Objective To discuss the microsurgical treatment, outcomes and complications of trigeminal neuralgia ( TN) caused by non-arterial compression factors. Methods A total of 251 patients with complete clinical data of TN undergoing microsurgical treatment at Department of Neurosurgery, China-Japan Friendship Hospital from May 2006 and December 2016 by the same surgeon were retrospectively enrolled into this study. Among them, 36 ( 14. 3％) patients were caused by non-arterial compression factors. Of the 36 patients, 19 (52. 8％) were caused by single offending venous compression, of which 12 cases underwent microvascular decompression ( MVD) , 7 cases over 60 years old underwent selective partial rhizotomy (PR) after MVD; 17 (47. 2％) cases had no offending vessels, of which 12 cases underwent radical release of trigeminal nerve root, and the trigeminal nerve root was completely dissected from the brain stem to the Meckel's cave, and 5 cases over 60 years old underwent additional PR. Evaluation of efficacy was based on the Brisman criteria. Results Among 19 patients with single venous compression, 11 cases of 12 patients showed immediate effect post MVD, and 1 case did not; all the 7 patients with unsatisfactory decompression undergoing PR showed immediate effect after operation. Among 17 patients without definite offending vessels, 11 cases of 12 patients with completely trigeminal nerve release demonstrated immediate effect after operation, 1 case did not; and 5 cases with additional PR showed immediate effect after operation. The total effective rate was 94. 4％ ( 34/36 ) immediately after operation. Postoperative neurological complications occurred in 3 (8. 3％) cases including 1 case of tinnitus, 1 case of diplopia and 1 case of masticatory weakness. Thirty-six patients were followed up from 14 to 142 months, and the average follow-up time was 67. 0 ± 9. 2 months. The total effective rate was 88. 9％ (32/36) and the recurrence rate was 5. 9％ (2/34). The patients with no relief or recurrence obtained improvement after radiofrequency and gamma knife therapy. Three patients with neurological complications recovered after conservative treatment during the follow-up period. Conclusions MVD could be performed in patients with single venous compression after complete dissociation of the offending vein. Adhesion around the trigeminal nerve sensory root should be fully released in patients without offending vessels compression. PR of the trigeminal nerve sensory root should be performed in patients over 60 years old. After the treatment of TN with non-arterial compression, the outcome was satisfactory, and there was no increase in operative complications.

Acute kidney injury (AKI) has one of the highest mortalities in terms of inflammatory sepsis. MiR-20a is involved in a variety of inflammatory reactions, but its role in AKI remains unknown. The purpose of this study was to investigate specific in vitro function and mechanisms of miR-20a in AKI. We used, lipopolysaccharide (LPS) against human proximal tubular epithelial (HK-2) cells to induce an in vitro model of AKI. Then, our data showed that miR-20a expression levels were down-regulated in LPS-treated HK-2 cells. Overexpression of miR-20a promoted cell viability, inhibited apoptosis rate and inhibited the expression of apoptotic factors and inflammatory cytokines in HK-2 cells after LPS stimulation. In addition, CXCL12 was identified as a direct target of miR-20a by luciferase reporter gene assay, and CXCL12 expression was negatively regulated by miR-20a. Moreover, CXCR4 attenuated the suppression of miR-20a on inflammation and apoptosis in LPS-stimulated HK-2 cells, and further data indicated that miR-20a deactivated CXCL12/CXCR-4, NFκB and ERK1/2 signaling by targeting CXCL12. Therefore, our data revealed that miR-20a may play an anti-inflammatory and antiapoptotic roles in LPS-induced HK-2 cells via deactivation of CXCL12/CXCR-4, NFκB and ERK1/2 signaling.

