Objective To build rat models and observe changes of behavior and monoamine of PDD. Methods The rats were injected with 6-OHDA and accepted CUMS for the establishment of PDD model , so as to assess its behavior changes and detect brain tissue monoamine contents by ELISA. Results Significant behavioral and monoamine abnormalities can be observed in model rats. Behavioral and monoamine improvement can be observed after treated with Chaigan Jieyou. Conclusion The PDD model can be established by 6-OHDA and CUMS. Chaigan Jieyou decoction may reach therapeutic purposes by increasing monoamine contents.

Objective To evaluate the clinical efficacy and safety of Chaigan Jieyou decoction in treating Parkinson's disease depression (PDD).Methods Applying the method of simple random contrast,this research collects 70 patients who meet the study criteria and divide the patients into two groups of 35 peoples each:Chaigan Jieyou decoction group,which received treatment of Chaigan Jieyou decoction and fluoxetine group with treatment of fluoxetine.Treatment period was 2 months.Apply the HAMD-17 (Hamilton Depression Scale),Beck Depression Scale (Beck Depression Inventory,BDI),Parkinson's composite score (unified Parkinson disease rating scale,UPDRS) and TCM symptoms rating scale to evaluate the clinical efficacy before and after treatment.Resuits Compared the two groups by HAMD Score reduction rate,there is no statistical significance in the general efficacy rate (P ＞ 0.05);compared by the curative effect of TCM syndrome,Chaigan Jieyou decoction group is better than fluoxetine group (P ＜ 0.05).There is statistical significance in the differences of all the HAMD,BDI,UPDRS Ⅱ,UPDRS Ⅲ scores between the two groups after the treatment (P ＜ 0.01,P ＜ 0.05).Compared the treatment efficacy by the HAMD scores,Chaigan Jieyou decoction can alleviate the clinical symptoms of patients of varying degrees.Conclusions Chaigan Jieyou decoction can significantly relieve depression of PDD patients,and there is exact curative effect to the mild and moderate PDD patients,improving their quality of life to a certain extent.

Objective:To analyze the clinical characteristics of patients with anterior and posterior circulation large vessel occlusion ischemic stroke and clinical prognoses after successful endovascular recanalization.Methods:A retrospective analysis was performed; 170 patients with large vessel occlusive ischemic stroke, admitted to Stroke Center, Second Hospital of Dalian Medical University from January 2016 to September 2022 were chosen; these patients had modified Thrombolysis in Cerebral Infarction (mTICI) 2b or 3 after endovascular treatment. These patients were divided into anterior-circulation large vessel occlusion group ( n=138) and posterior-circulation large vessel occlusion group ( n=32) according to the locations of vessel occlusion. Clinical data, parameters related to endovascular treatment, and clinical prognoses of the 2 groups were collected and compared. Results:Posterior-circulation large vessel occlusion group had significantly higher percentages of male patients and patients with atherosclerotic type (81.3% vs. 61.6%; 78.1% vs. 47.1%), significantly higher ratio of neutrophil to lymphocyte and NIHSS scores (3.78 [1.93, 10.86] vs. 2.77[1.77, 4.72]; 20.50±8.96 vs. 14.83±4.67), significantly lower percentage of patients with atrial fibrillation (21.9% vs. 58%), and significantly longer times from onset to puncture, onset to recalculation, admission to puncture, and admission to recalculation (367.50 [246.25, 630.00] min vs. 240.00 [198.75, 330.00]; 515.00 [292.50, 701.25] vs. 345.50 [270.00, 425.75] min; 163.00 [123.25, 218.50] min vs. 125.50 [97.00, 161.00]; 258.00 [200.25,389.00] vs. 219.50 [178.00, 276.25]) than anterior-circulation large vessel occlusion group ( P<0.05). The NIHSS scores 24 h after endovascular treatment, NIHSS scores at discharge, and mortality within 90 d in posterior-circulation large vessel occlusion group were significantly higher than those in anterior-circulation large vessel occlusion group (21.31±9.23 vs. 15.74±6.53; 25.5 [4.25, 40.25] vs. 10.00 [4.00, 18.25]; 40.6% vs. 20.3%, P<0.05); however, no significant differences in symptomatic intracranial hemorrhage, incidence of intracranial hemorrhage, in-hospital mortality or 90-d good prognosis were noted between the 2 groups ( P>0.05). Conclusion:Posterior circulation large vessel occlusion ischemic stroke patients have higher neurological impairment at onset than anterior circulation acute large vessel occlusion ischemic stroke patients; both patients enjoy similar results in terms of 90-d good prognosis and complications, but 90-d mortality is higher than that in anterior ones.

