Objective:To explore the clinical application of portable head and neck magnetic resonance imaging (MRI) device in neurosurgery.Methods:A total of 213 patients with brain diseases who were scanned by portable head and neck MRI device in Center of Neurosurgery, Zhujiang Hospital, Southern Medical University from June to September 2022 were selected. The portable head and neck MRI images and 3.0T conventional MRI images of 10 randomly selected patients were compared; the differences in signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different sequences were analyzed. Thirty-one patients accepted tracheal intubation/tracheotomy, or ventilator-assisted breathing were selected as special patient group, and another 30 patients were as general patient group; the differences in comprehensive diagnostic scores of portable head and neck MRI images were compared. Noise intensity differences in different sequences between 3.0T conventional MRI and portable head and neck MRI were statistically compared. Twenty hospitalized volunteers with normal hearing in our center from July to August 2022 were selected, conventional 3.0T MRI and portable head and neck MRI were performed successively, and the noise intensity of different sequences in them was evaluated by using a 5-point system.Results:Compared with those in 3.0T conventional MRI images, the SNR and CNR of T1WI, T2WI, and Liquid attenuated reverse recovery sequence (FLAIR) sequences in portable head and neck MRI images were significantly lower ( P<0.05). No significant difference was noted in the comprehensive diagnostic scores of portable head and neck MRI images between special patients and general patients ( P>0.05). Compared with that in the 3.0T conventional MRI, the noise intensity of different sequences in portable head and neck MRI was significantly reduced ( P<0.05). These volunteers had significantly reduced noise intensity scores of different sequences in portable head and neck MRI compared with that in conventional 3.0T MRI ( P<0.05). Conclusion:Portable head and neck MRI device is easy to use, enjoying high safety, imaging quality and suitability, which meets the clinical needs for neurosurgery patients.

[Abstract] Objective: To investigate the effects of exosome originated from bone marrow mesenchymal stem cell (BMSCs) on proliferation, migration and invasion of prostate cancer PC-3 cell and its mechanism. Methods: qPCR was used to detect the expression level of miR-21-5p in prostate cancer cell lines. The morphology of exosomes isolated from BMSCs was observed with an electron microscope. Western blotting was used to detect the expressions of exosome surface markers and the epithelial-mesenchymal transition (EMT)-related proteins (E-cadherin, N-cadherin and Vimentin). Dual luciferase reporter gene experiment was used to detect the targeted regulation relationship between miR-21-5p and PH domain leucine-rich repeat protein phosphatase 2 (PHLPP2). PC-3 cells were co-cultured with 10 μl BMSCs exosomes suspension (Exo group), transfected with sh-PHLPP2 or antagomiR, then CCK-8 and Transwell experiments were used to detect changesinproliferation,migrationandinvasionofPC-3cell.Results: miR-21-5p was highly expressed in prostate cancer PC-3 cell line. The exosomes in the supernatant of BMSCs culture fluid were successfully isolated, and the typical vesicle-like structures of exosomes were observed under transmission electron microscope. Exosomes expressed specific proteins such as CD9, CD63 and CD81. In the Exo group, the proliferation, invasion, migration, as well as the expressions of N-cadherin, Vimentin and miR-21-5p in PC-3 cells were significantly higher than those in the control group (all P<0.05). PHLPP2 is a target gene of miR-21-5p. Compared with the control group, the expression of PHLPP2 in PC-3 cells of Exo group and sh-PHLPP2 group was significantly reduced (0.66±0.09, 0.42±0.05 vs 1.09±0.08, all P<0.01); cell viability, invasion and migration were significantly improved (all P<0.01); and E-cadherin expression level was significantly reduced while N-cadherin and Vimentin expressions were significantly increased (both P<0.05). Conclusion: miR-21-5p is highly expressed in prostate cancer PC-3 cell line. BMSC exosome miR-21-5p can increase the proliferation, migration and invasion ability of PC-3 cells through targeted down-regulation of PHLPP2.

Objective To compare the clinical outcomes and complications of alloplasfic cranioplasty performed with custom-designed polyetheretherketone (PEEK) and titanium mesh after decompressive craniectomy.Methods Eighty-six patients admitted to our hospital from June 2014 to December 2017 were chosen;and 28 patients underwent cranioplasty with PEEK and 58 with titanium mesh by the same surgical team.The general clinical data and postoperative complications were compared between the two groups.Multivariable Logistic regression analysis was performed to analyze the influencing factors of postoperative complications.The surgical time,molding quality and cost were compared between the two groups.Results Patients in PEEK group trended to be younger and had higher GOS scores as compared with patients in the titanium group,with significant differences (P＜0.05).Overall complication rates of 10.7％ and 32.8％ for PEEK and titanium cranioplasty were identified respectively;as compared with that in titanium group,the incidence of overall complication in PEEK group was significant lower (P＜0.05).Logistic regression analysis identified material was the independent influencing factor for cranioplasty complications (OR=4.486,P=0.047,95％CI:1.021-19.703).Overall satisfaction rate with cranioplasty and aesthetic result in PEEK group was significantly higher than that in titanium group (96.4％ vs.79.3％,P＜0.05);however,the treatment cost for cranioplasty with PEEK was considerably higher than skull bone reconstruction based on titanium mesh.Conclusion Despite of high treatment cost,custom-designed PEEK implants seem to be good choice for patients with large cranial defects after decompressive craniectomy,enjoying few complications and high satisfaction of cranioplasty and aesthetic result.

