Background To compare the safety and efficacy of pipeline embolization device(PED)and Tubridge flow diverter(TFD)for unruptured posterior circulation aneurysms.Methods Posterior aneurysm patients treated with PED or T...Background To compare the safety and efficacy of pipeline embolization device(PED)and Tubridge flow diverter(TFD)for unruptured posterior circulation aneurysms.Methods Posterior aneurysm patients treated with PED or TFD between January,2019,and December,2021,were retrospectively reviewed.Patients’demographics,aneurysm characteristics,treatment details,complications,and follow-up information were collected.The procedural-related complications and angiographic and clinical outcome were compared.Results A total of 107 patients were involved;PED was applied for 55 patients and TFD for 52 patients.A total of 9(8.4%)procedural-related complications occurred,including 4(7.3%)in PED group and 5(9.6%)in TFD group.During a mean of 10.3-month angiographic follow-up for 81 patients,complete occlusion was achieved in 35(85.4%)patients in PED group and 30(75.0%)in TFD group.The occlusion rate of PED group is slightly higher than that of TFD group.A mean of 25.0-month clinical follow-up for 107 patients showed that favorable clinical outcome was achieved in 53(96.4%)patients in PED group and 50(96.2%)patients in TFD group,respectively.No statistical difference was found in terms of procedural-related complications(p=0.737),occlusion rate(p=0.241),and favorable clinical outcome(0.954)between groups.Conclusions The current study found no difference in complication,occlusion,and clinical outcome between PED and TFD for unruptured PCAs.展开更多
Stem cell research has become a hot topic in biology,as the understanding of stem cell biology can provide new insights for both regenerative medicine and clinical treatment of diseases.Accurately deciphering the fate...Stem cell research has become a hot topic in biology,as the understanding of stem cell biology can provide new insights for both regenerative medicine and clinical treatment of diseases.Accurately deciphering the fate of stem cells is the basis for understanding the mechanism and function of stem cells during tissue repair and regeneration.Cre-loxP-mediated recombination has been widely applied in fate mapping of stem cells for many years.However,nonspecific labeling by conventional cell lineage tracing strategies has led to discrepancies or even controversies in multiple fields.Recently,dual recombinase-mediated lineage tracing strategies have been developed to improve both the resolution and precision of stem cell fate mapping.These new genetic strategies also expand the application of lineage tracing in studying cell origin and fate.Here,we review cell lineage tracing methods,especially dual genetic approaches,and then provide examples to describe how they are used to study stem cell fate plasticity and function in vivo.展开更多
Background:Deregulation of miRNA-21 expression has been reported to be associated with vascular smooth muscle behavior and cytoskeletal stability.This study is aimed to investigate the density of serum miRNA-21 in pat...Background:Deregulation of miRNA-21 expression has been reported to be associated with vascular smooth muscle behavior and cytoskeletal stability.This study is aimed to investigate the density of serum miRNA-21 in patients with different phases of intracranial aneurysms(IAs)and explore its warning function for IA rupture.Methods:A total of 16 in 200 IA patients were selected and categorized into 4 groups based on the phase of IA.Microarray study was carried out using serum miRNA and differentially expressed miRNAs were identified.Another 24 samples from a cohort of 360 patients were added and real-time polymerase chain reaction(RT-PCR)was performed on expanded sample size(n=40)for miRNA-21 validation.Potential gene targets of miRNA-21 were screened out from Gene Ontology(GO)database and literatures.Results:Microarray study identified 77 miRNAs with significantly different expression levels between experimental groups and the control group.RT-PCR assays validated significant downregulation of miRNA-21 in experimental groups,among which miRNA-21 expression level of daughter aneurysm group decreased the most.Bioinformatic analyses revealed that several target genes related with miRNA-21 may be involved in IA formation and rupture.Conclusions:This study suggested that miRNA-21 had a protective effect for intracranial vascular wall against remodeling and warning function for intracranial aneurysm rupture.Significant suppression of serum miRNA-21 in IA patients may provide diagnostic clues for aneurysm rupture and guide clinical intervention.展开更多
