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Individualised evaluation based on pathophysiology for moyamoya vasculopathy:application in surgical revascularisation

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Stroke & Vascular Neurology 2024年第3期9卷 268-278,I0241-I0246页

作者： Xin Zhang Yu Lei Jiabin Su Chao Gao Yanjiang Li Rui Feng Ding Xia Peng Gao Yuxiang Gu Ying Mao Department of Neurosurgery Huashan Hospital Fudan UniversityShanghaiChina Department of Radiology Huashan Hospital Fudan UniversityShanghaiChina

Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still *** study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV,and to assess its clinical *** This multicentre,prospective study enrolled adult patients with MMV from Huashan hospital,Fudan University and National Center for Neurological Disorders,China between March 2021 and February *** neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field,avoid invalid regions and propose alternative recipient *** recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological *** preanastomosis and postanastomosis data were compared with assist with the postoperative *** who received such tailored revascularisations were included in the novel group and the others were included in the traditional *** 30-day surgical outcomes and intermediate long-term follow-up were *** Totally 375 patients(145 patients in the novel group and 230 patients in the traditional group)were *** overall complication rate was significantly lower in the novel group(p˂0.001).In detail,both the rates of postoperative infarction(p=0.009)and hyperperfusion syndrome(p=0.010)were significantly *** functional outcomes trended to be more favourable in the novel group,though not significantly(p=0.260).Notably,the proportion of good functional status was higher in the novel group(p=0.009).Interestingly,the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications(P˂0.0001).Conclusions This novel evaluating system helps to identify appropriate surgical field and recipient arteries during b

关键词： surgical bypass metabolism

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Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第7期25卷 617-627页

作者： Xueqing YIN Xinzhong RUAN Yongmeng ZHU Yongfang YIN Rui HUANG Chao LIANG The First Affiliated hospital of Ningbo University Ningbo 315000China Ningbo Medical Center Lihuili hospital Ningbo 315000China

objectiveperitoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer *** enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification *** was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, *** DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

关键词： Gastric cancer Magnetic resonance Golden-angle radial sampling Nomogram model Peritoneal free cancer cells

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Sinonasal Polyposis: About 60 Cases at Fann University hospital Center, Senegal

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International Journal of otolaryngology and Head & Neck Surgery 2024年第1期13卷 53-61页

作者： Mame Sanou Diouf Moustapha Ndiaye Ahmadou Dembele Evelyne Siga Diom Ciré Ndiaye Amadou Thiam Richard E. A. Deguenonvo Abdou Sy Malick Ndiaye Abdourahmane Tall Issa Cheikh Ndiaye Raymond Diouf HoGIP hospital Center Dakar Senegal Fann University hospital Center Dakar Senegal ourossogui hospital Center Matam Senegal La Paix hospital Center Ziguinchor Senegal Children hospital Center of Diamniadio Dakar Senegal

Introduction: Sinonasal polyposis (SNP) is a chronic inflammatory disease of the mucosa of the nasal cavities and facial sinuses. It is characterized by an oedematous, multifocal and bilateral degeneration of the nasosinus mucosa, which originates in the lateral masses of the ethmoid, where it causes the formation of smooth, gelatinous, translucent and pyriform polyp lesions. The objective of this study was to review epidemiological, clinical, paraclinical data and evaluate the results of endoscopic surgical treatment. Patients and Methods: This is a retrospective study on 60 patients followed at the ENT department of the Fann National University hospital Center, from January 2010 to December 2015. All patients with sinonasal polyposis were included in the study. Results: The average age of our patients was 38 years and the sex ratio (M/F) was 0.8. In the patients’ histories, we found 18% asthma and 10% Widal’s disease. The average consultation time was 8.5 years. All patients had consulted for nasal obstruction;rhinorrhea was bilateral and found in 67.7% of cases, with olfactory disorders accounting for 50%. The CT scan performed in 58% of cases made it possible to specify the extent of the lesions;the involvement of the ethmoidal sinus was constant and extended to the other sinuses except in 2 cases. All patients had received medical treatment with local corticosteroids. Endoscopic surgical treatment was initiated in 43% of cases after failure of corticosteroid-based medical treatment. The evolution under treatment marked by the reappearance of symptoms that increased each month. At one month postoperatively, all clinical symptomatology had improved with the exception of olfactory disorders, which persisted in 3 patients. At 12 months we noted 12 cases of reappearance of nasal obstruction. Conclusion: SNP is a disease of little known etiology. The diagnosis is almost always clinical. Endoscopic surgery remains a recourse to medical treatment. For good local contro

