1.Role and mechanism of neuronal restriction silencing factor REST/NRSF in regulation of epilepsy
Hui LIU ; Bai-Hui YU ; Ya-Qi WANG ; Yi-Ling CHEN ; Zi-Hao CHENG ; Jia-Rui MA ; Zi-Shuo KANG ; Fan ZHANG
Chinese Pharmacological Bulletin 2024;40(9):1727-1734
		                        		
		                        			
		                        			Aim To investigate the effect and role of neuronal restriction silencing factor(REST/NRSF)in epilepsy disorder.Methods Immunohistochemistry,immunofluorescence,Western blot and qPCR tech-niques were used to detect REST/NRSF expression levels in hippocampal tissues of mice induced by kainic acid and human brain tissue.Viral injections,EEG re-cordings and behavioral methods were used to test the effects on epileptic mice after knockdown and overex-pression of REST/NRSF in the hippocampal CA1 re-gion,respectively.Results The positive rate of REST/NRSF in the lesions of epileptic patients was significantly higher compared with that in the control group.The levels of REST/NRSF protein and mRNA in the CA1 region of the hippocampus of mice in the KA model group were significantly higher.Kv7.2 and Kv7.3 potassium channel mRNA expression levels were significantly down-regulated.Significant up-regu-lation of REST/NRSF expression levels was observed in mouse hippocampus after NMDA injection.Knock-down of REST/NRSF in the CA1 region of hippocam-pus significantly elevated the expression levels of Kv7.2 and Kv7.3 potassium channel mRNAs.The fre-quency of EEG spiking and sharp-wave issuance and epileptic seizure grade were significantly lower.Over-expression of REST/NRSF in the CA1 region of hippo-campus significantly reduced the mRNA expression lev-els of Kv7.2 and Kv7.3 potassium channels.The fre-quency of EEG spiking and sharp-wave issuance was significantly higher and epileptic symptoms were exac-erbated.Conclusion REST/NRSF in mouse hipp-ocampal brain regions is involved in epileptic disease development through transcriptional regulation of Kv7.2 and Kv7.3 potassium channels.
		                        		
		                        		
		                        		
		                        	
2.Coagulation Factors for Diagnosis of Periprosthetic Joint Infection
Xiao-yu WU ; Yong-yu YE ; Bai-qi PAN ; Xuan-tao HU ; Lin-li ZHENG ; Wei-shen CHEN ; Zi-ji ZHANG ; Pu-yi SHENG
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(2):188-197
		                        		
		                        			
		                        			ObjectivePeriprosthetic joint infections (PJI) are currently the most calamitous complication after arthroplasty. Although achievements have been made in many markers for the diagnosis of PJI, the lack of a gold standard remains a great obstacle for early diagnosis. This study aimed to investigate the association between coagulation markers and the development of PJI in patients undergoing revision total joint arthroplasty (TJA). MethodsWe conducted a retrospective cohort study with a total of 2 517 patients who underwent hip or knee arthroplasties from January 2011 to January 2022 (2 394 with primary TJA, 87 with aseptic revision and 36 with PJI). We applied univariate analysis and multivariate logistic regression to analyze differences of coagulation factors between primary TJA and aseptic revision or PJI group. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to measure the diagnostic value of coagulation factors in predicting PJI. ResultsCoagulation factors and their ratios including plasma fibrinogen (FBG), prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), PLT / MPV, PLT / PDW and PLT / PCT were included in this study. High FGB level was strongly correlated with the risk of PJI compared to other coagulation factors. The optimal threshold value of FBG was 4.53 g/L with a sensitivity of 47.22%, a specificity of 93.07% (Primary TJA group vs. PJI group). Similarly, the optimal threshold value of FBG was 4.44 g/L with a sensitivity of 47.22%, a specificity of 95.40% between the other two groups (Aseptic revision group vs. PJI group). ROC curve analysis demonstrated moderate diagnostic performance of FBG (AUC value), indicating a potential to be a diagnostic marker for PJI. ConclusionsFBG is significantly correlated with PJI and it can be used as a potential non-invasive marker for early detection. It may serve as a safe and cost-effective tool for assessing PJI in clinical work. 
		                        		
