Subarachnoid hemorrhage(SAH)is a major subtype of stroke,characterized by high mortality and disability rates.Pyroptosis,a form of programmed cell death,has been identified as a key pathological process in early brain injury.Current research indicates that pyroptosis can occur in neurons,microglia,astrocytes,and cerebral vascular endothelial cells after SAH,leading to neurological dysfunction,brain edema,and disruption of the blood-brain barrier.The NOD-like receptor protein 3(NLRP3)inflammasome is regarded as a central regulatory component of pyroptosis,and its activation mechanisms and roles in various cell types have become focal points of research.A variety of therapeutic strategies targeting this pathway have emerged,including NLRP3 inhibitors,Caspase-1 inhibitors,and Gasdermin-D inhibitors.The aforemenetioned approaches all have demonstrated efficacy in animal studies.Additionally,novel technologies such as stem cell therapy,exosome therapy,and gas therapy offer novel intervention approaches for modulating pyroptosis.Although,various therapeutic strategies targeting pyroptosis-related pathways have emerged in recent years,a comprehensive summary remains absent.This article reviewed the advancements in pyroptosis research following SAH and associated treatment strategies,aiming to provide a theoretical foundation for subsequent mechanistic studies and clinical translation.

Objective:To evaluate the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in patients with middle cerebral artery bifurcation aneurysms.Methods:A retrospective analysis was performed; the clinical data of 46 patients with middle cerebral artery bifurcation aneurysms accepted Neuroform Atlas stent-assisted coil embolization in First Affiliated Hospital of Zhengzhou University, Beijing Tiantan Hospital Affiliated to Capital Medical University, First Affiliated Hospital of Harbin Medical University, Zhujiang Hospital of Southern Medical University and First Affiliated Hospital of Chongqing Medical University from January 2022 to March 2024 were collected. There were 28 ruptured aneurysms (60.87%) and 18 unruptured aneurysms (39.13%). Follow-up was performed for more than 3 months; Raymond-Roy grading was used to evaluate the aneurysm embolization immediately after embolization and during follow-up; perioperative hemorrhagic or ischemic complications were recorded; modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at discharge and during follow-up (mRS score≤2: good prognosis, and mRS score>2: poor prognosis).Results:Coil embolization was successful in all 46 patients. DSA immediately after embolization showed that 41 patients (89.13%) had completely occluded aneurysms (Raymond-Roy grading I), 2 patients (4.35%) had residual aneurysm neck (Raymond-Roy grading Ⅱ) and 3 patients (6.52%) had partially occluded aneurysms (Raymond-Roy grading Ⅲ). Perioperative complications occurred in 5 patients, including 2 with postoperative cerebral infarction, 1 with hydrocephalus, 1 with postoperative pneumonia leading to respiratory failure, and 1 with stent thrombosis during embolization. Both at discharge and 3 months after embolization, 43 patients (93.48%) had good prognosis and 3 patients (6.52%) had poor prognosis. No obvious ischemic complications (such as stent restenosis) or hemorrhagic complications (such as re-rupture of the aneurysms) were found in all patients. Thirty patients (65.22%) had imaging follow-up for 6-12 months: 26 (86.67%) had Raymond-Roy grading I, 3 (10.00%) had Raymond-Roy grading II, and 1 (3.33%) had Raymond-Roy grading III.Conclusion:Neuroform Atlas stent-assisted coil embolization has good short-term efficacy and high safety in middle cerebral artery bifurcation aneurysms, but long-term follow-up observation is still needed to verify its efficacy.

Subarachnoid hemorrhage(SAH)is a major subtype of stroke,characterized by high mortality and disability rates.Pyroptosis,a form of programmed cell death,has been identified as a key pathological process in early brain injury.Current research indicates that pyroptosis can occur in neurons,microglia,astrocytes,and cerebral vascular endothelial cells after SAH,leading to neurological dysfunction,brain edema,and disruption of the blood-brain barrier.The NOD-like receptor protein 3(NLRP3)inflammasome is regarded as a central regulatory component of pyroptosis,and its activation mechanisms and roles in various cell types have become focal points of research.A variety of therapeutic strategies targeting this pathway have emerged,including NLRP3 inhibitors,Caspase-1 inhibitors,and Gasdermin-D inhibitors.The aforemenetioned approaches all have demonstrated efficacy in animal studies.Additionally,novel technologies such as stem cell therapy,exosome therapy,and gas therapy offer novel intervention approaches for modulating pyroptosis.Although,various therapeutic strategies targeting pyroptosis-related pathways have emerged in recent years,a comprehensive summary remains absent.This article reviewed the advancements in pyroptosis research following SAH and associated treatment strategies,aiming to provide a theoretical foundation for subsequent mechanistic studies and clinical translation.

