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OBJECTIVE: Cartilage and meniscus are important structures that maintain the health of the knee joint. Early detection of changes in the internal components of cartilage and meniscus before morphological changes occur is essential to prevent and delay the development of osteoarthritis (OA). This study was designed to determine the changes in the matrix composition of morphologically intact cartilage and meniscus during the acute phase of an anterior cruciate ligament (ACL) rupture, as well as the effect of different states of meniscus (intact or tear) on adjacent cartilage during the acute phase. METHODS: This cross-sectional study compared and analyzed 50 patients in the acute phase of ACL rupture who underwent surgical treatment and 66 age-, weight- and height-matched healthy volunteers from May 2022 to May 2023 at our institution. Mean T2 relaxation times and effect sizes in different regions of tibiofemoral articular cartilage and meniscus were compared between the two groups using the Mann-Whitney nonparametric t-test, and correlations between different meniscal states and adjacent cartilage were analyzed. RESULTS: Both in the lateral and medial compartments of the knee, T2 relaxation times were significantly higher in all subregions of cartilage and meniscus in the ACL rupture group (p < 0.05), and the site of injury was predominantly centered in the medial compartment (femur, p = 0.000; tibia, p = 0.000; anterior horn, p = 0.000). In the respective compartments, the posterior horn of the lateral meniscus showed a significant positive correlation with the mid-cartilage of the femoral and tibial (r = 0.566, p = 0.035; r = 0.611, p = 0.02); and the posterior horn of the medial meniscus showed a significant positive correlation with the posterior tibial cartilage (r = 0.668, p = 0.018). CONCLUSION: During the acute phase of ACL rupture, the internal composition of the cartilage and meniscus undergoes significant changes, even if the morphology is intact. More importantly, the state of the meniscus significantly affects the internal composition of the adjacent cartilage. This is an early warning sign of OA, which should be closely monitored and carefully managed in clinical practice.
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RATIONALE AND OBJECTIVES: This study aimed to evaluate the safety and effectiveness of transbrachial access (TBA) and transradial access (TRA) compared to transfemoral access (TFA) for large-bore neuro stenting (≥7 F). METHODS: From January 2019 to January 2024, 4752 patients received large-bore neuro stenting in our center. The primary outcomes were procedural metrics. Safety outcomes were significant access site complications, including substantial hematoma, pseudoaneurysm, artery occlusion, and complications requiring treatment (medicine, intervention, or surgery). After propensity score matching with a ratio of 1:1:2 (TBA: TRA: TFA), adjusting for age, gender, aortic arch type, and neuro stenting as covariates, outcomes were compared between groups. RESULTS: 46 TBA, 46 TRA and 92 TFA patients were enrolled. The mean age was 67.8 ± 11.2 years, comprising 127 (69.0%) carotid artery stenting and 57 (31.0%) vertebral artery stenting. The rates of technical success (TBA: 100%, TRA: 95.7%, TFA: 100%) and significant access site complications (TBA: 4.3%, TRA: 6.5%, TFA: 1.1%) were comparable between the groups (P > 0.05). Compared to TFA, the TRA cohort exhibited significant delays in angiosuite arrival to puncture time (14 vs. 8 min, P = 0.039), puncture to angiography completion time (19 vs. 11 min, P = 0.027), and procedural duration (42 vs. 29 min, P = 0.031). There were no substantial differences in procedural time metrics between TBA (10, 14, and 31 min, respectively) and TFA. CONCLUSION: TBA and TRA as the primary access for large-bore neuro stenting are safe and effective. Procedural delays in TRA may favor TBA as the first-line alternative access to TFA.
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Intestinal dysbiosis is believed to play a role in the development of necrotizing enterocolitis (NEC). The efficacy of JNK-inhibitory peptide (CPJIP) in treating NEC was assessed. Treatment with CPJIP led to a notable reduction in p-JNK expression in IEC-6 cells and NEC mice. Following LPS stimulation, the expression of RNA and protein of claudin-1, claudin-3, claudin-4 and occludin was significantly decreased, with this decrease being reversed by CPJIP administration, except for claudin-3, which remained consistent in NEC mice. Moreover, the expression levels of the inflammatory factors TNF-α, IL-1ß and IL-6 were markedly elevated, a phenomenon that was effectively mitigated by the addition of CPJIP in both IEC-6 cells and NEC mice. CPJIP administration resulted in improved survival rates, ameliorated microscopic intestinal mucosal injury, and increased the total length of the intestines and colon in NEC mice. Additionally, CPJIP treatment led to a reduction in serum concentrations of FD-4, D-lactate and DAO. Furthermore, our results revealed that CPJIP effectively inhibited intestinal cell apoptosis and promoted cell proliferation in the intestine. This study represents the first documentation of CPJIP's ability to enhance the expression of tight junction components, suppress inflammatory responses, and rescue intestinal cell fate by inhibiting JNK activation, ultimately mitigating intestinal severity. These findings suggest that CPJIP has the potential to serve as a promising candidate for the treatment of NEC.
