Dynamic regulation of the irrigation-nitrogen-biochar nexus for the synergy of yield,quality,carbon emission and resource use efficiency in tomato

Integrated water and fertilizer management is important for promoting sustainable development of facility agriculture,and biochar plays an important role in guaranteeing food production,as well as alleviating water shortages and the overuse of fertilizers.The field experiment had twelve treatments and a control(CK)trial including two irrigation amounts(I1,100%ETm;I2,60%ETm;where ETm is the maximum evapotranspiration),two nitrogen applications(N1,360 kg ha^(−1);N2,120 kg ha^(−1))and three biochar application levels(B1,60 t ha^(−1);B_(2),30 t ha^(−1)and B3,0 t ha^(−1)).A multi-objective synergistic irrigation-nitrogen-biochar application system for improving tomato yield,quality,water and nitrogen use efficiency,and greenhouse emissions was developed by integrating the techniques of experimentation and optimization.First,a coupled irrigation-nitrogen-biochar plot experiment was arranged.Then,tomato yield and fruit quality parameters were determined experimentally to establish the response relationships between irrigation-nitrogen-biochar dosage and yield,comprehensive quality of tomatoes(TCQ),irrigation water use efficiency(IWUE),partial factor productivity of nitrogen(PFPN),and net greenhouse gas emissions(NGE).Finally,a multi-objective dynamic optimization regulation model of irrigation-nitrogen-biochar resource allocation at different growth stages of tomato was constructed which was solved by the fuzzy programming method.The results showed that the application of irrigation and nitrogen to biochar promoted increase in yield,IWUE and PFPN,while it had an inhibitory effect on NGE.In addition,the optimal allocation amounts of water and fertilizer were different under different scenarios.The yield of the S1 scenario increased by 8.31%compared to the B_(1)I_(1)N_(2) treatment;TCQ of the S2 scenario increased by 5.14%compared to the B_(2)I_(2)N_(1) treatment;IWUE of the S3 scenario increased by 10.01%compared to the B1I2N2 treatment;PFPN of the S4 scenario increased by 9.35%compared to the B_(1)I_(1)N_(2) treatment;and NGE of the S5 scenario decreased by 11.23%compared to the B_(2)I1N1 treatment.The optimization model showed that the coordination of multiple objectives considering yield,TCQ,IWUE,PFPN,and NGE increased on average from 4.44 to 69.02%compared to each treatment when the irrigation-nitrogen-biochar dosage was 205.18 mm,186 kg ha^(−1)and 43.31 t ha^(−1),respectively.This study provides a guiding basis for the sustainable management of water and fertilizer in greenhouse tomato production under drip irrigation fertilization conditions.

Application of transmesenteric vein extrahepatic portosystemic shunt in treatment of symptomatic portal hypertension with cavernous transformation of portal vein

Purpose:To evaluate the feasibility and efficacy of a transmesenteric vein extrahepatic portosystemic shunt(TmEPS)for the treatment of cavernous transformation of the portal vein(CTPV).Materials and methods:The clinical data of 20 patients with CTPV who underwent TmEPS between December 2020and January 2022 at Henan Provincial People’s Hospital were retrospectively collected.The superior mesenteric vein(SMV)trunk was patent or partially occluded in these patients.An extrahepatic portosystemic shunt between the inferior vena cava and the SMV was established using a stent graft through an infraumbilical median longitudinal mini-laparotomy.The technical success,efficacy,and complication rates were evaluated,and the preand postoperative SMV pressures were compared.Patients’clinical outcomes and shunt patency were assessed.Results:TmEPS was successfully performed in 20 patients.The initial puncture success rate of the balloon-assisted puncture technique is 95%.The mean SMV pressure decreased from 29.1±2.9 mmHg to 15.6±3.3 mmHg(p<0.001).All symptoms of portal hypertension resolved.No fatal procedural complications occurred.During the follow-up period,hepatic encephalopathy occurred in two patients.The remaining patients remained asymptomatic.All shunts were patent.Conclusions:TmEPS is a feasible,safe,and effective treatment option for patients with CTPV.

