Objective:To evaluate the effect of superficial temporal artery to middle cerebral artery (STA-MCA) bypass on cognitive function, cerebral perfusion, and integrity of white matter tracts by comparing cognitive function scores, fractional anisotropy (FA), time to maximum (T max), and cerebral blood flow (CBF) at different time points before and after STA-MCA bypass, and analyze the relations of cognitive function with cerebral perfusion and white matter tract integrity so as to provide evidences for treatment of moyamoya disease (MMD) patients with mild cognitive impairment. Methods:A retrospective analysis was performed; 30 MMD patients with mild cognitive impairment received STA-MCA bypass at Department of Neurosurgery, Lianyungang Hospital Affiliated to Xuzhou Medical University (Lianyungang First People's Hospital) from January 2023 to August 2024 were enrolled. Before and 1, 3, and 6 months after STA-MCA bypass, all patients accepted Montreal cognitive assessment (MoCA), CT perfusion imaging, and diffusion tensor imaging (DTI). Differences in MoCA score, CBF, T max, and FA at different time points before and after surgery were compared. Spearman rank correlation was used to analyze the correlation of MoCA score with cerebral perfusion parameters and FA. Results:(1) In these MMD patients with mild cognitive impairment, CBF 3 and 6 months after STA-MCA bypass was significantly increased compared with that before STA-MCA bypass, and CBF 6 months after STA-MCA bypass was significantly higher than that 1 and 3 months after STA-MCA bypass ( P<0.05); T max 1, 3 and 6 months after STA-MCA bypass was significantly shortened compared with that before STA-MCA bypass, and T max 6 months after STA-MCA bypass was significantly shortened than that 1 and 3 months after STA-MCA bypass ( P<0.05); FA 6 months after STA-MCA bypass was significantly increased compared with that before, and 1 and 3 months after STA-MCA bypass ( P<0.05); MoCA score 6 months after STA-MCA bypass was significantly increased compared with that before and 1 month after STA-MCA bypass ( P<0.05). (2) In MMD patients with mild cognitive impairment, the preoperative MoCA score was positively correlated with preoperative CBF and FA ( r s=0.428, P=0.018; r s=0.438, P=0.015) and negatively correlated with preoperative T max ( r s=-0.380, P=0.039); 6 months after STA-MCA bypass, the MoCA score was positively correlated with CBF and FA ( r s=0.365, P=0.047; r s=0.400, P=0.028) and negatively correlated with T max ( r s=-0.371, P=0.043). Conclusion:STA-MCA bypass can improve cerebral perfusion, white matter fiber tract repair and cognitive function in MMD patients with mild cognitive impairment, and improvement of cognitive function is related to cerebral perfusion and white matter fiber tract repair.

Objective:To evaluate the effect of superficial temporal artery to middle cerebral artery (STA-MCA) bypass on cognitive function, cerebral perfusion, and integrity of white matter tracts by comparing cognitive function scores, fractional anisotropy (FA), time to maximum (T max), and cerebral blood flow (CBF) at different time points before and after STA-MCA bypass, and analyze the relations of cognitive function with cerebral perfusion and white matter tract integrity so as to provide evidences for treatment of moyamoya disease (MMD) patients with mild cognitive impairment. Methods:A retrospective analysis was performed; 30 MMD patients with mild cognitive impairment received STA-MCA bypass at Department of Neurosurgery, Lianyungang Hospital Affiliated to Xuzhou Medical University (Lianyungang First People's Hospital) from January 2023 to August 2024 were enrolled. Before and 1, 3, and 6 months after STA-MCA bypass, all patients accepted Montreal cognitive assessment (MoCA), CT perfusion imaging, and diffusion tensor imaging (DTI). Differences in MoCA score, CBF, T max, and FA at different time points before and after surgery were compared. Spearman rank correlation was used to analyze the correlation of MoCA score with cerebral perfusion parameters and FA. Results:(1) In these MMD patients with mild cognitive impairment, CBF 3 and 6 months after STA-MCA bypass was significantly increased compared with that before STA-MCA bypass, and CBF 6 months after STA-MCA bypass was significantly higher than that 1 and 3 months after STA-MCA bypass ( P<0.05); T max 1, 3 and 6 months after STA-MCA bypass was significantly shortened compared with that before STA-MCA bypass, and T max 6 months after STA-MCA bypass was significantly shortened than that 1 and 3 months after STA-MCA bypass ( P<0.05); FA 6 months after STA-MCA bypass was significantly increased compared with that before, and 1 and 3 months after STA-MCA bypass ( P<0.05); MoCA score 6 months after STA-MCA bypass was significantly increased compared with that before and 1 month after STA-MCA bypass ( P<0.05). (2) In MMD patients with mild cognitive impairment, the preoperative MoCA score was positively correlated with preoperative CBF and FA ( r s=0.428, P=0.018; r s=0.438, P=0.015) and negatively correlated with preoperative T max ( r s=-0.380, P=0.039); 6 months after STA-MCA bypass, the MoCA score was positively correlated with CBF and FA ( r s=0.365, P=0.047; r s=0.400, P=0.028) and negatively correlated with T max ( r s=-0.371, P=0.043). Conclusion:STA-MCA bypass can improve cerebral perfusion, white matter fiber tract repair and cognitive function in MMD patients with mild cognitive impairment, and improvement of cognitive function is related to cerebral perfusion and white matter fiber tract repair.

