BACKGROUND: In China, stroke burden remains severe as it is a major cause of mortality and disability. Detailed analyses across different subtypes will help optimize intervention strategies, enhance resource allocation efficiency, and ultimately reduce the overall disease burden. METHODS: We conducted a descriptive analysis of the incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) of stroke and its subtypes using data (1990-2021) from the Global Burden of Disease (GBD) database. A Joinpoint regression model was applied to quantitatively analyze the indicators and calculate the annual percentage change (APC) and average annual percentage change (AAPC). We applied the Bayesian age-period-cohort (BAPC) model to project trends for 2022-2040. RESULTS: Incidence of stroke increased by 100.64% from 1990 to 2021, with ischemic stroke (IS) exhibiting the largest increase (201.13%) among all the subtypes, and the incidence being consistently higher in males than in females. The YLL/YLD ratio for stroke and its subtypes has decreased, with the YLL/YLD ratio falling from 20.13 to 9.48 in 1990-2021, indicating an increase in non-fatal burden. After adjusting for age, the age-standardized incidence rates (ASIRs) of stroke and its subtypes declined, except for IS. The age-standardized mortality rate (ASMR) for subarachnoid hemorrhage (SAH) decreased significantly (APC: -15.31%; 2000-2004), with the largest reduction in the age-standardized DALY rate (ASDR) also occurring during this period (APC: -14.22%). Furthermore, BAPC projections (2022-2040) indicate that stroke ASIRs in males will slightly decline but increase in females. Meanwhile, the ASIR of IS is expected to continue to rise. Overall, the ASMR and ASDR are projected to decline. CONCLUSIONS Although China has made some progress in stroke prevention and control, several challenges remain. Controlling IS must be prioritized, especially due to the high stroke burden among males.

Psoriasis is a chronic inflammatory skin disease, and its pathogenesis is largely modulated by abnormal angiogenesis. Previous research has indicated that AlkB homolog 5 (ALKBH5), an important demethylase affecting N⁶-methyladenosine (m⁶A) modification, plays a role in regulating angiogenesis in cardiovascular and eye diseases. Our present study found that ALKBH5 was upregulated and co-localized with cluster of differentiation 31 (CD31) in the skin of IMQ group compared with control group. ALKBH5-deficient mice decreased IMQ-induced psoriatic dermatitis and exhibited histological improvements, including decreased epidermal thickness, hyperkeratosis, numbers of dermal capillary vessels and inflammatory cell infiltration. ALKBH5-KO mice alleviated angiogenesis in psoriatic lesions by downregulating the protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. Additionally, the expression of ALKBH5 was significantly upregulated in IL-17A-induced human umbilical vein endothelial cells (HUVECs), which further promoted the expression of angiogenesis-related cytokines and endothelial cell proliferation. Cell proliferation and angiogenesis were suppressed in ALKBH5 knockdown group, whereas ALKBH5 overexpression promoted these processes. The regulation of angiogenesis in HUVECs by ALKBH5 was facilitated through the AKT-mTOR pathway. Collectively, ALKBH5 plays a pivotal role in psoriatic dermatitis and angiogenesis, which may offer a new potential targets for treating psoriasis.
Animals ; Psoriasis/chemically induced* ; Mice ; Humans ; Neovascularization, Pathologic/genetics* ; Human Umbilical Vein Endothelial Cells/metabolism* ; AlkB Homolog 5, RNA Demethylase/genetics* ; Proto-Oncogene Proteins c-akt/metabolism* ; TOR Serine-Threonine Kinases/metabolism* ; Cell Proliferation ; Mice, Knockout ; Disease Models, Animal ; Signal Transduction ; Male ; Skin/blood supply* ; Mice, Inbred C57BL ; Angiogenesis

Adolescents and young adults (AYAs) are one of the major populations susceptible to tuberculosis. However, little is known about the unique characteristics and diagnostic biomarkers of tuberculosis in this population. In this study, 81 AYAs were recruited, and the high-quality serum proteome of the AYAs with tuberculosis was profiled by quantitative proteomics. The data of serum proteomics indicated that the relative abundance of hemoglobin and apolipoprotein was significantly reduced in the patients with active tuberculosis (ATB). The pathway enrichment analysis showed that the downregulated proteins in the ATB group were mainly involved in the antioxidant and cell detoxification pathways, indicating extensive oxidative stress damage. Random forest (RF) and extreme gradient boosting (XGBoost) were employed to evaluate protein importance, which yielded a set of candidate proteins that can distinguish between ATB and non-ATB. The analysis with the support vector machine algorithm (recursive feature elimination) suggested that the combination of apolipoprotein A-I (APOA1), hemoglobin subunit beta (HBB), and hemoglobin subunit alpha-1 (HBA1) had the highest accuracy and sensitivity in diagnosing ATB. Meanwhile, the levels of hemoglobin (HGB) and albumin (ALB) can be used as blood biochemical indicators to evaluate changes in the protein levels of APOA1 and HBB. This study established the serum proteome landscape of AYAs with tuberculosis and identified new biomarkers for the diagnosis of tuberculosis in this population.
Humans ; Proteomics/methods* ; Biomarkers/blood* ; Adolescent ; Young Adult ; Apolipoprotein A-I/blood* ; Machine Learning ; Tuberculosis/blood* ; Proteome/analysis* ; Male ; Hemoglobins/analysis* ; Female ; Blood Proteins/analysis* ; Adult

