Matrix metalloproteinase-responsive hydrogels with tunable retention for on-demand therapy of inflammatory bowel disease.

Therapeutic options for addressing inflammatory bowel disease (IBD) include the administration of an enema to reduce intestinal inflammation and alleviate associated symptoms. However, uncontrollable retention of enemas in the intestinal tract has posed a long-term challenge for improving their therapeutic efficacy and safety. Herein we have developed a protease-labile hydrogel system as an on-demand enema vehicle with tunable degradation and drug release rates in response to varying matrix metalloproteinase-9 (MMP-9) expression. The system, composed of three tailored hydrogel networks, is crosslinked by poly (ethylene glycol) (PEG) with 2-, 4- and 8-arms through dynamic hydrazone bonds to confer injectability and generate varying network connectivity. The retention time of the hydrogels can be tuned from 12 to 36 h in the intestine due to their different degradation behaviors induced by MMP-9. The drug-releasing rate of the hydrogels can be controlled from 0.0003 mg/h to 0.278 mg/h. In addition, injection of such hydrogels in vivo resulted in significant differences in therapeutic effects including MMP-9 consumption, colon tissue repair, reduced collagen deposition, and decreased macrophage cells, for treating a mouse model of acute colitis. Among them, GP-8/5-ASA exhibits the best performance. This study validates the effectiveness of the tailored design of hydrogel architecture in response to pathological microenvironment cues, representing a promising strategy for on-demand therapy of IBD. STATEMENT OF SIGNIFICANCE: The uncontrollable retention of enemas at the delivery site poses a long-term challenge for improving therapeutic efficacy in IBD patients. MMP-9 is highly expressed in IBD and correlates with disease severity. Therefore, an MMP-9-responsive GP hydrogel system was developed as an enema by linking multi-armed PEG and gelatin through hydrazone bonds. This forms a dynamic hydrogel characterized by in situ gelation, injectability, enhanced bio-adhesion, biocompatibility, controlled retention time, and regulated drug release. GP hydrogels encapsulating 5-ASA significantly improved the intestinal phenotype of acute IBD and demonstrated notable therapeutic differences with increasing PEG arms. This method represents a promising on-demand IBD therapy strategy and provides insights into treating diseases of varying severities using endogenous stimulus-responsive drug delivery systems.

Low Levels of IgM Recognizing 4-Hydroxy-2-Nonenal-Modified Apolipoprotein A-I Peptide and Its Association with the Severity of Coronary Artery Disease in Taiwanese Patients.

Autoantibodies against apolipoprotein A-I (ApoA-I) are associated with cardiovascular disease risks. We aimed to examine the 4-hydroxy-2-nonenal (HNE) modification of ApoA-I in coronary artery disease (CAD) and evaluate the potential risk of autoantibodies against their unmodified and HNE-modified peptides. We assessed plasma levels of ApoA-I, HNE-protein adducts, and autoantibodies against unmodified and HNE-peptide adducts, and significant correlations and odds ratios (ORs) were examined. Two novel CAD-specific HNE-peptide adducts, ApoA-I251-262 and ApoA-I70-83, were identified. Notably, immunoglobulin G (IgG) anti-ApoA-I251-262 HNE, IgM anti-ApoA-I70-83 HNE, IgG anti-ApoA-I251-262, IgG anti-ApoA-I70-83, and HNE-protein adducts were significantly correlated with triglycerides, creatinine, or high-density lipoprotein in CAD with various degrees of stenosis (<30% or >70%). The HNE-protein adduct (OR = 2.208-fold, p = 0.020) and IgM anti-ApoA-I251-262 HNE (2.046-fold, p = 0.035) showed an increased risk of progression from >30% stenosis in CAD. HNE-protein adducts and IgM anti-ApoA-I251-262 HNE may increase the severity of CAD at high and low levels, respectively.

Genomics of hybrid parallel origin in Aquilegia ecalcarata.

