Risk factor analysis of changes in blood flow in the A1 segment of the anterior cerebral artery after flow-diverter coverage of it.

Few studies have explored the effect of a flow-diverter device (FD) on blood flow in the A1 segment of the anterior cerebral artery (ACA), after treatment of intracranial aneurysms in the bifurcation region of the internal carotid artery (ICA). The main objective of this article is to investigate the factors that affect A1 blood flow after FD covers the A1 artery. This is a single-center, retrospective study. Data were collected retrospectively from our center, and patients whose FDs were placed for treatment from the terminal of the ICA to the M1 segment were analyzed. A total of 42 patients were included in the study. Immediate post-procedural angiography following device placement revealed decreased blood flow in the A1 of 15 (35.7%) patients and complete occlusion of the A1 segment in 11 (26.2%) patients. During an average follow-up period of 9.8 months, the A1 segment was ultimately occluded in 25 patients (59.5%) and decreased blood flow in 4 patients (9.5%). When using FD to cover the A1 artery for the treatment of intracranial aneurysms, patients with preoperative opening of the anterior communicating artery (AcomA) are more prone to occlusion or decreased blood flow of the A1 artery, compared to patients without opening.

Randomized, prospective, multicenter trial assessing the numen coil embolization system in the endovascular treatment of small intracranial aneurysms: outcomes from the CATCH Trial.

BACKGROUND AND PURPOSE: The CATCH (Coil Application Trial in China) trial was designed to assess the safety and efficacy of the Numen Coil Embolization System in the treatment of intracranial aneurysms in comparison with the Axium coil (ev3/Medtronic). Although the endovascular treatment of small (< 5 mm) intracranial aneurysms has been reported with favorable long-term clinical and angiographic outcomes, randomized trials are still lacking. Data for aneurysms smaller than 5 mm were extracted from the CATCH trial. MATERIALS AND METHODS: A randomized, prospective, multicenter trial was conducted at ten centers throughout China. Enrolled subjects with small intracranial aneurysms were randomly assigned to receive treatment with the Numen Coil or the Axium coil. The primary outcome was successful aneurysm occlusion at the 6-month follow-up. In contrast, the secondary outcomes included complete aneurysm occlusion, recurrence rate, clinical deterioration, and safety data at the 6-month and 12-month follow-ups. RESULTS: A total of 124 patients were enrolled in the study. Overall, 58 patients were assigned to the Numen group, and 66 were assigned to the Axium group. At the 6-month follow-up, the successful aneurysm occlusion rate was 93.1% (54/58) in the MicroPort NeuroTech group and 97.0% (64/66) in the Axium group, with a common odds ratio of 0.208 (95% confidence interval, 0.023-1.914; P = 0.184). Complications were comparable between the groups. CONCLUSIONS: Compared with the Aixum coil, the Numen coil is safe and effective in treating small intracranial aneurysms. TRIAL REGISTRATION: (13/12/2016, NCT02990156).

Qualitative and Quantitative Wall Enhancement on Magnetic Resonance Imaging Is Associated With Symptoms of Unruptured Intracranial Aneurysms.

BACKGROUND AND PURPOSE: Aneurysmal wall enhancement (AWE) on vessel wall magnetic resonance imaging (VW-MRI) has been described as a new imaging biomarker of unstable unruptured intracranial aneurysms (UIAs). Previous studies of symptomatic UIAs are limited due to small sample sizes and lack of AWE quantification. Our study aims to investigate whether qualitative and quantitative assessment of AWE can differentiate symptomatic and asymptomatic UIAs. METHODS: Consecutive patients with UIAs were prospectively recruited for vessel wall magnetic resonance imaging at 3T from October 2014 to October 2019. UIAs were categorized as symptomatic if presenting with sentinel headache or oculomotor nerve palsy directly related to the aneurysm. Evaluation of wall enhancement included enhancement pattern (0=none, 1=focal, and 2=circumferential) and quantitative wall enhancement index (WEI). Univariate and multivariate analyses were used to identify the parameters associated with symptoms. RESULTS: Two hundred sixty-seven patients with 341 UIAs (93 symptomatic and 248 asymptomatic) were included in this study. Symptomatic UIAs more frequently showed circumferential AWE than asymptomatic UIAs (66.7% versus 17.3%, P<0.001), as well as higher WEI (median [interquartile range], 1.3 [1.0-1.9] versus 0.3 [0.1-0.9], P<0.001). In multivariate analysis, both AWE pattern and WEI were independent factors associated with symptoms (odds ratio=2.03 across AWE patterns [95% CI, 1.21-3.39], P=0.01; odds ratio=3.32 for WEI [95% CI, 1.51-7.26], P=0.003). The combination of AWE pattern and WEI had an area under the curve of 0.91 to identify symptomatic UIAs, with a sensitivity of 95.7% and a specificity of 73.4%. CONCLUSIONS: In a large cohort of UIAs with vessel wall magnetic resonance imaging, both AWE pattern and WEI were independently associated with aneurysm-related symptoms. The qualitative and quantitative features of AWE can potentially be used to identify unstable intracranial aneurysms.

