Cerebral proliferative angiopathy(CPA)was initially regarded as a variant of arteriovenous malformation.However,its distinct histological,angiographic,and pathophysiological features have led to its reclassification as an independent entity.CPA is an exceptionally rare form of cerebral vascular malformation,its pathogenesis is primarily linked to diffuse vascular proliferation secondary to chronic hypoperfusion.Clinically,CPA presents with a heterogeneous spectrum of manifestations,most commonly severe headaches and epileptic seizures.Neuroimaging(MR)typically reveals a complex interplay of aberrant vessels within the brain parenchyma,which may complicate the clinical management and lead to a higher rate of poor prognosis.This article reviewed current knowledge on the pathogenesis,epidemiology,clinical features,diagnostic approaches,and treatment options for CPA,with the aim of enhancing understanding of its underlying mechanisms and guiding future therapeutic strategy optimizations.

Objective:To investigate effect and mechanism of Morin on inflammatory response of young asthmatic rats by regu-lating mammalian target of rapamycin(mTOR)/signal transducers and activators of transcription 3(STAT3)signaling pathway.Methods:An asthma rat model was established.Experiment was separated into Control group,Model group,Morin low-dose[Morin-L,10 mg/(kg·d)]group,Morin medium dose[Morin-M,30 mg/(kg·d)]group,Morin high-dose[Morin-H,100 mg/(kg·d)]group and Morin high-dose+mTOR activator group[Morin-H+MHY-1485,100 mg/(kg·d)Morin+7 mg/(kg·d)MHY-1485]group.Enhanced expiratory interval value was detected and recorded;Total IgE,ovalbumin(OVA)specific IgE,IL-4,IL-5,IL-17,IL-13,IFN-γ and TGF-β1 levels were determined by ELISA;Giemsa staining was applied to observe and record situation of related inflammatory cells;proportion of Th1,Th2 and Th17 cells were detected by flow cytometry;HE and PAS staining were applied to observe pathologi-cal changes in lung tissue and goblet cell proliferation;GATA-binding protein 3(GATA-3)expression was detected by immunohisto-chemistry and qRT-PCR;Western blot was applied to detect expression and phosphorylation levels of mTOR and STAT3 proteins.Results:Compared with Control group,inflammatory cell infiltration was obvious in Model group,with irregular thickening of tube wall and basement membrane,obviously more goblet cells,and increased mucus secretion,Penh value,IL-4,IL-5,IL-17,IL-13,total IgE and OVA-sIgE levels,macrophages,lymphocytes,eosinophils and neutrophils numbers,Th2 and Th17 cells proportion,average optical density of GATA-3,GATA-3 mRNA and phosphorylation levels of mTOR and STAT3 were obviously increased(P<0.05),proportion of Th1 cells and IFN-γ level were significantly reduced(P<0.05).Compared with Model group,bronchial wall structure of rats in Morin-L,Morin-M and Morin-H groups was smoother and more complete,with epithelial cells arranged in a more orderly manner,moderate airway wall thickness,reduced inflammatory cell infiltration,and reduced goblet cell proliferation,Penh value,IL-4,IL-5,IL-17,IL-13,TGF-β1,total IgE and OVA-sIgE levels,numbers of macrophages,lymphocytes,eosinophils and neutrophils,proportion of Th2 and Th17 cells,average optical density of GATA-3,GATA-3 mRNA,and phosphorylation levels of mTOR and STAT3 were obviously decreased(P<0.05),proportion of Th1 cells and IFN-γ level were significantly increased(P<0.05).MHY-1485 reversed inhibitory effect of morin on inflammatory response in asthmatic rats(P<0.05).Conclusion:Morin may inhibit activation of mTOR/STAT3 signaling pathway,inhibit inflammatory response in young rats with asthma,and thereby improve asthma symptoms.