关键词： Sinonasal Polyposis Endonasal Endoscopic Surgery CHNU Fann

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Effect of autologous bone marrow stem cells-scaffold transplantation on the ongoing pregnancy rate in intrauterine adhesion women:a randomized,controlled trial

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Science China(Life Sciences) 2024年第1期67卷 113-121页

作者： Hui Zhu Taishun Li Peizhen Xu Lijun Ding Xianghong Zhu Bin Wang Xiaoqiu Tang Juan Li Pengfeng Zhu Huiyan Wang Chenyan Dai Haixiang Sun Jianwu Dai Yali Hu Department of obstetrics and Gynecology Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210008China Department of Biostatistics Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210008China Department of Gynecology Changzhou Maternal and Child Health Care HospitalChangzhou Medical CenterNanjing Medical UniversityChangzhou 213004China Clinical Center for Stem Cell Research Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210008China Department of Hematology Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210008China Institute of Genetics and Developmental Biology Chinese Academy of SciencesBeijing 100190China

Intrauterine adhesion is a major cause of female reproductive *** we and others uncontrolled pilot studies showed that treatment with autologous bone marrow stem cells made a few patients with severe intrauterine adhesion obtain live birth,no large sample randomized controlled studies on this therapeutic strategy in such patients have been reported so *** verify if the therapy of autologous bone marrow stem cells-scaffold is superior to traditional treatment in moderate to severe intrauterine adhesion patients in increasing their ongoing pregnancy rate,we conducted this randomized controlled clinical *** 195 participants with moderate to severe intrauterine adhesion were screened and 152 of them were randomly assigned in a 1:1 ratio to either group with autologous bone marrow stem cells-scaffold plus Foley balloon catheter or group with only Foley balloon catheter(control group)from February 2016 to January *** per-protocol analysis included 140 participants:72 in bone marrow stem cells-scaffold group and 68 in control *** ongoing pregnancy occurred in 45/72(62.5%)participants in the bone marrow stem cells-scaffold group which was significantly higher than that in the control group(28/68,41.2%)(RR=1.52,95%CI 1.08–2.12,P=0.012).The situation was similar in live birth rate(bone marrow stem cells-scaffold group 56.9%(41/72)*** group 38.2%(26/68),RR=1.49,95%CI 1.04–2.14,P=0.027).Compared with control group,participants in bone marrow stem cells-scaffold group showed more menstrual blood volume in the 3rd and 6th cycles and maximal endometrial thickness in the 6th cycle after hysteroscopic *** incidence of mild placenta accrete was increased in bone marrow stem cells-scaffold group and no severe adverse effects were *** conclusion,transplantation of bone marrow stem cells-scaffold into uterine cavities of the participants with moderate to severe intrauterine adhesion increased their ongoing pregnancy and

关键词： intrauterine adhesion Asherman’s syndrome uterine infertility autologous bone marrow stem cells transplantation endometrial regeneration ongoing pregnancy rate

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Efficacy and Safety of Sanjie Analgesic Capsule in Patients with Endometriosis-Associated Pain:A Multicenter,3:1 Randomized,Double-Blind,Placebo-Controlled Trial

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Chinese Journal of Integrative Medicine 2024年第9期30卷 780-787页

作者： LENG Jin-hua DUAN Hua GUAN Zheng ZHoU Ying-fang QU Hong XU Kai-hong ZHANG Shao-fen ZHANG Qin WANG Xin LIN Kai-qing LANG Jing-he Department of obstetrics and Gynecology Peking Union Medical College HospitalBeijing100730China Department of Gynecology Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing100006China Department of Gynecology Chinese PLA General HospitalBeijing100039China Department of Gynecology Peking University First HospitalBeijing100034China Department of Gynecology Beijing Chao-yang HospitalBeijing100020China Department of Gynecology Womens Hospital School of Medicine Zhejiang UniversityHangzhouZhejiang Province310006China Department of Gynecology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai200090China Department of Gynecology Hangzhou Hospital of Traditional Chinese MedicineHangzhou310007China Department of Gynecology Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang110032China

