Volume 38 · Issue 08 · 2022

To investigate the surgical treatment and prognosis of middle cerebral artery (MCA) mirror aneurysms.

The clinical data of 29 patients with MCA mirror aneurysms admitted to the Department of Neurosurgery, Affiliated Hospital of Qingdao University from October 1997 to February 2021 were retrospectively analyzed. There were a total of 68 aneurysms (including 29 pairs of MCA mirror aneurysms and 10 non-mirror aneurysms. Early or elective, one-stage or staged, unilateral or bilateral approach surgery was used to manage aneurysms according to the specific conditions of the patient. All patients underwent CT angiography (CTA) or digital subtraction angiography (DSA) at 1 month after operation and 6 months after discharge. Clinical follow-up was performed after operation, and Glasgow Outcome Scale (GOS) was used to evaluate the outcomes.

The success rate of intraoperative clipping of the mirror aneurysm was 96.3% (52/54). One patient died of severe cerebral edema during the perioperative period, and the follow-up time of the remaining 28 patients was 52±38 months (3-180 months). One-stage unilateral pterional approach was used to clip bilateral aneurysms in 12 patients. During the follow-up period, 10 cases were GOS grade Ⅴ, 1 case was grade Ⅳ, and 1 case was grade Ⅰ. Four cases underwent bilateral clipping of aneurysms through one-stage coronal approach, and all were GOS grade Ⅴ in the follow-up period. Eight patients underwent clipping of bilateral aneurysms by the staged bilateral pterional approach; 5 cases were GOS grade Ⅴ in the follow-up period, 1 case was grade Ⅳ, 1 case was grade Ⅱ, and 1 case was grade Ⅰ. One case underwent embolization of offending aneurysm and then clipping of the contralateral aneurysm, and the follow-up indicated GOS grade Ⅴ. Three cases underwent treatment of only unilateral offending aneurysm, and the follow-up revealed GOS grade Ⅴ in 2 cases and grade Ⅳ in 1 case.

Surgical clipping of bilateral aneurysms through one-stage unilateral pterional approach is an effective method for the treatment of MCA mirror aneurysms, which is associated with relatively good surgical outcome and clinical prognosis as well as few complications.

To investigate the clinical and imaging features and surgical outcomes of intraventricular cavernous malformations (IVC).

From October 2012 to October 2020, 482 patients with IVC were admitted to the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and 15 (3.1%) patients with IVC were included for a retrospective study. We analyzed the clinical and imaging features, surgical data and efficacy of the patients.

Preoperative imaging showed that the lesions were located in the body of the lateral ventricle in 5 cases, in the frontal horn of the lateral ventricle in 4 cases, in the triangular region in 4 cases, and in the occipital horn of the lateral ventricle in 1 case. Seven patients had acute intraventricular hemorrhage, and two had acute obstructive hydrocephalus. The maximum diameter of the lesions was 2.6±0.8 cm (1.5-4.9 cm). Enhanced MRI showed homogeneous enhancement in 2 cases and no enhancement in 13 cases; 5 cases of susceptibility-weighted imaging (SWI) showed typical " popcorn" sign. Before surgery, 2 cases were misdiagnosed as choroid plexus papilloma, 2 cases were misdiagnosed as meningiomas, and 1 case was misdiagnosed as craniopharyngioma. All 15 cases were treated by surgery, including 4 cases of transfrontal approach, 5 cases of interhemispheric-transcallosal approach, and 6 cases of transtemporal approach. During the operation, it was shown that the lesions originated from the ventricle wall in 10 cases and the choroid plexus in 5 cases. All 15 patients underwent total resection. Postoperatively, 1 patient had intracerebral hematoma in the surgical pathway, and 1 patient had epidural hematoma, both of which were cured by conservative treatment. The median follow-up time of the 15 patients after operation was 48.6 months (6 months to 9 years). The modified Rankin scale score (mRS) was lower than that before operation, and the postoperative mRS scores were 0 points in 10 cases, 1 point in 4 cases, and 3 points in 1 case.

