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Burden of epilepsy in China and its provinces,1990 to 2019:findings from the Global Burden of Disease Study 2019

Chinese Medical Journal 2023年第3期136卷 305-312页

作者： Wei Liu Yangyang Xu Yicong Lin Lijun Wang Maigeng Zhou Peng Yin Guoguang Zhao National Center for Chronic and Non-Communicable Disease Control and Prevention Chinese Center for Disease Control and PreventionBeijing 100050China department of Neurology Xuanwu HospitalCapital Medical UniversityNational Center for Neurological DisordersBeijing 100053China department of neurosurgery Xuanwu HospitalCapital Medical UniversityNational Center for Neurological DisordersBeijing 100053China

Background: Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. Methods: We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. Results: In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92–1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33–133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03–98.74%) and 35.72% (95% UI: 0.47–86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43–5.66]/100,000), Qinghai (1.80 [95% UI: 1.15–2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88–1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39–0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44–0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41–0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. Conclusions: The disease burden of epilepsy is still heavy in China, especially in the wes

关键词： Aged Epilepsy Global Burden of disease Quality-adjusted life years Disability-adjusted life years Incidence Prevalence China

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Stereopure AIMer:A Promising RNA Base-editing Tool for Monogenic neurological Diseases

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Neuroscience Bulletin 2023年第2期39卷 353-355页

作者： Jingyu Yu Tianwen Li Kezhu Chen Qisheng Tang Jianhong Zhu department of neurosurgery Huashan HospitalShanghai Medical CollegeFudan UniversityNational Center for Neurological DisordersNational Key Laboratory for Medical NeurobiologyInstitutes of Brain ScienceShanghai Key Laboratory of Brain Function and RegenerationInstitute of NeurosurgeryMOE Frontiers Center for Brain ScienceShanghai 200000China

The continuous development of various gene therapies has brought new light to the treatment of genetic *** them,therapies targeting monogenic diseases are relatively progressive and promising due to the explicit and clear *** discovery and development of clustered regularly interspaced short palindromic repeats/associated nuclease(CRISPR/Cas)and related technologies was undoubtedly an extraordinary leap forward for gene therapy.

关键词： CRISPR/Cas Stereo doubt

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CCL17 exerts neuroprotection through activation of CCR4/mTORC2 axis in microglia after subarachnoid haemorrhage in rats

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Stroke & Vascular Neurology 2023年第1期8卷 4-16页

作者： Anke Zhang Yibo Liu Houshi Xu Zeyu Zhang Xiaoyu Wang Ling Yuan Cameron Lenahan Chuan Zhang Junkun Jiang Chaoyou Fang Yuanjian Fang Jianmin Zhang Sheng Chen department of neurosurgery Zhejiang University School of Medicine Second Affiliated HospitalHangzhouZhejiangChina Clinical Research Center for neurological Diseases of Zhejiang Province HangzhouZhejiangChina department of neurosurgery Shanghai General HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina department of Biomedical Sciences Burrell College of Osteopathic MedicineLas CrucesNew MexicoUSA department of Biology Tongji UniversityShanghaiChina

Background and purpose C-C motif chemokine ligand 17(CCL17)presents an important role in immune regulation,which is critical in the pathophysiology of brain injury after subarachnoid haemorrhage(SAH).There is rare evidence to illustrate the function of CCL17 towards *** this study,we try to reveal the therapeutic effects of CCL17 and its underlying mechanism in rat SAH *** SAH rat models were assigned to receive recombinant CCL17(rCCL17)or phosphate buffer saline(PBS).AZD2098 and JR-AB2-011 were applied to investigate the C-C motif chemokine receptor 4(CCR4)/mammalian target of rapamycin complex 2(mTORC2)axis in CCL17-mediated *** elucidate the underlying mechanism,the in vitro kinase assay was performed in primary ***-specific Rictor knockdown was administered via intracerebroventricular injection of adenovirus-associated *** water content,short-term neurobehavioural evaluation,western blot analysis,quantitative RT-PCR and histological staining were *** The expression of CCL17 was increased and secreted from neurons after oxyhaemoglobin *** rCCL17 significantly alleviated neuronal apoptosis,and alleviated short-term neurofunction after SAH in *** addition,rCCL17 increased M2-like polarisation of microglia in rats post-SAH and in primary microglia *** neuroprotection of rCCL17 was abolished via inhibition of either CCR4 or *** CCL17 activated the CCR4/mTORC2 axis in microglia,which can alleviate SAH-induced neurological deficits by promoting M2-like polarisation of microglia.

