Along with the continuous publication of a series of large-scale clinical trials results,endovascular thrombolytic therapy (or combined with intravenous thrombolysis) has been recommended as the treatment of first choice for acute ischemic stroke caused by large intracranial artery occlusion.Nevertheless,there are a variety of factors that may affect the clinical outcome of endovascular recanalization procedure.This article aims to make a comprehensive review about the factors that may affect the prognosis of patients with acute ischemic stroke who are receiving endovascular treatment.

Objective To discuss the impact of hyperthyroidism on pregnancy outcome.Methods Clinical data of 80 pregnancy patients with hyperthyroidism(hyperthyroidism group)were retrospectively analyzed,in accordance with the norms of treatment during pregnancy is divided into treatment group(61 cases)and untreated group(19 cases);At the same time,in accordance with the ratio of 1:2 160 cases of healthy pregnant women were randomly selected as control group.childbirth,the maternal and perinatal outcome in three groups were compared.Results Graves disease group the incidence of pregnancy-induced hypertension 10.0%,3.8% incidence of heart failure,cesarean section rate of 61.4%,7.6% incidence of prematurity,asphyxia incidence of 7.6%,a low incidence of 3.8%,the mortality rate 3.8%,and 1.3% of the control group,41.3%,1.3%,0.6%,0,0,the differences were statistically significant(P＜0.05),the incidence of neonatal abnormalities in two groups is not different(P＞0.05);the treatment group of diseases of pregnancy-induced hypertension,heart failure,premature birth,asphyxia,such as the incidence were 3.3%,3.3%,3.3%,0,0 mortality,with non-governing group of 31.6%,15.8%,21.1%,15.8%,10.5%.The differences were statistically significant(P＜0.05),and a low incidence of the two groups,the cesarean section rate,incidence of deformities such as no difference.Conclusion Hyperthyroidism can increase the incidence of pregnancy complications,and standardize the treatment can improve pregnancy outcome.

Objective To investigate the value of percutaneous transhepatic cholangiobiopsy (PTCB) in the diagnosis of obstructive jaundice.Methods The clinical data of 826 patients with obstructive jaundice who received PTCB at the First Affiliated Hospital of Zhengzhou University from April 2001 to December 2011 were retrospectively analyzed.The pathological results,positive rates of PTCB and complications were analyzed.The safety and efficacy of PTCB and the pathological features of malignancy causing obstructive jaundice were summarized.The difference in the positive rates of PTCB for biliary and non-biliary malignancies was analyzed by chi-square test.Results A total of 826 patients received PTCB,and the success rate was 100％.Eighty-six patients had complications postoperatively,including transit bilhaemia in 47 patients,bile leakage in 11 patients,temporary biliary hemorrhage in 28 patients,no severe complications occurred.There were 740 patients were with malignant biliary stricture and 86 with benign biliary stricture.Seven Hundred and twenty-seven patients were with positive results of PTCB (641 were with cancerous stricture and 86 with inflammation of biliary tract or fibrogenesis),and 99 patients were with false negative results.The overall positive rate of PTCB was 88.01％ (727/826).Malignant neoplasm accounted for 89.59％ (740/826) of the factors causing obstructive jaundice,and well-,moderate-and poor-differentiated neoplasms were accounted for 57.88％ (371/641),19.97％ (128/641) and 22.15％ (142/641).Biliary adenocarcinoma was the main pathologic type,which was accounted for 96.41％ (618/641).The positive rates of PTCB for biliary and non-biliary neoplasms were 89.50％ (469/524)and 79.63％ (172/216),with significant difference (x2 =12.87,P ＜ 0.05).Conclusions PTCB is a safe,feasible and easy way to diagnose obstructive jaundice.Biliary neoplasms are the best indications for PTCB.Well differentiated neoplasm is the main pathological type causing the obstructive jaundice.

