The incidence of intracranial aneurysms is higher in population, and the death and disability rates after rupture are extremely high. Early detection of intracranial aneurysms, prediction of rupture risk, operation program, and evaluation of treatment outcomes are all the clinical concerns. With the continuously deepening integration of artificial intelligence technology and medicine, its application in the diagnosis and treatment of intracranial aneurysms is becoming increasingly widespread. This article reviews the current application status of artificial intelligence technology in the diagnosis and treatment of intracranial aneurysms.

OBJECTIVE: Our study aimed to conduct genomic characterization of Salmonella strains carrying the bla _NDM-1 gene in the intestinal tract of healthy individuals. The objectives were to underscore the importance of genomic surveillance for drug resistance in both commensal and pathogenic bacteria among healthy populations, and to establish protocols for regulating drug resistance plasmids based on the completion of a comprehensive map of drug resistance plasmid genomes. METHODS: We performed antimicrobial susceptibility testing and employed second- and third-generation sequencing techniques to analyze Salmonella strains harboring the bla _NDM-1 gene, to surveil drug-resistant bacteria in the intestines of healthy subjects. Sequence comparison was conducted using both core- and pan-genome approaches. Concurrently, conjugation experiments were carried out to assess the efficiency of plasmid transfer. RESULTS: We isolated a carbapenem-resistant Salmonella enterica serovar Typhimurium strain from a healthy food worker in China. This strain harbored an IncHI2/IncHI2A plasmid carrying bla _NDM-1 along with multiple antibiotic resistance genes (ARGs). Our findings highlight the potential for asymptomatic carriers to facilitate the transmission of ARGs. Pan-genomic analysis revealed that bla _NDM-1-positive plasmids could traverse bacterial species barriers, facilitating cross-host transmission. CONCLUSION This study marks the first detection of bla _NDM-1 in Salmonella strains isolated from healthy individuals. We underscore the risk associated with the transmission of conjugative hybrid plasmids carrying bla _NDM-1, which have the potential to be harbored and transmitted among healthy individuals. Enhanced surveillance of drug-resistant pathogens and plasmids in the intestinal microbiota of healthy individuals could provide insights into the risk of ARG transmission and pathways for population-wide dissemination via ARG transfer factors.
beta-Lactamases/genetics* ; Plasmids/genetics* ; Humans ; Anti-Bacterial Agents/pharmacology* ; China ; Microbial Sensitivity Tests ; Salmonella typhimurium/isolation & purification* ; Salmonella/isolation & purification* ; Salmonella Infections/microbiology*

Objective:To compare the safety and efficacy of ticagrelor and clopidogrel in dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms.Methods:Patients with unruptured intracranial aneurysms received stent-assisted embolization in the Department of Neurosurgery, Linyi People's Hospital from January 2021 to June 2022 were retrospectively included. According to the preprocedural dual antiplatelet therapy scheme, they were divided into aspirin+clopidogrel group (clopidogrel group) and aspirin+ticagrelor group (ticagrelor group). The incidence of ischemic and bleeding events was compared between the clopidogrel group and the ticagrelor group at 3 months after procedure. Multivariate logistic regression model was used to analyze independent risk factors for postprocedural ischemic and bleeding events. Results:A total of 195 patients were included. Their age was 58.15±10.11 years and 75 were males (38.5%). There was no statistically significant difference in the incidence of bleeding events (12.8% vs. 5.9%) and ischemic events (14.9% vs. 18.8%) at 3 months after procedure between the ticagrelor group ( n=94) and the clopidogrel group ( n=101). Multivariate logistic regression analysis showed that smoking (odds ratio [ OR] 6.085; 95% confidence interval [ CI] 1.589-13.012; P=0.019], hypertension ( OR 4.547, 95% CI 1.589-13.012; P=0.005), aneurysm at the branch vessel ( OR 3.089, 95% CI 1.122-8.504; P=0.029), and the use of flow diverter ( OR 3.111, 95% CI 1.062-9.110; P=0.038) were the independent risk factors for postprocedural ischemic events. Triglycerides might be an independent risk factor for postprocedural bleeding events ( OR 1.435, 95% CI 0.989-2.082; P=0.057), but did not reach statistical significance. Conclusions:In dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms, ticagrelor and clopidogrel have the same safety and efficacy.

