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 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 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.

Objective To investigate the influences of stereotactic puncture drainage treatment and conservative treatment in clinical prognoses of patients with spontaneous intracerebral hematoma in the basal ganglia. Methods A retrospective analysis of Sixty-five patients with spontaneous basal ganglia cerebral hemorrhage(Glasgow comascale(GCS)>8 scores and hemorrhage volume 20 ml to 40 ml) admitted to our department from January 2019 to December 2021.All patients were divided into surgical group (accepted stereotactic puncture drainage with thrombolysis treatment, n=32) and conservative treatment group ( n=33).The data during hospitalization and 12 months follow-up data of patients from the 2 groups were compared.The baseline general data,average hospitalization time,complications,Glasgow outcome scale (GOS) scores,modified Rankin scale (mRS) scores and modified Barthel index (MBI)were compared after treatment. Results There were no significant differences in age,gender,volume of bleeding and hypertension related factors between the 2 groups ( P＞0.05).There were no significant differences in GCS on admission,one week after admission and discharge between the 2 groups ( P＞0.05).The hematoma clearance rate at 1 week after admission was 87.18±4.49%,average hospitalization time was (12.13±1.75)d and the rate of pulmonary infection on admission was 25% (8/32) on admission in surgical group and that in conservative treatment group with hematoma clearance rate was 25.75±3.04%,average hospitalization day was(16.97±1.64)d and the rate of pulmonary infection on admission was 48.5%(16/33),the differences between the 2 groups were statistically significant ( P＜0.05).There were significant differences in GOS scores,mRS scores and MBI between the 2 groups in the four follow-up of 1 month,3 months,6 months and 12 months afte treatment( P＜ 0.05). Conclusion The overall efficacy of stereotactic puncture drainage with thrombolysis has more obvious advantages in patients with cerebral hemorrhage volume of 20 ml to 40ml in the basal ganglia and GCS>8 scores than conservative treatment.

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 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 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 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 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.