Use of the Neuroform Atlas Stent or LVIS Jr Stent for Treatment of Unruptured Intracranial Aneurysms in Parent Arteries of <2 mm in Diameter: A Multicenter Experience.

BACKGROUND AND PURPOSE: The Neuroform Atlas stent and the LVIS Jr stent are intracranial microstent systems for the treatment of wide-neck intracranial aneurysms. Hence, this study aimed to compare the efficacy and safety of the Neuroform Atlas stent and the LVIS Jr stent for the treatment of unruptured intracranial aneurysms in parent arteries of <2 mm in diameter. MATERIALS AND METHODS: From March 2022 to April 2023, the clinical and imaging data of 135 patients with unruptured intracranial aneurysms treated with stent-assisted coiling using the Neuroform Atlas or LVIS Jr stent in parent arteries of <2 mm in diameter were retrospectively analyzed. Stent apposition was evaluated by high-resolution conebeam CT (HR-CBCT). Immediate aneurysm-embolization attenuation and occlusion at 6-month follow-up were evaluated using 2D DSA and the modified Raymond-Roy classification. Adverse events were recorded. Multivariate logistic regression analysis was undertaken to determine the independent factors affecting incomplete stent apposition. RESULTS: One hundred thirty-five patients (135 aneurysms) underwent stent-assisted coiling (66 Neuroform Atlas stents and 69 LVIS Jr stents). Intraoperative HR-CBCT showed that 1 Neuroform Atlas stent and 11 LVIS Jr stents had incomplete stent apposition at the aneurysm neck (P < .05). Perioperative complications occurred in 3 cases (2.22%). These comprised 2 cases of neurologic complications (1 case of distal intracranial vascular embolism and 1 case of cerebral parenchymal hemorrhage) and 1 case of severe postprocedural gastrointestinal hemorrhage. DSA follow-up showed 3 cases of aneurysm recurrence in the LVIS Jr group. Multivariate regression analysis showed that a stent angle of ≥75° (OR, 23.963; P = .005) or a parent artery diameter mismatch ratio of ≥1.25 (OR, 8.043; P = .037) were risk factors for incomplete stent apposition, especially for the LVIS Jr stent (OR, 20.297; P = .015). CONCLUSIONS: The Neuroform Atlas stent and LVIS Jr stent are efficacious in the treatment of unruptured intracranial aneurysms in parent arteries of <2 mm in diameter. Apposition of the LVIS Jr stent was worse than in the Neuroform Atlas stent at the neck of some aneurysms.

Risk assessment and pathogen profile of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy: A retrospective study.

Emergency craniotomy in patients with traumatic brain injury poses a significant risk for surgical site infections (SSIs). Understanding the risk factors and pathogenic characteristics of SSIs in this context is crucial for improving outcomes. This comprehensive retrospective analysis spanned from February 2020 to February 2023 at our institution. We included 25 patients with SSIs post-emergency craniotomy and a control group of 50 patients without SSIs. Data on various potential risk factors were collected, including demographic information, preoperative conditions, and intraoperative details. The BACT/ALERT3D Automated Bacterial Culture and Detection System was utilized for rapid bacterial pathogen identification. Statistical analyses included univariate and multivariate logistic regression to identify significant risk factors for SSIs. The study identified Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus as the most prevalent pathogens in SSIs. Significant risk factors for SSIs included the lack of preoperative antibiotic use, postoperative drainage tube placement, diabetes mellitus, and the incorporation of invasive procedures, all of which showed a significant association with SSIs in the univariate analysis. The multivariate analysis further highlighted the protective effect of preoperative antibiotics and the increased risks associated with anaemia, diabetes mellitus, postoperative drainage tube placement, and the incorporation of invasive procedures. Our research underscores the critical role of factors like insufficient preoperative antibiotics, postoperative drainage, invasive techniques, anaemia, and diabetes mellitus in elevating the risk of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy. Enhanced focus on these areas is essential for improving surgical outcomes.

Pain relief effect of angiopuncture therapy on patients with postoperative pain: A clinical trial.

