Objective To explore the effects of mild hypothermia (MH) on the nitric oxide (NO) and water content of brain tissues (WBT) in rats with traumatic brain edema (TBE). Methods Fifty-four Wistar rats were divided into a control group (group C), a normithermal traumatic group (NT group) and a mild hypothermia traumatic group (MHT group). The NT and MHT groups were then divided into 4 subgroups for study at 30 min, 2 h, 4 h and 8 h post-trauma. TBE models were established according to Yuan Shaoji′s method. The concentration of NO in the jugular vein was measured using chemical luminescence, and water in the brain tissues was calculated with Elliot′s formula. Results Compared with those in the group C, the concentrations of WBT and NO were significantly increased 30 min post-trauma in the NT group, and reached a peak 8h after trauma. These levels were markedly decreased in the MHT group in comparison with the NT group. Conclusions NO levels might play an important role in the development of TBE, and change synchronously with WBT. TBE could be mitigated by MH, which might promote early rehabilitation of TBE by reducing NO.

AIM:To study the effect of transient receptor potential channel 1 ( TRPC1) on the survival of hip-pocampal neurons in mice.METHODS:TRPC1 knockout mice and the control mice (6 months old) were used in this study.Immunofluorescence staining of neuron-specific marker NeuN, Nissl staining and TUNEL staining were performed to measure the changes of the neurons in hippocampal CA1, CA3 and dentate gyrus (DG).Western blot analysis was used to detect the levels of pro-apoptotic protein C/EBP homologous protein ( CHOP) and cleaved caspase-3.RESULTS:Immuno-fluorescence staining and Nissl staining showed that the number of neuronal cells was significantly decreased in hippocampal CA1, CA3 and DG of TRPC1 knockout mice compared with the control mice.TUNEL staining showed that the apoptosis neuronal cell number of the above areas in TRPC1 knockout mice was significantly increased compared with the control mice.The results of Western blot revealed that the levels of CHOP and cleaved caspase-3 were significantly increased in the hippocampus of TRPC1 knockout mice relative to the control mice.CONCLUSION:The depletion of TRPC1 induces neu-ronal loss through a mechanism of TRPC1-mediated apoptosis.

Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found. The 18 cases under surgery included endoscopic approach(12 cases), extra-nasal approach(4 cases), transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

In order to improve medical students' cognition of neurosurgery specialty and clinical practice,and cultivate students' self-learning ability,the model of flipping classroom combined with problem based learning was applied in clinical teaching in our department.The experimental group adopted flip classroom combined with PBL which penetrated the pre-class teaching design,classroom activity design,after-class summary and teaching feedback,while the control group adopted the traditional teaching method.The evaluation results showed that the students in the experimental group had significantly higher scores in-class knowledge and examination results than those in the control group.In addition,students had a high degree of recognition and satisfaction with the newly combined teaching model.The combination of flipped classroom and PBL teaching method could make up their deficiency,complement each other to achieve the best clinical teaching effect and improve students comprehensive ability.Meanwhile it puts forward new requirements for students and teachers,during which teachers need to be fully prepared and update teaching concepts for the sake of fulfilling the mutual promotion of teaching and learning.

Objective To study the anatomic characteristics and clinical values of the internal auditory artery via the neuroendoscope and microscope.Methods We observed the related microdissection of the internal auditory artery of 15 cadavers through retrosigmoid approach by operative microscope and neuroendoscope,in which 3 cadavers were fresh.Results The internal auditory arteries were observed bilaterally in all specimens (100％).Among them,17 sides (56.7％,17/30) were isolated branch type,9 sides were dual trunk (30％,9/30),and 4 sides were three branches type (13.3％,4/30).The diameter of the vessel at its origin was 0.12～0.28 mm,the average caliber of IAA was 0.22±0.04 mm,the length of IAA ranged from 7.12 to 14.82 mm,and the Mean 10.18± 2.63 mm.The starting-point of IAA was quite variable,13.3％ (4/30) of the IAA origined from the inferior segment of the basilar artery,and 86.7 ％(26/30) of the IAA origined from ACIA.Among them,17 sides (65.4％,17/26) of the IAA origined from the ansa of the inferior cerebellar artery,9 sides (34.6％,9/26) of the IAA origined from the anterior inferior cerebellar artery involved in the inner ear canal.We observed that 73.3 ％(22/30) of the IAA branches were along the ventral side of the vestibulocochlear nerve;26.7 ％(8/30) of the IAA branches were above the nerves.It's easy to identify the IAA and its adjacent structures by various neuroendoscope through various anatomic fissures.Conclusion Most of internal auditory arterys were located anterior and posterior to the facial nerve,the microscope was impossible to see it directly.A thorough identification of the internal auditory artery requires theuse of both surgical microscopy and neuroendoscope.

