To investigate the effects of miR-145-5p on the proliferation, invasion, and apoptosis of adamantinomatous craniopharyngioma (aCP) cells and its mechanism of action.

Five cases of aCP and five cases of papillary craniopharyngioma (pCP) resected at Neurosurgery Department of West China Hospital of Sichuan University and Guangyuan Central Hospital from September 2019 to September 2022 were selected. The expression differences of miR-145-5p, SOX9, and CTNNB1 (β-catenin gene) mRNA in aCP and pCP were detected by real-time fluorescence quantitative PCR (qRT-PCR). The expression of SOX9 and β-catenin proteins were detected by immunofluorescence and Western blot. The proliferation, invasion, and apoptosis levels of craniopharyngioma cells were measured through CCK8 assay, Transwell chamber, and flow cytometry, respectively. aCP cells were divided into aCP group (blank control, untransfected), aCP+miR-145-5p control group (negative control), and aCP+miR-145-5p mimic group (overexpression) to study the effects of miR-145-5p on the proliferation, invasion, and apoptosis of aCP cells and on the expression of SOX9 and β-catenin.

Compared with pCP, aCP cells showed significantly reduced expression of miR-145-5p mRNA and increased expression of SOX9、CTNNB1 mRNA, SOX9、nuclear β-catenin proteins, and a decreased in cytoplasmic β-catenin protein expression, concurrently, cell proliferation and invasion were significantly enhanced, with all differences being statistically significant (P<0.05). There were differences among the aCP group, aCP+miR-145-5p control group, and aCP+miR-145-5p mimic group in terms of miR-145-5p, SOX9, and CTNNB1 mRNA expression, as well as SOX9, nuclear β-catenin, and cytoplasmic β-catenin protein expression, and in cell proliferation and invasion (P<0.05). Pairwise comparisons between groups showed that the aCP+miR-145-5p mimic group had significantly increased expression of miR-145-5p mRNA, weakened proliferation and invasion, and increased apoptosis compared to the other two groups. The expression of SOX9 and CTNNB1 mRNA was significantly reduced. Compared to the aCP+miR-145-5p control group, the expression of SOX9 and nuclear β-catenin proteins decreased, while cytoplasmic β-catenin protein expression increased in the aCP+miR-145-5p mimic group, with all differences being statistically significant (P<0.05).

miR-145-5p may inhibit the proliferation、invasion of aCP and promote cell apoptosis by down-regulating the SOX9 and β-catenin.

To observe the clinical effect of controlled decompression technique on patients with different degrees of traumatic brain injury (TBI) based on Rotterdam CT score.

A total of 100 patients with severe TBI requiring decompressive craniectomy were selected from the Neurosurgery Department of Brain Hospital of Hunan Province from September 2019 to September 2022. The patients were randomly divided into an experimental group (controlled decompression) and a control group (rapid decompression) using a random number table method, with 50 patients in each group. All patients underwent preoperative Rotterdam CT score assisted evaluation, and were followed up for 3 months postoperatively to compare the incidence and prognosis of transient encephalocele in each Rotterdam CT score interval between the two groups of patients.

The incidence of transient encephalocele in each Rotterdam CT score range (4-6 points) of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). After a 3-month follow-up, 40 patients had a good prognosis, including 27 in the experimental group and 13 in the control group. The good prognosis rate of the experimental group was higher than that of the control group, and the difference was statistically significant (P<0.05). The GOS scores of each Rotterdam CT score range (5-6 points) in the experimental group were higher than those in the control group, and the difference was statistically significant (P<0.05).

The occurrence of intraoperative encephalocele in patients with severe TBI is closely related to the state of high intracranial pressure before operation. stage-by-stage and step-by-step control of decompression for patients with decompensated intracranial pressure can significantly reduce the incidence of perioperative complications and improve the prognosis.

To explore the construction and validation of a prediction model for the prognosis of traumatic brain injury (TBI) based on Rotterdam CT score and coagulation function indicators.

