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Xie T, Shu Y, Huang W, Ren A, Lin J, Tan Y, Zhao S, Bu J. β-eudesmol inhibits cell growth and enhances cell chemosensitivity of NPC through targeting FGF1/FGFR signaling. Oral Oncol 2025; 162:107168. [PMID: 39864398 DOI: 10.1016/j.oraloncology.2024.107168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 12/19/2024] [Accepted: 12/25/2024] [Indexed: 01/28/2025]
Abstract
BACKGROUND Chemoresistance is one ofthe main challenges for advanced NPCtreatment.We previouslyproved LHX2 transcriptionally regulates FGF1 and promotes cancer progression through activating FGF1/FGFR axis,which prompted us toexplore the potential inhibitors for FGFR to improve the therapy response. METHODS RT-qPCR, immunohistochemistry, western blot assayand immunofluorescencewere applied to verify the gene expression levels. Xenograftmodel as well as lung metastasis model was performed forin vitroassays. Flow cytometry and Tunel stainingwere used to determine the apoptosis of NPC cells.The interaction between β-eudesmol and FGFR1/2 was analyzed by Autodock software. RESULTS β-eudesmol inhibited the growth and metastasisof NPCin vivoandin vitro.In addition,β-eudesmol treatment promoted NPC apoptosis and sensitized NPC to cisplatin. β-eudesmol putatively bound to FGFR and blocked the Akt signaling, STAT3 signalingandERKsignaling,which in turn restrainedABCC1 transcription. CONCLUSION β-eudesmol suppressed cell growth, metastasis and chemoresistance in NPC through targetingFGF1/FGFR signaling, thereby blocking the Akt signaling, STAT3 signaling andERKsignaling, as well as down-regulating ABCC1 expression. Our findings provided a novel potential drug for NPC treatment.
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Affiliation(s)
- Tao Xie
- Department of Radiation Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China; Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Yuqi Shu
- Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Laboratory of Heart Center, Department of Cardiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Wei Huang
- Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Anbang Ren
- Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China; Department of Radiation Oncology, Shunde Hospital, Southern Medical University, Foshan, Guangdong Province, People's Republic of China
| | - Jie Lin
- Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Yujing Tan
- Department of Radiation Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Shufen Zhao
- Department of Radiation Oncology, Shunde Hospital, Southern Medical University, Foshan, Guangdong Province, People's Republic of China.
| | - Junguo Bu
- Department of Radiation Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China.
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Chechani B, Roat P, Hada S, Yadav DK, Kumari N. Psidium guajava: An Insight into Ethnomedicinal Uses, Phytochemistry, and Pharmacology. Comb Chem High Throughput Screen 2024; 27:2-39. [PMID: 37170987 DOI: 10.2174/1386207326666230426093315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Psidium guajava (guava) is widely distributed in tropical and subtropical regions and adapted to various environmental conditions. Guava is an important economic fruit widely used as food and folk medicine. It contains flavonoids, alkaloids, tannins, triterpenoids, reducing sugars, essential oils, carotenoids, polyphenols, etc. The presence of triterpenoid acids such as guavacoumaric, ursolic, jacoumaric, guajavanoic, guavenoic, and Asiatic acids helps to develop novel drugs against various diseases. It is used traditionally for medicinal purposes, mainly for antioxidant, antimicrobial, antispasmodic, antidiabetic, anticancer, antiallergy, anti-inflammatory, and hepato-protective properties. OBJECTIVE The systematic literature study aims to summarize its botanical description, phytochemicals, pharmacological activities, and clinical trials. This review focuses on the plant's chemical composition and scientific approaches to human welfare. METHODS A systematic literature search was done on Psidium guajava through previous literature and online databases such as Google Scholar, Pubmed, Science Direct, etc., to explain its ethnomedicinal uses, phytochemistry, and pharmacological applications. RESULTS Previous literature studies of Psidium guajava suggest it can serve as antioxidant, antimicrobial, antispasmodic, antidiabetic, anticancer, anti-allergy, anti-inflammatory, and hepatoprotective effects. Successful clinical trials performed on the plant extracts against infantile rotaviral enteritis and infectious gastroenteritis showed future directions to work with the plant for clinical applications. CONCLUSION In this review, an attempt is made to show all literature studied, especially in phytochemistry, pharmacology, clinical trials and uses as traditional folk medicine around the world. The leaves have been used by folklore over the years to treat various ailments such as skin ulcers, diarrhoea, vaginal irritation, cough, conjunctivitis, etc. Further studies are required to explore more therapeutic remedies and to develop new medicines for future perspectives.
