Objective To investigate theresearch on the effect of carmustine combined with temozolomide in the treatment of glioma by regulating the levels of growth factors and their receptors. Methods sA retrospective analysis was conducted to select 122 glioma patients admitted to our hospital from September 2018 to August 2020.All patients underwent surgical resection.According to the chemotherapy regimen, the patients were divided into the temozolomide group and the combination group.The neurological functions of the two groups were compared, ability to carry out activities of daily living, levels of growth factors and their receptors (VEGF, EGF and EGFR), quality of life, levels of T lymphocyte subpopulations, and adverse reactions.Follow-up was conducted until July 2023, and the overall survival and progression-free survival of the two groups of patients were compared. Results Six months post-surgery, patients in the combined therapy group manifested a significantly diminished CSS score (17.05±4.02 vs 26.95±5.30, t=11.742, P=0.000) in contrast to the temozolomide-only group, while their modified Barthel index (75.99±10.05 vs 62.15±9.12, t=7.957, P=0.000) markedly surpassed that of the temozolomide group.The KPS(84.28±8.41 vs 72.92±7.08, t=19.970, P=0.000) and QOL score (44.39±4.51 vs 35.81±3.50, t=11.498, P=0.000) of the combination group were significantly elevated compared to the temozolomide-only group.Further, patients under combined therapy exhibited significantly elevated levels of CD3+ (32.55±3.14 vs 28.67±3.71, t=6.135, P=0.000), CD4+ (56.49±5.03 vs 40.84±4.51, t=17.860, P=0.000), and CD4+/CD8+ ratio (2.41±0.25 vs 1.12±0.17, t=33.827, P=0.000) as opposed to those under temozolomide alone, whereas their CD8+ levels (23.48±2.87 vs 36.71±3.81, t=21.186, P=0.000) were significantly decreased in comparison.Additionally, combined group patients demonstrated significantly reduced levels of VEGF (158.33±19.05 vs 235.59±21.61, t=20.962, P=0.000), EGF (48.11±4.81 vs 80.78±6.54, t=30.702, P=0.000), EGFR (7.05±1.04 vs 11.32±3.09, t=9.727, P=0.000) and VEGFR (2.51±0.38 vs 3.10±0.23, t=10.591, P=0.000) compared to the temozolomide-only group.This denotes a profound augmentation in therapeutic efficacy with the implementation of combined therapy, highlighting the pivotal role of integrated treatment modalities in optimizing clinical outcomes.During treatment, patients in both groups experienced side effects such as nausea, vomiting, leukopenia, thrombocytopenia, anemia, and nephrotoxicity, and the incidence of grade I~ II side effects exceeded grade III~IV, there was no statistical difference between the two groups.significance ( P＞0.05).After 3 years of follow-up, 2 cases in the temozolomide group and 3 cases in the combination group were lost to follow-up.The 3-year overall survival rate in the combination group was 63.96%, which was higher than 48.53% in the temozolomide group, but there was no significant difference ( χ ²=1.847, P=0.174);the 3-year progression-free survival rate of the combination group was 55.56%, which was significantly higher than the 30.88% of the temozolomide group ( χ ²=7.771, P=0.005). Conclusion The administration of Carmustine in conjunction with Temozolomide post-surgery has demonstrated efficacy in augmenting neurological function, bolstering capabilities for conducting daily activities, and enhancing quality of life for glioma patients.This combined treatment approach also aids in the restoration of T lymphocyte subpopulation levels, extends survival duration, and mitigates the proliferation of growth factors.The effectiveness and safety of this therapeutic combination are correlated with its receptor concentration, warranting further clinical investigation and control to validate its benefits and optimize its application in clinical settings.

