Association between ASPECTS region of infarction and clinical outcome in non-acute large vessel occlusion ischaemic stroke after endovascular recanalisation.

PURPOSE: This study retrospectively investigated whether infarction in specific Alberta Stroke Program Early CT Score (ASPECTS) regions is associated with clinical outcome in patients with symptomatic non-acute internal carotid or middle cerebral artery occlusion who underwent endovascular recanalisation (ER). METHODS: Preoperative ASPECTS and region of infarction were recorded before recanalisation. Clinical outcome was evaluated 90 days after the procedure using the modified Rankin Scale; a score>2 was defined as poor outcome. Secondary outcomes included postprocedural cerebral oedema, intracranial haemorrhage (ICH) and symptomatic ICH. RESULTS: Among the 86 patients included, 90-day outcome was poor in 30 (34.9%) and 40 experienced cerebral oedema (46.5%). Multivariate logistic regression models showed that lenticular nucleus infarction (OR 19.61-26.00, p<0.05), admission diastolic blood pressure (OR 1.07-1.08, p<0.05), preprocedural National Institutes of Health Stroke Scale (OR 1.96-2.05, p<0.001) and haemorrhagic transformation (OR 14.99-18.81, p<0.05) were independent predictors of poor 90-day outcome. The area under the receiver operating characteristic curve for lenticular nucleus infarction as a predictor of poor outcome was 0.73. M2 region infarction (OR 26.07, p<0.001) and low American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral circulation grade (OR 0.16, p=0.001) were independent predictors of postprocedural cerebral oedema. The area under the receiver operating characteristic curve for M2 region infarction as a predictor of cerebral oedema was 0.64. Region of infarction did not significantly differ between patients with and without postprocedural ICH or symptomatic ICH. CONCLUSIONS: Lenticular nucleus and M2 region infarction were independent predictors of poor 90-day outcome and postprocedural cerebral oedema, respectively, in patients with non-acute anterior circulation large artery occlusion who underwent ER.

Establishment and Application of a Radiation Dose Rate Model for Nuclear Medicine Examinees.

Introduction: Traditional methods for determining radiation dose in nuclear medicine include the Monte Carlo method, the discrete ordinate method, and the point kernel integration method. This study presents a new mathematical model for predicting the radiation dose rate in the vicinity of nuclear medicine patients. Methods: A new algorithm was created by combining the physical model of "cylinder superposition" of the human body with integral analysis to assess the radiation dose rate in the vicinity of nuclear medicine patients. Results: The model accurately predicted radiation dose rates within distances of 0.1-3.0 m, with a deviation of less than 11% compared to observed rates. The model demonstrated greater accuracy at shorter distances from the radiation source, with a deviation of only 1.55% from observed values at 0.1 m. Discussion: The model proposed in this study effectively represents the spatial and temporal distribution of the radiation field around nuclear medicine patients and demonstrates good agreement with actual measurements. This model has the potential to serve as a radiation dose rate alert system in hospital environments.

Causal association between particulate matter 2.5 and Alzheimer's disease: a Mendelian randomization study.

Background: Although epidemiological evidence implies a link between exposure to particulate matter (PM) and Alzheimer's disease (AD), establishing causality remains a complex endeavor. In the present study, we used Mendelian randomization (MR) as a robust analytical approach to explore the potential causal relationship between PM exposure and AD risk. We also explored the potential associations between PM exposure and other neurodegenerative diseases. Methods: Drawing on extensive genome-wide association studies related to PM exposure, we identified the instrumental variables linked to individual susceptibility to PM. Using summary statistics from five distinct neurodegenerative diseases, we conducted two-sample MR analyses to gauge the causal impact of PM on the risk of developing these diseases. Sensitivity analyses were undertaken to evaluate the robustness of our findings. Additionally, we executed multivariable MR (MVMR) to validate the significant causal associations identified in the two-sample MR analyses, by adjusting for potential confounding risk factors. Results: Our MR analysis identified a notable association between genetically predicted PM2.5 (PM with a diameter of 2.5 µm or less) exposure and an elevated risk of AD (odds ratio, 2.160; 95% confidence interval, 1.481 to 3.149; p < 0.001). A sensitivity analysis supported the robustness of the observed association, thus alleviating concerns related to pleiotropy. No discernible causal relationship was identified between PM and any other neurodegenerative diseases. MVMR analyses-adjusting for smoking, alcohol use, education, stroke, hearing loss, depression, and hypertension-confirmed a persistent causal relationship between PM2.5 and AD. Sensitivity analyses, including MR-Egger and weighted median analyses, also supported this causal association. Conclusion: The present MR study provides evidence to support a plausible causal connection between PM2.5 exposure and AD. The results emphasize the importance of contemplating air quality interventions as a public health strategy for reducing AD risk.

