Efficacy of Willis covered stent of intracranial pseudoaneurysms in the internal carotid artery: A systematic review and meta-analysis

Objective:To evaluate the efficacy of a novel coated stent in the treatment of intracranial pseudoaneurysm.Methods:MEDLINE,EMBASE,and PubMed databases were searched for literature published between 1990 and April 2022 according to PRISMA guidelines.All studies with≥10 patients reporting successful implantation of Willis covered stent,therapeutic effect,complications,and postoperative follow-up were included.The combined incidence and corresponding 95%confidence intervals were assessed using a generalized linear mixed method and random effects model.Results:Five studies(116 patients with pseudoaneurysms)were included.The experimental groups in the selected studies showed a combined technical success rate of 81.03%(OR=18.31,95%CI=9.39-35.69,I^(2)=79%,P<0.001).Clinical follow-up showed that the complete cure rate was as high as 94.4%after the follow-up(OR=106.81,95%CI=39.08-291.88,I^(2)=0%,P=0.71).Conclusions:Willis covered stent is feasible,safe,and effective in the treatment of intracranial pseudoaneurysm.

Anti-phospholipase A2 receptor-associated membranous nephropathy with human immunodeficiency virus infection treated with telitacicept:A case report

BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.

Protective effect of fu-qi granule on carbon tetrachloride-induced liver fibrosis in rats

AIM: To investigate the efficacy of fu-qi granule(FQG) on carbon tetrachloride(CCl4) induced liver fibrosis in rats and the underlying mechanisms. METHODS: Sixty rats were randomly divided into sixgroups: normal control group, CCl4 induced liver fibrosis group, Anluo Huaxian Wan group and three treatment groups of FQG. Treatment of rats with intraperitoneal injection of carbon tetrachloride solution at 0.3 mL per 100 g body weigh twice a week for 8 wk. The normal control group the rats were given the media(olive oil) at the same time. In the first 2 wk, rats were raised with feedstuff(80% corn meal, 20% lard, 0.5% cholesterol). Serum samples were collected for alanine transaminase, aspartate aminotransferase, alkaline phosphatase, albumin, total protein assay and typical histopathological changes was observed in Hematoxylin-eosin staining sections. Smooth muscle alpha actin(α-SMA) was analyzed with immunohistochemistry. Mammalian target of rapamycin(m TOR) and hypoxia-inducible factor-1(HIF-1α) expressions were detected by Western blotting. Tissue inhibitor of matrix metalloproteinases-1(TIMP-1) and matrix metalloproteinases-9(MMP-9) were measured with semi-quantitative reverse transcriptasepolymerase chain reaction. RESULTS: FQG significantly reduced the serum levels of alanine transaminase, aspartate aminotransferase, alkaline phosphatase and increased the serum contents of albumin, total protein in rats with liver fibrosis. Moreover, FQG promoted extracellular matrix degradation by increasing MMP-9 and inhibiting TIMP-1 and α-SMA. m TOR and HIF-1α expression in liver significantly decreased in the rats treated with FQG. CONCLUSION: The results indicated that FQG significantly reverse fibrosis induced by CCl4, which should be developed as a new and promising preparation for the prevention of liver fibrosis.

Effects of dexmedetomidine and sufentanil on hemorheology,stress response and inflammatory factors in patients undergoing laparoscopic repair of gastrointestinal perforation

