Objective To compare the safety and efficacy of endovascular treatment(EVT)transradial approach and transfemoral approach in patients with acute ischemic stroke with large vessel occlusion in the posterior circulation.Methods Patients with acute ischemic stroke with large vessel occlusion in the posterior circulation admitted to the Stroke Center of Linyi People's Hospital,Shandong Second Medical University from February 2022 to April 2024 were retrospectively recruited.The baseline and clinical data were collected,including age,sex,past medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary artery disease,myocardial infarction and stroke),smoking,blood pressure at admission,National Institutes of Health stroke scale(NIHSS)score at admission,modified Rankin scale(mRS)score before the onset of stroke,Alberta stroke program early CT score(ASPECTS),whether intravenous thrombolysis was performed,volume of core infarct zone,volume of hypoperfused zone,occlusion location,etiology of stroke,time indexes(including time from onset to door,time from door to arterial puncture,arterial puncture to recanalization,and time from onset to revascularization),anesthesia modality,EVT first-line strategy,number of passes and whether with vascular access conversion.Clinical data included 90-day postoperative mRS scores,postoperative puncture site complications in 24 hours,symptomatic intracranial hemorrhage at 72 hours postoperatively,modified thrombolysis in cerebral infarction(mTICI)grade at the last angiography introperative and length of stay.The groups were categorized into transradial(TRA)and transfemoral(TFA)groups according to the final access route for EVT.The baseline and clinical data of the two groups were compared.Results A total of 129 patients underwent EVT with acute ischemic stroke with large vessel occlusion in the posterior circulation were finally included,including 47 patients in TRA group and 82 patients in TFA group.The differences about sex,age,past medical history,smoking,blood pressure at admission,NIHSS score at admission,mRS score before the onset of the stroke,ASPECTS,whether intravenous thrombolysis was performed,volume of core infarct zone,volume of hypoperfused zone,occlusion location,etiology of stroke,anesthesia modality,EVT first-line strategy,number of passes,mTICI grade at the last angiography introperative and other aspects were not statistically significant(all P＞0.05).The good prognosis rate at 90 d after surgery(53.2％[25/47]vs.48.8％[40/82],P=0.630),distribution of mRS scores at 90d postoperatively(P=0.991),all-cause mortality at 90 days after surgery(27.7％[13/47]vs.28.0％[23/82],P=1.000),rate of good recanalization(mTICI grade≥2b)on intraoperative last angiogram(97.9％[46/47]vs.95.1％[78/82],P=0.436),rate of complication of puncture site(4.3％[2/47]vs.12.2％[10/82],P=0.209)between the two groups were not statistically significant.The time from door to arterial puncture was significantly longer in the TRA group than in the TFA group,and the difference between the two groups was statistically significant(122.00[95.00,153.00]min vs.105.00[80.25,118.00]min,Z=-2.937,P=0.03);average length of stay in the TFA group was significantly longer than that of the TRA group,and the difference between the two groups was statistically significant(6.00[4.95,7.05]d vs.7.00[6.95,8.88]d,Z=-2.573,P=0.010).Conclusions Patients who underwent EVT via radial or femoral artery approach with acute ischemic stroke with large vessel occlusion in the posterior circulation had similar safety and efficacy,and the number of days of hospitalization was shorter via the TRA.However,more large prospective randomized controlled clinical trials are needed to validate the results of this study.

Objective To explore the affective response and dynamic attributes of obese adolescents in high-and moderate-intensity interval training.Methods Between February and July 2023,a total of 42 obese adolescents(Age:12.3±0.5 years,BMI:24.0±1.1 kg/m2)were recruited and randomly divided into a high-intensity interval training group(HIIT),a moderate-intensity interval training group(MIIT),and a non-training control group.Before and after the intervention,all groups were measured and compared their weight,BMI,body composition(body fat percentage and visceral adipose fat),car-diorespiratory fitness(VO2max),and affective response during exercise(affect valence,perceived arousal,rating of perceived exertion),as well as post-exercise enjoyment.Results After the 12-week interven-tion,there were significant decrease in the average BMI,body fat percentage,and visceral adipose tis-sue in the HIIT group(P<0.05),but a significant increase in the average VO2max(P<0.05).Moreover,a-fter the training,the average VO2max of the HIIT group was significantly higher than the MIIT group(P<0.05).Meanwhile,both HIIT and MIIT had a positive effect on emotional valence and post-exercise enjoyment.However,MIIT participants had more positive affect responses than HIIT ones,while the arousal(P<0.01)and physical activity enjoyment scores(P<0.05)in the HIIT group were significantly higher than the MIIT group.Conclusions Interval training is effective in improving body composition and cardiorespiratory fitness of obese adolescents.Higher intensity and arousal are key to the improve-ment.Moreover,the positive affect response and exercise enjoyment after interval training may help them maintain high exercise adherence and play a long-term promoting role.

