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No differences were seen in perioperative complications. At the time of last follow-up, improvement in radiculopathy was observed in 94% of the resected PLL group compared with 81% of the unresected PLL group (P = 0.008). After controlling for confounders, PLL resection had 3.8 times greater odds of leading to postoperative improvement in radiculopathy. CONCLUSIONS ACDF leads to a high rate of success in improvement of preoperative radiculopathy. Excision of PLL during surgery leads to 3.8 times greater odds of improvement in this symptom, with no significant difference in the complication rate. BACKGROUND Rheumatoid meningitis is a rare manifestation of autoimmune rheumatoid arthritis. CASE DESCRIPTION A 70-year-old man with rheumatoid arthritis had presented with speech difficulties and limb weakness. Magnetic resonance imaging of his brain demonstrated diffuse meningeal enhancement. A biopsy confirmed the presence of rheumatoid meningitis. CONCLUSION In the present report, we have discussed the diagnostic and therapeutic approach to rheumatoid meningitis. BACKGROUND Few studies have examined the usefulness of intraoperative magnetic resonance spectroscopy (iMRS) for identifying abnormal signals at the resection margin during glioma surgery. The aim of this study was to assess the value of iMRS for detecting proliferative remnants of glioma at the resection margin. METHODS Fifteen patients with newly diagnosed glioma underwent single-voxel 3-T iMRS concurrently with intraoperative magnetic resonance imaging-assisted surgery. Volumes of interest (VOIs) were placed at T2-hyperintense or contrast-enhancing lesions at the resection margin. In addition to technical verification, the correlation between the MIB-1 labeling index (a pathologic feature) and metabolites measured using iMRS (N-acetyl-L-aspartate [NAA], choline [Cho], and Cho/NAA ratio) was analyzed. RESULTS iMRS was performed for 20 VOIs in 15 patients. Fourteen (70%) of these VOIs were confirmed to be MIB-1-positive. There was a significant positive correlation between the Cho/NAA ratio and MIB-1 index (r = 0.46, P = 0.04). Cho level (P = 0.003) and Cho/NAA ratio (P = 0.002) were significantly higher in VOIs that were MIB-1-positive than in those that were MIB-1-negative. Detection of a Cho level >1.074 mM and a Cho/NAA ratio >0.48 using iMRS resulted in high diagnostic accuracy for MIB-1-positive remnants (Cho level sensitivity 86%, specificity 100%; Cho/NAA ratio sensitivity 79%, specificity 100%). CONCLUSIONS This study provides evidence that 3-T iMRS can detect proliferative remnants of glioma at the resection margin using the Cho level and Cho/NAA ratio, suggesting that intraoperative magnetic resonance imaging-assisted surgery with iMRS would be practicable in glioma. BACKGROUND M2 occlusions represent 16%-41% of all middle cerebral artery occlusions, with >50% of functional independence achieved. The American Heart Association/American Stroke Association 2018 guidelines suggest that, with a level of evidence B-R, thrombectomy with stent retrievers may be appropriate for selected patients with M2 or M3 occlusions. The purpose of this study is to illustrate a new technique of distal (M2-M3) thrombectomy. METHODS Eight patients from May 2018 to February 2019 underwent a thrombectomy procedure for a M2 or M3 occlusion with a 3MAX or 4MAX intermediate aspiration catheter, a Headway Duo 167 cm microcatheter, and a Catchview Mini stent retriever. RESULTS All thrombectomies were technically successful, defined as thrombolysis in cerebral infarction score ≤2b. Five out of the 8 patients attained a good functional outcome at 3 months, defined as modified Rankin scale score ≤2. CONCLUSIONS This technique allows a safe and effective distal thrombectomy for M2-M3 occlusions. Implantation of blood-contacting materials/devices usually causes severe thrombus formation, inflammatory reactions, excessive hyperplasia, and ultimately, induce endothelial dysfunction. In this work, a biomimetic approach was established to address those adverse problems through constructing a catechol-mediated and copper-incorporated multilayer coating. The biomimetics was mainly obtained via two paths. The first one was structure bionics, which used polyelectrolytes (heparin and polyethyleneimine) to modify with catechol moieties and then further formed a multilayer coating via layer-by-layer assembly, so as to mimic the mussel adhesive DOPA-rich structure; the second one was function bionics, which copper ions were then incorporated to function as the catalysts to decompose the endogenous S-nitrosothiols to release nitric oxide (NO), so as to mimic the key function of healthy endothelial cells. CCT251545 ic50 The quartz crystal microbalance with dissipation (QCM-D) was used to monitor the multilayer construction process and demonstrated the enhanced stability of the catechol-mediated multilayer coatings. Besides, the catechol-rich coating could also support the sustained release of heparin. Copper ions were incorporated into the multilayer coatings via the catechol-Cu coordination, and could effectively generate NO in situ at a physiological level. Due to the sustained release of heparin and continuous NO generation, the synergistic antithrombogenicity and anti-hyperplasia ability were obtained. The ex-vivo arteriovenous (AV) shunt model for blood perfusion test and metal wire implantation in blood vessels further demonstrated the high biomimetic functionality of potential applications for blood-contacting devices. Despite the promising anticancer effects of kinesin spindle protein (KSP) inhibition, functional plasticity of kinesins induced resistance against KSP inhibitors in a variety of cancers, leading to clinical failure. Additionally, paclitaxel is a widely used anticancer agent, but drug resistance has limited its use in the recurrent cancers. To overcome resistance against KSP inhibitors, we paired KSP inhibition with microtubule stabilization using KSP siRNA and paclitaxel. To enable temporal co-localization of both drugs in tumor cells in vivo, we exploited PEGylated cationic liposomes carrying both simultaneously. Drug synergism study shows that resistance against KSP inhibition can be suppressed by the action of microtubule-stabilizing paclitaxel, because microtubule stabilization prevents a different kinesin Kif15 from replacing all essential functions of KSP when KSP is inhibited. Our combination therapy showed more effective antiproliferative activity in vitro and in vivo than either paclitaxel or KSP siRNA alone.
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