Objective:To investigate effect and mechanism of Morin on inflammatory response of young asthmatic rats by regu-lating mammalian target of rapamycin(mTOR)/signal transducers and activators of transcription 3(STAT3)signaling pathway.Methods:An asthma rat model was established.Experiment was separated into Control group,Model group,Morin low-dose[Morin-L,10 mg/(kg·d)]group,Morin medium dose[Morin-M,30 mg/(kg·d)]group,Morin high-dose[Morin-H,100 mg/(kg·d)]group and Morin high-dose+mTOR activator group[Morin-H+MHY-1485,100 mg/(kg·d)Morin+7 mg/(kg·d)MHY-1485]group.Enhanced expiratory interval value was detected and recorded;Total IgE,ovalbumin(OVA)specific IgE,IL-4,IL-5,IL-17,IL-13,IFN-γ and TGF-β1 levels were determined by ELISA;Giemsa staining was applied to observe and record situation of related inflammatory cells;proportion of Th1,Th2 and Th17 cells were detected by flow cytometry;HE and PAS staining were applied to observe pathologi-cal changes in lung tissue and goblet cell proliferation;GATA-binding protein 3(GATA-3)expression was detected by immunohisto-chemistry and qRT-PCR;Western blot was applied to detect expression and phosphorylation levels of mTOR and STAT3 proteins.Results:Compared with Control group,inflammatory cell infiltration was obvious in Model group,with irregular thickening of tube wall and basement membrane,obviously more goblet cells,and increased mucus secretion,Penh value,IL-4,IL-5,IL-17,IL-13,total IgE and OVA-sIgE levels,macrophages,lymphocytes,eosinophils and neutrophils numbers,Th2 and Th17 cells proportion,average optical density of GATA-3,GATA-3 mRNA and phosphorylation levels of mTOR and STAT3 were obviously increased(P<0.05),proportion of Th1 cells and IFN-γ level were significantly reduced(P<0.05).Compared with Model group,bronchial wall structure of rats in Morin-L,Morin-M and Morin-H groups was smoother and more complete,with epithelial cells arranged in a more orderly manner,moderate airway wall thickness,reduced inflammatory cell infiltration,and reduced goblet cell proliferation,Penh value,IL-4,IL-5,IL-17,IL-13,TGF-β1,total IgE and OVA-sIgE levels,numbers of macrophages,lymphocytes,eosinophils and neutrophils,proportion of Th2 and Th17 cells,average optical density of GATA-3,GATA-3 mRNA,and phosphorylation levels of mTOR and STAT3 were obviously decreased(P<0.05),proportion of Th1 cells and IFN-γ level were significantly increased(P<0.05).MHY-1485 reversed inhibitory effect of morin on inflammatory response in asthmatic rats(P<0.05).Conclusion:Morin may inhibit activation of mTOR/STAT3 signaling pathway,inhibit inflammatory response in young rats with asthma,and thereby improve asthma symptoms.

Cerebral proliferative angiopathy(CPA)was initially regarded as a variant of arteriovenous malformation.However,its distinct histological,angiographic,and pathophysiological features have led to its reclassification as an independent entity.CPA is an exceptionally rare form of cerebral vascular malformation,its pathogenesis is primarily linked to diffuse vascular proliferation secondary to chronic hypoperfusion.Clinically,CPA presents with a heterogeneous spectrum of manifestations,most commonly severe headaches and epileptic seizures.Neuroimaging(MR)typically reveals a complex interplay of aberrant vessels within the brain parenchyma,which may complicate the clinical management and lead to a higher rate of poor prognosis.This article reviewed current knowledge on the pathogenesis,epidemiology,clinical features,diagnostic approaches,and treatment options for CPA,with the aim of enhancing understanding of its underlying mechanisms and guiding future therapeutic strategy optimizations.

