The Indonesian Throughflow(ITF), which connects the tropical Pacific and Indian oceans, plays important roles in the inter-ocean water exchange and regional or even global climate variability. The Makassar Strait is t...The Indonesian Throughflow(ITF), which connects the tropical Pacific and Indian oceans, plays important roles in the inter-ocean water exchange and regional or even global climate variability. The Makassar Strait is the main inflow passage of the ITF, carrying about 77% of the total ITF volume transport. In this study, we analyze the simulated ITF in the Makassar Strait in the Simple Ocean Data Assimilation version 3(SODA3) datasets. A total of nine ensemble members of the SODA3 datasets, of which are driven by different surface forcings and bulk formulas, and with or without data assimilation, are used in this study. The annual mean water transports(i.e.,volume, heat and freshwater) are related to the combination of surface forcing and bulk formula, as well as whether data assimilation is employed. The phases of the seasonal and interannual variability in water transports cross the Makassar Strait, are basically consistent with each other among the SODA3 ensemble members. The interannual variability in Makassar Strait volume and heat transports are significantly correlated with El Ni?oSouthern Oscillation(ENSO) at time lags of-6 to 7 months. There is no statistically significant correlation between the freshwater transport and the ENSO. The Makassar Strait water transports are not significantly correlated with the Indian Ocean Dipole(IOD), which may attribute to model deficiency in simulating the propagation of semiannual Kelvin waves from the Indian Ocean to the Makassar Strait.展开更多
AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfu...AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfusion. The changes induced by diethylnitrosamine (DEN) developed into liver nodular lesions due to hepatic cirrhosis during the progression of carcinogenesis. The MR perfusion data [positive enhancement integral (PEI)] were compared between the nodular lesions corresponding well with MR images and pathology and their surrounding hepatic parenchyma. RESULTS: A total of 46 nodules were located by MR imaging and autopsy, including 22 dysplastic nodules (DN), 9 regenerative nodules (RN), 10 early HCCs and 5 overt HCCs. Among the 22 DNs, 6 were low-grade DN (lGDN) and 16 were high-grade DN (HGDN). The average PEI of RN, DN, early and overt HCC was 205.67 ± 31.17, 161.94 ± 20.74, 226.09 ± 34.83, 491.86 ± 44.61 respectively, and their liver parenchyma nearby was 204.84 ± 70.19. Comparison of the blood perfusion index between each RN and its surrounding hepatic parenchyma showed no statistically significant difference (P = 0.06). There were significant differences in DN (P = 0.02). During the late hepatic arterial phase, the perfusion curve in DN declined. DN had an iso-signal intensity at the early hepatic arterial phase and a low signal intensity at the portal venous phase. Of the 10early HCCs, 4 demonstrated less blood perfusion and 6 displayed minimally increased blood flow compared to the surrounding parenchyma. Five HCCs showed significantly increased blood supply compared to the surrounding parenchyma (P = 0.02). CONCLUSION: Non-invasive MR perfusion can detect changes in blood supply of precancerous lesions.展开更多
Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomati...Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.展开更多
Purpose: The endovascular treatment of intracranial aneurysms was proven safe and effective compared to the alternative method of surgical clipping, despite the high recurrence rate. Follow-up of embolized intracrania...Purpose: The endovascular treatment of intracranial aneurysms was proven safe and effective compared to the alternative method of surgical clipping, despite the high recurrence rate. Follow-up of embolized intracranial aneurysms is mandatory for the early detection of recurrence and improved outcomes. DSA is used as the reference standard for this assessment. To determine the effectiveness of MRA in follow-up evaluations of intracranial aneurysms after embolization by comparing DSA, CE-MRA, and TOF-MRA. Materials and Methods: Sixty-eight