Objective:To investigate the influencing factors, periprocedural complications, and long-term outcomes of successful recanalization after endovascular treatment in patients with non-acute symptomatic internal carotid artery occlusion.Methods:Patients with non-acute internal carotid artery occlusion received endovascular treatment in the Nanjing Stroke Registration System between January 2010 and December 2021 were retrospectively enrolled. Clinical endpoint events were defined as successful vascular recanalization, periprocedural complications (symptomatic embolism and symptomatic intracranial hemorrhage), neurological function improvement, and recurrence of ipsilateral ischemic events. Multivariate logistic regression analysis was used to investigate the independent influencing factors of successful vascular recanalization. Cox proportional hazards regression analysis was used to investigate the correlation between endovascular treatment outcomes and neurological function improvement, as well as ipsilateral ischemic cerebrovascular events. Results:A total of 296 patients were included, of which 190 (64.2%) were successfully recanalized. Multivariate logistic regression analysis showed that symptoms manifest as ischemic stroke (odds ratio [ OR] 3.353, 95% confidence interval [ CI] 1.399-8.038; P=0.007), the time from the most recent symptom onset to endovascular therapy within 1 to 30 d ( OR 2.327, 95% CI 1.271-4.261; P=0.006), proximal conical residual cavity ( OR 2.853, 95% CI 1.242-6.552; P=0.013) and focal occlusion (C1-C2: OR 3.255, 95% CI 1.296-8.027, P=0.012; C6/C7: OR 5.079, 95% CI 1.334-19.334; P=0.017) were the independent influencing factors for successful vascular recanalization. Successful recanalization did not increase the risk of symptomatic intracranial hemorrhage within 7 d after procedure (3.2% vs. 0.9%; P=0.428). The median follow-up time after procedure was 38 months. Cox proportional hazards regression analysis showed that after adjusting for confounding factors, successful recanalization was significantly associated with postprocedural neurological improvement (hazard ratio 1.608, 95% CI 1.091-2.371; P=0.017), and significantly reduced the risk of recurrence of long-term ischemic events (hazard ratio 0.351, 95% CI 0.162-0.773; P=0.010). Conclusion:In patients with non-acute internal carotid artery occlusion, successful endovascular recanalization can effectively reduce the risk of long-term ischemic events without increasing the risk of symptomatic intracranial hemorrhage.

Objective:To investigate predictive factors for successful endovascular recanalization in patients with non-acute symptomatic internal carotid artery occlusion (SICAO), to develop a decision tree model using the Classification and Regression Tree (CART) algorithm, and to evaluate the predictive performance of the model.Methods:Patients with non-acute SICAO received endovascular therapy at 8 comprehensive stroke centers in China were included retrospectively. They were randomly assigned to a training set and a validation set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen important variables, and a decision tree prediction model was constructed based on CART algorithm. The model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and confusion matrix in the validation set.Results:A total of 511 patients with non-acute SICAO were included. They were randomly divided into a training set ( n=357) and a validation set ( n=154) in a 7:3 ratio. The successful recanalization rates after endovascular therapy were 58.8% and 58.4%, respectively. There was no statistically significant difference ( χ2=0.007, P=0.936). A CART decision tree model consisting of 5 variables, 5 layers and 9 classification rules was constructed using the six non-zero-coefficient variables selected by LASSO regression. The predictive factors for successful recanalization included fewer occluded segments, proximal tapered stump, ASITN/SIR collateral grading of 1-2, ischemic stroke, and a recent event to endovascular therapy time of 1-30 d. ROC analysis showed that the area under curve of the decision tree model in the training set was 0.810 (95% confidence interval 0.764-0.857), and the optimal cut-off value for predicting successful recanalization was 0.71. The area under curve in the validation set was 0.763 (95% confidence interval 0.687-0.839). The accuracy was 70.1%, precision was 81.4%, sensitivity was 63.3%, and specificity was 79.7%. The Hosmer-Lemeshow test in both groups showed P>0.05. Conclusion:Based on the type of ischemic event, the time from the latest event to endovascular therapy, proximal stump morphology, the number of occluded segments, and the ASITN/SIR collateral grading constructed the decision tree model can effectively predict successful recanalization after non-acute SICAO endovascular therapy.