		                        		
		                        		
		                        	
3.Inhibition of glutaminolysis alleviates myocardial fibrosis induced by angiotensin II.
Pan-Pan WANG ; Hao-Miao BAI ; Si-Yu HE ; Zi-Qi XIA ; Mei-Jie LIU ; Jiong AN ; Jia-Heng ZHOU ; Chen-Han LI ; Wei ZHANG ; Xing ZHANG ; Xin-Pei WANG ; Jia LI
Acta Physiologica Sinica 2023;75(2):179-187
		                        		
		                        			
		                        			The present study was aimed to investigate the role and mechanism of glutaminolysis of cardiac fibroblasts (CFs) in hypertension-induced myocardial fibrosis. C57BL/6J mice were administered with a chronic infusion of angiotensin II (Ang II, 1.6 mg/kg per d) with a micro-osmotic pump to induce myocardial fibrosis. Masson staining was used to evaluate myocardial fibrosis. The mice were intraperitoneally injected with BPTES (12.5 mg/kg), a glutaminase 1 (GLS1)-specific inhibitor, to inhibit glutaminolysis simultaneously. Immunohistochemistry and Western blot were used to detect protein expression levels of GLS1, Collagen I and Collagen III in cardiac tissue. Neonatal Sprague-Dawley (SD) rat CFs were treated with 4 mmol/L glutamine (Gln) or BPTES (5 μmol/L) with or without Ang II (0.4 μmol/L) stimulation. The CFs were also treated with 2 mmol/L α-ketoglutarate (α-KG) under the stimulation of Ang II and BPTES. Wound healing test and CCK-8 were used to detect CFs migration and proliferation respectively. RT-qPCR and Western blot were used to detect mRNA and protein expression levels of GLS1, Collagen I and Collagen III. The results showed that blood pressure, heart weight and myocardial fibrosis were increased in Ang II-treated mice, and GLS1 expression in cardiac tissue was also significantly up-regulated. Gln significantly promoted the proliferation, migration, mRNA and protein expression of GLS1, Collagen I and Collagen III in the CFs with or without Ang II stimulation, whereas BPTES significantly decreased the above indices in the CFs. α-KG supplementation reversed the inhibitory effect of BPTES on the CFs under Ang II stimulation. Furthermore, in vivo intraperitoneal injection of BPTES alleviated cardiac fibrosis of Ang II-treated mice. In conclusion, glutaminolysis plays an important role in the process of cardiac fibrosis induced by Ang II. Targeted inhibition of glutaminolysis may be a new strategy for the treatment of myocardial fibrosis.
		                        		
		                        		
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Angiotensin II/pharmacology*
		                        			;
		                        		
		                        			Fibroblasts
		                        			;
		                        		
		                        			Mice, Inbred C57BL
		                        			;
		                        		
		                        			Fibrosis
		                        			;
		                        		
		                        			Collagen/pharmacology*
		                        			;
		                        		
		                        			Collagen Type I/metabolism*
		                        			;
		                        		
		                        			RNA, Messenger/metabolism*
		                        			;
		                        		
		                        			Myocardium/pathology*
		                        			
		                        		
		                        	
4.Characteristics of the left heart structure and function in 86 term neonates with intrauterine growth restriction.
Mo-Qi LI ; Ying-Xue DING ; Hong CUI ; Li-Na JIANG ; Zi-Wei WANG ; Yan-Ru LAI ; Bai-Hong LI ; Wen-Hong DING
Chinese Journal of Contemporary Pediatrics 2023;25(10):1016-1021
		                        		
		                        			OBJECTIVES:
		                        			To study the left heart structure and functional characteristics of term neonates with intrauterine growth restriction (IUGR).
		                        		
		                        			METHODS:
		                        			This study included 86 term neonates with IUGR admitted to the Neonatal Ward of Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2022 as the IUGR group, as well as randomly selected 86 term neonates without IUGR born during the same period as the non-IUGR group. The clinical data and echocardiographic data were compared between the two groups.
		                        		
		                        			RESULTS:
		                        			The analysis of left heart structure and function showed that compared with the non-IUGR group, the IUGR group had significantly lower left ventricular mass, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, end-diastolic interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic volume, left ventricular end-systolic volume, and stroke volume (P<0.05) and significantly higher ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness, proportion of neonates with a mitral peak E/A ratio of ≥1, and cardiac index (P<0.05). The Spearman correlation analysis suggested that stroke volume was positively correlated with birth weight and body surface area (rs=0.241 and 0.241 respectively; P<0.05) and that the ratio of end-diastolic interventricular septal thickness to left ventricular posterior wall thickness was negatively correlated with birth weight and body surface area (rs=-0.229 and -0.225 respectively; P<0.05).
		                        		
