Parkinson's disease （PD） is a progressive neurodegenerative disorder with both motor and non-motor symptoms. Deep brain stimulation （DBS） is applicable to advanced PD patients whose symptoms cannot be adequately controlled by medication and whose quality of life cannot be well guaranteed，as well as to those who have severe adverse reactions（such as dyskinesia）due to dopaminergic drugs. DBS can provide personalized treatment according to the specific symptoms of patients，and the treatment is carried out for different nodes in the basal ganglia-thalamus pathway，and these nodes play a mediating role in various symptoms of the disease. DBS of the ventral intermediate nucleus of the thalamus is the most effective in controlling tremors，DBS of the globus pallidus is significantly effective in controlling rigidity and dyskinesia，while DBS of the subthalamic nucleus can simultaneously treat tremors，bradykinesia，rigidity and dyskinesia，and can reduce the amount of medication used by patients，and is also the preferred treatment goal in the late stage of the disease. DBS has a long-term therapeutic effect on limb symptoms，but as the disease progresses，the response of non-dopaminergic axial features to DBS will gradually deteriorate.The DBS treatment of PD is highly specialized and requires a multidisciplinary team composed of movement disorder neurologists，functional neurosurgeons，professional DBS programmers，and neuropsychologists to screen and follow up patients. This article reviews the pathological mechanism，the applicability，efficacy，adverse reactions，and brain targets of DBS，in order to provide a more comprehensive understanding of the application of DBS in the treatment of PD and promote the further development in this field.
To investigate the expression and prognosis of plasminogen activator（PLAT） gene in glioma through The Cancer Genome Atlas （TCGA） and Genotype-Tissue Expression（GTEx），and to provide a target for the diagnosis and treatment ofglioma.
Methods
The TCGA and GTEx databases were used to analyze the expression difference of PLAT between gliomatissues and normal tissues. The relationship between PLAT expression level and clinicopathological parameters such as gender，age，isocitrate dehydrogenase （IDH） promoter mutation status and 1p/19q co-deletion； Kaplan-Meier survival analysis of the prognostic value of PLAT in glioma；Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were used to screen molecular functions and signaling pathways. CIBERSORT algorithm was used to analyze the correlation between immune infiltration level and PLAT expression level in glioma. Single-cell transcriptome sequencing and spatial transcriptome sequencing were performed.
Results
PLAT was highly expressed in glioma （P=0.002，95%CI：0.06-0.30），and was also expressed in 1p/19q non-codeletion[P＜0.05，95%CI：-2.79-（2.46）] ，IDH wild-type[P＜0.05，95%CI：-2.79-（2.46）] ，patients aged ＞60 years （P＜0.05，95%CI：1.26-1.88），yet was no statistically significant difference in expression between males and females （P＞0.05）. Upregulation of PLAT gene was associated with worse overall survival （OS）in glioma patients（HR=6.48，95%CI：4.81-8.74，P＜0.001）and had a high diagnostic value [area under the curve（AUC）=0.931].The AUC values for predicting of the 1-，3-，and 5-year survival rates of glioma patients based on PLAT expression levels were higher than 0.7.Signal pathway analysis showed that PLAT gene included neuroactive ligand-receptor interaction，cytokine-cytokine receptor interaction and IL-17 signaling pathway. In addition，PLAT expression was positively correlated with the infiltration level of macrophage M0 and follicular helper T cells in the tumor immune microenvironment，but negatively correlated with the infiltration level of monocytes. Single - cell transcriptome analysis further indicated that the PLAT gene was significantly expressed in mesenchymallike cells and oligodendrocyte progenitor cells. The spatial transcriptome results also showed that PLAT was mainly distributed near the tumor cells，which was highly consistent with the above mapping results，and the expression level of PLAT was significantly positively correlated with of tumor cells.
Conclusion
The expression level of PLAT is significantly increased in glioma and is associated with worse survival.PLAT is a potential tumor marker for diagnosis，treatment and prognosis.
To systematically review the clinical effect of extracorporeal shock wave therapy （ESWT） in the treatment of muscle spasm after stroke.
