Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium(ASPP)mainly used European and American national healthcare databases,lacking detailed patient-level data and pr...Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium(ASPP)mainly used European and American national healthcare databases,lacking detailed patient-level data and precise event timing.Aim(1)To identify the risk factors and prognostic factors for ASPP,(2)to assess the risk of recurrent stroke,particularly during subsequent pregnancies,and(3)to evaluate offspring prognosis.Design This study is a retrospective,observational,nationwide,multicenter research project planned to include 400 ASPP patients from 36 centers across 22 provinces in China,from 2015 to 2024.ASPP is defined as acute ischemic or hemorrhagic stroke during pregnancy or within 6 weeks postpartum,confirmed by neuroimaging.Two matched groups will be included for comparison:400 pregnant/puerperal participants without a stroke history and 400 nonpregnant/puerperal participants with a recent stroke,matched by age and/or stroke etiology.Methods All participants will be followed up through telephone interviews.The initial follow-up is scheduled to take place between December 2024 and February 2025.The follow-up phase will consist of three rounds,each lasting 3 months and conducted every 3 years.Primary outcomes include unfavorable functional outcomes(mRS>2 or EQ-5D index score<0.7)at follow-up for Aim 1,recurrent strokes(neuroimaging-confirmed)for Aim 2,and neonatal asphyxia(Apgar scoring)and future development(ASQ-3)of offspring for Aim 3.Discussion The ASPP study is the first nationwide multicenter study to systematically evaluate the risk factors,prognosis,and risk of recurrent stroke in ASPP patients,particularly during subsequent pregnancies.This research may offer new insights into the long-term impacts of pregnancy-related stroke.展开更多
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 a...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.展开更多
Background Moyamoya disease(MMD)is a rare and complex cerebrovascular disorder characterized by the progressive narrowing of the internal carotid arteries and the formation of compensatory collateral vessels.The etiol...Background Moyamoya disease(MMD)is a rare and complex cerebrovascular disorder characterized by the progressive narrowing of the internal carotid arteries and the formation of compensatory collateral vessels.The etiology of MMD remains enigmatic,making diagnosis and management challenging.The MOYAOMICS project was initiated to investigate the molecular underpinnings of MMD and explore potential diagnostic and therapeutic strategies.Methods The MOYAOMICS project employs a multidisciplinary approach,integrating various omics technologies,including genomics,transcriptomics,proteomics,and metabolomics,to comprehensively examine the molecular signatures associated with MMD pathogenesis.Additionally,we will investigate the potential influence of gut microbiota and brain-gut peptides on MMD development,assessing their suitability as targets for therapeutic strategies and dietary interventions.Radiomics,a specialized field in medical imaging,is utilized to analyze neuroimaging data for early detection and characterization of MMD-related brain changes.Deep learning algorithms are employed to differentiate MMD from other conditions,automating the diagnostic process.We also employ single-cellomics and mass cytometry to precisely study cellular heterogeneity in peripheral blood samples from MMD patients.Conclusions The MOYAOMICS project represents a significant step toward comprehending MMD’s molecular underpinnings.This multidisciplinary approach has the potential to revolutionize early diagnosis,patient stratification,and the development of targeted therapies for MMD.The identification of blood-based biomarkers and the integration of multiple omics data are critical for improving the clinical management of MMD and enhancing patient outcomes for this complex disease.展开更多
Brain aneurysms can be treated with flow diversion embolization.We describe a case of an internal carotid artery aneurysm treated with the Pipeline Vantage flow diverter device,who developed a post‐procedural retinal...Brain aneurysms can be treated with flow diversion embolization.We describe a case of an internal carotid artery aneurysm treated with the Pipeline Vantage flow diverter device,who developed a post‐procedural retinal hemorrhage,presenting as an acutelypresenting,painless“floater”in the visual field.Outpatient evaluation by a retinal specialist yielded a recommendation to observe the hemorrhage,with the option to intervene with retinal surgery if the hemorrhage worsens or does not resolve.Within one month,there was substantial improvement in his visual symptoms without need for further intervention,and follow‐up imaging demonstrated that the aneurysm was successfully treated.展开更多
基金supported by the China Postdoctoral Science Foundation(2024M762182).