BACKGROUND: The objective of this study is to study the pain relief effects of angiopuncture therapy in patients with postoperative pain. METHODS: Forty-one patients were randomly selected based on the inclusion and exclusion criteria. Doppler imaging was performed to locate the cutaneous perforator. Angiopuncture was performed on the first postoperative day. A Numerical Rating Scale was used to evaluate the degree of pain before and after angiopuncture. Utilizing the paired t test or Wilcoxon signed rank test, all pre- and post-data were examined, and further subgroup analysis based on time was performed. RESULTS: Variance analysis revealed a significant difference before and after angiopuncture (P < .05). The results of the subgroup analysis showed the pain-relieving effect of angiopuncture for postoperative pain patients at the time points of 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours was apparent (P < .05). CONCLUSION: The angiopuncture therapy approach may assist in pain relief in patients with postoperative pain.

The SNHG12/microRNA-15b-5p/MYLK axis regulates vascular smooth muscle cell phenotype to affect intracranial aneurysm formation.

OBJECTIVE: This research was dedicated to investigating the impact of the SNHG12/microRNA (miR)-15b-5p/MYLK axis on the modulation of vascular smooth muscle cell (VSMC) phenotype and the formation of intracranial aneurysm (IA). METHODS: SNHG12, miR-15b-5p and MYLK expression in IA tissue samples from IA patients were tested by RT-qPCR and western blot. Human aortic vascular smooth muscle cells (VSMCs) were cultivated with H2O2 to mimic IA-like conditions in vitro, and the cell proliferation and apoptosis were measured by MTT assay and Annexin V/PI staining. IA mouse models were established by induction with systemic hypertension combined with elastase injection. The blood pressure in the tail artery of mice in each group was assessed and the pathological changes in arterial tissues were observed by HE staining and TUNEL staining. The expression of TNF-α and IL-1ß, MCP-1, iNOS, caspase-3, and caspase-9 in the arterial tissues were tested by RT-qPCR and ELISA. The relationship among SNHG12, miR-15b-5p and MYLK was verified by bioinformatics, RIP, RNA pull-down, and luciferase reporter assays. RESULTS: The expression levels of MYLK and SNHG12 were down-regulated and that of miR-15b-5p was up-regulated in IA tissues and H2O2-treated human aortic VSMCs. Overexpressed MYLK or SNHG12 mitigated the decrease in proliferation and increase in apoptosis of VSMCs caused by H2O2 induction, and overexpression of miR-15b-5p exacerbated the decrease in proliferation and increase in apoptosis of VSMCs caused by H2O2 induction. Overexpression of miR-15b-5p reversed the H2O2-treated VSMC phenotypic changes caused by SNHG12 up-regulation, and overexpression of MYLK reversed the H2O2-treated VSMC phenotypic changes caused by up-regulation of miR-15b-5p. Overexpression of SNHG12 reduced blood pressure and ameliorated arterial histopathological damage and VSMC apoptosis in IA mice. The mechanical analysis uncovered that SNHG12 acted as an endogenous RNA that competed with miR-15b-5p, thus modulating the suppression of its endogenous target, MYLK. CONCLUSION: Decreased expression of SNHG12 in IA may contribute to the increasing VSMC apoptosis via increasing miR-15b-5p expression and subsequently decreasing MYLK expression. These findings provide potential new strategies for the clinical treatment of IA.

Up-regulation of the long non-coding RNA RMRP contributes to glioma progression and promotes glioma cell proliferation and invasion.

INTRODUCTION: Gliomas are the most common malignant tumors of the brain. Long non-coding RNAs (lncRNAs) play key regulatory roles in various tumors. In this study, we aimed to determine the expression and biological roles of lncRNA RMRP in glioma. MATERIAL AND METHODS: The relative expression level of lncRNA RMRP was determined by quantitative real-time polymerase chain reaction (qRT-PCR) in a total of 39 patients with glioma. RNA interference (RNAi) approaches were used to investigate the biological functions of RMRP. The effect of lncRNA RMRP on proliferation was determined by CCK8 assay. Cell cycle and apoptosis were evaluated by flow cytometry analysis. Cell migration was explored by the wound-healing assay. Cell invasion was investigated by the Transwell invasion assay. RESULTS: LncRNA RMRP was up-regulated in human glioma tissues compared with normal brain tissues (p < 0.05). LncRNA RMRP up-regulation was significantly correlated with advanced tumor grade and low Karnofsky Performance Score (KPS) (p < 0.05). Moreover, patients with a high expression level of lncRNA RMRP had a relatively poor prognosis (p < 0.05). Multivariate analyses revealed that lncRNA RMRP expression served as an independent predictor for overall survival of glioma patients (p < 0.05). In addition, inhibition of lncRNA RMRP by RNAi significantly suppressed the proliferation, migration and invasion of glioma cells in vitro (p < 0.05). CONCLUSIONS: lncRNA RMRP might act as an oncogene and could be used as a therapeutic target for the treatment of glioma. Our findings provide an in-depth insight into the role of lncRNA RMRP in glioma progression.

