Abstract:Brain function protection has always been an important goal of neurosurgery for the treatment of cerebrovascular diseases. With the development of brain imaging technology and complex network theory， brain network analysis has been gradually applied in neurosurgery， striving to achieve more accurate preservation of neurological and cognitive function through the protection of brain network， so as to deepen the understanding of cerebrovascular diseases. We summarized the application of brain network analysis technology in cerebrovascular surgery in three directions， including helping to deepen the understanding of the symptom mechanism of cerebrovascular disease， assisting in preoperative evaluation of cerebrovascular disease， and assisting in the formulation of surgical plan of cerebrovascular disease. Driven by the rapid development of image scanning and brain network analysis technology， more systematic and detailed comprehensive protection of neural and cognitive functions has become the treatment target of cerebrovascular surgery.

Abstract:Objective To study the cognitive function and characteristics of infarct-free severe carotid artery stenosis （CAS） patients with vascular cognitive impairment （VCI）， and to analyze the risk factors for VCI in these patients. Methods A total of 55 severe CAS patients who were treated in Beijing Tiantan Hospital Affiliated to Capital Medical University from September 2020 to December 2021 were included. The patients were assessed by 2019 Chinese Guidelines for Diagnosis and Treatment of VCI. The cognitive function of patients with or without VCI was compared using the Trail Making Test-A （TMT-A）， Trail Making Test-B （TMT-B）， Boston Naming Test Version 2 （BNT-2）， Chinese version of Hopkins Verbal Learning Test （HVLT）， Clock Drawing Test （CDT） and Montreal Cognitive Assessment Scale （MoCA）. The influencing factors of VCI in patients with severe CAS without cerebral infarction were analyzed by multivariate Logistic regression analysis. Results Among 55 patients with severe CAS without cerebral infarction， 40 patients （72.7%） were complicated with VCI. 67.6% （27/40） of patients with VCI had more the 3 dimensions of cognitive impairment. The results of univariate analysis showed that there was significant difference in the age ［（64.00±6.61） years old vs （58.13±6.66） years old］， years of education ［9 （9，12） years vs 12 （12，16） years］ and vertebral artery stenosis ［65.0% （26/40） vs 5/15］ of patients with or without VCI （P＜ 0.05）. When multifactor correction was applied， advanced age （OR=1.165， 95%CI=1.019-1.332） was a risk factor for VCI in patients with carotid stenosis， while higher education （OR=0.681，95%CI=0.490-0.947） and effective Willis loop compensation （OR=5.531， 95%CI=1.027-29.797）were then protective factors. Conclusions Severe CAS patients with VCI have extensive cognitive function impairment， higher education and effective Willis loop compensation are protective factors for cognitive function， and advanced age is a risk factor for cognitive impairment.

Abstract:Objective To explore the plasticity of language cortex and language-related white matter fibers in patients with cerebral arteriovenous malformations in Broca region. Methods A total of 5 patients with cerebral arteriovenous malformations in Broca region （B-BAVM） who underwent microsurgical resection in Beijing Tiantan Hospital from September 2016 to May 2019 were prospectively selected as the study subjects. Blood oxygen level-dependent functional MRI （BOLD-fMRI） and diffusion tensor imaging （DTI） were performed within 1 week before and 6 months after microsurgery. The fiber bundle of the language-related white matter functional area and its homologous fiber profile on the opposite side were evaluated. The laterality index （LI） between the lesion and the activated voxels of the language cortex in the opposite hemisphere was calculated. Results Six months after operation， the number of arcuate fibers in the left hemisphere of the 5 patients was 67 （20，217）， lower than 781 （285，1 191） before operation； The number of fibers in the left hemisphere hook bundle after operation was 386 （190，852）， higher than 220 （114，422） before operation， and the differences were statistically significant （P＜ 0.05）. There was no statistically significant difference in the number of fibers in the anterior segment， posterior segment， inferior longitudinal segment and inferior fronto-occipital segment of the arcuate tract between the two hemispheres of 5 patients before and 6 months after operation （P＞ 0.05）. The preoperative LI of Broca area was 1.000 （0.753，1.000）， higher than the postoperative LI of 0.070 （-0.890， 0.537）， and the difference was statistically significant （Z=-0.023， P ＜ 0.05）. Conclusions After surgical resection of cerebral arteriovenous malformations in the Broca region， the contralateral homologous region and the ipsilateral hemispheric hook bundle in the Broca region of the patient's brain participated in compensation， providing evidence for the functional reorganization of the Broca region after injury.

