Search

Background Intracranial aneurysms may be misdiagnosed with other vascular lesions such as vascular loops, infundibulum, or the stump of an occluded artery (very rare and reported compromising only the middle cerebral artery and the posterior circulation territory). Our aim was to describe a unique case of occlusion of an anterior cerebral artery mimicking a cerebral aneurysm in a probable moyamoya disease patient, and to highlight its clinical presentation, diagnosis, and management, and to perform an extensive literature review. Case A 67-year-old man suffering from recurrent dizziness for 3 months. Previous medical history was unremarkable. Brain magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) demonstrated occlusion of the right middle cerebral artery (MCA) associated with a “probable moyamoya disease” and an aneurysm-like shadow protruding lesion at the anterior communicating artery (AcomA). Perfusion images showed ischemia along the right temporo-occipital lobe. Due to MCA occlusion with perfusion deficits and unspecific symptoms, we offered a right side encephalo-duro-myo-synangiosis (EDMS) and clipping of the AcomA aneurysm in one session. Intraoperatively, there was no evidence of the AcomA aneurysm; instead, this finding corresponded to the stump of the occluded right anterior cerebral artery (A1 segment). This segment appeared to be of yellowish color due to atherosclerosis and lacked blood flow. The patient underwent as previously planned a right side EDMS and the perioperative course was uneventful without the presence of additional ischemic attacks. Conclusion Arterial branch occlusions can sometimes present atypical angiographic characteristics that can mimic a saccular intracranial aneurysm. It is relevant to consider this radiographic differential diagnosis, especially when aneurysm treatment is planned.

Our aim was to determine the impact of targeted blood pressure modifications on cerebral blood flow in ischemic moyamoya disease patients assessed by single-photon emission computed tomography (SPECT). From March to September 2018, we prospectively collected data of 154 moyamoya disease patients and selected 40 patients with ischemic moyamoya disease. All patients underwent in-hospital blood pressure monitoring to determine the mean arterial pressure baseline values. The study cohort was subdivided into two subgroups: (1) Group A or relative high blood pressure (RHBP) with an induced mean arterial pressure 10–20% higher than baseline and (2) Group B or relative low blood pressure (RLBP) including patients with mean arterial pressure 10–20% lower than baseline. All patients underwent initial SPECT study on admission-day, and on the following day, every subgroup underwent a second SPECT study under their respective targeted blood pressure values. In general, RHBP patients showed an increment in perfusion of 10.13% (SD 2.94%), whereas RLBP patients showed a reduction of perfusion of 12.19% (SD 2.68%). Cerebral blood flow of moyamoya disease patients is susceptible to small blood pressure changes, and cerebral autoregulation might be affected due to short dynamic blood pressure modifications.

Porous silicon nanowires (SiNWs) is considered as one of promising candidates for high-performance NO2 sensor application in human health and quality life owing to its fast response and stable operation at room temperature. However, the development of SiNWs-based gas sensors for stable detection of ppb-level NO2 in practical high-humidity environments remains a challenge. In this study, octadecyltrichlorosilane (OTS) was utilized to modify partially insensitive SiNWs surface with the Si-O bond, yielding an immunity to high humidity in gas detection process. The modified OTS provides an umbrella-like barrier blocking water molecules attraction on the nanowire surface which disinhibits the main adsorption sites and sensing channels of the sensor. The OTS-modified porous SiNWs (OTS/SiNWs) sensor exhibited a practical capability to detect 5 ppb NO2 at humidity of 25%–55% RH and a response of 1.8% to 50 ppb NO2 at 75% RH at room temperature. Moreover, the fast response/recovery characteristics and good reversibility of the OTS/SiNWs sensor was observed even under high humidity conditions. In addition, the OTS/SiNWs sensor displayed excellent stability to humidity variations. The enhanced gas sensing performance is attributed to a marriage of porous structure of SiNWs and OTS. The simple modification for SiNWs-based gas sensor will broaden new avenues, not only in chemical trace detection, but also in high humidity health monitoring.

At present, most of the small-scale solar power generation systems are fixed, which generally have low power generation efficiency and single system function. In order to solve this problem, this paper designs a set of solar power generation system with light tracing to achieve higher power generation efficiency. At the same time, it has a rainwater collection system, so that the system can collect rainwater resources in rainy days, which can be applied to urban and road lighting and greening and other occasions. Through theoretical analysis, the scale model is built and tested. The experimental results show that the power generation under sunny and cloudy test can be improved by 20.229% and 19.096% respectively. It show that the system can track the sun's path intelligently by sensors, increase the efficiency of power generation, and effectively solve the problem that the popular power generation system can only play a role in sunny days.