Robust Grape Cluster Detection in a Vineyard by Combining the AdaBoost Framework and Multiple Color Components.

The automatic fruit detection and precision picking in unstructured environments was always a difficult and frontline problem in the harvesting robots field. To realize the accurate identification of grape clusters in a vineyard, an approach for the automatic detection of ripe grape by combining the AdaBoost framework and multiple color components was developed by using a simple vision sensor. This approach mainly included three steps: (1) the dataset of classifier training samples was obtained by capturing the images from grape planting scenes using a color digital camera, extracting the effective color components for grape clusters, and then constructing the corresponding linear classification models using the threshold method; (2) based on these linear models and the dataset, a strong classifier was constructed by using the AdaBoost framework; and (3) all the pixels of the captured images were classified by the strong classifier, the noise was eliminated by the region threshold method and morphological filtering, and the grape clusters were finally marked using the enclosing rectangle method. Nine hundred testing samples were used to verify the constructed strong classifier, and the classification accuracy reached up to 96.56%, higher than other linear classification models. Moreover, 200 images captured under three different illuminations in the vineyard were selected as the testing images on which the proposed approach was applied, and the average detection rate was as high as 93.74%. The experimental results show that the approach can partly restrain the influence of the complex background such as the weather condition, leaves and changing illumination.

[POSTERIOR ATLANTOAXIAL LATERAL MASS SCREW FIXATION AND SUBOCCIPITAL DECOMPRESSION FOR TREATMENT OF Arnold-Chiari MALFORMATION ASSOCIATED WITH ATLANTOAXIAL DISLOCATION].

OBJECTIVE: To evaluate the effectiveness of the posterior atlantoaxial lateral mass screw fixation and suboccipital decompression in the treatment of Arnold-Chiari malformation associated with atlantoaxial joint dislocation. METHODS: Between September 2012 and November 2015, 17 cases of Arnold-Chiari malformation associated with atlantoaxial dislocation were treated by the posterior atlantoaxial lateral mass screw fixation and suboccipital decompression and expansion to repair the dura mater and bone graft fusion. There were 10 males and 7 females, aged 35-65 years (mean, 51.4 years). The disease duration was 14 months to 15 years with an average of 7.4 years. According to Arnold-Chiari malformation classification, 13 cases were rated as type I, 3 cases as type II, and 1 case as type III-IV. Cervical nerve root stimulation and compression symptoms were observed in 12 cases, occipital foramen syndrome in 11 cases, cerebellar compression symptoms in 6 cases, and syringomyelia in 10 cases. RESULTS: Primary healing of incision was obtained in the other patients except 1 patient who had postoperative cerebrospinal fluid leakage after removal of drainage tube at 3 days after operation, which was cured after 7 days. All patients were followed up 6 months to 2 years, with an average of 18.4 months. The neurological dysfunction was improved in different degrees after operation. The Japanese Orthopedic Association (JOA) score was significantly increased to 16.12±1.11 at 6 months from preoperative 11.76±2.01 (t=13.596, P=0.000); compression of spinal cord and medulla was improved. X-ray examination showed bone graft fusion at 6 months after operation. In 10 patients with spinal cord cavity, MRI showed empty disappearance in 3 cases, empty cavity lessening in 6 cases, and no obvious change in 1 case at 6 months. CONCLUSIONS: Atlantoaxial lateral mass screw fixation and suboccipital decompression and expansion to repair the dura mater can obtain good effectiveness in the treatment of Arnold Chiari malformation associated with atlantoaxial transarticular dislocation.