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Background: Classic trigeminal neuralgia (CTN) seriously affects patients' quality of life. Percutaneous balloon compression (PBC) is a surgical program for treating trigeminal neuralgia. But some patients are ineffective or relapse after treatment. The aim is to use machine learning to construct clinical imaging models to predict relapse after treatment (PBC). Methods: The clinical data and intraoperative balloon imaging data of CTN from January 2017 to August 2023 were retrospectively analyzed. The relationship between least absolute shrinkage and selection operator and random forest prediction of PBC postoperative recurrence, ROC curve and decision -decision curve analysis is used to evaluate the impact of imaging histology on TN recurrence. Results: Imaging features, like original_shape_Maximum2D, DiameterRow, Original_Shape_Elongation, etc. predict the prognosis of TN on PBC. The areas under roc curve were 0.812 and 0.874, respectively. The area under the ROC curve of the final model is 0.872. DCA and calibration curves show that nomogram has a promising future in clinical application. Conclusion: The combination of machine learning and clinical imaging and clinical information has the good potential of predicting PBC in CTN treatment. The efficacy of CTN is suitable for clinical applications of CTN patients after PBC. [ABSTRACT FROM AUTHOR]

To predict the volume and shape of the balloon before PBC by reconstructing the Meckel's cave (MC) and establishing a volumetric measurement model, supporting preoperative preparation and intraoperative decisions.Methods: The clinical data of 31 patients with good therapeutic effects who underwent PBC are retrospectively collected, including preoperative MRI, the volume of contrast agent injected into the balloon, and intraoperative lateral X-ray images. The MC on the affected side of the 31 patients is reconstructed based on MRI using 3D Slicer, while the volume of the MC is calculated to compare with the volume of contrast agent. The width (W) and length (L) of the model of the MC in lateral view are measured and used to classify the shape of the MC based on W/L. The consistency between the W/L of the model of the MC and the W/L of the intraoperative balloon is evaluated.Results: For volume, the mean value of the models of the MC (V1) in 31 patients is 399.77± 155.13 mm³, while the mean value of the contrast agent injected during PBC (V2) is 539.03± 111.93 mm³. The formula obtained by linear regression is V2= 392.1 + 0.3676×V1. Based on the value of W/L, the shape of the MC is classified into thin "pear" in 5 patients (16.13%), standard "pear" in 22 patients (70.97%), and square "pear" in 4 patients (12.90%). There is no significant difference in W/L between the models of the MC and the intraoperative balloons in 31 patients (P=0.221).Conclusion: In 31 patients with good efficacy, it is verified that the prediction of the MC before PBC by 3D Slicer is consistent with the actual situation of the intraoperative balloon. This method can provide certain basis for preoperative preparation and intraoperative judgment. [ABSTRACT FROM AUTHOR]

Background: Vertebrobasilar dolichoectasia (VBD) is one of the rare causes of trigeminal neuralgia (TN). The common surgical treatments for patients with TN caused by VBD (VBD-TN) are microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically compared, so this study was performed to evaluate the treatment outcomes of MVD and GKRS for patients with VBD-TN. Methods: The retrospective study was performed from March 2011 to March 2019 in Wuhan Union Hospital. A total of 80 patients diagnosed with VBD-TN were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. The imaging data, intraoperative findings, treatment outcomes, and complications of the two groups were analyzed and compared. Meanwhile, the influencing factors of the treatment effect are also explored on the two groups. Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, respectively, p = 0.03). The median follow-up was 61.1 months for the MVD group and 56.8 months for the GKRS group. The favorable outcomes [Barrow Neurological Institute (BNI) pain score, BNI scores I–II] occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (p = 0.009). The favorable outcomes in the percentage of patients after MVD 1, 3, 5, and 7 years were 95.7, 85.1, 74.2, and 74.2%, respectively, whereas the corresponding percentages after GKRS were 76.5, 66.2, 56.6, and 47.2%, respectively (p = 0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (p = 0.036), but the incidence of new and worsening facial numbness was lower in the GKRS group (p < 0.001). Conclusions: MVD is superior to GKRS in obtaining and maintaining favorable outcomes for patients with VBD-TN, but it also comes with more complications other than facial numbness. Thus, the treatment program can be tailored to a patient's unique condition and wishes. [ABSTRACT FROM AUTHOR]