		                        			CONCLUSIONS
		                        			The left ventricular systolic function of neonates with IUGR is not significantly different from that of neonates without IUGR. However, the ventricular septum is thicker in neonates with IUGR. This change is negatively correlated with birth weight and body surface area. The left ventricular diastolic function may be impaired in neonates with IUGR.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Birth Weight
		                        			;
		                        		
		                        			Echocardiography
		                        			;
		                        		
		                        			Fetal Growth Retardation
		                        			;
		                        		
		                        			Heart
		                        			;
		                        		
		                        			Heart Ventricles/diagnostic imaging*
		                        			;
		                        		
		                        			Ventricular Function, Left
		                        			
		                        		
		                        	
5.Expression of IGLL1 Gene and Its Clinical Significance in Pediatric T-ALL.
Shui-Yan WU ; Xin-Ran CHU ; Qi JI ; Xiao-Chen LIN ; Zhen-Jiang BAI ; Jian-Qin LI ; Jian PAN ; Zi-Xing CHEN ; Shao-Yan HU
Journal of Experimental Hematology 2023;31(4):999-1004
		                        		
		                        			OBJECTIVE:
		                        			To detect the relative expression of IGLL1 (immunoglobulin lambda-like polypeptide 1) mRNA in bone marrow of children with T-cell acute lymphoblastic leukemia (T-ALL), and analyze its correlation with the clinical characteristics and prognosis of the patients, so as to clarify the clinical significance of IGLL1 in pediatric T-ALL patients.
		                        		
		                        			METHODS:
		                        			A total of 56 pediatric T-ALL patients hospitalized in Children's Hospital of Soochow University from June 2012 to December 2017 and treated with CCLG-ALL 2008 regimen were selected. Transcriptome sequencing technology was used to detect the transcription level of IGLL1 gene in children with T-ALL. According to 25% of the IGLL1 transcription level (cutoff value:448), the enrolled children were divided into IGLL1 low expression group (17 cases) and IGLL1 high expression group (39 cases). Combined with clinical data, the correlation between the expression level of IGLL1 and prognosis of the patients was analyzed.
		                        		
		                        			RESULTS:
		                        			The comparative analysis showed that the transcription level of IGLL1 was not correlated with the clinical characteristics of the patients, such as sex, age, bone marrow blast, white blood cell (WBC) count at initial diagnosis. The 5-year OS rate of patients with high IGLL1 expression was significantly higher than that of patients with low IGLL1 expression (76.9%±6.7% vs 47.1%±12.1%, P =0.018). Further comparison of relapse-free survival (RFS) rate between the two groups showed that the 5-year RFS rate of patients with high IGLL1 expression was higher than that of patients with low IGLL1 expression, but the difference between the two groups was not statistically significant (P =0.095). Multivariate COX analysis was conducted on common clinical prognostic factors (age, sex, WBC count at diagnosis, prednisone response on the 7th day, bone marrow response on the 15th day after treatment) and IGLL1 expression level, and the results showed that IGLL1 expression (P =0.012) and prednisone response (P =0.017) were independent risk factors for overall survival in pediatric T-ALL patients.
		                        		
		                        			CONCLUSION
		                        			In pediatric T-ALL, the OS rate of children with high expression of IGLL1 gene was significantly higher than that of children with low expression of IGLL1 gene, and the expression level of IGLL1 gene was an independent factor affecting the survival of children with T-ALL, which suggests that IGLL1 is a marker of good clinical prognosis of children with T-ALL.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
		                        			;
		                        		
		                        			Clinical Relevance
		                        			;
		                        		
		                        			Disease-Free Survival
		                        			;
		                        		
		                        			Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/genetics*
		                        			;
		                        		
		                        			Prednisone/therapeutic use*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Recurrence
		                        			;
		                        		
		                        			Immunoglobulin Light Chains, Surrogate/genetics*
		                        			
		                        		
		                        	
6.Interferon-α mediating the functional damage of CD56dimCD57+natural killer cells in peripheral blood of systemic lupus erythematosuss.
Xiang Ge ZHAO ; Jia Qing LIU ; Hui Na HUANG ; Zhi Min LU ; Zi Ran BAI ; Xia LI ; Jing Jing QI
Journal of Peking University(Health Sciences) 2023;55(6):975-981
		                        		
		                        			OBJECTIVE:
		                        			To investigate the regulatory effect of interferon-α (IFN-α) on the apoptosis and killing function of CD56dimCD57+ natural killer (NK) cells in systemic lupus erythematosus (SLE) patients, and to explore the specific mechanism.
		                        		
