Abstract:Objective To explore the levels of serum steroid receptor coactivator 3(SRC-3)and axon guidance factor 4(Netrin-4)in elderly patients with vascular cognitive impairment(VCI)after ischemic cerebral infarction and their clinical significance.Methods A total of 102 elderly patients with VCI ischemic after cerebral infarction admitted to our hospital from November 2021 to December 2024 were selected as the VCI group,and another 102 elderly patients with ischemic cerebral infarction without VCI were selected as the non-VCI group.The differences in serum SRC-3 and Netrin-4 levels between the two groups were compared.The predictive value of serum SRC-3 and Netrin-4 for VCI after ischemic cerebral infarction in the elderly patients was analyzed by the ROC curve.The influencing factors of VCI after ischemic cerebral infarction in the elderly patients were investigated by multivariate logistic stepwise regression.Results The levels of serum SRC-3 and Netrin-4 in the VCI group were lower than those in the non-VCI group(P<0.05).ROC analysis showed that the area under the curve(AUC)of the combined(serial)prediction of serum SRC-3 and Netrin-4 for VCI after ischemic cerebral infarction in the elderly patients was 0.904,which was higher than the AUC of 0.761 and 0.815 for the individual predictions of serum SRC-3 and Netrin-4(Z=13.584,10.231,P<0.001).The VCI group had higher proportions of age,hypertension,diabetes,and multiple infarction foci,and lower MoCA scores than the non-VCI group(P<0.05).Multivariate analysis showed that advanced age,hypertension,diabetes,SRC-3≤0.53 ng/mL,and Netrin-4≤49.60 ng/mL were risk factors for VCI after ischemic cerebral infarction in the elderly patients(P<0.05).Conclusions Levels of serum SRC-3 and Netrin-4 in elderly patients with VCI after ischemic cerebral infarction will decrease,and the combined detection of the two factors has a good predictive value for VCI after cerebral infarction in the elderly patients.

Abstract:Objective To investigate the status of postoperative fatigue in elderly patients with hypertensive intracerebral hemorrhage and analyze its related influencing factors.Methods A cross-sectional study was consecutively conducted on 100 elderly patients with hypertensive intracerebral hemorrhage who underwent surgical treatment in Qilu Hospital(Qingdao)from January 2022 to January 2025.Their general and clinical data were collected,and the Revised Piper Fatigue Scale(PFS-R)was used to assess their fatigue status.The correlation between patients'fatigue status and various factors was analyzed,and univariate analysis and multiple linear regression analysis were used to identify independent influencing factors for postoperative fatigue.Results The total PFS-R score of the 100 elderly patients with hypertensive intracerebral hemorrhage was(6.15±1.68),indicating a moderate level of overall fatigue,with the sensory dimension scoring the highest.Univariate analysis showed that there were statistically significant differences in fatigue scores among patients with different surgical methods,intraoperative blood loss,preoperative NIHSS score,postoperative complications,C-reactive protein(CRP),hemoglobin(Hb),hypoproteinemia,sleep disorders and pain degree(all P<0.05).Pearson correlation analysis showed that intraoperative blood loss,preoperative NIHSS score,postoperative CRP level,pain VAS score,Lac level,SDBG,and COR level were significantly and positively correlated with the total postoperative PFS-R score.In contrast,postoperative Hb level,serum Alb level,grip strength and average daily step count were significantly and negatively correlated with the total PFS-R score(all P<0.05).Multiple linear regression analysis further indicated that craniotomy(β=0.199,P=0.040),high NIHSS score(β=0.307,P<0.001),high CRP(β=0.255,P=0.009),hypoalbuminemia(β=0.224,P=0.013),sleep disorders(β=0.261,P=0.004),and moderate to severe pain(β=0.235,P=0.026)were independent risk factors for postoperative fatigue.Conclusions Moderate fatigue is prevalent among elderly patients with hypertensive intracerebral hemorrhage after surgery,with the sensory dimensions being the most prominent.Neurological deficits,inflammatory response,nutritional status,sleep quality,and pain severity are key factors influencing postoperative fatigue.To alleviate fatigue and promote recovery,clinical attention should be given to early identification and comprehensive interventions,such as optimizing surgical approaches,enhancing nutritional support,controlling inflammation and pain,and improving sleep quality.

