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OBJECTIVES We reviewed our institutional experience during a 10-year period for improvement of safety and efficacy of stereotactic biopsy procedures. METHODS We performed a retrospective review of inpatient summaries, stereotactic worksheets and radiologic investigations of 208 consecutive patients, who underwent MRI-guided stereotactic biopsies between March 2010 and March 2020. RESULTS The overall diagnostic yield was 96.2%. CT-confirmed intracranial hemorrhage occurred in 17 patients (8.2%), and the overall mortality rate was 0.5%. Combined MRS and PWI helped target selection in 27 cases (13.0%), the diagnostic yield was 100%. The results of the regression analysis revealed that non-diagnostic biopsy specimen significantly correlated with the cystic trait (p

To study the feasibility of plasma extracellular vesicles (EVs) miRNAs as diagnostic biomarkers for Parkinson's disease (PD).Plasma EVs were isolated from 30 PD patients and 30 age- and sex-matched healthy controls. Plasma EVs miRNAs were analysed by qRT-PCR. SH-SY5Y cells were induced by different concentrations of 1-Methyl-4-phenil-pyridinium (MPPThe level of hsa-miR-30c-2-3p in plasma EVs was significantly higher in PD patients than that in controls, and the levels of hsa-miR-15b-5p, hsa-miR-138-5p, hsa-miR-338-3p, hsa-miR-106b-3p and hsa-miR-431-5p in plasma EVs were lower in PD patients than that in controls. When compared with the control group, the area under the curve (AUC) values for hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p, hsa-miR-431-5p, hsa-miR-338-3p and hsa-miR-106b-3p were all greater than 0.6. The target genes of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-338-3p were enriched in dopaminergic synapse and PD pathway.The hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p, hsa-miR-106b-3p, hsa-miR-338-3p and hsa-miR-431-5p may be used as potential biomarkers for the diagnosis of PD, and the combined diagnostic accuracy of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-106b-3p was better. The target genes of hsa-miR-15b-5p, hsa-miR-30c-2-3p, hsa-miR-138-5p and hsa-miR-338-3p may regulate the expression of dopamine by dopaminergic synapse and PD pathway.HighlightsIsolation and identification of plasma EVs.The miRNAs in plasma EVs may be used as potential biomarkers for the diagnosis of PD.When SH-SY5Y cells were induced by different concentrations of MPP

Glioma is the most common malignant tumor in the central nervous system. Altered long noncoding RNAs (lncRNAs) are playing regulatory roles in physiological and pathogenic processes in cancer. Here, we uncovered a differentially expressed lncRNA called brain cytoplasmic RNA 1 (BCYRN1), and elucidated its function and molecular mechanism in the progression and development of glioma. Three fresh tumor tissues from glioma patients and three normal brain tissues from craniocerebral trauma patients were prepared for high-throughput RNA sequencing. Differential RNA transcripts and BCYRN1 were identified by RT-qPCR in glioma samples and controls. CCK-8, colony formation assays, flow cytometry, TUNEL assays, cell migration assays, wound-healing assays, and xenograft model were established to investigate the biological function of BCYRN1 both in vitro and in vivo. Various bioinformatics analysis, dual-luciferase reporter assays, biotinylated RNA pulldown assays, and rescue experiments were conducted to reveal the underlying mechanisms of competitive endogenous RNAs (ceRNAs). 183 lncRNAs were identified with significant dysregulation in glioma and randomly selected differential RNAs were further confirmed by RT-qPCR. Among them, BCYRN1 was the most downregulated lncRNA, and its low expression positively correlated with glioma progression. Functionally, BCYRN1 overexpression inhibited cell proliferation, migration in glioma cell lines, whereas BCYRN1 depletion resulted in the opposite way. MiR-619-5p was further confirmed as the direct target of BCYRN1. Mechanistically, miR-619-5p specifically targeted the CUE domain containing protein 2 (CUEDC2), and BCYRN1/miR-619-5p suppressed glioma tumorigenesis by inactivating PTEN/AKT/p21 pathway in a CUEDC2-dependent manner. Overall, our data presented that the reduced expression of BCYRN1 was associated with poor patient outcome in glioma. BCYRN1 functioned as a ceRNA to inhibit glioma progression by sponging miR-619-5p to regulate CUEDC2 expression and PTEN/AKT/p21 pathway. Our results indicated that BCYRN1 exerted tumor suppressor potential and might be a candidate in the diagnosis and treatment of glioma.

Objectives Diffusion tensor imaging (DTI) has been used to detect microstructural alteration and effect of surgical treatment of the trigeminal nerve root (TR) in patients with classical trigeminal neuralgia (CTN) underwent microvascular decompression (MVD). Patients with CTN without neurovascular compression (woNVC) is a special population of TN, however, the pathogenesy of CTN woNVC and the mechanism of internal neurolysis (IN) remain unknown. Materials and methods 21 patients with CTN woNVC who underwent IN and 20 healthy controls were included in this study. The differences in the means, kurtosis and skewness of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between the affected and unaffected nerves in patients and both nerves in controls were investigated by independent t-test and paired t-test respectively. Longitudinal changes of FA and ADC were correlated with outcome of IN via Spearman correlation coefficient. Results Significant differences were found in preoperative mean and kurtosis values for both FA and ADC of the affected side TR, compared to the unaffected side and control group respectively. However, these differences remarkably reduced postoperatively. Further, the Spearman correlation coefficient showed a strong negative correlation between decrease of ADC in the affected side and the surgical outcome in BNI total score. Conclusion The changes of diffusive property of TR, especially the FA and ADC, provide alternative radiological evidence for evaluating the mechanism of CTN woNVC. The modification of DTI metrics could be an effective factor for providing potential noninvasive biomarkers for determining the prognosis of patients with CTN woNVC underwent IN.

Objective: To investigate the efficacy and safety of percutaneous balloon compression (PBC) for the treatment of trigeminal neuralgia in elderly patients. Methods: We retrospectively analysed data ...

Glioblastoma (GBM) patients have extremely poor prognoses, and currently no effective treatment available including surgery, radiation, and chemotherapy. MAPK-interacting kinases (MNK1/2) as the downstream of the MAPK-signaling pathway regulate protein synthesis in normal and tumor cells. Research has shown that targeting MNKs may be an effective strategy to treat GBM. In this study we investigated the antitumor activity of osimertinib, an FDA-approved epidermal growth factor receptor (EGFR) inhibitor, against patient-derived primary GBM cells. Using high-throughput screening approach, we screened the entire panel of FDA-approved drugs against primary cancer cells derived from glioblastoma patients, found that osimertinib (3 μM) suppressed the proliferation of a subset (10/22) of EGFR-negative GBM cells (>50% growth inhibition). We detected the gene expression difference between osimertinib-sensitive and -resistant cells, found that osimertinib-sensitive GBM cells displayed activated MAPK-signaling pathway. We further showed that osimertinib potently inhibited the MNK kinase activities with IC(50) values of 324 nM and 48.6 nM, respectively, against MNK1 and MNK2 kinases; osimertinib (0.3–3 μM) dose-dependently suppressed the phosphorylation of eukaryotic translation initiation factor 4E (eIF4E). In GBM patient-derived xenografts mice, oral administration of osimertinib (40 mg· kg(−1) ·d(−1), for 18 days) significantly suppressed the tumor growth (TGI = 74.5%) and inhibited eIF4E phosphorylation in tumor cells. Given the fact that osimertinib could cross the blood–brain barrier and its toxicity was well tolerated in patients, our results suggest that osimertinib could be a new and effective drug candidate for the EGFR-negative GBM patients.

