1.Treatment Modalities and Long-Term Outcomes in Unruptured Vertebrobasilar Fusiform Aneurysms: A Nationwide Observational Cohort Study
Linggen DONG ; Dachao WEI ; Xiheng CHEN ; Mingtao LI ; Yang ZHAO ; Yong SUN ; Qingbin NIE ; Jun FENG ; Guomin XIAO ; Jinghua ZHOU ; Shengli HU ; Lifei FENG ; Lifeng QI ; Hongen LIU ; Geng GUO ; Yufang LI ; Renfu TIAN ; Jianghua YU ; Dianshi JIN ; Liang HAO ; Tian TIAN ; Shizhong ZHANG ; Yang WANG ; Liping LIU ; Ming LV
Journal of Stroke 2026;28(2):250-262
Background:
and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis.
Methods:
This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed.
Results:
Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs.
Conclusions
Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.
2.Risk analyses of infection source during the consolidation phase of schistosomiasis elimination in Lushan County of Sichuan Province
Chaofu WANG ; Shizhong WANG ; Zhiqiang REN ; Yang TANG ; Luyao HU ; Shoumei AI ; Mingzhou LI ; Rongzhi LI ; Chen PU ; Zisong WU
Shanghai Journal of Preventive Medicine 2026;38(5):394-397
ObjectiveTo analyze the potential risk of infection sources during the consolidation phase of schistosomiasis elimination in Lushan County (a mountainous region) of Sichuan Province, and to provide prevention and control strategies for the consolidation of schistosomiasis elimination achievements in mountainous areas. MethodsIn 2024, one to two villages with historically severe epidemics were selected in the heavily endemic townships of Lushan County as monitoring sites to carry out monitoring for wild animal feces, domestic animals, wild rats, free-roaming dogs, local residents, and mobile populations. Follow-up monitoring for previously infected individuals was carried out in Caoping Village of Siyan Town. Statistical analyses were performed to assess the risks associated with infection sources. ResultsA total of 115 fecal samples from 13 species of wildlife were incubated, with all negative. Blood tests were conducted on 492 cattle, 34 sheep, and 261 dogs, with all negative. A total of 2 520 rodent traps were set, capturing 67 wild rats with a capture rate of 2.66%, and no positive wild rats were found upon dissection. The activity track of 25 loose dogs was 2 212 meters at the farthest, 236 meters at the nearest, and 744 meters on average. a total of 68 wild droppings (all dog feces) were picked up along the way, with all negative. Blood tests were performed on 3 540 local population, yielding 39 blood-positive cases with a blood positive rate of 1.1%. Fecal examinations were conducted on 193 individuals, with all negative. A total of 315 blood tests were performed on the mobile population, identifying 1 positive case with a blood-positive rate of 0.32%. One person received a fecal examination, with zero positive. A follow-up survey of 505 previously infected individuals revealed 5 blood-positive cases, with a positive rate of 0.99%. Fecal examinations were conducted on 15 individuals, with all negative. ConclusionIn this investigation, no local or imported sources of schistosomiasis transmission were found. However, there was a wide variety and a large number of potential sources of infection in the local area. It is necessary to actively explore regional monitoring models for schistosomiasis elimination flexibly adjust prevention and control strategies according to local conditions, achieve precise prevention and control, and consolidate the achievements of elimination.