文摘Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium(ASPP)mainly used European and American national healthcare databases,lacking detailed patient-level data and precise event timing.Aim(1)To identify the risk factors and prognostic factors for ASPP,(2)to assess the risk of recurrent stroke,particularly during subsequent pregnancies,and(3)to evaluate offspring prognosis.Design This study is a retrospective,observational,nationwide,multicenter research project planned to include 400 ASPP patients from 36 centers across 22 provinces in China,from 2015 to 2024.ASPP is defined as acute ischemic or hemorrhagic stroke during pregnancy or within 6 weeks postpartum,confirmed by neuroimaging.Two matched groups will be included for comparison:400 pregnant/puerperal participants without a stroke history and 400 nonpregnant/puerperal participants with a recent stroke,matched by age and/or stroke etiology.Methods All participants will be followed up through telephone interviews.The initial follow-up is scheduled to take place between December 2024 and February 2025.The follow-up phase will consist of three rounds,each lasting 3 months and conducted every 3 years.Primary outcomes include unfavorable functional outcomes(mRS>2 or EQ-5D index score<0.7)at follow-up for Aim 1,recurrent strokes(neuroimaging-confirmed)for Aim 2,and neonatal asphyxia(Apgar scoring)and future development(ASQ-3)of offspring for Aim 3.Discussion The ASPP study is the first nationwide multicenter study to systematically evaluate the risk factors,prognosis,and risk of recurrent stroke in ASPP patients,particularly during subsequent pregnancies.This research may offer new insights into the long-term impacts of pregnancy-related stroke.
基金sponsored by National Natural Science Foundation of China(grant numbers:81220108007,81801156,81801158,81471167 and 81671139).
文摘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.
基金supported by the National Natural Science Foundation of China(82301451)the National Key Research and Development Program of China(2021YFC2500502).
文摘Background Moyamoya disease(MMD)is a rare and complex cerebrovascular disorder characterized by the progressive narrowing of the internal carotid arteries and the formation of compensatory collateral vessels.The etiology of MMD remains enigmatic,making diagnosis and management challenging.The MOYAOMICS project was initiated to investigate the molecular underpinnings of MMD and explore potential diagnostic and therapeutic strategies.Methods The MOYAOMICS project employs a multidisciplinary approach,integrating various omics technologies,including genomics,transcriptomics,proteomics,and metabolomics,to comprehensively examine the molecular signatures associated with MMD pathogenesis.Additionally,we will investigate the potential influence of gut microbiota and brain-gut peptides on MMD development,assessing their suitability as targets for therapeutic strategies and dietary interventions.Radiomics,a specialized field in medical imaging,is utilized to analyze neuroimaging data for early detection and characterization of MMD-related brain changes.Deep learning algorithms are employed to differentiate MMD from other conditions,automating the diagnostic process.We also employ single-cellomics and mass cytometry to precisely study cellular heterogeneity in peripheral blood samples from MMD patients.Conclusions The MOYAOMICS project represents a significant step toward comprehending MMD’s molecular underpinnings.This multidisciplinary approach has the potential to revolutionize early diagnosis,patient stratification,and the development of targeted therapies for MMD.The identification of blood-based biomarkers and the integration of multiple omics data are critical for improving the clinical management of MMD and enhancing patient outcomes for this complex disease.
文摘Brain aneurysms can be treated with flow diversion embolization.We describe a case of an internal carotid artery aneurysm treated with the Pipeline Vantage flow diverter device,who developed a post‐procedural retinal hemorrhage,presenting as an acutelypresenting,painless“floater”in the visual field.Outpatient evaluation by a retinal specialist yielded a recommendation to observe the hemorrhage,with the option to intervene with retinal surgery if the hemorrhage worsens or does not resolve.Within one month,there was substantial improvement in his visual symptoms without need for further intervention,and follow‐up imaging demonstrated that the aneurysm was successfully treated.
