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 and investigate the postoperative clinical outcomes and recurrence of meningioma patients and their influencing factors. Methods Demographic,clinical,oncologic,and perioperative data of patients first diagnosed with meningioma at our hospital from January 2018 to February 2021 were retrospectively analyzed.Patients were followed up for a mean of 22.4 ± 9.6 months by telephone or outpatient,and patients were divided into two subgroups of good prognosis (0~3) and poor prognosis (>3) according to their mRS scores at follow-up.Multivariate logistic regression analysis was performed to determine the factors affecting the prognosis and recurrence of patients. Results The mean age of the 85 patients was 47 years,the ratio of female to male patients was 2:1,and 29 patients had a combined prior medical history.Among them,83.5% of the tumors were located in the supratentorial,82.4% of the tumors were >5 cm,85.9% underwent gross total resection (SM grade I-III),and 92.9% of the tumors were WHO pathologically graded as grade I.The follow-up results suggested that 92.9% of patients had a good prognosis and 5.9% of patients had recurrence.Multivariate logistic regression analysis showed that tumors <3 cm (OR=0.023,95% CI 0.001~0.518; P=0.009),gross total resection (OR=17.650,95% CI 4.761~61.026; P＜0.001) and medical comorbidities (OR=0.205,95% CI 0.014~0.837; P=0.002) were significant factors affecting prognosis,while age (OR=3.534,95% CI 1.293~11.851; P=0.028) and WHO pathological classification (OR=0.021,95% CI 0.001~0.324, P＜0.001) were significantly associated with tumor recurrence. Conclusion Most patients with meningioma had a good prognosis,and tumor size,extent of resection,age,tumor pathologic grade,and medical comorbidities were significantly associated with postoperative outcome and recurrence.

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 study the distribution characteristics of cerebral blood vessels in mice and the spatial relationship with adjacent nerve cells using fast three-dimensional microscopic imaging technology. Methods The adult Tie2-Cre::Ai9 hybrid transgenicmice(C57BL/6) with fluorescent protein labeled vascular endothelial cells were perfused with 4% paraformaldehyde in the heart to obtain complete brain tissue,clearing tissue,andstained the nerve cells of the whole brain.The rapid three-dimensional imaging system (VISoR) was used to obtain the microscopic images of the whole brain vessels and nerve cells in mice with 1×1×3.5 μm ³ voxel resolution,and the two-dimensional image sequence was reconstructed into a three-dimensional whole brain image.Part of cortex,hippocampus and thalamus were selected to segment and extract blood vessels and analyze their morphological characteristics;Automatically identify nerve cells and quantitatively analyze the distribution characteristics of the distance between nerve cells and the nearest blood vessels. Results The three-dimensional images of the distribution of blood vessels and nerve cells in the whole brain of mice were successfully collected.The whole brain view of C57BL/6 mouse's complex vascular network was provided through high-resolution brain atlas.The analysis showed that the density of bifurcation points and the volume fraction of blood vessels in hippocampus were smaller than those in cortex and thalamus,and the difference was statistically significant.The staining of neurons with Nissl stain showed that there were differences in the distribution of blood vessels and nerve cells in different brain regions.In the regions of interest of different brain regions,the distance between neurons and blood vessels was counted,and the results were statistically different. Conclusion The whole brain vessels and neurons of mice can be imaged by fast 3D microscopic imaging technology.Through the quantitative analysis of regional blood vessels and nerves,it was found that there were regional distribution characteristics between blood vessels and nerves in mice.

Objective To investigate the important factors affecting the early prognosis of patients over 75 years old after embolization of ruptured intracranial aneurysm. Methods A retrospective collection of 78 patients with intracranial aneurysm who were admitted to the Department of Neurosurgery of Xiamen Third Hospital from January 2016 to January 2022,all cases were over 75 years old,and relevant clinical data of embolization treatment,including gender,Weight,smoking history,hypertension,diabetes,hyperlipidemia,atrial fibrillation,cerebrovascular disease history,aneurysm location,Hunt-Hess classification,WFNSS classification,CT Fisher classification,etc.The prognosis results were divided into a good outcome group (mRS grade I-II) and a poor outcome group (mRS grade III-V) using the modified Rankin scale (mRS) scale.Statistical analysis of clinical data,screening of independent risk factors that affect the poor prognosis of patients. Results Tatistical univariate analysis showed that,compared with the good prognosis group,the higher the GCS grade,WFNSS grade and Hunt-Hess grade of the poor prognosis group,the worse the relative prognosis,and the difference was statistically significant ( P＜0.05).Logistic regression analysis showed that GCS classification (OR=1.024,95%CI:0.214~4.914, P=0.976),WFNSS classification (OR=9.021,95%CI:2.557~31.824, P=0.001) and Hunt-Hess classification (OR=6.848,95%CI:1.435~32.682, P=0.016) was a prognostic factor.ROC curve analysis showed that the combination of Hunt-Hess classification and WFNSS classification could be used as an important influencing factor for neurological recovery (AUC=0.855),When taking the best cut-off point,the sensitivity was 89.6% and the specificity was 70.0%. Conclusion For the short-term prognosis of ruptured intracranial aneurysm interventional embolization in people over 75 years old,the combination of Hunt-Hess classification and WFNSS classification is more valuable than other factors.

