[This corrects the article DOI: 10.1016/j.heliyon.2024.e25912.].

Objective: This work focused on investigating if robot-assisted minimally invasive surgery improved middle term vital outcome for primary brainstem hemorrhage (PBSH). Methods: This work obtained clinical data from patients with PBSH admitted from July 2019 to August 2021. All cases were classified as surgical or conservative treatment group. The general information, Glasgow coma scale (GCS) score, Glasgow outcome score (GOS), along with survival time in patients 60 days after robot-assisted surgery were recorded and analyzed. Results: A prospective analysis was performed on 82 cases meeting eligibility criteria, including 36 from surgical group whereas 46 from the conservative group. Sixty days after onset, the death rate was found to be 19.44% and 50.00% of surgical and conservative groups, separately (cases versus controls, P < 0.05). Furthermore, postoperative GOS and GCS scores of surgical group were significantly higher, and hydrocephalus was lower compared with conservative group. Central fever incidence did not exhibit any significant difference between two groups. Conclusion: Robot-assisted PBSH drainage may improve survivorship and reduce the occurrence of hydrocephalus.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is the only reversible cause of dementia, but many patients fail to receive shunt surgery in time due to underdiagnosis. This study aimed to determine the relationship between surgery timepoint and sustained postoperative improvement in patients with iNPH. Methods: We divided the patients into the early surgery group (0–3 months) and the late surgery group (> 3 months) according to the duration from the disease onset to surgery. Patients from 3 general hospitals in different provinces of China were included. Primary endpoints included improvements on the idiopathic normal pressure hydrocephalus grading scale (INPHGS) and modified Rankin Scale (mRS). Results: A total of 120 patients were included in the study. The mean age was 62.76 ± 12.27, the mean duration of symptoms was 22.00 ± 37.99 months, the mean INPHGS was 7.15 ± 1.759 (cognitive: 2.71 ± 0.91; gait: 2.47 ± 0.95; urinary: 1.96 ± 0.88), and the mean mRS were 2.45 ± 0.77. In the early surgery group, patients’ symptoms improved continuously from discharge to 1-year follow-up. Regarding mRS improvement, the early surgery group is superior to the late surgery group at postoperative time points and 1-year follow-up (p < 0.05). Conclusions: The results of this multicenter study indicate that early shunting promotes sustained improvement in patients with iNPH.

目的 探讨神经外科手术机器人辅助穿刺引流治疗原发性丘脑出血的可行性和安全性.方法 本研究共纳入53例确诊为原发性丘脑出血的患者.分为神经外科手术机器人(RS)组和脑室外引流(EVD)组.比较分析两组患者的血肿清除率、术后第1天和第14天GCS评分、术后再出血发生率、颅内感染发生率、癫痫、脑梗死和住院时间.术后6个月对患者进行随访评估预后,行头颅CT或MRI检查,以确定是否有脑积水或其他相关并发症.结果 RS组(34例)患者在血肿清除率、术后第14天的GCS评分、术后颅内感染发生率均明显优于EVD组(19例)(P＜0.05).随访6个月后,RS组的死亡率和脑积水发生率较EVD组降低,预后明显优于EVD组(P＜0.05).结论 与传统EVD相比,RS治疗丘脑出血的血肿清除率更高,颅内感染和脑积水患者更少,改善了临床预后,因此具有较高的临床应用价值.