Evaluation of using a double helical, closed-cell stent-retriever(Skyflow) for thrombectomy procedures in acute arterial occlusion: A preclinical study and a clinical trial

Background and purpose:Stent retriever thrombectomy is the standard therapeutic approach for ischemic stroke with acute large-vessel occlusion.This study evaluated the safety and efficacy of a new thrombectomy device(Skyflow)in the treatment of acute ischemic stroke.Methods:After an arterial occlusion model was established,stent-retriever thrombectomy was performed.Digital subtraction angiography(DSA)and autopsy were carried out immediately after thrombectomy in six animals in the acute experimental group.Simulated stent-retriever thrombectomy was performed for three animals in the subacute experimental group,and follow-up angiography and vascular pathological examination were assessed 90 days after the operation.In the clinical trial,192 patients with intracranial anterior circulation large vessel occlusion,within 8 h of symptom onset,were included to undergo thrombectomy with either Skyflow or Solitaire FR stent retriever.Efficacy and safety endpoints were recorded(including successful reperfusion,favorable clinical outcomes,time from puncture to reperfusion,instrument operation success rates and National Institutes of Health Stroke Scale(NIHSS)scores at 7 days for efficacy endpoints,and symptomatic intracranial hemorrhage(sICH),subarachnoid hemorrhage(SAH)and all-cause mortality rates for safety endpoints).Results:All blood vessels achieved successful recanalization in the animal models.In the clinical trial,successful recanalization was attained in 88.4%of patients of the Skyflow group,which was comparable to that of the Solitaire FR group(82.5%)in the full analysis set of the clinical trial.There were no severe complications on DSA,an animal autopsy,or vessel pathological examination in animal experiments.Additionally,no statistically significant difference was observed between the Skyflow and Solitaire FR groups in the clinical trial regarding the safety endpoints.Conclusion:This study showed that the new Skyflow stent retriever is safe and effective for the treatment of acute large vessel occlusion,as demonstrated in our animal study and human trial.

Safety and efficacy of the Separ GateTM balloon-guiding catheter in neurointerventional surgery: Study protocol of a prospective multicenter single-arm clinical trial

Background: The balloon-guiding catheter(BGC) reportedly reduces the number of retrievals and occurrence of distal emboli, achieving superior revascularization results and improved clinical outcomes in acute stroke. This study will aim to examine the efficacy and safety of the new Separ GateTM BGC.Design: This prospective multicenter single-arm clinical trial will aim to include 128 patients who fulfill its inclusion and exclusion criteria. All patients will receive endovascular interventional therapy with BGC assistance.The primary endpoint will be the immediate surgical success rate, while the secondary endpoint will be product performance. The safety evaluation will include serious adverse events such as puncture site hematoma and bleeding, cerebral vasospasm, vessel dissection, vessel perforation, air embolism, thrombus(acute or subacute),vessel occlusion, distal embolization, infection, adverse reaction to antiplatelet and anticoagulant drugs, intracranial hemorrhage, stroke, death, and device defect.Discussion: The prospective multicenter trial will provide safety and efficacy information for the Separ GateTM BGC.Its findings will provide a clinical reference for endovascular adjuvant therapy of cerebrovascular disease.Trial registration: Chi CTR1800014459.

