Objective To investigate the serum levels of long non-coding RNA(lncRNA)HOX transcript antisense RNA(HOTAIR)and homeobox A11 antisense RNA(LncRNA HOXA11-AS)in patients with traumatic brain injury(TBI),and their relationship with cognitive function.Methods From January 2022 to December 2023,106 TBI patients who visited Fuling Hospital Affiliated to Chongqing University were regarded as the TBI group.They were separated into a cognitive impairment group(n=44)and a non-cognitive impairment group(n=62)based on whether they experienced cognitive impairment.78 healthy individuals who underwent physical examinations in Fuling Hospital Affiliated to Chongqing University were regarded as the control group.Real-time fluorescence quantitative PCR(qRT-DCR)method was applied to detect serum LncRNA HOTAIR and LncRNA HOXA11-AS levels.Spearman and Pearson methods were used to analyze the correlation between serum LncRNA HOTAIR and LncRNA HOXA11-AS levels,cognitive function,and inflammatory factors in TBI patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum LncRNA HOTAIR and LncRNA HOXA11-AS for cognitive impairment in TBI patients.Logistic regression was applied to analyze the impacts of serum LncRNA HOTAIR and LncRNA HOXA11-AS expression on cognitive impairment after TBI.Results Compared with the control group,the expression levels of serum LncRNA HOTAIR(1.75±0.29 vs 1.03±0.15)and LncRNA HOXA11-AS(1.59±0.35 vs 0.99±0.18)in the TBI group were significantly increased,and the differences were statistically significant(t=20.034,13.846,all P<0.05).The cognitively impaired group had significantly higher serum LncRNA HOTAIR,LncRNA HOXA11-AS,tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β)and interleukin 6(IL-6)levels were significantly higher in the cognitive impairment group than in the group without cognitive impairment(t=3.011～9.615),and Montreal Cognitive Assessment(MoCA)scale was considerably lower than that of the no cognitive impairment group(t=17.633),and the differences were statistical significance(all P<0.05).Spearman correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS in TBI patients were negatively correlated with MoCA scores(r=-0.515,-0.430,all P<0.001),Pearson correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were positively correlated with TNF-α,IL-1βand IL-6 levels(r=0.423,0.397,0.452,0.437,0.512,0.390,all P<0.001).The AUC(95%CI)of serum LncRNA HOTAIR and LncRNA HOXA11-AS alone and in combination predicted cognitive impairment after TBI was 0.896(0.822～0.947),0.864(0.784～0.923)and 0.960(0.903～0.988),respectively,the combined predictive value of the two was better than that of individual prediction(Z=2.457,2.998,all P<0.05).Logistic regression analysis showed that elevated expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were risk factors for cognitive impairment in TBII patients,while MoCA score was a protective factor(all P<0.05).Conclusion The levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS have certain value in the functional impairment of TBI patients,and they may participate in the occurrence and progression of cognitive impairment in TBI patients by regulating the levels of inflammatory factors in the body.