Objective: To examine the effects of high intensity interval training (HIIT) on body composition and cardiorespiratory fitness of obese primary school students, so as to provide a theoretical basis and practical reference for HIIT exercise prescription in schools. Methods: From August to December 2022, 25 obese children [age:(11.0±0.4)years, BMI:(23.3±0.8)kg/m 2] from a primary school in Shenzhen were recruited and divided into an exercise group ( n =13) and a control group ( n =12). After 12 weeks of exercise intervention [The durations of load period and intermittent period were 15 s, load exercise intensity was 100% maximal aerobic speed (MAS), and intermittent exercise intensity was 50% MAS, each time there were 2 groups× 8 rounds, and the rest between groups was 2 minutes, totaling 10 minutes, and 20 meter shuttle run test (20 m-SRT) was performed once every 4 weeks to adjust and update MAS], the changes in body composition and cardio respiratory fitness indexes of obese subjects before and after the intervention were compared. Results: After the intervention, body weight, BMI, body fat, body fat percentage, and visceral adipose tissue area of obese subjects in the exercise group decreased from (55.6±6.2)kg, (22.7±0.6)kg/m 2, (41.8±6.9)kg, ( 23.4± 5.5)% and (102.4±39.0)cm 2 to (52.3±5.8)kg, (21.1±0.8)kg/m 2, (38.6±6.3)kg, (20.2±4.5)% and (84.2±26.9)cm 2, respectively( t =8.73, 10.96, 7.02, 4.92, 4.95, P <0.05). SBP decreased from (115.4±9.7)mmHg to (112.3±8.7)mmHg ( t = 2.96 , P <0.05). The content of skeletal muscle, 20 m-SRT and VO 2max increased from (21.3±5.3)kg, (21.6±4.9) times and (39.4±2.0)mL/(kg ·min) to (21.8±5.2)kg, (31.4±6.3)times and (43.6±2.6)mL/(kg ·min), respectively ( t =-3.33, -8.37, -10.56 , P <0.05). Conclusions HIIT is an effective way to improve the body composition and cardiorespiratory fitness of obese primary school students. It is recommended that schools with the necessary conditions use this method as an intervention measure to help reduce weight and improve cardiovascular health among obese students.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

【Objective】 To explore and evaluate the application of blood intelligent management platform (scheme) based on the Internet of Things(IoT)in the clinical blood management for hospitals. 【Methods】 Based on radio frequency identification technology (RFID), smart blood refrigerators, IoT blood shipping containers, automated blood bank systems, smart blood management software, etc. were developed and integrated as an IoT blood intelligent management platform (scheme). The blood storage, management software and hardware systems were organically combined, and the blood storage equipment was moved forward to the clinical departments to solve the concerns of clinicians. 【Results】 The in-depth integration of IoT technology, RFID and refrigeration technology has built an RFID-based IoT blood management solution, which integrates blood storage, transfusion, and quality control management, also realizes the entire process of supervision and traceability of clinical blood transfusion. The forward movement of blood bank to the clinical departments and the implementation of electronic cross-matching streamlined and optimized the clinical blood flow. The waiting time of patient′s for blood transfusion was shortened from (40±10) min to less than 2 min. The whole process of cold chain logistics ensured the storage quality of blood products issued, so that the clinical departments can return the untransfused blood and Blood Transfusion Department can reissue it to other hospitals. 【Conclusion】 IoT blood intelligent management based on RFID realizes the intelligent management of clinical blood transfusion and blood information traceability. The forward movement of blood bank to the clinical departments improves the efficiency of clinical blood transfusion, avoids the waste of blood source, and ensures the safety of blood transfusion. It is worth promoting in the whole process of blood transfusion.