A novel cerebrovascular drug-coated balloon catheter for treating symptomatic intracranial atherosclerotic stenosis lesions:Study protocol for a prospective,multicenter,single-arm,target-value clinical trial

Background:Previous single-center studies have demonstrated that drug-coated balloons(DCBs)may reduce restenosis rates,which is an important factor affecting the prognosis for intracranial interventional therapy.However,currently available cardiac DCBs are not always suitable for the treatment of intracranial atherosclerotic stenosis(ICAS).This study aimed to evaluate the safety and efficacy of a novel DCB catheter designed for patients with severely symptomatic ICAS.Methods:This prospective,multicenter,single-arm,target-value clinical trial was conducted in 9 Chinese stroke centers to evaluate the safety and efficacy of a novel DCB catheter for treating symptomatic severe ICAS.Primary metrics and other indicators were collected and analyzed using SAS version 9.4(SAS Institute,Cary,NC,USA).Results:A total of 155 patients were enrolled in this study.The preliminary collection of follow-up data has been completed,while data quality control is ongoing.Conclusion:Results of this study demonstrated the patency rate,safety,and effectiveness of a novel on-label paclitaxel DCB designed for the treatment of ICAS.Ethics and dissemination:This study,involving human participants,was reviewed and approved by the Ethics Committee of Drugs(Devices)Clinical Experiment at Henan Provincial People’s Hospital(reference number:2020-145-03)and other research centers participating in the clinical trial.The results of this study will be presented at international conferences and sent to peer-reviewed journals for publication.Standard protocol items:The Recommendations for Interventional Trials checklist was used when drafting the study protocol.Trial registration number:Registered with the Chinese Clinical Trial Registry on June 11,2021(Chi CTR2100047223).

Safety and efficacy of the SeparGateTM balloon-guiding catheter in neurointerventional surgery:A prospective,multicenter,single-arm clinical trial

Objective:To evaluate the safety and efficacy of the SeparGateballoon-guiding catheter(BGC)for blocking flow and delivering devices in neurointerventional surgery.Method:This prospective multicenter single-arm trial enrolled patients who received BGC adjuvant therapy to provide temporary blood flow arrest of the supra-aortic arch arteries and their branch vessels in interventional therapy.The primary endpoint was immediate procedural success rate in flow arrest,device delivery,and withdrawal.The efficacy endpoints were intraoperative product performance,including rigidity,smoothness,fracture resistance of the catheter wall,catheter push performance,compatibility and radiopaque display,integrity,adhesion thrombus after withdrawal and balloon rupture.The safety endpoints were adverse and serious adverse events associated with the test device and serious adverse events resulting in death or serious health deterioration.Result:A total of 129 patients were included;of them,128 were analyzed in the full analysis set(FAS)and per protocol set(PPS).Immediate procedural success was achieved in 97.7%of patients with FAS and PPS.The lower bound of the 95%confidence interval was 94.6%,higher than the preset efficacy margin of 94%.Device-related adverse events occurred in 2(1.6%)cases.One was mild adverse event of vasospasm,which resolved spontaneously.The other was serious adverse event of dissection aggravation,which was treated with stenting angioplasty.No device defects were observed.Conclusion:In neurointerventional surgery,the SeparGateBGC can be used to temporarily block the flow of the supra-aortic arch arteries and their branch vessels and guide the interventional device to the target vascular position.

Nursing care of 22 patients with complex intracranial aneurysms treated with flow-diverting stents:A retrospective study

Objective:To summarize the nursing treatment of patients who underwent implantation of a blood flow diverter to treat complex intracranial aneurysms.Methods:Data from 22 patients with complex aneurysms,diagnosed at an interventional center for blood flow diverter implantation between February 2015 and February 2016,treated in the Henan Provincial People’s Hospital(Zhengzhou,China),were retrospectively analyzed.Nursing methods,including preoperative,intraoperative,and postoperative care,were analyzed.Results:All 22 patients underwent successful surgery,with no related complications or hospital mortality,and were cured in hospital.Conclusion:Interventional flow diverter therapy for patients with complex intracranial aneurysms is a new technology,and involves intensive care by nursing staff and appears to be a promising new treatment method.