consecutive patients undergoing DSA, TOF-MRA, and CE-MRA during an interval of <1 week were enrolled in this 6-month study. Images were evaluated for occlusion status, patency of the parent vessels, and artifacts. The modified Raymond-Roy occlusion classification and Aneurysm Embolization Grades were used to assess the occlusion status and initial DSA images for detection of recurrence in two filtered study phases with optimized selection criteria. Seventeen observers(phase I: 9, phase II: 8) independently interpreted the double-blinded images. Agreement was expressed with a Fleiss kappa value; p < 0.05 was considered significant. Results: This study included 68 patients with 77 aneurysms; 38(49.35%) were treated with coil alone and 39(50.65%) with stent-assisted coiling. In both phases, DSA was superior to TOF-MRA and CE-MRA using MRRC(Phase I: k = 0.567, p ≤ 0.001; k = 0.287, p ≤ 0.001; k = 0.117, p ≤ 0.001, respectively; Phase II: k = 0.503, p ≤ 0.001; k = 0.303, p ≤ 0.001; k = 0.115, p = 0.038, respectively). TOF-MRA was as effective as DSA(TOF: k = 0.335, p ≤ 0.001; DSA: k = 0.323, p ≤ 0.001) for recurrence detection. Conclusion: We suggest TOF-MRA as a first-line follow-up tool to detect aneurysm recurrence, and DSA to quantify the filling space to make a definite decision on re-embolization.展开更多
Blood blister-like aneurysms(BBAs)are fragile and difficult to treat.However,the optimal treatment has yet to be determined.Pipeline embolization devices and Willis covered stent implementation are still controversial...Blood blister-like aneurysms(BBAs)are fragile and difficult to treat.However,the optimal treatment has yet to be determined.Pipeline embolization devices and Willis covered stent implementation are still controversial strategies for treating BBA.Herein,we report a case of recurrent BBA successfully treated with a Willis covered stent.A long-term follow-up angiography after the procedure indicated complete occlusion of the aneurysm.This case demonstrates the safety and efficacy of applying the Wills cover stent in the treatment of recurrent BBA after Pipeline implantation.展开更多
Background Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding,relieves symptoms and improve the quality of life for patients.This study aimed to assess the safety and e...Background Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding,relieves symptoms and improve the quality of life for patients.This study aimed to assess the safety and efficacy of Pipeline Embolization Device(PED,Covidien/Medtronic,Irvine,CA)treatment for intracranial aneurysms presenting with mass effect in real-world settings.Methods We selected patients from the PED in China Post-Market Multi-Center Registry Study with mass effect presentation.The study endpoints included postoperative mass effect deterioration and mass effect relief at follow-up(3–36 months).We conducted multivariate analysis to identify factors associated with mass effect relief.Subgroup analyses by aneurysm location,size and form were also performed.Results This study included 218 patients with a mean age of 54.3±11.8 years and a female predominance of 74.0%(162/218).The postoperative mass effect deterioration rate was 9.6%(21/218).During a median follow-up period of 8.4 months,the mass effect relief rate was 71.6%(156/218).Notably,immediate aneurysm occlusion following treatment was significantly associated with mass effect relief(OR 0.392,95%CI,0.170 to 0.907,p=0.029).Subgroup analysis demonstrated that adjunctive coiling contributed to mass effect relief in cavernous aneurysms,while dense embolism impeded symptom relief in aneurysms<10mm and saccular aneurysms.Conclusions Our data confirmed the efficacy of PED in relieving mass effect.The findings of this study provide support for endovascular treatment to alleviate mass effect in unruptured intracranial aneurysms.Trial registration number NCT03831672.展开更多
Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not b...Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not been investigated.Methods CVST patients,admitted to the First Affiliated Hospital of Zhengzhou University,were retrospectively identified from November 2010 to January 2017.Functional outcomes of patients were evaluated with the modified Rankin Scale(mRS).Patients were divided into good(mRS 0-2)and poor(mRS 3-6)outcomes groups.Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome.Results A total of 228 patients were included of which 41 had poor outcomes(18.0%).The duration of follow-up was 22 months(6-66 months).LMR(2.3±1.2 vs 3.2±1.8,p<0.01)was significantly lower in the poor outcome group.Multivariate Cox regression analysis showed that LMR(HR 0.726,95%CI 0.546 to 0.964,p=0.027)was a independent predictor of poor prognosis.Conclusions LMR may be a predictor of poor prognosis in CVST patients.展开更多
Objectives The aim of this study was to compare complications and outcomes between intracranial aneurysms treated with the Pipeline embolisation device(PED)alone or with PED combined with coiling for different-sized a...Objectives The aim of this study was to compare complications and outcomes between intracranial aneurysms treated with the Pipeline embolisation device(PED)alone or with PED combined with coiling for different-sized aneurysms.Method Patients with aneurysms treated by PED were collected from the PED in China postmarket multicentre registry study.We performed a propensity match analysis to compare the efficacy and safety between PED alone and PED combined with coiling treatment,and then aneurysms were organised into three groups based on their size:small(≤7 mm),medium(≤15 mm to>7 mm)and large/giant(>15 mm).Complications and aneurysm occlusion rates in the aneurysm size groups were compared between PED alone and PED combined with coiling patients.Result A total of 1171 patients with 1322 aneurysms were included.All patients received clinical follow-up,while angiographic follow-up was available in 967 aneurysms.For small aneurysms,there was no difference in the aneurysm occlusion rate between two groups(79.1%vs 88.4%,respectively),while there was a significant increase in the ischaemic complication rate(8.3%vs 19.3%,respectively,p=0.0001).For medium and large/giant saccular aneurysms,PED combined with coiling significantly improved the occlusion rate(medium aneurysms:74.7%vs 88.8%,respectively,p<0.0001;large/giant saccular aneurysms:72.9%vs 86.9%,respectively,p=0.018),while there were no differences in the total complication rate.For large/giant non-saccular aneurysms,two groups showed no differences.Conclusion Use of the PED with adjunctive coils can significantly improve the occlusion rate of medium aneurysms,without increasing the total complication rate.展开更多
基金The Fund of Laoshan Laboratory under contract No. LSKJ202202700the National Natural Science Foundation of China under contract Nos 42076023, 42076024 and 41876027the Global Change and Air-Sea Interaction Ⅱ Project under contract No.GASI-01-AIP-STwin。
文摘The Indonesian Throughflow(ITF), which connects the tropical Pacific and Indian oceans, plays important roles in the inter-ocean water exchange and regional or even global climate variability. The Makassar Strait is the main inflow passage of the ITF, carrying about 77% of the total ITF volume transport. In this study, we analyze the simulated ITF in the Makassar Strait in the Simple Ocean Data Assimilation version 3(SODA3) datasets. A total of nine ensemble members of the SODA3 datasets, of which are driven by different surface forcings and bulk formulas, and with or without data assimilation, are used in this study. The annual mean water transports(i.e.,volume, heat and freshwater) are related to the combination of surface forcing and bulk formula, as well as whether data assimilation is employed. The phases of the seasonal and interannual variability in water transports cross the Makassar Strait, are basically consistent with each other among the SODA3 ensemble members. The interannual variability in Makassar Strait volume and heat transports are significantly correlated with El Ni?oSouthern Oscillation(ENSO) at time lags of-6 to 7 months. There is no statistically significant correlation between the freshwater transport and the ENSO. The Makassar Strait water transports are not significantly correlated with the Indian Ocean Dipole(IOD), which may attribute to model deficiency in simulating the propagation of semiannual Kelvin waves from the Indian Ocean to the Makassar Strait.