The incidence of IVC is low, and acute bleeding symptoms are more common. IVC has certain imaging features, but some patients are atypical and easy to be misdiagnosed. The surgical outcome of IVC is good.

To investigate the safety and efficacy of the Tubridge flow diverter (FD) in the treatment of internal carotid artery dissection.

The clinical data of 19 patients with internal carotid artery dissection treated with the Tubridge FD and followed up for ≥ 6 months in the Cerebrovascular Disease Center of the First Affiliated Hospital of Naval Military Medical University from January 2013 to December 2020 were analyzed retrospectively. There were 19 aneurysms in 19 patients, including 4 cases of carotid segment of internal carotid artery, 3 cases of petrosal segment, 2 cases of ruptured foramen segment, 4 cases of cavernous sinus segment, 1 case of supraclinoid segment, 2 cases of ocular segment and 3 cases of communicating segment. Modified Rankin Scale score (mRS) was used to evaluate the neurological function during perioperative and follow-up; O′Kelly Marotta (OKM) grade was used to evaluate the embolization degree of aneurysms immediately after operation and during follow-up.

A total of 22 Tubridge FDs were implanted in 19 aneurysms and 2 Tubridge FDs were placed in 3 aneurysms. The success rate of implantation was 100%. All Tubridge FDs were deloyed well, the parent artery was unobstructed, and no adverse events such as ischemia or bleeding occurred during the operation. The immediate OKM grades of 19 patients were grade A in 9 cases, grade B in 3 cases, grade C in 1 case and grade D in 6 cases. No adverse events occurred during perioperative period, and the mRS score was 0 at discharge in all cases. Eighteen patients received clinical follow-up for [M (Q₁, Q₃)] 24.0 (14.3, 41.0) months, with a mRS score of 0. Fourteen patients (14 aneurysms) received imaging follow-up for [M (Q₁, Q₃)] 8.0 (6.0, 10.8) months. The OKM rating results were grade C in 4 cases and D in 10 cases.

The Tubridge FD has high technical success rate, satisfactory immediate effect, high occlusion rate of aneurysms in mid-term follow-up and low incidence of complications, but the long-term efficacy and safety need to be further observed.

To investigate the correlation between cerebral infarction location determined based on ASPECTS (The Alberta Stroke Program Early CT Score) and futile recanalization after mechanical thrombectomy.

The cases in this study were collected from a prospective, randomized controlled study of mechanical thrombectomy (Skyflow study) in the treatment of acute cerebral infarction of the internal carotid artery system conducted by 14 hospitals including the Department of Cerebrovascular Disease of He′nan Provincial People′s Hospital from January 2018 to January 2019. A retrospective study of 192 patients with extended thrombolysis in cerebral infarction (eTICI) grade ≥2b immediately after thrombectomy and follow-up time ≥90 days was performed. According to the modified Rankin scale score (mRS) at 90 days after operation, the patients were divided into futile recanalization (mRS≥3 points) group (105 cases, 54.7%) and effective recanalization (mRS<3 points) group (87 cases, 45.3%). Patients were divided into M6 and non-M6 infarction groups according to the location of cerebral infarction assessed by the ASPECTS system. Univariate and multivariate logistic regression models were used to analyze the correlation between ASPECTS-based M6 cerebral infarction and futile recanalization.

Among the 105 patients in the futile recanalization group, 53.3% (56 cases) had infarction located in the M6 area; in the 87 cases of effective recanalization group, 36.8% (32 cases) had infarction located in the M6 area, and the difference was statistically significant (P=0.016). Multivariate logistic regression analysis showed that, in addition to the history of hypertension (OR=1.78, 95%CI: 1.09-3.47), preoperative NIHSS (National Institutes of Health Stroke Scale, OR=1.86, 95%CI: 1.24-2.77) and ASPECTS (OR=1.92, 95%CI: 1.22-3.16), time from onset to recanalization (OR=2.65, 95%CI: 1.27-4.65), postoperative eTICI 2c-3 grade (OR=2.34, 95%CI: 1.32-3.54), infarction located in the M6 area was also an important factor related to the futile recanalization after thrombectomy (OR=2.25, 95%CI: 1.15-3.47), and the difference was statistically significant (all P<0.05).

