Objective To investigate the efficacy and safety of domestic RECO flow restoration device in endovascular treatment of acute ischemic stroke(AIS)patients in a real-world setting.Methods From January 2019 to June 2021,consecutive patients with acute intracranial vessel occlusion treated with RECO device from 8 stroke centers in Jiangsu Province were analyzed retrospectively.Baseline and clinical data were collected,including age,gender,baseline modified Rankin scale(mRS)scores,National Institutes of Health stroke scale(NIHSS)score on admission,trial of Org 10172 in acute stroke treatment(TOAST)classification,responsible location of occlusion,wake-up stroke,and medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary heart disease,peripheral arterial disease),smoking,and alcohol consumption.Furthermore,surgical parameters were collected,including time indicators(intervals between symptom onset,admission,puncture and recanalization),preoperative intravenous thrombolysis,general anesthesia,combination of aspiration,number of passes,first pass effect(modified thrombolysis in cerebral infarction[mTICI]grade 3 achieved with s single stent-based thrombectomy),rescue therapy(including thrombectomy with other stents,intra-arterial urokinase thrombolysis,intra-arterial application of tirofiban,emergency angioplasty[stent implantation,balloon dilatation,balloon dilatation combined with stent implantation]),balloon guided catheter and NIHSS score at discharge.The effectiveness indicators included immediate successful recanalization after the operation(mTICI grade ≥ 2b),complete recanalization(mTICI grade 3),and a good prognosis at 90 d after the operation(mRS score ≤2).The safety indicators included symptomatic intracranial hemorrhage(sICH)within 24 h after the operation,device-related intraoperative complications(such as thrombus escape,iatrogenic dissection,bleeding at the surgical site),and all-cause mortality within 90 days after the operation.All patients were divided into the anterior circulation occlusion group and the posterior circulation occlusion group according to the location of the responsible occluded vessel,and the effectiveness and safety indexes were analyzed.Results A total of 366 patients with AIS caused by intracranial vessel occlusion who underwent mechanical thrombectomy with the domestic RECO thrombectomy stent were included.The average age was(69±11)years,with 54 patients(14.8％)over 80 years old and 221 patients(60.4％)male.There were 296 patients in the anterior circulation occlusion group and 70 patients in the posterior circulation occlusion group.(1)Immediate successful recanalization(mTICI grade≥2b)was achieved in 337 patients(92.1％),and complete recanalization was achieved in 282 patients(77.0％)immediately after the operation.The average number of thrombectomies was(1.9±1.0)times,and 141 patients(38.5％)achieved recanalization on the first attempt.9 patients(2.5％)used other stents during the operation,and 65 patients(17.8％)underwent emergency angioplasty.The incidence of sICH within 24 h after the operation was 10.9％(40/366),the good prognosis rate at 90 d after the operation was 53.6％(196/366),and the all-cause mortality rate at 90 d after the operation was 23.0％(84/366).The incidence of device-related intraoperative complications was 3.6％(13/366).The median time from arterial puncture to recanalization was 75(52,110)min,and the median time from onset to recanalization was 370(280,488)min.(2)The good prognosis rates at 90 d after the operation in the anterior and posterior circulation occlusion groups were 55.1％(163/296)and 47.1％(33/70),respectively.The immediate successful recanalization rates were 93.2％(276/296)and 87.1％(61/70),respectively.The immediate complete recanalization rates were 79.1％(234/296)and 68.6％(48/70),respectively.The incidence of sICH within 24h after the operation was 12.2％(36/296)and 5.7％(4/70),respectively.The incidence of device-related intraoperative complications was 3.7％(11/296)and 2.9％(2/70),respectively.The all-cause mortality rate within 90 d after the operation was 21.6％(64/296)and 28.6％(20/70),respectively.There were no statistically significant differences between the two groups in the above aspects(all P＞0.05).Conclusions The application of the domestic RECO thrombectomy stent in the treatment of AIS caused by intracranial vessel occlusion can effectively and safely achieve vascular recanalization.The results of this study still need to be further verified by prospective controlled studies.

