Objective Exploring the therapeutic effects,imaging,and therapeutic mechanisms of a rechargeable and remotely programmable 3.0T MRI compatible deep brain stimulation system in patients with Parkinson's disease after subthalamic nucleus stimulation surgery. Methods Analyze the clinical data of one Parkinson's patient treated with the world's first rechargeable and remote 3.0T MRI compatible deep brain stimulation system at the Neurosurgery Department of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) on October 10,2022.Follow up data for one year will be analyzed.3.0T cranial magnetic resonance imaging was performed 1 week and 1 year postoperatively to evaluate clinical symptoms,magnetic resonance imaging,and stability of electrode impedance. Results From 4 weeks after surgery to 1 year of follow-up,the improvement rates of exercise (UPDRS-III and UPDRS-IV were 95.31% and 75.00%,respectively) and non exercise symptoms (NMSS,PDSS,PDQ39,MoCA,HAMA,HAMD,CCS improvement rates were 85.42%,24.53%,91.23%,7.14%,84.61%,100.00%,57.14%,respectively) were significantly improved,and the dosage of medication was reduced (LED decreased by 34.61%),with stable stimulation parameters.3.0T magnetic resonance imaging examination (T1,T2,3DT1,DTI,rs fMRI) showed normal imaging,and the structural image could clearly display the position of electrodes and nuclei.Functional magnetic resonance imaging indicated increased local neuronal activity and enhanced brain functional connectivity in the turned on state.The electrode impedance during the inspection process is stable and no adverse events have occurred. Conclusion The application of 3.0T MRI compatible deep brain stimulation equipment in the surgical treatment of Parkinson's disease patients has a definite effect,while improving the accuracy of postoperative imaging evaluation.It is of great value for exploring the imaging mechanism of deep brain stimulation treatment for Parkinson's disease.

Objective To investigate the clinical and imaging manifestations,pathology and treatment of pituicytoma. Methods The clinical data,imaging findings,pathology and treatment of 2 patients who were diagnosed as pituicytoma in our hospital from January 2019 to October 2023 were retrospectively analyzed,and the relevant literature was reviewed. Results There were 2 patients of pituicytoma,1 male and 1 female.The main symptoms include headache and vision decreased,and the head magnetic resonance imaging showed iso-intense on T1 weighted imaging and hypo- or iso-intense on T2 weighted imaging in and above the sellar region,substantial lesions were increased signal intensity after enhancement.Transnasal sphenoid approach under microscope and neuroendoscope were performed respectively.The postoperative pathology was pituicytoma (WHO Grade I),which was not treated with radiotherapy.Two cases were followed up for 4 years and 3 months without recurrence. Conclusion Pituicytoma is rare and easily misdiagnosed,the blood supply of tumor tissue is affluent,total surgical resection is the main way of treatment.

Objective To investigate the application value of neuroendoscopy combined with microscope in the resection of cerebellopontine angle epidermoid cyst. Methods he clinical data of 15 cases of cerebellopontine angle epidermoid cyst were retrospectively analyzed.The posterior suboccipital sigmoid sinus approach was adopted in all cases,and the lesions were resected by neuroendoscope combined with microscope. Results All of the 15 patients,12 (80.0%) were completely resected.Subtotal resection was performed in 2 cases (13.3%).The majority was resected in 1 case (6.7%).After 2-22 months follow-up,10 patients with clinical symptoms were relieved.One patient developed new abducens nerve palsy within 1 week after surgery,and one patient developed mild facial paralysis,which returned to normal within 6 months after surgery.One patient developed aseptic meningitis postoperation and was cured by external drainage of lumbar cisterna. Conclusion Microscopy and neuroendoscopy are surgical instruments,both of them have their own advantages and disadvantages.For the operation of complex cerebellopontine angle epidermoid cyst,the advantages of both surgical instruments should be utilized to remove the tumor as much as possible while protecting the patient's neurological function and reducing complications.

