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This study aimed to investigate the effects of G1-activated G protein-coupled estrogen receptor 1 (GPER1) on neurological impairments and neuroinflammation in traumatic brain injury (TBI) mice. The controlled cortical impingement (CCI) method was used to establish the TBI model. The mice were subjected to ovariectomy (OVX) for two weeks prior to modeling. GPER1 agonist G1 was administered by intracerebroventricular injection. Brain tissue water content was detected by wet/dry method, and blood-brain barrier damage was detected by Evans blue extravasation. The neurological impairments in mice were evaluated by open field test, Y-maze test, nest-building test, object location memory test and novel object recognition test. Ionized calcium-binding adapter molecule 1 (Iba1) staining was used to indicate the activation of microglia. Expression of M1/M2-type microglia markers and inflammatory factors were evaluated by ELISA and qRT-PCR. The G1 administration significantly reduced cerebral edema and Evans blue extravasation at injury ipsilateral cortex and basal ganglia in TBI mice. Activation of GPER1 by G1 improved the anxiety behavior and the cognitive dysfunction of mice induced by TBI. G1 administration significantly decreased Iba1-positive staining cells and the mRNA levels of CD86, macrophage cationic peptide 1 (Mcp-1), nitric oxide synthase 2 (Nos2), interleukin 1 beta (IL-1β), and macrophage inflammatory protein-2 (MIP-2), while increased the mRNA levels of interleukin 10 (IL-10), arginase1 (Arg-1) and CD206. Activation of GPER1 through G1 administration has the potential to ameliorate cognitive dysfunction induced by TBI in mice. It may also inhibit the activation of M1 microglia in cortical tissue resulting from TBI, while promoting the activation of M2 microglia and contributing to the regulation of inflammatory responses. [ABSTRACT FROM AUTHOR]

Intracranial chondrosarcoma is a rare tumor with limited reports. We reviewed the clinical outcomes, imaging findings, and pathological characteristics at three centers to improve the diagnosis and treatment of intracranial chondrosarcoma. We retrospectively analyzed 26 patients with intracranial chondrosarcoma who had undergone surgical treatment at Tangdu Hospital of Air Force Military Medical University, Mianyang Central Hospital, and Nanchong Central Hospital from January 2010 to July 2022. Clinical manifestations, imaging features, surgical treatment, prognosis, and overall survival (OS) were analyzed. All 26 chondrosarcomas were located at the skull base. Gross total resection (GTR), subtotal resection (STR), and partial resection (PR) were performed in 14, 10, and 2 cases, respectively. Four cases underwent endoscopic transnasal surgery, while the remaining cases underwent craniotomy. The clinical symptoms were evaluated 1 week after surgery, and 15 cases were relieved to varying degrees. Postoperative complications included pulmonary infection, subcutaneous hydrops, dysphagia and choking, facial numbness, abducens paralysis, and intracranial infection (ICI). Fifteen cases received postoperative adjuvant radiotherapy. Seven cases showed recurrence: two with PR, four with STR, and one with GTR. Six cases received reoperation or radiotherapy after tumor progression, and one untreated patient died 5 months after tumor recurrence. The extent of tumor resection (HR 21.74, 95% CI 1.25–376.6, P = 0.03) and pathological grading (HR 131.99, 95% CI 4.05–4300.5, P = 0.006) were associated with improved OS. We presented our experience in the treatment of intracranial chondrosarcoma at three centers in the past 12 years. Intracranial chondrosarcoma lacked typical imaging features and are difficult to differentiate from other skull base lesions. Maximum extent of tumor resection with minimal injury to neurological function remains the most important treatment strategy. The extent of surgical resection and pathological grading were found to be predictors for OS. [ABSTRACT FROM AUTHOR]