Methods
Computer searches were conducted on CNKI，VIP，Wanfang，Chinese Medical Journal Full Text Database，PubMed，Web of Science，Embase，and Cochrane Library databases to collect randomized controlled trials related to extracorporeal shock wave therapy for post-stroke muscle spasms.The search deadline was from database establishment until March 17，2024. Two screeners selected literature that met the inclusion criteria and extracted data，and conducted meta-analysis using RevMan5.3 software.
Results
A total of 12 articles were included，with a total of 736 patients，including 368 in the observation group （treated with ESWT combined with other traditional rehabilitation methods） and 368 in the control group （treated with traditional rehabilitation methods corresponding to the observation group）.The Meta-analysis results showed that the MAS score of the observation group was significantly lower than that of the control group，and the difference was statistically significant [MD=-0.32，95%CI：-0.58-（0.06），P=0.02] ； The FMA score of the observation group was significantly higher than that of the control group，and the difference was statistically significant （MD=4.63，95%CI：2.60-6.65，P＜0.001）； The MBI score of the observation group was significantly higher than that of the control group，and the difference was statistically significant（MD=8.21，95%CI：3.91-12.50，P＜0.001）； The PROM score of the observation group was significantly higher than that of the control group，and the difference was statistically significant （MD=5.88，95%CI：1.33-10.42，P=0.01）.
Conclusion
Simple ESWT or ESWT combined with other therapies have significant therapeutic effects in alleviating muscle spasms after stroke.
To evaluate the correlation between the disturbance coefficient （DC） of a non-invasive brain edema monitor and the severity of patients with aneurysmal subarachnoid hemorrhage（SAH）.
Methods
The clinical data of 121 patients with aneurysmal SAH and 60 patients with unruptured aneurysm in the Neurosurgery Department of General Hospital Northern Theater Command from September 2020 to June 2021 were analyzed. The severity of the patient's condition was evaluated using modified Fisher （mFisher） score，GCS score，and Hent-Hess （H-H） grading. The DC value was measured using a non-invasive brain edema dynamic detector，and the relationship between DC value and mFisher score，GCS score，and H-H grading was analyzed using the Spearman method.
Results
The DC value of patients with aneurysmal SAH （169.38±2.24） was higher than that of patients without ruptured aneurysm（127.84±1.95），and the difference was statistically significant （P＜0.01）.The DC values of aneurysmal SAH patients with mild，moderate，and severe consciousness disorders were compared pairwise，and the differences were statistically significant （P＜0.01）； The DC value of patients with mild aneurysmal SAH is higher than that of patients with unruptured aneurysm，and the difference was statistically significant （P＜0.01）. The DC values of H-H Ⅱ，Ⅲ，and Ⅳpatients were compared pairwise，and the differences were statistically significant （P＜0.01）； The average DC value of patients with H-H grade Ⅰ-Ⅱaneurysmal SAH is higher than that of patients with unruptured aneurysm，and the difference was statistically significant （P＜0.01）. The DC values of mFisher Ⅱ，Ⅲ，and Ⅳpatients were compared pairwise，and the differences were statistically significant （P＜0.01）； The average DC value of mFisher grade Ⅰ-Ⅱaneurysmal SAH patients was higher than that of patients with unruptured aneurysm，and the difference was statistically significant （P＜0.01）. The DC value was correlated with GCS score and H-H grading （r=-0.743，-0.713，P＜0.001），and has a weak correlation with mFisher grading （r=-0.512，P＜0.001）.
Conclusion
The DCs among H-H Ⅱ，Ⅲ，Ⅳwere different，indicated DC value of the third generation of non-invasive brain edema monitor can sensitively reflact the condition of SAH patients，which provide benefit for patient.
To observe the effect of Tongdu Tiaoshen acupuncture combined with swallowing therapy device on swallowing function in patients with post-stroke dysphagia （PSD）.
Methods
One hundred PSD patients admitted to Hefei Second People's Hospital for rehabilitation from June 2021 to June 2023 were selected as the research subjects. According to the random number table method，the patients were divided into an observation group （n=50） and a control group （n=50）. The control group received routine swallowing function training combined with a swallowing therapy device，while the observation group used the Tongdu Tiaoshen acupuncture method in combination with the control group.The patient's oral transit time （OTT），pharyngeal transit time （PTT），hyoid bone superior movement（HSM），and upper esophageal opening （UO） of the cricopharyngeal muscle，nutritional support time，autonomous feeding time，hospitalization time，and incidence of adverse reactions were recorded. The patient's nutritional status and prognosis were evaluated，and the clinical efficacy was determined based on the grading changes of the water swallowing test （WST） before and after treatment.