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 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 explore the therapeutic effect of deep brain stimulation on non-motor symptoms and quality of life in patients with Parkinson's disease. Methods A total of 413 patients with Parkinson's disease admitted to our hospital from November 2021 to June 2024 were retrospectively selected and divided into the conservative group (201 cases) and the surgical group (212 cases) based on the treatment plan.The conservative group received conventional drug treatment,while the surgical group received deep brain stimulation on the basis of conventional drugs.The treatment effects were evaluated by comparing the non-motor symptoms,quality of life,and levels of biochemical indicators such as malondialdehyde and uric acid before and after treatment in both groups. Results Six months after treatment,the scores of non-motor symptoms such as depression and anxiety,dizziness and falls,cognition,and sleep fatigue in both groups were lower than those before treatment,and the improvement in the surgical group was significantly better than that in the conservative group ( P＜0.05).The PDQ-39 scores and the levels of MDA and UA in both groups were lower after treatment than before treatment,and the reduction in the surgical group was more significant than that in the conservative group ( P＜0.05). Conclusion The implementation of deep brain stimulation intervention in patients with Parkinson's disease can effectively alleviate non-motor symptoms,reduce oxidative stress levels,and improve quality of life,providing clinical evidence for the optimization of comprehensive management strategies for Parkinson's disease patients.

Objective To explore the correlation between the dose segmentation pattern of stereotactic radiotherapy (SRT) and the local control rate,and analyze the factors affecting the local control rate,so as to provide a scientific and reasonable dose segmentation scheme reference for the clinical treatment of brain metastases. Methods Data of 90 patients with brain metastases who underwent SRS and SRT in the Radiotherapy Department,the First Affiliated Hospital of Hebei Northern University from February 2023 to February 2025 were retrospective reviewed.According to the different radiotherapy dose segmentation patterns,patients were divided into group A (single high dose group,single 18 Gy irradiation),group B (hypofractionated less high dose group,4 fraction,7.5 Gy,total dose of 30 Gy),and Group C (multiple low dose group,10fraction,3.5 Gy,total dose of 35 Gy).After regular follow-up after the completion of treatment,the tumor local control was evaluated by MRI examination and the local control rate was calculated.At the same time,general data,clinical characteristics,and radiotherapy related data were collected,and univariate and multivariate analysis were used to explore the correlation and local control rate. Results Local control rates varied significantly in different dose segmentation modes ( P＜0.05),and group B had the highest local control rate.Univariate analysis showed that tumor volume,radiotherapy dose segmentation pattern,KPS score,primary tumor type,and whether combined systemic therapy were associated with local control rate ( P＜0.05).The results of binary Logistic regression analysis showed that tumor volume,primary tumor type,and whether combined systemic treatment were all independent factors affecting the local control rate ( P＜0.05).The ROC curve showed that the AUC of tumor volume,primary tumor type,and general treatment were 0.746,0.680,0.640,indicating that the above factors have some predictive value for local control rate ( P＜0.05). Conclusion The dose segmentation pattern of stereotactic radiotherapy for brain metastases is closely related to the local control rate,and the effect of local control is more prominent,and factors such as tumor volume and KPS score have an important influence on the local control rate.These factors should be taken into account in clinical treatment,and an individualized radiotherapy regimen should be developed to improve the local control rate and patient quality of life of brain metastases.There were differences in BED among the groups in this study,and the radiotherapy fractionation mode should be further optimized under the premise of equal biological dose.

Objective To explore the application value of 3D printed nasal skull base tumor model in the clinical and teaching of neurosurgery. Methods Total of 13 patients with skull base tumor were selected,the virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed according to the image data before surgery.40 students who participated in the standardized training of residents in the neurosurgery department were selected as teaching objects,and they were randomly divided into the traditional teaching group and the 3D printing model teaching group.The teaching effect of the two teaching modes was evaluated from the examination of theoretical knowledge and clinical skills,the satisfaction of teaching methods,the increase of understanding of neuroanatomical structure,the improvement of three-dimensional space imagination and the stimulation of active learning interest.Before surgery,the surgeon evaluated the spatial location of the tumor,preoperative talk,preoperative planning,intraoperative reference and postoperative anastomosis according to the 3D printed tumor model and traditional image data. Results The virtual 3D model was reconstructed and the equal-scale tumor model was 3D printed before operation in all the 13 patients with skull base tumor.The 3D model clearly showed the tumor and its adjacent skull,blood vessels and nerves.We found that students in the 3D printed model teaching group had better scores in the assessment of theoretical knowledge and clinical skills than those in the traditional teaching group,and the difference between the two groups was statistically significant ( P＜0.05).Moreover,the 3D printed model teaching group was higher than the traditional teaching group in terms of satisfaction with teaching methods,increasing understanding of neuroanatomical structure,improving three-dimensional space imagination and stimulating active learning interest.We also found that,in addition to preoperative planning,the 3D printed model group scored higher than the traditional image group on tumor spatial display,preoperative talk,intraoperative reference,and postoperative anastomosis.The difference between the two groups was statistically significant ( P＜0.05). Conclusion Compared with the traditional surgical planning and clinical teaching based on two-dimensional image data,3D printed tumor model has better surgical planning and clinical teaching value.

