Many patients fail to return to independence despite successful recanalization by thrombectomy for acute ischemic stroke with large vessel occlusion. Among them, the phenomenon of tissue no-reflow is an important influencing factor. In this review, we highlight the pathogenesis, imaging evaluation, and adjunctive treatment strategies, such as intra-arterial thrombolysis following thrombectomy, of the no-reflow phenomenon in patients with successful recanalization by thrombectomy for acute ischemic stroke, so as to provide a basis for exploring effective treatment for no-reflow phenomenon.

Objective:To explore the relationships among psychological resilience,spiritual health,and illness uncertainty in cancer patients,and to analyze the mediating role of disease uncertainty.Methods:The cancer patients were selected by convenience sampling method from Feb 2024 to May 2024 in the Department of Oncology of a Grade Ⅲ-A general hospital in Wuhu City.Data were collected using a general information questionnaire,the Mishel Uncertainty in Illness Scale(MUIS),the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale(FACIT-SP-12,Chinese version),and the Connor-Davidson Resilience Scale(CD-RISC-10).Pearson correlation analysis was conducted to assess the relationships among psychological resilience,illness uncertainty,and spiritual health.The mediating effect of illness uncertainty was tested using Hayes'PROCESS Model 4 and the Bootstrap method.Results:The total scores of spiritual health,psychological resilience and illness uncertainty of cancer patients was(25.11±7.19),(24.36±6.75)and(67.75±13.06),respectively.The spiritual health was positively correlated with psychological resilience(r=0.415,P＜0.01)and negatively correlated with illness uncertainty(r=-0.398,P＜0.01).The psychological resilience was negatively correlated with illness uncertainty(r=-0.668,P＜0.01).Illness uncertainty partially mediated the relationship between psychological resilience and spiritual health,accounting for 35.29%of the total effect.Conclusions:The spiritual health of cancer patients is at a moderate level.Enhancing psychological resilience and reducing illness uncertainty can alleviate psychological burden and improve spiritual health,thereby promoting overall quality of life.

Cerebral infarction caused by cardiac myxoma is relatively rare.The authors reported two cases of cerebral infarction caused by cardiac myxoma treated with intravascular mechanical thrombectomy,aiming to enhance neurologists'understanding of the secondary neurological lesions caused by cardiac myxoma and provide certain basis for the formulation of diagnostic and treatment strategies for cerebral infarction secondary to cardiac myxoma.

Objective To investigate the impact of long non-coding RNA maternal expression gene 3(lncRNA MEG3)on hypoxia/reoxygenation(H/R)-induced cardiomyocyte apoptosis by modulating the miR-202-5p/signal transducer and activator of transcription 3(STAT3)axis.Methods An H/R cell model was constructed and randomly separated into four groups:sh-NC(transfected with NC shRNA),sh-MEG3(transfected with lncRNA MEG3 shRNA),miR-NC(transfected with lncRNA MEG3 shRNA and NC miR),and in-miR-202-5p(transfected with lncRNA MEG3 shRNA and miR-202-5p inhibitor).In addition,the H/R group(nontransfected H/R model cells)and the AC 16 group(normal AC 16 cells)were set.Quantitative real-time PCR method was used to analyze the expression of lncRNA MEG3,miR-202-5p,and STAT3 in cells from each group.CCK-8 method was used to analyze cell viability.Flow cytometry was used to analyze apoptosis.Enzyme-linked immunosorbent,colorimetric,and probe assays were applied to detect the levels of inter-leukin-6(IL-6),tumor necrosis factor α(TNF-α),malondialdehyde(MD A),glutathione peroxidases(GSH-Px),and reactive oxygen spe-cies(ROS).Western blotting was carried out to examine the expression of STAT3,Bcl-2-associated X protein(Bax),B-cell lymphoma-2(Bcl-2),caspase-3,and caspase-9.A dual luciferase assay was used to analyze the relationship between lncRNA MEG3 and miR-202-5p,as well as the relationship between miR-202-5p and STAT3.Results Compared with that in the AC 16 group,the expression of lncRNA MEG3 and STAT3 in cells in the H/R group increased,while the expression of miR-202-5p decreased(P＜0.05).Compared with that in the H/R group and sh-NC group,the expression of lncRNA MEG3 and STAT3 decreased in the sh-MEG3 group,while the expression of miR-202-5p increased(P＜0.05).Compared with that in the sh-MEG3 group and miR-NC group,the expression of lncRNA MEG3 and STAT3 increased in the in-miR-202-5p group,while the expression of miR-202-5p decreased(P＜0.05).Compared with that in the AC 16 group,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 increased in the H/R group.In contrast,the cell viability,clone count,levels of superoxide dismutase(SOD)and GSH-Px,and the expression of Bcl-2 decreased(P＜0.05).Compared with that in the H/R group and sh-NC group,the cell viability,clone count,levels of SOD and GSH-Px,and the expression of Bcl-2 increased in the sh-MEG3 group.In contrast,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 decreased(P＜0.05).Compared with that in the sh-MEG3 group and miR-NC group,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 increased in the in-miR-202-5p group.In contrast,the cell viability,clone count,levels of SOD and GSH-Px,and the expression of Bcl-2 decreased(P＜0.05).There were multiple binding sites between lncRNA MEG3 and miR-202-5p,and between miR-202-5p and STAT3.The luciferase activity was lower in the WT-MEG3+miR-202-5p group than in the WT-MEG3+miR-NC group(P＜0.05).The luciferase activity was lower in the WT-STAT3+miR-202-5p group than in the WT-STAT3+miR-NC group(P＜0.05).Conclusion Knocking down lncRNA MEG3 can downregulate STAT3 by negatively regulating miR-202-5p,inhibiting H/R-induced cardiomyocyte apoptosis.