Hematopoietic Substrate-1-Associated Protein X-1 Regulates the Proliferation and Apoptosis of Endothelial Progenitor Cells Through Akt Pathway Modulation.

Endothelial precursor cells (EPCs) are involved in vasculogenesis of various physiological and pathological processes. The proliferation and survival mechanism of EPCs needs to be explored further for the purpose of developing an effective glioma treatment. Hematopoietic substrate-1-associated protein X-1 (HAX-1) has been reported as an anti-apoptotic protein that plays an important role in several malignant tumors. However, the effect and mechanism of HAX-1 on EPCs remains unknown. This study aims to investigate the effect of HAX-1 on the proliferation and apoptosis of EPCs and explore its mechanism. According to our results, HAX-1 was overexpressed in EPCs. The results of clone formation and 5-ethynyl-2'-deoxyuridine proliferation assay showed that HAX-1 promoted multiplication of EPCs. Flow cytometry showed HAX-1 knockout cell cycle arrest mainly in G0/G1 phase. Apoptosis analysis showed that HAX-1 could protect EPCs from apoptosis in oxidative stress. Western blot assay indicated that HAX-1 could inhibit the activation of caspase cascade and reduce the expression of p21, Bcl-2-associated X protein, and p53. HAX-1 also enhanced the degradation rate and ubiquitination of p53 through the promotion of phosphorylation of proteins MDM-2 and Akt1. Co-immunoprecipitation and immunofluorescent colocalization assays were performed to test the influence of HAX-1 on the interaction between Akt1 and heat shock protein 90 (Hsp90), which is crucial for the activity of Akt1. In conclusion, this novel study suggests that HAX-1 could facilitate the Akt1 pathway through Hsp90, which led to a decline in the levels of p53, and finally promoted the proliferation and inhibited the apoptosis of EPCs. Stem Cells 2018;36:406-419.

Dehydration Status Predicts Short-Term and Long-Term Outcomes in Patients with Cerebral Venous Thrombosis.

BACKGROUND: Dehydration is associated with a higher risk of poor outcome and venous thromboembolism in acute ischemic stroke patients. However, the relationship between dehydration and prognosis in patients with cerebral venous thrombosis (CVT) has not yet been investigated. METHODS: Consecutive CVT patients at the First Affiliated Hospital of Zhengzhou University were retrospectively identified from November 2011 through January 2017. Dehydration was evaluated by blood urea/creatinine (U/Cr) ratio > 80. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3-6. Factors such as age, sex, coma, intracerebral hemorrhage, and straight sinus and/or deep CVT involved were adjusted to assess the relationship between dehydration, and prognosis at discharge and long-term follow-up in CVT patients. RESULTS: A total of 220 CVT patients were included, and 85 patients (38.64%) were dehydrated. Multivariate logistic regression analysis indicated that patients with dehydration had a higher risk of mRS of 3-6 at discharge (adjusted odds ratio [OR] 3.629, 95% confidence intervals [CI] 1.526-8.633, P = 0.004) and long-term outcome (adjusted OR 3.831, 95% CI 1.597-9.190, P = 0.003). Subgroup analysis stratified by potential factors that might be associated with dehydration, such as infection, vomiting, pregnancy, and/or postpartum, showed similar results. Multivariate Cox regression analysis further demonstrated that dehydration was associated with higher mortality (adjusted hazard ratio [HR] = 2.301, 95% CI 1.025-5.166, P = 0.043). CONCLUSIONS: The present findings indicate that dehydration is an independent predictor for short-term and long-term unfavorable functional outcome in patients with CVT.

