Flow diverter (FD) devices have gradually become the mainstream approach for interventional treatment of intracranial aneurysms. In-stent stenosis (ISS) is a common complication after FD implantation, which can lead to ischemic events and affect the prognosis of patients. Current studies have shown that ISS occurrence is closely related to hemodynamic changes. From the perspective of hemodynamics, this article reviews the research progress of mechanisms, evaluation methods and treatments of ISS after FD implantation, in order to provide reference for clinical practice.

Objective:To investigate the relevant factors for rupture of basilar tip aneurysms.Methods:This is a retrospective cohort study. Patients who underwent cerebrovascular digital subtraction angiography at Department of Cerebrovascular Disease Surgery,Zhujiang Hospital of Southern Medical University from July 2008 to February 2023 and were confirmed to have basilar tip aneurysms were retrospectively analyzed. There were 45 males and 56 females, aged (57.5±10.2) years (range: 36 to 76 years); the maximum diameter of the basilar tip aneurysm ( M(IQR)) was 6.85 (5.79) mm (range: 1.28 to 27.48 mm). Finally, 101 basilar tip aneurysms were included, and divided into two groups based on whether the basilar tip aneurysm ruptured or not. There were 37 cases (36.6%) in the ruptured group and 64 cases (63.4%) in the unruptured group. Data were analyzed using independent t-test, Mann-Whitney U test, chi-square test, or Fisher′s exact test, as appropriate, and predictive factors for rupture of basilar tip aneurysms were explored by Logistic regression analysis. Variance inflation factors was used for analysis of collinearity. Results:The univariate results showed statistically significant differences between the ruptured and unruptured groups in terms of aneurysm neck width, basilar artery diameter, mean diameter of the parental artery, the ratio of neck width to parent artery diameter, aneurysm width and maximum diameter of the aneurysm (all P<0.05). In multivariate analysis, basilar artery diameter ( OR=0.347, 95% CI:0.176 to 0.687, P=0.002), and NRP ( OR=0.366, 95% CI:0.192 to 0.696, P=0.002) were predictive factors for rupture of aneurysms occurring at the basilar tip. There was no multiple covariance between NRP and basilar artery diameter in the analysis of covariance (VIF=1). Conclusion:Smaller basilar artery diameter and smaller NRP are relevant factors for rupture of basilar tip aneurysms.

Flow diverter (FD) devices have gradually become the mainstream approach for interventional treatment of intracranial aneurysms. In-stent stenosis (ISS) is a common complication after FD implantation, which can lead to ischemic events and affect the prognosis of patients. Current studies have shown that ISS occurrence is closely related to hemodynamic changes. From the perspective of hemodynamics, this article reviews the research progress of mechanisms, evaluation methods and treatments of ISS after FD implantation, in order to provide reference for clinical practice.

Objective:To investigate the relevant factors for rupture of basilar tip aneurysms.Methods:This is a retrospective cohort study. Patients who underwent cerebrovascular digital subtraction angiography at Department of Cerebrovascular Disease Surgery,Zhujiang Hospital of Southern Medical University from July 2008 to February 2023 and were confirmed to have basilar tip aneurysms were retrospectively analyzed. There were 45 males and 56 females, aged (57.5±10.2) years (range: 36 to 76 years); the maximum diameter of the basilar tip aneurysm ( M(IQR)) was 6.85 (5.79) mm (range: 1.28 to 27.48 mm). Finally, 101 basilar tip aneurysms were included, and divided into two groups based on whether the basilar tip aneurysm ruptured or not. There were 37 cases (36.6%) in the ruptured group and 64 cases (63.4%) in the unruptured group. Data were analyzed using independent t-test, Mann-Whitney U test, chi-square test, or Fisher′s exact test, as appropriate, and predictive factors for rupture of basilar tip aneurysms were explored by Logistic regression analysis. Variance inflation factors was used for analysis of collinearity. Results:The univariate results showed statistically significant differences between the ruptured and unruptured groups in terms of aneurysm neck width, basilar artery diameter, mean diameter of the parental artery, the ratio of neck width to parent artery diameter, aneurysm width and maximum diameter of the aneurysm (all P<0.05). In multivariate analysis, basilar artery diameter ( OR=0.347, 95% CI:0.176 to 0.687, P=0.002), and NRP ( OR=0.366, 95% CI:0.192 to 0.696, P=0.002) were predictive factors for rupture of aneurysms occurring at the basilar tip. There was no multiple covariance between NRP and basilar artery diameter in the analysis of covariance (VIF=1). Conclusion:Smaller basilar artery diameter and smaller NRP are relevant factors for rupture of basilar tip aneurysms.