Abstract:With the arrival of the aging society,the number of patients with hypertensive intracerebral hemorrhage is gradually increasing,and such hemorrhage is often accompanied with adverse outcomes with a high mortality and morbidity rate.Nomograms,as visual predictive models,have now been widely used in predicting the risk and outcomes of hypertensive intracerebral hemorrhage.These predictive nomogram models are constructed on multidimensional data such as clinical information,imaging features,radiomics and genomics.Their straightforward and intuitive nature allows clinical physicians to identify more accurately disease progression and prognosis,which provides a scientific and reasonable basis for personalized treatment.Furthermore,interdisciplinary research that combines clinical,imaging,and genetic studies can help further enhance the predictive performance of nomograms,which is worth further exploration.

Abstract:Objective To construct a model for predicting the risk of vestibular schwannoma(VS)using plasma immune markers based on the Dryad database.Methods A secondary analysis was performed on patient data from the Dryad database.Participants were divided into a VS group(n=213)and a non-VS group(n=113).Univariate analysis,multivariate Logistic regression,and LASSO regression were used to screen risk factors and construct a nomogram prediction model.Results Univariate analysis revealed statistically significant differences(P<0.05)in plasma markers including TNF-R2,MIF,SDF-1α,IL-2R,MCP-2,CD30,IL-16,TWEAK,BLC,and MCP-3 between the two groups.Multivariate Logistic regression combined with LASSO regression identified SDF-1α[OR(95%CI)=1.001(1.000～1.001)],IL-2R[OR(95%CI)=1.002(1.001～1.003)],BLC[OR(95%CI)=1.015(1.006-1.023)],and MCP-3[OR(95%CI)=1.294(1.159-1.444)]as independent risk factors for VS.A nomogram model was constructed using these four variables.The analysis of the receiver operating characteristic(ROC)curve revealed an area under the curve(AUC)value of 0.856(95%CI:0.815-0.897),which suggested a high level of predictive accuracy.The model exhibited strong predictive accuracy,as evidenced by a well-calibrated curve that closely aligned with the ideal line,achieved through bootstrap resampling with 1 000 iterations.Furthermore,decision curve analysis(DCA)indicated robust clinical utility,with the decision curve surpassing both the"None"and"All"reference lines across a threshold probability range of 0-60%.Conclusions The nomogram prediction model for VS risk,constructed on plasma immune markers screened by LASSO regression,can provide a reference for the early clinical diagnosis.