Objective To explore the efficacy and safety of percutaneous transhepatic portal vein or transjugular intrahepatic portosystemie shunt (TIPS)to implant the portal vein metallic stent in treatment of cavernous transformation of portal vein (CTPV).Methods Clinical and imaging data of 8 patients with CTPV were retrospectively analyzed who were treated in our hospital.All patients were treated with metallic stent implantation in portal vein including 3 patients by TIPS and 5 by percutaneous transhepatic portal vein.Results All patients were successful in the stent implantation without any occurrence of serious complications such as intra-abdominal hemorrhage and so on.Intraoperative angiography showed blood circulated freely in these stents.1 day-2 weeks later,the patients symptoms of abdominal pain and gastrointestinal bleeding were obviously relieved or disappeared.Follow up 1 month-3 years,1 patient with stent occlusion after one year of operation,the blood flow recovery after stent reimplantation,and the remaining patients,color doppler ultrasound reflected patency of blood flows in their stents.No one suffered from gastrointestinal bleeding or abdominal pain again.Conclusion Implantation of portal vein metallic stent via percutaneous transhepatic portal vein or via TIPS in treatment of cavernous transformation of portal vein is safe and effective.

BACKGROUND: In recent years, with the progress of shock therapy as well as the establishment and promoted application of arterial bypass grafting, thrombolytic therapy, percutaneous transluminal coronary angioplasty, extracorporeal circulation on cardiac surgery, cardiopulmonary resuscitation, limb replantation, and organ transplantation, blood reperfusion in multiple organs after ischemia has been achieved. However, the organs which undergo a period of ischemia appear to have the performance of damage aggravation.OBJECTIVE: To summarize the research progress of MG53 protein in protecting five organs from ischemia/reperfusion injury, thereby providing reference for further in-depth study.METHODS: A computer-based online search of PubMed, Duxiu Knowledge Search and CNKI databases was performed for relevant literatures puldished between 1986 and 2016. The key words were MG53, TRIM, Mitsugumin53, ischemic, reperfusion, preconditioning, postconditioning, RISK, membrane damage, Connexin43, KChIP2 in English and MG53, ischemia/reperfusion in Chinese. Finally 61 eligible articles were reviewed in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION: As a muscle-specific TRIM family protein, endogenous MG53 is involved in the repair of muscle cytomembrane damage, and the protective effects of ischemic preconditioning and postconditioning. Exogenous recombinant human MG 53 protein not only repairs membrane damage of various muscles and non-muscle cells, but also protects the myocardium, skeletal muscle, brain, lung and kidney from ischemia/reperfusion injury.

Objective:To investigate the effect of thrombus burden on the clinical outcome of endovascular recanalization in large vessel occlusive stroke.Methods:Patients with acute anterior circulation occlusion who underwent endovascular treatment within 24 hours after onset in Zhengzhou University People′s Hospital from January 2018 to December 2019 were retrospectively collected. According to the clot burden score (CBS) of DSA, total objectives were divided into CBS≥6 group (24 cases) and CBS<6 group (38 cases). Clinical data of the two groups were collected and the modified Rankin scale (mRS) was used to evaluate the clinical outcome at 90 days after surgery. Independent sample t-test, Wilcoxon rank sum test and χ 2 test were used to compare the clinical data between the two groups. Independent risk factors affecting the clinical outcome were analyzed by binary logistic regression. Results:There were no statistically significant differences in basic demographic data, stroke risk factors and other factors between the CBS≥6 group and CBS<6 group ( P>0.05).The proportion of using tirofiban after surgery in the CBS≥6 group (63.2%, 24/38) was lower than that in the CBS<6 group (87.5%, 21/24) (χ2=4.380, P=0.044). The discharge NIHSS score of the CBS≥6 group was [5.0 (3.3, 7.8) points] lower than CBS<6 group [8.5 (1.8, 14.5) points] ( Z=5.221, P=0.022). The proportion of postoperative mRS 0-2 was (91.7%, 22/24) in the CBS≥6 group higher than CBS<6 group(39.5%, 15/38) (χ2=20.486, P=0.001), there were no statistically significant differences between the two groups ( P<0.05). The results of binary logistics regression analysis showed the CBS groups (OR=0.042, 95%CI 0.007-0.244 , P=0.001) was an independent risk factor affecting good outcome. Subgroup analysis of whether tirofiban was used or not showed there was no statistically significant difference in clinical prognosis between the two groups ( P>0.05). Conclusions:The clinical outcome of CBS≥6 group is significantly better than that of CBS<6 group, and patients with small thrombus burden are more likely to get a good clinical outcome of 90 days.