Patients with M6 region infarction based on ASPECTS have a higher risk of futile recanalization after mechanical thrombectomy.

To investigate the efficacy of flow diverters (FD) in the treatment of unruptured tandem intracranial aneurysms.

The clinical data of 19 patients with unruptured tandem intracranial aneurysms treated with FD from April 2018 to October 2020 in the Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University were retrospectively analyzed. Of the 19 patients, 3 had bilateral tandem intracranial aneurysms and 16 had unilateral tandem intracranial aneurysms, and there were a total of 47 unruptured aneurysms. All aneurysms were treated with FD. The modified Rankin scale score (mRS) was used to evaluate the outcome after operation. Follow-up with digital subtraction angiography (DSA) was performed more than 6 months after operation, and the occlusion of aneurysm was evaluated according to O′Kelly-Marotta (OKM) classification. Univariate logistic regression analysis was used to explore the related factors of aneurysm OKM grade D occlusion during follow-up.

A total of 22 FDs (14 Pipeline devices and 8 Tubridge devices) were implanted in 47 aneurysms, all of which were successfully placed in place and released; 3 of them were filled with coils. Transient ischemic attack occurred in 1 patient after operation, which improved after symptomatic conservative treatment. The median time of clinical follow-up in 19 patients was 29 months (11-41 months). At the last follow-up, the mRS of all patients was 0. Seventeen patients (40 aneurysms) were followed up by DSA, and the median follow-up time was 10 months (3-19 months). Among them, there were 3 cases(7.5%) of OKM grade A, 3 cases(7.5%) of grade B, 2 cases(5.0%) of grade C, and 32 cases(80.0%) of grade D. The results of univariate logistic analysis showed that aneurysm neck width, maximum diameter, dome-to-neck ratio, aneurysm location on the ventral or dorsal side of the parent artery, whether coil embolization was used or not, or the type of FD did not affect aneurysm occlusion (all P>0.05).

Application of FD in the treatment of unruptured tandem intracranial aneurysms has a relatively high occlusion rate, fewer complications, and seems safe and effective.

To preliminarily observe the safety and efficacy of multiple flow diverting devices (FD) in the treatment of complex intracranial aneurysms.

The clinical data of patients with complex intracranial aneurysms treated with multiple FDs in the Department of Neurointerventional Radiology, the First Affiliated Hospital of Zhengzhou University from April 2015 to November 2020 were retrospectively analyzed. There were a total of 19 cases (19 aneurysms). Among them, 14 were anterior circulation aneurysms, 5 were posterior circulation aneurysms; 6 were long fusiform aneurysms, 8 were large or giant saccular aneurysms on the lateral wall of vascular curvature, or saccular aneurysms with obvious neck ejection signs, 2 were aneurysms with large diameter difference between both ends of the parent artery, and 3 were aneurysms with salvage treatment or re-treatment following failed FD treatment. The safety was assessed by modified Rankin scale (mRS), and the effect of aneurysm occlusion was assessed by O′Kelly-Marotta (OKM) classification.