Background and purpose The safety and effectiveness of endovascular treatment for non-Galenic pial arteriovenous fistula(NGPAVF)is inadequately known.The aim of this study is to explore the role of endovascular emboli...Background and purpose The safety and effectiveness of endovascular treatment for non-Galenic pial arteriovenous fistula(NGPAVF)is inadequately known.The aim of this study is to explore the role of endovascular embolisation for curative treatment of NGPAVF.Materials and methods Patients with NGPAVF underwent endovascular treatment from January 2011 to November 2019 in our institution were retrospectively reviewed.Demographics,clinical information,treatment details and clinical outcomes were collected.Factors associated with clinical outcomes were statistically analysed.Results Twenty patients were included,with a total of 22(2 patients have 2 fistulas)lesions.A total of 25 procedures were performed and 5 patients underwent 2 procedures.Follow-up ranged from 3 to 84 months(mean=34.5 months).Thirteen(59.1%)lesions in 12(60.0%)patients acquired immediate occlusion after initial treatment(immediately occluded group)and follow-up confirmed the complete obliteration.A total of 17(77.3%)lesions in 15(75.0%)patients were cured at last follow-up.The maximal diameter of feeding arteries(p=0.04)and the maximal diameter of the varix(p=0.01)in immediately occluded group was smaller than non-immediately occluded group.The number of feeding artery(p=0.004)and the maximal diameter of the varix(p<0.001)were much smaller in curative group than non-curative group.Seven patients suffered procedure-related complications.No patients had an increased Modified Rankin Scale(mRS)and all patients had favourable clinical outcome(mRS≥2)at last follow-up.Conclusions Endovascular therapy plays an important role in curative treatment of NGPAVF.Patients with less feeding arteries and small varix may be easier to be cured by endovascular embolisation.展开更多
Objective The aims of this study are to clarify the long-term outcomes of brainstem arteriovenous malformations(AVMs)after different management modalities.Methods The authors retrospectively reviewed 61 brainstem AVMs...Objective The aims of this study are to clarify the long-term outcomes of brainstem arteriovenous malformations(AVMs)after different management modalities.Methods The authors retrospectively reviewed 61 brainstem AVMs in their institution between 2011 and 2017.The rupture risk was represented by annualised haemorrhagic rate.Patients were divided into five groups:conservation,microsurgery,embolisation,stereotactic radiosurgery(SRS)and embolisation+SRS.Neurofunctional outcomes were evaluated by the modified Rankin Scale(mRS).Subgroup analysis was conducted between different management modalities to compare the long-term outcomes in rupture or unruptured cohorts.Results All of 61 brainstem AVMs(12 unruptured and 49 ruptured)were followed up for an average of 4.5 years.The natural annualised rupture risk was 7.3%,and the natural annualised reruptured risk in the ruptured cohort was 8.9%.13 cases were conservative managed and 48 cases underwent intervention(including 6 microsurgery,12 embolisation,21 SRS and 9 embolisation+SRS).In the selection of interventional indication,diffuse nidus were often suggested conservative management(p=0.004)and nidus involving the midbrain were more likely to be recommended for intervention(p=0.034).The risk of subsequent haemorrhage was significantly increased in partial occlusion compared with complete occlusion and conservative management(p<0.001,p=0.036,respectively).In the subgroup analysis,the follow-up mRS scores of different management modalities were similar whether in the rupture cohort(p=0.064)or the unruptured cohort(p=0.391),as well as the haemorrhage-free survival(p=0.145).In the adjusted Bonferroni correction analysis of the ruptured cohort,microsurgery and SRS could significantly improve the obliteration rate compared with conservation(p<0.001,p=0.001,respectively)and SRS may have positive effect on avoiding new-onset neurofunctional deficit compared with microsurgery and embolisation(p=0.003,p=0.003,respectively).Conclusions Intervention has similar neurofunctional outcomes as conservation in these brainstem AVM cohorts.If intervention is adopted,partial obliteration should be avoided because of the high subsequent rupture risk.展开更多
