Brain & Heart

Distinctive clinicopathological features and differential gene expression of cerebral venous thrombosis mimicking brain tumors

2023-07-05T21:55:40+08:00

Cerebral venous thrombosis (CVT), a rare type of cerebrovascular disease, can mimic a brain tumor (CVT mimicking brain tumor [CVTMBT]), due to its space-occupying imaging features. We aimed to describe the clinicopathological features and identify the thrombophilia-related gene expression changes in the brain following CVT. We conducted a retrospective qualitative study of CVT patients who were misdiagnosed with brain tumors before surgery at our hospital from 2016 to 2021. We analyzed the clinicopathological characteristics of the cases from our hospital and previously published cases. Five subjects were retrospectively studied, but one refused to provide biological specimens. We performed messenger ribonucleic acid (mRNA) sequencing from eight specimens (four CVTMBT and four non-CVTMBT samples). Differentially expressed genes (DEGs) were screened using the “edge” package in R 3.6.1 software. Thrombophilia-related genes were obtained from the MalaCards human disease database and were cross-checked with DEGs. The intersection was considered to be the potential genes in the pathogenesis of CVTMBT. The medical histories of the five patients with CVTMBT included oral non-steroidal anti-inflammatory drug use, oral contraceptive use, cesarean section, and anemia. All patients underwent craniotomy and were pathologically diagnosed with CVT. The follow-up results revealed that all patients had favorable outcomes without any recurrence. DEG analysis revealed 813 upregulated and 253 downregulated DEGs between patients with CVTMBT and controls. Nine DEGs were associated with thrombophilia, including SERPINE1, SELP, THBD, ITGB3, TFPI, F13A1, PROS1, PPBP, and PROCR, which were considered potential key genes in CVTMBT. CVTMBT presents with enhancement and mass effect on magnetic resonance imaging, accompanied by various predisposing factors, shorter disease duration, and coagulation dysfunction. The nine key genes identified as potential key genes in the pathogenesis of CVTMBT may be potential biomarkers for accurate screening and appropriate treatment.

Potential use of prophylactic intracoronary atropine in reducing reperfusion vagal reflex-related events in ST-elevation myocardial infarction

2023-07-05T21:55:26+08:00

In this study, we evaluated the potential use of atropine in reducing reperfusion vagal reflex-related events during emergency percutaneous coronary intervention (PCI) for acute inferior ST-elevation myocardial infarction (STEMI). Retrospectively, we included 142 patients with inferior wall STEMI, who were treated between October 2015 and October 2020, in this study. The patients were divided into an experimental group (n = 70) and a control group (n = 72) depending on whether they received prophylactic intracoronary atropine. The experimental group was then subdivided into a low-dose group (0.5 – 1 mg atropine, n = 40) and a high-dose group (2 mg atropine, n = 30). We compared the incidence of reperfusion vagal reflex-related events and the application of temporary pacemakers between these groups. The results showed that the incidence of bradycardia (24.3% vs. 45.8%, P = 0.007), hypotension (18.6% vs. 40.3%, P = 0.005), ventricular tachycardia (4.3% vs. 19.4%, P = 0.005), and ventricular fibrillation (8.6% vs. 20.8%, P = 0.040) as well as the application of temporary pacemakers (14.3% vs. 29.2%, P = 0.032) were all much lower (all P < 0.05) in the experimental group than in the control group. In addition, the incidence of bradycardia (10% vs. 35%, P = 0.016), hypotension (6.7% vs. 27.5%, P = 0.027), ventricular tachycardia (6.7% vs. 25%, P = 0.044), and ventricular fibrillation (0 vs. 15%, P = 0.034) as well as the application of temporary pacemakers (3.3% vs. 22.5%, P = 0.036) were all much lower (all P < 0.05) in the high-dose group than the low-dose group. Our findings demonstrate that atropine pretreatment could prevent reperfusion vagal reflex-related events and reduce the application of temporary pacemakers during emergency PCI for acute inferior STEMI. These effects can be significantly enhanced by high-dose (2 mg) atropine pretreatment.

Application of the concept of neural networks surgery in cerebrovascular disease treatment

2023-07-05T21:55:53+08:00

Based on advanced techniques, both the brain structural network and functional network can be reflected, giving rise to a new field: neural networks. Entering the 21^st century, along with the extensive research on neural networks and the digital brain imaging field of neuromodulation, the neurosurgical field has entered into a novel stage: neural networks surgery. Neural networks surgery was developed to devote to protecting the cognitive function of patients with central nervous system diseases. By lucubrate, multiple new views of cerebrovascular disease have emerged. In this paper, we review the applications of this novel concept in treating cerebrovascular diseases, primarily through three aspects: disease mechanism, progression, and treatment strategy. Based on recent research, the development of a novel treatment system for cerebrovascular diseases might help clarify the course of these diseases, provide optimal treatment strategies, and protect the cognitive function of patients to the greatest extent.