Objective To investigate the changes of non-motor symptoms and quality of life in patients with Parkinson's disease (PD) after bilateral subthalamic nucleus deep brain stimulation (STN-DBS). Methods Questionnaires were conducted among a convenience sample of 45 PD patients who met the indications of STN-DBS in the Functional Neurosurgery Center of Ruijin Hospital,Shanghai JiaoTong University School of Medicine in Shanghai from June 1,2020 to August 31,2020.The Non-motor Symptom Scale (NMSS) and 8-item Parkinson's Disease Questionnaire (PDQ-8) were used to evaluate the patients' non-motor symptoms and quality of life preoperatively and at 3,6,12 and 24-month postoperative visits. Results Generalized estimation equation analysis showed a significant overall change of PDQ-8 and levodopa equivalent daily dose (LEDD) over five follow-up visits ( P＜0.05).Sleep/fatigue,Mood/apathy,Attention/memory,Gastrointestinal,Urinary,Sexual function and Miscellaneous subscores showed a statistically significant decreasing trend ( P＜0.05),while Cardiovascular and Perceptual subscores of NMSS were unchanged ( P>0.05). Conclusion Bilateral STN-DBS has a long-term benefit on sleep/fatigue and urinary symptoms and a short-term benefit on Sleep/fatigue,Mood/apathy,Attention/memory,Gastrointestinal,Urinary,Sexual function and Miscellaneous symptoms in PD patients.Moreover,it can reduce the medication intake and improve the patients' quality of life.

Objective To analyze the occurrence of second primary malignancies (SPM) in patients with glioma and identify their risk factors. Methods Cases of glioma patients diagnosed from January 2000 to December 2021 were collected from the Surveillance,Epidemiology,and End Results (SEER) database.A retrospective analysis was performed on patients' demographic characteristics,clinical features,and SPM occurrence,using univariate and multivariate Cox regression analysis to identify risk factors. Results A total of 87,889 glioma patients were screened from the SEER database,with 1,043 developing SPM.The median overall survival (OS) for patients with SPM was 105.0 months.The most common sites for SPMs were the breast (34.08%),lung and bronchi (11.27%),and thyroid (10.99%).Multivariate Cox regression analysis showed that age (≥65 years:HR=3.047,95% CI:2.570~3.613, P＜0.001),pathology (glioblastoma:HR=2.091,95% CI:1.793~2.438, P＜0.001),and radiotherapy (HR=1.489,95% CI:1.276~1.736, P＜0.001) were independent risk factors for the occurrence of SPM. Conclusion Breast,lung and bronchi,and thyroid are the most common sites of SPM in glioma patients.Age,pathology,and radiotherapy are significant risk factors for SPM occurrence.Identifying these risk factors can guide personalized follow-up and screening for SPM in glioma patients.

Objective To investigate the expression changes of GLDN (Gliomedin) in glioblastoma (GBM) tissues and cell lines,and its impact on patient prognosis. Methods By conducting further mining and analysis of sequencing data from previously published studies on glioblastoma multiforme (GBM) drug resistance within our research group,we downloaded the GSE113510 mRNA sequencing data from the international GEO database,GLDN was identified as the gene with the most significant differential expression.The expression differences of GLDN between primary and recurrent GBM tissues were analyzed using the CGGA database.GLDN mRNA levels in GBM cell lines were measured by quantitative real-time PCR,and protein levels were detected by Western blotting.Survival analysis using the CGGA and TCGA databases was conducted to examine the relationship between GLDN expression and patient prognosis. Results Analysis of the GSE113510 dataset revealed that GLDN exhibited the most significant differential expression in drug-resistant GBM cell lines.GLDN expression was significantly higher in recurrent GBM tissues compared to primary GBM tissues ( P＜0.05).Additionally,GLDN expression was markedly elevated in drug-resistant cell lines 229R,251R,and HG7R compared to their non-resistant counterparts ( P＜0.05).Survival analysis showed that high GLDN expression was associated with poorer patient prognosis,with a significantly shorter survival time. Conclusion GLDN is highly expressed in glioblastoma and is closely associated with drug resistance and poor prognosis.It may serve as a potential therapeutic target in GBM treatment.