Abstract:Objective To compare the clinical efficacy of cerebellar tonsillectomy and posterior cranial fossa decompression with expanded dura mater repair in the treatment of patients with Chiari malformation type Ⅰ(CMI).Methods A retrospective analysis was conducted on the clinical data of patients with Chiari malformation type Ⅰ who were admitted to the Neurosurgery Departments of Third Hospital of Peking University-Yan'an Branch(Yan'an Central Hospital),Affiliated Hospital of Yan'an University,and Third Hospital of Peking University and underwent surgical treatment from January 2013 to October 2022.A total of 64 patients were included in this study,who were divided into the cerebellar tonsillectomy group(Group A=38 cases)and the posterior cranial fossa decompression with expanded dura mater repair group(Group B=26 cases)based on the surgical methods.Among the 64 patients,20(31.25％)were male and the age ranged from 34 to 62 years;44(68.75％)were female and the age ranged from 42 to 69 years.The indicators such as operation time,intraoperative blood loss,postoperative complications,and prognosis were recorded.Results Preoperative imaging showed that the number of spinal syrinxes in both groups was 31(81.58％)and 22(84.62％)respectively,with no statistical difference between the two groups(P=0.75).The most common clinical manifestations were limb numbness(73.68％vs 65.38％),followed by shoulder-neck and limb pain(65.79％vs 57.69％)and pain and temperature sensation disorders(47.37％vs 42.31％).The postoperative relief rates of the two groups were similar(73.68％vs 65.38％),and the difference did not reach statistical significance(P=0.58).The common postoperative complications were central nervous system infection and cerebrospinal fluid leakage.The average operation time of Group A patients was 148.64 minutes,with about 80 ml of intraoperative blood loss and an average hospital stay of 10 days;the average operation time of Group B was 132 minutes,with about 52 ml of intraoperative blood loss and an average hospital stay of 8 days;there were statistically significant differences in operation time between the two groups(P=0.03).Conclusions Cerebellar tonsillectomy,simple posterior cranial fossa decompression and expanded dura mater repair can all improve the clinical symptoms of CMI.However,the cerebellar tonsillectomy group has more intraoperative time than the control group.Therefore,simple posterior cranial fossa decompression and expanded dura mater repair for the treatment of CMI is recommended.

Abstract:Objective To analyze the relationship between peripheral blood matrix metalloproteinase-9(MMP-9),25-hydroxyvitamin D[25(OH)D],neutrophil-to-lymphocyte ratio(NLR)and hemorrhagic transformation(HT)in patients with ischemic stroke after interventional thrombectomy.Methods The clinical data of 116 patients with acute ischemic stroke(AIS)admitted to Xingtai Central Hospital from February 2023 to January 2025 were retrospectively collected.Patients were divided into the HT group(n=34)and the non-HT group(n=82)based on the occurrence of HT after thrombectomy.Clinical data were compared between the two groups,and the influencing factors of HT were analyzed using multivariate logistic regression.Receiver operating characteristic(ROC)curves were plotted,and the areas under the curve(AUCs)were used to evaluate the predictive efficacy of these factors for HT.Results The HT group showed an increase in preoperative NIHSS score,the proportion of patients with more than two times of thrombectomy,the levels of D-dimer,MMP-9,and NLR,and a decrease in 25(OH)D level compared to the non-HT group(P<0.05).Logistic regression analysis demonstrated that elevated levels of MMP-9(OR:2.215,95%CI:1.190-3.797)and NLR(OR:2.651,95%CI:1.299-5.411)were independent risk factors for HT following endovascular thrombectomy in patients with AIS.Conversely,increased level of 25(OH)D(OR:0.438,95%CI:0.236-0.812)was identified as an independent protective factor(all P<0.05).ROC curve analysis showed that the AUC values of MMP-9,25(OH)D,and NLR for predicting HT were 0.745,0.766,and 0.772 respectively.The combined AUC of these factors was 0.926(95%CI:0.862-0.966),with a sensitivity of 88.24%and specificity of 87.80%.The AUC was significantly greater than that of each indicator(ZMMP-9=3.376,Z25(OH)D=3.377,ZNLR=3.436,all P<0.05).Conclusions Peripheral blood MMP-9,25(OH)D,and NLR are closely related to HT risk in patients with AIS after interventional thrombectomy.These markers can serve as predictors for HT,and their combined detection can improve the predictive efficacy.

