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Research 2024年第3期6卷 51-69页

作者： Jianan Lu Huaming Li Guoqiang Zhangi Fan Yangi Xiaotao Zhangi An Pingi Zhouhan Xui Yichen Gui Rui Wangi Dan Yingi Jianjian Liui Jianmin Zhangi Ligen Shi department of neurosurgery Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiangChina Clinical Research Center for neurological Diseases of Zhejiang Province HangzhouChina.

Immunosenescence refers to the multifaceted and profound alterations in the immune system brought about by aging,exerting complex influences on the pathophysiological processes of diseases that manifest upon *** a combination of single-cell RNA sequencing,cytometry by time of flight,and various immunological assays,we investigated the characteristics of immunosenescence in the peripheral blood of aged mice and its impact on the cerebral immune environment after ischemic *** results revealed some features of *** observed an increase in neutrophil counts,concurrent with accelerated neutrophil aging,characterized by altered expression of aging-associated markers like CD62L and consequential changes in neutrophil-mediated immune ***/macrophages in aged mice exhibited enhanced antigen-presentation capabilities.T cell profiles shifted from naive to effector or memory states,with a specific rise in T helper 1 cells and T helper 17 cells subpopulations and increased regulatory T cell activation in CD4 T ***,regulatory CD8 T cells marked by Klra decreased with aging,while a subpopulation of exhausted-like CD8 T cells expanded,retaining potent immunostimulatory and proinflammatory ***,these inherent disparities not only persisted but were further amplified within the ischemic hemispheres following *** summary,our comprehensive insights into the key attributes of peripheral immunosenescence provide a vital theoretical foundation for understanding not only ischemic strokes but also other age-associated diseases.

关键词： alterations retaining Impact

Model based on single-nucleotide polymorphism to discriminate aspirin resistance patients

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Stroke & Vascular Neurology 2024年第3期9卷 212-220,I0110-I0129页

作者： Qingyuan Liu Shuaiwei Guo Nuochuan Wang Kaiwen Wang Shaohua Mo Xiong Li Yanan Zhang Hongwei He Shuo Wang Jun Wu department of neurosurgery and China National Clinical Research Center for neurological Diseases Beijing Tiantan HospitalBeijingChina department of Blood Transfusion Beijing Tiantan HospitalBeijingChina department of neurosurgery Beijing Chao-Yang Hospital Capital Medical UniversityBeijingChina Beijing Neurosurgical institution Capital Medical UniversityBeijingChina

Background Aspirin is widely used for preventing ischaemic *** 20%–40%of patients have aspirin resistance(ASR),which prevents them from benefiting from aspirin *** study aimed to develop and validate a model based on single-nucleotide polymorphism(SNP)to distinguish ASR *** We included patients with spontaneous intracerebral haemorrhage and continuing antiplatelet therapy from a multicentre,prospective cohort study as the derivation ***(inhibition of arachidonic acid channeltherapy for unruptured intracranial aneurysm embolism were prospectively included in the validation *** embolism,30-day ischaemic events,including ischaemic stroke,new or more frequent transient ischaemic attack,stent thrombosis and cerebrovascular death,were *** The derivation cohort included 212 patients(155 male patients and the median age as 59).87(41.0%)individuals were identified with *** multivariate logistic analysis demonstrated six SNPs of GP1BA,TBXA2R,PTGS2 and NOS3 as risk factors related to *** ASR-CN score integrating these SNPs performed well to discriminate ASR patients from non-ASR patients(AUC as 0.77).Based on the validation cohort of 372 patients receiving antiplatelet therapy after embolism(including 130 ASR patients),the ASR-CN score continued to distinguish ASR patients with good accuracy(AUC as 0.80).Patients with high a ASR-CN score were more likely to suffer from 30-day ischaemic events after embolism(OR,1.28;95%CI,1.10 to 1.50;p=0.002).Conclusion GP1BA,TBXA2R,PTGS2 and NOS3 were SNPs related to *** ASR-CN score is an effective tool to discriminate ASR patients,which

关键词： patients aspirin resistance

Spi1 regulates the microglial/macrophage inflammatory response via the PI3K/AKT/mTOR signaling pathway after intracerebral hemorrhage

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Neural Regeneration Research 2024年第1期19卷 161-170页

