1.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
2.Hepatotoxicity and Anti-osteoporotic Mechanism of Evodiamine
Jiaqi LI ; Xiaolu CHEN ; Xiaoyu TAO ; Shan LU ; Qiqi FAN ; Jiarui WU ; Chongjun ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):79-86
ObjectiveBased on the zebrafish model, the hepatotoxicity and anti-osteoporotic activity of evodiamine (EVO) were studied. The mechanism of EVO in treating osteoporosis was explored by using network pharmacology and real-time polymerase chain reaction(Real-time PCR). MethodsThree days after fertilization (3 dpf), zebrafish were randomly selected and exposed to different concentrations of EVO solution for 96 hours. The mortality rate of zebrafish at different concentrations was calculated at the exposure endpoint, and a "dose-toxicity" curve was drawn. The 10% lethal concentration (LC10) was calculated. Liver phenotype, acridine orange staining, and pathological tissue sections of liver-transgenic zebrafish [CZ16 (gz15Tg.Tg (fabp 10a: ds Red; ela31: EGFP))] were used to confirm hepatotoxicity of EVO. On this basis, prednisolone was used to create a model of osteoporosis in zebrafish. The skull development, area of the skull stained by alizarin red, and cumulative optical density were used as indicators to evaluate the anti-osteoporotic activity of EVO in a safe dose. Based on network pharmacology, the mechanism of action of EVO in the treatment of osteoporosis was predicted and verified through Real-time PCR. ResultsThe LC10 of EVO on zebrafish (7 dpf) was determined to be 0.4 mg·L-1. Compared with the control group, sublethal concentrations (
3.Effects of clopidogrel on the pharmacokinetics and pharmacodynamics of ciprofol in rats
Ming LU ; Xiaoyu YIN ; Wenli LI ; Shan LI ; Xiangchen LI ; Zhiqing ZHANG
China Pharmacy 2025;36(2):179-184
OBJECTIVE To investigate the effects of clopidogrel on the pharmacokinetics and pharmacodynamics of ciprofol in rats. METHODS Eighteen male SD rats were randomly divided into control group, clopidogrel normal-dose group and clopidogrel high-dose group, with 6 rats in each group. Among them, rats in the normal-dose group and high-dose group were given 7.5 mg/kg and 15 mg/kg clopidogrel by gavage, respectively, and rats in the control group were given the same volume of 0.5% sodium carboxymethyl cellulose solution, once a day, for 14 consecutive days. Afterward, 2.4 mg/kg ciprofol was injected by tailvein and blood samples were collected from the inner canthus of the eye at 2, 4, 8, 12, 16, 20, 30, 45 and 60 min after the end of the administration. During this period, the duration of the loss of righting reflex (LORR) in rats was counted. After the proteins were precipitated by acetonitrile, the rat plasma sample was analyzed by LC-MS/MS using deuterated ciprofol as the internal standard, Symmetry C18 as the chromatographic column, and acetonitrile-0.01% ammonia solution containing 5 mmol/L ammonium acetate (gradient elution) as the mobile phase to detect the concentration of ciprofol in the plasma. The pharmacokinetic parameters in rats were calculated by using DAS 2.0 software. RESULTS Compared with control group, area under the drug concentration-time curve and mean residence time of ciprofol increased or prolonged significantly, while plasma clearance decreased significantly in clopidogrel normal-dose and high-dose groups; the duration of LORR in rats was prolonged by 19.5% and 23.9%, with statistical difference (P<0.05). However, there was no statistically significant difference in the pharmacokinetic parameters or LORR duration of ciprofol between the different dose groups of clopidogrel (P>0.05). CONCLUSIONS Clopidogrel could inhibit the metabolism of ciprofol in rats and prolong the duration of LORR.