Endovascular treatment of chronic, recurrent headache secondary to chronic cerebral venous sinus thrombosis.

Headache is a clinical diagnosis linked to a number of medical and surgical disorders. A common etiology has not yet been established. It would seem that these cases can be related to some degree of cerebral venous outflow obstruction. We report 2 cases of chronic superior sagittal sinus thrombosis causing isolated intracranial hypertension. The patients were treated with intrasinus thrombolytic therapy.

Reconstructive endovascular treatment of vertical stenosis associated with adjacent aneurysm at the same arterial anatomic segment.

One case had a symptomatic vertebral artery stenosis coupled with a coincidental unruptured cerebral aneurysm at the same arterial anatomic segment. And another case had an asymptomatic vertebral artery stenosis coupled with a ruptured cerebral aneurysm at the same arterial anatomic segment. They underwent intracranial stenting. Both lesions were treated successfully and neither complications nor strokes occurred after the procedures. Covered stent placement in an intracranial stenosis with an adjacent ruptured or unruptured aneurysm may be a feasible method.

[Preliminary experiences of "Waffle cone" technique for the treatment of intracranial aneurysm].

OBJECTIVE: To explore the preliminary experiences of "Waffle cone" technique for the treatment of intracranial aneurysm. METHODS: Retrospective data analyses were performed for patients with intracranial aneurysms embolized by the "Waffle cone" technique from stent-assisted coiling at our hospital from December 2010 to November 2012. RESULTS: Six patients used the "Waffle cone" technique from 138 stent-assisted coiling. All had complex wide-neck bifurcation cerebral aneurysms. And the angles between parental artery and distal vessels were acute. Six rupture aneurysms were at the terminus of basilar artery (BA) (n = 2), right anterior communicating artery (AcomA) (n = 3) and trifurcation middle cerebral artery (MCA) (n = 1). All stents were of Solitaire with specification 4×15 mm (ev3, USA) .Four patients had Raymond classification Class I while another 2 Class II. No perioperative complication occurred. The average follow-up period was 6 months. CONCLUSION: This technique is safe, time-saving, simple and effective for complex, wide-necked bifurcation aneurysms with acute angles between parental artery and distal vessels.Long-term follow-ups are needed to further evaluate its efficacy.

HAX-1 interferes in assembly of NLRP3-ASC to block microglial pyroptosis in cerebral I/R injury.

Acute cerebral ischemia has a high rate of disability and death. Although timely recanalization therapy may rescue the ischemic brain tissue, cerebral ischemia-reperfusion injury has been shown to limit the therapeutic effects of vascular recanalization. Protein HAX-1 has been reported as a pro-survival protein that plays an important role in various disorders, particularly in association with the nervous system. However, the effects and mechanisms of HAX-1 in cerebral IR injury have yet to be elucidated. So, we aimed to investigate the effect of HAX-1 on microglial pyroptosis and explore its potential neuroprotective effects in ischemia-reperfusion injury. Our results show that the expression of HAX-1 decreased after cerebral IR injury, accompanied by an increase in pyroptosis pathway activation. In addition, HAX-1 could inhibit microglial pyroptosis both in vivo and in vitro and reduce the release of inflammatory mediators. The above neuroprotective effects might be partially mediated by inhibiting of interaction of NLRP3 and ASC through competitive binding, followed by the attenuation of NLRP3 inflammasome formation. In conclusion, Our findings support that HAX-1 exhibits a protective role in cerebral I/R injury, and further study on HAX-1 expression regulation will contribute to cerebral infarction therapy.

Predictors of In-Stent Stenosis Following the Implantation of Pipeline Embolization Devices for the Treatment of Aneurysms Located at or beyond the Circle of Willis in the Anterior Circulation.

