Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

Objective To investigate the predictive factors of short-term poor outcome in patients with cerebral venous sinus thrombosis (CVST).Methods The clinical data of 42 consecutive inpatients with CVST were analyzed retrospectively.The clinical outcomes were assessed with the modified Rankin scale (mRS) at discharge.The patients were divided into either a good outcome group (mRS 0 to 2) or a poor outcome group (mRS 3 to 6).The related factors,such as demographic,etiology,and clinical features were compared between the two groups,Multivariate logistic regression analysis was used to determine the independent predictive factors for short-term poor outcome in patients with CVST.Results A total of 42 patients with CVST were enrolled,29 of them (69.05％) had good outcome and 13 (30.95％) had poor outcome.The proportions of central nervous system infections (20.69％ vs.61.54％ ; x2 =6.740,P =0.009),cancer (6.90％ vs.38.46％ ;x2 =6.439,P =0.011),pregnancy,postpartum,oral contraceptives or hormone replacement therapy (6.90％ vs.38.46％ ; x2 =6.439,P =0.011),and high homocysteine hyperlipidemia (27.59％ vs.76.92％ ;x2 =8.922,P =0.003),as well as the baseline D-dimer levels (730 ± 240 ng/ml vs.1 060 ± 250 ng/ml; t =4.485,P =0.000) in patients of the good outcome group were significantly lower than those of the poor outcome group.There was significant difference in treatment modalities (x2 =11.274,P =0.004) with the poor outcome group.The proportions of patients in anticoagulants,thrombolysis and anticoagulants + thrombolysis were 13.79％,24.14％,and 62.07％,respectively,in the good outcome group,while those were 61.54％,23.08％,and 15.39％,respectively,in the poor outcome group.Multivariate logistic regression analysis showed that the baseline D-dimer level ＞990 ng/mL was an independent predictive factor for short-term poor outcome in patients with CVST (odds ratio [OR] 1.006,95％ confidence interval [CI] 1.002-1.011; P=0.005).Anticoagulants + thrombolytic therapy was an independent protective factor for short-term poor outcome in patients with CVST (OR 0.027,95％ CI 0.002-0.447; P=0.033).The ROC curve analysis showed that when the cutoff value of the baseline D-dimer was 990 ng/ml,the sensitivity and specificity of predicting short-term poor outcome of CVST were 76.9％ and 86.2％ respectively.Conclusions The level of baseline D-dimer ＞990 ng/ml is an independent predictive factor for short-term poor outcomes in patients with CVST.The effect of anticoagulants in combination with thrombolytic therapy is best in patients with CVST.

Objective:To investigate the efficacy and safety of endovascular recanalization in the treatment of chronically occluded internal carotid artery (COICA).Methods:From January 2014 to January 2019, patients over 50 years of age with symptomatic COICA underwent endovascular recanalization in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University were enrolled retrospectively. The modified Rankin Scale (mRS) was used to evaluate the improvement of neurological function.Results:A total of 19 patients with symptomatic COICA were enrolled, of which 16 (84.21%) were successfully recanalized. None of the patients had severe neurological deficits during the periprocedural period and after procedure. The neurological function of patients with successful recanalization gradually improved over time. The neurological function improved in 4 patients (25.0%) at 24 h after endovascular treatment and 9 (56.3%) at 18 months postprocedural follow-up. The follow-up of CT angiography showed that the internal carotid artery in patients with successful recanalization was unobstructed, and there was no obvious in-stent stenosis.Conclusion:Endovascular recanalization is feasible, safe and effective in patients with symptomatic COICA.

Objective:To investigate the correlation between serum cystatin C (CysC), blood lipids and the risk of intracranial aneurysm (IA) rupture.Methods:Patients with saccular IA admitted to the First Affiliated Hospital of Xinjiang Medical University from December 2017 to May 2019 were enrolled retrospectively. The patients were divided into the ruptured group and the unruptured group. The correlation between CysC, lipids and IA rupture was identified by univariate and multivariate logistic regression analyses. Results:A total of 392 patients were enrolled, including 143 (36.5%) males and 249 (63.5%) females. Two hundred and seventy-eight patients (70.9%) were ruptured IAs, 114 (29.1%) were unruptured IAs. Univariate analysis showed that triglyceride (1.26±0.94 mmol/L vs. 2.12±1.45 mmol/L; t=5.872, P<0.001), apolipoprotein A-Ⅰ (0.95±0.29 g/L vs. 1.08±0.34 g/L; t=3.744, P<0.001 ), CysC (0.63±0.20 mg/L vs. 0.80±0.48 mg/L; t=3.650, P<0.001) level, and the proportions of hypertension (46.8% vs. 61.4%; χ2=6.938, P=0.008), hyperlipidemia (19.4% vs. 48.2%; χ2=32.493, P<0.001) and aneurysm diameter >7 mm (24.4% vs. 41.2%; χ2=11.504, P<0.001) of the ruptured group were significantly lower than those of the unruptured group, while the level of apolipoprotein B was significantly higher than that of the unruptured group (1.07±0.29 g/L vs. 0.99±0.30 g/L; t=2.417, P=0.016). Multivariate logistic regression analysis showed that aneurysm diameter ≤7 mm (odds ratio [ OR] 2.281, 95% confidence interval [ CI] 1.342-3.876; P=0.002), and the serum levels of triacylglycerol ( OR 0.484, 95% CI 0.333-0.705; P<0.001), apolipoprotein A-Ⅰ ( OR 0.248, 95% CI 0.105-0.587; P=0.002) and CysC ( OR 0.130, 95% CI 0.038-0.444; P=0.001) were significantly independently correlated with the risk of IA rupture. Conclusions:CysC, apolipoprotein A-Ⅰ and triacylglycerol are protective markers for IA rupture, and aneurysm diameter ≤7 mmis associated with IA rupture.

