1, and autophagy-related gene 5(ATG5). Furthermore, SPARC could promote p62 degradation. The autophagy inhibitor 3- methyladenine (3-MA) significantly blocked SPARC-induced phenotypic modulation of HBVSMCs. We further sought to elucidate the molecular mechanism involved in SPARC-induced autophagy, and found that SPARC could activate the AMPK/mTOR signaling pathway in HBVSMCs. AMPK could be pharmacologically inhibited by Compound C (CC), which significantly decreased the phosphorylation of AMPK into p-AMPK, increased the phosphorylation of mTOR into p-mTOR, and decreased LC3-II, Beclin-1 and ATG5 levels. This suggested that activated AMPK/ mTOR signaling is related to SPARC-mediated autophagy. These results indicated that SPARC plays a role in the phenotypic modulation of HBVSMCs through autophagy activation by AMPK/mTOR signaling pathway.

Objective: Nuclear factor-kappa B (NF-kappa B) is a critical regulator of inflammatory responses after ICH, and different subunits may have different influences on the cell death and prognosis. The aim of the present study is to clarify whether the prognosis can be influenced by inhibiting NF-kappa B activation and subunits expression using PDTC at different stages after ICH. Methods: Rats were divided into sham group, ICH group, early interference group and late interference group. At preset time points after ICH, the ipsilateral striatum and tissue around was obtained for detection of NF-kappa B activation, cell death, and expression of caspase-3, bcl-2, and NF-kappa B subunits, to evaluate of the effect of PDTC. Results: NF-kappa B subunit p65 mainly expressed at the early stage after ICH, and c-Rel at the late stage. NF-kappa B activation can be inhibited at the early stage after ICH by administrating PDTC at 10 min, 1d and 2d after ICH, and at the late stage at 6d,7d and 8d. NF-kappa B activation inhibition at the early stage was due to p65, and c-Rel at the late stage. Inhibiting p65 expression at the early stage after ICH can reduce the apoptotic factor caspase-3 expression and cell death, and raise the antiapoptotic factor bcl-2. Meanwhile, inhibiting c-Rel expression at the late stage after ICH can lead to the opposite result. Conclusion: Measures of inhibiting NF-kappa B subunits can be performed to influence the secondary brain damage and prognosis of ICH. We can also speculate that early inhibition of p65 expression and late promotion of c-Rel expression may be a more efficient method to improve the prognosis of ICH.

目的:研究分析超声引导下粗针穿刺活检在甲状腺结节鉴别诊断中的应用价值.方法:收集在我院接受手术治疗的甲状腺结节患者86例作为研究对象,所有患者在术前接受超声引导下粗针穿刺活检,对比穿刺病理与手术病理,探讨诊断价值.结果:超声引导下粗针穿刺活检病理结果:恶性结节37个,良性结节50个,3个未定性;诊断准确率为96.67％,敏感性为97.37％,特异性为96.15％.结论:超声引导下粗针穿刺活检在甲状腺结节鉴别诊断中诊断准确性高,对甲状腺结节的治疗具有积极意义.

Objective: Manual counting and measuring of axon counts, axon calibers, and g-ratios are time consuming and can be biased by observer variation. Methods: This study introduces a quick, reproducible, and semi-automatic method for screening eligible graphs from the mass image using Image Pro Plus software, objectively defining the image to be analyzed and further clarifying the research object by manual assistance while excluding images that do not meet standards. This method was compared with the manual method using toluidine blue samples of nerve transections. Results: There were no significant differences for axon counts, axon calibers, or axon g-ratios between semi-automatic and manual methods. Pearson's correlation coefficient for axon calibers or axon g-ratios, from both methods, showed no statistically significant differences. Bland-Altman image analysis showed similar results for axon counts obtained by two methods. The time taken by semi-automatic analysis was less than that taken by manual identification. Conclusion: In conclusion, this semi-automatic method is accurate and rapid compared to the traditional manual method.

To discuss the significance of the radiculomuscular artery in typical variations of the distal vertebral artery (VA) from the viewpoint of microsurgical anatomy.