BACKGROUND AND PURPOSE: In-stent stenosis is commonly observed after stent implantation. There is no consensus on the contributing factors for in-stent stenosis, especially for aneurysms located at or beyond the circle of Willis in the anterior circulation. This study aimed to investigate the morbidity and determinants of in-stent stenosis in distal anterior circulation aneurysms following the implantation of Pipeline Embolization Devices. MATERIALS AND METHODS: Patients who underwent Pipeline Embolization Device treatment at our center between January 1, 2018, and June 15, 2023, were enrolled. Distal anterior circulation aneurysms were defined as those occurring at or beyond the circle of Willis, including anterior communicating artery aneurysms, anterior cerebral artery aneurysms, and MCA aneurysms. Baseline information, aneurysm characteristics, and follow-up data of patients were analyzed. Patients were divided into 2 groups: the in-stent stenosis group (patients with a loss of >25% of the lumen diameter of the parent artery) and the non-in-stent stenosis group. Binary logistic regression and restricted cubic spline curves were used to explore risk factors. RESULTS: We included 85 cases of 1213 patients treated with flow-diverter devices at our hospital. During an average follow-up period of 9.07 months, the complete occlusion rate was 77.64%. The overall incidence of in-stent stenosis was 36.47% (31/85), of which moderate stenosis accounted for 9.41% (8/85), and severe stenosis, 5.88% (5/85) (triglyceride-glucose index ≥ 8.95; OR = 6.883, P = .006). The difference in diameters between the stent and parent artery of ≥0.09 mm (OR = 6.534, P = .015) and 55 years of age or older (OR = 3.507, P = .036) were risk factors for in-stent stenosis. The restricted cubic spline curves indicated that the risk of in-stent stenosis increased as the difference in diameter between stent and parent artery and the triglyceride-glucose index increased. CONCLUSIONS: Compared with the on-label use of Pipeline Embolization Devices, the rate of in-stent stenosis did not obviously increase when treating distal anterior circulation aneurysms with these devices. The incidence of in-stent stenosis was 36.47% when defined as a lumen diameter loss of >25%, and 15.2% when defined as a lumen diameter loss of >50%. Stent-size selection and biochemical indicators can potentially impact the incidence of in-stent stenosis.

Emergent angioplasty and stent placement recanalization without thrombolysis in acute middle cerebral artery occlusions.

A significant proportion of patients with infarcts from large-vessel lesions have shown a poor response to systemic thrombolysis. Stents have been used to recanalize occluded or severely stenosed intracranial arteries in patients with acute stroke. This study evaluated the feasibility, efficacy, and safety of intracranial artery recanalization for acute middle cerebral artery (MCA) occlusion using emergent angioplasty and stent placement without thrombolysis. All patients from a retrospectively collected database who met the inclusion criteria and were treated with an intracranial stent for acute MCA occlusion were included. Treatment comprised angioplasty and stenting without interventional thrombolytic therapy. Recanalization was assessed by angiography immediately after stent placement based on the Thrombolysis in Myocardial Infarction (TIMI) score. Complications related to the procedure and outcomes were assessed. Neurologic status was evaluated before and after treatment. Eleven patients were treated with emergent angioplasty and stent placement. Partial or complete recanalization (TIMI 2 and 3) was achieved in 11 patients (100%) assessed by digital subtraction angiography immediately after MCA stenting. One patient died due to reocclusion of MCA 2 days after the procedure. Among the survivors, 7 patients (70%) had a good outcome (modified Rankin Scale score, 0-2) and 3 patients (30%) had a moderate outcome (modified Rankin Scale score, 3). Follow-up computed tomography angiography or magnetic resonance angiography revealed mild restenosis in 2 of the 10 patients. This preliminary experience demonstrates the technical feasibility and high rate of recanalization with emergent angioplasty and stenting without thrombolysis in patients with acute MCA occlusion.

Safety and efficacy of endovascular treatment for tiny ruptured intracranial aneurysms with low-profile visualized intraluminal support stents.