Objective To investigate the long-term efficacy and complications of modified Foerster-Dandy operation in the treatment of spasmodic torticollis (ST).Methods A total of 550 cases of ST admitted to Neurosurgery Department of China-Japan Friendship Hospital from April 2005 to April 2013 were retrospectively enrolled into this study.All patients were treated with modified Foerster-Dandy operation,in which occipitocervical posterior median approach was used without opening of occipital squama and foramen magnum.Limited laminectomy,endoscope-assisted bilateral subdural accessory nerve and C1 spinal nerve root cutting and selective partial cutting of anterior and posterior roots of C2-4 spinal nerve were conducted.The international Tsui scale was used to evaluate the efficacy post operation.We also analyzed the complications occurring following the operations.Results All patients were followed up for 60-156 months,with an average of 117.0 ± 5.5 months.The median improvement rate of spasticity at 6 months,12 months and the latest follow-up was 73.6％ (54.7％,86.4％),70.2％ (48.8％,85.1％) and 73.2％ (51.1％,88.5％),respectively.The Tsui score before operation was 17.2 (13.6,20.6).However,at 6 months,12 months and the latest follow-up,the Tsui scores were 4.6 (2.2,7.3),4.9 (2.6,8.1) and 4.3 (2.0,7.5),respectively,which were significantly lower than those prior to operation (all P ＜ 0.05).However,30 (5.5％) cases had neck rotation weakness,34 (6.2％) reported shoulder shrug weakness,32 (5.8％) had limited arms abduction,45 (8.2％) developed long-term neck back pain and numbness,11 (2.0％) reported neck circumference narrowing,and 62 (11.3％) suffered from dysphagia.Among them,no obvious improvement was achieved in 5 cases with neck rotation weakness and 9 cases with dysphagia.All the other complications were relieved to various degrees during the follow-up period after rehabilitation training.During the follow-up,spasm recurrence to various degrees was reported in 25 (4.5％) cases.Conclusion Modified Foerster-Dandy operation is a safe and effective surgical therapy for patients with ST.

Objective To study the efficacy of selective peripheral neurotomy in treating cerebral spasticity in adults.Methods Sixty-one cerebral spasticity cases in adults treated by selective peripheral neurotomy at Shengli Oilfield Central Hospital from March 2015 to November 2017 were selected.They were analyzed retrospectively in spasticity,muscular tension,gait,quality of life and complication right after operation.Results With a period of follow up for 11-26 months (mean duration:19.5 ± 7.6 months),5 upper limbs and 68 lower limbs of 73 limbs of 61 patients involved 94 peripheral nerves all experienced notable alleviation of spasticity right after operation,and the alleviation rate in follow-up duration was 91.8％ (67/73).The rate of decrease in muscle tension was 100％ and it in follow-up duration was 94.5％ (69/73).The improvement rate of motor capacities 3 months after operation was 83.6％ (51/61),and was 90.2％ (55/61) half year after operation.The rate of improvement in upper limb function was 80.0％ (4/5)in follow-up duration.A total of 91.8％ (56/61)cases had better quality of life by follow-up studying.Postoperative complications like dysaesthesias of limbs were found in 6 cases (8.2％),muscle weakness in 3 cases (4.1％) and recurrence of spasticity in 2 cases (2.7％).Conclusion Selective peripheral neurotomy is a safe and effective surgical nethod in treating cerebral spasticity in adults.

In clinic, two or more cranial neuropathy is defined as combined hyperactive dysfunction syndrome; combined hyperactive dysfunction syndrome is extremely rare and systemic reports about the syndrome are rather sparse. This article focuses on the pathogenesis, clinical features, surgical treatments and prognoses of combined hyperactive dysfunction syndrome to deepen their understanding and provide evidence for clinical diagnoses and treatments.

Objective To investigate the lumbar spine stability in children with spastic cerebral palsy (SCP) following modified selective posterior rhizotomy (SPR).Methods A total of 90 cases of SCP underwent lumbosacral SPR at Neurosurgery Department of China-Japan Friendship Hospital from January 2012 to December 2017 and were retrospectively enrolled into this study.Paired t-test was used to compare the differences of lordosis angle (Cobb's method),lumbosacral angle,arch-vertex distance,Cobb's angle before and after surgery (final follow-up) to observe the occurrence of lumbar spine deformity post operation.Results Postoperative follow-up lasted for 6-60 months with an average of 27.0 ± 12.8 months.The average preoperative and postoperative lordosis angles were 36.1° ± 1.8° and 39.9° ± 2.6° respectively,which had statistical difference (P =0.029).Pre-and post-operative lumbosacral angles [33.1 ° ± 1.4° vs.33.6° ± 1.4°],arch-vertex distance (15.6 ± 1.3 mm vs.17.3 ± 1.2 mm),Cobb's angle[5.9° ±0.9° vs.7.3° ±0.9°].Those difference were not statistically significant (P ＞0.05).Of 90 patients,9 (10.0％) had lumbar deformities before surgery,including 7 cases of scoliosis and 2 cases of lumbar spondylolisthesis.After operation,24 (26.7％) cases had lumbar spinal deformities,18 reported scoliosis,and 6 had Ⅰ ° lumbar spondylolisthesis.Among the 7 cases with scoliosis before operation,2 were improved to different degrees after operation and 5 were aggravated.Conclusion Little effect on lumbar spine stability is found among children with spastic cerebral palsy in long-term study following SPR.