A total of 108 TBI patients admitted to Neurosurgery Department of Lingbi Hospital of the Second People's Hospital of Anhui Province from January 2020 to January 2022 were selected as the study objects. CT image examination and Rotterdam CT score were performed on all patients within 24 h of admission, and coagulation function index was also detected. Based on the GOS score at 6 months after treatment, patients were divided into a good prognosis group (4-5 score) and a poor prognosis group (1-3 score). Binary Logistic regression analysis was used to screen the independent factors influencing the prognosis of TBI patients, and a prediction model of TBI prognosis was constructed based on Rotterdam CT score and coagulation function index [prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D)]. Receiver operating characteristic (ROC) curve was established to evaluate the predictive efficiency of the model. At the same time, the clinical data of 46 TBI patients admitted to our hospital from January to December 2019 were collected as a validation set to verify the accuracy of the prediction model.

Among 108 patients, there were 73 patients in the good prognosis group and 35 patients in the poor prognosis group. The severity of the disease, combined hypoxemia, Rotterdam CT score, and coagulation function indicators (PT, APTT, D-D) in the poor prognosis group were higher than those in the good prognosis group, with statistical significance (P<0.05). Logistic regression analysis showed that disease condition, Rotterdam CT score, PT, and D-D were independent influencing factors for poor prognosis in TBI patients (P<0.05). The predictive model for poor prognosis of TBI is Y=3.078×Rotterdam score CT score-0.847×PT+1.211×D-1.672×severity severity of the disease-3.195. The prediction model predicted poor prognosis with 0.886 sensitivity, 0.836 specificity, 0.722 Jorden index, 0.262 cut-off value and 0.937 area under curve. The Hanley&McNeil method was used to compare the predictive model and the validation curve, and it was found that there was no statistically significant difference in the AUC comparison of the ROC curves between the two models (P<0.05).

For patients with TBI, the prediction model based on Rotterdam CT score and coagulation function has good accuracy and is worthy of promotion.

To investigate the relationship between high-mobility group protein B1-toll-like receptor 2/ toll-like receptor 4/ receptor of advanced glycation end products (HMGB1-TLR2/TLR4/RAGE) pathway and the severity of cognitive dysfunction complicated by traumatic brain injury (TBI).

A total of 323 patients with craniocranial injury admitted to Yueyang Central Hospital from November 2019 to November 2022 were prospectively selected and divided into normal cognitive function group (n=209) and cognitive dysfunction group (n=114) based on the absence or presence of cognitive dysfunction. Among them, patients with cognitive impairment were classified into mild (n=38), moderate (n=52), and severe (n=24) based on their degree of cognitive impairment. Another 100 healthy individuals who underwent physical examinations in our hospital during the same period were set as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum HMGB1, RAGE, TLR2 and TLR4. Comparison of those levels was conducted among three groups and among patients with different severity of cognitive dysfunction. Using multiple logistic regression analysis to screen for independent risk factors that affect patient cognitive function. Correlation between serum HMGB1, RAGE, TLR2, TLR4 and the cognitive dysfunction degree was analyzed by spearman correlation analysis.

Serum levels of HMGB1, RAGE, TLR2, and TLR4 in the normal cognitive function group and the cognitive dysfunction group were significantly higher than those in the control group, and the serum levels of HMGB1, RAGE, TLR2, and TLR4 in the cognitive dysfunction group were significantly higher than those in the normal cognitive function group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that serum concentrations of HMGB1, RAGE, TLR2, and TLR4 were independent risk factors for cognitive impairment. Serum levels of HMGB1, RAGE, TLR2, and TLR4 in TBI patients with mild, moderate, and severe cognitive impairment showed an increasing trend with the severity of the condition (P<0.05). Serum levels of HMGB1, RAGE, TLR2, and TLR4 at different time points after admission were positively correlated with the severity of cognitive impairment in TBI patients (all P<0.05). The combined prediction of serum levels of HMGB1, RAGE, TLR2, and TLR4 for TBI with cognitive impairment showed AUC, sensitivity, specificity, and accuracy of 0.970, 93.9%, 92.3%, and 91.69%, respectively, which were superior to individual detection of various indicators (P<0.05).