BACKGROUND: Endovascular treatment for tiny ruptured intracranial aneurysms is known to be technically challenging. Thus, we aimed to investigate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stents in the treatment of tiny ruptured intracranial aneurysms. METHODS: From April 2014 to June 2019, among 90 patients with tiny ruptured aneurysms who were treated at our institution endovascularly, 28 underwent stent-assisted coiling with LVIS stents. The clinical and angiographic results were reviewed. RESULTS: In the LVIS group, complete occlusion was achieved in 27 patients (96.4%). Intraprocedural thrombus formation occurred in 3 patients (10.7%). Follow-up angiography in 24 patients at 6-12 months showed complete occlusion in 23 patients (95.8%) and no aneurysm recurrence. In the coiling-only group, complete occlusion was achieved in 58 patients (93.5%). Intraprocedural aneurysm rupture occurred in 2 patients (3.2%), and postprocedural ischemia occurred in 4 patients (6.5%), with a complication rate of 9.7%. Follow-up angiography in 52 patients at 6-12 months showed complete occlusion in 43 patients (82.7%) and aneurysm recurrence in 7 patients (9.2%). No significant (p > 0.05) differences existed between the two groups. CONCLUSIONS: The LVIS stent is safe and effective in the treatment of tiny ruptured intracranial aneurysms.

Safety and efficacy analysis of the off-label use of pipeline embolization devices for intracranial aneurysms: a propensity score matching study.

Background and objective: The safety and efficacy of on-label use of pipeline embolization devices (PEDs) are well established; however, there is much controversy over their off-label use. This study aimed to investigate the safety and efficacy of the off-label use of PEDs for treating intracranial aneurysms. Methods: This single-center study retrospectively included patients with digital subtraction angiography, computed tomographic angiography, or magnetic resonance angiography confirmed intracranial aneurysms treated with PEDs who were admitted to our institution between 1 January 2018 and 1 July 2022. Patients were divided into on- and off-label groups according to the Food and Drug Administration criteria published in 2021. Propensity score matching (PSM) was used to balance disparities in baseline information between the two groups. Safety outcomes included postoperative mortality and complication rates, whereas effectiveness outcomes included aneurysm occlusion rate (O'Kelly-Marotta grading system C + D grades), retreatment rate within 12 months, and postoperative functional score [modified Rankin scale (mRS) score]. The study was approved by the Ethics Committee of Scientific Research and Clinical Trial of the First Affiliated Hospital of Zhengzhou University (Ethics number: KY 2018-098-02). All patients provided informed consent. Results: A total of 242 patients with 261 aneurysms (160 on-label and 101 off-label aneurysms) were included in this study. PSM yielded 81 pairs of patients matched for baseline information. Postoperative hemorrhagic, ischemic, and procedure-related complication rates did not reach statistical significance. In addition, no statistically significant differences in the aneurysm occlusion rate, retreatment rate within 12 months, postoperative functional score (mRS score), or mRS score deterioration rate were observed between the two groups. A higher incidence of in-stent stenosis was observed in the off-label (4.9% vs. 21%, p = 0.002) group than in the on-label group; however, all patients were asymptomatic. Conclusion: Compared with on-label use, off-label use of PEDs for treating intracranial aneurysms did not increase the risk of complications, and the occlusion rates were comparable. Therefore, decisions regarding clinical management should not rely solely on on- or off-label indications.

Case Report: Tubridge flow diverter for a ruptured fusiform aneurysm of the M1 segments of the middle cerebral artery.

We report a case of the middle cerebral artery (MCA) M1 segment ruptured fusiform aneurysm that was successfully treated using a domestic Tubridge flow diverter (TFD). A 40-year-old man was admitted to the hospital because of a headache and was diagnosed with subarachnoid hemorrhage. Cerebral angiography revealed a ruptured fusiform aneurysm in the M1 segment of the right MCA. TFD, combined with coil embolization, was used for perioperative treatment. No obvious complications were observed. Follow-up digital subtraction angiography 2 and 12 months after the surgery showed that the aneurysm was occluded, and the patient recovered well. This is the first known case of this treatment with this type of stent in such an aneurysm and demonstrates that TFD can be used to treat ruptured fusiform aneurysms in the M1 segment of the MCA.

Pipeline embolization of complex, wide-necked middle cerebral artery bifurcation aneurysms: A single-center experience.

