Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Objective To investigate the frequency and dose of X-ray computed tomography (CT) medical exposure in Shantou City, and to evaluate the collective effective dose burden of residents caused by CT medical exposure. Methods The study subjects were selected using the stratified random sampling method from CT scanners in all medical institutions in Shantou City in 2020. CT application units were divided into the four tiers of municipal hospitals, district hospitals, subdistrict hospitals, and private hospitals, and 50% of the hospitals in each tier were randomly selected according to the number of hospitals in the tier. The study analyzed CT dose index results, CT scanning standard conditions, and the distribution of characteristic doses of medical exposure to evaluate the dose burden of residents in Shantou City caused by CT medical exposure. Results There were 51 CT scanners in medical institutions in Shantou City. By the end of 2020, the average number of CT scanners per million population was 9.30, and the frequency of CT medical exposure was 135.24 per 1000 population. Jinping District had the highest number of CT scanners per million population (23.2), while Chaoyang District had the lowest number of CT scanners per million population (3.6). The median and range of effective doses for different scan regions were 1.65 (0.76, 4.49) mSv in the head, 4.12 (1.90, 53.21) mSv in the chest, 5.96 (2.68, 10.25) mSv in the abdomen, and 10.30 (4.12, 12.67) mSv in the lumbar spine. By the end of 2020, the effective dose to the public in Shantou City was 6080.67 Sv·person, and the average annual effective dose per person was 1.10 mSv. Conclusion Medical exposure is the most important factor affecting resident dose burden, particularly the overuse of medical exposure examinations. CT examination is the most significant component of medical exposure causing resident dose burden. Reducing unnecessary medical exposure, ensuring the rational use of CT examination, and properly utilizing personal protective equipment are effective measures to minimize the dose burden on examinees.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Objective To explore the clinical efficacy of different ligation methods in laparoscopic radi-cal resection of rectal cancer and sigmoid colon cancer and the influencing factors of anastomotic leakage.Methods A total of 82 patients who underwent laparoscopic radical resection of rectal cancer and sigmoid co-lon cancer in this hospital from December 2022 to December 2023 were selected and divided into the low-liga-tion group(n=42)and the high-ligation group(n=40)according to different surgical methods.The inferior mesenteric artery(IMA)classification,IMA length,operation time,intraoperative blood loss,total number of lymph node dissections,number of lymph node dissections in group 253,postoperative hospital stay,exhaust time,incidence of urinary retention,incidence of anastomotic leakage,and incidence of preventive stoma were compared between the two groups.Univariate and multivariate logistic regression analyses were conducted to analyze the influencing factors of anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer.Results There was no statistically significant difference in IMA length,IMA classi-fication proportion,operation time,intraoperative blood loss,the total number of lymph node dissections,the number of lymph node dissections in group 253,and the postoperative hospital stay between the two groups(P>0.05).Compared with the high-ligation group,the low-ligation group had a shorter exhaust time,lower incidence of anastomotic leakage and preventive ostomy,the differences were statistically significant(P<0.05).Anastomotic leakage occurred in 7 patients.Univariate analysis showed that whether left colic artery(LCA)was preserved,tumor location,presence of underlying diseases,and preventive stoma were associated with anastomotic leakage in patients undergoing radical resection of rectal cancer and sigmoid colon cancer(P<0.05).Multivariate logistics analysis showed that whether LCA was preserved,tumor location,presence of underlying diseases,and presence of preventive stoma were not influencing factors for anastomotic leakage in patients undergoing radical resection of rectal cancer or sigmoid colon cancer(P>0.05).Conclusion In laparoscopic radical resection of rectal and sigmoid colon cancer,the clinical efficacy of preserving LCA is com-parable to that of not preserving LCA,and it can reduce the risk of anastomotic leakage and the probability of preventive stoma,promoting the early recovery of intestinal function.

