Explore the vast range of titles available.

There are currently two main treatment strategies mainly for high-risk patients: percutaneous transluminal angioplasty and stenting (PTAS) and aggressive medical management (AMM). However, the choice between PTAS or AMM remains controversial for patients with stroke or intracranial atherosclerotic stenosis (ICAS). The investigators searched the PubMed, Web of Science, Embase, Scopus, and Cochrane library databases. Randomized controlled trial (RCT) comparing PTAS and AMM for patients with stroke or ICAS were selected. RevMan 5.3 was used to analyze the results and assess risk of bias. The primary endpoints are stroke and death within 30 days after enrollment, or ischemic stroke in the territory of the qualifying artery beyond 30 days, and entire follow-up endpoints. The secondary outcomes were the disabling or fatal stroke, and incidence of death within 3 years. Four studies, 989 patients were included in this article. The AMM group was superior in the entire follow-up endpoint (OR 0.56; 95% CI 0.40, 0.79). The AMM also better in primary endpoint within 30 days (OR 0.32; 95% CI 0.17, 0.61). There was no significant difference beyond 30 days (OR 1.08; 95% CI 0.63, 1.86). The remaining outcomes, such as stroke and death, were not significantly different (P > 0.05). This meta-analysis shows AMM is significantly more effective than PTAS in subjects with ICAS due to the high rate of periprocedural stroke (OR 0.32; 95% CI 0.17, 0.61) and stroke during the entire follow-up (OR 0.56; 95% CI 0.40, 0.79) associated with PTAS. Furthermore, PTAS offers no additional benefits over AMM beyond 30 days (OR 1.08; 95% CI 0.63, 1.86).

Background Cases of multiple cerebral aneurysms are rare. In this case report, we describe a male patient with multiple, enlarging, and ruptured aneurysms. The two aneurysms were believed to be dissecting aneurysms. Case description A 47-year-old man presented with left limb paralysis. Magnetic resonance imaging revealed a cerebral infarction. Digital subtraction angiography (DSA) identified an aneurysm and occlusion in the right middle cerebral artery (MCA). The MCA aneurysm was remarkably enlarged on the eighth day after cerebral ischemia and was treated using endovascular techniques. Two weeks after the endovascular treatment, the patient experienced a severe headache and became comatose, and a subarachnoid re-hemorrhage was confirmed. The fourth DSA revealed an enlarging dissecting aneurysm in the posterior cerebral artery. The patient died without further treatment. Conclusion Some dissecting aneurysms rapidly enlarge and rupture.

Over the last decade, Nitrogen Oxide (NOx) emissions have garnered significantly greater attention due to the worldwide emphasis on sustainable development strategies. In response to the issues of dynamic measurement delay and low measurement accuracy in the NOx sensors of heavy-duty diesel vehicles, a novel Multilayer Perceptron (MLP)–Random Forest Regression (RFR) fusion algorithm was proposed and explored in this research. The algorithm could help perform post-correction processing on the measurement results of diesel vehicle NOx sensors, thereby improving the reliability of the measurement results. The results show that the measurement errors of the On-board Nitrogen oxide Sensors (OBNS) were reduced significantly after the MLP-RFR fusion algorithm was corrected. Within the concentration range of 0–90 ppm, the absolute measurement error of the sensor was reduced to ±4 ppm, representing a decrease of 73.3%. Within the 91–1000 ppm concentration range, the relative measurement error was optimised from 35% to 17%, providing a reliable solution to improve the accuracy of the OBNS. The findings of this research make a substantial contribution towards enhancing the efficacy of the remote monitoring of emissions from heavy-duty diesel vehicles.

IntroductionThe safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown. The Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis (CRTICAS) was a prospective, multicentre, real-world registry designed to assess these outcomes and the impact of centre experience.Methods1140 severe, symptomatic intracranial arterial stenosis (ICAS) patients treated with endovascular therapy were included from 26 centres, further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years: (1) high volume for ≥25 cases/year; (2) moderate volume for 10–25 cases/year and (3) low volume for <10 cases/year.ResultsThe rate of 30-day stroke, transient ischaemic attack or death was 9.7% (111), with 5.4%, 21.1% and 9.7% in high-volume, moderate-volume and low-volume centres, respectively (p<0.05). Multivariable logistic regression confirmed high-volume centres had a significantly lower primary endpoint compared with moderate-volume centres (OR=0.187, 95% CI: 0.056 to 0.627; p≤0.0001), while moderate-volume and low-volume centres showed no significant difference (p=0.8456).ConclusionCompared with the preceding randomised controlled trials, this real-world, prospective, multicentre registry shows a lower complication rate of endovascular treatment for symptomatic ICAS. Non-uniform utilisation in endovascular technology, institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment.

