Objective To explore the clinical efficacy of stent-assisted thrombectomy combined with intermediate catheter aspiration in the treatment of acute basilar artery occlusive cerebral infarction.Methods Eighty patients with acute basilar artery occlusive cerebral infarction admitted to the Department of Neurology of Cangzhou People's Hospital from July 2022 to July 2023 were selected as the research subjects.The patients were divided into the control group(stent-assisted thrombectomy)and the observation group(stent-assisted thrombectomy combined with intermediate catheter aspiration)according to the treatment method,with 40 patients in each group.The neurological deficit of the patients in both groups was evaluated by using the National Institutes of Health Stroke Scale(NIHSS)before and after the intervention;the vascular recanalization of the patients was evaluated by using the modified thrombolysis in cerebral infarction(mTICI)grade;and the clinical prognosis of the patients was assessed by using the modified Rankin scale(mRS)at 3 months after treatment(mRS score ≤2:favorable prognosis;mRS score＞2:poor prognosis).A 12-month postoperative follow-up was conducted to monitor the incidence of complications and the mortality rate.Results There was no significant difference in the NIHSS score of patients between the two groups before treatment(P＞0.05);the NIHSS scores of patients in both groups at 24 hours and 3 months after treatment were significantly lower than those before treatment(P＜0.01);the NIHSS scores of patients in the observation group at 24 hours and 3 months after treatment were significantly lower than those in the control group(P＜0.01).There were a total of 22 patients with mTICI grades of 2b and 3 in the control group,and the first vascular recanalization rate was 55.0％(22/40);there were a total of 35 patients with mTICI grades of 2b and 3 in the observation group,and the first vascular recanalization rate was 87.5％(35/40);and the first vascular recanalization rate of patients in the observation group was significantly higher than that in the control group(x2=0.375,P＞0.05).Three months after treatment,there were 13 patients in the control group with an mRS score of 0 to 2,and the favorable prognosis rate was 32.5％(13/40);there were 21 patients in the observation group with an mRS score of 0 to 2,and the favorable prognosis rate was 52.5％(21/40);the favorable prognosis rate of patients in the observation group was significantly higher than that in the control group(x2=6.619,P＜0.05).During the 12-month follow-up,stroke-associated pneumonia occurred in 18 patients(45.0％),cerebral hernia occurred in 5 patients(12.5％),symptomatic intracranial hemorrhage occurred in 4 patients(10.0％),and 12 patients died,with a fatality rate of 30.0％in the control group;while in the observation group,stroke-associated pneumonia occurred in 10 patients(25.0％),cerebral hernia occurred in 4 patients(10.0％),symptomatic intracranial hemorrhage hemorrhage occurred in 2 patients(5.0％),and 8 patients died,with a fatality rate of 12.0％.There was no significant difference in the incidence of cerebral hernia and symptomatic intracranial hemorrhage between the observation group and control group(x2=0.125,0.721;P＞0.05).The incidence of stroke-associated pneumonia and the fatality rate of patients in the observation group were significantly lower than those in the control group(x2=4.016,3.954;P＜0.05).Conclusion Stent-assisted thrombectomy combined with intermediate catheter aspiration can effectively improve the first recanalization rate and enhance the neurological function and prognosis of patients with acute basilar artery occlusive cerebral infarction.

Objective To investigate the effect of minocycline(Mino)on the polarization of types M1/M2 microglia(pro-and anti-inflammatory type)in the spinal dorsal horn of rats with neuropathic pain(NP)induced by spinal nerve ligation(SNL)and its underlying mechanism.Methods A total of 36 adult male SD rats were randomly stratified into Sham-operation(Sham)group,SNL group and Mino+SNL group by stratified random sampling based on body weight.Mechanical pain threshold and cold nociceptive thresholds of rat hind paw were measured in 1 d before and 14 d after modelling.Spinal cord tissue at the lumbar 5(L5)segment was taken at 14 d after modelling,and the total number of microglia as well as the numbers of M1 and M2 microglia in the spinal dorsal horn were measured with immunohistochemistry and stereology.With aid of bioinformatics techniques,the core target in the spinal cord,Cst7,was selected.Then,the protein levels of microglia marker Iba-1,M1 microglia marker iNOS,M2 microglia marker CD206,Cst7 encoded protein cystatin F(CF)and pathway CatS/CX3CL1/CX3CR1 were detected with Western blotting.The expression levels of TNF-α,IL-6 and IL-10 in the spinal cord tissues were measured with ELISA.Results The mechanical pain and cold nociceptive thresholds were both significantly higher in the M+SNL group than the SNL group at 7～14 d after modelling(P＜0.01).The total number of microglia and the numbers of M1/M2 microglia in the spinal dorsal horn as well as the expression levels of CatS,CX3CL1,CX3CR1,TNF-α,IL-6,and IL-10 in the spinal cord tissues were obviously increased,and the expression level of CF was notably decreased in the SNL model group than the Sham group(P＜0.01).While,Mino treatment remarkably reversed above phenomena,with decreased total number of microglia and number of M1 microglia as well as expression levels of CatS,CX3CL1,CX3CR1,TNF-α and IL-6,and increased number of M2 microglia as well as CF and IL-10 levels when compared with the SNL group(P＜0.05).Conclusion Mino alleviates SNL induced neuropathic pain,probably through up-regulating CF in the microglia,and thus inhibiting the CatS/CX3CL1/CX3CR1 signaling pathway,promoting the conversion of microglia from type M1 to M2 to balance the imbalance in the M1/M2 polarization,and thus reducing neuroinflammation.