Objective:To investigate the clinical features of pediatric patients with intracranial primary non-germinomatous germ cell tumors (NGGCT) and evaluate the treatment outcomes and prognostic factors of NGGCT.Methods:Clinical data of 40 children with NGGCT who were treated with radiotherapy (RT) at our department between November 2008 and June 2019 were retrospectively analyzed. Ninety percent of them received craniospinal irradiation (CSI). All children received platinum-based chemotherapy. Survival analysis was conducted using the Kaplan-Meier estimate. The prognostic factors were analyzed by log-rank test.Results:The primary sites were pineal gland, sellar / suprasellar region and basal ganglia. The median age of onset was 108 months (20-204 months). The median follow-up time was 33 months (8-131 months), and the 3-year and 5-year overall survival (OS) rates were 82.0%. The 3-year and 5-year progression-free survival (PFS) rates were 78.6% and 73.0%. Univariate analysis showed that increased alpha-fetoprotein (AFP) ( P=0.02), age at first diagnosis>10 years ( P=0.006), metastasis at first diagnosis ( P<0.001), and the pathological type (choriocarcinoma, yolk sac tumor and / or embryonal carcinoma) ( P=0.036) were independent adverse prognostic factors. Conclusions:Increased AFP, age>10 years at first diagnosis, tumor metastasis and pathological type were independent adverse prognostic factors of NGGCT. The overall prognosis of NGGCT children is worse than that of their counterparts with germinoma, and multidisciplinary intensive therapy is needed to improve survival.

Objective To analyze the risk factors and pathogen drug resistance of senile stroke-associated pneumonia (SAP), and to provide references for early clinical intervention. Methods A total of 859 elderly patients with cerebral stroke admitted to our hospital from June 2018 to June 2020 were selected and divided into the study group (SAP, n=375) and the control group (no SAP, n=484) according to the occurrence of stroke associated pneumonia. Clinical data of age, gender, and other complications of the two groups were analyzed. The sputum culture and drug sensitivity test of senile SAP patients were analyzed. Results A total of 313 pathogens were detected in 375 SAP patients, including 211 strains of gram-negative bacteria (67.41%), mainly consisting of 92 Acinetobacter baumannii (29.39%), 54 Pseudomonas aeruginosa (17.25%), and 42 Klebsiella pneumoniae (13.42%), and 73 strains (23.32%) of gram-positive bacteria, mainly 62 strains of Staphylococcus aureus (19.81%). In addition, there were 29 strains of fungi (9.27%). Pseudomonas aeruginosa was highly sensitive to piperacillin/tazobactam and ceftazidime. Acinetobacter baumannii and Klebsiella pneumoniae were highly sensitive to imipenem, meropenem, and cefoperazone sodium and sulbactam sodium. Staphylococcus aureus and Enterococcus were highly sensitive to teicolanin, linezolid and vancomycin. The proportion of patients aged ≥80 years old, mechanical ventilation, bed rest and use of prophylactic antibiotics in the experimental group was significantly higher than that in the control group (P<0.05). Logistic regression analysis showed that age ≥80 years, mechanical ventilation, hypoproteinemia and use of prophylactic antibiotics were independent risk factors for SAP (P<0.05). Conclusion The main pathogens of stroke-associated pneumonia in the elderly are Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. It is necessary to rationally choose antibiotics according to the results of drug sensitivity. The risk factors are patients' age ≥ 80 years old, mechanical ventilation, and bed rest. Clinicians should attach great importance to the prevention of stroke-related pneumonia in the elderly.

Curcumin-loaded poly (α-isobutyl cyanoacrylate) microspheres (Cur-HP-β-CD-PiBCA) were prepared by one-step emulsification with α-isobutyl cyanoacrylate as materials, poloxamer 188 as emulsifier, and curcumin complex with hydroxypropyl-β-cyclodextrin (Cur-HP-β-CD) as drug prepared by kneading method. Effects of emulsifier and drug concentration on microspheres size and distribution, drug loading and encapsulation efficiency were investigated in detail. And the curcumin release of drug-loaded microspheres was also studied. Results showed that as the emulsifier concentration increased from 0.01% to 0.07%, particle size of the drug-loaded microspheres decreased while particle size distribution, drug loading and entrapment efficiency increased. The optimized concentration of surfactant was 0.05%. With increasing the concentration of drug from 0.03% to 0.07%, drug loading of Cur-HP-β-CD-PiBCA increased, but encapsulation efficiency decreased. Additionally, the results of drug release experiments revealed that the higher drug loading of Cur-HP-β-CD-PiBCA was, the lower cumulative release percentage was. Drug-loading of cumulative inclusions in HP-β-CD by PiBCA can improve its wettability, and increase the degree of dissolution and bioavailability.

