To explore the expression of polyomavirus enhancer activator 3 (PEA3) and erythropoietin-producting hepatocellular receptor 2 (EPHA2) in glioblastoma and their expression in Wnt/β-catenin pathway.

A gene transfection model of U87 glioma cells was constructed, and the cell lines were divided into 5 groups: blank group, PEA3 interference group, PEA3 interference empty group, EPHA2 interference group, and EPHA2 interference empty group. The protein expression levels of EPHA2 and PEA3 in U87 cells were detected through Western blotting experiments; The proliferation rate was detected by CCK-8 test, and the the expression levels of T cytokines factor-4 (TCF-4) and lymph enhancer factor 1 (LEF1) genes, the downstream genes of Wnt/β-catenin pathway, were detected by quantitative real time polymerase chain reaction (qRT-PCR) assay.

The Western blotting experiment showed that compared with the blank group, the expression level of PEA3 was reduced in the PEA3 interference group and EPHA2 interference group, while the expression level of EPHA2 was reduced in the EPHA2 interference group, and the differences were statistically significant (P<0.05); There was no statistically significant difference in the expression levels of Wnt1 and β-catenin proteins among 5 groups (P>0.05). The CCK-8 experiment showed that compared with the blank group, the cell proliferation rates of the PEA3 interference group and the EPHA2 interference group were significantly reduced, and the differences were statistically significant (P<0.05). The qRT-PCR results showed that the expression levels of TCF-4 and LEF1 genes decreased in the PEA3 interference group and EPHA2 interference group, and the differences were statistically significant (P<0.05).

Interference with PEA3 and EPHA2 genes can reduce the proliferation ability of glioblastoma; whether PEA3 and EPHA2 promote the proliferative capacity of glioblastoma through the Wnt/β-catenin pathway deserves further investigation.

To investigate the clinical efficacy of scalp acupuncture (SA) combined capsaicin in patients with chronic dysphagia after stroke, and to explore a non-invasive, safe and effective method for the treatment of such patients.

Ninety patients diagnosed with stroke and suffering from chronic dysphagia from January 2022 to April 2023 were collected and divided into 3 groups by random number table method: capsaicin group, SA group and SA combined with capsaicin group, with 30 cases in each group. The course of treatment was 1 month. Before and after treatment, the patients were evaluated by Watian drinking water test (WST), the standard swallowing function assessment scale (SSA), eating assessment tool-10 (EAT-10) and videofluoroscopic swallowing study (VFSS), respectively, to determine the degree scores of 3 groups swallowing function after intervention.

The WST grading of all three groups significantly were decreased compared to before treatment, the difference among the three groups after treatment was statistically significant (P<0.05). The SSA, EAT-10, and VFSS scores of 3 groups after treatment all showed varying degrees of improvement compared to before treatment, and the improvement of various indexes in the SA combined with capsaicin group was better than that in the capsaicin group and SA group, and the differences were statistically significant (P<0.05).

Compared with using capsaicin or SA alone, the combination of SA and capsaicin has a more significant improvement in swallowing function in patients with chronic dysphagia after stroke.

To compare the clinical efficacy of neuroendoscopic hematoma evacuation and external ventricular drainage in the treatment of intraventricular hemorrhage (IVH).

A total of 42 patients with IVH admitted to Neurosurgery Department of the People's Hospital of Gaomi from January 2019 to February 2022 were selected and divided into an endoscopy group and a puncture group according to the random number table method, with 21 cases in each group. The endoscopic group was treated with endoscopic evacuation of ventricular hematoma, while the puncture group was treated with lateral external drainage. The Graeb score at the 8 h postoperative time point, the number of urokinase injection, the time of extubation, and the incidence of postoperative complications (intracranial infection, rebleeding, hydrocephalus), and the neurological function recovery of patients 3 months after surgery (GOS score) were compared between the two groups.

The clearance of hematoma in the endoscopic group was better than that in the puncture group at 8 h after surgery, and the Graeb score was lower than that in the puncture group, with a statistically significant difference (P<0.05). The number of urokinase injections and extubation time in the endoscopic group were less than those in the puncture group, and the differences were statistically significant (P<0.05). The incidence of postoperative complications in the endoscopic group (14.29%) was lower than that in the puncture group (38.10%), but the difference was not statistically significant (P>0.05). The good prognosis rate of the endoscopic group at 3 months after surgery was higher than that of the puncture group, and the difference was statistically significant (P<0.05).

Neuroendoscopic treatment of IVH is safe and feasible, and it is a potentially effective surgical method, which needs to be verified by more clinical trial data.

To investigate the impacts of different basilar artery bending length (BL) on mechanical thrombectomy of patients with acute basilar artery occlusion (ABAO).

The clinical and imaging data of 110 ABAO patients admitted to the Neurology Department of Xuyi County People's Hospital and the Interventional Radiology Department of Jiangsu Provincial People's Hospital from January 2018 to December 2021 were retrospectively analyzed. According to the BL of basilar artery, patients were divided into non-severe basilar artery tortuosity group (60 cases) and severe basilar artery tortuosity group (50 cases). BL of basilar artery was analyzed on DSA. The baseline data, mechanical thrombectomy and prognosis of 2 groups were compared to analyze the influence of severe basilar artery tortuosity on mechanical thrombectomy.