Objective:To explore the effects of Ophiopogon D combined with cyclooxygenase-2 (COX-2) gene silencing on the proliferation, migration and invasion of human pancreatic cancer BxPC-3 cells.Methods:BxPC-3 cells were divided into blank control group, Ophiopogonin D high-dose group (40 μmol/L), medium-dose group (20 μmol/L) and low-dose group (10 μmol/L). The COX-2-slienced cells were divided into control group, COX-2 inhibited group (50 pmol/ml siRNA-COX-2), Ophiopogonin D group (20 μmol/L) and combination treatment group (Ophiopogonin D 20 μmol/L+ 50 pmol/ml siRNA-COX-2). The proliferation activity of BxPC-3 cells was detected by CCK-8, and the migration distance of BxPC-3 cells was detected by scratched assay. The invasion degree of BxPC-3 cells was detected by Transwell, the relative expression level of COX-2 gene in BxPC-3 cells was detected by real-time quantitative PCR (RT-qPCR), and the relative expressions of COX-2, hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) proteins in BxPC-3 cells were detected by Western blotting.Results:The cell proliferation rates of blank control group, Ophiopogonin D high-dose, medium-dose and low-dose groups were (100.0±4.9)%, (71.8±5.4)%, (80.5±5.8)% and (89.7±5.7)%, respectively. The migration distances were (279.8±24.0) μm, (141.9±21.2) μm, (168.8±37.1) μm and (224.6±19.9) μm, respectively. The absorbance ( A) values of invasion number were 1.107±0.095, 0.390±0.030, 0.596±0.017 and 0.826±0.034, respectively.There were statistically significant differences ( F=19.770, P<0.001; F=48.270, P<0.001; F=198.400, P<0.001). The above indexes of the Ophiopogonin D high-, medium- and low-dose groups were significantly lower than those in the blank control group (all P<0.05). The relative expression levels of COX-2 gene were 1.007±0.178, 0.387±0.169, 0.567±0.142 and 0.740±0.030, respectively, and the relative protein expression levels were 1.000±0.033, 0.654±0.085, 0.762±0.110 and 0.881±0.049, respectively, with statistically significant differences ( F=10.280, P=0.004; F=11.780, P=0.003). The above indexes of the Ophiopogonin D high- and medium-dose groups were significantly lower than those in the blank control group (all P<0.05), and there was no statistically significant difference between the Ophiopogonin D low-dose group and blank control group (both P>0.05). The medium-dose of Ophiopogonin D (20 μmol/L) was selected as the subsequent concentration.After COX-2 silencing, the proliferation rates of the control group, COX-2 inhibited group, Ophiopogonin D group and combination treatment group were (100.0±2.8)%, (68.4±6.7)%, (67.7±5.9)% and (57.0±8.5)%, respectively, the migration distances were (274.4±23.8) μm, (217.0±18.8) μm, (186.2±18.6) μm and (115.7±15.8) μm, respectively, and the A values of invasion number were 1.143±0.092, 0.791±0.058, 0.715±0.026 and 0.424±0.058, respectively, with statistically significant differences ( F=34.430, P<0.001; F=103.400, P<0.001; F=131.100, P<0.001). The proliferation rates, migration distances and invasion numbers in each treatment group were significantly lower than those in the control group (all P<0.001). Compared with the COX-2 inhibited group and Ophiopogonin D group, the cell proliferation, migration and invasion were significantly inhibited in the combination treatment group (all P<0.05). Compared with the Ophiopogonin D group, only the migration distance of the COX-2 inhibited group was significantly different ( P<0.05). The relative expression levels of COX-2 protein in the above groups were 0.995±0.037, 0.779±0.060, 0.806±0.076 and 0.645±0.079, respectively, the relative expression levels of HIF-1α were 1.083±0.104, 0.749±0.070, 0.736±0.070 and 0.394±0.016, respectively, and the relative expression levels of VEGF protein were 1.016±0.103, 0.757±0.090, 0.745±0.021 and 0.603±0.023, respectively, with statistically significant differences ( F=14.650, P=0.001; F=45.220, P<0.001; F=18.180, P<0.001). The expression levels of the three proteins in each treatment group were significantly lower than those in the control group (all P<0.05). Compared with the COX-2 inhibited group and Ophiopogonin D group, the relative protein expression levels of COX-2, HIF-1α and VEGF in the combination treatment group were significantly decreased (all P<0.05). Compared with the Ophiopogonin D group, there were no significant differences in the expression of the three proteins in the COX-2 inhibited group (all P>0.05). Conclusion:Ophiopogon D combined with COX-2 gene silencing can inhibit the proliferation, migration and invasion of pancreatic cancer cells, and the mechanism may be related to the inhibition of COX-2 pathway and the decrease of HIF-1α and VEGF protein expression levels.

Laparoscopic hepatectomy has the advantages of less trauma and pain,cosmetics and shorter duration of hospital stay,with a widespread application in all kinds of hepatectomy.Intraoperative bleeding control is the most important technology.In recent studies,effective hepatic vascular occlusion,usages of various devices for liver parenchymal transection and low-center venous pressure technology are effective to control bleeding in laparoscopic hepatectomy.