Association of Hypothyroidism with Hypertensive Intracerebral Hemorrhage: A Case-Control Study

Signature and function of plasma exosome-derived circular RNAs in patients with hypertensive intracerebral hemorrhage

Intracerebral hemorrhage (ICH) is one of the major causes of death and disability, and hypertensive ICH (HICH) is the most common type of ICH. Currently, the outcomes of HICH patients remain poor after treatment, and early prognosis prediction of HICH is important. However, there are limited effective clinical treatments and biomarkers for HICH patients. Although circRNA has been widely studied in diseases, the role of plasma exosomal circRNAs in HICH remains unknown. The present study was conducted to investigate the characteristics and function of plasma exosomal circRNAs in six HICH patients using circRNA microarray and bioinformatics analysis. The results showed that there were 499 differentially expressed exosomal circRNAs between the HICH patients and control subjects. According to GO annotation and KEGG pathway analyses, the targets regulated by differentially expressed exosomal circRNAs were tightly related to the development of HICH via nerve/neuronal growth, neuroinflammation and endothelial homeostasis. And the differentially expressed exosomal circRNAs could mainly bind to four RNA-binding proteins (EIF4A3, FMRP, AGO2 and HUR). Moreover, of differentially expressed exosomal circRNAs, hsa_circ_00054843, hsa_circ_0010493 and hsa_circ_00090516 were significantly associated with bleeding volume and Glasgow Coma Scale score of the subjects. Our findings firstly revealed that the plasma exosomal circRNAs are significantly involved in the progression of HICH, and could be potent biomarkers for HICH. This provides the basis for further research to pinpoint the best biomarkers and illustrate the mechanism of exosomal circRNAs in HICH.

Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage

BACKGROUND

Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men.

AIM

To investigate the correlation between vascular endothelial growth factor (VEGF) and cortisol (Cor) and the prognosis of patients with hypertensive cerebral hemorrhage.

METHODS

A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group. Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group. Peripheral venous blood was collected, and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay.

RESULTS

A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment (P < 0.05). Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group. Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses. Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage (P < 0.05).

CONCLUSION

Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.

Hypertensive intracerebral hemorrhage: Which one should we choose between laser navigation and 3D navigation mold?

Background

Hypertensive intracerebral hemorrhage (HICH) is a severe life-threatening disease, and its incidence has gradually increased in recent years. Due to the particularity and diversity of its bleeding sites, the early treatment of hematoma needs to be more meticulous and accurate, and minimally invasive surgery is often one of the measures that are commonly adopted now. The lower hematoma debridement and the navigation template created by 3D printing technology were compared in the external drainage of a hypertensive cerebral hemorrhage. Then the effect and feasibility of the two operations were explicitly evaluated.

Material and methods

We performed a retrospective analysis of all eligible patients with HICH who underwent laser-guided hematoma evacuation or hematoma puncture under 3D-navigated molds at the Affiliated Hospital of Binzhou Medical University from January 2019 to January 2021. A total of 43 patients were treated. Twenty-three patients were treated with laser navigation-guided hematoma evacuation (group A); 20 patients were treated with 3D navigation minimally invasive surgery (group B). A comparative study was conducted between the two groups to evaluate the preoperative and postoperative conditions.

Results

The preoperative preparation time of the laser navigation group was significantly shorter than that of the 3D printing group. The operation time of the 3D printing group was better than that of the laser navigation group (0.73 ± 0.26 h vs. 1.03 ± 0.27 h P = 0.00070). In the improvement in the short-term postoperatively, there was no statistically significant difference between the laser navigation group and the 3D printing group (Median hematoma evacuation rate P = 0.14); And in the three-month follow-up NIHESS score, there was no significant difference between the two (P = 0.82).

Conclusion

Laser-guided hematoma removal is more suitable for emergency operations, with real-time navigation and shortened preoperative preparation time; hematoma puncture under a 3D navigation mold is more personalized and shortens the intraoperative time course. There was no significant difference in therapeutic effect between the two groups.

Association of Thyroid Hypofunction with Clinical Outcomes after Microvascular Decompression for Hemifacial Spasm

INTRODUCTION

Data regarding the association between thyroid dysfunction and hemifacial spasm (HFS) are limited. We conducted a single-center, retrospective study to investigate the predictive value of thyroid dysfunction in patients with HFS after microvascular decompression (MVD).

METHODS

Between July 2004 and January 2015, 156 patients who were tested for thyroid hormones after MVD for HFS were enrolled in the present study. We assessed their detailed history, clinical manifestations, serum thyroid hormone levels, and surgical outcomes. The patients were classified into low and high groups based on thyroid hormone concentrations, and clinical outcomes were evaluated in each group.

RESULTS

In a total of 156 patients with a median follow-up period of 40.9 months, the improvement rate was 87.8%. The patients were classified into low (76, 48.7%) or high (80, 51.3%) groups based on serum thyroxine (T4) levels. There was a difference between the 2 groups in terms of postoperative outcomes following MVD (p = 0.020). There were no differences in the outcomes according to serum tri-iodothyronine (T3) levels as well as other factors associated with the outcomes.

CONCLUSIONS

We found that decreased serum T4 levels are associated with poor postoperative outcomes among patients with HFS. Further studies are needed to examine the clinical benefit of thyroid hormone replacement therapy for patients with suboptimal T4 concentrations as well as active thyroid hormone screening for patients with HFS.

Efficacy of minimally invasive surgery for the treatment of hypertensive intracerebral hemorrhage: A protocol of randomized controlled trial

INTRODUCTION

Hypertensive intracerebral hemorrhage (HICH) is the most serious complication of hypertension. Clearing intracranial hematoma as soon as possible, reducing brain cell edema, and controlling intracranial pressure could effectively reduce neuron damage, lower patient mortality, and improve patient prognosis. At present, minimally invasive surgery (MIS) has been widely used and plays an important role in the treatment of HICH. However, it is still in controversies about the choice of surgical treatment and medication treatment for HICH. Therefore, we try to conduct a randomized, controlled, prospective trial to observe the efficacy of MIS treatment against HICH compared with medication treatment.

METHODS

Patients will be randomly divided into treatment group and control group in a 1:1 ratio using the random number generator in Microsoft Excel. Stereotactic soft channel minimally invasive intracranial hematoma puncture and drainage treatment and medication treatment will be applied respectively. The outcomes of intracerebral hemorrhage volume, Glasgow coma scale, National Institutes of Health Stroke Scale will be recorded.

CONCLUSIONS

The findings of the study will be helpful for the choice of MIS and conservative treatment when treating HICH patients.

TRIAL REGISTRATION

OSF Registration number: DOI 10.17605/OSF.IO/ME6Y5.