1.Connotation and Prevention Strategies of Traditional Chinese Medicine for Panvascular Diseases
Jie WANG ; Jun LI ; Yan DONG ; Cong CHEN ; Yongmei LIU ; Chao LIU ; Lanchun LIU ; Xuan SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):1-14
Panvascular disease, with vascular diseases as the common pathological feature, is mainly manifested as atherosclerosis. Panvascular disease mainly affects the important organs of the heart, brain, kidney, and limbs. It is one of the leading causes of death for Chinese residents at present. Previously, due to the narrow branches of disciplines, too much attention was paid to local lesions, resulting in the neglect of panvascular disease as a systemic one. The fact that panvascular disease has overall pathology and comprehensive and individualized treatment strategies, makes the disease highly compatible with the principles of holism concept and syndrome differentiation and treatment in traditional Chinese medicine (TCM). It is believed that blood stasis is the core pathogenesis of atherosclerosis and is involved in the whole process of atherosclerosis. The theories of ''blood vessel'', ''meridians'', ''visceral manifestation'', and ''organs-meridians'' in TCM are helpful to comprehensively understand the complexity of panvascular diseases. Moreover, those theories can provide systematic treatment strategies. The TCM syndromes of panvascular diseases evolve from ''phlegm, stasis, stagnation, and deficiency''. Panvascular arteriosclerosis is related to the syndrome of ''stasis and phlegm'', and the treatment mainly promotes blood circulation and removes phlegm. There are different specific drugs and mechanisms of action for coronary atherosclerosis, cerebral atherosclerosis, and renal artery atherosclerotic stenosis. Panvascular venous lesions are related to the syndrome of ''deficiency and stasis'' in TCM, and the TCM treatment mainly invigorates Qi and promotes blood circulation, which can inhibit venous thrombosis, improve venous ulcers, and resist venous endothelial damage. Panvascular microcirculatory lesions are inseparable from the ''stagnation and stasis'' in TCM, and the treatment mainly promotes Qi and dredges collaterals, which has a good effect on coronary microvascular lesions, diabetic microvascular lesions, pulmonary microvascular lesions, and pancreatic microvascular lesions. Panvascular lymphatic lesions are related to the syndrome of ''water and stasis'' in TCM. The treatment method focuses on promoting blood circulation and water excretion, which can promote lymphangiogenesis and enhance lymphatic reflux. In addition, the combination of TCM and modern technology, especially the application of artificial intelligence, can improve the efficiency of early identification and personalized treatment, resulting in early screening and comprehensive management of panvascular diseases. Therefore, TCM will play a vital role in the prevention and treatment of panvascular diseases.
2.Connotation and Prevention Strategies of Traditional Chinese Medicine for Panvascular Diseases
Jie WANG ; Jun LI ; Yan DONG ; Cong CHEN ; Yongmei LIU ; Chao LIU ; Lanchun LIU ; Xuan SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):1-14
Panvascular disease, with vascular diseases as the common pathological feature, is mainly manifested as atherosclerosis. Panvascular disease mainly affects the important organs of the heart, brain, kidney, and limbs. It is one of the leading causes of death for Chinese residents at present. Previously, due to the narrow branches of disciplines, too much attention was paid to local lesions, resulting in the neglect of panvascular disease as a systemic one. The fact that panvascular disease has overall pathology and comprehensive and individualized treatment strategies, makes the disease highly compatible with the principles of holism concept and syndrome differentiation and treatment in traditional Chinese medicine (TCM). It is believed that blood stasis is the core pathogenesis of atherosclerosis and is involved in the whole process of atherosclerosis. The theories of ''blood vessel'', ''meridians'', ''visceral manifestation'', and ''organs-meridians'' in TCM are helpful to comprehensively understand the complexity of panvascular diseases. Moreover, those theories can provide systematic treatment strategies. The TCM syndromes of panvascular diseases evolve from ''phlegm, stasis, stagnation, and deficiency''. Panvascular arteriosclerosis is related to the syndrome of ''stasis and phlegm'', and the treatment mainly promotes blood circulation and removes phlegm. There are different specific drugs and mechanisms of action for coronary atherosclerosis, cerebral atherosclerosis, and renal artery atherosclerotic stenosis. Panvascular venous lesions are related to the syndrome of ''deficiency and stasis'' in TCM, and the TCM treatment mainly invigorates Qi and promotes blood circulation, which can inhibit venous thrombosis, improve venous ulcers, and resist venous endothelial damage. Panvascular microcirculatory lesions are inseparable from the ''stagnation and stasis'' in TCM, and the treatment mainly promotes Qi and dredges collaterals, which has a good effect on coronary microvascular lesions, diabetic microvascular lesions, pulmonary microvascular lesions, and pancreatic microvascular lesions. Panvascular lymphatic lesions are related to the syndrome of ''water and stasis'' in TCM. The treatment method focuses on promoting blood circulation and water excretion, which can promote lymphangiogenesis and enhance lymphatic reflux. In addition, the combination of TCM and modern technology, especially the application of artificial intelligence, can improve the efficiency of early identification and personalized treatment, resulting in early screening and comprehensive management of panvascular diseases. Therefore, TCM will play a vital role in the prevention and treatment of panvascular diseases.