Objective To investigate the significance of the classification of vertebral artery in vertebral artery related hemifacial spasm,explore the strategies of microvascular decompression,improve the therapeutic effects and reduce the complications. Methods A retrospective study was performed to analyze the clinical data of 109 cases with microvascular decompression for vertebral artery related hemifacial spasm in our hospital.In these cases,the vertebral arteries were classified into four types by its movable space.Based on the surgical practice,the influence of the classification of vertebral artery on decompression process was evaluated and the security and difficulty of operation was analyzed.The surgical strategies were summed up according to the different four types of vertebral arteries. Results The microvascular decompression surgery for hemifacial spasm with vertebral artery was a safe and effective method.In 60.55% of cases,the vertebral artery can be moved ventrally at the level of posterior cranial nerves;In 23.85% of cases,the vertebral artery can only be moved at the facial nerve level;In 0.92% of cases,there was no movable space at the level of posterior cranial nerves and the facial nerve,which made the operation difficult;In 14.68% of the cases,the bilateral vertery arteries were highly deviated to one side,which made the offending vessels complex and difficult to recognize,so the relative position of the bilateral vertebral arteries should be changed firstly,in order to win the decompression space. Conclusion The classification of the vertebral arteries is significant in microvascular decompression for vertebral artery related hemifacial spasm,which can improve the operative outcome and reduce the incidence of postoperative complications.

Objective To observe the effect of 3D-slicer software combined with microscope small bone window operation on hypertensive basal ganglia intracerebral hemorrhage. Methods The clinical data of 66 patients with hypertensive basal ganglia intracerebral hemorrhage treated in our hospital from August 2019 to August 2021 were analyzed retrospectively.According to the treatment plan,they were divided into 3D-slicer software combined with microscope group small bone window operation group(observation group n=35) and microscope small bone window operation group(control group n=31).According to the analysis of the results,the operation time,intraoperative bleed loss,incidence of postoperative complications,hematoma clearance rate,length of hospital stay and GOS,GCS and ADL scores 90 days after operation were compared between the two groups. Results The operation time,intraoperative blood loss,length of hospital stay and incidence of postoperative complications in observation group were significantly lower than those in control group ( P<0.05).The hematoma clearance rate of observation groupwas better than thatincontrol group ( P<0.05);90 days after operation,the GOS,GCS and ADLscores of observation group were better than those incontrol group ( P<0.05). Conclusion 3D-slicer software can better help locate the hematoma,clarify the blood vessels and nerve conduction bundle around the hematoma,and guide the operation to avoid important blood vessels and nerve conduction bundle.3D-slicer software can help operators find the shortest and optimal surgical path,effectively shorten the operation time,reduce the amount of intraoperative bleeding,reduce the length of hospital stay,reduce the incidence of postoperative complications,Improve the prognosis 90 days after operation,improve the clinical prognosis,and better restore self-care.

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 atorvastatin (ATO) combined with dexamethasone (DXM) on the recurrence of chronic subdural hematoma after drilling and drainage. Methods By using the method of systematic evaluation,the relevant literatures on Atorvastatin Combined with dexamethasone in the treatment of chronic subdural hematoma in PubMed,Cochrane,EMBASE,CNKI,Wanfang and other databases were retrieved,and the database was established until December 31,2021.The eligible literatures were included in the study.The extracted analysis index was the recurrence rate of hematoma.The quality of the included literatures was evaluated by the Newcastle Ottawa document quality rating scale (NOS).The revman5.3 statistical software was used for meta-analysis. Results A total of 5 articles were included in this study,including 338 patients.The NOS score of the included articles was 6~8.The recurrence rate of hematoma in ATO combined with DXM group (1.2%) was significantly lower than that in control group (single oral ATO) (13.6%),and the difference was statistically significant ( OR=0.12,95%CI:0.04~0.39, P＜0.001, I ²=0%). Conclusion Compared with single oral ATO,oral ATO and DXM can reduce the recurrence rate of hematoma in CSDH patients after drilling and drainage.For CSDH patients with repeated recurrence or high risk of recurrence,oral ATO and DXM can be taken after drilling and drainage.

