Objective:To explore the clinical efficacy of percutaneous balloon compression (PBC) in the treatment of trigeminal neuralgia (TN) based on the double difference (DID) model.Methods:A retrospective case - control study method was adopted to analyze the general data of 130 patients with trigeminal neuralgia (TN) who were treated in the Department of Neurosurgery of Hebei General Hospital from January 2022 to October 2023. Among them, 49 were males and 81 were females. The age was (53.28±11.67) years, ranging from 25 to 80 years old. According to different treatment methods, the patients were divided into an experimental group ( n=63) and a control group ( n=67). Patients in the experimental group were given percutaneous balloon compression (PBC) treatment, while those in the control group were treated with conservative drug therapy. Propensity score matching method was used for 1∶1 matching. After matching, there were 52 cases in each group. The general data of the two groups were compared. The visual analogue scale (VAS), 36-item short form health survey (SF-36) score, Hamilton depression rating scale (HAMD) score, Hamilton anxiety rating scale (HAMA) score, 5-hydroxytryptamine, neuropeptide P, inflammatory factor interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) before and after treatment, as well as the clinical efficacy of the two groups of patients were comparatively analyzed. Meanwhile, the incidence of postoperative complications in the two groups was compared. The generalized estimating equation (GEE) model was used to analyze the influencing factors of clinical efficacy, and the difference-in-differences (DID) model was used to evaluate the efficacy before and after treatment. Measurement data conforming to the normal distribution were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; the chi- square test was used for comparison between count data. Results:After treatment, the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, and TNF-α level in the experimental group were (2.98±0.83) points, (75.56±1.18) points, (7.2±0.83) points, (7.15±0.85) points, (76.34±5.47) ng/mL, (50.95±11.01) pg/mL, (29.45±7.08) ng/L, and (21.18±3.55) ng/L respectively. In the control group, there were (3.63±0.95) points, (73.23±1.13) points, (7.98±0.80) points, (8.04±0.84) points, (186.31±11.61) ng/mL, (86.52±13.32) pg/mL, (34.47±6.58) ng/L, and (26.36±5.80) ng/L, respectively. The differences between the two groups were statistically significant ( P<0.05).The cure rate and the total incidence of postoperative complications in the experimental group were 55.77% and 13.46% respectively, while in the control group, they were 40.38% and 30.77% respectively. The differences between the two groups were statistically significant ( P<0.05).The results of the GEE model analysis showed that age, course of disease, VAS, SF-36 score, HAMA score, HAMD score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, TNF-α level, treatment method, and the long - diameter ratio of FO significantly affected the clinical efficacy of patients ( P<0.05).The results of the DID model showed that the experimental group was superior to the control group in improving the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine level, neuropeptide P level, IL-1 level, and TNF-α level( P<0.05). Conclusion:PBC can significantly improve the VAS, SF-36 score, HAMD score, HAMA score, 5-hydroxytryptamine, neuropeptide P, IL-1, TNF-α, and incidence of complications in patients with TN. It can also improve the psychological status and quality of life of patients.

Diffuse pediatric-type high-grade glioma (pHGG), H3- and isocitrate dehydrogenase (IDH)-wild-type, is a World Health Organization (WHO) grade 4 diffuse glioma with malignant histological features, which typically affects in children and adolescents. This multidisciplinary treatment case involves a 24-year-old young female patient initially diagnosed via biopsy. After concurrent chemoradiotherapy reduced the tumor size, complete resection was achieved, followed by adjuvant therapy with temozolomide and regorafenib. After recurrence, the tumor was resected again, and a second course of radiotherapy was administered, but the disease ultimately progressed rapidly, with an overall survival exceeding 32 months. pHGGs are highly malignant, aggressive, and associated with poor prognosis. Accurate diagnosis and targeted intervention require close collaboration among a multidisciplinary team, which highlights the critical value of multidisciplinary manage-ment in clinical practice.