Epoxyeicosatrienoic acids (EETs) are mainly from intracellular arachidonic acids catalyzed by cytochrome P450 cyctooxygenase and degraded to lower active dihydroxyeicosapentaenoic acids by soluble epoxide hydrolase.In recent years,EETs have been found to be a new target for prevention and treatment of various nervous system diseases,such as anti-inflammatory reaction,anti-atherosclerosis,anti-cell apoptosis and angiogenesis.Intracerebral hemorrhage is a kind of serious acute cerebrovascular disease.Cerebral hemorrhage is a kind of acute cerebrovascular disease;secondary injury is one of the important mechanisms of cerebral hemorrhage;the present studies have confirmed that EETs have protective role in brain tissues after cerebral hemorrhage,thus,become new hotspot in the research of cerebral hemorrhage.This review focuses on the role and mechanism of EETs in intracerebral hemorrhage,hoping to provide some references for exploration of new research directions and therapeutic targets in the treatment ofintracerebral hemorrhage.

OBJECTIVE： To optimize the processing technology of fried Radix Paeoniae， and to provide reference for quality control of the processed products. METHODS： The content of paeoniflorin in fried Radix Paeoniae was determined by HPLC. The determination was performed on Agilent ZORBAX SB-C18 column with mobile phase consisted of acetonitrile-0.05 mol/L potassium dihydrogen phosphate solution （15 ∶ 85， V/V） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， and detection wavelength was set at 230 nm. The sample size was 10 μL. The appearance character of fried Radix Peaoniae were investigated by appearance color， crosssection color， hardness and smell. Taking the comprehensive score of appearance character and paeoniflorin content as evaluation index， the dosage， stir-frying temperature and stir-frying time were investigated. According to the results of single factor test， Box-Behnken response surface methodology was used to optimize above 3 factors. The optimized processing technology was validated. RESULTS： The linear range of paeoniflorin were 0.02-4.15 mg/mL （r＝0.999 9）； precision， stablity， repeatability and sample recovery rate meet the requirements. The optimal technology of fried Radix Paeoniae included the dosage of 374.60 g， frying temperature of 101.61 ℃， frying time of 20 min. Under optimal technology， comprehensive score of fried Radix Paeoniae ranged 97.39-98.82 in 6 times of parallel verification tests （RSD＝0.54％）， which was close to predicted value 98.18. The color of fried Radix Paeoniae was slightly deeper than Radix Paeoniae， which was crisp and fragrant. CONCLUSIONS： The optimized processing technology of fried Radix Paeoniae is stable and feasible， and is suitable for the preparation of the processed products.

Intracerebral hemorrhage (ICH) is a serious acute cerebrovascular disease,and secondary injury is one of the important mechanisms of injury after ICH.Studies have confirmed that regulatory T cells (Tregs) play important protective roles after ICH by modulating microglial phenotype and inhibiting inflammation,and other pathways.This article reviews the protective mechanism of Tregs in the secondary injury,in order to provide a new therapeutic target for ICH.

Objective To investigate the effect of polyphosphazene(PAGP) microspheres controled release of growth factors on the adhesion and proliferation of bone marrow mesenchymal stem cells (BMSCs).Methods Two kinds of functional poly(alanine ethyl ester-co-glycine ethyl ester) phosphazene microspheres with different ratios of side-substituent groups were synthesized using the emulsion technique.The rate of degradation/hydrolysis of the polymers was carefully tuned to suit the desired application for controlled release.The enzyme-linked immune sorbent assay was utilized to investigate the characterization of the temporal controlled release strategy of microspheres loaded with transforming growth factor-beta 1(TGF-β1) and insulin-like growth factor-l(IGF-1) respectively.The cell adhesion and proliferation stimulated by different growth factors were evaluated by acridine orange staining.Resuits The morphological difference between two PAGP microspheres was identified according to SEM images.The average diameter of two microspheres was 54.22 ± 19.19 μm and 34.11 ± 18.82 μm respectively.The release assay showed that two kinds of microspheres had different release characteristics,with earlier outburst of TGF-β1 and IGF-1 for them to cooperate and later sustained release of TGF-β1 to stimulate the differentiation of stem cells.The result of the acridine orange staining demonstrated that PAGP microspheres supported cell adhesion and growth without obvious cytotoxicity.Meanwhile,the growth factors release strategy significantly improved the proliferation of BMSCs.Conclusion The two polyphosphazene microspheres have a great release-control effect and their controlled release system will have a promising prospect in the future tissue engineering field.

