Influencing factors for efficacy of microvascular decompression in primary trigeminal neuralgia / 中华神经医学杂志

Objective:To analyze the influencing factors for efficacy of microvascular decompression (MVD) in primary trigeminal neuralgia (PTN).Methods:A retrospective study was performed. Clinical data of 178 patients with PTN underwent MVD at Department of Neurosurgery, Affiliated Hospital Affiliated to Nantong University from January 2018 to April 2022 were collected. Efficacy was evaluated according to Brisman's criteria. Differences of MVD efficacy in patients with different clinical characteristics or different neurovascular characteristics were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for MVD efficacy.Results:All patients were followed up for about 2 years; at the last follow-up, 164 patients (92.13%) had good postoperative efficacy (130 were cured, 28 were obvious improved, and 6 were improved); 14 patients (7.87%) had poor postoperative efficacy (10 were ineffective and 4 were relapsed). No significant difference in surgical efficacy was noted among patients with different gender, age, left/right lateral pain, disease courses or pain degrees ( P>0.05). Patients with different contact degrees between the trigeminal nerve and blood vessels, different distances between the trigeminal nerve and blood vessels, and different curvature degrees of the posterior trigeminal nerve had significantly different surgical efficacy ( P<0.05). Multivariate Logistic regression indicated that contact degrees between the trigeminal nerve and blood vessels ( OR=0.233, 95% CI: 0.080-0.675, P=0.007), distances between the trigeminal nerve and blood vessels ( OR=6.991, 95% CI: 3.261-14.984, P=0.000), and curvature degrees of the posterior trigeminal nerve ( OR=0.351, 95% CI: 0.158-0.776, P<0.001) were independent influencing factors for postoperative outcomes. Conclusion:The postoperative efficacy is good in patients with slight contact between the trigeminal nerve and blood vessels, with distance between the trigeminal nerve and blood vessels greater than 1×time median width of the trigeminal nerve (WTN), or with hypotenuse height of the arced trigeminal nerve less than 1/2 WTN.

Characteristics of polysomnography in depression patients complicating moderate-to-severe obstructive sleep apnea hypopnea syndrome / 四川精神卫生

ObjectiveTo investigate the characteristics of polysomnography （PSG） in depression patients complicating moderate-to-severe obstructive sleep apnea hypopnea syndrome （OSAHS）. MethodsA retrospective analysis was conducted on the outpatients， inpatients and physical examination population who completed overnight PSG monitoring in the sleep medicine center of Suzhou Guangji Hospital from December 2017 to October 2019. Four groups of subjects were finally enrolled， including depression patients with moderate-to-severe OSAHS （n=31）， depression patients without OSAHS （n=79）， moderate-to-severe OSAHS patients （n=96） and normal control group （n=32）. The sleep process related indicators （total sleep time， sleep latency， number of awakenings）， sleep structure related indicators （N1， N2， N3， percentage of REM sleep， REM latency， REM sleep duration）， sleep-related respiratory variables （oxygen reduction index） and other polysomnographic parameters of the four groups were compared. ResultsIn terms of sleep process， the total sleep time， sleep latency and number of awakenings yielded significant differences among the four groups （F=2.874， 3.959， 12.291， P<0.05 or 0.01）. In terms of sleep structure， the percentage of total sleep time in N2 and N3 stages demonstrated significant differences among the four groups （F=13.885， 48.013， P<0.01）. The REM latency， REM sleep duration and percentage of REM sleep manifested significant differences among the four groups （F=41.492， 11.827， 10.552， P<0.01）. In terms of sleep-related respiratory variables， the oxygen reduction index exhibited significant differences among the four groups （F=170.585， P<0.05）. ConclusionDepression patients complicating moderate-to-severe OSAHS suffer from severe sleep process and structural disturbances， accompanied by quite frequent and severe sleep-related respiratory events.