Objective To explore the clinical efficacy of scalp-positioning combined with stereotactic puncture and external drainage in the treatment of cerebral hemorrhage in the basal ganglia. Methods From January 2023 to January 2025,the Department of NeuroSurgery of Jianhe County People's Hospital,Guizhou Province,performed preoperative CT reconstruction of the head and localization of scalp electrode films on 42 patients with spontaneous basal ganglia intracerebral hemorrhage.Based on the principle of spatial stereocoordinate orientation,the central position of the largest layer of intracerebral hematoma was taken as the target,and the frontal nodule was used as the main puncture point.The puncture path was located using the principle that the sagittal plane and the cross-section “intersect in a straight line”.The basal ganglia hematoma was punctured under the positioning correction of the scalp electrode patch,and relevant data were collected for evaluation. Results Among the 42 cases of basal ganglia intracerebral hemorrhage,26 cases had excellent puncture site localization,15 cases had moderate localization,and 1 case had poor localization.The average operation time was 42 minutes and the average intraoperative blood loss was 12.4ml.The neurological function was evaluated 24 hours after the operation.The limb muscle strength improved in 25 cases,remained unchanged in 14 cases,and worsened in 3 cases.The language function score improved in 14 cases,remained unchanged in 11 cases,and worsened in 2 cases.Three months after discharge,the Activities of daily Living (ADL) classification included 6 cases at grade I,17 cases at grade II,14 cases at grade III,and 4 cases at grade IV. Conclusion The scalp-positioning combined with stereotactic puncture and drainage has a good clinical effect in the treatment of cerebral hemorrhage in the basal ganglia region.It is a simple,practical and accurately positioned method,which is conducive to reducing the surgical difficulty and trauma,and is worthy of clinical promotion and application.

Objective To explore the correlation between the changes of electroencephalogram (EEG) power spectrum and sleep disorder (SD) in patients with drug-resistant epilepsy (DRE),and to evaluate the effect of agomelatine (AGM) combined with eszopiclone (ESZ) on improving sleep and epilepsy (EP) frequency in patients with DRE. Methods 110 patients with DRE admitted from June 2023 to April 2025 were selected and divided into the SD group ( n=50) and the non-SD group ( n=60) based on pittsburgh sleep quality index (PSQI≥7),and clinical data,EEG parameters (δ,θ,α,β relative power),and polysomnography parameters[sleep onset latensy (SOL),total sleep time (TST),etc] of the patients were collected.Patients in the SD group were treated with AGM and ESZ for 12 weeks in addition to maintaining the original anti EP drug therapy,and the correlation between EEG parameters and SD and the treatment effect were analyzed. Results The age of patients in the SD group,the proportion of generalized seizures,high-frequency seizures (>1/month),and the use of traditional anti EP drugs were all higher than those in the non SD group ( P＜0.05).The relative power of the β,δ,and θ frequency bands in the SD group was significantly higher than that in the non SD group ( P＜0.05),and was positively correlated with PSQI score and SOL ( P＜0.05),and negatively correlated with TST and sleep efficiency (SE) ( P＜0.05).Multiple Logistic regression showed that the relative power of the β,δ,and θ frequency bands was an independent influencing factor of SD (OR=1.545~1.744, P＜0.05).RCS analysis showed a non-linear dose-response relationship between relative power in the β,δ,and θ frequency bands and SD risk (nonlinear test all P＜0.001).After treatment,the PSQI score,insomnia severity index scale (ISI),and frequency of EP attacks in the SD group were significantly reduced ( P＜0.05),and the incidence of adverse reactions was 16%,all of which were mild.Compared with before treatment,DRE patients with SD had lower relative power in the β,δ,and θ frequency bands after 12 weeks of treatment ( P＜0.05). Conclusion The abnormal EEG power spectrum of DRE patients (relative power of the β,δ,and θ frequency band increases) is closely related to SD,and AGM combined with ESZ can effectively improve sleep quality and reduce EP episodes,with good safety,and EEG parameters may serve as potential biomarkers for assessing the risk of SD in DRE patients.

