Isolation and target identification of antihepatoma polyprenylphenols from the edible mushroom Suillus granulatus.

Eight polyprenylphenol derivatives were isolated from the wild edible mushroom Suillus granulatus, including seven novel compounds, named suillin F-L (2-8), and one previously identified compound (1). The structures of the new compounds were elucidated using HR-ESI-MS and 1D and 2D NMR data. The absolute configuration of compound 8 was assigned based on the comparison of the experimental and calculated ECD data. All isolated compounds were evaluated for their cytotoxicity against HepG2 cancer cell lines. Compounds 1 and 3-6 demonstrated significant antitumor activity compared to the positive control (cisplatin), with IC50 values ranging from 8.19 to 13.97 µM. Furthermore, DARTS assay and LC-MS/MS analysis were used to identify HSP90AA1 as the direct target of compound 5, and the interaction between compound 5 and HSP90AA1 was verified by molecular docking.

Occurrence and seasonal variations of organophosphate flame retardants in air and dust from college microenvironments at Qingdao, China: Implications for student's exposure and risk assessment.

Organophosphate flame retardants (OPFRs) are widely used as alternatives to brominated flame retardants in a variety of consumer products and their consumption has continuously increased in recent years. However, their concentrations and human exposures in indoor microenvironments, particularly in a university environment, have received limited attention. In this study, the concentrations and seasonal variations of 15 OPFRs were assessed in typical microenvironments of two universities, including dormitories, offices, public microenvironments (PMEs: classroom, dining hall, gymnasium and library), and laboratories on the northern coast of China. Analysis of the OPFRs in both air and dust samples indicated widespread distribution in college campuses. The average concentration of ∑15OPFRs in the winter (12,774.4 ng/g and 5.3 ng/m3 for dust and air, respectively) was higher than in the summer (2460.4 ng/g and 4.6 ng/m3 for dust and air, respectively). The dust and air samples collected from PMEs and laboratories exhibited higher concentrations of OPFRs, followed by offices and dormitories. An equilibrium was reached between dust and air in all collected microenvironments. The daily intakes of OPFRs were significantly lower than the reference dose. Dust ingestion was the primary intake pathway in the winter, while inhalation and dust ingestion were the main intake pathways in the summer. The non-carcinogenic hazard quotients fell within the range of 10-7-10-3 in both the summer and winter, which are below the theoretical risk threshold. For the carcinogenic risk, the LCR values ranged from 10-10 to 10-8, indicating no elevated carcinogenic risk due to TnBP, TCEP, and TDCP in indoor dust and air.

Anti-Hyperglycemic Effect of the Brown Slime Cap Mushroom Chroogomphus rutilus (Agaricomycetes) Crude Polysaccharide In Vitro and In Vivo.

The prevalence of diabetes is increasing worldwide, and it is very important to study new hypoglycemic active substances. In this study, we investigated the hypoglycemic effect of Chroogomphus rutilus crude polysaccharide (CRCP) in HepG2 cells and streptozotocin-induced diabetic mice. A glucose consumption experiment conducted in HepG2 cells demonstrated the in vitro hypoglycemic activity of CRCP. Furthermore, CRCP exhibited significant hypoglycemic effects and effectively ameliorated insulin resistance in insulin resistant HepG2 cells. In high-fat diet and streptozotocin-induced diabetic mice, after 4 weeks of CRCP administration, fasting blood glucose, fasting serum insulin, triglyceride, total cholesterol, low-density lipoprotein cholesterol, glutamate transaminase, alanine transaminase, and insulin resistance index significantly decreased, while high-density lipoprotein cholesterol and insulin sensitivity index (ISI) were markedly increased. Moreover, hematoxylin-eosin (HE) staining and immunofluorescence labeling of tissue sections indicated that CRCP attenuated the pathological damage of liver and pancreas in diabetic mice. These results indicate that CRCP is a potential hypoglycemic agent.

Six new polyphenolic metabolites isolated from the Suillus granulatus and their cytotoxicity against HepG2 cells.

