2016年 · 第32卷第03期

Acoustic neuroma is a benign tumor mainly originating from Schwann cells in the vestibular nerve sheath of the internal auditory tract^[1,2,3], also known as vestibular schwannoma, accounts for 6% to 9% of intracranial tumors and 80% to 90% of cerebellopontine angle tumors^[4,5]。 Because it is located in the internal auditory tract and cerebellopontine angle area, it gradually compresses the surrounding important tissues as the tumor grows, which can cause severe symptoms and even threaten the patient's life, so reasonable treatment strategies need to be adopted.

With the development of subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for the treatment of movement disorders such as Parkinson's disease (PD), essential tremor and dystonia, many patients have benefited from it and greatly improved their quality of life. More and more evidence shows that different partitions of STN have different functions, and stimulating different parts of STN will have different effects. In order to improve the surgical outcome and reduce surgical complications, the anatomical study of STN, especially the study of STN subdivisions and their functions, is particularly important. In this paper, the anatomical research status of STN is reviewed from the perspectives of gross anatomy, fiber connection, functional anatomy and imaging.

microRNA (miRNA) is a kind of endogenous non-coding small molecule RNA with a length of about 19-25 nt^[1]Widely involved in the regulatory activities after gene transcription. Among them, most miRNAs have high sequence conservation, expression timing and tissue specificity. MiRNAs usually target multiple mRNAs and regulate gene expression by inhibiting translation or degrading target mRNAs. Therefore, it determines the functional specificity of the cells and tissues to which it belongs. Mature miRNAs are usually transcribed by RNA polymerase II (RNA-polⅡ) into primary miRNAs (pri-miRNAs) with cap structure (7 mGpppG) and Poly A tail, and then treated by nuclease Drosha-DGCR8 complex into 70-100 nt precursor miRNAs (pre-miRNAs) with stem-loop structure^[2]Transported out of the nucleus with the help of the Exprotin-5 complex, cleaved into double-stranded miRNA by the nucleic acid cleavage enzyme Dicer enzyme in the cytoplasm, and two inhibitory gene expression occurred at the post-transcriptional level: one is double-stranded miRNA unwinding, in which a single strand completely complementary to the target mRNA is bound into an RNA-induced silencing complex (RISC), which is usually bound into the coding region or open reading frame of the mRNA, similar to the action of small interfering RNA (siRNA) to cleave and degrade the target mRNA and inhibit gene expression; The second is a miRNA that is not completely complementary to the target mRNA and usually binds to the 3 '-end untranslated regions (3' UTRs) of the mRNA^[3]and directs the RISC to degrade the target mRNA or repress the translation of the target mRNA according to different degrees of complementarity.

temporal lobe epilepsy (TLE) is a more common type of drug-resistant epilepsy treated by surgery. The main modes of surgical treatment include anterior temporal lobectomy and elective hippocampal amygdalectomy. In 49% to 83% of patients, the seizures were relieved after surgery^[1]。 Because the medial temporal lobe, including hippocampus, entorhinal cortex, parahippocampal gyrus and other structures are the functional areas of memory, the memory of patients after operation decreased significantly^[1]。 Long-term follow-up after surgery revealed that there was a dynamic process of this memory dysfunction^[2]。 Therefore, it is very important to predict the memory impairment caused by surgery before surgery. In recent years, functional magnetic resonance imaging (fMRI) has been actively used in this field. Because of the advantage of this method of non-invasive, there is a trend to replace Wada test^[3,4]。 Notably, there were obvious individual differences in memory function changes after surgery in patients with TLE^[5]And the types of memory dysfunction caused by surgery vary. The author summarizes the related studies in recent years to assess the changes of memory function after TLE, aiming to help clinicians deepen their understanding of TLE and improve the quality of preoperative assessment.

Interleukin-6 (IL-6) has a variety of functions in the body. Studies have shown that the content of IL-6 is increasing in some lesions of malformation of cortical development (MCD)^[1]Moreover, its content increases rapidly during seizures^[2]。 IL-6 may play an important role in the pathogenesis of MCD-induced epilepsy. This article reviews the relationship between IL-6 and IL-6.

Since Jannetta et al.^[1]Since microvascular decompression (MVD) was pioneered in the treatment of idiopathic hemifacial spasm (HFS), primary trigeminal neuralgia (TN), primary glossopharyngeal neuralgia (GN) and other cranial nerve diseases, clinical practice has proved that its curative effect is definite, and it has become the first choice surgical treatment method for related cranial nerve diseases^[1,2,3]。 Although this kind of cranial neurological disease often brings great pain to patients and even seriously affects their life and work, it is all non-fatal diseases. A basic principle of functional neurosurgery is to relieve the patient's pain without causing serious complications that are unacceptable to the patient. Once serious complications after MVD surgery occur, it is often difficult for patients to accept. Therefore, it is an eternal task for neurosurgeons performing MVD surgery to minimize the incidence of severe complications after surgery^[4]。 Postoperative intracranial hemorrhage is one of the most serious complications after MVD, and its incidence is about 1%^[5,6,7,8]It is also the leading cause of death from MVD. This article reviews the general situation, causes, related risk factors, prevention and treatment of intracranial hemorrhage after MVD and recent research progress.

Malignant glioma is the most common malignant tumor in the central nervous system, accounting for 41% ~50% of all intracranial tumors. Its incidence, recurrence and mortality are high, but the cure rate is low^[1]And is therefore one of the most difficult tumors to treat at present. About half of all glioma patients are glioblastoma, with a 1-year survival rate of only 30% and a 5-year survival rate of less than 5%^[2]。 Nowadays, the main treatment method used is surgical resection, but surgery is often difficult to completely remove, and it is prone to recurrence after surgery. Although the combined chemoradiotherapy has achieved some efficacy in the treatment of glioma, the effect is still not good. How to improve the therapeutic effect of glioma is still a big problem in the clinical treatment of glioma.

From February 1 to 4, 2016, the 12th International Neurotrauma Congress, sponsored by the International Neurotrauma Association and co-organized by six academic groups and institutions including J Neurotrauma, was held at the Cape Town International Convention Center in Cape Town, South Africa. Nearly 1,300 delegates from 34 countries around the world registered to attend the conference. World-renowned experts in the field of neurotrauma, including Professor Buki, currently president of the International Neurotrauma Society and director of neurosurgery at Budapest Hospital in Hungary, Professor Unterberg, former president of the International Neurotrauma Society and Professor of Neurosurgery at Heidelberg University in Germany, and Professor Hovda, former president of the International Neurotrauma Society, attended the conference. The delegation of the Neurological Injury Training Committee of Chinese Medical Doctors Association attended the meeting as the only invited academic group in China, with Chairman Liu Baiyun as the head of the delegation, and organized 13 members from all over the country to attend the meeting.