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Endoscopy-assisted purely total outer wall excision for pediatric Sylvian arachnoid cysts

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Chinese Neurosurgical Journal 2023年第4期9卷 326-332页

作者： Mingxing Wu Fei Di Mingle Ma Jiye Li Yanbin Li Bingke Zhang department of neurosurgery The Affiliated Children’s HospitalCapital Institute of PediatricsBeijingChina

Background To present a novel endoscopy-assisted surgical strategy of Sylvian arachnoid cysts(ACs).Case presentation Endoscopy-assisted surgery was performed on 9 children(May 2019-December 2021).All patients were evaluated with CT and/or MRI and had regular follow-up *** procedure consisted of performing a small temporal craniotomy(2 cm)behind the *** dural opening,the surgery was performed with the assistance of a rigid 30-degree transcranial endoscope,self-irrigating bipolar forceps,and other standard endoscopic *** included total excision of the AC outer wall and dissection of arachnoid adhesion around the cystic edge to communicate the residual cyst cavity with subdural *** with the microscopical procedure,a 30-degree transcranial endoscope provides a wider view,especially for the lateral part exposure of the outer *** average age of the patients was 27.7 months(range 13-44 months).The Sylvian AC was in the right hemisphere in three patients and six in the left,respectively.1 patient suffered transient postoperative *** was no mortality or additional postoperative neurological deficit in this *** of the patients achieved significant clinical improvement after *** examination after the operation showed a significant reduction in all cases(100%,9/9)and disappearance in one case(11.1%,1/9).Postoperative subdural fluid collection occurred in six cases and completely resolved spontaneously in 9 *** The study demonstrated the minimally invasive,safety,and effectivity of the endoscopy-assisted purely total outer wall excision.

关键词： Arachnoid cysts Endoscopy Treatment

Role of Regulatory T cell in Clinical Outcome of Traumatic Brain Injury

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Chinese Medical Journal 2015年第8期128卷 1072-1078页

作者： Min Li Yun-Peng Lin Jie-Li Chen Hong Li Rong-Cai Jiang Jian-Ning Zhang department of neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin 300052 China department of Neurology Henry Ford Hospital Detroit MI 48202 USA department of neurosurgery Second Hospital of Tianjin Medical University Tianjin 300211 China

Background： Traumatic brain injury （TBI） is a life-threatening disease worldwide. Regulatory T cells （Treg ceils） were involved in the immunological system in central nervous system. It is defined as a subpopulation of CD4＋ cells that express CD25 and transcription lactor forkhead box P3. The level of circulating Treg cells increases in a variety of pathologic conditions. The purpose of this study was to uncover the role of circulating Treg cells in TBI. Methods： A clinical study was conducted in two neurosurgical intensive care units of Tianjin Medical University General Hospital and Second Hospital of Tianjin Medical University （Tianjin, China）. Forty patients and 30 healthy controls were recruited t＇rom August 2013 to November 2013. Circulating Treg cells was detected on the follow-up period of 1,4, 7, 14, and 21 days alter TBI. Blood sample （ 1 ml） was withdrawn in the morning and processed within 2 h. Results： There was no significant difference in the level of circulating Treg cells between TBI patients and normal controls during follow-up. TBI patients exhibited higher circulating Treg level than normal controls on the 1st day after TBI. Treg level was decreased on the 4th day, climbed tip on the 7th day and peaked on 14th day after TBI. Treg cells declined to the normal level on 21th day alter TBI. The level of circulating Treg cells was significantly higher in survival TBI patients when compared to nonsurvival TBI patients. TBI patients with improved conditions exhibited significantly higher circulating Treg level when compared to those with deteriorated conditions. The circulating Treg level was correlated with neurologic recovery after TBI. A better neural recovery and lower hospital mortality were found in TBI patients with circulating Treg cells more than 4.91% in total CD4＋ inononuclear cells as compared to those with circulating Treg cells less than 4.91% in total CD4 mononuclear cells in the first 14 days. Conclusions： The level of circulating Tr

关键词： Clinical Outcome Dynamic Change Prognostic Marker Regulatory T cell Traumatic Brain Injury

A distinct pattern of memory and attention deficiency in patients with depression

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Chinese Medical Journal 2013年第6期126卷 1144-1149页

作者： LUO Lan-lan CHEN Xin CHAI Yan LI Jin-hong HANG Mian ZHANG Jian-ning department of Psychology Tianjin Huanhu Hospital Tianjin 300060 China department of neurosurgery Tianjin Neurological InstituteTianjin Medical University General Hospital Tianjin 300052China

