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 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 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 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 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 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 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 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.

Objective To explore the efficacy and safety of stereotactic electroencephalography (SEEG)-guided radiofrequency thermocoagulation ablation in the treatment of refractory central zone epilepsy. Methods A retrospective analysis was conducted on 9 patients with refractory central zone epilepsy confirmed by SEEG from March 2019 to March 2024.The relationship between epileptogenic foci and functional cortex was precisely located in three-dimensional space.SEEG-guided radiofrequency thermocoagulation ablation was performed on the clearly identified epileptogenic initiation zone under awake conditions.Postoperative follow-up was conducted regularly,and the prognosis of patients was evaluated according to the Engel classification,as well as the status of epileptic seizures and neurological function impairment. Results A total of 70 electrodes were implanted in 9 patients.According to the SEEG results,45 electrodes were thermocoagulated.After 12 months of follow-up after thermocoagulation,6 patients (66.67%) were classified as Engel I,1 patient (11.11%) as Engel II,1 patient (11.11%) as Engel III,and 1 patient (11.11%) as Engel IV.The total effective rate (Engel I-III) was 88.89%.One patient had postoperative bleeding in the surgical area,one had facial paralysis,and eight had decreased muscle strength in one limb.After treatment with hyperbaric oxygen and limb rehabilitation,only one patient had slightly poor fine finger movement,and the neurological functions of the other patients were restored. Conclusion Radiofrequency thermocoagulation under SEEG guidance is an effective,minimally invasive and relatively safe method for treating intractable central zone epilepsy,and it has clinical promotion value.

Objective To investigate the mechanism by which carbamazepine reduces pyroptosis induced by the NLRP3/Caspase-1/IL-1β signaling pathway in a lithium-pilocarpine-induced rat model of chronic spontaneous recurrent seizures. Methods Ninety-six rats were randomly and equally assigned to four groups:normal control group,CSRS group,CSRS+CBZ50 group,and CSRS+CBZ100 group.The lithium-pilocarpine model of epileptic rats was established.Hippocampal neuronal pyroptosis was detected using immunofluorescence.IL-1β protein levels were measured by immunohistochemistry and ELISA.The expression levels of Caspase-1,ASC,and NLRP3 were detected using real-time PCR and Western blot. Results Carbamazepine alleviated the frequency of lithium-pilocarpine-induced seizures and reduced IL-1β levels in hippocampal neurons.Furthermore,the reduction in IL-1β levels was achieved through carbamazepine-induced inhibition of Caspase-1-dependent pyroptosis.The decrease in neuronal pyroptosis resulted from reduced NLRP3 inflammasome formation. Conclusion The effect of carbamazepine in reducing IL-1β may be achieved by decreasing pyroptosis induced by the NLRP3/Caspase-1 pathway in hippocampal neurons.

Objective To explore the neuroprotective effect and potential mechanism of Hirsutine in rat cerebral ischemia-reperfusion injury (CIRI). Methods SD rats were used to establish a middle cerebral artery occlusion reperfusion (MCAO/R) model and were divided into 6 groups ( n=6):Control group; Model group; Hirsutine low-dose (5 mg/kg) group; Hirsutine medium dose (10 mg/kg) group; Hirsutine high-dose (20 mg/kg) group; Edaravone (30 mg/kg,positive control) group.TTC staining was performed on brain tissue,the cerebral infarction and neurobehavioral defects were measured.HE and Nissl staining were used to detect neuronal damage.Tunel staining was used to detect hippocampal cell apoptosis; ELISA method was used to detect the levels of reactive oxygen species (ROS),malondialdehyde (MDA),superoxide dismutase (SOD),and glutathione peroxidase (GSH Px) in brain tissues.Western blotting is used to detect the expression level of proteins related to the mechanism. Results The results showed that Hirsutine treatment significantly reduced cerebral infarction and neuronal damage in MCAO/R rats,and improved brain neurobehavioral deficits.Hirsutine effectively inhibited oxidative stress and cell apoptosis.In addition,Hirsutine activated the PI3K/Akt/Nrf2 pathway in MCAO/R rat neurons. Conclusion Hirsutine improveed oxidative stress and apoptosis in MCAO/R rat brain by activating PI3K/Akt/ Nrf2 signaling pathway,thereby alleviating CIRI-induced neuronal injury.

