Abstract:Objective To develop a miniaturized electric field device suitable for human-derived glioblastoma organoids,explore the effect of tumor electric field therapy on glioblastoma organoids,and provide an experimental basis for the optimization of individualized electric field therapy parameters.Methods Based on the previous high-voltage equipment,the research and development of a miniaturized electric field equipment was carried out;the materials of organoid culture dishes were optimally designed,and the equipment structure and function were improved through three-dimensional simulation;the patient-derived glioblastoma organoid model was used to study the effect of electric fields on tumor cell proliferation.Results The independently developed miniaturized electric field device was suitable for glioblastoma organoid experiments.In the electric field of 200kHz/2V/cm,it could significantly inhibit the early proliferation of organoids,reducing the growth rate by more than 30%within 1 week,but some organoids showed the phenomenon of regrowth after 2 weeks.Conclusions This study provides important preliminary experimental support for the optimization of individualized electric field therapy parameters for glioblastoma,and helps promote the development of personalized strategies for the application of external electric fields in the treatment of glioblastoma.

Abstract:Objective To explore the clinical efficacy of deep brain stimulation(DBS)in the treatment of primary Parkinson's disease(PD).Methods A retrospective study was conducted on 40 PD patients admitted to the 940th Hospital of the PLA Joint Logistics Support Force from January 2019 to December 2023.Among them,20 patients received DBS(bilateral subthalamic nucleus DBS,including 13 cases of stereotactic intracranial neurostimulator implantation and 7 cases of robot-assisted deep brain electrode implantation),and 20 patients received medication(levodopa-carbidopa tablets combined with selegiline).The motor function improvement of patients was evaluated using the Unified Parkinson's Disease Rating Scale Part III(UPDRS-Ⅲ)before surgery and at 6 months postoperatively.Results Compared with the baseline,the UPDRS-Ⅲ scores of PD patients in both groups decreased at 6 months after treatment,with the DBS group showing lower scores than the medication group.The difference in score changes before and after treatment between the two groups was statistically significant(all P<0.05).Compared with preoperative scores,the UPDRS-Ⅲ scores of patients undergoing either stereotactic intracranial neurostimulator implantation or robot-assisted deep brain electrode implantation decreased at 6 months postoperatively(P<0.05),but there was no statistically significant difference between the two surgical methods(P>0.05).The operation time of patients undergoing stereotactic intracranial neurostimulator implantation was significantly longer than that of patients undergoing robot-assisted deep brain electrode implantation(P<0.05).Conclusions DBS treatment can significantly improve symptoms and enhance the quality of life for patients with primary PD.

Abstract:Objective To investigate and analyze the related risk factors of prognosis in patients with intraventricular hemorrhage secondary to hemorrhagic stroke.Methods The clinical data of 152 patients with intraventricular hemorrhage secondary to hemorrhagic stroke treated in our hospital from June 2022 to January 2025 were retrospectively analyzed.According to the prognosis status,the patients were divided into survival group(n=95)and death group(n=57).Univariate and multivariate logistic regression analyses were performed to explore the correlation between prognosis status of patients and age,gender,body mass index(BMI),admission consciousness level,hematoma volume,bleeding site,midline shift,Glasgow coma score(GCS)at admission,NIHSS score,mean arterial pressure(MAP)at admission,concurrent diabetes mellitus,concurrent hyperlipidemia,concurrent hyperuricemia,hematoma morphology,hemoglobin(Hb),red blood cell count(RBC),mean corpuscular volume(MCV),C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)and white blood cell count(WBC).Results Univariate results showed that there were significant differences in age,admission consciousness level,hematoma volume,bleeding site,midline shift,GCS score,Hb,RBC,CRP and IL-6 between the two groups(P<0.05).Multivariate analysis showed that bleeding site(basal ganglia region or brainstem),GCS score at admission,hematoma volume and midline shift were independent risk factors affecting the prognosis in patients with intraventricular hemorrhage secondary to hemorrhagic stroke(P<0.05).Conclusions The bleeding site,GCS at admission,hematoma volume and midline shift of patients with intraventricular hemorrhage secondary to hemorrhagic stroke are closely related to the prognosis.It is necessary to focus on the dynamic changes of the above indicators,and assist doctors to evaluate the disease conditions and optimize treatment decisions by strengthening consciousness monitoring,vital sign management,complications prevention and individualized nursing intervention,so as to improve the prognosis of patients.