Background Depression related cognitive deficits are frequently considered as simple epiphenomena of the disorder. However, whether or not the depression might directly bring about cognitive deficits is still under investigation. This study was to investigate the distinctpattern of cognitive deficits in patients with depression by comparing the cognitive function before and after anti-depressive drug therapy. Me^ods Sixty cases of patients, first-time diagnosed with depression, were assessed by 17-item Hamilton Rating Scale for Depression （HAMD17scale）The memory ability was tested by quantitatively clinical memory scale, while the attention ability by modified Ruff 2＆7 Selective Attention Test. Forty-two healthy volunteers were recruited as controls. The depressive patients were treated with Venlafaxine （75-300 mg/d）, Fluoxetine （20-40 mg/d）, Paroxetine （20-40 rag/d）, and Sertraline （50-150 mg/d）. After 12 weeks treatment, patients were tested again by HAMD17scale, quantitatively clinical memory scale, and modified Ruff 2＆7 selective attention test to assess the effect of anti-depressive drugs on cognitive deficits. Results The memory quotient （MQ） was significantly lowered in depressive patients. The selection speed was also significantly decreased and the number of missing and error hits increased in the depression group as compared to control. However, there was no significant difference in clinical memory scale and Ruff 2＆7 selective attention test between mild-to-moderate and severe depression group. Importantly, after anti-depressive drug therapy, the HAMD17 scale scores in depressive patients were significantly decreased, but the MQ, directional memory （DM）, free recall （FR）, associative learning （AL）, and face recognition were comparable with those before the treatment. Furthermore, the selection speed and the number of missing and error hits were also not significantly different after anti-depressive drugs treatment. Conclusions Depressive patients suffer f

关键词： cognitive deficits anti-depressive drugs depression attention memory

Clinical Decision on Disorders of Consciousness After Acquired Brain Injury:Stepping Forward

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Neuroscience Bulletin 2023年第1期39卷 138-162页

作者： Rui-Zhe Zheng Zeng-Xin Qi Zhe Wang Ze-Yu Xu Xue-Hai Wu Ying Mao department of neurosurgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai200040China National Center for neurological Disorders Shanghai200040China Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration Shanghai200040China Neurosurgical Institute of Fudan University Shanghai200040China Shanghai Clinical Medical Center of neurosurgery Shanghai200040China State Key Laboratory of Medical Neurobiology MOE Frontiers Center for Brain ScienceSchool of Basic Medical Sciences and Institutes of Brain ScienceFudan UniversityShanghai200032China

Major advances have been made over the past few decades in identifying and managing disorders of consciousness(DOC)in patients with acquired brain injury(ABI),bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific *** the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools,sophisticated neuroimaging,and electrophysiological techniques,a considerably higher diagnostic accuracy rate of DOC may now be *** the treatment of patients with DOC,a variety of intervention methods are available,including amantadine and transcranial direct current stimulation,which have both provided class II evidence,zolpidem,which is also of high quality,and non-invasive stimulation,which appears to be more encouraging than pharmacological ***,heterogeneity is profoundly ingrained in study designs,and only rare schemes have been recommended by authoritative *** is still a lack of an effective clinical protocol for managing patients with DOC following *** advance future clinical studies on DOC,we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of *** propose a preliminary clinical decision protocol,which could serve as an ideal reference tool for many medical institutions.

关键词： Clinical decision Disorders of consciousness Acquired brain injury Identification Management

Downregulation of miR-491-5p promotes neovascularization after traumatic brain injury

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Neural Regeneration Research 2022年第3期17卷 577-586页

作者： Wei Tang Zong-Duo Guo Wei-Na Chai Dong-Lin Du Xiao-Min Yang Lang Cao Hong Chen Chao Zhou Chong-Jie Cheng Xiao-Chuan Sun Zhi-Jian Huang Jian-Jun Zhong department of neurosurgery First Affiliated Hospital of Chongqing Medical UniversityChongqingChina department of Ophthalmology First Affiliated Hospital of Chongqing Medical UniversityChongqingChina

