Objective:To analyze the current status of registrations in randomized controlled trials (RCTs) of endovascular therapy for ischemic stroke.Methods:The ClinicalTrials.gov database was searched for RCTs of endovascular therapy for ischemic stroke from January 1, 1994 to June 30, 2024. The registration time, sites, sample size, complete status and design types, contents, and outcome evaluation methods of the trails were analyzed.Results:(1) A total of 195 RCTs were included. Number of RCTs registrations during 1994-2004, 2005-2014 and 2015-2024 were 2, 21 and 172, respectively. RCTs registration sites mainly concentrated in China, the United States and France, with 90 (46.1%), 29 (14.9%) and 24 (12.3%) registrations, respectively. There were 43 RCTs with sample size≤100 (22.1%), 143 RCTs with sample size of 100-1000 (73.3%), and 9 RCTs with sample size ≥1000 (4.6%). Fifty-seven RCTs were completed (29.2%, the average time from registration to trial completion was 1044 days); 91 RCTs (46.7%) were in the recruitment or pre-recruitment states; 23 RCTs (11.8%) were suspended or terminated. (2) RCTs design types included parallel design ( n=189, 96.9%), factorial design ( n=2, 1.0%), group-sequential design ( n=2, 1.0%), cross-over design ( n=1, 0.5%), and single-arm design ( n=1, 0.5%). Forty-four open trials (22.6%) and 151 blinded trials (77.4%) were recorded; among the blind trials, 108 RCTs (71.5%) were single-blind design, 19 (12.6%) were double-blind design, and 24 RCTs (15.9%) were triple-blind design. (3) A total of 69 RCTs (35.4%) focused on drug use, including 23 trails related to arterial thrombolysis drugs (mainly alteplase and tenecteplase); 67 RCTs (34.4%) were about endovascular therapy and perioperative management, among which 27 trials compared the efficacy of endovascular therapy, intravenous thrombolysis or placebo; 49 RCTs (25.1%) were about equipment use during treatment. (4) Outcome evaluation method: modified Rankin scale was most frequently used (153 RCTs), followed by National Institutes of Health Stroke Scale (100 RCTs). Conclusions:In the past decade, the number of RCTs about endovascular treatment for ischemic stroke has increased rapidly, and most of them were multi-center and blinded RCTs investigating the selection of arterial thrombolytic drugs, optimization of thrombectomy devices, and perioperative management. China is particularly prominent in this area of research.

The"2024 Guideline for the Primary Prevention of Stroke:A Guideline from the American Heart Association/American Stroke Association"published in October,2024 is the updated version of the"2014 Guideline for the Primary Prevention of Stroke"published 10 years ago.The new guideline updated several recommendations and included several new topics.This article introduced briefly the recommended content of the new version of the guideline to provide reference for clinical practice in the primary prevention of stroke in China.

With the rapid development of artificial intelligence(AI)technology and its extensive application in the medical field,Al has gradually been applied to all aspects of cerebrovascular disease diagnosis and treatment,including but not limited to prevention,prediction,diagnosis,treatment,and prognosis assessment.This article reviewed the current application of Al technology in the field of cerebrovascular disease diagnosis and treatment and discussed the improvement of the diagnostic and therapeutic process with AI technology application.It provides novel insights and strategies for the clinical management of cerebrovascular diseases.

The"2024 Guideline for the Primary Prevention of Stroke:A Guideline from the American Heart Association/American Stroke Association"published in October,2024 is the updated version of the"2014 Guideline for the Primary Prevention of Stroke"published 10 years ago.The new guideline updated several recommendations and included several new topics.This article introduced briefly the recommended content of the new version of the guideline to provide reference for clinical practice in the primary prevention of stroke in China.

