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 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 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 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 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 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 clinical features of paraneoplastic neurological syndrome (PNS). Methods A retrospective analysis was conducted on the clinical data of 47 patients,who were diagnosed with PNS and were admitted to the Department of Neurology,the First Affiliated Hospital of University of Science and Technology of China from May 2018 to December 2021. Results Among the 47 PNS patients,26 were male,accounting for 55.3%,and 21 were female,accounting for 44.7%.40 (85.1%) of 47 patients had chronic or subacute oneset.The scope of age of onset was from 29 years old to 75 years old,and the medium age of onset was 58 years old.Combination tumors were found in 35 (74.5%) of 47 patients,including 18 cases of lung cancers,accounting for 51.4%,and 25 (71.4%) patients had neurological symptoms before tumor discovery.47 PNS patients covered a total of 9 clinical syndrome types,28 (59.6%) patients showed classic syndrome,with subacute cerebellar degeneration and limbic encephalitis being the most common;19 (40.4%) patients showed non-classical syndrome,with sensorimotor neuropathy being the most common.For patients with classical syndrome,the central nervous system was mainly involved,while for patients with non-classical syndrome,the peripheral nervous system was often involved.Neuroparatumor antibodies were detected in 40 of the 47 patients,of which 28 were positive for characteristic antibodies.The detection rate of anti-Hu antibody (21%) was the highest,followed by anti-Yo antibody (14.9%).A total of 12 cases were positive for other non-characteristic antibodies,and 3 cases were positive for double antibodies.Of the 47 patients,41 received tumor therapy and/or immunotherapy,of which 31 (31/41;75.6%) had their clinical symptoms relieved one month after treatment,and the differences in mRS scores before and after treatment that were tested by Wilcoxon rank test were statistically significant ( P＜0.05).Of the 47 patients,31 had good short-term prognosis (31/47;66.0%) and 16 had poor short-term prognosis (16/47;34.0%).The clinical data of the two groups of patients with good and poor short-term prognosis were compared and analyzed,and there was a significant difference in whether the two subgroups of patients received tumor and/or treatment ( P＜0.05). Conclusion PNS is commonly found in male patients,and mostly occurs in middle-aged and elderly patients,who have subacute and chronic oneset.Most complicated tumors are lung cancers,of which the clinical manifestations are complex and diverse.The detection of neural paraneoplastic antibodies is vital to the diagnosis of PNS.For patients diagnosed with PNS,tumor therapy and/or immunotherapy should be carried out as soon as possible to relieve the clinical symptoms and improve the prognosis of the 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 investigate the therapeutic effect of Globus pallidus internus-Deep brain stimulation (GPi-DBS) in the treatment of segmental craniocervical dystonia (SCCD) non-motor symptoms (NMS) and the improvement of quality of life (QoL). Methods A total of 16 patients undergoing GPi-DBS surgery for SCCD from March 2020 to June 2021 were collected and assessed for motor symptoms,non-motor symptoms,depression,anxiety and quality of life using the BFMDRS scale,DNMSQuest questionnaire,HAM-D scale,HAM-A scale and CDQ-24 questionnaire before surgery and at the 1st,3rd,6th,12th and 18th months after postoperative onset.Pre-operative and post-operative patients were analyzed for differences,and NMS was correlated with QoL. Results Patients had a significant reduction in NMS and improvement in QoL after surgery compared to the preoperative period ( P<0.05).The patients showed a significant correlation between each NMS and QoL ( P<0.01). Conclusion GPi-DBS was effective in treating NMS in SCCD,and QoL could be significantly improved,and NMS was significantly correlated with QoL.

Objective The aim of this study was to investigate the differences in clinical response and imaging data before and after surgery in patients with Parkinson's disease and to attempt to predict clinical response using connectivity differences. Methods Connectivity analysis was performed on resting-state functional magnetic resonance imaging (rs-MRI) of 41 patients with Parkinson's disease who underwent deep brain stimulation,and the subcortical connectivity network was calculated,evaluated before and one year after surgery on the UPDRSIII scale,correlated with the above-mentioned brain connectivity network,and predicted clinical motor symptoms,and predictive performance was discussed based on actual clinical improvement. Results Functional connectivity (FC) between the subcortical nuclei of interest and the DBS response showed that FC from bilateral red nuclei to the shell nuclei correlated with overall changes in UPDRS-III (left: r=-0.44P=0.0056,right r=-0.46p=0.0029, P<0.05 after FDR correction).In addition,FC predicted the change in UPDRSIII 1 year after DBS ( r=0.5P=0.0011 error rate=0.175). Conclusion The functional connectivity between the putamen and the red nucleus can serve as an important predictor of treatment outcomes in PD patients undergoing DBS surgery.