Objective To investigate the therapeutic effects of a newly constructed Aβ25-35-based recombinant gene vaccine for Alzheimer's disease(AD).Methods The pcDNA-Aβ25-35-GRP94 recombinant gene vaccine was con-structed using Aβ25-35 as the epitope and pcDNA3.1 plasmid as the vector.Early APP/PS1 double-transgenic mice were selected as experimental subjects,including the AD control group and the pcDNA-Aβ25-35-GRP94 immunized group for regular immunization.ELISA was performed to detect the titers and isotypes of Aβ-specific antibodies;Morris Water Maze(MWM)Test and Open-Field Test(OFT)were performed to determine the changes in both cognitive ability and mental state of mice;Immunohistochemistry was used to assess the effects of the vac-cine on both Aβ plaques and glial cells in the brains of AD mouse models;ELISA kit was used to evaluate the level of inflammatory factors(TNF-α,IL-1β)in the mouse brain.Results Compared with the AD control group,the pcDNA-Aβ25-35-GRP94 vaccine induced APP/PS1 mice to produce higher levels of Aβ specific antibodies(P<0.05),and mainly induced IgG1 antibodies(P<0.01).The vaccine significantly reduced Aβ plaques in the brain tissue(P<0.05)and effectively alleviated learning memory impairment in APP/PS1 mice(P<0.05)without causing mental behavioral abnormalities.Moreover,the vaccine inhibited the abnormal proliferation of glial cells(P<0.05)and did not cause obvious inflammatory reactions in the brain,suggesting the vaccine was safe and effective.Conclusions Early vaccination with a Aβ25-35-based recombinant gene vaccine can induce the formation of high level of Aβ specific antibodies,effectively alleviate the learning memory impairment of AD and related neu-ro-pathological changes.It may be used to treat AD.

Objective To investigate the molecular mechanism of the induction of gastric cancer cell line AGS death by p97 inhibitor eeyarestatin Ⅰ(Eer Ⅰ).Methods AGS cells were treated with Eer Ⅰ.Then liquid chro-matography-mass spectrometry was used to perform proteome analysis for screening differentially expressed proteins and to find underlying signaling pathways.At the same time,the proteins of related pathway were investi-gated by protein immunoblotting.Cell proliferation was detected using the CCK-8 test kit;Cell apoptosis was detec-ted using TUNEL staining test kit;Liperfluo probe was used to detect ferroptosis-related lipid peroxides.Results In Eer Ⅰ treatment group,there were significant changes in proteins(fold change＞1.5 and P＜0.05),in which 125 proteins were increased and 132 proteins were decreased.The enrichment analysis of these DEPs showed that Eer Ⅰ might significantly affect cell apoptosis and ferroptosis-related signaling pathways.Furthermore,Eer Ⅰcould increase genomic DNA fragmentation related to cell apoptosis,increase of lipid peroxides in the ferroptosis pathway,causes changes in cell death related proteins,and inhibit the proliferation of gastric cancer cells.Conclusions p97 inhibitor Eer Ⅰ can induce cell apoptosis and ferroptosis in AGS cells,thereby inhibiting tumor cell proliferation.

Objective To establish a rapid immunological detection method for MPT64 protein based on red microspheres and select highly-sensitive and highly-specific antibody pairs.Methods A His-tagged prokaryotic expression vector was constructed for expression of MPT64 protein that was used to immunize New Zealand white rabbits after purification and validation.Peripheral blood mononuclear cells(PBMCs)were isolated from the rabbits,and antigen-specific B cells expressing antibodies were sorted using single B-cell flow cytometry.mRNA in B cells was reverse-transcribed into cDNA,and paired antibody heavy-and light-chain sequences were amplified via nested PCR.Expression vectors were constructed,and recombinant antibodies were produced in Expi293F cells.Fluorescent immunochromatography was employed to screen for matched antibody pairs.The selected antibodies were used to establish a rapid detection method based on red microsphere immunochromatography.Results Ten high-affinity monoclonal antibodies against MPT64 were generated.Two antibody pairs were selected for MPT64 immunodetection that reached a sensitivity of 0.0125 ng/mL.Conclusion High-affinity rabbit monoclonal antibodies against MPT64 are obtained via single B-cell technology,and a rapid red microspheres-based immunodetection method is established,enabling highly sensitive detection of Mycobacterium tuberculosis MPT64 protein.

