Clipping and coiling of intracranial aneurysms in the elderly patients: clinical features and treatment outcomes

ObjectiveIn recent years, more and more cases of intracranial aneurysms (IAs) have been found in elderly patients, and neurosurgical interventions have increased, but there is still no consensus on the best treatment strategy for elderly patients. In elderly patients, endovascular coiling (EC) is more popular than surgical clipping (SC) due to its advantages of less trauma and faster recovery. However, SC has made great progress in recent years, significantly improving the prognosis of elderly patients. Therefore, it is necessary to further explore the effects of different treatment modalities on clinical prognosis, hospital stay, and hospital cost of elderly IA patients, and select the most appropriate treatment modalities.MethodsThe authors retrospectively analyzed 767 patients with intracranial aneurysms admitted to the facility between August 2017 and December 2022. Prognostic risk factors and multivariate logistic regression were analyzed for elderly patients treated with EC or SC. The area under the receiver operating characteristic (ROC) curve was used to calculate the predictive power of each independent predictor between the treatment groups.ResultsOur study included 767 patients with aneurysms, of whom 348 (45.4%) were elderly, 176 (22.9%) underwent endovascular coiling, and 172 (22.4%) underwent microsurgical clipping. A comparison of elderly patients treated with EC and SC showed a higher prevalence of hypertension in the EC group (P = 0.011) and a higher Hunt–Hess score on admission in the SC group (P = 0.010). Patients in the EC group had shorter hospital stays but higher costs (P = 0.000 and P = 0.000, respectively). Patients treated with SC had a higher incidence of postoperative cerebral infarction and poor prognosis (P = 0.002 and P = 0.008, respectively). Through multi-factor logistic analysis, it was found that age (OR 1.209, 95% CI 1.047–1.397, P = 0.010), length of stay (LOS) (OR 1.160, 95 CI% 1.041–1.289, P = 0.007), and complications (OR 31.873, 95 CI% 11.677–320.701, P = 0.000) was an independent risk factor for poor prognosis in elderly patients with EC. In elderly patients treated with SC, age (OR 1.105, 95% CI 1.010–1.209, P = 0.029) was an independent risk factor for poor prognosis.ConclusionEC and SC interventions in elderly adults carry higher risks compared to non-older adults, and people should consider these risks and costs when making a decision between intervention and conservative treatment. In elderly patients who received EC or SC treatments, EC showed an advantage in improving outcomes in elderly patients although it increased the economic cost of the patient's hospitalization

Evolution of green leaf volatile profile and aroma potential during the berry development in five Vitis vinifera L. Cultivars

Green leaf volatiles (GLVs), play important roles in the green and fresh aroma characteristics of grape berries. The evolution of GLV profiles regarding the varietal difference during grapevine phenological ripening is not well understood. This study generated the GLV profiles of five Vitis vinifera L. cultivars (‘Cabernet Sauvignon,’ ‘Cabernet Franc,’ ‘Cabernet Gernischt,’ ‘Chardonnay,’ and ‘Sauvignon Blanc’) at five ripening stages. GLVs were distinctive at different E-L stages for each grape variety. (E)-2-hexen-1-ol, 1-hexanol, and hexanal were the dominant components in all mature berries. In terms of total GLV content, all varieties reached the maximum at maturity in the 2019 vintage, and the total GLV content was higher in mature Sauvignon Blanc and Cabernet Sauvignon grapes. In the 2020 vintage, the total GLV content in Chardonnay and Sauvignon Blanc berries rapidly accumulated at veraison and peaked before harvest. The present results could help winemakers create a good balance of wine aroma

Aberrant Lipid Metabolism in Hepatocellular Carcinoma Revealed by Liver Lipidomics

