Objective To investigate the safety and efficacy of sodium fluorescein-guided microsurgery in children with medulloblastoma,and to analyze the surgical efficacy and prognosis.Among them,12 cases underwent unilateral telovelar approach,2 cases underwent bilateral telovelar approach,and 6 cases underwent telovelar approach combined with transvermian approach.The intraoperative dose of sodium fluorescein was 2 mg/kg.Methods The clinical data of 20 patients with medulloblastoma treated with fluorescein sodium assisted microsurgery from January 2018 to August 2023 in Xinjiang Autonomous Region People's Hospital were retrospectively analyzed.Results Of the 20 patients,12 were male and 8 were female.The mean age of onset was(7.9±3.7)years.In all cases,there was clear tumor fluorescence,none of the cases had adverse reaction associated with the use of sodium fluorescein.There were 16 cases of gross-total resection,3 cases of near-total resection,1 case of partial resection,1 case of intracranial infection,2 case of subcutaneous effusion,2 cases of cerebellar mutism.The follow-up time was from 3 to 72 months.5 cases did not receive sufficient radiotherapy and chemotherapy,and 9 cases died due to tumor progression or recurrence.In all cases,the longest overall survival was 72 months,the mean survival time was 39.2 months,and the median survival time was 41.2 months.Conclusion Fluorescein sodium assisted microsurgery is safe and effective in pediatric medulloblastoma surgery.

Objective:To investigate the potential effect and mechanism of docosahexaenoic acid(DHA) on hippocampal neuronal apoptosis and c-Jun N-terminal kinase(JNK) protein in rats with subarachnoid hemorrhage(SAH).Methods:Forty eight SPF-grade male SD rats were randomly divided into control group, sham group, model group and DHA intervention group according to the random number table method, with 12 rats in each group.The rats in model group and DHA group were injected with autologous blood(0.3 mL) into the optic chiasma to establish the SAH model.Rats in model group were intraperitoneally injected with DHA(35 mg/kg) 3 hours after SAH model establishment, rats in sham operation group were injected with 0.3 mL 0.9% sodium chloride solution into the optic chiasma, and rats in control group were fed normally.Neurobehavioral function of all rats was evaluated after 24 hours.The apoptosis of neuron was observed by TUNEL staining, and the expression of phosphorylated JNK(p-JNK)and apoptosis-related proteins Bax and Bcl-2 was observed by Western blot.Statistical analysis was performed using GraphPad Prism 7.0 software.One-way ANOVA was used for comparison among multiple groups, and Tukey test was used for further pairwise comparison.Results:(1)The differences in neurobehavioral function scores among the 4 groups of rats were statistically significant( F=103.60, P<0.05), the neurobehavioral function scores in model group(8.67±1.37) and DHA intervention group(13.67±1.51) were lower than that in control group(18.00±0.00) and sham group(17.67±0.52)( all P<0.05), while the neurobehavioral function score in DHA intervention group was higher than that in the model group( P<0.05).(2)The results of TUNEL staining showed that there were statistical differences in the number of hippocampal neuron apoptosis among the 4 groups( F=30.76, P<0.05), the number of hippocampal neuron apoptosis in model group(55.67±5.28) was higher than those in control group(25.83±7.06) and sham group(25.50±6.72) (both P<0.05), the number of hippocampal neuron apoptosis in DHA intervention group(35.17±5.78) was lower than that in model group.(3)The results of Western blot showed that there were no statistical differences in the Bax protein levels among the four groups( F=2.00, P>0.05).There were statistical differences in the expression levels of Bcl-2, p-JNK and Bax/Bcl-2 ratio among the 4 groups( F=8.48, 5.69, 5.39, all P<0.05).There was no statistical difference in Bcl-2, p-JNK protein levels and Bax/Bcl-2 ratio between the control group and sham group(all P>0.05).The p-JNK protein levels and Bax/Bcl-2 ratio in model group ((1.93±0.25), (2.05±0.86)) were higher than those in sham group ((1.42±0.33), (1.05±0.26)) (both P<0.05), the Bcl-2 protein level in model group (1.04±0.23) was lower than that in sham group (1.61±0.16) ( P<0.05).The p-JNK protein level and Bax/Bcl-2 ratio in DHA intervention group((1.43±0.33), (1.19±0.30)) were lower than those in model group(both P<0.05), the Bcl-2 protein level in DHA intervention group(1.42±0.28) was higher than that in model group( P<0.05). Conclusion:DHA can reduce neuronal apoptosis, inhibit the activation of p-JNK and improve neurological function of SAH model rats.