BACKGROUND:Synovitis plays a leading role in the early progression of knee osteoarthritis and is a potential early therapeutic target.However,the mechanism of synovitis remains unclear.In animal models,increased systemic iron and intracellular iron uptake can induce and exacerbate osteoarthritis,but the association with ferroptosis in synovitis remains unclear.Further studies are needed to investigate the role of ferroptosis in the development and progression of synovitis in osteoarthritis. OBJECTIVE:To investigate the role of ferroptosis mediated by glutathione peroxidase 4(GPX4)in the development of synovitis in knee osteoarthritis. METHODS:The synovial tissues of 43 patients with osteoarthritis who underwent arthroscopic or joint replacement surgery and 10 patients undergoing arthroscopic treatment of meniscal injury or ligament tear were collected and divided into three groups according to the Kellgren-Lawrence grading of X-ray images:normal control group(KLG 0,n=10),early knee osteoarthritis group(KLG 1,2,n=20)and late knee osteoarthritis group(KLG 3,4,n=23).Hematoxylin-eosin staining was used to observe the severity of synovitis in each group,and iron deposition in the synovium in each group was evaluated by Prussian blue staining.The expressions of Acyl-CoA Synthetase Long Chain Family Member 4(ACSL4),GPX4,cyclooxygenase 2 and tumor necrosis factor α in the synovium were detected by immunohistochemical staining.Western blot and immunofluorescence were used to detect the expression of ferroptosis-related proteins ACSL4 and GPX4. RESULTS AND CONCLUSION:Compared with the normal control group,iron content in synovial tissue was increased in the knee osteoarthritis groups,and iron deposition in the late knee osteoarthritis group was higher than that in the early osteoarthritis group.ACSL4 was highly expressed in the synovial tissue of knee osteoarthritis compared with the normal control group(P＜0.01),and GPX4 was lowly expressed in the synovial tissue of knee osteoarthritis(P＜0.01).The expression level of ACSL4 increased with the progression of osteoarthritis,while the expression level of GPX4 decreased with the progression of osteoarthritis.The expression of cyclooxygenase 2 in the synovium of osteoarthritis was significantly higher than that in the normal synovium,and the expression was the highest in the early stage of osteoarthritis,which was significantly different from that in the advanced stage of osteoarthritis(P＜0.01).The expression of tumor necrosis factor α in the synovium of osteoarthritis was significantly higher than that in the normal synovium,but there was no significant difference between early and late osteoarthritis groups(P＞0.05).To conclude,the deposition of iron exists in the synovial tissue of osteoarthritis and ferroptosis is involved in the occurrence and progression of synovitis in knee osteoarthritis.

BACKGROUND:Myocardial patches are used as an effective way to repair damaged myocardium,and there is controversy over which cells to use to make myocardial patches and how to maximize the therapeutic effect of myocardial patches in vivo. OBJECTIVE:To find out the best way to make myocardial patches by overviewing the cellular sources of myocardial patches and strategies for perfecting them. METHODS:The first author searched PubMed and Web of Science databases by using"cell sheet,cell patch,cardiomyocytes,cardiac progenitor cells,fibroblasts,embryonic stem cell,mesenchymal stem cells"as English search terms,and searched CNKI and Wanfang databases by using"myocardial patch,biological 3D printing,myocardial"as Chinese search terms.After enrollment screening,94 articles were ultimately included in the result analysis. RESULTS AND CONCLUSION:(1)The cellular sources of myocardial patches are mainly divided into three categories:somatic cells,monoenergetic stem cells,and pluripotent stem cells,respectively.There are rich sources of cells for myocardial patches,but not all of them are suitable for making myocardial patches,e.g.,myocardial patches made from fibroblasts and skeletal myoblasts carry a risk of arrhythmogenicity,and mesenchymal stem cells have a short in vivo duration of action and ethical concerns.With the discovery of induced multifunctional stem cells,a reliable source of cells for making myocardial patches is available.(2)There are two methods of making myocardial patches.One is using cell sheet technology.The other is using biological 3D printing technology.Cell sheet technology can preserve the extracellular matrix components intact and can maximally mimic the cell growth ring in vivo.However,it is still difficult to obtain myocardial patches with three-dimensional structure by cell sheet technology.Biologicasl 3D printing technology,however,can be used to obtain myocardial patches with three-dimensional structures through computerized personalized design.(3)The strategies for perfecting myocardial patches mainly include:making myocardial patches after co-cultivation of multiple cells,improving the ink formulation and scaffold composition in biological 3D printing technology,improving the therapeutic effect of myocardial patches,suppressing immune rejection after transplantation,and perfecting the differentiation and cultivation protocols of stem cells.(4)There is no optimal cell source or method for making myocardial patches,and myocardial patches obtained from a particular cell or technique alone often do not achieve the desired therapeutic effect.Therefore,researchers need to choose the appropriate strategy for making myocardial patches based on the desired therapeutic effect before making them.