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Affiliation(s)
- Bhawna Chechani
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur-313001, India
| | - Priyanka Roat
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur-313001, India
| | - Sonal Hada
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur-313001, India
| | - Dinesh Kumar Yadav
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur-313001, India
| | - Neetu Kumari
- Department of Chemistry, Mohanlal Sukhadia University, Udaipur-313001, India
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Tayama Y, Mizukami S, Toume K, Komatsu K, Yanagi T, Nara T, Tieu P, Huy NT, Hamano S, Hirayama K. Anti-Trypanosoma cruzi activity of Coptis rhizome extract and its constituents. Trop Med Health 2023; 51:12. [PMID: 36859380 PMCID: PMC9976467 DOI: 10.1186/s41182-023-00502-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/09/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Current therapeutic agents, including nifurtimox and benznidazole, are not sufficiently effective in the chronic phase of Trypanosoma cruzi infection and are accompanied by various side effects. In this study, 120 kinds of extracts from medicinal herbs used for Kampo formulations and 94 kinds of compounds isolated from medicinal herbs for Kampo formulations were screened for anti-T. cruzi activity in vitro and in vivo. METHODS As an experimental method, a recombinant protozoan cloned strain expressing luciferase, namely Luc2-Tulahuen, was used in the experiments. The in vitro anti-T. cruzi activity on epimastigote, trypomastigote, and amastigote forms was assessed by measuring luminescence intensity after treatment with the Kampo extracts or compounds. In addition, the cytotoxicity of compounds was tested using mouse and human feeder cell lines. The in vivo anti-T. cruzi activity was measured by a murine acute infection model using intraperitoneal injection of trypomastigotes followed by live bioluminescence imaging. RESULTS As a result, three protoberberine-type alkaloids, namely coptisine chloride, dehydrocorydaline nitrate, and palmatine chloride, showed strong anti-T. cruzi activities with low cytotoxicity. The IC50 values of these compounds differed depending on the side chain, and the most effective compound, coptisine chloride, showed a significant effect in the acute infection model. CONCLUSIONS For these reasons, coptisine chloride is a hit compound that can be a potential candidate for anti-Chagas disease drugs. In addition, it was expected that there would be room for further improvement by modifying the side chains of the basic skeleton.
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Affiliation(s)
- Yuki Tayama
- grid.174567.60000 0000 8902 2273Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ,grid.174567.60000 0000 8902 2273Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Shusaku Mizukami
- grid.174567.60000 0000 8902 2273Department of Immune Regulation, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan ,grid.174567.60000 0000 8902 2273School of Tropical Medicines and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ,grid.174567.60000 0000 8902 2273The Joint Usage/Research Center On Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523 Japan
| | - Kazufumi Toume
- grid.267346.20000 0001 2171 836XSection of Pharmacognosy, Institute of Natural Medicine, University of Toyama, Toyama, Japan
| | - Katsuko Komatsu
- grid.267346.20000 0001 2171 836XSection of Pharmacognosy, Institute of Natural Medicine, University of Toyama, Toyama, Japan
| | - Tetsuo Yanagi
- grid.174567.60000 0000 8902 2273NEKKEN Bio-Resource Center (NBRC), Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan ,grid.174567.60000 0000 8902 2273The Joint Usage/Research Center On Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523 Japan
| | - Takeshi Nara
- grid.411789.20000 0004 0371 1051Faculty of Pharmacy, Iryo Sosei University, Iwaki, Fukushima Japan
| | - Paul Tieu
- grid.25073.330000 0004 1936 8227Faculty of Health Sciences, McMaster University, Hamilton, ON Canada ,Online Research Club, Nagasaki, Japan
| | - Nguyen Tien Huy
- grid.174567.60000 0000 8902 2273Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ,grid.174567.60000 0000 8902 2273School of Tropical Medicines and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ,Online Research Club, Nagasaki, Japan
| | - Shinjiro Hamano
- grid.174567.60000 0000 8902 2273Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ,grid.174567.60000 0000 8902 2273Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan ,grid.174567.60000 0000 8902 2273The Joint Usage/Research Center On Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523 Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,School of Tropical Medicines and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,The Joint Usage/Research Center On Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan.
