Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms: Long-term follow-up from a single center.

Background: To evaluate the efficacy of stent-assisted coiling (SAC) for the treatment of carotid ophthalmic segment aneurysm segment aneurysms (OSAs) of the internal carotid artery (ICA) through detailed long-term follow-up of a large patient cohort. Methods: We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 â€‹at our center. Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale. The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up. The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone. Results: We enrolled 88 patients with 99 OSAs treated with coiling, of whom 76 were treated with SAC. The coiling procedures were successful in all 88 patients. Overall, complications occurred in 8 patients (9.1%). No procedure-related mortality was observed. 67 (76.1%) experienced immediate aneurysm occlusion at the end of the procedure. Long-term angiographic follow-up (18 months) was available in 45/88 aneurysms (51%) (average 18.7 â€‹± â€‹5.2 months). Four patients continued their follow-up for 5 years after initial aneurysm treatment. After a clinical follow-up time of 28.7 months (range, 12-51 months), 85 patients (95.5%) achieved favorable clinical outcomes (mRS scores of 0-2). Conclusions: This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs. The procedural risks are low with relatively long-term effectiveness.

Influence of anthropogenic nitrogen inputs and legacy nitrogen change on riverine nitrogen export in areas with high agricultural activity.

Increased riverine nitrogen (N) concentrations due to human activities is one of the leading causes of water quality decline, worldwide. Therefore, quantitative information about the N exported from watershed to the river (TN exports) is essential for defining N pollution control practices. This paper evaluated the changes in net anthropogenic N inputs (NANI) and the N stored in land ecosystems (legacy N) in the Jianghan Plain (JHP) from 1990 to 2019 and their impacts on TN exports. Moreover, an empirical model was developed to estimate TN exports, trace its source, and predict its future variations in 2020-2035 under different scenarios. According to the results, NANI exhibited a rise-decrease-rise-decrease M-shaped trend, with N fertilizer application being the dominant driver for NANI change. In terms of the NANI components, non-point-source was the primary N input form (96%). Noteworthy is that the correlation between NANI and TN exports became weaker over time, and large differences in changing trends were observed after 2014. A likely cause for this abnormal trend was that the accumulation of N surplus in soil led to N saturation in agricultural areas. Legacy N was also an important source of TN exports. However, the contribution of legacy N has rarely been considered when defining N pollution control strategies. An empirical model, incorporating legacy N, agricultural irrigation water use, and cropland area ratio, was developed. Based on this model, legacy N contributed a large proportion (15-31%). Furthermore, the results of future predictions indicated that legacy N had a larger impact on future TN exports changes compared to other factors, and increased irrigation water would increase rather than decrease TN exports. Therefore, an integrated N management strategy considering the impact of NANI, legacy N, and irrigation water use is crucial to control N pollution in areas with intensive agriculture.

Hypothermia impairs glymphatic drainage in traumatic brain injury as assessed by dynamic contrast-enhanced MRI with intrathecal contrast.

Introduction: The impact of hypothermia on the impaired drainage function of the glymphatic system in traumatic brain injury (TBI) is not understood. Methods: Male Sprague-Dawley rats undergoing controlled cortical impact injury (CCI) were subjected to hypothermia or normothermia treatment. The rats undergoing sham surgery without CCI were used as the control. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with intrathecal administration of low- and high-molecular-weight contrast agents (Gd-DTPA and hyaluronic acid conjugated Gd-DTPA) was performed after TBI and head temperature management. The semiquantitative kinetic parameters characterizing the contrast infusion and cleanout in the brain, including influx rate, efflux rate, and clearance duration, were calculated from the average time-intensity curves. Results and discussion: The qualitative and semiquantitative results of DCE-MRI obtained from all examined perivascular spaces and most brain tissue regions showed a significantly increased influx rate and efflux rate and decreased clearance duration among all TBI animals, demonstrating a significant impairment of glymphatic drainage function. This glymphatic drainage dysfunction was exacerbated when additional hypothermia was applied. The early glymphatic drainage reduction induced by TBI and aggravated by hypothermia was linearly related to the late increased deposition of p-tau and beta-amyloid revealed by histopathologic and biochemical analysis and cognitive impairment assessed by the Barnes maze and novel object recognition test. The glymphatic system dysfunction induced by hypothermia may be an indirect alternative pathophysiological factor indicating injury to the brain after TBI. Longitudinal studies and targeted glymphatic dysfunction management are recommended to explore the potential effect of hypothermia in TBI.