3.Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage in spontaneous intracerebral hemorrhage: a retrospective study
Yinan XIE ; Long ZHANG ; Zhiyuan ZHU ; Chen YAO ; You LING ; Chaoxin LONG ; Fengfei LU ; Ming GUO ; Shizhong ZHANG
Chinese Journal of Neuromedicine 2024;23(12):1246-1250
Objective:To explore the efficacy and safety of combining minimally invasive hematoma puncture with urokinase irrigation and continuous drip drainage in patients with spontaneous intracerebral hemorrhage.Methods:A total of 22 patients with spontaneous intracerebral hemorrhage admitted to Department of Functional Neurosurgery, Zhujiang Hospital of Southern Medical University and Department of Neurosurgery of Yuebei People's Hospital from May 2023 to January 2024 were chosen. Using precise localization, a minimally invasive haematoma puncture was used to insert a balloon drainage catheter into the hematoma cord; urokinase irrigation was administered during the procedure, followed by continuous drip drainage postoperatively. A retrospective analysis was performed; their clinical data before and after the procedure were collected; and Glasgow Coma Scale (GCS) score, hematoma residual volume, hematoma evacuation rate and complications were analyzed.Results:In these 22 patients, the residual hematoma volume after intraoperative suction was (20.89±10.74) mL, with a residual rate of (51.86±14.88)%. After the 1 st urokinase injection for continuous drainage, the residual hematoma volume in the 22 patients was (12.72±7.92) mL, with a hematoma evacuation rate of (35.01±30.41)%. After the 2 nd injection, the residual hematoma volume in the 13 patients was (9.48±6.12) mL, with a hematoma evacuation rate of (42.03±20.89)%. After the 3 rd injection, the residual hematoma volume in the 7 patients was (5.84±2.84) mL, with a hematoma evacuation rate of (49.32±11.09)%. After the 4 th injection, the residual hematoma volume in the 3 patients was (3.67±3.79) mL, with a hematoma evacuation rate of (54.44±32.03)%. After the 5 th injection, the residual hematoma volume in the left 1 patient was 5 mL, with a hematoma evacuation rate of 37.50%. Before tube removal, the residual hematoma volume in these 22 patients was (6.73±5.01) mL, with a hematoma evacuation rate of (81.48±13.56)%. During hospitalization, 1 patient experienced postoperative hemorrhage and ultimately died of cardiac arrest; 1 patient developed pulmonary infection after surgery and cured with antibiotics. These patients had GCS scores of 12.23±3.16 at discharge, which was significantly increased than those at admission (9.45±3.19, P<0.05). Conclusion:Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage is a safe and effective new treatment in spontaneous cerebral hemorrhage.
4.Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage in spontaneous intracerebral hemorrhage: a retrospective study
Yinan XIE ; Long ZHANG ; Zhiyuan ZHU ; Chen YAO ; You LING ; Chaoxin LONG ; Fengfei LU ; Ming GUO ; Shizhong ZHANG
Chinese Journal of Neuromedicine 2024;23(12):1246-1250
Objective:To explore the efficacy and safety of combining minimally invasive hematoma puncture with urokinase irrigation and continuous drip drainage in patients with spontaneous intracerebral hemorrhage.Methods:A total of 22 patients with spontaneous intracerebral hemorrhage admitted to Department of Functional Neurosurgery, Zhujiang Hospital of Southern Medical University and Department of Neurosurgery of Yuebei People's Hospital from May 2023 to January 2024 were chosen. Using precise localization, a minimally invasive haematoma puncture was used to insert a balloon drainage catheter into the hematoma cord; urokinase irrigation was administered during the procedure, followed by continuous drip drainage postoperatively. A retrospective analysis was performed; their clinical data before and after the procedure were collected; and Glasgow Coma Scale (GCS) score, hematoma residual volume, hematoma evacuation rate and complications were analyzed.Results:In these 22 patients, the residual hematoma volume after intraoperative suction was (20.89±10.74) mL, with a residual rate of (51.86±14.88)%. After the 1 st urokinase injection for continuous drainage, the residual hematoma volume in the 22 patients was (12.72±7.92) mL, with a hematoma evacuation rate of (35.01±30.41)%. After the 2 nd injection, the residual hematoma volume in the 13 patients was (9.48±6.12) mL, with a hematoma evacuation rate of (42.03±20.89)%. After the 3 rd injection, the residual hematoma volume in the 7 patients was (5.84±2.84) mL, with a hematoma evacuation rate of (49.32±11.09)%. After the 4 th injection, the residual hematoma volume in the 3 patients was (3.67±3.79) mL, with a hematoma evacuation rate of (54.44±32.03)%. After the 5 th injection, the residual hematoma volume in the left 1 patient was 5 mL, with a hematoma evacuation rate of 37.50%. Before tube removal, the residual hematoma volume in these 22 patients was (6.73±5.01) mL, with a hematoma evacuation rate of (81.48±13.56)%. During hospitalization, 1 patient experienced postoperative hemorrhage and ultimately died of cardiac arrest; 1 patient developed pulmonary infection after surgery and cured with antibiotics. These patients had GCS scores of 12.23±3.16 at discharge, which was significantly increased than those at admission (9.45±3.19, P<0.05). Conclusion:Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage is a safe and effective new treatment in spontaneous cerebral hemorrhage.