作者： Guoqiang Zhang Jianan Lu Jingwei Zheng Shuhao Mei Huaming Li Xiaotao Zhang An Ping Shiqi Gao Yuanjian Fang Jun Yu department of neurosurgery The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiang ProvinceChina department of neurosurgery Huashan Hospital of Fudan University School of MedicineShanghaiChina Clinical Research Center for neurological Diseases of Zhejiang Province HangzhouZhejiang ProvinceChina Key Laboratory of Precise Treatment and Clinical Translational Research of neurological Diseases HangzhouZhejiang ProvinceChina

Preclinical and clinical studies have shown that microglia and macrophages participate in a multiphasic brain damage repair process following intracerebral *** E26 transformation-specific sequence-related transcription factor Spi1 regulates microglial/macrophage commitment and ***,the effect of Spi1 on intracerebral hemorrhage remains *** this study,we found that Spi1 may regulate recovery from the neuroinflammation and neurofunctional damage caused by intracerebral hemorrhage by modulating the microglial/macrophage *** showed that high Spi1expression in microglia/macrophages after intracerebral hemorrhage is associated with the activation of many pathways that promote phagocytosis,glycolysis,and autophagy,as well as debris clearance and sustained ***,microglia with higher levels of Soil expression were chara cterized by activation of pathways associated with a variety of hemorrhage-related cellular processes,such as complement activation,angiogenesis,and *** conclusion,our results suggest that Spi1 plays a vital role in the microglial/macrophage inflammatory response following intracerebral *** new insight into the regulation of Spi1 and its target genes may advance our understanding of neuroinflammation in intracerebral hemorrhage and provide therapeutic targets for patients with intracerebral hemorrhage.

关键词： intracerebral hemorrhage macrophage microglia neuroinflammation phagocytosis PI3K/AKT/mTOR signaling pathway Spi1 transcriptomics

Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation:a multi-institutional,retrospective study

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Stroke & Vascular Neurology 2024年第3期9卷 221-229,I0130,I0131页

作者： Chloe Dumot Georgios Mantziaris Sam Dayawansa Zhiyuan Xu Stylianos Pikis Selcuk Peker Yavuz Samanci Gokce D Ardor Ahmed M Nabeel Wael A Reda Sameh R Tawadros Khaled Abdelkarim Amr M N El-Shehaby Reem M Emad Eldin Ahmed H Elazzazi Nuria Martínez Moreno Roberto MartínezÁlvarez Roman Liscak Jaromir May David Mathieu Jean-Nicolas Tourigny Manjul Tripathi Akshay Rajput Narendra Kumar Rupinder Kaur Piero Picozzi Andrea Franzini Herwin Speckter Wenceslao Hernandez Anderson Brito Ronald E Warnick Juan Alzate Douglas Kondziolka Greg N Bowden Samir Patel Jason Sheehan department of neurological Surgery Hospices Civils de LyonLyonFrance department of neurological Surgery University of VirginiaCharlottesvilleVirginiaUSA department of neurosurgery Koc University School of MedicineIstanbulTurkey Gamma-knife Center Nasser institute HospitalCairoEgypt neurosurgery department Benha UniversityBenhaEgypt departments of neurosurgery Ain Shams UniversityCairoEgypt department of Clinical Oncology Ain Shams UniversityCairoEgypt department of Radiation Oncology National Cancer InstituteCairo UniversityGizaEgypt Faculty of Medicine Extended Modular ProgramAin Shams UniversityCairoEgypt department of Radiosurgery Rúber Internacional HospitalMadridSpain department of Stereotactic and Radiation neurosurgery Na Homolce HospitalPragueCzech Republic neurosurgery Centre de recherche du CHUSUniversitéde SherbrookeSherbrookeQuebecCanada neurosurgery PGIMERChandigarhChandigarhIndia Radiation therapy PGIMERChandigarhChandigarhIndia neurosurgery IRCCS Istituto Clinico HumanitasRozzanoMilanItaly Dominican Gamma Knife Center and Radiology department CEDIMATSanto DomingoDominican Republic Gamma Knife Center Mayfield ClinicThe Jewish Hospital-Mercy HealthCincinnatiOhioUSA neurosurgery NYU Langone HealthNew YorkNew YorkUSA neurosurgery University of AlbertaEdmontonAlbertaCanada Division of Radiation Oncology Department of OncologyUniversity of AlbertaEdmontonAlbertaCanada