Intracranial aneurysm (IA) is recognized as a lethal form of cerebrovascular disease mainly featured with a modulated phenotype of vascular smooth muscle cells (SMCs). It is generally believed that enhanced SMC proliferation and migration capabilities are the main characteristics in this process. In this study, we revealed that microRNA-4735 (miR-4735) participates in phenotypic modulation in a hypoxia-inducible factor-1 (HIF-1)-dependent manner of SMCs. miR-4735 targets the 3'-untranslated region of HIF-1. The downregulated expression of miR-4735 in IA tissues leads to elevated expression of HIF-1, which activates autophagy and promotes autophagy-mediated SMC proliferation and migration. Overexpression of miR-4735 suppressed HIF-1 expression and HIF-1-mediated autophagy, which led to impaired SMC proliferation and migration abilities. Forced expression of HIF-1 in miR-4735-overexpressed SMCs rescued the impaired SMC proliferation and migration abilities. In conclusion, miR-4735 plays an important role in phenotypic modulation in IA by regulating autophagy-promoted SMC proliferation and migration.

Spinal epidural angiolipomas are rare lesions composed of mature lipomatous and angiomatous elements. In this paper, the authors review a surgical series of ten patients with epidural angiolipomas. All patients had performed preoperative and postoperative magnetic resonance imaging. The diagnosis of angiolipoma was based on pathology. All the follow-up data were obtained during office visits. There were 5 males and 5 females with a mean age of 53.6 years. One tumor was located in the cervicothoracic, six in the thoracic, and three in the lumbar spine. The most common symptom was progressive motor deficit. Gross total resection of the tumor was achieved in nine cases, and subtotal resection was obtained in one case. No recurrence or regrowth of the residual tumor was observed during a follow-up period of 50.8 months. At the last follow-up, 90% of patients experienced improvement in the neurological function. Epidural angiolipomas are benign but clinically progressive lesions. Early surgery should be performed to prevent irreversible neurological deficits. Postoperative radiotherapy is not recommended. The risk of long-term recurrence/regrowth of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected.

Gliomas are the most common malignant primary brain tumors with poor prognosis. We attempted to explore the role of CYP17A1 in glioma progression. We demonstrated that the expression of CYP17A1 was significantly higher in the glioma tissues than the normal brain tissues, especially in malignant glioma. Moreover, the expression of CYP17A1 gene was positively correlative with glioma pathological grades. In vitro, CYP17A1 gene silence inhibited the proliferation and invasion of glioma cells and promoted the apoptosis in glioma cells. Also, the subcutaneously transplanted tumour in BALB/C-nu showed that CYP17A1 gene silence inhibited glioma growth. These results reveal that CYP17A1 plays a major role in the progress of glioma.

The Wnt/Frizzled signaling pathway participates in many inflammation-linked diseases. However, the inflammatory response mediated by the Wnt/Frizzled signaling pathway in experimental subarachnoid hemorrhage has not been thoroughly investigated. Consequently, in this study, we examined the potential role of the Wnt/Frizzled signaling pathway in early brain injury in rat models of subarachnoid hemorrhage. Simultaneously, possible neuroprotective mechanisms were also investigated. Experimental subarachnoid hemorrhage rat models were induced by injecting autologous blood into the prechiasmatic cistern. Experiment 1 was designed to examine expression of the Wnt/Frizzled signaling pathway in early brain injury induced by subarachnoid hemorrhage. In total, 42 adult rats were divided into sham (injection of equivalent volume of saline), 6-, 12-, 24-, 48-, 72-hour, and 1-week subarachnoid hemorrhage groups. Experiment 2 was designed to examine neuroprotective mechanisms of the Wnt/Frizzled signaling pathway in early brain injury induced by subarachnoid hemorrhage. Rats were treated with recombinant human Wnt1 (rhwnt1), small interfering Wnt1 (siwnt1) RNA, and monoclonal antibody of Frizzled1 (anti-Frizzled1) at 48 hours after subarachnoid hemorrhage. Expression levels of Wnt1, Frizzled1, β-catenin, peroxisome proliferator-activated receptor-γ, CD36, and active nuclear factor-κB were examined by western blot assay and immunofluorescence staining. Microglia type conversion and inflammatory cytokine levels in brain tissue were examined by immunofluorescence staining and enzyme-linked immunosorbent assay. Our results show that compared with the sham group, expression levels of Wnt1, Frizzled1, and β-catenin were low and reduced to a minimum at 48 hours, gradually returning to baseline at 1 week after subarachnoid hemorrhage. rhwnt1 treatment markedly increased Wnt1 expression and alleviated subarachnoid hemorrhage-induced early brain injury (within 72 hours), including cortical cell apoptosis, brain edema, and neurobehavioral deficits, accompanied by increasing protein levels of β-catenin, CD36, and peroxisome proliferator-activated receptor-γ and decreasing protein levels of nuclear factor-κB. Of note, rhwnt1 promoted M2-type microglia conversion and inhibited release of inflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-α). In contrast, siwnt1 RNA and anti-Frizzled1 treatment both resulted in an opposite effect. In conclusion, the Wnt/Frizzled1 signaling pathway may participate in subarachnoid hemorrhage-induced early brain injury via inhibiting the inflammatory response, including regulating microglia type conversion and decreasing inflammatory cytokine release. The study was approved by the Animal Ethics Committee of Anhui Medical University and First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (approval No. LLSC-20180202) in May 2017.