4.Effects of clopidogrel on the pharmacokinetics and pharmacodynamics of ciprofol in rats
Ming LU ; Xiaoyu YIN ; Wenli LI ; Shan LI ; Xiangchen LI ; Zhiqing ZHANG
China Pharmacy 2025;36(2):179-184
OBJECTIVE To investigate the effects of clopidogrel on the pharmacokinetics and pharmacodynamics of ciprofol in rats. METHODS Eighteen male SD rats were randomly divided into control group, clopidogrel normal-dose group and clopidogrel high-dose group, with 6 rats in each group. Among them, rats in the normal-dose group and high-dose group were given 7.5 mg/kg and 15 mg/kg clopidogrel by gavage, respectively, and rats in the control group were given the same volume of 0.5% sodium carboxymethyl cellulose solution, once a day, for 14 consecutive days. Afterward, 2.4 mg/kg ciprofol was injected by tailvein and blood samples were collected from the inner canthus of the eye at 2, 4, 8, 12, 16, 20, 30, 45 and 60 min after the end of the administration. During this period, the duration of the loss of righting reflex (LORR) in rats was counted. After the proteins were precipitated by acetonitrile, the rat plasma sample was analyzed by LC-MS/MS using deuterated ciprofol as the internal standard, Symmetry C18 as the chromatographic column, and acetonitrile-0.01% ammonia solution containing 5 mmol/L ammonium acetate (gradient elution) as the mobile phase to detect the concentration of ciprofol in the plasma. The pharmacokinetic parameters in rats were calculated by using DAS 2.0 software. RESULTS Compared with control group, area under the drug concentration-time curve and mean residence time of ciprofol increased or prolonged significantly, while plasma clearance decreased significantly in clopidogrel normal-dose and high-dose groups; the duration of LORR in rats was prolonged by 19.5% and 23.9%, with statistical difference (P<0.05). However, there was no statistically significant difference in the pharmacokinetic parameters or LORR duration of ciprofol between the different dose groups of clopidogrel (P>0.05). CONCLUSIONS Clopidogrel could inhibit the metabolism of ciprofol in rats and prolong the duration of LORR.
5.Trends in global burden due to visceral leishmaniasis from 1990 to 2021 and projections up to 2035
Guobing YANG ; Aiwei HE ; Yongjun LI ; Shan LÜ ; Muxin CHEN ; Liguang TIAN ; Qin LIU ; Lei DUAN ; Yan LU ; Jian YANG ; Shizhu LI ; Xiaonong ZHOU ; Jichun WANG ; Shunxian ZHANG
Chinese Journal of Schistosomiasis Control 2025;37(1):35-43
Objective To investigate the global burden of visceral leishmaniasis (VL) from 1990 to 2021 and predict the trends in the burden of VL from 2022 to 2035, so as to provide insights into global VL prevention and control. Methods The global age-standardized incidence, prevalence, mortality and disability-adjusted life years (DALYs) rates of VL and their 95% uncertainty intervals (UI) were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources. The trends in the global burden of VL were evaluated with average annual percent change (AAPC) and 95% confidence interval (CI) from 1990 to 2021, and gender-, age-, country-, geographical area- and socio-demographic index (SDI)-stratified burdens of VL were analyzed. The trends in the global burden of VL were projected with a Bayesian age-period-cohort (BAPC) model from 2022 to 2035, and the associations of age-standardized incidence, prevalence, mortality, and DALYs rates of VL with SDI levels were examined with a smoothing spline model. Results The global age-standardized incidence [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)], prevalence [AAPC = -0.06%, 95% CI: (-0.06%, -0.06%)], mortality [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)] and DALYs rates of VL [AAPC = -2.38%, 95% CI: (-2.44%, -2.33%)] all appeared a tendency towards a decline from 1990 to 2021, and the highest age-standardized incidence [2.55/105, 95% UI: (1.49/105, 4.07/105)], prevalence [0.64/105, 95% UI: (0.37/105, 1.02/105)], mortality [0.51/105, 95% UI: (0, 1.80/105)] and DALYs rates of VL [33.81/105, 95% UI: (0.06/105, 124.09/105)] were seen in tropical Latin America in 2021. The global age-standardized incidence and prevalence of VL were both higher among men [0.57/105, 95% UI: (0.45/105, 0.72/105); 0.14/105, 95% UI: (0.11/105, 0.18/105)] than among women [0.27/105, 95% UI: (0.21/105, 0.33/105); 0.06/105, 95% UI: (0.05/105, 0.08/105)], and the highest mortality of VL was found among children under 5 years of age [0.24/105, 95% UI: (0.08/105, 0.66/105)]. The age-standardized incidence (r = -0.483, P < 0.001), prevalence (r = -0.483, P < 0.001), mortality (r = -0.511, P < 0.001) and DALYs rates of VL (r = -0.514, P < 0.001) correlated negatively with SDI levels from 1990 to 2021. In addition, the global burden of VL was projected with the BAPC model to appear a tendency towards a decline from 2022 to 2035, and the age-standardized incidence, prevalence, mortality and DALYs rates were projected to be reduced to 0.11/105, 0.03/105, 0.02/105 and 1.44/105 in 2035, respectively. Conclusions Although the global burden of VL appeared an overall tendency towards a decline from 1990 to 2021, the burden of VL showed a tendency towards a rise in Central Asia and western sub-Saharan African areas. The age-standardized incidence and prevalence rates of VL were relatively higher among men, and the age-standardized mortality of VL was relatively higher among children under 5 years of age. The global burden of VL was projected to continue to decline from 2022 to 2035.
