Objective:To compare the effect of anesthesia mode on the neurological functional outcomes in patients undergoing endovascular treatment for acute posterior circulation ischemic stroke.Methods:Clinical data of 656 patients undergoing intravascular therapy for acute posterior circulation ischemic stroke registered in online Acute Stroke Patients for Stroke Management Quality Evaluation Database from January 2017 to December 2022 were retrospectively analyzed.The data included 163 cases with conscious sedation and 493 cases with general anesthesia during the procedure.After propensity score matching,428 patients were included in the analysis,including 155 cases in the conscious sedation group and 273 cases in the general anesthesia group.The differences of operation mode,etiology type,vascular recanalization,hemorrhagic transformation at 24 h,modified Rankin Scale(mRS)score at 3 months and mortality within 3 months were compared between the two groups.Binary logistic regression was used to explore the effect of different anesthesia mode on neurological functional outcomes.Results:There was a significant difference in operation mode between the two groups(P<0.01),while there were no significant differences in etiology type,vascular recanalization,hemorrhagic transformation at 24 h,mRS score at 3 months or mortality within 3 months(all P>0.05).Binary logistic regression analysis revealed that anesthesia modes were not significantly associated with functional outcomes of patients(OR=1.151,95%CI:0.751-1.765,P>0.05).Conclusion:Anesthesia mode(conscious sedation or general anesthesia)will not affect the neurological functional outcomes in patients with acute posterior circulation ischemic stroke undergoing endovascular treatment.

Pustular psoriasis is a serious life-threatening disease, and patients usually show poor response to traditional treatments. In recent years, interleukin-17 and interleukin-23 inhibitors have shown favorable efficacy in the treatment of psoriasis. This review summarizes the latest progress in interleukin-17 and interleukin-23 inhibitors for the treatment of pustular psoriasis.

Advances in genetic testing field have contributed to the boom in carrier screening technology. Expanded carrier screening can effectively identify more high-risk couples than traditional guideline-based carrier screening. The introduction of extended carrier screening has increased the number of referrals for preimplantation genetic testing (PGT) for monogenic disease and enriched the types of disease diagnosed. Expanded carrier screening combined with PGT technology is changing the clinical strategy of genetic risk assessment and preventing birth defects by accurately identifying reproductive risk information and rationalizing fertility planning.

Advances in genetic testing field have contributed to the boom in carrier screening technology. Expanded carrier screening can effectively identify more high-risk couples than traditional guideline-based carrier screening. The introduction of extended carrier screening has increased the number of referrals for preimplantation genetic testing (PGT) for monogenic disease and enriched the types of disease diagnosed. Expanded carrier screening combined with PGT technology is changing the clinical strategy of genetic risk assessment and preventing birth defects by accurately identifying reproductive risk information and rationalizing fertility planning.

Alzheimer's disease (AD) is a degenerative neurological disease with unclear pathogenesis. The disease progress/trajectory of AD patients can be adequately described by establishing quantitative pharmacological disease progression model. Integrating biomarker information into the model can provide more insight to understand the potential pathological mechanisms and facilitate the optimization of future trial design. Several empirical and semi-mechanism disease progression models have been published. This mini-review is expected to offer some references for the further AD clinical research and new drug development.

Pyroptosis is a form of programmed cell death, and recently described as a new molecular mechanism of chemotherapy drugs in the treatment of tumors. Miltirone, a derivative of phenanthrene-quinone isolated from the root of Bunge, has been shown to possess anti-cancer activities. Here, we found that miltirone inhibited the cell viability of either HepG2 or Hepa1-6 cells, and induced the proteolytic cleavage of gasdermin E (GSDME) in each hepatocellular carcinoma (HCC) cell line, with concomitant cleavage of caspase 3. Knocking out switched miltirone-induced cell death from pyroptosis to apoptosis. Additionally, the induction effects of miltirone on GSDME-dependent pyroptosis were attenuated by siRNA-mediated caspase three silencing and the specific caspase three inhibitor Z-DEVD-FMK, respectively. Miltirone effectively elicited intracellular accumulation of reactive oxygen species (ROS), and suppressed phosphorylation of mitogen-activated and extracellular signal-regulated kinase (MEK) and extracellular regulated protein kinases 1/2 (ERK1/2) for pyroptosis induction. Moreover, miltirone significantly inhibited tumor growth and induced pyroptosis in the Hepa1-6 mouse HCC syngeneic model. These results provide a new insight that miltirone is a potential therapeutic agent for the treatment of HCC GSDME-dependent pyroptosis.

