Feasibility and Safety of Flow Diversion in the Treatment of Intracranial Aneurysms via Transradial Approach: A Single-Arm Meta-Analysis

BackgroundWhile studies have confirmed that flow diversion (FD) can treat intracranial aneurysms via transradial approach (TRA), it remains unclear whether their treatment ultimately impacts safety and feasibility. We aim to conduct a systematic review and meta-analysis assessing the safety and feasibility after FD treatment of intracranial aneurysms via TRA.MethodsPubMed, EMBASE, and Web of Science were systematically reviewed. The primary outcomes were the success rate and the access-related complications of deploying FD via TRA. Meta-analysis was performed using a random or fixed effect model based on heterogeneity. And the publication bias was evaluated using a funnel plot. This study was registered with PROSPERO, number CRD42021244448.ResultsData from 8 studies met inclusion criteria (250 non-duplicated patients). The success rate was 93% (95% confidence interval [CI] 0.86–0.98; I2 = 61.05%; p = 0.01). The access-related complications rate was 1% (95% CI 0–0.03; I2 = 0.00%; p < 0.01). The mainly access-related complications included radial artery spasm (85.7%) and radial artery occlusion (14.3%). The TRA convert to transfemoral approach (TFA) was 7% (95% CI 0.02–0.14; I2 = 61.05%; p = 0.01).ConclusionsAlthough TFA is still the main access for FD in the treatment of intracranial aneurysms, the TRA also has a higher success rate and lower access-related complications rate. With the improvement of future experience and equipment, the TRA may become the main access for FD which has more advantages. Future studies should design prospective, multicenter randomized controlled studies for long-term follow-up

Fabrication of Asymmetric Polysaccharide Composite Membranes as Guided Bone Regeneration Materials

Periodontal regeneration can be achieved by guided tissue and guided bone regeneration (GTR/GBR) membranes, which act as a physical barrier to exclude migration of connective and epithelium, favoring the repopulation of periodontal ligament cells. Asymmetric polysaccharide GBR membranes with two different surfaces were developed in this study. Positive chitosan (CS), negative hyluronaic acid (HA) and konjac glucomannan (KGM) were composited by electrostatic interaction, forming smooth and dense membranes as upper surface to inhibit the ingrowth of cells from gingiva. The lower porous and coarse surface was obtained by gel freeze-drying and mineralization to improve the regeneration of the bone tissue. The performance of the membranes was characterized by Infrared Radiation (IR), X-ray diffraction (XRD), scanning electron microscope (SEM), tensile strength and biological evaluation. It was found that the composite membranes with chitosan content of 56.7 wt%in the dry state possess the highest tensile strength, with elongation 10 times more higher than that of the pure CS ones. Additionaly, open pores with diameter of 10-100 µm and homogenouse distributed nano-hydroxyapatite (HAP) were investigated on the coarse part. Cell studies demonstrated that the porous surface promoted the growth of the preosteoblast. Overall, the composite membranes may be useful for regeneration of periodontal regeneration

The rational dose for MaXingShiGan decoction is crucial for its clinical effectiveness in treating bronchial pneumonia: three randomized, double-blind, dose-parallel controlled clinical studies