Objective:To compare the efficacy of neuroendoscopy-assisted small bone window craniotomy and large bone flap craniotomy for acute subdural hematoma (ASDH) evacuation in elderly patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 57 elderly patients with ASDH admitted to Chongqing University Fuling Hospital from November 2020 to November 2023, including 27 males and 30 females, aged 65-89 years [(75.0±7.0)years]. The preoperative Glasgow coma scale (GCS) ranged 8-15 points [11.0(11.0, 12.0)points]. Among them, 27 patients were treated with neuroendoscopy-assisted small bone window craniotomy to evacuate ASDH (small bone window group) and 30 received large bone flap craniotomy to evacuate ASDH (large bone flap group). The following parameters were compared between the two groups: surgical duration, intraoperative blood loss, and length of hospital stay; residual subdural hematoma volume before surgery and at 1 day after surgery; GCS before surgery, at 1 and 3 days after surgery; good rate of Glasgow outcome scale (GOS) at 7 days and 6 months after surgery; and postoperative complication rate.Results:All the patients were followed up for 6 months. The surgical duration, intraoperative blood loss, and length of hospital stay were 89.0(85.0, 96.0)minutes, 65.0(55.0, 85.0)ml, and 15.0(14.0, 16.0)days, respectively in the small bone window group, which were shorter or less than 135.0(127.5, 150.0)minutes, 332.0(308.0, 367.5)ml, and 18.5(16.0, 20.0)days in the large bone flap group ( P<0.01). There was no statistically significant difference in the residual subdural hematoma volume between the two groups before surgery and at 1 day after surgery ( P>0.05). No statistically significant difference was found in GCS scores between the two groups before surgery ( P>0.05), while the GCS scores in the small bone window group at 1 and 3 days after surgery [12.0(12.0, 13.0)points and 15.0(14.0, 15.0)points] were higher than 11.5(11.0, 12.0)points and 13.0(12.8, 14.0)points in the large bone flap group ( P<0.01). The good rate of GOS in the small bone window group at 7 days after surgery was 100% (27/27), higher than 77% (23/30) in the large bone flap group ( P<0.05), but no statistically significant difference was found in the good rate of GOS between the two groups at 6 months after surgery ( P>0.05). Two patients in the small bone window group had pulmonary infection after surgery, with a complication rate of 7% (2/27), while in the large bone flap group, four patients had pulmonary infection, two epidural hematoma, one intracranial infection, one delayed wound healing, one subcutaneous fluid accumulation, and one epilepsy after surgery, with a complication rate of 33% (10/30) ( P<0.05). Conclusion:Compared with the conventional large bone flap craniotomy, neuroendoscopy-assisted small bone window craniotomy can shorten the surgical duration and length of hospital stay, reduce the intraoperative bleeding volume, promote early functional recovery, improve prognosis, and reduce the complication rate in elderly patients with ASDH.

Objective To investigate the serum levels of long non-coding RNA(lncRNA)HOX transcript antisense RNA(HOTAIR)and homeobox A11 antisense RNA(LncRNA HOXA11-AS)in patients with traumatic brain injury(TBI),and their relationship with cognitive function.Methods From January 2022 to December 2023,106 TBI patients who visited Fuling Hospital Affiliated to Chongqing University were regarded as the TBI group.They were separated into a cognitive impairment group(n=44)and a non-cognitive impairment group(n=62)based on whether they experienced cognitive impairment.78 healthy individuals who underwent physical examinations in Fuling Hospital Affiliated to Chongqing University were regarded as the control group.Real-time fluorescence quantitative PCR(qRT-DCR)method was applied to detect serum LncRNA HOTAIR and LncRNA HOXA11-AS levels.Spearman and Pearson methods were used to analyze the correlation between serum LncRNA HOTAIR and LncRNA HOXA11-AS levels,cognitive function,and inflammatory factors in TBI patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum LncRNA HOTAIR and LncRNA HOXA11-AS for cognitive impairment in TBI patients.Logistic regression was applied to analyze the impacts of serum LncRNA HOTAIR and LncRNA HOXA11-AS expression on cognitive impairment after TBI.Results Compared with the control group,the expression levels of serum LncRNA HOTAIR(1.75±0.29 vs 1.03±0.15)and LncRNA HOXA11-AS(1.59±0.35 vs 0.99±0.18)in the TBI group were significantly increased,and the differences were statistically significant(t=20.034,13.846,all P<0.05).The cognitively impaired group had significantly higher serum LncRNA HOTAIR,LncRNA HOXA11-AS,tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β)and interleukin 6(IL-6)levels were significantly higher in the cognitive impairment group than in the group without cognitive impairment(t=3.011～9.615),and Montreal Cognitive Assessment(MoCA)scale was considerably lower than that of the no cognitive impairment group(t=17.633),and the differences were statistical significance(all P<0.05).Spearman correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS in TBI patients were negatively correlated with MoCA scores(r=-0.515,-0.430,all P<0.001),Pearson correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were positively correlated with TNF-α,IL-1βand IL-6 levels(r=0.423,0.397,0.452,0.437,0.512,0.390,all P<0.001).The AUC(95%CI)of serum LncRNA HOTAIR and LncRNA HOXA11-AS alone and in combination predicted cognitive impairment after TBI was 0.896(0.822～0.947),0.864(0.784～0.923)and 0.960(0.903～0.988),respectively,the combined predictive value of the two was better than that of individual prediction(Z=2.457,2.998,all P<0.05).Logistic regression analysis showed that elevated expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were risk factors for cognitive impairment in TBII patients,while MoCA score was a protective factor(all P<0.05).Conclusion The levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS have certain value in the functional impairment of TBI patients,and they may participate in the occurrence and progression of cognitive impairment in TBI patients by regulating the levels of inflammatory factors in the body.

