[Multiplicity and prevention for patients with hydrocephalus secondary to severe traumatic brain injury after surgery].

OBJECTIVE: To investigate the factors for hydrocephalus secondary to severe traumatic brain injury after surgery, and to explore a new theory and guideline for clinical early prevention and treatment for hydrocephalus.
 METHODS: The clinical data regarding 107 patients with severe traumatic brain injury, who were admitted to our hospital from June 2010 to June 2013, were analyzed. Logistic multi-factor regression was used to analyze the different factors including ages, gender, the Glasgow coma scale (GCS) score before or after surgery, the situation of ventricular system bleeding secondary to surgery, the situation of midbrain aqueduct and ambient cistern before or after surgery, the relationship between early lumbar puncture and the hydrocephalus. The risk and protective factors for postoperative hydrocephalus were discussed.
 RESULTS: The results showed that patients with low GCS score in pre/postoperative (OR=0.099, 95%CI: 0.028-0.350)/(OR=0.088, 95%CI: 0.012-0.649), ventricular system bleeding in postoperative (OR=0.168, 95%CI: 0.029-0.979) and dim CT image for midbrain aqueduct and ambient cistern (OR=0.134, 95%CI: 0.038-0.473)/(OR=0.221, 95%CI: 0.055-0.882) are risk factors. Whereas lumbar puncture (OR=75.885, 95%CI: 9.612-599.122) is a protective factor for postoperative hydrocephalus in STBI patients. The secondary hydrocephalus was mainly occurred in 2 weeks and 2 weeks to 3 months after operation. The incidence of the control group that occurred secondary hydrocephalus is higher than that of the lumbar puncture group (P<0.05). The secondary hydrocephalus were mainly occurred in 2 weeks and 2 weeks to 3 months after operation, with no statistical significance between the 2 groups after 3 months of operation (P>0.05).
 CONCLUSION: For patients with stable vital signs, early lumbar puncture could significantly reduce the incidence of secondary hydrocephalus in acute and subacute stage after severe traumatic brain injury.

Machine Learning-Enabled Optical Architecture Design of Perovskite Solar Cells.

Perovskite solar cells, emerging as a cutting-edge solar energy technology, have demonstrated a power conversion efficiency (PCE) of >26%, which is below the theoretical limit of 33%. This study, employing a combination of neural network models and high-throughput simulation calculations, taking the single-junction FAPbI3 cell as an illustrative example, indicates that a pyramid structure, in comparison of a planar one, can increase the highest Jsc to 27.4 mA/cm2 and the PCE to 28.4%. Both Jsc and PCE surpass the currently reported experimental results. The optimized periodicity and tilt angle of the pyramid structure align with the textured structure of crystalline silicon solar cells. These results underscore the substantial development potential of neural network inverse design based on high-throughput calculations in the field of optoelectronic devices and provide theoretical guidance for the design of monolithic perovskite-silicon tandem solar cells.

Pregabalin can interact synergistically with Kv7 channel openers to exert antinociception in mice.

Chronic pain is a common public health problem and remains an unmet medical need. Currently available analgesics usually have limited efficacy for the treatment of chronic pain, including neuropathic pain and persistent inflammatory pain, or they are accompanied by many adverse side effects. The voltage-gated calcium channel blocker (pregabalin) and potassium channel openers (flupirtine and retigabine) have been widely used for the management of chronic pain, but their effectiveness in combination is unclear. In this research, we evaluated the antinociceptive effects of pregabalin in combination with flupirtine or retigabine in carrageenan-induced inflammatory pain and paclitaxel-induced peripheral neuropathy in mice using the von Frey test. Isobolographic analysis indicated that pregabalin exerted synergistic antinociceptive effects when combined with flupirtine or retigabine in neuropathic and inflammatory pain models. Furthermore, the antinociceptive effects of pregabalin, flupirtine/retigabine, and their combinations were significantly attenuated by the Kv7 channel blocker XE991. The favored dose ratio between pregabalin and flupirtine/retigabine in combinations was also investigated. Finally, we evaluated the motor coordination of their combinations using the rotarod test, and the outcomes underpinned their safety. Collectively, our results support the potential use of pregabalin in combination with flupirtine or retigabine to alleviate chronic pain.

Microsurgical and tractographic anatomical study of insular and transsylvian transinsular approach.