Objective:To investigate the efficacy and safety of Tubridge flow diverter (TFD) in the treatment of unruptured intracranial aneurysms (UIAs).Methods:The clinical data of patients with UIAs treated with TFD in the Department of Neurosurgery, Linyi People's Hospital from July 2021 to July 2023 were retrospectively analyzed. The modified Rankin Scale (mRS) was used to evaluate functional outcomes during postoperative follow-up. Digital subtraction angiography (DSA) follow-up was performed at least 3 months after procedure, and the occlusion degree of the aneurysm was assessed with the O'Kelly-Marotta (OKM) grading system.Results:A total of 52 patients (71 aneurysms) were included and 54 TFDs were successfully implanted. Forty-one patients (78.8%) were treated with TFD alone, while 11 (21.2%) were treated with TFD combined with coil embolization. One patient experienced in-stent thrombosis during the procedure, and the symptoms disappeared after medical treatment. Postoperative hemorrhage and ischemic complications occurred in each 2 cases, respectively. No patient died during the follow-up period. DSA follow-up was performed on a total of 45 aneurysms in 34 patients. The followed-up time was 8.3±3.1 months (range, 3-15 months), including 2 OKM grade A (4.4%), 11 grade B (24.4%), 1 grade C (2.2%), and 31 grade D (68.9%). At the last follow-up, 51 patients had good outcomes (mRS score 0-2), and 1 patient had poor outcome (mRS score 4).Conclusion:TFD for UIAs has a high complete occlusion rate and a low complication rate.

Objective:To design a modified S1PR3 specific agonist, GPS-725.017, and investigate its protective effect on acute lung injury by promoting macrophage clearance of bacteria.Methods:A short peptide derived from the intracellular region of S1PR3 receptor was named GPS725.017, which was modified with norleucine (Nle) and myristicacid (myr) at its N terminus. Mice were divided into the sham operation group, solvent group and GPS-725.017 treatment group. The acute lung injury model was induced by endotracheal injection of E. coli (5×10 6 CFU), and the experimental group was treated with GPS-725.017 (10 mg/kg). The 48-h survival rate of mice was recorded. After 5 h of modeling, the bacterial load and inflammatory cytokines in peripheral blood and lung were detected, and Vps34 protein content in alveolar macrophages was determined by Western blot. After 12-h of modeling, lung tissues were collected for H&E staining and pathological scores. Results:Compared with the solvent group, the survival rate of mice in the GPS-725.017 treatment group was significantly improved ( P<0.01), the bacterial CFU in blood and alveolar lavage fluid was significantly lower than that in the solvent group ( P<0.001), and the levels of TNF-α and IL-1β in blood and alveolar lavage fluid were significantly lower than those in the solvent group ( P<0.001). Western blot showed that the expression level of Vps34 protein in alveolar macrophages was significantly higher than that in the solvent group ( P<0.01). Histopathology result showed that the pathological damage of lung in the treatment group was significantly less than that in the solvent group ( P<0.001). Conclusions:The modified synthetic S1PR3 specific agonist GPS-725.017 could specifically activate the S1PR3 receptor on the membrane of alveolar macrophages and up-regulate the expression level of intracellular Vps34 protein, which can promote the removal of bacteria in alveolar macrophages, significantly reduce the degree of lung injury and improve the survival rate in ALI mice.