Polyethyleneimine in designed nanocomposite based magnetic halloysite nanotubes for extraction and determination of gallic acid in green tea.

An innovative and simple nanocomposite denoted as MHNTs@PEI was synthesized for gallic acid (GA) analytical sample pretreatment. Polyethyleneimine (PEI) functionalized was binded onto magnetic halloysite nanotubes (MHNTs) to inhence adsorption capacity. MHNTs@PEI was obtained only through two steps modification (amination and PEI modification). Characterizations showed that there are layers of synthetic PEI on the tubular structure of the material and magnetic spheres on its surface, both indicating successful synthesis of the nanocomposite. Furthermore, the adsorption isotherms and kinetic modeling showed that the Langmuir model and pseudo-first-order model fit the adsorption data, respectively. MHNTs@PEI achieved an adsorption capacity of 158 mg·g-1. Overall, the abundant adsorption sites significantly improved the adsorption performance of the MHNTs@PEI. Regeneration tests demonstrated that the MHNTs@PEI exhibits effective adsorption, even after undergoing five consecutive cycles. Optimization of key parameters (ratio, volume of elution, elution time and frequency) in the process of adsorption and desorption was also conducted. The limit of detection (LOD) and that of the quantification (LOQ) were 0.19 and 0.63 µg·mL-1, respectively, and the recoveries were 95.67-99.43 %. Finally, the excellent magnetism (43.5 emu·g-1) and the adsorption feature of MHNTs@PEI enabled its successful utilization in analytical sample pretreatment through the extraction of GA from green tea.

Influencing Factors of Constipation in Elderly Patients With Intracerebral Hemorrhage: Implication for Clinical Care.

Background: Constipation is common in elderly inpatients with intracerebral hemorrhage. This study aimed to construct a model for predicting the risk of constipation in elderly inpatients with intracerebral hemorrhage and to provide reference for formulating targeted intervention measures. Methods: Elderly patients with intracerebral hemorrhage who were treated in the department of Neurosurgery of a third-class hospital in Suzhou from January 2018 to September 2023 were included. Clinical data of patients with and without constipation were compared. Logistic regression analysis was used to explore the influencing factors of constipation in elderly patients with intracerebral hemorrhage, and R software was used to construct a line chart model to verify its predictive effect. Results: A total of 504 elderly patients with intracerebral hemorrhage were included. The incidence of constipation in elderly patients with cerebral hemorrhage was 63.9%. Logistic regression analysis showed that GCS score (OR = 1.094, 95%CI: 1.019∼1.174), hypertension (OR = 2.911, 95%CI: 1.797∼4.715), use of dehydrating agent (OR = 3.794, 95%CI: 2.337∼6.158), surgical treatment (OR = 3.986, 95%CI: 2.339∼6.793), use of sedative drugs (OR = 4.212, 95%CI:2.386-7.435), and limb paralysis (OR = 6.313, 95%CI:3.689∼10.803) were the independent risk factors for constipation in elderly patients with intracerebral hemorrhage. The area under the ROC curve of the prediction model was 0.872 (95%CI: 0.8401∼0.9033), the best critical value was 0.705, the sensitivity was 0.748, and the specificity was 0.857. Conclusion: The constipation risk prediction model of elderly patients with cerebral hemorrhage has good differentiation and calibration, which is helpful for health care providers to identify the risk of constipation in elderly patients with intracerebral hemorrhage.