Background and Purpose Subarachnoid hemorrhage (SAH)‐induced cerebral vasospasm and early brain injury is a fatal clinical syndrome. Cerebral vasospasm and early brain injury are associated with inflammatory response and oxidative stress. Whether curcumin, which plays important roles to regulate inflammatory cytokines and inhibit oxidative stress, inhibits SAH‐induced inflammation and oxidative stress are largely unknown. Methods Adult male rats underwent autologous blood injection into prechiasmatic cistern to induce SAH. Curcumin (150 mg/kg) was administered at 0.5, 24 and 48 hr post‐SAH. Mortality calculation and neurological outcomes as well as morphological vasospasm of anterior cerebral artery were studied. Superoxide dismutase, lipid peroxidation, and inflammatory cytokines (MCP‐1 and TNF‐α) expression in prefrontal region were quantified. Furthermore, p65 and phosphor‐p65 were quantitatively analyzed. Results Curcumin remarkedly reduced mortality and ameliorated neurological deficits after SAH induction (p < .05); morphological results showed that cerebral vasospasm in curcumin‐treated group was mitigated (p < .05). SAH‐induced MCP‐1 and TNF‐α overexpression were inhibited in curcumin‐treated group (p < .05). Importantly, phosphor‐p65 was significantly inhibited after curcumin treatment (p < .05). Conclusions Curcumin can inhibit SAH‐induced inflammatory response via restricting NF‐κB activation to alleviate cerebral vasospasm and early brain injury. According to the results of present study, we demonstrated that Curcumin could inhibit subarachnoid hemorrhage (SAH) induced inflammatory response via restricting NF‐κB activation to alleviate cerebral vasospasm and early brain injury.

To explore the association between high-sensitivity C-reactive protein (hs-CRP) and the progression of arteriosclerosis. Using a prospective cohort study design, 11,577 participants from the Kailuan Study cohort who underwent at least two brachial-ankle pulse wave velocity (baPWV) examinations and met the inclusion criteria were included as the study subjects. Based on baseline hs-CRP levels, they were divided into three groups: hs-CRP <1 mg/L group, 1 mg/L≤hs-CRP≤3 mg/L group, and hs-CRP >3 mg/L group. Poisson regression analysis was employed for longitudinal comparison to assess the impact of different hs-CRP levels on baPWV≥1,400 cm/s. (1) After a mean follow-up of 5.12 ± 2.84 years, the detection rates of baPWV≥1,400 cm/s at the end of follow-up were 28.54%, 33.36%, and 36.25% in the hs-CRP<1 mg/L (n=5,998), 1 mg/L≤ hs-CRP≤3 mg/L (n=4,101), and hs-CRP>3 mg/L (n=1,578) groups, respectively ( <0.001). (2) Multivariable-adjusted Poisson regression analysis for baPWV≥1,400 cm/s showed that, after adjusting for confounding factors, compared to the hs-CRP<1 mg/L group, the 1 mg/L≤hs-CRP≤3 mg/L group had a 2.4% higher risk of arterial stiffness (RR: 1.024; 95% CI: 1.002 to 1.047; <0.05) and hs-CRP>3 mg/L group had a 6.3% higher risk (RR: 1.063; 95% CI: 1.031 to 1.095; <0.001). Sensitivity analysis validated the robustness of the results. Elevated hs-CRP is an independent risk factor for arteriosclerosis progression.