Edible mushrooms are an important source of nutraceuticals and for the discovery of bioactive metabolites as pharmaceuticals. In this work, six new polyphenolic metabolites suillusol A-D (1-4), suillusinoic acid (5), ethyl suillusinoate (6), were isolated from the Suillus granulatus. The structures of new compounds were elucidated using high-resolution electrospray ionization mass spectroscopy, nuclear magnetic resonance data, and single-crystal X-ray diffraction analysis. As far as we know, compound 1 represents an unprecedented type of natural product and compound 3 represents a new type of polyphenol fungal pigment, which may be biosynthetically related to thelephoric acid. The cytotoxicity against HepG2 cells of the new compounds were also evaluated. Compound 2 demonstrate significant inhibitory activity against HepG2 cells with IC50 values of 10.85 µM, surpassing that of positive control cisplatin. Moreover, compound 1 and 3 also exhibited moderate cytotoxic activity with their IC50 values measured at 35.60 and 32.62 µM, respectively. Our results indicate that S. granulatus is a rich source of chemical constituents that may provide new lead compounds for the development of anticancer agents.

Chemical Compounds, Bioactivities, and Potential Applications of the Mushroom Species of Genus Suillus (Agaricomycetes): A Review.

The genus Suillus, also known as "Song mo," falls under the order Boletales and consists of various higher fungi. It establishes mycorrhizae primarily with pine trees and has a good taste and medicinal values. Herein, we reviewed the chemical compounds present in the genus Suillus, including polysaccharides, steroids, phenols, polyprenyl phenol derivatives, fatty acids, organic acids, and amino acids, and their reported bioactivities and potential applications. This review aims to promote the utilization of the resources belonging to the genus Suillus and serves as a theoretical basis for their future studies and clinical applications.

Two new compounds from edible mushroom Sarcomyxa edulis.

Chemical investigation of the edible mushroom Sarcomyxa edulis led to the isolation of one new highly degraded sterol (1), and one new ß-carboline alkaloid (2), along with nine known compounds (3-11) for the first time from this mushroom. The structures of new compounds were elucidated using HR-ESI-MS data and NMR spectroscopy. In addition, anti-inflammatory activity of new compounds was evaluated against lipopolysaccharide-induced NO production in RAW 264.7 macrophages. Compound 2 exhibited a good anti-inflammatory activity with IC50 value of 9.88 ± 0.48 µM, and compound 1 exhibited a weak inhibitory effect with IC50 value of 71.36 ± 5.11 µM.

Accuracy and digital screw path design of TiRobot-assisted pedicle screw placement for lumbar spondylolisthesis.

PURPOSE: To investigate lumbar spondylolisthesis screw placement assisted by TiRobot in terms of digital screw path design, accurate implementation, and accuracy evaluation method. METHODS: In this study, we enrolled 40 patients with lumbar spondylolisthesis between December 2020 and August 2021 who underwent spine surgery at the Affiliated Hospital of PuTian University. Pre-operative computed tomography position and screw path designation, intra-operative pedicle screw placement according to pre-operative planning, and post-operative evaluation of the accuracy of screw placement were performed. 3D coordinates of the entry and exit points before and after the operation were collected. The qualified points at different levels of accuracy were counted. The screw placement accuracy was based on the absolute difference using the Chi-squared test. RESULTS: In total, 194 screws were successfully implanted with no screws penetrating the cortex. The absolute difference of entry points X, Y, and Z coordinates before and after the operation was 0.425 ± 0.294 mm, 0.417 ± 0.310 mm, and 0.466 ± 0.327 mm, respectively. The corresponding values in terms of exit points were 0.702 ± 0.470 mm, 0.963 ± 0.595mm, and 0.983 ± 0.566 mm, respectively. No obvious differences in coordinates before and after the operation were observed with an entry point degree of accuracy of ≥ 1.2 mm and exit point degree of accuracy of ≥ 2.1 mm. Therefore, the real surgery was consistent with the design. CONCLUSIONS: TiRobot-assisted lumbar spondylolisthesis surgery achieved optimal path designation and precise surgery.

Chemical Constituents from Mushroom Suillus luteus (Agaricomycetes) and Their Bioactivities.

Wild edible mushrooms are a huge source to discover bioactive natural products. In this work, one new polyprenylphenol derivative, termed 2-geranylgeranyl-1,4-benzenediol 1-O-acetate (1), together with eight known compounds (2-9) were isolated from wild edible mushroom Suillus luteus. The structure of new compound was elucidated by high-resolution electrospray ionization mass spectroscopy and nuclear magnetic resonance data. The structures of known compounds were elucidated by comparison of their nuclear magnetic resonance data with literature data. Compounds 1-7 exhibited significant 2,2-diphenyl-1-picrylhydrazyl free radical scavenging activity with IC50 values ranging from 1.55 ± 0.29 to 19.89 ± 2.28 µM. In addition, compounds 1-7 also showed tyrosinase inhibitory activity with IC50 values ranging from 21.97 ± 3.74 to 66.26 ± 6.85 µM.