Objective: To observe the clinical application of dexmedetomidine combined with sufentanil anesthesia in patients undergoing laparoscopic repair of gastrointestinal perforation, and the changes of hemodynamics, stress response and inflammatory factors were analyzed before and after operation. Methods: A total of 102 patients with laparoscopic gastrointestinal perforation were randomly divided into control group (n=51) and observation group (n=51) according to the lottery method. The control group was given anesthesia with sufentanil, and the observation group was given dexmedetomidine combined with sufentanil anesthesia, and the other anesthesia drugs were the same. The hemodynamics before anesthesia induction (T1), 10 min after medication (T2), pneumoperitoneum (T3), and tube drawing (T4), serum stress response and inflammatory factor levels before operation and after 24 h of operation were measured in all subjects. Results: At T1 and T2, there was no significant difference in hemodynamics between the two groups. At T3and T4, HR, SBP, and DBP in observation group were significantly lower than those in the control group at corresponding period, and compared with the observation group at T, there were no significant difference. At T3, and T4, the HR, SBP and DBP of the control group were significantly higher than those of T1. There was no significant difference in serum stress hormone between the two groups before surgery. After surgery 24 h, two groups of serum ACTH, Cor and ALD levels were higher than those of preoperative, and the observation group was significantly lower than those of the control group. There was no significant difference in serum inflammatory cytokines between the two groups before surgery. After surgery 24 h, the levels of serum IL-10 and TNF-毩 in the two groups were higher than those before operation, and the observation group was significantly lower than those of the control group. Conclusion: The combination of dexmedetomidine and sufentanil anesthesia can maintain hemodynamic stability of patients reduce the stress response and serum inflammatory factor concentration, which is one of the potential effective anesthesia method.

MicroRNAs of bone marrow mesenchymal stem cell-derived exosomes regulate acute myeloid leukemia cell proliferation and apoptosis

Background:Acute myeloid leukemia(AML)is a malignant hematological disease,originating from hematopoiesis stem cell differentiation obstruction and clonal proliferation.New reagents or biologicals for the treatment of AML are urgently needed,and exosomes have been identified as candidate biomarkers for disease diagnosis and prognosis.This study aimed to investigate the effects of exosomes from bone marrow mesenchymal stem cells(BMSCs)on AML cells as well as the underlying microRNA(miRNA)-mediated mechanisms.Methods:Exosomes were isolated using a precipitation method,followed by validation using marker protein expression and nanoparticle tracking analysis.Differentially expressed miRNAs were identified by deep RNA sequencing and confirmed by quantitative real-time polymerase chain reaction(qPCR).Cell proliferation was assessed by the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium inner salt method,and cell cycle progression and apoptosis were detected by flow cytometry.Functional gene expression was analyzed by qPCR and Western blotting(WB).Significant differences were determined using Student’s t test or analysis of variance.Results:BMSCs-derived exosomes effectively suppressed cell proliferation(both P<0.0001 at 10 and 20μg/mL)and cell cycle progression(P<0.01 at G0-G1 stage),and also significantly enhanced cell apoptosis(P<0.001)in KG-1a cells.There were 1167 differentially expressed miRNAs obtained from BMSCs-derived exosomes compared with KG-1a cell-derived exosomes(P<0.05).Knockdown of hsa-miR-124-5p in BMSCs abrogated the effects of BMSCs-derived exosomes in regulating KG-1a such as the change in cell proliferation(both P<0.0001 vs.normal KG-1a cell[NC]at 48 and 72 h).KG-1a cells treated with BMSCs-derived exosomes suppressed expression of structural maintenance of chromosomes 4(P<0.001 vs.NC by qPCR and P<0.0001 vs.NC by WB),which is associated with the progression of various cancers.This BMSCs-derived exosomes effect was significantly reversed with knockdown of hsa-miR-124-5p(P<0.0001 vs.NC by WB).Conclusions:BMSCs-derived exosomes suppress cell proliferation and cycle progression and promote cell apoptosis in KG-1a cells,likely acting through hsa-miR-124-5p.Our study establishes a basis for a BMSCs-derived exosomes-based AML treatment.

肝移植术后患者口服他克莫司引起的肝窦梗阻综合征

Introduction Hepatic sinusoidal obstruction syndrome(HSOS)is a hepatic vascular disease characterized by injury of the endothelial cells in the sinusoidal hepatic and interlobular veins,intra-hepatic congestion,liver dysfunction,and portal hypertension[1].In Western countries,HSOS is often associated with myeloablative regimens used for hematopoietic stem-cell transplantation,while,in China,it is often associated with oral intake of Gynura segetum plants that contain pyrrolidine alkaloids[2].In addition,new-onset HSOS after solid-organ transplantation has received increasing attention[3-8].