Objective To investigate the therapeutic efficacy,complications,and clinical insights of intrathecal drug delivery system (IDDS) implantation in cancer pain patients. Methods A retrospective analysis was conducted on 5 cancer pain patients who underwent IDDS implantation at the Department of Neurosurgery,The First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2024 to March 2025.Clinical data,treatment,and relevant literature were reviewed. Results Among the 5 cases,4 received fully implanted IDDS,while 1 underwent semi-implanted (port-catheter) IDDS.Postoperatively,the average visual analogue scale (VAS) score decreased from 9.4 to 3.2,and the Barrow Neurological Institute (BNI) pain intensity score improved from grade V to II,demonstrating significant pain relief. Conclusion IDDS implantation is an effective and low-adverse-effect intervention for cancer pain management,serving as a viable therapeutic option.

Objective To investigate the correlation between the optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in patients after aneurysmal subarachnoid hemorrhage (aSAH) surgery,evaluate the diagnostic value of ONSD for elevated ICP from the perspectives of anatomical mechanism and clinical practice,and provide a basis for non-invasive ICP monitoring after aSAH surgery. Methods A total of 28 aSAH patients who underwent surgical treatment and invasive ICP monitoring in the Department of Neurosurgery,Anqing First People's Hospital from November 2022 to February 2024 were prospectively enrolled.On the 1st,3rd,5th,and 7th days after surgery,bedside ultrasound was used to measure ONSD (3 mm behind the eyeball,with the mean value of 6 bilateral measurements),and the ICP values were recorded simultaneously.Spearman correlation analysis was used to assess the association between ONSD and ICP,and ROC curve analysis was used to evaluate the efficacy of ONSD in diagnosing ICP > 21 mmHg. Results A total of 112 pairs of data were obtained.The ONSD ranged from 5.06 to 6.60 mm,and the ICP ranged from 15 to 45 mmHg.Overall analysis showed a significant positive correlation between ONSD and ICP ( r=0.91, P＜0.01).In subgroup analysis,the correlation was the highest in patients with Hunt-Hess Grade III ( r=0.92, P＜0.01),followed by Grade IV ( r=0.71, P＜0.01) and Grade V ( r=0.62, P＜0.01).The correlation coefficients at each time point ranged from 0.86 to 0.91 (all P＜0.01).When ONSD ≥ 5.49 mm was used to diagnose ICP >21 mmHg,the sensitivity was 95.24%,specificity 96.43%,positive predictive value 98.77%,negative predictive value 87.09%,and the area under the ROC curve was 0.979. Conclusion ONSD measured by ultrasound is significantly positively correlated with ICP in patients after aSAH surgery.ONSD ≥ 5.49 mm can be used as a highly effective diagnostic indicator for elevated ICP.Its advantages of non-invasiveness and repeatability at the bedside make it particularly suitable for dynamic ICP monitoring in critically ill patients after aSAH surgery.