PURPOSE: To evaluate the performance of Pipeline Embolization Device (PED) in complex, wide-necked middle cerebral artery (MCA) bifurcation aneurysms. METHODS: We performed a retrospective review of patients treated with PED for complex, wide-necked MCA bifurcation aneurysms between August 2016 and March 2021. In addition to demographic data, we collected aneurysmal neck width, dome-to-neck ratio, complications, and clinical and angiographic follow-up. The embolization degree of aneurysms was evaluated by O'Kelly-Marotta (OKM) grading scale, and the prognosis was assessed with the modified Rankin Scale (mRS). RESULTS: From August 2016 to March 2021, a total of 46 patients with 49 MCA bifurcation aneurysms in our center were enrolled, of whom all received PEDs successfully. The O'Kelly-Marotta (OKM) grading showed that post-procedure 15 patients (32.6%) were grade C, another 8 patients (17.4%) were grade D. Aneurysms with small remnant or complete occlusion were 50%, symptomatic ischemic events occurred in 3 (6.5%), and bleeding events in 1 (2.2%). 41 patients underwent a 6-month angiography follow-up, in which 7 patients (17.1%) remained OKM grade C and 30 patients (73.2%) achieved OKM grade D. Complete occlusion and small remnant aneurysms were up to 90.3%. 40 (97.6%) patients' mRS scores were 0, and 1 (2.4%) patient was 2. No new bleeding and ischemic events occurred during the 6-month. CONCLUSIONS: The Pipeline Embolization Device provides a safe and effective treatment alternative for complex, wide-necked MCA aneurysms. A larger number with longer-term follow-up data is needed for further verification.

Homocysteine Levels Are Associated With the Rupture of Intracranial Aneurysms.

Background: Homocysteine (Hcy) levels may be associated with the development of intracranial aneurysms (IAs). However, whether it increases the risk of rupture of IAs is unknown. This study aimed to determine the association between homocysteine levels and IA rupture. Methods: We retrospectively reviewed patients with IAs and subarachnoid hemorrhage (SAH) at our hospital between January 2019 and May 2021. Clinical data, including Hcy levels and IA images, were assessed. The association between Hcy level and IA rupture was investigated using multivariate logistic regression analyses in patients with IAs and SAH. Results: A total of 589 patients were included. 546 patients with IAs, including 331 UIA (Unruptured IA) and 215 RIA (Ruptured IA). The average age was 57.43 ± 10.86 years old, and 67.03% were women. Among them, all 215 RIAs lead to SAH. In addition, we also enrolled 43 non-aneurysmal subarachnoid hemorrhage (Na-SAH) patients. The average age was 54.12 ± 10.55 years old, and 53.48% were female. After adjusting for confounders in the multivariate model, Hcy levels were correlated with the rupture of IA (odds ratio [OR] 1.069; 95% confidence interval [CI] 1.025-1.114, p = 0.002) and a-SAH (OR 1.083; 95% CI 1.002-1.170, p = 0.046). Conclusion: Hcy levels were associated with IA rupture. These findings provide novel insights into IAs rupture, and future studies are needed to confirm this relationship.

Vitamin D level is associated with rupture of intracranial aneurysm in patients with subarachnoid hemorrhage.

Background: Increasing evidence supports the relationship between vitamin D levels and stroke. However, there are few studies on the association between vitamin D levels and subarachnoid hemorrhage (SAH), especially in patients with aneurysmal SAH. The present study investigated the association between vitamin D level and rupture of intracranial aneurysm in a cohort of patients with SAH. Methods: The data of patients diagnosed with SAH at our hospital between September 2019 and December 2020 were retrospectively reviewed. Patients' information was collected, and serum vitamin D levels were measured. Computed tomography was performed to confirm SAH diagnosis, and digital subtraction angiography was performed to determine whether SAH was caused by rupture of an intracranial aneurysm. Multivariate logistic regression analyses were performed to investigate the association between vitamin D level and aneurysmal SAH. Results: Overall, 193 patients with SAH were evaluated; 160 with aneurysmal SAH (age 55.86 ± 12.30 years, 63.15% female) and 33 with non-aneurysmal SAH (age 56.21 ± 9.92 years, 45.45% female). Univariate analysis showed that the vitamin D level in aneurysmal SAH was lower than that in non-aneurysmal SAH (16.95 ± 8.69 vs. 22.74 ± 9.12 ng/ml, p = 0.001). In addition, there were more patients with hypertension in aneurysmal SAH group than in non-aneurysmal SAH group (53.75 vs. 24.24%, p = 0.002). Notably, there was still a strong correlation between vitamin D level and aneurysmal SAH after adjusting for confounders in the multivariate model [OR (odds ratio), 0.935; 95% CI (confidence interval), 0.890-0.983; p = 0.008]. Conclusion: Vitamin D level is associated with rupture of intracranial aneurysm in patients with SAH. Patients with aneurysmal SAH have lower vitamin D levels than those with non-aneurysmal SAH.

