[Retrospective study for the risk factors of the early complication after carotid endarterectomy].

OBJECTIVE: To review the influencing factors of the early complication after carotid endarterectomy (CEA). METHODS: Retrospective analysis of clinical data of 509 cases received CEA in Xuan Wu Hospital of Capital Medical University, Liaocheng People's Hospital and Dalian Central Hospital from January 2001 to December 2011. There are 422 male patients and 72 female patients among the 494 patients, 15 patients underwent CEA by stages. The patients were between 35-84 years old,and the mean age was (64 ± 9) years. The complications within 30 days after CEA were analyzed, and find the risk factors for the major adverse events. Chi-square analysis was performed to analyze the correlation between the each variable of the basic characteristics of population, clinical features and intraoperative data and early adverse events after CEA. Logistic regression analysis was used to assess the relationship between a variety of factors and the postoperative complications within 30 days. RESULTS: Technical complete rate of 98.6%, 7 cases of near-total occlusion patients could not been recanalized. Major complications in 30 days after CEA occurred in 20 cases (3.9%), including 6 cases of deaths (1.2%), 9 cases of cerebral infarction (1.8%) and 5 cases of cerebral hemorrhage (1.0%). Secondary complications occurred in 120 cases (23.6%). Univariate analysis showed modified Rankin scale (mRS) ≥ 3 on the incidence of early postoperative complication had significantly difference (χ² =20.517, P < 0.01), multivariate logistic regression analysis revealed that smoking (OR=2.667, 95% CI: 1.048-6.791, P=0.040) and mRS ≥ 3 (OR=8.690, 95% CI: 3.279-23.031, P=0.000) were the significant predictors of 30 days of the end event. CONCLUSION: The complications after CEA are uncommon, the security is proved. Smoking and mRS ≥ 3 can increase the risk of CEA.

Motor improvement of remote programming in patients with Parkinson's disease after deep brain stimulation: a 1-year follow-up.

Background: Remote programming (RP) is an emerging technology that enables the adjustment of implantable pulse generators (IPGs) via the Internet for people with Parkinson's disease (PwPD) who have undergone deep brain stimulation (DBS). Previous studies have not comprehensively explored the effectiveness of RP in managing motor symptoms, often omitting assessments such as the rigidity and retropulsion tests during the follow-up. This study evaluates the comprehensive improvements in motor performance and the potential cost benefits of RP for PwPD with DBS. Methods: A retrospective analysis was conducted on two groups of patients-those who received RP and those who received standard programming (SP). Clinical outcomes including motor improvement, quality of life, and daily levodopa dosage were compared between the groups during a 12 (± 3)-month in-clinic follow-up. Results: A total of 44 patients were included in the study, with 18 in the RP group and 26 in the SP group. No significant differences were observed in the frequency of programming sessions or clinical outcomes between the groups (p > 0.05). However, the RP group experienced significantly lower costs per programming session than the SP group (p < 0.05), despite patients in the former group living further from our center (p < 0.05). Conclusions: Our findings suggest that RP could significantly reduce the costs of programming for PwPD with DBS, especially without compromising the effectiveness of treatment across all motor symptoms in the short term.

Telemedicine in patients with obsessive-compulsive disorder after deep brain stimulation: a case series.

Background: Patients suffering from refractory obsessive-compulsive disorder (OCD) who have undergone deep brain stimulation (DBS) surgery require repeated in-person programming visits. These sessions could be labor-intensive and may not always be feasible, particularly when in-person hospital visits are restricted. Telemedicine is emerging as a potential supplementary tool for post-operative care. However, its reliability and feasibility still require further validation due to the unconventional methods of interaction. Methods: A study was conducted on three patients with refractory OCD who had undergone DBS. Most of their programming sessions were completed via a remote programming system. These patients were recruited and monitored for a year. Changes in their clinical symptoms were assessed using the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II), the Hamilton Anxiety Scale-14 (HAMA), the Hamilton Depression Scale-17 (HAMD), and the Short Form 36 Health Survey Questionnaire (SF-36). The scores from these assessments were reported. Results: At the last follow-up, two out of three patients were identified as responders, with their Y-BOCS-II scores improving by more than 35% (P1: 51%, P3: 42%). These patients also experienced some mood benefits. All patients observed a decrease in travel expenses during the study period. No severe adverse events were reported throughout the study. Conclusion: The group of patients showed improvement in their OCD symptoms within a 1-year follow-up period after DBS surgery, without compromising safety or benefits. This suggests that telemedicine could be a valuable supplementary tool when in-person visits are limited.

Rescue subthalamic stimulation after unsatisfactory outcome of pallidal stimulation in Parkinson's disease: a case series and review.