OBJECTIVETo investigate the factors which may influence the imatinib plasma concentration in Chinese patients with gastrointestinal stromal tumor(GIST), and to illuminate the significance of monitoring imatinib plasma concentration in adjuvant therapy for patients with GIST.

METHODSA cross-sectional study with 60 GIST patients who accepted the imatinib therapy after surgery was conducted. They were respectively administrated in 10 domestic hospitals from December 2014 to April 2016, including The First Affiliated Hospital of Nanjing Medical University(n=28), The Affiliated Hospital of Nantong University(n=9), The Affiliated Hospital of Xuzhou Medical College(n=6), Nanjing Drum Tower Hospital(n=5), The Second Affiliated Hospital of Nanjing Medical University (n=2), Jingling Hospital (n=2), The Second People's Hospital of Lianyungang(n=2), Shandong Provincial Hospital(n=2), Jiangsu Province Tumor Hospital(n=2), and The First Affiliated Hospital of Zhejiang University(n=2). Some specific time points for collecting blood sample before and after taking imatinib were determined, then liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used for monitoring imatinib plasma concentration in patients with GIST. Linear regression analysis was used for the correlation analysis of imatinib plasma concentration with dosage, clinicopathologic feature and side effect.

RESULTSPatients who could not tolerate 400 mg imatinib per day(n=3) received 300 mg per day. There was no significant difference in imatinib plasma concentration between patients with 300 mg and those with 400 mg imatinib(n=53)(P=0.527). However, the imatinib plasma concentration in patients with 600 mg imatinib per day (n=4) was significantly higher as compared to those with 400 mg(P=0.000). Linear regression analysis indicated a negative correlation between the imatinib plasma concentration in patients with 400mg imatinib per day for 90 days continuously and body surface area(R=0.074, P=0.035), but no significant correlations of with age, creatinine clearance and serum albumin concentration were observed (all P>0.05). The differences in imatinib plasma concentration were not statistically significant between patients of different gender and those taking proton-pump inhibitor (PPI) or not (both P>0.05). Difference in imatinib plasma concentration between patients with different surgery was significant (P=0.026). Compared to patients who underwent wedge resection, enterectomy and other surgeries, the imatinib plasma concentration of patients with subtotal gastrectomy or total gastrectomy decreased significantly (all P<0.05). After 90 days of taking imatinib continuously, linear regression analysis revealed a negative correlation between imatinib plasma concentration in patients with 400 mg imatinib per day and white blood cell count (R=0.103, P=0.013), and a positive correlation with serum alanine aminotransferase (ALT) concentration (R=0.076, P=0.033).

CONCLUSIONSThe imatinib plasma concentration in patients with larger body surface area, subtotal gastrectomy or total gastrectomy may be lower. For these patients, dosage of imatinib should be considered to increase in order to achieve effective plasma concentration. Excessive imatinib plasma concentration can result in some side effects, such as decrease of white blood cells and liver damage. Therefore, it is significant for receiving optimal clinical therapeutic efficacy to monitor imatinib plasma concentration, adjust imatinib dosage timely and keep imatinib plasma concentration in effective and safe range.

Adult ; Antineoplastic Agents ; administration & dosage ; pharmacokinetics ; Benzamides ; Combined Modality Therapy ; Cross-Sectional Studies ; Female ; Gastrectomy ; Gastrointestinal Stromal Tumors ; drug therapy ; surgery ; Humans ; Imatinib Mesylate ; administration & dosage ; pharmacokinetics ; Male ; Middle Aged ; Piperazines ; Pyrimidines ; Tandem Mass Spectrometry