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Apoptose , Enterocolite Necrosante , Inflamação , Mucosa Intestinal , Enterocolite Necrosante/tratamento farmacológico , Enterocolite Necrosante/metabolismo , Enterocolite Necrosante/patologia , Animais , Camundongos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/patologia , Inflamação/metabolismo , Inflamação/tratamento farmacológico , Inflamação/patologia , Apoptose/efeitos dos fármacos , Peptídeos/farmacologia , Modelos Animais de Doenças , Proliferação de Células/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Linhagem Celular , Ratos , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Lipopolissacarídeos , Função da Barreira IntestinalRESUMO
Richter's transformation (RT) is a progression of chronic lymphocytic leukemia (CLL) to aggressive lymphoma. MGA (Max gene associated), a functional MYC suppressor, is mutated at 3% in CLL and 36% in RT. However, genetic models and molecular mechanisms of MGA deletion that drive CLL to RT remain elusive. We established an RT mouse model by knockout of Mga in the Sf3b1/Mdr CLL model using CRISPR-Cas9 to determine the role of Mga in RT. Murine RT cells exhibited mitochondrial aberrations with elevated oxidative phosphorylation (OXPHOS). Through RNA sequencing and functional characterization, we identified Nme1 (nucleoside diphosphate kinase) as an Mga target, which drives RT by modulating OXPHOS. Given that NME1 is also a known MYC target without targetable compounds, we found that concurrent inhibition of MYC and electron transport chain complex II substantially prolongs the survival of RT mice in vivo. Our results suggest that the Mga-Nme1 axis drives murine CLL-to-RT transition via modulating OXPHOS, highlighting a potential therapeutic avenue for RT.
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Leucemia Linfocítica Crônica de Células B , Mitocôndrias , Fosforilação Oxidativa , Animais , Mitocôndrias/metabolismo , Leucemia Linfocítica Crônica de Células B/genética , Leucemia Linfocítica Crônica de Células B/patologia , Leucemia Linfocítica Crônica de Células B/metabolismo , Camundongos , Deleção de Genes , Humanos , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/metabolismo , Proteínas Proto-Oncogênicas c-myc/metabolismo , Proteínas Proto-Oncogênicas c-myc/genética , Modelos Animais de DoençasRESUMO
Sustained deep emission reduction in road transportation is encountering bottleneck. The Intelligent Transportation-Speed Guidance System (ITSGS) is anticipated to overcome this challenge and facilitate the achievement of low-carbon and clean transportation. Here, we compiled vehicle emission datasets collected from real-world road experiments and identified the mapping relationships between four pollutants (CO2, CO, NOx, and THC) and their influencing factors through machine learning. We developed random forest models for each pollutant and achieved strong predictive performance, with an R2 exceeding 0.85 on the test dataset for all models. The environmental benefits of ITSGS at the urban scale were quantified by combining emission models with large-scale real trajectory data from Zibo, Shandong Province. Based on temporal and spatial analyses, we found that ITSGS has varying degrees of emission reduction potential during the morning peak, flat peak, and evening peak hours. Values can range from 5.71 %-8.16 % for CO2 emissions, 13.63 %-16.25 % for NOx emissions, 13.69 %-16.45 % for CO emissions, and 4.84-7.07 % for THC emissions, respectively. Additionally, ITSGS can significantly expand the area of low transient emission zones. The best time for achieving maximum environmental benefits from ITSGS is during the workday flat peak. ITSGS limits high-speed and aggressive driving behavior, thereby smoothing the driving trajectory, reducing the frequency of speed switches, and lowering road traffic emissions. The results of the ITSGS environmental benefits evaluation will provide new insights and solutions for sustainable road traffic emission reduction. SYNOPSIS: Large-scale deployment of Intelligent Transportation - Speed Guidance System is a sustainable solution to help achieve low-carbon and clean transportation.