Dynamic characteristics of net anthropogenic phosphorus input and legacy phosphorus reserves under high human activity - A case study in the Jianghan Plain.

The increase of phosphorus (P) input related to human activities is one of the main reasons for eutrophication. Notably, in areas with high population densities and intensive agricultural activities, eutrophication has occurred frequently in the Jianghan Plain, so quantitative evaluation of anthropogenic P input is of great significance for the formulation of P pollution control measures. This study estimated net anthropogenic P input (NAPI), riverine total P exports (TP exports), and the pool of P stored in the terrestrial system (legacy P reserves) at the county scale from 1990 to 2019 in the Jianghan Plain. The results showed that NAPI increased from 2645 kg·km-2·yr-1 in 1991 to 5812 kg·km-2·yr-1 in 2014, and then decreased to 4509 kg·km-2·yr-1 in 2019. Non-point sources were the main form of NAPI, of which 75-96% came from agricultural systems. Meanwhile, P fertilizer input was the largest source of NAPI. It is worth noting that the contribution of seed P input in some counties, such as Jiangling County, is relatively high, even exceeding that of net food/feed P input. The P fertilizer application and livestock density were the main drivers for NAPI change. Only 3% of NAPI was exported into rivers, so a large amount of legacy P accumulated in the terrestrial system. An empirical model incorporating NAPI components, cultivated land area ratio, and annual precipitation was established. Based on this model, the average contribution of annual NAPI and the sum of legacy P and natural background sources to TP exports were calculated to be 71% and 29%, respectively. So it is necessary to control P pollution by improving fertilizer use efficiency and enhancing manure management. The results provide a scientific basis for targeted solutions to the sources of P nutrient and its control measures in the middle reach of the Yangtze River.

Biochar effects on soil properties, water movement and irrigation water use efficiency of cultivated land in Qinghai-Tibet Plateau.

Biochar, has recently, been widely used as a potential soil additive to improve the quality of cultivated land. However, the effect of biochar on irrigation water use efficiency (IWUE) remains unclear in the Qinghai-Tibet Plateau (QTP). Therefore, the purpose of this study was to explore the effects of biochar on the soil properties, water infiltration, and irrigation water efficiency of QTP cultivated land. A column experiment with four biochar application levels (0, 3, 6, and 9 kg·m-2 denoted CK, BC1, BC2, and BC3, respectively) was conducted to explore the biochar effect on the soil water infiltration process. The soil bulk density (γ), saturated water content (θs), soil water retention curve (SWRC), specific water capacity C(h), and saturated hydraulic conductivity (Ks) were measured after the trial. The effects of biochar application level, biochar application depth, irrigation water depth, and initial soil moisture on water loss and IWUE were then simulated by HYDRUS-2D. The results showed that biochar slowed the process of soil water infiltration by changing the soil physical properties and hydraulic properties, reducing the water loss by 5%-15.02%, effectively alleviating the waste of irrigation water, and therefore increasing IWUE by 2%-9.43%. Water loss and IWUE were significantly associated with the biochar application depth and level. Additionally, a biochar level of 6 kg·m-2 showed the best effect for ameliorating the QTP's cultivated soil. These results provide a novel approach for reducing water loss and enhancing the irrigation water use efficiency of QTP cultivated soil.

Combined molybdenum target X-ray and magnetic resonance imaging examinations improve breast cancer diagnostic efficacy.

