Objective To investigate the risk factors of perioperative isolated deep vein thrombosis of the distal lower extremities in patients with acute stroke. Methods A retrospective analysis of the case data of acute stroke patients admitted to the First Affiliated Hospital of University of Science and Technology of China from September 2019 to May 2020,the patients were grouped according to the results of the dynamic ultrasound examination of the whole lower extremity veins,and multivariate logistics regression was applied.Analyze and determine the patient's age,gender,body mass index,admission GCS score,APACHE Ⅱ score,NICU stay time,whether there is brain hernia and shock,operation time,gastrointestinal hemorrhage,acute kidney injury,acute liver injury,blood transfusion and other factors and isolation The relationship between the occurrence of deep vein thrombosis in the distal lower limbs. Results A total of 105 patients with acute stroke were included,of which 83 were hemorrhagic stroke and 22 were ischemic stroke;71(68%) patients had isolated deep vein thrombosis of the distal lower extremities,and 57 cases(80%) were asymptomatic,12 cases(17%) developed thrombosis progression;univariate analysis showed that the patient's age( P=0.02),body mass index( P=0.009),admission GCS score( P=0.004),and red blood cell transfusion( P=0.035) were acute The risk factors of perioperative isolated deep vein thrombosis of the lower extremities in stroke patients.Multivariate logistic regression analysis showed that the patient's age was >60 years old( P=0.036,95% CI=1.068～7.458),and the admission GCS score was >8 Score( P=0.005,95% CI=0.087～0.641) and red blood cell transfusion( P=0.049,95% CI=0.44～0.932) are independent risk factors for the occurrence of deep vein thrombosis in the distal lower limbs. Conclusion The incidence and progression rate of isolated distal deep vein thrombosis in patients with acute stroke during the perioperative period are relatively high.Patient age,GCS score and blood transfusion are independent risk factors for thrombosis.For this type of patients,deep vein thrombosis of lower extremity should be strengthened,screening work.

Objective To study the perioperative safety and postoperative efficacy of percutaneous balloon compression(PBC) in patients with trigeminal neuralgia with heart disease,a retrospective analysis was performed on the clinical data of patients with trigeminal neuralgia with heart disease. Methods In June 2019 to March 2021 in our department application PBC treatment of primary trigeminal neuralgia patients,109 cases were selected,according to the presence of comorbid patients with heart disease can be divided into normal group and associated with heart disease,and according to whether intraoperative changes in heart rate decline,divided the patients into heart rate descent group and the group,the comparative analysis of two groups of patients with clinical data,The clinical efficacy,complications and perioperative problems of the two groups were compared and analyzed. Results There was no significant difference in the rate of pain relief 6 months after operation between the normal group and the group with heart disease.In the normal group,56 patients(84.8%) had complete pain relief 6 months after operation,and 10 patients(15.2%) still had pain;in the group with heart disease,40 patients(93.0%) had complete pain relief 6 months after operation,and 3 patients(7.0%) still had pain.The incidence of the decrease of the operation center rate in the group with heart disease was significantly higher than that in the normal group,13 cases(30.2%) of the operation center rate in the group with heart disease,6 cases(9.0%) of the normal group, P＜0.001.By comparing the clinical data of patients in the descending heart rate group and the non-descending group,it was found that the age of patients in the descending heart rate group was significantly older than that in the non-descending heart rate group,and the majority of patients in the descending heart rate group had heart disease. Conclusion PBC is an effective treatment for trigeminal neuralgia,and it is still reliable and safe for patients with trigeminal neuralgia with heart disease.For patients with heart disease,preoperative cardiac examination should be improved,and vital signs should be closely monitored before and during surgery.Timely treatment should be taken for cardiac disorders and other conditions occurred during surgery.