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Two-dimensional topological insulators hosting the quantum spin Hall effect have application potential in dissipationless electronics. To observe the quantum spin Hall effect at elevated temperatures, a wide band gap is indispensable to efficiently suppress bulk conduction. Yet, most candidate materials exhibit narrow or even negative band gaps. Here, via elegant control of van der Waals epitaxy, we have successfully grown monolayer ZrTe5 on a bilayer graphene/SiC substrate. The epitaxial ZrTe5 monolayer crystalizes in two allotrope isomers with different intralayer alignments of ZrTe3 prisms. Our scanning tunneling microscopy/spectroscopy characterization unveils an intrinsic full band gap as large as 254 meV and one-dimensional edge states localized along the periphery of the ZrTe5 monolayer. First-principles calculations further confirm that the large band gap originates from strong spin-orbit coupling, and the edge states are topologically nontrivial. These findings thus provide a highly desirable material platform for the exploration of the high-temperature quantum spin Hall effect.
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Vehicle exhaust is the primary source of polycyclic aromatic compounds (PACs). Real road tests using a portable vehicle measurement system on light-duty gasoline vehicles and light-duty diesel trucks were conducted to investigate gas- and particle-phase polycyclic aromatic hydrocarbons (PAHs), nitro-PAHs (NPAHs), and oxy-PAHs (OPAHs) in vehicle exhaust with different emission standards, fuel types, and altitudes. The results showed that with the tightening of emission standards, the overall emission factors (EFs) of PACs decreased. Compared with China V diesel vehicles, the emissions of PAHs, OPAHs, and NPAHs from China VI diesel vehicles were 75.1 %, 84.4 %, and 61.2 % lower, respectively. With a â¼100 m increase in altitude, the EFs of PAHs, OPAHs, and NPAHs of diesel vehicles increased 1.88, 1.92, and 1.59 times due to incomplete combustion. In addition, the EFs of PAHs and OPAHs in gasoline vehicles were lower than those in diesel vehicles. In contrast, the proportion of PAHs with highly toxic components, such as dibenzo[a,h]anthracene (DahA) and benzo[a]pyrene (BaP), and the EFs of gas-phase NPAHs in gasoline vehicles were higher than those in diesel vehicles. Furthermore, the emissions of 1,8-DNP from diesel vehicles cannot be disregarded. 1,8-DNP was the main gas-phase NPAHs emitted by China VI and China V diesel vehicles, accounting for 49.3 % and 26.0 %, respectively. Moreover, gas-phase PACs contributed more to the EFs than particle-phase PACs, whereas particle-phase PACs have greater toxic effects. Although the EFs of PAHs are more than 100 times those of NPAHs, the toxic equivalent concentrations (TEQBaP) of PAHs in diesel and gasoline vehicles were approximately 6.5 times and 35 times those of NPAHs. The spatial distribution characteristics revealed that PACs emissions were mainly concentrated in urban areas and highways, and the differences in the toxicity of PACs emissions between different cities depended on the proportion of diesel vehicles. The average TEQBaP of PAHs and NPAHs in Haidong, Haibei, Huangnan, Hainan, Guoluo, and Yushu was 8.42 µg/m3 and 0.36 µg/m3, respectively, while those of Xining and Haixi were 0.24-0.29 µg/m3 and 0.09-0.108 µg/m3 higher, respectively. This study provides a comprehensive understanding of the emission characteristics, health risks, and spatial distribution of PACs from diesel and gasoline vehicle PACs in urban areas.