Objective To study the effect of neuroendoscopy on postoperative neurological function after surgical treatment of cerebral hemorrhage. Methods This study selected 60 patients with cerebral hemorrhage admitted to our hospital from January 2023 to January 2024 as the research subjects.They were randomly divided into a control group and an observation group,with 30 patients in each group.The control group received surgical treatment,while the observation group received neuroendoscopic intracranial hematoma removal surgery. Results When using neuroendoscopy to treat patients with cerebral hemorrhage,the neurological function scores of the observation group were better than those of the control group at 1 month and 3 months after surgery ( P＜0.05).The incidence of postoperative complications (intracranial infection,postoperative rebleeding,and communicating hydrocephalus) in the observation group was lower than that in the control group,and the difference was statistically significant.The ADL (daily living ability) score of the observation group was also better than that of the control group at 1 and 3 months after surgery ( P＜0.05). Conclusion Neuroendoscopic removal of intracranial hematoma has achieved significant results in improving the postoperative neurological function of patients.

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 analyze the risk factors for recurrence of trigeminal neuralgia(TN) after percutaneous balloon compression(PBC),construct a recurrence risk prediction model,and verify its prediction effect. Methods Retrospective collection of data from January 2020 to December 2023 on 317 TN patients treated with PBC at the Fourth Affiliated Hospital of Harbin Medical University was conducted to form the modeling group.Univariate analysis and logistic regression analysis were employed to screen for risk factors for TN recurrence after PBC.Three machine learning algorithms(Logistic regression,random forest,and XGBoost) were utilized in R software to construct predictive models,and their performance was compared.The optimal algorithm for predicting TN recurrence after PBC was determined,followed by external validation of the model using data from 131 patients treated at the First Affiliated Hospital of Harbin Medical University from January 2020 to December 2023 as the validation group. Results The logistic regression analysis indicated that a disease duration > 5 years,non-typical pain,non-pear-shaped balloon,compression time > 120 seconds,and delayed disappearance of pain are independent risk factors for the TN recurrence following PBC( P<0.05).On the other hand,facial numbness serves as a protective factor against recurrence in patients undergoing this procedure (OR=0.289,95%CI:0.143~0.582).Furthermore,the random forest model exhibited superior performance compared to the other two predictive models,with areas under the ROC curve of 0.824(95%CI:0.774~0.873) for the modeling group and 0.835(95%CI:0.763~0.892) for the validation group,indicating its greater efficacy in predicting postoperative recurrence. Conclusion The model based on the random forest algorithm is the optimal predictive model for TN recurrence after PBC.It is beneficial for clinical screening of high-risk groups for recurrence of trigeminal neuralgia post-surgery.This can provide a reference for medical staff to take targeted preventive measures early.

Objective To explore the spatio-temporal characteristics of electroencephalogram (EEG) in patients with focal epilepsy and its correlation with drug resistance. Methods A total of 123 patients with focal epileptic seizures who underwent electroencephalogram (EEG) examination in our hospital from January 2020 to July 2022 were selected for this study.According to whether they were resistant to drug,they were divided into a drug-resistant group (45 cases) and a sensitive group (78 cases).The clinical data and electroencephalogram (EEG) spatio-temporal characteristics were compared between the drug resistance group and the sensitive group.Multivariate logistic regression was used to analyze the influencing factors of drug resistance in patients with focal seizures.The structural equation prediction model was established and verified. Results The total EEG energy and the level of EEG seizures in the sensitive group were significantly higher than those in the resistant group ( P＜0.001).The proportion of α energy in the sensitive group was significantly lower than that in the drug-resistant group ( P=0.015),and the proportion of γ energy was significantly higher than that in the drug-resistant group ( P＜0.001).The course of disease ≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharge after treatment were independent risk factors for drug resistance in patients with focal epilepsy ( P<0.05).The overall fitness of the structural equation model was better,which could well reflect the relationship between various influencing factors and the occurrence of drug resistance in patients with focal epilepsy.The convergent validity and combined reliability of the model were good.The course of disease≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharges after treatment are independent risk factors for drug resistance in patients with focal epilepsy.There are characteristic differences in the power spectrum of EEG between drug-resistant focal epilepsy patients and sensitive focal epilepsy patients. Conclusion The course of disease≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharges after treatment are independent risk factors for drug resistance in patients with focal epilepsy.There are characteristic differences in the power spectrum of EEG between drug-resistant focal epilepsy patients and sensitive focal epilepsy patients.