Objective To retrospectively analyze the distribution characteristics of risk factors in patients with acute ischemic stroke(AIS) and the influencing factors of hemorrhagic transformation after stent thrombectomy,so as to provide reference basis for clinical prevention of AIS and timely detection of disease changes. Methods The clinical data of 258 patients with AIS treated in our hospital from January 2019 to June 2021 were analyzed retrospectively,including 62 cases in the hemorrhagic transformation(HT) group and 196 cases in the non HT group.The common risk factors of AIS and the possible influencing factors of HT were analyzed by univariate analysis and logistic regression analysis. Results (1) Pearson chi square analysis was performed on 258 common AIS risk factors(past history of cardiovascular disease,family history of hypertension,history of hypertension,history of coronary heart disease,history of diabetes,hyperlipidemia,smoking history,drinking history,hypercholesterolemia,hypertriglyceridemia,hyperhomocysteinemia),and 258 common risk factors(including previous history of cardiovascular disease,family history of stroke,history of diabetes,history of hyperlipidemia,smoking history,drinking history,high cholesterol,hypertriglyceridemia,hyperhomocysteinemia).The common risk factors were all P＜0.01,with statistical significance;Logistic regression analysis showed that all common risk factors were independent risk factors of AIS.(2) The possible influencing factors of HT after stent thrombectomy in 258 patients with AIS were analyzed by univariate analysis,including gender,history of hypertension,history of atrial fibrillation,drinking history,occlusion of blood vessels(anterior circulation),intraoperative injection of tirofiban and postoperative systolic blood pressure( P＜0.05);Gender,history of hypertension,history of atrial fibrillation,drinking history,occlusion of blood vessels(anterior circulation),intraoperative injection of tirofiban and postoperative systolic blood pressure were independent risk factors for HT after stent thrombectomy in AIS patients by logistic regression analysis. Conclusion Previous cardiovascular history,family history of hypertension,family history of stroke,history of hypertension,history of diabetes,history of hyperlipidemia,smoking,drinking history,high cholesterol,hypertriglyceridemia,hyperuricemia,and Gao Tong's type of cysteinemia are the main risk factors for AIS.Gender,history of hypertension,history of atrial fibrillation,drinking history,etc.Occlusion of blood vessels(anterior circulation),intraoperative injection of tirofiban and postoperative systolic blood pressure are the risk factors of HT after stent thrombectomy.The risk factors should be closely monitored and managed in clinical prevention and treatment.

Objective To investigate the olfactory disorder and clinical characteristics of spastic torticollis(ST),and to analyze the relationship between ST patients and motor symptoms and non motor symptoms. Methods A total of 32 patients with ST diagnosed in the Institute of Neurology of Anhui University of Traditional Chinese medicine from January 2021 to December 2021 and 32 healthy controls roughly matched with the right-hand,gender,age and educational background of the patient group were collected the odor thresholds,odor discrimination and odor identification of ST group and control group were evaluated with the olfactory stick developed by the Institute of Psychology of the Chinese Academy of Sciences,Toronto Western spasmodic torticollis rating scale(TWSTRS) was used to evaluate the motor symptoms,disability index and pain score of ST group.The Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD),Pittsburgh sleep quality index(PSQI) and Montreal Cognitive Assessment(MoCA) were compared between the two groups. Results (1) The total scores of odor thresholds,odor discrimination,odor identification and olfactory function in ST group were lower than those in the control group( P＜0.001),and the scores of HAMA( P=0.007),HAMD( P=0.023) and PSQI( P＜0.001) in ST group were higher than those in the control group( P＞0.05,table 1) there was no difference between the two groups.(2) The total score of odor identification function in ST patients was positively correlated with MOCA( r=0.589, P=0.000),and negatively correlated with age( r=-0.385, P=0.03).There was no correlation between olfactory function and course of disease,TWSTRS motor score,TWSTRS disability score,TWSTRS pain score,HAMA,HAMD and PSQI. Conclusion The incidence of olfactory disorder in ST patients was high,which was manifested by the overall reduction of odor thresholds,odor discrimination and odor identification function.There was no correlation between olfactory disorder and motor symptoms,pain,anxiety,depression and sleep disorder relevance.