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Poluentes Atmosféricos , Monitoramento Ambiental , Gasolina , Hidrocarbonetos Policíclicos Aromáticos , Emissões de Veículos , Emissões de Veículos/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Atmosféricos/análise , Gasolina/análise , China , Medição de Risco , HumanosRESUMO
PURPOSE: To determine whether posterior cruciate ligament (PCL) buckling (angular change) is associated with anterior cruciate ligament (ACL) status (intact or ruptured), meniscal bone angle (MBA), anterior tibial translation (ATT), body weight, femoral-tibial rotation (FTR), posterior tibial slope (PTS), PCL length and femoral-tibial distance (FTD) and to identify the factors that have the greatest influence. METHODS: All enrolled participants were scanned with a 3.0 T, 8-channel coil MRI system (Magnetom Verio; Siemens). Bone and soft tissue parameters were measured by MIMICS software for each subject and each measured parameter was correlated with PCL buckling phenomena. The correlated and statistically significant parameters were then analyzed by multiple linear regression to determine the magnitude of the effect of the different parameters on the PCL buckling phenomenon. RESULTS: A total of 116 subjects (50 ACL ruptured and 66 age, weight and height matched volunteers with uninjured knees) were enrolled. Among all measured parameters, there were 8 parameters that correlated with PCL angle (PCLA), of which ACL status had the strongest correlation with PCLA (r = - 0.67, p = < 0.001); and 7 parameters that correlated with PCL-posterior femoral cortex angle (PCL-PCA), of which ATT had the strongest correlation with PCL-PCA (r = 0.69, p = < 0.001). PCLIA was not significantly correlated with any of the measured parameters. Multiple linear regression analyses revealed four parameters can explain PCLA, of which ACL status had the strongest effect on PCLA (absolute value of standardized coefficient Beta was 0.508). Three parameters can explain PCL-PCA, of which ATT had the strongest effect on PCLIA (r = 0.69, p = < 0.001), ATT has the greatest effect on PCL-PCA (absolute value of normalized coefficient Beta is 0.523). CONCLUSIONS: PCLA may be a simple and easily reproducible and important supplement for the diagnosis of ACL injury; PCL-PCA is a simple and easily reproducible and important complementary tool for the detection of ATT. The use of PCLA is more recommended to aid in the diagnosis of ACL injury.
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Articulação do Joelho , Imageamento por Ressonância Magnética , Ligamento Cruzado Posterior , Tíbia , Humanos , Ligamento Cruzado Posterior/diagnóstico por imagem , Masculino , Feminino , Adulto , Articulação do Joelho/diagnóstico por imagem , Modelos Lineares , Adulto Jovem , Tíbia/diagnóstico por imagem , Tíbia/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Fêmur/diagnóstico por imagem , Fêmur/anatomia & histologia , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , AdolescenteRESUMO
AIMS: Radiofrequency ablation is used as a first-line therapy for accessory pathways (APs). However, data regarding the effects of pulsed field ablation (PFA) on APs are limited. We sought to evaluate the acute procedural and 6-month success and safety of PFA in a cohort of patients with APs. METHODS AND RESULTS: A focal contact force-sensing PFA catheter was used for patients with APs. Pulsed field ablation generator generated a bipolar and biphasic waveform (±1000â V) with a duration of 100â ms from the tip of the PFA catheter. A 100% acute procedural success was achieved in 10 conscious patients with APs (7 left anterolateral, 2 left inferolateral, and 1 right posteroseptal APs) including 6 (60%) patients after an initial application. The average total ablation time was 6.3 ± 4.9â s for 4.7 ± 1.8 ablation sites (ASs), including 3.1 ± 2.4â s at targets and 3.2 ± 2.9â s at 3.2 ± 2 bolus ASs. The mean skin-to-skin time was 59.3 ± 15.5â min, and PFA catheter dwell time was 29.4 ± 7.8â min. One patient encountered transient sinus arrest during PFA due to parasympathetic overexcitation. Sinus rhythm was restored in all patients without any significant adverse events during the short-term follow-up. CONCLUSION: Pulsed field ablation of APs was feasible, effective, and safe. Its efficiency was remarkable for its ultrarapid termination of AP conduction. Further studies are warranted to prove whether utilization of PFA with current parameters can extend to manifold AP ablation.