Background: Subthalamic nucleus (STN) and globus pallidus interna (GPi) are two main structures primarily targeted by deep brain stimulation (DBS) to treat advanced Parkinson's disease (PD). A subset of cases with unsatisfactory outcomes may benefit from rescue DBS surgery targeting another structure, while these patients' characteristics have not been well described and this phenomenon has not been well reviewed. Methods: This monocentric retrospective study included patients with PD, who underwent rescue STN DBS following an unsatisfactory outcome of the initial bilateral GPi DBS in a retrospective manner. A short review of the current literature was conducted to report the clinical outcome of rescue DBS surgeries. Results: Eight patients were identified, and six of them were included in this study. The rescue STN DBS was performed 19.8 months after the initial GPi DBS. After 8.8 months from the rescue STN DBS, patients showed a significant off-medication improvement by 29.2% in motor symptoms compared to initial GPi DBS. Non-motor symptoms and the health-related quality of life were also significantly improved. Conclusion: Our findings suggest that the rescue STN DBS may improve off-medication motor and non-motor symptoms and quality of life in patients with failure of initial GPi DBS. The short review of the current literature showed that the target switching from GPi to STN was mainly due to poor initial outcomes and was performed by target substitution, whereas the switching from STN to GPi was mainly due to a gradual waning of benefits, long-term axial symptoms, dyskinesia, and dystonia and was performed by target addition.

LncRNA NEAT1 promoted MPP+­induced ferroptosis via regulating miR­150­5p/BAP1 pathway in SK­N­SH cells.

As widely reported, dysregulated ferroptosis is closely associated with Parkinson's disease (PD) progression. The goal of the present study was to probe the roles of long non­coding RNA (lncRNA) nuclear enriched assembly transcript 1 (NEAT1) in regulating ferroptosis in PD. PD cell model was constructed by subjecting SK­N­SH cells to 1­methyl­4­phenylpyridinium (MPP+) for 24 h. The RNA levels of NEAT1, miRNA (miR)­150­5p, and BRCA1­associated protein 1 (BAP1) were evaluated using qRT­PCR. The protein levels of glutathione peroxidase 4 (GPX4), BAP1, and solute carrier family 7 member 11 (SLC7A11) were determined using western blot. Cell viability was assessed using 3­(4,5­dimethylthiazolyl2)­2, 5­diphenyltetrazolium bromide (MTT) assay. In addition, fluorescent probe 2,7­dichlorodihydrofluorescein diacetate (DCFH­DA) was employed to determine the ROS level. Moreover, the levels of GSH, MDA, and Fe2+ were also measured. Finally, the interactions among NEAT1, miR­150­5p, and BAP1 were identified by dual luciferase reporter gene assay, and/or RIP assay. Upregulated NEAT1 was observed in PD cell model. Knockdown of NEAT1 elevated viability and GSH level in PD cell model and reduced ROS, MDA, and Fe2+ levels. Moreover, NEAT1 functioned as a sponge to suppress miR­150­5p expression. Moreover, miR­150­5p overexpression suppressed ferroptosis in PD cell model. We subsequently found that miR­150­5p regulated SLC7A11 expression by directly binding to BAP1. miR­150­5p inhibition or BAP1 overexpression mitigated the anti­ferroptosis effect meditated by sh­NEAT1. Taken together, knockdown of NEAT1 mitigated MPP+­induced ferroptosis through regulating BAP1/SLC7A11 axis by sponging miR­150­5p, indicating the potential of NEAT1 as a promising therapeutic target for PD.

[Effects of Stalk Incorporation on Soil Carbon Sequestration, Nitrous Oxide Emissions, and Global Warming Potential of a Winter Wheat-Summer Maize Field in Guanzhong Plain].

The net greenhouse gas emissions from upland soils, as indicated by global warming potential (GWP), mainly depend on the soil carbon sequestration and nitrous oxide (N2O) emissions. The annual changes in surface (0-20 cm) soil organic carbon (SOC) content from 2010 to 2017 and the N2O emissions from 2014 to 2017 were measured within a long-term fertilization experiment. The objective was to quantify the effect of stalk incorporation on the soil carbon sequestration, annual N2O emissions, and GWP of a winter wheat-summer maize field in the Guanzhong Plain. The field experiment included three treatments:conventional fertilization (CF), conventional fertilization plus maize stalks (CFS), and an unfertilized control (CK). The CF and CFS treatments received the same amount of urea per year, with nitrogen (N) input at 165 kg·hm-2 and 188 kg·hm-2 in the winter wheat season and summer maize season, respectively. The CF treatment retained the stubbles (about 10 cm above ground) when harvesting the winter wheat and summer maize crops. The CFS treatment retained the same wheat stubbles and all maize stalks (containing approximately 40 kg·hm-2 of N). The CK treatment was unfertilized throughout the year, with the stubble management the same as that in the CF treatment. The results showed that the CK treatment displayed few changes in SOC content and low N2O emissions, with GWP varying from 0.04 to 0.11 t·(hm2·a)-1. The SOC contents in the CF and CFS treatments increased linearly with the fertilization years (P<0.001), and their SOC sequestration rates were 0.69 t·(hm2·a)-1 and 0.97 t·(hm2·a)-1, respectively. The N2O emissions from the CF and CFS treatments varied from 1.65 to 5.36 kg·(hm2·a)-1 and from 3.08 to 7.73 kg·(hm2·a)-1, respectively. The annual N2O emissions from the CFS treatment were 43%-94% higher than those from the CF treatment, whereas the difference was only significant between 2015 and 2016 (P<0.05). The GWP of the CF and CFS treatments varied from -1.95 to -0.28 t·(hm2·a)-1 and from -2.59 to -0.35 t·(hm2·a)-1, respectively. The cumulative GWP of the CFS treatment was 42% lower than that of the CF treatment between 2014 and 2017. In summary, the studied winter wheat-summer maize field acted as a sink of greenhouse gases under the conventional fertilization regime. The stalk incorporation further favored greenhouse gas mitigation despite the trade-offs between SOC sequestration and N2O emissions.