关键词： CCL17 CCR4 mTORC2

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Long-term functional outcomes improved with deep brain stimulation in patients with disorders of consciousness

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Stroke & Vascular Neurology 2023年第5期8卷 368-378页

作者： Yi Yang Qiheng He Yuanyuan Dang Xiaoyu Xia Xin Xu Xueling Chen Jizong Zhao Jianghong He department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Translational Medicine Center Chinese Institute for Brain ResearchBeijingChina Beijing Institute of Brain Disorders Capital Medical UniversityBeijingChina department of neurosurgery PLA General HospitalBeijingChina Academician Office China National Clinical Research Center for Neurological DiseasesBeijingChina

Background Deep brain stimulation(DBS)has been preliminarily applied to treat patients with disorders of consciousness(DoCs).The study aimed to determine whether DBS was effective for treating patients with DoC and identify factors related to patients’*** Data from 365 patients with DoCs who were consecutively admitted from 15 July 2011 to 31 December 2021 were retrospectively *** regression and subgroup analysis were performed to adjust for potential *** primary outcome was improvement in consciousness at 1 *** An overall improvement in consciousness at 1 year was achieved in 32.4%(12/37)of the DBS group compared with 4.3%(14/328)of the conservative *** full adjustment,DBS significantly improved consciousness at 1 year(adjusted OR 11.90,95%CI 3.65-38.46,p<0.001).There was a significant treatment×follow up interaction(H=14.99,p<0.001).DBS had significantly better effects in patients with minimally conscious state(MCS)compared with patients with vegetative state/unresponsive wakefulness syndrome(p for interaction<0.001).A nomogram based on age,state of consciousness,pathogeny and duration of DoCs indicated excellent predictive performance(c-index=0.882).Conclusions DBS was associated with better outcomes in patients with DoC,and the effect was likely to be significantly greater in patients with *** should be cautiously evaluated by nomogram preoperatively,and randomised controlled trials are still needed.

关键词： stimulation patients admitted

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Schisandrin B Inhibits NLRP3 Inflammasome Pathway and Attenuates Early Brain Injury in Rats of Subarachnoid Hemorrhage

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Chinese Journal of Integrative Medicine 2022年第7期28卷 594-602页

作者： CHEN Song DING Yi-hang SHI Song-sheng TU Xian-kun department of neurosurgery Fujian Medical University Union HospitalNeurosurgery Research Institute of Fujian ProvinceFuzhou 350001China

Objective: To determine whether Schisandrin B(Sch B) attenuates early brain injury(EBI) in rats with subarachnoid hemorrhage(SAH). Methods: Sprague-Dawley rats were divided into sham(sham operation), SAH, SAH+vehicle, and SAH+Sch B groups using a random number table. Rats underwent SAH by endovascular perforation and received Sch B(100 mg/kg) or normal saline after 2 and 12 h of SAH. SAH grading, neurological scores, brain water content, Evan’s blue extravasation, and terminal transferase-mediated dUTP nick end-labeling(TUNEL) staining were carried out 24 h after SAH. Immunofluorescent staining was performed to detect the expressions of ionized calcium binding adapter molecule 1(Iba-1) and myeloperoxidase(MPO) in the rat brain, while the expressions of B-cell lymphoma 2(Bcl-2), Bax, Caspase-3, nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3), apoptosis-associated specklike protein containing the caspase-1 activator domain(ASC), Caspase-1, interleukin(IL)-1β, and IL-18 in the rat brains were detected by Western blot. Results: Compared with the SAH group, Sch B significantly improved the neurological function, reduced brain water content, Evan’s blue content, and apoptotic cells number in the brain of rats(P<0.05 or P<0.01). Moreover, Sch B decreased SAH-induced expressions of Iba-1 and MPO(P<0.01). SAH caused the elevated expressions of Bax, Caspase-3, NLRP3, ASC, Caspase-1, IL-1β, and IL-18 in the rat brain(P<0.01), all of which were inhibited by Sch B(P<0.01). In addition, Sch B increased the Bcl-2 expression(P<0.01). Conclusion: Sch B attenuated SAH-induced EBI, which might be associated with the inhibition of neuroinflammation, neuronal apoptosis, and the NLRP3 inflammatory signaling pathway.

