Objective To summarize the technique of stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysms. Methods 15 patients were reported. Results 11 of 15 aneurysms were completely occluded and 4 were incompletely (>95%) occluded. Transient ischemia of cerebral occurred in a case. 8 aneurysms were followed up for 6～12 months, 1 presented neck remnant growth. Conclusion It is satisfied to use the stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysm, which may protect the parent artery.

ObjectiveTo summarize the technique and preliminary outcome of Neuroform stent combined with Guglielmi detachable coil (GDC) to treat wide-necked intracranial aneurysms. Methods32 cases with aneurysms which underwent 32 endovascular procedures performed by using stent were retrospectively analyzed.The ratio of aneurysm neck/body is 1/2～1/1. Results24 aneurysms were completely occluded and other 8 were incompletely (>95%) occluded. Transient ischemia of cerebral occured in 2 cases. 14 aneurysms were followed up 0.5～1 year after. 2 aneurysms of them appeared neck remnant growth.ConclusionUsing Neuroform stent combined with GDC to treat wide-necked intracranial aneurysm may prevent the herniation of GDC into the artery and increase the outcome of wide-necked intacranial aneurysm.

Objective To investigate the effect of transcription factor atonal homolog 8(ATOH8)and miR-125a on lung cancer progres-sion and its potential upstream regulatory mechanism.Methods ATOH8 expression levels in lung adenocarcinoma and their correlation with survival rate were analyzed using the online database UALCAN.miR-125a expression levels in lung adenocarcinoma and their rela-tionship with lung cancer progression were also analyzed using the UALCAN database.Total RNA extracted from lung adenocarcinoma tumors and adjacent normal tissues was used to perform real-time PCR in order to analyze these expression levels.The effect of ATOH8 overexpression on lung adenocarcinoma cell survival was detected using CCK-8 assays.A miR-125a mimic and inhibitor were transfected into lung adenocarcinoma cells,and ATOH8 expression levels were detected by real-time PCR and Western blotting.Results Statistical analysis showed that ATOH8 was significantly down-regulated in lung adenocarcinoma tissues(P＜0.01)and ATOH8 overexpression significantly reduced the survival of lung adenocarcinoma cells(P＜0.05).Furthermore,the five-year survival rate of patients with high ATOH8 expression levels was significantly increased(P＜0.05).miR-125a can bind to the 3'untranslated regions(3'UTR)of ATOH8 and significantly inhibit its expression levels(P＜0.05).However,miR-125a was significantly up-regulated in lung adenocarcinoma patients with a history of smoking,middle and advanced stage,and lymphatic metastasis(P＜0.05).Conclusion ATOH8,as a poten-tial tumor suppressor gene,can inhibit lung adenocarcinoma cell survival and affect the five-year survival rate of patients.miR-125a expression levels were closely related to smoking history,tumor stage,and lymphatic metastasis.Overall,the inhibiting effect of miR-125a against ATOH8 is a potential reason for abnormal ATOH8 expression in lung adenocarcinoma.

Objective: Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology associated with venous sinus stenosis. This study aimed to develop a magnetic resonance venography (MRV)-based radiomics model for predicting a high trans-stenotic pressure gradient (TPG) in IIH patients diagnosed with venous sinus stenosis. Materials and Methods: This retrospective study included 105 IIH patients (median age [interquartile range], 35 years [27– 42 years]; female:male, 82:23) who underwent MRV and catheter venography complemented by venous manometry. Contrast enhanced-MRV was conducted under 1.5 Tesla system, and the images were reconstructed using a standard algorithm. Shape features were derived from MRV images via the PyRadiomics package and selected by utilizing the least absolute shrinkage and selection operator (LASSO) method. A radiomics score for predicting high TPG (≥ 8 mmHg) in IIH patients was formulated using multivariable logistic regression; its discrimination performance was assessed using the area under the receiver operating characteristic curve (AUROC). A nomogram was constructed by incorporating the radiomics scores and clinical features. Results: Data from 105 patients were randomly divided into two distinct datasets for model training (n = 73; 50 and 23 with and without high TPG, respectively) and testing (n = 32; 22 and 10 with and without high TPG, respectively). Three informative shape features were identified in the training datasets: least axis length, sphericity, and maximum three-dimensional diameter.The radiomics score for predicting high TPG in IIH patients demonstrated an AUROC of 0.906 (95% confidence interval, 0.836– 0.976) in the training dataset and 0.877 (95% confidence interval, 0.755–0.999) in the test dataset. The nomogram showed good calibration. Conclusion Our study presents the feasibility of a novel model for predicting high TPG in IIH patients using radiomics analysis of noninvasive MRV-based shape features. This information may aid clinicians in identifying patients who may benefit from stenting.

