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Glioma stem cell (GSC)-derived extracellular vesicles (EVs) can mediate the communication between GSCs and microglia. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) expression in GSCs, EVs, and supernatant was detected by real-time PCR. The direct targeting between MALAT1 and miR-129-5p, miR-129-5p, and HMGB1 were tested with luciferase reporter analysis. The expression and secretion of interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α were determined in lipopolysaccharide-stimulated microglia or miR-129-5p inhibitor transferred to microglia exposed to GSC EVs or EVs derived from siMALAT1 pre-transferred GSCs. MALAT1 was enriched in GSC EVs compared with GSCs, and up-regulated MALAT1 was also observed in microglia upon GSC EVs incubation. The relative expression and secretion of IL-6, IL-8, and TNF-α in lipopolysaccharide-stimulated microglia were up-regulated in the GSC supernatant group, which could be reversed by dimethyl amiloride (DMA) (EV secretion inhibitor) co-administration or si-MALAT1 pre-transfection of GSCs. Luciferase reporter assay testified the direct binding of MALAT1 and miR-129-5p, miR-129-5p, and HMGB1, and si-MALAT1 could up-regulate miR-129-5p expression and down-regulate HMGB1 expression in microglia cells. The concentration of IL-6, IL-8, and TNF-α in lipopolysaccharide-stimulated microglia exposed to EVs from siMALAT1 transfected GSCs could be up-regulated by miR-129-5p inhibition. EVs lncRNA MALAT1 released from GSCs could modulate the inflammatory response of microglia after lipopolysaccharide stimulation through regulating the miR-129-5p/HMGB1 axis.

We evaluated the efficacy and administration time of intraventricular (IVT) polymyxin B in the treatment of carbapenem-resistant and multidrug-resistant/extensively drug-resistant (MDR/XDR) Gram-negative bacilli in central nervous system (CNS) infections and investigated prognostic factors. This retrospective analysis comprised 41 post-surgical carbapenem-resistant CNS infections from October 2016 to October 2021. All patients were treated with effective intravenous antibiotics and IVT polymyxin B. Patient characteristics, therapeutic procedure, symptoms, cerebrospinal fluid (CSF) examination, laboratory tests, and complications were recorded. The effectiveness of IVT polymyxin B was evaluated using temperature, Glasgow Coma Scale, CSF contents, bacterial clearance rate, cure rate, and mortality. Mortality between early (7 days) and late administration of IVT polymyxin B was compared. Prognostic factors were evaluated using the pupillary light reflex and multiloculated hydrocephalus. The 41 patients acquired carbapenem-resistant MDR/XDR bacteria, including 24 , 15 , 3 , and 1 . The bacterial clearance rate was 32/41 (78.0%), and 9 patients (22.0%) with uncured bacterial infections died. Adverse events included 1 case of skin pigmentation. Among the 32 cured patients, 31 received a ventriculoperitoneal shunt, and 1 patient had an extraventricular drainage tube removed. Mortality in the late (>7 days) group was higher (39.1% vs 0%, P < 0.05). The group without pupillary light reflex showed a higher death rate (41.2% vs 8.3%; P < 0.05). The multiloculated hydrocephalus group had a higher mortality rate than that of the normal group (34.8% vs 5.6%, P < 0.05). All 32 cured patients were followed up for 9 to 66 months, and all survived without recurrent infections. Intraventricular polymyxin B is an effective treatment for carbapenem-resistant MDR/XDR Gram-negative bacilli, with a 78% cure rate and significant mortality reduction if administered within 7 days of bacterial identification. Multiloculated hydrocephalus and the pupillary light reflex may be used as prognostic indicators of mortality.

To investigate the clinical effect of ventricular polymyxin B supplemented by continuous external ventricular drainage in the treatment of intracranial infection with multidrug-resistant (MDR) or extensively drug-resistant (XDR) Gram-negative (G-) bacilli following neurosurgery. A retrospective analysis was performed on 28 patients who had G-bacilli intracranial infection following neurosurgery in our department between January 2017 and December 2019. The patients were treated with intraventricular polymyxin B supplemented by continuous external ventricular drainage. The clinical characteristics, treatment process, cerebrospinal-fluid-related indicators, results and prognosis were analysed. All of 28 patients developed an infection subsequent to neurosurgery, and cerebrospinal fluid (CSF) cultures demonstrated MDR/XDR G- bacilli, including in 14 cases, in 9 cases, in 3 cases, and in 2 cases. The ventricular drainage tube remained unobstructed in all patients during treatment, and intraventricular polymyxin B combined with intravenous antibiotics were administered each day. The duration of treatment with intraventricular polymyxin B was 14.96±4.28 days, and the time required to obtain a negative CSF culture was 8.23±4.02 days. The bacterial clearance rate from cerebrospinal fluid was 92.9% (26/28), and the clinical cure rate was 82.1% (23/28). Among them, 18 patients underwent ventriculoperitoneal shunt insertion for hydrocephalus 82.5 (59.5,114.75) days after the infection was cured, and the mortality rate was 17.6% (5/28). There was no significant change in patient blood creatinine levels before and after treatment. Cured patients were followed up for 4 months to 3 years, and no recurrences were observed. Treatment of intracranial infection with MDR/XDR G- bacilli using early intraventricular polymyxin B supplemented by continuous external ventricular drainage treatment may be a safe and effective treatment strategy.