Identification of significant m6A regulators and immune microenvironment characterization in ischemic stroke.

The role of m6A modification in the regulation of the immune microenvironment (IME) of ischemic stroke (IS) is barely known. Thus, we aim to investigate the impact of m6A modification on the IME of IS and its diagnostic value in IS. We comprehensively assessed the m6A modification patterns, the relationship between these modification patterns and the characteristics of the IME. The m6A modification patterns of individual IS sample were quantified by m6Ascore. The performance of m6A phenotype-related genes as potential biomarkers was evaluated by the area under the receiver operating characteristic curve. Experimental validation was also performed by qRT-PCR. Six dysregulated m6A regulators were identified and a classification model consisting of four key m6A regulators (METLL3, RBMX, RBM15B, YTDHF3) could distinguish IS and healthy control samples well. METTL3 and YTHDF3 are closely related to circulating neutrophil abundance. Two distinct m6A modification patterns were determined which differed in immunocyte abundance. We also identified six m6A phenotype-related genes (APOBEC3A, PTMA, FCGR3A, LOC440926, LOC649946, and FTH1L11), and further explored their biological function. Among them, APOBEC3A, FCGR3A, and FTH1L11 were positively associated with neutrophil abundance. APOBEC3A and FCGR3A were stable diagnostic m6A-associated genes in both the discovery and validation cohorts. This study reveals that m6A modification plays a non-negligible role in the formation of a diversified and complex IME in IS. The m6A phenotype-related genes could be diagnostic biomarkers of IS.

Portable paper-based probe for on-site ratiometric fluorescence determination of total flavonol glycosides in plant extract using smartphone imaging.

A smartphone-assisted, paper-based ratio fluorescence probe is presented for the rapid, low-cost and on-site quantification of total flavonol glycosides in Ginkgo biloba extracts (GBE). The Al3+/Eu-MOF/paper-based probe utilizes lanthanide metal-organic framework (Ln-MOF) nanoparticles immobilized on Whatman filter paper along with Al3+ for detecting flavonols, which are the hydrolyzed products of flavonol glycosides. The color change of the paper-based fluorescence image from red to orange depends on the concentration of the target analyte in the sample solution. The smartphone equipped with a red, green, blue (RGB) color detector measured the fluorescence signal intensity on the paper substrate after adding flavonol. The analytical variables affecting the performance of the probe, including the addition sequence of the aluminum nitrate solution, its concentration, that of the Ln-MOF solution, the drying time of the paper probe, the reaction time and the sensitivity parameters of the mobile phone camera (ISO), were optimized. Under optimal conditions, the Al3+/Eu-MOF/paper-based probe has good linear response in the concentration range 7 ~ 80 µg mL- 1 and a lower detection limit of 2.07 µg mL- 1. The results obtained with the paper-based ratio fluorescence probe and smartphone combination were validated by comparing them with high-performance liquid chromatography (HPLC) measurements. This study provides a potential strategy for fabricating Al3+/Eu-MOF/paper-based probe used for total flavonol glycosides determination.

PS-MPs or their co-exposure with cadmium impair male reproductive function through the miR-199a-5p/HIF-1α-mediated ferroptosis pathway.

Microplastics (MPs) and cadmium (Cd) exist extensively in ambient environments and probably influence negatively on human health. However, the potential reproductive toxicity of MPs or MPs + Cd remains unknown. This study was aimed to observe the reproductive changes of male mice treated orally for 35 days with PS-MPs (100 mg/kg), CdCl2 (5 mg/kg) and PS-MPs plus CdCl2 mixture. We found that subchronic exposure to PS-MPs damaged mouse testicular tissue structure, reduced sperm quality and testosterone levels. Moreover, the reproductive toxicity in 0.1 µm group was stronger than 1 µm group, and mixture group was more severe than single particle size ones. Meanwhile, co-exposure of PS-MPs and Cd exacerbated reproductive injury in male mice, with an ascending toxicity of Cd, 1 µm + Cd, 0.1 µm + Cd, and 0.1+1 µm + Cd. In addition, we discovered that the testicular damage induced by PS-MPs or PS-MPs + Cd was associated with interfering the miR-199a-5p/HIF-1α/ferroptosis pathway. Promisingly, these findings will shed new light on how PS-MPs and PS-MPs + Cd damage male reproductive function.