Objective:To compare the efficacy of neuroendoscopy-assisted small bone window craniotomy and large bone flap craniotomy for acute subdural hematoma (ASDH) evacuation in elderly patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 57 elderly patients with ASDH admitted to Chongqing University Fuling Hospital from November 2020 to November 2023, including 27 males and 30 females, aged 65-89 years [(75.0±7.0)years]. The preoperative Glasgow coma scale (GCS) ranged 8-15 points [11.0(11.0, 12.0)points]. Among them, 27 patients were treated with neuroendoscopy-assisted small bone window craniotomy to evacuate ASDH (small bone window group) and 30 received large bone flap craniotomy to evacuate ASDH (large bone flap group). The following parameters were compared between the two groups: surgical duration, intraoperative blood loss, and length of hospital stay; residual subdural hematoma volume before surgery and at 1 day after surgery; GCS before surgery, at 1 and 3 days after surgery; good rate of Glasgow outcome scale (GOS) at 7 days and 6 months after surgery; and postoperative complication rate.Results:All the patients were followed up for 6 months. The surgical duration, intraoperative blood loss, and length of hospital stay were 89.0(85.0, 96.0)minutes, 65.0(55.0, 85.0)ml, and 15.0(14.0, 16.0)days, respectively in the small bone window group, which were shorter or less than 135.0(127.5, 150.0)minutes, 332.0(308.0, 367.5)ml, and 18.5(16.0, 20.0)days in the large bone flap group ( P<0.01). There was no statistically significant difference in the residual subdural hematoma volume between the two groups before surgery and at 1 day after surgery ( P>0.05). No statistically significant difference was found in GCS scores between the two groups before surgery ( P>0.05), while the GCS scores in the small bone window group at 1 and 3 days after surgery [12.0(12.0, 13.0)points and 15.0(14.0, 15.0)points] were higher than 11.5(11.0, 12.0)points and 13.0(12.8, 14.0)points in the large bone flap group ( P<0.01). The good rate of GOS in the small bone window group at 7 days after surgery was 100% (27/27), higher than 77% (23/30) in the large bone flap group ( P<0.05), but no statistically significant difference was found in the good rate of GOS between the two groups at 6 months after surgery ( P>0.05). Two patients in the small bone window group had pulmonary infection after surgery, with a complication rate of 7% (2/27), while in the large bone flap group, four patients had pulmonary infection, two epidural hematoma, one intracranial infection, one delayed wound healing, one subcutaneous fluid accumulation, and one epilepsy after surgery, with a complication rate of 33% (10/30) ( P<0.05). Conclusion:Compared with the conventional large bone flap craniotomy, neuroendoscopy-assisted small bone window craniotomy can shorten the surgical duration and length of hospital stay, reduce the intraoperative bleeding volume, promote early functional recovery, improve prognosis, and reduce the complication rate in elderly patients with ASDH.

Objective To study the clinical efficacy of temporal small bone window microscopic craniot-omy in treating cerebral hemorrhage in basal ganglia region.Methods The retrospective analysis was adopt-ed.A total of 130 patients with intracerebral hemorrhage in the basal ganglia region treated in the Department of Neurosurgery of this hospital from January 2020 to January 2023 were selected as the study subjects.The patients treated by traditional frontotemporal large bone flap craniotomy hematoma removal were included in-to the control group (n=82) and the patients adopting temporal straight incision small bone window hemato-ma removal were included into the study group (n=48).The general data,surgical indicators,clinical efficacy,degree of neurological impairment,postoperative complications and postoperative quality of life of the patients were statistically analyzed.Results There were no statistically significant differences in preoperative Glasgow (GCS) score,gender,age and hematoma volume between the two groups (P>0.05);there was no statistically significant difference in the average hematoma clearance rate between the two groups (P>0.05);compared with the control group,the operation time and hospital stay of the study group were shorter,the incidence of severe edema and suboccipital fluid accumulation were lower,and the good prognosis rate was higher,with sta-tistical significance (P<0.05).Conclusion Temporal straight incision small bone window microscopic hema-toma removal in treating cerebral hemorrhage in basal ganglia region has mild edema reaction of brain tissue in operative area,the neurological function obtains the better protection and the good prognostic rate of the pa-tients is significantly increased.

