Objective To explore the potential prognostic factors of patients with acute ischemic stroke(AIS)after undergoing endovascular mechanical thrombectomy and to construct an effective predictive model.Methods A retrospective analysis of clinical data was conducted on 202 patients with anterior circulation large vessel occlusion AIS from 2 stroke centers.All patients received endovascular mechanical thrombectomy treatment,with treatment and follow-up lasting at least 90 d.Basic demographic characteristics,medical records,and baseline blood biomarker data were collected,and the potential prognostic indicators for AIS after 90 d were screened using least absolute shrinkage and selection operator(LASSO)-logistic regression analysis.Results It was found that alcohol drinking(P=0.029),hypertension(P=0.001),diabetes mellitus(P=0.021),stroke or transient ischemic attack(P=0.049),systolic blood pressure on admission(P=0.009),diastolic blood pressure on admission(P=0.038),blood glucose(P=0.003),white blood cell count(P=0.001),neutrophil count(P=0.001),fibrinogen(P=0.010),systemic immune-inflammation index(P=0.008)and neutrophil-to-lymphocyte ratio(NLR)(P＜0.001)were associated with adverse clinical outcomes.Nine significant prognostic determinants were screened through LASSO-logistic regression analysis.Multivariate logistic regression analysis revealed that male sex(P=0.008),smoking history(P=0.013),hypertension(P=0.011),lymphocyte(P=0.028),fibrinogen(P=0.016),and NLR(P＜0.001)were significant predictive factors for poor prognosis in AIS patients after endovascular thrombectomy treatment.The constructed prognostic model had an accuracy of 76.2％,a sensitivity of 78.2％,a specificity of 71.7％,and a positive predictive value of 86.7％.Conclusion The predictive model established in this study can assist clinicians in identifying high-risk patients with AIS who have undergone endovascular thrombectomy,and it provide guidance for formulating individualized treatment strategies.

BACKGROUND: Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes. METHODS: A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome. RESULTS: At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046). CONCLUSIONS For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
Humans ; Treatment Outcome ; Percutaneous Coronary Intervention/methods* ; Coronary Occlusion/surgery* ; Prognosis ; Angina, Unstable/surgery* ; Chronic Disease ; Risk Factors

Objective:To analyze the predictive value of tumor-infiltrating lymphocyte (TIL) fraction in patients with breast cancer treat-ed with neoadjuvant chemotherapy. Methods: Clinicopathological data of 156 female patients with breast cancer diagnosed using core needle biopsy and treated with neoadjuvant chemotherapy and surgery between November 2015 and April 2017 in Tianjin Medi-cal Uninvertity Cancer Institute and Hospital were retrospectively analyzed. Patients were assigned into 3 groups based on the TIL frac-tim, namely high, intermediate and low TIL fractin gronp. The response to neoadjuvant chemotherapy was evaluated using the histo-pathological criteria for assessment of therapeutic response in breast cancer. The relation between TIL fraction and response to neoad-juvant chemotherapy was then analyzed. Results:Neoadjuvant chemotherapy was effective in 78.2%(122/156) of the patients. Pa-tients harboring tumors with a higher TIL fraction were more likely to achieve a better response to neoadjuvant chemotherapy than those harboring tumors with a lower TIL fraction (P<0.01). Patients harboring hormonal receptor (HR)-negative tumors generally exhib-ited a higher TIL fraction than those harboring HR-positive tumors (P<0.01). The TIL fraction, but not HR status, human epidermal growth factor receptor 2 (HER-2) status, or Ki-67 index, correlated with response to neoadjuvant chemotherapy. Conclusion:TIL frac-tion is an independent predictive factor of response to neoadjuvant chemotherapy in patients with breast cancer. Patients with breast cancer exhibiting higher TIL fraction achieve better response to neoadjuvant chemotherapy than those exhibiting lower TIL fraction.

Objective To determine the effect of miR-196 on sensitivity of endocrine therapy for breast cancer and to explore its possible molecular mechanism.Methods The expression of miR-196 was detected by real-time quantitative PCR (RT-qPCR) in MCF7 (ER+) and BT549 (ER-).The sensitivity of tamoxifen on MCF7 cells was evaluated by MTT and colony formation.Dual-luciferase,RT-qPCR and western blot assays were used to determine the regulation of miR-196 on p27.Results The expression of miR-196 was up-regulated in BT549 compared to that in MCF7 cells.The cell viability and colony formation were increased in miR-196-overexpressed MCF7 cells compared to those in the control cells after treatment with tamoxifen.The luciferase activity and expression of p27 were decreased in miR-196-overexpressed MCF7 cells compared to those in the control cells.Overexpression of p27 eliminated the effect of miR-196-induced endocrine therapy resistance in MCF7 cell.Conclusion miR-196 promotes breast cancer endocrine resistance by targeting p27.