As a disorder of the brain in adults and children, traumatic brain injury (TBI) is considered the major cause of mortality and morbidity. As a serious complication of TBI, post-traumatic hydrocephalus (PTH) is commonly identified and significantly associated with neurocognitive impairment, motor dysfunction, and growth impairment. The long-term functional outcomes after shunt dependence are totally not clear. This study included 6279 patients between 2012 and 2022. To identify the unfavorable functional outcomes and the PTH-related factors, we carried out univariable logistic regression analyses. To identify the occurrence time of PTH, we conducted the log-rank test and Kaplan–Meier analysis. Mean patient age was 51.03 ± 22.09 years. Of the 6279 patients with TBI, 327 developed PTH (5.2

目的:探讨微创颅内血肿清除术治疗高血压脑出血的临床疗效.方法:选择医院收治的66例高血压脑出血患者随机分为对照组和观察组,各33例,对照组患者采取小骨窗显微血肿清除术,观察组患者采取微创颅内血肿清除术.对比两组患者临床疗效.结果:观察组患者的治疗总有效率高于对照组(P＜0.05).观察组患者手术时间、术中出血量、住院时间均少于对照组(P＜0.05).观察组患者NIHSS评分低于对照组,BI指数、GCS评分均高于对照组(P＜0.05).观察组患者并发症总发生率低于对照组(P＜0.05).结论:与传统小骨窗显微血肿清除术相比,微创颅内血肿清除术对高血压脑出血的疗效更佳,可改善患者神经功能,促进其恢复正常意识和日常生活能力,手术安全性高,值得应用.

Introduction: Working memory (WM) refers to the temporary storage and manipulation of information. Short-term memory storage can be divided into separate subsystems for verbal information and visual information. We explored the capacity of visual WM in patients with temporal lobe glioma. Methods: In this study, we assessed 30 patients with temporal lobe glioma and 30 healthy controls (HCs) using a method that combined memory tests with visual WM tasks (digital span task, spatial capacity N-back task, and emotional N-back task). Results: The results revealed that groups did not differ in terms of demographics, estimated intelligence, and level of psyc distress. For visual WM tasks, statistically significant differences were not found on the 1-back tasks and forward versions of simple span tasks between the temporal patient (TP) group and the HC group. Analysis of correct responses of the experimental tasks suggested that the TP group was significantly different from the HC group in the 2-back tasks and backward versions of simple span tasks. For reaction times, spatial capacity 2-back task and emotional 2-back task showed the TP group was significantly different from the HC group. Conclusion: These findings revealed that visual WM scores of temporal glioma patients were lower than HCs, and hence, the temporal lobe may be a certain neuroanatomical structure in the WM network.

Objective: To compare the prognosis of patients with spontaneous basal ganglia intracerebral hematoma treated by endoscopic evacuation, craniotomy, or puncture aspiration.Methods: This retrospective observational study included information from patients with basal ganglia hematoma who received craniotomy, endoscopic evacuation, or puncture aspiration in the Department of Neurosurgery of the First Affiliated Hospital of USTC between January 2016 and May 2021. Patients were grouped according to their treatment method for comparison.Results: From a total of 184 patients, 62 cases (51 males, aged 54.44 +/- 9.92 years) received craniotomy, 64 cases (45 males, aged 53.97 +/- 11.87 years) received endoscopic evacuation, and 58 cases (43 males, aged 54.25 +/- 10.35 years) received puncture aspiration. No significant difference was found in baseline characteristics among three surgical procedures. Patients in the endoscopy group had the shortest hospital stay (15.16 +/- 4.89 days vs. 17.88 +/- 5.97 and 20.77 +/- 6.96 days), lowest infectious meningitis [1(1.6 %) vs. 2(3.4%) and 8(12.9%)] and pulmonary infection [3(4.7%) vs. 5(8.6%) and 13(21.0%)] rates, and highest hematoma removal rate (90.39 +/- 5.22% vs. 35.87 +/- 6.23 and 84.76 +/- 4.91%) and Glasgow outcome scale 6 months after surgery (4.41 +/- 0.53 vs. 3.74 +/- 1.09 and 3.81 +/- 1.03). The occurrence of gastrointestinal bleeding, epilepsy, and mortality were similar (all p > 0.05) among the groups.Conclusion: Patients with spontaneous basal ganglia intracerebral hematoma who received endoscopic evacuation might have better prognosis than those treated with craniotomy or puncture aspiration. In future, endoscopic surgery could become the most common method for treating spontaneous basal ganglia hemorrhages.

