To assess clinicopathologic correlations of a novel placental lesion featuring a distinct ring-like periarterial edema of stem villi (PASE). A retrospective case-control statistical comparison (Yates χ2 or analysis o...To assess clinicopathologic correlations of a novel placental lesion featuring a distinct ring-like periarterial edema of stem villi (PASE). A retrospective case-control statistical comparison (Yates χ2 or analysis of variance) of 30 clinical and 41 placental features of 100 consecutive placentas with PASE and 100 gestational age-matched cases without PASE, extracted from 2403 placentas from high-risk pregnancies signed out by the author since year 2006. The PASE was seen in 4.2% of placentas, average gestational age 35.9 weeks (range, 24 - 42 weeks). Frequencies of stem obliterative endarteritis and hypercoiled umbilical cord (coiling index > 0.3) were 23% vs 5% (p = 0.005), and 20% vs 9% (p = 0.04) in the study group and comparative group, respectively. There were no statistically significant differences (p > 0.05) between the groups in clinical or other placental variables. The PASE may be linked to chronically abnormal blood flow in umbilical cord arteries and their stem branches and may be a histological placental sign of non-obliterative umbilical cord compromise.展开更多
Glymphatic flow has been proposed to clear brain waste while we sleep.Cerebrospinal fluid moves from periarterial to perivenous spaces through the parenchyma,with subsequent cerebrospinal fluid drainage to dural lymph...Glymphatic flow has been proposed to clear brain waste while we sleep.Cerebrospinal fluid moves from periarterial to perivenous spaces through the parenchyma,with subsequent cerebrospinal fluid drainage to dural lymphatics.Glymphatic disruption is associated with neurological conditions such as Alzheimer’s disease and traumatic brain injury.Therefore,investigating its structure and function may improve understanding of pathophysiology.The recent controversy on whether glymphatic flow increases or decreases during sleep demonstrates that the glymphatic hypothesis remains contentious.However,discrepancies between different studies could be due to limitations of the specific techniques used and confounding factors.Here,we review the methods used to study glymphatic function and provide a toolkit from which researchers can choose.We conclude that tracer analysis has been useful,ex vivo techniques are unreliable,and in vivo imaging is still limited.Finally,we explore the potential for future methods and highlight the need for in vitro models,such as microfluidic devices,which may address technique limitations and enable progression of the field.展开更多
Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BR...Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BRVO)by widefield swept-source optical coherence tomography angiography(SS-OCTA)and assess their associations with clinical outcomes.Methods:In this retrospective observational study of 54 treatment-naive BRVO patients with macular edema,we reviewed the findings of 12×12 mm^(2)SS-OCTA at baseline,3,6,and 12 months after intravitreal ranibizumab injections.The paCFZ and major retinal artery areas were measured on SS-OCTA images.The paCFZ area to artery area(P/A)ratio was calculated.Results:The paCFZ areas and P/A ratios of first-and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes(all P<0.01),but there were no differences in the first-and second-order artery areas(P=0.20 and 0.25,respectively).The paCFZ areas and P/A ratios decreased significantly at 3,6,and 12 months after anti-VEGF therapy(all P<0.01).The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity(BCVA),central retinal thickness,and their improvements at 3,6,and 12 months(all P<0.05).Baseline BCVA and P/A ratios of first-and second-order arteries were independently associated with the final BCVA in multivariate linear regression.Conclusions:Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO.Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.展开更多
Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological...Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.展开更多
文摘To assess clinicopathologic correlations of a novel placental lesion featuring a distinct ring-like periarterial edema of stem villi (PASE). A retrospective case-control statistical comparison (Yates χ2 or analysis of variance) of 30 clinical and 41 placental features of 100 consecutive placentas with PASE and 100 gestational age-matched cases without PASE, extracted from 2403 placentas from high-risk pregnancies signed out by the author since year 2006. The PASE was seen in 4.2% of placentas, average gestational age 35.9 weeks (range, 24 - 42 weeks). Frequencies of stem obliterative endarteritis and hypercoiled umbilical cord (coiling index > 0.3) were 23% vs 5% (p = 0.005), and 20% vs 9% (p = 0.04) in the study group and comparative group, respectively. There were no statistically significant differences (p > 0.05) between the groups in clinical or other placental variables. The PASE may be linked to chronically abnormal blood flow in umbilical cord arteries and their stem branches and may be a histological placental sign of non-obliterative umbilical cord compromise.
