Background: With the development of radiological technologies, radiotherapy has been gradually widely used in the clinic to intracranial tumours and become standardised. However, the related central nervous system disorders are still the most obvious complications after radiotherapy. This study aims to quantify the effectiveness of anlotinib, a small molecule inhibitor of multiple receptor tyrosine kinases, in mitigating acute phase of radiation-induced brain injury (RBI) in a mouse model. Methods:The onset and progression of RBI were investigated in vivo. All mice, (except for the sham group) were irradiated at a single-fraction of 20 Gy and treated with different doses of anlotinib (0, 0.2 and 0.8 mg/kg, respectively). The expression levels of glial fibrillary acidic protein (GFAP), hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and phosphorylated vascular endothelial growth factor receptor-2 (p-VEGFR2) were assessed by western blot. Histological changes were identified by luxol fast blue (LFB) staining. Results:The expression levels of GFAP, HIF-1α, and VEGF were downregulated following treatment with anlotinib. However, anlotinib failed to inhibit the development of demyelination. Cerebral edema [as measured by brain water content (BWC)] was also mitigated following treatment with anlotinib.Conclusions: In summary, treatment with anlotinib significantly mitigated the adverse effects of acute RBI in a dose-dependent manner by downregulating the activation of astrocytes, improving brain hypoxia, and alleviating cerebral edema.
We describe the case of a 58-year-old woman who was presented with pancytopenia and hypofibrinogenemia. Treatment with iron supplementation was not satisfactory. Physical findings and a history of a massive postpartum hemorrhage suggested Sheehan's syndrome(SS). After thyroxine and glucocorticoid replacement therapy, the blood cell count improved. SS is a rare etiology of hemocytopenia, of which hematologists need to be aware. We conclude that hormonal therapy can produce full hematological recovery.
Angioimmunoblastic T-cell lymphoma (AITL) is a specific subtype of peripheral T-cell lymphoma that is challenging to diagnose due to the lack of specific pathological characteristics. This report describes the case of a 56-year-old man with Hodgkin lymphoma in whom the gene rearrangement results were positive for TCRβDB+Jβ1/2. Pathological and immunochemical examinations revealed a diagnosis of lymphoma that was a composite of AITL and focal classical Hodgkin lymphoma. Unfortunately, he died soon after the correct diagnosis was made. This case shows that a combination of immunohistochemistry and gene rearrangement analysis can increase the diagnostic accuracy for AITL. A review of the literature on the misdiagnosis of AITL indicates that this disease progresses rapidly with a high mortality rate. Our experience, in this case, highlights the need for early diagnosis.
Malignant tumors are one of the serious public health problems that threaten the survival time of human beings. They are prone to metastasis to distant organs and the central nervous system is one of the common target organs. As it is difficult for chemotherapeutics, targeted drugs and other macromolecules to pass through the blood brain barrier (BBB), local radiation therapy is often used for treating intracranial primary or metastatic tumors. However, whether it is whole brain radiation therapy (WBRT) or stereotactic body radiation therapy (SBRT), the choice of radiation dose is limited by the side effects of radiation therapy on the surrounding normal brain tissues. Radiation-induced brain injury (RBI) can further develop into radiation necrosis (RN) in the late stage. Bevacizumab is often effective against RBI by antagonizing vascular endothelial growth factor (VEGF), but it still cannot completely reverse RN. Emerging treatment options such as human pluripotent stem-cell transplantation have made it possible to reverse the process of RN.
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