Objective To investigate the clinical imaging and molecular pathological features of elderly patients with brain tumor. Methods A retrospective analysis of imaging,promoter methylation of O6-methylguanine-DNA-methyltransferase (MGMT) and IDH1R132H in 43 elderly patients with brain tumor with complete follow-up data from May 2016 to May 2020 in the First Affiliated Hospital of University of Science and Technology of China And 1p/19q co-deletion and prognosis of patients. Results Among the 43 elderly patients,32 cases were high-grade glioma and 11 cases were low-grade glioma.The MRI manifestations of high-grade gliomas were as follows:slightly long T1 mixed with T2 signals,with unclear boundaries,obvious uneven enhancement on enhanced scan,accompanied by cystic changes of different sizes,and patchy edema around the lesions.The mean survival time of elderly gliomas was 14.12± 9.09 months,the mean survival time of elderly high-grade gliomas was 9.69± 3.94 months,and the mean survival time of elderly low-grade gliomas was 27.00± 7.31 months.There was a significant difference in survival between high-grade and low-grade elderlygliomas ( P<0.0001).The demethylation degree of MGMT promoter in elderly gliomas was 27.90%,and the positive rate of MGMT methylation promoter in high-grade tumors was only 15.63%.The IDH1R132H mutation rate was only 34.88%,among which,the IDH1R132H mutation rate in high-grade glioma was only 18.75%.Combined deletion of 1p/19q accounted for 20.93%,of which only 12.50% were high-grade gliomas.Moreover,these molecular pathological markers were statistically significant in different grades of geriatric gliomas. Conclusion The Results of this single-center study showedthatelderly gliomas are mainly high-grade gliomas,brain gliomas have obvious imaging specificity,MGMT promoter methylation,IDH1R132H mutation and 1p/19q combined deletion have statistical differences in different grades of elderly gliomas.

Objective Analyzing the relationship between the ratio of preoperative infarcted brain tissue volume to whole brain volume and the prognosis of patients with cerebral infarction after decompressive craniectomy,to explore the risk factors of the poor outcomes after decompressive craniectomy due to cerebral infarction based on this neuroiaging study. Methods The patients admitted to the department of neurosurgery,the first affiliated hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from January 2019 to September 2022 who underwent decompressive craniectomy for massive cerebral infarction in the cerebral hemisphere were selected,the clinical data were retrospectively analyzed,the cranial CT imaging data before and after surgery were reconstructed and analyzed using 3D Slicer software,with the aim of further exploring the risk factors of decompressive craniectomy for cerebral infarction from neuroimaging study. Results Forty-two clinical cases of massive cerebral infarction undergoing decompressive craniectomy were finally enrolled,including 23 males and 19 females;the age ranged from 36 to 68 years,with an average age of 56.21±8.57 years;the GCS score ranged from 5 to15 points,with an average age of 10.55±3.19 points,the time from emerging symptoms to operation is between 3 and 1440 hours,with an average time of 121.48±230.77 hours.The patients were divided into survival group (30 cases) and death group (12 cases) according to the survival condition one month after operation.The differences between groups were statistically significant ( P＜0.05) for preoperative infarcted brain tissue volume( t=-2.260, P=0.029),the whole brain volume before surgery( t=2.660, P=0.011),the ratio of preoperative infarcted brain tissue volume to whole brain volume( t=-3.724, P=0.001),the whole brain volume after surgery( t=-2.464, P=0.018),the ratio of postoperative infarcted brain tissue to whole brain volume(Z=-2.589, P=0.010) and the postoperative midline offset distance( t=-2.484, P=0.017).Dichotomous logistic regression analysis suggested that preoperative whole brain volume and the ratio of preoperative infarcted brain tissue volume to whole brain volume were risk factors for poor prognosis in the short term after decompressive craniectomy. Conclusion The larger ratio of preoperative infarcted brain tissue volume to whole brain volume and smaller preoperative whole brain volume are risk factors for death after decompressive craniectomy due to large cerebral infarction.Therefore,multimodal imaging monitoring is recommended for patients with massive cerebral infarction,and adequate decompression is required to reduce the mortality rate.

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.