Objective:To investigate the efficacy and complications of ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus in children.Methods:This study was a retrospective analysis. A total of 120 children with hydrocephalus admitted to Xi'an Children's Hospital from January 2021 to March 2024 were selected. Among them, 49 children who underwent VPS treatment were included in the VPS group, and 71 children who underwent ETV treatment were included in the ETV group. Perioperative indicators, complication rates, postoperative recovery outcomes, levels of neurological injury markers, and developmental status at 6 months postoperatively were compared between the two groups. Measurement data with normal distribution were expressed as Mean ± SD, and intergroup comparisons was performed by independent samples t-test; counting data were expressed as case (%), and intergroup comparisons were performed by χ2 test. Results:The operation time [(83.26±10.67) min], time to first flatus [(2.58±0.44) days], and total complication rate [24.49% (12/49)] in the VPS group were all higher than those in the ETV group [(74.68±8.64) min, (2.21±0.42) days, and 9.86% (7/71)], while the one-time success rate [81.63% (40/49)] was lower than that in the ETV group [95.77% (68/71)]. The differences between the groups were statistically significant ( t=4.85, P<0.001; t=4.65, P<0.001; χ2=4.66, P=0.031; χ2=4.97, P=0.026, respectively). On postoperative day 3, the Glasgow Coma Scale score in the VPS group [(12.46±0.72) points] was lower than that in the ETV group [(12.89±0.67) points], and on postoperative day 7, the National Institutes of Health Stroke Scale score in the VPS group [(8.96±1.09) points] was higher than that in the ETV group [(8.54±1.02) points], with statistically significant differences ( t=3.35, P=0.001; t=2.16, P=0.033, respectively). On postoperative day 3, the levels of central nervous system-specific protein [(12.57±2.51) mg/L], high mobility group box 1 protein [(28.83±3.77) μg/L], and neuron-specific enolase [(21.47±2.56) μg/L] in the VPS group were all higher than those in the ETV group [(10.54±2.11) mg/L, (25.63±3.26) μg/L, (19.27±2.31) μg/L], and the differences were statistically significant ( t=5.04, P<0.001; t=4.96, P<0.001; t=4.91, P<0.001, respectively). At 6 months postoperatively, the developmental quotient score in the VPS group [(84.15±3.14) points] was lower than that in the ETV group [(86.51±3.27) points], and the difference was statistically significant ( t=3.93, P<0.001). Conclusion:Both VPS and ETV can be used for the treatment of hydrocephalus in children. However, ETV has a higher one-time success rate, better perioperative indicators, fewer complications, and superior postoperative neurological recovery compared to VPS.

Objective:To investigate the efficacy and complications of ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus in children.Methods:This study was a retrospective analysis. A total of 120 children with hydrocephalus admitted to Xi'an Children's Hospital from January 2021 to March 2024 were selected. Among them, 49 children who underwent VPS treatment were included in the VPS group, and 71 children who underwent ETV treatment were included in the ETV group. Perioperative indicators, complication rates, postoperative recovery outcomes, levels of neurological injury markers, and developmental status at 6 months postoperatively were compared between the two groups. Measurement data with normal distribution were expressed as Mean ± SD, and intergroup comparisons was performed by independent samples t-test; counting data were expressed as case (%), and intergroup comparisons were performed by χ2 test. Results:The operation time [(83.26±10.67) min], time to first flatus [(2.58±0.44) days], and total complication rate [24.49% (12/49)] in the VPS group were all higher than those in the ETV group [(74.68±8.64) min, (2.21±0.42) days, and 9.86% (7/71)], while the one-time success rate [81.63% (40/49)] was lower than that in the ETV group [95.77% (68/71)]. The differences between the groups were statistically significant ( t=4.85, P<0.001; t=4.65, P<0.001; χ2=4.66, P=0.031; χ2=4.97, P=0.026, respectively). On postoperative day 3, the Glasgow Coma Scale score in the VPS group [(12.46±0.72) points] was lower than that in the ETV group [(12.89±0.67) points], and on postoperative day 7, the National Institutes of Health Stroke Scale score in the VPS group [(8.96±1.09) points] was higher than that in the ETV group [(8.54±1.02) points], with statistically significant differences ( t=3.35, P=0.001; t=2.16, P=0.033, respectively). On postoperative day 3, the levels of central nervous system-specific protein [(12.57±2.51) mg/L], high mobility group box 1 protein [(28.83±3.77) μg/L], and neuron-specific enolase [(21.47±2.56) μg/L] in the VPS group were all higher than those in the ETV group [(10.54±2.11) mg/L, (25.63±3.26) μg/L, (19.27±2.31) μg/L], and the differences were statistically significant ( t=5.04, P<0.001; t=4.96, P<0.001; t=4.91, P<0.001, respectively). At 6 months postoperatively, the developmental quotient score in the VPS group [(84.15±3.14) points] was lower than that in the ETV group [(86.51±3.27) points], and the difference was statistically significant ( t=3.93, P<0.001). Conclusion:Both VPS and ETV can be used for the treatment of hydrocephalus in children. However, ETV has a higher one-time success rate, better perioperative indicators, fewer complications, and superior postoperative neurological recovery compared to VPS.