Abstract:Objective To explore the changes in serum connective tissue growth factor(CTGF)and matrix metalloproteinase-1(MMP-1)levels in patients with urinary incontinence after stroke during the rehabilitation course and their relationship with treatment outcomes.Methods A total of 110 patients with urinary incontinence after stroke from May 2023 to June 2025 were selected as the study subjects(observation group),which were further divided into the effective treatment group(n=86)and the ineffective treatment group(n=24)based on treatment outcomes.Another 150 stroke patients without urinary incontinence were selected as the control group.Serum CTGF and MMP-1 levels were compared among the groups.The relationship between serum CTGF and MMP-1 levels and treatment outcomes in patients with urinary incontinence after stroke was explored by Spearman correlation analysis.The predictive value of serum CTGF and MMP-1 for treatment outcomes in patients with urinary incontinence after stroke were evaluated by the ROC curve.Results Serum CTGF and MMP-1 levels in the observation group were higher compared with control group(P<0.05).Serum CTGF and MMP-1 levels in both groups gradually decreased over time(P<0.05).At the same time points,serum CTGF and MMP-1 levels in the ineffective treatment group were higher than those in the effective treatment group after 2 weeks,4 weeks,and 6 weeks of treatment(P<0.05).Serum CTGF and MMP-1 levels in patients with urinary incontinence after stroke were negatively correlated with treatment outcomes after 2 weeks,4 weeks,and 6 weeks of treatment(P<0.05).The area under the curve(AUC)of serum CTGF and MMP-1 for predicting treatment outcomes in patients with urinary incontinence after stroke was 0.782 and 0.865 respectively(Z=7.910,8.116,both P<0.05),which was lower than that of the combined prediction(AUC=0.914).Conclusions Serum CTGF and MMP-1 levels decrease with the progress of the rehabilitation course in patients with urinary incontinence after stroke and can be used as important markers for predicting treatment outcomes.

Abstract:Objective To explore the effects of predictive psychological nursing on the rehabilitation of female patients with hemifacial spasm(HFS)after microvascular decompression(MVD).Methods A total of 82 female patients with HFS after MVD were prospectively included and randomly divided into the intervention group and the control group,with 41 patients in each group.General data,spasm ratings,depression/anxiety scale scores,total effective rate and postoperative complications,quality of life assessment and nursing satisfaction survey results were collected and analyzed by statistical means.Results 40 patients in the intervention group and 41 patients in the control group completed this study.After psychological nursing,the total effective rate of the intervention group was 100%,the scores of the Depression/Anxiety Scale were 9.71±1.85 and 10.98±3.17,the incidence of complications was 5%,the score of quality of life was 11.9±1.99,and the nursing satisfaction rate was 85%,all of which were significantly better than those of the control group.The difference was statistically significant(P<0.05).Conclusions Psychological nursing has potential benefits for the postoperative rehabilitation of female patients with HFS after MVD.It is recommended to explore its application in clinical practice and conduct multi-center large-sample studies for further verification.

Abstract:Central nervous system germ cell tumors are common malignant tumors in children and adolescents.Pure germ cell tumors are significantly more sensitive to radiotherapy and chemotherapy than other types of germ cell tumors,so other types of germ cell tumors are collectively referred to as non-germinomatous germ cell tumors(NGGCT).The internationally recognized treatment method for central nervous system NGGCT is an integrated treatment approach combining surgery,chemotherapy,and radiotherapy.However,due to the diversity and complexity of its subtypes,treatment strategies also vary based on multiple related factors such as patient age,clinical symptoms,tumor marker expression,tumor location,tumor size,and pathological type.To standardize the diagnosis and treatment of central nervous system NGGCT,the Pediatric Neurosurgery Group of the Chinese Medical Association's Neurosurgery Branch has developed guidelines for the diagnosis and treatment of central nervous system NGGCT in Chinese children and adolescents based on domestic and international clinical research and experience.This guideline covers the integrated diagnosis and treatment plans for primary and recurrent central nervous system NGGCT in patients over 3 years old,hoping to further improve the treatment outcomes and prognosis of patients with central nervous system NGGCT in China.