α-Lipoic acid-plus (LAP), an amine derivative of α-lipoic acid, has been reported to protect cells from oxidative stress damage by reacting with lysosomal iron and is more powerful than desferrioxamine (DFO). However, the role of LAP in experimental carotid artery intimal injury (CAII) has not yet been well investigated. Therefore, we sought to uncover the role and potential endovascular protective mechanisms of LAP in endothelial injury. In vitro, oxyhemoglobin (OxyHb) stimulation of cultured human umbilical vein endothelial cells (HUVECs) simulated intimal injury. In vivo, balloon compression injury of the carotid artery was used to establish a rat CAII model. We found that the protein levels of cathepsin B/D, ferritin, transferrin receptor (TfR), cleaved caspase-3, and Bax increased in the injured endothelium and HUVECs but were rectified by DFO and LAP treatments, as revealed by western blotting and immunofluorescence staining. Additionally, DFO and LAP decreased oxidative stress levels and endothelial cell necrosis of the damaged endothelium. Moreover, DFO and LAP significantly ameliorated the increased oxidative stress, iron level, and lactic dehydrogenase activity of HUVECs and improved the reduced HUVEC viability induced by OxyHb. More importantly, DFO and LAP significantly reduced mitochondrial damage and were beneficial for maintaining lysosomal integrity, as indicated by acridine orange (AO), Lyso-Tracker Red, JC-1, and ATPB staining in HUVECs. Finally, LAP might offer more significant endovascular protective effects than DFO. Our data suggested that LAP exerted endovascular protective effects by inhibiting the apoptosis signaling pathway mediated by intralysosomal cathepsins by reacting with excessive iron in endothelial lysosomes after intimal injury.

BACKGROUND:The diagnosis of hydrocephalus is mainly based on imaging findings. However, the significance of many imaging indicators may change, especially in some degenerative diseases, and even lead to misdiagnosis. METHODS:This study explored the effectiveness of commonly used morphological parameters and typical radiographic findings in hydrocephalus diagnosis. The patients' imaging data were divided into three groups, including the hydrocephalus group, the symptomatic group, and the normal control group. The diagnostic validity and weight of various parameters were compared between groups by multiple machine learning methods. RESULTS:Our results demonstrated that Evans' ratio is the most valuable diagnostic indicator compared to the hydrocephalus group and the normal control group. But frontal horns' ratio is more useful in diagnosing patients with symptoms. Meanwhile, the sign of disproportionately enlarged subarachnoid space and third ventricle enlargement could be effective diagnostic indicators in all situations. CONCLUSION:Both morphometric parameters and radiological features were essential in diagnosing hydrocephalus, but the weights are different in different situations. The machine learning approaches can be applied to optimize the diagnosis of other diseases and consistently update the clinical diagnostic criteria.

目的 重型弥漫性轴索损伤(DAI)具有较高的致死率和致残率.由于常规MRI成像技术的局限性,病情评估及预后判断仍具有挑战性.磁敏感加权成像(SWI)和弥散张量成像(DTI)可以识别创伤后脑微出血和白质纤维的完整性.我们利用多种MRI技术综合评估脑损伤程度与预后之间的相关性.方法 纳入中国科学技术大学附属第一医院(安徽省立医院)神经外科138例重型弥漫性轴索损伤患者,收集临床资料、量表评估及影像学资料.利用软件将全脑分割为五大脑区,提取微出血数量、体积和白质异向性(FA),统计分析与脑损伤程度与预后之间的相关性.结果 大脑中线结构区域的微出血数量和体积与FA值相关(P＜0.05),而其他区域无明显相关.正中矢状区、脑干、丘脑和基底神经节微出血的数量和体积与重度颅脑损伤患者的入院GCS评分、6个月和12个月后的GOS评分呈线性负相关(P＜0.05),与CRS-R评分呈线性正相关(P＜0.05);脑干、丘脑和基底神经节区域的平均FA与重度颅脑损伤患者的入院GCS评分、6个月和12个月后的GOS评分呈线性正相关(P＜0.05),与CRS-R评分呈线性负相关(P＜0.01).结论 深部脑结构中微出血(SWI)和微观结构变化(DTI)是创伤后脑损伤的影像学标志物,SWI和DTI的MRI指标对脑损伤程度的评估及判断预后有着重要意义.