		                        			METHODS:
		                        			A total of sixty-four newly treated SLE patients and sixteen healthy controls (HC) enrolled in the Second Hospital of Dalian Medical University were selected as the research subjects. And the gene expression levels of molecules related to NK cell-killing function were detected by real-time quantitative polymerase chain reaction. CD56dimCD57+ NK cells were co-cultured with the K562 cells, and the apoptotic K562 cells were labeled with Annexin-Ⅴ and 7-amino-actinomycin D. Peripheral blood mononuclear cells were treated with 20, 40, and 80 μmol/L hydrogen peroxide (H2O2), and treated without H2O2 as control, the expression level of perforin (PRF) was detected by flow cytometry. The concentration of IFN-α in serum was determined by enzyme linked immunosorbent assay. The expression levels of IFN-α receptors (IFNAR) on the surface of CD56dimCD57+ NK cells were detected by flow cytometry, and were represented by mean fluorescence intensity (MFI). CD56dimCD57+ NK cells were treated with 1 000 U/mL IFN-α for 24, 48 and 72 h, and no IFN-α treatment was used as the control, the apoptosis and the expression levels of mitochondrial reactive oxygen species (mtROS) were measured by flow cytometry and represented by MFI.
		                        		
		                        			RESULTS:
		                        			Compared with HC(n=3), the expression levels of PRF1 gene in peripheral blood NK cells of the SLE patients (n=3) were decreased (1.24±0.41 vs. 0.57±0.12, P=0.05). Compared with HC(n=5), the ability of peripheral blood CD56dimCD57+ NK cells in the SLE patients (n=5) to kill K562 cells was significantly decreased (58.61%±10.60% vs. 36.74%±6.27%, P < 0.01). Compared with the control (n=5, 97.51%±1.67%), different concentrations of H2O2 treatment significantly down-regulated the PRF expression levels of CD56dimCD57+ NK cells in a dose-dependent manner, the 20 μmol/L H2O2 PRF was 83.23%±8.48% (n=5, P < 0.05), the 40 μmol/L H2O2 PRF was 79.53%±8.56% (n=5, P < 0.01), the 80 μmol/L H2O2 PRF was 76.67%±7.16% (n=5, P < 0.01). Compared to HC (n=16), the serum IFN-α levels were significantly increased in the SLE patients (n=45) with moderate to high systemic lupus erythematosus disease activity index (SLEDAI≥10) [(55.07±50.36) ng/L vs. (328.2±276.3) ng/L, P < 0.001]. Meanwhile, compared with HC (n=6), IFNAR1 expression in peripheral blood CD56dimCD57+ NK cells of the SLE patients (n=6) were increased (MFI: 292.7±91.9 vs. 483.2±160.3, P < 0.05), and compared with HC (n=6), IFNAR2 expression in peripheral blood CD56dimCD57+ NK cells of the SLE patients (n=7) were increased (MFI: 643.5±113.7 vs. 919.0±246.9, P < 0.05). Compared with control (n=6), the stimulation of IFN-α (n=6) significantly promoted the apoptosis of CD56dimCD57+ NK cells (20.48%±7.01% vs. 37.82%±5.84%, P < 0.05). In addition, compared with the control (n=4, MFI: 1 049±174.5), stimulation of CD56dimCD57+ NK cells with IFN-α at different times significantly promoted the production of mtROS in a time-dependent manner, 48 h MFI was 3 437±1 472 (n=4, P < 0.05), 72 h MFI was 6 495±1 089 (n=4, P < 0.000 1), but there was no significant difference at 24 h of stimulation.
		                        		