5.Honokiol alleviated neurodegeneration by reducing oxidative stress and improving mitochondrial function in mutant SOD1 cellular and mouse models of amyotrophic lateral sclerosis.
Yujun ZHOU ; Jingshu TANG ; Jiaqi LAN ; Yong ZHANG ; Hongyue WANG ; Qiuyu CHEN ; Yuying KANG ; Yang SUN ; Xinhong FENG ; Lei WU ; Hongtao JIN ; Shizhong CHEN ; Ying PENG
Acta Pharmaceutica Sinica B 2023;13(2):577-597
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting both upper and lower motor neurons (MNs) with large unmet medical needs. Multiple pathological mechanisms are considered to contribute to the progression of ALS, including neuronal oxidative stress and mitochondrial dysfunction. Honokiol (HNK) has been reported to exert therapeutic effects in several neurologic disease models including ischemia stroke, Alzheimer's disease and Parkinson's disease. Here we found that honokiol also exhibited protective effects in ALS disease models both in vitro and in vivo. Honokiol improved the viability of NSC-34 motor neuron-like cells that expressed the mutant G93A SOD1 proteins (SOD1-G93A cells for short). Mechanistical studies revealed that honokiol alleviated cellular oxidative stress by enhancing glutathione (GSH) synthesis and activating the nuclear factor erythroid 2-related factor 2 (NRF2)-antioxidant response element (ARE) pathway. Also, honokiol improved both mitochondrial function and morphology via fine-tuning mitochondrial dynamics in SOD1-G93A cells. Importantly, honokiol extended the lifespan of the SOD1-G93A transgenic mice and improved the motor function. The improvement of antioxidant capacity and mitochondrial function was further confirmed in the spinal cord and gastrocnemius muscle in mice. Overall, honokiol showed promising preclinical potential as a multiple target drug for ALS treatment.
6.Portable head and neck magnetic resonance imaging device in neurosurgery
Hongwei ZHU ; Houminji CHEN ; Long ZENG ; Qingshan XIAO ; Tao XIE ; Yanwu GUO ; Wangming ZHANG ; Qinghua WANG ; Chuanzhi DUAN ; Shizhong ZHANG ; Yiquan KE ; Hongbo GUO
Chinese Journal of Neuromedicine 2023;22(1):58-63
Objective:To explore the clinical application of portable head and neck magnetic resonance imaging (MRI) device in neurosurgery.Methods:A total of 213 patients with brain diseases who were scanned by portable head and neck MRI device in Center of Neurosurgery, Zhujiang Hospital, Southern Medical University from June to September 2022 were selected. The portable head and neck MRI images and 3.0T conventional MRI images of 10 randomly selected patients were compared; the differences in signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different sequences were analyzed. Thirty-one patients accepted tracheal intubation/tracheotomy, or ventilator-assisted breathing were selected as special patient group, and another 30 patients were as general patient group; the differences in comprehensive diagnostic scores of portable head and neck MRI images were compared. Noise intensity differences in different sequences between 3.0T conventional MRI and portable head and neck MRI were statistically compared. Twenty hospitalized volunteers with normal hearing in our center from July to August 2022 were selected, conventional 3.0T MRI and portable head and neck MRI were performed successively, and the noise intensity of different sequences in them was evaluated by using a 5-point system.Results:Compared with those in 3.0T conventional MRI images, the SNR and CNR of T1WI, T2WI, and Liquid attenuated reverse recovery sequence (FLAIR) sequences in portable head and neck MRI images were significantly lower ( P<0.05). No significant difference was noted in the comprehensive diagnostic scores of portable head and neck MRI images between special patients and general patients ( P>0.05). Compared with that in the 3.0T conventional MRI, the noise intensity of different sequences in portable head and neck MRI was significantly reduced ( P<0.05). These volunteers had significantly reduced noise intensity scores of different sequences in portable head and neck MRI compared with that in conventional 3.0T MRI ( P<0.05). Conclusion:Portable head and neck MRI device is easy to use, enjoying high safety, imaging quality and suitability, which meets the clinical needs for neurosurgery patients.
