Background: and Purpose Accurately predicting long-term functional outcomes of basilar artery occlusion (BAO) remains challenging. We compared the predictive performance of the baseline, 24-hour, and 72-hour National Institutes of Health Stroke Scale (NIHSS) scores for 90-day BAO functional outcomes using the Acute Basilar Artery Occlusion: Endovascular Thrombectomy versus Standard Medical Treatment (ATTENTION) trial data. We identified the optimal assessment time point, determined treatment-specific NIHSS cutoff values, and explored the role of early neurological function in treatment effects. Methods: This retrospective post hoc analysis included 324 patients with acute BAO with baseline NIHSS scores ≥10 and complete NIHSS assessments at each time point. The primary outcome was a favorable 90-day functional outcome (modified Rankin Scale score, 0–3). Receiver operating characteristic curve analysis was used to assess the predictive ability of NIHSS scores. The optimal 72-hour NIHSS predictive cutoff values were determined for the endovascular treatment (EVT) and best medical management (BMM) subgroups. Results: The 72-hour NIHSS score showed the highest predictive accuracy for the primary outcome (area under the receiver operating characteristic curve [AUC]: 0.954), outperforming the 24-hour (AUC: 0.903) and baseline (AUC: 0.688) scores; its optimal predictive cut-off value was ≤11 in the EVT group (sensitivity: 85.6%, specificity: 92.9%, positive predictive value [PPV]: 91.8%, negative predictive value [NPV]: 87.4%) and ≤9 in the BMM group (sensitivity: 84.6%, specificity: 95.1%, PPV: 84.6%, NPV: 95.1%). Conclusions The 72-hour NIHSS score outperformed the baseline and 24-hour scores in predicting 90-day functional outcomes and mediating the effects of EVT. Treatment-specific 72-hour NIHSS cut-off values may guide early risk stratification and prognostic assessments.

Objective Analyze the changes in serum levels of fibrinogen monomer(FM),high-density lipoprotein(HDL-C),homocysteine(Hcy),D-dimer(D-D)in patients with lower limb fractures before and after surgery,and analyze their correlation with deep vein thrombosis(DVT).Methods 187 patients with lower limb fractures admitted from July 2020 to June 2023 were divided into DVT group(53 cases)and non DVT group(134 cases)according to the presence or absence of DVT after surgery.Independent sample t-tests were used to compare the levels of serum FM,HDL-C,Hcy,and D-D between the two groups on the day before and after surgery.Spearman correlation analysis was used to investigate the correlation between serum FM,HDL-C,Hcy,D-D and DVT on the day before and after surgery.Receiver operating characteristic(ROC)curves were used to analyze the effects of serum FM,HDL-C,Hcy,and D-D on lower limbs on the day after surgery.The predictive value of postoperative DVT in fracture patients.Results Compared with 1 day before surgery,the serum FM,HDL-C,Hcy,and D-D levels in both groups increased on the day after surgery(P＜0.05),and compared with the non DVT group,the DVT group had higher serum FM,HDL-C,Hcy,and D-D levels on the day after surgery(P＜0.05).According to Spearman correlation analysis,there was no correlation between preoperative serum FM,HDL-C,Hcy,D-D and DVT on day 1(P＞0.05),while postoperative serum FM,HDL-C,Hcy,D-D were positively correlated with DVT on day 1(P＜0.05).ROC curve analysis showed that the AUC of FM,HDL-C,Hcy,D-D,and their combined prediction of postoperative DVT in patients with lower limb fractures on the 1st day after surgery were 0.781,0.756,0.754,0.781,and 0.879,respectively.The sensitivity and specificity corresponding to the optimal critical value were:After 1 day of surgery,the FM was 45.3％and 100.0％,the HDL-C was 100.0％and 49.3％,the Hcy was 49.1％/100.0％,and the D-D was 100.0％and 49.3％,respectively.The combined rates of the four were 83.0％and 86.6％.Conclusion Compared with patients with lower limb fractures who did not experience DVT after surgery,patients with lower limb fractures experienced elevated serum levels of FM,HDL-C,Hcy,and D-D.There was a correlation between preoperative and postoperative serum levels of FM,HDL-C,Hcy,and D-D.The combination of serum levels of FM,HDL-C,Hcy,and D-D at 1 day after surgery has a high predictive value for postoperative DVT in patients with lower limb fractures.