		                        			CONCLUSION
		                        			High serum IFN-α level in SLE patients may induce apoptosis by promoting mtROS production and inhibit perforin expression, which can down-regulate CD56dimCD57+ NK killing function.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-alpha/metabolism*
		                        			;
		                        		
		                        			Perforin/metabolism*
		                        			;
		                        		
		                        			Leukocytes, Mononuclear/metabolism*
		                        			;
		                        		
		                        			Hydrogen Peroxide/metabolism*
		                        			;
		                        		
		                        			Interferon-gamma/metabolism*
		                        			;
		                        		
		                        			CD56 Antigen/metabolism*
		                        			;
		                        		
		                        			Killer Cells, Natural/metabolism*
		                        			;
		                        		
		                        			Lupus Erythematosus, Systemic
		                        			
		                        		
		                        	
7.Protective effect of Renqing Changjue on acute respiratory distress syndrome in rabbits
Meng-Qi YAO ; Shu-Yan FU ; Zi-Qiang ZHOU ; Sang GENG ; Li-Ma SE ; Fang-Yun SUN ; Luo-Bu BAI-MA
Chinese Journal of Pharmacology and Toxicology 2021;35(10):739-739
		                        		
		                        			
		                        			OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory dis?tress syndrome (ARDS) induced by endotoxin lipopolysaccharide (LPS) in rabbits. METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups: normal control group, model group, dexamethasone group, Renqing Changjue high, middle and low dose group, with six rabbits in each group. LPS was used to replicate the ARDS model after five consecutive days of gavage. Arterial pressure, respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0, 0.5, 1, 2 and 4 h, respectively. At the end of the four-hour experiment, rab?bits were killed by bloodletting, and the lung tissue was quickly removed to determine the cytokines, SOD, MDA and pathological examination of rabbit lung. RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group. The expression of AQP1 and MPO in rabbit lung was significantly decreased by immuno?histochemistry (P<0.05) ,reduce the lung wet/dry weight ratio, increase the ratio of PaO2/FiO2, inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects. CONCLUSION Renqing Changjue can effec?tively protect rabbits with acute respiratory distress syndrome induced by LPS, and may protect the lung by inhibiting the release of cytokines and anti-oxidation.
		                        		
		                        		
		                        		
		                        	
8.Effect of Sishenwan, Baitouweng Tang, and Lianlitang on Ulcerative Colitis in Rats
Zi-han GONG ; Ling ZHANG ; Li-mei LIU ; He-qi LU ; Zhen-li LIU ; Dong BAI ; Rui-hai WANG ; Guang-xin YUE
Chinese Journal of Experimental Traditional Medical Formulae 2021;27(16):1-8
		                        		
		                        			
		                        			Objective:To explore the mechanism of Sishenwan, Baitouweng Tang, and Lianlitang in the treatment of ulcerative colitis (UC), and compare their efficacies on UC in rats. Method:Ninety SD rats of SPF grade were randomly divided into blank group (distilled water, 2 mL·d-1) and experimental group. The rats in the experimental groups were administered with 2,4,6-trinitrobenzene sulfonic acid (TNBS) by clysis to induce the UC model. Subsequently, the model rats were divided into a model group (distilled water, 2 mL·d-1), positive group [sulfasalazine (SASP), 0.4 g·kg-1·d-1], Sishenwan group (1.76 g·kg-1·d-1), a Baitouweng Tang group (1.40 g·kg-1·d-1), and Lianlitang group (2.13 g·kg-1·d-1) according to the random number table. The rats in each group were dosed at 2 mL·d-1 for 14 days. The pathological score for colonic mucosa was detected. Cytokines were detected by the cytokine chip. The enzyme-linked immunosorbent assay (ELISA) was used to detect the free triiodothyronine (FT3), glucagon-like peptide-1 (GLP-1), and corticosterone (CORT) in plasma, and neurotensin (NT), substance P (SP), vasoactive intestinal peptide (VIP), and somatostatin (SST) in colon tissues. Result:Compared with the normal group, the model group showed increased colon mass-length ratio and pathological score for colonic mucosa (
		                        		
		                        	
9.Cross-neutralizing Anti-hemagglutinin Antibodies Isolated from Patients Infected with Avian Influenza A (H5N1) Virus.
Ying SUN ; Yang CAO ; Zi LI ; Tian BAI ; Hong ZHANG ; Shi Xiong HU ; Fang Cai LI ; Xiang ZHAO ; Yong Kun CHEN ; Jian LU ; Li Qi LIU ; Da Yan WANG ; Yue Long SHU ; Jian Fang ZHOU
Biomedical and Environmental Sciences 2020;33(2):103-113
		                        		
		                        			Objective:
		                        			To recover broad-neutralizing monoclonal antibodies (BnAbs) from avian influenza A (H5N1) virus infection cases and investigate their genetic and functional features.
		                        		