BACKGROUND: The parallel evolution of similar traits or species provides strong evidence for the role of natural selection in evolution. Traits or species that evolved repeatedly can be driven by separate de novo mutations or interspecific gene flow. Although parallel evolution has been reported in many studies, documented cases of parallel evolution caused by gene flow are scarce by comparison. Aquilegia ecalcarata and A. kansuensis belong to the genus of Aquilegia, and are the closest related sister species. Mutiple origins of A. ecalcarata have been reported in previous studies, but whether they have been driven by separate de novo mutations or gene flow remains unclear. RESULTS: In this study, We conducted genomic analysis from 158 individuals of two repeatedly evolving pairs of A. ecalcarata and A. kansuensis. All samples were divided into two distinct clades with obvious geographical distribution based on phylogeny and population structure. Demographic modeling revealed that the origin of the A. ecalcarata in the Eastern of China was caused by gene flow, and the Eastern A. ecalcarata occurred following introgression from Western A. ecalcarata population. Analysis of Treemix and D-statistic also revealed that a strong signal of gene flow was detected from Western A. ecalcarata to Eastern A. ecalcarata. Genetic divergence and selective sweep analyses inferred parallel regions of genomic divergence and identified many candidate genes associated with ecologically adaptive divergence between species pair. Comparative analysis of parallel diverged regions and gene introgression confirms that gene flow contributed to the parallel evolution of A. ecalcarata. CONCLUSIONS: Our results further confirmed the multiple origins of A. ecalcarata and highlighted the roles of gene flow. These findings provide new evidence for parallel origin after hybridization as well as insights into the ecological adaptation mechanisms underlying the parallel origins of species.

Proteasome inhibitors FHND6091 enhance the ability of NK cells to kill tumor cells through multiple mechanisms.

The immune system has a strong connection to tumors. When a tumor cell is recognized as an abnormal cell by the immune system, the immune system may initiate an immune response to kill the tumor cell. In this study, RNA sequencing was performed on multiple myeloma (MM) cells treated with the proteasome inhibitor FHND6091. The transcriptional changes induced by FHND6091 in RPMI8226 cells aligned notably with immune response activation and results indicated upregulation of cGAS-STING pathway-related genes in the FHND6091-treated group. In vivo and in vitro experiments had demonstrated that FHND6091 stimulated the immunoreaction of MM cells via activation of the cyclic guanosine monophosphate-adenosine synthase/stimulator of interferon genes (cGAS-STING) pathway. This activation resulted in the generation of type-I interferons and the mobilization of natural killer (NK) cells. Notably, FHND6091 upregulated the levels of calreticulin and the protein ligands UL16-binding protein 2/5/6, MHC class I chain-related A (MICA), and MICB on the surface of MM cells. Subsequently, upon engaging with the surface activation receptors of NK cells, these ligands triggered NK cell activation, leading to the subsequent elimination of tumor cells. Thus, our findings elucidated the mechanism whereby FHND6091 exerted its immunotherapeutic activity as a STING agonist, enhancing the killing ability of NK cells against tumor cells.

The trend of radiographic healing after root canal treatment in teeth with apical periodontitis based on cone-beam computed tomography: A 4-year longitudinal study.

OBJECTIVES: The aim of this study was to observe the radiographic healing of periapical lesions after root canal treatment via volumetric measurements based on cone-beam computed tomography (CBCT) over 4 years. METHODS: In total, 162 single-root teeth from patients with chronic periapical periodontitis who underwent primary root canal treatment were included in this retrospective study. Follow-up visits were scheduled at 1, 2, and 4 years after treatment. The volume of radiolucency at pretreatment and follow-up were measured, and the radiographic outcomes were classified into 4 categories: absence, reduction, uncertain or enlargement. Reduction or enlargement was considered when the volumetric change in radiolucency was 20 % or more. RESULTS: During the 4-year follow-up period, 128 teeth were reviewed at least once, including 3 extracted teeth. Of the remaining 125 teeth, the volume of radiolucency was reduced in 116 teeth (90.6 %), uncertain in 5, and enlarged in 4 teeth during 1 to 4 years after treatment. Among the 43 teeth with reduced radiolucency at 1 year after treatment, 42 (97.7 %) had continuing reduced lesions at 4 years. In the 2 teeth with enlarged radiolucency at 1 year, the volume of radiolucency doubled at 4 years. Cox regression analysis revealed that the preoperative radiolucency size was a risk factor for persistent periapical radiolucency. CONCLUSIONS: The efficacy of root canal treatment for apical periodontitis was predictable. When the radiolucency changed by 20 % or more in volume on CBCT scans at 1 year after treatment, reversal of the radiographic healing tendency was rare. CLINICAL SIGNIFICANCE: The volumetric changes in radiolucency on CBCT could reflect trends in the healing process and may foster early clinical decision-making.

A transthyretin-like protein acts downstream of miR397 and LACCASE to regulate grain yield in rice.