Objective To explore the application value of 3D printed nasal skull base tumor model in the clinical and teaching of neurosurgery. Methods Total of 13 patients with skull base tumor were selected,the virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed according to the image data before surgery.40 students who participated in the standardized training of residents in the neurosurgery department were selected as teaching objects,and they were randomly divided into the traditional teaching group and the 3D printing model teaching group.The teaching effect of the two teaching modes was evaluated from the examination of theoretical knowledge and clinical skills,the satisfaction of teaching methods,the increase of understanding of neuroanatomical structure,the improvement of three-dimensional space imagination and the stimulation of active learning interest.Before surgery,the surgeon evaluated the spatial location of the tumor,preoperative talk,preoperative planning,intraoperative reference and postoperative anastomosis according to the 3D printed tumor model and traditional image data. Results The virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed before operation in all the 13 patients with skull base tumor.The 3D model clearly showed the tumor and its adjacent skull,blood vessels and nerves.We found that students in the 3D printed model teaching group had better scores in the assessment of theoretical knowledge and clinical skills than those in the traditional teaching group,and the difference between the two groups was statistically significant ( P＜0.05).Moreover,the 3D printed model teaching group was higher than the traditional teaching group in terms of satisfaction with teaching methods,increasing understanding of neuroanatomical structure,improving three-dimensional space imagination and stimulating active learning interest.We also found that,in addition to preoperative planning,the 3D printed model group scored higher than the traditional image group on tumor spatial display,preoperative talk,intraoperative reference,and postoperative anastomosis.The difference between the two groups was statistically significant ( P＜0.05). Conclusion Compared with the traditional surgical planning and clinical teaching based on two-dimensional image data,3D printed tumor model has better surgical planning and clinical teaching value.

Objective To analyze the characteristics of blood lipid metabolism in patients with Moyamoya disease(MMD) and the relationship between blood lipid levels and clinical features. Methods The clinical characteristics and blood lipid test results of 214MMD patients in Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2015 to October 2023 were collected,and 214 healthy subjects were selected as the control group.SPSS 26.0 was used to compare the lipid levels and the characteristics of abnormal lipid metabolism in each group,and the correlation between lipid levels and clinical characteristics was analyzed. Results The prevalence of abnormal lipid metabolism in MMD was 50.9%,mainly hypertriglyceridemia and low HDL-C.Compared with the control group,the level of TG in MMD patients was significantly higher ( P＜0.05).With the increase of BMI,the level of TG was higher and the level of HDL-C was lower ( P＜0.05).The levels of TC,TG and LDL-C in ischemic patients were higher than those in hemorrhagic patients. Conclusion Patients with MMD have a high rate of dyslipidemia,mainly hypertriglyceridemia and low HDL-C,especially in patients with cerebral infarction as the first symptom.In clinical work,patients with MMD should be intervened as early as possible.

Objective To analyze the efficacy and influencing factors of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. Methods The clinical data of 80 patients with depression who were given drug therapy combined with high-frequency rTMS admitted to the Affiliated Hospital of Wanxi Health Vocational College were retrospectively analyzed between May 2019 and May 2022,and the patients were classified as the study group.Another 80 patients with depression who only adopted drug therapy during the same period were used for controls,and they were set as the control group.Hamilton Depression Scale (HAMD) was used to evaluate the depressive symptoms of patients after treatment,and the treatment effect was compared.The patients in the study group were divided into effective treatment group ( n=51) and ineffective treatment group ( n=29) according to the changes in HAMD score after treatment.Univariate comparison was performed on clinical data such as gender,age,education level,family history of mental illness,disease course,sleep status,exercise status,treatment compliance,quality of life,family intimacy,cognitive ability and combined physical diseases,and unconditional Logistic multivariate stepwise regression analysis was performed on indicators with significant differences to analyze the influencing factors affecting the efficacy of high-frequency rTMS in the treatment of patients with depression. Results The effective rate of drug therapy combined with high-frequency rTMS treatment was 63.75%,and the efficacy of the study group was significantly higher than that of the control group ( P＜0.05).Sleep status,treatment compliance,family intimacy and cognitive ability were all independent factors that affected the efficacy of high-frequency rTMS in the treatment of depression (all P＜0.05). Conclusion Drug therapy combined with high-frequency rTMS has a high efficacy in the treatment of depression,and the sleep status,treatment compliance,family intimacy and cognitive ability during treatment are the influencing factors of its efficacy.In clinical practice,corresponding intervention measures can be implemented according to the influencing factors so as to improve the prognosis of patients.

