Search

OBJECTIVE Pediatric patients are at risk of persistent hydrocephalus after posterior fossa tumor resection. The relationship between surgery-related factors and postoperative symptomatic hydrocephalus has not been elucidated. The objective of this study was to analyze features influencing postoperative hydrocephalus in Chinese children. METHODS The authors retrospectively evaluated 197 patients younger than 15 years of age who underwent posterior fossa tumor resection at their institution from January 2015 to June 2021. The outcome was whether children underwent CSF diversion within 6 months of resection. Preoperative characteristics, surgery-related factors, and postoperative features were included to identify independent prognosticators. A new logistic model containing independent prognosticators was developed and compared with the modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH). RESULTS In this study, 30 patients (15.2%) underwent CSF diversion within 6 months after tumor resection. Tumor location and consistency, intracranial or spinal tumor metastasis determined by perioperative cerebral and spinal MRI, intraoperative blood loss, ventricular blood as determined on postoperative CT, and pathology were statistically significant variables in the univariate analysis. The only two independent predictors of postoperative symptomatic hydrocephalus were tumor metastasis (OR 3.463, 95% CI 1.137–10.549; p = 0.029) and postoperative ventricular blood (OR 4.212, 95% CI 1.595–11.122; p = 0.004). The final logistic model comprising tumor metastasis and postoperative ventricular blood was found to have better discrimination than the mCPPRH. CONCLUSIONS Tumor characteristics and surgery-related features were associated with postoperative symptomatic hydrocephalus. Tumor metastasis and postoperative ventricular blood were found to be important prognosticators of persistent hydrocephalus.

BACKGROUND Dexamethasone added to incision-site infiltration has been routinely used to reduce pain after tonsillectomy in children. However, this has not been studied in pediatric craniotomy patients yet. We hypothesized that incision-site infiltration with a combination of ropivacaine and dexamethasone might provide superior analgesia to ropivacaine alone in pediatric craniotomy patients. METHODS In this multicenter, double-blind, randomized, controlled trial, children aged 2-12 years, scheduled for craniotomy, were prospectively enrolled at two study centers, from September 2, 2019, to July 5, 2020. Eighty children were randomly assigned (1:1) to either ropivacaine plus dexamethasone group who received pre-emptive incision-site infiltration with 0.2% ropivacaine plus 0.025% dexamethasone, or ropivacaine group who received 0.2% ropivacaine alone. Primary outcome was the modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) at 24 h postoperatively. Primary analysis was performed using the modified intention-to-treat principle. RESULTS Pre-emptive incision-site infiltration with ropivacaine plus dexamethasone had a reduced pain score of 2.0, compared with the pain score of 2.9 in the ropivacaine group, at 24 h postoperatively (mean difference -0.9, 95% confidence interval [CI], -1.7 to -0.2; p = .019). Estimated median of the time of first rescue analgesic demand was 24 h in the ropivacaine plus dexamethasone group and 8.5 h in the ropivacaine group [hazard ratio 0.43, 95% CI 0.24 to 0.08; Log-rank p = .0025]. No adverse events related to incision-site infiltration with dexamethasone were observed in this study. DISCUSSION Dexamethsone reduces the local production of pro-inflammatory factors after tissue damage and as a ropivacaine adjuvant for incision-site infiltration reduced the pain scores by 31% at 24 h postoperatively. The results were similar to several prior studies on to tonsillectomy patients. However, this changes on pain scores might has limited clinical significance. CONCLUSIONS The addition of dexamethasone to ropivacaine for preoperative incision-site infiltration has better postoperative analgesic effect than ropivacaine alone in pediatric craniotomy patients.

Background Choroid plexus carcinoma is a central nervous system tumor pathologically corresponding to World Health Organization grade III. Choroid plexus carcinoma mainly affects pediatric patients with a poor prognosis. Due to its rarity, standardized treatment has not yet been outlined. Methods We retrospectively analyzed 11 patients with histopathologically diagnosed choroid plexus carcinoma between January 2008 and December 2016. They were treated with surgical resection with or without adjuvant therapies. The clinical profiles and outcomes were analyzed. Results The mean age at diagnosis was 16.0 years (median, 7.0 years; range, 4 months to ∼59 years). Gross total resection was achieved in 9 cases, and subtotal resection in 2 cases. Seven patients received adjuvant radiotherapy, and 2 patients underwent chemotherapy. The mean overall survival was 34.8 months, and the mean progression-free survival was 24.5 months. During the follow-up period, 4 patients succumbed to central nervous system dissemination of choroid plexus carcinoma including 2 patients with malignant transformation from atypical choroid plexus papilloma to choroid plexus carcinoma and 1 patient treated with the combined chemotherapy protocol. Conclusions In this study, we described the clinicoradiologic characteristics of choroid plexus carcinomas. Surgical resection is the mainstream treatment. Due to the paucity of clinical evidence, the standard regimen of adjuvant therapies still needs further research.