Objective To evaluate the muscle mass in maintenance hemodialysis (MHD) patients and analyze the influential factors.Methods Ninety-seven patients on MHD and 34 healthy people were recruited.Muscle mass was measured by bioelectrical impedance analysis and compared.Patients'age,sex,height,body weight,walking activity,modified quantitative subjective global assessment (MQSGA) score and laboratory tests were recorded.The relationship of appendicular skeletal muscle mass/height2 (ASM/H2) and other factors were analyzed using multivariate linear regression.Results Compared with normal cohort,the MHD patients showed lower body fat rate and lower ASM/H2 (both P ＜ 0.05).In 97 MHD patients,21.4％ of male patients suffered from sarcopenia,and 24.4％ of female patients suffered from sarcopenia.Patients were divided into two groups according to the level of ASM/H2 (male ＜ 7.0 kg/m2,female ＜ 5.8 kg/m2).The grip strength,serum creatinine,1,25(OH)2D and mid-arm muscle circumference in low ASM/H2 group were lower than those in normal ASM/H2 group,and the differences were significant (all P ＜ 0.05).In multivariable regression model,male (β=0.534,P=0.003),1,25(OH)2D (β=0.582,P=0.024),creatinine (β=0.421,P=0.037),grip strength (β=0.681,P=0.001),and lg[NT-proBNP] (β=-1.760,P=0.042) were independently associated with ASM/H2 in MHD patients.Conclusion The prevalence of sarcopenia is much higher in MHD patients than in healthy people.The levels of grip strength,NT-proBNP,creatinine and 1,25(OH)2D are the important influential factors for muscle mass in MHD patients.

Objective:To evaluate the extent and progression of coronary artery calcification in maintenance hemodialysis (MHD) patients, and to explore the risk factors of rapid progression of coronary artery calcification in MHD patients.Methods:The patients who underwent MHD in the Huashan Hospital affiliated to Fudan University from January 1, 2013 to December 31, 2017 were enrolled. This study included cross-sectional study and prospective cohort study. Multi-slice spiral computed tomography was used to measure coronary artery calcification, and coronary artery calcium score (CACS) was calculated. In the cross-sectional study, 62 MHD patients were enrolled. According to baseline CACS, the patients were divided into low calcification group (CACS < 100) and high calcification group (CACS ≥ 100). The nutritional and bone mineral metabolism indexes were compared between the two groups. Multiple linear regression analysis was used to analyze the correlation between CACS and muscle mass and laboratory indicators. Since 6 patients were lost to follow-up, 56 MHD patients who were followed-up regularly were enrolled in the prospective cohort study. According to the progression of CACS, the patients were divided into slow progression group (ΔCACS/year < 100) and rapid progression group (ΔCACS/year ≥ 100). Logistic regression equation was used to analyze the risk factors of coronary calcification progression. Hosmer-Lemeshow goodness of fit test and receiver operating characteristic curve were used to evaluate the performance of multivariate logistic regression model.Results:In the cross-sectional study, the age of 62 patients was (62.34±10.82) years old, and the median dialysis age was 78 (39,139) months. Among the 33 male patients, compared with the low calcification group ( n=7), the high calcification group ( n=26) had older age ( t=-2.281, P=0.030) and higher blood triglyceride ( Z=-1.985, P=0.047), and there was no statistically significant difference in muscle mass between the two groups; among the 29 female patients, the muscle mass/height 2 ( t=-2.600, P=0.015) and serum calcium ( t=-2.641, P=0.014) in the high calcification group ( n=15) were both higher than those in the low calcification group ( n=14), and the hemoglobin level was lower ( t=2.531, P=0.018), and the difference in muscle mass between the two groups was not statistically significant. High sensitivity C-reactive protein ( β=0.425, P=0.022) was independently correlated with CACS in male patients, and muscle mass/extracellular water ( β=-0.580, P=0.001) was independently correlated with CACS in female patients. In the prospective cohort study, the age of 56 patients was (59.82±11.14) years old, and the median dialysis age was 82 (40, 146) months. There was no significant difference in all-cause mortality between slow progression group ( n=22) and rapid progression group ( n=34), but the proportion of cardiovascular events in rapid progression group was significantly higher than that in slow progression group ( P=0.017). Compared with the slow progression group, the rapid progression group had higher proportion of males ( χ2=4.791, P=0.029), older age ( Z=-2.131, P=0.038), lower baseline muscle mass/extracellular water ( Z=2.482, P=0.016) and high-density lipoprotein cholesterol ( t=2.133, P=0.042), and faster rate of muscle mass loss (Δmuscle mass·height -2·year -1) ( Z=-2.282, P=0.023). Multivariate logistic regression analysis results showed that muscle mass loss ( OR=0.089, 95% CI 0.010-0.792, P=0.030) and baseline CACS ( OR=1.003, 95% CI 1.000-1.005, P=0.021) were influencing factors for progression of coronary artery calcification in MHD patients. Conclusion:Increasing baseline CACS and rapid reduction in muscle mass are risk factors for the progression of coronary artery calcification in MHD patients.