Objective:To evaluate the safety and feasibility of endovascular recanalization for non-acute internal carotid artery occlusion (NA-ICAO), and to propose a new angiographic classification.Methods:From April 2015 to October 2019, 95 consecutive patients with symptomatic NA-ICAO who received endovascular recanalization were retrospectively analyzed in Beijing Tiantan Hospital, Capital Medical University. All the patients were divided into four groups according to DSA: type Ⅰ, petrous segments were distally reconstituted by collateral vessels; type Ⅱ, cavernous segments were distally reconstituted by collateral vessels; type Ⅲ, ophthalmic segments were distally reconstituted by collateral vessels; type Ⅳ, communicating segments were distally reconstituted by collateral vessels. Study data including clinical characteristics, surgical details, lesion classification, recanalization rate and perioperative complications. For the counting data, the χ 2 test was used to compare between groups. For the quantitative data, the ANOVA was used for the normal distribution data, otherwise the Kruskal-Wallis H test was used. The primary safety outcome was any stroke or death within 30 days. Results:Among the 95 patients, 67 (70.53%) had successful recanalization. The recanalization rates of type Ⅰ－Ⅳ were 92.31% (36/39), 81.82% (18/22), 47.83% (11/23) and 18.18% (2/11) respectively (χ2=29.557, P<0.001). And the complication rates of the four types were 5.13% (2/39), 13.64% (3/22), 21.74% (5/23) and 9.10% (1/11) respectively. The incidence of perioperative ischemic stroke was 2.11% (2/95). No other serious stroke and death occurred. Conclusions:Endovascular recanalization may be feasible and safe for carefully selected patients with NA-ICAO and therefore represents an alternative treatment. The patients with type Ⅰ and Ⅱ lesions had higher recanalization rates, while the patients with type Ⅳ lesions had significantly lower recalculation rate. The new angiographic classification is conducive to the selection of suitable patients and difficulty in grading.

Objective Metformin ( MET) is the first-line medications of choice for patients with type 2 diabetes. In recent years,a large number of studies at home and abroad have shown that metformin not only has significant effects in controlling blood sugar level of diabetic patients and intervening in impaired glucose tolerance,but also has ＂ magical＂ effects in in the field of hypoglycemic outside. In addition to the early discovery that metformin can be used to treat metabolic syndrome and polycystic ovary syndrome,control body weight,blood pressure,blood lipid,and reduce the risk of cardiovascular events,metformin can also play anti-tumor,anti-inflammatory effects,delay aging,and treat mental disorders such as depression. This article reviews the effect of metformin in the field out of hypoglycemic.

Objective To explore the relationship between plasma adiponectin, visfatin, leptin, and resistin levels, and the onset of colonic polyps in prediabetes subjects. Methods A total of 468 prediabetes subjects, who received colonoscopy examination, were enrolled in this study, including 248 cases of colon polyps (polyps group with prediabetes) and 220 cases without colonic mucosal lesions ( polyps-free group with prediabetes). According to the clinical characteristics of colonic polyps, colonic polyps patients with prediabetes were subdivided into single polyp group, multiple polyps group, low-risk polyps group, and high-risk polyps group, respectively. In addition, 108 subjects with normal glucose tolerance, who were matched with prediabetes subjects on gender and age, were selected as control group, and 46 cases of them were refered to polyps group with normal glucose tolerance and 62 cases were refered to polyps-free group with normal glucose. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all subjects, and related risk factors of colonic polyps in prediabetes patients were analyzed. Results Not only in normal glucose tolerance subjects, but also in prediabetes subjects, plasma visfatin levels in polyps group were significantly higher than those in polyps-free group (P＜0.05), and plasma adiponectin levels were significantly lower than those in polyps-free group [normal glucose tolerance (9.8±4.8 vs 13.3±3.9)mg/L, P＜0.05; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4)mg/L, P＜0.01], respectively. However, no significant difference in the plasma leptin and resistin levels were observed between polyps-free group and polyps group ( both P＞0. 05), respectively. In addition, in prediabetes subjects, plasma visfatin levels increased (P＜0.05) and adiponectin levels decreased significantly [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P＜0.05] in multiple polyps group than in single polyp group. Nevertheless, there were no significant differences in plasma leptin and resistin levels between two groups (both P＞0.05). Moreover, plasma adiponectin levels decreased significantly in high-risk polyps group with prediabetes than in low-risk polyps group with prediabetes[(3.7±2.9vs7.4±3.5)mg/L,P＜0.05].Meanwhile,noneofplasmavisfatin,leptin,andresistinlevels had shown significant difference between two groups (all P＞0.05). The multivariate logistic regression analysis found that adiponectin was an independent protective factor for colon polyps, multiple colon polyps and high-risk colon polyps. Conclusion The changes of plasma adiponectin levels might be associated with onset of colonic polyps in prediabetes.