Objective:To analyze the anatomical relations between operating spaces of different paths via far lateral approach and exposure of the anterior part of the foramen magnum based on data of virtual reality three-dimensional model. Methods:The CT and MRI images of 50 patients with trigeminal neuralgia, admitted to our hospital from September 2015 to January 2019 were extracted from Gamma Knife databases and inputted into Vitrea virtual reality system to establish a three-dimensional anatomy model of the posterior cranial fossa. Posterior margin of the articular surface of occipital condyle was selected as starting point to open the skull via far lateral approach; the ipsilateral sublingual neural tube opening, anterior margin of the jugular tubercle, and anterior margin of the foramen magnum were selected as the exposed targets in the base of skull bony structure; the ligatures between starting point and the 3 exposed targets were used as axis to reveal a radius of 5 mm cylinder to simulate the surgical paths exposed the anterior margin of the foramen magnum via far lateral approach, and these surgical paths were named as Path 1, 2 and 3. The operating spaces of different paths were observed, and the frequency of each path passing through certain anatomical tissues was recorded and the volume of anatomical structures was measured. Results:There were significant differences in operating space volume, bony structure and volume of lower cranial nerves among the 3 paths ( P<0.05). The operating space volume of Path 3 was significantly increased as compared with that of Path 1 and 2, and bony structure and volume of lower cranial nerves of Path 2 were significantly increased as compared with those of Path 1 and 3 ( P<0.05). Conclusion:The data collected in the surgical paths via distal lateral approach simulated by virtual reality technology can help reveal the anatomical relationship in the operating space and provide a basis for selecting the best surgical path.

Objective:To construct and validate a prediction model combined machine learning with imaging omics characteristics in differentiating anaplastic glioma from glioblastoma.Methods:Imaging data of 241 patients with anaplastic glioma or glioblastoma, confirmed by pathology in our hospital from August 2005 to August 2012, were retrospectively collected. These patients were divided into a training group ( n=140) and a verification group ( n=101) according to random number table method. MRIcron software was used to delineate tumor boundaries of patients from the training group on preoperative T1 enhanced MR imaging. The regions of interest (ROIs) were outlined on preoperative T1 enhanced MR imaging, and the radiomic features were extracted from ROIs by Matlab software. Least absolute shrinkage and selection operator (LASSO) regression model was used to screen the features, and then, the selected features were used to construct the prediction model by support vector machine (SVM) classifier. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of the model. Results:In these 241 patients, 101 were with anaplastic glioma and 140 were with glioblastoma confirmed by pathology. In the training group and validation group, there was statistical difference in age between patients with anaplastic glioma and glioblastoma ( P<0.05); there was no significant difference in gender distribution, tumor location, and percentages of tumor necrosis or edema between patients with anaplastic glioma and glioblastoma ( P>0.05). Totally, 431 radiomic features were extracted; 11 radiomic features were screened by LASSO regression model and the prediction model was established. The AUC of ROC curve was 0.942 and 0.875, respectively, in the training group and validation group. Conclusion:The prediction model combined machine learning and imaging omics characteristics can effectively discriminate anaplastic glioma from glioblastoma.

Immunotherapy has become the fourth cancer therapy after surgery, chemotherapy, and radiotherapy. In particular, immune checkpoint inhibitors are proved to be unprecedentedly in increasing the overall survival rates of patients with refractory cancers, such as advanced melanoma, non-small cell lung cancer, and renal cell carcinoma. However, inhibitor therapies are only effective in a small proportion of patients with problems, such as side effects and high costs. Therefore, doctors urgently need reliable predictive biomarkers for checkpoint inhibitor therapies to choose the optimal therapies. Here, we review the biomarkers that can serve as potential predictors of the outcomes of immune checkpoint inhibitor treatment, including tumor-specific profiles and tumor microenvironment evaluation and other factors.
Autoantibodies ; blood ; immunology ; Biomarkers, Tumor ; blood ; immunology ; Humans ; Immunotherapy ; Neoplasms ; blood ; therapy ; Tumor Microenvironment

Objective To discuss the impact of target exposure via retrosigmoidal approach in surgical injury based on virtual reality anatomic models.Methods CT and MR imaging data of 15 adult cadaver heads were utilized to establish three-dimensional anatomy models of petrous bone.Surgical routes exposing different targets though retrosigmoidal approach were simulated by selecting osseous landmark points on the calvaria and skull base.Special form and sequence of anatomic structures in different routes were observed.Volumes of anatomic tissues were measured.Results All the surgical routes passed below the transverse sinus and lateral to the cerebellum.Route a exposed the lower cranial nerve and anterior inferior cerebellar artery;when reached the jugular tubercle,the route exposed inferior petrous sinus.Route b exposed the anterior inferior cerebellar artery,labyrinth and facial-acoustic nerve complex.Route c passed the medial to the superior petrous sinus and exposed the facial-acoustic nerve complex;when being arrived at petrous apex,the route exposed the trigeminal nerve,superior cerebellar artery and cavernous sinus.The volumes of the lower cranial nerve,osseous structures,cerebellum and artery were significantly different in models adopted different routes (P＜0.05);the volume of the lower cranial nerve was as follows:route c＞route a＞route b,the volume of osseous structures was as follows:route c ＞route b＞route a,the volume of cerebellum was as follows:route b ＞route a＞route c,and the volume of artery was as follows:route a ＞route c＞route b.Venous structure involved in route a ([68.91 ±1.91] mm3) was larger than that in route c ([248.92±11.26] mm3) with statistical significance (P＜0.05),and route b did not involve venous structure.Conclusions Targets in skull base has significant impaction on the size of anatomic structures involved in the route of retrosigmoidal approach.Relationship between injury and exposure can be evaluated objectively by the volume measurement.

