The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation. This stereoelectroencephalography (SEEG) study investigated how the dorsolateral prefrontal cortex (DLPFC) interacts with the hippocampus in the online processing of sequential information. Twenty patients with epilepsy (eight women, age 27.6 ± 8.2 years) completed a line ordering task with SEEG recordings over the DLPFC and the hippocampus. Participants showed longer thinking times and more recall errors when asked to arrange random lines clockwise (random trials) than to maintain ordered lines (ordered trials) before recalling the orientation of a particular line. First, the ordering-related increase in thinking time and recall error was associated with a transient theta power increase in the hippocampus and a sustained theta power increase in the DLPFC (3-10 Hz). In particular, the hippocampal theta power increase correlated with the memory precision of line orientation. Second, theta phase coherences between the DLPFC and hippocampus were enhanced for ordering, especially for more precisely memorized lines. Third, the theta band DLPFC → hippocampus influence was selectively enhanced for ordering, especially for more precisely memorized lines. This study suggests that theta oscillations may support DLPFC-hippocampal interactions in the online processing of sequential information.
Adult ; Female ; Humans ; Young Adult ; Epilepsy ; Hippocampus ; Memory, Short-Term ; Mental Recall ; Prefrontal Cortex ; Theta Rhythm ; Male

Chinese expert consensus on neurosurgical treatment of psychiatric disorders is compiled by national experts in neurosurgery,psychiatry,and other related fields.Based on clinical research published up to December 2023 and evidence-based medicine standards,the consensus provides recommendations for neurosurgical treatment of psychiatric disorders.The covered diseases include obsessive-compulsive disorder,depressive disorder,tic disorder,bipolar disorder,anorexia nervosa,substance use-related disorders,and schizophrenia.This expert consensus outlines the safety and efficacy of neurosurgical treatments for psychiatric disorders in clinical practice,and preliminarily standardizes treatment procedures and surgical techniques.The aim is to establish professional standards for the application of surgical treatment techniques for clinical practitioners in the field of psychiatric disorder surgery,thereby maximizing treatment outcomes and promoting the future development of this treatment technology.

Deep brain electrical stimulation is one of the emerging therapeutic approaches for treatment-resistant depressive disorders.This article outlines a variety of potential targets for deep brain electrical stimulation in the treatment of treatment-resistant depressive disorders and summarizes the results of relevant clinical studies.These targets include the subgenual cingulate gyrus,nucleus accumbens,ventral capsule and ventral striatum area,medial forebrain bundle,and lateral habenula,among other regions.Based on these studies,the article integrates relevant basic research and further discusses the possible mechanisms through which deep brain stimulation may exert therapeutic effects,including synaptic plasticity,neurophysiology,neural circuits,and neurotransmitters.The article also assesses and prospects the further application potential of deep brain electrical stimulation.The authors believe that the multi-target stimulation combining existing clinical research results and neurobiological mechanisms could be a crucial development direction to enhance the treatment of treatment-resistant depressive disorders using deep brain electrical stimulation.

Objective:To summarize the clinical researches of Wumei Pill and provide reference for clinical application and follow-up research.Methods:The databases CNKI, VIP, Wanfang, CBM, PubMed, Embase were retrieved from the inception to June 30,2022. CiteSpace 6.1.R3 software was used to analyze the research hotspots and keywords in the literature. Using EndNote X9 software and Microsoft Office Excel 2013, we recorded and analyzed the published year, literature type, affiliated journal, disease treated, TCM syndrome type, single drug dose and treatment duration of the included articles.Results:212 articles were included. Diarrhea, gastritis, diabetes, insomnia were the research hotspots. The types of diseases treated by Wumei Pill mainly include digestive system, endocrine system and tumor, mainly for cold-heat syndrome and Jueyin syndrome. The average dosage of Mume Fructus was the largest, 21 g. The average treatment time was 5.78 weeks. Conclusion:At present, the overall clinical research of Wumei pill shows an increasing tendency, mainly involving gastrointestinal disease.