Increasing grain yield is a major goal of breeders due to the rising global demand for food. We previously reported that the miR397-LACCASE (OsLAC) module regulates brassinosteroid (BR) signaling and grain yield in rice (Oryza sativa). However, the precise roles of laccase enzymes in the BR pathway remain unclear. Here, we report that OsLAC controls grain yield by preventing the turnover of TRANSTHYRETIN-LIKE (OsTTL), a negative regulator of BR signaling. Overexpressing OsTTL decreased BR sensitivity in rice, while loss-of-function of OsTTL led to enhanced BR signaling and increased grain yield. OsLAC directly binds to OsTTL and regulates its phosphorylation-mediated turnover. The phosphorylation site Ser226 of OsTTL is essential for its ubiquitination and degradation. Overexpressing the dephosphorylation-mimic form of OsTTL (OsTTLS226A) resulted in more severe defects than did overexpressing OsTTL. These findings provide insight into the role of an ancient laccase in BR signaling and suggest that the OsLAC-OsTTL module could serve as a target for improving grain yield.

Assessing mortality risk in Type 2 Diabetes patients with prolonged ASCVD risk factors: the inclusive Poh-Ai predictive scoring system with CAC Score integration.

PURPOSE: To enhance the predictive risk model for all-cause mortality in individuals with Type 2 Diabetes (T2DM) and prolonged Atherosclerotic Cardiovascular Disease (ASCVD) risk factors. Despite the utility of the Coronary Artery Calcium (CAC) score in assessing cardiovascular risk, its capacity to predict all-cause mortality remains limited. METHODS: A retrospective cohort study included 1929 asymptomatic T2DM patients with ASCVD risk factors, aged 40-80. Variables encompassed demographic attributes, clinical parameters, CAC scores, comorbidities, and medication usage. Factors predicting all-cause mortality were selected to create a predictive scoring system. By using stepwise selection in a multivariate Cox proportional hazards model, we divided the patients into three risk groups. RESULTS: In our analysis of all-cause mortality in T2DM patients with extended ASCVD risk factors over 5 years, we identified significant risk factors, their adjusted hazard ratios (aHR), and scores: e.g., CAC score > 1000 (aHR: 1.57, score: 2), CAC score 401-1000 (aHR: 2.05, score: 2), and more. These factors strongly predict all-cause mortality, with varying risk groups (e.g., very low-risk: 2.0%, very high-risk: 24.0%). Significant differences in 5-year overall survival rates were observed among these groups (log-rank test < 0.001). CONCLUSION: The Poh-Ai Predictive Scoring System excels in forecasting mortality and cardiovascular events in individuals with Type 2 Diabetes Mellitus and extended ASCVD risk factors.

Computer aided diagnosis of diabetic retinopathy based on multi-view joint learning.

Diabetic retinopathy (DR) is a kind of ocular complication of diabetes, and its degree grade is an essential basis for early diagnosis of patients. Manual diagnosis is a long and expensive process with a specific risk of misdiagnosis. Computer-aided diagnosis can provide more accurate and practical treatment recommendations. In this paper, we propose a multi-view joint learning DR diagnostic model called RT2Net, which integrates the global features of fundus images and the local detailed features of vascular images to reduce the limitations of single fundus image learning. Firstly, the original image is preprocessed using operations such as contrast-limited adaptive histogram equalization, and the vascular structure of the extracted DR image is segmented. Then, the vascular image and fundus image are input into two branch networks of RT2Net for feature extraction, respectively, and the feature fusion module adaptively fuses the feature vectors' output from the branch networks. Finally, the optimized classification model is used to identify the five categories of DR. This paper conducts extensive experiments on the public datasets EyePACS and APTOS 2019 to demonstrate the method's effectiveness. The accuracy of RT2Net on the two datasets reaches 88.2% and 85.4%, and the area under the receiver operating characteristic curve (AUC) is 0.98 and 0.96, respectively. The excellent classification ability of RT2Net for DR can significantly help patients detect and treat lesions early and provide doctors with a more reliable diagnosis basis, which has significant clinical value for diagnosing DR.

Synergistic effects of photodynamic therapy and chemotherapy: Activating the intrinsic/extrinsic apoptotic pathway of anoikis for triple-negative breast cancer treatment.