The SOCS1/JAK2/STAT3 axis is strongly associated with tumor growth and progression, and participates in cytokine secretion in many diseases. However, the effects of the SOCS1/JAK2/STAT3 axis in experimental subarachnoid hemorrhage remain to be studied. A subarachnoid hemorrhage model was established in rats by infusing autologous blood into the optic chiasm pool. Some rats were first treated with JAK2/STAT3 small interfering RNA (Si-JAK2/Si-STAT3) or overexpression plasmids of JAK2/STAT3. In the brains of subarachnoid hemorrhage model rats, the expression levels of both JAK2 and STAT3 were upregulated and the expression of SOCS1 was downregulated, reaching a peak at 48 hours after injury. Simultaneously, the interactions between JAK2 and SOCS1 were reduced. In contrast, the interactions between JAK2 and STAT3 were markedly enhanced. Si-JAK2 and Si-STAT3 treatment alleviated cortical neuronal cell apoptosis and necrosis, destruction of the blood-brain barrier, brain edema, and cognitive functional impairment after subarachnoid hemorrhage. This was accompanied by decreased phosphorylation of JAK2 and STAT3 protein, decreased total levels of JAK2 and STAT3 protein, and increased SOCS1 protein expression. However, overexpression of JAK2 and STAT3 exerted opposite effects, aggravating subarachnoid hemorrhage-induced early brain injury. Si-JAK2 and Si-STAT3 inhibited M1-type microglial conversion and the release of pro-inflammatory factors (inducible nitric oxide synthase, interleukin-1β, and tumor necrosis factor-α) and increased the release of anti-inflammatory factors (arginase-1, interleukin-10, and interleukin-4). Furthermore, primary neurons stimulated with oxyhemoglobin were used to simulate subarachnoid hemorrhage in vitro, and the JAK2 inhibitor AG490 was used as an intervention. The in vitro results also suggested that neuronal protection is mediated by the inhibition of JAK2 and STAT3 expression. Together, our findings indicate that the SOCS1/JAK2/STAT3 axis contributes to early brain injury after subarachnoid hemorrhage both in vitro and in vivo by inducing inflammatory responses. This study was approved by the Animal Ethics Committee of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China (approval No. LLSC-20180202) on March 1, 2018.

Intracranial hematoma is a common and serious secondary lesion in craniocerebral injury, using computer aided diagnosis (CAD) system to assist clinicians to complete various tasks can greatly improve the accuracy and efficiency of hospital diagnosis. The traditional method require manual annotations of a large number of pathological feature data to train a voxel-level classifier. However, intracranial hematoma may occur in different parts of the brain and vary in severity. At the same time, there is great differences between the same subcategories and certain similarities between different subcategories of intracranial hematoma. Traditional methods require professionals to spend a lot of time to complete the part annotation and the annotation process is difficult. In order to reduce the cost of annotation and to get accurate results only by image level annotation, we propose a new intracranial hematoma classification network model (PHBP) based on the hierarchical bilinear pooling method. This model only uses the dataset of image level annotation to realize the cross-layer bilinear pooling communication of feature maps at different scales, and has better interpretability and sensitivity to the lesion area. In addition, to investigate the effectiveness of our approach, we establish a dataset of three types of hematoma (epidural hematoma, subdural hematoma and intracerebral hematoma) combined with physician’s diagnostic reports. In the experimental part, we compare our method with several state-of-the-art classification methods and the results show that our method has better performance.