Neurostimulation remarkably alleviates the symptoms in a variety of brain disorders by modulating the brain-wide network. However, how brain-wide effects on the direct and indirect pathways evoked by focal neurostimulation elicit therapeutic effects in an individual patient is unknown. Understanding this remains crucial for advancing neural circuit-based guidance to optimize candidate patient screening, pre-surgical target selection, and post-surgical parameter tuning. To address this issue, we propose a functional brain connectome-based modeling approach that simulates the spreading effects of stimulating different brain regions and quantifies the rectification of abnormal network topology in silico. We validated these analyses by pinpointing nuclei in the basal ganglia circuits as top-ranked targets for 43 local patients with Parkinson's disease and 90 patients from a public database. Individual connectome-based analysis demonstrated that the globus pallidus was the best choice for 21.1% and the subthalamic nucleus for 19.5% of patients. Down-regulation of functional connectivity (up to 12%) at these prioritized targets optimally maximized the therapeutic effects. Notably, the priority rank of the subthalamic nucleus significantly correlated with motor symptom severity (Unified Parkinson's Disease Rating Scale III) in the local cohort. These findings underscore the potential of neural network modeling for advancing personalized brain stimulation therapy, and warrant future experimental investigation to validate its clinical utility.
Adult ; Aged ; Brain Mapping ; Connectome ; Deep Brain Stimulation ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways ; diagnostic imaging ; physiology ; Oxygen ; blood ; Parkinson Disease ; diagnostic imaging ; pathology ; therapy ; ROC Curve ; United Kingdom

Objective To investigate the application of carotid artery resection and reconstruction in surgical management of thyroid carcinoma with carotid artery involvement.Methods We conducted a retrospective cohort study involving 10 patients whose common carotid arteries were invaded by thyroid carcinoma.All patients underwent tumor en bloc resection and carotid arteries reconstruction.Patients were evaluated by muhidisciplinary team and surgeries were cooperated by general surgeons,orthopedists and vascular surgeons.The perioperative complications and surgical outcomes were also recorded and analyzed.Results No patient had complications of central nervous system.One patient suffered Horner syndrome and one presented hoarseness postoperative.Two patients had wound infection,two patients presented carcinoma recurrence and two patients presented distant metastasis during the follow-up.Conclusion En bloc resection of tumor and carotid artery reconstruction is a feasible modality in treatment of thyroid carcinoma with carotid artery invasion.

Objective To analyze whether preoperative serum thyroglobulin (Tg) can be the indicator for predicting malignancy in follicular thyroid tumors (FTC).Methods A retrospective analysis was done for 125 patients with FTC who had been diagnosed by pathology in our hospital.The patients were grouped into benign group and malignant group.Sex,age,tumor size and preoperative serum Tg concentration were analyzed.Results There were 62 patients in benign group (23 male and 39 female).The mean age was 49 years old,ranging from 19 to 78 years,and the mean diameter of tumors was (3.4±1.374) cm,ranging from 0.1 to 5.5 cm.There were 63 patients in malignant group (13 male and 50 female).The mean age was 46 years old,ranging from 15 to 79 years,and the mean diameter of tumors was (3.14±1.143) cm,ranging from 0.3 to 7 cm.The mean preoperative serum Tg concentration was (299.73± 495.02) ng/ml in malignant group and(48.20 ±43.68)ng/ml in the benign group.Through comparing the two groups,we found age and tumors diameter had no statistical difference between the two groups (P＞0.05),while sex and Tg had statistical difference (P＜0.05).When the cutoff of Tg was 100 ng/ml,the sensitivity and specificity for the diagnosis of malignancy was 48.7％ and 90％ respectively.Conclusions Tg can be used as auxiliary diagnosis index of thyroid FTC.High preoperative Tg levels should be highly suspected the possibility of FTC.