Objective To observe the effectiveness and safety of intravenous thrombolysis with rt-PA in patients of acute mild ischemic stroke. Methods Retrospective analyze a total of 107 acute ischemic stroke patients with baseline NIHSS≤3 were enrolled in the study who hospitalized in Shanghai Jiading District Central Hospital from January 2021 to December 2021.Acco rding to whether performing intravenous thrombolysis or not, 107 patients were divided into intravenous thrombolysis group( n=49) and non-venous thrombolysis group( n=58).The baseline and clinical data were recorded for both groups and their differences were compared.The scores and the rates of reduction of NIHSS in 24 h, 7d and 14 d after treatment of the two groups were analyzed, also the scores of 7dmRs and 90dmRS.The incidence of extracranial /intracranial hemorrhage, the rate of death was also compared between the two groups. Results There were no significant differences in baseline data and 24 hNIHSS score.NIHSS in 7 d and 14d after treatment were lower in intravenous thrombolysis group, p was 0.020 and 0.008 respectively.The rate of reduction of NIHSS in 24 h, 7d and 14 d were higher in intravenous thrombolysis group, all the three p were 0.000.The scores of 7 d and 90dmRS were lower in intravenous thrombolysis group, but only 7dmRS score between the two groups was statistically significant, P=0.014, while 90dmRS score between the two groups was not statistically significant, P=0.153.Both at 7 d and 90 d, the proportions of good prognosis(mRS score 0-2)inintravenous thrombolysis group were higher, but there was no differencebetween the two groups , neither at 7 d nor at 90 d after treatment, p were 0.109 and 0.358 respectively.The incidences of extracranial hemorrhage and intracranial hemorrhagewere higher in intravenous thrombolysis group, p was 0.000 and 0.018 respectively.But no symptomatic intracranial hemorrhageand death occurred in both groups. Conclusion Thrombolysis with rt-PA inmildacuteischemicstroke(NIHSS≤3) can improve early neurological deficits, increase the incidence of mild extracranial /intracranial hemorrhage, but with no serious adverse outcome.

Objective To investigate the prognosis of patients with WFNS grade IV aneurysmal subarachnoid hemorrhage treated by interventional embolization and craniotomy clamp. Methods Collect clinical data of 70 patients with WFNS grade IV aneurysmal subarachnoid hemorrhage admitted to the Neurosurgery Department of the First Affiliated Hospital of the University of Science and Technology of China from June 2020 to June 2023.According to different surgical methods,the patients were divided into intervention embolization group and craniotomy clamp group.Compare and analyze the hospitalization time of the two groups of patients,including recurrent bleeding,cerebral infarction,hydrocephalus,deep vein thrombosis,intracranial infection,pneumonia,cognitive impairment Differences in the incidence of vasospasm and GOS scores at 3 months after surgery. Results A total of 70 patients were included,including 39 in the interventional embolization group and 31 in the craniotomy clamp group; There was no statistically significant difference ( P>0.05) between the two groups of patients in terms of hospital stay,incidence of rebleeding,cerebral infarction,hydrocephalus,deep vein thrombosis,and intracranial infection; There was a statistically significant difference in the incidence of postoperative pneumonia,cognitive impairment,and vasospasm ( P＜0.05); The proportion of GOS grade 5 group at 3 months after surgery was higher in the interventional embolization group than in the craniotomy clamp group,and there was a statistically significant difference between the two groups ( P＜0.05). Conclusion For patients with WFNS grade IV aneurysmal subarachnoid hemorrhage,endovascular embolization is superior to craniotomy clipping therapy in terms of perioperative complications and prognosis.

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 compare the effects of microballoon compression and microvascular decompression guided by digital subtraction angiography(digitalsubtractionangiography,DSA) in the treatment of trigeminal neuralgia. Methods One hundred patients with trigeminal neuralgia treated in our hospital from January 2019 to January 2022 were randomly divided into study group( n=50) and control group( n=50).The former was treated with DSA-guided microballoon compression and the latter was treated with microvascular decompression.The pain relief rates,serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),serum prostaglandin E2(PGE2),plasma substance P(SP) and serum calcitonin gene-related peptide(calcitoningenerelatedpeptide,CGRP) were compared between the two groups before and after operation.The concentration of peroxisome proliferator-activated receptor gamma coactivator 1-α(PGC-1 α) and serum 5-hydroxytryptamine(5-hydroxytryptamine),the incidence of complications and the recurrence rate after 6 months follow-up. Results The pain relief rate at 24 hours after operation in the study group was higher than that in the reference group( P＜0.05).24h after operation,the serum IL-6,TNF-α,CRP concentrations,serum PGE2,plasma SP concentrations,and serum CGRP concentrations in the study group were lower than those in the reference group( P＜0.05).24h after operation,the PGC-1α concentration and serum 5-HT concentration in the study group were higher than those in the reference group( P＜0.05).The complication rate and recurrence rate of the study group were similar to those of the reference group( P>0.05). Conclusion The DSA-guided microballoon compression in the treatment of trigeminal neuralgia can effectively reduce pain and is relatively less invasive.