Objective Introduction of neuroendoscopic-assisted techniques in the surgical treatment of microvascular decompression of primary facial muscle spasm and discussion of their efficacy. Methods Fifty patients with primary hemifacial spasm treated in our hospital from January 2019 to January 2022 were randomly divided into two groups.The control group ( n=25) and the observation group ( n=25) were treated with traditional microvascular decompression and the latter were treated with microvascular decompression assisted by neuroendoscope.To study the operation time,hospital stay,total effective rate of clinical treatment,muscle spasm intensity score,hemifacial spasm frequency score,facial disability index (Facial Disability Index,FDI)score,hearing level,specific quality of life (HemifacialSpasm-8,HFS-8) score,complication incidence and recurrence rate before and 6 months after treatment. Results The time of operation and hospitalization in the observation group was shorter than that in the control group,the scores of muscle spasm intensity and hemifacial spasm frequency after 6 months treatment,the incidence of complications after 7 days and 6 months follow-up,and the recurrence rate of 12 months follow-up in the observation group were lower than those in the control group,and the total effective rate,FDI score,hearing score and HFS-8 score in the observation group were higher than those in the control group.There were significant differences in the above-mentioned indexes between the two groups ( P＜0.05). Conclusion The clinical effect and safety of microvascular decompression assisted by neuroendoscopy in the treatment of patients with primary hemifacial spasm are better,it is more effective to reduce the incidence of short-term and long-term complications,avoid recurrence,and improve the quality of life of patients,and wider clinical prospect.

Objective To investigate the interaction of MRI parameters volume transport constant (Ktrans) and rate constant (Ve) with serum interleukin 10 (IL-10) and vascular endothelial growth factor (VEGF) in patients with glioma and their diagnostic value in the grading of glioma. Methods A retrospective study was conducted,120 patients with brain glioma who were treated in neurosurgery of our hospital from October 2020 to October 2022 were selected as the study group,and another 90 patients who underwent craniotomy due to cerebral hemorrhage were selected as the control group.The study group used dynamic contrast-enhanced MRI to obtain the Ktrans value and Ve value,and compared the levels of serum IL-10 and VEGF between the two groups.Pearson correlation analysis showed the correlation between Ktrans value and Ve value and serum IL-10 and VEGF levels,respectively.The Ktrans and Ve values,serum IL-10 and VEGF levels of patients with different grades of glioma were analyzed,and the diagnostic value of each index on the grade of glioma was analyzed by ROC curve. Results The levels of serum IL-10(25.97±7.41 pg/ml 比 14.79±3.37 pg/ml) and VEGF(167.01±34.32 pg/ml vs 90.86±13.64 pg/ml) in the study group were significantly higher than those in the control group ( P＜0.05).There were 63 patients with high grade and 57 patients with low grade,and the levels of serum IL-10(30.62±6.22 pg/ml vs 20.97±4.93 pg/ml),VEGF(191.05±28.61 pg/ml vs 141.22±16.63 pg/ml),Ktrans(0.333±0.097 min ^-1 vs 0.234±0.068 min ^-1) and Ve(0.473±0.136 min ^-1 vs 0.277±0.091 min ^-1) in high grade patients were significantly higher than those in low grade patients ( P＜0.05).Pearson correlation analysis showed that the grade of glioma was positively correlated with the levels of IL-10,VEGF,Ktrans and Ve ( r=0.538,0.624,0.502,0.541; P＜0.001),and the serum levels of IL-10,VEGF were positively correlated with Ktrans and Ve ( r=0.552,0.695,0.550,0.602; P＜0.05).The AUC of serum IL-10,VEGF,KTrans and Ve values in diagnosis of high-grade tumors were 0.804 (0.704~0.905),0.808 (0.717~0.900),0.793 (0.701~0.886),0.815 (0.721~0.909),0.882 (0.810~0.953),respectively.The AUC of combined diagnosis was higher than that of single diagnosis ( P＜0.05). Conclusion The MRI parameters Ktrans and Ve are positively correlated with the serum levels of IL-10 and VEGF in patients with glioma,and have good diagnostic efficacy for the grading of glioma.

Objective To assess the value of neutrophil-to-lymphocyte ratio (NLR) in predicting the occurrence of symptomatic haemorrhage after endovascular treatment in patients with acute ischaemic stroke (AIS). Methods The clinical data of 182 endovascularly treated AIS patients admitted to the tertiary stroke centre of the First Affiliated Hospital of the University of Science and Technology of China between November 2020 and May 2023 were retrospectively analysed and grouped according to the presence or absence of symptomatic cerebral hemorrhage (sICH).The differences in clinical data between the two groups were compared to assess the predictive value of NLR before and after EVT treatment (Pre-EVT NLR,Post-EVT NLR) for the occurrence of sICH after EVT in AIS patients. Results Among 182 patients with endovascularly treated AIS,46 developed sICH.Multifactorial logistic regression analysis suggested that higher Pre-EVT NLR and Post-EVT NLR were independent risk factors for the development of sICH after EVT in patients with AIS (Pre-EVT NLR:OR=1.146,95%CI:1.052~1.250, P=0.002;Post-EVT NLR:OR=1.128,95%CI:1.030~1.236, P=0.009).The area under the curve (AUC) for Pre-EVT NLR and Post-EVT NLR predicting the development of sICH after EVT in AIS patients was 0.683 (95%CI:0.586~0.781, P＜0.001) and 0.619 (95%CI:0.523~0.715, P=0.016),respectively. Conclusion Pre-EVT NLR and Post-EVT NLR were both predictors of sICH after EVT in AIS patients.