Objective:To explore the influence of pulmonary nodule size, nodule location, fissure, surgical approach, surgical entrance, postoperative pathology, surgical method and other factors on the relevant information of basal segmentectomy under thoracoscopy.Methods:Retrospectively analyze 103 patients who underwent thoracoscopic basal segmentectomy of the lung from January 2023 to February 2024. According to the classification of nodule size, nodule position, development of pulmonary fissure, surgical approach, number of surgical entrance, postoperative pathology, surgical method, tc., the influence of single factor Logistic regression analysis was used to explore the influence of various factors on the relevant information of pulmonary basal segmentectomy under thoracoscopy. Results:When the dependent variable was the surgery duration, single factor analysis showed that CT location( P=0.024), nodule composition( P=0.029), surgical entry( P=0.002), surgical method( P<0.001), and surgical approach( P=0.052) significantly influenced the surgery duration. Variables with P<0.1 in the single factor analysis were included in the multivariate analysis, which showed that surgical entry and surgical method significantly influenced surgery duration( P<0.05). When the dependent variable was the total hospitalization cost, single factor analysis showed that CT location, surgical approach, and surgical method significantly influenced the total hospitalization cost( P<0.1). Multiple factor analysis showed that the surgical method affected the total hospitalization cost, with significantly higher costs when S9 or S10 lung segments were resected( P=0.050). When the dependent variable was postoperative drainage duration, single factor analysis showed that the condition of the lung fissures significantly influenced postoperative drainage duration( P=0.028). Multiple factor regression analysis showed that incomplete lung fissure development significantly increased the possibility of postoperative air leaks( P=0.034). Conclusion:The surgical access may significantly affect the operation time, which is the use of uniport thoracoscopy is shorter than the multi-port operation time, the surgical method does not contain S9/S10 is shorter than that of S9/S10, and the total cost of hospitalization is lower. The completeness of the fissure will significantly decrease the possibility of postoperative pulmonary leakage.

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.
Humans ; White Matter/diagnostic imaging* ; Diffusion Tensor Imaging/methods* ; Alzheimer Disease/complications* ; Reproducibility of Results ; Cognition ; Cognitive Dysfunction/complications* ; Brain/diagnostic imaging*

Traumatic intracranial hematoma progresses rapidly and may cause quick increase of intracranial pressure and even brain hernia, ultimately leading to coma or death. Therefore, traumatic intracranial hematoma needs prompt treatment, but the prerequisite of treatment is early examination and diagnosis. Due to the limited transportation and other reasons, the existing large-scale detection devices such as CT and MRI cannot be deployed on the rescue site or during patient transportation. Instead, the portable diagnosis devices have the characteristics of miniaturization and high flexibility, which is conducive to promoting early detection, assisting diagnosis and further guiding the formulation of treatment plans. At present, more and more attention has been paid to the portable diagnosis devices in the diagnosis of intracranial hematoma. The authors summarized the conventional diagnosis methods and application of portable diagnosis devices for traumatic intracranial hematoma, aiming to provide a reference for the diagnosis of traumatic intracranial hematoma.

Objective:To investigate the value of brainstem auditory evoked potential (BAEPs) combined with cochlear electrogram (ECochG) monitoring in the protection of auditory function during microvascular decompression (MVD) for patients with facial spasm (HFS).Methods:Clinical data of 908 patients with HFS who received MVD treatment in our hospital from January 2018 to December 2020 were retrospectively analyzed. The patients were divided into BAEPs group ( n=309), ECochG group ( n=301) and BAEPs+ECochG group ( n=298) according to the different methods of auditory nerve function monitoring. Waveform extraction rate, mean extraction time, amplitude, latency, intraoperative warning effect of 3 monitoring methods, as well as hearing status immediately after surgery and during follow-up were compared in patents from the 3 groups. Results:(1) The overall waveform extraction rate in ECochG group and BAEPs+ECochG group was significantly higher than that in BAEPs group, and the average waveform extraction time in ECochG group and BAEPs+ECochG group was significantly shorter than that in BAEPs group ( P<0.05). The amplitude of compound action potential (CAP) wave in ECochG group was significantly higher than that of V wave in BAEPs group, and the latency of CAP wave was also significantly earlier than that of V wave ( P< 0.05). (2) A total of 48 patients of the 288 patients in the BAEPs group showed warning signs; a total of 73 of the 292 patients in the ECochG group showed warning signs; and a total of 65 of the 292 patients in the BAEPs+ECochG group showed warning signs. (3) There was significant difference in hearing grading (American Association of Otolaryngology Head and Neck Surgery [AAO-HNS] grading) among the 3 groups immediately after surgery ( H=18.041, P=0.000), and the average rank suggested that the hearing of patients in the BAEPs+ECochG group was superior to the other two groups. All patients were followed up for an average of 15 months (ranged 3-24 months); there was still a significant difference in AAO-HNS grading among the 3 groups ( H=29.625, P=0.000), and the hearing of patients in the BAEPs+ECochG group was still superior to the other two groups. Conclusion:The combined application of ECochG and BAEPs monitoring can reflect the changes of intraoperative hearing impairment comprehensively, accurately and timely, which is of great significance for the protection of auditory function in HFS patients during MVD.