Objective To evaluate 3D printing used in the treatment of complex acetabular fractures.Methods Between January 2009 and December 2013,121 patients with complex acetabular fracture were treated at our department.3D printing was used in surgical planning in 53 of them,including 36 males and 17 females with an average age of 41.2 ± 10.4 years (3D group).The other 68 patients received conventional surgery without use of 3D printing,including 42 males and 26 females with an average age of 42.6 ± 8.9 years (conventional group).By the Judet-Letournel classification system,there were respectively 7 and 9 T-type fractures,4 and 6 posterior column with posterior wall fractures,21 and 28 transverse and posterior wall fractures,5 and 6 anterior with the second half transverse fractures,and 16 and 19 double column fractures.Surgical time,blood loss,transfusion,fluoroscopy times and complications were recorded in the 2 groups.At the final follow-ups,the clinical results were assessed by Merle D'Aubigné & Postel scoring and the radiographic results were assessed by Matta records.The 2 groups were similar in preoperative demographic data (P ＞ 0.05).Results In the 3D and conventional groups,respectively,surgical time was 3.5 ±O.9 hours versus 4.5 ± 1.1 hours,blood loss was 1,200.2 ±232.8 mL versus 1,550.4 ±211.6 mL,transfusion was 8.9 ± 3.8 U versus 12.3 ± 2.9 U,and fluoroscopy times were 8.7 ± 2.1 versus 11.9 ± 2.4.The differences between the 2 groups were statistically significant (P ＜ 0.05).The 3D and conventional groups were respectively followed up for 20.3 and 37.8 months on average.All the acetabular fractures healed.The time from surgery to full-weight-bearing walking averaged 3.5 months.Iatrogenic ischiadic nerve injury occurred in 5 and 7 cases and superficial infection in 3 and 5 cases in the 3D and conventional groups,respectively.No iatrogenic vascular injury,nonunion,or implant failure occurred in the 2 groups.By the Merle D' Aubigné & Postel records,the excellent and good rate was 64.2％ (34/53) in the 3D group versus 64.7％ (44/68) in the conventional group.By the Matta records,the excellent and good rate was 73.6％ (39/53) in the 3D group versus 75.0％ (51/68) in the conventional group.The differences were not statistically significant (P ＞ 0.05).Conclusion Since 3D printing can contribute to better preoperative plan,it helps to lead to more accurate operation,shorter surgical time,and enhanced perioperative safety.

BACKGROUND:With the continuous development and progress of medical model, the treatment and rehabilitation recovery from peripheral nerve defects needs higher requirements; therefore, stem cel culture-based nerve tissue engineering technology provides a new strategy for nerve defect repair. OBJECTIVE:To explore the feasibility of combining bone marrow mesenchymal stem cels and new nerve conduits to repair peripheral nerve defects. METHODS:Fifty New Zealand white rabbits, clean grade, were randomly divided into experimental group and control group, with 25 rabbits in each group. Animal models of peripheral nerve defects were made about 15 mm distant to the middle segment of the radius of the rabbit foreleg. At 1 week after modeling, bone marrow mesenchymal stem cels/new nerve conduit composite material was implanted into the defect in the experimental group; and in the control group, only bone marrow mesenchymal stem cels were transplantation. At 4 weeks after transplantation, a 5-mm nerve fiber was taken from the defect site, stained with hematoxylin-eosin and observed under scanning electron microscope. Density and diameter of regenerated nerve fibers were compared between the two groups. RESULTS AND CONCLUSION:Compared with the control group, the density of nerve fibers was significantly higher in the experimental group, but the diameter of nerve fibers was significantly lower (P < 0.05). There were more cels with good growth, large size and many processes on the surface of regenerated nerve tissues in the experimental group than the control group. Moreover, in the experimental group, interconnected cels were woven into a mesh and the axons were longer and thicker, both of which were the performance of typical neuron-like cels. Taken together, the bone marrow mesenchymal stem cels/new nerve conduit composite material can be used for peripheral nerve repair and present exact achievements.

Objective To investigate the clinical value of gauze packing for haemodynamically unstable pelvic fracture.Methods Between January 2006 and January 2014,gauze packing was used to treat haemodynamically unstable pelvic fracture in 42 patients consisting of 23 males and the 19 females aged 34.2 years (range,18 to 54 years).AO classification of the fracture was type B1 in 9,B2 in 5,B3 in 3,C1 in 13,C2 in 4,and C3 in 8 patients.All the patients were diagnosed with hypovolemic shock upon admission with the systolic pressure of (75.4 ± 4.3) mmHg and heart rate of (126.5 ± 12.4) beats/ min.Injury severity score (ISS) was (38.7 ± 6.2)points.Anti-shock treatment,internal or external fixation of pelvic ring,and gauze packing were performed immediately to control the hemorrhage following pelvic fracture.Results Systolic pressure was (95.2 ± 4.6) mmHg and mean heart rate was declined to (85.4 ± 13.2)beats/min after pelvis volume control and gauze packing,with significant differences compared to these preoperatively (P ＜ 0.05).Red blood cell transfusion before internal or external fixation and gauze packing was (15.0 ± 2.4) units versus (8.3 ± 1.5) units within the first postoperative 24 hours (P ＜ 0.05).Twenty-four out of the 42 patients underwent temporary abdominal aorta occlusion.Six patients died postoperatively with the death rate of 14％.Mean time of removing the packing gauze was (51.4 ± 10.3) hours (range,24-168 hours).Conclusion Anti-shock treatment with concurrent gauze packing and pelvis volume control is effective to arrest the massive hemorrhage in hemodynamically unstable pelvic fracture.