Objective: Evaluate the impact of adjusting the overall dose, Gypsum Fibrosum [Mineral; Gypsum] (ShiGao, SG) dose, and Prunus armeniaca L. [Rosaceae; Semen Armeniacae Amarum] (KuXingRen, KXR) dose on the efficacy of MaXingShiGan Decoction (MXSG) in treating children with bronchial pneumonia (Wind-heat Blocking the Lung), in order to provide strategy supported by high-quality evidence for the selection of rational clinical doses of MXSG.Methods: Based on the basic dose of MXSG, we conducted three randomized, double-blind, dose parallel controlled, multicenter clinical trials, involving adjustments to the overall dose, SG dose, and KXR dose, and included 120 children with bronchial pneumonia (Wind-heat Blocking the Lung) respectively. And the patients were divided into low, medium, and high dose groups in a 1:1:1 ratio, with 40 cases in each group. The intervention period lasted for 10 days. The primary outcome was the clinical cured rate, while the secondary outcomes included the effectiveness in alleviating major symptoms of bronchial pneumonia (including fever, cough, dyspnea, and phlegm congestion). And the occurrence of adverse events was recorded.Results: We first recorded and analyzed the baseline characteristics of the three studies, including age, gender, height, and so on. The results indicated that there were no significant differences among the dose groups within each study. For the study adjusting the overall dose of MXSG, the results showed that both the medium-dose group and high-dose group had significantly higher clinical cured rates compared to the low-dose group (Chi-square value 9.01, p = 0.0111). However, there was no significant benefit between the high-dose group and the medium-dose group (81.58% vs. 81.08%). Regarding phlegm congestion, excluding fever, cough, and dyspnea, both the medium-dose group and high-dose group had significantly higher clinical cured rates than the low-dose group (Chi-square value 6.31, p = 0.0426), and there was no significant benefit between the high-dose group and the medium-dose group (69.23% vs. 75.00%). A total of 5 adverse events were observed, of which only 1 case in the medium-dose group was possibly related to the experimental medication. For the study adjusted the SG dose in MXSG, the results showed that the high-dose group had the highest clinical cured rate, but the inter-group difference was not statistically significant (Chi-square value 3.36, p = 0.1864). The area under the curve (AUC) for cough in the medium-dose group was significantly lower than in the low-dose group and high-dose group (F-test value 3.14, p = 0.0471). Although no significant differences were observed in fever and dyspnea among the groups, the AUC in the high-dose group was lower than in the medium-dose and low-dose groups. In comparing the complete defervescence time, both the high-dose group (p < 0.0001) and the medium-dose group (p = 0.0015) achieved faster than the low-dose group. The high-dose group slightly outperformed the medium-dose group (0.50 (0.50, 0.80) vs. 0.80 (0.40, 1.40)), although the difference was not significant. In the medium-dose group, 1 adverse event was observed, but it was not related to the experimental medication. For the study adjusted the KXR dose in MXSG, the results showed that both the medium-dose group and high-dose group had significantly higher cured rates compared to the low-dose group (Chi-square value 47.05, p < 0.0001). However, there was no significant benefit comparing the high-dose group to the medium-dose group (90.00% vs. 92.50%). Regarding clinical symptoms, the results indicated that for cough (F-test value 3.16, p = 0.0460) and phlegm congestion (F-test value 3.84, p = 0.0243), the AUC for both the medium-dose group and high-dose group were significantly lower than in the low-dose group. Although there was benefit in the high-dose group compared to the medium-dose group, it was not statistically significant. No adverse events were observed during the study period.Conclusion: The synthesis of the three conducted clinical studies collectively indicates that for children with bronchial pneumonia (Wind-heat Blocking the Lung), the basic clinical dose of MXSG may represents an optimal intervention dose based on the accumulated clinical experience of doctors. If the dose is insufficient, the clinical effects might be compromised, but using a higher dose does not significantly enhance benefits. Concerning different symptoms, increasing the overall formula’s dose has a favorable impact on improving phlegm congestion, increasing the SG is effective in improving symptoms such as fever, cough, and dyspnea, while higher dose of KXR is effective in alleviating cough and phlegm congestion. These findings suggest that for MXSG, achieving the optimal intervention dose is crucial to achieve better clinical efficacy. For the SG and KXR, if certain symptoms are more severe, increasing the dose can be considered within safe limits, can lead to significant clinical benefits in symptom improvement. This also explains why the dose of MXSG might vary among clinical doctors, while maintaining a balance between safety and effectiveness. Of course, our study is still exploratory clinical trials, and further studies are needed to confirm our findings.Clinical Trial Registration:https://www.chictr.org.cn/index.html; Identifier: ChiCTR-TRC-13003093, ChiCTR-TRC-13003099

Research on the importance and structural vulnerability assessment of RC frame components and robustness improvement methods