7.Inhibition of ASCT2 induces hepatic stellate cell senescence with modified proinflammatory secretome through an IL-1α/NF-κB feedback pathway to inhibit liver fibrosis.
Feixia WANG ; Zhanghao LI ; Li CHEN ; Ting YANG ; Baoyu LIANG ; Zili ZHANG ; Jiangjuan SHAO ; Xuefen XU ; Guoping YIN ; Shijun WANG ; Hai DING ; Feng ZHANG ; Shizhong ZHENG
Acta Pharmaceutica Sinica B 2022;12(9):3618-3638
Senescence of activated hepatic stellate cells (aHSCs) is a stable growth arrest that is implicated in liver fibrosis regression. Senescent cells often accompanied by a multi-faceted senescence-associated secretory phenotype (SASP). But little is known about how alanine-serine-cysteine transporter type-2 (ASCT2), a high affinity glutamine transporter, affects HSC senescence and SASP during liver fibrosis. Here, we identified ASCT2 is mainly elevated in aHSCs and positively correlated with liver fibrosis in human and mouse fibrotic livers. We first discovered ASCT2 inhibition induced HSCs to senescence in vitro and in vivo. The proinflammatory SASP were restricted by ASCT2 inhibition at senescence initiation to prevent paracrine migration. Mechanically, ASCT2 was a direct target of glutaminolysis-dependent proinflammatory SASP, interfering IL-1α/NF-κB feedback loop via interacting with precursor IL-1α at Lys82. From a translational perspective, atractylenolide III is identified as ASCT2 inhibitor through directly bound to Asn230 of ASCT2. The presence of -OH group in atractylenolide III is suggested to be favorable for the inhibition of ASCT2. Importantly, atractylenolide III could be utilized to treat liver fibrosis mice. Taken together, ASCT2 controlled HSC senescence while modifying the proinflammatory SASP. Targeting ASCT2 by atractylenolide III could be a therapeutic candidate for liver fibrosis.
