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endovascular treatment for acute ischaemic stroke due to medium vessel occlusion:data from ANGEL-ACT registry

Stroke & Vascular Neurology 2023年第1期8卷 51-58页

作者： Dapeng Sun Raynald Xiaochuan Huo Baixue Jia Xu Tong Anxin Wang Gaoting Ma Ning Ma Feng Gao Dapeng Mo Zhongrong Miao 无 department of Interventional Neuroradiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of neurosurgery Beijing Fengtai You anmen HospitalBeijingChina China National Clinical Research Center for neurological Diseases Beijing Tiantan HospitalBeijingChina on behalf of the ANGEL-ACT Study Group

Objectives To investigate the safety and efficacy of endovascular treatment(EVT)for acute medium vessel occlusion(MeVO)in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such *** Data from ANGEL-ACT Registry were analysed in our *** outcomes,such as the modified Rankin Scale(mRS)at 90 days,successful recanalisation rate and symptomatic intracranial haemorrhage(SICH)rate,were compared between MeVO and acute large vessel occlusions(LVO).Then,the independent predictors of the good outcome at 90 days in MeVO patients were determined by the logistic regression *** We included 1032 subjects in the analysis,of which,147 were MeVO and 885 were *** at 90 days distribution(3(0-4)vs 3(0-5),common odds ratio(OR)=1.00,95%confidence interval(CI)0.73 to 1.38,p=0.994),SICH rate(4.8%vs 8.9%;OR=0.59,95%CI 0.26 to 1.34,p=0.205)and successful recanalisation rate(89.8%vs 89.7%;OR=1.0095%CI 0.51 to 1.93,p=0.992)were similar between the MeVO and LVO groups after adjusting for the *** identified that baseline neutrophil-to lymphocyte ratio≤4.1(OR=2.13,95%CI 1.14 to 3.99,p=0.019),baseline National Institutes of Health Stroke Scale≤14(OR=1.96,95%CI 1.02 to 3.80,p=0.045)and mechanical thrombectomy passes≤1(OR=2.16,95%CI 1.14 to 4.11,p=0.021)were independent predictors of the 90-day good outcome in MeVO patients undergoing *** Patients with MeVO achieved similar 90-day mRS,SICH rate and successful recanalisation rate after EVT compared with patients with *** independent predictors of 90-day good outcome in MeVO patients undergoing EVT were determined,which should be highly considered in MeVO stroke management.

关键词： acute occlusion treatment

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Development of localized interictal epileptiform discharges following vagus nerve stimulation for lennox-gastaut syndrome: a case report

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Acta Epileptologica 2022年第4期5卷 286-291页

作者： Renli Qi Wei Wang Yaoduan Xu Zongling Shen Xin Geng Na Li Jinghui Li Hualin Yu Second department of neurosurgery First Affiliated Hospital of Kunming Medical UniversityKunming650032China department of neurosurgery The Third People’s Hospital of Honghe PrefectureGejiu661000China department of Psychiatry First Affiliated Hospital of Kunming Medical UniversityKunming650032China Yunnan Provincial Clinical Research Center for neurological Disease Kunming650032China

Background Lennox-gastaut syndrome(LGS)is an epileptic encephalopathy often associated with behavioral and psychiatric *** nerve stimulation(VNS)has been approved effective for LGS *** resection is also an option for LGS patients with focal pathology,offering a high probability of seizure ***,it is challenging to accurately localize the seizure *** presentation The case presented here is a 19-year-old male with a 16-year history of epilepsy with comorbid severe cognitive and psychiatric *** was diagnosed with LGS due to generalized slow spike-wave discharges and multiple seizure *** was treated with VNS in 2017 at the age of *** that,the frequency of the short tonic seizures decreased from 4–5 times per day to 2–5 times per year,and the generalized tonic–clonic seizure pattern did not recur,which had a frequency of 2–4 times per month before the *** 2019,the generalized abnormal interictal epileptiform discharges changed to be localized in the right frontal–temporal lobe at the age of 17 years(2019).Conclusions This case report suggested that the generalized epileptiform discharges evolve into localized discharges after VNS treatment,which may help reveal the primary seizure focus for resection surgery in patients with LGS.