Mechanical thrombectomy can improve the clinical outcome of patients with acute anterior circulation larger vessel occlusive stroke.However,a remarkable proportion of patients,even they have achieved a successful recanalization,still develop adverse outcomes,such as futile recanalization(FR).According to relevant literature reports,there are many factors that can affect futile recanalization.In this paper,a series of factors such as age,recanalization time,infarct volume,baseline severity,blood pressure that may affect futile recanalization of mechanical thrombectomy in patients with inanterior circulation large vessel occlusion will be comprehensively described and analyzed.(J Intervent Radiol,2024,33:321-324)

Objective To investigate the relationship between ischemic time and thrombus types in patients with ST-segment elevation myocardial infarction (STEMI).Methods Eighty-two STEMI patients undergone emergency percutaneous coronary intervention (PCI) and coronary thrombus aspiration (CTA) from Sep.2012 to Apr.2016 were included and divided into 3 groups according to the ischemic time:≤4 hours (n=36),4-7 hours (n=30) and ＞7 hours (n=16).Visible aspirated thrombi were collected and separated into erythrocyte-rich type,platelet/fibrin-rich type and combined type thrombi by HE dying.The percentage difference of the 3 types thrombi was compared among the 3 groups.Results The percentage of platelet/fibrinrich type,erythrocyte-rich type and combined type thrombi in the 3 groups were as follows:in ≤4h group:61.1％(22/36),8.3％(3/36) and 30.6％(11/36),P=0.019;in 4-7h group:23.3％(7/30),10.0％(3/30) and 66.7％(20/30),P=0.012;and in ＞7h group:43.8％(7/16),12.5％(2/16) and 43.8％(7/16),P=0.913.For platelet/fibrin-rich type thrombi,the percentages in 3 periods were 61.1％(22/36),19.4％(7/36) and 19.4％(7/36),P=0.009;For combined type thrombi,the percentages in 3 periods were 28.9％(11/38),52.6％(20/38) and 18.4％(7/38),P=0.013;For erythrocyte-rich type thrombi,the percentages in 3 periods were 37.5％(3/8),37.5％(3/8) and 25.0％(2/8),P=0.895.Conclusions The types of intracoronary aspirated thrombi differ from various periods.Ischemia time may be an important predicted factor.

Maxillary sinus membrane lesions have been broadly detected before implant surgery in the posterior maxilla region, resulting in uncertainty regarding maxillary sinus floor elevation surgery. In this context, we composed this commentary article based on the current literature and the clinical experience of our department. We discuss the common lesion types shown by CBCT including membrane pathological thickening, polyps/cystic lesions and air-liquid level in the sinus. Maxillary sinus floor elevation surgery can be conducted in patients with membrane thickening of 2-5 mm or with polyps/cysts of less than half of the sinus height (because the above symptoms have little influence on the outcome of surgery). Membrane thickening of more than 5 mm with ostium obstruction, antrochoanalpolyps, mucoceles and cysts of more than half of the sinus height should be carefully treated. Different treatments can be performed such as conducting elevation surgery while retaining the cyst, removing the cyst before surgery or removing the cyst during surgery based on the cyst type and size, inflammation, patency of the ostium, etc. Antibiotics-anti-inflammatory-aspiration, surgical debridement and oral lesions eliminations are generally used for treating post-operative sinusitis. Presurgical radiographic evaluation is the key to diagnosing and treating these membrane lesions. We highly advocate collaboration between our dentists and otolaryngologists on this issue.

Objective:To investigate the effect of multi line therapy for lung adenocarcinoma transformed into small cell lung cancer (SCLC), and review and discuss the related literature.Methods:Combined with the clinical examples of lung adenocarcinoma transformed SCLC after treatment with anti epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), the diagnostic process and multi line treatment plan of transformed SCLC were analyzed, and the therapeutic effect was evaluated by imaging. At the same time, it was reviewed and discussed in combination with relevant literature.Results:Serological tumor markers were significant for the diagnosis of transformed SCLC after EGFR-TKI treatment of lung adenocarcinoma, and pathology was still the gold standard for its diagnosis. The multiline therapy of SCLC has certain effect on transformed small cell lung cancer.Conclusion:The overall prognosis of lung adenocarcinoma transformed into SCLC after EGFR TKIs treatment is poor, so it is necessary to diagnose and treat it as early as possible, evaluate the effect of imaging in time, and make treatment adjustment quickly.