8.Study on Protective Effects of Scoparone on Acute Liver Injury Induced by CCl 4 in Mice
China Pharmacy 2021;32(2):231-235
OBJECTIVE:To study the protec tive effects of scoparone on acute liver injury induced by CCl 4 in mice and its potential molecular mechanism. METHODS :Fifty male Kunming mice were randomly divided into normal control group ,model group,silymarin group (positive control ,120 mg/kg),scoparone high-dose and low-dose groups (60,30 mg/kg),with 10 mice in each group. Administration groups were given relevant medicine intragastrically. Normal control group and model group were given constant volume of 0.5% sodium carboxymethyl cellulose solution ,once a day ,for 7 days. Two hours after last medication , except normal control group was intraperitoneally injected constant volume of olive oil ,other groups were intraperitoneally injected 0.1% CCl4 olive oil solution (10 mL/kg)at one time to establish the acute liver injury model. The pathological changes of liver tissues in mice were observed by HE staining ;the activity of AST ,ALT,SOD and CAT and the contents of IL- 1β,IL-6,TNF-α and MDA in serum were measured by ELISA ;the phosphorylation of nuclear factor κB(NF-κB)pathway related proteins (NF-κB p65,IκBα)in liver tissue were detected by Western blotting assay. RESULTS :Compared with normal control group ,serum activities of AST and ALT ,the contents of MDA ,IL-1β,IL-6 and TNF-α were significantly increased in model group,the activities of SOD and CAT were decreased significantly (P<0.05);obvious pathological changes were observed in liver tissues ; phosphorylation levels of NF-κB p65 and IκBα protein in liver tissues were significantly increased(P<0.05). Compared with model group ,the activities or contens of related factors in serum of mice were significantly reversed in silymarin group and scoparone high-dose and low-dose groups (P<0.05);the pathological changes of liver tissues were significantly reduced ;the phosphorylation levels of NF-κB p65 and IκBα protein in liver tissues were significantly reduced(P<0.05). CONCLUSIONS : Scoparone has a protective effect on CCl 4-induced acute liver injury in mice ,which is related to reducing oxidative stress levels and blocking the activation of NF-κB pathway,thereby inhibiting inflammatory response.
9.Analysis of serum vitamin B levels and its correlation with social function in children with attention deficit hyperactivity disorder
Xiaoyun LU ; Yan CHEN ; Shizhong CAI ; Ling SHEN ; Zhiying JIANG ; Xuqin CHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(4):283-286
Objective:To analyze the associations between attention deficit hyperactivity disorder (ADHD) and serum vitamin B levels in children.Methods:A total of 103 ADHD children who were diagnosed in the Department of Child and Adolescent Healthcare of Children′s Hospital of Soochow University from September 2018 to April 2019 were selected as the ADHD group, and 89 children of the same age who underwent routine physical examinations served as the healthy control group.The serum levels of vitamin B, including vitamin B 1, vitamin B 2, vitamin B 6, vitamin B 9, and vitamin B 12, were measured by the methods of electrochemistry.Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) was applied to analyze the correlation between social function scores and vitamin B levels in ADHD children. Results:The levels of vitamin B 9[(12.55±2.22) nmol/L vs.(13.26±2.54) nmol/L] and vitamin B 12 [(278.54±32.00) ng/L vs.(288.90±31.32) ng/L] in ADHD children were significantly lower than those in healthy children( t=-2.064, -2.261, all P<0.05). No significant difference was observed in serum levels of vitamin B 1, vitamin B 2 and vitamin B 6 between the 2 groups (all P>0.05). Correlation analysis displayed that only vitamin B 12 level was significantly and negatively correlated with social function in the learning/school dimension ( r=-0.208, P=0.035), and no significant correlation was found between other vitamin B levels and social function (all P>0.05). Conclusions:The serum levels of vitamin B 9 and B 12 in ADHD children were obviously lower than those in healthy children of the same age.Serum vitamin B 12 deficiency had an influence on the social function of the learning/school in ADHD children.Attention to the monitoring and timely supplementation of vitamin B in childhood, especially vitamin B 9 and B 12, may be of positive significance in the prevention of the occurrence and development of ADHD to some extent.
10.Mechanism of attention deficit hyperactivity disorder accompanied with obesity in children
Yiting JI ; Shizhong CAI ; Zhiying JIANG ; Xiaoyan SHI ; Cailong CHEN ; Ying WU ; Yan CHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(14):1118-1120
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children and adolescents, and it is commonly accompanied with other developmental and psychological disorders.The prevalence of obesity in children continues to rise, and it is also a major social public concern that threatens human health.As a somatic comorbidity with ADHD, obesity is characterized by a high incidence.In this paper, the focus would be placed on the underlying mechanisms of ADHD accompanied with obesity from the aspects of genetics, perinatal period, environmental and neurobiological factors, which could provide a theoretical basis and intervention strategies for the early identification, rational treatment and long-term comprehensive management, as well as prevention and treatment effects of ADHD and its comorbidities.

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