PURPOSE:Posttraumatic cerebral infarction (PTCI) is a common and relatively serious complication of traumatic brain injury (TBI) without a clear etiology. Evaluating risk factors in advance is particularly important to predict and avoid the occurrence of PTCI.PATIENTS AND METHODS:We retrospectively analyzed 297 patients with moderate to severe TBI admitted to the Department of Neurosurgery in our hospital from January 2019 to September 2020 and evaluated the effects of various factors such as age, sex, admission Glasgow Coma Scale (GCS), skull base fracture, subarachnoid hemorrhage (SAH), brain herniation, hypotensive shock, and decompressive craniectomy on the incidence of PTCI. We also performed a multivariate logistics regression analysis on the relevant factors identified and evaluated the diagnostic value of each risk factor in advance by receiver operating characteristic (ROC) analyses.RESULTS:Among the patients, 32 (10.77%) suffered PTCI. The incidence rates of PTCI in those with GCS scores of 3-8 and 9-12 were 15.87% (30/189) and 1.85% (2/108), respectively, while the rates were 18.84% (13/69), 15.03% (29/193), 18.57% (13/70), and 20.59% (14/68) in those with skull base fractures, traumatic SAH, brain herniation, and hypotensive shock, respectively, and 14.38% (23/160) in those who underwent decompressive craniectomy. These differences in PTCI incidence were statistically significant. However, the differences in PTCI incidence caused by patient age and sex were not statistically significant.CONCLUSION:Low GCS score, skull base fractures, traumatic SAH, brain herniation, hypotensive shock, and decompressive craniectomy are risk factors for the occurrence of PTCI, while age and sex are not significantly correlated with the occurrence of PTCI.

目的:探讨青年患者轻度颅脑损伤后形成慢性硬膜下血肿的危险因素及其意义.方法:回顾性分析2015年4月-2019年5月安徽省立医院神经外科连续收治的375例有CT阳性表现的青年轻度颅脑损伤患者病例,平均随访时间为32个月,分析青年患者轻度颅脑损伤后形成CSDH和各临床指标的关系.结果:本组患者平均年龄为(31.8±8.38)岁,男性占70.9％,形成CSDH者29例(7.7％),单因素分析结果表明:蛛网膜囊肿、急性硬膜下血肿、抗凝/抗血小板治疗及酗酒与CSDH形成有显著关系(P<0.05).Logistic回归分析示:有蛛网膜囊肿(OR=5.756,95％CI 1.847-17.937,P=0.003)、急性硬膜下血肿(OR=2.615,95％CI 1.015-6.734,P=0.046)及抗凝/抗血小板治疗(OR=8.850,95％CI 2.648-29.581,P=0.000)为影响CSDH形成的独立危险因素.急性硬膜下血肿最大厚度ROC曲线示3.5mm是预测CSDH形成的一个较好指标.结论:蛛网膜囊肿、急性硬膜下血肿及抗凝/抗血小板治疗是青年患者轻度颅脑损伤后CSDH的独立危险因素,此类患者应加强临床随访.

Background : Working memory refers to the temporary storage and manipulation of information. Although working memory is generally considered to rely primarily on a fronto-parietal network, there is recent evidence that the temporal lobe has an important role in specific aspects of working memory. Methods : In this study, we assessed 30 patients with temporal tumor and 30 healthy controls using a method that combined memory tests with working memory tasks ( Digital span task, Spatial capacity N-back task and Emotional N-back task ). Results : The results revealed that there are no significant difference between the groups with regard to the neuropsychological functionings. For working memory tasks, statistically significant differences were not found on the 1-back tasks and forward versions of simple span tasks between the temporal patients group (TP) and the healthy controls group (HC). Analysis of correct responses of the experimental tasks suggested that the TP group was significantly different from the HC group in the 2-back tasks and backward versions of simple span tasks. For reaction times, spatial capacity 2-back task and emotional 2-back task showed the TP group were significantly different from the HC group. Conclusion : These findings revealed that working memory capacity was impaired in patients with a temporal tumour and that the temporal lobe may be a certain neuroanatomical structure in the working memory network.