Abstract:Objective To investigate the efficacy of early intravascular embolization in the treatment of senile ruptured cerebral aneurysms （≥ 60 years old）. Methods A total of 82 senile patients with ruptured cerebral aneurysms， who were admitted to the Second People's Hospital of Guiyang from January 2020 to December 2021， were selected as the study subjects. According to the timing of intravascular embolization， they were divided into three groups： ultra-early group （within 48 h after attack， n=25）， early group （within 48 h to 72 h after attack， n=27） and postpone group （more than 72 h after attack， n=30）. The embolizasion and complication rate of the three groups were compared. The NIHSS scores of the three groups were compared before and after the operation， and blood samples were collected before and 3 months after the operation to measure the related indexes of vascular endothelial function in the three groups， and the complication rate and prognosis of the three groups were compared. Results The comparison of embolization degree among the three groups showed that the complete embolization rate of ultra-early group was 88.00%（22/25） ， which was higher than 70.37% （19/27） in the early group and 50.00% （15/30） in the delayed group （P＜ 0.05）. The incidence of complications in the postpone group was 33.33%（10/30）， higher than 4.00% （1/25） in the ultra-early group and 14.81% （4/27） in the early group， with a statistically significant difference （P＜ 0.05）. There was no statistically significant difference in the incidence of complications between the ultra-early group and the early group （P＞ 0.05）. The NIHSS score of ultra-early group was （2.16±0.88） ， which was lower than （3.72±0.74） of the early group and （6.78±1.05） of the delayed group， and the difference was statistically significant （P＜ 0.05）. The levels of serum vWF and ET-1 in the three groups were significantly lower than those before operation， and the level of NO was significantly higher than that before operation （P＜ 0.05）. At 3 months after surgery， the vWF and ET-1 levels in the ultraearly group were （56.39±14.14） ng/ml and （31.76±10.57） pg/ml， which were lower than （95.72±20.33） ng/ml and （56.87±11.08） pg/ml in the postponed group， with statistically significant differences （P ＜ 0.05）. The good prognosis rate was 92.00% （23/25） in the ultra-early group， which was higher than 60.00% （18/30） and 77.78% （21/27） in the postpone group and early group， with a statistically significant difference （P ＜ 0.05）. Conclusions Intravascular embolization can achieve satisfactory results in elderly patients with cerebral aneurysms. Early and ultra-early interventional therapy can accelerate the recovery of nerve function and reduce the risk of complications.

Abstract:Moyamoya disease （MMD） is a progressive cerebrovascular obstructive disorder with unknown causes. Cognitive impairment is a common concomitant symptom of MMD， which seriously reduces the quality of life. As a new analysis technology， brain network aims to study the interaction of various regions of the brain macroscopically， which plays an important role in deeply understanding the brain structure and function， exploring the occurrence and progression mechanism and evaluating diagnosis and treatment of brain diseases. Meanwhile， brain network also provides an important method for exploring the mechanism of cognitive impairment of MMD and the diagnosis， treatment and prognosis evaluation of cognitive impairment. This paper reviews the research on cognitive impairment related brain networks of MMD.

Abstract:Cerebral vascular malformations （CVM） are non-neoplastic lesions caused by abnormalities in the number and structure of brain vessels. Epileptic seizure is a frequent presenting symptom in patients with CVM， particularly in patients with brain arteriovenous malformations and cavernous malformations. CVMrelated epilepsy brings a series of burdens to patients， which is an essential factor to be considered in achieving a favorable prognosis for CVM. In this paper， we review the research advances in CVM-related epilepsy， including its incidence， pathogenesis， altered brain functional connectivity， risk factors， individualized evaluation， treatment， and prognosis， with the goal of assisting the diagnosis and treatment of CVM.