Objective:To investigate the clinical characteristics of cerebellopontine angle (CPA) tumors with hemifacial spasm (HFS) or trigeminal neuralgia (TN) as first symptoms.Methods:From May 2015 to November 2018, 70 patients with CPA tumors found in preoperative imaging examination or during operation and with TN or HFS as first symptoms, were enrolled into experimental group; 66 patients with CPA tumors without TN or HFS were chosen as control group. Gender, age, course of the disease, pathological types of the tumors, and tumor sizes were retrospectively analyzed and compared between the two groups.Results:In the experimental group, 54 patients were with TN as first symptom and 16 were with HFS as first symptom. The ratio of male to female in the experimental group was about 1∶2.18, and the difference was not statistically significant as compared with that in the control group (1∶3.00, P>0.05). The median course of disease in the experimental group was 36 (24, 84) months, which was significantly longer than that in the control group (9 [2, 24] months, P<0.05). In the experimental group, 34 patients (48.6%) had cholesteatoma, 24(34.3%) had meningioma, 8 (11.4%) had acoustic neuroma, 2 (2.9%) had lipoma, and 2 (2.9%) had jugular bulb tumor. In the control group, 39 patients (59.1%) had acoustic neuroma, 18 (27.3%) had meningioma, 5 (7.6%) had cholesteatoma, 3 (4.5%) had jugular bulb tumor, and one (1.5%) had lipoma. The tumor size in the experimental group (2.00 [1.60, 4.25] cm 2) was significantly smaller than that in the control group (5.60 [4.00, 8.50] cm 2, P<0.05). In the experimental group, 53 patients (75.7%) were found to have offending arteries compressing on corresponding cranial nerves during surgery; the offending artery of patients with TN was superior cerebellar artery; that of 14 patients with HFS was anterior inferior cerebellar artery and that of 2 patients with HFS was posterior inferior cerebellar artery. All patients with confirmed offending arteries underwent microvacular decompression (MVD) after tumor resection. The patients in the experimental group were followed up for 2-48 months after surgery, and the TN or HFS symptoms disappeared. Conclusions:The female patients with CPA tumors with TN or HFS as first symptoms are more common, and TN is far more common than HFS. Cholesteatoma is the most common tumor. As compared with patients with CPA tumors without TN or HFS, CPA tumors patients with TN or HFS have longer course of disease and smaller tumor volume. Most patients have offending vascular compression on the corresponding cranial nerves, tumor resection+MVD is safe and effective treatment for these patients.

Objective:To compare the treatment efficacy of microvascular decompression (MVD) in hemifacial spasm (HFS) patients with stable disappearance of abnormal muscle response (AMR) and recurrence of AM.Methods:A total of 1705 HFS patients who received MVD and accepted AMR monitoring during the whole process were selected in our hospital from January 2014 to January 2019. According to the intraoperative AMR monitoring results, these patients were divided into AMR stable disappearance group and AMR recurrence group. All patients were followed up for 12-68 months; the delayed cure rate and total cure rate were compared between the two groups.Results:Among the 1158 patients from AMR stable disappearance group, 1086 patients were cured immediately after surgery, 48 were cured within 0.2-3 months of surgery, and 24 patients were not effective. Among the 547 patient from AMR recurrence group, 301 patients achieved immediate cure after surgery, 232 patients had delayed cure in the follow up period (ranged from 0.5 to 6 months), and 14 patients were not effective. The total cure rate showed no significant difference between the two groups (97.9% vs. 97.4%, P>0.05), but the delayed cure rate in patients from AMR recurrence group was significantly higher than that from AMR stable disappearance group (42.4% vs. 4.1%, P<0.05). Re-examination of AMR at the end of surgery showed that AMR disappeared again in 294 patients from the AMR recurrence group without intracranial intervention, and AMR continued to exist in 253 patients at the end of surgery. Conclusion:After complete intraoperative decompression of HFS by MVD, the AMR recurrence does not require immediate re-operative exploration and decompression, which can still ensure excellent curative effect and has a relatively high probability of delayed cure; and the evaluation of its curative effect should be extended to at least one year after surgery.