关键词： Vagus nerve stimulation Lennox-gastaut syndrome Epileptiform discharges

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Prognostic values of optic nerve sheath diameter for comatose patients with acute stroke:An observational study

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World Journal of Clinical Cases 2022年第33期10卷 12175-12183页

作者： Sha Zhu Chao Cheng Liu-Liu Wang Dian-Jiang Zhao Yuan-Li Zhao Xian-Zeng Liu department of Neurology Peking university international hospitalBeijing 102206China department of Radiology Peking University International HospitalBeijing 102206China department of Intensive Care Unit Peking University International HospitalBeijing 102206China department of neurosurgery China National Clinical Research Center for Neurological DiseasesBeijing Tiantan HospitalBeijing 100070China

BACKGROUND Optic nerve sheath diameter(ONSD)measurement is one of the non-invasive methods recommended for increased intracranial pressure(ICP)*** This study aimed to evaluate the roles of optic nerve sheath diameter(ONSD)and ONSD/eyeball transverse diameter(ETD)ratio in predicting prognosis of death in comatose patients with acute stroke during their *** A total of 67 comatose patients with acute stroke were retrospectively *** ONSD and ETD were measured by cranial computed tomography(CT)*** patients underwent cranial CT scan within 24 h after coma *** were divided into death group and survival group according to their survival status at *** differences of the ONSD and ONSD/ETD ratio between the two groups and their prognostic values were *** The ONSD and ONSD/ETD ratio were 6.07±0.72 mm and 0.27±0.03 in the comatose patients,*** ONSD was significantly greater in the death group than that in the survival group(6.32±0.67 mm vs 5.65±0.62 mm,t=4.078,P5.7 mm or the ONSD/ETD ratio was>*** indexes could be used as prognostic tools for comatose patients with acute *** ONSD/ETD ratio was more stable than the ONSD alone,which would be preferred in clinical practice.

关键词： Optic nerve sheath diameter Eyeball transverse diameter Coma Intracranial pressure Stroke Prognosis

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HOXA11-AS aggravates microglia-induced neuroinflammation after traumatic brain injury

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Neural Regeneration Research 2022年第5期17卷 1096-1105页

作者： Xiang-Long Li Bin Wang Fu-Bing Yang Li-Gang Chen Jian You department of neurosurgery the Affiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina Neurosurgical Clinical Research Center and Academician(Expert)Workstation of Sichuan Province LuzhouSichuan ProvinceChina Laboratory of neurological Diseases and Brain Functions the Affiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina

Long noncoding RNAs(lnc RNAs)participate in many pathophysiological processes after traumatic brain injury by mediating neuroinflammation and *** A11 antisense RNA(HOXA11-AS)is a member of the lnc RNA family that has been reported to participate in many inflammatory reactions;however,its role in traumatic brain injury remains *** this study,we established rat models of traumatic brain injury using a weight-drop hitting device and injected LV-HOXA11-AS into the right lateral ventricle 2 weeks before *** results revealed that overexpression of HOXA11-AS aggravated neurological deficits in traumatic brain injury rats,increased brain edema and apoptosis,promoted the secretion of proinflammatory factors interleukin-1β,interleukin-6,and tumor necrosis factorα,and promoted the activation of astrocytes and *** were treated with 100 ng/m L lipopolysaccharide for 24 hours to establish in vitro cell models,and then transfected with pc DNA-HOXA11-AS,mi R-124-3 p mimic,or *** results revealed that HOXA11-AS inhibited mi R-124-3 p expression and boosted MDK expression and TLR4-nuclear factor-κB pathway ***,lipopolysaccharide enhanced potent microglia-induced inflammatory responses in *** overexpression of mi R-124-3 p or downregulating MDK repressed microglial activation and the inflammatory response of ***,the mi R-124-3 p-mediated anti-inflammatory effects were reversed by *** findings suggest that HOXA11-AS can aggravate neuroinflammation after traumatic brain injury by modulating the mi R-124-3 p-MDK *** study was approved by the Animal Protection and Use Committee of Southwest Medical University(approval ***-2019-042)on February 4,2019.

