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Mesenchymal stem cell-derived extracellular vesicles therapy in traumatic central nervous system diseases:a systematic review and meta-analysis

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Neural Regeneration Research 2023年第11期18卷 2406-2412页

作者： Zhelun Yang Zeyan Liang Jian Rao Fabin Lin Yike Lin Xiongjie Xu Chunhua Wang Chunmei Chen department of neurosurgery Fujian Medical University Union HospitalFuzhouFujian ProvinceChina

Although there are challenges in treating traumatic central nervous system diseases,mesenchymal stem cell-de rived extracellular vesicles(MSC-EVs) have recently proven to be a promising non-cellular the rapy.We comprehensively evaluated the efficacy of mesenchymal stem cell-de rived extracellular vesicles in traumatic central nervous system diseases in this meta-analysis based on preclinical studies.Our meta-analysis was registered at PROSPERO(CRD42022327904,May 24,2022).To fully retrieve the most relevant articles,the following databases were thoro ughly searched:PubMed,Web of Science,The Cochrane Library,and Ovid-Embase(up to April 1,2022).The included studies were preclinical studies of mesenchymal stem cell-derived extracellular vesicles for traumatic central nervous system diseases.The Systematic Review Centre for Laboratory Animal Experimentation(SYRCLE)’s risk of bias tool was used to examine the risk of publication bias in animal studies.After screening 2347studies,60 studies were included in this study.A meta-analysis was conducted for spinal co rd injury(n=52) and traumatic brain injury(n=8).The results indicated that mesenchymal stem cell-derived extracellular vesicles treatment prominently promoted motor function recovery in spinal co rd injury animals,including rat Basso,Beattie and Bresnahan locomotor rating scale scores(standardized mean difference [SMD]:2.36,95% confidence interval [CI]:1.96-2.76,P <0.01,I2=71%) and mouse Basso Mouse Scale scores(SMD=2.31,95% CI:1.57-3.04,P=0.01,I2=60%) compared with controls.Further,mesenchymal stem cell-de rived extracellular vesicles treatment significantly promoted neurological recovery in traumatic brain injury animals,including the modified N eurological Severity Score(SMD=-4.48,95% CI:-6.12 to-2.84,P <0.01,I2=79%) and Foot Fault Test(SMD=-3.26,95% CI:-4.09 to-2.42,P=0.28,I2=21%) compared with controls.Subgroup analyses showed that characteristics may be related to the therapeutic effect of mesenchymal stem cell-de rived extra cellular vesicles.For Basso,Bea

关键词： animals central nervous system diseases extracellular vesicles mesenchymal stromal cell meta-analysis spinal cord injury traumatic brain injury

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Long-term follow-up of vagus nerve stimulation in drug-resistant KCNT1-related epilepsy: a case presentation

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Acta Epileptologica 2022年第4期5卷 275-280页

作者： Meng Wang Guifu Geng Yao Meng Hongwei Zhang Zaifen Gao Jianguo Shi department of Epilepsy Center Children’s Hospital Affiliated to Shandong UniversityJinan Children’s HospitalJinan250000China department of functional neurosurgery Children’s Hospital Affiliated to Shandong UniversityJinan Children’s HospitalJinan250000China

Background The KCNT1 gene encodes a Na+-activated K+channel.Gain-of-function mutations of KCNT1 lead to autosomal dominant sleep-related hypermotor epilepsy,early-onset epileptic encephalopathy,focal epilepsy and other epileptic encephalopathies.In this paper,we report a boy carrying a KCNT1 gene mutation,who presented with drug-resistant focal-onset seizures.He had decreased seizure frequency and improvement of background changes in electroencephalography(EEG)after vagus nerve stimulation(VNS).Case presentation The case was a nonverbal 9-year-old male who presented with drug-resistant focal-onset seizures since age 3 and had underwent VNS therapy for 2 years.He had hypermotor symptoms,automatism and bilateral asymmetric tonic seizures with cognitive decline and aphasis from age 3.The patient had a variety of seizure types that only occurred at night.The most common seizure type was automatisms,and ictal video EEG showed high-amplitude delta waves,followed by a fast rhythmic sharp activity in the mesial frontal and bitemporal regions.The patient was diagnosed with KCNT1-related epilepsy,epileptic encephalopathy and cognitive disorder.He was refractory to multiple anti-seizure medicines(ASM)and ketogenic diet.After VNS treatment at age 7,the frequency of seizures was reduced significantly and EEG was improved in background slowing.Conclusions Children with KCNT1-related epilepsy usually have early onset of disease,are nonverbal,and are refractory to ASM.This boy with drug-resistant KCNT1-related epilepsy showed significantly reduced seizure frequency after VNS.This report may provide reference for management of cases of KCNT1-related epilepsy.