OBJECTIVE: To analyze the clinical manifestations and the cause of misdiagnosis of congenital vallecular cyst. METHOD: Nineteen cases of congenital vallecular cysts were collected and reviewed retrospectively. Their clinical manifestations and diagnosis were analyzed. RESULT: Their clinical manifestations included inspiratory stridor, respiratory distress, inspiratory dyspnea, feeding difficulty etc. Among 19 cases, 15 cases were misdiagnosed as neonate pneumonia (9 cases), bronchial pneumonia (5 cases), and laryngitis (1 case), respectively. All cases were diagnosed as congenital vallecular cysts by fibrolaryngoscope. The diagnosis was confirmed by pathological examination. CONCLUSION Congenital vallecular cyst is fairly uncommon. To cure these patients on time, early examination of upper airway is recommended for patients with inspiratory stridor and inspiratory dyspnea. Fibrolaryngoscope would be useful for diagnosis and timely treatment.
Cysts ; congenital ; diagnosis ; Diagnostic Errors ; Epiglottis ; pathology ; Female ; Humans ; Infant ; Infant, Newborn ; Laryngeal Diseases ; congenital ; diagnosis ; Male ; Retrospective Studies

OBJECTIVE: To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid (CSF) rhinorrhea. METHOD: Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Jan 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery. RESULT: Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery, and no relapse case was found. The 18 cases under surgery included endoscopic approach (12 cases), extra-nasal approach (4 cases), transnasal approach under microscope (2 cases). CONCLUSION It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; surgery ; Child ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Retrospective Studies ; Young Adult

OBJECTIVE: To compare the efficacy of sublingual immunotherapy (SLIT) with standardized house dust mite extract in mono sensitized and polysensitized children with allergic rhinitis. METHOD: One hundred and fifty-seven children who were sensitized to house dust mites and treated with SLIT for house dust mites for at least 1 year were studied. The monoallergen sensitized group included patients who were sensitized to Dermatophagoides pteronyssinus and/or Dermatophagoides farinae (n=92). The polyallergen sensitized group included patients who were simultaneously sensitized to house dust mites and other allergens (n = 65). A standardized extract of house dust mites was used for immunotherapy. Antiallergic medication and the total nasal symptom score (TNSS) were evaluated before and 1 year after SLIT. RESULT: One hundred and twenty-five children completed 1-year SLIT. The TNSS improved significantly after SLIT in both groups, with monoallergen sensitized group 11.42 +/- 1.60 vs 3.55 +/- 1.57 (t=30.03, P<0.01), and polyallergen sensitized group 11.54 +/- 1.55 vs 3.23 +/- 1.56 (t=27.76, P< 0.01). But the change in the TNSS did not differ significantly between the groups (TNSS change, 7.94 +/- 2.24 vs 8.32 +/- 2.18, P>0.05). The AMSs were decreased significantly after SLIT in both groups, with monoallergen sensitized group 1.62 +/- 0.44 vs 0.56 +/- 0.37 (t=15.01, P<0.01), and polyallergen sensitized group 1.63 +/- 0.43 vs 0.50 +/- 0.40 (t=13.49, P<0.01). But the AMSs improvement did not differ significantly between the two groups(AMSs change 1.03 +/- 0.58 vs 1.13 +/- 0.61, P>0.05). CONCLUSION In polysensitized allergic rhinitis patients, SLIT for D pteronyssinus and/or D farinae produced improvements in both nasal symptoms and rescue medication scores comparable to those in mono sensitized patients. SLIT for D pteronyssinus and/or D farinae should be considered in polysensitized allergic rhinitis patients.
Administration, Sublingual ; Adolescent ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; immunology ; therapeutic use ; Asthma ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Desensitization, Immunologic ; Female ; Humans ; Immunotherapy ; Male ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy

Objective:To investigate the effects and mechanism of sciadopitysin combined with CK2 inhibitor CX-4945 on proliferation and apoptosis of glioblastoma U87 cells.Methods:Glioblastoma U87 cells were cultured in vitro, and treated with 0.01, 0.10, 1.00, 10.00, 100.00 μmol/L of sciadopitysin respectively. U87 cells were treated with 1.25, 2.50, 5.00, 10.00, 20.00 μmol/L of CX-4945. U87 cells were divided into control group (without any treatment), sciadopitysin group (100.00 μmol/L of sciadopitysin), CX-4945 group (5.00 μmol/L of CX-4945), sciadopitysin combined with CX-4945 group (100.00 μmol/L of sciadopitysin plus 5.00 μmol/L of CX-4945). MTT method was used to detect cell viability, Caspase3/7 activity assay and Annexin Ⅴ/ PI double staining were used to detect cell apoptosis, and Western blotting was used to detect the expressions of Notch1 pathway related proteins ICN1, HES1 and DLL3. Results:The cell viabilities of U87 cells treated with 0, 0.01, 0.10, 1.00, 10.00, 100.00 μmol/L of sciadopitysin were (100.00±6.30) %, (112.02±7.63) %, (140.84±6.73) %, (113.92±7.92) %, (102.60±7.12) % and (73.16±2.74) % respectively, and there was a statistically significant difference ( F=55.21, P<0.001). There were statistically significant differences in the cell viabilities of U87 cells between 0 μmol/L and 0.01, 0.10, 1.00, 100.00 μmol/L of sciadopitysin treatment ( P=0.009; P<0.001; P=0.003; P<0.001). The cell viability of U87 cells was inhibited by 100.00 μmol/L of sciadopitysin, while sciadopitysin at other low concentrations manifested as enhancement or no obvious effect. The cell viabilities of U87 cells treated with 0, 1.25, 2.50, 5.00, 10.00, 20.00 μmol/L of CX-4945 were (100.00±5.53) %, (108.70±10.24) %, (93.14±2.82) %, (81.46±4.92) %, (56.92±3.99) % and (31.24±2.67) % respectively, and there was a statistically significant difference ( F=135.18, P<0.001). There were statistically significant differences in the cell viabilities of U87 cells between 0 μmol/L and 1.25, 5.00, 10.00, 20.00 μmol/L of CX-4945 treatment ( P=0.022; P<0.001; P<0.001; P<0.001). Low concentration (1.25 μmol/L) of CX-4945 enhanced the cell viability of U87 cells, however higher concentrations (5.00, 10.00, 20.00 μmol/L) of CX-4945 shown inhibitory effect. The cell viabilities of U87 cells in the control group, sciadopitysin group, CX-4945 group and sciadopitysin combined with CX-4945 group were (100.00±5.53) %, (71.96±2.10) %, (77.66±4.12) % and (42.56±4.22) % respectively, and there was a statistically significant difference ( F=160.56, P<0.001). There were statistically significant differences between the control group and each treatment groups (all P<0.001). There were statistically significant differences between the sciadopitysin combined with CX-4945 group and sciadopitysin group, CX-4945 group (both P<0.001). The Caspase3/7 activities of U87 cells in the above four groups were 2.34±0.47, 4.02±0.22, 3.67±0.32 and 5.85±0.28 respectively, and there was a statistically significant difference ( F=55.80, P<0.001). The apoptosis rates of each groups were (0.40±0.10) %, (17.37±0.57) %, (3.00±0.66) % and (33.47±0.87) % respectively, and there was a statistically significant difference ( F=1 822.18, P<0.001). Further pairwise comparison showed that there were statistically significant differences in Caspase3/7 activities and apoptosis rates between the control group and each treatment groups ( P<0.001, P=0.001, P<0.001; P<0.001, P=0.001, P<0.001). There were statistically significant differences in Caspase3/7 activities and apoptosis rates between the sciadopitysin combined with CX-4945 group and sciadopitysin group, CX-4945 group (all P<0.001). The protein expression levels of Notch 1 pathway related proteins ICN1 (0.55±0.07 vs. 1.01±0.09), HES1 (0.66±0.08 vs. 1.00±0.06) and DLL3 (0.74±0.04 vs. 1.01±0.09) in U87 cells decreased significantly after treatment with 100.00 μmol/L of sciadopitysin ( t=5.94, P=0.004; t=5.15, P=0.007; t=4.00, P=0.016) . Conclusion:Sciadopitysin can synergize with CK2 inhibitor CX-4945 to inhibit the proliferation and promote apoptosis of glioblastoma U87 cells by inhibiting Notch1 signaling pathway.