Objective To explore the expression,role and mechanism of long non-coding RNA (lncRNA) BANCR in astrocytoma.Methods (1) Twenty-four astrocytoma tissues and 6 normal brain tissues were collected from patients accepted surgical resection and conformed by pathology in our hospital from January 2016 to September 2017;the mRNA expressions of BANCR and signal transduction and transcriptional activator 3 (STA T3) were detected by real-time quantitative(qRT)-PCR;the glioma dataset GSE4290 including astrocytomas were downloaded and BANCR expressions in GSE4290 were analyzed by the web software R2.(2) Astrocytoma cell line LN18,cultured in vitro were divided into short hairpin RNA (shBANCR) group,full-length BANCR (BANCR) group,shControl group and empty vector group;cells in these groups were transfected with recombinant lentiviruses packing genomes encoding short hairpin RNA (shBANCR),full-length BANCR (BANCR),or their corresponding controls (shControl and empty vector);BANCR and STA T3 mRNA expressions in the 4 groups were detected by qRT-PCR;the cell proliferation,migration and invasion,and apoptosis were detected by CCK-8 assay,Transwell assay and flow cytometry,respectively;Western blotting was employed to detect the protein expressions of STAT3,matrix metalloproteinase (MMP)2,MMP9 and mitogen-activated protein kinase (MAPK),and Akt pathway protein expression.(3) Astrocytoma cell line LN18 were divided into si398 group,si1265 group,negative control group Ⅰ,and blank control group Ⅰ;cells in the blank control group Ⅰ were transfected with lipofectamine 2000,and cells in the other three groups were transfected with small interfering RNA si398,si1265 and negative control nonsense sequences targeting STAT3;48 h after transfection,BANCR and STAT3 mRNA expressions were detected by qRT-PCR;Western blotting was employed to detect the STAT3 protein expression.Results (1) In collected samples and glioma dataset GSE4290:the BANCR mRNA expression in astrocytoma tissues was significantly decreased as compared with that in the normal brain tissues (P＜0.05);a positive correlation was noted between BANCR and STA T3 mRNA expressions in astrocytomas (P＜0.05).(2) As compared with the negative control group,the shBANCR group had significantly decreased BANCR mRNA expression,and the BANCR mRNA expression in the BANCR group was significantly increased as compared with that in the empty vector group (P＜0.05);the number of migration and invasion cells in the shBANCR group was significantly larger as compared with that in the negative control group,and that in the BANCR group was significantly increased as compared with that in the empty vector group (P＜0.05);the protein levels of MMP2,MMP9,phosphorylated (p)-extracellular regulated protein kinase and p-mitogen-activated protein kinase in the shBANCR group were significantly increased as compared with those in the negative control group,and those in the BANCR group was significantly increased as compared with those in the empty vector group (P＜0.05).(3) As compared with negative control group Ⅰ and blank control group Ⅰ,si398 group and si1265 group had significantly decreased STA T3 and BANCR mRNA expressions and STAT3 protein expression (P＜0.05).Conclusion The BANCR expression is decreased in astrocytoma;STAT3-induced BANCR can inhibit cell migration and invasion by modulating MMP2,MMP9 and MAPK signaling pathway in astrocytoma.

Objective To explore the effect of fibroblast growth factor receptor(FGFR)inhibitor BGJ398 on the vasculogenic mimicry(VM)formation of glioma cells. Methods The phosphor-FGFR(pFGFR)was de-tected by Western blot,the expressions of MMP2 and MMP14 were detected by Western blot and immunocytochem-istry;the VM formation of U87MG and U251MG was tested by tube formation assay;subcutaneously implanted tu-mor model in nude mouse was established and tumor sections were CD34/PAS double-stained to detect the forma-tion of VM in vivo. Results Western blot showed that pFGFR in the experimental groups decreased significantly (P < 0.05);western blot and immunohistochemical staining showed that the expression of MMP2 and MMP14 in the experimental groups decreased significantly compared to the control group. In the tube formation assay ,the tube formation of U87MG and U251MG cells were restrained. In the subcutaneously implanted tumor model ,the VM number of the experimental group(13.85 ± 3.96)was significantly lower than that in the control group(26.40 ± 5.06,P < 0.05). Conclusions In vivo and in vitro experiments confirmed that BGJ398 can inhibit the activa-tion of FGFR,and inhibit the VM formation of glioma cells. These indicate FGFR signaling pathway is involved in the formation of VM.