Background: The aim of this study was to characterize the disorder of lipid metabolism in hepatocellular carcinoma (HCC). HCC is a worldwide disease. The research into the disorder of lipid metabolism in HCC is very limited. Study of lipid metabolism in liver cancer tissue may have the potential to provide new insight into HCC mechanisms. Methods: A lipidomics study of HCC based on Ultra high performance liquid chromatography-electronic spray ionization-QTOF mass spectrometer (UPLC-ESI-QTOF MS) and Matrix assisted laser desorption ionization-fourier transform ion cyclotron resonance mass spectrometer (MALDI-FTICR MS) was performed. Results: Triacylglycerols (TAGs) with the number of double bond (DB) > 2 (except 56:5 and 56:4 TAG) were significantly down-regulated; conversely, others (except 52:2 TAG) were greatly up-regulated in HCC tissues. Moreover, the more serious the disease was, the higher the saturated TAG concentration and the lower the polyunsaturated TAG concentration were in HCC tissues. The phosphatidylcholine (PC), phosphatidylethanolamine (PE) and phosphatidylinositol (PI) were altered in a certain way. Sphingomyelin (SM) was up-regulated and ceramide (Cer) were down-regulated in HCC tissues. Conclusions: To our knowledge, this is the first such report showing a unique trend of TAG, PC, PE and PI. The use of polyunsaturated fatty acids, like eicosapentanoic and docosahexanoic acid, as supplementation, proposed for the treatment of Non-alcoholic steatohepatitis (NASH), may also be effective for the treatment of HCC

Acute Response of Right Ventricular Function to Iloprost Inhalations in Patients with Pulmonary Arterial Hypertension: Preliminary Evaluation with Cardiac Magnetic Resonance Imaging

Background and objective Pulmonary arterial hypertension (PAH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. Without treatment, PAH progresses rapidly to right ventricular (RV) failure and even death. Cardiac magnetic resonance imaging (CMRI) has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PAH. The aim of this study is to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMRI. Method From March 2012 to March 2014, 48 patients with PAH underwent CMRI before and immediately after inhalation of iloprost with a single dose of 20 μg over 15 min-20 min. RV function parameters derived from CMRI images were analyzed before and after iloprost inhalation, including end-diastolic volume (EDV), end-diastolic area (EDA), end-systolic volume (ESV), end-systolic area (ESA), stroke volume (SV), ejection fraction (EF) and cardiac output (CO). Percentage of RV area change was also calculated [%RVAC=(EDA-ESA)/EDA×100%]. Wilcoxon's Sign Rank Test or Paired Samples t-Test was used to compare the differences of RV function parameters before and after inhalation. Results After iloprost inhalation, all patients showed significant decrease in RV EDV and RV ESV (P=0.007, P<0.001 respectively). Whereas, there were significant increase in RV SV (P=0.014), RV EF (P=0.009) and %RVAC (P=0.006). RV CO had no significant difference before and after inhalation (P=0.851). Conclusions Inhalation of iloprost can immediately improve RV function in patients with PAH, and noninvasive evaluation of the acute response with CMRI is feasibility

IL-17A inhibits autophagic activity of HCC cells by inhibiting the degradation of Bcl2

Hepatocellular carcinoma (HCC) is associated with poor prognosis due to many unknowns about its inflammatory microenvironment. As a pivotal proinflammatory cytokine, IL-17A exerts a protective effect on the survival and function of HCC cells. It is widely accepted that IL-17A plays an important role in regulating autophagy. Bcl2, a key molecule promoting the survival of HCC cells, also plays an indispensable role as an autophagy regulator. The aim of this study was to investigate the role of Bcl2 in IL-17A-regulated autophagy of HCC cells. The results showed that IL-17A not only inhibited autophagic activity, but also increased Bcl2 levels in HCC cells under starvation. Besides, IL-17A could prevent the dissociation of autophagy protein Beclin1 from Bcl2-Beclin1 complex upon starvation. Overexpression of Beclin1 rescued the autophagy deficiency of HCC cells in presence of IL-17A. Moreover, RNAi-induced Bcl2 silencing impaired the function of IL-17A in inhibiting the activation of autophagy, subsequently reducing the viability and migration of HCC cells, while the inhibition of Beclin1 by spautin-1 could reduce autophagic activity to a certain degree, thus restoring the viability and migration of HCC cells. In summary, it was suggested that the inhibition of Bcl2 degradation may be an important mechanism by which IL-17A inhibits autophagy response, subsequently maintaining the survival in HCC cells. •IL-17A-inhibited autophagy is related to Bcl2 degradation in HCC cells.•Bcl2 may be degraded via the autophagosome-lysosome pathway in HCC cells.•IL-17A-Bcl2-Beclin1-autophagy inactivation pathway maintains HCC cells' survival