Objective:To discuss the association between occupational acid fog exposure and accelerated biological aging of the workers,and to clarify its related risk factors.Methods:A total of 341 male workers exposed to occupational acid fog and 201 male workers without occupational exposure were selected as the study subjects,and they were divided into exposure group and control group,respectively.The general informations of the subjects in two groups were collected through questionnaires and physical examinations.The levels of red blood cell count(RBC),platelet count(PLT),albumin(ALB),urea(Urea),creatinine(CR),triglycerides(TG),total cholesterol(TC),glycated hemoglobin(HBA1c),and high-sensitivity C-reactive protein(Hs-CRP)in serum of the subjects in two groups were detected.The Klemera-Doubal method(KDM)was used to construct the composite aging measure,KDM-biological age(BA)(KDM-BA).The model parameters were trained using samples from the 2009 China Health and Nutrition Survey(CHNS)Database to calculate the BA acceleration of the subjects in two groups;stratified analysis based on the population characteristics was conducted to analyze the BA of the subjects in two groups with different population characteristics;generalized linear model was used to analyze the factors influencing BA acceleration due to acid fog exposure.Results:The model parameters were trained using samples from the 2009 CHNS Database,including 8 133 cases aged 20-79 years,of which 3 788 were male.The levels of Urea,CR,HBA1c,ALB,and TC,as well as systolic blood pressure(SBP),total working years,sleep duration,and body mass index(BMI)of the subjects between two groups had significant differences(P<0.05).Compared with control group,the BA acceleration of the subjects in exposure group was significantly increased(P<0.05).In entire population and exposure group,the BA acceleration in the smokers was significantly higher than that in the non-smokers(P<0.05).In entire population,control group,and exposure group,the BA accelerations of the subjects in different BMI groups were significantly decreased with the increase of BMI(P<0.05).Compared with control group,the BA acceleration of the subjects in exposure group was significantly increased(P<0.05),including those under 40 years old,with total working years of 4-7 years,Han nationality,unmarried,smokers,and sleep duration 6-7 h,and with overweight.Acid fog exposure,smoking,and BMI were associated with the BA acceleration(β=0.72,95%CI:0.24-1.21;β=0.59,95%CI:0.11-1.06;β=-0.29,95%CI:-0.35—-0.22).Conclusion:Occupational acid fog exposure may accelerate the biological aging in the workers,and acid fog is a risk factor to accelerate the biological aging of the body.