Spinal cord hemangioblastomas are rare benign tumors, with difficult surgical management and poor prognosis due to high vascularization. We aim to evaluate the diagnostic methods and microsurgical treatment of spinal cord hemangioblastoma. This retrospective study assessed 25 patients treated for spinal hemangioblastoma using microsurgery at Beijing Tiantan Hospital and Department of Neurosurgery, The General Hospital of Chinese People’s Armed Police Forces, between October 2008 and October 2013. Clinical, imaging, and treatment data were collected. Meanwhile, efficacy was assessed with the McCormick grading system for spinal cord function. The symptoms lasted 17.0 ± 15.1 months. Sixteen (64 %) patients were suffering from von Hippel-Lindau disease; magnetic resonance imaging revealed the lesions in all patients. Intraoperative fluorescence angiography was helpful in identifying the feeding arteries and draining veins. Total tumor removal was achieved in all subjects. Patients were followed up for 21.3 ± 8.5 months. One week after surgery, neurological symptoms were improved in 22 patients, remained stable in 2 patients, and were aggravated in 1. The latter patient began to recover 7–10 days after surgery and was completely recovered within a month. At the last follow-up, all patients were alive, and all showed a McCormick grade ≤II. Microsurgery seems effective in the treatment of spinal cord hemangioblastoma. Intraoperative fluorescence angiography is helpful in defining the resection scope, to reduce intraoperative bleeding and prevent spinal swelling, which results in improved success rate.

ObjectivesTo predict cavernous sinus (CS) invasion by pituitary adenomas (PAs) pre-operatively using a radiomics method based on contrast-enhanced T1 (CE-T1) and T2-weighted magnetic resonance (MR) imaging.MethodsA total of 194 patients with Knosp grade two and three PAs (training set: n = 97; test set: n = 97) were enrolled in this retrospective study. From CE-T1 and T2 MR images, 2553 quantitative imaging features were extracted. To select the most informative features, least absolute shrinkage and selection operator (LASSO) was performed. Subsequently, a linear support vector machine (SVM) was used to fit the predictive model. Furthermore, a nomogram was constructed by incorporating clinico-radiological risk factors and radiomics signature, and the clinical usefulness of the nomogram was validated using decision curve analysis (DCA).ResultsThree imaging features were selected in the training set, based on which the radiomics model yielded area under the curve (AUC) values of 0.852 and 0.826 for the training and test sets. The nomogram based on the radiomics signature and the clinico-radiological risk factors yielded an AUC of 0.899 in the training set and 0.871 in the test set.ConclusionsThe nomogram developed in this study might aid neurosurgeons in the pre-operative prediction of CS invasion by Knosp grade two and three PAs, which might contribute to creating surgical strategies.Key Points• Pre-operative diagnosis of CS invasion by PAs might affect creating surgical strategies• MRI might help for diagnosis of CS invasion by PAs before surgery• Radiomics might improve the CS invasion detection by MR images.

Intraorbital meningoencephalocele is a rare manifestation of neurofibromatosis type 1 (NF1) caused by secondary changes in sphenoid dysplasia, and it seriously affects patients’ vision and facial appearance. We retrospectively analyzed the clinical data of 23 patients with NF1 and intraorbital meningoencephalocele, summarized the surgical strategies employed, and evaluated their clinical efficacy in order to better understand its management in clinical practice, establish a reasonable surgical strategy, and assess prognosis. Before surgery, 22 patients had unilateral pulsatile exophthalmos, 18 patients had significant visual impairment, and 13 patients had ptosis associated with an orbital plexiform neurofibroma (PNF). All 23 patients underwent microsurgical craniotomy with skull base reconstruction using a soft titanium mesh. One month after surgery, the degree of exophthalmos in the 22 (95.65%) patients was significantly reduced compared with before surgery (P < 0.001), and ocular pulsation had subsided. The visual acuity did not decrease significantly (P = 0.298) compared with before surgery. Eleven (47.83%) patients received phase-II eyelid PNF resection and/or oculoplastic surgery, and the degree of ptosis was significantly reduced (P < 0.001). There was no recurrence of pulsatile exophthalmos, displacement of titanium mesh, decreased visual acuity, or increased degree of ptosis noted during follow-up. The best strategy is to reconstruct the skull base under microscopy to relieve pulsating exophthalmos and preserve existing visual function. In cases of ptosis caused by an eyelid PNF, surgical resection should be performed as soon as possible to remove the tumor, and/or oculoplastic surgery should be performed to improve the cosmetic outcome.