6.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
7.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
8.Prevalence of soil-transmitted nematode infections in Congjiang County of Guizhou Province in 2023
Shan CAI ; Danya SHE ; Songping LI ; Guangchu LIN ; Lan HE ; Zhangjing SHI ; Lidan LU
Chinese Journal of Schistosomiasis Control 2025;37(3):289-293
Objective To investigate the prevalence of human soil-transmitted nematode infections in Congjiang County, Guizhou Province in 2023, so as to provide insights into soil-transmitted nematodiasis prevention and control in the county. Methods Congjiang County was divided into 5 areas according to geographical locations, and one township was randomly sampled from each area, followed by one administrative village randomly sampled from each township as the survey site. Two hundred permanent residents without deworming during the past three months were randomly sampled from each survey site using the random cluster sampling method. Participants’ fecal samples were collected, soil-transmitted nematode eggs were detected using the KatoKatz technique and the prevalence of human soil-transmitted nematode infections was compared among participants. Mild, moderate and severe soil-transmitted nematode infections were classified according to eggs per gram (EPG), and the proportions of mild, moderate and severe infections were estimated. In addition, participants’ family status and household sanitary toilets construction were investigated using questionnaires. Results A total of 1 001 participants were included at 5 survey sites in Congjiang County, and the overall prevalence of soil-transmitted nematode infections was 19.08% (191/1 001). The prevalence rates of Ascaris lumbricoides and hookworm infections were 2.30% (23/1 001) and 1.90% (19/1 001), with all egg-positives identified as mild infections, and the prevalence of Enterobius vermicularis infections was 0.10% (1/1 001). The prevalence of Trichuris trichiura infections was 15.78% (158/1 001) among participants, and there was a significant difference in the prevalence among survey villages (χ2 = 123.345, P < 0.001), with the highest prevalence detected in Liujia Village (39.00%), followed by in Longjiang Village (18.00%). There was an age-specific prevalence rate of T. trichiura infections among participants (χ2 = 166.050, P < 0.001), and the highest prevalence was detected among participants at ages of 10 to 19 years (48.19%), followed by at ages of over 70 years (14.53%) and 50 to 59 years (13.04%). There was an occupation-specific prevalence rate of T. trichiura infections among participants (χ2 = 74.134, P < 0.001), and the highest prevalence was detected among students (32.32%), followed by among workers/migrant workers (10.34%) and farmers (10.12%). There was an educational level-specific prevalence rate of T. trichiura infections among participants (χ2 = 28.761, P < 0.001), and the highest prevalence was detected among participants with an educational level of primary school (21.60%), followed by among illiterate participants (12.03%). There was an ethnicity-specific prevalence rate of T. trichiura infections among participants (χ2 = 42.193, P < 0.001). The proportions of mild, moderate and severe T. trichiura infections were 76.58% (121/158), 14.56% (23/158) and 3.16% (5/158), and all severe infections were identified among primary school students. T. trichiura infections were detected in 123 families, and there were 27 families (21.95%) in which two and more family members were identified with T. trichiura infections. A total of 1 001 valid questionnaires were recovered, and the prevalence rates of T. trichiura infections were 14.69% (139/964) and 34.55% (19/55) in families with and without sanitary toilets (χ2 = 15.410, P < 0.001). Conclusions The prevalence of soil-transmitted nematode infections was relatively high in Congjiang County, Guizhou Province in 2023, and the T. trichiura infections was notably serious. Intensified soil-transmitted nematodiasis control measures are recommended targeting primary school students, middle-aged and elderly farmers and migrant workers.
9.Association between mental health and muscle strength among Chinese adolescents aged 13-18
Chinese Journal of School Health 2025;46(9):1232-1236
Objective:
To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion.
Methods:
Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents.
Results:
In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14),and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05).
Conclusions
The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.
10.Role of mitochondrial division/fusion in different liver diseases
Yuanqian MIN ; Shan LI ; Xianghua LIU ; Yi YANG ; Baoping LU
Journal of Clinical Hepatology 2025;41(9):1937-1942
Mitochondria are abundant in hepatocytes and play an important role in the normal operation of the liver. Mitochondrial division/fusion is two biological processes that maintain the dynamic balance of mitochondria, and it is closely associated with the change of cell function and the development and progression of diseases. Balance of mitochondrial division/fusion is of key significance in the treatment of many diseases. Recent studies have shown that abnormal mitochondrial division/fusion plays a significant role in fatty liver disease, hepatitis, liver fibrosis, and liver cancer, which are the four stages of the progression of liver diseases, and the therapeutic targets based on the regulation of such abnormalities are constantly being identified. By reviewing the role of mitochondrial division/fusion in different stages of liver disease, this article further demonstrates the role of mitochondrial division/fusion mechanism in chronic liver diseases and also provides a scientific basis for more ideas on the treatment, remission or even reversal of liver disease progression based on mitochondrial division/fusion.


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