Abstract:Objective To investigate the changes in serum occludin and syndecan-1(SDC-1)levels before and after interventional embolization in elderly patients with aneurysms and their association with disease outcomes.Methods A retrospective study was conducted on 162 elderly patients with intracranial aneurysms admitted to Xinghua People's Hospital Affiliated to Yangzhou University from February 2019 to January 2025,all of whom underwent interventional embolization.Serum occludin and SDC-1 levels were measured by ELISA on the day before surgery and 7 days after surgery.Patients were followed up for 3 months after surgery and classified into a good outcome group(modified Rankin scale(mRS)≤2,n=134)and a poor outcome group(mRS>2,n=28)based on the mRS scores.Serum marker levels were analyzed in these two groups,and independent risk factors for disease outcomes were screened by multivariate logistic regression analysis.The predictive value was analyzed using the ROC curve.Results On the day before surgery,the serum occludin and SDC-1 levels between the poor outcome group and the good outcome group was not significantly different(P>0.05).Seven days after surgery,serum occludin and SDC-1 levels in both groups were lower,but the levels in the poor outcome group were higher compared with good outcome group(P<0.05).The proportions of hypertension,Fisher grade 3-4,Hunt-Hess grade Ⅲ-Ⅳ,and cerebral vasospasm in the poor outcome group were higher than those in the good outcome group,while the Glasgow coma scale score was lower than that in the good outcome group(P<0.05).Multivariate analysis showed that hypertension,Hunt-Hess grade Ⅲ-Ⅳ,cerebral vasospasm,and high serum occludin and SDC-1 levels 7 days after surgery were independent risk factors for poor outcomes in elderly patients with aneurysms after interventional embolization(P<0.05).ROC analysis showed that the area under the curve(AUC)of the combined(serial)prediction of serum occludin and SDC-1 7 days after surgery for disease outcome in elderly patients with aneurysms after interventional embolization was 0.905,which was higher than that of serum occludin or SDC-1(0.783 and 0.851 respectively;Z=10.409,11.761,P<0.001).Conclusions Serum occludin and SDC-1 levels decrease after interventional embolization in elderly patients with aneurysms.High serum occludin and SDC-1 levels 7 days after surgery are closely related to poor disease outcome.The combination of serum occludin and SDC-1 7 days after surgery has good predictive value for disease outcome in elderly patients with aneurysms after interventional embolization and can be used as a reference indicator for evaluating disease outcome.

Abstract:Severe traumatic brain injury is characterized by high disability and mortality rates,and these patients have high nutritional demands under a state of high stress.Music therapy,which can stimulate auditory function,regulate neurological function and psychological state,has shown positive effects in promoting the recovery of patients'consciousness and improving their psychological conditions.The application of early enteral nutrition support combined with music therapy in patients with severe traumatic brain injury can synergistically enhance their nutritional status,neurological function and psychological state,reduce the incidence of complications,and improve the awakening rate and quality of life.However,there is currently a lack of unified standard for the clinical application of this combined treatment regimen.This article aims to conduct an in-depth exploration of the application progress of this combined regimen in the prognosis of treating patients with severe traumatic brain injury,hoping to provide new ideas for the treatment and nursing of such patients.

Abstract:Objective To explore the effectiveness of combining 3D printing technology with personalized teaching methods in standardized resident clinical teaching for neurosurgery specialists(referred to as"Standardized Residency Training for Specialists,SRTS").Methods A total of 32 neurosurgery specialty training residents at the First Affiliated Hospital of the Air Force Medical University from March 2021 to September 2024 were selected as the study subjects.Based on the teaching methods,they were divided into a control group(traditional teaching method)and an observation group(3D printing technology combined with personalized teaching method),with 16 participants in each group.The theoretical assessment scores and subjective survey questionnaire scores on teaching effectiveness were compared between the two groups.Results The average theoretical assessment score of the observation group was(87.60±6.56)points,significantly higher than that of the control group(76.21±6.27)points(P<0.05).The approval rates in the observation group for six dimensions—improvement in self-learning ability,enhancement of comprehensive problem-solving skills,improvement in independent problem-solving ability,enhancement of memory and comprehension ability,stimulation of learning interest,and satisfaction with the current teaching method—were significantly higher than those in the control group(P<0.05).Conclusions The application of 3D printing technology combined with personalized teaching methods in the clinical teaching of various neurosurgical diseases can not only help specialty training residents efficiently master professional knowledge,but also improve the general teaching effectiveness.