A total of 42 FDs were implanted in 19 patients, 16 patients had 2 implants, 2 patients had 3 implants, and 1 patient had 4 implants (for re-treatment). In 9 patients, FD implantation was combined with coiling. In 2 patients with posterior circulation aneurysm, an ordinary stent was placed after balloon dilatation due to poor adhesion. Neurological dysfunction occurred in 5 patients during the perioperative period, including 3 patients with basilar artery aneurysm, and 1 patient died due to postoperative brainstem infarction; 2 patients had residual neurological deficit, and the mRS at last follow-up was 5 and 1, respectively. Two patients had internal carotid artery aneurysm, 1 patient had intraoperative hemorrhage, and the final follow-up mRS was 0 points; 1 patient had delayed intraparenchymal hemorrhage 1 month after operation, and the final follow-up mRS was 1 point. The patients were followed up for 3 to 45 months (median: 6 months). The last follow-up mRS was 0-1 in 17 cases and 5 in 1 case. Fifteen cases were followed up by digital subtraction angiography, and the aneurysm was completely occluded (OKM Grade D) in 11 cases, significant shrinkage (OKM grade C) was reported in 2 cases, and non-healing (OKM grade B) was indicated in 2 cases. The parent artery was patent in all patients and there was no stenosis.

Multiple FDs are relatively safe and effective in the treatment of complex intracranial anterior circulation aneurysms. The risk of treating aneurysms in the posterior circulation using multiple FDs, particularly those involving the basilar artery, is high.

To investigate the feasibility and safety of transvenous embolization in the treatment of brain arteriovenous malformations (BAVM).

The clinical data of 24 patients with BAVM admitted to the Department of Neurosurgery, Henan Provincial People′s Hospital from November 2016 to February 2020 were retrospectively analyzed. Among them, there were 4 cases of Spetzler-Martin grade Ⅰ, 4 cases of grade Ⅱ, 13 cases of grade Ⅲ, and 3 cases of grade Ⅳ. All patients were treated with intravenous embolization. The surgical outcome and the occurrence of complications 30 days after operation were observed. Clinical follow-up was performed after operation, and the modified Rankin scale (mRS) was used to evaluate the clinical efficacy. The recurrence of the lesion was assessed by imaging follow-up.

Among the 24 patients, 2 patients failed to undergo the operation due to the difficulty of placing the microcatheter in place via transvenous approach, and the remaining 22 patients successfully underwent embolization of BAVM, with a technical success rate of 91.7% (22/24). Among the 22 patients, 19 patients achieved radiographic cure, and 3 patients had a small amount of residual malformation. The cure rate was 86.4% (19/22). The overall perioperative complication rate was 31.8% (7/22), including 6 cases of bleeding and 1 case of ischemic complication. The serious complication rate was 4.5% (1/22), and the mortality rate was 4.5% (1/22). Fifteen patients underwent clinical follow-up with a median time of 12.5 months (1-22 months). Except for 1 patient with ischemic complication whose mRS score was 4, the patients′ symptoms remained unchanged or were relieved compared with preoperative conditions whose mRS scores were all 2. Fifteen patients were followed up by imaging, and the median follow-up time was 6 months (2-11 months). The follow-up results showed no recurrence.

With strict evaluations of surgical indications, the technical success rate of transvenous embolization in the treatment of BAVM is high, and the clinical effect seems reliable. In some patients with BAVM that are otherwise difficult to treat, transvenous embolization may be performed cautiously as an exploratory therapy.

To analyze the correlation between the size of vestibular schwannoma and the patient age.

The preoperative clinical and imaging data of patients with unilateral vestibular schwannoma who underwent surgery via retrosigmoid approach at Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from October 2016 to November 2018 were retrospectively analyzed. According to preoperative MRI, the patients were divided into small and medium vestibular schwannoma (<3 cm) group (218 cases) and large vestibular schwannoma (≥3 cm) group (144 cases). Univariate analysis was performed to compare the differences in age, gender, disease course, tumor properties (cystic, cystic-solid, solid) and tumor signal on T2-weighted imaging between the two groups. Variables with P<0.20 in univariate analysis were included in multivariate logistic regression analysis.