Triple-negative breast cancer (TNBC) is a highly invasive and metastatic subtype of breast cancer that often recurs after surgery. Herein, we developed a cyclodextrin-based tumor-targeted nano delivery system that incorporated the photosensitizer chlorin e6 (Ce6) and the chemotherapeutic agent lonidamine (LND) to form the R6RGD-CMßCD-se-se-Ce6/LND nanoparticles (RCC/LND NPS). This nanosystem could target cancer cells, avoid lysosomal degradation and further localize within the mitochondria. The RCC/LND NPS had pH and redox-responsive to control the release of Ce6 and LND. Consequently, the nanosystem had a synergistic effect by effectively alleviating hypoxia, enhancing the production of cytotoxic reactive oxygen species (ROS) and amplifying the efficacy of photodynamic therapy (PDT). Furthermore, the RCC/LND NPS + light weakened anoikis resistance, disrupted extracellular matrix (ECM), activated both the intrinsic apoptotic pathway (mitochondrial pathway) and extrinsic apoptotic pathway (receptor death pathway) of anoikis. In addition, the nanosystem showed significant anti-TNBC efficacy in vivo. These findings collectively demonstrated that RCC/LND NPS + light enhanced the anticancer effects, induced anoikis and inhibited tumor cell migration and invasion through a synergistic effect of chemotherapy and PDT. Overall, this study highlighted the promising potential of the RCC/LND NPS + light for the treatment of TNBC.

Enhancing moisture detection in coal gravels: A deep learning-based adaptive microwave spectra fusion method.

The accurate and effective detection of moisture in coal gravels is crucial. Conventional air oven-drying method suffers from prolonged processing times and their disruptive nature. This paper proposes a deep learning-based adaptive fusion method for multiple microwave spectra to non-destructively detect the moisture content of coal gravels. First, a purpose-built free-space measurement platform is employed to acquire microwave spectra of coal samples, encompassing the magnitude and phase spectra of reflection coefficients (S11) and transmission coefficients (S21). Subsequently, a Monte-Carlo cross-validation-based method is adopted to detect and eliminate outliers in the spectra. Furthermore, a novel feature extraction module is proposed, enhancing the traditional U-shaped network using residual learning (ResNet) and the convolutional block attention module (CBAM) to extract and reconstruct subtle spectral features. Inspired by the high-level data fusion, an adaptive spectra fusion method is then introduced that can autonomously balance the contributions between different spectra. The experimental results underscore the advantages of the proposed method, with narrow frequency intervals between 2.50-3.25 GHz, 3.75-4.00 GHz, and 4.75-5.00 GHz exhibiting superior detection accuracy compared to the entire frequency band, achieving R2 = 0.9034, MAE = 1.0254, RMSE = 1.2948 and RPIQ = 6.0630.

Exercise capacity-hemodynamics mismatch in elderly patients with pulmonary hypertension: A nationwide multicenter study from Taiwan Society of Cardiology Pulmonary Hypertension Registry (TAIPANS).

Background: Demographics of pulmonary hypertension (PH) has changed a lot over the past forty years. Several recent registries noted an increase in mean age of PH but only a few of them investigated the characteristics of elderly patients. Thus, we aimed to analyze the characteristics of PH in such a population in this study. Methods: This multicenter study enrolled patients diagnosed with PH in group 1, 3, 4, and 5 consecutively from January 1, 2019 to December 31, 2020. A total of 490 patients was included, and patients were divided into three groups by age (≤45 years, 45-65 years, and >65 years). Results: The mean age of PH patients diagnosed with PH was 55.3 ± 16.3 years of age. There was higher proportion of elderly patients classified as group 3 PH (≤45: 1.3, 45-65: 4.5, >65: 8.1 %; p = 0.0206) and group 4 PH (≤45: 8.4, 45-65: 14.5, >65: 31.6 %; p < 0.0001) than young patients. Elderly patients had shorter 6-min walking distance (6 MWD) (≤45 vs. >65, mean difference, 77.8 m [95% confidence interval (CI), 2.1-153.6 m]), lower mean pulmonary arterial pressure (mPAP) (≤45 vs. >65, mean difference, 10.8 mmHg [95% CI, 6.37-15.2 mmHg]), and higher pulmonary arterial wedge pressure (PAWP) (≤45 vs. 45-65, mean difference, -2.1 mmHg [95% CI, -3.9 to -0.3 mmHg]) compared to young patients. Elderly patients had a poorer exercise capacity despite lower mPAP level compared to young population, but they received combination therapy less frequently compared to young patients (triple therapy in group 1 PH, ≤45: 16.7, 45-65: 11.3, >65: 3.8 %; p = 0.0005). Age older than 65 years was an independent predictor of high mortality for PH patients. Conclusions: Elderly PH patients possess unique hemodynamic profiles and epidemiologic patterns. They had higher PAWP, lower mPAP, and received combination therapy less frequently. Moreover, ageing is a predictor of high mortality for PH patients. Exercise capacity-hemodynamics mismatch and inadequate treatment are noteworthy in the approach of elderly population with PH.