Background Cerebral cavernous malformations(CCMs)frequently manifest with *** radiosurgery(SRS)has been employed for CCM not suitable for *** effect on reducing haemorrhage risk is still *** aim of this study was to expand on the safety and efficacy of SRS for haemorrhagic *** This retrospective multicentric study included CCM with at least one haemorrhage treated with single-session *** annual haemorrhagic rate(AHR)was calculated before and after *** event analysis and Cox regression were used to evaluate factors associated with *** radiation effects(AREs)and occurrence of new neurological deficits were *** The study included 381 patients (median age:37.5 years(Q1–Q3:25.8–51.9))with 414 *** AHR from diagnosis to SRS excluding the first haemorrhage was 11.08 per 100 CCM-years and was reduced to 2.7 per 100 CCM-years after *** recurrent event analysis,SRS,HR 0.27(95%CI 0.17 to 0.44),p13 Gy,HR 2.27(95%CI 1.20 to 4.32),p=0.012 and the presence of DVA,HR 2.08(95%CI 1.00 to 4.31),p=0.049 were factors associated with higher probability of post-SRS ***-SRS haemorrhage was symptomatic in 22 out of 381(5.8%)patients,presenting with transient(15/381)or permanent(7/381)neurological *** occurred in 11.1%(46/414)CCM and was responsible for transient neurological deficit in 3.9%(15/381)of the patients and permanent deficit in 1.1%(4/381)of the *** doses>13 Gy and CCM volume>0.7 cc were associated with increased risk of ARE.

关键词： doses haemorrhagic diagnosis

Transcranial direct current stimulation efficacy in trigeminal neuralgia

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World Journal of Clinical Cases 2024年第5期12卷 1036-1038页

作者： Theodoros Fasilis Stylianos Gatzonis Panayiotis Patrikelis Stefanos Korfias Athanasia Alexoudi 1^(st) department of neurosurgery National and Kapodistrian University of AthensAthens 10676Greece department of Neurology Neurological Institute of AthensAthens 10676Greece

Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health *** direct current stimulation is a non-invasive stimulation technique which finds new utility in managing ***-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.

关键词： Trigeminal neuralgia Patient-controlled intravenous analgesia Neuromodulation Transcranial direct current stimulation

Intra-arterial tenecteplase during thrombectomy for acute stroke(BRETIS-TNK II):rationale and design

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Stroke & Vascular Neurology 2024年第1期9卷 59-65页

作者： Zi-Ai Zhao Jing Qiu Wei Li Thanh Nguyen Shouchun Wang Huaizhang Shi Ming Wei Feng Wang Di Li Hui-Sheng Chen department of Neurology General Hospital of Northern Theater CommandShenyangLiaoning ProvinceChina Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA department of Neurology First Affiliated Hospital of Jilin UniversityChangchunJilinChina department of neurosurgery First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina department of neurosurgery Tianjin Huanhu HospitalTianjinTianjinChina department of Interventional therapy First Affiliated Hospital of Dalian Medical UniversityDalianChina neurological Intervention department Dalian Municipal Central HospitalDalianLiaoningChina

Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(AIS)patients with large-vessel occlusion(LVO).Aims To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom *** size estimates A maximum of 380 patients are required to test the superiority hypothesis with 80%power according to a two-side 0.05 level of significance,stratified by age,gender,baseline systolic blood pressure,prestroke modified Rankin Scale(mRS),baseline National Institute of Health stroke scale,baseline ASPECTS,time from onset to groin puncture,intravenous thrombolysis before EVT,stroke territory and stroke *** Intra-arterial TNK during thrombectomy for acute stroke(BRETIS-TNK II)study is a prospective,randomised,adaptive enrichment,open-label,blinded end point,multicentre *** AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:*** experimental group will be treated with intra-arterial infusion of TNK during *** control group will be treated with standard *** The primary end point is a favourable outcome,defined as an mRS score of 0–2 at 90 *** primary safety end point is symptomatic intracranial haemorrhage within 48 hours,which is defined as an increase in the National Institutes of Health Stroke Scale score of≥4 points as a result of the intracranial *** The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.