The age of the patients in the large vestibular schwannoma group was 44.2±13.3 years old, and that in the small and medium vestibular schwannoma group was 47.4±11.0 years old, and the difference was statistically significant (P=0.017). In the large vestibular schwannoma group, the proportions of patients aged <40, ≥40-59 years, and >59 years were 38.2% (55/144), 47.2% (68/144), and 14.6% (21/144), respectively; in the small and medium vestibular schwannoma group, the proportions of patients aged <40, ≥40-59 years, and >59 years were was 21.1% (46/218), 64.7% (141/218), 14.2% (31/218); the difference was statistically significant (P=0.009). Multivariate logistic regression analysis showed that in addition to cystic-solid and cystic tumors, age <40 years was also a risk factor for large vestibular schwannoma (>59 years old as reference, OR=2.09, 95%CI: 1.01-4.30), and the difference was statistically significant (all P<0.05).

Preliminary observations show that the size of vestibular schwannoma is correlated with the patient age, and patients aged <40 years are at high risk of developing large vestibular schwannomas.

To explore the application effect of Raman spectroscopy in intraoperative pathological diagnosis of gliomas.

Intraoperative frozen pathological specimens were collected from patients undergoing surgical treatment at the Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University. A total of 29 specimens were collected, including 24 cases of glioblastoma (WHO grade 4) and 5 cases of normal brain tissue which was around the tumor and confirmed by pathological examination. Raman spectra were collected at multiple spots for each specimen, and the main differences in spectra between glioblastoma tissue and peritumoral normal brain tissue were extracted. The principal component analysis technique was used to determine the main components, and a support vector machine (SVM) classifier was established on this basis as the diagnostic model. The sensitivity, specificity and accuracy of the principal component spectrum were calculated, the receiver operating characteristic curve was drawn and the area under the curve was calculated to evaluate the diagnostic performance of the model.

A total of 101 Raman spectra, consisting of 55 spectra collected from glioblastomas and 46 spectrum from brain tissues based on 532 nm green laser, were gained in this study. Relatively stronger Raman intensity was shown at 1 168 cm^-1, 1 640 cm^-1 and 2 860 cm^-1. The change of relative strength was calculated and directly applied to establish a single SVM classifier with 98.2% of sensitivity, 80.4% of specificity, 90.1% of accuracy, and 0.875 of AUC. In other way, training on the basis of PC1, PC2 managed to establish a classifier with 90.9% of sensitivity, 95.7% of specificity, 93.1% of accuracy, and 0.942 of AUC; PC1, PC2 and PC3-based classifier was associated with 96.4% of sensitivity, 95.7% of specificity, 96.0% of accuracy, and 0.984 of AUC.

Raman spectroscopy can distinguish glioma tissue from normal brain tissue relatively well. Thus, it is expected to be used as an intraoperative rapid diagnostic technique to guide surgical treatment.

To investigate the surgical efficacy of transmastoid facial nerve decompression in the treatment of severe traumatic facial paralysis caused by temporal bone fracture.

The clinical data of 24 patients with severe traumatic facial paralysis due to temporal bone fractures who underwent transmastoid facial nerve decompression in the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2016 to September 2017 were retrospectively analyzed. Preoperative assessment of facial nerve function using House-Brackmann (H-B) system indicated grade Ⅵ in 17 cases and grade Ⅴ in 7 cases. All patients underwent selective transmastoid facial nerve decompression, and the range of decompression was determined according to the location of nerve damage before surgery and intraoperative findings. At 1, 3, 6, 12, and 18 months after the operation, the patients were followed up in outpatient clinic for H-B grading of facial nerve function, and nerve electrophysiological examination was performed. The postoperative recovery of facial nerve function to H-B grades Ⅰ and Ⅱ was defined as excellent, grades Ⅲ and Ⅳ were defined as good, and grades Ⅴ and Ⅵ were defined as poor.