Objective:To compare the effectiveness of intravenous thrombolysis(IVT)alone versus mechanical thrombectomy(MT)in treating acute large vessel occlusive stroke(AIS-LVO).Amd to analyze the factors that are associated with the prognosis of MT.Methods:A total of 197 patients with acute ischemic stroke with large vessel occlusion(AIS-LVO)who received intravenous thrombolysis(IVT)and/or mechanical thrombectomy(MT)at the Stroke Center of the Second Hospital of Dalian Medical University from April 2016 to July 2021 were included in this retrospective analysis.Baseline data, clinical data, and 90-day Modified Rankin Scale(mRS)scores were collected for each group.The efficacy and risk of IVT alone and MT were compared using univariate and multivariate logistic regression analysis.Additionally, factors influencing the prognosis of MT were identified.Results:A total of 197 patients who met the inclusion criteria were included in this study.Out of these, 62 patients were in the IVT alone group and 135 patients were in the MT group.The results of the univariate analysis showed that the MT group had lower admission systolic blood pressure(147±23 vs.158±27 mmHg, P=0.003), higher baseline NIHSS score[15(12, 19) vs.12(8, 16), P=0.003], and there were also differences in vascular occlusion between the two groups( χ2=15.504, P=0.004).Specifically, the middle cerebral artery and basilar artery occlusion were higher in the MT group.In terms of outcome, the MT group had a higher percentage of good outcomes at 90 days[53(39%) vs.13(21%), χ2=6.381, P=0.012], and there was no significant difference in symptomatic intracranial hemorrhage(sICH)and mortality within 90 days.Among the 135 patients who underwent MT, 53 patients were classified as having a good prognosis, while 82 patients were classified as having a poor prognosis.Multivariate analysis revealed that age( OR=1.078, 95% CI: 1.025-1.133, P=0.003), neutrophil to lymphocyte ratio(NLR)( OR=1.164, 95% CI: 1.013-1.338, P=0.032), time from onset to recanalization( OR=1.004, 95% CI: 1.000-1.007, P=0.049), sICH( OR=15.585, 95% CI: 1.397-173.865, P=0.026), ASPECTS/pc-ASPECTS score( OR=0.524, 95% CI: 0.017-0.582, P=0.024), and good recanalization( OR=0.099, 95% CI: 1.718-59.046, P=0.010)were identified as independent prognostic factors.The results indicate that percutaneous transluminal angioplasty, stent implantation, and the use of tirofiban and butylphthalide did not significantly affect the prognosis of the MT group. Conclusions:The use of mechanical thrombectomy(MT)in patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)is more effective than intravenous thrombolysis(IVT)alone and has a similar safety profile.However, there are certain factors that can influence the prognosis of MT treatment.Older age, higher neutrophil-to-lymphocyte ratio(NLR), longer time from symptom onset to recanalization, and the occurrence of postoperative symptomatic intracranial hemorrhage(sICH)were identified as independent predictors of poor prognosis in MT treatment.On the other hand, a higher ASPECTS/pc-ASPECTS score and successful recanalization were found to be protective factors associated with a favorable prognosis in MT treatment.