Yin-gang Wu,1,2 Yingjiu Chao,1 Ge Gao,1 Dejun Bao,1 Yongfei Dong,1 Xiangpin Wei,1 Chaoshi Niu1,2 1Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 2Brain Function and Brain Disease Anhui Provincial Key Laboratory, Hefei, Anhui, 230001, People’s Republic of ChinaCorrespondence: Chaoshi NiuDepartment of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of ChinaTel +86 18963788788Email niuchaoshi@126.comPurpose: Posttraumatic cerebral infarction (PTCI) is a common and relatively serious complication of traumatic brain injury (TBI) without a clear etiology. Evaluating risk factors in advance is particularly important to predict and avoid the occurrence of PTCI.Patients and Methods: We retrospectively analyzed 297 patients with moderate to severe TBI admitted to the Department of Neurosurgery in our hospital from January 2019 to September 2020 and evaluated the effects of various factors such as age, sex, admission Glasgow Coma Scale (GCS), skull base fracture, subarachnoid hemorrhage (SAH), brain herniation, hypotensive shock, and decompressive craniectomy on the incidence of PTCI. We also performed a multivariate logistics regression analysis on the relevant factors identified and evaluated the diagnostic value of each risk factor in advance by receiver operating characteristic (ROC) analyses.Results: Among the patients, 32 (10.77%) suffered PTCI. The incidence rates of PTCI in those with GCS scores of 3– 8 and 9– 12 were 15.87% (30/189) and 1.85% (2/108), respectively, while the rates were 18.84% (13/69), 15.03% (29/193), 18.57% (13/70), and 20.59% (14/68) in those with skull base fractures, traumatic SAH, brain herniation, and hypotensive shock, respectively, and 14.38% (23/160) in those who underwent decompressive craniectomy. These differences in PTCI incidence were statistically significant. However, the differences in PTCI incidence caused by patient age and sex were not statistically significant.Conclusion: Low GCS score, skull base fractures, traumatic SAH, brain herniation, hypotensive shock, and decompressive craniectomy are risk factors for the occurrence of PTCI, while age and sex are not significantly correlated with the occurrence of PTCI.Keywords: moderate or severe traumatic brain injury, posttraumatic cerebral infarction, risk factor

Background and Objective Trigeminal neuralgia is a common neurologic disease that seriously impacts a patient's quality of life. We retrospectively investigated the efficacy and safety of internal neurolysis (nerve combing) for trigeminal neuralgia without vascular compression. Patients and Methods This study was a retrospective review of all patients with trigeminal neuralgia who were admitted between January 2014 and February 2019. A subgroup of 36 patients had no vascular compression at surgery and underwent internal neurolysis. Chart review and postoperative follow-up were performed to assess the overall outcomes of internal neurolysis. Results Thirty-six patients were identified, with a mean age of 44.89 ± 7.90 (rang: 31–65) years and a disease duration of 5.19 ± 2.61 years. The immediate postoperative pain relief (Barrow Neurological Institute [BNI] pain score of I or II) rate was 100%. The medium- to long-term pain relief rate was 91.7%. Three patients experienced recurrence. Facial numbness was the primary postoperative complication. Four patients with a score of III on the BNI numbness scale immediately after surgery had marked improvement at 6 months. No serious complications occurred. Conclusion Internal neurolysis is a safe and effective treatment for trigeminal neuralgia without vascular compression or clear responsible vessels.

Sleep disorders and multiple sensory impairments have been noticed as the potential first sign of neurodegenerative diseases such as the Parkinson disease. The relationship between sleep quality and the sensory neural basis would help us consider their combination in early diagnosis. In the present study, 32 out of 45 healthy subjects' resting-state functional magnetic resonance imaging data survived from motion correction and entered into the connectivity analysis. We found that the connectivity between two regions of interest (the left olfactory gyrus and the left superior temporal pole) and the regional homogeneity in the left middle temporal gyrus were negatively correlated with their Pittsburgh sleep quality index. These results suggest that these sensory-related brain regions are related to sleep quality and they may together predict the diseases.

We report a case of cholesteatoma that caused left facial pain with facial numbness. The tumour was located in the left cerebellopontine angle (CPA) and Meckel's cave. A balloon was first placed into Meckel's cave, and then, under electrophysiological monitoring, the tumour within the CPA cistern was resected via the retrosigmoid approach. The balloon was inflated in Meckel's cave to push the tumour out of Meckel's cave, and then, the tumour was completely removed under endoscopy. The symptoms, including pain and numbness, subsided after surgery.

Purpose Previous researches have reported gray and white matter microalterations in primary trigeminal neuralgia (TN) with neurovascular compression (NVC). The central mechanism underlying TN without NVC are unknown but may include changes in specific brain regions or circuitries. This study aimed to investigate abnormalities in the gray matter (GM) and white matter (WM) of the whole brain and the possible pathogenetic mechanism underlying this disease. Methods We analyzed brain morphologic images of TN patients, 23 with NVC (TN wNVC) and 22 without NVC (TN wNVC) compared with 45 healthy controls (HC). All subjects underwent 3T-magnetic resonance imaging and pain scale evaluation. Voxel-based morphometry (VBM) and surface-based morphometry (SBM) were used to investigate whole brain grey matter quantitatively; graph theory was applied to obtain network measures based on extracted DTI data based on DTI data of the whole brains. Sensory and affective pain rating indices were assessed using the visual analog scale (VAS) and short-form McGill Pain Questionnaire (SF-MPQ). Results The VBM and SBM analyses revealed widespread decreases in GM volume and cortical thickness in TN wNVC compared to TN woNVC, and diffusion metrics measures and topology organization changes revealed DTI showed extensive WM integrity alterations. However, above structural changes differed between TN wNVC and TN woNVC, and were related to specific chronic pain modulation mechanism. Conclusion Abnormalities in characteristic regions of GM and WM structural network were found in TN woNVC compared with TN wNVC group, suggesting differences in pathophysiology of two types of TN.

Background: Glioma is the most common primary malignant intracranial tumor with poorly clinical prognosis in adults. Accumulating evidences indicate that long non-coding RNAs (lncRNAs) have served as important regulators in cancer progression, including glioma. Here, we identified a new lncRNA LPP antisense RNA-2 (LPP-AS2) and investigated its function and mechanism in the occurrence and development of glioma.Methods: High-throughput RNA sequencing was performed to discriminate the differentially expression lncRNAs and mRNAs between glioma tissues and normal brain tissues. The expression of LPP-AS2, epidermal growth factor receptor (EGFR) and miR-7-5p in glioma tissues and cell lines were detected by real-time quantitative PCR (RT-qPCR). The functions of lncRNA LPP-AS2 in glioma were measured by in vivo and in vitro assays. Insights of the underlying mechanism of competitive endogenous RNAs (ceRNAs) were originated from bioinformatic analysis, dual luciferase reporter assays, RNA pulldown assays, RNA immunoprecipitation (RIP) and rescue experiments. Results: The results of high-throughput RNA-seq indicated that lncRNA LPP-AS2 was upregulated in glioma tissues and further confirmed by RT-qPCR. Higher LPP-AS2 expression was related to poor prognosis of glioma patients. Functional studies illustrated that LPP-AS2 depletion inhibited glioma cell proliferation, invasion and promoted apoptosis in vitro and restrained tumor growth in vivo, whereas overexpression of LPP-AS2 resulted in opposite effects. In addition, LPP-AS2 and EGFR were observed of co-expression networks, and LPP-AS2 functioned as a ceRNA to regulate EGFR expression by sponging miR-7-5p in glioma cells. Result of chromatin immunoprecipitation (ChIP) assay validated that c-MYC was directly bind with promoter region of LPP-AS2. As a downstream protein of EGFR, c-MYC was modulated by LPP-AS2 and in turn increased LPP-AS2 expression. Thus, lncRNA LPP-AS2 promoted glioma tumorigenesis via a miR-7-5p/EGFR/PI3K/AKT/c-MYC feedback loop. Conclusions: Our study elucidated that LPP-AS2 acted as an oncogene through a novel molecular pathway in glioma and might be a potential therapeutic approach for glioma diagnosis, therapy and prognosis.

