A prospective cohort study on serum A20 as a prognostic biomarker of aneurysmal subarachnoid hemorrhage

BACKGROUND:A20 may be a neuroprotective factor.Herein,we aimed to investigate whether serum A20 levels were associated with disease severity,delayed cerebral ischemia(DCI),and outcome after aneurysmal subarachnoid hemorrhage(aSAH).METHODS:In this prospective cohort study containing 112 aSAH patients and 112 controls,serum A20 levels were quantified.At 90 d poststroke,Modified Rankin Scale(MRS) scores≥3 were defined as a poor outcome.All correlations and associations were assessed using multivariate analysis.RESULTS:Compared with controls,there was a significant elevation of serum A20 levels in patients(median 123.7 pg/mL vs.25.8 pg/mL;P<0.001).Serum A20 levels were independently correlated with Hunt-Hess scores(β 9.854;95% confidence interval [95% CI] 2.481-17.227,P=0.009) and modified Fisher scores(β 10.349,95% CI 1.273-19.424,P=0.026).Independent associations were found between serum A20 levels and poor outcome(odds ratio [OR] 1.015,95%CI 1.000-1.031,P=0.047) and DCI(OR 1.018,95% CI 1.001-1.035,P=0.042).Areas under the curve for predicting poor outcome and DCI were 0.771(95% CI 0.682-0.845) and 0.777(95% CI 0.688-0.850),respectively.Serum A20 levels ≥128.15 pg/mL predicted poor outcome,with a sensitivity of 73.9% and specificity of 74.2%,and A20 levels ≥160.55 pg/mL distinguished the risk of DCI with65.5% sensitivity and 89.2% specificity.Its ability to predict poor outcome and DCI was similar to those of Hunt-Hess scores and modified Fisher scores(both P>0.05).CONCLUSION:Enhanced serum A20 levels are significantly associated with stroke severity and poor clinical outcome after aSAH,implying that serum A20 may be a potential prognostic biomarker for aSAH.

The Influences of an Embedded Structure Fiber-Optic Radiation Dosimeter in Different SSD and Beam Field Size

With a rapidly increasing demand and widespread use of radiotherapy treatment, the subject area of in-vivo real time dose rate dosimeters has become a significant area of study. An embedded structure fiber-optic radiation dosimeter has proved to be a promising candidate to fulfil this role because of its high SNR (signal-to-noise ratio) and excellent light conversion efficiency. In this paper, the properties of this kind of dosimeter with respect to different SSD (Source to Surface Distance) and beam field size in a clinical Linac are studied. The characteristics of the dosimeter were evaluated by the sensor’s output intensity response in these conditions.

The Influences of Inorganic Scintillator Optical Fiber Radiation Dosimeter in Some Conditions

In order to meet the increasing demands of modern radiotherapy, real time in-vivo dose measurement has recently attracted significant attention. A small, flexible optical fiber radiation dosimeter, with high signal-to-noise ratio (SNR) that employs inorganic scintillator materials is presented. In this paper, some properties are investigated under special conditions, such as saturation properties when the intensity of the X-Ray is increased and the influence of the temperature of the environment. These properties are important to practical considerations if the sensor is to be successfully deployed in-vivo.