Objective:To evaluate the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in patients with middle cerebral artery bifurcation aneurysms.Methods:A retrospective analysis was performed; the clinical data of 46 patients with middle cerebral artery bifurcation aneurysms accepted Neuroform Atlas stent-assisted coil embolization in First Affiliated Hospital of Zhengzhou University, Beijing Tiantan Hospital Affiliated to Capital Medical University, First Affiliated Hospital of Harbin Medical University, Zhujiang Hospital of Southern Medical University and First Affiliated Hospital of Chongqing Medical University from January 2022 to March 2024 were collected. There were 28 ruptured aneurysms (60.87%) and 18 unruptured aneurysms (39.13%). Follow-up was performed for more than 3 months; Raymond-Roy grading was used to evaluate the aneurysm embolization immediately after embolization and during follow-up; perioperative hemorrhagic or ischemic complications were recorded; modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at discharge and during follow-up (mRS score≤2: good prognosis, and mRS score>2: poor prognosis).Results:Coil embolization was successful in all 46 patients. DSA immediately after embolization showed that 41 patients (89.13%) had completely occluded aneurysms (Raymond-Roy grading I), 2 patients (4.35%) had residual aneurysm neck (Raymond-Roy grading Ⅱ) and 3 patients (6.52%) had partially occluded aneurysms (Raymond-Roy grading Ⅲ). Perioperative complications occurred in 5 patients, including 2 with postoperative cerebral infarction, 1 with hydrocephalus, 1 with postoperative pneumonia leading to respiratory failure, and 1 with stent thrombosis during embolization. Both at discharge and 3 months after embolization, 43 patients (93.48%) had good prognosis and 3 patients (6.52%) had poor prognosis. No obvious ischemic complications (such as stent restenosis) or hemorrhagic complications (such as re-rupture of the aneurysms) were found in all patients. Thirty patients (65.22%) had imaging follow-up for 6-12 months: 26 (86.67%) had Raymond-Roy grading I, 3 (10.00%) had Raymond-Roy grading II, and 1 (3.33%) had Raymond-Roy grading III.Conclusion:Neuroform Atlas stent-assisted coil embolization has good short-term efficacy and high safety in middle cerebral artery bifurcation aneurysms, but long-term follow-up observation is still needed to verify its efficacy.

OBJECTIVE:To observe the efficacy and safety of paclitaxel combined with cisplatin and fluorouracil for gastric cancer with liver metastases via indwelling hepatic arterial catheter. METHODS:56 gastric cancer patients with liver metastases were randomly divided into control group(28 cases)and observation group(28 cases). Control group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5,pumping administrated via central venous. Ob-servation group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5, administrated via indwelling hepatic arterial catheter. 3-4 weeks were a course,it lasted 8 courses at most. Magnesium isoglycyrrhiz-inate injection 200 mg/d was intravenously infused for liver protection in 2 groups during treatment. Clinical efficacy,serum car-cinoembryonic antigen (CEA),alanine aminotransferase (ALT),aspartate aminotransferase (AST) levels before and after treat-ment,and the incidence of adverse reactions in 2 groups observed. RESULTS:Short-term clinical efficacy in observation group was significantly higher than control group,with statistical significance(P<0.01). Before treatment,there were no significant dif-ferences in CEA,ALT and AST levels(P>0.05). After treatment,CEA,ALT and AST levels in 2 groups were significantly high-er than before,ALT and AST levels in observation group were significantly higher than control group,while CEA level in observa-tion group was lower than control group,with statistical significances(P<0.05). The incidences of bone marrow suppression,nau-sea,vomiting and fever in observation group were significantly lower than control group,with statistical significances (P<0.05). CONCLUSIONS:Paclitaxel combined with cisplatin and fluorouracil has good efficacy for gastric cancer with liver metastases via indwelling hepatic arterial catheter,while it exists liver dysfunction.