Objective To observe the clinical efficacy of Xingnaojing combined with butylphthalide in the treatment of vascular dementia (VD). Methods One hundred and twenty VD patients admitted to First People's Hospital of Tongxiang from August 1st 2014 to December 1st 2017 were enrolled, all the patients were given routine treatment according to their disease conditions, 53 cases were treated by intravenous drip of butylphthalide and sodium chloride injection (100 mL containing butylphthalide 25 mg and sodium chloride 0.9 g), 100 mL once, 2 times each day (single-use group); another 67 patients were treated with Xingnaojing 20 mL added into 200 mL glucose solution intravenous drip, once a day, on the basis of the treatment in the single-use group (combined group), and both groups were treated for 4 weeks. The changes of mini-mental state examination (MMSE) and activity of daily life (ADL) scores, clinical efficacy and adverse reactions were observed before and after treatment in the two groups. Results The MMSE and ADL scores in both groups were higher after treatment than those before treatment, and the MMSE and ADL scores in the combined group were significantly higher than those in the single-use group (MMSE scores: 26.77±1.30 vs. 25.64±2.81, ADL: 74.77±3.30 vs. 59.23±4.21, both P < 0.05); the clinical efficacy of the combined group was significantly higher than that of the single-use group [97.0% (65/67) vs. 81.1% (43/53), P < 0.05], however, there was no significant difference in the incidence of adverse reactions between the combined group and the single-use group [7.5% (5/67) vs. 7.6% (4/53), P > 0.05 ]. Conclusions After treatment of VD with the combination of Xingnaojing and butylphthalide, the cognitive function and daily living ability of the patients are improved to some extent, the combined treatment is more effective than the single application of butylphthalide, and no obvious adverse reaction occurs during the therapeutic course.

OBJECTIVE:To observe therapeutic efficacy and safety of shuxuetong combined with butylphthalide in the treat-ment of elderly acute massive cerebral infarction. METHODS:76 elderly patients with acute massive cerebral infarction selected were randomly divided into observation group and control group,with 38 cases in each group. Control group was treated with bu-tylphthalide,100 ml,bid;observation group was additionally given shuxuetong 6 ml added into 55 Glucose injection 200 ml, ivgtt,qd,on the basis of control group. The NIHSS,coagulation index,hematocrit,platelet aggregation rate and clinical efficacy were observed in 2 groups before and after treatment. RESULTS:After 14 d treatment,NIHSS of observation group [(3.57±0.25) points] was significantly lower than that of control group [(5.98±1.13)points],with statistical significance(P<0.05);after treat-ment,total effective rate of observation group(81.58%)was significantly higher than that of control group(57.89%),with statis-tical significance(P<0.05);platelet aggregation rate [(52.38±3.74)%] and hematocrit [(36.21±3.26)%] of observation group were significantly lower than those of control group,with statistical significance (P<0.05). Before and after treatment,coagula-tion indexes of both groups had no significant change,without statistical significance(P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Shuxuetong combined with butylphthalide is effective in the treatment of elderly acute massive cerebral infarction,and help restore neurological function with good safety.

Objective To find out the correlation of C -reactive protein (CRP)and acute cerebral infarc-tion,and to provide research data for acute cerebral infarction.Methods 43 cases with acute cerebral infarction were set as the observation group,and 40 healthy people were set as the control group.The CRP level of the observation group and the control group,and CRP level of different infarction volume and neurological function defect degree were compared.The influence factors of CRP level were analyzed with single factor analysis and Logistic regression.Results The CRP level of the observation group was (14.19 ±2.60)mg/L,which was significantly higher than that of the control group (t =7.453,P <0.05).With the increase of infarction volume,CRP levels increased (t =3.451,8.534, 5.930,all P <0.05).With the increase of nerve function defect degree,CRP level elevated (t =3.845,9.077, 6.730,all P <0.05).CRP level and systolic blood pressure,fasting glucose,total cholesterol,fibrinogen were positively correlated (r =0.479,0.603,0.508,0.603,all P <0.05 ).Cerebral infarction,systolic blood pressure,fasting glucose,total cholesterol and fibrinogen were the influence factors of CRP level.Conclusion There is correlation between C -reactive protein and acute cerebral infarction;detecting CRP level can assist in diagnosis of cerebral infarction.It was favorable to prevent and control the occurrence and progress of acute cerebral infarction.

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