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Feixe Acessório Atrioventricular , Ablação por Cateter , Humanos , Projetos Piloto , Feminino , Masculino , Feixe Acessório Atrioventricular/cirurgia , Feixe Acessório Atrioventricular/fisiopatologia , Resultado do Tratamento , Adulto , Ablação por Cateter/métodos , Ablação por Cateter/efeitos adversos , Pessoa de Meia-Idade , Adulto Jovem , Fatores de Tempo , Frequência Cardíaca , Adolescente , Cateteres CardíacosRESUMO
This study addresses the literature gap concerning accurately identifying vehicle carbon emission characteristics in high-altitude areas. Utilizing a portable emission measurement system (PEMS) for real-world testing, we quantified the influence of altitude on carbon emissions from light-duty gasoline (LDGV) and diesel vehicles (LDDV). The Random Forest (RF) algorithm was employed to analyze the complex nonlinear relationships between altitude, meteorological conditions, driving patterns, and carbon dioxide (CO2) emissions, enabling predictions across different altitudes. The results showed that CO2 emissions progressively increase with elevation. Furthermore, as altitude increases, combustion efficiency declines, and the overall impact of driving conditions on emission rates diminishes. Altitude and meteorological factors significantly contributed to CO2 emissions, whereas driving conditions and road grades contributed less. Compared with the COPERT model, the RF model demonstrates strong accuracy in predicting carbon emissions at different altitudes. Specifically, the CO2 emission rate nearly triples as altitude increases from 2.0 km to 4.5 km. This research bridges a critical gap in the understanding carbon emissions from high-altitude vehicles, offering insights into policy development for emission reduction strategies in such regions. Future studies should integrate diverse testing methodologies and comprehensive surveys to validate and extend the findings.
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Semitransparent perovskite solar cells (STPSCs) have excellent potential for widespread application as building integrated photovoltaics. Widespread application of STPSCs could result in decreased CO2 footprints for buildings. Unfortunately, STPSCs tend to have poor aesthetic qualities (being usually red-brown in color) and low stability. Building on our previous work, here we use new poly(N-isopropylacrylamide) microgels (PNP MGs) to provide highly ordered non-close packed arrays within perovskite films that reflect some of the incident light to provide structural color to STPSCs. (MGs are swellable crosslinked polymer colloid particles.) We introduce PNP MGs into two different perovskites and achieve a wide gamut of reflected color and iridescence from the perovskite films. Devices containing the MGs have average visible transparency (AVT) values of greater than 25%. The best PCE for a MG-containing STPSC is 10.60% compared to 9.14% for the MG-free control. The MGs not only introduce structural color to the STPSCs but increase the PCE and stability. Equations are provided that enable the reflected color to be predicted from the formulation used to deposit the films. Our work shows that the self-ordering tendency of PNP MGs gives a viable new method for introducing structural color into STPSCs. Because our one-step method for introducing structural color into STPSCs is general, does not introduce any additional processing steps and is scalable whilst also improving device stability, this study may bring deployment of STPSCs closer.
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Prostate cancer (PCa) is a prevalent malignancy among men worldwide, and biochemical recurrence (BCR) after radical prostatectomy (RP) is a critical turning point commonly used to guide the development of treatment strategies for primary PCa. However, the clinical parameters currently in use are inadequate for precise risk stratification and informing treatment choice. To address this issue, we conducted a study that collected transcriptomic data and clinical information from 1662 primary PCa patients across 12 multicenter cohorts globally. We leveraged 101 algorithm combinations that consisted of 10 machine learning methods to develop and validate a 9-gene signature, named BCR SCR, for predicting the risk of BCR after RP. Our results demonstrated that BCR SCR generally outperformed 102 published prognostic signatures. We further established the clinical significance of these nine genes in PCa progression at the protein level through immunohistochemistry on Tissue Microarray (TMA). Moreover, our data showed that patients with higher BCR SCR tended to have higher rates of BCR and distant metastasis after radical radiotherapy. Through drug target prediction analysis, we identified nine potential therapeutic agents for patients with high BCR SCR. In conclusion, the newly developed BCR SCR has significant translational potential in accurately stratifying the risk of patients who undergo RP, monitoring treatment courses, and developing new therapies for the disease.
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Antígeno Prostático Específico , Neoplasias da Próstata , Masculino , Humanos , Benchmarking , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/terapia , Neoplasias da Próstata/metabolismo , Próstata/patologiaRESUMO
BACKGROUND AND PURPOSE: Collateral circulation plays an important role in steno-occlusive internal carotid artery disease (ICAD) to reduce the risk of stroke. We aimed to investigate the utility of planning-free random vessel-encoded arterial spin-labeling (rVE-ASL) in assessing collateral flows in patients with ICAD. MATERIALS AND METHODS: Forty patients with ICAD were prospectively recruited. The presence and extent of collateral flow were assessed and compared between rVE-ASL and DSA by using Contingency (C) and Cramer V (V) coefficients. The differences in flow territory alterations stratified by stenosis ratio and symptoms, respectively, were compared between symptomatic (n = 19) and asymptomatic (n = 21) patients by using the Fisher exact test. RESULTS: Good agreement was observed between rVE-ASL and DSA in assessing collateral flow (C = 0.762, V = 0.833, both P < .001). Patients with ICA stenosis of ≥90% were more likely to have flow alterations (P < .001). Symptomatic patients showed a higher prevalence of flow alterations in the territory of the MCA on the same side of ICAD (63.2%), compared with asymptomatic patients (23.8%, P = .012), while the flow alterations in the territory of anterior cerebral artery did not differ (P = .442). The collateral flow to MCA territory was developed primarily from the contralateral internal carotid artery (70.6%) and vertebrobasilar artery to a lesser extent (47.1%). CONCLUSIONS: rVE-ASL provides comparable information with DSA on the assessment of collateral flow. The flow alterations in the MCA territory may be attributed to symptomatic ICAD.
