Objective:To investigate the clinical effect of deep brain stimulation (DBS) in the treatment of Parkinson′s disease (PD).Methods:32 PD patients treated in Hunan Brain Hospital from January 2016 to December 2018 were selected for the study. Guided by MRI and supplemented by electrophysiological stimulation to correct the target, PD patients were treated with DBS for the nucleus accumbens. Based on Webster and Unified Parkinsons Disease Rating Scale (UPDRS) scores before and after DBS treatment, the clinical treatment effects were evaluated. And the content of Aβ1-42, interleukin (IL)-1β, IL-6, uric acid (UA), malondialdehyde (MDA), homocysteine (Hcy), S-nitrosylated dynamin-relatedprotein 1 (SNO-Drp1) and Drp1 was measured before and after DBS treatment. The ratio of SNO-Drp1/Drp1 was also measured.Results:The Webster score and UPDRS score of PD patients after DBS treatment were lower than those before DBS treatment ( P<0.05). The Aβ1-42 and Drp1content of PD patients after DBS treatment was higher than that before DBS treatment ( P<0.05), while the content of IL-1β, UA, MDA, Hcy and the ratio of SNO-Drp1/Drp1 were lower than before treatment ( P<0.05). Conclusions:DBS has confirmed a good clinical effect in the treatment of PD patients and significantly improved the quality of life of patients.

Objective:To investigate the effect of vagus nerve stimulation (VNS) on serum cytokines and neurotransmitters in epilepsy patients with depression.Methods:From March 2015 to 2018, 13 patients with epilepsy combined with depression undergoing VNS surgery in Brain Hospital of Hunan Province were selected as the research objects. The surgical efficacy, depression degree, serum cytokines and neurotransmitter changes before operation, 6 months and 12 months after operation were compared.Results:The effective rate of epilepsy treatment at 6 and 12 months after VNS were 61.5%(8/13) and 76.9%(10/13), respectively. After 6 months and 12 months, Hamiton Depression scale (HAMD) and self-rating depression scale (SDS) scores were significantly lower than those before operation ( P<0.05 or P<0.01). At 6 months after operation, serum 5-hydroxytryptamine (5-HT) level was significantly higher than that before operation, while serum interleukin (IL)-1α, IL-6 and tumor necrosis factor α (TNF- α) were significantly lower than those before operation ( P<0.05 or P<0.01). At 12 months after operation, 5-HT and dopamine (DA) were significantly increased, while IL-1 α, IL-2, IL-6 and TNF -α were significantly decreased ( P<0.05 or P<0.01). Conclusions:VNS may can improve epilepsy and depression by regulating the level of neurotransmitter and serum cytokines.

Psychiatric symptoms are common after traumatic brain injury (TBI), and some patients have poor drug therapeutic efficacy. We report a successfully treated case of psychiatric symptoms after TBI using deep brain stimulation (DBS) to the anterior limb of internal capsule (ALIC)-nucleus accumbens (NAc) in a 76-year-old woman. The patient suffered from auditory hallucination, mood changes, and insomnia caused by TBI. Psychological test assessment showed the scores of Hamilton Anxiety Scale, Hamilton Depression Scale and Positive and Negative Syndrome Scale were 30, 35, and 96 respectively. Head magnetic resonance imaging scan showed right temporal lobe encephalomalacia. Head magnetic resonance spectroscopy (MRS) showed bilateral basal ganglia choline increased relatively. After DBS to the ALIC-NAc, the target parameters were adjusted. The psychiatric symptoms were completely improved and the result of head MRS was normal in the end. The current report declares that DBS is reversible, adjustable and safe in the treatment of psychiatric symptoms caused by TBI. DBS to the ALIC-NAc should be considered as a possible treatment choice once a patient showed psychiatric symptoms after TBI.