Analytic hierarchy process (AHP) combined with response surface methodology (RSM) was used to optimize the purification processes of the crude flavonoids of Carex meyeriana Kunth (CMK). The bioactivities of flavonoids were evaluated in terms of antioxidant and antimicrobial activities. The weighted coefficients of comprehensive scoring method on AHP included recovery, purity, and decolorization rate. The optimal results were as follows: the sample concentration was 3.04 mg/mL, the ethanol concentration was 70.33 %, pH was 2.93, the elution velocity was 2.95 Bv/h, and the comprehensive score was 75.52 ± 0.53 % (n = 3). The purified flavonoids of CMK (PFCMK) were compared with a reference substance through ultra high-performance liquid chromatography and ultraviolet spectra. Results of composition analyses were as follows: (−)−gallocatechin, 5−Caffeoylquinic acid, (−)−naringin, myricetin, luteolin, and isorhamnetin. The IC50 values of 2,2–dIphenyl–1-picrylhydrazyl (0.034 mg/mL), hydroxyl radical method (0.643 mg/mL), and reducing power (0.025 mg/mL) showed that PFCMK had strong antioxidant activity. The minimum inhibitory concentrations on Bacillus pumilus, Bacillus subtilis, and Escherichia coli were 1.75, 1.75, and 0.875 mg/mL, respectively. PFCMK can be prepared as an antioxidant and antimicrobial for natural pharmaceutical, cosmetic products, and other industrial products.

The present work determines the anticancer activity of bio-mediated synthesized cadmium sulfide nanoparticles using the ionic liquid and bacterial cells (Shewanella oneidensis). Bacterial cells have been exposed to be important resources that hold huge potential as ecofriendly, cost-effective, evading toxic of dangerous chemicals and the alternative of conventional physiochemical synthesis. The Shewanella oneidensis is an important kind of metal reducing bacterium, known as its special anaerobic respiratory and sulfate reducing capacity. The crystalline nature, phase purity and surface morphology of biosynthesized cadmium sulfide nanoparticles were analyzed by Fourier transform infrared spectroscopy, X-ray diffraction, Field emission scanning electron microscopy, Energy dispersive spectroscopy and Transmission electron microscopy. The use of imidazolium based ionic liquids as soft templating agent for controlling self-assembly and crystal growth direction of metal sulfide nanoparticles has also advanced as an important method. The microscopic techniques showed that the nanoparticles are designed on the nano form and have an excellent spherical morphology, due to the self-assembled mechanism of ionic liquid assistance. The antitumor efficiency of the cadmium sulfide nanoparticles was investigated against brain cancer cell lines using rat glioma cell lines. The effectively improved nano-crystalline and morphological structure of CdS nanoparticles in the presence of IL exhibit excellent cytotoxicity and dispersion ability on the cell shape is completely spread out showing a nice toxic environment against cancer cells. The cytotoxicity effect of cadmium sulfide nanoparticles was discussed with a diagrammatic representation.

The effects of tumorigenesis and tumor growth on the non-involved organs remain poorly understood although many research efforts have already been made for understanding the metabolic phenotypes of various tumors. To better the situation, we systematically analyzed the metabolic phenotypes of multiple non-involved mouse organ tissues (heart, liver, spleen, lung and kidney) in an A549 lung cancer xenograft model at two different tumor-growth stages using the NMR-based metabonomics approaches. We found that tumor growth caused significant metabonomic changes in multiple non-involved organ tissues involving numerous metabolic pathways, including glycolysis, TCA cycle and metabolisms of amino acids, fatty acids, choline and nucleic acids. Amongst these, the common effects are enhanced glycolysis and nucleoside/nucleotide metabolisms. These findings provided essential biochemistry information about the effects of tumor growth on the non-involved organs.