Symptoms of Parkinson’s diseases are very complex with great individual differences. However, clinical diagnosis of PD now still depends on subjective observation limited to motor symptoms. Furthermore, screening of advantageous therapies to different indications is in short of an objective index. Can biomarkers help us predict individual PD symptoms and treatment effects? This review emphasized individual differences in PD symptoms and in therapeutic effects at first. Then we reviewed potential clinical biomarkers. Finally, machine learning as well as currently popular algorithms was reviewed as a practical tool in biomarkers screening. The review points out that the direction of future studies on biomarker screening is individual differences and robustness, which can be achieved with machine learning.

Background Microvascular decompression is the most effective treatment for hemifacial spasm. However, when encountering hemifacial spasm associated with vertebral artery (VA), the procedure is more challenging and requires complicated operation techniques. The authors retrospectively analyzed the clinical characteristics of this group of cases and investigated reasonable transposition procedures for different anatomic classifications. Methods We retrospectively analyzed 117 cases that underwent their first microvascular decompression for hemifacial spasm between June 2010 and December 2016, which had all associated with vertebral artery compression diagnosed by preoperational radiology examination. The study first classified offending vessels into 3 types according to operative anatomy and designed personalized decompression management according to different forms of neurovascular conflict. Curative effects and complications were assessed. Results The offending vessels were artificially divided into 3 types according to both arterial pattern and compression direction: 1) ipsilateral VA plus anterior inferior cerebellar artery compressing the facial nerve from the ventrolateral direction in 72 (61.5%) cases; 2) ipsilateral VA plus posterior inferior cerebellar artery compressing the facial nerve from the caudal-medial direction in 31 (26.5%) cases; 3) bilateral VA compressing the facial nerve in 14 (12.0%) cases. We selected corridors to expose the neurovascular conflict site between the suprafloccular-transhorizontal fissure approach and subtonsillar-transcerebellomedullary fissure approach. The methods of decompression consist of anteromedial and posterolateral transposition by using biomedical glue−coated Teflon sling. Sufficient decompression of the offending vessels was safely performed in all cases. All cases had total relief of symptoms immediately after their operations. Follow-up periods ranged from 16–90 months, and total recovery occurred in 110 cases (94.0%). In 7 cases (6.0%), 90% recovery occurred. Conclusions Accuracy and comprehensive recognition of anatomic features of the offending vessels are crucial for the management of hemifacial spasm associated with vertebral artery compression. Appropriate approaches combined with the biomedical glue−coated Teflon sling transposition technique can allow adequate mobilization of the vertebral artery and bring complete postoperative symptom relief for most cases.

Background: Internal neurolysis (IN) is an effective surgical treatment for trigeminal neuralgia (TN) without neurovascular compression (NVC) or postoperative recurrence. However, the trigeminal nerve is directly manipulated during the procedure, and there is a high incidence of trigeminocardiac reflex (TCR). The aim of this study was to retrospectively analyze the outcome of IN and to explore its relationship with the occurrence of intraoperative TCR. Methods: Surgical and anesthesia records of 27 TN patients who underwent surgical treatment with IN at our department between March 2010 and September 2016 were retrospectively analyzed. Patients were divided into 2 groups on the basis of the occurrence of TCR during surgery, and clinical characteristics were compared. Pain intensity was assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. Results: TCR was observed in 23 of 27 patients (85.2%); it manifested as obvious changes in mean arterial pressure and heart rate by at least 20% of the baseline values. Trigeminal nerve atrophy was found in 9 patients (33.3%). The immediate pain-free rate was 96.3%, and the “excellent” rate was 72.1% for follow-up, with a rate of numbness or hypesthesia of 97.1%. These outcomes were retrospectively compared between the TCR and non-TCR groups, and there was a nonsignificantly higher “excellent” rate in the TCR group than in the non-TCR group. Conclusions: This study demonstrated that IN is an effective treatment for TN without NVC and has a close relationship with intraoperative TCR. To our knowledge, this is the first research describing TCR during IN.

Objective Deep brain stimulation (DBS) for treatment of advanced Parkinson’s disease (PD) has two anatomical targets: the subthalamic nucleus (STN) and the globus pallidus internus (GPI). The clinical effectiveness of these two stimulation targets was compared in the present study. Methods A systematic review and meta-analysis was performed to evaluated the postoperative changes in the United Parkinson’s Disease Rating Scale (UPDRS) on- and off-phase, on-stimulation motor scores; activities of daily living score (ADLS); and levodopa equivalent dose (LED) after STN and GPI stimulation. Randomized and nonrandomized controlled trials of PD treated by STN and GPI stimulation were considered for inclusion. Results Eight published reports of eligible studies involving 599 patients met the inclusion criteria. No significant differences were observed between the STN and GPI groups in the on-medication, on-stimulation UPDRS motor score [mean difference, 2.15; 95% confidence interval (CI), −0.96–5.27] or ADLS (mean difference, 3.40; 95% CI, 0.95–7.76). Significant differences in favor of STN stimulation were noted in the off-medication, on-stimulation UPDRS motor score (mean difference, 1.67; 95% CI, 0.98–2.37) and LED (mean difference, 130.24; 95% CI, 28.82–231.65). Conclusion The STN may be the preferred target for DBS in consideration of medication reduction, economic efficiency, and motor function improvement in the off phase. However, treatment decisions should be made according to the individual patient’s symptoms and expectations.

We attempt to demonstrate the regulatory role of miR-200c in glioma progression and its mechanisms behind. Here, we show that miR-200c expression was significantly reduced in the glioma tissues compared to paratumor tissues, especially in malignant glioma. Exogenous overexpression of miR-200c inhibited the proliferation and invasion of glioma cells. In addition, the in vivo mouse xenograft model showed that miR-200c inhibited glioma growth and liver metastasis, which is mainly regulated by targeting moesin (MSN). We demonstrated that the expression of MSN in glioma specimens were negatively correlated with miR-200c expression, and MSN overexpression rescued the phenotype about cell proliferation and invasion induced by miR-200c. Moreover, knockdown of MSN was able to mimic the effects induced by miR-200c in glioma cells. These results indicate that miR-200c plays an important role in the regulation of glioma through targeting MSN.

