Objective:To explore the risk factors of neurological complications after interventional treatment of ruptured intracranial aneurysms(RIAS), and to establish a predictive model of nomogram.Methods:The clinical data of 89 patients with RIAS who underwent endovascular treatment in Nanyang Second General Hospital Affiliated to Xingxiang Medical University from January 2016 to January 2019 were retrospectively studied.The clinical imaging data were collected and followed up for 6 months.The patients were divided into two groups: no neurological complications group (61 cases) and neurological complications group (28 cases). To analyze the clinical indicators and the possible related factors of neurological complications after RIAS interventional therapy.A nomogram was established to score the influencing factors, and a scoring prediction model was constructed; the clinical calibration of the model was evaluated by consistency index (C-index) and calibration curve, and the clinical differentiation of the model was evaluated by nomogram relying on ROC curve.Results:Multivariate logistic regression analysis showed that Hunt-Hess classification ( OR=4.927, 95% CI: 1.189-20.426, P=0.028), Fisher classification ( OR=4.633, 95% CI: 1.012-21.208, P=0.048 ), aneurysm cyst xiaofu ( OR=5.918, 95% CI: 1.104-24.948, P=0.015), wide carotid aneurysm ( OR=4.381, 95% CI: 1.029-18.645, P=0.046) and treatment Strategy ( OR=4.887, 95% CI: 1.235-19.329, P=0.024) is an independent risk factor for nerve-related complications after RIAs interventional therapy.The predictive model of nomogram showed that Hunt-Hess classification (grade IV, V) was 100, aneurysm bleb (with) 98, treatment strategy (stent implantation) 95, wide-necked aneurysm (yes) 92 and Fisher grade (grade III, IV) 81; the C-index of the predictive model was 0.871; the nomogram relied on ROC curve AUC 0.871, and the treatment strategy (stent implantation) was 95; the Fisher grade (grade III, IV) was 81; the C-index of the predictive model was 0.871.The sensitivity and specificity were 85.71%(24/28) and 77.05%(47/61) respectively. Conclusion:Hunt Hess classification, Fisher classification, aneurysmal sac caruncle, wide necked aneurysms and treatment strategies will affect the occurrence of neurological complications after RIAS interventional therapy.The nomogram established by this method can provide intuitive and reliable reference for clinical practice.

Objective:To investigate the expression of octamer-binding transcription factor 4(OCT4) in glioma tissues and its relationship with prognosis of patients.Methods:From March 2015 to June 2016, 168 patients with glioma and 72 normal brain tissues in the Second People's Hospital of Nanyang were collected.The expression levels of OCT4A and OCT4B were detected by reverse transcription-polymerase chain reaction(RT-PCR), and the relationship between clinicopathological characteristics and prognosis of glioma patients was analyzed.Results:The relative expressions of OCT4A(2.28±0.85) and OCT4B(2.84±1.29) in 168 glioma tissues were significantly higher than those in normal tissues [(1.05±0.41), (1.18±0.46)] ( t=11.649, 14.798, all P<0.01), and there was a positive correlation between OCT4A and OCT4B in glioma tissues( r=0.682, P=0.001). The expression levels of OCT4A and OCT4B in glioma patients with different pathological stages, pathological types, degree of differentiation and depth of invasion had statistically significant differences( t=14.695, 11.309, 16.038, 13.721, 17.216, 15.083, 14.871, 15.417, all P<0.01). Taking the median value of OCT4A and OCT4B mRNA expression as the cutoff value, the patients were divided into low expression group and high expression group.The overall survival of patients with low expression of OCT4A and OCT4B was (24.17±3.41)months and (25.30±4.16)months, which were significantly longer than (15.80±2.93)months and (15.94±3.07)months of high expression patients, the differences were statistically significant( t=15.639, 16.143, all P=0.000). Cox regression model analysis showed that the expression levels of OCT4A and OCT4B were independent factors affecting the prognosis of glioma patients.The hazard ratio (95% CI) was 1.731(0.804-3.181) and 1.605(0.795-2.942), respectively. Conclusion:The expression levels of OCT4A and OCT4B in glioma tissues are abnormally elevated, which is closely related to the severity of the disease.The patients with high expression of OCT4A and OCT4B have a shorter overall survival period, which has a certain predictive value for the treatment effect and prognosis of glioma.

Objective:To investigate the relations of serum hypoxia inducible factor 2α (HIF-2α) and miR-21 expressions with cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH) after interventional embolization.Methods:One hundred and seventy-four patients with aSAH underwent interventional embolization in our hospital from October 2017 to June 2019 were prospectively selected. DSA examination was performed 4 d after surgery, and severity of cerebral vasospasm was evaluated. Enzyme-linked immunosorbent assay was used to detect the level of serum HIF-2α and reverse transcription-PCR was employed to detect the serum miR-21 expression before and 3 and 7 d after interventional embolization. The clinical data and changes of serum HIF-2α and miR-21 expressions in patients with different degrees of cerebral vasospasm were compared. Correlation analysis was performed to analyze the relation of HIF-2α expression with miR-21 expression 3 and 7 d after interventional embolization. Receiver operating characteristics curve was used to analyze the diagnostic values of serum HIF-2α and miR-21 levels in cerebral vasospasm 3 d after interventional embolization.Results:There were 100 patients without vasospasm, and 20, 38 and 16 patients with mild, moderate and severe cerebral vasospasm, respectively. The serum levels of HIF-2α and miR-21 in patients with mild, moderate and severe cerebral vasospasm increased successively 3 and 7 d after interventional embolization, with significant differences ( P<0.05). Positive correlation was noted between expressions of HIF-2α and miR-21 in serum 3 and 7 d after interventional embolization ( P<0.05). Area under the curve (AUC) of HIF-2α in diagnosis of cerebral vasospasm was 0.748 ( 95%CI: 0.615-0.883, P=0.000) 3 d after interventional embolization. AUC of serum miR-21 level in diagnosis of cerebral vasospasm was 0.715 ( 95%CI: 0.590-0.842, P=0.000). AUC of serum HIF-2α combined with miR-21 in diagnosis of cerebral vasospasm was 0.893 ( 95%CI: 0.792-0.985, P=0.000). When diagnostic critical points of HIF-2α and miR-21 were 82.75 pg/mL and 1.15, the sensitivity, accuracy and negative predictive value of HIF-2α combined with miR-21 in the diagnosis of cerebral vasospasm were higher than those of HIF-2α or miR-21 alone. Conclusion:The expressions of serum HIF-2α and miR-21 in patients with aSAH after interventional embolization can effectively predict the occurrence of cerebral vasospasm, and may be involved in the occurrence and development of cerebral vasospasm.