Background: To examine whether embolization of dural or pial blood supply branch is more efficient for symptom alleviation for unruptured mixed dural-pial arteriovenous malformations (DPAVMs). Methods: We retrospectiv...Background: To examine whether embolization of dural or pial blood supply branch is more efficient for symptom alleviation for unruptured mixed dural-pial arteriovenous malformations (DPAVMs). Methods: We retrospectively reviewed 30 DPAVM patients from a database of 425 consecutive cerebral arteriovenous malformation (CAVM) patients who underwent endovascular embolization between January 2010 and December 2015 at our institution. Demographics, angioarchitectural characteristics, endovascular embolization details and patients clinical outcomes were recorded. The modified Rankin Scale (mRS), Engel‘s classification and Visual Analogue pain scale (VAS) were used to assess clinical outcomes. Results: The single center cohort data shows that the incidence of DPAVM is 7.1%. Among the 30 DPAVM patients, 9 (30.0%) are ruptured and 21 (70.0%) are unruptured. Four (19.0%) of the 21 unruptured DPAVM patients are failed to follow-up, leaving 17 to analysis the clinical outcomes. Clinical presentations of the 17 unruptured DPAVM patients are epilepsy (n=10), headache (n=5) and focal neurological dysfunction (n=2). Six patients have DPAVMs occluded via pial blood supply branches, 4 via dural branches and 7 via both pial and dural branches. Unruptured DPAVM patients with nidus occluded via dural blood supply branches, or both pial and dural branches have higher symptom alleviation rate than patients with nidus occluded via pial branches (100%/85.7% vs 66.7%). Conclusions: For DPAVM patients presented with epilepsy, headache and FND, embolization via dural blood supply branches may be more efficient for symptom alleviation. Large cohort study is needed to confirm the generalizability.展开更多
基金supported by the National Natural Science Foundation of China(Grant Number 82171289)the Beijing Gold-Bridge Project(Grant number ZZ21060)
文摘Background To compare the safety and efficacy of pipeline embolization device(PED)and Tubridge flow diverter(TFD)for unruptured posterior circulation aneurysms.Methods Posterior aneurysm patients treated with PED or TFD between January,2019,and December,2021,were retrospectively reviewed.Patients’demographics,aneurysm characteristics,treatment details,complications,and follow-up information were collected.The procedural-related complications and angiographic and clinical outcome were compared.Results A total of 107 patients were involved;PED was applied for 55 patients and TFD for 52 patients.A total of 9(8.4%)procedural-related complications occurred,including 4(7.3%)in PED group and 5(9.6%)in TFD group.During a mean of 10.3-month angiographic follow-up for 81 patients,complete occlusion was achieved in 35(85.4%)patients in PED group and 30(75.0%)in TFD group.The occlusion rate of PED group is slightly higher than that of TFD group.A mean of 25.0-month clinical follow-up for 107 patients showed that favorable clinical outcome was achieved in 53(96.4%)patients in PED group and 50(96.2%)patients in TFD group,respectively.No statistical difference was found in terms of procedural-related complications(p=0.737),occlusion rate(p=0.241),and favorable clinical outcome(0.954)between groups.Conclusions The current study found no difference in complication,occlusion,and clinical outcome between PED and TFD for unruptured PCAs.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB19000000 and XDA16010507)the National Key Research and Development Program of China(2019YFA0110403 and 2019YFA0802000)National Natural Science Foundation of China(31730112,31625019,91849202,and 82008810001)。
文摘Stem cell research has become a hot topic in biology,as the understanding of stem cell biology can provide new insights for both regenerative medicine and clinical treatment of diseases.Accurately deciphering the fate of stem cells is the basis for understanding the mechanism and function of stem cells during tissue repair and regeneration.Cre-loxP-mediated recombination has been widely applied in fate mapping of stem cells for many years.However,nonspecific labeling by conventional cell lineage tracing strategies has led to discrepancies or even controversies in multiple fields.Recently,dual recombinase-mediated lineage tracing strategies have been developed to improve both the resolution and precision of stem cell fate mapping.These new genetic strategies also expand the application of lineage tracing in studying cell origin and fate.Here,we review cell lineage tracing methods,especially dual genetic approaches,and then provide examples to describe how they are used to study stem cell fate plasticity and function in vivo.