Objective To investigate the safety and efficacy of bybrid surgery in the treatment of cerebral arteriovenous malformation(CAVM)and possible factors for postoperative symptom progression.Methods A total of 61 patients with CAVM admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University from January 1,2016 to December 31,2021 who underwent bybrid surgery were retrospectively included.Demographic information(sex,age),incidence(first diagnosis of CAVM by imaging and/or first appearance of CAVM-related symptoms such as hemorrhage and epilepsy),time from onset to hybrid surgery,modified Rankin scale(mRS)score at admission,history of previous CAVM treatment(surgical removal of previous CAVM and intravascular treatment),CAVM imaging data(lesion location,size,drainage),Spetzler-Martin grade,lesion density(loose,dense),CAVM combined with aneurysm or aneurysmal structure,surgical method(microsurgery+intraoperative DSA,microsurgery+intraoperative DSA+endovascular embolism),treatment-related complications(intracranial hemorrhage and/or ischemic events and/or edema in surgery-related areas,puncture site hematoma and/or fistula and/or pseudoaneurysm,gastrointestinal and/or gingival bleeding and/or epistaxis,contrast hypersensitivity,all-cause death),clinical and radiological follow-up data were recorded.The safety(treatment-related complications,symptom progression[positive difference between the mRS score at 6 months postoperatively and the baseline mRS score])and effectiveness(occlusion,complete absence of the malformation on DSA at 6 months postoperatively;good prognosis,mRS score≤2 at 6months postoperatively)of hybrid surgery treatment were evaluated.Based on the clinical follow-up results at 6 months after surgery,patients who underwent hybrid surgery for CAVM were divided into the progressive group and the non-progressive group,and their baseline and clinical characteristics were compared.Results(1)Among the 61 patients who underwent hybrid surgery for CAVM,37(60.7％)were male,with a median age of 25(13,42)years;11(18.0％)were asymptomatic,and 39(63.9％)had hemorrhage as their initial symptom,while 11(18.0％)had seizures as their initial symptom.At admission,54(88.5％)patients had an mRS score of ≤2,including 38(62.3％)patients who had undergone previous endovascular embolization and had residual or recurrent CAVM;the Spetzler-Martin grade of the CAVM lesion was Ⅰ,Ⅱ,Ⅲ,or Ⅳ in 13(21.3％),22(36.1％),21(34.4％),and 5(8.2％)patients,respectively;24 patients underwent DSA verification during surgery using a hybrid surgical platform,and 37 patients underwent DSA verification and assisted endovascular embolization using a hybrid surgical platform.(2)Clinical follow-up completion rate was 77.0％(47/61);the follow-up time ranged from 6 to 24 months and the median follow-up time was 12(6,24)months.The good prognosis rate was 91.5％(43/47),there was no death.The incidence of treatment-related complications was 10.6％(5/47).The completion rate of imaging follow-up was 72.1％(44/61)and the median follow-up time was 15(10,22)months.There were 40(90.9％)of CAVM occlusion,2(4.5％)of residual CAVM and 2(4.5％)of recurrent CAVM.(3)Among the 47 patients who completed clinical follow-up,15 patients developed symptoms and 32 patients did not develop symptoms.There were no significant differences in sex,age,onset symptoms,mRS score at admission,lesion location,lesion density and aneurysm or aneurysmal structure between the two groups(all P＞0.05).In the progressive group,the proportion of lesions with the largest diameter＜3 cm,3-6 cm and＞6 cm were 3/15,10/15 and 2/15,respectively,and the largest diameter was mainly 3-6 cm.In the non-progressive group,the proportion of the largest diameter＜3 cm and 3-6 cm were 18/32 and 14/32,respectively,and the largest diameter＜3 cm was the main proportion(x2=8.321).Deep venous drainage(x2=11.937)and residual and/or recurrence(x2=8.507)were present in the progressive group,and the differences between the groups were statistically significant(all P＜0.05).Conclusions Hybrid surgery has certain safety and effectiveness in the treatment of CAVM.Patients with CAVM who experienced progression after undergoing composite surgery have characteristics such as larger maximum diameter,the presence of deep venous drainage and residual and/or recurrence,and the factors affecting progression need to be further explored in the future.