Objective To investigate pulmonary function in terms of tidal respiration and the influencing factors on it in ＜ 34 weeks premature infants with RDS at corrected gestational age of 40 weeks.Methods A total of 49 of ＜ 34 weeks premature infants with RDS (RDS group) and 36 of ＜ 34 weeks premature infants without RDS (non-RDS group) followed throughout entire twelve months were collected fromn December 2013 to October 2015.Of them,35 RDS patients and 20 non-RDS patients had the pulmonary function examination.A total of 26 full term infants with hyperbilirubinemia (full term group) were recruited for comparison study.The differences in parameters of tidal respiration were compared among the three groups.The RDS patients were further divided into the mild RDS subgroup and severe RDS subgroup according to the severity of illness.Result ①The TPEF [(0.17 ± 0.04) s vs.(0.23 ± O.09) s],VPEF [(6.74±2.70) mLvs.(9.33±2.92) mL],TPEF/TE [(29.06±4.21)％ vs.(38.27± 7.16) ％],VPEF/VE [(32.54 ± 4.43) ％ vs.(39.64 ± 5.88) ％] in RDS group were significantly lower than those in full term group (P ＜0.05).The TPEF [(0.19 ±0.06) s vs.(0.23 ±0.09) s],TPEF/TE [(30.31 ±11.53)％ vs.(38.27±7.16)％],VPEF/VE [(34.39±8.44)％ vs.(39.64±5.88)％] in non-RDS group were significantly lower than those in full termn group (P ＜ 0.05).The TPEF,TPEF/TE,VPEF/VE in RDS group were lower than those in non-RDS group,but the differences were not significant (P ＞ 0.05).②The TPEF,VPEF,TPEF/TE,VPEF/VE in mild RDS group were higher than those in severe RDS group,but the differences were.not significant (P ＞ 0.05).③ Logistic regression analysis indicated that the gestational age was the protective factor of pulmonary function in premature infants with RDS.Conclusions Small airway resistance in ＜ 34 weeks premature infants with RDS is higher than that in full term infants.There was no significant difference in pulmonary function between RDS premature infants and non-RDS premature infants.The gestational age was the influencing factor of pulmonary function in premature infants with RDS.

Purpose To investigate the correlation of Dock180 and miR-31 expression in breast cancer cells,and to observe the effect of miR-31 on the invasion of breast cancer cells by Dock180.Methods MiR-31 was transfected into breast cancer cells by liposome transfection technique.The actual binding site of miR-31 to the 3'-untranslated region of Dock180 was confirmed through luciferase assay.Western blot was performed to detect the expression of Dockl80 and other related proteins.Real-time PCR was used to measure the expression of Dock180.Matrigel invasion were performed to detect the invasion of breast cancer cell lines with miR-31 increased.Resuits The protein levels of Dock180 in breast cancer cell lines negatively correlated with miR-31 expression,and Dock180 was directly targeted by miR-31.Dock180 downregulation and miR-31 overexpression reduced breast cancer cells invasion.Conclusion Dock180 modulated by miR-31 plays an important function in breast cancer cell lines invasion.

Objective To explore how the severity of periventricular-intraventricular hemorrhage (PIVH)impact on physique and neurodevelopment in premature infants.Methods A total of 80 preterm infants with PIVH admitted to NICU of Qingdao Women and Children's Hospital from December 2013 to June 2015 were eligible.According to the Papile classification,the premature infants were divided into 4 groups.They were grade Ⅰ PIVH group,grade Ⅱ PIVH group,grade Ⅲ PIVH group and grade Ⅳ PIVH group.The infants with grade Ⅰ PIVH and grade Ⅱ PIVH belong to the low-grade PIVH group.The infants with grade Ⅲ PIVH and grade Ⅳ belong to the severe-grade PIVH group.All of them were regularly followed up for 12 months.Neurodevelopmental outcomes of infants at 6 and 12-month correction age were assessed by using the 20 items neuromotor assessment applying for 0-1 year old and the Bayley scales of infant development-Ⅱ.The differences in physical and neurophysical development of premature infants among 4 groups were compared.Results There were no significant differences in physical growth indicators such as body weight,body length and the incidence of weight growth retardation among 4 groups (all P＞0.05).The incidence of neurobehavioral abnormalities in infants with grade Ⅲ-Ⅳ PIVH was significantly higher than that of infants with grade Ⅰ-Ⅱ PIVH at 12-month correction age (21.05％ vs 3.28％,x2 =4.284,P=0.038).Physical development index(PDI) of grade Ⅰ-Ⅱ PIVH infants was significantly higher than that of grade Ⅲ-Ⅳ PIVH infants at 6-month correction age(F=11.500,P＜0.05).At 12-month correction age,grade Ⅰ-Ⅱ PIVH infants showed a significant higher mental development index(MDI) scores and PDI scores than those of grade Ⅲ-Ⅳ PIVH infants(F=14.227,16.515,all P＜0.05).Of the 80 cases assessed,infants with grade Ⅲ-Ⅳ PIVH had significantly higher rates of cerebral palsy(21.05％ vs 1.64％,x2 =6.300,P=0.012) and developmental delay (26.32％ vs 4.92％,x2=5.185,P=0.023) compared with grade Ⅰ-Ⅱ PIVH infants.Conclusions The severe PIVH can have negative effect on the neurodevelopmental outcomes of preterm infants and might induce mental retardation,cerebral palsy and other neurodevelopmental disabilities.Therefore,the regular follow-up and early intervention in preterm infants with PIVH should be implemented to improve the quality of their lives.