关键词： Vagus nerve stimulation KCNT1 gene Epileptic encephalopathy KCNT1-related epilepsy

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Endovascular treatment of direct carotid cavernous fistula resulting from rupture of intracavernous carotid aneurysm: A case report

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World Journal of Clinical Cases 2024年第11期12卷 1940-1946页

作者： Guang Ouyang Kai-Li Zheng Kuan Luo Mu Qiao Yuan Zhu De-Rui Pan department of neurosurgery Puren Hospital Affiliated to Wuhan University of Science and TechnologyWuhan 430081Hubei ProvinceChina department of neurosurgery The Third Hospital of WuhanWuhan 430081Hubei ProvinceChina

BACKGROUND Direct carotid cavernous fistulas(CCFs)are typically the result of a severe traumatic brain injury.High-flow arteriovenous shunts secondary to rupture of an intracavernous aneurysm,resulting in direct CCFs,are rare.The use of a pipeline embolization device in conjunction with coils and Onyx glue for treatment of direct high-flow CCF resulting from ruptured cavernous carotid artery aneurysm in a clinical setting is not well documented.CASE SUMMARY A 58-year-old woman presented to our department with symptoms of blepharoptosis and intracranial bruits for 1 wk.During physical examination,there was right eye exophthalmos and ocular motor palsy.The rest of the neurological examination was clear.Notably,the patient had no history of head injury.The patient was treated with a pipeline embolization device in the ipsilateral internal carotid artery across the fistula.Coils and Onyx were placed through the femoral venous route,followed by placement of the pipeline embolization device with assistance from a balloon-coiling technique.No intraoperative or perioperative complications occurred.Preoperative symptoms of bulbar hyperemia and bruits subsided immediately after the operation.CONCLUSION Pipeline embolization device in conjunction with coiling and Onyx may be a safe and effective approach for direct CCFs.

关键词： Intravascular therapy Carotid cavernous fistulas Intracavernous carotid aneurysms Case report

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Surgical site infections after elective craniotomy for brain tumor:a study on potential risk factors and related treatments

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Chinese Neurosurgical Journal 2023年第4期9卷 267-275页

作者： Yifan Lv Xiang Mao Yuxuan Deng Lanbing Yu Junsheng Chu Shuyu Hao Nan Ji department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China department of neurosurgery The First Affiliated Hospital of Anhui Medical UniversityHefei 230022AnhuiChina

Background Surgical site infection(SSI)is a common complication following craniotomy that increases morbidity,mortality,and medical expenses.The objectives of this study were to determine the relevant risk factors associated with SSI after elective craniotomy for brain tumor and analyse the treatments for SSI.Methods A retrospective nested case-control study was conducted using data from patients who underwent craniotomy for brain tumor resection at the Neurosurgical Oncology department No.6 of Beijing Tiantan Hospital,Capital Medical University,between January 2019 and December 2021.Risk factors for SSI were determined using multivariate logistic regression analysis.We analyzed microbiological and related treatment data for different SSI types.Results Among 2061 patients who underwent craniotomy for brain tumor,31 had SSI(1.50%).In the multivariate logistic regression analysis,body mass index(BMI)and operative duration were identified as independent risk factors for SSI.The most common microorganism isolated from SSIs was Staphylococcus epidermidis(22.9%),and drug sensitivity results showed that gram-positive bacteria were sensitive to linezolid,vancomycin and tigecycline,whereas gram-negative bacteria were sensitive to meropenem,cefepime and ceftazidime.Six of the seven patients who underwent bone flap removal due to osteomyelitis were infected with gram-negative bacteria.Conclusions BMI and operative duration were identified as independent risk factors for SSI.Diabetes mellitus,previous ratio therapy,type of incision,recurrence tumor and other risk factors were not found to be associated with the occurrence of SSI in this study.

关键词： Brain tumor Elective craniotomy neurosurgery Surgical site infection Risk factors Infection control

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Long non-coding RNA DPP10-AS1 represses the proliferation and invasiveness of glioblastoma by regulating miR-24-3p/CHD5 signaling pathway

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BIOCELL 2023年第12期47卷 2721-2733页

作者： JIWEI SUN LIANG XU YESEN ZHANG HAORAN LI JIE FENG XUEFENG LU JUN DONG department of neurosurgery The Second Affiliated Hospital of Soochow UniversitySuzhou215004China department of neurosurgery The First Affiliated Hospital of Bengbu Medical CollegeBengbu233000China