Armillaria mellea fermentation liquor ameliorates p-chlorophenylalanine-induced insomnia associated with the modulation of serotonergic system and gut microbiota in rats.

In China, Armillaria mellea (Vahl) P. Kumm. has been used as a folk medicine to treat insomnia for several hundred years. However, the underlying mechanisms involved are currently unknown. In this study, the anti-insomnia efficacy of A. mellea fermentation liquor (AFL) was evaluated in p-chlorophenylalanine-induced insomnia rats by measuring the serotonergic systems and gut microbiota. Our results demonstrate that all doses of AFL significantly reduced locomotor activity and alleviated decreasing weights in insomnia rats. Further, AFL exhibited better sedative effects by reducing sleep latency and increasing sleep duration in pentobarbital-treated rats. AFL treatment also elevated serum glutathione peroxidase and superoxide dismutase levels, while reducing serum interleukin-6, tumor necrosis factor-α, and interleukin-1ß levels. Furthermore, AFL alleviated insomnia by enhancing 5-hydroxytryptamine content and the expression 5-HT1A and 5-HT2A receptor in the hippocampus. Meanwhile, AFL treatment normalized the composition of gut microbiota in insomnia-model rats, while increasing relative abundance of Lachnospiraceae, Ruminococcaceae, and Saccharimonadaceae restores the gut microbial ecosystem altered in insomnia rats. The experiments show that A. mellea alleviated insomnia by modulating serotonergic system and gut microbiota. PRACTICAL APPLICATIONS: Insomnia has become a serious health issue of global concern. As a well-known traditional Chinese medicine, Armillaria mellea has been clinically employed in the treatment of insomnia for centuries in Asia with significant efficacy. In the present study, we firstly reported A. mellea fermentation liquor potentially relieved insomnia rats by alteration of gut microbiota and serotonergic systems and could guide future clinical studies. As a popular edible and medicinal mushroom, A. mellea also can be potentially used in the development and production of novel food products in the future.

Structural characterisation and antitumor activity against non-small cell lung cancer of polysaccharides from Sanghuangporus vaninii.

The medicinal fungus Sanghuangporus vaninii can be cultivated in large scale and has outstanding antitumour activity. In this study, water-soluble S. vaninii polysaccharides (SVPs) were extracted from fruiting bodies. Four polysaccharide sub-fractions (SVP-W, SVP-1, SVP-2 and SVP-3) were isolated, with molecular weights from 90.50 kDa to 261.70 kDa, and all inhibited the proliferation of non-small cell lung cancer cell lines A549, 95-D and NCI-H460, especially the acidic SVP-1. SVP-1 affected cell morphology and colony formation in NCI-H460 cells. It also promoted cell apoptosis following nuclear fluorescence staining and flow cytometry. Methylation and nuclear magnetic resonance analyses revealed that SVP-1 is a heteroglycan with the main chain →4)-ß-D-Glcp-(1 â†’ 6)-ß-D-Glcp-(1 â†’ 6)-α-D-Galp-(1 â†’ 6)-ß-D-Glcp-(1→, and the branched chain α-D-Manp-(1 â†’ 2)-α-D-Manp-(1 â†’ 3)-ß-D-Glcp-(1 â†’ 3,6)-ß-D-Glcp-(1→. The findings indicate that this natural acidic polysaccharide has potential for non-small cell lung cancer therapy.

Impact of septal myectomy on diastolic function in patients with obstructive hypertrophic cardiomyopathy.

BACKGROUND: The impact of septal myectomy on diastolic function in patients with obstructive hypertrophic cardiomyopathy is not well studied. METHODS: A transcatheter hemodynamic study was performed before and 3 to 6 months after septal myectomy in 12 patients with obstructive hypertrophic cardiomyopathy (HCM). RESULTS: Postoperative hemodynamic studies were done 4.4±1.2 months after myectomy. The left ventricular outflow tract peak-to-peak gradient decreased from 83.2±43.3 mmHg preoperatively to 11.6±4.3 mmHg after myectomy (P<0.00). The left ventricular diastolic time constant (Tau) was 64.2±26.1 ms before surgery and 42.2±15.7 ms postoperatively (P=0.029). The average left atrial pressure (LAP) decreased from 20.2±7.0 to 12.1±4.5 mmHg after myectomy (P=0.008). Pulmonary artery hypertension was present in 6 patients preoperatively and remained in 2 patients after myectomy. Mean pulmonary artery pressure decreased from 29.3±16.2 to 20±6.7 mmHg after surgery (P=0.05), and the systolic pulmonary artery pressure decreased from 46±26.9 to 30.5±8.3 mmHg (P=0.048). Pulmonary vascular resistance decreased from 5.7±4.1 to 3.6±1.6 wood after surgery (P=0.032). CONCLUSIONS: Septal myectomy improved left ventricular diastolic function and subsequently relieved the right ventricular congestion in patients with obstructive HCM.