Results
After treatment，the SSA scores of both groups decreased compared to before treatment，while the FOIS scores increased compared to before treatment，the SSA scores of the observation group were lower than that of the control group，and the FOIS scores were higher than that of the control group，with statistically significant differences （P＜0.05）. After treatment，the OTT and PTT of both groups decreased compared to before treatment，while HSM and UO increased compared to before treatment，the observation group had lower OTT and PTT than the control group，while HSM and UO were higher than the control group，with statistically significant differences （P＜0.05）. The nutritional support time，independent eating time，and hospitalization time of the observation group patients were shorter than those of the control group，and the differences were statistically significant （P＜0.05）. The total effective rate of the observation group was 96.0%，which was higher than that of the control group （86.0%），and the difference was statistically significant （P＜0.05）.
Conclusion
The use of Tongdu Tiaoshen acupuncture combined with swallowing therapy device can improve patients' oral and pharyngeal swallowing conditions，promote autonomous eating，reduce nutritional support and hospitalization time，shorten oral feeding time，and help improve PSD.
To study the clinical application effect of rigid endoscopic assisted surgery technique in ventriculorrhagia and hematoma molding surgery.
Methods
A retrospective analysis was conducted on the clinical data of 81 patients with ventriculorrhagia and hematoma molding who underwent surgical treatment in the Neurosurgery Department of the 908th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army from February 2016 to February 2023. According to whether the surgical technique applied rigid endoscopic assisted technology，the patients were divided into endoscope group （n=41） and control group （n=40）. The control group underwent traditional blind double frontal approach for bilateral lateral ventricle anterior horn external drainage surgery，while the endoscope group underwent rigid endoscopic assisted ventriculorrhagia clearance and lateral ventricle anterior horn external drainage surgery under direct vision. The postoperative hematoma clearance，GCS score changes，drainage tube removal time，and complications were compared between the two groups.Follow-up for 6 months，activity of daily living scale （ADL） was used to evaluate the patient's prognosis.
Results
The GCS scores of the two groups were higher than those before treatment after 2 weeks of treatment，and the brain endoscopy group was better than that of the control group，and the difference was statistically significant （P＜0.05）. The extubation time in the brain endoscopy group was shorter than that in the control group，and the difference was statistically significant （P＜0.05）. The immediate hematoma clearance rate of the patients in the brain endoscopy group was more than 50%，and the hematoma clearance rate （88.51%±7.74%） on the 5th day after surgery was higher than that of the control group（66.52%±10.38%），the incidence of postoperative complications （21.95%） was significantly lower than that of the control group （42.50%），and the rate of excellent clinical efficacy （65.85%） was significantly higher than that of the control group （35.00%），and the differences were statistically significant （P＜0.05）.
Conclusion
The surgical method of ventricular hematoma removal and endoscopic direct view side ventricular catheterization and drainage is accurate and reliable，with good drainage and intracranial pressure relief，high hematoma clearance rate，significantly shortened catheterization time，and significantly reduced clinical complication rate，which can be used as a surgical treatment option for ventricular hemorrhage hematoma casting.
To investigate the effects of edaravone dexborneol treatment on thioredoxin（Trx），neutrophil-to-lymphocyte ratio （NLR） and neurological function in patients with acute ischemic stroke （AIS）.
Methods
One hundred and twenty AIS patients who received treatment in the Neurology Department of Jurong People's Hospital from January 2022 to December 2023 were divided into the experimental group （60 cases） and the control group （60 cases） through the random number table method.The control group was given conventional treatment，and the experimental group was treated with edaravone dexborneol in addition to conventional treatment，with a treatment duration of 14 d for both groups. The National Institutes of Health stroke scale （NIHSS） was used to assess the degree of neurological deficit in patients. The Trx levels，NLR levels，NIHSS scores before and after 14 d of treatment，and incidence of adverse reactions during treatment were compared between two groups of patients.