关键词： rational stratified TNK

Pipeline Embolization Device for intracranial aneurysms presenting with mass effect:a large Chinese cohort

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Stroke & Vascular Neurology 2024年第1期9卷 50-58页

作者： Yang Zhao Junlin Lu Hongqi Zhang Tianxiao LI Donglei Song Sheng Guan Aisha Maimaitili Yunyan Wang Wenfeng Feng Yang Wang Jieqing Wan Guohua Mao Huaizhang Shi Xinjian Yang Jianmin Liu Yuanli Zhao department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of neurosurgery Peking University International HospitalBeijingChina department of neurosurgery West China HospitalSichuan UniversityChengduSichuanChina department of neurosurgery Xuanwu HospitalCapital Medical UniversityBeijingChina department of Interventional Neuroradiology Zhengzhou University People's HospitalZhengzhouHenanChina department of neurosurgery Shanghai Donglei Brain HospitalShanghaiChina department of Interventional Neuroradiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina department of neurosurgery The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina department of neurosurgery Qilu Hospital of Shandong University QingdaoJinanShandongChina department of neurosurgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina department of neurosurgery The First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina department of neurosurgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina department of neurosurgery The Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina department of neurosurgery The First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina department of neurosurgery Changhai HospitalNaval Medical UniversityShanghaiChina

Background Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding,relieves symptoms and improve the quality of life for *** study aimed to assess the safety and efficacy of Pipeline Embolization Device(PED,Covidien/Medtronic,Irvine,CA)treatment for intracranial aneurysms presenting with mass effect in real-world *** We selected patients from the PED in China Post-Market Multi-Center Registry Study with mass effect *** study endpoints included postoperative mass effect deterioration and mass effect relief at follow-up(3–36 months).We conducted multivariate analysis to identify factors associated with mass effect *** analyses by aneurysm location,size and form were also *** This study included 218 patients with a mean age of 54.3±11.8 years and a female predominance of 74.0%(162/218).The postoperative mass effect deterioration rate was 9.6%(21/218).During a median follow-up period of 8.4 months,the mass effect relief rate was 71.6%(156/218).Notably,immediate aneurysm occlusion following treatment was significantly associated with mass effect relief(OR 0.392,95%CI,0.170 to 0.907,p=0.029).Subgroup analysis demonstrated that adjunctive coiling contributed to mass effect relief in cavernous aneurysms,while dense embolism impeded symptom relief in aneurysmsendovascular treatment to alleviate mass effect in unruptured intracranial *** registration number NCT03831672.

关键词： aneurysm intracranial Irvine

Surgical timing and long-term outcomes in patients with severe haemorrhagic spinal cord cavernous malformations

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Stroke & Vascular Neurology 2024年第4期9卷 439-445页

作者： An Tian Ziwei Cui Jian Ren Yeqing Ren Ming Ye Guilin Li Chuan He Xiaoyu Li Gao Zeng Peng Hu Yongjie Ma Jiaxing Yu Jingwei Li Lisong Bian Fan Yang Qianwen Li Feng Ling Tao Hong Liyong Sun Hongqi Zhang department of neurosurgery Xuanwu Hospital Capital Medical UniversityBeijingChina department of neurosurgery Beijing Haidian HospitalBeijingChina department of neurosurgery United Family HealthcareBeijingChina department of Radiology Xuanwu Hospital Capital Medical UniversityBeijingChina

Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations(SCCMs)to eliminate the occupation and associated subsequent lifelong haemorrhagic ***,the timing of surgical intervention remains controversial,especially for patients in the acute stage after severe *** Patients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively *** Modified McCormick Scale(MMS)was used to evaluate neurological and disability *** medical information was reviewed,and all patients were followed up for at least 6 *** A total of 279 patients were ultimately *** regard to long-term outcomes,110(39.4%)patients improved,159(57.0%)remained unchanged and 10(3.6%)*** patients with an MMS score of 2–5 on admission,in univariate and multivariate analyses,a≤6 weeks period between onset and surgery(adjusted OR 3.211,95%CI 1.504 to 6.856,p=0.003)was a significant predictor of improved *** 69 patients who first presented with severe haemorrhage,undergoing surgery within 6 weeks of the onset of severe haemorrhage(adjusted OR 4.901,95%CI 1.126 to 21.325,p=0.034)was significantly associated with improvement of MMS *** Surgical timing can influence the long-term outcome of *** patients with symptomatic SCCMs,especially those with severe haemorrhage,early surgical intervention within 6 weeks can provide more benefit.