Objective To explore the effect of fibroblast growth factor receptor (FGFR) receptor antagonist BGJ398 in growth, migration and invasiveness of gliomas. Methods (1) Glioma cells U87 and U251 were routinely cultured in vitro and divided into BGJ398 treatment group (10 μmol/L BGJ398 complete medium) and control group; the proliferation of U87 and U251 cells was detected by CCK-8 and colony formation; 2 d after cultivation, the migration and invasion of U87 and U251 cells were measured by wound-healing assay and Transwell assay. The phosphor-FGFR (pFGFR) level and vimentin expressions were detected by Western blotting. (2) Eight BALB/c nude mice were performed abdominal subcutaneous injection of 200 μL U87 cells (1×107 cells) and randomly divided into BGJ398 treatment group (giving physiological saline solution containing 20 mg/kg BGJ398) and control group (giving physiological saline solution); 15 d after cultivation, the quality of the subcutaneously implanted tumors was compared between the two groups, and the vimentin expression was detected by Western blotting. Results (1) Three, 4 and 5 d after cultivation, the optical density in the U87 cells of BGJ398 treatment group was significantly lower than that in the control group (3 d: t=4.059, P=0.015; 4 d: t=9.892, P=0.001; 5 d: t=10.259, P=0.001); 2, 3, 4 and 5 d after cultivation, the optical density in the U251 cells of BGJ398 treatment group was significantly lower than that in the control group (2 d: t=3.780, P=0.019; 3 d: t=4.515, P=0.011; 4 d: t=16.205, P=0.000; 5 d: t=17.613, P=0.000); 10 d after cultivation, the cloning number of U87 and U251 cells in the BGJ398 treatment group was significantly smaller than that in the control group (P<0.05); the results of wound-healing assay showed that the migration of U87MG cells in the BGJ398 treatment group was significantly slower than that in the control group (P<0.05); 24 h after cultivation, the number of U87 cells migration in the BGJ398 treatment group was significantly smaller as compared with that in the control group (P<0.05); 48 h after cultivation, the number of U87 and U251 cells passed the pore membrane in the BGJ398 treatment group was significantly smaller as compared with that in the control group (P<0.05). Western blotting showed that the content of pFGFR and vimentin in U87 and U251 cells of the BGJ398 treatment group decreased significantly as compared with that in the control group (P<0.05). (2) The subcutaneous tumor tissues in the BGJ398 treatment group[(0.186± 0.064) g] were significantly smaller than those in the control group[(0.450±0.106) g] (P<0.05); Vimentin expression in the BGJ398 treatment group (2.503±0.359) was significantly decreased than that in the control group (4.125±1.155, P<0.05). Conclusion Experiments in vivo and in vitro confirm that BGJ398 can inhibit the activation of FGFR and the growth, migration, and invasion of glioma cells, indicating that FGFR is one of effective targets for the treatment of gliomas.

Objective To compare the differences of hospital stays,hospitalization costs and effectiveness via keyhole hematoma debridement (KHED) and internal medicine conservative treatment (IMCT) in treating 30-40 mL hypertensive intracerebral hemorrhage.Methods Fifty-eight patients with hypertensive intracerebral hemorrhage whose bleeding was 30-40 mL,admitted to our hospital from January 2014 to September 2015,were chosen in our study;according to the will of the patients and their family members,the patients were divided into KHED group (n=31) and IMCT group (n=27).The differences of hospital stays,hospitalization costs,neurological dysfunction rate at hospital and three months after discharge,and recovery results were compared between the two groups.Results The average hospital stays of KHED group were (7.4±2.3) d and those of IMCT group were (14.5±5.1) d,with significant difference (P=0.012);the hospitalization costs for the two groups were (36 296.28±5292.12)yuan,and (41 769.48±6342.83) yuan,with significant difference (P=0.027).Glasgow outcome scale of KHED group at discharge indicated 29 patients with good recovery and 2 with poor recovery;that of IMCT group indicated 20 with good recovery and 7 with poor recovery,including two with cerebral edema accepted craniotomy operation in second time.Follow-up for three months showed that the KHED group had basic activities of daily living in 16 patients,mild hemiplegia in 11 and severe hemiplegia in 4,and IMCT group had basic activities of daily living in 9 patietns,mild hemiplegia in 13 and severe hemiplegia in 5;significant differences were noted between the two groups (Z=2.499,P=0.001).Conclusion KHED in treatment of 30-40 mL hypertensive intracerebral hemorrhage can shorten hospitalization time,reduce cost,have better prognosis and better short-term and long-term effectiveness than IMCT.