目的 探讨中青年患者轻度颅脑损伤后形成慢性硬膜下血肿的危险因素.方法 回顾性分析2018年1月～2019年5月安徽省立医院收治的轻度颅脑损伤患者236例,根据年龄分为青年组(18～44岁)116例和中年组(45～60岁)120例,另根据头颅CT复查结果将两个年龄组患者进一步分成CSDH患者和无CSDH患者,分析年龄组中CSDH患者和无CSDH患者各临床指标与慢性硬膜下血肿形成的关系,并采用Logistic回归分析不同年龄组创伤后CSDH形成的因素,采用ROC曲线分析脑实质距颅骨最大距离(Dm)预测CSDH形成的准确性.结果 青年组CSDH患者与无CSDH患者的Dm、蛛网膜囊肿、颅骨骨折及急性硬膜外血肿占比比较,差异有统计学意义(P＜0.05);中年组CSDH患者与无CSDH患者的Dm、蛛网膜囊肿、颅骨骨折及急性硬膜外血肿、高血压、糖尿病、抗凝/抗血小板治疗占比、吸烟饮酒量比较,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示,Dm、颅骨骨折及蛛网膜囊肿是青年患者创伤后CSDH形成的独立危险因素;Dm、颅骨骨折、高血压及抗凝/抗血小板治疗是中年患者创伤后CSDH形成的独立危险因素.ROC曲线分析显示,青年组曲线下面积为0.780,最佳截断值为3.5 mm,预测CSDH形成敏感度为58.33％,特异性为86.96％;中年组ROC曲线下面积为0.855,最佳截断值为2.6 mm,预测CSDH形成敏感度为90.00％,特异性为80.00％.结论 青年患者创伤后形成慢性硬膜下血肿的独立危险因素是脑实质与颅骨间的最大距离、颅骨骨折及蛛网膜囊肿;中年患者独立危险因素是脑实质与颅骨间的最大距离、颅骨骨折、抗凝/抗血小板治疗及高血压.同时青年患者硬膜外血肿,中年患者硬膜外血肿、蛛网膜囊肿、糖尿病、饮酒及吸烟亦与创伤后慢性硬膜下血肿的形成有相关性,有以上临床特征者应加强临床随访.

目的 探讨影响严重颅脑损伤患者不良预后的相关因素.方法 对重症医学科收治的114例经格拉斯哥昏迷量表(GCS)评为(3为＜GCS≤8分)严重颅脑损伤患者的临床资料进行回顾性分析,按疾病转归将患者分为两组:死亡组39例,好转组75例.将好转组和死亡组患者入住ICU 24h内各项临床资料进行比较,探寻影响患者不良预后的相关因素.结果 ①独立样本t检验提示,与好转组比较,死亡组脑疝患者比例(t=21.04,P＜0.001)、急性生理和慢性健康状况评分Ⅱ(APACHE Ⅱ)(t=-2.299,P=0.023)、机械通气时间(z=-4.722,P＜0.001)、白细胞(WBC)(t=-2.459,P=0.015)、血红蛋白(HGB)(t=-2.402,P=0.018)、白蛋白(ALB)(t=-4.028,P＜0.001)、前白蛋白(PAB)(t=-2.649,P=0.009)、钙离子浓度(Ca2+)(t=-3.417,P=0.001)均较高;②二元Logistic回归提示在相互校正单因素有意义的指标后,结果提示APACHE Ⅱ评分、机械通气时间、有无脑疝、ALB水平每减少1个单位,死亡风险分别减少30.2％ (P =0.007)、26.6％(P＜0.001)、89.1％(P=0.002)、25.4％ (P=0.001);③ROC曲线提示APACHE Ⅱ评分、有无脑疝、机械通气时间、ALB水平均对死亡有一定的预测价值,其中机械通气时间预测价值最佳,其敏感度为68.9％,特异度为81.6％.结论 APACHE Ⅱ评分、有无脑疝、机械通气时间、ALB水平对于严重颅脑损伤患者的预后有一定的预测价值,其中机械通气时间预测效能最佳.