Novel hypoglycemic compounds from wild mushroom Paxillus involutus.

Wild mushrooms are an important source of secondary metabolites possessing a broad range of biological activities. In this study, eight new compounds, named furanopaxin A-F (1-6), deoxybisinvolutone (7), and coumarinvol (8) along with two known compounds were isolated from fruiting bodies of the wild mushroom Paxillus involutus (Batsch) Fr. Their structures were established based on HR-ESI-MS and 1D and 2D NMR spectroscopic data. The results of hypoglycemic assays indicated that compounds 5-8 possessed significant α-glucosidase inhibitory activities, with IC50 values ranging from 14.65 ± 1.68 to 47.55 ± 1.47 µM, and each compound could enhance glucose consumption in insulin-resistance HepG2 cells. Further analysis by molecular docking implied that compounds 5-8 could interact with the amino acid residues of α-glucosidase, supporting the hypoglycemic activity of the compounds.

Novel 2,5-Diarylcyclopentenone Derivatives from the Wild Edible Mushroom Paxillus involutus and Their Antioxidant Activities.

Wild edible mushrooms are important as a source of nutraceuticals and for the discovery of bioactive metabolites as pharmaceuticals. In this work, 10 rare 2,5-diarylcyclopentenone derivatives were isolated from the wild edible mushroom Paxillus involutus (Batsch) Fr., including eight novel compounds termed involutenone A-H (1-8) and two previously identified compounds (9-10). Their structures were established using high-resolution electrospray ionization mass spectroscopy and 1D and 2D nuclear magnetic resonance data. The absolute configurations of compounds 1-3 and 6-8 were assigned based on the comparison of the experimental and calculated electronic circular dichroism data. The antioxidant activities of 1-8 were tested through DPPH free radical scavenging, hydroxyl radical scavenging, and superoxide anion radical scavenging assays. Compounds 3, 5, 6, and 7 demonstrated significant antioxidant activity compared to the positive control (tert-butylhydroquinone). These compounds could be effective natural antioxidants with considerable pharmaceutical value.

Transbrachial Access for Transcatheter Closure of Paravalvular Leak Following Prosthetic Valve Replacement.

Background: Transcatheter closure of paravalvular leak (PVL) has evolved into an alternative to surgery in high-risk patients. In this study, we introduce a new access for transcatheter closure of PVL and seek to evaluate the feasibility and safety of this access. Methods: We retrospectively analyzed patients undergoing transbrachial access for transcatheter mitral or aortic PVL closure (August 2017-November 2019) at our hospital. All patients underwent puncture of the brachial artery under local anesthesia. Results: The study population included 11 patients, with an average age of 55.91 ± 14.82 years. Ten out of 11 patients were successfully implanted with devices via the brachial artery approach, and one patient was converted to the transseptal approach. The technical success rate of transbrachial access was 90.9%. Mean NYHA functional class improved from 3.1 ± 0.5 before the procedure to 1.9 ± 0.5 after PVL closure. Severe paravalvular regurgitation (PVR) in five patients and moderate PVR in six patients prior to the procedure were significantly reduced to mild in four patients and none in seven patients after the procedure. Complications included one case of pseudoaneurysm and one case of moderate hemolysis aggravation after closure. One patient had an unknown cause of sudden death within 24 h after the procedure. The half-year mortality rate during follow-up was 9.1% (1/11). Conclusions: Transbrachial access for transcatheter closure of PVL may be a feasible and safe treatment and should include well-selected patients. It has several potential advantages of simplifying the procedure process and reducing postprocedural bed rest time.

Protective effect of coumarin-pi against t-BHP-induced hepatotoxicity by upregulating antioxidant enzymes via enhanced Nrf2 signaling.