Neurointervention plays an important role in the diagnosis and treatment of stroke, especially for acute stroke, which could significantly reduce the mortality and disability rates.5 6 During the epidemic, neurointerventional staff are faced with the dual pressures of disease treatment and infection prevention. [...]the Chinese Federation of Interventional and Therapeutic Neuroradiology (CFITN) and the International Society for Neurovascular Disease (ISNVD) have called on neurointerventional specialists from departments of neurosurgery, neurology, and interventional radiology to discuss and compile this expert consensus based on their working experience in fighting against the epidemic and related regulations issued by National Health Commission7–9 The aim was to provide protective strategies and recommendations for medical staff to carry out neurointerventional procedures under the circumstances of the COVID-19 epidemic, and to provide references for neurointerventional physicians around the world. [...]neurointerventional staff should participate in the training to update their knowledge of the epidemic, especially the epidemiological characteristics and diagnostic criteria of COVID-19 (figure 1), the stratified precautions for medical staff during the COVID-19 epidemic (table 1), and the instructions regarding common disinfection supplies, etc. (2) Neurointerventional staff who conduct diagnosis, treatment and disinfection in the isolation observation room, isolation ward or block Wear disposable caps, medical respirators (such as N95 mask), anti-fog safety goggles or anti-fog protective shields, medical protective suits, disposable gloves, and disposable shoe covers Level protection III (1) Neurointerventional staff performing close procedures that may produce aerosol, such as endotracheal intubation, nebulization treatment, sputum induction, tracheotomy, chest physiotherapy, nasopharyngeal aspiration, positive pressure ventilation, high frequency oscillatory ventilation, cardiopulmonary resuscitation and postmortem lung biopsy, etc. Infection prevention and control strategies for the catheterization lab Medical supplies preparation In addition to general surgical instruments, sufficient personal protective equipment should be provided, including N95 respirators, safety goggles or face shields, isolation gowns, protective suits, shoe covers or boot covers, and full face respirators, etc.

Introduction Some micro arteriovenous malformations (AVMs) located in deep brain are undetectable. How to choose a proper timing to detect these AVMs remains unclear. Case description A 21-year-old male patient was admitted to our center for intraventricular haematoma. Digital subtraction angiographies (DSAs) were performed one week and one month respectively after his haemorrhage, but no positive results were obtained. The patient was hospitalized for re-haemorrhage six years later. A micro AVM with two diffused niduses was detected and embolised three months after his re-haemorrhage. The patient recovered without any neurological deficit. Discussion and evaluation Compressive effects of haematoma and spontaneous obliteration of AVMs might play pivotal roles in negative DSA results. Conclusions Strategic and timely use of DSA could identify some dormant re-haemorrhagic AVMs.

Background Cases with brain tumor and subdural hematoma are rare; surgical management of the elderly patients with a glioblastoma multiform (GBM) and a chronic subdural hematoma (CSDH) can be intractable. Case description We report a 77-year-old patient, who had a left front lobe GBM and a giant, calcified, left frontoparietaloccipitotemporal CSDH. The patient recovered well from anesthesia after removal of the GBM and CSDH. However, the patient developed severe hemiplegia and aphasia because of the in-situ hemorrhage 1 day later. Laboratory tests indicated disseminated intravascular coagulation (DIC) leading to the postoperative hemorrhage. The patient was left with hemiparesis and alalia after the in-situ hematoma evacuation. Conclusions We presume elderly patients have a higher incidence of postoperative hemorrhage in residual intracranial cavity owing to higher possibility to get DIC. A less aggressive surgical management could be a more appropriate choice.

Understanding the sensing mechanism of metal oxide semiconductors is imperative to the development of high-performance sensors. The traditional sensing mechanism only recognizes the effect of surface chemisorbed oxygen from the air but ignores surface lattice oxygen. Herein, using in-situ characterizations, we provide direct experimental evidence that the surface chemisorbed oxygen participated in the sensing process can come from lattice oxygen of the oxides. Further density functional theory (DFT) calculations prove that the p -band center of O serves as a state of art for regulating the participation of lattice oxygen in gas-sensing reactions. Based on our experimental data and theoretical calculations, we discuss mechanisms that are fundamentally different from the conventional mechanism and show that the easily participation of lattice oxygen is helpful for the high response value of the materials. Understanding the sensing mechanism of metal oxide semiconductors is imperative for developing high-performance sensors. Here, the participation of lattice oxygen, caused by additional Ge, boosts the hydrogen sensing ability of SnO 2 .