COVID-19 vaccine acceptance and hesitancy in patients with Parkinson's disease.

Background: As coronavirus disease 2019 (COVID-19) vaccination campaign underway, little is known about the vaccination coverage and the underlying barriers of the vaccination campaign in patients with Parkinson's disease (PD). Objective: To investigate the vaccination status and reasons for COVID-19 vaccine acceptance and hesitancy among PD patients. Methods: In concordance with the CHERRIES guideline, a web-based, single-center survey was promoted to patients with PD via an online platform from April 2022 and May 2022. Logistic regression models were used to identify factors related to COVID-19 vaccine hesitancy. Results: A total of 187 PD cases participated in this online survey (response rate of 23%). COVID-19 vaccination rate was 54.0%. Most participants had a fear of COVID-19 (77.5%) and trusted the efficacy (82.9%) and safety (66.8%) of COVID-19 vaccine. Trust in government (70.3%) and concerns about the impact of vaccine on their disease (67.4%) were the most common reasons for COVID-19 vaccine acceptance and hesitancy, respectively. COVID-19 vaccine hesitancy was independently associated with the history of flu vaccination (OR: 0.09, p < 0.05), trust in vaccine efficacy (OR: 0.15, p < 0.01), male gender (OR: 0.47, p < 0.05), disease duration of PD (OR: 1.08, p < 0.05), and geographic factor (living in Shanghai or not) (OR: 2.87, p < 0.01). Conclusions: The COVID-19 vaccination rate remained low in PD patients, however, most individuals understood benefits of vaccination. COVID-19 vaccine hesitancy was affected by multiple factors such as geographic factor, history of flu vaccination, disease duration and trust in efficacy of vaccine. These findings could help government and public health authorities to overcome the barrier to COVID-19 vaccination and improve vaccine roll-out in PD patients.

Intrinsic Aerobic Capacity Affects Hippocampal pAkt and HSP72 Response to an Acute High Fat Diet and Heat Treatment in Rats.

BACKGROUND: Aerobic capacity is associated with metabolic, cardiovascular, and neurological health. Low-capacity runner (LCR) rats display low aerobic capacity, metabolic dysfuction, and spatial memory deficits. A heat treatment (HT) can improve metabolic dysfunction in LCR peripheral organs after high fat diet (HFD). Little is known about metabolic changes in the brains of these rats following HT. OBJECTIVE: Our objective was to examine the extent to which high or low aerobic capacity impacts Akt (a protein marker of metabolism) and heat shock protein 72 (HSP72, a marker of heat shock response) after HFD and HT in hippocampus. METHODS: We measured phosphorylated Akt (pAkt) in the striatum and hippocampus, and HSP72 in the hippocampus, of HFD-fed and chow-fed LCR and high-capacity runner (HCR) rats with and without HT. RESULTS: pAkt was lower in the hippocampus of chow-fed LCR than HCR rats. HFD resulted in greater pAkt in LCR but not HCR rats, but HT resulted in lower pAkt in the LCR HFD group. HSP72 was greater in both HCR and LCR rat hippocampus after HT. The HFD blunted this effect in LCR compared to HCR hippocampus. CONCLUSION: The abnormal phosphorylation of Akt and diminished HSP response in the hippocampus of young adult LCR rats might indicate early vulnerability to metabolic challenges in this key brain region associated with learning and memory.

Visualization of multiple anatomical structures with explicit isosurface manipulation.

In medical image analysis and surgical planning, it is an essential task to visualize and differentiate multiple anatomical structures. The traditional approaches require expensive 3D segmentation steps during pre-processing stage, which defeats the purpose of real-time interaction with the data. In this paper, we propose an interactive method for visualization of multiple anatomical structures. In our results, we show that the new method is a promising technique for visual analysis of medical datasets and a helpful tool for surgical planning. It can be very efficient for a wide range of visualization and analysis tasks.

Retinal vessel extraction by combining radial symmetry transform and iterated graph cuts.

In this paper, we propose a new method for the extraction of blood vessels in retinal images. This approach starts with a Hessian-based multiscale filtering method to enhance blood vessels in gray retinal images. Subsequently, a new radial symmetry transformation, which is based on line kernels, is proposed to improve the detection of vessel structures and restrain the response of nonvessel structures. Finally, an iterated segmentation algorithm is used to extract retinal vessels. The proposed approach has been tested on the two publicly available databases, DRIVE and STARE. The experimental results show the feasibility of the proposed method.