To explore whether the severity of LA in patients with acute ischemic stroke（AIS）with large vessel occlusion（AIS-LVO） was related to the prognosis of MT treatment. Methods A total of 75 AIS-LVO patients who received intravenous thrombolysis（IVT） bridging MT or MT alone were selected in the stroke center of our hospital from April 2016 to October 2021.According to the Fazekas score scale，the severity of LA was divided into non-mild group（0-2 points，n=44） and moderate-severe group（3～6 points，n=31）. The baseline data and postoperative outcome of MT were compared between the two groups. The prognosis at 90 days after operation was evaluated by modified Rankin scale（mRS）. The results were divided into two groups：good prognosis group（0～2 points，n=32） and poor prognosis group（3～6 points，n=43）. Univariate analysis and multivariate Logistic regression analysis were used to determine whether LA was related to the prognosis of at 90 days after MT.Results Univariate analysis showed that compared with the non-mild LA group，the moderate-severe LA group had an older age［（73.77±8.25） vs（63.00±10.50） years old］，higher female proportion（58.1% vs 22.7%），higher proportion of atrial fibrillation（61.3% vs 36.4%），lower proportion of hyperlipidemia（9.7% vs 29.5%），higher incidence of postoperative hemorrhage transformation（38.7% vs 13.6%），higher incidence of sICH at 72 hours after operation（19.4% vs 2%），higher rate of futile recanalization（78.6% vs 39.0%），and higher incidence of 90-day poor prognosis after operation（80.6% vs 40.9%）. There were significant differences between two groups（all P<0.05）. Univariate analysis showed that compared with the good prognosis group，the poor prognosis group had an older age［69.0（63.0，77.0）vs 63.5（53.0，75.5）years old］，higher baseline NIHSS score ［（17.8±6.8） vs（12.3±4.9） points］，higher fasting blood glucose level［6.78（5.71，10.43） vs 5.88（5.29，6.95）］ mmol/L］，higher neutrophil to lymphocyte ratio（NLR） ［4.48（1.92，8.11） vs 2.4（1.43，3.06）］，higher proportion of diabetes（37.2% vs 12.5%），and higher proportion of moderate-severe LA（58.1% vs 18.8%）. There were significant difference between two groups（all P<0.05）.Multivariate Logistic regressionanalysis showed that moderate-severe LA（OR=6.796，95%CI 1.564～29.530，P=0.011）and baseline NIHSS score（OR=1.156，95%CI 1.015～1.317，P=0.029） were independent risk factors for poor 90-day functional prognosis after MT.Conclusion Moderate-severe LA can independently predict the poor prognosis of patients with AIS-LVO after MT.

Objective:To construct a non-invasive pre-hospital screening model and early based on artificial intelligence algorithms to provide the severity of stroke in patients, provide screening, guidance and early warning for stroke patients and their families, and provide data support for clinical decision-making.Methods:A retrospective study was conducted. The clinical information of stroke patients ( n = 53?793) were extracted from the Yidu cloud big data server system of the Second Affiliated Hospital of Dalian Medical University from January 1, 2001 to July 31, 2023. Combined with the results of single factor screening and the opinions of experts with senior professional titles in neurology, the input variable was determined, and the output variable was the National Institutes of Health Stroke Scale (NIHSS) representing the severity of the disease at admission. Python 3.7 was used to build DeepFM algorithm model, and five data mining models including Logistic regression, CART decision tree, C5.0 decision tree, Bayesian network and deep neural network (DNN) were built at the same time. The original data were randomly divided into 80% training set and 20% test set, which were used to train and test the models, adjust the parameters of each model, respectively calculate the accuracy, sensitivity and F-index of the six models, carry out the comprehensive comparison and evaluation of the model. The receiver operator characteristic curve (ROC curve) and calibration curve were drawn, compared the prediction performance of DeepFM model and the other five algorithms. In addition, the data of stroke patients ( n = 1?028) were extracted from Dalian Central Hospital for external verification of the model. Results:A total of 14?015 stroke patients with complete information were selected, including 11?212 in the training set and 2?803 in the testing set. After univariate screening, 14 indicators were included to construct the model, including gender, age, recurrence, physical impairment, facial problems, speech disorders, head reactions, disturbance of consciousness, visual disorders, abnormal cough and swallowing, high risk factor, family history, smoking history and drinking history. DeepFM model adopted the two-order crossover feature. The number of hidden layers in DNN layer was 3. Dropout was used to discard the neurons in the neural network. Rule was used as the activation function. Each layer used Dense full connection. The objective function was random gradient descent. The number of iterations was 15. There were 133?922 training parameters in total. Comparing the predictive value of the six models showed that the accuracy of DeepFM model was 0.951, the sensitivity was 0.992, the specificity was 0.814, the F-index was 0.950, and the area under the curve (AUC) was 0.916. The accuracy of the other five data mining models were between 0.771-0.780, the sensitivity were between 0.978-0.987, the F-index were between 0.690-0.707, and the AUC were between 0.568-0.639. The calibration curve of the DeepFM model was more aligned with the ideal curve than the other five data mining models. Suggesting that the prediction performance of DeepFM model was the best. External validation was conducted on the DeepFM model, and its accuracy was 0.891, indicating good generalization performance of the model.Conclusion:The pre-hospital non-invasive screening prediction model based on DeepFM can accurately predict the severity grading of stroke patients, and has potential application value in rapid screening and early clinical decision-making of stroke.