Objective To investigate the efficacy of endovascular treatment (EVT) in acute cardioembolic large vessel occlusion (LVO) of anterior circulation and its influencing factors.Methods The clinical data of 83 patients with acute cardioembolic LVO of anterior circulation treated with EVT during June 2014 to June 2016 were analyzed retrospectively.The neurological outcomes in these patients were evaluated by National Institutes of Health Stroke Scale (NIHSS) on admission;cerebral vascular re-canalization after procedure was classified according to thrombolysis in cerebral infarction (TICI) grading;the recovery of neurological outcomes was classified by modified Rankin scale (mRS) at discharge.According to the mRS scores at discharge,these patients were divided into two groups:good curative effect group and poor curative effect group.Single factor analysis was performed on all clinical parameters that might influence the surgical outcomes;in addition,the influencing factors of surgical outcomes were analyzed by multiple factor Logistic regression analysis.Results Eighty-one patients (97.59％) had good re-canalization (TICI grading 2b-3) after EVT;41 patients (49.40％) had better curative effect (mRS scores ≤3 at discharge),and 42 patients (50.60％) had poor curative effect (mRS scores ≥4 at discharge);postoperative hemorrhagic transformation appeared in 26 patients,and 16 patients (19.28％) accepted decompressive craniectomy resulting from massive cerebral infarction,severe encephaledema or hemorrhagic transformation,and had poor curative effect.The single factor analysis showed that the differences of NIHSS scores on admission,occlusion site,angiographic re-canalization,time from the symptom onset to the vessel re-canalization and whether hemorrhagic transformation after operation between the good curative effect group and poor curative effect group were statistically significant (P＜0.05);multiple factor Logistic regression analysis showed that NIHSS scores on admission,angiographic re-canalization,time from the symptom onset to the vessel re-canalization and whether hemorrhagic transformation after procedure were significantly correlated to the treatment efficacy (OR=1.171,95％CI:1.028-1.333,P=0.017;OR=3.623,95％CI:0.931-14.095,P=0.063;OR=l.012,95％ CI:1.003-1.021,P=0.008;OR=3.146,95％CI:0.875-11.309,P=0.079).Conclusions Endovascular thrombectomy is an effective approach for cardioembolic acute anterior circulation stroke.Furthermore,the influential factors of surgical treatment are NIHSS scores on admission,angiographic re-canalization,time from the symptom onset to the vessel re-canalization and whether hemorrhagic transformation after procedure.

A 58-year-old male patient with diabetic foot ulcer was admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine on December 11, 2018. The patient was treated with local debridement, vacuum sealing drainage treatment, and dressing change and discharged after basic wound healing. On January 15, 2019, the patient was hospitalized again due to local infection and rupture of wound surface. He underwent a surgical debridement on the third day after second admission and was given intravenous infusion of 0.4 g teicoplanin twice daily. Histopathological examination after surgery showed keratinizing squamous-cell carcinoma. An extended squamous-cell carcinoma resection plus autologous split-thickness skin grafting and vacuum sealing drainage treatment was carried out on the 10th day after second admission. The patient′s whole body turned red after surgery with rash, recurrent fever over 39 ℃, leucopenia, and thrombocytopenia. A multi-disciplinary consultation of physicians attributed these symptoms to teicoplanin-induced hypersensitivity syndrome. After withdrawal of teicoplanin and administration of hormone, the patient′s temperature returned to normal, and the leucocyte count and platelet count recovered gradually. The patient was cured and discharged on the 49th day after second admission. The case presented reminds us of need to strictly follow the indications of teicoplanin prior to medication, be resolute to the administration and withdrawal, and be alert to adverse drug reactions when above-mentioned abnormalities occur, meanwhile, infection and rheumatic diseases are excluded.

The human immune system plays a key role in maintaining tissue homeostasis and disease progression. The development of biomaterials that can regulate the innate immune system and adapt to the immune system has great application prospects in the field of tissue engineering. This paper discusses how to design the surface interface topographies or the physicochemical properties of biomaterials, to regulate the fate of macrophages, such as activation, polarization, adhesion, migration, proliferation, and secretion. At the same time, the application of these biomaterials with immunoregulation function in the field of wound healing is discussed. In addition, this paper also put forward the limitations of biomaterials in immunoregulation applications and prospected the future development directions.