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Sonsomnuek P, Tarasuk M, Plengsuriyakarn T, Boonprasert K, Na-Bangchang K. Apoptotic and Anti-metastatic Effects of Atractylodes lancea (Thunb.) DC. in a Hamster Model of Cholangiocarcinoma. Asian Pac J Cancer Prev 2022; 23:3093-3101. [PMID: 36172672 PMCID: PMC9810284 DOI: 10.31557/apjcp.2022.23.9.3093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Cholangiocarcinoma (CCA) is a highly aggressive tumor with a greater risk of distant metastasis. The promising anti-CCA activity and safety profile of Atractylodes lancea (AL) have previously been reported in a series of in vitro, in vivo and clinical studies. The present study investigated the effect of AL extract on apoptosis and metastasis signaling pathways in the Opisthorchis viverrini/dimethylnitrosamine (OV/DMN)-induced CCA hamster model. MATERIALS AND METHODS Hamster liver tissues were obtained from the four groups (n = 5 per group), i.e., (i) 5-FU treated CCA (40 µg/mL); (ii) CCA; (iii) AL-treated CCA (5,000 mg/kg), and (iv) normal hamsters. Total RNA was isolated, and the expression levels of apoptosis-related and metastasis-related genes were determined by qRT-PCR analysis. RESULTS The expression levels of p16, caspase-3, caspase-8, caspase-9, Apaf-1, p53 and Eef1a1 were downregulated, while that of the remaining genes were upregulated in CCA hamsters compared with normal hamsters. AL treatment increased the expression of p16, caspase-9, caspase-3, Apaf-1, p53 and E-cadherin and decreased the expression of cyclin D1, cdk4, Bax, Akt/PKB, Bcl-2, Mfge-8, Lass4, S100A6, TGF-β, Smad-2, Smad-3, Smad-4, MMP-9, and N-cadherin. The expression of Eef1a1 was unchanged. CONCLUSION The anti-CCA activity of AL in OV/DMN-induced CCA hamsters could be due to the induction of cell cycle arrest at the G1 phase and activation of the apoptosis pathway, resulting in cancer cell death. The activation of the apoptosis pathway mainly involved the intrinsic pathway (activation of caspase-3 and caspase-9 through p53 and Mfge-8 modulation and downregulation of anti-apoptotic genes Akt and Bcl-2). In addition, AL could also inhibit the canonical TGF-β signaling pathway, MMP-9 and N-cadherin to suppress tumor metastasis.
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Affiliation(s)
- Paradon Sonsomnuek
- Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand., Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.
| | - Mayuri Tarasuk
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.
| | - Tullayakorn Plengsuriyakarn
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.
| | - Kanyarat Boonprasert
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.
| | - Kesara Na-Bangchang
- Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.,Director, Drug discovery, and Development Center, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand. ,For Correspondence:
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Amadike Ugbogu E, Emmanuel O, Ebubechi Uche M, Dike Dike E, Chukwuebuka Okoro B, Ibe C, Chibueze Ude V, Nwabu Ekweogu C, Chinyere Ugbogu O. The ethnobotanical, phytochemistry and pharmacological activities of Psidium guajava L. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.103759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Krenc D, Na-Bangchang K. Spectroscopic observations of β-eudesmol binding to human cytochrome P450 isoforms 3A4 and 1A2, but not to isoforms 2C9, 2C19 and 2D6. Xenobiotica 2022; 52:199-208. [PMID: 35139770 DOI: 10.1080/00498254.2022.2037168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
β-Eudesmol is a sesquiterpenoid component o Atractylodes lancea with cytotoxic activity against cholangiocarcinoma. Its lipophilic nature makes β-eudesmol a likely substrate of human cytochrome P450 (P450) enzymes.Using ligand-binding difference spectroscopy, the affinities of this compound to recombinant CYP1A2, CYP2C9, CYP2C19, CYP2D6 and CYP3A4 were investigated in Escherichia coli membrane preparations.CYP3A4 showed a type I spectral change, with a binding constant Ks of 77 ± 23 (mean ± SD) μM at 0.5 μM P450 (Ks/[P450] ≈ 155). The reference substrate testosterone and the inhibitor fluconazole bound to the enzyme with apparent affinities of 86 ± 4 μM (type I) and 21 μM (type II), respectively. β-Eudesmol was bound to CYP3A4 in a non-cooperative manner (Hill coefficient n ≈ 0.8). CYP1A2 showed reverse type I difference spectra with either β-eudesmol or caffeine. The CYP1A2 affinity for β-eudesmol was higher (0.23 mM) than for caffeine (0.37 mM) but lower than for phenacetin (0.11 mM, type I). β-Eudesmol did not bind significantly to CYP2C9, CYP2C19, and CYP2D6.Confirmation of metabolic activity and studies on the involvement of other human P450 isoforms studies are required. Double-beam spectrometry is needed to validate Ks measurements made with a plate reader.