基金the grants from Foundation of Ministry of Public Health of China, No. 20011420National Natural Science Foundation of China, No. 30470503
文摘AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfusion. The changes induced by diethylnitrosamine (DEN) developed into liver nodular lesions due to hepatic cirrhosis during the progression of carcinogenesis. The MR perfusion data [positive enhancement integral (PEI)] were compared between the nodular lesions corresponding well with MR images and pathology and their surrounding hepatic parenchyma. RESULTS: A total of 46 nodules were located by MR imaging and autopsy, including 22 dysplastic nodules (DN), 9 regenerative nodules (RN), 10 early HCCs and 5 overt HCCs. Among the 22 DNs, 6 were low-grade DN (lGDN) and 16 were high-grade DN (HGDN). The average PEI of RN, DN, early and overt HCC was 205.67 ± 31.17, 161.94 ± 20.74, 226.09 ± 34.83, 491.86 ± 44.61 respectively, and their liver parenchyma nearby was 204.84 ± 70.19. Comparison of the blood perfusion index between each RN and its surrounding hepatic parenchyma showed no statistically significant difference (P = 0.06). There were significant differences in DN (P = 0.02). During the late hepatic arterial phase, the perfusion curve in DN declined. DN had an iso-signal intensity at the early hepatic arterial phase and a low signal intensity at the portal venous phase. Of the 10early HCCs, 4 demonstrated less blood perfusion and 6 displayed minimally increased blood flow compared to the surrounding parenchyma. Five HCCs showed significantly increased blood supply compared to the surrounding parenchyma (P = 0.02). CONCLUSION: Non-invasive MR perfusion can detect changes in blood supply of precancerous lesions.
文摘Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.
文摘Purpose: The endovascular treatment of intracranial aneurysms was proven safe and effective compared to the alternative method of surgical clipping, despite the high recurrence rate. Follow-up of embolized intracranial aneurysms is mandatory for the early detection of recurrence and improved outcomes. DSA is used as the reference standard for this assessment. To determine the effectiveness of MRA in follow-up evaluations of intracranial aneurysms after embolization by comparing DSA, CE-MRA, and TOF-MRA. Materials and Methods: Sixty-eight consecutive patients undergoing DSA, TOF-MRA, and CE-MRA during an interval of <1 week were enrolled in this 6-month study. Images were evaluated for occlusion status, patency of the parent vessels, and artifacts. The modified Raymond-Roy occlusion classification and Aneurysm Embolization Grades were used to assess the occlusion status and initial DSA images for detection of recurrence in two filtered study phases with optimized selection criteria. Seventeen observers(phase I: 9, phase II: 8) independently interpreted the double-blinded images. Agreement was expressed with a Fleiss kappa value; p < 0.05 was considered significant. Results: This study included 68 patients with 77 aneurysms; 38(49.35%) were treated with coil alone and 39(50.65%) with stent-assisted coiling. In both phases, DSA was superior to TOF-MRA and CE-MRA using MRRC(Phase I: k = 0.567, p ≤ 0.001; k = 0.287, p ≤ 0.001; k = 0.117, p ≤ 0.001, respectively; Phase II: k = 0.503, p ≤ 0.001; k = 0.303, p ≤ 0.001; k = 0.115, p = 0.038, respectively). TOF-MRA was as effective as DSA(TOF: k = 0.335, p ≤ 0.001; DSA: k = 0.323, p ≤ 0.001) for recurrence detection. Conclusion: We suggest TOF-MRA as a first-line follow-up tool to detect aneurysm recurrence, and DSA to quantify the filling space to make a definite decision on re-embolization.
文摘Blood blister-like aneurysms(BBAs)are fragile and difficult to treat.However,the optimal treatment has yet to be determined.Pipeline embolization devices and Willis covered stent implementation are still controversial strategies for treating BBA.Herein,we report a case of recurrent BBA successfully treated with a Willis covered stent.A long-term follow-up angiography after the procedure indicated complete occlusion of the aneurysm.This case demonstrates the safety and efficacy of applying the Wills cover stent in the treatment of recurrent BBA after Pipeline implantation.
基金sponsored by the National Natural Science Foundation of China(82071302)Bai Qian Wan Talent Plan(2017A07)and Beijing Municipal Administration of Hospital Incubating Program(PX2016034).