Objective: To observe influences of Chaihu-Longgu-Muli decoction (CLMD) on electroencephalogram (EEG), serum nerve growth factor (NGF) and brain derived neurotrophie factor (BDNF) level of patients with temporal lobe epilepsy. Methods: Single blind randomized controlled trial design was used. 138 patients with temporal lobe epilepsy were divided into oxcarbazepine group (including 67 patients), oxcarbazepine+ CLMD group (including 71 patients). After 28 d of treatment, EEG changes, NGF and BDNF changes in serum, and relevant serological indicator inspection of drug reactions in both groups were observed. Results: The effective rate of EEG in oxcarbazepine+ CLMD group was 81.8%, which was obviously higher than the oxcarbazepine group (50.7%), with significant difference (P<0.01). After treatment, NGF and BDNF of both groups were higher than those before treatment (P<0.05). Moreover, serum NGF and BDNF of oxcarbazepine+ CLMD group were higher than the oxcarbazepine group (P<0.05). There was no statistical significance in serological indicator of drug reactions in both groups (P>0.05). Conclusions The curative effects of oxcarbazepine+ CLMD is superior to the individual oxcarbazepine and it can obviously enhance serum NGF and BDNF of patients with temporal lobe epilepsy and reduce the status epilepticus of patients with temporal lobe epilepsy and it has the high safety.

Objective To study the surgical skills, clinical effects and complications prevention of microelectrode as-sisted stereotactic surgery in treatment of Parkinson's disease. Methods A total of 456 cases of patients with Parkin-son's disease were treated with microelectrode assisted stereotactic surgery. Surgical skills were summarized and post-operative symptoms improvement and complications were analyzed. Results The recent total effective rate was 97.59%without serious or permanent complications. Conclusion Stereotactic surgery is a safe and effective treatment of Parkinson's disease. The precise positioning of target and surgical shills are keys to improving surgical outcome and re-ducing complications.

OBJECTIVE: To determine the clinical characteristics and cognitive dysfunction of bipolar depression and unipolar depression. METHODS: Fifty patients with unipolar depression, 48 bipolar depression, and 50 normal controls were assessed with Hamilton Depression Scale, Hamilton Anxiety Scale, Life Events Scale, and The Wisconsin Card Sorting Test. General demographic data, clinical data, and the scores of recognitive function in the 3 groups were compared. RESULTS: The patients with bipolar depression occured at young age and had obvious family history compared with those with unipolar depression. The patients with bipolar or unipolar disorders had lower scores in most neuropsychological tests than those in the control group (P<0.05). The patients with bipolar depression in understanding memory and Wisconsin card sorting test were worse than those with unipolar depression (P<0.05). CONCLUSION There is cognitive dysfunction in patients with bipolar or unipolar disorder. Understanding memory and executive function damage may be cognitive features in bipolar disorder.
Adolescent ; Adult ; Bipolar Disorder ; complications ; diagnosis ; physiopathology ; China ; Cognition ; physiology ; Cognition Disorders ; complications ; physiopathology ; Depressive Disorder ; complications ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Neuropsychological Tests ; Young Adult

ObjectiveTo investigate the etiology, clinical characteristics, diagnosis and treatment of regional portal hypertension caused by left upper abdominal malignant tumors.MethodsFrom January 2006 to December 2009, a total of 8 patients presenting regional portal hypertension were treated at our hospital, whose clinical data were analyzed retrospectively. ResultsPancreatic tumors (5/8) and retroperitoneal tumors(3/8)were the primary etiology,andthe main symptoms included upper gastrointestinal bleeding and irregular left upper abdominal pain.Isolated gastric varices were the most distinct clinical features. All patients underwent multi-visceral resection including pancreatic body and tail and spleen. Tumor involved stomach, left kidney, left adrenal and splenic flexure of colon were also removed en bloc. During the follow-up period there was no recurrent upper gastrointestinal bleeding, one patient died and two patients developed metastasis or tumor local recurrence.ConclusionRegional portal hypertension caused by malignant tumor was relatively rare,aggressive resection of multi-viscera combined with devascularization was an effective therapy.

OBJECTIVE: To determine the long-term effect and security of refractory schizophrenia with brain stereotaxis multi-target therapy technique. METHODS: A total of 87 patients with refractory schizophrenia were treated with brain stereotaxis multi-target therapy and were followed up over 2 years. The scores of Clinical Global Impression, Brief Psychiatric Rating Scale, Positive and Negative Symptom Scale, Wechsler Adult Intelligence Scale, Wechsler Memory Scale, Actives of Daily Living, and Social Disability Screening Schedule were compared before and after the operation. RESULTS: Of the 87 patients, 40 obviously improved, 24 improved, 12 improved little, 7 did not change. None grew worse, 1 died, and 3 shed. There was a significant difference in the scales before and after the operation (P<0.01). No severe complications and sequelae occurred. CONCLUSION Stereotaxic multi-target therapy is effective and safe for refractory schizophrenia. After the operation, drug therapy should be maintained and recovery of social function is helpful.
Adult ; Brain ; surgery ; Brief Psychiatric Rating Scale ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Schizophrenia ; surgery ; Stereotaxic Techniques ; Young Adult