// Dejun Bao 2, 3, 4, * , Chuandong Cheng 2, 3, 4, * , Xiaoqiang Lan 1, 5, * , Rong Xing 1 , Zhuo Chen 7 , Hua Zhao 8 , Junyan Sun 1 , Yang Wang 1 , Chaoshi Niu 2, 3, 4 , Bo Zhang 5 , Shengyun Fang 6 1 Department of Pathophysiology, School of Basic Medical Science, Dalian Medical University, Dalian, China 2 Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China 3 Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China 4 Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, China 5 Department of Neurosurgery, 2nd Hospital of Dalian Medical University, Dalian, China 6 Center for Biomedical Engineering and Technology, Department of Physiology, Department of Biochemistry and Molecular Biology, University of Maryland, School of Medicine, Baltimore, Maryland, USA 7 Anhui Provincial Cancer Hospital (West Branch of Anhui Provincial Hospital), Hefei, China 8 Department of Clinical Laboratory, Cancer Hospital, Chinese Academy of Science, Hefei, China * These authors contributed equally to this work Correspondence to: Yang Wang, email: wang_yang10@aliyun.com Chaoshi Niu, email: niuchaoshi@163.com Bo Zhang, email: zhangbo@126.com Shengyun Fang, email: sfang@umaryland.edu Keywords: AR signaling, SVIP, cell proliferation, serum testosterone, p53 Received: November 22, 2016 Accepted: February 08, 2017 Published: February 19, 2017 ABSTRACT The incidence of glioma in men is higher than that in women; however, little is known about the expression and basic function of the androgen receptor (AR) in gliomas. AR inhibited the small VCP/p97-interacting protein (SVIP) on the transcriptional level was previously reported. The present study shows that the protein level of AR is highly expressed in cell lines of the nervous system. Moreover, the AR expression is increased while SVIP expression is decreased in tumor tissue of glioma patients, which is in agreement with the progressing WHO grades. A statistically significant increase in serum testosterone level of glioma patients compared with that of non-cancer patients was also detected. Furthermore, it has been proved that SVIP is down-regulated as well as AR is up-regulated in glioma cell lines with R1881 treatment. Interestingly, the depletion of SVIP using siRNA facilitated cell proliferation and decreased p53 expression. In addition, overexpression of SVIP increased cell death only in p53 wt cell lines. Moreover, U87MG cells, p53 wt cell line was susceptible to AR antagonists in vitro and in vivo . The current study provides insight into the biological role of AR in suppressing SVIP and p53 and promoting the progression of glioma as well as the clinical treatment of glioma patients.

This study addressed the benefit of intraoperative magnetic resonance imaging (iMRI) compared with conventional neuronavigation-guided resection in patients with gliomas.The Medline, PubMed, Cochrane, and Google Scholar databases were searched up to 26 September 2015. Randomized controlled trials (RCTs), two-arm prospective studies, and retrospective studies in patients with glioblastoma/glioma who had received surgical treatment were included.The primary outcome measures were the extent of tumor resection and tumor size reduction for using iMRI-guided or conventional neuronavigation-guided neurosurgery. Secondary outcomes included impact of surgery on 6 month progression-free survival (PFS), 12 month overall survival (OS) rates and surgical duration.We found that iMRI was associated with greater rate of gross total resection (rGTR) compared with conventional neuronavigation procedures (3.16, 95% confidence interval [CI] 2.07-4.83, P .001). We found no difference between the two neuronavigation approaches in extent of resection (EOR), tumor size reduction, or time required for surgery (P values ≥.065). Intraoperative MRI was associated with a higher rate of progression-free survival (PFS) compared with conventional neuronavigation (odds ratio, 1.84; 95% CI 1.15-2.95; P = .012), but the rate of overall survival (OS) between groups was similar (P = .799). Limitations of the study included the fact that data from non-RCTs was used, the small study population, and heterogeneity of outcomes across studies.Our findings indicate that iMRI more frequently resulted in more complete resections leading to improved PFS in patients with malignant gliomas.

Objective: To date, there are several published studies on the value of IDH-1 (isocitrate dehydrogenase-1) mutation and MGMT (O6-Methylguanine-DNA methyltransferas) promoter methylated status on the diagnosis of pseudoprogression (PSP) and true tumor progression after or within chemo-radiotherapy of high grade glioma (HGG). We performed a meta-analysis about the significant value of these 2 molecular markers on the diagnosis of PsP in high- grade glioma. Methods: We searched the eligible studies from PubMed, Medline, Embase, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI) and Wan Fang Database. The relevant studies published before October 2018 were identified. ORs (odds ratios) with 95%CIs (confidence intervals) were used to evaluate the value using fixed- or random-effect model. Results: Thirteen studies about MGMT promoter methylated status and 4 studies about IDH-1 mutations were found eligible for this present meta-analysis. Significant value of MGMT promoter methylation status (OR = 4.02, 95%CI = 2.76–5.87, P

Objective The clinical data of patients with hemifacial spasm (HFS) were analyzed statistically to identify factors leading to delayed cure after microvascular decompression (MVD). Methods A retrospective analysis of the clinical data of 600 patients with HFS subjected to MVD from March 2016 to May 2018 was performed. Student t test, chi-square test, logistic regression analysis, and multivariate analysis of variance were used to analyze the correlation between delayed cure and its related factors. Results Among the 600 patients enrolled, 117 had delayed cure after MVD. The shortest duration of delayed cure was 4 days, and the longest was 540 days, with an average of 108 days. The frequency of delayed improvement in these patients was not associated with sex, age, or offending vessel type (p > 0.05); however, delayed cure was positively correlated with the course of the disease, grade of HFS severity, and disappearance of abnormal muscle responses during the operation (p Conclusion MVD is an effective treatment for HFS. Given that postoperative delayed cure was unavoidable, even with accurate identification of the offending vessel and sufficient decompression of the root exit zone, delayed cure should be considered in patients undergoing reoperation due to lack of remission or relapse after the operation. Additionally, the timing of efficacy assessments should be delayed.

Purpose: Parkinson’s disease is a progressive disorder. To investigate the biochemical alterations in the striatum of rats with different stages of Parkinson’s disease induced by proteasoma...

The purpose of the present study was to construct a nomogram for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD).The present study retrospectively enrolled 165 patients with PD who had undergone DBS surgery. The patients were assessed using the Confusion Assessment Method for the Intensive Care Unit and were divided into 2 groups: the delirium group and nondelirium group. The nomogram for POD after DBS surgery was constructed from the results of univariate analysis and multivariate logistic analysis of the influencing factors for POD after DBS surgery.Univariate analysis revealed that the preoperative length of stay and the presence of preoperative brain atrophy, preoperative pulmonary inflammation, and postoperative cerebral edema were statistically significant. The results from the nonmotor symptoms scale for PD, mini-mental state examination, PD sleep scale, and unified PD rating scale III were also statistically significant (P0.05). Multivariate logistic regression analysis showed that the unified PD rating scale III (odds ratio [OR], 2.284; 95% confidence interval [CI], 1.614-3.232), nonmotor symptoms scale for PD (OR, 8.191; 95% CI, 5.629-11.917), PD sleep scale (OR, 0.058; 95% CI, 0.05-0.067), preoperative length of stay (OR, 1.230; 95% CI, 1.053-1.437), and preoperative brain atrophy (OR, 3.912; 95% CI, 3.5-4.255) were independent factors that influenced the occurrence of POD after DBS surgery. A nomogram model was constructed using these indicators. The model predicted an area under the receiver operating characteristic curve after DBS surgery of 0.870 (95% CI, 0.808-0.918), sensitivity of 74.19%, and specificity of 91.54%.The present study has presented a reliable and useful nomogram that can accurately predict the occurrence of POD after DBS surgery in patients with PD. This tool is easy to use and could assist physicians during the therapeutic decision-making process.