3.Mid-long term follow-up reports on head and neck rhabdomyosarcoma in children
Chao DUAN ; Sidou HE ; Shengcai WANG ; Mei JIN ; Wen ZHAO ; Xisi WANG ; Zhikai LIU ; Tong YU ; Lejian HE ; Xiaoman WANG ; Chunying CUI ; Xin NI ; Yan SU
Chinese Journal of Pediatrics 2025;63(1):62-69
Objective:To analyze the clinical characteristics of children with head and neck rhabdomyosarcoma (RMS) and to summarize the mid-long term efficacy of Beijing Children′s Hospital Rhabdomyosarcoma 2006 (BCH-RMS-2006) regimen and China Children′s Cancer Group Rhabdomyosarcoma 2016 (CCCG-RMS-2016) regimen.Methods:A retrospective cohort study. Clinical data of 137 children with newly diagnosed head and neck RMS at Beijing Children′s Hospital, Capital Medical University from March 2013 to December 2021 were collected. Clinical characteristic of patients at disease onset and the therapeutic effects of patients treated with the BCH-RMS-2006 and CCCG-RMS-2016 regimens were compared. The treatments and outcomes of patients with recurrence were also summarized. Survival analysis was performed by Kaplan-Meier method, and Log-Rank test was used for comparison of survival rates between groups.Results:Among 137 patients, there were 80 males (58.4%) and 57 females (41.6%), the age of disease onset was 59 (34, 97) months. The primary site in the orbital, non-orbital non-parameningeal, and parameningeal area were 10 (7.3%), 47 (34.3%), and 80 (58.4%), respectively. Of all patients, 32 cases (23.4%) were treated with the BCH-RMS-2006 regimen and 105 (76.6%) cases were treated with the CCCG-RMS-2016 regimen. The follow-up time for the whole patients was 46 (20, 72) months, and the 5-year progression free survival (PFS) and overall survival (OS) rates for the whole children were (60.4±4.4)% and (69.3±4.0)%, respectively. The 5-year OS rate was higher in the CCCG-RMS-2016 group than in BCH-RMS-2006 group ((73.0±4.5)% vs. (56.6±4.4)%, χ2=4.57, P=0.029). For the parameningeal group, the 5-year OS rate was higher in the CCCG-RMS-2016 group (61 cases) than in BCH-RMS-2006 group (19 cases) ((57.3±7.6)% vs. (32.7±11.8)%, χ2=4.64, P=0.031). For the group with meningeal invasion risk factors, the 5-year OS rate was higher in the CCCG-RMS-2016 group (54 cases) than in BCH-RMS-2006 group (15 cases) ((57.7±7.7)% vs. (30.0±12.3)%, χ2=4.76, P=0.029). Among the 10 cases of orbital RMS, there was no recurrence. In the non-orbital non-parameningeal RMS group (47 cases), there were 13 (27.6%) recurrences, after re-treatment, 7 cases survived. In the parameningeal RMS group (80 cases), there were 40 (50.0%) recurrences, with only 7 cases surviving after re-treatment. Conclusions:The overall prognosis for patients with orbital and non-orbital non-parameningeal RMS is good. However, children with parameningeal RMS have a high recurrence rate, and the effectiveness of re-treatment after recurrence is poor. Compared with the BCH-RMS-2006 regimen, the CCCG-RMS-2016 regimen can improve the treatment efficacy of RMS in the meningeal region.