Objective To investigate the relationship between preoperative serum levels of microRNA-22-3p (miR-22-3p) and microRNA-4297 (miR-4297) and clinical features,pathological characteristics,and postoperative recurrence in patients with glioma. Methods From January 2021 to January 2024,194 patients with glioma were included as the study subjects.According to whether the original lesion location recurred one year after surgery,they were assigned into a recurrence group of 92 cases and a non recurrence group of 102 cases.Real-time quantitative fluorescence PCR (qPCR) was used to detect serum miR-22-3p and miR-4297 in patients with glioma.Multivariate logistic regression was used to explore the influencing factors of postoperative recurrence in patients with glioma.Receiver operating characteristic (ROC) curves were plotted to explore the predictive value of serum miR-22-3p and miR-4297 for postoperative recurrence in glioma patients. Results Compared with the non-recurrence group,patients in the recurrence group had significantly lower serum levels of miR-22-3p and miR-4297 ( P＜0.05).Multivariate logistic regression analysis showed that clinical features such as extent of resection and postoperative radiochemotherapy,pathological features such as tumor diameter,pathological grade,differentiation degree,invasion and infiltration,and serum levels of miR-22-3p and miR-4297 were independent factors affecting postoperative recurrence in glioma patients ( P＜0.05).The ROC curve analysis indicated that the combined prediction of postoperative recurrence using serum miR-22-3p and miR-4297 had an area under the curve (AUC) of 0.893,which was significantly higher than individual predictions (miR-22-3p:Z=3.051, P=0.002; miR-4297:Z=2.157, P=0.031). Conclusion Serum miR-22-3p and miR-4297 in glioma patients with postoperative recurrence are reduced and correlated with clinical pathological features.The union of the two has a higher predictive effect on postoperative recurrence.

Objective To retrospectively investigate the efficacy and safety of different peripheral dose fractionation strategies in staged stereotactic radiosurgery (SRS) for the treatment of large brain metastases (LBM),and to explore histologically relevant strategy selection. Methods A retrospective study was conducted on 116 patients with 138 LBMs (diameter ≥3 cm or volume ≥10 cm ³).All patients received two-stage staged SRS.MRI was performed approximately 25 days after the initial stage to plan for the second stage.Patients were divided into an escalation group ( n=39),a maintenance group ( n=41),and a de-escalation group ( n=36) based on the peripheral dose changes between the two stages.Tumor volume changes,1-year local control rate (LCR),overall survival (OS),and adverse reactions were evaluated. Results The median LBM volume decreased from 17.65 cm ³ in SRS1 to 9.95 cm ³ in SRS2,and further to 5.85 cm ³ at the last follow-up (all P＜0.001); the volume decreased significantly in all three groups (all P＜0.05).The overall 1-year LCR was 87.9%,with no statistically significant difference in 1-year LCR among the three groups ( P=0.799).The median OS was 18.0 months,with no statistically significant difference in OS among the three groups ( P=0.282).The incidence of AREs was 16.38%,with no statistically significant difference among the three groups ( P=0.858).Subgroup analysis showed that the volume of LBM from lung cancer continued to decrease significantly after stage Ⅱ in the increasing and maintenance groups,while no further significant decrease was observed in the decreasing group; for LBM from breast cancer,only the increasing group continued to decrease significantly after stage II.In 41 patients,bevacizumab was added 3 days after the initial treatment,and no radiation necrosis or hemorrhage events were observed overall. Conclusion Two-stage SRS treatment for LBM can achieve good local control and safety.Given that the initial volume is larger in the escalation group,there are no significant differences in overall LCR,OS,and acute radiation effects (AREs) among the three dose fractionation strategies.However,histological subgroups suggest that the second-stage prescription should be optimized according to the individual:escalation or maintenance is more suitable for lung cancer LBM,while escalation is more suitable for breast cancer LBM.

Objective To investigate the effect of middle meningeal artery embolization (MMAE) combined with drilling and drainage on the clinical come oh and short-term prognosis of elderly chronic subdural hematoma (CSDH) patients. Methods In this study,88 cases of elderly CSDH patients admitted to our hospital between May 2023 and February 2025 were selected as the study subjects,and were divided into the conventional treatment group and the observation group by randomized grouping method,each containing 44 patients,and were given drilling and drainage treatment for the conventional treatment group,and the observation group was treated with MMAE on the basis of the conventional treatment group,and the two groups were compared in terms of their clinical efficacy and Compare the clinical efficacy of the two groups and the recurrence,brain tissue reexpansion and disability of the two groups after 1 month of follow-up. Results The total clinical efficacy rate of the observation group was significantly higher than that of the conventional treatment group,and the hematoma elimination time,hospitalization time,and complication rate were significantly lower than that of the conventional treatment group ( P＜0.05).After surgery,the quality of life scores of the observation group were higher than those of the conventional treatment group ( P＜0.05).At 1-month follow-up,the recurrence and disability rates of the observation group were lower than those of the conventional treatment group,and the rate of good brain tissue reopening was higher than that of the conventional treatment group (both P＜0.05). Conclusion MMAE combined with drilling and drainage can effectively improve the clinical efficacy of elderly patients with CSDH,reduce the incidence of complications,improve their quality of life,and the short-term prognosis is better,which has a high clinical value.

