Objective To investigate the expression levels of serum miR-186-5p and miR-942-5p in patients with glioma and their clinical significance.Methods A total of 98 patients with glioma who were treated in this hospital from October 2019 to December 2021 were selected as the monitored group,and 101 healthy indi-viduals who underwent physical examinations a the same time were selected as the control group.Quantitative fluorescent PCR(qPCR)method was applied to detect the expression levels of miR-186-5p and miR-942-5p in serum,and multivariate COX regression was applied to analyze the prognostic factors of glioma patients.Re-ceiver operating characteristic(ROC)curve and area under curve(AUC)were used to analyze the diagnostic value of serum miR-186-5p and miR-942-5p in glioma.Kaplan-Meier survival curve was used to analyze the re-lationship between serum miR-186-5p and miR-942-5p expression and prognosis of patients.Results The ex-pression level of serum miR-186-5p in monitored group was lower than that in the control group(P＜0.05),and the expression level of miR-942-5p was higher than that in the control group(P＜0.05).The AUC of ser-um miR-186-5p and miR-942-5p in the diagnosis of glioma alone and in combination were 0.735,0.809 and 0.895,respectively.There were significant differences in the proportion of low miR-186-5p expression and high miR-942-5p expression in serum of patients with different preoperative Karnofsky performance status(KPS)scores,World Health Organization(WHO)grades and local infiltration(P＜0.05).The 2-year surviv-al rate of patients with high expression of miR-186-5p was higher than that of patients with low expression of miR-186-5p(x2=6.455,P=0.011).The 2-year survival rate of patients with high miR-942-5p expression was lower than that of patients with low miR-942-5p expression(x2=9.858,P=0.002).miR-186-5p was a protective factor for mortality in glioma patients(P＜0.05),while miR-942-5p was a risk factor(P＜0.05).Conclusion Serum miR-186-5p expression level decreases and miR-942-5p expression level increases in glioma patients,both of which have certain diagnostic value for the occurrence of glioma.

Objective To analyze the vascular architecture characteristics of the complex direct cavernous arteriovenous fistula (cd-CAVF) and to discuss its treatment and the curative effect of interventional embolization. Methods The hospitalization records, imaging features and operation records of 12 patients with cd-CAVF were retrospectively analyzed. Results In the 12 patients with cd-CAVF, the lesion’s blood supply arteries included internal carotid artery (ICA,n=8), primary trigeminal artery (PTA,n=1), middle cerebral artery (MMA,n=2) and basilar artery (BA,n=1). Different degrees of “arterial steal” phenomenon could be observed in all patients. The drainage routes included the superior ophthalmic vein and the inferior petrosal sinus (n=10), and cortical vein (n=2). Interventional embolization was carried out via ICA (n=4), through both ICA and BA (n=5), through MMA (n=2), or through BA (n=1). For the embolization of the lesion the balloons were used in 8 patients, steel coils were adopted in 2 patients, and balloons together with coils were employed in 2 patients. All the patients were followed up for 3-6 months. After the treatment the clinical symptoms and signs disappeared, and the lesions were completely cured in all patients with no complications. During the follow-up period of (60.2 ±26.8) months no recurrence of CAVF was observed. Conclusion The blood supply of cd-CAVF comes directly from the rupture of the blood vessels surrounding the cavernous sinus wall, the “arterial steal” phenomenon is prone to occur, and the drainage via the superior ophthalmic vein and the inferior petrosal sinus is more often seen. Transarterial balloon embolization is very effective for the treatment of cd-CAVF, and the use of coils together with multi-artery approaches is an effective supplementary method.

Objective To study the ways,mechanism,indication,curative effect of " Basket" skill applied in the interventional therapy for intracranial aneurysm. Methods Intracranial aneurysm with 1 : 1 ≥ neck/body ≥ 1 : 2 ," 3 D coil" was used to form a basket in it;in that with 1:2 > neck/body,common "2D coil" was applied. And the following coils were applied with hydrocoil or fibered coil combined with common platinum coil to increase the embol-ism density. Results In 156 cases with 158 aneurysms,143 aneurysms were 100% embolized (90. 5% ) ;131 ca-ses discharged with GOS 5 score(84.0% ),and 2 cases died ( 1.3% ). Conclusion " Basket" skill can increase the embolization density in aneurysm,reducing the residual of the neck,getting embolizated fully and improving the prognosis.