Intracranial Inflammatory Myofibroblastic Tumor: A Literature Review and a Rare Case Misdiagnosed as Acoustic Neuroma.

Inflammatory myofibroblastic tumor (IMT) stands as a rare neoplasm, initially documented by Bahadori and Liebow in 1973; however, its biological behavior and underlying pathogenesis continue to elude comprehensive understanding. Throughout the years, this tumor has been designated by various alternative names, including pseudosarcomatoid myofibroblastoma, fibromyxoid transformation, and plasma cell granuloma among others. In 2002, the World Health Organization (WHO) officially classified it as a soft tissue tumor and designated it as IMT. While IMT primarily manifests in the lungs, the common clinical symptoms encompass anemia, low-grade fever, limb weakness, and chest pain. The mesentery, omentum, and retroperitoneum are subsequent sites of occurrence with intracranial involvement being exceedingly rare. Due to the absence of specific clinical symptoms and characteristic radiographic features, diagnosing intracranial inflammatory myofibroblastic tumor (IIMT) remains challenging. Successful instances of pharmacological treatment for IIMT indicate that surgery may not be the sole therapeutic recourse, thus underscoring the imperative of an accurate diagnosis and apt treatment selection to improve patient outcomes.

pH-Responsive doxorubicin-loaded magnetosomes for magnetic resonance-guided focused ultrasound real-time monitoring and ablation of breast cancer.

MR-guided focused ultrasound surgery (MRgFUS) is driving a new direction in non-invasive thermal ablation therapy with spatial specificity and real-time temperature monitoring. Although widely used in clinical practice, it remains challenging to completely ablate the tumor margin due to fear of damaging the surrounding tissues, thus leading to low efficacy and a series of complications. Herein, we have developed novel pH-responsive drug-loading magnetosomes (STPSD nanoplatform) for increasing the T2-contrast and improved the ablation efficiency with a clinical MRgFUS system. Specifically, this STPSD nanoplatform is functionalized by pH-responsive peptides (STP-TPE), encapsulating superparamagnetic iron oxide (SPIO) and doxorubicin (DOX), which can cause drug release and SPIO deposition at the tumor site triggered by acidity and MRgFUS. Under MRgFUS treatment, the increased vascular permeability caused by hyperthermia can improve the uptake of SPIO and DOX by tumor cells, so as to enhance ultrasound energy absorption and further enhance the efficacy of chemotherapy to completely ablate tumor margins. Moreover, we demonstrated that a series of MR sequences including T2-weighted imaging (T2WI), contrast-enhanced T1WI imaging (T1WI C+), maximum intensity projection (MIP), volume rendering (VR) and ADC mapping can be further utilized to monitor the MRgFUS ablation effect in rat models. Overall, this smart nanoplatform has the capacity to be a powerful tool to promote the therapeutic MRgFUS effect and minimize the side effects to surrounding tissues.

PPM1K mediates metabolic disorder of branched-chain amino acid and regulates cerebral ischemia-reperfusion injury by activating ferroptosis in neurons.

Ischemic stroke is a neurological disorder caused by vascular stenosis or occlusion, accounting for approximately 87% of strokes. Clinically, the most effective therapy for ischemic stroke is vascular recanalization, which aims to rescue neurons undergoing ischemic insults. Although reperfusion therapy is the most effective treatment for ischemic stroke, it still has limited benefits for many patients, and ischemia-reperfusion (I/R) injury is a widely recognized cause of poor prognosis. Here, we aim to investigate the mechanism of protein phosphatase Mg2+/Mn2+ dependent 1 K (PPM1K) mediates metabolic disorder of branched-chain amino acids (BCAA) by promoting fatty acid oxidation led to ferroptosis after cerebral I/R injury. We established the I/R model in mice and used BT2, a highly specific BCAA dehydrogenase (BCKD) kinase inhibitor to promote BCAA metabolism. It was further verified by lentivirus knocking down PPM1K in neurons. We found that BCAA levels were elevated after I/R injury due to dysfunctional oxidative degradation caused by phosphorylated BCKD E1α subunit (BCKDHA). Additionally, the level of phosphorylated BCKDHA was determined by decreased PPM1K in neurons. We next demonstrated that BCAA could induce oxidative stress, lipid peroxidation, and ferroptosis in primary cultured cortical neurons in vitro. Our results further showed that BT2 could reduce neuronal ferroptosis by enhancing BCAA oxidation through inhibition of BCKDHA phosphorylation. We further found that defective BCAA catabolism could induce neuronal ferroptosis by PPM1K knockdown. Furthermore, BT2 was found to alleviate neurological behavior disorders after I/R injury in mice, and the effect was similar to ferroptosis inhibitor ferrostatin-1. Our findings reveal a novel role of BCAA in neuronal ferroptosis after cerebral ischemia and provide a new potential target for the treatment of ischemic stroke.