Abstract:Objective To investigate the influence of the vascular structure of cavernous sinus dural arteriovenous fistula(CS-DAVF)on the selection and efficacy of endovascular treatment methods.Methods A retrospective analysis was conducted on 75 patients with CS-DAVF who underwent endovascular embolization,and the selection of treatment strategies and clinical outcomes for them were reported.Results All 75 patients(12 males and 63 females;average age 51.61 years)underwent CS-DAVF embolization.The most common symptoms were proptosis(34.7%),bulbar conjunctival edema(42.7%),and headache(24%).On digital subtraction angiography images,33.3%of DAVF were unilateral,and 66.7%were supplied by the external carotid artery and internal carotid artery.In the inferior petrosal sinus(IPS)of patients,54.7%were not visualized.The most common endovascular approaches included the IPS(37.3%)and trans-arterial(26.7%)approaches.64%CSDAVFs were treated with coils and Onyx embolization.84%of fistulas were completely embolized after the surgery,and the follow-up rate was 77.3%.The final modified Rankin scale score was(0.8±0.9).Conclusions The vascular structure of CS-DAVF is closely related to the choice and outcome of intravascular treatment methods.Combined with the improved IPS recanalization technique,the IPS approach is safe and effective.The dual microcatheter and balloon-assisted technique ensure the safety and completeness of the embolization.

Abstract:As modern warfare evolves toward greater intelligence and unmanned operations,the management of combat-related traumatic brain injury(TBI)faces increasing challenges,including complex battlefield environment,higher demands for treatment timeliness,and limited medical resources.Emerging intelligent,remote and unmanned medical technologies are gradually being deployed to address these needs.In the diagnostic domain,portable CT scanners,near-infrared spectroscopy(NIRS),and rapid biomarker detection technologies have enabled ultra-early diagnosis under battlefield conditions.In treatment systems,artificial intelligence-assisted decision-making,robotic surgery,and brain-computer interface(BCI)technologies have significantly compressed the treatment window and improved treatment efficiency and functional recovery rates.However,existing technologies still face bottlenecks,such as limited adaptability to battlefield conditions and difficulties in multimodal data integration.Future developments should focus on:(1)building AI-driven automated tiered treatment networks;(2)developing intelligent neural repair materials and personalized therapeutic strategies;and(3)optimizing intelligent logistical support systems.By deeply integrating intelligent,remote and personalized technologies,a highly efficient,precise,and intelligently coordinated modern combat casualty care system for traumatic brain injury can be ultimately established.

Abstract:Gliomas,originated from the central nervous system,are a group of malignant tumors with poor prognosis.Early diagnosis of gliomas is still quite challenging.Scholars place high expectations on such non-invasive diagnostic technique as liquid biopsy to improve the situation.This paper is based on a bibliometric analysis of the literatures on liquid biopsy in gliomas retrieved from the Web of Science Core Collection database,with a time span from January 1,2015 to December 31,2024.It is found that the studies of liquid biopsy in gliomas have developed rapidly and researchers in the US have contributed the largest share of research findings.Scholars interested in this field can pay particular attention to the journals of Neuro-Oncology,Clinical Cancer Research,Oncotarget and Cancers.Louis DN and other scholars have made significant contribution to this research field.Currently,the research hotspots related to liquid biopsy in gliomas are exosomes,biomarkers,and novel combination therapies.This paper summarizes the research status,hotspots and trends of the studies on liquid biopsy in gliomas and provides visualized materials.

Abstract:Objective To clarify the anatomical characteristics of the suboccipital venous plexus,provide a reference for craniotomy,and reduce the risks of intraoperative bleeding and air embolism.Methods Five formalin-fixed head and neck specimens were used.After arteriovenous pressure perfusion and dye injection,the structure of the suboccipital venous plexus was observed by layered dissection under a microscope.Results The suboccipital venous plexus can be divided into three parts:the superficial layer,the muscular layer and the deep layer.It has a close anatomical relationship with the sigmoid sinus,jugular foramen and paravertebral venous plexus.In addition,it has morphological asymmetry.Conclusions Mastering the anatomical characteristics of the suboccipital venous plexus can avoid injury to the suboccipital venous plexus in surgeries via the retrosigmoid approach(cerebellopontine angle area),paramedian approach(ventral side of the brainstem)and far-lateral approach(posterior cranial fossa),reduce complications,and improve surgical safety.