4.Study on the modeling method of general model of Yaobitong capsule intermediates quality analysis based on near infrared spectroscopy
Le-ting SI ; Xin ZHANG ; Yong-chao ZHANG ; Jiang-yan ZHANG ; Jun WANG ; Yong CHEN ; Xue-song LIU ; Yong-jiang WU
Acta Pharmaceutica Sinica 2025;60(2):471-478
The general models for intermediates quality analysis in the production process of Yaobitong capsule were established by near infrared spectroscopy (NIRS) combined with chemometrics, realizing the rapid determination of notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rd and moisture. The spray-dried fine powder and total mixed granule were selected as research objects. The contents of five saponins were determined by high performance liquid chromatography and the moisture content was determined by drying method. The measured contents were used as reference values. Meanwhile, NIR spectra were collected. After removing abnormal samples by Monte Carlo cross validation (MCCV), Monte Carlo uninformative variables elimination (MC-UVE) and competitive adaptive reweighted sampling (CARS) were used to select feature variables respectively. Based on the feature variables, quantitative models were established by partial least squares regression (PLSR), extreme learning machine (ELM) and ant lion optimization least squares support vector machine (ALO-LSSVM). The results showed that CARS-ALO-LSSVM model had the optimum effect. The correlation coefficients of the six index components were greater than 0.93, and the relative standard errors were controlled within 6%. ALO-LSSVM was more suitable for a large number of samples with rich information, and the prediction effect and stability of the model were significantly improved. The general models with good predicting effect can be used for the rapid quality determination of Yaobitong capsule intermediates.
5.Analysis of characteristics of adverse drug reactions in a hospital from 2021 to 2023
Yan WANG ; Ming FANG ; Hongwei SONG ; Chao ZHONG ; Feng XU ; Ting ZHOU
Journal of Pharmaceutical Practice and Service 2025;43(4):200-204
Objective To analyze the characteristics of adverse drug reactions (ADR) reported in Sixth People’s Hospital South Campus, Shanghai Jiaotong University from 2021 to 2023, to provide reference for promoting rational clinical drug use. Methods ADR data reported in our hospital were collected retrospectively, including patients’ basic information, drugs causing adverse reactions, types of adverse reactions and outcomes. Descriptive analysis methods were used to summarize and analyze the data. Results A total of 979 cases of ADR were reported in our hospital from 2021 to 2023. The highest proportion of patients with ADR occurred in the age range of 31 to 50, and more male patients (63.5%). The top five drugs involved with adverse reactions were antibiotics (48.8%), Chinese medicine injections(19.2%), vitamins(7.5%), Chinese traditional medicine(7.2%), equine tetanus immunoglobulin(6.3%). Among antibiotics, cefuroxime, ceftazidime and cefotiam were the majority. The organs/systems involved in all ADR were mainly skin and accessories damage (55.4%). The clinical manifestations were rash, itching, and maculopapular rash. Conclusion From 2021 to 2023, the most common drugs causing adverse drug reactions in our hospital were mainly antibacterial drugs, and the rational clinical use of antibacterial drugs still needs to be concerned.