Objective To study the influencing factors of intradialytic hypotension(IDH)in diabetic maintenance hemodialysis(MHD)patients,and to provide references for clinical prevention of IDH quality control.Methods A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects.According to the definition of IDH[systolic blood pressure during hemodialysis≤90 mmHg(1 mmHg=0.133 kPa)or systolic blood pressure reduction during dialysis≥30 mmHg],the patients were divided into IDH group(frequency of hypotension events during dialysis≥30%during 7 months of follow-up)and non-IDH group.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH.receive operating characteristic curve(ROC)curve analysis was used to evaluate the predictive value of each influencing factor for IDH.Results Univariate analysis showed that compared with non-IDH group,IDH group had higher systolic blood pressure,higher blood glucose and lower serum albumin before dialysis(P<0.05).There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group(P<0.05).Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure,orthostatic hypotension and serum albumin were the influencing factors of IDH(P<0.05).ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH.The area under the ROC curve was 0.787(95%CI:0.720-0.854,P<0.001),the threshold of IDH predicted by the Jorden index was 153 mmHg,the sensitivity was 75.5%,and the specificity was 75.4%.Conclusion Pre-hemodialysis systolic blood pressure,blood albumin and postural hypotension are independent factors of IDH in diabetic patients.In order to predict the occurrence of IDH,the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Objective To study the influencing factors of intradialytic hypotension(IDH)in diabetic maintenance hemodialysis(MHD)patients,and to provide references for clinical prevention of IDH quality control.Methods A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects.According to the definition of IDH[systolic blood pressure during hemodialysis≤90 mmHg(1 mmHg=0.133 kPa)or systolic blood pressure reduction during dialysis≥30 mmHg],the patients were divided into IDH group(frequency of hypotension events during dialysis≥30%during 7 months of follow-up)and non-IDH group.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH.receive operating characteristic curve(ROC)curve analysis was used to evaluate the predictive value of each influencing factor for IDH.Results Univariate analysis showed that compared with non-IDH group,IDH group had higher systolic blood pressure,higher blood glucose and lower serum albumin before dialysis(P<0.05).There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group(P<0.05).Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure,orthostatic hypotension and serum albumin were the influencing factors of IDH(P<0.05).ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH.The area under the ROC curve was 0.787(95%CI:0.720-0.854,P<0.001),the threshold of IDH predicted by the Jorden index was 153 mmHg,the sensitivity was 75.5%,and the specificity was 75.4%.Conclusion Pre-hemodialysis systolic blood pressure,blood albumin and postural hypotension are independent factors of IDH in diabetic patients.In order to predict the occurrence of IDH,the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Objective:To explore the relationships among psychological resilience,spiritual health,and illness uncertainty in cancer patients,and to analyze the mediating role of disease uncertainty.Methods:The cancer patients were selected by convenience sampling method from Feb 2024 to May 2024 in the Department of Oncology of a Grade Ⅲ-A general hospital in Wuhu City.Data were collected using a general information questionnaire,the Mishel Uncertainty in Illness Scale(MUIS),the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale(FACIT-SP-12,Chinese version),and the Connor-Davidson Resilience Scale(CD-RISC-10).Pearson correlation analysis was conducted to assess the relationships among psychological resilience,illness uncertainty,and spiritual health.The mediating effect of illness uncertainty was tested using Hayes'PROCESS Model 4 and the Bootstrap method.Results:The total scores of spiritual health,psychological resilience and illness uncertainty of cancer patients was(25.11±7.19),(24.36±6.75)and(67.75±13.06),respectively.The spiritual health was positively correlated with psychological resilience(r=0.415,P＜0.01)and negatively correlated with illness uncertainty(r=-0.398,P＜0.01).The psychological resilience was negatively correlated with illness uncertainty(r=-0.668,P＜0.01).Illness uncertainty partially mediated the relationship between psychological resilience and spiritual health,accounting for 35.29%of the total effect.Conclusions:The spiritual health of cancer patients is at a moderate level.Enhancing psychological resilience and reducing illness uncertainty can alleviate psychological burden and improve spiritual health,thereby promoting overall quality of life.