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Doenças das Artérias Carótidas , Estenose das Carótidas , Humanos , Estenose das Carótidas/diagnóstico por imagem , Constrição Patológica , Marcadores de Spin , Angiografia Digital , Artéria Carótida Interna/diagnóstico por imagem , Circulação Colateral , Circulação Cerebrovascular , Angiografia por Ressonância MagnéticaRESUMO
PURPOSE: Endovascular reconstruction has emerged as a viable alternative for carotid artery dissections (CADs) that are unresponsive to antithrombotic therapy. However, high cervical and long-segment CADs pose challenges during endovascular treatment due to their distal location and tortuous anatomy. We presented our experiences using endovascular reconstruction with the Leo plus stent for this type of CAD. METHODS: We conducted a retrospective review of patients with high cervical and long-segment CADs treated using the Leo plus stent. We analyzed patient demographics, clinical presentations, procedural features, complications, and follow-up outcomes. RESULTS: A total of 17 patients (mean age, 48.1 years) with 17 CADs were identified. Seven of these dissections were accompanied by pseudoaneurysm. The mean length of the dissection was 5.7 cm, and the mean degree of stenosis was 92.3%. A single Leo plus stent was deployed in 15 patients, while another Wallstent carotid stent was used in 2 cases. All stents were successfully positioned in their intended sites. The average degree of residual stenosis was 22.2%. There were no perioperative complications. With a median follow-up duration of 29 months, no ischemic stroke events occurred. All but one Leo plus stent remained patent during follow-up, and all 7 pseudoaneurysms had disappeared at the last radiological assessment. CONCLUSION: Our experience in treating high cervical and long-segment CADs with the Leo plus stent demonstrates that this approach is practical, safe, and effective, as evidenced by long-term observations. The Leo Plus stent appears to be a suitable option for managing this type of CAD.
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Dissecção Aórtica , Dissecação da Artéria Carótida Interna , Procedimentos Endovasculares , Humanos , Pessoa de Meia-Idade , Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Dissecação da Artéria Carótida Interna/cirurgia , Constrição Patológica/complicações , Resultado do Tratamento , Stents , Estudos Retrospectivos , Artérias CarótidasRESUMO
BACKGROUND: Spinal subarachnoid hematoma (SSH) is a known but rare entity that can cause cauda equina compression. The occurrence of SSH associated with aneurysmal subarachnoid hemorrhage has rarely been described in the literature. CASE PRESENTATION: A 56-year-old woman presented with subarachnoid hemorrhage secondary to a ruptured middle cerebral artery aneurysm and was managed with coiling embolization without stent assistance. There was no history of either lumbar puncture or the use of anticoagulants. The patient developed severe lumbago radiating to bilateral legs nineâ days after the procedure. Subsequent magnetic resonance imaging demonstrated a SSH extending from L5 to S2 and wrapping around the cauda equina. The patient was treated with intravenous methylprednisolone (250 mg/day) for four consecutive days, followed by a taper of oral prednisolone (20 mg/day) until complete recovery. Magnetic resonance imaging at one month follow-up revealed complete resolution of the SSH. CONCLUSIONS: Here, we report a case of acute cauda equina syndrome caused by a SSH after aneurysmal subarachnoid hemorrhage, which will facilitate timely intervention of patients with this disorder.