objective:To assess the efficacy and safety of Sanjie Analgesic Capsule(SAC)in Chinese patients with endometriosis-associated ***:This was a multicenter,randomized,double-blind,placebo-controlled trial conducted at 15 centers between November 2013 and July 2017 in *** 323 patients with endometriosis were randomized at a 3:1 ratio to the SAC group(241 cases)and placebo group(82 cases)by stratified block *** in the SAC or placebo groups were given SAC or placebo 1.6 g 3 times per day,orally,respectively since the first day of menstruation for 3 consecutive menstrual *** primary endpoint was clinical response to dysmenorrhea evaluated using a 10-point Visual Analogue Scale at 3 and 6 *** secondary endpoint was the pain score evaluated by VAS(chronic pelvic pain,defecation pain,and dyspareunia)at 3 and 6 months,and the pain recurrence rate at 6 *** events(AEs)were recorded during the ***:A total of 241 women were included in the SAC group,and 82 were in the placebo *** these women,217(90.0%)and 71(86.6%)completed the intervention,*** 3 months,overall response rate(oRR)was significantly higher in women administered SAC(80.1%)compared with those who received a placebo(30.5%,Ponths after treatment,the oRR for dysmenorrhea was 62.7%in the SAC group and 31.7%in the placebo group(Ponic pelvic pain and defecation pain were significantly improved by SAC compared with placebo(both Pof total AEs events in the SAC and placebo groups were 6.6%and 9.8%,respectively,and no significant difference was shown between the two groups(P=0.339).Conclusion:SAC is well-tolerated and may improve dysmenorrhea in women with endometriosis-associated pain.

关键词： endometriosis pain Sanjie Analgesic Capsule randomized controlled trial Chinese medicine

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Thrombus migration in patients with acute ischaemic stroke undergoing endovascular thrombectomy

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Stroke & Vascular Neurology 2024年第2期9卷 126-133,I0006-I0395页

作者： ZeFeng Tan Lei Zhang Li'an Huang Hongyu Qiao Min Guan Bing Yang Pengfei Yang Yongwei Zhang Hongjian Shen Yu Zhou Bo Hong Huaizhang Shi Hongxing Han Xinyi Leng Yi Dong Changlin Lian Wenhuo Chen Anding Xu Jianmin Liu Neurology First People's Hospital of FoshanFoshanGuangdongChina Department of Neurology Jinan University First Affiliated HospitalGuangzhouGuangdongChina Neurovascular Center Changhai HospitalNaval Medical UniversityShanghaiChina Department of Neurosurgery First Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of Neurology Linyi People's HospitalLinyiShandongChina Medicine&Therapeutics The Chinese University of Hong KongHong KongChina Neurology Huashan Hospital Fudan UniversityShanghaiChina Neurology Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical UniversityZhangzhouFujianChina Stroke Center Jinan University First Affiliated HospitalGuangzhouGuangdongChina

objective The impact of thrombus migration(TM)prior to endovascular thrombectomy(EVT)on clinical outcomes and revascularisation rates remains *** aimed to examine whether preinterventional TM modifies the treatment effects of direct EVT versus bridging EVT in acute large vessel occlusion *** All patients undergoing catheter angiography in the Direct Intra-arterial thrombectomy in order to Revascularise acute ischaemic stroke patients with large vessel occlusion Efficiently in Chinese Tertiary hospitals:A Multicentre randomised clinical Trial were *** was determined by radiologists unaware of the study by analysing discrepancies between computed tomographic angiography at baseline and first-run digital subtraction angiography before *** primary outcome was the score on the modified Rankin scale(mRS)assessed at 90 *** of 627 included patients,the TM rate was 11.3%(71/627).In the multivariable logistic regression model,baseline National Institutes of Health Stroke Scale score(adjusted oR 0.956,95%CI 0.916 to 0.999;p=0.043)and intravenous thrombolysis(adjusted oR 2.614,95%CI 1.514 to 4.514;pociated with *** patients with TM were less likely to be completely recanalised than those without TM(21.27%vs 36.23%,p=0.040).The interaction of TM and the EVT treatment effect did not significantly affect mRS shift analysis(p=0.687)or mRS scores of 0 to 1(p=0.436).Conclusion Preinterventional TM does not modify the treatment effects of direct versus bridging EVT on functional outcomes in patients with acute ischaemic stroke with anterior large vessel *** leads to a lower complete recanalisation rate.

关键词： patients throm acute

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Effects of extracellular vesicle-derived noncoding RNAs on pre-metastatic niche and tumor progression

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Genes & Diseases 2024年第1期11卷 176-188页

作者： Zhuang Chen Qiming Wang Jinbo Liu Wenkang Wang Weitang Yuan Yang Liu Zhenqiang Sun Chengzeng Wang Department of Colorectal Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Academy of Medical Sciences of Zhengzhou University ZhengzhouHenan 450001China Department of Internal Medicine Affiliated Cancer Hospital of Zhengzhou UniversityHenan Cancer HospitalZhengzhouHenan 450008China Department of Breast Surgery The First Affliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Radiotherapy Affiliated Cancer Hospital of Zhengzhou UniversityHenan Cancer HospitalZhengzhouHenan 450008China The First Affiliated hospital of Zhengzhou University ZhengzhouHenan 450052China