The efficacy of intensity-modulated radiotherapy (IMRT) combined with chemotherapy in the treatment of elderly patients with locally advanced oropharyngeal cancer and its effect on survival rate were studied. Elderly patients (n=150) diagnosed with locally advanced oropharyngeal cancer by histopathology were selected and randomly divided into the observation group (n=75) and the control group (n=75). Patients in the observation group were treated with IMRT combined with chemotherapy, while those in the control group were treated with conventional radiotherapy and chemotherapy. The two groups were treated with docetaxel + cisplatin (TP regimen). All patients received 1 to 2 cycles of docetaxel + cisplatin-induced chemotherapy, and after the radiotherapy began, the chemotherapy with docetaxel was synchronously conducted. The recent efficacy (tumor regression condition was observed at 3 months after the treatment), 1-year, 3-year and 5-year overall survival (OS), local-regional control (LRC), progression-free survival (PFS), disease-free survival (DFS) and the incidence rate of adverse reactions of patients in the two groups were compared. In the observation group, 73 patients completed the radiotherapy and chemotherapy, while all the patients in the control group completed the treatments. The 1-year OS of the observation group and the control group was 97.3 and 85.3%, respectively. In the observation group, the 3-year LRC, OS, PFS and DFS of the observation group was 94.5, 91.8, 90.4 and 87.7%, respectively; the 5-year LRC, OS, PFS and DFS was 64.4, 56.2, 56.2 and 54.8%, respectively. In the control group, the 3-year LRC, OS, PFS and DFS was 86.7, 73.3, 82.7 and 68.0%, respectively; the 5-year LRC, OS, PFS and DFS were 54.7, 45.3, 44.0 and 56.7%, respectively. The differences were statistically significant (P<0.05). In the observation group, the number of leukocytes was decreased, and the incidence rates of acute oropharyngeal mucosa reaction and radiation dermatitis were significantly lower than those in the control group. The differences were statistically significant (P<0.05). In conclusion, IMRT combined with chemotherapy can improve the OS and the 3-year and 5-year LRC, PFS and DFS of elderly patients with locally advanced oropharyngeal cancer, reduce toxic and side effects, and improve patients' quality of life.

BACKGROUND: Primary intracranial neuroendocrine carcinomas (NECs) are extremely rare malignant tumors with no previous reports of multiple ones in the literatures. CASE DESCRIPTION: The clinical presentation, preoperative and reexamined magnetic resonance imaging findings, as well as histopathologic studies of a 56-year-old female subject with multiple intracranial NECs mimicking multiple intracranial meningiomas, who underwent 3 operations with left parietal craniotomy, right occipital parietal craniotomy, and left frontal craniotomy, separately and chronologically, are presented in this article. Noteworthy, the first and second tumors were confirmed as NECs exhibiting histologic characteristics of typical anaplastic meningiomas with features of whorl formation, while the third tumor was a typical NEC with features of organoid cancer nests. In other words, the first 2 lesions were diagnosed as meningioma as opposed to NEC. It was only after the third surgery that the pathology for the first 2 cases was reviewed and had a revised diagnosis. After the third surgical resection, the patient further received whole brain radiotherapy and systemic chemotherapy (temozolomide combined with YH-16). At her 10-month follow-up, the patient achieved a good outcome. CONCLUSIONS: Multiple primary intracranial NECs are extremely rare. The tumor might be of arachnoidal or leptomeningeal origin, with histologic patterns that might lead to transformation and/or progression. Maximal surgical resection is warranted for symptomatic mass effect. Postoperative adjuvant treatments including radiotherapy and chemotherapy should be a recommended therapeutic modality.

Objective Impaired immunonutritional status has disadvantageous effects on outcomes for cancer patients. Preoperative albumin-to-globulin ratio (AGR) and the prognostic nutrition index (PNI) have been used as prognostic factors in various cancers. We aimed to evaluate the clinical significance of the AGR and PNI in glioblastoma. Materials and methods This retrospective analysis involved 166 patients. Demographic, clinical, and laboratory data were collected. AGR and the PNI were calculated as AGR = albumin/(total serum protein − albumin) and PNI = albumin (g/L) + 5 × total lymphocyte count (109/L). Overall survival (OS) was estimated by Kaplan–Meier analysis. Receiver-operating characteristic analysis was used to assess the predictive ability of AGR and the PNI. Cox proportional-hazard models estimating hazard ratios (HRs) and 95% confidence intervals (CIs) were used for univariable and multivariable survival analyses. Results The cutoff values of AGR and PNI were 1.75 and 48. OS was enhanced, with high AGR (>1.75) and the PNI (>48) (P<0.001 for both). Areas under the receiver-operating characteristic curve for AGR and the PNI were 0.68 and 0.631 for 1-year survival and 0.651 and 0.656 for 2-year survival (P<0.05 for all), respectively. On multivariable analyses, both AGR and the PNI were independent predictors of OS (AGR, HR 0.785, 95% CI 0.357–0.979 [P=0.04]; PNI, HR 0.757, 95% CI 0.378–0.985 [P=0.039]). On subgroup analysis, AGR and the PNI were significant prognostic factors for OS in patients with adjuvant therapy (AGR P<0.001; PNI P=0.001). Conclusion Preoperative AGR and the PNI may be easy-to-perform and inexpensive indices for predicting OS with glioblastoma. AGR and the PNI could also help in developing good adjuvant-therapy schedules.