关键词： patients Surgical haemorrhagic

Naoxueshu Oral Liquid Accelerates Post-Craniotomy Hematoma Absorption in Patients:An Open-Label,Multicenter,and Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2024年第8期30卷 675-683页

作者： HE Qiu LIN Fu-xin SU Jin-ye ZHUO Ling-yun ZHU Qing SUN Xiao-chuan JIANG Rong-cai YAO Zhi-gang WANG Lei DANG Yan-wei LIU De-zhong LIU Yang FANG Wen-hua WANG Fang-yu LIN Yuan-xiang WANG An-xin WANG Deng-liang KANG De-zhi department of neurosurgery Neurosurgery Research InstituteThe First Affiliated Hospital of Fujian Medical UniversityFuzhou350004China department of neurosurgery Binhai Branch of National Regional Medical CenterThe First Affiliated HospitalFujian Medical UniversityFuzhou350209China Clinical Research and Translation Center The First Affiliated Hospital of Fujian Medical UniversityFuzhou350004China Fujian Clinical Research Center for neurological Diseases The First Affiliated Hospital of Fujian Medical UniversityFuzhou350004China Fujian Provincial Institutes of Brain Disorders and Brain Sciences The First Affiliated Hospital of Fujian Medical UniversityFuzhou350004China department of neurosurgery The Second Affiliated Hospital of Soochow UniversitySuzhouJiangsu Province215000China department of neurosurgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing400000China department of neurosurgery Tianjin Medical University General HospitalTianjin300000China department of neurosurgery The Third Hospital of ShijiazhuangShijiazhuang050000China department of neurosurgery The First College of Clinical Medical ScienceChina Three Gorges UniversityYichangHubei Province443000China department of neurosurgery Yichang Central People’s HospitalYichangHubei Province443000China department of neurosurgery Xiangyang No.1 People’s Hospital Affiliated to Hubei University of MedicineXiangfanHubei Province441100China department of neurosurgery Zhoukou Central HospitalZhoukouHenan Province466000China department of neurosurgery The Third Hospital of MianyangMianyangSichuan Province621000China department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijing100000China China National Clinical Research Center for neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijing100000China department of Clinical Epidemiology and Clinical Trial Capital Medical UniversityBeijing100000China Beijing Municipal Key Laboratory of Clinical

Objective: To investigate whether Naoxueshu Oral Liquid(NXS) could promote hematoma absorption in post-craniotomy hematoma(PCH) patients. Methods: This is an open-label, multicenter, and randomized controlled trial conducted at 9 hospitals in China. Patients aged 18–80 years with post-craniotomy supratentorial hematoma volume ranging from 10 to 30 mL or post-craniotomy infratentorial hematoma volume less than 10 mL, or intraventricular hemorrhage following cranial surgery were enrolled. They were randomly assigned at a 1:1 ratio to the NXS(10 m L thrice daily for 15 days) or control groups using a randomization code table. Standard medical care was administered in both groups. The primary outcome was the percentage reduction in hematoma volume from day 1 to day 15. The secondary outcomes included the percentage reduction in hematoma volume from day 1 to day 7, the absolute reduction in hematoma volume from day 1 to day 7 and 15, and the change in neurological function from day 1 to day 7 and 15. The safety was closely monitored throughout the study. Moreover, subgroup analysis was performed based on age, gender, history of diabetes, and etiology of intracerebral hemorrhage(ICH). Results: A total of 120 patients were enrolled and randomly assigned between March 30, 2018 and April 15, 2020. One patient was lost to follow-up in the control group. Finally, there were 119 patients(60 in the NXS group and 59 in the control group) included in the analysis. In the full analysis set(FAS) analysis, the NXS group had a greater percentage reduction in hematoma volume from day 1 to day 15 than the control group [median(Q1, Q3): 85%(71%, 97%) vs. 76%(53%, 93%), P0.05). Furthermore, no adverse events were reported during the study. In the FAS analysis, the NXS group exhibited a higher percentage reduction in hematoma volume on day 15 in the following subgroups:

关键词： post-craniotomy hematoma Naoxueshu Oral Liquid hematoma absorption randomized controlled trial Chinese medicine