Clinical characteristics and treatments of arachnoid cyst combined with chronic subdural hematoma / 中华神经医学杂志

Objective To investigate the clinical characteristics and treatment strategies of arachnoid cyst combined with chronic subdural hematoma.Methods Seventeen patients with arachnoid cyst combined with chronic subdural hematoma,who received treatment in our hospital from February 2008 to March 2016,were chosen in our study;13 of them were performed burr hole irrigation and drainage,2 received craniotomy for removing hematoma and cystectomy,and 2 received endoscopic cyst excision and hematoma removal surgery.A retrospectively analysis of clinical characteristics and treatment strategies of these patients was performed.Results Follow up for 0.5-2 years was performed in the 13 patients performed burr hole irrigation and drainage,and no hematoma relapse was noted;one was found rebleeding in the cyst associated with a small amount of subdural hematoma on the 5th d of surgery,and the subdural hematoma was absorbed during the follow-up observation;one was found that the cyst and subdural hematoma both disappeared in the postoperative check,while the cyst reappeared 40 days after surgery,and during the follow-up observation,the cyst was not enlarged and the chronic subdural hematoma was not relapsed.Two patients recovered after receiving the craniotomy for removing hematoma and cystectomy;two patients recovered after receiving the endoscopic cyst excision andhematoma removal surgery.Conclusion For patients with arachnoid cyst associated with chronic subdural haematoma,burr-hole irrigation and drainage are generally selected;for patients with reappeared cyst or hematoma,there is no need to burr hole again or perform the surgery aiming at the cyst in a haste,and follow-up observation is suggested;for patients whose symptoms in the cyst have appeared before hemorrhage or whose hemorrhage appeared recurrently in the cyst,surgery of hematoma removal and cyst excision can be chosen at the same time.

Phosphatase and tensin homology deleted on chromosome ten inhibition in improving growth of neurons cultured in inhibitive microenvironment / 中华神经医学杂志

Objective To investigate the effect of inhibiting tumor suppressor gene phosphatase and tensin homology deleted on chromosome ten (PTEN) on growth of neurons cultured in inhibitive microenvironment.Methods Primary cortical neurons were separated from fetal rats and cultured with adult rat brain-derived myelin membrane proteins as inhibitory substrate.Cells were divided into 3 groups:normal control group,inhibitory control group (myelin membrane proteins as inhibitory substrate) and bpv treatment group (200 nmol/L bpv+myelin membrane proteins).Real-time quantitative-PCR was performed to detect the expressions of PTEN and mammalian target ofrapamycin (mTOR) genes,and immunofluorescence staining was used to observe the growth ofneurites 24,48 and 72 h,and 5 d after inoculation.Results Immunofluorescence staining revealed that significant differences of the growth of neurites at the four observation time points existed among the 3 groups (P＜0.05); during the early days of culture (24,48 and 72 h),cells in normal control group had the longest neurite (43.5±12.2,94.9±23.6 and 154.3±35.4 μm),those in the bpv treatment group enjoyed the second prize (28.8±10.2,75.4±22.5 and 136.8±40.8 μm) and those in the inhibitory control group was obviously inhibited (17.4±5.8,46.3± 13.7 and 78.4 ±29.8 μm).But the difference on the 5th d of cultivation changed into bpv treatment group＞normal control group＞inhibitory control group with the neurite length of (225.9±50.6),(218.4±58.1) and (173.6±48.7) μm,respectively (P＜0.05).PCR revealed no significant difference in expressions of PTEN and mTOR genes of the three groups between each two time points (P＞0.05); while at the same time point,significantly increased expressions ofmTOR and PTEN in the bpv treatment group were noted as compared with those in the normal control group and inhibitory control group (P＜0.05).Conclusions Growth of neurons in inhibitive microenvironment is improved on condition that the tumor suppressor gene PTEN is inhibited,which is probably related to the activation of PI3K/AKT/MTOR pathway.

Rapid detection of common bacterial infections of cerebrospinal fluid by genetics approach / 中华神经科杂志

ObjectiveTo assess gene chip application value in detecting pathogenic bacteria in intracranial infection cases.MethodsPrimers and probes aiming at the specific DNA sequences of 4 kinds of common pathogenic bacteria and 6 kinds of common drug resistance genes (DRGs) were designed and used to identify the bacteria and DRGs among 30 cerebrospinal fluid (CSF) specimens (12 positive,18negative in CSF culture) from patients with intracranial infection using multiplex polymerase chain reaction (mPCR) and gene chip.The results of gene detection were compared with those of CSF culture and drug sensitivity testing.ResultsBacteria were identified and DRGs were detected in 15 specimens; DRGs and 16S gene were detected in 8 specimens; neither bacterium nor DRG was detected in 7 specimens.ConclusionGene chip technique is characterized by its relative sensitivity and rapidity of detecting the pathogenic bacteria in CSF of intraeranial infection cases.