BackgroundMetacognition， the capacity to monitor and control one's cognitive processes， has been identified as a crucial component of effective decision-making and behavioral adaptation. Previous research has revealed cognitive deficits in patients with major depressive disorder （MDD）， while findings about metacognitive capacities in patients with MDD have been inconsistent across studies， and the exact relationship between metacognitive capacities and clinical symptoms in MDD patients remains uncertain. ObjectiveTo examine the metacognitive capacities of adolescent hospitalized patients with MDD and to explore its relationship with depressive and anxiety symptoms， thus providing an unprecedented insight into the prevention of MDD. MethodsA coherent 56 adolescent hospitalized patients with MDD in the Psychiatry Department at the Affiliated Hospital of Southwest Medical University from March 2022 to June 2023 and met the diagnostic criteria for depression as defined by the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were enrolled as MDD group. At the same time， 62 healthy individuals matched with the age and sex of the MDD group residing in Luzhou were concurrently selected as control group. The metacognitive ability of the two groups was evaluated by perceptual decision-making task and confidence rating task， and the indicators included confidence deviation， reaction time of confidence evaluation and metacognitive efficiency. Additionally， the severity of depressive and anxiety symptoms was measured with Beck Depression Inventory （BDI） and Beck Anxiety Inventory （BAI）. Pearson correlation analysis was utilized to examine the relationship between metacognitive capacities and clinical symptoms. ResultsMDD group scored higher on BDI and BAI when compared with control group （t=-13.722， -9.674， P<0.01）. In terms of decision-making performance， no statistically significant difference was noted in accuracy and response time between two groups （t=-0.655， 0.975， P>0.05）. In terms of metacognitive performance， MDD group reported a reduction in overall confidence， confidence in correct decisions， confidence in incorrect decisions and metacognitive efficiency compared with control group （t=3.044， 2.769， 2.836， 3.667， P<0.01）. MDD group demonstrated significantly longer confidence evaluation response time than that of control group （t=-2.561， P<0.05）. Correlation analysis revealed that among the MDD patients， overall confidence， confidence in correct decisions and confidence in incorrect decisions were negatively correlated with BDI score （r=-0.310， -0.307， -0.298， P<0.05）， and the overall confidence and confidence in correct decisions were negatively correlated with BAI score （r=-0.284， -0.280， P<0.05）， while no statistical significance existed in the correlation between confidence in incorrect decisions and BAI score （r=-0.229， P>0.05）. Furthermore， metacognitive efficiency in MDD patients exhibited negative correlation with both BDI and BAI scores （r=-0.269， -0.290， P<0.05）. ConclusionHospitalized adolescent patients with MDD have impaired metacognition， and metacognitive capacity is found to be associated with severity of depressive and anxiety symptoms. ［Funded by Luzhou Science and Technology Bureau-Southwest Medical University Collaborative Project （number， 2019LZXNYDJ39）； Southwest Medical University Institutional Research Project （number， 2022ZD004）］

The endocrown, a modified overlay or crown, is considered to have the advantages of adhesive retention and mechanical retention. Marginal adaptation and mechanical strength are common criteria for evaluating endocrowns. This review studied these aspects of endocrowns to guide further clinical application. Results from previous academic studies indicate that endocrowns made of different materials, such as glass-based ceramics, zirconia-based ceramics and resin-based ceramics, exhibit clinically acceptable marginal adaptation. Zirconia is a common dental material, but when used in endocrowns, it tends to present a risk of irreparable tooth root fractures. Compared with products manufactured with zirconia, endocrowns manufactured with resin-based ceramics and glass-based ceramics, such as lithium disilicate ceramics, do not tend to cause irreparable results, such as tooth root fracture, but their mechanical strengths are not as good as those of zirconia. At the same time, the tooth prepration design such as the types of endocrowns, the pulp chamber extension depth and angles, the endocrown thickness can influence the mechanical strength of endocrowns as well. Compared with traditional zirconia, self-glazed zirconia, a new type of material used to restore defective teeth, has the similar elasticity modulus（210 GPa）and better aesthetic advantages, and is suitable for short crown patients with insufficient occlusal space. Further study is warranted to improve the performance of endocrowns made from ceramic materials to prevent root fracture.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*