The blood-brain barrier (BBB) is an essential structure of the central nervous system (CNS), and its existence makes the local internal environment of the CNS a relatively independent structure distinct from other internal environments of the human body to ensure normal physiological and high stability of activities of the CNS. Changes in BBB structure and function are fundamental to the pathophysiology of many diseases. The occurrence and development of glioma are often accompanied by a series of changes in the structure and function of the internal environment, the most significant of which is remodelling of the BBB. The remodelling of the BBB usually leads to changes in the permeability of local microvessels, which provide certain favourable conditions for the occurrence and development of glioma. Meanwhile, the newly generated abnormal blood vessels and the remaining intact regions of the BBB also hinder the effects of drug treatments. Changes in permeability and structural function often lead to the creation of abnormally functioning vascular regions, which pose further treatment challenges. At present, therapeutic methods for glioma have not achieved satisfactory effects in clinical practice, and emerging therapeutic methods have not yet been widely used in clinical practice. In this review, we summarize the knowledge of remodelling of the BBB in the glioma environment, the type of changes that occur, and current BBB treatment methods and prospects for the treatment of glioma. [ABSTRACT FROM AUTHOR]

Background: Glioma is a primary malignancy of the central nervous system (CNS). As biomedicine advances, an efficient molecular target is urgently needed for the diagnosis and treatment of glioma. Meanwhile, several studies have demonstrated that glioma development is closely related to immunity. PARP9 is an inactive mono‐ADP‐ribosyltransferase belonging to the poly‐ADP ribosyltransferase (ARTD) family. In this article, we aimed to reveal the relationship between PARP9 and glioma and explore the potential prognostic value and immunotherapeutic targetability of PARP9 in glioma. Methods: PARP9 transcript levels were analyzed with TCGA and GEO databases. The clinicopathological information of patients with glioma in the TCGA database and gene expression profiles were analyzed to determine the relationship between the expression of PARP9 and clinicopathologic characteristics. Kaplan‐Meier survival analysis, univariate Cox regression analysis, and multivariate Cox regression analysis were used for survival analysis. Gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) were used for bioinformatics analysis. Correlation analysis explored the relationships between PARP9, infiltrating inflammatory immune cells, and immune checkpoint molecules. Results: PARP9 is highly expressed in glioma, and high expression of PARP9 is associated with poor prognosis and advanced clinicopathological features. Bioinformatics analysis showed that some immune‐related pathways were closely associated with high expression of PARP9. Correlation analysis indicated that PARP9 was closely related to inflammatory and immune responses, high immune cell infiltration, and immune checkpoint molecules. Conclusions: PARP9 may serve as an unfavorable prognosis predictor for glioma and a potential immunotherapeutic target. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic isolated caudate lobectomy remains a challenging procedure because of its deep location and proximity to the important vessels. We present a novel technique, Arantius ligament suspension, which could improve operative field exposure in laparoscopic isolated caudate lobectomy through retraction of the left lateral lobe liver.Materials and Methods: The Arantius ligament suspension technique was performed in 6 selected patients during laparoscopic isolated caudate lobectomy in our center: 2 with symptomatic hepatic cavernous hemangioma and 4 with hepatocellular carcinoma (HCC). The Arantius ligament suspension technique was performed using a 2-0 polypropylene suture (Prolen2-0®; Ethicon, Somerville, NJ), which was secured to the Arantius ligament with surgical clips at its halfway point and the left lateral lobe of liver would be retracted toward the abdominal wall when the suture was tightened. Perioperative data of these patients and follow-up data of HCC patients were retrospectively reviewed.Results: All 6 procedures were completed without conversion to open surgery or requiring additional ports. The mean tumor size was 5.4 cm (2.2-7.8 cm), the mean blood loss was 260 mL (50-440 mL), and no patients required blood transfusion during the operation. The mean time required for this technique was 2 minutes 5 seconds (1 minutes 36 seconds-2 minutes 44 seconds) and the mean duration of entire surgery was 249 minutes (173-300 minutes). The mean postoperative hospital stay was 7 days (5-9 days) and no postoperative complication related to the suspension procedure occurred.Conclusions: Our outcomes demonstrated the Arantius ligament suspension technique is a feasible and ideal method during laparoscopic isolated caudate lobectomy for providing a rapid and safe left lateral lobe retraction. [ABSTRACT FROM AUTHOR]