Analysis of clinical characteristics and health resource costs in children hospitalised for injuries in southern Sichuan, China.

Aim: To investigate the clinical characteristics and health resource costs among children hospitalised for injuries in southern Sichuan, China, and to provide guidance for prevention and treatment. Methods: We collected clinical data concerning children aged from 29 days to 18 years hospitalised for injuries from January 1, 2017, to December 31, 2021, retrospectively analysing the basic characteristics, evolution of injury characteristics over time, risk factors for events with adverse outcomes, and health resource costs. Results: Among 5,826 hospitalised children with injuries, males (63.6%), those in rural areas (40.3%), and adolescents (33.5%) were most commonly injured. Most injuries occurred at home (52.6%), and during summer. The most common injury types were falls, burns, road traffic injuries, poisoning, and foreign body injuries (32.0%, 17.9%, 13.6%, 8.8%, and 7.9%, respectively). After 2019, the proportion of intentional injuries among adolescent girls was significantly higher. Road traffic injuries most commonly led to poor clinical outcomes (95%CI: 5.39-31.51), followed by falls (95%CI: 2.20-10.67). Adolescents were at higher risk of poor prognosis. Injuries occurring in rural areas, adolescents, road traffic injuries, and falls cost high health resource. Conclusion: Injuries among children remain serious, with males and adolescents from villages predominantly affected. Attention should be paid to intentional injuries among adolescent females also. Targeted prevention and control measures for road traffic injuries and falls should be strengthened.

Preoperative computed tomography-guided transscapular sens-cure needle localization for pulmonary nodule located behind the scapula.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is an approach that is commonly used to resect pulmonary nodules (PNs). However, when these PNs are located behind the scapula, a transscapular access approach is generally required. In this study, the safety, efficacy, and feasibility of preoperative computed tomography (CT)-guided Sens-cure needle (SCN) localization was assessed for PNs located behind the scapula. METHODS: From January 2020 - June 2022, a total of 122 PN patients in our hospital underwent preoperative CT-guided SCN localization and subsequent VATS resection, of whom 12 (9.8%) exhibited PNs behind the scapula necessitating a transscapular approach for this localization procedure. RESULTS: This study included 12 patients, each of whom had one PN located behind the scapula. The CT-guided transscapular SCN localization approach was successful in all patients, and no complications near the operative site were observed. The median localization time was 12 min, and 2 (16.7%) and 1 (8.3%) patients respectively developed pneumothorax and pulmonary hemorrhage after the localization procedure was complete. Wedge resection procedures for these PNs achieved technical success in all cases. Four patients were diagnosed with invasive adenocarcinomas and subsequently accepted lobectomy and systematic lymph node dissection. The median VATS duration and the median blood loss was 80 min and 10 mL, respectively. In total, 3, 5, and 4 PNs were respectively diagnosed as benign, mini-invasive adenocarcinomas, and invasive adenocarcinomas. CONCLUSION: Preoperative CT-guided transscapular SCN localization represents a safe, straightforward, and effective means of localizing PNs present behind the scapula.

The fibrinogen-to-albumin ratio is associated with intracranial atherosclerosis plaque enhancement on contrast-enhanced high-resolution magnetic resonance imaging.