		                        			Methods:
		                        			We screened the Abs repertoires of expanded B cells circulating in the peripheral blood of H5N1 patients. The genetic basis, biological functions, and epitopes of the obtained BnAbs were assessed and modeled.
		                        		
		                        			Results:
		                        			Two BnAbs, 2-12D5, and 3-37G7.1, were respectively obtained from two human H5N1 cases on days 12 and 21 after disease onset. Both Abs demonstrated cross-neutralizing and Ab-dependent cellular cytotoxicity (ADCC) activity. Albeit derived from distinct Ab lineages, , V 1-69-D2-15-J 4 (2-12D5) and V 1-2-D3-9-J 5 (3-32G7.1), the BnAbs were directed toward CR6261-like epitopes in the HA stem, and HA I45 in the hydrophobic pocket was the critical residue for their binding. Signature motifs for binding with the HA stem, namely, IFY in V 1-69-encoded Abs and LXYFXW in D3-9-encoded Abs, were also observed in 2-12D5 and 3-32G7.1, respectively.
		                        		
		                        			Conclusions
		                        			Cross-reactive B cells of different germline origins could be activated and re-circulated by avian influenza virus. The HA stem epitopes targeted by the BnAbs, and the two Ab-encoding genes usage implied the VH1-69 and D3-9 are the ideal candidates triggered by influenza virus for vaccine development.
		                        		
		                        		
		                        		
		                        	
10.Symptomatic intracranial hemorrhage after mechanical thrombectomy in patients with acute ischemic stroke caused by anterior circulation tandem occlusion: predictive factors and impact on outcomes
Yongjie BAI ; Shuai ZHANG ; Shun LI ; Xianjin SHANG ; Wenjie ZI ; Peiyang DUAN ; Jisheng QI
International Journal of Cerebrovascular Diseases 2019;27(6):401-407
		                        		
		                        			
		                        			Objective To investigate the predictive factors of symptomatic intracranial hemorrhage(SICH) and the effect on outcomes after mechanical thrombectomy in patients with acute ischemic strokecaused by anterior circulation tandem occlusion. Methods From January 2014 to September 2018, patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy from the Departments of Neurology in 5 general hospitals (the First Affiliated Hospital of Henan University of Science and Technology, the Affiliated Hospital of Yangzhou University,General Hospital of Eastern Theatre Command of PLA, Yijishan Hospital of Wannan Medical College,Xinqiao Hospital of Army Medical University of PLA) were enrolled retrospectively. SICH was evaluated according to the criteria of Heidelberg Bleeding Classification. The functional outcome was assessed by the modified Rankin Scale score at 90 d after onset, and 0-2 was defined as good outcome. Multivariate logistic regression analysis was used to determine the effect of SICH on the outcome at 90 d and the independent risk factors for SICH. Results A total of 124 patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy were enrolled in this study. Among them, 19 (15. 3%) had SICH, 60 (48. 4%) had good outcomes, and 28 (22. 6%) died. The incidence of poor outcomes (94. 7% vs. 43. 8%; χ2 = 16. 708, P < 0. 001 ) and mortality (57. 9% vs.16. 2%; P < 0. 001 ) in the SICH group were significantly higher than those in the non-SICH group.Multivariate logistic regression analysis showed that SICH was an independent risk factor for poor outcome(odds ratio [OR] 27. 78, 95% confidence interval [CI] 2. 60-96. 70; P = 0. 006), while larger infarct core(low ASPECT score) was the only independent predictor of SICH (OR 2. 63, 95% CI 1. 18-5. 88; P =0. 018). Conclusion In patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy, SICH is associated with poor outcome and higher mortality at 3 months, and larger preoperative infarction core is an independent predictor of SICH.
		                        		
		                        		
		                        		
		                        	
            
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