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Affiliation(s)
- Dawid Krenc
- Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand
| | - Kesara Na-Bangchang
- Graduate Program in Bioclinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand.,Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand.,Drug Discovery and Development Center, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand
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Acharya B, Chaijaroenkul W, Na-Bangchang K. Therapeutic potential and pharmacological activities of β-eudesmol. Chem Biol Drug Des 2021; 97:984-996. [PMID: 33449412 DOI: 10.1111/cbdd.13823] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/21/2020] [Indexed: 12/24/2022]
Abstract
Herbal medicines are attracting the attention of researchers worldwide. β-Eudesmol is one of the most studied and major bioactive sesquiterpenes, mainly extracted from Atractylodes lancea (Thunb) DC. rhizomes. It has potential anti-tumor and anti-angiogenic activities and is an inhibitor of tumor growth by inhibiting angiogenesis by suppressing CREB activation of the growth factor signaling pathway. It also stimulates neurite outgrowth in rat pheochromocytoma cells with activation of mitogen-activated protein kinases. It may be a promising lead compound for enhancing neural function, and it may help to explain the underlying mechanisms of neural differentiation. In this review, we summarized the currently available clinical and preclinical studies describing the therapeutic applications of β-eudesmol.
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Affiliation(s)
- Bishwanath Acharya
- Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand
| | - Wanna Chaijaroenkul
- Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.,Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.,Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand.,Drug discovery, and Development Center, Thammasat University, Rangsit Center, Klong Luang, Pathum Thani, Thailand
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Liu X, Huang H, Li X, Zheng X, Zhou C, Xue B, He J, Zhang Y, Liu L. Knockdown of ADAMDEC1 inhibits the progression of glioma in vitro. Histol Histopathol 2020; 35:997-1005. [PMID: 32378728 DOI: 10.14670/hh-18-227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Glioma is one of the most lethal malignant tumors all over the world. The prognosis of patients with high‑grade glioma remains very poor. Therefore, it is urgent to find a novel strategy for the treatment of glioma. It has been reported that ADAMDEC1 could regulate the progression of multiple diseases, including cancers. However, the role of ADAMDEC1 during the tumorigenesis of glioma remains largely unknown. Methods, Gene expression of ADAMDEC1 in glioma tissues or in cells was detected by qRT-PCR. Western blot was performed to measure the protein expressions of p53, active caspase3, active caspase9, CDK2 and Cyclin A in glioma cells. Cell proliferation was detected by CCK-8 assay. Cell apoptosis or cycle was tested by flow cytometry. Transwell was used to test the invasion of glioma cells. RESULTS The expression of ADAMDEC1 in glioma tissues or cells was significantly upregulated. In addition, downregulation of ADAMDEC1 notably inhibited the proliferation and induced apoptosis of glioma cells through upregulation of active caspase 3 and active caspase 9. Besides, silencing of ADAMDEC1 obviously induced G1 arrest in glioma cells via modulation of cell cycle-related proteins. Finally, knockdown of ADAMDEC1 significantly inhibited the migration and invasion of glioma cells. In contrast, overexpression of ADAMDEC1 promoted cell proliferation, migration and invasion of glioma cells. CONCLUSION Downregulation of ADAMDEC1 could significantly inhibit the tumorigenesis of glioma in vitro, which may serve as a novel target for the treatment of glioma.
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Affiliation(s)
- Xueliang Liu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Hao Huang
- Department of Neurosurgery, Guang'an People's Hospital, Guangan, Sichuan, China
| | - Xuehan Li
- Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaomei Zheng
- Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Chong Zhou
- Department of Neurology, Jianyang People's Hospital, Jianyang, Sichuan, China
| | - Bin Xue
- Department of Neurosurgery, Nanbu People's Hospital, Nanchong, Sichuan, China
| | - Jimin He
- Department of Neurosurgery, Suining Central Hospital, Suining, Sichuan, China
| | - Ye Zhang
- Department of Neurosurgery, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Liang Liu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
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