BACKGROUND:Hot-melt adhesive is safe and environmental friendly adhesive due to free of solvent, which is particularly suitable for medical applications. OBJECTIVE:To describe the types and characteristics of currently used hot-melt adhesives and to prospect the technical research and development of hot-melt adhesive for polyolefin tubes or catheters as wel as to point out the corresponding key points to the hot-melt adhesion. METHODS:Literature search was carried out in SCI, Elsevier, and CNKI with the key words of“hot melt adhesive, medical application”in English and Chinese, respectively, for the initial retrieval of relevant articles or patents published January 1995 to December 2015. RESULTS AND CONCLUSION:To date, the medical hot-melt adhesives reported in the literature could be grouped as amorphous polyolefin, thermoplastic elastomer, acrylic and polyurethane types. The heat resistance of the most of the hot-melt adhesives does not meet the requirement for steam sterilizing process. In the present review, a strategy is proposed to develop a novel hot-melt adhesive which is good for binding polyolefin parts and can undergo the sterilization process. Given this, it is essential to choose a kind of polypropylene random copolymer with a suitable melting point as a substrate. With the aid of an adjuvant agent, therefore, we can develop a novel hot-melt adhesive that exhibits a lower melting point than the polyolefin tube, withstands steam sterilization temperature to ensure that the tube is not deformed during melt adhesion and is not become invalid during sterilization.

BACKGROUNDErythropoietin (EPO) and granulocyte colony-stimulating factor (G-CSF) are both potential novel therapeutics for use after myocardial infarction (MI). However, their underlying mechanisms remain unclear and the efficacy of monotherapy with EPO or G-CSF is also controversial. Therefore, we investigated the effects of combined treatment with EPO and G-CSF on neovascularization and cardiac function in post-infarction rats and explored the potential mechanisms.

METHODSFour groups of rats were used: control (saline injection after MI, i.h.), EPO (a single dose of 5 000 IU/kg after MI, i.h.), G-CSF (a dose of 50 µg× kg(-1)× d(-1) for 5 days after MI, i.h.), and both EPO and G-CSF (EPO+G-CSF, using the same regiment as above). Cardiac function was assessed by echocardiography before and 1 day, 7 days, 14 days and 21 days after MI. CD34(+)/Flk-1(+) cells in the peripheral blood were evaluated by flow cytometry before and 3 days, 5 days and 7 days after MI. The infarct area and angiogenesis in the peri-infarct area were analyzed. The mRNA and protein expression of vascular endothelial growth factor (VEGF) and stromal-derived factor-1a (SDF-1α) in the peri-infarct area were detected by real-time quantitative RT-PCR and Western blotting.

RESULTSCompared with the control and monotherapy groups, the EPO+G-CSF group had significantly increased CD34(+)/Flk-1(+) endothelial progenitor cells (EPCs) in the peripheral blood (P < 0.05), up-regulated VEGF and SDF-1α levels in the peri-infarct region (P < 0.05), enhanced capillary density (P < 0.05), reduced infarct size (P < 0.05) and improved cardiac structure and function (P < 0.05). G-CSF alone did not dramatically increase EPCs in the peripheral blood, enhance capillary density in the peri-infarct area or reduce infarct size compared with the control group.

CONCLUSIONSCombined treatment with EPO and G-CSF increased EPCs mobilization, up-regulated VEGF and SDF-1α levels in the post-infarction microenvironment, subsequently enhanced neovascularization in the peri-infarct region and reduced infarct size. All factors contributed to its beneficial effects on cardiac function in post-infarction rats.

Animals ; Blotting, Western ; Chemokine CXCL12 ; metabolism ; Echocardiography ; Erythropoietin ; therapeutic use ; Flow Cytometry ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Male ; Myocardial Infarction ; drug therapy ; metabolism ; Neovascularization, Physiologic ; drug effects ; Rats ; Rats, Sprague-Dawley