1.Precise mechanical thrombectomy guided by ABC 2D scale in acute intracranial large vessel occlusive stroke
Weiwen YI ; Geng LIAO ; Zhenyu ZHANG ; Yuemei HE ; Weijie DU ; Chuanpiao ZHONG ; Xinghang LAN ; Chaomao LI
Chinese Journal of Neuromedicine 2023;22(8):765-771
Objective:To investigate the efficacy and safety of precise mechanical thrombectomy based on ABC 2D scale in acute intracranial large artery occlusion stroke (ALVOs). Methods:A prospective study was performed. Two hundred and two patients with ALVOs accepted early mechanical thrombectomy in Department of Neurology, Maoming Clinical School of Guangdong Medical University from January 2021 to February 2022 were enrolled. They were randomly divided into experimental group ( n=102) and control group ( n=100). Stent retriever partially retracted with intermediate catheter for mechanical thrombectomy (SWIM) was the first choice for patients in control group. ABC 2D scale was used to prejudge the pathogenesis of patients in experimental group: patients with scores of 0-3 were considered as having embolic occlusion and a direct aspiration first pass technique (ADAPT) was the first choice, and SWIM would be chosen if suction catheter could not be in place; patients with scores of 4-7 were considered as having intracranial atherosclerotic stenosis occlusion and SWIM was the first choice. The clinical data, surgical effectiveness, surgical safety, and good prognosis rate 90 d after mechanical thrombectomy (modified Rankin scale scores of 0-2 as good prognosis) of the 2 groups were compared. Results:Experimental group had significantly shorter time from puncture to recanalization (51.0[35.0, 78.5] min vs. 67.0[45.0, 100.0] min), and statistically lower NIHSS scores 24 h after mechanical thrombectomy (10.00[4.75, 16.25] vs. 13.00[8.00, 19.00]), significantly higher good prognosis rate 90 d after mechanical thrombectomy (69.6% vs. 46.0%), statistically lower mortality 90 d after mechanical thrombectomy (3.9% vs. 13.0%) compared with control group ( P<0.05). No significant differences were noted in first-pass effect rate, successful vascular revascularization rate, or incidences of symptomatic intracranial hemorrhage (sICH) and ectopic embolization between the control group and experimental group ( P>0.05). Conclusion:Patients with ALVOs accepted early mechanical thrombectomy can have shorter time from puncture to vascular recanalization and better prognosis after etiologically prejudging by ABC 2D scale for thrombectomy.
2.Effects of Intestinal Flora and Local Renin-angiotensin System on Diabetic Nephropathy and Traditional Chinese Medicine Intervention: A Review
Chaomao YANG ; Yuanyuan LI ; Shunxiao ZHANG ; Jiandong GAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(15):242-248
Diabetic nephropathy (DN) is a common clinical complication of diabetes, the main cause of end-stage renal disease (ESRD), and a key determinant of survival in diabetic patients. The pathogenesis of DN is complex, and it is currently believed to be associated with hemodynamic abnormalities, intestinal flora disturbances, glucose and lipid metabolism disorders, oxidative stress, genetic susceptibility, and protein non-enzymatic glycosylation. The local renin-angiotensin system (RAS) has always been the core of the pathogenic and progressive changes of DN. Once activated, it will induce the massive release of oxygen free radicals in the blood vessels, damage the endothelial function, and affect the microcirculation of the body. The recent studies demonstrate that intestinal flora and its metabolites may affect the occurrence and development of DN by activating or antagonizing the local RAS. Compared with western medicine treatment, traditional Chinese medicine (TCM) has the advantages of multiple targets and little toxic and side effects. Many TCM scholars have found that single herbs, their active ingredient extracts, and TCM compound prescriptions can improve kidney function by regulating the local RAS or intestinal flora. Specifically, the Chinese medicinal materials tonifying spleen (Codonopsis Radix, Dioscoreae Rhizoma, Atractylodis Macrocephalae Rhizoma, and Poria), replenishing kidney (Rehmanniae Radix Praeparata, Corni Fructus, and Pseudostellariae Radix), and activating blood, resolving stasis, and dredging collaterals (Hirudo, Salviae Miltiorrhizae Radix et Rhizoma, and Angelicae Sinensis Radix) have the regulatory effect. This article summarizes the roles of intestinal flora and local RAS in the occurrence and development of DN, and analyzes the animal experiments or clinical trials of TCM intervention in DN in recent years, aiming to provide more therapies and a theoretical basis for the treatment of DN with integrated TCM and Western medicine.
3.Modified Liuwei Dihuangtang Combined with Losartan Potassium Regulates ACE1/AngⅡ/AT1R Axis and Intestinal Flora in Rat Model of Diabetic Kidney Disease
Chaomao YANG ; Shunxiao ZHANG ; Yuanyuan LI ; Jiandong GAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):1-9
ObjectiveTo explore the mechanism of modified Liuwei Dihuangtang in preventing and treating renal injury in diabetic kidney disease (DKD) via the angiotensin-converting enzyme 1 (ACE1)/angiotensin Ⅱ (AngⅡ)/angiotensin Ⅱ type 1 receptor (AT1R) axis. MethodFifty male SD rats were randomized into a normal group (n=8) and a modeling group (n=42). The rats in the modeling group were fed with a high-sugar and high-fat diet for 6 weeks and intraperitoneally injected with 35 mg