Objective To explore the influence of cerebrospinal fluid extraction on drainage effect and short-term prognosis in patients with hypertensive intracerebral hemorrhage (HICH) on the basal ganglia undergoing puncture and drainage combined with urokinase. Methods Clinical data of 75 HICH patients receiving puncture and drainage combined with urokinas were analyzed retrospectively.Based on the presence or absence of CSF drainage during treatment,the differences of drainage effect,complications and short-term prognosis were compared between the group with cerebrospinal fluid extraction (A group) and the group without cerebrospinal fluid extraction (B group). Results Compared with group A,the residue hematoma volume was lower ( P<0.001) in group B.And the lengths of hospitalisation and drain tube stay were shorter in group B( P=0.002, P=0.003).While no significant differences in the postoperative complications and short-term prognosis were found between the two groups ( P＞0.05).The rate of intracranial infection was significantly elevated in group A( P=0.027).Patients in Group A used less mannitol during hospitalization ( P=0.038). Conclusion It had a better drainage effect without cerebrospinal fluid extraction for HICH in the basal ganglia patients receiving puncture and drainage combined with urokinas.Meanwhile,the risk of intracranial infection and the average length of hospital stay reduced.Patients with intraventricular hemorrhage puncture and drainage combined with urokinas was an effective treatment for HICH on the basal ganglia.

Objective Analyze the clinical efficacy of endoscopic assisted subtemporal approach in the treatment of severe brainstem hemorrhage. Methods Retrospective analysis of 78 patients with severe brainstem hemorrhage admitted to our hospital from January 2021 to January 2023,according to the choice of the patients' family members,they were divided into operation group and conservative management.There were 36 cases in the surgical group and 42 cases in the conservative group.The surgical group used endoscope to clear the hematoma through the subtemporal approach,while the conservative group used symptomatic treatment according to the treatment guidelines for cerebral hemorrhage.Compare the complications,clinical prognosis,and changes in serum NSE and S100B levels between the two groups. Results Compared with the conservative group,the number of patients with severe pneumonia,lower limb venous thrombosis,electrolyte disorder and Irritability ulcer in the operation group was less than that in the conservative group.The difference between the two groups was statistically significant ( P＜0.05).By comparing the Glasgow prognostic score (GOS) of the two groups,it was found that the number of patients with normal life and mild disability in the operation group was more than that in the Conservative management group,and the number of patients with severe disability was less than that in the Conservative management group.The difference between the two groups was statistically significant ( P＜0.05).After 1 and 2 weeks of treatment,it was found that the levels of NSE and S100B in the serum of the surgical group were significantly lower than those of the conservative group,with a statistically significant difference ( P＜0.05). Conclusion The treatment of severe brainstem hemorrhage through the infratemporal approach assisted by neuroendoscopy can reduce complications and mortality in patients,and improve their prognosis.

Objective To investigate the influencing factors of brain lesions in Wilson's disease(WD) and to construct a predictive model for brain lesions in WD to facilitate early identification and intervention. Methods A retrospective analysis was conducted on the clinical and laboratory data of 198 patients with neurological WD who were treated at the Neurology Institute affiliated with Anhui University of Chinese Medicine from April 2019 to April 2023.All patients underwent cranial magnetic resonance imaging(MRI) and exhibited varying degrees of MRI changes in the brain.LASSO regression and multivariate Logistic regression analysis were used to identify factors influencing the occurrence of brain pathology and to construct a nomogram prediction model.The effectiveness of the predictive model was verified using the receiver operating characteristic(ROC) curve, calibration curve, and decision curve analysis(DCA).The model was internally validated using 1000 bootstrap resamples and 10-fold cross-validation. Results The age of WD patients, and MRI findings of pontine and thalamic lesions were identified as independent risk factors for brain pathology.The nomogram demonstrated good discrimination, calibration, and clinical utility.After 1000 bootstrap resamples and 10-fold cross-validation, the model maintained robust predictive performance. Conclusion The nomogram prediction model developed in this study has good predictive and discriminative capabilities, which can assist clinicians in predicting the occurrence of brainstem lesions in WD patients and has potential clinical translational application value.