基金supported by the European Union Horizon 2020 Research and Innovation Programme(Marie Skłodowska-Curie grant agreement No 847419)supported by the Biotechnology and Biological Sciences Research Council via a Discovery Fellowship(BB/W00934X/1)+6 种基金the Aston University RKE Pump Priming Programmefunded by UKRI’s Research England as part of their Expanding Excellence in England(E3)fundsupported by a UKRI Frontier Research Grant EP/Y023684/1(following assessment as an ERC Advanced grant,FORTIFY,ERC-2022-ADG-101096882 under the UK Government Guarantee scheme)acknowledged a Biotechnology and Biological Sciences Research Council Pioneer Award(BB/Y512874/1)MMS was supported by a Medical Research Council Career Development Award(MR/W027119/1)acknowledged support from the BHF Centre of Research Excellence,University of Oxford(grant code:RE/24/130024)a Biotechnology and Biological Sciences Research Council Pioneer Award(BB/Y512874/1).
文摘Glymphatic flow has been proposed to clear brain waste while we sleep.Cerebrospinal fluid moves from periarterial to perivenous spaces through the parenchyma,with subsequent cerebrospinal fluid drainage to dural lymphatics.Glymphatic disruption is associated with neurological conditions such as Alzheimer’s disease and traumatic brain injury.Therefore,investigating its structure and function may improve understanding of pathophysiology.The recent controversy on whether glymphatic flow increases or decreases during sleep demonstrates that the glymphatic hypothesis remains contentious.However,discrepancies between different studies could be due to limitations of the specific techniques used and confounding factors.Here,we review the methods used to study glymphatic function and provide a toolkit from which researchers can choose.We conclude that tracer analysis has been useful,ex vivo techniques are unreliable,and in vivo imaging is still limited.Finally,we explore the potential for future methods and highlight the need for in vitro models,such as microfluidic devices,which may address technique limitations and enable progression of the field.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82101150,82171078)Shanghai clinical 3-year action plan-major clinical research(Grant Nos.SHDC2020CR2041B,SHDC2020CR5014-003)+1 种基金Shanghai Sailing Program(Grant No.21YF1405300)Shanghai Committee of Science and Technology(Grant Nos.20Y11911100,18411965100).
文摘Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BRVO)by widefield swept-source optical coherence tomography angiography(SS-OCTA)and assess their associations with clinical outcomes.Methods:In this retrospective observational study of 54 treatment-naive BRVO patients with macular edema,we reviewed the findings of 12×12 mm^(2)SS-OCTA at baseline,3,6,and 12 months after intravitreal ranibizumab injections.The paCFZ and major retinal artery areas were measured on SS-OCTA images.The paCFZ area to artery area(P/A)ratio was calculated.Results:The paCFZ areas and P/A ratios of first-and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes(all P<0.01),but there were no differences in the first-and second-order artery areas(P=0.20 and 0.25,respectively).The paCFZ areas and P/A ratios decreased significantly at 3,6,and 12 months after anti-VEGF therapy(all P<0.01).The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity(BCVA),central retinal thickness,and their improvements at 3,6,and 12 months(all P<0.05).Baseline BCVA and P/A ratios of first-and second-order arteries were independently associated with the final BCVA in multivariate linear regression.Conclusions:Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO.Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.
基金supported by the Natural Science Foundation of Beijing(Key Program)No.Z200025(to JHY)+1 种基金the National Natural Science Foundation of China,No.81873818(to LHQ)Supporting Platform Construction Project of Peking University Health Science Center,No.BMU2021ZC011(to JHY).
文摘Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.