Objective To investigate the value of fine needle aspiration thyroglobulin (FNAB-Tg) testing in cervical lymph node metastasis of papillary thyroid carcinoma.Methods A total of 41 patients with thyroid cancer underwent surgical treatment from September 2013 to September 2015 in the Central People's Hospital of Tengzhou.Intraoperative rapid pathologically confirmed PTC parallel neck dissection was performed.A total of 152 lymph nodes from dissection specimens were arbitrarily selected to fine needle aspiration biopsy,then biopsy needle content was expelled onto a slide and smeared using a second slide,which were read by an experienced cytopathologist.Another biopsy tissue was repeatedly washed with 0.5mL of normal saline in EP tube,using ECLIA quantitative Tg.The dissected nodes were send to histopathologic diagnosis as the gold standard.The value of the two methods were compared in the diagnosis of cervical lymph node metastasis of thyroid cancer.PTC patients were divided into positive and negative groups based on values of serum thyroglobulin antibody (serum thyroglobulin antibodies,S-TgAb).The impact of S-TgAb to FNAB-Tg was analyzed comparatively.Results The sensitivity,specificity and the diagnosis accurate rate of cervical lymph node metastasis in thyroid cancer diagnosis by FNAB-Tg were 95.3％,95.5％,95.4％,respectively.Those of fine needle aspiration cytology (FNAC) were 84.4％,86.4％,85.5％,respectively.The difference had significance statistically.The influence of S-TgAb on FNAB-Tg diagnosis of cervical lymph node metastasis displayed P=0.415 ＞ 0.05,and the difference had not significance statistically.Conclusion FNA-Tg can improve the diagnostic accuracy of PTC lymph node metastasis,and is not affected by S-TgAb,which can be widely used in clinic to determine the staging and treatment programs of thyroid cancer.

BACKGROUND: Combined hyperactive dysfunction syndrome (HDS) is defined as the combination symptoms arising from overactivity in cranial nerves, specifically, trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN), without an obvious explanatory structural lesion. This study retrospectively analyzes the clinical characteristics of combined HDS treated with microvascular decompression (MVD) in a single institution.METHODS: A total of 1450 patients with HDS were treated with MVD in our department during a 10-year period, among which 44 cases of combined HDS were identified. Clinical records and follow-ups were reviewed.RESULTS: Combined HDS comprised 3.03% (44/1450) of all HDS in our series, with female predominance compared with single HDS (P = 0.002), including combined TN-HFS (14 cases), combined TN-GPN (26 cases), bilateral TN (2 cases), and combined TN-HFS-GPN (2 cases). The average age at diagnosis of patients with combined HDS (60.9 years) was significantly older than that of patients with single HDS (53.5 years) (P = 0.035). Hypertension was closely associated with the prevalence of combined HDS compared with single HDS (P [ 0.009). The curative rate was 97.7% (43/44) after MVD, and the recurrence rate was 3.33%. The incidence rates of postoperative cardiac, pulmonary, thromboembolic, and delirium complications were higher in combined HDS than in single HDS (P < 0.05).CONCLUSIONS: Combined HDS is a rarely occurring syndrome usually observed in older females, and the most common types are combined TN-GPN and combined TN-HFS. Age and gender seemed to be causes for developing combined HDS, and MVD shows potential as a favorable treatment choice.

Objective To compare the efficacy of different techniques in setting up the retroperitoneal cavity in retroperitoneoscopy.Methods Clinical data of 320 patients treated with retroperitoneoscopy during Mar.2014 and Mar.2015were retrospectively reviewed.The retroperitoneal cavity was established in various ways,including finger dilatation in 41 cases,single balloon dilatation in 80 cases and double balloon dilatation in 199 cases.The body mass index (BMI) of patients,time used to establish the cavity,and related complications were compared.Results The BMI was higher in the balloon dilatation group than that in the finger dilatation group [(25.8±2.7) vs.(17.6±2.3)kg/m2,P＜0.001].The mean time used to establish cavity was shorter in finger dilatation group than that in the balloon dilatation group [(3.6 ± 0.8) vs.(7.2 ± 1.3)min,P＜0.001],while the peritoneum injury rate was higher (P＜0.05).The mean time used to arrange the cavity was shorter in double balloon dilatation group than that in single balloon dilatation group [(4.5 ± 1.1) vs.(7.4± 1.6)min,P＜0.001],and the balloon burst rate was lower (P＜0.05).Conclusion The finger dilatation technique is a simple method to establish the retroperitoneal cavity in low BMI patients,but we should be careful to avoid peritoneum injury when putting trocar near the anterior axillary line.The double balloon dilatation technique is effective for arranging the retroperitoneal cavity,with lower balloon burst rate than single balloon dilatation.