Treatment of cavernous sinus dural arteriovenous fistula using different surgical approaches:Analysis of 32 consecutive cases

Objective:Transarterial and transvenous embolization methods are considered effective and safe approaches for the treatment of cavernous sinus dural arteriovenous fistula(CSDAVF).Here.,we report the angioarchitectural features and clinical outcomes of CSDAVF in patients treated with either the inferior arterial approach(IAA) or the inferior petrosal sinus approach(IPSA).Methods:The clinical data of 32 patients with CSDAVF treated at our institution from May 2008 to May 2014 were retrospectively analyzed.All patients underwent routine diagnostic digital subtraction angiography(DSA) before surgery.Embolization was performed using the IPSA through the internal jugular vein or IAA,based on angioarchitectural features.Results:Of the 32 patients with CSDAVF,24 underwent embolization treatment through the internal jugular veinIPSA and 8 patients underwent treatment through IAA.Nineteen patients in the IPSA group experienced mild headache,which improved after specific treatment.The immediate postembolization angiographic results revealed complete occlusion in 26 cases(18 IPSA and 8 IAA) and almost complete occlusion in 6 cases(IPSA).Complications that occurred during the procedure included abducens nerve palsy(n=1,IPSA) and prosopoplegia(n=1,IAA).One patient developed tinnitus,which was diagnosed as anterior cranial fossa new-onset dural arteriovenous fistula on DSA,whereas the symptoms of other patients all improved with no recurrence.Conclusions:On the basis of the angioarchitectural features of CSDAVF,IAA can be considered the primary treatment when the blood-supplying artery and fistula are relatively singular,and when the microcatheter can easily reach the fistula through the artery.The venous approach should be selected as the primary approach when the fistula is indistinguishable and blood is supplied by multiple arteries through small plexiform vessels.Choosing the optimal surgical approach may increase the success rate of intravascular CSDAVF surgery and may help avoid complications.

Transradial versus transfemoral approach for cerebral angiography: A prospective comparison

Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach(TRA) for cerebral angiography versus the transfemoral approach(TFA) in patients.Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate,oppression time on puncture points, local vascular complication incidence(including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs(DVT), and bradycardia/hypotension were observed and compared between the two groups.Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in1070 patients;compared with 1219 patients with transfemoral access, there was no significant difference(P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients.Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach.

Pipeline Embolization Device for intracranial aneurysms presenting with mass effect:a large Chinese cohort

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.

In vitro investigation of a new thrombus aspiration and autologous blood reinfusion system

Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyvinyl chloride(PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12 F aspiration catheters were used to aspirate the thrombus in the right–pulmonary-artery model, 8 French and 14 F aspiration catheters were used in the inferior–vena cava model, and 8 French and 10 F aspiration catheters were used in the left-–iliofemoral-vein model. A thrombus filtration and auto-blood reinfusion bottle was used to filter the thrombus and re-infuse auto-blood. We evaluated the thrombus aspiration capability of each catheter by comparing preaspirated with the post-aspirated thrombus volume, and we evaluated the difference in aspiration capability between the two catheters in each model by comparing their thrombus aspiration rates. We used Student’s t-test for statistical analysis.Results: Differences between pre-aspirated and post-aspirated thrombus volumes for each catheter were insignificant, as were those between the thrombus aspiration rates of the two catheters in each venous model. Using the thrombus aspiration and auto-blood reinfusion system, each aspiration catheter could fluently aspirate the thrombus out of the venous model.Conclusion: In this study, we designed a new venous-thrombus aspiration system. This system could be used to aspirate acute venous thrombi and re-infuse autologous blood.

A canine model of aortic arch aneurysm created with autologous pericardium

Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic arch.Materials and methods:Fifteen mongrel dogs underwent surgery.The autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic arch.The animals were followed up for 3 months postoperatively.Computed tomography angiography was used to visualize and measure the aneurysm model.Hematoxylin and eosin staining was used to observe the histological characteristics of the aneurysm model.Changes in aneurysm diameter over time were analyzed using analysis of variance.Results:One dog died of hemorrhage during surgery.Fourteen dogs survived the surgical procedure.Two of them died on the first postoperative day because of ruptures at the suturing margin.The diameter of the aneurysm model was twice as large as that of the aortic arch.There was no significant change in the maximum diameter of the aneurysm model during the follow-up period.Conclusions:We established a controllable and stable aortic arch aneurysm model created with an autologous pericardium patch.The aneurysm model can be used to research endoleaks after thoracic endovascular aortic repair and new endovascular techniques can be applied to the aortic arch.