Objective To explore the expression levels of microRNA-15a-5p(miR-15a-5p) and miR-125a in children with epilepsy,and analyze their diagnostic value in children with epilepsy. Methods A total of 82 children with epilepsy admitted to our hospital from September 2017 to April 2021 were included as the epilepsy group,and 65 healthy children who received physical examination in our hospital during the same period were selected as the control group.To detect the expression of serum miR-15a-5p,miR-125a and the levels of interleukin-1β(IL-1β),IL-2,and tumor necrosis factor-α(TNF-α) in the two groups.To analyze the correlation between miR-15a-5p,miR-125a and IL-1β,IL-2,TNF-α and the correlation between miR-15a-5p and miR-125a in children with epilepsy.To analyze the relationship between the expression of miR-15a-5p,miR-125a and clinical features in children with epilepsy.A receiver operating characteristic curve(ROC) was drawn to evaluate the area under the curve(AUC) of the two in diagnosing childhood epilepsy. Results The expressions of serum miR-15a-5p and miR-125a in the epilepsy group were lower than those in the control group,and the levels of IL-1β,IL-2,and TNF-α were higher than those in the control group( P＜0.05).Pearson linear correlation test showed that serum miR-15a-5p and miR-125a in children with epilepsy were negatively correlated with IL-1β,IL-2,TNF-α levels,and miR-15a-5p was positively correlated with miR-125a( P＜0.05).The miR-15a-5p and miR-125a low expression group had frequent attacks,the duration of symptoms was more than 10 minutes,and the proportion of generalized attacks was higher than that in the miR-15a-5p and miR-125a high expression group( P＜0.05).The AUC of serum miR-15a-5p and miR-125a alone and combined with the diagnosis of childhood epilepsy were 0.773,0.756,0.862,respectively. Conclusion The expression of serum miR-15a-5p and miR-125a in children with epilepsy is decreased,and their expression is closely related to inflammatory factors,which has a certain diagnostic value for children with epilepsy.

Objective To compare the safety and efficacy of transsphenoidal neuroendoscopic and microscopical resection of pituitary tumors. Methods 391 cases of pituitary tumor in our hospital from July 2019 to August 2021 were retrospectively analyzed,including 212 cases in the neuroendoscopy group and 179 cases in the microscope group.Operation time,intraoperative blood loss,length of stay,the rate of total removal of tumor,incidence of intraoperative cerebrospinal fluid leakage,occurrence of postoperative complications,improvement of postoperative visual field and related perioperative indicators were compared between the two groups. Results Compared with the microscope group,the operation time of patients in the neuroendoscopy group was significantly longer (129.66±49.66mins vs.76.87± 19.23mins,P< 0.001),and the total tumor resection rate in the two groups was not significantly abnormal (70.8% vs.63.7%, P=0.137).However,for Knosp III-IV patients,the total surgical resection rate was significantly higher in the neuroendoscopic group (67.1% vs.32.3%,P< 0.001).Intraoperative blood loss (67.33±19.95mL vs.62.21±15.45mL, P=0.082),postoperative hospital stay (4.65±1.31 days vs.4.31±1.24 days, P=0.237),the incidence of intraoperative high-flow cerebrospinal fluid leakage (4.7% vs.6.1%, P=0.533),intraoperative internal carotid artery injury (0.5% vs.0.6%, P=0.904),and postoperative recovery of pituitary-related hormone levels were not significantly different.The incidence of postoperative complications was low in both groups,and there was no statistical difference between the two groups,including: Postoperative cerebrospinal fluid rhinorrhea (0.9% vs.1.6%, P=0.558),intracranial infection (0.9% vs.1.1%, P=0.865),diabetes insipidus (4.2% vs.6.1%, P=0.533),and rebleeding (0.9% vs.1.1%, P=0.865).Postoperative visual field was significantly improved in both groups,but there was no significant difference in the rate of improvement between the two groups (77.9% vs.85.7%, P=0.170). Conclusion Bothtranssphenoidalneuroendoscopic and microscopic resection of pituitary tumors have satisfactory safety and efficacy.For patients with Knosp III-IV,whose tumors invading the cavernous sinus,neuroendoscopic surgery is more advantageous.