Abstract:Objective To investigate the incidence trend of ischemic stroke among Chinese residents from 1990 to 2021 using data from the Global Burden of Disease Database(GBD 2021),and to analyze the impact of age,period,and cohort on this trend.Methods Based on GBD 2021 data,Joinpoint software was utilized to examine the changing trends in ischemic stroke incidence.Additionally,an age-period-cohort model was employed to identify influencing factors and forecast future incidence trends.Results From 1990 to 2021,the incidence of ischemic stroke in the Chinese population exhibited significant fluctuations,with mean annual percentage changes of 1.2%for men and 0.78%for women(1.03%for the total population,P<0.001).The age-period-cohort model analysis revealed that the incidence rate increased with advancing age,peaking in men aged 80～84 years and in women aged 85～89 years.For individuals aged 15～39 years,the incidence rate was lower in males compared to females.However,between the ages of 40 and 89,the incidence rate was higher in males than in females.Recent periods and cohorts showed higher risks,particularly among men compared to women.It is projected that by 2044,the overall incidence will continue to rise,with crude male incidence and standardized incidence rates estimated to be 1.10～1.26 times those of females.Conclusions The incidence of ischemic stroke among Chinese residents has shown an upward trend from 1990 to 2021,with a consistently higher rate observed in males compared to females.Projections indicate that by 2044,the male incidence rate will continue to escalate,further widening the gender disparity.Additionally,the incidence increases with advancing age.Consequently,middle-aged and elderly men constitute a critical demography for targeted ischemic stroke prevention efforts.

Abstract:Objective To enhance the clinical recognition and differential diagnostic capabilities for autoimmune glial fibrillary acidic protein(GFAP)astrocytopathy,a recently identified autoimmune disorder of the central nervous system.Methods The case of a 67-year-old male patient admitted to the First Department of Neurology at the Affiliated Hospital of Shandong Second Medical University with a chief complaint of"neck pain and recurrent fever lasting more than 50 days"was reported.The patient initially was presented with marked daytime somnolence,fever,and urinary difficulty.Initial cerebrospinal fluid(CSF)analyses conducted both prior to admission and upon hospitalization revealed decreased glucose and chloride concentrations along with elevated protein levels.No anti-GFAP antibody testing was performed initially,and the patient showed no response to antimicrobial or antiviral therapies.Subsequently,CSF analysis detected positive anti-GFAP antibodies at a titer of 1:1 000.Results Following the diagnosis of autoimmune GFAP astrocytopathy,the patient received methylprednisolone pulse therapy,resulting in significant improvement in clinical symptoms.Conclusions This case highlights that in patients presented with nonspecific manifestations such as excessive somnolence,urinary dysfunction,and fever,particularly after exclusion of common infectious etiologies and lack of response to antimicrobial or antiviral treatments,autoimmune GFAP astrocytopathy should be considered in the differential diagnosis.Early detection of anti-GFAP antibodies in the CSF is critical for timely and accurate diagnosis,and prompt initiation of immunotherapy,such as corticosteroid treatment,can lead to favorable clinical outcomes.

Abstract:Objective To investigate the efficacy and safety of the Pipeline embolization device(PED)versus stent-assisted coiling(SAC)in the treatment of unruptured intracranial aneurysms.Methods Clinical and follow-up data of 32 patients with unruptured intracranial aneurysms who underwent PED or SAC treatment from January 2019 to December 2024 were collected,including age,aneurysm characteristics,treatment process,postoperative complications and follow-up outcomes,with no statistically significant difference in baseline data between the two groups(P>0.05).Statistical analysis was performed to compare the therapeutic efficacy and safety between the two groups.Results The incidence of postoperative complications was 0 in the PED group and 3.1%in the SAC group,showing no statistically significant difference(P>0.05).The PED group had shorter operation time,lower postoperative aneurysm recurrence rate,higher incidence of postoperative in-stent stenosis and better neurological function recovery,with all differences statistically significant(P<0.05).Conclusions In the endovascular treatment of unruptured intracranial aneurysms,compared with stent-assisted coiling,Pipeline embolization device has the advantages of shorter operation time,lower aneurysm recurrence rate and better postoperative neurological function recovery,but it is associated with a higher incidence of postoperative parent artery stenosis.