6.Exercise Regulates Structural Plasticity and Neurogenesis of Hippocampal Neurons and Improves Memory Impairment in High-fat Diet-induced Obese Mice
Meng-Si YAN ; Lin-Jie SHU ; Chao-Ge WANG ; Ran CHENG ; Lian-Wei MU ; Jing-Wen LIAO
Progress in Biochemistry and Biophysics 2025;52(4):995-1007
ObjectiveObesity has been identified as one of the most important risk factors for cognitive dysfunction. Physical exercise can ameliorate learning and memory deficits by reversing synaptic plasticity in the hippocampus and cortex in diseases such as Alzheimer’s disease. In this study, we aimed to determine whether 8 weeks of treadmill exercise could alleviate hippocampus-dependent memory impairment in high-fat diet-induced obese mice and investigate the potential mechanisms involved. MethodsA total of sixty 6-week-old male C57BL/6 mice, weighing between 20-30 g, were randomly assigned to 3 distinct groups, each consisting of 20 mice. The groups were designated as follows: control (CON), high-fat diet (HFD), and high-fat diet with exercise (HFD-Ex). Prior to the initiation of the treadmill exercise protocol, the HFD and HFD-Ex groups were fed a high-fat diet (60% fat by kcal) for 20 weeks. The mice in the HFD-Ex group underwent treadmill exercise at a speed of 8 m/min for the first 10 min, followed by 12 m/min for the subsequent 50 min, totally 60 min of exercise at a 0° slope, 5 d per week, for 8 weeks. We employed Y-maze and novel object recognition tests to assess hippocampus-dependent memory and utilized immunofluorescence, Western blot, Golgi staining, and ELISA to analyze axon length, dendritic complexity, number of spines, the expression of c-fos, doublecortin (DCX), postsynaptic density-95 (PSD95), synaptophysin (Syn), interleukin-1β (IL-1β), and the number of major histocompatibility complex II (MHC-II) positive cells. ResultsMice with HFD-induced obesity exhibit hippocampus-dependent memory impairment, and treadmill exercise can prevent memory decline in these mice. The expression of DCX was significantly decreased in the HFD-induced obese mice compared to the control group (P<0.001). Treadmill exercise increased the expression of c-fos (P<0.001) and DCX (P=0.001) in the hippocampus of the HFD-induced obese mice. The axon length (P<0.001), dendritic complexity (P<0.001), the number of spines (P<0.001) and the expression of PSD95 (P<0.001) in the hippocampus were significantly decreased in the HFD-induced obese mice compared to the control group. Treadmill exercise increased the axon length (P=0.002), dendritic complexity(P<0.001), the number of spines (P<0.001) and the expression of PSD95 (P=0.001) of the hippocampus in the HFD-induced obese mice. Our study found a significant increase in MHC-II positive cells (P<0.001) and the concentration of IL-1β (P<0.001) in the hippocampus of HFD-induced obese mice compared to the control group. Treadmill exercise was found to reduce the number of MHC-II positive cells (P<0.001) and the concentration of IL-1β (P<0.001) in the hippocampus of obese mice induced by a HFD. ConclusionTreadmill exercise led to enhanced neurogenesis and neuroplasticity by increasing the axon length, dendritic complexity, dendritic spine numbers, and the expression of PSD95 and DCX, decreasing the number of MHC-II positive cells and neuroinflammation in HFD-induced obese mice. Therefore, we speculate that exercise may serve as a non-pharmacologic method that protects against HFD-induced hippocampus-dependent memory dysfunction by enhancing neuroplasticity and neurogenesis in the hippocampus of obese mice.
7.Jiebiao Qingli Decoction Regulates TLR7/MAPK/NF-κB Pathway to Prevent and Treat Pneumonia Induced by IAV Infection
Yu MING ; Yichuan MA ; Ruiqi YAO ; Yan CHAO ; Hongchun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):173-181
ObjectiveTo explore the mechanism of Jiebiao Qingli decoction (JQD) in treating pneumonia caused by influenza A virus (IAV) infection. MethodsA total of 132 Balb/c mice were randomly assigned into normal control (NC), model control (IAV), oseltamivir (OSV, 37.5 mg·kg-1), and high-, medium-, low-dose JQD (H-, M-, and L-JQD: 6.05, 3.02, and 1.51 g·kg-1, respectively) groups. The NC group was treated with normal saline nasal drops, and the other groups were intranasally inoculated with A/Brisbane/02/2018 (H1N1) [pdm09-like virus (H1N1)] for the modeling of IAV infection. Two hours post-modeling, the NC and IAV groups were administrated with normal saline by gavage, while other groups received corresponding drugs for 7 d. The body mass, survival status, and deaths of mice were recorded daily during the administration of the drugs. On days 3 and 7, the lung