Neuroendoscopic Surgery Versus Stereotactic Aspiration in the Treatment of Supratentorial Intracerebral Hemorrhage: A Meta-Analysis.

BACKGROUND: Debate persists over the relative merits of neuroendoscopic surgery (NS) compared to stereotactic aspiration (SA) for treating supratentorial intracerebral hemorrhage (ICH). Consequently, we undertook this meta-analysis to assess the efficacy and safety of NS versus SA. METHODS: We searched for the all-relevant studies systematically from English databases including PubMed, Embase, Web of Science, and the Cochrane Library. Three independent researchers identified and selected these literatures that met the inclusion criteria. Then we evaluated the quality of these studies according to the Cochrane Collaboration's risk of bias tool and the Newcastle-Ottawa Scale. RevMan 5.4 statistical software was used to conduct this meta-analysis. RESULTS: Sixteen studies, including 2722 supratentorial ICH patients, were included in our meta-analysis. The pooled results showed that NS could effectively improve the functional prognosis (P = 0.002), reduce the postoperative mortality (P < 0.00001), and increase the hematoma evacuation rate (P < 0.00001). In addition, SA had more advantages in shortening operation time (P < 0.00001) and reducing intraoperative blood loss (P < 0.0001). However, there was no obvious statistical difference in intensive care unit stays (P = 0.23) between NS and SA. Besides, no sufficient evidence could support a significant difference in hospital stays. In the aspect of complications, NS was discovered to have a positive effect on preventing rebleeding (P = 0.005) and intracranial infection (P = 0.003). However, no significant differences between the 2 groups in digestive tract ulcer (P = 0.34), epilepsy (P = 0.99), and pneumonia (P = 0.58) were discovered. In the subgroup analysis, factors including publication time, Glasgow Coma Scale score, age, and follow-up, all significantly influenced the good functional outcome and mortality. Meanwhile, NS behaved more advantageous in improving functional prognosis for patients with hematoma located in the basal ganglia. CONCLUSIONS: NS may hold more advantages over SA in the treatment of supratentorial ICH. However, SA is also an effective and suitable alternative for elderly patients, especially those with multiple comorbidities intolerant to extended surgical procedures. Further high-quality studies are warranted to substantiate our findings in the future.

Programmable Nanoscale Crack Lithography for Multiscale PMMA Patterns.

Crack lithography is important for preparing microstructured materials. This strategic use of cracking breaks with the traditional idea that cracks are unwanted and has great potential for high-resolution and high-throughput production. However, the ability to control nanoscale crack patterning is still insufficient. Here, we present a nanoscale, programmable angle-dependent technique to control crack generation that relies on standard electron-beam lithography. Multiscale patterns of poly(methyl methacrylate) of arbitrary shape, geometric size, and large area were obtained, greatly expanding the processing capacity of electron-beam lithography. In addition, we observed the interaction between adjacent structures and cracks, which resulted in crack suppression or second-order cracks. We also demonstrated that angle-dependent nanoscale cracks can be used in physical unclonable functions and have great application prospects in the field of information security. We believe that our strategy for programmable nanoscale crack patterning provides new opportunities and perspectives for nanofabrication.

Endoscopic surgery to chronic subdural hematoma with neovessel septation: technical notes and literature review.

OBJECTIVE AND IMPORTANCE: We report Septated Chronic Subdural Hematoma (sCSDH) cases with the neovessel in the hematoma cavity, and evaluate surgical effect of the neuroendoscope-assisted neovessel coagulation for these sCSDH patients. CLINICAL PRESENTATION: Four patients suffered from sCSDH with different clinical symptoms. Magnetic resonance imaging (MRI) was applied to differentiate the neovessel from the bridge vein and septa fibra. Endoscopic surgeries were performed after their admission. TECHNIQUE: Through the small bone window, we used suction to clean the surgical field so that the neovessels can be exposed, which is thought to be the one of recurrence factors for the sCSDH, then we coagulated and cut them under the neuroendoscope. Case examples are described here to illustrate the technique. CONCLUSION: This report illustrates that the neovessel is one of recurrence factors of sCSDH and has special characteristics showed on MRI. Through this technique with the guidance of MRI the recurrence rate of sCSDH can be reduced.