To reasonably evaluate the robustness of RC frame structures, the ability to resist continuous collapse is improved. In this paper, the members’ contribution to the bearing capacity of the structure and the impact of the member’s failure are comprehensively considered, and the calculation method of the importance coefficient of the member is improved. At the same time, the structural vulnerability coefficient based on the change of the strain energy of the structure is combined with the reasonable assessment of the structural robustness through the two aspects of the member and the structure finishing. The redundancy analysis of the peripheral components of the failed components is carried out, and the low redundancy components are strengthened to improve the robustness of the structure to achieve the purpose of “strengthening the part and improving the whole”. On this basis, this paper evaluates the robustness of a four-story RC frame structure. It strengthens the low redundancy components under the influence of failure components to meet the requirements of improving the robustness of the structure, which verifies the rationality of the robustness evaluation method of the RC frame structure in this paper and the feasibility of improving the robustness of the structure

Application of Sensitivity Analysis to Progressive Collapse Resistance of Planar Truss Structures

The conventional sensitivity analysis method unanimously takes all remaining elements except the damaged ones as statistical objects, and element importance is evaluated by the mean value of the sensitive indices of statistical objects. However, from the perspective of resisting progressive collapse, the method is not sufficiently targeted, and the evaluation results have some mistakes. The shortcomings of the traditional sensitivity analysis method in element importance evaluation were analyzed and compared through finite element investigations of two types of planar trusses. Based on the anti-progressive collapse mechanism of the planar truss, the sensitivity analysis method with lower chords as statistical objects was proposed to evaluate the importance of planar truss structural elements. This method is conceptually straightforward, and the assessment results are beyond-compare regarding accuracy via comparison against the results of other evaluation methods. Furthermore, based on identifying important elements, the structure’s bearing capacity can be improved by targeted anti-progressive collapse design

Shape Effects of Cylindrical versus Spherical Unimolecular Polymer Nanomaterials on in Vitro and in Vivo Behaviors

To date, how the shape of nanomaterials influences their biological properties is poorly understood, due to the insufficient controllability of current preparative methods, especially in the shape and size of nanomaterials. In this paper, we achieved the precise syntheses of nanoscale unimolecular cylindrical polymer brushes (CPBs) and spherical polymer nanoparticles (SPNPs) with the same volume and surface chemistry, which ensured that shape was essentially the only variable when their biological performance was compared. Accurate shape effects were obtained. Impressively, the CPBs had remarkable advantage in tissue penetration over the SPNPs. The CPBs also exhibited higher cellular uptake and rapider body clearance than the SPNPs, whereas the SPNPs had longer blood circulation time, rapider tumor vascular extravasation, and higher tumor accumulation than the CPBs. Additionally, this work also provided a controllable synthesis strategy for nanoscale unimolecular SPNPs by integrating 21 CPBs to a β-cyclodextrin core, whose diameter in dry state could be up to 45 nm

The Flora Compositions of Nitrogen-Fixing Bacteria and the Differential Expression of nifH Gene in Pennisetum giganteum z.x.lin Roots

The flora compositions of nitrogen-fixing bacteria in roots of Pennisetum giganteum z.x.lin at different growth stages and the expression and copy number of nitrogen-fixing gene nifH were studied by Illumina Miseq second-generation sequencing technology and qRT-PCR. The results showed that there were more than 40,000~50,000 effective sequences in 5 samples from the roots of P. giganteum, with Proteobacteria and Cyanobacteria as the dominant nitrogen-fixing bacteria based on the OTU species annotations for each sample and Bradyrhizobium as the core bacterial genera. The relative expression and quantitative change of nifH gene in roots of P. giganteum at different growth stages were consistent with the changes in the flora compositions of nitrogen-fixing microbia. Both revealed a changing trend with an initial increase and a sequential decrease, as well as changing order as jointing stage>maturation stage>tillering stage>seedling stage>dying stage. The relative expression and copy number of nifH gene were different in different growth stages, and the difference among groups basically reached a significant level (p<0.05). The relative expression and copy number of nifH gene at the jointing stage were the highest, and the 2-△△CT value was 4.43 folds higher than that at the seedling stage, with a copy number of 1.32×107/g. While at the dying stage, it was the lowest, and the 2-△△CT value was 0.67 folds, with a copy number of 0.31×107/g