A fixed retractor is routinely used during surgery for vestibular schwannoma to maintain the surgical corridor; however, brain injuries can be caused by use of retractors. The aim of this study was to present strategies for retractorless surgery for giant vestibular schwannomas and compare retractorless surgery with traditional retractor-assisted surgery to illustrate feasibility and potentially superiority of retractorless surgery.Clinical data of 61 patients with giant (≥4 cm diameter) vestibular schwannomas undergoing craniotomy were retrospectively analyzed. Patients were divided into 2 cohorts: 1) 35 patients with traditional retractor surgery performed between June 2016 and July 2017; 2) 26 patients with retractorless surgery performed between June 2016 and July 2018. Duration of operation, intraoperative blood loss, extent of resection, rate of retention of facial nerve function, postoperative brain injury rate, intracranial infection rate, hospitalization time, and grade of facial nerve function were compared between the 2 groups.The incidence of postoperative brain injury was 3.84% in the retractorless surgery group, which was significantly lower compared with the traditional retractor surgery group (22.86%) (P0.05). No significant differences were found regarding the other characteristics compared.Through appropriate comprehensive measures, retractorless surgery for giant vestibular schwannomas is an achievable goal. This procedure can reduce the incidence of postoperative brain injury with satisfactory tumor resection.

Multi-modal magnetic resonance images (MRIs) play an important role in the diagnosis and treatment of brain tumors. Due to heterogeneous diversities, it’s of great challenge to segment gliomas into hierarchical regions. Decomposing the multi-class segmentation task into sequential subtasks with cascaded models has proved its effectiveness, but leads to model redundancy, training complexity, and task isolation. In this paper, we propose a simple yet efficient 3D deep cascaded attention network (DCAN) for brain tumor segmentation. Specifically, we settle multi-tasks into corresponding branches with a shared feature extractor to reduce model complexity. Second, instead of explicitly extracting spatial evolutionary relationships of sub-regions using several consecutive models, a cascaded attention mechanism is introduced to implicitly involve potential subregions correlations as guidance. Moreover, we present a feature bridge module (FBM) to narrow feature fusion gaps. Thus, DCAN is able to capture the hierarchical correlations of overlapping regions and simultaneously tackle multi-tasks in a single model. The comprehensive experimental comparisons on the BRATS 2018 dataset show DCAN achieves top performance with dice scores of 81.71%, 91.18% and 86.19% for the enhancing tumor, whole tumor and tumor core, respectively.

Embolisation of irregular and complicated aneurysms is a great challenge for neuroradiologists. To overcome possible complications of endovascular treatment of these type of aneurysms, methods such as intracranial stents, balloon remodelling, and the double microcatheter technique have been developed. The aim of the study was to report our preliminary experience with endovascular treatment of irregular and complicated intracranial aneurysm with coils using double microcatheter technique, and evaluation of its feasibility and clinical advantages. In this retrospective study, 37 cases diagnosed with irregular and complicated intracranial aneurysms and treated using double microcatheter method from July, 2013 to May, 2015, were followed up for six months after discharge. All the aneurysms were successfully embolized using the double microcatheter technique. Immediate post-embolization angiography showed no residual contrast filling in 35 cases, and residual filling in 2 cases. At discharge, according to the modified Rankin Scale score, all the patients recovered without any complications or death. A follow-up of 24 cases with digital subtraction angiography for 6 months revealed no recanalization. In conclusion, the double microcatheter technique for irregular intracranial aneurysms is effective and simple with few complications.

Objective To investigate the role and mechanisms of HAUSP (Herpesvirus Associated Ubiquitin Specific Protease) and NANOG in pathogenesis of malignant human gliomas progression. Methods Lentivirus-mediated HAUSP over-expression and RNAiHAUSP mediated HAUSP down-regulation were established in the glioma cells (U87 and U251 cell lines). Firstly, Real-time qPCR, western-blot (WB) and immunofluorescence staining were performed to detect mRNA levels, protein expressions and deposition of HAUSP and NANOG in the glioma cells, respectively. Then cell proliferation, invasion, apoptosis and xenograft tumor growth in nude mice were assessed by using cell counting kit-8 (CCK-8) assay, transwell assay, flow cytometry (FCM) and Hematoxylin-Eosin (HE) staining. Results We first demonstrated HAUSP was significantly increased in lentivirus- mediated HAUSP over-expression cells compared to the Control group. HAUSP over-expression could upregulate genes involved in proliferation and invasion such as NANOG. However, the mRNA of NANOG had no significant changes. Similarly, in RNAiHAUSP mediated HAUSP down-regulation group, HAUSP were significantly decreased compared to the Control group. Simultaneously, NANOG protein were decreased significantly, which decreased the proliferation and invasion, increased the apoptosis rate of glioma cells. Finally, low expression of HAUSP could suppress xenograft tumors growth in nude mice in different periods. Conclusion This study revealed that HAUSP-NANOG pathway is a key target to inhibit glioma cells proliferation, and NANOG play important role in the formation and evolution of glioma cells. The regulation of HAUSP could change the biological activity of glioma cells through regulate NANOG expression.

Background and purpose Epilepsy is one of the most common diseases of the nervous system. Approximately one-third of epilepsy cases are drug-resistant, among which generalized-onset seizures are very common. The present study aimed to analyze abnormalities of the thalamocortical fiber pathways in each hemisphere of the brains of patients with drug-resistant generalized epilepsy. Materials and methods The thalamocortical structural pathways were identified by diffusion tensor imaging (DTI) in 15 patients with drug-resistant generalized epilepsy and 16 gender/age-matched controls. The thalami of both groups were parcellated into subregions according to the local thalamocortical connectivity pattern. DTI measures of thalamocortical connections were compared between the two groups. Results Probabilistic tractography analyses showed that fractional anisotropy of thalamocortical pathways in patients with epilepsy decreased significantly, and the radial diffusivity of the left thalamus pathways with homolateral motor and parietal-occipital cortical regions in the drug-resistant epilepsy group increased significantly. In addition to the right thalamus pathway and prefrontal cortical region, fractional anisotropy of all other pathways was inversely correlated with disease duration. Conclusion The results provide evidence indicating widespread bilateral abnormalities in the thalamocortical pathways in epilepsy patients and imply that the degree of abnormality in the pathway increases with the disease duration.