Comparison of continuous 24-hour and 14-day ECG monitoring for the detection of cardiac arrhythmias in patients with ischemic stroke or syncope.

BACKGROUND: Previous studies show that using 12-lead electrocardiogram (ECG) or 24-h ECG monitor for the detection of cardiac arrhythmia events in patients with stroke or syncope is ineffective. HYPOTHESIS: The 14-day continuous ECG patch has higher detection rates of arrhythmias compared with conventional 24-h ECG monitoring in patients with ischemic stroke or syncope. METHODS: This cross-sectional study of patients with newly diagnosed ischemic stroke or syncope received a 24-h ECG monitoring and 14-day continuous cardiac monitoring patch and the arrhythmia events were measured. RESULTS: This study enrolled 83 patients with ischemic stroke or syncope. The detection rate of composite cardiac arrhythmias was significantly higher for the 14-day ECG patch than 24-h Holter monitor (69.9% vs. 21.7%, p = .006). In patients with ischemic stroke, the detection rates of cardiac arrhythmias were 63.4% for supraventricular tachycardia (SVT), 7% for ventricular tachycardia (VT), 5.6% for atrial fibrillation (AF), 4.2% for atrioventricular block (AVB), and 1.4% for pause by 14-day ECG patch, respectively. The significant difference in arrhythmic detection rates were found for SVT (45.8%), AF (6%), pause (1.2%), AVB (2.4%), and VT (9.6%) by 14-day ECG patch but not by 24-h Holter monitor in patients with ischemic stroke or syncope. CONCLUSIONS: A 14-day ECG patch can be used on patients with ischemic stroke or syncope for the early detection of AF or other cardiac arrhythmia events. The patch can be helpful for physicians in planning medical or mechanical interventions of patients with ischemic stroke and occult AF.

Dual strategies of mild C-F scissoring fluorination and local high-concentration electrolyte to enable reversible Li-Fe-F conversion batteries.

Batteries taking conversion-type iron fluorides as energy-dense cathodes provide the possibility for the power electrification of the transportation and aviation industries. However, a safe and low-toxicity synthesis method for fluorides and the design of a compatible electrolyte formula are still challenging. Here, we propose a dual strategy of mild C-F scissoring fluorination and a local high-concentration electrolyte (LHCE) to enable highly reversible Li-Fe-F conversion batteries. A facile and safe scissoring strategy at a low temperature (95 °C) enables the preparation of a carbon-iron fluoride composite with a porous cubic cage-like structure. CFx plays a double role as a solid fluorination agent and an in situ conductive network after defluorination. The as-prepared fluoride cathode delivers a reversible capacity as high as 300 mA h g-1 over 100 cycles. The further LHCE strategy not only enhances the oxidation stable voltage of the electrolyte (>5 V) and the transference number of Li+ (0.74), but also realizes dual protection of the fluoride cathode and Li metal anode by facilitating the construction of robust cathode- and anode-electrolyte interfaces, respectively. The LHCE-assisted fluoride battery releases a higher reversible capacity of 335 mA h g-1 after 130 cycles. This work provides a solution to high-performance carbon-fluoride conversion cathodes by a synergetic effect of tailored synthesis, electroactive particle texture and electrolyte formula.

Combined Photosensitive Gene Therapy Effective Against Triple-Negative Breast Cancer in Mice Model.