Objective Severe diffuse axonal injury(DAI) has a high rate of mortality and disability.Due to the limitations of conventional imaging techniques,condition assessment and prognosis still remain challenging.Susceptibility weighted imaging(SWI) and diffusion tensor imaging(DTI) can identify posttraumatic cerebral microbleeds and white matter fiber integrity.We utilized multiple MRI techniques to comprehensively assess the correlation between the extent of brain injury and prognosis. Methods Fifty patients with severe DAI from the Department of Neurosurgery,the First Affiliated Hospital of University of science and technology of China were included,and clinical data,scale assessment,and imaging data were collected.Software was used to segment the whole brain into five brain regions and extract the number,volume of microbleeds,and white matter fractional anisotropy(FA) .Analyze the correlation between the degree of brain damage and prognosis. Results The number and volume of microbleeds in the midline structural regions of the brain were correlated with FA values( P＜0.05),but not in other regions.The number and volume of microbleeds in the midsagittal region,brainstem,thalamus,and basal ganglia were positively correlated( P＜0.05) with the GCS score,GOS-6 and GOS-12 score;and negatively correlated correlated( P＜0.05) with the CRS-R score in patients with severe brain injury;Mean FA in brainstem,thalamus,and basal ganglia regions was positively correlated with GCS score,GOS-6 and GOS-12 score( P＜0.05);and negatively correlated with CRS-R score( P＜0.01) in patients with severe brain injury. Conclusion Microbleeds(SWI) and microstructural changes(DTI) in deep brain structures are pathological markers of post-traumatic brain injury,and the MRI indexes of SWI and DTI are of great significance for the evaluation of the extent of brain injury and for judging the prognosis.

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 effect of small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring in the treatment of hypertensive hemorrhage. Methods Sixty-eight patients with hypertensive hemorrhage admitted to our hospital from July 2021 to July 2022 were selected and divided into two groups: In the trial group,35 patients underwent small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring,and in the control group,33 patients only underwent small bone-window craniotomy under microscope.Postoperative complicationsand GOS score were compared between the two groups. Results The incidence of postoperative complications in the trial group were significantly lower than those in the control group ( P<0.05).The GOS score of trial group was significantly higher than that of control group 6 months after operation ( P<0.05). Conclusion Small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring can improve the prognosis of hypertensive hemorrhage patients,reduce postoperative complications,reduce hospital stay,and improve the quality of life of patients.

Objective To investigate the application of intraoperative wake-up anesthesia technique based on accelerated rehabilitation surgery (ERAS) in patients with glioma and its effects on the extent of tumor resection,postoperative language and motor function. Methods 159 patients with glioma in our hospital from January 2020 to January 2022 were selected and grouped differently according to the order of admission and establishment,with the observation group adopting intraoperative arousal anesthesia technique based on ERAS,the control A group adopting intraoperative arousal anesthesia technique,and the control B group receiving conventional anesthesia management.The surgery-related indexes,degree of tumor resection and pre- and post-operative speech function,motor function,quality of life and postoperative complications were compared among the three groups. Results When comparing the bleeding volume and operation time of the three groups,there was no significant difference ( P＞0.05);the ICU supervision and postoperative hospitalization time of the observation group were shorter than those of the control A and B groups ( P＜0.05);when comparing the degree of tumor resection of the three groups,the difference was not statistically significant ( P＞0.05);the VFT,BNT,and ABC scores of the observation group were higher than those of the control A and B groups,and those of the control A group were higher than those of the control B group 1 month after surgery ( P<0.05);Fugl-Meye and ADL scores were higher in the observation group than in control groups A and B,and higher in control group A than in control group B at 1 month after surgery ( P<0.05);EORTCQLQ-C30 scores were higher in the observation group than in control groups A and B,and higher in control group A than in control group B at 1 month after surgery ( P<0.05).Complication rates in the three groups were not statistically significant compared with each other ( P>0.05). Conclusion In ERAS-based arousal anesthesia technique applied to patients with glioma can promote early postoperative recovery,improve language and motor function,and enhance the level of survival quality.