BACKGROUND: Early-stage breast cancer patients often lack specific clinical manifestations, making diagnosis difficult. Molybdenum target X-ray and magnetic resonance imaging (MRI) examinations both have their own advantages. Thus, a combined examination methodology may improve early breast cancer diagnoses. AIM: To explore the combined diagnostic efficacy of molybdenum target X-ray and MRI examinations in breast cancer. METHODS: Patients diagnosed with breast cancer at our hospital from March 2019 to April 2021 were recruited, as were the same number of patients during the same period with benign breast tumors. Both groups underwent molybdenum target X-ray and MRI examinations, and diagnoses were given based on each exam. The single (i.e., X-ray or MRI) and combined (i.e., using both methods) diagnoses were counted, and the MRI-related examination parameters (e.g., T-wave peak, peak and early enhancement rates, and apparent diffusion coefficient) were compared between the groups. RESULTS: In total, 63 breast cancer patients and 63 benign breast tumor patients were recruited. MRI detected 53 breast cancer cases and 61 benign breast tumor cases. Molybdenum target X-ray detected 50 breast cancer cases and 60 benign breast tumor cases. The combined methodology detected 61 breast cancer cases and 61 benign breast tumor cases. The sensitivity (96.83%) and accuracy (96.83%) of the combined methodology were higher than single-method MRI (84.13% and 90.48%, respectively) and molybdenum target X-ray (79.37% and 87.30%, respectively) (P < 0.05). The combined methodology specificity (96.83%) did not differ from single-method MRI (96.83%) or molybdenum target X-ray (95.24%) (P > 0.05). The T-wave peak (169.43 ± 32.05) and apparent diffusion coefficient (1.01 ± 0.23) were lower in the breast cancer group than in the benign tumor group (228.86 ± 46.51 and 1.41 ± 0.35, respectively). However, the peak enhancement rate (1.08 ± 0.24) and early enhancement rate (1.07 ± 0.26) were significantly higher in the breast cancer group than in the benign tumor group (0.83 ± 0.19 and 0.75 ± 0.19, respectively) (P < 0.05). CONCLUSION: Combined molybdenum target X-ray and MRI examinations for diagnosing breast cancer improved the diagnostic sensitivity and accuracy, minimizing the missed- and misdiagnoses risks and promoting timely treatment intervention.

Analysis of Risk Factors for Anterior Communicating Artery Aneurysm Rupture: A Single-Center Study.

BACKGROUND: Congenital hypoplasia or aplasia of the A1 segment of the anterior cerebral artery is associated with an increased incidence of berry aneurysms at the anterior communicating artery (ACoA) complex. We analyzed the factors contributing to ACoA aneurysm rupture. METHODS: We retrospectively analyzed the data of patients with ACoA aneurysms who had undergone cerebral angiography from July 2008 to January 2020. The risk factors for rupture were identified using univariate and multivariate logistic regression models. We used the imaging data of patients without intracranial aneurysms as the control population. RESULTS: We confirmed 253 aneurysms in 253 patients, including 137 men (54.2%) and 116 women (45.8%), with a mean age of 54.6 ± 12.7 years. Of the 253 aneurysms, 218 (86.2%) were ruptured and 35 (13.8%) were unruptured, with a mean diameter of 4.56 ± 1.96 mm and 3.24 ± 1.79 mm, respectively. Of the 253 aneurysms, 176 (69.6%) were <5 mm in diameter, 146 (83%) of which were ruptured. Of the 253 patients, 141 (55.7%) exhibited A1 segment hypoplasia or aplasia: 106 (41.9%) on the right side of the circle of Willis and 35 (13.8%) on the left. Multivariate logistic regression analysis identified the aneurysm diameter (odds ratio, 4.11; 95% confidence interval, 1.601-16.07; P = 0.003) and age <65 years (odds ratio, 0.17; 95% confidence interval, 0.062-0.48; P < 0.001) as independent predictors of rupture. CONCLUSIONS: ACoA aneurysms are small (<5 mm) and have a high risk of rupture. A1 segment hypoplasia or aplasia is a risk factor for ACoA aneurysm formation; however, it was uncorrelated with aneurysm diameter or rupture risk. The strongest independent risk factors for rupture were age <65 years and aneurysm diameter.

An assessment of how the anterior cerebral artery anatomy impacts ACoA aneurysm formation based on CFD analysis.