Introduction: Tumor hypoxia and invasion present significant challenges for the efficacy of photodynamic therapy (PDT) in triple-negative breast cancer (TNBC). This study developed a mitochondrial targeting strategy that combined PDT and gene therapy to promote each other and address the challenges. Methods: The positively charged amphiphilic material triphenylphosphine-tocopherol polyethylene glycol succinate (TPP-TPGS, TPS) and the photosensitizer chloride e6 (Ce6) formed TPS@Ce6 nanoparticles (NPs) by hydrophobic interaction. They electrostatically condensed microRNA-34a (miR-34a) to form stable TPS@Ce6/miRNA NPs. Results: Firstly, Ce6 disrupted the lysosomal membrane, followed by successful delivery of miR-34a by TPS@Ce6/miRNA NPs. Meanwhile, miR-34a reduced ROS depletion and further enhanced the effectiveness of PDT. Consequently, the mutual promotion between PDT and gene therapy led to enhanced anti-tumor effects. Furthermore, the TPS@Ce6/miRNA NPs promoted apoptosis by down-regulating Caspase-3 and inhibited tumor cell migration and invasion by down-regulating N-Cadherin. In addition, in vitro and in vivo experiments demonstrated that the TPS@Ce6/miRNA NPs achieved excellent anti-tumor effects. These findings highlighted the enhanced anticancer effects and reduced migration of tumor cells through the synergistic effects of PDT and gene therapy. Conclusion: Taken together, the targeted co-delivery of Ce6 and miR-34a will facilitate the application of photodynamic and genic nanomedicine in the treatment of aggressive tumors, particularly TNBC.

Room-temperature reversible F-ion batteries based on sulfone electrolytes with a mild anion acceptor additive.

Rechargeable fluoride ion batteries (FIBs) as an emerging anion shuttle system are attracting much attention due to their potential advantages in terms of energy density, cost and safety. A liquid electrolyte system enables the FIB operation at low or room temperature due to its higher ionic conductivity than that of a solid F-ion electrolyte. However, the insolubility of fluoride salts in aprotic solvents limits the development of liquid F-ion electrolytes. Although the boron-based anion acceptors (AAs) can facilitate the dissolution of F-ion salts, they are prone to lead to a tough desolvation process for F- due to strong Lewis acidity and therefore an inferior electrochemical performance. Here, a new non-boron AA (6-thioguanine) with moderate Lewis acidity is proposed to dissolve F- in the sulfone solvent. The ionic conductivity of the corresponding electrolytes reaches a level of mS cm-1 at room temperature. A model FIB coin cell is successfully operated with high conversion reaction reversibility based on the coupled defluorination/fluorination mechanism of electrodes, enabling a low overpotential of 0.36 V and a reversible capacity of 126 mA h g-1 after 40 cycles.

The efficacy of Surpass Streamline flow diversion for intracranial aneurysms / 介入放射学杂志

Objective To make a further understanding of the curative efficacy of Surpass Streamline flow diversion treatment for intracranial aneurysms.Methods The clinical data of a total of 68 patients with intracranial aneurysm,who received Surpass Streamline flow diverter treatment at the Affiliated Suzhou Hospital of Anhui Medical University of China between January 2020 and January 2022,were retrospectively analyzed.The preoperative and postoperative changes in hemodynamic parameters,and the preoperative and postoperative 3-,6-,and 12-month modified Rankin Scale(mRS)scores were collected.The imaging findings were analyzed,and the status of aneurysm occlusion was determined.Results Compared with the preoperative values,the postoperative blood flow velocity at the WSS and the tumor neck was decreased,while the blood flow velocity of LSA,RRT,tumor carrier artery and M1 on the affected side was increased(P＜0.05),and the blood flow velocity of Ml on the healthy side showed no significant change(P＞0.05).After surgery,the proportion of patients with low-grade mRS score gradually increased with the time passing,and the difference was statistically significant(P＜0.05).The postoperative 6-month and 12-month incidences of in-stent stenosis were 7.35％ and 8.82％ respectively,incidences of aneurysmal complete occlusion were 52.94％and 63.24％ respectively,and the differences were not statistically significant(P＞0.05).Of the 68 patients having been treated with Surpass Streamline flow diverter,4 patients developed ischemic complications,and 2 of the 4 presented with blurred vision and cortical blindness,one patient had limb weakness and one patient had a in-stent thrombus,all of which were effectively relieved after intervention therapy.Conclusion For the treatment of intracranial aneurysms,Surpass Streamline flow diversion treatment has good efficacy,it can improve hemodynamics,besides,it carries high postoperative complete aneurysmal occlusion rate with satisfactory safety.Therefore,this technique is worthy of clinical popularization.(J Intervent Radiol,2024,33:285-288)

Clinical evaluation of brain structural changes in patients with alcohol dependence complicated by major depressive disorder using functional magnetic resonance imaging / 中国基层医药