Cerebral arteriovenous malformation (AVM) is a common cerebrovascular disease in clinical practice. Although the treatment of AVMs has been w idely studied, the prognosis of the patients does not get significantly improvement. The main therapeutic purpose of AVMs is to reduce the risk of bleeding. This article review s the risk of bleeding and treatment modalities of AVMs.

Objective To investigate the incidence and risk factors of neck and back pain in pilots, aviation cadets and me-chanical maintenance personnel, with an aim to prevent the occurrence of the disorder among them.Methods A survey of 2001 cases of medical data was conducted, and then, the derived data concerning neck and back pain were compared and analyzed between pilots, aviation cadets and mechanical maintenance personnel.Results The incidence of neck and back pain in aviation cadets was 19.3%, and the incidence rates of the same disorder in pilots and mechanical maintenance personnel were 43.0%and 31.9%respectively.The incidence of neck and back pain in the aviation cadets flying fighters was 29%, and the incidence rates of the same disorder in the avia-tion cadets flying transports and helicopters were 44.1%and 37.4% respectively.Risk factors of neck and back pain among aviation cadets included age, flying time, smoking history, body mass index and lumbodorsal muscular exercise.Conclusion The incidence of neck and back pain in pilots was significantly higher than that in aviation cadets and mechanical maintenance personnel, and the inci-dence of the disorder was also relatively high in pilots flying transports.Flying time was the most important risk factor of neck and back pain, and the survey revealed that lumbodorsal muscular exercise was an effective protective factor.Close attention should be paid to the prevention of neck and back pain and counter measures should be developed for effective prevention of the disorder.

A 57-year-old male patient received oral sorafenib 400 mg twice daily for pulmonary metastases after operation of thyroid carcinoma. About 3 and a half months of treatment,the patient experienced dizziness,pain in the anterior region of the heart and blood pressure of 180 / 105 mmHg(before treatment it was 120 / 75 mmHg). He received oral metoprolol administration(initial dose of 25 mg twice daily,gradually increased to 200 mg twice daily). About one and a half months later,he received sustained release capsules of isosorbide mononitrate 50 mg once daily because of the intermittent attack of precordial pain. Angina pectoris still occurred frequently. He underwent percutaneous coronary intervention twice(a total of 2 stents implantation). Hypertension and angina pectoris were still poorly controlled. On month 19 of sorafenib treatment,the dose of drug was reduced to 400 mg once daily. His blood pressure was 135 / 85 mmHg but angina still occurred intermittently. On month 22,sorafenib was stopped. Two months later,the patient's blood pressure declined to 130 / 80 mmHg,and the frequency of angina pectoris decreased. Four months after the termination of sorafenib,his blood pressure was 120 / 75 mmHg and no episode of angina pectoris occurred.

A 57-year-old male patient received oral sorafenib 400 mg twice daily for pulmonary metastases after operation of thyroid carcinoma. About 3 and a half months of treatment,the patient experienced dizziness,pain in the anterior region of the heart and blood pressure of 180 / 105 mmHg(before treatment it was 120 / 75 mmHg). He received oral metoprolol administration(initial dose of 25 mg twice daily,gradually increased to 200 mg twice daily). About one and a half months later,he received sustained release capsules of isosorbide mononitrate 50 mg once daily because of the intermittent attack of precordial pain. Angina pectoris still occurred frequently. He underwent percutaneous coronary intervention twice(a total of 2 stents implantation). Hypertension and angina pectoris were still poorly controlled. On month 19 of sorafenib treatment,the dose of drug was reduced to 400 mg once daily. His blood pressure was 135 / 85 mmHg but angina still occurred intermittently. On month 22,sorafenib was stopped. Two months later,the patient's blood pressure declined to 130 / 80 mmHg,and the frequency of angina pectoris decreased. Four months after the termination of sorafenib,his blood pressure was 120 / 75 mmHg and no episode of angina pectoris occurred.