A Nomogram Prediction Model Based on Tissue Window for the Prognosis of Patients with Acute Ischemic Stroke Undergoing Thrombectomy.

OBJECTIVE: Thrombectomy greatly improves the clinical prognosis of patients with acute ischemic stroke (AIS). The aim of this study is to develop a nomogram model that can predict the prognosis of patients with acute ischemic stroke undergoing thrombectomy. METHODS: We retrospectively collected information of patients with acute ischemic stroke who were admitted to the stroke Green Channel of the First Affiliated Hospital of Soochow University from September 2018 to May 2022. The main outcome was defined as a three-month unfavorable outcome (modified Rankin Scale 3-6). Based on the results of multivariate regression analysis, a nomogram was established. We tested the accuracy and discrimination of our nomogram by calculating the consistency index (C-index) and plotting the calibration curve. RESULTS: National Institutes of Health Stroke Scale (NIHSS) score (OR, 1.418; 95% CI, 1.177-1.707; P＜0.001), low density lipoprotein cholesterol (LDL-C) (OR, 2.705; 95% CI, 1.203-6.080; P = 0.016), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (OR, 0.633; 95% CI, 0.421-0.952; P = 0.028), infarct core volume (OR, 1.115; 95% CI, 1.043-1.192; P = 0.001) and ischemic penumbra volume (OR, 1.028; 95% CI, 1.006-1.050; P = 0.012) were independent risk factors for poor clinical prognosis of AIS patients treated with thrombectomy. The C-index of our nomogram was 0.967 and the calibration plot revealed a generally fit in predicting three-month unfavorable outcomes. Based on this nomogram, we stratified the risk of thrombectomy population. We found that low-risk population is less than or equal to 65 points, and patients of more than 65 points tend to have a poor clinical prognosis. CONCLUSION: The nomogram, composed of NIHSS, LDL-C, ASPECTS, infarct core volume and ischemic penumbra volume, may predict the clinical prognosis of cerebral infarction patients treated with thrombectomy.

Characteristics of symptomatic plaque on high-resolution magnetic resonance imaging and its relationship with the occurrence and recurrence of ischemic stroke.

BACKGROUND: Atherosclerosis is the most common cause of ischemia stroke. Computed tomographic angiography (CTA) and digital subtraction angiography (DSA) are used to evaluate the degree of lumen stenosis. However, these examinations are invasive and can only reveal mild to moderate stenosis. High-resolution magnetic resonance imaging (HRMRI) seems a more intuitive way to show the pathological changes of vascular wall. Hence, we conducted a systematic retrospective study to determine the characteristics of symptomatic plaques in patients with intracranial atherosclerosis on HRMRI and their association with the occurrence and recurrence of ischemic stroke events. METHODS: The PubMed database was searched for relevant studies reported from January 31, 2010, to October 31, 2020. RESULTS: We selected 14 clinical outcome studies. We found that plaque enhancement and positive remodeling on HRMRI indicate symptomatic plaques. Besides, intraplaque hemorrhage and positive remodeling index are closely related to the occurrence of stroke. However, it is still controversial whether the initial enhancement of plaque and the occurrence and recurrence of stroke are related. There is also no significant correlation between vascular stenosis and symptomatic plaque or the occurrence and recurrence of ischemic stroke. CONCLUSION: High-resolution magnetic resonance imaging can be used as an assessment tool to predict the risk of stroke onset and recurrence in patients with atherosclerosis, but further research is also needed.

[Effects of Nano Material on Cadmium Accumulation Capacity and Grain Yield of Indica Hybrid Rice Under Wetting-drying Alternation Irrigation].

Wetting-drying alternation irrigation (WDI) can harvest high grain yield under effective irrigation water saving conditions. However, the kernel cadmium (Cd) content usually exceeds the national standard of 0.20 mg Cd per kg kernel in WDI. Applying a passivating agent with high-efficient repairing capabilities could be a feasible approach to reduce Cd content lower than 0.20 mg·kg-1 in WDI. Therefore, a field experiment was conducted with different irrigation regimes and passivating agents in a mildly Cd-polluted paddy field, of which the irrigation regimes were WDI and traditional flooded irrigation (FI) and the six passivating agents treatments were CK (no passivating agent; T1), slaked lime with 1125 kg·hm-2(T2), 1125 kg slaked lime and 3000 kg biochar per hectare (T3), 1125 kg slaked lime and 3000 kg organic fertilizer per hectare (T4), 1500 kg porous Nano stupalith per hectare (T5), and 1125 kg slaked lime combined with 1500 kg porous Nano stupalith per hectare (T6). Two typical Indica hybrid rice varieties with a high accumulated capacity named cultivar Shenliangyou 1813 and a low accumulated trait named cultivar Liangyou 6206 were utilized. The main reason that Indica hybrid rice cultivars were selected was their higher absorbed and accumulated characteristics than that of Japonica rice. The results indicated that available Cd content of the soil significantly declined with 17.13%-61.01% decreasing amplitude at maturity when compared with pre-transplanting in WDI; however, the reduction was in the range of -43.45%-21.07% for the FI treatment across cultivars and passivating agents treatments. The available Cd content at maturity was significantly greater in FI than in WDI (P<0.05). In contrast, WDI had higher Cd content on stem, leaf, and kernel organs at maturity than with FI treatment of both cultivars and all of the passivating agents (P<0.05). Generally, the T1 treatment had the maximum available Cd content in the soil layer and highest accumulated Cd content on different aboveground organs, followed by the T2, T3, T4, T5, and T6 treatments considering both cultivars and irrigation regimes. The Cd kernel contents were 0.23-0.24 mg·kg-1 and 0.16-0.21 mg·kg-1 for cultivars Shenliangyou 1813 and Liangyou 6206, respectively, in the T6 treatment. The higher Cd kernel content was generally related to a larger Cd content in the stem organ. For the grain yield, no significant differences were observed among cultivars, irrigation regimes, or passivating agents treatments (P>0.05). Under WDI, the kernel Cd content was still slightly higher than 0.20 mg·kg-1 in the T6 treatment (0.24 mg·kg-1 for cultivar Shenliangyou 1813 and 0.21 mg·kg-1 for cultivar Liangyou 6206); however, there is a predictability potential to produce lower than 0.20 mg·kg-1 kernel content in the T6 treatment if a cultivar with low accumulated capacity is used. Thus, the combined mode of the WDI+T6+cultivar with accumulated low Cd content could be considered an optimized cultivation scheme to obtain no Cd contaminated kernels with high grain yield and water-use efficiency in mildly polluted paddy fields.