A pre-metastatic niche(PMN)is a protective microenvironment that facilitates the colonization of disseminating tumor cells in future metastatic *** vesicles(EVs)play a role in intercellular communication by delivering cargoes,such as noncoding RNAs(ncRNAs).The pivotal role of extracellular vesicle-derived noncoding RNAs(EV-ncRNAs)in the PMN has attracted increasing *** this review,we summarized the effects of EV-ncRNAs on the PMN in terms of immunosuppression,vascular permeability and angiogenesis,inflammation,metabolic reprogramming,and fibroblast *** particular,we provided a comprehensive overview of the effects of EV-ncRNAs on the PMN in different ***,we discussed the promising clinical applications of EV-ncRNAs,including their potential as diagnostic and prognostic markers and therapeutic targets.

关键词： Biomarker Extracellular vesicles Noncoding RNAs

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Biochanin A attenuates spinal cord injury in rats during early stages by inhibiting oxidative stress and inflammasome activation

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Neural Regeneration Research 2024年第9期19卷 2050-2056页

作者： Xigong Li Jing Fu Ming Guan Haifei Shi Wenming Pan Xianfeng Lou Department of orthopedics The First Affiliated Hospital of Zhejiang UniversityHangzhouZhejiang ProvinceChina Department of Stomatology Xixi HospitalHangzhouZhejiang ProvinceChina Department of orthopedics and Spine Surgerythe Affiliated Hospital of Xuzhou Medical Schoolthe Second People’s Hospital of ChangshuChangshuJiangsu ProvinceChina

Previous studies have shown that Biochanin A,a flavonoid compound with estrogenic effects,can serve as a neuroprotective agent in the context of cerebral ischemia/reperfusion injury;howeve r,its effect on spinal cord injury is still unclea r. In this study,a rat model of spinal cord injury was established using the heavy o bject impact method,and the rats were then treated with Biochanin A(40 mg/kg) via intrape ritoneal injection for 14 consecutive *** res ults showed that Biochanin A effectively alleviated spinal cord neuronal injury and spinal co rd tissue injury,reduced inflammation and oxidative stress in spinal cord neuro ns,and reduced apoptosis and *** addition,Biochanin A inhibited the expression of inflammasome-related proteins(ASC,NLRP3,and GSDMD)and the Toll-like receptor 4/nuclear factor-κB pathway,activated the Nrf2/heme oxygenase 1 signaling pathway,and increased the expression of the autophagy markers LC3 Ⅱ,Beclin-1,and *** r,the therapeutic effects of Biochanin A on early post-s pinal cord injury were similar to those of *** findings suggest that Biochanin A protected neurons in the injured spinal cord through the Toll-like receptor 4/nuclear factor κB and Nrf2/heme oxygenase 1 signaling *** findings suggest that Biochanin A can alleviate post-spinal cord injury at an early stage.

关键词： apoptosis autophagy Biochanin A heme oxygenase 1 inflammation Nrf2 protein nuclear factor kappa-B oxidative stress spinal cord injury Toll-like receptor 4

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Clinical value of oral contrast-enhanced ultrasonography in diagnosis of gastric tumors

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World Journal of Gastrointestinal oncology 2024年第1期16卷 110-117页

作者： Chuan-Yu Wang Xiao-Jing Fan Fei-Liang Wang Yue-Yue Ge Zhao Cai Wei Wang Xin-Ping Zhou Jun Du De-Wei Dai Department of Ultrasound Medicine Beijing HospitalBeijing 100005China Department of Gastroscopy Beijing HospitalBeijing 100005China Department of General Surgery Beijing HospitalBeijing 100005China Department of Pathology Beijing HospitalBeijing 100005China

BACKGRoUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths *** contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric *** To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric *** The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological *** Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological *** Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,*** sensitivity and specificity were both 100%for stages T3 and *** diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,*** The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.

关键词： oral contrast-enhanced ultrasonography Gastric tumor Electronic gastroscopy Controlled study Pathological examination Diagnosis

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Physico-chemical characterization of acid base disorders in patients with CoVID-19:A cohort study

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World Journal of Nephrology 2024年第2期13卷 16-23页

作者： Sergio Pinto de Souza Juliana R Caldas Marcelo Barreto Lopes Marcelo Augusto Duarte Silveira Fernanda oliveira Coelho Igor oliveira Queiroz Pedro Domingues Cury Rogério da Hora Passos Department of Nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of Nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGRoUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(CoVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill CoVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill CoVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： CoVID-19 Physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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