Objective To investigate the impact of Atractylodin on lung tissue damage in young asthmatic rats by regulating the CXC chemokine ligand 12(CXCL12)/CXC chemokine receptor 4(CXCR4)signaling pathway.Methods Twelve young SD rats were randomly selected from 60 rats as the control group(CON group),while the remaining 48 rats were used to construct asthma models using ovalbumin(OVA).Successfully modeled asthma rats were randomly separated into Model group,Atractylodin group(50 mg/kg Atractylodin),and CXCL-12 group(5 μ g/kg recombinant CXCL-12 protein)and Atractylodin+CXCL-12 group(50 mg/kg Atractylodin+5 μ g/kg recombinant CXCL-12 protein),with 12 in each group,continuously administered for 14 days.The CON and Model groups were given equal amounts of physiological saline.The percentages of neutrophils and eosinophils in bron-choalveolar lavage fluid(BALF)were detected.ELISA method was applied to detect cytokine levels in serum and BALF fluid;HE staining was applied to detect pathological changes in lung tissue;Western blot was applied to detect the levels of CXCL12/CXCR4 pathway related proteins.Results Compared with the CON group,the pathological score of lung tissue,percentage of neutrophils,percentage of eosinophils,the levels of IL-17,IL-4,IL-5,IL-13,IgE,OVA sIgE,and the protein levels of CXCL12 and CXCR4 in Model group were obviously increased(P<0.05);compared with the Model group,the pathological score of lung tissue,percentage of neutro-phils,percentage of eosinophils,the levels of IL-17,IL-4,IL-5,IL-13,IgE,OVA sIgE,and the protein levels of CXCL12 and CXCR4 in the Atractylodin group were obviously reduced(P<0.05),the results in the CXCL-12 group were opposite to those in the Atractylodes group;CXCL-12 eliminated the improvement effect of atractylodes on asthma rats.Conclusion Atractylodin may improve lung tissue damage in asthmatic rats by down-regulating the CXCL12/CXCR4 signaling pathway.

Hypoglossal canal dural arteriovenous fistula(DAVF)is a subtype of DAVF involving the anterior condylar vein and/or anterior condylar confluence.Due to its low incidence and the complex venous anatomy around the hypoglossal canal,hypoglossal canal DAVF is often underrecognized by clinicians.Endovascular treatment has become the first-line choice for hypoglossal canal DAVF.In this paper,the authors summarized the anatomy surrounding the hypoglossal canal,various endovascular treatment strategies and approaches,and related complications,with the aim of offering clinical insights into hypoglossal canal DAVF treatment.

Hypoglossal canal dural arteriovenous fistula(DAVF)is a subtype of DAVF involving the anterior condylar vein and/or anterior condylar confluence.Due to its low incidence and the complex venous anatomy around the hypoglossal canal,hypoglossal canal DAVF is often underrecognized by clinicians.Endovascular treatment has become the first-line choice for hypoglossal canal DAVF.In this paper,the authors summarized the anatomy surrounding the hypoglossal canal,various endovascular treatment strategies and approaches,and related complications,with the aim of offering clinical insights into hypoglossal canal DAVF treatment.

Objective:To investigate the role of plasma neurofilament light chain (NfL) in diagnosing and differentiating Parkinson's disease (PD) and multiple system atrophy-Parkinsonian subtype (MSA-P).Methods:Forty PD patients and 23 MSA-P patients admitted to Department of Neurology, Henan Provincial People's Hospital from June 2019 to December 2021 were recruited; 27 healthy subjects accepted physical examination during the same period were selected as controls. Ultrasensitive Simoa technology was used to measure the plasma NfL. Differences in clinical data and plasma NfL were compared among all subjects. Correlations of plasma NfL with clinical characteristics, such as disease course, Hoehn-Year (H-Y) staging, Unified Parkinson's Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT) and levodopa equivalent daily dosage (LEDD), were analyzed with Pearson correlations. Receiver operating characteristic (ROC) curve was used to analyze the value of plasma NfL in diagnosing and differentiating PD and MSA-P.Results:Compared with MSA-P group, PD group had significantly longer disease course and statistically lower scores of UPDRS-II and SCOPA-AUT ( P<0.05). The plasma NfL in MSA-P group, PD group and healthy control group was decreased successively ([37.69±10.47] pg/mL, [17.85±4.23] pg/mL, [12.86±3.14] pg/mL, respectively), with statistical differences ( P<0.05). In MSA-P patients, Pearson correlations showed positive correlation between plasma NfL and age ( r=0.442, P=0.035); and Partial correlations showed positive correlations between plasma NfL and scores of UPDRS-I and UPDRS-III ( P<0.05), and plasma NfL showed no significant correlation with H-Y staging, UPDRS-III, MoCA, LEDD or SCOPA-AUT scores ( P>0.05). In PD patients, Pearson correlations showed that plasma NfL was positively correlated with age ( r=0.342, P=0.031); partial correlations showed that plasma NfL was positively correlated with H-Y staging and UPDRS-III, and negatively correlated with MoCA scores ( P<0.05); plasma NfL showed no significant correlation with disease course, scores of UPDRS-I and UPDRS-II, LEDD, and SCOPA-AUT scores ( P>0.05). ROC curve showed that the area under the curve (AUC) of plasma NfL in diagnosing PD was 0.814 (95% CI: 0.712-0.920, P<0.001); AUC of plasma NfL in differentiating and diagnosing PD and MSA-P was 0.980 (95% CI: 0.954-1.000, P<0.001); AUC of plasma NfL in diagnosing MSA-P was 0.998 (95% CI: 0.993-1.000, P<0.001). Conclusions:Plasma NfL is correlated with severity of motor symptoms in MSA-P patients; plasma NfL is correlated with cognitive function and disease course in PD patients. Besides, plasma NfL has high sensitivity and specificity in differentiating PD and MSA-P, therefore, plasma NfL could serve as a biomarker to diagnosis and differentiate PD.