Objective To assess the disease severity and prognosis value by observing the kinetic change of serum procalcitonin(PCT),PCT clearance rate(PCT-C) and Δsequential organ failure assessment (ΔSOFA) score in the patients with septic shock.Methods A single-center observational study was conduc-ted.A total of 274 patients with septic shock admitted into intensive care unit of Hunan Province Children′s Hospital from July 2013 to December 2015 were enrolled.The patients were divided into survival group(n=178) and nonsurvival group(n=96)according to the therapeutic outcome on day 28.The PCT and SOFA scores were estimated within 24 hours when septic shock was diagnosed.PCT-C and ΔSOFA were examined on day 2,day 3,day 5,day 7,day 9 after the septic shock was diagnosed.The diagnostic and predictive per-formance of PCT,PCT-C and ΔSOFA score were assessed by the receiver operating characteristic curve (ROC).Results There were no statistical differences on serum concentrations of PCT at 24 hour,48 hour, 72 hour between two groups.But PCT-C in survival group on day 2,day 3,day 5,day 7,day 9 were signifi-cant higher than those of nonsurvival group.The area under the ROC curve were 0.800(95%CI 0.69~0.91, P=0.000)for PCT-C on day 9,0.980(95%CI 0.78 ~0.95,P<0.000)for ΔSOFA on day 9 and 0.779 (95%CI 0.66 ~0.89,P <0.001)for SOFA score when septic shock was diagnosed. A ROC analysis identified a PCT-C on day 9 more than 38.98%(sensitivity:78.90%,specificity:66.80%) as the most accurate cut-off in predicting death.A ROC analysis identified ΔSOFA score on day 9 less than -0.5(sensi-tivity:89.10%,specificity:91.50%) as the most accurate cut-off in predicting death. Conclusion The increased levels of PCT in patients with septic shock were associated with the poor control of infection and may indicate the deterioration of septic shock,it also can reflect the activity of infection in time. Keeping observing the dynamic change of PCT and analyzing PCT-C are more useful.The PCT-C levels and ΔSOFA score may provide evidence of disease progression and be helpful in risk stratification in patients with septic shock,and lower level of PCT-C and ΔSOFA score may accompany serious infection and predict poor prognosis.

Objective To investigate the infection of hemorrhagic fever with renal syndrome (HFRS) in host animals and inapparent infection of HFRS in general population in Dongting Lake areas after floods. Methods The night trapping method was used to capture rodents. The immunofluorescence assays were used to detect the hantavirus (HV) antigens and antibodies in rodents lung and in the serum of general population. Nonconditional logistic regression was applied to analyze risk factors for inapparent infection with HV. Results In flood region,draw-near flood region and new migration region,rodent density was 6.95%,6.28%, and 8.67%, respectively, and the virus-carrying rate in rodents was 15.07%,9.25%, and 4.47%, respectively. The virus-carrying rat index was the highest in flood region (0.10). Apodemus agrarius was the dominant species. The standardized positive rate of HV antibody in general population from above mentioned regions was 4.49%, 3.11%, and 3.13%, respectively. There was no significant difference among different age or gender groups. The results of logistic regression analysis indicated that people who were involved in construction of water conservancy facilities in winter or practice of rat extermination at home were the principal factors related to inapparent infection with HV. Conclusion The virus-carrying rate in main host animals of HV in the 3 regions is high, whereas the positive rate of HV antibody is low in general population. Comprehensive measures should be taken to prevent and control HFRS, such as reinforcing surveillance of HFRS, strengthening deratization, and preventive inoculation.

To study the response of cultured cells to the cyclical biaxial biomechanical strain, a system was made according to the principle of Winston. The system was made of culture dish, pressure cavity and step motor. The culture dishes were made of polymethyl methacrylate and the bottom of the culture dishes were made of silicone rubber membrane. When the diameter of the silicone rubber tube and the distance between rollers and curvilinear plate changed, the pressure in the pressure cavity changed and the strain of the membrane changed from 0 to 4%. When the roll of the step motor changed, the frequency of the strain changed from 0.1 to 5 Hz.
Animals ; Cell Culture Techniques ; instrumentation ; Equipment Design ; Finite Element Analysis ; Rats ; Stress, Mechanical