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Background: Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Methods: Consecutive patients who underwent Pipeline embolization device (Medtronic) deployment via transradial access were included in the study, irrespective of location and laterality of the intracranial aneurysm. The cases were performed between July 2016 and October 2019. Demographics, aneurysm characteristics, and procedure-related details (including catheter systems used) were recorded and statistically evaluated. Results: Thirty-five transradial flow diversion procedures were attempted in 32 patients, of which 33 procedures were successful. In two cases involving left common carotid artery and internal carotid artery access, guide catheter herniation into the aortic arch led to abandonment of transradial access in favor of transfemoral access. The most common aneurysm locations in the transradial access procedures were the posterior communicating artery (n = 7), ophthalmic artery (n = 7), and superior hypophyseal artery (n = 7). Most transradial access procedures (66.7%) were performed using a biaxial catheter system. 6-French Benchmark (Penumbra) and Phenom 27 (Medtronic) were the most commonly utilized guide- and microcatheters, respectively. One patient had intraprocedural subarachnoid hemorrhage. No access-site complications occurred. Conclusion: This study demonstrates safety and feasibility of transradial access for Pipeline embolization device deployment and shows the versatility of this approach for different catheter systems. Tortuosity and acute angulation of the left common carotid artery and internal carotid artery were associated with approach failure. [ABSTRACT FROM AUTHOR]

Background: Controversy exists regarding the optimum number of flow diverters for the treatment of intracranial aneurysms. We explored the effect of the number of Pipeline embolization devices (PEDs; Medtronic, Dublin, Ireland) deployed on rates of aneurysm occlusion and complications. Methods: Consecutive patients who underwent saccular intracranial aneurysm treatment solely with the PED were included in this retrospective study. Computed tomographic, magnetic resonance, or digital subtraction angiographic images at 6 and 12 months and last follow-up (>12 months) were reviewed for aneurysm occlusion. Complication and retreatment rates were recorded and analyzed statistically. Results: The study included 141 aneurysm treatments in 119 patients. A single PED was deployed in 105 cases, two PEDs in 31 cases, and three PEDs in 5 cases (total = 182 devices). Six-month angiographic data were available for 103 patients. Occlusion rates were 67.1% for single-PED cases and 90.0% for cases with > 1 PED (p = 0.028). The 12-month occlusion rate (follow-up available for 132) for single-PED cases was 74.7% compared to 91.7% for multiple-PED cases (p = 0.04). On multivariate analysis, number of PEDs was an independent predictor of aneurysm occlusion at 12 months (odds ratio 6.3, 95% confidence interval 1.8–22.8, p = 0.005). Thromboembolic complication rates were the same in the single- and multiple-PED treatment groups (2.8%). The retreatment rate was higher in patients treated with a single PED (16.2% vs. 0%, p = 0.01). Conclusions: Deployment of > 1 Pipeline embolization device was associated with higher intracranial aneurysm occlusion and lower retreatment rates. No significant difference was found in complication rates. [ABSTRACT FROM AUTHOR]

The combination of electrochemical immunosensors using single-wall carbon nanotubes (SWNT) forest platforms with multi-label secondary antibody-nanotube bioconjugates for highly sensitive detection of a cancer biomarker in serum and tissue lysates is described. The results suggest that SWNT immunosensors can accurately detect cancer biomarkers in complex biological samples with high sensitivity and selectivity.