Objective To analyze the characteristics of blood lipid metabolism in patients with Moyamoya disease(MMD) and the relationship between blood lipid levels and clinical features. Methods The clinical characteristics and blood lipid test results of 214MMD patients in Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2015 to October 2023 were collected,and 214 healthy subjects were selected as the control group.SPSS 26.0 was used to compare the lipid levels and the characteristics of abnormal lipid metabolism in each group,and the correlation between lipid levels and clinical characteristics was analyzed. Results The prevalence of abnormal lipid metabolism in MMD was 50.9%,mainly hypertriglyceridemia and low HDL-C.Compared with the control group,the level of TG in MMD patients was significantly higher ( P＜0.05).With the increase of BMI,the level of TG was higher and the level of HDL-C was lower ( P＜0.05).The levels of TC,TG and LDL-C in ischemic patients were higher than those in hemorrhagic patients. Conclusion Patients with MMD have a high rate of dyslipidemia,mainly hypertriglyceridemia and low HDL-C,especially in patients with cerebral infarction as the first symptom.In clinical work,patients with MMD should be intervened as early as possible.

Objective To explore the efficacy of intraoperative virtual reality (VR) assisted neuroendoscopic hematoma removal and stereotactic drainage in patients with hypertensive intracerebral hemorrhage (HICH) in the basal ganglia region. Methods 106 HICH patients admitted to the hospital from September 2022 to May 2023 were selected as the study subjects.They were divided into group A and group B by random number table method.Group A was treated with intraoperative VR-assisted neural endoscopic hematoma evacuation (NEIHE),and group B was treated with stereotactic intracranial hematoma drainage surgery.The perioperative indicators,puncture conditions,hematoma clearance,and levels of inflammatory indicators before and 3 months after surgery were compared between the two groups,and the prognosis of the two groups 3 months after surgery was observed. Results The surgical time in Group A was longer than that in Group B,and the postoperative hematoma drainage time and hospitalization time were shorter than those in Group B ( P＜0.05).The success rate of the first puncture in Group A was higher than that in Group B,and the hematoma clearance rate on the 1st and 5th day after surgery was higher than that in Group B ( P＜0.05).The levels of serum C-reactive protein (CRP),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were lower than those before operation,and those in group A were lower than those in group B at 3 months after operation ( P＜0.05).The National Institutes of Health Stroke Scale (NIHSS) scores of both groups decreased 3 months after surgery,and Group A was lower than Group B.The Barthel (BI) index increased in both groups,and Group A was higher than Group B ( P＜0.05). Conclusion Compared to stereotactic intracranial hematoma drainage,intraoperative VR assisted NEIHE can improve the success rate of intraoperative puncture and hematoma removal rate,shorten the postoperative hematoma drainage time and hospitalization time of patients,reduce the body's inflammatory response,and promote the recovery of neurological function and daily life ability of patients.

Objective Analyze the clinical efficacy of endoscopic assisted subtemporal approach in the treatment of severe brainstem hemorrhage. Methods Retrospective analysis of 78 patients with severe brainstem hemorrhage admitted to our hospital from January 2021 to January 2023,according to the choice of the patients' family members,they were divided into operation group and conservative management.There were 36 cases in the surgical group and 42 cases in the conservative group.The surgical group used endoscope to clear the hematoma through the subtemporal approach,while the conservative group used symptomatic treatment according to the treatment guidelines for cerebral hemorrhage.Compare the complications,clinical prognosis,and changes in serum NSE and S100B levels between the two groups. Results Compared with the conservative group,the number of patients with severe pneumonia,lower limb venous thrombosis,electrolyte disorder and Irritability ulcer in the operation group was less than that in the conservative group.The difference between the two groups was statistically significant ( P＜0.05).By comparing the Glasgow prognostic score (GOS) of the two groups,it was found that the number of patients with normal life and mild disability in the operation group was more than that in the Conservative management group,and the number of patients with severe disability was less than that in the Conservative management group.The difference between the two groups was statistically significant ( P＜0.05).After 1 and 2 weeks of treatment,it was found that the levels of NSE and S100B in the serum of the surgical group were significantly lower than those of the conservative group,with a statistically significant difference ( P＜0.05). Conclusion The treatment of severe brainstem hemorrhage through the infratemporal approach assisted by neuroendoscopy can reduce complications and mortality in patients,and improve their prognosis.