Objective To discuss the effect of PI3K-AKT signaling pathway regulated by microRNA-155(miRNA-155)targeted protein tyrosine phosphatase non-receptor type 21(PTPN21)on the proliferation,migration and invasion of hepatocellular carcinoma(HCC)cells.Methods Lentivirus transfection was used to silence the expression of miRNA-155 in human Huh7 HCC cells,and real-time fluorescent quantitative polymerase chain reaction(RT-qPCR)was used to detect the silencing effect of miR-155.After obtaining stable cell lines,the cell lines were randomly divided into Blank group(normal Huh7 cells),shNC group(Huh7 cells+empty miR-155 vector),sh-miR-155(Huh7 cells+miR-155 silencing),sh-miR-155+Recilisib group(Huh7 cells+miR-155 silencing+PI3K-AKT agonist),shNC+Recilisib group(Huh7 cells+empty miR-155 vector+PI3K-AKT agonist).Dual luciferase assay was used to determine whether PTPN21 was the downstream of miR-155.The cell proliferation ability of cells in each group was detected by MTT assay.The apoptosis level of each group was tested by flow cytometry.The invasion and migration ability of cells was assessed by Transwell assay.Western blot analysis was used to observe the differences in protein expression of PTPN21,PI3K,P-PI3K,AKT,P-AKT,and apoptosis-related proteins including BAX,BCL-2 and caspase-3 in all groups.Results The expression level of miR-155 in sh-miR-155 group was lower than that in Blank group and shNC group(P＜0.000 1),and the difference in miR-155 expression level between Blank group and shNC group was not statistically significant(P＞0.05).MTT results showed that A values of Huh7 cells at 2,3,4 and 5 day in sh-miR-155 group were lower than those in Blank group and shNC group(P＜0.000 1),while these differences between Blank group and shNC group were not statistically significant(P＞0.05).In sh-miR-155 group the A values at 2,3,4 and 5 day were lower than those in sh-miR-155+Recilisib group and shNC+Recilisib group(P=0.0052 and P＜0.0001,respectively),while the A values at 2,3,4 and 5 day in sh-miR-155+Recilisib were lower than those in shNC+Recilisib group(P＜0.000 1).There was no significant differences in cell migration and number of invasion cells between the Blank group and shNC group(P＞0.05).After activation of PI3K-AKT signaling pathway,the migration and invasion capacity of HCC cells in the shNC+Recilisib group were significantly enhanced when compared with the Blank group(P＜0.000 1).In contrast,the number of migrated and invaded Huh7 cells after miR-155 silencing was significantly lower than that in the Blank group and shNC group(P＜0.000 1)and this phenomenon became reversed by PI3K agonist.Compared with the sh-miR-155 group,in the sh-miR-155+Recilisib group the migration and invasion ability of HCC cells was enhanced(P=0.000 2).Lentiviral transfection of Huh7 human HCC cells to silence miR-155 and downregulate miR-155 inhibiting PTPN21 regulation of the PI3K-AKT signaling pathway,thus inhibiting the invasion,migration and proliferation ability of HCC cells and promoting the apoptosis of HCC cells.Conclusion miR-155 inhibits the migration,invasion and proliferation of HCC cells through targeting PTPN21 regulation of PI3K-AKT signaling pathway.The miR-155 may be a potential therapeutic target for HCC in the future.(J Intervent Radiol,2024,32:44-51)

Objective:To investigate the efficacy and safety of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis.Methods:A retrospective analysis was carried out on 46 patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis who received endovascular treatment at the Strategic Support Force Medical Center from January 2015 to August 2022. Twenty-seven patients underwent balloon angioplasty alone and 19 patients underwent acute stent implantation. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of the responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality of the two groups were evaluated.Results:The proportion of effective recanalization of the offending vessels (mTICI≥2b) in the acute stenting group was slightly higher than that in the balloon angioplasty group (16/19 vs. 81.5%), but the difference was not statistically significant ( P>0.05). Besides, there was no significant difference in the median of mRS between the acute stenting group [3.0(0, 4.0)] and the balloon angioplasty group [4.0(1.0, 5.0)] 90 days after operation ( P>0.05). In terms of safety, the incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups ( P>0.05). Conclusions:The effect of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis is not inferior to that of balloon angioplasty, and it does not increase the risk of intracranial bleeding complications.

Dysregulated Epiregulin(EREG)can activate epidermal growth factor receptor(EGFR)and promote tumor progression in head and neck squamous cell carcinoma(HNSCC).However,the mechanisms underlying EREG dysregulation remain largely unknown.Here,we showed that dysregulated EREG was highly associated with enhanced PDL1 in HNSCC tissues.Treatment of HNSCC cells with EREG resulted in upregulated PDL1 via the c-myc pathway.Of note,we found that N-glycosylation of EREG was essential for its stability,membrane location,biological function,and upregulation of its downstream target PDL1 in HNSCC.EREG was glycosylated at N47 via STT3B glycosyltransferases,whereas mutations at N47 site abrogated N-glycosylation and destabilized EREG.Consistently,knockdown of STT3B suppressed glycosylated EREG and inhibited PDL1 in HNSCC cells.Moreover,treatment of HNSCC cells with NGI-1,an inhibitor of STT3B,blocked STT3B-mediated glycosylation of EREG,leading to its degradation and suppression of PDL1.Finally,combination of NGI-1 treatment with anti-PDLl therapy synergistically enhanced the efficacy of immunotherapy of HNSCC in vivo.Taken together,STT3B-mediated N-glycosylation is essential for stabilization of EREG,which mediates PDL1 upregulation and immune evasion in HNSCC.