Objective To investigate the expression changes of long non-coding RNA plasmacytoma variant translocation 1 (lncRNA PVT1) in the plasma of patients with intracranial aneurysms and its clinical significance. Methods A total of 30 patients with unruptured intracranial aneurysms and 30 patients with ruptured aneurysms were selected from Anqing Traditional Chinese Medicine Hospital between January 2023 and June 2024.An additional 30 healthy individuals undergoing routine health check-ups were included as a control group.The expression levels of LncRNA PVT1 in plasma samples from all enrolled subjects were measured using quantitative real-time PCR (qRT-PCR),and the levels of inflammatory factors IL-8 and TNF-α were analyzed using ELISA.Clinical data and plasma LncRNA PVT1 levels were compared between the healthy control group and the intracranial aneurysm group.Receiver operating characteristic (ROC) curve analysis was performed to assess the value of plasma LncRNA PVT1 levels in evaluating intracranial aneurysms and differentiating between unruptured and ruptured aneurysms.The correlation between plasma LncRNA PVT1 levels and inflammatory factors IL-8 and TNF-α was analyzed using Pearson correlation. Results The levels of plasma LncRNA PVT1 in patients with intracranial aneurysms were significantly higher than those in the control group,with the ruptured aneurysm group showing higher levels than the unruptured group.A positive correlation was found between plasma LncRNA PVT1 levels and the expression of IL-8 and TNF-α,which was statistically significant ( P＜0.05).The ROC curve showed that the AUC for plasma LncRNA PVT1 in predicting intracranial aneurysms was 0.808,with a sensitivity of 80.0% and specificity of 97.8%.The AUC for differentiating between unruptured and ruptured intracranial aneurysms was 0.769,with a sensitivity of 86.7% and specificity of 73.3%. Conclusion The elevated expression levels of plasma LncRNA PVT1 in patients with intracranial aneurysms are associated with inflammatory factors and the severity of aneurysms.This suggests that LncRNA PVT1 may play a role in the progression of intracranial aneurysms by regulating the expression levels of inflammatory cytokines.

Objective To explore the related risk factors of postoperative cerebral infarction in patients with hypertensive cerebral hemorrhage. Methods A total of 78 patients with hypertensive cerebral hemorrhage who were treated by surgery in our hospital from November 2018 to November 2023were selected,and the risk factors of 20 patients with postoperative cerebral infarction were analyzed by single factor,and the statistically significant high-risk factors were screened for Logistic regression analysis. Results Univariate analysis showed that gender,age,smoking,drinking,history of cerebral infarction,bleeding site,bleeding volume,pupil size,GCS score and surgical methods were not risk factors for postoperative cerebral infarction in patients with hypertensive cerebral hemorrhage ( P＞0.05);however,the duration of hypertension≥20 years,brain herniation,midline shift ≥5 mm and intraoperative hypotension were the risk factors,and the difference was statistically significant ( P＜0.05).Logistic regression analysis showed that intraoperative hypotension was its independent riskfactor,the difference was statistically significant ( P＜0.05). Conclusion The duration of hypertension≥20 years,brain herniation,midline shift≥5 mm and intraoperative hypotension are risk factors for postoperative cerebral infarction in patients with hypertensive intracerebral hemorrhage.Intraoperative hypotension is an independent risk factor,and intraoperative blood pressure should be well controlled,and patients with high risk factors should be treated to prevent cerebral infarction.

Objective To explore the efficacy and postoperative complications of neuroendoscope combined with electrophysiological monitoring in the treatment of primary trigeminal neuralgia during microvascular decompression. Methods The clinical data of 142 patients with primary trigeminal neuralgia admitted to the First People's Hospital of Zhenjiang and Zhongda Hospital affiliated to Southeast University from January 2016 to October 2022 were retrospectively analyzed,including 66 patients who underwent microvascular decompression under neuroendoscope combined with electrophysiological monitoring (study group ) and 76 patients who underwent microvascular decompression under microscope (control group).The surgical effects and postoperative complications of the two groups were analyzed. Results The effective rate of the research group was 96.96%,while the effective rate of the control group was 96.05%.There was no statistically significant difference in the effective rates between the two groups ( P＞0.05).There was no statistical difference in the grade distribution between the two groups ( P＞0.05),indicating that the efficacy of the study group was as accurate as that of the control group.The incidence of complications in the study group was 10.60%,while the incidence of complications in the control group was 14.47%.There was no statistically significant difference between the two groups ( P＞0.05).The incidence of facial auditory nerve injury in the study group was significantly lower than that in the control group,with a statistical difference ( P＜0.05). Conclusion Neuroendoscope combined with electrophysiological monitoring for microvascular decompression in the treatment of primary trigeminal neuralgia has the same exact effect as that of traditional microscope.Electrophysiological monitoring can give corresponding protection to facial and auditory nerves during the operation,which is an effective and safe surgical method for the treatment of primary trigeminal neuralgia.