Analysis of the Efficacy of Neuroendoscopic Hematoma Removal Combined With Ventricular Lavage in Severe Intraventricular Hemorrhage-A Prospective Randomized Controlled Study.

BACKGROUND AND OBJECTIVES: The current widely utilized clinical approach for severe intraventricular hemorrhage involves ventriculostomy with supportive drainage. The aim of our study was to evaluate the overall efficacy of neuroendoscopic hematoma removal combined with ventricular lavage as a treatment approach for severe intraventricular hemorrhage. METHODS: A prospective randomized controlled study was conducted, selecting a total of 98 patients with severe intraventricular hemorrhage at our hospital from February 2021 to November 2022. The patients were randomly distributed into 2 groups using a randomized number table method: the neuroendoscopic group (undergoing neuroendoscopic hematoma removal combined with ventricular lavage) and the control group (undergoing intraventricular trepanation and drainage), with 49 patients in each group. RESULTS: The neuroendoscopic group had significantly higher intraoperative blood loss than that of the control group (P = .037), while the drainage tube indwelling time and hospital stay in the neuroendoscopic group were significantly shorter (P < .001). At 6 hours (P = .021), 1 day (P = .002), 3 days (P < .001) and 7 days (P = .007) following surgery, the neuroendoscopic group exhibited evidently higher hematoma clearance rates compared with the control group. At 1 day and 3 days after surgery, the cerebrospinal fluid drainage volume in the neuroendoscopic group was significantly higher than that in the control group (P < .001), whereas at 7 days after surgery, it was significantly lower in the neuroendoscopic group compared with the control group (P < .001). Moreover, significantly lower incidence of intracranial infection (P = .045) and increased intracranial pressure (P = .008) was observed in the neuroendoscopic group compared with the control group. CONCLUSION: Neuroendoscopic hematoma removal combined with ventricle lavage emerged as an effective treatment strategy for severe intraventricular hemorrhage, yielding significant therapeutic benefits. Therefore, this approach holds promise for broader clinical application and promotion.

Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms.

This study aims to evaluate the efficacy and safety of endovascular therapy versus neurosurgical clipping carried out for patients with unruptured middle cerebral artery bifurcation aneurysms (MCABAs). Patients diagnosed with MCABAs were enrolled in this prospective study according to the inclusion and exclusion standard. Enrolled patients were divided into a study group (endovascular therapy) and a control group (neurosurgical clipping), with 65 cases in each group. In terms of efficacy, we found that the proportion of Glasgow Outcome Scale (GOS) grade 1 after treatment in the study group was significantly higher than in the control group (p<0.001), while the proportion of GOS grades 2, 3, and 4 after treatment was significantly lower in the study group than in the control group (p<0.05). The postoperative brain injury indicators neuron-specific enolase and S100ß in the study group were significantly lower than in the control group (p<0.001), and the postoperative life activity score of patients in the study group was significantly higher than in the control group (p<0.001). In terms of safety, the postoperative hospital stay of patients in the study group was significantly shorter than in the control group (p<0.001), and the incidence rate of postoperative pulmonary and intracranial infections in the study group was significantly lower than in the control group (p<0.05). Endovascular therapy for patients with unruptured MCABAs may be effective in improving outcomes and has better safety profile compared with neurosurgical clipping, but may increase the risk of postoperative recurrence.

EIF4A3-induced circCCNB1 (hsa_circ_0001495) promotes glioma progression by elevating CCND1 through interacting miR-516b-5p and HuR.

To explore the functions of circRNA cyclin B1 (circCCNB1) in glioma and its possible mechanisms. The expression of circCCNB1, eukaryotic translation initiation factor 4A3 (EIF4A3), cyclin D1 (CCND1) and miR-516b-5p was determined by qRT-PCR, western blot or immunohistochemistry (IHC) assay. The feature of circCCNB1 was analyzed by Actinomycin D (ActD), RNase R and subcellular fraction assays. The molecule relationships were analyzed by RIP, dual-luciferase reporter and RNA pull-down assays. CCK-8, EdU and colony formation assays were performed to analyze cell proliferation. Flow cytometry analysis was executed to estimate the cell cycle. Murine xenograft model assay was used for the role of circCCNB1 in vivo. CircCCNB1 was overexpressed in glioma tissues and cells. EIF4A3 positively regulated circCCNB1 expression. CircCCNB1 knockdown repressed glioma cell proliferation and cell cycle process in vitro and blocked tumor growth in vivo. CircCCNB1 knockdown reduced CCND1 expression in glioma cells and CCND1 overexpression bated the effect of circCCNB1 knockdown on glioma cell growth. CircCCNB1 interacted with HuR to elevate CCND1 expression. miR-516b-5p could interact with circCCNB1 and CCND1. CircCCNB1 regulated glioma cell progression and CCND1 expression by miR-516b-5p and HuR. CircCCNB1 aggravated glioma cell growth by elevating CCND1 through targeting miR-516b-5p and HuR.

Lack of associations between rs2910164 and rs11614913 polymorphisms and the risk of ischemic stroke.

Emerging evidence suggests that single nucleotide polymorphisms (SNPs) in microRNA genes may play a role in the development of cerebrovascular diseases including ischemic stroke through functionally modulating the expression of microRNA target genes. However, the current studies regarding the associations of the common microRNA polymorphisms with susceptibility to ischemic stroke have obtained discrepant results, which prompted us to perform a meta-analysis for a more precise estimation of the concerned associations. Relevant studies evaluating the associations between two common polymorphisms (miR-146a rs2910164 and miR-196a2 rs11614913) and the risk of ischemic stroke were retrieved from the PubMed, Embase, Cochrane Library, Google Scholar, Chinese Wanfang, Chinese Biomedical Database, and Chinese National Knowledge Infrastructure databases. The odds ratio (OR) with its 95% confidence interval (95% CI) were pooled to assess the strength of the associations using RevMan 5.2 and Stata 12.0 software. A total of 5 case-control studies with 2069 cases and 2061 controls on rs2910164, 4 case-control studies with 1873 cases and 1856 controls on rs11614913 polymorphisms were enrolled in the meta-analysis. Overall, neither allele frequency nor genotype distribution of the two common polymorphisms was found to be associated with risk for ischemic stroke in all genetic models. The subgroup analysis revealed a significant association between miR-146a rs2910164 polymorphism and increased risk of ischemic stroke in large sample size group and in Koreans under homozygous, allele, dominant and recessive models. The present meta-analysis suggests that the two common polymorphisms (rs2910164, rs11614913) may not contribute to the susceptibility to ischemic stroke. However, more well-designed studies with large sample size are warranted to further validate the results in different ethnicities.