关键词： schisandrin B subarachnoid hemorrhage early brain injury inflammation neuronal apoptosis nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 Chinese medicine

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Y-shaped branched ventriculo-peritoneal shunt for adult multiloculated hydrocephalus

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Chinese Medical Journal 2022年第8期135卷 980-982页

作者： Xiaohui Ren Chuanwei Yang Xiangrong Li Yong Cui Yonggang Wang Dali Sui Zhongli Jiang Song Lin department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing Neurosurgical InstituteChina National Clinical Research Center for Neurological DiseasesCenter of Brain TumorBeijing Institute for Brain DisordersBeijing Key Brain Tumor LaboratoryBeijing 100070China School of neurosurgery Capital Medical UniversityBeijing 100069China

Multiloculated hydrocephalus(MLH)due to neurosurgical manipulation,hemorrhage,infection,or tumors is uncommon in adults and cannot be easily resolved by endoscopic fenestration or unilateral ventriculo-peritoneal shunt(VPS)and no consensus on surgical strategy for MLH has yet been *** goal of treatment is to restore communication between trapped ventricular compartments,[1]and current treatment methods include microsurgical fenestration of separate entrapments by endoscopy or craniotomy,shunt surgery with multiple catheters placed in trapped compartments,or combinations of these modalities.

关键词： shunt peritoneal manipulation

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Radiotherapy delays malignant transformation and prolongs survival in patients with IDH-mutant gliomas

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Cancer Biology & Medicine 2022年第10期19卷 1477-1486页

作者： Yanwei Liu Huiyuan Chen Guanzhang Li Jing Zhang Kun Yao Chenxing Wu Shouwei Li Xiaoguang Qiu department of Radiation Oncology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China National Clinical Research Center for neurological Diseases Beijing 100070China department of Neuropathology Beijing Neurosurgical InstituteCapital Medical UniversityBeijing 100070China department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China department of Neuropathology department of neurosurgery Sanbo Brain HospitalCapital Medical UniversityBeijing 100093China

Objective:IDH-mutant lower-grade gliomas(LGGs,grade 2 or 3)eventually transform into secondary grade 4 astrocytomas(sAIDHmut/G4).Here,we sought to describe the transformation time,risk factors,and outcomes in malignant transformation of IDHmutant ***:We screened data for 108 patients with sAIDHmut/G4 in the Chinese Glioma Genome Atlas who had initial IDH-mutant LGGs and underwent reoperation during 2005–*** evaluated the transformation time from IDH-mutant LGGs to sAIDHmut/G4,and associated risk factors and *** transformation was defined as pathological confirmation of grade 4 ***:The median age of the 108 patients with IDH-mutant LGGs was 35 years(range,19–54);the median age at transformation was 40 years(range,25–62);and the median follow-up time for all patients was 146 months(range,121–171).The average transformation time was 58.8 months for all patients with LGGs(range,5.9–208.1);63.5 and 51.9 months for grade 2 and 3 gliomas,respectively;and 58.4 and 78.1 months for IDH-mutant/1p/19q-non-codeleted astrocytomas and IDH-mutant/1p/19q-codeleted oligodendrogliomas,*** and multivariate analysis indicated that radiotherapy[hazard ratio(HR),0.29;95%confidence interval(CI),0.137–0.595;P=0.001]and non-A blood type(HR,0.37;95%CI,0.203–0.680;P=0.001)were protective factors against delayed malignant *** was associated with improved survival after transformation(HR,0.44;95%CI,0.241–0.803;P=0.008),overall survival(HR,0.50;95%CI,0.265–0.972;P=0.041),and progression-free survival(HR,0.25;95%CI,0.133–0.479;Ptherapy is associated with delayed malignant transformation and improved survival in patients with IDHmutant gliomas.