There were significant differences among male, hypertension, hyperlipidemia, use of intermediate catheters, large artery atherosclerosis, cardiac embolism, basal artery occlusion of lower segment, combined with angioplasty, baseline National Institute of Health stroke scale score, and recanalization rate between the non-severe basilar artery tortuosity group and the severe basilar artery tortuosity group (P<0.05). Multivariate Logistic regression analysis of risk factors for basilar artery recanalization failure showed that: basilar artery tortuosity (OR=1.315, 95%CI: 1.017-1.700, P=0.037) and times of thrombectomy (OR=3.167, 95%CI: 1.626-6.168, P=0.001) were independent risk factors for recanalization failure of mechanical thrombectomy.

Severe basilar artery tortuosity is not correlated with symptomatic intracranial hemorrhage, mortality rate and the modified Rankin scale score at 90 d in patients with ABAO treated with mechanical thrombectomy, and severe basilar artery tortuosity may lead to recanalization failure.

To compare the therapeutic effects between ultra-early microsurgery through the cerebral sulcus fissure and the cerebral gyrus cortex approach for the treatment of basal ganglia hemorrhage.

A retrospective analysis was conducted on 122 patients with basal ganglia hemorrhage treated at Neurosurgery Department of the Second Affiliated Hospital of Xi'an Medical University from January 2021 to December 2022. All patients underwent surgery within 7 h after the onset of symptoms and were divided into two groups based on the surgical approach: 68 cases in the cerebral sulcus fissure group and 54 cases in the cerebral gyrus cortex group. The study compared the surgical-related indicators, complication rates, serum 5-hydroxytryptamine (5-HT) and norepinephrine (NE) levels before and 7 d after surgery, National Institutes of Health stroke scale (NIHSS) scores and scandinavian stroke scale (SSS) scores before and 30 d after surgery, as well as the prognosis 30 d post-surgery between the two groups.

There were no statistically significant differences between the two groups in terms of surgery duration, hematoma clearance rate, intraoperative blood loss, hospital stay, and re-bleeding rates (P>0.05). At 7 d post-surgery, both groups showed a significant increase in serum 5-HT and NE levels compared to pre-surgery, with higher levels observed in the cerebral sulcus fissure group than in the cerebral gyrus cortex group, with statistical significance (P<0.05). At 30 d post-surgery, both groups had significantly lower NIHSS scores and higher SSS scores compared to pre-surgery, with the cerebral sulcus fissure group showing lower NIHSS scores and higher SSS scores than the cerebral gyrus cortex group, with statistical significance (P<0.05). The favorable prognosis rate of the cerebral sulcus fissure group (94.12%) was higher than that of the cerebral gyrus cortex group (66.66%), with statistical significance (P<0.05).

The efficacy of ultra-early microsurgery through the cerebral sulcus fissure for the treatment of basal ganglia hemorrhage is superior to that of microsurgery through the cerebral gyrus cortex, which can reduce the inhibition of 5-HT and NE, and help the recovery of neurological function.

To investigate the techniques and clinical efficacy of microsurgical clipping for elderly patients with ruptured anterior circulation aneurysms.

A retrospective analysis was conducted on the medical records of 80 elderly patients with acute ruptured anterior circulation aneurysms who were treated in the Department of Neurosurgery at Dujiangyan Medical Center from May 2012 to December 2022. The surgical approaches included the supraorbital lateral approach, the pterional approach, or an extended pterional incision. Under the microscope and through the lateral fissure approach, some patients underwent puncture of the lateral ventricle's frontal horn at Pain's point or modified Pain's point, followed by intracerebral hematoma evacuation and aneurysm clipping. The aneurysm clipping status was recorded. Follow up for 6 months after surgery, using the modified Rankin scale (mRS) to evaluate the clinical prognosis of patients.

There were a total of 89 aneurysms in this group of patients, of which 74 patients (87 aneurysms) were completely clipped, with a success rate of 97.75%. Postoperative complications included cerebral edema in 31 cases (38.75%), which improved after dehydration treatment; vasospasm in 38 cases (47.50%), which improved after vasodilatory treatment; and hydrocephalus in 24 cases (30.00%), with 9 cases undergoing ventriculoperitoneal shunting resulting in the disappearance of hydrocephalus, and the remaining 15 cases improved after symptomatic treatment. At the 6-month postoperative follow-up, one patient was lost to follow-up. Among the remaining 79 patients, 10 cases had a poor prognosis (mRS 3-6), and 69 cases had a good prognosis (mRS 0-2), with a good prognosis rate of 87.34%.

The method of microsurgical technique for evacuating intracerebral hematoma and clipping aneurysms is highly safe and effective in elderly patients with acute ruptured anterior circulation aneurysms.