Objective To explore the effect of deep brain stimulation on quality of life in patients with medium-late stage Parkinson's disease. Methods There were 82 males and 85 females in this group.Their ages ranged from 41 to 77 years(mean 62.55 years).Their illness duration ranged from 3 to 22 years(mean 5.52 years).The clinical classification showed tremor-type in 35 cases,rigidity-type in 59 cases and tremor-rigidity-mixed-type in 73 cases.All the 167 cases were divided into three different groups according to different treatment methods:DBS group,lesioning group and medical treatment alone group.Activity of Daily Living(ADL) Scale and Parkinson's Disease Questionnaire (PDQ-39) were used to evaluate the patient's quality of life(QOL) before the therapy and 12 months after the therapy respectively. Results Bilateral STN-DBS was performed in 22 cases,deep nuclus lesioning was performed in 74 cases(including Gpi in 8 cases and Vim in 66 cases),and 71 cases received medical treatment alone.There was significant difference( P<0.05)in UPDRS of both surgical groups between 1 week before-operation and 1 year after-operation.12 months after the operation the ADL scores of both surgical groups were significantly higher than those before treatment( P＜0.05),and PDQ-39 scores were significantly lower than those before treatment( P＜0.05).Meanwhile the ADL scores of both surgical groups were significantly higher than those of medical treatment alone group( P＜0.05),and PDQ-39 scores were significantly lower than those of medical treatment alone group( P＜0.05).The ADL scores of DBS group were significantly higher than those of lesioning group( P＜0.05),and PDQ-39 scores of DBS were significantly lower than those of lesioning group( P＜0.05). Conclusion DBS not only can improve the motor symptoms of PD significantly,but also can ameliorate the non-motor symptoms (NMS),which can greatly improve the quality of life in patients with medium-late stage Parkinson's disease.

Objective To study the effect of non-tractive translateral cleft-insula approach (LFA) microsurgery (LFA) on the treatment of hypertensive basal ganglia hemorrhage (HBGH) in elderly patients. Methods A total of 100 HBGH in elderly patients treated in our hospital from January 2018 to December 2020 were selected and divided into LFA group ( n=50) and control group ( n=50) according to the surgical methods.The LFA group underwent LFA,and the control group underwent transtemporal cortical hematoma removal.The perioperative indexes such as operation time,hematoma residue,postoperative consciousness disturbance time and hematoma clearance rate were observed in both groups.Postoperative complications,Preoperative and postoperative intracranial pressure,serum levels of nerve injury factors such as vascular endothelial growth factor (VEGF),human chondoglycoprotein-39 (YKL-40),plus pentagprotein-3 (PTX3).Serum levels of stress factors such as β-endorphin( β-EP),Adrenocorticotropic hormone (ACTH),Cortisol (Cor).Prognosis at 6 months after surgery. Results The operation time,hematoma residue,postoperative consciousness disturbance time and hematoma clearance rate in LFA group were all lower than those in control group ( P＜0.05).The incidence of postoperative complications in LFA group was lower than that in control group ( P<0.05).On 7d after operation,the levels of serum VEGF,YKL-40,PTX3 and intracranial pressure in experimental group were lower than those in control group ( P<0.05).On 7d after operation,the levels of serum β-EP,ACTH and Cor in experimental group were lower than those in control group( P＜0.05).GOS score of LFA group was better than control group 3 months after surgery ( P＜0.05). Conclusion LFA therapy for HBGH in elderly patients can effectively remove hematoma,repair hemorrhagic spots,reduce brain nerve injury and systemic stress response,and contribute to the rehabilitation of patients,and has the advantages of less trauma,less postoperative complications,and better prognosis of patients.