关键词： astrocyte competitive endogenous RNA HOXA11-AS microglia midkine miR-124-3p neuroinflammation traumatic brain injury

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Roles of light transmission aggregometry and CYP2C19 genotype in predicting ischaemic complications during interventional therapy for intracranial aneurysms

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Stroke & Vascular Neurology 2023年第4期8卷 327-334页

作者： Yangyang Zhou Wenqiang Li Chao Wang Ruhang Xie Yongnan Zhu Qichen Peng Limin Zhang Hongqi Zhang Yuxiang Gu Shiqing Mu Jian Liu Xinjian Yang department of Interventional Neuroradiology Beijing Neurosurgical Institute and Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of neurosurgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina department of Clinical Diagnosis Laboratory Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of neurosurgery Xuanwu HospitalCapital Medical UniversityBeijingChina department of neurosurgery Huashan HospitalFudan UniversityShanghaiChina

Background and purpose Light transmission aggregometry(LTA)and CYP2C19 genotype analysis are commonly used to evaluate the antiplatelet effects of clopidogrel during the interventional treatment of intracranial *** aim of this study was to determine which test can predict ischaemic events during these *** Patient demographic information,imaging data,laboratory data and ischaemic complications were *** and CYP2C19 genotype results were compared,and multiple linear regression was performed to examine factors related to platelet *** regression analysis was performed to determine whether LTA and CYP2C19 could predict ischaemic complications and to identify other clinical risk *** operating characteristic curve analysis was conducted to calculate the cut-off value for predicting ischaemic complications.A subgroup analysis was also performed for different CYP2C19 genotype metabolisers,as well as for patients with flow diverters and traditional *** A total of 379 patients were included,of which 22 developed ischaemic *** platelet aggregation induced by ADP(ADP-MPA)could predict ischaemic events(p10 years(p=0.022)were independent risk factors for ischaemic events,while the CYP2C19 genotype was not associated with ischaemic *** the subgroup analysis,ADP-MPA could predict ischaemic events in fast metabolisers(p=0.004)and intermediate metabolisers(p=0.003).The cut-off value for ischaemic events was lower in patients with flow diverters(ADP-MPA=36.4%)than in patients with traditional stents(ADP-MPA=42.9%).Conclusions ADP-MPA can predict ischaemic complications during endovascular treatment of intracranial *** with flow diverters require stronger antiplatelet medication than patients with traditional stents.

关键词： CYP2C19 ischaemic intracranial

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Individualized treatment of ruptured intracranial aneurysms by microsurgical clipping and endovascular coiling： results from a consecutive series of 212 patients

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Chinese Medical Journal 2012年第19期125卷 3584-3586页

作者： LIU Bing WEI Wei WANG Yong-li YANG Xin-yu ZHU Tao YUE Shu-yuan ZHANG Jian-ning department of neurosurgery Tianjin Medical University General HospitalTianjin Neurological InstitutionTianjin 300052China

Subarachnoid hemorrhage （SAH） is a subtype of stroke that is most commonly caused by the rupture of intracranial aneurysm. endovascular occlusion of intracranial aneurysms has emerged as an alternative to the established microsurgical clipping, The decision process when choosing a treatment for ruptured intracranial aneurysm should comprise an algorithm that was based on the characteristics of the aneurysm and patient status, age, and neurological condition, rather than a blanket assumption that one modality is superior to another.