文摘Background Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding,relieves symptoms and improve the quality of life for patients.This study aimed to assess the safety and efficacy of Pipeline Embolization Device(PED,Covidien/Medtronic,Irvine,CA)treatment for intracranial aneurysms presenting with mass effect in real-world settings.Methods We selected patients from the PED in China Post-Market Multi-Center Registry Study with mass effect presentation.The study endpoints included postoperative mass effect deterioration and mass effect relief at follow-up(3–36 months).We conducted multivariate analysis to identify factors associated with mass effect relief.Subgroup analyses by aneurysm location,size and form were also performed.Results This study included 218 patients with a mean age of 54.3±11.8 years and a female predominance of 74.0%(162/218).The postoperative mass effect deterioration rate was 9.6%(21/218).During a median follow-up period of 8.4 months,the mass effect relief rate was 71.6%(156/218).Notably,immediate aneurysm occlusion following treatment was significantly associated with mass effect relief(OR 0.392,95%CI,0.170 to 0.907,p=0.029).Subgroup analysis demonstrated that adjunctive coiling contributed to mass effect relief in cavernous aneurysms,while dense embolism impeded symptom relief in aneurysms<10mm and saccular aneurysms.Conclusions Our data confirmed the efficacy of PED in relieving mass effect.The findings of this study provide support for endovascular treatment to alleviate mass effect in unruptured intracranial aneurysms.Trial registration number NCT03831672.
基金This work was supported by the Science and Technology Department of the Henan Province grant number(No.152102310058)the National Natural Science Foundation of China grant number(No 81530037)the China Scholarship Council(to KL).
文摘Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not been investigated.Methods CVST patients,admitted to the First Affiliated Hospital of Zhengzhou University,were retrospectively identified from November 2010 to January 2017.Functional outcomes of patients were evaluated with the modified Rankin Scale(mRS).Patients were divided into good(mRS 0-2)and poor(mRS 3-6)outcomes groups.Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome.Results A total of 228 patients were included of which 41 had poor outcomes(18.0%).The duration of follow-up was 22 months(6-66 months).LMR(2.3±1.2 vs 3.2±1.8,p<0.01)was significantly lower in the poor outcome group.Multivariate Cox regression analysis showed that LMR(HR 0.726,95%CI 0.546 to 0.964,p=0.027)was a independent predictor of poor prognosis.Conclusions LMR may be a predictor of poor prognosis in CVST patients.
基金sponsored by National Natural Science Foundation of China(grant numbers:81220108007,81801156,81801158,81471167 and 81671139).
文摘Objectives The aim of this study was to compare complications and outcomes between intracranial aneurysms treated with the Pipeline embolisation device(PED)alone or with PED combined with coiling for different-sized aneurysms.Method Patients with aneurysms treated by PED were collected from the PED in China postmarket multicentre registry study.We performed a propensity match analysis to compare the efficacy and safety between PED alone and PED combined with coiling treatment,and then aneurysms were organised into three groups based on their size:small(≤7 mm),medium(≤15 mm to>7 mm)and large/giant(>15 mm).Complications and aneurysm occlusion rates in the aneurysm size groups were compared between PED alone and PED combined with coiling patients.Result A total of 1171 patients with 1322 aneurysms were included.All patients received clinical follow-up,while angiographic follow-up was available in 967 aneurysms.For small aneurysms,there was no difference in the aneurysm occlusion rate between two groups(79.1%vs 88.4%,respectively),while there was a significant increase in the ischaemic complication rate(8.3%vs 19.3%,respectively,p=0.0001).For medium and large/giant saccular aneurysms,PED combined with coiling significantly improved the occlusion rate(medium aneurysms:74.7%vs 88.8%,respectively,p<0.0001;large/giant saccular aneurysms:72.9%vs 86.9%,respectively,p=0.018),while there were no differences in the total complication rate.For large/giant non-saccular aneurysms,two groups showed no differences.Conclusion Use of the PED with adjunctive coils can significantly improve the occlusion rate of medium aneurysms,without increasing the total complication rate.