The injury was located between the geniculate ganglion and the pyramidal segment. Most cases had nerve edema and contusion. Facial nerve disruption was found in only 1 case. Among the 24 patients, 3 had local damage in the horizontal semicircular canal during surgery, 5 had postoperative hearing impairment, 1 had hearing loss, and 2 reported skin damage in the external auditory canal. There were no serious complications such as cerebrospinal fluid leakage or infection. The follow-up time of 24 patients ranged from 12 to 18 (14.3±2.5) months. At the last follow-up of 24 patients, there were 3 cases of H-B grade Ⅰ, 16 cases of grade Ⅱ, 4 cases of grade Ⅲ, and 1 case of grade Ⅳ. The therapeutic effect was excellent in 19 cases (79.2%) and good in 5 cases (20.8%).

Transmastoid facial nerve decompre-ssion in the treatment of severe traumatic facial paralysis caused by temporal bone fracture can effectively promote the recovery of facial paralysis, with good efficacy and safety.

To investigate the feasibility of amide proton transfer weighted (APTw) magnetic resonance imaging (MRI) in the assessment of meningioma stiffness.

The clinical data of 48 patients with meningioma admitted to the Department of Neurosurgery, Affiliated Hospital of Jining Medical University from January 2017 to July 2020 were retrospectively analyzed. All patients were evaluated for tumor stiffness during operation, and were divided into three grades: soft (6 cases), medium stiffness (21 cases), and hard (21 cases). The conventional head MRI and APTw-MRI images of 48 patients with meningioma were analyzed, and the APTw_min, APTw_mean, and APTw_max values in the tumor core were measured (the minimum, average, and maximum APTw signal intensities of the five regions of interest, respectively). The gender, age, edema index, T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) signal intensities, as well as APTw_min, APTw_mean, and APTw_max values of the three groups were compared. The differences in APTw_min, APTw_mean and APTw_max values were compared between the hard and non-hard groups (including patients with soft and moderate stiffness) by using two indepedent samples T-test. The receiver operating characteristic (ROC) and area under the curve (AUC) were used to evaluate the diagnostic performance of APTw parameters in differentiating meningiomas with different stiffness.

There were no significant differences in age, gender, edema index, T1WI, T2WI signal characteristics or APTw_max value among the three groups of meningiomas with varying stiffness (all P>0.05). The difference between the three groups of tumor pathological types was statistically significant (P=0.030). The APTw_min and APTw_mean values of the hard group were lower than those of the medium-stiffness group and the soft group (both P<0.001), but there was no significant difference between the medium-stiffness group and the soft group (both P>0.05). The APTw_min value [(1.94±0.70)% vs. (2.86±0.45)%] and APTw_mean value [(2.47±0.83)% vs. (3.29±0.35)%] in the hard group were lower than those in the non-hard group (both P<0.001). According to the ROC curve, APTw_min had the largest AUC value of 0.904. When the APTw_min value was less than 2.47%, the sensitivity, specificity, and accuracy of predicting stiff meningioma were 88.9%, 85.7%, and 85.4% respectively.

Preliminary study shows that APTw-MRI technique can be used to predict meningioma stiffness, with APTw_min having the best predictive performance.

To establish a nomogram model for risk prediction of postoperative central nervous system (CNS) infection in patients with severe traumatic brain injury (sTBI), and to provide reference for the prevention, early diagnosis and treatment of postoperative CNS infection in sTBI patients.

The clinical data of 370 patients with sTBI who underwent neurosurgery at Department of Neurosurgery, Northern Jiangsu People′s Hospital of Jiangsu Province, from January 2017 to September 2020 were retrospectively analyzed. A total of 370 patients were randomly divided into training set (n=259) and validation set (n=111) according to the ratio of 7 ∶3. Patients in the training set were divided into infection group (n=45) and non-infection group (n=214) according to whether CNS infection occurred. Univariate and multivariate logistic regression analyses (forward method) were used to screen the risk factors of postoperative CNS infection after sTBI and establish nomogram prediction models. The receiver operating characteristic (ROC) curve was drawn with the area under the curve (AUC) calculated to evaluate the efficacy of the nomogram model in prediction of CNS infection. The AUC >0.80 indicated that the efficacy was high. Internal validation of the model was carried out, and decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the clinical utility and net benefit of the prediction model.