Endovascular transvenous treatment for superficial intracranial arteriovenous malformations

Objective:The objective of this study was to evaluate the feasibility and outcomes of transvenous endovascular embolization(TVE) for superficial intracranial arteriovenous malformations(AVMs).Methods:After collecting clinical and imaging data,a prospective series of 11 patients presenting with superficial AVMs were treated by endovascular embolization using a transvenous approach between November 2016 and October 2018.Results:Ten patients(90.9%) had ruptured AVMs before TVE.The mean nidus size was 3.27 ± 1.47 cm,and the median Spetzler-Martin grade was II.The rate of immediate angiographic occlusion of the AVMs was 90.9%(10/11).One patient was treated with transarterial embolization since TVE was not achieved due to an unsuccessful positioning of the microcatheter.Two patients(cases 8 and 11) suffered a intracranial hemorrhage and a cerebral infarction with encephaledema,respectively,but no procedure-related mortalities were observed.Eight patients(72.7%) were independent with a modified Rankin Score(mRS) 2 at discharge and the m RSs of all patients,which were collected 30 days postintervention,were not more than 2.The mean follow-up period was 17 months.There were no nidus recurrences during the follow-up period.Conclusions:The curative transvenous embolization of superficial AVMs seems feasible and effective while carefully monitoring for embolization-related complications.

Utilization threshold of surface water and groundwater based on the system optimization of crop planting structure

Based on the diversity of the agricultural system, this research calculates the planting structures of rice, maize and soybean considering the optimal economic-social-ecological aspects. Then, based on the uncertainty and randomness of the water resources system,the interval two-stage stochastic programming method,which introduces the uncertainty of the interval number, is used to calculate the groundwater exploitation and the use efficiency of surface water. The method considers the minimum cost of water as the objective of the uncertainty model for surface water and groundwater joint scheduling optimization for different planting structures. Finally, by calculating harmonious entropy, the optimal exploitation utilization interval of surface water and groundwater is determined for optimal cultivation in the Sanjiang Plain.The optimal matching of the planting structure under the economic system is suitable when the mining ratio of the surface is in 44.13%–45.45% and the exploitation utilization of groundwater is in 54.82%–66.86%, the optimal planting structure under the social system is suitable when surface water mining ratio is in 47.84%–48.04% and the groundwater exploitation threshold is in 67.07%–72.00%. This article optimizes the economicsocial-ecological-water system, which is important for the development of a water- and food-conserving society and providing a more accurate management environment.

Comparison of the Pipeline embolisation device alone or combined with coiling for treatment of different sizes of intracranial aneurysms

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.

LaBr_(3)(Ce)-CsI(Tl)紧凑式叠层反康伽马探测器研制

本工作研制了一套由圆柱形LaBr_(3)(Ce)主晶体和井形CsI(Tl)次晶体组成的叠层伽马探测器,该探测器主要用于鉴别来自LaBr_(3)(Ce)主晶体的康普顿散射光子并进行反符合测量。两种不同的晶体耦合到同一个光电倍增管上。入射辐射沉积在每一层探测器的能量,可以通过PMT给出的信号脉冲形状差异进行识别。利用Geant4模拟结果,验证了脉冲形状甄别性能和康普顿散射抑制效果。利用^(60)Co伽马源对探测器进行了实验测试,测试结果表明,该探测器本底抑制系数为2.33(1),达到了康普顿本底抑制两倍以上的预期目标。

Impact factors and dynamic simulation of tillage-layer temperature in frozen-thawed soil under different cover conditions