Objective:To analyze the morphology and distribution characteristics of subchondral bone cysts of the talus by CT three-dimensional reconstruction.Methods:A total of 176 patients diagnosed with subchondral bone cyst of the talus after CT scan of the ankle or foot from 2015 to 2020 were retrieved from the imaging report database of Tianjin Hospital, including 77 males and 99 females, aged 14-84 years［(56.1±14.0)years］. After three-dimensional reconstruction of the talus and cyst area by Mimics 20.0 software, an equal 2×2 grid configuration was constructed to divide the domed articular surface into four regions: anteromedial, anterolateral, posteromedial and posterolateral. For subchondral cyst of the talus, area involved under grid localization, gender, age and side of the onset were recorded. The anteroposterior diameter, transverse diameter, depth, surface area and volume of the subchondral bone cyst of the talus were measured.Results:Subchondral cyst of the talus was anteromedial in 131 patients (74.4%), anterolateral in 5(2.8%), posteromedial in 34(19.3%), and posterolateral in 6(3.4%). Subchondral cyst of the talus occurred in the older aged (≥60 years) for 78 patients (44.3%), in the middle aged (45-59 years) for 62(35.2%), in young adults for 32(18.2%), and in preadolescents for 4(2.3%). The age composition of the subchondral cyst of the talus involving the anteromedial, anterolateral, posteromedial and posterolateral regions was 59(49, 64)years, 44(39, 45)years, 61(54, 68)years and 40(22, 58) years, respectively (all P<0.01). There were no statistically significant differences in gender and side of the onset (all P>0.05). The anteroposterior diameter of the subchondral bone cysts located anteromedially, anterolaterally, posteromedially and posterolaterally was (9.7±4.4)mm, (3.5±1.1)mm, (10.3±4.4)mm and (2.1±0.8)mm, respectively; the transverse diameter was (5.4±1.7)mm, (3.9±1.8)mm, (5.9±2.2)mm and (3.4±1.1)mm, respectively; the depth was (7.1±2.4)mm, (3.2±2.2)mm, (8.2±3.0)mm and (3.9±1.9)mm, respectively; the surface area was 156.1(82.6, 198.2)mm 2, 23.0(21.4, 28.9)mm 2, 180.0(75.1, 230.4)mm 2 and 28.0(20.3, 36.7)mm 2, respectively; the volume was 77.1(37.1, 129.1)mm 3, 23.9(14.2, 37.8)mm 3, 104.6(37.7, 157.4)mm 3 and 13.0(10.4, 16.0)mm 3, respectively. When comparing the anteroposterior diameter, transverse diameter, depth, surface area and volume of the subchondral bone cysts in the anteromedial and posteromedial regions with the anterolateral and posterolateral regions, the differences were statistically significant (all P<0.01) except for the transverse diameter of the subchondral bone cysts in the anteromedial region and the anterolateral region ( P>0.05). In addition, the depth of subchondral bone cysts in the anteromedial region was significantly greater than that in the posteromedial region ( P<0.05). Conclusions:Subchondral bone cysts of the talar are commonly found in the middle- and old-aged population. Anteromedial lesions of the talar dome are the most commonly seen, with large and deeply involved cysts, followed by posteromedial lesions of the dome, while anterolateral and posterolateral lesions of the dome are less common and have smaller cyst sizes. An equal 2×2 grid configuration for talar cysts is useful in positioning and characterizing bone cysts, and can assist clinicians in accurately diagnosing and treating bone cysts.