关键词： Lower-grade gliomas IDH mutation radiotherapy malignant transformation survival

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Sodium and water perturbations in patients who had an acute stroke:clinical relevance and management strategies for the neurologist

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Stroke & Vascular Neurology 2022年第3期7卷 258-266页

作者： Kevin C J Yuen Valerie Sharf Elizabeth Smith Minhwan Kim Alissya S M Yuen Paul R MacDonald departments of Neuroendocrinology and neurosurgery Barrow Neurological InstitutePhoenixArizonaUSA University of Arizona College of Medicine and Creighton School of Medicine PhoenixArizonaUSA department of Neurology Barrow Neurological InstitutePhoenixArizonaUSA Midwestern University GlendaleIllinoisUSA Creighton University School of Medicine PhoenixArizonaUSA University of California Davis DavisCaliforniaUSA

Sodium and water perturbations,manifesting as hyponatraemia and hypernatraemia,are common in patients who had an acute stroke,and are associated with worse outcomes and increased *** non-stroke related causes of sodium and water perturbations in these patients include underlying comorbidities and concomitant ***,hospitalised patients who had an acute stroke may receive excessive intravenous hypotonic solutions,have poor fluid intake due to impaired neurocognition and consciousness,may develop sepsis or are administered drugs(eg,mannitol);factors that can further alter serum sodium *** and water perturbations can also be exacerbated by the development of endocrine consequences after an acute stroke,including secondary adrenal insufficiency,syndrome of inappropriate antidiuretic hormone secretion and diabetes ***,COVID-19 infection has been reported to increase the risk of development of sodium and water perturbations that may further worsen the outcomes of patients who had an acute *** there are currently no accepted consensus guidelines on the management of sodium and water perturbations in patients who had an acute stroke,we conducted a systematic review of the literature published in English and in peer-reviewed journals between January 2000 and December 2020,according to PRISMA guidelines,to assess on the current knowledge and clinical practices of this *** this review,we discuss the signs and symptoms of hyponatraemia and hypernatraemia,the pathogenesis of hyponatraemia and hypernatraemia,their clinical relevance,and we provide our recommendations for effective treatment strategies for the neurologist in the management of sodium and water perturbations in commonly encountered aetiologies of patients who had an acute stroke.

关键词： patients impaired consequences

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Molecular diagnosis and treatment of meningiomas:an expert consensus(2022)

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Chinese Medical Journal 2022年第16期135卷 1894-1912页

作者： Jiaojao Deng Lingyang Hua Liuguan Bian Hong Chen Ligang Chen Hongwei Cheng Changwu Dou Dangmurenjiapu Geng Tao Hong Hongming Ji Yugang Jiang Qing Lan Gang Li Zhixiong Liu Songtao Qi Yan Qu Songsheng Shi Xiaochuan Sun Hajun Wang Yongping You Hualin Yu Shuyuan Yue Jianming Zhang Xiaohua Zhang Shuo Wang Ying Mao Ping Zhong Ye Gong Group of Neuro-Oncology Society of neurosurgery Chinese Medical Association department of neurosurgery Huashan HospitalFudan UniversityShanghai 200040China National Center for neurological Disorders Huashan HospitalFudan UniversityShanghai 200040China Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration Shanghai 200040China Neurosurgical Institute of Fudan University Shanghai 200040China Shanghai Clinical Medical Center of neurosurgery Shanghai 200040China department of neurosurgery Rujn HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China department of Pathology Huashan HospitalFudan UniversityShanghai 200040China department of neurosurgery The Affiliated Hospital of Southwest Medical UniversityLuzhouSichuan 646000China department of neurosurgery The First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui 230022China department of neurosurgery The Affiliated Hospital of Inner Mongolia Medical UniverstyHohoInner Mongolia 750306China department of neurosurgery The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjang 830011China department of neurosurgery The First Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006China department of neurosurgery Shanxi Medical Universty Shanxi Provincial People's HospitaTaiyuanShanxi 030012China department of neurosurgery The Second Xiangya HospitalCentral South UniversityChangshaHunan 410011China department of neurosurgery The Second Affiliated Hospital of Soochow UniversitySoochowJjangsu 215004China Deparment of neurosurgery Qiu HospitalCheeloo College of Medicine and Insttute of Brain and Brain-Inspired ScienceShandong University JinanShandong 25003China department of Neurosurger Xiangya HospitalCentral South UuniversitChangshaHunan 410008China department of neurosurgery Nanfang HospitalSouthern Medical UniverstyGuangzhouGuangdong 510515China department of neurosurgery Tangdu HospitalThe Fourth Miltay Medial UniverstXi'anShaanxi 710038China department of neurosurgery Fujian Medial University fliated Union H

Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical *** fifth edition of the WHO Classification of Tumors of the Central Nervous System(WHO CNS5),published in 2021,introduces major changes that advance the role of molecular diagnostics in *** follow the revision of WHO CNS5,this expert consensus statement was formed jointly by the Group of Neuro-Oncology,Society of neurosurgery,Chinese Medical Association together with neuropathologists and evidence-based *** consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients.

关键词： Clinical diagnosis Expert consensus Meningioma Molecular subtyping Therapeutic treatment

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Safety of endovascular therapy for symptomatic intracranial artery stenosis:a national prospective registry

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Stroke & Vascular Neurology 2022年第2期7卷 166-171页

作者： Yabing Wang Tao Wang Adam Andrew Dmytriw Kun Yang Liqun Jiao Huaizhang Shi Jie Lu Tianxiao Li Yujie Huang Zhenwei Zhao Wei Wu Jieqing Wan Qinjian Sun Bo Hong Yongli Li Liyong Zhang Jianfeng Chu Qiong Cheng Yiling Cai Pengfei Wang Qi Luo Hua Yang Baijing Dong Yang Zhang Jun Zhao Zuoquan Chen Wei Li Xiaoxin Bai Weiwen He Xueli Cai Maimai Ti Osama O Zaidat department of neurosurgery Xuanwu HospitalBeijingChina Neuroendovascular Program Massachusetts General HospitalBostonMassachusettsUSA department of Evidence-Based Medicine Xuanwu HospitalBeijingChina department of neurosurgery First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina department of Radiology Xuanwu HospitalBeijingChina Center of Neurointerventional therapy Henan Provincial People's HospitalZhengzhouChina department of Neurology Nanjing Drum Tower HospitalNanjingJiangsuChina department of neurosurgery Tangdu Hospital Fourth Military Medical UniversityXi'anShaanxiChina department of Neurology Shandong University Qilu HospitalJinanShandongChina department of neurosurgery Shanghai Jiao Tong University School of Medicine Affiliated Renji HospitalShanghaiShanghaiChina department of Neurology Shandong Provincial HospitalJinanShandongChina Neusurgery Changhai HospitalShanghaiChina department of neurosurgery Second Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina department of neurosurgery Liaocheng People's HospitalLiaocheng CityShandongChina department of neurosurgery Jining First People's HospitalJiningShandongChina department of Neurology Fujian Provincial HospitalFuzhouFujianChina department of Neurology 306 Hospital of People's Liberation ArmyBeijingChina department of neurosurgery Tianjin Huanhu HospitalTianjinTianjinChina department of neurosurgery Jilin University First HospitalChangchunJilinChina department of Neurology Affiliated Hospital of Guiyang Medical CollegeGuiyangGuizhouChina department of neurosurgery Fourth Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina department of neurosurgery Peking University First HospitalBeijingBeijingChina department of Neurology Liaocheng Second People's HospitalLiaochengChina department of Neurology Shanghai Tenth People's HospitalShanghaiChina department of neurosurgery Tianjin Medical University General HospitalTianjinTianjin

Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely *** Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis(CRTICAS)was a prospective,multicentre,real-world registry designed to assess these outcomes and the impact of centre *** 1140 severe,symptomatic intracranial arterial stenosis(ICAS)patients treated with endovascular therapy were included from 26 centres,further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years:(1)high volume for≥25 cases/year;(2)moderate volume for 10–25 cases/year and(3)low volume forendovascular treatment for symptomatic ***-uniform utilisation in endovascular technology,institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment.

关键词： intracranial prospective stenosis

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