Objective To study the relationship between circulating tumor cells(CTCs) in peripheral blood of the pa‐tients with hepatocellular carcinoma (HCC) and its metastasis and prognosis .Methods 35 patients with hepatocellular carci‐noma were collected as the research objects .CTCs density were enriched through gradient centrifugation and negative‐immu‐nomagnetic methods ,then the cells were detected by chromosome fluorescence in situ hybridization combined with immunofluo‐rescence tests to identify CTCs .The clinical characters were recorded and the data were statistically analyzed .Results All the patients were detected CTC positive .The number of CTC was (4 .1 ± 2 .5) .The patients were divided into 2 groups .Group Ⅰincluded patients whose CTCs were <5 ,and others were included in group Ⅱ .The difference between number of group I and group Ⅱ had significant significance(P=0 .001);Metastasis had nothing to do with patients′sex and age(P=0 .581 ,0 .531);The number of CTCs was related to metastasis and prognosis(P=0.024 ,0.01) ,and there was significant statistic significance between group I and groupⅡ .Conclusion The number of CTCs was related to tumor metastasis .The tumor may be more prone to occur metas‐tasis and may had worse prognosis ,and the patients may had shorter life time when the number of CTCs was≥5 .

Objective To discuss the microanatomy features of jugular foramen region in transpetrosal-presigmoidal minimally invasive approach based on virtual reality image models.Methods CT and MRI scans were performed to fifteen adult cadaver heads,and then,imaging data were inputted into Vitrea virtual reality system to establish three-dimensional anatomy models of jugular foramen region.Different minimally invasive transpetrosal-presigrnoidal approaches exposing superior edge of internal acoustic meatus (route A),anterior edge of jugular foramen (route B),and posterior edge of jugular foramen (route C) were simulated by selecting osseous landmark points.Anatomic exposures in surgical trajectory following alternation of minimally invasive approach were observed,measured and compared.Results Spacial sequence of nerves and vessels in the route simulating transpetrosal-presigmoidal approach for exposure of jugular foramen region was displayed clearly;route A had the highest location and route C was the lowest.Volumes of route and petrosal osseous structure involved in route A was the largest,and then,volumes of route and osseous structure involved in route B was larger than those in route C,with significant differences (P＜0.05).Volumes of involved venous sinus were as follow:route B＞route A＞route C,with significant differences (P＜0.05).Volumes of facial-acoustic nerve complex and anterior inferior cerebellar artery involved in route A were (53.32± 5.54) mm3 and (30.55±3.51) mm3,respectively.Volumes of lower cranial nerves involved in route B were (84.59±9.23) mm3.Conclusion There are different impacts on the osseous structures and venous sinus for the minimally invasive routes of transpetrosal-presigmoidal approach exposing different targets,of which combinations are helpful to utilize respective advantages.

Objective To investigate the correlation of rupture risk of intracranial aneurysms with aneurysm diameter,blood pressure,neck width,gender,age,and smoking and alcohol histories of the patients.Methods Retrospective analysis of the clinical and radiological data of 928 patients with intracranial aneurysm,admitted to our hospital from January 2011 to December 2012,was performed; according to rupture situation,these patients were divide into ruptured group (n=411) and unruptured group (n=517); univariate analysis and multivaviable Logistic regression analysis were used to analyze the rupture risk of intracranial aneurysms,including aneurysm diameter,blood pressure,neck width,gender,age,and smoking and alcohol histories.Results Univariate analysis showed that there were statistical significances between the two groups on aneurysm diameter,blood pressure,aneurysm neck width,gender,smoking history (P＜0.05); multivariate Logistic regression analysis showed that aneurysm diameter was the independent risk factor of rupture of aneurysms (P=0.001).Conclusion Aneurysm diameter is a key risk of rupture for intracranial aneurysms,while rupture of intracranial aneurysms is not correlated to the blood pressure,aneurysm neck width,gender,age,and smoking and alcohol histories.