基金This work was supported by the National Key R&D Program of China,grant no.2017YFB1304400.
文摘Background:Deregulation of miRNA-21 expression has been reported to be associated with vascular smooth muscle behavior and cytoskeletal stability.This study is aimed to investigate the density of serum miRNA-21 in patients with different phases of intracranial aneurysms(IAs)and explore its warning function for IA rupture.Methods:A total of 16 in 200 IA patients were selected and categorized into 4 groups based on the phase of IA.Microarray study was carried out using serum miRNA and differentially expressed miRNAs were identified.Another 24 samples from a cohort of 360 patients were added and real-time polymerase chain reaction(RT-PCR)was performed on expanded sample size(n=40)for miRNA-21 validation.Potential gene targets of miRNA-21 were screened out from Gene Ontology(GO)database and literatures.Results:Microarray study identified 77 miRNAs with significantly different expression levels between experimental groups and the control group.RT-PCR assays validated significant downregulation of miRNA-21 in experimental groups,among which miRNA-21 expression level of daughter aneurysm group decreased the most.Bioinformatic analyses revealed that several target genes related with miRNA-21 may be involved in IA formation and rupture.Conclusions:This study suggested that miRNA-21 had a protective effect for intracranial vascular wall against remodeling and warning function for intracranial aneurysm rupture.Significant suppression of serum miRNA-21 in IA patients may provide diagnostic clues for aneurysm rupture and guide clinical intervention.
基金supported by the National Key Research and Development Program of China(Grant No.2017YFB1304400)。
文摘Background and purpose The safety and effectiveness of endovascular treatment for non-Galenic pial arteriovenous fistula(NGPAVF)is inadequately known.The aim of this study is to explore the role of endovascular embolisation for curative treatment of NGPAVF.Materials and methods Patients with NGPAVF underwent endovascular treatment from January 2011 to November 2019 in our institution were retrospectively reviewed.Demographics,clinical information,treatment details and clinical outcomes were collected.Factors associated with clinical outcomes were statistically analysed.Results Twenty patients were included,with a total of 22(2 patients have 2 fistulas)lesions.A total of 25 procedures were performed and 5 patients underwent 2 procedures.Follow-up ranged from 3 to 84 months(mean=34.5 months).Thirteen(59.1%)lesions in 12(60.0%)patients acquired immediate occlusion after initial treatment(immediately occluded group)and follow-up confirmed the complete obliteration.A total of 17(77.3%)lesions in 15(75.0%)patients were cured at last follow-up.The maximal diameter of feeding arteries(p=0.04)and the maximal diameter of the varix(p=0.01)in immediately occluded group was smaller than non-immediately occluded group.The number of feeding artery(p=0.004)and the maximal diameter of the varix(p<0.001)were much smaller in curative group than non-curative group.Seven patients suffered procedure-related complications.No patients had an increased Modified Rankin Scale(mRS)and all patients had favourable clinical outcome(mRS≥2)at last follow-up.Conclusions Endovascular therapy plays an important role in curative treatment of NGPAVF.Patients with less feeding arteries and small varix may be easier to be cured by endovascular embolisation.