Abstract:Hemangioblastomas(HBs)are highly vascular tumors where early diagnosis is crucial for minimizing intraoperative bleeding.While HBs predominantly occur in the infratentorial region,their presence in the pineal region is exceptionally rare,with only five documented cases in literature--four associated with Von Hippel-Lindau(VHL)syndrome and just one sporadic case.The Department of Neurosurgery at Guangyuan Central Hospital treated a middle-aged female patient in August 2022 presenting with nausea,vomiting,and dizziness.MRI revealed a markedly enhanced solid nodule in the pineal region compressing the cerebral aqueduct,accompanied by hydrocephalus.The tumor was resected via a left prone infratentorial supracerebellar approach,encountering significant intraoperative hemorrhage.Postoperative pathological examination and genetic testing confirmed a diagnosis of sporadic hemangioblastoma.The patient's symptoms resolved completely post-operation,with MRI demonstrating total resection and no recurrence during one-year follow-up.

Abstract:Objective To analyze the existence of commonalities in the molecular interaction networks(MINWs)architecture between glioblastoma(GBM)hypoxia and bacterial biofilm.Methods Algebraic topology methods were used to analyze the topological invariants of the GBM-MINW and the Biofilm-MINW by comparing them with random networks.Results Both networks exhibited complex and stable non-random topological features:each contained a substantial number of high-dimensional simplices and maximal simplices,far exceeding those found in random networks.Persistent homology analysis further revealed highly stable topological characteristics in both networks,including cyclic and cavity structures with long life cycles.Conclusions The MINWs of glioblastoma hypoxia and bacterial biofilms share similar topological structures,both forming highly interconnected and stable high-dimensional architectures.This finding provides a cross-domain example for understanding universal principles governing complexity in living systems.

Abstract:Alzheimer's disease(AD)is the most prevalent neurodegenerative dementia,clinically characterised by progressive episodic-memory decline that eventually encompasses multiple cognitive domains.Its neuropathological hallmarks are the extracellular deposition of β-amyloid(Aβ)in senile plaques and the intracellular accumulation of hyper-phosphorylated Tau protein in neurofibrillary tangles.With the aging acceleration of global population,the incidence of AD is steadily rising,imposing a substantial burden on public-health and healthcare systems.Breakthrough studies have recently highlighted the pivotal role of the meningeal lymphatic system in clearing cerebrospinal and interstitial metabolic waste,thereby influencing AD pathogenesis.Against this backdrop,deep cervical lymphatic-venous anastomosis(DLVA)has been proposed as a"clearance-end"surgical strategy that reconstructs brain-neck lymphatic outflow to expedite Aβ removal.This review synthesises the anatomical and surgical foundations of DLVA,collates current pre-clinical and clinical evidence,analyses its advantages and limitations,and outlines future research priorities—namely multicentral randomised controlled trials,precision imaging-guided planning,and multidisciplinary combination therapies—to provide a theoretical framework and technical roadmap for its clinical translation.