OBJECTIVE: The aim of this study was to evaluate the effect of micro ribonucleic acid (miR)-26a on myocardial ischemia-reperfusion (I/R) injury in rats and to explore its potential mechanism. Our findings might help to provide references for clinical prevention and treatment of myocardial I/R. MATERIALS AND METHODS: A total of 60 male Sprague-Dawley (SD) rats were randomly divided into three groups using a random number table, including: Control group (n=20), I/R group (n=20) and I/R + miR-26a siRNA group (n=20). I/R model was established via recanalization after ligation of left anterior descending coronary artery (LAD). The model of miR-26a knockdown was established in rats of I/R + miR-26a siRNA group via tail intravenous injection of miR-26a siRNA. Ejection fraction (EF%) and fractional shortening (FS%) of rats in each group were detected via echocardiography. The infarction area of each group was detected via 2,3,5-triphenyltetrazolium chloride (TTC) assay. Subsequently, morphological changes in myocardial cells of each group were detected via hematoxylin-eosin (H&E) staining. Myocardial apoptosis level was measured via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. At the same time, the expression levels of pro-apoptotic proteins Bcl-2 associated X protein (Bax) and cleaved (C)-caspase3 in myocardial tissues of the three groups were determined using Western blotting. Finally, the effects of miR-26a knockdown on the expressions of glycogen synthase kinase (GSK)-3β/β-catenin signaling pathway-related proteins were detected via Western blotting and immunohistochemistry. RESULTS: The expression of miR-26a in myocardial tissues of I/R group increased significantly when compared with that in Control group (p<0.05). Knockdown of miR-26a significantly improved cardiac insufficiency caused by I/R, which also obviously increased both EF% and FS% in rats (p<0.05). In addition, knockdown of miR-26a significantly inhibited myocardial infarction caused by I/R injury, and reduced infarction area from (43.08±2.43) to (21.54±1.82) (p<0.05). The results of H&E staining revealed that in I/R + miR-26a siRNA group, myofilaments were arranged more orderly, the degree of degradation and necrosis was significantly lower, and cellular edema was significantly alleviated when compared with I/R group. Subsequent TUNEL staining demonstrated that rats in I/R + miR-26a siRNA group showed remarkably lower level of myocardial apoptosis than I/R group (p<0.05). Meanwhile, the protein expression levels of Bax and C-caspase3 were remarkably declined in I/R + miR-26a siRNA group (p<0.05). Furthermore, the results of Western blotting showed that miR-26a siRNA could significantly reverse the inhibition of GSK-3β/β-catenin signaling pathway induced by I/R injury (p<0.05). CONCLUSIONS: Knockdown of miR-26a could significantly improve I/R-induced myocardial injury and promote cardiac function in rats. The possible underlying mechanism might be related to targeted regulation of miR-26a on GSK-3β/β-catenin signaling pathway. Therefore, miR-26a was expected to be a new therapeutic target for myocardial I/R injury. [ABSTRACT FROM AUTHOR]

There is an ongoing debate to which extent the phenotypic plasticity is associated with the shade-tolerance of species along a broad environmental gradient. Seedlings of five species of varying shade tolerance were grown under each of the four combinations of high and low light or nutrient availabilities in shade houses. Leaf, fine root and whole-plant traits were measured to evaluate the phenotypic plasticity in seedlings of five species in response to light and nutrition gradients. Generally, leaf nitrogen and phosphorus concentrations, specific leaf area (SLA), leaf area ratio, specific fine-root length and surface area (SRL, SRSA), leaf mass ratio, and relative growth rate decreased, whereas total root mass ratio increased with increasing shade tolerance of species, indicating light-demanding species had higher ability to capture above- and below-ground resources and thus had higher growth rate than shade-tolerant species. Light was a more important limiting factor than soil nutrients for the five studied species; and the light responsiveness at different nutrient availability for most morphological variables was similar among different species. In response to light and nutrient gradients, the mean plasticity index of all variables measured did not differ significantly among the five species, indicating that the species with contrasting shade tolerance have similar plasticity. There were significantly positive correlations in leaf area (mass) and fine-root surface area (mass) for each species along light and nutrient gradients. Moreover, there were significant correlations between leaf and fine-root nitrogen and phosphorus concentrations, leaf area and fine-root surface area, SLA and SRL or SRSA across all species and treatments. Our result thus provided an evidence of a common leaf and root traits syndrome linking traits to effects on plant and ecosystem process. [ABSTRACT FROM AUTHOR]

Graphic methods of curve fitting for discrete data make use of informal exploratory techniques to test regression models for binary data.