The Optimization and Production of Ginkgolide B Lipid Microemulsion

In this study, we introduce a method to formulate Ginkgolide B lipid microemulsion (GB-LM). We have assessed its general characteristics and pharmacokinetics in animals. Soybean oil (10.0%) and oleic acid (2.4%) were chosen as the oil phase, refined egg yolk lecithin (PC98T) (1.8%) as the surfactant, and glycerol (2.25%) as the co-surfactant. The optimized formulation process resulted in particles with average diameter of 185.9 ± 52.5 nm and the zeta potential of −19.8 ± 1.3 mV. The GB-LM remained steady for three months at room temperature. Giving each dose of 4 mg/kg to rats through the vein, a clearance rate of CL (L/h): 2.594 and C max (ng/mL) was achieved: 353.8 through pharmacokinetic analysis and statistical analysis. The AUC of GB-LM was about 1.57-fold higher than that of the products available in the market. In addition, brain tissue distribution studies show that after 0.5 h administration of GB, the concentration of GB in brain tissue can reach its maximum, and then significantly decrease after 2 hours. Therefore, the improved formulation of GB-LM shows encouraging results compared with present products in several features

A Genome-Wide Analysis of Long Noncoding RNAs in Circulating Leukocytes and Their Differential Expression in Type 1 Diabetes Patients

Long noncoding RNAs (lncRNAs) regulate gene expression at different levels in various diseases, including type 1 diabetes (T1D). However, the expression of circulating lncRNAs in leukocytes in T1D has not been well documented. To identify differentially expressed lncRNAs between T1D patients and healthy controls, RNA sequencing was performed on samples of leukocytes collected from both healthy persons and T1D patients. The categories, enriched pathways, coexpression networks, and the characteristics of novel lncRNAs were analyzed to provide an extensive profile. qPCR was adopted to validate the differential expression of lncRNAs in the validation cohort. A total of 14,930 lncRNAs and 16,063 mRNAs were identified in the peripheral blood leukocyte of T1D patients. After optimization using an adjusted p value (threshold of <0.05), 393 circulating lncRNAs were identified, of which 69 were downregulated and 324 were upregulated in T1D patients. Gene Ontology analysis indicated that these lncRNAs and mRNAs were enriched in the immune system category. Further analysis showed that 61.28% of the novel lncRNAs were conserved in humans. A set of 12 lncRNAs were selected for qPCR validation, and 9 of 12 lncRNAs were confirmed to show significant differential expression between the T1D and control validation cohorts. Among the 9 confirmed lncRNAs, lncRNA MSTRG.128697 and lncRNA MSTRG.128958 were novel and human-specific; however, further validation is required. lncRNA MSTRG.63013 has orthologous sequences in the mouse genome and was identified as a key node for etiology and pathophysiology in animal studies, which will help understand the epigenetic mechanisms of T1D complications

Development of Microsatellite Marker System to Determine the Genetic Diversity of Experimental Chicken, Duck, Goose, and Pigeon Populations

Poultries including chickens, ducks, geese, and pigeons are widely used in the biological and medical research in many aspects. The genetic quality of experimental poultries directly affects the results of the research. In this study, following electrophoresis analysis and short tandem repeat (STR) scanning, we screened out the microsatellite loci for determining the genetic characteristics of Chinese experimental chickens, ducks, geese, and pigeons. The panels of loci selected in our research provide a good choice for genetic monitoring of the population genetic diversity of Chinese native experimental chickens, ducks, geese, and ducks