Micro RNA-491-5 p(miR-491-5 p) plays an important role in regulating cell proliferation and migration;however,the effect of miR-491-5 p on neovascularization after traumatic brain injury remains poorly *** this study,a controlled cortical injury model in C57 BL/6 mice and an oxygen-glucose deprivation model in microvascular endothelial cells derived from mouse brain were established to simulate traumatic brain injury in vivo and in vitro,*** the in vivo model,quantitative real-time-polymerase chain reaction results showed that the expression of miR-491-5 p increased or decreased following the intracerebroventricular injection of an miR-491-5 p agomir or antagomir,respectively,and the expression of miR-491-5 p decreased slightly after traumatic brain *** detect the neuroprotective effects of miR-491-p,neurological severity scores,Morris water maze test,laser speckle techniques,and immunofluorescence staining were assessed,and the results revealed that miR-491-5 p downregulation alleviated neurological dysfunction,promoted the recovery of regional cerebral blood flow,increased the number of lectin-stained microvessels,and increased the survival of neurons after traumatic brain *** the in vitro experiments,the potential mechanism of miR-491-5 p on neovascularization was explored through quantitative real-time-polymerase chain reaction,which showed that miR-491-5 p expression increased or decreased in brain microvascular endothelial cells after transfection with an miR-491-5 p mimic or inhibitor,***-luciferase reporter and western blot assays verified that metallothionein-2 was a target gene for miR-491-5 *** counting kit 8(CCK-8) assay,flow cytometry,and 2′,7′-dichlorofluorescein diacetate(DCFH-DA) assay results confirmed that the downregulation of miR-491-5 p increased brain microvascular endothelial cell viability,reduced cell apoptosis,and alleviated oxidative stress under oxygen-glucose deprivation conditions.C

关键词： brain injury cell migration cell proliferation endothelial cell hypoxia-inducible factor-1 alpha metallothionein 2 microRNA neovascularization neurons vascular endothelial growth factor

Adult Diffuse Intrinsic Pontine Glioma:Clinical,Radiological,Pathological,Molecular Features,and Treatments of 96 patients

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Adult Diffuse Intrinsic Pontine Glioma:Clinical,Radiological...

Inhibiting phosphatase and actin regulator 1 expression is neuroprotective in the context of traumatic brain injury

第十六届中国医师协会神经外科医师年会

作者： Yi Wang Changcun Pan Mingguo Xie Pengcheng Zuo Xiaoou Li Guocan Gu Tian Li Zhuang Jiang Zhen Wu Junting Zhang Liwei Zhang department of neurosurgery Beijing Tiantan HospitalCapital Medical University department of neurosurgery Sanbo Brain Hospital China National Clinical Research Center for neurological Diseases

*** its pediatric counterpart,adult diffuse intrinsic pontine glioma(DIPG) remains largely *** study examined the clinical,radiological,pathological,molecular,and clinical aspects of 96 adult *** National Brain Tumor Registry of China(2013/04-2019/12) was used to collect data on radiologically diagnosed adult DIPG *** analysis was conducted using the Kaplan–Meier Curve,univariate and multivariate Cox *** Chi-square test/Wilcoxon rank-sum test and multivariable logistic regression were used to examine the characteristics of long-term survival.P<0.05 was deemed *** median age at onset was 33.5 years,and the median duration of symptoms was 4.5 months.H3K27M and IDH1 mutations were 37.2% and 26.5%,*** patients had a median overall survival(OS) of 19.5 months,with 1-,2-and 3-year survival rates of 67.0%,42.8%,and 36.0%,*** patients with H3K27M showed a poorer prognosis than IDH-mutant patients(P<0.001) and H3K27M(-)/IDH-WT patients(P=0.002).The median OS of patients treated with RT+CT,RT/CT,and NO was 23.0 months,17.0 months,13.4 months respectively(P=0.097).The median OS of H3K27M patients who received the treatments and those who did not get treatments was 13.8 months and 7.5 months respectively(P=0.016).Short-term survival was related with cranial nerve palsy at diagnosis(OR,9.788;95%CI,2.242-42.731;P=0.002) and contrast enhancement in MRI(OR,7.741;95%CI,1.335-44.874;P=0.022).In patients with and without a pathological diagnosis,H3K27M(HR 8.084;95% CI 2.493-26.216;P<0.001) and contrast enhancement on MRI(HR 12.246;95% CI 2.356-63.650;P=0.003) both imparted a worse prognosis,*** were the predictive factor for H3K27M patients(P=0.038),whereas contrast enhancement in MRI was the prognostic factor for H3K27M(-) group(P=0.038).*** is recommended that all adult DIPG patients get genomic testing for H3K27M and IDH *** the

关键词： adult diffuse intrinsic pontine glioma prognosis H3K27M IDH mutation

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Neural Regeneration Research 2023年第7期18卷 1578-1583页

作者： Yao Jing Lin Zhang Shi-Wen Chen Yan Guo Shi-Ming Ju Fang Yuan Hao Chen Dian-Xu Yang Heng-Li Tian Zhi-Ming Xu Jun Ding department of neurosurgery Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina

Studies have found that the phosphatase actin regulatory factor 1 expression can be related to stroke,but it remains unclear whether changes in phosphatase actin regulatory factor 1 expression also play a role in traumatic brain *** this study we found that,in a mouse model of traumatic brain injury induced by controlled cortical impact,phosphatase actin regulatory factor 1 expression is increased in endothelial cells,neurons,astrocytes,and *** we overexpressed phosphatase actin regulatory factor 1 by injection an adeno-associated virus vector into the contused area in the traumatic brain injury mice,the water content of the brain tissue ***,when phosphatase actin regulatory factor 1 was knocked down,the water content *** also found that inhibiting phosphatase actin regulatory factor 1 expression regulated the nuclear factor kappa B signaling pathway,decreased blood-brain barrier permeability,reduced aquaporin 4 and intercellular adhesion molecule 1 expression,inhibited neuroinflammation,and neuronal apoptosis,thereby improving neurological *** findings from this study indicate that phosphatase actin regulatory factor 1 may be a potential therapeutic target for traumatic brain injury.

关键词： apoptosis aquaporin 4 blood brain barrier intercellular adhesion molecule 1 neuroinflammation nuclear factor kappa B occludin phosphatase and actin regulator-1 traumatic brain injury zonula occludens 1

endovascular treatment with or without intravenous alteplase for acute ischaemic stroke due to basilar artery occlusion

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Stroke & Vascular Neurology 2022年第3期7卷 190-199页

作者： Ximing Nie David Wang Yuehua Pu Yufei Wei Qixuan Lu Hongyi Yan Xin Liu Lina Zheng Jingyi Liu Xinxuan Yang Yarong Ding Dacheng Liu Wanying Duan Zhe Zhang Zhonghua Yang Miao Wen Weibin Gu Xinyi Hou Xinyi Leng Yuesong Pan Zhongrong Miao Liping Liu department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for neurological Diseases BeijingChina Neurovascular Division Department of NeurologyBarrow Neurological InstitutePhoenixArizonaUSA department of Medicine and Therapeutics Prince of Wales HospitalHong KongChina department of Radiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of Interventional Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina

Background and purpose It remains controversial if endovascular treatment(EVT)can improve the outcome of patients with acute basilar artery occlusion(BAO).This study aims to compare the functional outcomes between EVT with and without intravenous thrombolysis(IVT)first in patients who had acute ischaemic stroke(AIS)due to *** Patients who had AIS with BAO who underwent EVT within 24 hours of onset were enrolled in this multicentre cohort study,and the efficacy and safety were compared between IVT+EVT and direct *** primary outcome was 90-day functional *** outcomes were assessed with adjusted OR(aOR)from the multivariable logistic *** addition,a meta-analysis was performed on all recently published pivotal studies on functional independence after EVT in patients with *** Of 310 enrolled patients with BAO,241(78%)were treated with direct EVT and 69(22%)with IVT+*** EVT was associated with a worse functional outcome(aOR,0.46(95%CI 0.24 to 0.85),p=0.01).IVT+EVT was associated with a lower percentage of patients who needed≥3 passes of stent retriever(10.14%vs 20.75%).The meta-analysis regression revealed a potential positive correlation between bridging with IVT first and functional independence(r=0.14(95%CI 0.05 to 0.24),p<0.01).Conclusions This study showed that compared with direct EVT,EVT with IVT first was associated with better functional outcomes in patients with BAO treated within 24 hours of *** meta-analysis demonstrated similar favourable efficacy of IVT first followed by EVT in patients with BAO.

关键词： acute intravenous occlusion

A thermodynamic model showing that information recording can drive active ion transport

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Signal Transduction and Targeted therapy 2023年第5期8卷 2058-2060页

作者： Xiang Zou Kun Song Minbiao Ji Lingzhao Min Liangfu Zhou Ying Mao Liang Chen department of neurosurgery Neurosurgical Institute of Fudan UniversityNational Center for Neurological DisordersHuashan HospitalFudan UniversityShanghai200040China department of Physics Fudan UniversityShanghai200433China State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science School of Basic Medical Sciences and Institutes of Brain ScienceFudan UniversityShanghai200040China

Dear Editor,Ion gradients are characteristic features of a living cell that do not represent thermodynamic *** unequilibrium status are maintained by various ion pumps such as Na-K-ATPase,which are known as the P-type *** mechanism of Na-K-ATPase is described as Post-Albers cycle1(Fig.1a).However,the reaction scheme is non-Michaelis-Menten kinetics assembled from transient-state results,which can hardly be used to rebuild the real reaction cycle.

关键词： recording maintained showing