Abstract:Central nervous system germ cell tumors are common malignant tumors in children and adolescents,often occurring in the pineal region,sellar region or basal ganglia-thalamus region,and in a few cases,multiple intracranial lesions may exist.Due to the differences in tumor location,clinical manifestations,and pathological types,treatment methods and prognosis vary.The treatment of central nervous system germ cell tumors is rather complex.The common treatment for pure central nervous system germ cell tumors is surgical biopsy to confirm the pathology,followed by chemotherapy combined with radiotherapy or radiotherapy alone,which can achieve good clinical outcomes.The Pediatric Neurosurgery Group of the Chinese Medical Association's Neurosurgery Branch has formulated the diagnosis and treatment guidelines for pure central nervous system germ cell tumors in Chinese children and adolescents based on domestic and international clinical research and experience.This guideline covers the integrated diagnosis and treatment plans for primary and recurrent central nervous system pure germinoma in patients over 3 years old,aiming to standardize the diagnosis and treatment of such patients in China and further improve their therapeutic efficacy.

Abstract:Objective To analyze the global incidence trend of central nervous system(CNS)tumors in adolescents and young adults around the world from 1990～2021,with an emphasis on the influence mechanism of age,period and cohort,and predict the incidence trend in 2022～2044.Methods The 2021 Global Burden of Disease database included worldwide CNS tumor data in adolescents and young adults.The Joinpoint regression model was used to analyze the trend of standardized incidence of CNS tumors in adolescents and young adults around the world from 1990～2021.At the same time,the age-period-cohort model was used to analyze the effects of age,period and cohort on the incidence of CNS tumors in adolescents and young adults around the world.The Nordpred package using R language was used to predict the trend of this disease burden in 2022～2044.Results The incidence of CNS tumors in adolescents and young adults increased by 62.51%in 1990～2021,and the standardized incidence showed a fluctuating upward trend(AAPC=0.61%,P<0.01,the trend change was statistically significant).Based on the comparison of gender perspectives,it was found that although the increase in women was larger,the male group was higher than the female in terms of the number of cases,crude incidence and standardized incidence.Analysis of the age-period-cohort model showed that the age,period and cohort effects all showed an increasing trend.The prediction results show that the incidence of CNS tumors in adolescents and young adults would continue to increase in 2022～2044.Conclusions The incidence of CNS tumors in adolescents and young adults increased year by year from 1990～2021,and it is predicted that the number of cases will continue to increase in the future,and the disease burden situation is severe.

Abstract:Objective To explore the c-Myc-dependent R-loop structure and its regulatory effect on the proliferation,invasion and migration of glioma cells.Methods DRIP-PCR was used to detect the R-loop structure of c-Myc in glioma cells(U251 and U87-MG).U251 and U87-MG were transfected into empty plasmids,c-Myc overexpression plasmids,and RNASEH1 overexpression plasmids respectively,which were used respectively to establish control group(CTRL group),RNASEH1 overexpression group(RNASEH1-OE group),c-Myc overexpression group(c-Myc-OE group),and co-transfected c-Myc and RNASEH1 overexpression group(c-Myc-OE+RNASEH1-OE group).CCK-8 assay,EdU assay,scratch assay,and Transwell assay were used to detect the proliferation,migration,and invasion levels of glioma cells.The Western blot was used to detect the expression levels of RNASEH1 and c-Myc proteins expressions in glioma cells.Results c-Myc had an R-loop structure in glioma cells(P<0.05).Overexpression of RNASEH1 could knock out the c-Myc-dependent R-loop structure,further reducing glioma cell proliferation,invasion,and migration(P<0.05).Overexpression of c-Myc could upregulate the expression of knockdown RNASEH1,thereby rescuing the c-Myc-dependent R-loop structure and enhancing the invasion and migration abilities of glioma cells(P<0.05).Conclusions c-Myc-dependent R-loop structure can promote the proliferation,invasion and migration of glioma cells.