Altered store-operated calcium entry (SOCE) has been suggested to be involved in many diabetic complications. However, the association of altered SOCE and diabetic neuronal damage remains unclear. This study aimed to investigate the effects of altered SOCE on primary cultured rat neuron injury induced by high glucose. Our data demonstrated that high glucose increased rat neuron injury and upregulated the expression of store-operated calcium channel (SOC). Inhibition of SOCE by a pharmacological inhibitor and siRNA knockdown of stromal interaction molecule 1 weakened the intracellular calcium overload, restored mitochondrial membrane potential, downregulated cytochrome C release and inhibited cell apoptosis. As well, treatment with the calcium chelator BAPTA-AM prevented cell apoptosis by ameliorating the high glucose-increased intracellular calcium level. These findings suggest that SOCE blockade may alleviate high glucose-induced neuronal damage by inhibiting apoptosis. SOCE might be a promising therapeutic target in diabetic neurotoxicity.

OBJECTIVE:To investigate the effect of Yiguanjian(YGJ) cataplasm on the development of opioid dependence in a mouse model of naloxone-induced opioid withdrawal syndrome.METHODS:One hundred Swiss albino mice,of equal male to female ratio,were randomly and equally divided into 10 groups.A portion(3 cm2) of the backside hair of the mice was removed 1 day prior to the experiment.Morphine(5 mg/kg) was intraperitoneally administered twice daily for 5days.YGJ cataplasm was prepared and pasted on the bare region of the mice immediately beforemorphine administration on day 3 and subsequently removed at the end day 5.On day 6,naloxone(8mg/kg) was intraperitoneally injected to precipitate opioid withdrawal syndrome.Behavioral observation was performed in two 30-min phases immediately after naloxone injection.RESULTS:The YGJ cataplasm significantly and dose-dependently attenuated morphine-naloxone-induced experimental opioid withdrawal,in terms of withdrawal severity score and the frequencies of jumping,rearing,forepaw licking,and circling behaviors.However,YGJ cataplasm treatment did not alter the acute analgesic effect of morphine.CONCLUSION:YGJ cataplasm could attenuate opioid dependence and its associated withdrawal symptoms.Therefore,YGJ cataplasm could serve as a potential therapy for opioid addiction in the future.

AIM:To explore clinical features and surgical treatment of asymptomatic meningiomas (AMs).MATERIAL AND METHODS:Clinical materials of 122 patients with AMs treated surgically were analyzed retrospectively and the associated literatures were reviewed.RESULTS:There were 39 males and 83 females whose ages ranged from 38 to 72 years with a mean of 58.6 years in this series. The cerebral convexity (32.8%), parasagittal region (31.1%), and parafalcine (29.5%) ranked in the top three of all locations of AMs. The average size of the tumors was 2.8 cm in diameter, with a tumoral calcification rate of 33.6%. Among the 82 cases of AMs monitored with serial computerized tomography (CT) or magnetic resonance imaging (MRI) scannings, 44 had no obvious growth during a period of 3 to 18 months (mean 10.5 months) whereas 38 increased in diameter from 0.2 to 1.8 cm (mean 0.4 cm) every year during a period of 6 to 38 months (mean 26 months). Total resection was achieved in all cases. No death or permanent neurological deficits occurred.CONCLUSION:AMs have some marked clinical characteristics compared with the symptomatic meningiomas. Their definitive treatment project rests with patients'age, results of follow-up, surgical risk-effect ratio, size, calcification of the tumor as well as patient preference.

Nuclear factor-κB (NF-κB) plays an important role in the inflammatory response after intracerebral hemorrhage (ICH). We therefore proposed that NF-κB activation in perihematomal brain tissue might correlate with clinical outcome in patients with ICH. To confirm this, we studied clinical data of 45 patients with ICH and NF-κB activation in perihematomal brain tissue and analyzed predictors of clinical outcome as well as the predictive value of NF-κB activation.