Background: Cataract is the most prevalent cause of blindness worldwide, and millions of cataract surgeries are performed in China every year. Postoperative endophthalmitis (POE), a devastating infectious complication of cataract surgery, often results in extremely poor visual prognosis, even blindness. We investigated the incidence of acute POE after cataract surgery in Northern China from 2012 to 2018, evaluated the effectiveness of perioperative infection prophylaxis and analyzed the potential prognosis factor for the final visual outcome of POE patients. Methods: The study was designed as a retrospective multicenter research, with seven hospitals in Northern China enrolled. The diagnosis of acute-onset POE was mainly made on the basis of clinical manifestations within six weeks after initial surgery. By reviewing electronic medical system, the number of cataract surgeries and acute POE cases were recorded to estimate the overall incidence and incidences among different years and hospitals. Perioperative measures for preventing infection in different hospitals were collected to evaluate their effectiveness in reducing the risk of developing POE. The correlations between final visual acuity and potential factors including basal information and clinical characteristics were examined to determine the predictive factors for the visual prognosis. Findings: Of 72,255 cataract surgeries performed during seven years in the seven hospitals, 19 cases developed acute POE, yielding an incidence of 0·026% (95%CI 0·015%, 0·038%). The occurrence rate of acute POE significantly declined year by year over the period (p=0·021), from 0·056% in 2012 to 0·007% in 2018. The incidence of acute POE significantly decreased in Hospital-D after the application of 0·5% povidone-iodine (PVP-I) for conjunctival washing (p =0·003). Two hospitals adopting tobramycin in the irrigation solution achieved a significant lower incidence than the other hospitals (p=0·044). At the onset of endophthalmitis, the best BCVA presented was 20/70 and only four patients (21·1%) achieved BCVA better than counting fingers (CF). The positive rate of pathogen culture was just 17·6% (3/19) in our study, with Staphylococcus hominis isolated in two cases and Streptococcus cultured in one case. Patients with presenting BCVA of CF or better was more likely to achieve a better final visual outcome than those with worse presenting BCVA (p=0·003). Interpretation: In the past seven years, the incidence of POE after cataract surgery declined annually in Northern China, but there are still broad gaps among different level hospitals which much more effort should be made to eliminate. Due to the regional variation in the POE incidence, it is essential for cataract surgeons to figure out the recent incidence and changing tendency of POE in their own regions, thereby being sensitive and keeping alerting to its occurrence. Prophylactic use of 0·5% PVP-I and tobramycin in irrigation solution should be applied to prevent POE after cataract surgery, and presenting BCVA could be regarded as a prognosis factor for the final visual outcome. Funding Statement: National Science and Technology Major Project (2018ZX10101004) Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was designed as a retrospective multicenter research. It was approved by the Ethical Committees of all the included hospitals and conformed to the tenets of the Declaration of Helsinki.

Previous studies suggest a relationship between sleep disordered breathing (SDB) and lower extremity artery disease (LEAD) though disagreements remain. This study was performed to assess the association between SDB and LEAD in a metaanalysis. PubMed and Embase databases were searched for observational studies. A random-effects model incorporating between-study heterogeneity was used to pool the data. The search revealed 7 studies including 152,885 participants. Patients with SDB had higher odds of LEAD (risk ratio [RR] = 1.32, 95% confidence interval [CI] = 1.07 to 1.63, p = 0.01, I 2 = 66%) compared to non-SDB participants. In subgroup analyses, SDB was related to higher odds of LEAD in patients with stroke or diabetes (RR = 3.28, p < 0.001) than in a community-derived population (RR = 1.17, p = 0.08; p for subgroup difference < 0.001). Furthermore, the odds of LEAD was increased in patients with moderate (RR = 1.34, 95% CI = 1.04 to 1.73, p = 0.02) or severe SDB (RR = 1.81, 95% CI = 1.08 to 3.03, p = 0.02), but not in those with mild SDB (RR = 0.94, 95% CI = 0.69 to 1.29, p = 0.71). Differences in study design or methods for LEAD diagnosis did not appear to affect the association between SDB and LEAD. Patients with SDB have higher odds of LEAD compared to non-SDB participants.

Objective: The purpose of this study is to explore the therapeutic effect of autologous bone marrow stem cell (ABMSC) mobilization combined anti-infection therapy on patients with moyamoya disease (MMD), and to provide reference for the clinical treatment of MMD and cerebrovascular disease. Methods: 54 adult patients with MMD diagnosed in Henan Provincial People’s Hospital from March 2017 to March 2019 were chosen as research objects. All patients were randomly divided into study group (SG) and control group (CG), with 27 patients in each group. Patients in both groups received conventional drug treatment after diagnosis of MMD, and received dura turnover of brain - temporal muscle - superficial temporal artery application surgery during indirect vascular reconstruction. On the basis of surgical treatment, patients in the SG were given ABMSC mobilization combined with low-dose dexamethasone for anti-inflammatory and anti-infection treatment. ABMSCs were mobilized by recombinant human granulocyte colony stimulating factor (rhG-csF) and recombinant human granulocyte - macrophage colony stimulating factor (rhoM-esF). The therapeutic effects of the patients were evaluated BF, one month after treatment (AF), three months AF, and six months AF. The number of hematopoietic stem cells (HpCs) and inflammatory indicators were compared between the two groups before and 4 weeks AF. Results: Firstly, the Barthcl index of patients in the two groups showed a gradual increase trend at the 3rd and 6th months AF, and the ascensional range in the research group was higher than that in the CG (P

To solve the complicated problem elevator fault classifications, a Bayesian confidence network structural learning algorithm based on Stigmergy is put forward. It was put into tests in the Bayesian network to diagnose elevator faults. With three fault datasets of the elevator of the same model, a Stigmergy Strategy based Bayesian Elevator Fault Classification Network, SSBCN for short, is constructed. In the 20 times of 10-crossing-over tests, the average classification accuracy of SSBCN experiments validates the effectiveness of the approach.