关键词： intracranial aneurysm clipping coiling subarachnoid hemorrhage

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A three-dimensional matrix system containing melatonin and neural stem cells repairs damage from traumatic brain injury in rats

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Neural Regeneration Research 2022年第11期17卷 2512-2517页

作者： Xuan-Yu Fang Da-Wei Zhao Chao Zhang Hong-Fei Ge Xu-Yang Zhang Feng-Chun Zhao Yi-Bin Jiang Hua Feng Rong Hu department of neurosurgery and Key Laboratory of Neurotrauma Southwest HospitalArmy Medical UniversityChongqingChina

Brain lesions can cause neural stem cells to activate,proliferate,diffe rentiate,and migrate to the injured ***,after traumatic brain injury,brain tissue defects and microenvironment changes greatly affect the survival and growth of neural stem cells;the resulting reduction in the number of neural stem cells impedes effective repair of the injured *** can promote the survival,proliferation,and differentiation of neural stem cells under adverse conditions such as oxidative stress or hypoxia that can occur after traumatic brain ***,we investigated the therapeutic effects of melatonin combined with neural stem cells on traumatic brain injury in ***,in vitro studies confirmed that melatonin promoted the survival of neural stem cells deprived of oxygen and ***,we established a three-dimensional Matrigel-based transplantation system containing melatonin and neural stem cells and then used it to treat traumatic brain injury in *** found that treatment with the Matrigel system containing melatonin and neural stem cells decreased brain lesion volume,increased the number of surviving neuro ns,and improved recove ry of neurological function compared with treatment with Matrigel alone,neural stem cells alone,Matrigel and neural stem cells combined,and Matrigel and melatonin *** findings suggest that the three-dimensional Matrigelbased transplantation system containing melatonin and neural stem cells is a potential treatment for traumatic brain injury.

关键词： cell therapy magnetic resonance imaging Matrigel melatonin neural stem cells neurological function recovery three-dimensional transplantation traumatic brain injury

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Expression and Distribution Characteristics of Human Ortholog of Mammalian Enabled (hMena) in Glioma

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Chinese Journal of Cancer Research 2011年第4期23卷 312-316页

作者： Xue-tao Dong Xue-jun Yang Hua-min Wang Wei Wang Li Yu Bin Zhang Sheng-ping Yu Hao-lang Ming department of neurosurgery Tianjin Medical University General Hospital Tianjin Neurological Institute Tianjin 300052 China

Objective: To investigate the utility of hMena, a family of enabled/vasodilator-stimulated phosphoprotein (Ena/VASP), we sought to characterize the expression profile and distribution characteristics of hMena in a large panel of glioma samples and determine whether hMena expression levels might correlate with the pathological grade of glioma. Methods: Sixty-five specimens of glioma with different pathological grades and five control brain tissues were collected. In 6 of the 21 glioblastoma patients, multi-specimens were obtained respectively from the main tumor mass, the junction zone between the tumor and the normal tissue, and adjacent brain tissue 1.5 cm away from the tumor boundary under assistance of neuronavigation system during the operation. Immunohistochemistry was used to detect the expression and distribution characteristics of hMena. hMena expression was analyzed by Western blot in 20 specimens. Results: The hMena expression was negative in control brain tissue but positive in different grades of glioma. The expression rate of hMena was positively correlated with the increasing grade of the World Health Orgnization (WHO) classification (rs=0.682, P=0.000). hMena was located in cytoplasm. Positive cells only distributed around the vessels within the tumor mass in low grade glioma, while in high grade glioma, these cells were able to be detected not only in the tumor but also in the boundary zone and adjacent brain parenchyma. In the tumor mass, hMena expressed highly and diffusedly. In the junction zone, hMena positive cells formed radiolitic pattern around the vessels. In adjacent brain parenchyma, single positive cell was scattered. hMena expression was markedly elevated in Grade III and IV glioma compared with Grade II and I. Conclusion: Our data suggested that the expression of hMena is closely related to malignant grade of glioma. hMena can label the migrating cells, and indicate the migrating path of glioma cells from the tumor to adjacent tissue al

关键词： Glioma hMena Migration Immunohistochemistry

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PTPRZ1-METFUsion GENe(ZM-FUGEN)trial:study protocol for a multicentric,randomized,open-label phase II/III trial

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Chinese Neurosurgical Journal 2023年第4期9卷 315-319页