Objective To explore the correlations of intracranial pressure (ICP) with changes of neuron specific enolase (NSE),D-Dimer (D-D) and C-reactive protein (CRP) levels in patients with severe traumatic brain injury.Methods A serial of 35 patients with severe traumatic brain injury,admitted to our hospital from January 2012 to January 2014,were chosen as experimental group,and 20 healthy subjects performed physical examination in our Physical Examination Center at the same period were as controls.ICP monitoring was performed in these 35 patients.The patents were divided into two groups according to ICP:severely elevated ICP group (＞40 mmHg) and moderately elevated ICP group (20-40 mmHg).The NSE,D-D and CRP levels were measured,and these data were compared with those from the control group.The correlations of ICP with changes of NSE,D-D and CRP levels were analyzed.Results The levels of NSE,D-D and CRP in the severely elevated ICP group and moderately elevated ICP group were obviously higher than those in the control group ([12.11 ±2.35] lg/L,[0.39±0.61] mg/L,[3.72±0.69] mg/L) (P＜0.05).The levels ofNSE,D-D and CRP in the severely elevated ICP group ([104.08±7.90] μg/L,[1.55±0.26] mg/L,[47.66±8.60] mg/L) were also obviously higher than those in the moderately elevated ICP group ([61.89±30.35] μg/L,[0.93±0.32] mg/L,[30.87±9.84] mg/L)(P＜0.05).Significant positive correlations were noted between ICP and changes ofNSE,D-D and CRP levels in the patient group (regression equation:ICP=18.598+0.256 NSE [t=7.200,P=0.000],ICP=10.779+23.955D-D [t=10.29,P=0.000],ICP=9.932+0.771 CRP [t=8.423,P=0.000]).Multivariant stepwise regression analysis indicated the closest correlation between ICP and D-D (multiple correlation coefficient=0.873,coefficient of determination=0.762,F=105.917,P=0.000).Conclusions Significant positive correlations can be noted between ICP and changes of NSE,D-D and CRP levels,and the closest correlation is between ICP and D-D in patients with severe traumatic brain injury.The combined application of ICP and NSE,D-D and CRP levels can promote the diagnosis and treatment of severe traumatic brain injury patients.

Objective To preliminarily explore the influence of intervention of atorvastatin in vasculogenic mimicry of glioblastoma and its mechanism.Methods CCK-8 experiment was carried out to detect the cell activity of glioma cell line U87 under the intervention of atorvastatin at different concentrations (1010-10-4 mol/L),aiming at screening out the safety concentration of atorvastatin.U87 cells were incubated in the mediums containing atorvastatin with different safety concentrations as well as in the control medium without atorvastatin.Three-D cultivation was performed in the Matrgel to establish the in vitro vasculogenic mimicry models,then the ability ofvasculogenic mimicry was observed and the length of the tube structure was counted.RT-PCR and Western blotting were performed to detect the mRNA and protein expression levels of matrix metalloproteinase-2 (MMP-2) in the U87 cells of intervention group and control group,respectively.Results Safety concentrations of atorvastatin screened by CCK-8 experiment were 10-7,10-6 and 10-5 mol/L.U87 cells formed the typical vasculogenic mimicry tube structure at 6-8 h after inoculation; the number of tube structure decreased with the increase ofatorvastatin concentration.Compared with the control group,the length counting of tube structure in intervention groups (10-7,10-6 and 10-5 mol/L) was significantly reduced and the mRNA and protein expression levels of MMP-2 were markedly decreased (P＜0.05).Conclusion Atovastatin significantly inhibits the vasculogenic mimicry formation via down-regulating the MMP-2 expression level.

Objective To explore the value ofintraoperative CT (iCT) in endoscopic endonasal surgery for pituitary adenomas.Methods A retrospective analysis was conducted in the clinical data of 37 patients with pituitary adenomas performed endoscopic endonasal surgery with assistance of iCT in our hospital from November 2012 to June 2013.The influences of iCT on surgical process and results were analyzed.Results Intraoperative scanning was performed 1 to 3 times in each patient,averaging 1.43 times.The scanning time was only 50-60 s.Among the 37 patients,iCT revealed residual tumor in 11,9 of which underwent further resection with total removal in 6 and subtotal in 3,and the tumors in the other two patients were unable to be resected because the adenomas were tenacious and adhered closely to the internal carotid artery.Finally,the rate of gross total removal increased from 70.3％ to 86.5％,rising by 16.2％.No iCT related complications and severe surgical complication occurred.Conclusion The application of iCT in endoscopic endonasal surgery for pituitary adenomas provides objective evidence for the guidance of surgical procedure and real-time judgment of surgical results,which not only leads to higher percentage of tumor removal but also eliminates the unnecessary blind surgical manipulation to increase the safety of the operation.