To investigate the effect of transtemperal approach and placement of intracranial pressure sensor into temporal horn of lateral ventricle in management of spontaneous supratentorial intracerebral hemorrhage broken into ventricles, a total of 37 patients with spontaneous supratentorial intracerebral hemorrhage broken into ventricles treated by operation from January 2016 to December 20l6 were analyzed retrospectively, of which 25 patients in simple transtemporal approach group and 12 patients in transtemperal approach and placement of intracranial pressure sensor into temporal horn of lateral ventricle group. All patients were followed up for 8 months to 1.5 years. Two groups were estimated by mortality, clearance rate of hematoma, removal rate of bone flap, good prognosis rate of ADL and incidence of hydrocephalus. The good prognosis rate of ADL and the incidence of hydrocephalus are only statistically significant between the two groups (P

Purpose Epilepsy is considered a disorder of neural networks. Patients diagnosed with refractory epilepsy frequently experience attention impairments. Seizure activity in epilepsy may disturb brain networks and damage the brain function of attention. The aims of this study were to assess functional and causal connectivities of the attention networks and default mode network using resting-state functional magnetic resonance imaging (fMRI). Method Resting-state fMRI data were gathered from 19 patients with refractory epilepsy (mixed localization and aetiologies) and 21 healthy people. The fMRI data were analyzed by group independent component analysis (ICA) fMRI toolbox to extract dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN). The components of the selected networks were compared between patients and healthy controls to explore the change in functional connectivity (FC). Granger causality analysis was performed by taking the aforementioned significant brain areas as regions of interest (ROIs) to calculate autoregression coefficients of each pair of ROIs. Comparisons were done to find the significantly different causal connectivity when FC was changed between patients and healthy controls. Results In DAN, the FC values of the bilateral frontal eye field (FEF) and left intraparietal sulcus (IPS) were decreased. In VAN, the FC values of the double-side ventral prefrontal cortex (vPFC) and the temporoparietal junction (TPJ) were reduced. As for DMN, the FC values of the bilateral medial prefrontal cortices (mPFC) were decreased whereas those for the bilateral precuneus (PCUN) were increased. Granger causal connectivity values were correlated: causal influence was decreased significantly from the left IPS (in DAN) to the double side of the vPFC but remained the same for the right FEF (in DAN) to the right TPJ. The value was decreased from the left PCUN (in DMN) to the right TPJ and FEF, and the causal flow from the right PCUN to the right TPJ and bilateral vPFC was also significantly inhibited (p Conclusion Frequent seizures in patients with refractory epilepsy may damage the cortex and disturb DAN, VAN, and DMN, leading to functional and causal connectivity alteration. In addition, epileptic activity may disrupt network interactions and further influence information communication.

The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre- and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively. Solitary epidural CAs generally exhibited isointensity on T1-weighted images and hyperintesity on T2-weighted images. Contrast-enhanced T1-weighted images showed homogeneous markedly enhancement. Gross total resection (GTR) was achieved in 11 cases, and subtotal resection (STR) was achieved in 1 case. During an average follow up of 35.9 months, neurological function was improved in 11 patients and in one patient, preoperative status was maintained. No patient experienced tumor recurrence. These findings suggest that CAs should be considered in the differential diagnosis of spinal epidural lesions. Early surgery is advocated to prevent irreversible neurological deficits. When aggravated by a large amount of acute hemorrhage, neurological deterioration is usually acute and prompt surgical decompression is the optimal choice. Because of the excessive vascularity of CAs, en bloc resection is recommended. In addition, a good clinical outcome after GTR can be expected, and the risk of long-term recurrence is low.

Background Microvascular decompression of the trigeminal nerve is the most effective treatment for trigeminal neuralgia. However, when encountering classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence because of incomplete decompression may become frequent. This study aimed to investigate the anatomic variation of the culprit veins and discuss the surgical strategy for different types. Methods We performed a retrospective analysis of 64 consecutive cases in whom veins were considered as responsible vessels alone or combined with other adjacent arteries. The study classified culprit veins according to operative anatomy and designed personalized approaches and decompression management according to different forms of compressive veins. Curative effects were assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. Results The most commonly encountered veins were the superior petrosal venous complex (SPVC), which was artificially divided into 4 types according to both venous tributary distribution and empty point site. We synthetically considered these factors and selected an approach to expose the trigeminal root entry zone, including the suprafloccular transhorizontal fissure approach and infratentorial supracerebellar approach. The methods of decompression consist of interposing and transposing by using Teflon, and sometimes with the aid of medical adhesive. Nerve combing (NC) of the trigeminal root was conducted in situations of extremely difficult neurovascular compression, instead of sacrificing veins. Pain completely disappeared in 51 patients, and the excellent outcome rate was 79.7%. There were 13 patients with pain relief treated with reoperation. Postoperative complications included 10 cases of facial numbness, 1 case of intracranial infection, and 1 case of high-frequency hearing loss. Conclusions The accuracy recognition of anatomic variation of the SPVC is crucial for the management of classical trigeminal neuralgia caused by venous compression. Selecting an appropriate approach and using reasonable decompression methods can bring complete postoperative pain relief for most cases. NC can be an alternative choice for extremely difficult cases, but it could lead to facial numbness more frequently.

Annexin A3 (ANXA3) is dysregulated and plays an important role in various cancers. However, the role of ANXA3 in breast cancer is still unclear. Here, we observed that the expression level of ANXA3 was significantly upregulated in breast cancer tissues. ANXA3 knockdown inhibited cell invasion but promoted cell proliferation in both in vitro and in vivo assays. Furthermore, we found that ANXA3 knockdown inhibited the NFκB pathway via upregulating IκBα, resulting in mesenchymal–epithelial transition (MET) and a heterogeneity change of breast cancer stem cells (BCSCs). In addition, we demonstrated that ANXA3 knockdown increased the sensitivity of breast cancer cells to doxorubicin by increasing the drug uptake. The combination of ANXA3 knockdown and doxorubicin treatment simultaneously inhibited tumor growth and metastasis in vivo. This study described the role and mechanisms of ANXA3 in regulating BCSCs and breast cancer growth and metastasis, indicating that downregulating ANXA3 together with chemotherapy might be a novel therapeutic strategy for treating breast cancer.

// Dong-Xue Li 1, 2 , Xiao-Rui Fei 2 , Yong-Fei Dong 2 , Chuan-Dong Cheng 2 , Yang Yang 2 , Xue-Fei Deng 3 , Hai-Liang Huang 3 , Wan-Xiang Niu 2 , Chen-Xu Zhou 2 , Cheng-Yu Xia 2 and Chao-Shi Niu 2 1 Shandong University, Jinan, Shandong, China 2 Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China 3 School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China Correspondence to: Chao-Shi Niu, email: niuchaoshi@126.com Keywords: CRNDE, glioma, miR-136-5p, Bcl-2, Wnt2 Received: June 16, 2017 Accepted: September 08, 2017 Published: October 04, 2017 ABSTRACT The colorectal neoplasia differentially expressed (CRNDE) gene encodes a long non-coding RNA (lncRNA) that is the most unregulated among 129 lncRNAs differentially expressed in gliomas. In this study, we confirmed high CRNDE expression in clinical glioma specimens and observed through experiments in human glioma cell lines a novel molecular mechanism by which CRNDE may contribute to glioma pathogenesis. By inducing or silencing CRNDE expression, we detected a positive correlation between CRNDE levels and the proliferative, migratory, and invasive capacities of glioma cells, which were concomitant with a decreased apoptosis rate. Our experiments also suggest that these effects are mediated by downregulation of miR-136-5p, which correlated with the glioma WHO grade. Based on predicted CRNDE/miR-136-5p/mRNA interactions, both the mRNA and protein expression analyses suggested that miR-136-5p-mediated repression of Bcl-2 and Wnt2 underlies the pro-tumoral actions of CRNDE. We therefore propose that CRNDE functions as a competing endogenous RNA (ceRNA) that binds to and negatively regulates miR-136-5p, thereby protecting Bcl-2 and Wnt2 from miR-136-5p-mediated inhibition in glioma.