Objective To investigate the efficacy and safety of domestic RECO flow restoration device in endovascular treatment of acute ischemic stroke(AIS)patients in a real-world setting.Methods From January 2019 to June 2021,consecutive patients with acute intracranial vessel occlusion treated with RECO device from 8 stroke centers in Jiangsu Province were analyzed retrospectively.Baseline and clinical data were collected,including age,gender,baseline modified Rankin scale(mRS)scores,National Institutes of Health stroke scale(NIHSS)score on admission,trial of Org 10172 in acute stroke treatment(TOAST)classification,responsible location of occlusion,wake-up stroke,and medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary heart disease,peripheral arterial disease),smoking,and alcohol consumption.Furthermore,surgical parameters were collected,including time indicators(intervals between symptom onset,admission,puncture and recanalization),preoperative intravenous thrombolysis,general anesthesia,combination of aspiration,number of passes,first pass effect(modified thrombolysis in cerebral infarction[mTICI]grade 3 achieved with s single stent-based thrombectomy),rescue therapy(including thrombectomy with other stents,intra-arterial urokinase thrombolysis,intra-arterial application of tirofiban,emergency angioplasty[stent implantation,balloon dilatation,balloon dilatation combined with stent implantation]),balloon guided catheter and NIHSS score at discharge.The effectiveness indicators included immediate successful recanalization after the operation(mTICI grade ≥ 2b),complete recanalization(mTICI grade 3),and a good prognosis at 90 d after the operation(mRS score ≤2).The safety indicators included symptomatic intracranial hemorrhage(sICH)within 24 h after the operation,device-related intraoperative complications(such as thrombus escape,iatrogenic dissection,bleeding at the surgical site),and all-cause mortality within 90 days after the operation.All patients were divided into the anterior circulation occlusion group and the posterior circulation occlusion group according to the location of the responsible occluded vessel,and the effectiveness and safety indexes were analyzed.Results A total of 366 patients with AIS caused by intracranial vessel occlusion who underwent mechanical thrombectomy with the domestic RECO thrombectomy stent were included.The average age was(69±11)years,with 54 patients(14.8％)over 80 years old and 221 patients(60.4％)male.There were 296 patients in the anterior circulation occlusion group and 70 patients in the posterior circulation occlusion group.(1)Immediate successful recanalization(mTICI grade≥2b)was achieved in 337 patients(92.1％),and complete recanalization was achieved in 282 patients(77.0％)immediately after the operation.The average number of thrombectomies was(1.9±1.0)times,and 141 patients(38.5％)achieved recanalization on the first attempt.9 patients(2.5％)used other stents during the operation,and 65 patients(17.8％)underwent emergency angioplasty.The incidence of sICH within 24 h after the operation was 10.9％(40/366),the good prognosis rate at 90 d after the operation was 53.6％(196/366),and the all-cause mortality rate at 90 d after the operation was 23.0％(84/366).The incidence of device-related intraoperative complications was 3.6％(13/366).The median time from arterial puncture to recanalization was 75(52,110)min,and the median time from onset to recanalization was 370(280,488)min.(2)The good prognosis rates at 90 d after the operation in the anterior and posterior circulation occlusion groups were 55.1％(163/296)and 47.1％(33/70),respectively.The immediate successful recanalization rates were 93.2％(276/296)and 87.1％(61/70),respectively.The immediate complete recanalization rates were 79.1％(234/296)and 68.6％(48/70),respectively.The incidence of sICH within 24h after the operation was 12.2％(36/296)and 5.7％(4/70),respectively.The incidence of device-related intraoperative complications was 3.7％(11/296)and 2.9％(2/70),respectively.The all-cause mortality rate within 90 d after the operation was 21.6％(64/296)and 28.6％(20/70),respectively.There were no statistically significant differences between the two groups in the above aspects(all P＞0.05).Conclusions The application of the domestic RECO thrombectomy stent in the treatment of AIS caused by intracranial vessel occlusion can effectively and safely achieve vascular recanalization.The results of this study still need to be further verified by prospective controlled studies.

Objective:To explore the characteristic of dynamic function network connectivity (dFNC) of resting brain networks in internet gaming disorder (IGD) adolescents.Methods:Forty-four adolescent IGD subjects (IGD group, male/female: 38/6) and fifty healthy controls (HC group, male/female: 40/10) were collected, and the subjects completed demographic questionnaires, Young internet addiction scale(YIAS), Chinese adolescents' maladaptive cognitions scale(CAMAS), and functional magnetic resonance imaging (fMRI) tests. The fMRI data were preprocessed on the Matlab platform, and the preprocessed data was divided into 64 components for group level independent component analysis.The dynamic functional connectivity of obtained 18 effective independent components was analyzed by sliding time window technique, and the difference of dynamic functional connectivity of brain triple network between the IGD group and HC group was compared using SPSS 22.0 software.Results:Four repeated dFNC states were identified through cluster analysis.Each state indicated that different functional networks had different connection strengths.State 3, the most frequent state, had been indicated that the whole brain network of the subject was in a state of weak functional connectivity.The second frequent state was state 1, which indicated enhanced functional connectivity within the subject's central executive network (CEN).State 2 had been indicated enhanced functional connectivity within the subject's salience network (SN).State 4 had been indicated generally enhanced functional connectivity in the subjects' brain networks, and this state was the least frequent.The results of non-parametric permutation test on the time attribute showed that compared with the HC group, the IGD group had a longer time score (IGD group: 0.24±0.19, HC group: 0.13±0.15, t=1.19, P<0.05, non-parametric substitution test) for state 1 with strong connectivity within the CEN, which was positively correlated with the YIAS score and game time ( r=0.418, P=0.003; r=0.515, P=0.004).Compared with HC group, the functional connectivity of ICD group between the internal insula of the SN and the dorsal anterior cingulate cortex was enhanced ( P<0.05, FDR corrected), while the average residence time in weakly connected state 3 was longer ( Z=2.09, P<0.05, nonparametric substitution test). Conclusions:The difference in dynamic functional connectivity of the triple network in the brain of IGD adolescents under resting state is mainly manifested by strong connections in CEN, functional connections between insula and dorsal anterior cingulate cortex in SN is enhanced, and weakening of overall functional connections, which may play an important role in the pathological mechanism of IGD.