Objective:To explore the predictive values of tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) in donor sera and lavage fluid on delayed graft function (DGF) in donation after circulatory death (DCD) kidney transplant recipients.Methods:A total of 33 eligible kidney donors and 33 corresponding recipients were recruited. Preoperative serum and renal perfusion fluid samples of donors were collected to determine the levels of TIMP-2 and IGFBP7. Patients were grouped according to whether DGF occurred after kidney transplantation and measured indicators analyzed. Independent sample t test was utilized for comparing the groups with normal distribution measurement data. And χ2 test was employed for comparing the groups with normal distribution counting data and Mann-Whitney test for comparing the groups with non-normal distribution measurement data. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used for evaluating the diagnostic efficacy of indicators. Results:In donor-DGF group, lavage fluid TIMP-2, product of lavage fluid TIMP-2 and IGFBP7 (TIMP-2×IGFBP7), serum IGFBP7 and product of serum TIMP-2 and IGFBP7 (TIMP-2×IGFBP7) were higher than those in donor-non-DGF group ( P<0.05). The AUC of TIMP-2, TIMP-2×IGFBP7, serum IGFBP7 and serum TIMP-2×IGFBP7 in the diagnosis of DGF were 0.753 (95%CI 0.546~0.959), 0.747 (95%CI 0.510~0.984), 0.824 (95%CI 0.615~1.000) and 0.852 (95%CI 0.660~1.000) respectively. Conclusions:Donor serum IGFBP7, donor serum TIMP-2×IGFBP7, lavage fluid TIMP-2 and lavage fluid TIMP-2×IGFBP7 may be used for predicting the occurrence of early DGF after kidney transplantation. Among them, serum TIMP-2×IGFBP7 has the highest diagnostic efficiency and may be an excellent predictor of DGF occurrence.

Objective: To investigate the effects and underlying mechanisms of aspirin on endoplasmic reticulum stress in podocytes induced by hyperlipemia. Methods: Cultured podocytes were divided into four groups: control group, aspirin (100 μg/ml) group, oxidized low density lipoprotein (ox-LDL, 100 μg/ml) group, aspirin+ox-LDL group. The expression of protein kinase R-1ike endoplasmic reticulum kinase (PERK), eukaryotic translation initiation factor 2α (eIF2α), activating transcription factor-4 (ATF4) and CAAT/enhancer binding protein homologous protein (CHOP) at 6 h, 12 h, 24 h, 48 h were evaluated by real-time PCR. The related proteins of p-PERK and p-eIF2α at 24 h and ATF4 at 12 h were evaluated by Western blotting, respectively. Results: The expressions of PERK, eIF2α peaked at 24 h, while ATF4 and CHOP peaked at 12 h in ox-LDL group and aspirin+ox-LDL group. Compared with control group, the expressions of PERK, eIF2α, ATF4 and CHOP were significantly higher in ox-LDL group at each times (all P<0.05). Compared with ox-LDL group, the expressions of the above indicators were significantly lower in aspirin+ox-LDL group at each times (all P<0.05). At 24 h, compared with control group, the expressions of p-PERK and p-eIF2α were significantly higher in ox-LDL group (both P<0.05). Compared with ox-LDL group, the expressions of p-PERK and p-eIF2α were significantly lower in aspirin+ox-LDL group (both P<0.05). At 12 h, the expression of ATF4 protein in each group was similar to that of mRNA. There were no significant difference in the expressions of all indicators between aspirin group and control group. Conclusions Hyperlipidemia may cause endoplasmic reticulum stress in podocytes by inducing phosphorylation of PERK and eIF2α, activating ATF4 transcription and inducing high expression of CHOP. Aspirin may partially block the PERK pathway, which may have protective effects for podocytes.