This study is to define the operative anatomy of the insula with emphasis on the transsylvian transinsular approach. The anatomy was studied in 15 brain specimens, among five were dissected by use of fiber dissection technique; diffusion tensor imaging of 10 healthy volunteers was obtained with a 1.5-T MR system. The temporal stem consists mainly of the uncinate fasciculus, inferior occipitofrontal fasciculus, Meyer's loop of the optic radiation and anterior commissure. The transinsular approach requires an incision of the inferior limiting sulcus. In this procedure, the fibers of the temporal stem can be interrupted to various degrees. The fiber dissection technique is a very relevant and reliable method for neurosurgeons to study the details of brain anatomic features. The DTI fiber tracking technique can identify the fiber tracts of the temporal stem. Moreover, it will also help further functional study of human insula.

[Expression of neuropeptides ghrelin and Nesfatin-1 in kainic acid kindling rats].

OBJECTIVE: To observed the post-seizure expression level of neuropeptides ghrelin and Nesfatin-1 between the untreated and treated groups in kainic acid-kindling rats and understand the significance of their basic expressions. METHODS: The male S-D rats were divided randomly into NS and VPA groups after seizure. Each group was divided into 7 subgroups of 3 h, 6 h, 12 h, 24 h, 3 d, 7 d and 14 d. And the blank group (without NS or VPA) and sham group (normal saline instead of kainic acid) were established. RIA (radioimmunoassay), ELISA (enzyme-linked immunosorbent assay) and immunohistochemistry were used to detect the expression levels of ghrelin and Nesfatin-1 in the serum and hypothalamus of kainic acid-kindling rats. RESULTS: Compared with the blank and sham groups, the seizure rats had a decreased expression of ghrelin while there was an elevated expression of Nesfatin-1 in hypothalamus. This trend was consistent with the serum expressions of deacylated ghrelin and Nesfatin-1. The expression of ghrelin became elevated at all stages in the VPA group. Especially the subgroups of 24 h (0.320 ± 0.007) and 7 d (0.284 ± 0.004) had a significant increase (P < 0.05) while their expression levels remained lowed than that of the blank group (0.342 ± 0.039). The expressions of Nesfatin-1 had a significant decrease (P < 0.05) in all VPA subgroups while they were higher than those in the blank group (0.124 ± 0.007). CONCLUSION: An accurate detection of serum expression level of deacylated ghrelin and Nesfatin-1 may reflect the fluctuation trend of neuropeptides in hypothalamus. It may offer a simple, sensitive and noninvasive method of diagnosing and treating epilepsy.

[Microsurgical anatomy and surgical approach of the ambient cistern].

OBJECTIVE: to describe detailed anatomy and compare four surgical approach of the ambient cistern, to assist in the process of conceptualizing a reliable surgical approach to allow for a successful course of surgery. METHODS: The microsurgical anatomy of the ambient cistern and four surgical approach was studied in 12 formalin-fixed brain specimens (24 hemispheres). Four simply formalin-fixed, the cerebral arteries of eight brain specimens were perfused with colored silicone, and they were dissected with the aid of an operating microscope. Special attention was paid to the anatomic structures limiting visualization in each approach. RESULTS: The ambient cistern extends from the posterior margin of the crural cistern to the lateral edge of the midbrain colliculi, and round the lateral surface of the upper portion of the brainstem; The ambient cistern mainly contained P(2) segment of the posterior cerebral artery, superior cerebellar artery, anterior choroidal artery, basal vein and trochlear nerve. The subtemporal approach allow for excellent exposure of the lower half of the ambient cistern, the vein of Labbé and the parahippocampal gyrus obstacle to exposure through this approach; The transtemporal transchoroidal approaches exposed the upper half of the ambient cistern of non-dominance hemisphere, its major drawback is the need to perform a corticectomy in the temporal lobe. In addition, the vein of Labbé extended far enough anteriorly to limit the cortical incision in the temporal lobe. The transinsular transchoroidal exposed the anterior upper half of the ambient cistern. Its major disadvantage is damage the temporal stem, the longer the inferior limiting sulcus, the shorter the incision, the better for preservation the temporal stems; The occipital transtentorial approaches exposed the posterior lower half of the ambient cistern, the parahippocampal gyrus also blocked to exposure through this approach. CONCLUSION: Surgical approaches to lesions of the ambient cistern must be tailored to the site of the pathological findings. Position of the vein of Labbé, and the midpoint of the rounded medial edge of the parahippocampal gyrus, is key to determine Surgical Approach.