HMGB1-TLR2/TLR4/RAGE pathway is highly activated in TBI complicated with cognitive dysfunction. With the aggravation of cognitive dysfunction, the activation state of HMGB1-TLR2/TLR4/RAGE pathway is more obvious, which can provide reference for the early diagnosis, condition monitoring and effective intervention of TBI complicated with cognitive dysfunction.

To compare the clinical efficacy of cranioplasty in patients with craniocerebral trauma at different times.

Eighty-nine patients with craniocerebral trauma admitted to our hospital from January 2016 to August 2021 were retrospectively collected and divided into early group (less than 3 months) (n=22), intermediate group (3-6 months) (n=47) and late group (greater than 6 months) (n=20) according to the time of skull defect repair from large bone flap decompression. The mean blood flow velocity of bilateral posterior cerebral artery (PCA) and middle cerebral artery (MCA), karnofsky performance status (KPS) score, function independent measure (FIM) score, National Institute of Health stroke score (NIHSS), GOS score were compared among the 3 groups 3 d before and 3 months after surgery. The intracranial pressure in the 3 groups 1 d before and 1 week after surgery, and the incidence of postoperative complications such as intracranial infection, epilepsy, and intracranial edema were compared.

The mean blood flow velocity of PCA and MCA in the early group was significantly improved after operation, which was significantly higher than that in the intermediate and late groups (P<0.05). The KPS score and FIM score of the 3 groups were significantly improved after operation, and the KPS score, FIM score and GOS score of the early group were significantly higher than those of the intermediate and late groups, but the NIHSS score was significantly lower than that of the intermediate and late groups (P<0.05). The postoperative intracranial pressure of the 3 groups was significantly improved after operation, and the intracranial pressure of the early group was significantly higher than that of the intermediate and late groups (P<0.05). There was no significant difference in the incidence of complications among the 3 groups (P>0.05).

Early skull repair treatment has a good effect on patients with craniocerebral trauma, increase intracranial pressure, and improve prognosis.

To analyze the relationship between Helicobacter pylori (H. pylori) infection and stress ulcers in elderly patients with primary brainstem hemorrhage (PBSH), and to explore the predictive value of serum tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9), miR-204, and miR-182 for secondary stress ulcers in elderly PBSH patients.

A retrospective analysis was conducted on the clinical data of elderly PBSH patients admitted to Neurosurgery Department of the First Affiliated Hospital of Anhui Medical University from June 2019 to March 2021. Based on the results of gastric occult blood (OB) in PBSH patients, they were divided into stress ulcer group and non stress ulcer group; According to the results of the patient's serum H. pylori urease antibody, they were divided into H. pylori positive group and H. pylori negative group. The levels of TNF-α and MMP-9 in serum were analyzed by dual antibody sandwich enzyme-linked immunosorbent assay; miR-204 and miR-182 levels were detected by fluorescence quantitative PCR; serum H. pylori urease antibody was detected by colloidal gold method, and gastric juice OB was detected by OB gold gel strip. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of TNF-α, MMP-9, miR-204 and miR-182 levels for secondary stress ulcers in elderly PBSH patients.

Compared with the non stress ulcer group, the positive rate of H. pylori was significantly increased in the stress ulcer group, and serum TNF-α, MMP-9, miR-204 and miR-182 was also significantly increased (P<0.05). Compared with the H. pylori negative group, the incidence rate of stress ulcer (OB positive rate) in the H. pylori positive group was significantly increased, and the serum TNF-α, MMP-9, miR-204 and miR-182 was also significantly increased (P<0.05). The ROC curve analysis results showed that miR-204 showed the highest sensitivity (100%) in predicting stress ulcers, while TNF-α and MMP-9 showed the highest specificity (100%); miR-204 showed the highest sensitivity (100%) in predicting H. pylori infection, while TNF-α and MMP-9 showd the highest specificity (90%).

H. pylori is significantly associated with stress ulcer bleeding in elderly PBSH patients, TNF-α, MMP-9 and miR-204 may be new potential biomarkers for the progression of PBSH.