Cerebral infarction caused by cardiac myxoma is relatively rare.The authors reported two cases of cerebral infarction caused by cardiac myxoma treated with intravascular mechanical thrombectomy,aiming to enhance neurologists'understanding of the secondary neurological lesions caused by cardiac myxoma and provide certain basis for the formulation of diagnostic and treatment strategies for cerebral infarction secondary to cardiac myxoma.

Objective To investigate the impact of long non-coding RNA maternal expression gene 3(lncRNA MEG3)on hypoxia/reoxygenation(H/R)-induced cardiomyocyte apoptosis by modulating the miR-202-5p/signal transducer and activator of transcription 3(STAT3)axis.Methods An H/R cell model was constructed and randomly separated into four groups:sh-NC(transfected with NC shRNA),sh-MEG3(transfected with lncRNA MEG3 shRNA),miR-NC(transfected with lncRNA MEG3 shRNA and NC miR),and in-miR-202-5p(transfected with lncRNA MEG3 shRNA and miR-202-5p inhibitor).In addition,the H/R group(nontransfected H/R model cells)and the AC 16 group(normal AC 16 cells)were set.Quantitative real-time PCR method was used to analyze the expression of lncRNA MEG3,miR-202-5p,and STAT3 in cells from each group.CCK-8 method was used to analyze cell viability.Flow cytometry was used to analyze apoptosis.Enzyme-linked immunosorbent,colorimetric,and probe assays were applied to detect the levels of inter-leukin-6(IL-6),tumor necrosis factor α(TNF-α),malondialdehyde(MD A),glutathione peroxidases(GSH-Px),and reactive oxygen spe-cies(ROS).Western blotting was carried out to examine the expression of STAT3,Bcl-2-associated X protein(Bax),B-cell lymphoma-2(Bcl-2),caspase-3,and caspase-9.A dual luciferase assay was used to analyze the relationship between lncRNA MEG3 and miR-202-5p,as well as the relationship between miR-202-5p and STAT3.Results Compared with that in the AC 16 group,the expression of lncRNA MEG3 and STAT3 in cells in the H/R group increased,while the expression of miR-202-5p decreased(P＜0.05).Compared with that in the H/R group and sh-NC group,the expression of lncRNA MEG3 and STAT3 decreased in the sh-MEG3 group,while the expression of miR-202-5p increased(P＜0.05).Compared with that in the sh-MEG3 group and miR-NC group,the expression of lncRNA MEG3 and STAT3 increased in the in-miR-202-5p group,while the expression of miR-202-5p decreased(P＜0.05).Compared with that in the AC 16 group,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 increased in the H/R group.In contrast,the cell viability,clone count,levels of superoxide dismutase(SOD)and GSH-Px,and the expression of Bcl-2 decreased(P＜0.05).Compared with that in the H/R group and sh-NC group,the cell viability,clone count,levels of SOD and GSH-Px,and the expression of Bcl-2 increased in the sh-MEG3 group.In contrast,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 decreased(P＜0.05).Compared with that in the sh-MEG3 group and miR-NC group,the apoptosis rate,levels of IL-6,TNF-α,MDA,and ROS,and the expression of STAT3,Bax,cleaved caspase-3,and cleaved caspase-9 increased in the in-miR-202-5p group.In contrast,the cell viability,clone count,levels of SOD and GSH-Px,and the expression of Bcl-2 decreased(P＜0.05).There were multiple binding sites between lncRNA MEG3 and miR-202-5p,and between miR-202-5p and STAT3.The luciferase activity was lower in the WT-MEG3+miR-202-5p group than in the WT-MEG3+miR-NC group(P＜0.05).The luciferase activity was lower in the WT-STAT3+miR-202-5p group than in the WT-STAT3+miR-NC group(P＜0.05).Conclusion Knocking down lncRNA MEG3 can downregulate STAT3 by negatively regulating miR-202-5p,inhibiting H/R-induced cardiomyocyte apoptosis.

Many patients fail to return to independence despite successful recanalization by thrombectomy for acute ischemic stroke with large vessel occlusion. Among them, the phenomenon of tissue no-reflow is an important influencing factor. In this review, we highlight the pathogenesis, imaging evaluation, and adjunctive treatment strategies, such as intra-arterial thrombolysis following thrombectomy, of the no-reflow phenomenon in patients with successful recanalization by thrombectomy for acute ischemic stroke, so as to provide a basis for exploring effective treatment for no-reflow phenomenon.