Objective To investigate the efficacy and safety of endovascular therapy for small unruptured intracranial aneurysms (sUIAs). Methods Patients with unruptured intracranial aneurysms who underwent endovascular therapy in the Department of Neurology, Guangzhou First People's Hospital from January 2008 to January 2018 were retrospectively included. According to the size of the aneurysms, they were divided into the sUIAs group (diameter <5 mm) and the non-sUIAs group (diameter ≥5 mm). Demographics, vascular risk factors, aneurysm characteristics, and treatment method, effectiveness, perioperative complications, and outcomes of endovascular therapy were compared between the two groups. Results A total of 80 patients with unruptured intracranial aneurysms were enrolled, including 33 patients with sUIAs (41.25% ) and 47 patients with non-sUIAs. The age of patients (51.1 ± 9.7 years vs. 61.2 ± 8.1 years; t=5.058, P<0.001), and the maximum diameter (3.6 ± 1.1 mm vs. 8.2 ± 3.2 mm; t=7.923, P<0.001) and neck width (3.1 ± 0.5 mm vs. 4.5 ± 2.5 mm; t=3.167, P=0.002) of aneurysms as well as the proportion of patients with wide-neck aneurysm (3.0% vs. 21.3% ; χ2 =7.213, P=0.007) and stent-assisted embolization (6.1% vs. 23.4% ; χ2 =4.285, P=0.038) in the sUIA group were significantly less than those of the non-sUIAs group. The embolization results, the perioperative complication rate and the good outcome rate were comparable between the two groups. Conclusion For sUIAs, endovascular therapy is effective and safe, comparable to endovascular therapy for non-sUIAs.

Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) at admission for large vessel occlusion (LVO) in patients with acute ischemic stroke. Methods The clinical data of patients with acute ischemic stroke admitted to Guangzhou First People's Hospital from January 2016 to November 2017 were enrolled retrospectively. NLR was calculated according to results of blood routine examination within 6 h after admission. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and LVO. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for LVO. Results A total of 109 patients with acute ischemic stroke were enrolled, including 42 females (38. 5％) and 67 males (61. 5％). Their mean age was 63. 6 years. Forty-six patients (42. 2％) had LVO. The proportions of patients with atrial fibrillation, previous stroke or transient ischemic attack, and the National Institutes of Health Stroke Scale score, white cell count, NLR, neutrophil count, and fasting blood glucose in the LVO group were significantly higher than those in the non- LVO group, while lymphocyte count was significantly lower than that in the non-LVO group (all P < 0. 05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for LVO after adjusting for the confounding factors (odds ratio 2. 768, 95％ confidence interval, 2. 272-4. 984; P = 0. 001). The ROC curve analysis of NLR predicting LVO showed that the area under the curve was 0. 712 (95％ confidence interval 0. 638-0. 793), and the sensitivity and specificity were 79. 3％ and 73. 6％ respectively as the optimal cut-off value was 4. 18. Conclusions Increased NLR in early peripheral blood may effectively predict LVO in acute ischemic stroke.

Objective:To observe the effect of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) on efficacy and attention function in patients with first-episode unipolar depression.Methods:Fifty-two first-episode initial-naive unipolar depression patients were enrolled in Department of Neurology of Guangzhou First People's Hospital from March 2022 to April 2023 were chosen. They were randomly allocated to active stimulation group ( n=27) and sham stimulation group ( n=25); both were treated with escitalopram, and active treatment or sham treatment in the left dorsolateral prefrontal cortex (DLPFC) were given for 4 weeks (5 d per week, 20 d totally). Before treatment and 2 and 4 weeks after treatment, Hamilton Depression Rating Scale (HAMD)-24 was used to evaluate depressive symptoms, and Birmingham Cognitive Screening Scale-Chinese (BCoS-C) was used to evaluate the attention function. Results:(1) In terms of depressive symptoms: HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment (20.63±2.73, 15.85±2.43) were significantly lower than those before treatment (25.74±2.68, P<0.05); HAMD-24 scores of sham stimulation group 4 weeks after treatment were also significantly lower than those before treatment ([20.48±2.33] vs. [25.80±2.57], P<0.05); HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment were significantly lower than those of sham stimulation group ( P<0.05). (2) In terms of auditory attention indicators: total correct number (selective attention) in active stimulation group 4 weeks after treatment was significantly larger than that before treatment (51.74±1.38 vs. 47.48±1.60), and the sustained index (sustained attention) was significantly lower than that before treatment (0.74±0.71 vs. 4.37±1.15, P<0.05); total correct number in active stimulation group 4 weeks after treatment was significantly larger than that in sham stimulation group (48.00±1.66), and the sustained index was significantly lower than that in sham stimulation group (3.72±1.28, P<0.05). Conclusion:Combined with escitalopram, rTMS can more effectively mitigate the depressive symptoms in first-episode unipolar depression patients, and depressive symptoms improve more quickly than attentional function.