Objective: To observe the effects of continuous nursing(CN) on rehabilitation of patients with hypertensive intracerebral hemorrhage (HICH) and to explore the effective interventive measures for CN. Methods: Totally 129 admitted HICH patients from January to December 2017 were selected and randomly divided into study group (63 cases) and control group (66 cases), the control group was handed with Handbook of stroke prevention and control before discharge, the study group received CN intervention, which included pre-discharge health education, family visits, patient management and video interview via WeChat App, group lecture and psychological support, self-nursing ability, motor function and ability of daily life and emotional condition were evaluated before and post discharge, and the disabled ratio 6 months after discharge between the 2 groups were compared. Results: The 2 groups with the scores of exercise of self-care agency scale (ESCA) were increased significantly compared with before discharge (all P<0.05) ; the study group with the ESCA scores 3 months and 6 months after discharge were significantly higher than the control group [3months:118.5±8.2 vs. 112.3±7.5; 6 months: 127.7±8.7 vs. 119.3±9.1] (all P<0.05) . Fugl Meyer score and Barthel index of the 2 group after discharge were both lower than the pre-discharge levels (all P<0.05); Fugl Meyer score and Barthel index of the study group 3 months and 6 months after discharge were significantly higher than the control group [3 months: Fugl Meyer score 73.3±7.3 vs. 69.4±6.9; Barthel index 56.5±8.0 vs. 51.8±7.3; 6 months: Fugl Meyer score77.6±8.0 vs. 74.5±7.2; Barthel index 67.5±8.7 vs. 63.0±7.4] (all t=2.291-3.454, P<0.05). Two groups with HAD score after discharge were significantly decreased compared with before discharge (P<0.05); the study group with the HAD-A and HAD-D scores 3 and 6 months after discharge were significantly lower than the control group[3 months: HAD-A 6.75±2.23 vs. 8.02±2.85; HAD-D 6.07±1.75 vs. 7.23±1.94; 6 months: HAD-A 5.93±2.04 vs. 6.84±2.37; HAD-D 5.86±1.47vs. 6.75±1.76] (all P<0.05) . The study group with the re-admission rate and disabled ratio within 6 months after discharge were both lower than the control group, but the differences without statistical significance (all P>0.05). Conclusion The HICH patients added with CN can significantly improve self-care ability, improve prognosis; patient management via WeChat App and group lecture & psychological support are effective measures to carry out CN.

Aim To investigate the effeets of prolifera¬tion and autophagy of BV2 eells in OGD/R models when the 18 ku transloeator protein( TSPO) was inhibi¬ted.Methods BV2 microglia were eultured in vitro and the model established by oxygen-glueose depriva- tion/reperfusion( OGD/R) , the eells were divided into eontrol group and OGD/R group, OGD/R + small hair¬pin RNA negative eontrol group ( OGD/R + NCshR- NA) , OGD/R + TSPO small hairpin RNA group (OGD/R + TSPOshRNA ).The expression of TSPO mRNA and TSPO protein were deteeted by qRT-PCR and Western blot, respectively.In order to study the effeet of TSPO on BV2 microglial eells in OGD/R inju¬ry and autophagy, the cell viability was tested by CCK- 8 assey, the cytotoxicity was deteeted by reactive oxy¬gen speeies ( ROS) , autophagy-related mRNA ( p62 mRNA, LC3B mRNA, Beolin-1 mRNA) expressions were detected by qRT-PCR, and the expression levels of autophagy -related proteins ( p62 , LC3 II /LC3 1 , Beclin-1 ) were detected by Western blot in each group.Result The expression of TSPO mRNA and protein increased significantly in OGD/R group while compared to control group, the cell death and cytotox¬icity increased significantly, the expression levels of LC3B mRNA and Beclin-1 mRNA increased, while the p62 mRNA decreased significantly, the levels of LC3 II/LC3 1 and Beclin-1 protein increased, the expres¬sion of p62 protein decreased significantly in OGD/R group, and the autophagy was activated; compared with OGD/R group, the different levels of cell viabili¬ty, cytotoxicity and autophagy in OGD/R + NCshRNA group were not statistically significant.But the survival rate of cells in OGD/R + TSPOshRNA group signifi¬cantly increased, the levels of cytotoxicity and autoph¬agy were significantly reduced.Conclusions The in¬hibition of TSPO has a significant protective effect on OGD/R injury model in BV2 microglial cells, which may be related to the inhibition of autophagy.