Objective:To analyze the mediating role of maladaptive cognition between family relationships and internet gaming disorder (IGD) in adolescents.Methods:From September 2021 to April 2023, a total of 52 adolescents with IGD (IGD group) from the First Affiliated Hospital of Zhengzhou University and 51 normal adolescents (HC group) from community were selected as study subjects.The severity of adolescent internet addiction was assessed using the Young internet addiction scale (YIAS).Family relationships and maladaptive cognition were evaluated by the Chinese version of family environment scale (FES-CV) and the Chinese adolescents’ maladaptive cognitions scale (CAMCS).SPSS 22.0 software was used for descriptive analysis, correlation analysis and mediation analysis.Two-sample t-tests were used for quantitative data comparison, and chi-square tests were used for qualitative data comparison. Pearson correlation analysis was conducted to analyze the relationship of variables, and the intermediate variable test was performed using Bootstrap method. Results:(1) Compared with HC group, the score of YIAS in IGD group was higher, and the difference was statistically significant((63.69±10.36), (28.96±5.20), t=21.571, P<0.05). Compared with the HC group, the conflict score of FES-CV in the IGD group was higher((4.79±2.02), (3.33±1.42), t=4.228, P<0.05), and the cohesion score of FES-CV was lower ((4.46±1.64), (5.57±1.33), t=-3.768, P<0.05).Compared with the HC group, the CAMCS score in IGD group was higher, and the difference was statistically significant((28.88±10.11), (22.98±9.11), t=3.116, P<0.05). (2) There was a positive correlation between conflict of family relationships and IGD ( r=0.504, P<0.01), and a negative correlation between cohesion of family relationships and IGD( r=-0.474, P<0.01) in IGD group. (3) Path analysis and mediation effect test showed that conflict in family relationships positively predicted IGD ( β=0.331, 95% CI=0.100-0.563) and maladaptive cognition ( β=0.372, 95% CI=0.108-0.636). Maladaptive cognitive positively predicted IGD ( β=0.464, 95% CI=0.232-0.696). Maladaptive cognition played a mediating role between conflict of family relationships and IGD, and the mediating effect value was 0.173 (95% CI=0.020-0.366), accounting for 34.33%(0.173/0.504) of the total effect. Conclusion:Family relationships are related to IGD in adolescents. Maladaptive cognition may play a mediating role between family relationships and IGD in adolescents.

Objective:To analyze the mediating role of maladaptive cognition between family relationships and internet gaming disorder (IGD) in adolescents.Methods:From September 2021 to April 2023, a total of 52 adolescents with IGD (IGD group) from the First Affiliated Hospital of Zhengzhou University and 51 normal adolescents (HC group) from community were selected as study subjects.The severity of adolescent internet addiction was assessed using the Young internet addiction scale (YIAS).Family relationships and maladaptive cognition were evaluated by the Chinese version of family environment scale (FES-CV) and the Chinese adolescents’ maladaptive cognitions scale (CAMCS).SPSS 22.0 software was used for descriptive analysis, correlation analysis and mediation analysis.Two-sample t-tests were used for quantitative data comparison, and chi-square tests were used for qualitative data comparison. Pearson correlation analysis was conducted to analyze the relationship of variables, and the intermediate variable test was performed using Bootstrap method. Results:(1) Compared with HC group, the score of YIAS in IGD group was higher, and the difference was statistically significant((63.69±10.36), (28.96±5.20), t=21.571, P<0.05). Compared with the HC group, the conflict score of FES-CV in the IGD group was higher((4.79±2.02), (3.33±1.42), t=4.228, P<0.05), and the cohesion score of FES-CV was lower ((4.46±1.64), (5.57±1.33), t=-3.768, P<0.05).Compared with the HC group, the CAMCS score in IGD group was higher, and the difference was statistically significant((28.88±10.11), (22.98±9.11), t=3.116, P<0.05). (2) There was a positive correlation between conflict of family relationships and IGD ( r=0.504, P<0.01), and a negative correlation between cohesion of family relationships and IGD( r=-0.474, P<0.01) in IGD group. (3) Path analysis and mediation effect test showed that conflict in family relationships positively predicted IGD ( β=0.331, 95% CI=0.100-0.563) and maladaptive cognition ( β=0.372, 95% CI=0.108-0.636). Maladaptive cognitive positively predicted IGD ( β=0.464, 95% CI=0.232-0.696). Maladaptive cognition played a mediating role between conflict of family relationships and IGD, and the mediating effect value was 0.173 (95% CI=0.020-0.366), accounting for 34.33%(0.173/0.504) of the total effect. Conclusion:Family relationships are related to IGD in adolescents. Maladaptive cognition may play a mediating role between family relationships and IGD in adolescents.