Based on a winter field experiment between 2016 and 2017,four treatments(bare land(BL),natural snowfall coverage(NS),5-cm-deep straw+natural snowfall coverage(SC5),and 10-cm-deep straw+natural snowfall coverage(SC10))were established to determine the effects of the different treatments on soil temperature at the soil surface and at depths of 10 cm,20 cm,and 30 cm.The environmental factors of ambient temperature,ambient humidity,water vapor pressure,10-min wind speed,total radiation,net radiation,and long wave radiation were obtained from the weather station in the study area.Through correlation,multiple regression,and stepwise regression analysis,models for dynamic simulation of the tillage-layer soil temperature were constructed for analyzing the relation between tillage-layer soil temperature and environmental factors.The results showed that the environmental factors were all significantly correlated with tillage-layer temperature at the 0.01 level;when the impacts of other environmental factors were excluded,the correlations decreased significantly.The dynamic simulation models for tillage-layer soil temperature under different coverage conditions were different,and the larger the coverage amount,the fewer the environmental factors that could affect the tillage-layer temperature.The coefficients of determination of the prediction results of the dynamic models for the tillage-layer soil temperature under the four treatments(BL,NS,SC5,and SC10)were 0.8385,0.7110,0.7283,and 0.6216,respectively.The prediction had a high accuracy and can accurately depict the dynamic changes of the tillage-layer soil temperature.The results provided a theoretical basis for the efficient utilization of farmland soil water and heat resources.

Safety of endovascular therapy for symptomatic intracranial artery stenosis:a national prospective registry

Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown.The Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis(CRTICAS)was a prospective,multicentre,real-world registry designed to assess these outcomes and the impact of centre experience.Methods 1140 severe,symptomatic intracranial arterial stenosis(ICAS)patients treated with endovascular therapy were included from 26 centres,further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years:(1)high volume for≥25 cases/year;(2)moderate volume for 10–25 cases/year and(3)low volume for<10 cases/year.Results The rate of 30-day stroke,transient ischaemic attack or death was 9.7%(111),with 5.4%,21.1%and 9.7%in high-volume,moderate-volume and low-volume centres,respectively(p<0.05).Multivariable logistic regression confirmed high-volume centres had a significantly lower primary endpoint compared with moderate-volume centres(OR=0.187,95%CI:0.056 to 0.627;p≤0.0001),while moderate-volume and low-volume centres showed no significant difference(p=0.8456).Conclusion Compared with the preceding randomised controlled trials,this real-world,prospective,multicentre registry shows a lower complication rate of endovascular treatment for symptomatic ICAS.Non-uniform utilisation in endovascular technology,institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment.

Sulfation of the extracellular polysaccharide from the edible fungus Stropharia rugosoannulata with its antioxidant activity

An acidic extracellular polysaccharide(EPS)was gained from Stropharia rugosoannulata fermentation broth by the alcohol precipitate method.Sulfated derivative of EPS(S-EPS)was gained by chlorosulfonic acid-pyridine method and the conditions were as follows:pyridine as the reaction solvent,temperature 80°C,and reaction time 90 min.The chemical structure and chain conformation of EPS and S-EPS were characterized by FT-IR,NMR and size exclusion chromatography(SEC)coupled with multi-angle laser light scattering(MALLS)detection.FT-IR spectra indicated the sulfated group was linked to the polymer.The EPS mainly consists of mannose,glucose and glucuronic acid,and the glycosidic bond type is mainly(1→4)-linked and(1→6)-linked.C6 and C2 were substituted by sulfate groups.The EPS was degraded into smaller molecular weight(Mw)polysaccharides with the larger molecular size(Rg)after sulfation and S-EPS has better hydrophilicity.Moreover,the sulfated derivative S-EPS was found to have a better scavenging ability on hydroxyl radicals than EPS.It proved that the chemical modification of S.rugosoannulata polysaccharides by sulfation effectively enhanced their antioxidant activity.