This investigation aimed to unveil new prospective diagnosis-related biomarkers together with treatment targets against glioblastoma.Methods:The expression levels of long non-coding RNA(lncRNA)DPP10-AS1 were assessed using real-time quantitative polymerase chain reaction(RT-qPCR)within both the patient tissue specimens and glioblastoma cell lines.The relationship between lncRNA DPP10-AS1 expression in glioblastoma and patient prognosis was investigated.Cell Counting Kit-8(CCK-8),transwell,and clonogenic experiments were utilized to assess tumor cells’proliferation,invasiveness,and migratory potentials after lncRNA DPP10-AS1 expression was up or down-regulated.Using an online bioinformatics prediction tool,the intracellular localization of lncRNA DPP10-AS1 and its target miRNA were predicted,and RNA-FISH verified results.A dual-luciferase reporter experiment validated the relationship across miR-24-3p together with lncRNA DPP10-AS1.MiR-24-3p expression within glioblastoma was identified through RT-qPCR,and potential link across miR-24-3p and lncRNA DPP10-AS1 was assessed using Pearson correlation analysis.Moreover,influence from lncRNA DPP10-AS1/miR-24-3p axis upon glioblastoma cell progression was assessed in vivo via a subcutaneous xenograft tumor model.Results:The expression of lncRNA DPP10-AS1 was notably reduced in both surgical specimens of glioblastoma and the equivalent cell lines.Low level of lncRNA DPP10-AS1 in glioblastoma is following poor prognosis.The downregulation of lncRNA DPP10-AS1 in glioblastoma cells resulted in enhanced cellular proliferation,migration,and invasion capabilities,accompanied by downregulated E-cadherin and upregulated vimentin and N-cadherin.Additionally,the observed upregulation of lncRNA DPP10-AS1 demonstrated a substantial inhibitory function upon proliferation,invasion,and migratory capabilities of LN229 cells.Subcellular localization disclosed that lncRNA DPP10-AS1 had a binding site that interacted with miR-24-3p.Upregulated miR-24-3p was detected in glioblastomas,display

关键词： Glioblastoma lncRNA DPP10-AS1 miR-24-3p Chromodomain helicase DNA binding protein 5

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Treatment of drug-resistant epilepsy with vagus nerve stimulation m review of 45 cases

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Chinese Medical Journal 2011年第24期 4184-4188页

作者： BAO Min ZHOU Jian LUAN Guo-ming department of functional neurosurgery Beijing Sanbo BrainHospital Capital Medical University Beijing 100093 China

Background Vagus nerve stimulation （VNS） is an alternative treatment for drug-resistant epilepsy （DRE）. The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients with DRE. Methods We retrospectively examined 45 cases of DRE that received VNS treatment in our center from June 2004 to June 2010 and analyzed the parameters （age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration） by Student＇s t test, Fisher＇s exact and Mann-Whitney U tests, and multivariate Logistic regression. Results The overall response rate was 64% （29/45）, 67% （6/9） for adults and 64% （23/36） for children, with no significant difference （P=0.28）. Twenty-two cases had been in VNS therapy for over 1 year with a treatment efficacy of 73% （16/22）, whereas 23 cases had been in VNS therapy no more than 1 year with a treatment effecacy of 57% （13/23）, and has statistically significant difference （P=0.03）. The main side effect included hoarseness of voice and cough. One patient＇s device was removed due to infection. One patient＇s VNS was half-way terminated due to seizure aggravation. One patient died due to status epilepticus. Conclusions VNS is a safe and effective treatment for DRE. Duration of VNS therapy may be a crucial factor on prognosis.

关键词： epilepsy vagus nerve stimulation treatment outcome safety prognosis

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MR-guided laser interstitial thermal therapy for drug-resistant lesional epilepsy:a single-center experience

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Chinese Neurosurgical Journal 2023年第4期9卷 258-266页

作者： Hongchuan Niu Kai Li Xiaoning Liang Desheng Kong Zongze Li Fengqiao Sun Xianzeng Liu Zongsheng Xu Xuejiao Wei Shuang Lan Changyu Lu department of neurosurgery Peking University International HospitalBeijingChina department of neurosurgery PKUCare Zibo HospitalShandongChina department of Neurology Peking University International HospitalBeijingChina department of neurosurgery Peking University InternationalNo.1 Shengmingyuan RoadZhongguancun Life Science ParkChangping DistrictBeijing 102206China

Background To describe and report the efficacy and safety of MR-guided laser interstitial thermal therapy(MRgLITT)in the treatment of drug-resistant epilepsy.Methods A retrospective review of all MRgLITT procedures in our hospital was performed.All procedures were performed using a surgical laser ablation system.Demographic and outcome data were compiled and analyzed.Results A total of 19 patients underwent MRgLITT procedures from June 2021 to November 2021.The average age at surgery was 18.1 years(3-61.4 years).The average length of hospitalization post-surgery was 4.95 days(4-7 days).Surgical substrates included 8 patients with hypothalamic hamartomas,5 with medial temporal lobe epilepsy,3 with deep focal cortical dysplasia,1 with tuberous sclerosis,1 with a cavernous malformation,and 1 with Lennox-Gastaut syndrome who underwent anterior corpus callosotomy.Complications occurred in three patients.After an average follow-up of 1 year,6 patients were seizure-free(Engel I,31.6%),1 had significant seizure control(Engel II,5.3%),7 had seizure control(Engel III,36.8%),and 5 had no improvement in their seizures(Engel IV,26.3%).Fisher’s exact tests did not reveal statistical significance for the association between Engel class outcome and epileptic disease.Conclusion This study confirmed that MRgLITT,as a method for treating drug-resistant epilepsy,is minimally invasive,safe,and efficient and that it can reduce the incidence of surgery-related complications.