Current evidence indicates that conventional mechanical ventilation often leads to lung inflammatory response and oxidative stress, while lung-protective ventilation (LPV) minimizes the risk of ventilator-associated lung injury (VALI). This study evaluated the effects of LPV on relief of pulmonary injury, inflammatory response, and oxidative stress among patients undergoing craniotomy. Sixty patients undergoing craniotomy received either conventional mechanical (12 mL/kg tidal volume [VT] and 0 cm H2O positive end-expiratory pressure [PEEP]; CV group) or protective lung (6 mL/kg VT and 10 cm H2O PEEP; PV group) ventilation. Hemodynamic variables, lung function indexes, and inflammatory and oxidative stress markers were assessed. The PV group exhibited greater dynamic lung compliance and lower respiratory index than the CV group during surgery (P<0.05). The PV group exhibited higher plasma interleukin- (IL-) 10 levels and lower plasma malondialdehyde and nitric oxide and bronchoalveolar lavage fluid, IL-6, IL-8, tumor necrosis factor-α, IL-10, malondialdehyde, nitric oxide, and superoxide dismutase levels (P<0.05) than the CV group. There were no significant differences in hemodynamic variables, blood loss, liquid input, urine output, or duration of mechanical ventilation between the two groups (P>0.05). Patients receiving LPV during craniotomy exhibited low perioperative inflammatory response, oxidative stress, and VALI.

Recent studies have provided evidence that there are two possible systems for empathy: affective empathy (AE) and cognitive empathy (CE). Neuroimaging paradigms have proven that the insular cortex is involved in empathy processing, particularly in AE. However, these observations do not provide causal evidence for the role of the insula in empathy. Although impairments in empathy have been described following insular damage in a few case studies, it is not clear whether insular cortex is involved in CE and whether these two systems are impaired independently or laterally in patients with insular gliomas. In this study, we assessed 17 patients with an insular glioma, 17 patients with a noninsular glioma, and 30 healthy controls using a method that combined a self-report empathy questionnaire with the emotion recognition task, assessment of empathy for others' pain, and the emotional perspective-taking paradigm. We found that patients with an insular glioma had lower scores for empathic concern and perspective taking than did either healthy controls or lesion controls. The patients' abilities to recognize facial emotions, perceive others' pain, and understand the emotional perspectives of others were also significantly impaired. Furthermore, we did not observe a laterality effect on either AE or CE among those with insular lesions. These findings revealed that both AE and CE are impaired in patients with an insular glioma and that the insular cortex may be a central neuroanatomical structure in both the AE and CE systems.

To analyze the outcome in subjects with bacterial brain abscesses (BBAs) treated by operation and shorter antimicrobial duration than usual at a single center over a four-year period.Retrospective review was conducted on a series of 55 patients with BBAs surgically treated and managed by prospective antimicrobial protocol of shorter antimicrobial duration than usual. Sixty-one abscesses were diagnosed and surgically managed in 55 patients. Open craniotomy excision was the treatment of choice for 58.2% of the patients, whereas 31.8% of the cases were managed through stereotactically guided aspiration. Intravenous antimicrobial agents were given to all patients emipirically or changed later according to culture results. Intravenous antimicrobial administration was discontinued without following oral therapy when the patients' body temperature was continuously normal for 10-14 days after surgery and neuroimaging showed the resolution of BBAs at the same time [Follow-up CT or MRI showed no residue cavity, or the diffusion wedge images (DWI) showed the signal in the residue cavity was as low as the signal of cerebral spinal fluid].The mean total antimicrobial duration was 21.7 days (10-66 days), and the mean antimicrobial duration after operation was 19.2 days (10-64 days). Follow-up found there were two patients whose BBAs recurred and died 4-5 months after primary BBAs controlled. Follow-up data of the remaining 53 patients were available with a mean follow-up time of 36 months (12-58 months). Outcome was favorable in 65.5% of the subjects. General morbidity was 18.2%, and recurrence and mortality stood at 3.6%, respectively.This case series showed the short-course intravenous antimicrobial administration can be considered to be a standard therapy for bacterial brain abscess in the surgically treated group, and the thermal curve and DWI are the two paramount indicators that can safely evaluate the antimicrobial times for the treatment of BBAs.

To study the curative effect and prognosis of patients with basal ganglia cerebral hemorrhages treated using a transcortical-sulcus approach and compare with results obtained using the traditional cerebral cortex approach.Clinical data were collected from 106 patients with hypertensive hemorrhage in the basal ganglia who were treated using either a transcortical-sulcus approach or traditional cerebral cortex approach. The rate of rehemorrhage, incidence of epilepsy, and 3-month efficacy (defined by an activities of daily living score) rate between the 2 groups were compared.The 3-month efficacy rates of patients treated using the transcortical-sulcus and traditional cerebral cortex surgical approaches were 78.4% and 60%, respectively (P0.05). The incidence of epilepsy was lower in the transcortical-sulcus approach group compared with the traditional approach group, and significant differences were detected between the 2 groups (P0.05).The transcortical-sulcus approach can significantly improve the prognosis of patients with intracerebral hemorrhages in the basal ganglia and reduce the incidence of postoperative seizures.

Background: Refractory epilepsy is a common and troublesome neurosurgical disease. This study is designed to compare seizure control and degrees in intellectual outcome in children with refractory epilepsy after surgical treatment. Methods: 20 children with refractory epilepsy were treated with tailored epilepsy surgery or vagus nerve stimulation (VNS). We used the Engel Epilepsy Surgery Outcome Scale to evaluate seizure control and the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV), to test the children's intellectual outcomes 7-day preoperative and 3-, 6-, and 12-month postoperative. Results: In total, 14 cases were seizure free (Engel I) and 2 cases to have suffered few attacks since surgery (Engel II). In two cases, the frequency of seizures decreased by >90% (Engel III). In the remaining two cases, the effects of surgery on seizure control were not obvious (Engel IV). All children completed the WISC-IV test. On average, postoperative intelligence quotient (IQ) increased by 6.35 points 12-month postsurgery compared with the results of the preoperative tests (P < 0.01). Second, intellectual outcomes after surgery in the Engel I and II groups increased by >3.88 points compared with in the Engel III and IV groups (P < 0.05). Finally, there were no fatal complications over the long-term follow-up except for intracranial infection of two cases; postoperative subcutaneous hematoma occurred in one case and hoarseness in one case. Conclusion: Individualized epilepsy surgery is safe and effective for children with refractory epilepsy. It can control or reduce the frequency of postoperative attacks as well as improve postoperative intellectual outcomes to different degrees.