Objective Analyze the changes in serum levels of fibrinogen monomer(FM),high-density lipoprotein(HDL-C),homocysteine(Hcy),D-dimer(D-D)in patients with lower limb fractures before and after surgery,and analyze their correlation with deep vein thrombosis(DVT).Methods 187 patients with lower limb fractures admitted from July 2020 to June 2023 were divided into DVT group(53 cases)and non DVT group(134 cases)according to the presence or absence of DVT after surgery.Independent sample t-tests were used to compare the levels of serum FM,HDL-C,Hcy,and D-D between the two groups on the day before and after surgery.Spearman correlation analysis was used to investigate the correlation between serum FM,HDL-C,Hcy,D-D and DVT on the day before and after surgery.Receiver operating characteristic(ROC)curves were used to analyze the effects of serum FM,HDL-C,Hcy,and D-D on lower limbs on the day after surgery.The predictive value of postoperative DVT in fracture patients.Results Compared with 1 day before surgery,the serum FM,HDL-C,Hcy,and D-D levels in both groups increased on the day after surgery(P＜0.05),and compared with the non DVT group,the DVT group had higher serum FM,HDL-C,Hcy,and D-D levels on the day after surgery(P＜0.05).According to Spearman correlation analysis,there was no correlation between preoperative serum FM,HDL-C,Hcy,D-D and DVT on day 1(P＞0.05),while postoperative serum FM,HDL-C,Hcy,D-D were positively correlated with DVT on day 1(P＜0.05).ROC curve analysis showed that the AUC of FM,HDL-C,Hcy,D-D,and their combined prediction of postoperative DVT in patients with lower limb fractures on the 1st day after surgery were 0.781,0.756,0.754,0.781,and 0.879,respectively.The sensitivity and specificity corresponding to the optimal critical value were:After 1 day of surgery,the FM was 45.3％and 100.0％,the HDL-C was 100.0％and 49.3％,the Hcy was 49.1％/100.0％,and the D-D was 100.0％and 49.3％,respectively.The combined rates of the four were 83.0％and 86.6％.Conclusion Compared with patients with lower limb fractures who did not experience DVT after surgery,patients with lower limb fractures experienced elevated serum levels of FM,HDL-C,Hcy,and D-D.There was a correlation between preoperative and postoperative serum levels of FM,HDL-C,Hcy,and D-D.The combination of serum levels of FM,HDL-C,Hcy,and D-D at 1 day after surgery has a high predictive value for postoperative DVT in patients with lower limb fractures.

Objective:To analyze and compare the features of undifferentiated-typed early gastric cancer (UD-EGC) and gastric mucosa-associated lymphoid tissue(MALT) lymphoma under white light endoscopy (WLE) and magnifying endoscopy-narrow band imaging (ME-NBI).Methods:Data of patients with complete endoscopic images of WLE and ME-NBI in Shanghai General Hospital, Shanghai Jiao Tong University from March 2015 to July 2019 were retrospectively analyzed.Twenty-six UD-EGC patients and seven gastric MALT lymphoma patients in ⅠE1 stage were included, and the characteristics of the two diseases under WLE and ME-NBI were compared and summarized.Results:There were no significant differences in age, sex or infiltration depth of lesions between the two groups.Under WLE, UD-EGC was often manifested as a single lesion located in the lower part of the stomach, with unclear lesion boundaries. While MALT lymphoma lesions were mostly multifocal with clear boundaries, located in the middle of the stomach. Under ME-NBI, the microsurface pattern of UD-EGC showed dilation or disappearance of areas between the recesses, and the spiral microvascular pattern. However, the microsurface pattern of MALT lymphomas were characterized by " cross-road traffic sign" , " pebble sign" , and the presentation of residual glandular duct at the lesion was similar to that of Helicobacter pylori ( HP)-related gastritis. Furthermore, the microvascular pattern of MALT lymphomas often showed " tree like appearance (TLA)" . After HP eradication therapy, the morphology of microsurface pattern and microvascular pattern in the original lesion area gradually returned to normal. Conclusion:UD-EGC and gastric MALT lymphoma showed particular features in the number, site and boundary under WLE, and they showed significantly different microsurface pattern and microvascular pattern under ME-NBI. Differentiation of the two diseases will help reduce the risk of missed diagnosis and misdiagnosis.

Background:As the endogenous inhibitor of interleukin(IL)-22,IL-22 binding protein(IL-22BP)inhibits the protective effect of IL-22. Expression and significance of IL-22BP in intestinal mucosa of patients with active inflammatory bowel disease(IBD)remain unclear. Aims:To investigate the expression and significance of IL-22BP in intestinal mucosa of patients with active IBD. Methods:A total of 25 Crohn's disease(CD)and 36 ulcerative colitis(UC)patients from Jan. 2017 to Jan. 2018 at Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine were enrolled, and 30 colonic polyp patients were served as controls. The disease activity of CD and UC was assessed. Expressions of IL-22BP mRNA and protein in intestinal mucosa were determined by real-time fluorescent quantitative PCR and immunohistochemistry,respectively. Correlation of IL-22BP protein expression with the disease activity of CD,UC was analyzed. Results:Compared with corresponding control group,expressions of IL-22BP mRNA in intestinal mucosa in CD and UC groups were significantly increased(CD:3.59 ± 0.83 vs. 1.08 ± 0.45,P<0.001;UC:2.19 ± 0.52 vs. 1.05 ± 0.34,P<0.001),and expressions of IL-22BP protein were also significantly increased(CD:6.12 ± 2.30 vs. 1.83 ± 1.86,P<0.001;UC:5.58 ± 2.27 vs. 2.23 ± 1.77,P<0.001). Expression of IL-22BP protein in intestinal mucosa was positively correlated with disease activity of CD(r =0. 649,P <0. 001)and UC(r =0. 732,P <0.001). Conclusions:Expressions of IL-22BP mRNA and protein are increased in intestinal mucosa of patients with active IBD, and the expression of IL-22BP protein is positively correlated with disease activity of IBD.

Inflammatory bowel disease (IBD)is a chronic inflammatory disease of the digestive tract,including Crohn's disease (CD)and ulcerative colitis (UC). The cause and pathogenesis of IBD is not fully clear,and the disorder of immune function plays a key role in the pathogenesis of IBD. Th17 cells are CD4 + T cells that can specifically produce IL-17. Recent studies have demonstrated that Th17 cells play an important role in the abnormal immune response of IBD. This article reviewed the role of Th17 cells in the pathogenesis of IBD.