Based on the comparison between infection group and non-infection group, there were significant differences in admission GCS, combined cerebrospinal fluid otorrhea, cerebrospinal fluid rhinorrhea leakage, skull base fracture, intraventricular hemorrhage, emergency operation, operation time, placement of brain-ventricle drainage, placement of intracranial pressure probe, secondary operation, intracranial rebleeding, cerebrospinal fluid sampling, tracheal intubation, incision infection, serum albumin(ALB) and lactic acid levels (all P<0.05). The results of multivariate logistic regression analysis showed that combined skull base fracture, cerebrospinal fluid otorrhea, rhinorrhea, intracranial rebleeding and the decrease of serum ALB level were risk factors of postoperative CNS infection in sTBI patients (all P<0.05). The ROC curve of the nomogram model showed that the AUC values of the training set and the validation set were 0.98 (95%CI: 0.96-0.99) and 0.95 (95%CI: 0.88-1.00), respectively, with high prediction efficiency. Bootstrap self-sampling method was used to verify the model. The results showed that the average absolute error between the predicted risk and the actual risk of the training set was 0.02 after 1 000 times of repeated sampling, indicating that the predicted value was basically consistent with the measured value, and had good prediction and identification abilities. The DCA curve showed that the nomogram model was more accurate than the single risk factor in predicting the occurrence of CNS infection, which could improve the clinical benefit rate. The CIC curve showed that the nomogram prediction model had high net clinical benefit.

The nomogram prediction model based on the risk factors of CNS infection after sTBI is simple to utilize, which is helpful for early screening of high-risk patients with CNS infection after sTBI, so as to achieve early diagnosis and early treatment, and reduce the incidence of CNS infection.

To establish the patient-derived glioma cell model marked by luciferase in vitro, and to further investigate its application in oncolytic herpes simplex virus 1 (oHSV-1) or oncolytic adenovirus (oAD) therapy research.

The patient-derived U022 glioma cells established previously were observed under the microscope for study of their morphological features. The U022 cells were identified by glial fibrillary acidic protein (GFAP) immunofluorescence staining. Cell proliferation rate was detected by CCK-8 method (n=4). Glioma cells carrying luciferase were obtained by lentivirus infection following puromycin selection. The negative control and the luciferase lentivirus infected (Luc) groups were set up during this process. The cell survival rates under oHSV-1 or oAD were detected and analyzed by In Vivo Imaging System (IVIS) and CCK8 assay, and those experiments were grouped according to the gradient of multiplicity of infection (MOI, MOI = 0, 0.001, 0.01, 0.1, 1, 10, n=4) of different viruses.

Patient-derived U022 cells had the typical morphological features of glioma cells. And cell proliferation curve of U022 cells showed that the cells proliferated quickly and the doubling time of them was 19.2 h. Immunofluorescence staining showed that GFAP expression was positive in U022 cells. After that, U022-luc cells carrying luciferase gene were successfully obtained through lentivirus infection and puromycin selection, and fluorescein luminescence assay showed that cell fluorescence intensity increased with the enrichment of cell numbers, which indicated a positive linear regression (R²=0.97, P<0.001). IVIS and CCK-8 analysis showed that both the herpes simplex virus 1 (oHSV-1) and the oncolytic adenovirus (oAD) had significant inhibitory effect on U022-luc glioma cells. Moreover, the efficiency was increased following the rise of the virus titer (both P<0.010). When the multiplicity of infection reached 10, the inhibition effect of oHSV-1 on U022-luc cells detected by IVIS and CCK-8 were up to (68.77±5.96) % and (66.27±4.89) % respectively. Meanwhile, the inhibition effect of oAD on U022-luc cells were up to (64.34±3.13) % and (69.73±4.87) % respectively.

A luciferase-labeled patient-derived glioma cell model can be successfully constructed in vitro. This cell model can be applied to quantitative studies of oHSV-1 and oAD treatment.