关键词： Laser MRgLITT Epilepsy

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Baicalin Reduces Early Brain Injury after Subarachnoid Hemorrhage in Rats

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Chinese Journal of Integrative Medicine 2020年第7期26卷 510-518页

作者： ZHANG Hua-bin TU Xian-kun SONG Shi-wei LIANG Ri-sheng SHI Song-sheng department of neurosurgery Fujian Medical University Union HospitalNeurosurgery Research Institute of Fujian ProvinceFuzhou(350001)China

Objective: To evaluate the effect of baicalin on subarachnoid hemorrhage(SAH) in rats and explore the potential mechanisms. Methods: Sprague-Dawley rats underwent experimental SAH and received treatment with baicalin at 10 or 50 mg/kg after 2 and 12 h of SAH. Neurological scores, brain water content, Evans-blue extravasation, and levels of glutathione peroxidase(GSH-Px), superoxide dismutase(SOD), myeloperoxidase(MPO), and malondialdehyde(MDA) were measured 24 h after SAH. Expression of nuclear factor erythroid-related factor 2(Nrf2), NAD(P)H: quinone oxidoreductase 1(NQO1), matrix metalloproteinase-9(MMP-9), aquaporin 4(AQP4), occludin, and zonulaoccludens-1(ZO-1) were detected in the brain by Western blot. Heme oxygenase-1(HO-1) was detected by quantitative polymerase chain reaction, and tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) were assessed by enzyme-linked immunosorbent assay. Results: Baicalin attenuated EBI 24 h after SAH in rats(P<0.05). Baicalin elevated neurological scores, GSH-Px, SOD, and increased the expression of Nrf2, NQO1, HO-1, occludin, and ZO-1 in SAH rats(P<0.05 or P<0.01). Baicalin reduced MPO, MDA, and the expression of MMP-9, AQP4, TNF-α, and IL-1β(P<0.05 or P<0.01). Conclusion: Baicalin reduced SAH-induced EBI, partially via activation of the Nrf2/HO-1 pathway and inhibition of MMP-9 and AQP4.

关键词： aquaporin 4 baicalin Chinese medicine early brain injury matrix metalloproteinase-9 subarachnoid hemorrhage

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Repairing peripheral nerve injury using tissue engineering techniques

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Neural Regeneration Research 2015年第9期10卷 1393-1394页

作者： Ernest W.Wang Jun Zhang Jason H.Huang department of neurosurgery Baylor Scott & White department of neurosurgery PLA General Hospital

Each year approximately 360,000 people in the United States suffer a peripheral nerve injury （PNI）, which is a leading source of lifelong disability （Kelsey et al., 1997; Noble et al., 1998）. The most frequent cause of PNIs is motor vehicle accidents, while gunshot wounds, stabbings, and birth trauma are also common factors. Patients suffering from disabilities as a result of their PNIs are also burdensome to the healthcare system, with aver- age hospital stays of 28 days each year （Kelsey et al., 1997; Noble et al., 1998）.

关键词： PNI Repairing peripheral nerve injury using tissue engineering techniques DRG

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Treating traumatic brain injury at sea:how to improve the skills and capabilities of the naval medical personnel

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军事医学研究:英文版 2023年第4期10卷 575-576页

作者： Xin-Jie Hong Kai-Wei Han Rong-Bin Chen Liang Zhao Dan-Feng Zhang Lei Jiang Yi-Ming Li Li-Quan Lv Li-Jun Hou Tao Xu department of neurosurgery Changzheng HospitalNaval Medical UniversityShanghai 200003China

Dear Editor,Recent advances in military technology have led to the development of sophisticated and intelligent weapons, which increase mortality and morbidity. Since the advent of highexplosion weapons, "shock wave" has surpassed "shrapnel" and become the most important injurious component in conventional combat. Traumatic brain injury(TBI) is a leading cause of disability and death among military personnel and civilians during wartime[1]. Clinically, its symptoms and indications vary depending on the location and severity of the injury. The most frequently observed symptoms included altered consciousness and local dysfunction.

关键词： Skill set Competencies Traumatic brain injury Navy

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