BACKGROUND: Neural stem cells are a kind of special cells possessing self-renewal and multi-directional differentiation potential. They are ideal carriers for studying the occurence, development and development rule of nervous system and their inherent regulation mechanism of molecular biol ogy and cytology. They have wide applicative prospect in the treatment of nervous system disease and injury. Investigating a set of convenient, effective and useful culture system of neural stem cells cultured in vitro is the prerequisite and basis for application. OBJECTIVE: To observe the effect of serum culture medium containing basic fibroblast growth factor on the in vitro culture of neural stem cells of mice. DESIGN: Single-sample observation. SETTING: Department of Histology and Embryology, Youjiang Nationality Medical College. MATERIALS: Five 2-month-old Kunming white mice of either sex were used in this experiment. METHODS: This experiment was carried out at the Department of Histology and Embryology, Guangxi Medical University from June 2003 to May 2005. ① The cerebral cortical cells were isolated from cerebral cortex and cultured in vitro of the adult mouse cerebral cortex and made into cell suspension , then put in the DMEM/F12 (1:1)culture medium (containing fetal bovine serum of 0.15 volume fraction, basic fibroblast growth factor of 20 μg/L, penicillin of 100 u/mL and streptomycin of 100 u/mL ) .The attachment culture method was used to acquire the clone cells. ② Expression of nestin antigen of clone cells was detected with immunohistochemical technique. MAIN OUTCOME MEASURES: ① Morphological observation of cultured cells. ② Observation of cultured cells stained by haematoxylin and eosin . ③ Identification of neural stem cells. RESULTS: ① Morphological observation of cultured cells: After inoculation, most of the cells attached to the wall within 12 hours, cells were thin and flat. 3 days after inoculation, cells began to grow and proliferate. There were several scores to several hundreds of cell clones on the 5th day after inoculation and cells covered 80%-90% of the bottom of the bottle on the 7th to 8th days. After passage, the cells still grew adhesively with regular cellular morphology and clear borderline. ② Observation of cultured cells stained by haematoxylin and eosin: It was shown that the cells presented round or ellipse. There was little cytoplasm, presenting acidophily. Nucleus was big and round, single in the center, deep stained.③ Identification of neural stem cells: Immunofluorescent detection showed that cell nestin antigen positive. CONCLUSION: After cultured in serum culture medium containing basic fibroblast growth factor, cerebral cortex cells possess very strong reproductive activity and express nestin antigen, still possessing the characteristics of neural stem cells.

Objective To investigate the impact of smoking on the level of urinary 8-iso prostaglandin (PG) F2? (8-iso-PGF2?) of patients with acute cerebral infarction. 8-iso-PGF2? is a product of arachidonic acid catalyzed by free-radical, and it has been identified as an indicator of oxidative stress in vivo during reperfusion. Methods Plasma and urine samples were obtained from 28 patients with acute cerebral infarction. Among them 14 patients with no smoking habit were chosen as control group according to the selection criterion, and the other 14 patients with smoking habit were chosen as investigation group according to the same criterion. There was no significant difference between the two groups in age, gender ratio, blood pressure, lipids level, blood glucose, focus location, and degree of the cerebral focus of infaration. The concentration of urinary 8-iso PGF2? and levels of low-density lipoproteins (LDL), total cholesterol, LDL-triglyceride (TG) and LDL-free cholesterol in plasma were measured by enzyme immunoassay. The quantification of urinary 8-iso PGF2? and LDL levels in plasma were performed for each sample respectively. Results The concentration of urinary 8-epi PGF2? of the patients with smoking habit was significantly higher than that in the patients of control group (75.79?10.76 vs 67.36?9.18 ng/mmol creatinine, P0.05, respectively) between the two groups. Conclusions Cigarette smoking may raise the urinary 8-iso-PGF2? level of patients with acute cerebral infarction, suggesting an increase in the level of oxidative stress in vivo in these subjects.