With the rapid development of artificial intelligence(AI)technology and its extensive application in the medical field,Al has gradually been applied to all aspects of cerebrovascular disease diagnosis and treatment,including but not limited to prevention,prediction,diagnosis,treatment,and prognosis assessment.This article reviewed the current application of Al technology in the field of cerebrovascular disease diagnosis and treatment and discussed the improvement of the diagnostic and therapeutic process with AI technology application.It provides novel insights and strategies for the clinical management of cerebrovascular diseases.

Objective:To analyze the current status of registrations in randomized controlled trials (RCTs) of endovascular therapy for ischemic stroke.Methods:The ClinicalTrials.gov database was searched for RCTs of endovascular therapy for ischemic stroke from January 1, 1994 to June 30, 2024. The registration time, sites, sample size, complete status and design types, contents, and outcome evaluation methods of the trails were analyzed.Results:(1) A total of 195 RCTs were included. Number of RCTs registrations during 1994-2004, 2005-2014 and 2015-2024 were 2, 21 and 172, respectively. RCTs registration sites mainly concentrated in China, the United States and France, with 90 (46.1%), 29 (14.9%) and 24 (12.3%) registrations, respectively. There were 43 RCTs with sample size≤100 (22.1%), 143 RCTs with sample size of 100-1000 (73.3%), and 9 RCTs with sample size ≥1000 (4.6%). Fifty-seven RCTs were completed (29.2%, the average time from registration to trial completion was 1044 days); 91 RCTs (46.7%) were in the recruitment or pre-recruitment states; 23 RCTs (11.8%) were suspended or terminated. (2) RCTs design types included parallel design ( n=189, 96.9%), factorial design ( n=2, 1.0%), group-sequential design ( n=2, 1.0%), cross-over design ( n=1, 0.5%), and single-arm design ( n=1, 0.5%). Forty-four open trials (22.6%) and 151 blinded trials (77.4%) were recorded; among the blind trials, 108 RCTs (71.5%) were single-blind design, 19 (12.6%) were double-blind design, and 24 RCTs (15.9%) were triple-blind design. (3) A total of 69 RCTs (35.4%) focused on drug use, including 23 trails related to arterial thrombolysis drugs (mainly alteplase and tenecteplase); 67 RCTs (34.4%) were about endovascular therapy and perioperative management, among which 27 trials compared the efficacy of endovascular therapy, intravenous thrombolysis or placebo; 49 RCTs (25.1%) were about equipment use during treatment. (4) Outcome evaluation method: modified Rankin scale was most frequently used (153 RCTs), followed by National Institutes of Health Stroke Scale (100 RCTs). Conclusions:In the past decade, the number of RCTs about endovascular treatment for ischemic stroke has increased rapidly, and most of them were multi-center and blinded RCTs investigating the selection of arterial thrombolytic drugs, optimization of thrombectomy devices, and perioperative management. China is particularly prominent in this area of research.

Objective To explore the diagnostic value of insulin-like growth factor-1(IGF-1)and interleukin-17 A(IL-17A)in children with autism spectrum disorder(ASD).Methods Eighty-six children aged 1 to 6 years with highly suspected ASD were recruited from the Department of Children Health Care,Wuhan Children's Hospital from January 2023 to December 2023.Diagnostic and Statistical Manual of Mental Disorders-5(DSM-5)was used to screen out ASD group and control group.,and the serum IGF-1 and IL-17A levels in the two groups were detected.Results Fifty-six ASD children were confirmed,accounting for 65％(56/86).Serum IGF-1 and IL-17A levels in ASD group were higher than those in control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and IL-17A levels with different clinical characteristics were compared,and there was no statistically significant difference in serum IGF-1 and IL-17A levels with age and gender in ASD group(P＞0.05).The children with severe ASD had significant higher serum IL-17A level than those with mild-to-moderate ASD(P＜0.05),while the difference in serum IGF-1 level between the two groups of severe and mild-to-moderate ASD was not statistically significant(P＞0.05).The Logistic regression analysis showed that overexpression of serum IGF-1 and IL-17 A was the influencing factor in the occurrence of ASD(OR＞1,P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of serum IGF-1 and IL-17 A levels for diagnosing ASD alone and combination were 0.644,0.630 and 0.720.The combined detection had higher diag-nostic value.Conclusion Serum IGF-1 and IL-17A have the potential for early diagnosis of ASD,and the combined detection of the two levels is conducive to improving the diagnostic value of ASD.