Coumarin-pi, a new coumarin derivative isolated from the mushroom Paxillus involutus, has antioxidative activity, but the underlying mechanism against intracellular oxidative stress is still unclear. This study investigated its cytoprotective effects and the antioxidative mechanism in tert-butyl hydroperoxide (t-BHP)-induced HepG2 cells. The results demonstrated that coumarin-pi suppressed t-BHP-stimulated cytotoxicity, cell apoptosis, and generation of reactive oxygen species (ROS). Additionally, coumarin-pi promoted nuclear factor erythroid 2-related factor 2 (Nrf2) expression and upregulated the protein expression of antioxidantenzymes, including heme oxygenase-1 (HO-1), NAD(P)H: quinone oxidase (NQO1), glutamyl cysteine ligase catalytic subunit (GCLC), and glutamate-cysteine ligase regulatory subunit (GCLM). After coumarin-pi treatment, transcriptome sequencing and bioinformatic analysis revealed that 256 genes were differentially expressed; interestingly, only 20 genes were downregulated, and the rest of the genes were upregulated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional annotation were used to identify changes in metabolic pathways. Collectively, the results presented in this study indicate that coumarin-pi has a protective effect against t-BHP-induced cellular damage and oxidative stress.

Comparison of Percutaneous Transforaminal Endoscopic Discectomy with and without Epidural Steroid Application in the Treatment of Lumbar Disc Herniation: A Minimum of 2 Years of Follow-Up.

AIM: To compare the efficacy of percutaneous transforaminal endoscopic discectomy with and without epidural steroid application in the treatment of lumbar disc herniation. MATERIAL AND METHODS: A total of 101 patients who had indications for percutaneous transforaminal endoscopic discectomy were retrospectively reviewed. Patients were divided into two groups based on whether epidural steroids were applied following the surgical procedure. Each patient in group A received an epidural injection of 40mg triamcinolone acetonide through the working sleeve following the surgical procedure. However, patients in group B were not given the drug. Preoperative and postoperative radicular pain was measured with the visual analogue scale (VAS). Functional and satisfaction outcomes were measured with the Oswestry Disability Index (ODI) and the modified MacNab criteria, respectively. RESULTS: A total of 97 patients had a complete follow-up of longer than two years without recurrence. The sample sizes of group A and group B were 56 and 41. The VAS scores and ODI scores at each postoperative follow-up point were significantly lower than the preoperative values (p < 0.001). However, there were no significant between-group differences (p > 0.05). The secondary outcomes of the changes in the VAS and ODI scores were also equivalent between the groups at the 3-month and 2-year follow-ups (p > 0.05). No significant difference was observed in the modified MacNab criteria between the groups at 2 years (p=0.7715). CONCLUSION: Percutaneous transforaminal endoscopic discectomy is a safe and effective minimally invasive surgery for radiculopathy caused by lumbar disc herniation. Epidural steroid injection following the surgical procedure offered no benefit compared with surgery alone.

Emission characteristics and temporal variation of PAHs and their derivatives from an ocean-going cargo vessel.

Polycyclic aromatic hydrocarbons (PAHs), nitro- (NPAHs) and oxy-derivatives (OPAHs) are of considerable concern due to their toxicity and carcinogenic hazards. Ships are recognized as an important emission source of these compounds. Marine diesel oil (MDO) and heavy fuel oil (HFO) are the two most commonly used fuels. The emission characteristics and toxicities of PM2.5-bound PAHs, NPAHs and OPAHs due to HFO and MDO combustion in atypical ocean-going vessel were investigated. The EF variability of polycyclic aromatic compounds (PACs) varied considerably with the fuel formulation (HFO and MDO) and engine loading (20%-100%). The concentration of ΣPACs was 0.63 mg/kWh for MDO and ranged from 2.14 to 9.80 mg/kWh for HFO. Compared to HFO-20%, the EFs of ΣPAHs, ΣNPAHs and ΣOPAHs from MDO-20% were reduced by 97%, 77% and 73%, respectively. As identified through the coefficient of divergence, the profile of HFO-20% was notably different from those under the other three engine loadings for HFO. In addition, the emissions of ΣPAHs and ΣOPAHs showed a significant correlation with PM2.5, while they were relatively weak for ΣNPAHs. However, the CO and PAC emissions were not highly correlated. Furthermore, the BaPeq-ΣPAHs values were 0.010 mg/g for MDO and ranged from 0.092 mg/g to 0.306 mg/g for HFO, and the reduction ranged from 89% to 97% by substituting MDO for HFO. These data highlight the importance of improving fuel quality in close proximity to port areas and are useful for enhancing relevant databases.

Morphometric measurement of lower lumbar intervertebral foramina based on digital three-dimensional simulation.