Objective To summarize the clinical features of supratentorial subdural hematoma ( SDH) following microvascular decompression ( MVD ) . Methods A retrospective review of 4937 consecutive patients who underwent MVD at Department of Neurosurgery, China-Japan Friendship Hospital between January 2015 and September 2017 revealed 29 patients with postoperative supratentorial SDH accounting for 5. 9‰ of all MVD cases. Among the 29 patients with supratentorial SDH, 21 cases(5. 7‰) occurred out of 3656 patients following MVD for HFS (hemifacial spasm), 8(6. 7‰) out of 1197 patients for TN (trigeminal neuralgia). In addition, there were 84 cases of GN (glossopharyngeal neuralgia) and none of them developed SDH. A retrospective review of clinical features and outcomes of 29 patients with supratentorial SDH. Results The 29 patients included 11 males and 18 females. Their age ranged from 19 to 79 years old, with an average of 53. 0 ± 15. 3 years old. The duration of illness was 0. 5-20. 0 years, with the median of 5. 0 years. In 29 patients, supratentorial SDH occurred ipsilaterally in 16 ( 55. 2％) cases, contralaterally in 10(34. 5％)cases, and bilaterally in 3(10. 3％)cases. Hemorrhagic amount by CT analysis ranged from 2 ml to 15 ml, with the average of 6. 5 ± 3. 6 ml. Among 28 patients with conservative treatment, 26 displayed complete or obvious absorption of hematomas at discharge and 2 showed hematoma absorption during follow-up. One patient turned into chronic supratentorial SDH and achieved good outcome following single-bore drainage. There was no SDH-related symptoms developed during the 6-month follow-up. Treatment of original illness remained effective in 27 (93. 1％) cases. Conclusions The incidence of supratentorial SDH after MVD is much lower than other complications of MVD. Furthermore, most patients with conservative treatment seem to have good outcome. Even though, postoperative CT scan is recommended for all MVD patients.

The promotion of angiogenesis is a promising therapeutic strategy for ischemic stroke. Many long noncoding RNAs (lncRNAs) are related to angiogenesis following ischemic stroke. LncRNA small nucleolar RNA host gene 12 (SNHG12) was upregulated in oxygen-glucose deprivation (OGD)-exposed primary brain microvascular endothelial cells and in microvessel from middle cerebral artery occlusion (MCAO) animal brains. However, the role and underlying mechanism of SNHG12 in ischemic stroke especially associated with angiogenesis process remain unknown. The expression of SNHG12 and miR-150 was determined in OGD-stimulated mouse brain microvascular endothelial (bEnd.3) cells. The role and mechanism of SNHG12 in the angiogenesis after ischemic stroke were investigated using gain- and loss-of function approaches both in OGD-exposed bEnd.3 cells and in MCAO mouse models. We found SNHG12 expression was elevated, whereas miR-150 reduced in OGD-exposed bEnd.3 cells. Upregulation of SNHG12 elevated, and SNHG12 knockdown suppressed the capillary-like tube formation, viability, migration, and VEGF expression in OGD-injured bEnd.3 cells. miR-150 mimic reversed, whereas anti-miR-150 further strengthened the effect of SNHG12 upregulation on the angiogenesis in bEnd.3 cells. Furthermore, we found that SNHG12 functioned as a competing endogenous RNA for miR-150 to regulate VEGF expression. Additionally, overexpression of SNHG12 improved the recovery of neurological function, reduced infarct volume and miR-150 expression, increased vascular density and VEGF expression in the infarct border zone of MCAO mice. In conclusion, SNHG12 promotes the angiogenesis following ischemic stroke via miR-150/VEGF pathway, which further clarified the mechanism of angiogenesis after ischemic stroke and provides a target for the treatment of this disease.