Results
There was no statistically significant difference in Trx levels，NLR levels，and NIHSS scores between the two groups of patients before treatment （P＞0.05）. Compared with before treatment，the Trx levels，NLR levels，and NIHSS scores of both groups of patients decreased after treatment，and the experimental group was lower than the control group，with statistically significant differences （P＜0.05）.The total effective rate of the experimental group （96.67%） was higher than that of the control group（83.33%），and the difference was statistically significant （P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients （P＞0.05）.
Conclusion
Edaravone dexborneol can significantly reduce the level of Trx and NLR in AIS patients，improve neurological function，and do not increase adverse reactions.
To investigate the relationship between serum nucleotide - binding oligomerization domain-like receptor protein 3 （NLRP3） inflammasome and its downstream inflammatory factors and hemorrhagic transformation （HT） and prognosis in patients with large artery atherosclerotic（LAA） cerebral infarction after thrombolysis.
Methods
Two hundred and fifty-five patients with LAA cerebral infarction treated with intravenous thrombolysis in Neurology Department of Baoji People's Hospital between June 2019 and June 2023 were selected，and divided into HT group and non-HT group based on whether they developed HT after thrombolysis. The levels of serum NLRP3 inflammasome and its downstream inflammatory factors [cysteinyl aspartate specific protease 1 （Caspase-1），interleukin（IL） -1β，IL-18] were compared in two groups.After a 3-month follow-up，the patients with LAA cerebral infarction were divided into a good prognosis group and a poor prognosis group based on their prognosis.Using multivariate Logistic regression，the risk variables for a poor outcome in individuals with LAA cerebral infarction were examined. The predictive value of NLRP3 inflammasome and its downstream inflammatory factors for HT and poor prognosis in LAA cerebral infarction after thrombolysis patients were analyzed by receiver operating characteristic （ROC） curve.
Results
After thrombolysis，62 patients developed HT （HT group），while 193 patients did not develop HT （non-HT group）. The levels of serum NLRP3，Caspase-1，IL-1β and IL-18 in HT group were higher than those in non-HT group （P＜0.05）. The results of ROC curve analysis showed that the area under the curve （AUC） of serum NLRP3，Caspase-1，IL-1β，IL-18 alone and combined detection in predicting HT after thrombolysis in patients with LAA cerebral infarction were 0.683，0.769，0.700，0.679，0.887，respectively，and the combined detection had the highest predictive efficacy. During a 3-month follow-up，184 patients had a good prognosis （good prognosis group） and 71 patients had a poor prognosis （poor prognosis group）. The serum NLRP3，time from onset to thrombolysis，Caspase-1，National Institutes of Health stroke scale （NIHSS）score，IL-1β，HT ratio and IL-18 level in the poor prognosis group were higher than those in good prognosis group，and the differences were statistically significant（P＜0.05）.Multivariate Logistic regression analysis showed that the increase of time from onset to thrombolysis，the increase of NIHSS score，the occurrence of HT，the increase of serum NLRP3，Caspase-1，IL-1β and IL-18 levels were independent risk factors for patients' poor prognosis following a cerebral infarction caused by LAA （P＜0.05）. The results of ROC curve analysis showed that the AUC of serum NLRP3，Caspase-1，IL-1β，IL-18 alone and combined detection in predicting the poor prognosis of patients with LAA cerebral infarction were 0.734，0742，0.672，0.701，0.883，respectively，the combined detection had the highest predictive efficiency.
Conclusion
The elevated levels of serum NLRP3，Caspase-1，IL-1β and IL-18 in patients with LAA cerebral infarction are risk factors for poor prognosis，combined detection has a high predictive value for HT and poor prognosis after thrombolysis.
Extracellular vesicles （EV），as important mediators of intercellular communication，can stably carry proteins，lipids，nucleic acids，and other substances. Their surface shares specific markers with the parent cells，making them highly sensitive and specific biomarkers for clinical diagnosis.Multiple sclerosis （MS） is an autoimmune inflammatory demyelinating disease of the central nervous system，and there are currently no specific diagnostic markers for it. In recent years，the incidence and prevalence of MS have gradually increased. EV can assist in clarifying the clinical diagnosis of MS，distinguishing clinical subtypes，monitoring disease relapse，and predicting disease prognosis，which has attracted increasing attention.This article reviews the application of EV in the clinical diagnosis of MS.