AIM: This study aimed to investigate the morphology of the lower lumbar intervertebral foramina through use of a digital three-dimensional (3D) simulation model to guide the endoscope through the intervertebral foramina. MATERIAL AND METHODS: Individuals without disease affecting the lumbar vertebrae underwent computed tomography (CT) scanning in the supine position. The CT images obtained were imported to medical software to reconstruct a 3D model of the lumbar vertebrae. The stereoscopic longitudinal and transverse diameters of the lumbar intervertebral foramina were measured directly on the established simulation model. Comparisons in terms of sex and age were performed using t-test or analysis of variance. RESULTS: In total, 100 individuals were included in the study. Average longitudinal and transverse diameters of the lower lumbar intervertebral foramen decreased moving inferiorly. The longitudinal and transverse diameters of the lower lumbar intervertebral foramina were similar between sexes and between age groups. However, longitudinal diameter decreased with age (P 0.05). CONCLUSION: The reconstructed lumbar vertebrae simulation model presented in this study has high fidelity to the structure of the human lumbar spine. This approach provides individualized, accurate, standardized, and detailed guidance for endoscopic surgery through the lumbar intervertebral foramen.

Effect of end-grafted PEG conformation on the hemocompatibility of poly(styrene-b-(ethylene-co-butylene)-b-styrene).

Polyethylene glycol (PEG) with one and two ends are grafted onto poly(styrene-b-(ethylene-co-butylene)-b-styrene) (SEBS) via polydopamine (PDA) as a spacer to fabricate a hemocompatible surface. Linear and looped conformational PEGs modified SEBS are obtained, and the structures and compositions are confirmed by attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and X-ray photoelectron spectroscopy (XPS). The hemocompatibility of SEBS are improved by the modification of PDA and PEG, and the proteins resistances of the looped PEG are superior to that of the linear PEG with the same grafting length and mass. Quartz crystal microbalance with dissipation illustrates that the protein resistance mechanism of looped PEG is because of the huge viscoelasticity and deformation. Furthermore, looped and linear PEGs with the same grafting density are grafted onto SEBS surface to clarify the superiority of the looped conformation. Protein adsorption of looped PEG with twice length of linear PEG shows lower adsorbed amount than the others. Therefore, immobilizing the looped conformation of PEG on SEBS surface is a versatile and efficient way to improve the hemocompatibility of SEBS.

Risk factors predicting a higher grade of subarachnoid haemorrhage in small ruptured intracranial aneurysm (< 5 mm).

AIM: To identify the risk factors for clinical and radiographic grades of subarachnoid haemorrhage (SAH) in small (< 5 mm) intracranial aneurysms (SIAs). MATERIAL AND METHODS: We retrospectively analysed patients with SIAs treated in our centre between February 2009 and June 2018. The clinical status was graded using the Hunt and Hess (H&H) score and the radiological severity of SAH was graded by Fisher grades (FG). The risk factors were determined using multivariate logistic regression analysis. RESULTS: A total of 160 patients with ruptured SIAs (< 5 mm) were included. In univariate analysis, smoking (P = 0.007), alcohol use (P = 0.048), aspirin use (P = 0.001), and higher size ratio (SR) (P = 0.001) were significantly associated with a higher H&H grade (3-5) in SIAs; and smoking (P = 0.019), aspirin use (P = 0.031), inflow angle < 90 degrees (P = 0.011), and aneurysm size (P = 0.039) were significantly associated with a higher FG score (3-4). In the adjusted multivariate analysis, previous SAH (OR, 12.245, 95% CI, 2.261-66.334, P = 0.004), aspirin use (OR, 4.677, 95% CI, 1.392-15.718, P = 0.013), alcohol use (OR, 3.392, 95% CI, 1.146-10.045, P = 0.027), inflow angle < 90 (OR, 3.881, 95% CI, 1.273-11.831, P = 0.017), and higher SR (OR, 6.611, 95% CI, 2.235-19.560, P = 0.001) were independent risk factors for a higher H&H grade in ruptured SIAs; smoking (OR, 2.157, 95% CI, 1.061-4.384, P = 0.034), and inflow angle < 90 degrees (OR, 2.603, 95% CI, 1.324-5.115, P = 0.006) were independent risk factors for a higher FG (3-4). CONCLUSIONS: This study revealed that inflow angle < 90 degrees and size ratio, but not absolute size, may highly predict poorer grade of SAH in SRA. Aspirin use, previous SAH, and alcohol use were significantly associated with a higher H&H grade in ruptured SIAs, and smoking was a significant predictor of poorer FG.