Abstract:Objective To explore the risk factors for thrombus migration during mechanical thrombectomy for acute ischemic stroke with large vessel occlusion(AIS-LVO),and establish a nomogram prediction model.Methods A retrospective analysis was conducted on the clinical data of 171 patients with acute ischemic stroke with large vessel occlusion(AIS-LVO)who received mechanical thrombectomy at Suzhou Hospital Affiliated to Nanjing Medical University from December 2019 to December 2024.According to the occurrence of thrombus migration during mechanical thrombectomy,the patients were divided into the thrombus migration group(n=62)and the non-thrombus migration group(n=109).The clinical data between the two groups were compared,and those with statistically significant differences(P<0.05)were included in the multivariate logistic regression analysis to screen the independent risk factors for thrombus migration during the operation and construct a nomogram model.The efficiency,goodness of fit and benefit of the established model were tested through internal validation.Results Univariate analysis showed that there were statistically significant differences in the history of diabetes,bridging therapy,number of thrombectomy procedures,clot burden score(CBS),high-density vessel sign,primary thrombectomy strategy,thrombus location,and collateral status between the two groups(P<0.05).Multivariate logistic regression analysis showed that bridging therapy(OR=3.33,95%CI:1.44～7.72,P=0.005),the number of thrombectomy procedures>1 time(OR=8.82,95%CI:3.12～24.94,P<0.001),posterior circulation thrombosis(OR=4.17,95%CI:1.17～14.83,P=0.027),and poor collateral status(OR=5.27,95%CI:2.26～12.28,P<0.001)were all independent risk factors for thrombus migration during mechanical thrombectomy for AIS-LVO(P<0.05).A nomogram prediction model was established based on the above risk factors.The verification results showed that the area under the curve was 0.82,the Hosmer-Lemeshow test χ2=6.536,P=0.587,and the decision curve showed that when the threshold probability was in the range of 0.08 to 0.94,there was a relatively higher net benefit value.Conclusions The nomogram model constructed on the status of bridging therapy,the number of thrombectomy procedures,location of the thrombus in the posterior circulation,and collateral status can predict the probability of thrombus migration during the mechanical thrombectomy treatment for AIS-LVO.

Abstract:Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and hematocrit levels on prognosis in patients with traumatic brain injury(TBI).Methods A total of 166 patients with TBI admitted to Xingtai Central Hospital from August 2022 to August 2024 were selected and were classified into a poor prognosis group(n=54)and a favorable prognosis group(n=112)based on prognostic grouping.The baseline data,clinical indicators,NLR,PLR and hematocrit were compared between the two groups.Pearson correlation analysis was used to assess the correlation between NLR,PLR,hematocrit and clinical indicators.Independent influencing factors of poor prognosis and the predictive efficacy of the indicators for adverse prognosis were analyzed.Results Compared with good prognosis group,the proportion of concurrent hypertension,time from TBI to admission,proportion of concurrent other organ injury,fibrinogen(FIB),red blood cell distribution width(RDW),C-reactive protein(CRP),NLR,PLR and hematocrit were significantly higher in poor prognosis group(P<0.05).NLR,PLR and hematocrit were positively correlated with time from TBI to admission,FIB,RDW and CRP(P<0.05).Multivariate analysis suggested that concurrent hypertension,time from TBI to admission,concurrent other organ injury,GCS score at admission,RDW,NLR,PLR and hematocrit were the independent influencing factors of poor prognosis(P<0.05).The area under the curves(AUCs)of NLR,PLR and hematocrit in predicting poor prognosis were 0.854,0.674 and 0.698 respectively.The AUC of the combined applcation of the three indicators increased to 0.911,with a sensitivity of 98.15%and a specificity of 62.50%.Conclusions NLR,PLR and hematocrit are potential predictors of prognosis in patients with TBI,and the combined application of the three indicators can enhance the predictive efficiency.

Abstract:Objective To assess the therapeutic effects of repetitive transcranial magnetic stimulation on residual dizziness,gait performance,and postural stability of patients with benign paroxysmal positional vertigo after successful canalith repositioning.Methods 100 BPPV patients with persistent dizziness following successful repositioning recruited from three clinical centers between September 2023 and September 2024 were analyzed.Participants were randomly assigned to either an active intervention group or a control group,with 50 patients in each.All participants received standard medication,while the intervention group additionally underwent 5-day rTMS targeting the left dorsolateral prefrontal cortex.The control group received sham stimulation at the identical site for the same duration.Changes in vertigo intensity,gait characteristics,and balance capacity were evaluated on day 6.Results The two groups were comparable at baseline regarding demographic and clinical characteristics.After the intervention,the active rTMS group showed significantly greater improvements in vertigo scores,gait parameters,and balance function than the control group.Mild and transient tinnitus was reported by 3 participants in the intervention group,which resolved spontaneously within one day without any intervention.No adverse events were documented in the control group.Conclusions rTMS is an effective and well-tolerated intervention for alleviating residual dizziness and enhancing gait and balance recovery in BPPV patients'post-repositioning.