The analysis of 33 patients with painless myocardial infarction / 中国基层医药

Objective To investigate the clinical feature of painless myocardial infarction. Methods To retrospectively study the clinical data of 33 patients who suffered from painless myocardial infarction, and compare with that of typical acute myocardial infarction patients. Results There wash' t significant difference in gender(χ2 =1.63, P >0.05) and past history (χ2 = 4.88, P > 0.05) ,the time from visit to diagnosis (t = 1.44, P > 0.05) between painless myocardial infarction patients and typical acute myocardial infarction patients. But there was significant differ-ence in the age (χ2= 5.72, P < 0.05), the visit time (t = 30.98, P < 0.05), and the prognosis (χ2 = 32.17, P <0.0 ). Conclusion Patients with painless myocardial infarction have diverse clinical manifestations. They are usu-ally aged and delayed in seeking treatment and at last have a bad prognosis.

Therapeutic effect of NgR siRNA on nerve regeneration following spinal cord hemi-transsection injury in rats / 中华创伤杂志

Objective To investigate the therapeutic effect of NSR siRNA on nerve regeneration following spinal cord hemi-transsection injury in rats. Methods Rats with T8 spinal cord hemi-trans-section were didded into 3 groups, ie, siRNA group, NS group and control group. SiRNA or NS was in-jected into lateral cerebral ventricle just after spinal cord injury. The therapeutic effect of NgR siRNA was evaluated by using BBB locomotor rating scale, retrograde horseradish peroxidase(HRP)tracing and HE staining. Results BBB locomotor rating scale showed that the recovery of the locomotor function of siRNA group seemed to be better than that of the other two groups from the 4th week, but there was no statistical difference. Retrograde HRP tracing showed a large number of positive cells in the anterior horn of spinal cord, with statistical difference compared with NS group and control group(P<0. 05). Eight weeks after spinal injury, HE staining showed disorderly distribution of the fibres in NS group and control group but serial fibres in the injury region in siRNA group. Conclusion NSR siRNA may promote the nerve regeneration following spinal cord injury.

Effect of normal saline of different temperature on morphological changes and NOS expression of spinal cord / 第三军医大学学报

Objective To investigate the effect of normal saline(NS)of different temperature on morphological changes and nitric oxide synthase(NOS)expression of spinal cord.Methods The spinal canal of 96 SD adult rats was opened at T9.which of 24 rats was flushed with 37 ℃ NS,24 with 20 ℃ NS,24 with 4 ℃ NS respectively,and which of 24 rats in control group received no flushing.The spinal canal was closed one hour later,and the spinal cord was taken out 24 hours later.Then the water content in spinal cord was determined by dry-wet method.The morphological changes of spinal cord were observed under light microscope and the electronic microscope.The amount of NOS-positive neuron was measured by ?-NADPH histochemical methods.Results The water content in spinal cord was(66.53?0.61)% in control group,(66.75?1.00)% in 37 ℃ group,(70.55?0.77)% in 20 ℃ group,(71.92?2.50)% in 4 ℃ group.The spinal cord of control group and 37 ℃ group contained less water than that of 20 ℃ group and 4 ℃ group.There were no obvious morphological changes in the control group and 37 ℃ group.In 20 ℃ and 4 ℃ groups,the demyelination of axon,swelling of cell body and the disappearance of tigroid body were observed under light microscope,the partial disaggregation of medullary sheath,swelling of mitochondria and disappearance of mitochondria crista could be observed under electron microscope.The amount of NOS-positive neuron in spinal cord was(18.75?2.12),(18.63?1.41),(14.75?1.67),(8.13?1.25)in control,37 ℃,20 ℃ and 4 ℃ groups,respectively.The control group and 37 ℃ group showed more NOS-positive neuron than those of 20 ℃ group and 4 ℃ group.Conclusion NS below 20 ℃ can injury spinal cord.It is suitable to choose 37 ℃ NS to flush brain and spinal card during operation.