Dysregulated Epiregulin(EREG)can activate epidermal growth factor receptor(EGFR)and promote tumor progression in head and neck squamous cell carcinoma(HNSCC).However,the mechanisms underlying EREG dysregulation remain largely unknown.Here,we showed that dysregulated EREG was highly associated with enhanced PDL1 in HNSCC tissues.Treatment of HNSCC cells with EREG resulted in upregulated PDL1 via the c-myc pathway.Of note,we found that N-glycosylation of EREG was essential for its stability,membrane location,biological function,and upregulation of its downstream target PDL1 in HNSCC.EREG was glycosylated at N47 via STT3B glycosyltransferases,whereas mutations at N47 site abrogated N-glycosylation and destabilized EREG.Consistently,knockdown of STT3B suppressed glycosylated EREG and inhibited PDL1 in HNSCC cells.Moreover,treatment of HNSCC cells with NGI-1,an inhibitor of STT3B,blocked STT3B-mediated glycosylation of EREG,leading to its degradation and suppression of PDL1.Finally,combination of NGI-1 treatment with anti-PDLl therapy synergistically enhanced the efficacy of immunotherapy of HNSCC in vivo.Taken together,STT3B-mediated N-glycosylation is essential for stabilization of EREG,which mediates PDL1 upregulation and immune evasion in HNSCC.

Objective:To evaluate the impact of the Japanese encephalitis vaccine included in an expanded immunization program on the reported incidence rate of Japanese encephalitis in Gansu province.Methods:Information on the reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was collected through the National Population Health Science Data Center and the China Disease Prevention and Control Information System. In addition, the trend of Japanese encephalitis reported incidence rate in Gansu province before and after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program was analyzed using an interrupted time-series design.Results:The annual reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was 0.448/per 100 000. However, after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program in Gansu province in 2008, the amount of change in the level of Japanese encephalitis reported incidence rate was -2.223/per 100 000 ( t=-2.90, P=0.007), the amount of change in the slope of Japanese encephalitis reported incidence rate was 0.082 ( t=2.87, P=0.008) with the slope of Japanese encephalitis reported incidence rate as 0.071 ( β1+ β3=0.071). Conclusions:The Japanese encephalitis vaccine has achieved good prevention and control effects in Gansu province in the short term after its inclusion in the expanded immunization program, but outbreaks of Japanese encephalitis have still occurred. Therefore, in the future, Gansu province should promptly adjust the immunization strategy of the Japanese encephalitis vaccine, and strengthen the vaccination of the adult population, especially the rural adult population in the southeastern region of Gansu province, based on the continued focus on the works on Japanese encephalitis vaccination for children and adolescents.

OBJECTIVETo investigate the causes and strategy of difficult intraarterial mechanical thrombectomy (≥3 times) in patients with acute ischemic stroke (AIS).

METHODSThe clinical data of 8 cases of AIS with thrombectomy ≥3 times admitted in Department of Neurology, the 306(th) Hospital of People's Liberation Army from June to October in 2015 was analyzed retrospectively. There were 7 male and 1 female patients, aged from 38 to 86 years with an average age of (70±15) years, in which 5 cases were cardiogenic cerebral embolism and 3 cases were large artery atherosclerotic infarction. The National Institute of Health stroke scale (NIHSS) score (M (QR)) was 16 (12) before procedure and modified thrombolysis in cerebral infarction (mTICI)score were 0 in all the patients. Solitaire AB was used in thrombectomy in the occlusion of the arteries.

RESULTSThe causes of difficult intraarterial thrombectomy included multiple thrombus, tortuosity in vascular paths, guiding catheter being placed below the internal carotid artery siphon leading to weak strength of suction and support of stent, embolus dropping in the thrombectomy and inadequate anesthesia. After successful thrombectomy 3 cases had mTICI score of 2a, 4 cases of 2b, 1 case of 3. The NIHSS score was 5 (24) at 7(th) day after treatment. At the 90-day follow-up 5 patients had good prognosis (modified Rankin score 0 to 2) and 3 had disability (modified Rankin score 3 to 4).

CONCLUSIONCases of AIS with difficult intraarterial thrombectomy can be treated by improving thrombectomy materials and technique, reasonable anesthesia and perioperative medication in decision-making strategy.

Adult ; Aged ; Aged, 80 and over ; Carotid Artery, Internal ; pathology ; Female ; Humans ; Intracranial Embolism ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Stroke ; surgery ; Thrombectomy ; Treatment Outcome