Objective To evaluate the value of Ingenia 1.5T MRI combined with GFAP level in predicting neonatal brain injury. Methods A total of 120 neonates with neonatal brain injury admitted to our hospital from January 2019 to December 2020 were selected as the observation group,and 90 neonates born at term without brain injury during the same period were selected as the control group.Brain scans were performed using Ingenia 1.5T magnetic resonance imaging,and serum GFAP levels were determined by enzyma-linked immunosorbent assay.The serum GFAP levels of the two groups were compared,and the diagnostic analysis was conducted to explore the value of Ingenia 1.5T MRI combined with Serum glial fibrillary acidic protein(GFAP)level in predicting neonatal brain injury. Results The serum GFAP level of observation group (2.34±0.56) ng/ mL was significantly higher than that of control group (0.85±0.24) ng/ml,and the difference was statistically significant ( P＜0.05).Ingenia 1.5T MRI diagnosis showed that 103 of the 120 children in the observation group were positive and 17 were negative.In the control group,there were 21 positive cases and 69 negative cases.The Ingenia 1.5T MRI positive rate in observation group was significantly higher than that in control group ( χ ²=67.818, P=0.000).In the observation group,90 cases were positive and 30 cases were negative for GFAP.In the control group,there were 13 positive cases and 77 negative cases.The positive rate of serum GFAP in observation group was significantly higher than that in control group ( χ ²=72.909, P=0.000).Moreover,the Ingenia 1.5T MRI detection rate was significantly higher than serum GFAP diagnosis (26.598, P=0.010).The sensitivity of combined diagnosis was significantly better than Ingenia 1.5t MRI ( χ ²=5.819, P=0.016),serum GFAP ( χ ²=18.824, P=0.000),and the accuracy of combined diagnosis was significantly better than Ingenia 1.5t MRI ( χ ²=6.821, P=0.000). P=0.009),single serum GFAP test ( χ ²=9.226, P=0.002),while there was no significant difference in specificity of combined diagnosis ( P＞0.05).Ingenia 1.5T MRI showed that when the signal intensity value of bilateral globus pallidus and putamen was 1.26,the maximum area under ROC curve was 0.81,with sensitivity of 89.37%,specificity of 82.56%,and accuracy of 55.47%.The maximum area under ROC curve was 0.76 when serum GFAP level was 1.82 ng/mL,and the sensitivity,specificity and accuracy were 83.64%,91.35% and 78.39% respectively.The area under ROC curve of combined detection for the diagnosis of neonatal brain injury was 0.86,and the sensitivity,specificity and accuracy were 97.32%,89.34% and 93.61% respectively. Conclusion Ingenia 1.5T MRI combined with GFAP can improve the sensitivity of the diagnosis,and its good accuracy has good predictive value for neonatal brain injury,which can provide a basis for early clinical evaluation of brain injury.

Objective To explore the prognostic value of Notch3 and TIP30 expression in glioma patients. Methods From December 2019 to December 2020,135 pathological tissue specimens from 135 patients with brain gliomas diagnosed by pathology after surgical resection in Baoding No.7 Hospital were collected,and 60 paratumor tissues were collected.The expression of Notch3 and Tat-interactive protein 30 (TIP30) in glioma tissue and paratumor tissue were detected by western blot and immunohistochemistry.The positive rates of Notch3 and TIP30 in different tissues and the relationship between the expression of Notch3 and TIP30 and the clinicopathological characteristics of glioma were compared.The survival of patients was followed up for 1 year after operation.The Kaplan-Meier method was used to analyze the relationship between the expression of Notch3 and TIP30 and the prognosis of patients with glioma,and the relationship between Notch3 and TIP30 expression was analyzed by Spearman rank correlation. Results The expression of Notch3 protein in glioma tissue (2.25±0.63) was higher than that in paratumor tissue (0.95±0.21),the positive rate of Notch3 was 57.78% higher than that in paratumor tissue(36.67%),and the expression of TIP30 protein (0.42±0.11) The positive rate of TIP30 was 48.15% lower than that of the adjacent tissue (0.71±0.23),which was significantly lower than that of the adjacent tissue (86.67%) ( P<0.05).The positive expression of Notch3 in glioma tissue was not related to the patient's gender,tumor location,and resection range( P>0.05),but was related to the patient's age,tumor diameter,pathological grade,and Ki-67 expression ( P<0.05).The positive expression of TIP30 was not related to the patient's gender,age,tumor location and extent of resection ( P>0.05),but was related to tumor diameter,pathological grade and Ki-67 expression ( P<0.05).Cox analysis showed that pathological grade (HR=2.401,95%CI:1.572-3.667),high expression of Ki-67 (2.492,95%CI:1.542-4.028),high expression of Notch3 (HR=2.221,95%CI: 1.138~4.333) and low expression of TIP30 (HR=8.457,95%CI:2.050-34.886) were important influencing factors for the prognosis of glioma patients ( P＜0.05).Kaplan-Meier survival analysis showed that the one-year survival time of brain glioma patients in the high Notch3 expression (score < 2 points) group was lower than that in the low expression (score > 2 points) group ( P< 0.05);TIP30 high expression (score<2 points) The 1-year survival time of glioma patients in the group with glioma >3 points) was higher than that in the low expression (score <3 points) group ( P<0.05).Spearman rank correlation analysis showed that the expression of Notch3 and TIP30 in glioma tissue was negatively correlated ( r=-0.539, P<0.01). Conclusion The expression of Notch3 in the tissues of glioma patients is higher,and the expression of TIP30 is lower.With the increase of pathological grade,the expression of Notch3 is higher,the expression of TIP30 is lower,and the prognosis of patients is poor.Its expression has important reference value for early disease and prognosis evaluation.