index was measured for mice in each group. Pathological changes in the lung tissue were observed via hematoxylin-eosin staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was conducted to measure the viral load (IAV-M) and the mRNA levels of Toll-like receptor 7 (TLR7), p38 mitogen-activated protein kinase (p38 MAPK), and nuclear factor-kappa B (NF-κB) in the lung tissue. Western blot was employed to measure the protein levels of p38 MAPK and NF-κB. Enzyme-linked immunosorbent assay was used to quantify serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). ResultsCompared with the NC group, the IAV group showed reduced survival quality and survival days (P<0.01), lung congestion, inflammatory cell infiltration, elevated lung index (P<0.01), increased viral load (P<0.01), upregulated TLR7, p38 MAPK, and NF-κB levels (P<0.05, P<0.01), decreased IL-2 level (P<0.01), and elevated IL-6 and TNF-α levels (P<0.01). Compared with the IAV group, H-JQD prolonged survival days (P<0.05). All JQD groups alleviated pathological changes in the lung tissue and reduced the lung index (P<0.01). M-JQD and H-JQD decreased the viral load (P<0.01). H-JQD downregulated the mRNA levels of TLR7, p38 MAPK, and NF-κB (P<0.05, P<0.01) and the protein levels of p38 MAPK and NF-κB (P<0.01), increased the serum IL-2 level (P<0.01), and lowered the IL-6 and TNF-α levels (P<0.05, P<0.01). M-JQD downregulated the mRNA level of NF-κB (P<0.01) and the protein level of p38 MAPK (P<0.05), elevated the IL-2 level (P<0.01), and lowered the TNF-α level (P<0.01). ConclusionM- and H-JQD can prevent and control IAV infection-induced pneumonia dose-dependently by inhibiting the TLR7/MAPK/NF-κB signaling pathway, increasing IL-2, and reducing excessive secretion of IL-6 and TNF-α.
8.Jiebiao Qingli Decoction Regulates TLR7/MAPK/NF-κB Pathway to Prevent and Treat Pneumonia Induced by IAV Infection
Yu MING ; Yichuan MA ; Ruiqi YAO ; Yan CHAO ; Hongchun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):173-181
ObjectiveTo explore the mechanism of Jiebiao Qingli decoction (JQD) in treating pneumonia caused by influenza A virus (IAV) infection. MethodsA total of 132 Balb/c mice were randomly assigned into normal control (NC), model control (IAV), oseltamivir (OSV, 37.5 mg·kg-1), and high-, medium-, low-dose JQD (H-, M-, and L-JQD: 6.05, 3.02, and 1.51 g·kg-1, respectively) groups. The NC group was treated with normal saline nasal drops, and the other groups were intranasally inoculated with A/Brisbane/02/2018 (H1N1) [pdm09-like virus (H1N1)] for the modeling of IAV infection. Two hours post-modeling, the NC and IAV groups were administrated with normal saline by gavage, while other groups received corresponding drugs for 7 d. The body mass, survival status, and deaths of mice were recorded daily during the administration of the drugs. On days 3 and 7, the lung index was measured for mice in each group. Pathological changes in the lung tissue were observed via hematoxylin-eosin staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was conducted to measure the viral load (IAV-M) and the mRNA levels of Toll-like receptor 7 (TLR7), p38 mitogen-activated protein kinase (p38 MAPK), and nuclear factor-kappa B (NF-κB) in the lung tissue. Western blot was employed to measure the protein levels of p38 MAPK and NF-κB. Enzyme-linked immunosorbent assay was used to quantify serum levels of interleukin-2 (IL-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). ResultsCompared with the NC group, the IAV group showed reduced survival quality and survival days (P<0.01), lung congestion, inflammatory cell infiltration, elevated lung index (P<0.01), increased viral load (P<0.01), upregulated TLR7, p38 MAPK, and NF-κB levels (P<0.05, P<0.01), decreased IL-2 level (P<0.01), and elevated IL-6 and TNF-α levels (P<0.01). Compared with the IAV group, H-JQD prolonged survival days (P<0.05). All JQD groups alleviated pathological changes in the lung tissue and reduced the lung index (P<0.01). M-JQD and H-JQD decreased the viral load (P<0.01). H-JQD downregulated the mRNA levels of TLR7, p38 MAPK, and NF-κB (P<0.05, P<0.01) and the protein levels of p38 MAPK and NF-κB (P<0.01), increased the serum IL-2 level (P<0.01), and lowered the IL-6 and TNF-α levels (P<0.05, P<0.01). M-JQD downregulated the mRNA level of NF-κB (P<0.01) and the protein level of p38 MAPK (P<0.05), elevated the IL-2 level (P<0.01), and lowered the TNF-α level (P<0.01). ConclusionM- and H-JQD can prevent and control IAV infection-induced pneumonia dose-dependently by inhibiting the TLR7/MAPK/NF-κB signaling pathway, increasing IL-2, and reducing excessive secretion of IL-6 and TNF-α.