Objective:To retrospectively analyze the independent risk factors of complicated appendicitis(CA)in children under five years old and establish a clinical prediction model, and to evaluate the clinical application of this model.Methods:A retrospective analysis was performed on children under five years old who underwent appendectomy at Children′s Hospital of Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021.The children were divided into CA group and uncomplicated appendicitis group according to whether there was sign of perforation or gangrene in appendiceal tissue after operation.The differences in clinical features and preoperative laboratory test results between two groups were compared.The independent risk factors of CA were identified and a clinical prediction model was established.The clinical prediction model was verified by receiver operating characteristic curve.Results:A total of 140 children were enrolled in this study, including 84 cases in the CA group and 56 cases in uncomplicated appendicitis group.Univariate and binary Logistic regression analysis showed that the duration of symptoms>23.5 h( OR=6.650, 95% CI 2.469-17.912, P<0.05), abdominal muscle tension( OR=3.082, 95% CI 1.190-7.979, P<0.05) and C-reactive protein>41 mg/L ( OR=3.287, 95% CI 1.274-8.480, P<0.05) were independent risk factors for CA( P<0.05). The clinical prediction model of CA was constructed by the above mentioned three independent risk factors.The area under the receiver operating characteristic curve of the clinical prediction model was 0.881(95% CI 0.825-0.936), the sensitivity was 77.4%, the specificity was 87.5%, the positive predictive value was 91.3% and the negative predictive value was 70.0%. Conclusion:Acute appendicitis in children under five years old is more likely to progress to CA if the duration of symptoms>23.5 h, the level of C-reactive protein is increased, and the abdominal muscle tension is accompanied.The clinical prediction model of CA constructed by common clinical information in pediatric clinics has good prediction efficiency, which provides a simple and feasible reference method for clinicians to distinguish CA from uncomplicated appendicitis.

Androgen receptor (AR) is a ligand-activated transcription factor that plays a pivotal role in the development and progression of many severe diseases such as prostate cancer, muscle atrophy, and osteoporosis. Binding of ligands to AR triggers the conformational changes in AR that may affect the recruitment of coactivators and downstream response of AR signaling pathway. Therefore, AR ligands have great potential to treat these diseases. In this study, we searched for novel AR ligands by performing a docking-based virtual screening (VS) on the basis of the crystal structure of the AR ligand binding domain (LBD) in complex with its agonist. A total of 58 structurally diverse compounds were selected and subjected to LBD affinity assay, with five of them (HBP1-3, HBP1-17, HBP1-38, HBP1-51, and HBP1-58) exhibiting strong binding to AR-LBD. The IC values of HBP1-51 and HBP1-58 are 3.96 µM and 4.92 µM, respectively, which are even lower than that of enzalutamide (Enz, IC = 13.87 µM), a marketed second-generation AR antagonist. Further bioactivity assays suggest that HBP1-51 is an AR agonist, whereas HBP1-58 is an AR antagonist. In addition, molecular dynamics (MD) simulations and principal components analysis (PCA) were carried out to reveal the binding principle of the newly-identified AR ligands toward AR. Our modeling results indicate that the conformational changes of helix 12 induced by the bindings of antagonist and agonist are visibly different. In summary, the current study provides a highly efficient way to discover novel AR ligands, which could serve as the starting point for development of new therapeutics for AR-related diseases.
Androgen Receptor Antagonists ; pharmacology ; Androgens ; metabolism ; pharmacology ; Biological Assay ; Cell Line, Tumor ; Drug Discovery ; methods ; Humans ; Ligands ; Male ; Molecular Docking Simulation ; Molecular Dynamics Simulation ; Phenylthiohydantoin ; analogs & derivatives ; pharmacology ; Principal Component Analysis ; Prostatic Neoplasms ; drug therapy ; Protein Binding ; physiology ; Protein Conformation ; drug effects ; Receptors, Androgen ; metabolism