Objective To analyzed the treatment of intracranial aneurysms by mierosurgical clipping, endovascular embolization and embolization combined clipping therapy.In order to explore the ideal and effec- tive treatment plan of intracranial ruptured aneurysm.Methods The clipped group of 30 aneurysms.The embolized group of 34 aneurysms.The combined group of 15 aneurysms.Results Clipped group:All of aneurysms was clipped well,no recurrence,mortality 6%(2/30).Embolized Group:complete embolization rate 70.6%(24/34),recurrence rate 17.6%(6/34),mortality 11.8%(4/34).Combined group:no recur- rence,mortality 6.7%(1/15).All patients of three groups were evaluated by Glasgow Outcome Scale one month later and the rate of recovery well was 80.0%,79.4%and 80.0%.Following up for six months the data were 90.0%,88.2%and 86.7%.Conclusion Microsurgical clipping aneurysm(?)neck is still an ef- fective therapy.Meanwhile it has an absolute advantage of high completely cure rate and low recurrence rate, furthermore it is an available remediation method for those cases that failure of embolization,and for those re- currence aneurysms that have been embolized,microsurgical clipping should be,taken as soon as possible in case of aneurysms re-ruptured.For the patients the aneurysms are narrow shape,irregular shape,small(≤3 nun)or with cerebral hematomas microsurgical clipping is a fitting choice.

OBJECTIVE: To investigate the clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) after surgeries in Yunnan Province. METHODS: We retrospectively analyzed the demographic features, vascular risk factors, severity at admission, and aneurysm locations in 85 patients with aSAH receiving surgical interventions in Yunnan Province. All the patients were treated by aneurysm clipping or coiling and followed up for clinical outcomes and recovery of daily activities evaluated by modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scale, respectively. RESULTS: Thirty-four of the patients (40.0%) underwent aneurysm clipping and 51 (60.0%) underwent aneurysm coiling. During a median follow- up period of 66.23 months (IOR, 12.03 months), 84.7% of the patients had low mRS scores, and 78.8% lived independently. The WFNS grade at admission was significantly correlated with the follow-up mRS scores (95%: 1.48-19.09, =0.011) and ADL (95%: 2.55-28.77, < 0.001). Multivariate analysis showed that age (95%: 1.02-1.23, =0.017; 95%: 1.00-1.15, =0.038) and a high WFNS grade at admission (95%: 2.19-141.48, =0.007; 95%: 2.84-82.61, =0.002) were independent predictors of both mRS and ADL scores at follow-up. There was no significant difference in clinical outcomes or the length of hospital stay between the two treatment strategies ( > 0.05), but the cost of hospitalization was significantly higher in coiling group than in the clipping group ( < 0.001). CONCLUSIONS Both aging and a high WFNS grade at admission are associated with a poor prognosis of aSAH, for which aneurysm clipping and coiling have similar long- term outcomes, but for patients with a high WFNS score, aneurysm clipping is favored over coiling in terms of health economics.

Exosomal microRNAs (miRNAs) are miRNAs that are mediated by exosomes to achieve cell-to-cell communication, and they are widespread in organisms. In recent years, the key role of the multiple biological functions of exosomal miRNAs in the occurrence and development of cardiovascular diseases has been confirmed by a large number of studies, which has become a hot spot in clinical and basic research. Sudden cardiac death caused by cardiovascular disease is one of the important contents in forensic medical identification. This article introduces the research progress of cardiovascular disease prediction, treatment and prognosis on exosomal miRNA. The prospects of the application in forensic medical identification are discussed.
Cardiovascular Diseases/genetics* ; Exosomes/genetics* ; Humans ; MicroRNAs/genetics*