Abstract:Thoracic outlet syndrome(TOS)is a series of symptoms caused by compression of the neurovascular structure in the upper thoracic outlet.It can be classified into arterial TOS,venous TOS,and neurogenic TOS,with neurogenic TOS being the most common.Understanding the clinical manifestations and specific symptoms of TOS,as well as conducting appropriate auxiliary examinations,can aid in achieving an accurate diagnosis.Once TOS is diagnosed,treatment may include conservative therapy or surgical intervention.This article provides a comprehensive review of the anatomy,athophysiology,clinical manifestations,diagnosis,and treatment of thoracic outlet syndrome.

Abstract:Neurological disorders have become a serious public health challenge in today's society,and isoliquiritigenin(ISL),as a natural compound,has shown potential roles in neurorepair and combating neurological diseases.This compound demonstrates broad therapeutic prospects for various neurological disorders through multiple pharmacological mechanisms,including anti-inflammatory,antioxidant,immune-regulating effects,promoting neuronal growth,and reducing neuronal apoptosis.Studies in animal models have shown that isoliquiritigenin can improve the pathophysiological processes in models of Alzheimer's disease,traumatic brain injury,and subarachnoid hemorrhage,providing a foundation for its application in the treatment of human neurological diseases.This article mainly summarizes the current domestic and international research on ISL in the field of neural injury,offering new insights and potential strategies for the treatment of neurological disorders.

Abstract:Objective To explore the clinical features,causes of misdiagnosis,and optimal treatment strategies for intracranial subdural empyema(SDE).Methods The clinical data of five patients diagnosed with SDE at the Department of Neurosurgery at Ankang Central Hospital between November 2020 to February 2023 were retrospectively analyzed.Clinical presentations,treatments,and outcomes were systematically reviewed.Results All patients were preoperatively misdiagnosed,with the correct diagnosis confirmed intraoperatively.Two adolescent patients underwent SDE evacuation combined with decompressive craniectomy due to rapid clinical deterioration and cerebral herniation,both of whom underwent cranioplasty 3-6 months later and achieved a Glasgow Outcome Scale(GOS)score of 5.The other three elderly patients underwent burr-hole drainage,with one having a GOS score of 5 at the six-month follow-up,and the other two having a GOS score of 1.Conclusions SDE is rare but progresses rapidly.Timely and accurate diagnosis combined with appropriate surgical interventions can significantly improve the prognosis.

Abstract:Objective To investigate the evaluation value of amplitude-integrated electroencephalogram(aEEG)and serum homocysteine(Hcy)on the disease conditions of patients with vascular cognitive impairment(VCI).Methods A total of 150 patients with VCI admitted to First Hospital of Qinhuangdao from June 2023 to December 2024 were retrospectively selected.According to Montreal Cognitive Assessment(MoCA)score at admission,the patients were classified into mild-to-moderate group(n=123,78 cases of mild disease,45 cases of moderate disease)and severe group(n=27).All patients were monitored by aEEG.The aEEG score and serum Hcy level were compared between both groups.Receiver operating characteristic(ROC)curve was drawn to analyze the evaluation value of aEEG score and Hcy level on VCI conditions.The influencing factors of severe condition of VCI patients were explored by multivariate logistic regression analysis.Results The aEEG score in the severe group was lower while serum Hcy level was higher than that in the mild-to-moderate group(P<0.05).The areas under the curves(95%CI)of aEEG score,Hcy and their combination in predicting severe VCI were 0.870(0.814-0.926),0.806(0.698-0.913)and 0.915(0.780-0.968)respectively.The proportions of stroke history,diabetes mellitus history,multiple drug use and smoking history and levels of total cholesterol(TC),triacylglycerol(TG)and C-reactive protein(CRP)in the severe group were higher compared to the mild-to-moderate group(P<0.05).Reduced AEEG score,increased Hcy level,multiple drug use and concurrent diabetes mellitus were independent influencing factors for severe condition of VCI patients(P<0.05).Conclusion The decrease of aEEG score and increase of Hcy level are closely related to the disease severity of VCI patients.The two indexes can be used as sensitive markers to evaluate the disease severity of VCI patients.