OBJECTIVE: The aim of this study was to identify independent anatomic, morphologic and hemodynamic features of the ACoA (anterior communicating artery) complex that serve as risk factors for the occurrence of ACoA aneurysms. METHODS: Fifteen consecutive patients with 15 ACoA aneurysms were included. Computational fluid dynamics (CFD) simulations based on patient-specific models were carried out using 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA) images. A reverse reconstruction technique was used to generate a pre-aneurysm vessel anatomy. Geometric parameters and hemodynamic changes were compared and evaluated. RESULTS: The overall prevalence of symmetric, dysplastic, and absent A1 segments were 53.3%, 26.7%, and 20%. The mean wall shear stress (WSS) of the absent group (AG) was significantly higher than that of the symmetric group (SG) and dysplastic group (DG). The absolute mean A1 artery flow rate (410.2 ± 88 versus 439.4 ± 101 mL/min; p = .45) of the aneurysm side was similar between the SG and DG but significantly higher in the AG (528.1 ± 77 mL/min; p < .05). The A1-A2 angles of the aneurysm side showed no significant differences among the 3 groups (p = .32). However, the mean A1-A2 angle on the aneurysm side was smaller than the contralateral A1-A2 angle (101.9 ± 9.1˚ versus 120.3 ± 7.7˚; p <.05). A regression analysis demonstrated that high WSS was significantly associated with a large A1-A2 ratio (R2=0.52; p <.05). CONCLUSIONS: ACoA aneurysms are a high-WSS pathology. Severe flow impingement and the anatomic vasculature structures play a role in triggering the occurrence of ACoA aneurysms.

Erratum: An erratum on "Application of three-dimensional printing in interventional medicine" [J Interv Med (February 2020) 1-16].

[This corrects the article DOI: 10.1016/j.jimed.2020.01.001.].

Photocatalytic defluorination of perfluorooctanoic acid by surface defective BiOCl: Fast microwave solvothermal synthesis and photocatalytic mechanisms.

There is an urgent need for developing cost-effective methods for the treatment of perfluorooctanoic acid (PFOA) due to its global emergence and potential risks. In this study, taking surface-defective BiOCl as an example, a strategy of surface oxygen vacancy modulation was used to promote the photocatalytic defluorination efficiency of PFOA under simulated sunlight irradiation. The defective BiOCl was fabricated by a fast microwave solvothermal method, which was found to induce more surface oxygen vacancies than conventional solvothermal and precipitation methods. As a result, the as-prepared BiOCl showed significantly enhanced defluorination efficiency, which was 2.7 and 33.8 times higher than that of BiOCl fabricated by conventional solvothermal and precipitation methods, respectively. Mechanistic studies indicated that the defluorination of PFOA follows a direct hole (h+) oxidation pathway with the aid of •OH, while the oxygen vacancies not only promote charge separation but also facilitate the intimate contact between the photocatalyst surface and PFOA by coordinating with its terminal carboxylate group in a bidentate or bridging mode. This work will provide a general strategy of oxygen vacancy modulation by microwave-assisted methods for efficient photocatalytic defluorination of PFOA in the environment using sunlight as the energy source.

[Nerve classification with hyperspectral imaging technology].

In surgical nerve repair surgery, the identification of nerve fascicles is a key to a good repair of their broken end. Some of the existing nerve fascicles identification method are not ideal. Hyperspectral imaging (HSI) technology provides information of images and spectra of biological tissue at the same time. It can supply a qualitative, quantitative and positioning description of the test objectives, and identify different biological tissues by biochemical characteristic difference, and classify and position these tissues in the image. Compared to other medical imaging technology, this techriology has unique advantages. In this study, the hyperspectral imaging technology is used in the identification and classification of the nerve fascicles by the spectral characteristics of different nerve fascicles, and in determining the orientation of the nerve fascicles in the image by the image spectral information in order to better help surgical personnel to carry out the nerve repair surgery. The significance of this paper is: the first to propose a new method of identification and location of the nerve fascicles and assist surgical staff to improve the efficacy of nerve repair; the second to reserve hyperspectral imaging techniques used in qualitative and quantitative and orientation research combined with biological organization, and speed up the molecular hyperspectral imaging technology to the practical stage.