Objective To explore the epilepsy form,transmission network,diagnosis and treatment methods of supplementary motor area epilepsy. Methods The clinical data of a patient with epilepsy in the supplementary motor area diagnosed and treated with the aid of stereotaxic technology in our department were sorted out,and the clinical symptoms,EEG transmission network and treatment effect were analyzed in combination with domestic and foreign literature. Results After the first-stage evaluation of epilepsy,the patient was determined to undergo SEEG surgery assisted by stereotaxic technology,and entered the second-stage evaluation of epilepsy before epilepsy.After more than 2 months of observation,the patient's seizures increased.After the preoperative evaluation of epilepsy in the first two phases was reviewed again,the epilepsy foci resection was performed under the guidance of neuronavigator and cortical EEG,and the patient was seizure-free 18 months after operation. Conclusion The epileptic discharges from the supplementary motor area are rapidly transferred to the contralateral side through the corpus callosum,and the symptoms appear on both sides of the corpus callosum at the same time.Preoperative comprehensive evaluation cannotdetermine the location of epileptic focus,SEEG localization should be performed.Incomplete thermal coagulation can lead to aggravation of Epilepsy in the supplementary motor area.After excision of the epileptic foci in one SMA area,the patient's language and contralateral limb dysfunction did not appear.

Objective To investigate the clinical efficacy of Conventional Carotid Endarterectomy (CEA) for patients with Carotid artery stenosis disease. Methods The clinical data of 68 patients with Carotid endarterectomy treated in neurosurgery department of Cerebrovascular Surgery,Affiliated Hospital of Xuzhou Medical University,from January 2019 to September 2020,were analyzed retrospectively,there were 59 cases of mild and moderate stenosis in contralateral carotid artery (Group A),8 cases of severe stenosis in contralateral carotid artery (Group B) and 1 case of contralateral internal carotid artery occlusion (Group C).Standard Longitudinal Carotid endarterectomy was performed in all patients and carotid bypass was not performed during the operation.All patients were followed up for 30 days after operation,and no patientshadnew stroke,myocardial infarction,hyperperfusion and other complications and mortality,to evaluate the safety of routine carotid endarterectomy without shunt. Results CEA was successfully performed in all 68 patients.The mean time of operation was 120 ± 20 minutes,the mean time of block was 25 ± 5 minutes.All patients were relieved of neck CTA Stenosis,and no new cerebral infarction or myocardial infarction occurred in 30 days,8 patients presented with Severe Headache (5in Group A,3 in Group B and 0 in Group C).No deaths.All surgical results met the AHA criteria ^[1]. Conclusion Routine Carotid endarterectomy is safe and effective,but the compensation of Willis Circle and the function of coronary artery should be evaluated strictly before operation,TCD and cerebral oxygen saturation should be monitored during operation,and blood pressure should be raised if necessary,and try to minimize the blocking time.

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.