Abstract:Objective To evaluate the impact of a scenario-case-issue(SCI)pedagogical framework integrated with a 3E(essential knowledge and skills-English-essay)evaluation system on the teaching efficacy in neurology education.Methods This study involved two consecutive cohorts of five-year clinical medicine students from the Air Force Medical University:a control group(2019 grade,n=126)taught via traditional methods and an experimental group(2020 grade,n=125)instructed using the SCI+3E approach.At the end of the semester,both groups were evaluated through objective written examinations and subjective questionnaires measuring course satisfaction and perceived learning outcomes.Results Compared with the control group,the experimental group showed significantly higher scores in both theoretical assessment and teaching effectiveness feedback questionnaire,with statistically significant differences.(P<0.05).Conclusions The SCI+3E pedagogical model fosters structured clinical reasoning and multi-dimensional skill development,and hence elevates neurology education quality and clinical competency.These findings underscore the model's potential to facilitate medical pedagogy by bridging theoretical knowledge with practical application.

Abstract:Objective To investigate the influencing factors of deep vein thrombosis in perioperative patients undergoing craniocerebral trauma surgery and construct a risk prediction model.Methods A retrospective analysis was conducted on the clinical data of 200 patients who underwent craniocerebral trauma surgery at the First Affiliated Hospital of Henan University of Chinese Medicine from May 2023 to May 2025.The data of another 145 patients admitted to the same hospital from May 2023 to December 2024 were used for model construction(modeling group).The data of 55 patients admitted from January 2025 to May 2025 were used for the external validation of the model(validation group).Multivariate logistic regression analysis was performed to analyze the influencing factors of deep vein thrombosis in perioperative patients undergoing craniocerebral trauma surgery and establish a risk prediction model.The goodness of fit and predictive efficacy of the model were verified by using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic(ROC)curve.Results Factor analysis showed that age,time from injury to surgery,the use of vasoactive drugs,and plasma D-dimer were the influencing factors of deep vein thrombosis in perioperative patients undergoing craniocerebral trauma surgery.Based on the above factors,a risk prediction model for deep vein thrombosis in perioperative patients undergoing craniocerebral trauma surgery was constructed.The Hosmer-Lemeshow goodness-of-fit test showed that χ2=11.303,P=0.185;the area under the receiver operating characteristic curve was 0.952[95%CI(0.905,0.998)];the maximum Youden index of the model was 0.759,the optimal cut-off value was 0.5270,the sensitivity was 0.966,and the specificity was 0.793.The risk prediction model was verified.The area under the receiver operating characteristic curve of the verification group was 0.883[95%CI(0.765,0.991)],the sensitivity was 0.773,and the specificity was 0.909.Overall,it indicated that the model had a high predictive accuracy for the occurrence of DVT.Conclusion The risk prediction model for deep vein thrombosis in perioperative patients undergoing craniocerebral trauma surgery has a relatively good predictive effect.

Abstract:Objective To analyze the incidence trends of tension-type headache among Chinese adolescents and young adults(aged 15 to 39)from 1990 to 2021 and to explore the effects of age,period,and cohort on the variation in incidence rates.Methods The Joinpoint regression model was employed to analyze the changes in incidence rates from 1990 to 2021.By segmenting the time trend into distinct periods,the annual percentage change(APC)for each period and the average annual percentage change across the entire study period were calculated.Additionally,the age-period-cohort model was employed to conduct a three-dimensional analysis of the incidence risk for adolescents and young adults aged 15 to 39,categorizing birth cohorts and calculating the corresponding rate ratio(RR).Results The incidence of tension-type headaches decreased by about 12%.During the same period,the crude and standardized incidence rates of adolescents and young adults increased.However,in the stages of 2000-2005 and 2018-2021,the incidence fluctuated,and the APC values were 1.99%and 1.12%respectively.The incidence was consistently higher in women than in men,and this trend was stable.In the analysis of period effect,the risk of morbidity during 2002-2006 was the most stable,and the risk had rebounded in recent years.The birth cohort effect showed that the birth cohort had the highest RR of 1.128 in 2002.Conclusions Although the overall incidence of TTH in adolescents and young adults showed a downward trend during 1990-2021,the incidence rate still rebounds periodically,and the risk of birth cohort increases in recent years.Therefore,there is a need to strengthen TTH intervention and prevention in adolescents and young adults to improve long-term health.