The incidence of unplanned reoperation after surgery during the same hospitalization is considered one of most important evaluation indicators for health care quality. The purpose of this study was to determine the incidence and risk factors related to unplanned reoperation after an endoscopic endonasal approach (EEA). All patients who underwent elective endoscopic endonasal surgery from January 2016 to December 2021 in the Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, were included. We identified the patients who underwent an unplanned reoperation and those who did not and divided them into two groups. The demographic data and risk factors were compared between the groups by univariate and multivariate logistic regression analyses. Of the 1783 patients undergoing EEA for various lesions of the skull base, the incidence of unplanned reoperation was 2.3%. The most common unplanned reoperations were repair of cerebrospinal fluid (CSF) leakage (39%), sellar hematoma evacuation (34.1%), hemostasis of epistaxis (14.6%) and external ventricular drainage for obstructive hydrocephalus (9.8%). The maximum diameter of tumor ≥ 3 cm (OR 2.654, CI 1.236–5.698; p = 0.012), meningioma (OR 4.198, CI 1.169–15.072; p = 0.028), craniopharyngioma (OR 5.020, CI 2.020–12.476; p = 0.001) and other sellar lesions (OR 4.336, CI 1.390–13.527; p = 0.012) and an operation time ≥ 240 min (OR 2.299, CI 1.170–4.518; p = 0.016) were the independent risk factors for unplanned reoperations in multivariate regression analysis. Of the 41 patients undergoing unplanned reoperation, 16 patients died, twenty-one patients had panhypopituitarism, 13 patients had transient and 6 had permanent diabetes insipidus, and 11 patients presented with intracranial infection and 6 of these patients were cured. By reviewing our department's data, we stated the incidence and risk factors for unplanned reoperation. It is important for the hospital administration and neurosurgeons to place more emphasis on these indicators. Furthermore, we suggest some effective quality improvement initiatives to reduce the incidence of unplanned reoperation. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical outcomes of large or giant vestibular schwannomas (VSs) between older patients and younger patients who underwent microsurgery and to explore whether the incidence of postoperative complications increased and whether the postoperative hospital stay was prolonged. Methods: We conducted a retrospective matched cohort study based on the surgical approach, maximum tumor diameter and extent of resection. Older patients (≥ 60 years) and a matched group (<60 years) who had undergone microsurgery for VSs between January 2015 and December 2021 were included. Clinical data, surgical outcomes and postoperative complications were analyzed statistically. Results: Forty-two older patients (≥ 60 years, 66.0 ± 3.8 years) were identified and matched to younger patients (<60 years, 43.9 ± 11.2 years), and they all underwent microsurgery through a retrosigmoid approach. There were twenty-nine patients with 3–4 cm VSs and thirteen patients with > 4 cm VSs in both groups. The older patients had a higher proportion of imbalance (P = 0.016) and lower American Society of Anesthesiology scores (P = 0.003) before surgery than the younger patients. There was no significant difference in facial nerve function one week (p = 0.851) and one year (p = 0.756) after surgery and no difference in the postoperative complication incidence (40.5% vs. 23.8%, p = 0.102) between the older patients and controls. Furthermore, the older patients had longer postoperative hospital stays than the younger patients (p = 0.043). In the older group, six patients with near total resection and five with subtotal resection were administered stereotactic radiotherapy, and one had recurrence three years after surgery and received conservative treatment. The postoperative follow-up time ranged from 1 to 83 months, with an average of 33.5 ± 21.1 months. Conclusions: For older patients (≥ 60 years) with symptomatic, large or giant -VSs, microsurgery is the only effective method to prolong lifespan, alleviate clinical symptoms and cure the tumor. However, radical resection of VSs may result in a decreased preservation rate of facial-acoustic nerve function and an increased postoperative complication incidence. Therefore, subtotal resection followed by stereotactic radiotherapy should be recommended. [ABSTRACT FROM AUTHOR]

Endoscopic endonasal transsphenoidal resection has been accepted as a routine therapy for pituitary adenoma, but the postoperative hospital stay is typically several days long. With the advantages of reduced cost and improved patient satisfaction, the application of ambulatory surgery (AS) has developed rapidly. However, AS was still rarely adopted in neurosurgery. Here we designed an AS treatment protocol for pituitary adenoma with the endoscopic endonasal approach (EEA), and reported our initial experiences regarding the safety and efficacy of the AS protocol. 63 patients who presented with pituitary adenoma were screened at the Department of Neurosurgery, Tangdu Hospital from July to September, 2017. A total of 20 pituitary adenoma patients who met the inclusion criteria underwent EEA surgery using this evidence-based AS protocol, which emphasized adequate assessment for eligibility, full preparation to minimize invasiveness, enhanced recovery, and active perioperative patient education. Of the 20 patients enrolled, 18 were discharged on the afternoon of the operation day with a median total length of stay (LOS) of 31 hours (range, 29–32) hours. The median LOS after surgery was 6.5 (range, 5–8) hours. Two patients were transferred from the AS protocol to conventional care due to intraoperative cerebrospinal fluid leakage (one case) and an unsatisfying post-anesthetic discharge score (one case). Complications included transient and reversible mild postoperative nausea and vomiting [visual analog scale (VAS) score <3], headache (VAS score <3) after the operation or early after discharge. No patient was readmitted. Our results supported the safety and efficacy of the AS protocol for pituitary adenoma patients undergoing EEA resection among eligible patients, and further evaluation of this protocol in controlled studies with a larger sample size is warranted. [ABSTRACT FROM AUTHOR]

An efficient synthesis of 1,2,5-trisubstituted benzimidazoles was explored under microwave irradiation. Twenty novel 1,2,5-trisubstituted benzimidazoles were prepared using K2CO3 as an acid-binging agent starting from 2-substituted benzimidazoles and 4-substituted benzyl chloride. This method revealed broad substrate adaptability and provided the target products in moderate to excellent yield within 15 min. The effect of different substituents on the yield was investigated under the obtained optimal reaction conditions. Besides, the crystal structure of compound 4c in the orthorhombic space group P 2ac 2ab was presented. Also, the antibacterial activity of the synthesized compounds against Mycobacterium smegmatis in vitro at the cellular level was evaluated using rifampicin as a positive control. Product 4s had the best antibacterial activity among the synthesized compounds and was superior to rifampicin. [ABSTRACT FROM AUTHOR]