Objective To investigate the effect of miR-21 on neuroinflammation after subarachnoid hemorrhage (SAH) and its potential mechanism through in vitro and in vivo experiments. Methods In vitro,Transfection of N9 microglial cells with miR-21 mimics mediated by a transfection reagent was performed to upregulate miR-21 expression; a dual-luciferase reporter assay was conducted to verify that miR-21 can target and regulate the TLR4 gene; the effects of miR-21 overexpression on the TLR4/NF-κB inflammatory pathway were detected using RT-qPCR,Western Blot,and ELISA.In vivo,a rat SAH model was established by endovascular perforation,and miR-21 mimics were administered via intracerebroventricular injection.At 24 h post-modeling,neurological function was assessed using the modified Garcia score,and SAH severity was evaluated by the Sugawara score.TLR4 expression in the cerebral cortex was detected by immunohistochemistry and Western Blot. Results In vitro,Transfection with miR-21 mimics successfully upregulated miR-21 expression in N9 microglial cells; miR-21 was confirmed to target and regulate the TLR4 gene; overexpression of miR-21 inhibited the expression of TLR4,NF-κB,and related inflammatory factors.In vivo,overexpression of miR-21 significantly improved neurological function scores,reduced SAH severity,and suppressed the number of TLR4-positive cells and TLR4 protein expression in the cerebral cortex of SAH rats. Conclusion miR-21 alleviates neuroinflammation after SAH by targeting and inhibiting the TLR4/NF-κB signaling pathway and reducing the release of inflammatory factors,thereby exerting a neuroprotective effect.

Objective To establish an individualized column chart model for predicting the risk of rapid postoperative recovery in patients with traumatic brain injury(TBI). Methods A retrospective analysis was conducted on the clinical data of 240 TBI patients who underwent surgical treatment in our hospital from October 2023 to November 2025.70% of patients were randomly selected as the training group( n=168),and 30% of patients were selected as the validation group( n=72).Patients in the training group were assigned into a rapid recovery group( n=101) and a poor recovery group( n=67) based on whether they recovered quickly after surgery.The logistic regression model was used to screen high-risk factors that affected the rapid postoperative recovery of TBI patients in the training group,and the column chart prediction model was constructed.The predictive performance of the column chart model was evaluated through ROC curve,calibration curve,and Hosmer-Lemeshow goodness of fit test,and external validation was performed using data in validation group. Results There were statistically great differences in age,preoperative GCS score,BIS,length of hospital stay,midline shift,basal ganglia,lesion side,and bleeding site between the rapid recovery group and the poor recovery group( P＜0.05).Logistic regression analysis showed that age>65 years old( OR=1.545,95% CI=1.108~1.849),decreased GCS score( OR=1.392,95% CI=1.256~1.601),decreased BIS( OR=1.919,95% CI=1.869~1.973),and midline shift>15 mm( OR=1.326,95% CI=1.122~1.869) were independent risk factors for poor postoperative recovery in TBI patients( P＜0.05).The area under the ROC curve of the model in the training group was 0.935(95% CI=0.895~0.975),indicating good discriminability;the calibration curve tended towards the ideal curve,and the actual value was in good agreement with the predicted value.The area under the ROC curve of the model in the validation group was 0.929(95% CI=0.873~0.985),indicating good discriminability;the calibration curve tended towards the ideal curve,and the actual value was in good agreement with the predicted value. Conclusion The column chart model constructed based on the four independent risk factors selected by the logistic regression model has good predictive value for the risk of poor postoperative recovery in TBI patients.