9.PDGF-C: an Emerging Target in The Treatment of Organ Fibrosis
Chao YANG ; Zi-Yi SONG ; Chang-Xin WANG ; Yuan-Yuan KUANG ; Yi-Jing CHENG ; Ke-Xin REN ; Xue LI ; Yan LIN
Progress in Biochemistry and Biophysics 2025;52(5):1059-1069
Fibrosis, the pathological scarring of vital organs, is a severe and often irreversible condition that leads to progressive organ dysfunction. It is particularly pronounced in organs like the liver, kidneys, lungs, and heart. Despite its clinical significance, the full understanding of its etiology and complex pathogenesis remains incomplete, posing substantial challenges to diagnosing, treating, and preventing the progression of fibrosis. Among the various molecular players involved, platelet-derived growth factor-C (PDGF-C) has emerged as a crucial factor in fibrotic diseases, contributing to the pathological transformation of tissues in several key organs. PDGF-C is a member of the PDGFs family of growth factors and is synthesized and secreted by various cell types, including fibroblasts, smooth muscle cells, and endothelial cells. It acts through both autocrine and paracrine mechanisms, exerting its biological effects by binding to and activating the PDGF receptors (PDGFRs), specifically PDGFRα and PDGFRβ. This binding triggers multiple intracellular signaling pathways, such as JAK/STAT, PI3K/AKT and Ras-MAPK pathways. which are integral to the regulation of cell proliferation, survival, migration, and fibrosis. Notably, PDGF-C has been shown to promote the proliferation and migration of fibroblasts, key effector cells in the fibrotic process, thus accelerating the accumulation of extracellular matrix components and the formation of fibrotic tissue. Numerous studies have documented an upregulation of PDGF-C expression in various fibrotic diseases, suggesting its significant role in the initiation and progression of fibrosis. For instance, in liver fibrosis, PDGF-C stimulates hepatic stellate cell activation, contributing to the excessive deposition of collagen and other extracellular matrix proteins. Similarly, in pulmonary fibrosis, PDGF-C enhances the migration of fibroblasts into the damaged areas of lungs, thereby worsening the pathological process. Such findings highlight the pivotal role of PDGF-C in fibrotic diseases and underscore its potential as a therapeutic target for these conditions. Given its central role in the pathogenesis of fibrosis, PDGF-C has become an attractive target for therapeutic intervention. Several studies have focused on developing inhibitors that block the PDGF-C/PDGFR signaling pathway. These inhibitors aim to reduce fibroblast activation, prevent the excessive accumulation of extracellular matrix components, and halt the progression of fibrosis. Preclinical studies have demonstrated the efficacy of such inhibitors in animal models of liver, kidney, and lung fibrosis, with promising results in reducing fibrotic lesions and improving organ function. Furthermore, several clinical inhibitors, such as Olaratumab and Seralutinib, are ongoing to assess the safety and efficacy of these inhibitors in human patients, offering hope for novel therapeutic options in the treatment of fibrotic diseases. In conclusion, PDGF-C plays a critical role in the development and progression of fibrosis in vital organs. Its ability to regulate fibroblast activity and influence key signaling pathways makes it a promising target for therapeutic strategies aiming at combating fibrosis. Ongoing research into the regulation of PDGF-C expression and the development of PDGF-C/PDGFR inhibitors holds the potential to offer new insights and approaches for the diagnosis, treatment, and prevention of fibrotic diseases. Ultimately, these efforts may lead to the development of more effective and targeted therapies that can mitigate the impact of fibrosis and improve patient outcomes.
10.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

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