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Síndrome da Cauda Equina , Cauda Equina , Hemorragia Subaracnóidea , Feminino , Humanos , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/diagnóstico por imagem , Síndrome da Cauda Equina/complicações , Síndrome da Cauda Equina/diagnóstico por imagem , Hematoma/etiologia , Espaço Subaracnóideo , Imageamento por Ressonância MagnéticaRESUMO
OBJECTIVE: To report periprocedural thromboembolic complications of LEO Baby stent-assisted coiling of wide-necked intracranial aneurysms and to analyze the possible influencing factors. METHODS: We retrospectively identified 149 patients with aneurysms who underwent LEO Baby stent-assisted embolization between October 2018 and March 2022. Clinical and radiographic data of patients were reviewed to determine whether a thromboembolic event had occurred. Multivariate logistic analysis was performed to identify significant factors associated with thromboembolic events. RESULTS: Successful stent deployment of the stent was achieved in all patients in the target artery. There were 66 patients (44.3%) with acutely ruptured aneurysms and 83 patients (55.7%) with unruptured aneurysms. Fourteen (9.4%, 95% confidence interval: 4.7%-14.1%) patients were confirmed to have developed a thromboembolic event, including nine patients with acute intraoperative thrombosis and five patients with postoperative thromboembolic events. The rate of thromboembolic events was 6.0% (5/83) in patients with unruptured aneurysms and 13.6% (9/66) in patients with acutely ruptured aneurysms. There was a trend toward an increased rate of thromboembolic events in patients with acute ruptured aneurysms (p = 0.087). Thromboembolic events were significantly associated with the parent-artery diameter (p = 0.010). CONCLUSIONS: Our study demonstrates a low rate of thromboembolic complications in unruptured aneurysms treated with LEO Baby stent. Thromboembolic events appear to be more common in ruptured aneurysms. A small diameter of the parent artery is associated with an increased risk of thromboembolic complications, and more relevant studies are still needed.
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Background: Neuroendocrine neoplasms (NENs) are tumors that originate from secretory cells of the diffuse endocrine system and typically produce bioactive amines or peptide hormones. This paper describes the development and validation of a predictive model of the risk of lymph node metastasis among gastric NEN patients based on machine learning platform. Methods: In this investigation, data from 1256 patients were used, of whom 119 patients from the First Affiliated Hospital of Soochow University in China and 1137 cases from the surveillance epidemiology and end results (SEER) database were combined. Six machine learning algorithms, including the logistic regression model (LR), random forest (RF), decision tree (DT), Naive Bayes (NB), support vector machine (SVM), and k-nearest neighbor algorithm (KNN), were used to build the predictive model. The performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. Results: Among the 1256 patients with gastric NENs, 276 patients (21.97 %) developed lymph node metastasis. T stage, tumor size, degree of differentiation, and sex were predictive factors of lymph node metastasis. The RF model achieved the best predictive performance among the six machine learning models, with an AUC, accuracy, sensitivity, and specificity of 0.81, 0.78, 0.76, and 0.82, respectively. Conclusion: The RF model provided the best prediction and can help physicians determine the lymph node metastasis risk of gastric NEN patients to formulate individualized medical strategies.
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BACKGROUND: Alternative splicing (AS) is an omnipresent regulatory mechanism of gene expression that enables the generation of diverse splice isoforms from a single gene. Recently, AS events have gained considerable momentum in the pathogenesis of inflammatory bowel disease (IBD). METHODS: Our review has summarized the complex process of RNA splicing, and firstly highlighted the potential involved molecules that target aberrant splicing events in IBD. The quantitative transcriptome analyses such as microarrays, next-generation sequencing (NGS) for AS events in IBD have been also discussed. RESULTS: Available evidence suggests that some abnormal splicing RNAs can lead to multiple intestinal disorders during the onset of IBD as well as the progression to colitis-associated cancer (CAC), including gut microbiota perturbations, intestinal barrier dysfunctions, innate/adaptive immune dysregulations, pro-fibrosis activation and some other risk factors. Moreover, current data show that the advanced technologies, including microarrays and NGS, have been pioneeringly employed to screen the AS candidates and elucidate the potential regulatory mechanisms of IBD. Besides, other biotechnological progresses such as the applications of third-generation sequencing (TGS), single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics (ST), will be desired with great expectations. CONCLUSIONS: To our knowledge, the current review is the first one to evaluate the potential regulatory mechanisms of AS events in IBD. The expanding list of aberrantly spliced genes in IBD along with the developed technologies provide us new clues to how IBD develops, and how these important AS events can be explored for future treatment.