Abstract:Objective To investigate the effect of venlafaxine on the depression-like behavior， and the expression of CNPase， MBP and Nrg1 Ⅲ -ErbB2 expression in prefrontal cortex （PFC） of cuprizone （CPZ）treated mice. Methods A total of 32 C57BL/6 male mice aged 8-weeks were randomly divided into control group， venlafaxine （Ven） group， model （CPZ） group and CPZ+Ven group. Mice in CPZ and CPZ+Ven groups were fed with diet containing 0.2% CPZ for 5 weeks to establish CPZ model. Ven and CPZ+Ven groups received 20 mg/（kg·d） venlafaxine by gavage for 5 weeks. Control group and CPZ group were gavaged with 200 μl saline every day during the same time period. Open field experiment， sugar-water preference experiment and tail suspension experiment were carried out after 5-week intervention， and then 5 mice in each group were killed immediately. PFC was collected in liquid nitrogen. The protein levels of CNPase and MBP in PFC were detected by Western blot， and the level of Nrg1 Ⅲ-ErbB2 mRNA was detected by RT-PCR. The remaining mice （n=3） were perfused and fixed with 4% PFA，and then the morphological changes of oligodendrocytes were observed by immunofluorescence staining for CNPase. Results The total distance traveled in open field and distance of central movement of CPZ group were shorter than those of the control group ［（12.50±4.73） m vs （25.63±5.64） m， （5.92±1.98） % vs （11.78±4.17） %］. The immobility time of suspended tail test was longer than that of the control group ［（153.75±26.4） s vs （71.62±20.95） s］. Sugar preference index was lower than that of the control group ［（79.16±6.53） % vs （92.67±2.97） %］. The protein expression levels of CNPase and MBP in PFC were lower than those of the control group ［（0.56±0.08） vs （0.85±0.13）， （0.37±0.05） vs （1.01±0.08）］. The mRNA levels of Nrg1 Ⅲ and ErbB2 were lower than those of the control group ［（0.38±0.27） vs （1.06±0.16）， （0.42±0.41） vs （1.01±0.01）］. The differences of all the above were statistically significant （P ＜ 0.05）. The total distance traveled in open field and distance of central movement of CPZ+Ven group were longer than those of the CPZ group ［（22.64±6.59） m vs （12.50±4.73） m， （10.6±2.85） % vs （5.92±1.98） %］. The immobility time of suspended tail test was longer than that of the CPZ group ［（109.25±35.69） s vs （153.75±26.4） s］. Sugar preference index was lower than that of the CPZ group ［（91.63±2.98） % vs （79.16±6.53） %］. The protein expression levels of CNPase and MBP in PFC were lower than those of the CPZ group ［（0.84±0.09） vs （0.56±0.08）， （0.71±0.13） vs （0.37±0.05）］. The mRNA levels of Nrg1 Ⅲ and ErbB2 were lower than those of the CPZ group ［（0.70±0.33） vs （0.38±0.27）， （0.80±0.25） vs （0.42±0.41）］. The differences of all the above were statistically significant （P ＜ 0.05）. CNPase immunofluorescence staining showed that there were fewer CNPase oligodendrocytes in the PFC of mice in the CPZ group than in the control group and the CPZ+Ven group. Conclusions Venlafaxine can up-regulate the levels of CNPase and MBP protein and the mRNA levels of Nrg1 Ⅲ and ErbB2 in the PFC of CPZ mice，increase the number of oligodendrocytes，and alleviate depressionlike behaviors.

Abstract:Objective To explore the influencing factors of suicide and attempted suicide among rural residents in China and its relationship with their family environment. Methods In Kailu County， Inner Mongolia Autonomous Region， Meixian County， Shaanxi Province， Fengning County， Hebei Province and Chongzhou City， Sichuan Province， rural residents who committed suicide and attempted suicide from January 2008 to March 2011 were selected as suicide group （n=151） and attempted suicide group （n=118）， In 3 counties （except Fengning County， Hebei Province）， healthy residents were selected as health control group by stratified random sampling （n=140）. Demographic data of the 3 groups of cases were collected. Interviews were conducted to the subjects themselves （except the suicide group） and the insiders. The family environment of subjects was assessed with Family Intimacy and Adaptation Scale and Family Position and Housework Allocation Scale during the interviews. Logistic regression was used to analyze the influencing factors of suicide and attempted suicide among rural residents. Results Single factor analysis showed that the scores of family affairs decision， marital relationship， family intimacy， family adaptability in healthy control group were 3.5（1.3，5.3）， 11.0（10.0，11.9）， 61.3（57.0，65.5） and 53.0（49.9， 55.5）， respectively， all higher than those of suicide group 2.6（0， 4.7）， 10.0 （8.5， 11.0）， 56.0（50.6， 60.8） and 47.0（42.1， 50.9） and attempted suicide group 1.8 （0，4.4）， 10.0（8.5， 11.0）， 55.0（49.9， 60.5） and 47.0（42.0，50.5）. The differences were statistically significant （P＜ 0.01）. The results of binomial Logistic regression analysis showed that after controlling for variables such as gender， age， education level and mental illness， good family adaptability and good marital relationship were protective factors for suicide ［OR（95%CI）=0.12（0.04-0.37）， 0.11（0.03-0.36）］ and attempted suicide ［OR（95%CI）=0.08（0.03-0.22）， 0.13（0.04-0.41）］ （P＜ 0.05）. Conclusions Improving family environment can reduce the risk of suicide and suicide attempts among rural residents in China.