Dynamic changes of vascular endothelial growth factor and angiopoietin-1 in association with circulating endothelial progenitor cells after severe traumatic brain injury.

BACKGROUND: Vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) can promote angiogenesis and vascular stability after brain injury. Circulating endothelial progenitor cells (EPCs) also play a crucial role in neovascularization and tissue repair after traumatic brain injury (TBI). We sought to compare the expression of VEGF and Ang-1 in serum and the circulating EPCs in patients after severe TBI with that of healthy control subjects. METHODS: We obtained peripheral blood and serum samples from 21 patients with severe TBI and 11 healthy control subjects. EPCs in blood samples from severe TBI patients and healthy controls were quantified by flow cytometry 1 day, 4 days, 7 days, 14 days, and 21 days after severe TBI. VEGF and Ang-1 were measured by enzyme linked immunosorbent assay at the same time points. RESULTS: Compared with control subjects, circulating EPCs in patients with severe TBI decreased 4 days (p < 0.05), but increased 7 days and 14 days (p < 0.05) after TBI. VEGF increased significantly during the follow-up period (p < 0.05). Ang-1 increased gradually and reached peak at 7 days and 14 days after TBI. The circulating EPCs were significantly correlated with VEGF and Ang-1 at 7 days and 14 days after severe TBI. CONCLUSIONS: Our results suggest that the increased VEGF and Ang-1 are closely related to increase in circulating EPCs in response to severe TBI, which may be needed for vascular repairs after severe TBI.

Effect of forest floor fuel moisture content on chemical components of PM2.5 emitted during combustion.

The moisture content of forest floor fuels changes continuously with the influence of environmental factors; thus it has an important impact on the concentration and chemical composition of particulate matter emitted during forest fire. However, most previous studies quantify emissions of particulate matter and constituents using dry samples. In this study, we use a self-designed semi closed combustion simulator to quantify emission of total carbon (TC), organic carbon (OC), elemental carbon (EC) and water-soluble ions in fine particulate matter (PM2.5) using fuels of four tree species that differ in moisture content (0, 10, 20 and 30%). The results showed that the emissions of TC, OC and EC and total water-soluble inorganic ions increased significantly (<0.05) with increasing moisture content of fuels, and fuels of coniferous species emitted significantly more pollutants than fuels of broadleaved species. Similarly combustion of leaf samples emitted more carbonaceous components and water-soluble ions than combustion of branches. K+, NH4+ and Cl- were the main components of water-soluble ionic species, and emissions of K+, Ca2+, Na+, Mg2+, NH4+, Cl-, Br-, NO3-, NO2-, SO42- increased with increasing moisture content of fuels. Fuel moisture content had a great impact on the inorganic salt composition in the particulate matter emitted during combustion. The findings have an important implication on the use of prescribed early fire as management tools as the moisture content of the fuels early during the dry season is still high.

The relationship between the level of vitamin D and ruptured intracranial aneurysms.

The purpose of our research is to explore whether vitamin D levels were associated with the rupture of intracranial aneurysms. In this retrospective study, 105 patients diagnosed with ruptured intracranial aneurysms (RIAs) and 185 patients diagnosed with unruptured intracranial aneurysms (UIAs) at The First Affiliated Hospital of Zhengzhou University were recruited from September 2019 to September 2020. Patients' demographic and clinical information, including vitamin D levels, were recorded and compared. Univariate analysis showed that patients with UIAs had higher vitamin D levels than RIAs (p = 0.019). In addition, there were significant differences in aneurysm location (p < 0.001), aspirin use (p = 0.001), and comorbid diabetes mellitus (p = 0.037) between patients with UIAs and RIAs. Binary logistic regression analysis showed that the level of vitamin D was independently associated with RIAs [odds ratio (OR) 0.960; 95% confidence intervals (CI), 0.926-0.996, p = 0.028].