基金supported by Natural Science Foundation of China(81571110,81771234 to YZ,81500995 to XC,81801140 to LM)Bai Qian Wan Talent Plan(2017A07).
文摘Objective The aims of this study are to clarify the long-term outcomes of brainstem arteriovenous malformations(AVMs)after different management modalities.Methods The authors retrospectively reviewed 61 brainstem AVMs in their institution between 2011 and 2017.The rupture risk was represented by annualised haemorrhagic rate.Patients were divided into five groups:conservation,microsurgery,embolisation,stereotactic radiosurgery(SRS)and embolisation+SRS.Neurofunctional outcomes were evaluated by the modified Rankin Scale(mRS).Subgroup analysis was conducted between different management modalities to compare the long-term outcomes in rupture or unruptured cohorts.Results All of 61 brainstem AVMs(12 unruptured and 49 ruptured)were followed up for an average of 4.5 years.The natural annualised rupture risk was 7.3%,and the natural annualised reruptured risk in the ruptured cohort was 8.9%.13 cases were conservative managed and 48 cases underwent intervention(including 6 microsurgery,12 embolisation,21 SRS and 9 embolisation+SRS).In the selection of interventional indication,diffuse nidus were often suggested conservative management(p=0.004)and nidus involving the midbrain were more likely to be recommended for intervention(p=0.034).The risk of subsequent haemorrhage was significantly increased in partial occlusion compared with complete occlusion and conservative management(p<0.001,p=0.036,respectively).In the subgroup analysis,the follow-up mRS scores of different management modalities were similar whether in the rupture cohort(p=0.064)or the unruptured cohort(p=0.391),as well as the haemorrhage-free survival(p=0.145).In the adjusted Bonferroni correction analysis of the ruptured cohort,microsurgery and SRS could significantly improve the obliteration rate compared with conservation(p<0.001,p=0.001,respectively)and SRS may have positive effect on avoiding new-onset neurofunctional deficit compared with microsurgery and embolisation(p=0.003,p=0.003,respectively).Conclusions Intervention has similar neurofunctional outcomes as conservation in these brainstem AVM cohorts.If intervention is adopted,partial obliteration should be avoided because of the high subsequent rupture risk.
基金the National Science Foundation of China [grant No. 81471166] and Beijing Municipal Health Bureau (grant 2016-1-1075)
文摘Background: To examine whether embolization of dural or pial blood supply branch is more efficient for symptom alleviation for unruptured mixed dural-pial arteriovenous malformations (DPAVMs). Methods: We retrospectively reviewed 30 DPAVM patients from a database of 425 consecutive cerebral arteriovenous malformation (CAVM) patients who underwent endovascular embolization between January 2010 and December 2015 at our institution. Demographics, angioarchitectural characteristics, endovascular embolization details and patients clinical outcomes were recorded. The modified Rankin Scale (mRS), Engel‘s classification and Visual Analogue pain scale (VAS) were used to assess clinical outcomes. Results: The single center cohort data shows that the incidence of DPAVM is 7.1%. Among the 30 DPAVM patients, 9 (30.0%) are ruptured and 21 (70.0%) are unruptured. Four (19.0%) of the 21 unruptured DPAVM patients are failed to follow-up, leaving 17 to analysis the clinical outcomes. Clinical presentations of the 17 unruptured DPAVM patients are epilepsy (n=10), headache (n=5) and focal neurological dysfunction (n=2). Six patients have DPAVMs occluded via pial blood supply branches, 4 via dural branches and 7 via both pial and dural branches. Unruptured DPAVM patients with nidus occluded via dural blood supply branches, or both pial and dural branches have higher symptom alleviation rate than patients with nidus occluded via pial branches (100%/85.7% vs 66.7%). Conclusions: For DPAVM patients presented with epilepsy, headache and FND, embolization via dural blood supply branches may be more efficient for symptom alleviation. Large cohort study is needed to confirm the generalizability.
