Safety and Efficacy of Stereotaxic Surgery Combined with Urokinase in the Treatment of Ventricular Hemorrhage: A Retrospective Propensity-Matched Score Analysis.

BACKGROUND: Intraventricular hemorrhage (IVH) is a severe and devastating stroke. Research on existing treatment options has been controversial. Therefore, we aimed to evaluate the safety and efficacy of minimally implanted stereotactic puncture combined with urokinase (uPA) in the treatment of IVH. METHODS: The clinical data of 122 IVH patients admitted to our department from 2018 to 2022 were retrospectively analyzed. According to the modified RanKin score (mRS) after 30 days, the patients were divided into good prognosis (mRS 0-3) and poor prognosis (mRS 4-6), and the factors affecting the prognosis were screened by univariate and multivariate analysis, and then the tendency Score matching and paired patient screening were performed for comparative analysis between uPA and non-uPA groups. RESULTS: Patients' age, uPA usage, initial Glasgow Coma Scale and primary blood volume all could affect the mRS score of patients. One hundred patients were finally included, including 50 cases in the uPA group and 50 cases in the non-uPA group. The analysis showed that at follow-up after 30 days, 46.0% of the patients in the uPA group and 28.0% in the non-uPA group had an mRS score of 0-3; however, they were not statistically significantly different. The postoperative hematoma clearance rate in the uPA group was significantly higher than that in the non-uPA group (P < 0.001), and the incidence of postoperative complications was not increased (P > 0.05). CONCIUSIONS: uPA treatment can improve the treatment efficiency. However, its effect in improving patient outcomes does not appear to be significant.

Cerebrospinal fluid drainage and chronic hydrocephalus in aneurysmal subarachnoid hemorrhage patients with intraventricular hemorrhage.

Background: Patients with intraventricular hemorrhage (IVH) are at a higher risk of developing hydrocephalus and often require external ventricular drainage or long-term ventriculoperitoneal shunt surgery. Objective: To investigate whether cerebrospinal fluid drainage in patients with IVH due to aneurysmal subarachnoid hemorrhage (aSAH) reduces the incidence of chronic hydrocephalus. Method: A retrospective analysis was conducted on patients with aSAH treated at our hospital between January 2020 and December 2022. The first analysis compared patients with and without IVH, while the second analysis compared IVH patients with and without chronic hydrocephalus. The third analysis compared IVH patients who underwent in different drainage methods which is lumbar drainage (LD) or external ventricular drainage (EVD). The primary outcome measure was the incidence of chronic hydrocephalus. Result: Of the 296 patients hospitalized with aSAH, 108 (36.5%) had IVH, which was associated with a significantly higher incidence of chronic hydrocephalus compared to patients without IVH (49.1% vs. 16.5%, p < 0.001). Multivariate logistic regression analysis showed that IVH was independently associated with the formation of chronic hydrocephalus (OR: 3.530, 95% CI: 1.958-6.362, p < 0.001). Among the 108 IVH patients, 53 (49.1%) developed chronic hydrocephalus. Multivariate logistic regression analysis revealed that the Hunt Hess grade at admission (OR: 3.362, 95% CI: 1.146-9.863, p = 0.027) and postoperative cerebrospinal fluid drainage (OR: 0.110, 95% CI: 0.036-0.336, p < 0.001) were independent risk factors for the development of chronic hydrocephalus in IVH patients. Among all IVH patients who underwent cerebrospinal fluid drainage, 45 (75%) received continuous lumbar puncture drainage, and 15 (25%) received external ventricular drainage. Univariate analysis did not show a statistically significant difference between the two groups in terms of postoperative chronic hydrocephalus (p = 0.283). However, multivariate logistic regression analysis suggested that the drainage methods of LD and EVD might be associated with the development of chronic hydrocephalus. Conclusion: The presence of IVH increases the risk of chronic hydrocephalus in patients with aSAH, and postoperative cerebrospinal fluid drainage appears to reduce this risk. The specific effects of lumbar puncture drainage and ventricular drainage on the incidence of chronic hydrocephalus require further investigation.

Risk factors for emergency endoscopic variceal ligation treatment failure of acute variceal bleeding.

OBJECTIVE: To determine the risk factors for emergency endoscopic variceal ligation (EVL) failure in acute variceal bleeding (AVB). METHODS: Data from 161 cirrhosis patients with oesophageal variceal bleeding who underwent emergency EVL treatment at the Second Hospital of Hebei Medical University from January 2018 to May 2021 were retrospectively analysed. Enrolled patients were divided into a successful treatment group and a failed treatment group. The variables studied were demographic, clinical, imaging, laboratory, and endoscopic data from the enrolled patients. RESULTS: Of the enrolled patients, 19 patients experienced emergency EVL failure. Of these patients, nine underwent emergency endoscopic treatment again, six patients were treated with a Sengstaken-Blakemore tube for haemostasis and endoscopic treatment, four patients received drug therapy. The presence of portal vein thrombosis (PVT) in the failure group was higher than that in the success group (p < .05). Active bleeding on endoscopy was associated with emergency EVL failure for patients with Child-Pugh class C (p < .05). CONCLUSIONS: Child-Pugh class C with active bleeding on endoscopy or the presence of PVT could increase the risk of emergency EVL failure. The patient's condition should be fully evaluated before emergency endoscopic treatment to reduce the risk of failure.

Hydrogenated Amorphous Titania with Engineered Surface Oxygen Vacancy for Efficient Formaldehyde and Dye Removals under Visible-Light Irradiation.

Hydrogenated crystalized TiO2-x with oxygen vacant (OV) doping has attracted considerable attraction, owing to its impressive photoactivity. However, amorphous TiO2, as a common allotrope of titania, is ignored as a hydrogenated templet. In this work, hydrogenated amorphous TiO2-x (HAm-TiO2-x) with engineered surface OV and high surface area (176.7 cm2 g-1) was first prepared using a unique liquid plasma hydrogenation strategy. In HAm-TiO2-x, we found that OV was energetically retained in the subsurface region; in particular, the subsurface OV-induced energy level preferred to remain under the conduction band (0.5 eV) to form a conduction band tail and deep trap states, resulting in a narrow bandgap (2.36 eV). With the benefits of abundant light absorption and efficient photocarrier transportation, HAm-TiO2-x coated glass has demonstrated superior visible-light-driven self-cleaning performances. To investigate its formaldehyde photodegradation under harsh indoor conditions, HAm-TiO2-x was used to decompose low-concentration formaldehyde (~0.6 ppm) with weak-visible light (λ = 600 nm, power density = 0.136 mW/cm2). Thus, HAm-TiO2-x achieved high quantum efficiency of 3 × 10-6 molecules/photon and photoactivity of 92.6%. The adsorption capabilities of O2 (-1.42 eV) and HCHO (-1.58 eV) in HAm-TiO2-x are both largely promoted in the presence of subsurface OV. The surface reaction pathway and formaldehyde decomposition mechanism over HAm-TiO2-x were finally clarified. This work opened a promising way to fabricate hydrogenated amorphous photocatalysts, which could contribute to visible-light-driven photocatalytic environmental applications.