Objective To evaluate the value of kidney-sparing surgery in the treatment of upper urinary tract urothelial tumors by retrospectively analyzing and comparing the clinical data of elderly patients with upper urinary tract urothelial tumors between patients undergoing kidney-sparing surgery and nephroureterectomy in our hospital during the same period.Methods Thirty elderly patients with upper urinary tract urothelial tumors were treated with kidney-sparing surgery(ureteroscopy,segmental ureteral resection)and followed up from April 2004 to July 2017.One hundred and fortynine patients who underwent nephroureterectomy during the same period were selected as the control group.The survival rate and local recurrence rate were compared between the two groups.Results In the kidney-sparing group,23 cases were pathologically diagnosed as tumors,3 cases as inflammatory polyps and 4 cases without pathological findings.There were no statistically significant differences between kidney-sparing surgery and nephroureterectomy in bladder recurrence[4 cases(13.3％)vs.24 cases(16.1％),x2 =0.011,P =0.915],pelvic orthotopic recurrence [3 cases (10.0％) vs.6 cases (4.0％),x2 =0.825,P=0.364],cancer-specific death rate[2 cases(6.7％)vs.16 cases(10.7％),x2=0.118,P=0.731]and overall survival rate[4 cases(13.3％)vs.22 cases(14.8％),x2 =0.410,P =0.550].There were no significant differences between kidney-sparing surgery versus nephroureterectomy among postoperative 1-year,5-year and 10-year in the overall survival rates (100.0 ％vs.95.1％、85.9 ％ vs.84.1％、80.5 ％ vs.60.8 ％,P =0.156),tumor-specific survival rates (100.0 ％ vs.95.1％,85.7 ％ vs.87.6 ％,85.7 ％ vs.76.8 ％,P =0.380) and progression-free survival rates(100.0％vs.100.0％,90.9％vs.96.0％,90.9％ vs.79.7％,P =0.680).Conclusions Elderly patients have poor physical conditions and poor tolerance to radical surgery with a significant damage on postoperative renal function.Kidney-sparing surgery(ureteroscopy,segmental ureteral resection) as the treatment of upper urinary tract tumors can minimize the risk of surgery and optimize the quality of life.The individual assessment based on individual conditions,postoperative complications,and the recovery of renal function should be conducted and the operation with the greatest benefit should be adopted.

Sensory processing is strongly modulated by different brain and behavioral states, and this is based on the top-down modulation. In the olfactory system, local neural circuits in the olfactory bulb (OB) are innervated by centrifugal afferents in order to regulate the processing of olfactory information in the OB under different behavioral states. The purpose of the present study was to explore the organization of neural networks in olfactory-related cortices and modulatory nuclei that give rise to direct and indirect innervations to the glomerular layer (GL) of the OB at the whole-brain scale. Injection of different recombinant attenuated neurotropic viruses into the GL showed that it received direct inputs from each layer in the OB, centrifugal inputs from the ipsilateralanterior olfactory nucleus (AON), anterior piriform cortex (Pir), and horizontal limb of diagonal band of Broca (HDB), and various indirect inputs from bilateral cortical neurons in the AON, Pir, amygdala, entorhinal cortex, hippocampus, HDB, dorsal raphe, median raphe and locus coeruleus. These results provide a circuitry basis that will help further understand the mechanism by which olfactory information-processing in the OB is regulated.

Objective To investigate the effect of curcumin on autophagy and inflammatory response in mice subject to renal ischemia reperfusion.Method Forty male C57BL/6 mice were randomly divided into four groups (n =10 each):sham-operated (SO) group (Abdominal incision was made to expose the kidneys,bilateral renal pedicle dissociated and the abdomen sewed),ischemia reperfusion (IR) group,curcumin (CM) group (given CM 10 mg/kg) and 3-methyladenine (3-MA) group (given 3-MA 15 mg/kg).Six and 24 h after reperfusion,renal function was tested by determining the serum creatinine (Scr) and blood urea nitrogen (BUN) levels,and the morphological changes in the kidney tissue were observed.The expression of LC3,Beclin 1,Rab7 and LAMP2 in kidney tissue was detected by fluorescence quantitative RT-PCR and Western blotting.Fluorescence quantitative reverse transcription PCR and enzyme-linked immunosorbent assay were used to examine the expression of IL-6,IL-10,IL-17 and TNF-α in kidney tissue and serum.Result As compared with IR group and 3-MA group,the Scr and BUN levels in the CM group were significantly decreased (P＜0.01),and the renal morphological changes were improved significantly (P＜0.01).The mRNA and protein expression of LC3,Beclin 1,Rab7 and LAMP2 was significantly increased in kidney tissue,and the expression of IL-6,IL-17 and TNF-α was reduced,while IL-10 was increased (P＜ 0.01) in the CM group as compared with IR group and 3-MA group.Conclusion Curcumin possesses a protective effect against renal ischemia reperfusion injury in mice,which is probably mediated by promoting autophagy and subsequently inhibiting inflammatory response.