Abstract:Objective To explore the application effect of pre-hospital emergency intervention guided by process management theory for severe traumatic brain injury.Methods A total of 152 cases with severe traumatic brain injury admitted to our hospital from February 2021 to March 2024 were selected and randomly divided into the control group and the study group(76 cases each).The control group received conventional emergency care intervention,while the study group received pre-hospital emergency intervention guided by process management theory.The emergency duration(first treatment duration,hospital response duration),emergency success rate,rehabilitation status[National Institutes of Health Stroke Scale(NIHSS),Activities of Daily Living Scale(ADL)],complications rate,prognosis and family satisfaction with care were compared between the two groups.Results The study group showed significantly shorter duration to first treatment and hospital response duration,as well as a higher emergency success rate compared to the control group(P<0.05).The total complications rate in the control group(34.21%,26/76)was significantly higher than that in the study group(18.42%,14/76)(P<0.05).At discharge,both groups exhibited reduced NIHSS scores and improved ADL scores compared to admission,with the study group demonstrating significantly better outcomes(all P<0.05).The recovery rate of the control group was 46.05%(35/76),which was lower than 64.47%(49/76)of the study group(P<0.05).The overall satisfaction rate of nursing care for patients(or family members)in the study group was 97.37%(74/76),which was higher than the control group's 88.16%(67/76)(P<0.05).Conclusions Pre-hospital emergency intervention guided by the process management theory can shorten the emergency duration for patients with severe traumatic brain injury,improve their neurological function,daily living activity recovery and prognosis,reduce complications,and increase the success rate of emergency treatment and nursing satisfaction.

Abstract:Objective To explore the clinical value of serum CHR combined with Hcy in short-term prognosis evaluation of cases with acute ischemic stroke(AIS)after interventional therapy.Methods A total of 168 cases with AIS underwent interventional surgery from August 2023 to December 2024 were selected.According to the mRS scores at 30 days after surgery,the patients were divided into a good prognosis group(n=110)and a poor prognosis group(n=58).The predictive value was evaluated by constructing a ROC curve.The influencing factors were analyzed by multivariate logistic stepwise regression.Results The levels of CRP,CHR,and Hcy in the poor prognosis group were higher than those in the good prognosis group,while its HDL-C was lower(P<0.05).The area under the ROC curve(AUC)(95%CI)of CHR combined with Hcy in predicting the short-term prognosis of patients with acute ischemic stroke after interventional therapy was 0.903(0.864～0.943),which was significantly higher than that of CHR and Hcy alone at 0.841(0.790～0.892)and 0.752(0.712～0.797)respectively(P<0.001).The poor prognosis group had higher age,NIHSS score at admission,platelet count,D-dimer,and glycated hemoglobin than the good prognosis group(P<0.05).Multivariate analysis showed that higher NIHSS score at admission(OR=2.651,95%CI:1.405-5.003),elevated D-dimer(OR=2.228,95%CI:1.349～3.679),elevated glycated hemoglobin(OR=2.100,95%CI:1.370～3.220),CHR≥2.85(OR=2.784,95%CI:1.427～5.432),and Hcy≥16.96 μmol/L(OR=2.748,95%CI:1.479～5.106)were independent risk factors for short-term prognosis after interventional therapy in patients with acute ischemic stroke(P<0.05).Conclusions Elevated CHR and Hcy are closely related to the short-term prognosis of patients with acute ischemic stroke after interventional therapy,and the predictive efficacy of combined detection of the two is better.