作者： Zhaoshi Bao Shouwei Li Liang Wang Bisi Zhang Peilong Zhang Hepeng Shi Xiaoguang Qiu Tao Jiang department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Chinese Glioma Genome Atlas Network(CGGA)and Asian Glioma Genome Atlas Network(AGGA) BeijingChina department of neurosurgery Sanbo Brain HospitalCapital Medical UniversityBeijing 100093China department of neurosurgery Tangdu HospitalFourth Military Medical UniversityXi’anChina Beijing Pearl Biotechnology Limited Liability Company BeijingChina department of Radio‑therapy Beijing Tiantan HospitalCapital Medical UniversityBeijing 100050China Beijing Neurosurgical Institute Capital Medical UniversityBeijing 100070China Center of Brain Tumor Beijing Institute for Brain DisordersBeijing 100069China China National Clinical Research Center for neurological Diseases Beijing 100050China

Background PTPRZ1-MET fusion was reported to associate with glioma progression from low-grade to high-grade glioma,which was a target by a MET inhibitor ***,little is known about the further efficacy of vebreltinib among more glioma *** trial aims to evaluate the safety and efficacy of vebreltinib enteric-coated capsules in the treatment of sGBM/IDH mutant glioblastoma patients with the ZM fusion *** This multicentric,randomized,open-label,controlled trial plans to include 19 neurosurgical centers and recruit 84 sGBM or IDH mutant glioblastoma patients with the ZM fusion *** trial enrolls sGBM or IDH mutant glioblastoma patients with the inclusion criteria and without the exclusion *** was registered with ***(CTR20181664).The primary efficacy endpoint is overall survival(OS).The secondary endpoints are progression-free survival(PFS)and objective response rate(ORR).Discussion If proven effective,this targeted multifaceted intervention protocol will be extended for more glioma patients as a protocol to evaluate the safety and efficacy of MET *** registration It was registered with ***(CTR20181664).

关键词： Glioblastoma IDH mutation PTPRZ1-MET Vebreltinib Phase II/III Clinical trial

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Cell cycle exit and neuronal differentiation 1-engineered embryonic neural stem cells enhance neuronal differentiation and neurobehavioral recovery after experimental traumatic brain injury

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Neural Regeneration Research 2022年第1期17卷 130-136页

作者： Ren Wang Dian-Xu Yang Ying-Liang Liu Jun Ding Yan Guo Wan-Hai Ding Heng-Li Tian Fang Yuan department of neurosurgery Shanghai Jiao Tong University Affiliated Sixth People’s HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina department of neurosurgery Shanghai Tenth People’s HospitalTongji UniversityShanghaiChina

Our previous study showed that cell cycle exit and neuronal differentiation 1(CEND1)may participate in neural stem cell cycle exit and oriented ***,whether CEND1-transfected neural stem cells can improve the prognosis of traumatic brain injury remained *** this study,we performed quantitative proteomic analysis and found that after traumatic brain injury,CEND1 expression was downregulated in mouse brain *** days after traumatic brain injury,we transplanted CEND1-transfected neural stem cells into the area surrounding the injury *** found that at 5 weeks after traumatic brain injury,transplantation of CEND1-transfected neural stem cells markedly alleviated brain atrophy and greatly improved neurological *** vivo and in vitro results indicate that CEND1 overexpression inhibited the proliferation of neural stem cells,but significantly promoted their neuronal ***,CEND1 overexpression reduced protein levels of Notch1 and cyclin D1,but increased levels of p21 in CEND1-transfected neural stem *** with CEND1-transfected neural stem cells was superior to similar treatment without CEND1 *** findings suggest that transplantation of CEND1-transfected neural stem cells is a promising cell therapy for traumatic brain *** study was approved by the Animal Ethics Committee of the School of Biomedical Engineering of Shanghai Jiao Tong University,China(approval No.2016034)on November 25,2016.

关键词： cell cycle exit and neuronal differentiation 1 cyclin D1 embryonic neural stem cells neuronal differentiation genetic engineering overexpression mice Notch1 p21 traumatic brain injury

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