Nitrogen (N) ammonification and nitrification are two primary microbial processes controlling the availability of soil ammonium (NH4+), a key nutrient for vegetative growth. The large‐scale patterns of gross ammonification (GA) and gross nitrification (GN) rates represent soil microbial adaptations to different vegetative and environmental conditions. In this study, we investigated GA and GN rates in nine forest soils along a 3,700‐km north–south transect in eastern China. We used 15N‐labelling techniques, along with field experiments and laboratory incubations, to assess in situ and potential rates of the GA and GN. The mean in situ GA rate was 4.9 ± 0.5 mg N kg−1 day−1, whereas the mean potential rate of GA was 32.0 ± 8.6 mg N kg−1 day−1. The mean in situ GN rate was 1.7 ± 0.3 mg N kg−1 day−1 (potential GN rate: 3.2 ± 0.6 mg N kg−1 day−1). GA was significantly higher than GN along the transect, and there were high variations in GA and GN among different forests. Significant relationships were identified between meteorological factors (temperature and precipitation) and the GA and GN rates during the sampling month (August 2013). However, the mean GA rate in primary forest was significantly lower in the Huzhong (HZ), Dongling (DL), Taiyue (TY) and Dinghu (DH) sites compared with other sites, whereas with the exception of the Liangshui (LS) sampling site, the mean GN rate in primary and secondary forests showed the same trends. Significant differences in GA rates were found between primary and secondary forests at the LS and Changbai (CB) sites, and differences were detected in GN rate at the HZ, LS and Jiulian (JL) sites. Structural equation modelling analysis suggested that soil N contents, microbial biomass N pool sizes and bacterial abundance are the primary determinants of the in situ rates of GA and GN. The strong control of edaphic factors on GA and GN indicates a need to improve soil N models with more explicit representation of edaphic factors and their control on soil N transformations. A plain language summary is available for this article. Plain Language Summary

Solar tracking systems are key components of solar thermal power plants that reflect sunlight onto a central receiver. The heliostat is a representative example of this system. They are typically deployed in flat, open areas and are therefore exposed to significant wind loads. During operation, heliostats continuously adjust their orientation to track the sun, which makes the mirror assembly and supporting structure susceptible to wind-induced fatigue. In this study, the sun-tracking kinematics of heliostats are combined with local meteorological measurements of wind direction and speed. This approach is used to investigate the fatigue response of the supporting structure under fluctuating wind loads at different elevation and azimuth angles. The fatigue characteristics of representative nodes under various operating conditions are summarized, providing a basis for engineering design.

Purpose Benign prostatic hyperplasia (BPH) is one of the most prevalent diseases affecting aging males. However, approximately, 8% of the BPH patients under 50-year-old experience remarkably early progression, for reasons that remain elusive. Among the various factors implicated in promoting BPH advancement, the activation of fibroblasts and autophagy hold particular importance. Our research endeavors to explore the mechanisms behind the accelerated progression in these patients. Methods Immunohistochemistry and immunofluorescence were performed to detect the expression levels of LC3, p62, PDE5, and α-SMA in diverse BPH tissues and prostate stromal cells. The autophagy activator rapamycin, the autophagy suppressor chloroquine, and siRNA transfection were used to identify the impact of autophagy on fibroblast activation. Results Prostatic stromal fibroblasts in early progressive BPH tissues displayed activation of autophagy with an upregulation of LC3 and a concurrent downregulation of p62. After starvation or rapamycin treatment to a heightened level of autophagy, fibroblasts exhibited activation. Conversely, chloroquine treatment and ATG-7-knockdown effectively suppressed the level of autophagy and fibroblast activation. High expression of PDE5 was found in early progressive BPH stromal cells. The administration of PDE5 inhibitors (PDE5Is) hindered fibroblast activation through suppressing autophagy by inhibiting the ERK signaling pathway. Conclusion Our findings suggest that autophagy plays a pivotal role in promoting BPH progression through fibroblast activation, while PDE5Is effectively suppress autophagy and fibroblast activation via the ERK signaling pathway. Nevertheless, further investigations are warranted to comprehensively elucidate the role of autophagy in BPH progression.

Trait‐based community analysis provides a new approach to integrate functional ecology with community ecology. However, our understanding of the linkages between root chemical traits and community chemical diversity and assembly is still in its infancy. Environmental filtering and niche differentiation are two opposite driving forces of community assembly based on deterministic niche processes. We hypothesize that environmental filtering is a strong driver of root chemical assembly at a large spatial scale, whereas biogeochemical niche differentiation drives root chemical traits divergence among co‐occurring species at site scale. We analysed the concentrations of 15 elements in the fine roots of 281 species across five forest types of China. Discriminant analysis was used to measure the degree of similarity of root chemical traits at the community level and biogeochemical niche differentiation at the species level. Root chemical traits at the community level showed a systematic shift along environmental gradients. The growth rate‐related dimension represented by root P and Ca was the most important niche dimension associated with community root chemical assembly, driven by large‐scale environmental filters, particularly soils and climate. Biogeochemical niche differentiation of co‐occurring species could be a consequence of reducing nutrient competition, especially the competition for nitrogen. Root chemical traits provide a new dimension for assessing the functional niche and may help improve our understanding of the underlying mechanisms of root chemical assembly from the local to the biome scale. A plain language summary is available for this article. Plain Language Summary