Abstract:Objective To explore the mechanism of valproate-induced autism-like behavior in Wistar mice based on bioinformatics technique. Methods A total of 4 SPF grade Wistar male mice （300-350 g） and 8 female mice （200-250 g） were selected. The female and male mice were caged overnight at a ratio of 2︰1 in 8-10 weeks. The female mice were intraperitoneally injected with 600 mg/kg valproate on the 12.5 days of pregnancy. The newborn mice were included in the valproate group. Open field test， elevated cross maze test， new object recognition test and bead embedding experiment were used to evaluate the success of the model at the 35th day after birth. Another 4 pregnant mice were randomly selected to inject the same amount of normal saline once， and the newborn mice were included in the healthy control group. GSE42904 data set was used to search for genes with different expressions in the brain tissues of mice receiving valproate and methylcellulose. Genetic ontology （GO）， Kyoto Encyclopedia of Genes and Genome （KEGG）， GO/KEGG （combined with LogFC） and Gene Set Enrichment Analysis （GSEA） were used for enrichment analysis of differential genes. Quantitative real-time polymerase chain lock reaction （Q-PCR） was used to verify the expression of differential genes in the brain tissue of model mice in valproate group. Finally， 14 young mice in the valproate group and 7 young mice in the healthy control group were included. Results Compared with the control group， the time of entering the central area and the number of body extensions decreased in the open field experiment， the recognition index decreased in the new object recognition experiment， and the number of buried beads increased in the bead embedding experiment， and all the differences were statistically significant （P ＜ 0.05）. In the elevated cross maze test， there was no statistically significant difference between the valproate group and the healthy control group in the number of times of entering the open arm and the total distance of movement （P＞0.05）， indicating successful modeling. According to the analysis of GSE42904 data set， there are 267 genes in line with | Log2 （FC） | ＞ 1 and P ＜ 0.05， and these differential genes are mainly concentrated in metabolic pathway. The differential genes glutathione S-transferase α 3（Gsta 3）， gamma-glutamyl transferase 7（Ggt 7） and glucose-6-phosphate dehydrogenase （G6pd） in the glutathione metabolic pathway were verified. It was found that there was no statistical significance in the difference in mRNA expressions between Gsta 3 and Ggt 7 （P＞ 0.05）. The mRNA expression level of G6pd gene in valproate group was significantly lower than that in healthy control group， and the difference was statistically significant （P＜ 0.05）. Conclusions There are differences in the expression of G6pd gene in the valproate rat model， and the change in the expression of G6pd gene may be a pathogenic factor of autism spectrum disorder.

Abstract:Childhood abuse and neglect may be the risk factors for psychosomatic diseases in adolescence or adulthood， which may be related to immune dysfunction， allostatic load， brain structure and function changes. This article reviews the relationship between childhood abuse and neglect and psychosomatic diseases

Abstract:Dysphagia mainly refers to the inability that food cannot be safely and efficiently delivered from mouth to stomach due to various reasons. Dysphagia caused by neurological disorders is called neurogenic dysphagia. Neurogenic dysphagia can lead to serious consequences such as malnutrition， aspiration pneumonia， psychological disorders and even death by asphyxiation. At present， the treatment of neurogenic dysphagia is mainly based on rehabilitation intervention. Among them， neurostimulation technology is a more widely used category in clinical practice. There are many categories of neurostimulation technology which can be selected， and there is no clear clinical guideline on how to choose the most appropriate treatment plan. This paper reviews the rehabilitation efficacy of four neurostimulation techniques which are commonly used in clinical practice in patients with neurogenic dysphagia， aiming to provide a reference of individualized rehabilitation measures for patients with neurogenic dysphagia.

Abstract:Depressive disorder is a chronic mental disorder characterized by low mood， decreased interest and anhedonia. As one of the important social environmental factors， childhood traumatic experience increases the risk of depression in the future. It is important to study the relationship and mechanism between childhood traumatic experience and depression for the prevention and treatment of depression. Inflammatory reaction disorder may be one of the biological mechanisms of childhood traumatic experience leading to depression. This article reviews the inflammatory mechanism between childhood trauma and depression.

Abstract:Neuronal intranuclear inclusion disease with mental disorder as the first symptom： a case report and literaure review