Objective:To evaluate the clinical efficacy and safety of stereotactic surgery in patients with refractory mental disorders.Methods:A retrospective analysis was performed; clinical data, postoperative complications and medication intake of 149 patients with refractory mental disorders accepted stereotactic surgery in Department of Neurosurgery, People's Hospital, Wuhan University from August 2019 to December 2023 were collected. Outcomes were assessed at 1, 6, 12, and 24 months after surgery by Clinical Global Impression-Global Improvement (CGI-GI). Before and 1, 6, and 12 months after surgery, severities were assessed by Clinical Global Impression-Severity of Illness (CGI-SI); cognition was assessed by Montreal Cognitive Assessment (MoCA); positive and negative symptoms were evaluated by Positive and Negative Symptom Scale (PANSS); psychotic symptoms were evaluated by Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90 (SCL-90); obsessive-compulsive symptoms, depressive symptoms, anxiety symptoms and manic symptoms were assessed by Yale-Brown Obsessive-Compulsive Symptoms Scale (Y-BOCS), Beck Depression Inventory (BDI)-II, Beck Anxiety Inventory (BAI), and Young Mania Rating Scale (YMRS), respectively; social functioning and quality of survival were evaluated by Social Disability Screening Schedule (SDSS) and World Health Organization Quality of Life-Bref Form (WHOQOL-BREF).Results:(1) Increased sleep was noted in 47 patients and fatigue in 38 patients within 1 week after surgery. Behavioral laziness and emotional apathy were still presented at 1 month after surgery in 6 patients, and complications disappeared in the rest patients. Mildly reduced initiative was presented at 12 months after surgery in 5 patients. (2) CGI-GI indicated that 149 patients were followed up 1 month after surgery with an overall efficiency of 85.90%; 135 patients were followed up at 6 months after surgery with an overall efficiency of 83.21%, 106 patients were followed up at 12 months after surgery with an overall efficiency of 79.24%, and 63 patients were followed up at 24 months after surgery with an overall efficiency of 80.95%. (3) Compared with those before surgery, significantly lower BPRS scores, significantly lower PANSS positive, negative, and overall scores, statistically lower BAI, BDI-II, YMRS, and MOAS scores, significantly lower Y-BOCS obsessional thinking, compulsive behavior and total scores, significantly higher WHOQOL-BREF (physical and psychological domains) scores, and significantly lower SDSS and SCL-90 scores were noted in patients at 1, 6, and 12 months after surgery ( P<0.05). (4) At 12 months after surgery, withdrawal drug was noted in 13 patients, reduced drug in 38, same dose in 52, and increased drug in 2 patients. Conclusion:Stereotactic surgery can obviously improve obsession, anxiety, depression, mania and aggression, and modify social functioning and quality of survival in patients with refractory mental disorders, enjoying good safety.