Objective:Utilizing functional magnetic resonance imaging (fMRI) to investigate changes in brain structure and function in patients with alcohol dependence (AD) complicated by major depressive disorder (MDD), and assessing the clinical significance of fMRI in diagnosing alcohol dependence complicated by MDD.Methods:From August 2019 to October 2022, 90 patients with AD complicated by MDD and 90 healthy subjects who concurrently received physical examination in our hospital were included in the study. All participants underwent magnetic resonance imaging (MRI) and fMRI to observe the brain tissue structure of patients with AD complicated by MDD and to assess differences in N-acetylaspartic acid/creatine (NAA/Cr) and factional anisotropy (FA) values across different brain tissue regions.Results:The widths of the left and right ventricular temporal angles in the AD complicated by MDD group [(2.67 ± 0.24) mm, (2.63 ± 0.25) mm] were significantly higher than those observed in the healthy control group [(2.29 ± 0.21) mm, (2.31 ± 0.23) mm, t = 22.48, 20.64, both P < 0.001]. Additionally, the volumes of the left and right hippocampus and nucleus accumbens in the AD complicated by MDD group [(2 673.46 ± 155.74) mm 3, (2 692.29 ± 154.61) mm 3, (682.04 ± 65.37) mm 3, (729.65 ± 68.49) mm 3] were significantly lower compared with those in the healthy control group [(2 826.53 ± 158.95) mm 3, (2 849.17 ± 157.23) mm 3, (766.28 ± 69.51) mm 3, and (805.43 ± 71.36) mm 3, t = -9.53, -8.44, -15.62, -13.92, all P < 0.001]. Moreover, the NAA/Cr values in the left and right frontal lobes, temporal lobes, hippocampi, and nucleus accumbens in the AD complicated by MDD group were significantly lower than those in the healthy control group ( t = -11.36, -7.19, -9.96, -7.84, -14.59, -8.25, -7.64, -6.84, all P < 0.001). Similarly, the FA values of the left and right frontal lobes, temporal lobes, hippocampi, and right nucleus accumbens in the AD complicated by MDD group were significantly lower compared with those in the healthy control group ( t = -9.48, -11.74, -9.22, -10.36, -16.85, -14.67, -5.28, all P < 0.001). Conclusion:Patients with AD accompanied by MDD exhibit alterations in brain tissue structure, neuronal metabolic function, and the integrity of white matter nerve fibers. fMRI is effective in identifying changes in brain neuron metabolism and the integrity of white matter nerve fibers, making it invaluable for the diagnosis and assessment of AD accompanied by MDD.

Application effect and safety analysis of unilateral laminectomy and bilateral decompression under unilateral biportal endoscopy and microendoscope in lumbar spinal stenosis / 中国内镜杂志

Objective To analyze the efficacy and safety of unilateral laminectomy and bilateral decompression under unilateral biportal endoscopy(UBE)and microendoscope(MED)in lumbar spinal stenosis.Methods 80 patients with lumbar spinal stenosis from January 2021 to December 2022 were selected and divided into two groups by numerical table method,the control group and the study group,and the number of cases was 40.The grouping method was random number table method.The control group was treated with unilateral laminectomy and bilateral decompression under MED,while the study group was treated with unilateral laminectomy and bilateral decompression under UBE.Operation time,intraoperative blood loss,Oswestry disability index(ODI)and visual analogue scale(VAS)of lumbago and leg pain were obtained before surgery,1,3 months after surgery and at the last follow-up,efficacy and complications were compared between the two groups.Result There were no significant differences in operative time and blood loss between the study group and the control group(P>0.05).1,3 months after surgery and at the last follow-up,ODI in both groups were lower than those before surgery(P<0.05),but there was no difference between the study group and the control group(P>0.05).The VAS of lumbago and leg pain in both groups were lower than those before surgery(P<0.05),at 1,3 months after surgery and the last follow-up,and the study group was significantly lower than the control group(P<0.05).The excellent and good rate of clinical treatment in the study group was 97.50%,and there was no difference compared with 92.50%in the control group(P>0.05).The complication rate of the study group was 2.50%,significantly lower than that of the control group(15.00%)(P<0.05).Conclusion Unilateral laminectomy and bilateral decompression under the UBE and MED have similar efficacy in the treatment of lumbar spinal stenosis,both of which can effectively promote functional recovery,but UBE can reduce pain more effectively and has fewer postoperative complications.