Objective To explore the diagnostic value of insulin-like growth factor-1(IGF-1)and interleukin-17 A(IL-17A)in children with autism spectrum disorder(ASD).Methods Eighty-six children aged 1 to 6 years with highly suspected ASD were recruited from the Department of Children Health Care,Wuhan Children's Hospital from January 2023 to December 2023.Diagnostic and Statistical Manual of Mental Disorders-5(DSM-5)was used to screen out ASD group and control group.,and the serum IGF-1 and IL-17A levels in the two groups were detected.Results Fifty-six ASD children were confirmed,accounting for 65％(56/86).Serum IGF-1 and IL-17A levels in ASD group were higher than those in control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and IL-17A levels with different clinical characteristics were compared,and there was no statistically significant difference in serum IGF-1 and IL-17A levels with age and gender in ASD group(P＞0.05).The children with severe ASD had significant higher serum IL-17A level than those with mild-to-moderate ASD(P＜0.05),while the difference in serum IGF-1 level between the two groups of severe and mild-to-moderate ASD was not statistically significant(P＞0.05).The Logistic regression analysis showed that overexpression of serum IGF-1 and IL-17 A was the influencing factor in the occurrence of ASD(OR＞1,P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of serum IGF-1 and IL-17 A levels for diagnosing ASD alone and combination were 0.644,0.630 and 0.720.The combined detection had higher diag-nostic value.Conclusion Serum IGF-1 and IL-17A have the potential for early diagnosis of ASD,and the combined detection of the two levels is conducive to improving the diagnostic value of ASD.

Background and Objectives: Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. Methods: and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. Conclusions Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.

Objective:To analyze the predictive factors of GGU between biopsy and radical prostatectomy pathology based on 2014 ISUP grouping system, then establish and evaluate nomogram.Methods:Patients undergoing radical prostatectomy in Shanghai Ruijin Hospital from March 2012 to March 2019 were reviewed, and the clinical and pathological information were collected. Age(68.1±7.2), body mass indes(BMI) (24.2±3.2)kg/m 2, prostate specific antigen(PSA) 11.5(6.7-20.4)ng/ml, prostate specific antigen destiny(PSAD) 0.35(0.20-0.66). Before March 2017, the number of biopsy cores were 6 to 8; After then, all patients toke 12 cores systemic biopsy. Based on 2014 ISUP grouping system, the differences between biopsy and radical prostatectomy grades were counted. The independent predictors of GGU were analyzed by univariate and multivariate logistic regression analysis, then the nomogram for predicting GGU were established and evaluated. Results:429 patients were enrolled. There were 161 (37.5%) patients in GGU group and 268 (62.5%) patients in non-GGU group. After multivariate logistic regression analysis, body mass index (BMI)>28 kg/m 2( OR=2.54, P=0.021), prostate specific antigen density (PSAD)( OR=1.65, P=0.018)and 2014 ISUP grouping sysyem ( OR=0.53, P<0.001) of biopsy specimen were independent impact factors of GGU. The predicting model was established according to BMI, PSAD and 2014 ISUP grouping system. The area under the ROC cure of the model was 0.735 (95% CI 0.681-0.789). The nomogram model was well calibrated, with the mean absolute error of 6.7%, which means the prediction of GGU is fairly consistent with the actual situation. Conclusions:Based on the 2014 ISUP grouping system, BMI>28 kg/m 2, PSAD and 2014 ISUP grouping of biopsy specimen were independent predictors of GGU. The nomogram model for predicting GGU has a good statistical significance.