Objective: The anatomical relationship of ventral foramen magnum and jugular foramen tumour is complex and the operation is very difficult. The aim of this study was to summarize the microsurgical experience of the removal of the ventral foramen magnum and jugular foramen tumours via the modified far lateral suboccipital approach assisted by three-dimensional computed tomography angiography (3D-CTA). Methods: The clinical data and follow-up results of 13 cases of 3D-CTA assisted suboccipital far lateral approach from July 2011 to September 2017 were analyzed retrospectively. There were 5 males and 8 females. Preoperative CT and MRI were used for routine imaging diagnosis, and the 3D-CTA simulated surgical approach was performed. The preoperative operation scheme was established, and the risk of operation was evaluated according simulated operation. After individualized exposure, the modified far lateral suboccipital approach was completed under the neuroelectrophysiological monitoring technique. Results: The preoperative images were completely consistent with the findings in the surgery. There were 9 cases of jugular foramen tumour and 4 cases of ventral foramen magnum tumour. Of the 13 cases, only 1 case of jugular glomus tumour had extra-cranial residual, while the whole intracranial tumour was removed. In other 12 cases, the tumours were completely removed under the microscope. After operation, the headache disappeared, and hearing loss was improved. There was no perioperative deaths, infection and cerebrospinal fluid leakage. The facial paralysis was occurred in 1 patient. After 3–39 months of follow-up, there was no recurrence of tumour, or new nerve function defect. Hoarseness, choking of drinking water and numbness of limbs were all improved at the end of the follow-up period. The symptoms of postoperative facial paralysis were also improved during the follow-up period. Conclusion: After the preoperative simulation and evaluation by 3D-CTA, the ventral foramen magnum and jugular foramen tumours can be rescted safely and effectively via far modified lateral suboccipital approach.

Objective To explore the mechanism of curcumin (Cur) in enhancing the level of autophagy inside endothelial cells (ECs) and inhibiting damaged vascular intimal hyperplasia ( IH). Methods In vitro, Human Umbilical Vein Endothelial Cell ( HUVECs ) was divided into four groups: Control, 3-MA, Cur and Rapa group.Acridine orange(AO) staining and Lyso-Tracker Red method were used to observe the acidic compartment accumulation. Western-blot and immunofluorescence were used to evaluate the protein levels of microtubule-associated protein-Ⅱ(LC3-Ⅱ), p62, Akt and mTOR.In vivo, rat carotid artery endarterium injury model was created by balloon compression , and 60 SD rats were divided into Sham , injured+vehicle, 3-MA, Cur and Rapa group.The protein levels of LC3-Ⅱ, p62, Akt and mTOR in carotid artery tissue were detected by Western blot.HE staining was used to measure the IH thickness and effective lumen area of each group.Results In vitro, Cur and Rapa treatments significantly increased the acidic compartment accumulation , the protein level of LC3-Ⅱand inhibited the protein expression of p62, Akt and mTOR in HUVECs compared with control group.In vivo, protein level of LC3-Ⅱ markly increased and p62, Akt and mTOR decreased slightly after endometrial injury and reversed by Cur and Rapa treatments.In addition, HE staining presented obvious IH and vascular stenosis was observed after injury in 3 weeks, and Cur and Rapa both markedly suppressed IH and alleviated vascular stenosis.Finally, 3-MA treatment showed an opposite effect both in vitro and in vivo. Conclusion Cur increases the level of ECs autophagy and inhibits IH after vascular injury , possibly by inhibiting the AKt／mTOR signaling pathway in ECs.