Objective To explore the association between postoperative serum sodium levels and secondary hydrocephalus in patients with severe traumatic brain injury. Methods We collected data from patients with severe traumatic brain injury admitted to our hospital from January 2022 to January 2025.All patients were followed up for 6 months after discharge.Based on the diagnostic criteria for hydrocephalus,they were divided into a hydrocephalus group ( n=40) and a non-hydrocephalus group( n=220).Clinical data,serum sodium levels,and neuroinflammatory cytokine levels were compared between the two groups.The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of postoperative serum sodium levels for secondary hydrocephalus in patients with severe traumatic brain injury.Multiple linear regression was employed to analyze the relationship between serum sodium and neuroinflammatory cytokines.Restricted cubic spline analysis was conducted to assess the association between serum sodium levels and secondary hydrocephalus in patients with severe traumatic brain injury.A mediation effect model was constructed to analyze the role of neuroinflammatory cytokines in the relationship between serum sodium and secondary hydrocephalus. Results The proportions of patients with bone window area,midline shift distance,postoperative intracranial pressure,intracerebral hematoma,cerebral hernia,and dural suspension were higher in the hydrocephalus group than in the non-hydrocephalus group ( P＜0.05).The levels of interleukin-1β (IL-1β),interleukin-2 (IL-2),interleukin-5 (IL-5),interleukin-12 (IL-12),and tumor necrosis factor-α (TNF-α) were higher,while the serum sodium level was lower in the hydrocephalus group compared with the non-hydrocephalus group ( P＜0.05).A lower serum sodium level was independently associated with secondary hydrocephalus ( P＜0.001).The area under the curve (AUC) for predicting secondary hydrocephalus using postoperative serum sodium levels in patients with severe traumatic brain injury was 0.871,indicating good predictive efficacy.When the serum sodium level was < 139.27 mmol/L,the risk of secondary hydrocephalus increased with decreasing serum sodium levels;conversely,when the serum sodium level was ≥ 139.27 mmol/L,the risk of secondary hydrocephalus decreased with increasing serum sodium levels ( P＜0.05).As serum sodium levels decreased,IL-1β,IL-2,IL-5,IL-12,and TNF-α levels increased (β>0, P＜0.001).IL-1β,IL-2,IL-5,IL-12,and TNF-α all exerted partial mediating effects between serum sodium and secondary hydrocephalus,with mediating effects of 0.124,0.068,0.069,0.136,and 0.146,respectively,and the ratios of mediating effects to total effects were 46.32%,32.85%,14.82%,21.45%,and 20.48%,respectively ( P＜0.001). Conclusion Postoperative serum sodium levels in patients with severe traumatic brain injury can serve as an important biomarker for predicting the occurrence of secondary hydrocephalus,providing a basis for clinical practice.

Objective To identify differential proteins in serum between moyamoya disease (MMD) patients and healthy controls using Olink targeted proteomics,elucidate their potential roles in disease pathogenesis and progression,and evaluate their value as prognostic biomarkers. Methods We enrolled 43 MMD patients and 43 non-MMD controls admitted to Fuzhou First People's Hospital from January 2023 to May 2025 serum samples were collected,and clinical parameters (blood pressure,blood glucose,blood lipids,oxygen saturation,heart rate) were recorded.Differential proteins were detected using Olink targeted proteomics panels.GO and KEGG enrichment analyses were performed to identify critical signaling pathways. Results MMD patients exhibited significantly elevated blood pressure,blood glucose,blood lipids,and oxygen saturation compared to controls ( P<0.05).We identified 30 differentially expressed proteins,with ROBO2 showing the most pronounced upregulation in MMD.Enrichment analysis revealed significant involvement of these proteins in “protein binding,” “signal transduction,” and “cytokine-receptor interaction” pathways.Random forest modeling confirmed that ROBO2 expression level provides optimal predictive power for MMD diagnosis and adverse prognosis. Conclusion The “protein binding–signal transduction–cytokine receptor interaction” network is significantly activated in MMD patient serum.ROBO2 demonstrates marked upregulation and represents a potential biomarker for early diagnosis and prognostic assessment of MMD.