Background: Contrast-enhanced high-resolution magnetic resonance imaging (CE-HR-MRI) is a useful imaging modality to assess vulnerable plaques in intracranial atherosclerotic stenosis (ICAS) patients. We studied the relationship between the fibrinogen-to-albumin ratio (FAR) and plaque enhancement in patients with ICAS. Methods: We retrospectively enrolled consecutive ICAS patients who had undergone CE-HR-MRI. The degree of plaque enhancement on CE-HR-MRI was evaluated both qualitatively and quantitatively. Enrolled patients were classified into no enhancement, mild enhancement, and obvious enhancement groups. An independent association of the FAR with plaque enhancement was identified by multivariate logistic regression and receiver operating characteristic (ROC) curve analyses. Results: Of the 69 enrolled patients, 40 (58%) were classified into the no/mild enhancement group, and 29 (42%) into the obvious enhancement group. The obvious enhancement group had a significantly higher FAR than the no/mild enhancement group (7.36 vs. 6.05, p = 0.001). After adjusting for potential confounders, the FAR was still significantly independently associated with obvious plaque enhancement in multiple regression analysis (odds ratio: 1.399, 95% confidence interval [CI]: 1.080-1.813; p = 0.011). ROC curve analysis revealed that FAR >6.37 predicted obvious plaque enhancement with 75.86% sensitivity and 67.50% specificity (area under the ROC curve = 0.726, 95% CI: 0.606-0.827, p < 0.001). Conclusion: The FAR can serve as an independent predictor of the degree of plaque enhancement on CE-HR-MRI in patients with ICAS. Also, as an inflammatory marker, the FAR has potential as a serological biomarker of intracranial atherosclerotic plaque vulnerability.

Biomass-Derived Carbon-Based Multicomponent Integration Catalysts for Electrochemical Water Splitting.

Electrocatalytic water splitting powered by sustainable electricity is a crucial approach for the development of new generation green hydrogen technology. Biomass materials are abundant and renewable, and the application of catalysis can increase the value of some biomass waste and turn waste into fortune. Converting economical and resource-rich biomass into carbon-based multicomponent integrated catalysts (MICs) has been considered as one of the most promising ways to obtain inexpensive, renewable and sustainable electrocatalysts in recent years. In this review, recent advances in biomass-derived carbon-based MICs towards electrocatalytic water splitting are summarized, and the existing issues and key aspects in the development of these electrocatalysts are also discussed and prospected. The application of biomass-derived carbon-based materials will bring some new opportunities in the fields of energy, environment, and catalysis, as well as promote the commercialization of new nanocatalysts in the near future.

IR780-doped cobalt ferrite nanoparticles@poly(ethylene glycol) microgels as dual-enzyme immobilized micro-systems: Preparations, photothermal-responsive dual-enzyme release, and highly efficient recycling.

To solve the problems of separating dual enzymes from the carriers of dual-enzyme immobilized micro-systems and greatly increase the carriers' recycling times, photothermal-responsive micro-systems of IR780-doped cobalt ferrite nanoparticles@poly(ethylene glycol) microgels (CFNPs-IR780@MGs) are prepared. A novel two-step recycling strategy is proposed based on the CFNPs-IR780@MGs. First, the dual enzymes and the carriers are separated from the reaction system as a whole via magnetic separation. Second, the dual enzymes and the carriers are separated through photothermal-responsive dual-enzyme release so that the carriers can be reused. Results show that CFNPs-IR780@MGs is 281.4 ± 9.6 nm with a shell of 58.2 nm, and the low critical solution temperature is 42 °C, and the photothermal conversion efficiency increases from 14.04% to 58.41% by doping 1.6% of IR780 into the CFNPs-IR780 clusters. The dual-enzyme immobilized micro-systems and the carriers are recycled 12 and 72 times, respectively, and the enzyme activity remains above 70%. The micro-systems can realize whole recycling of the dual enzymes and carriers and further recycling of the carriers, thus providing a simple and convenient recycling method for dual-enzyme immobilized micro-systems. The findings reveal the micro-systems' important application potential in biological detection and industrial production.

Endovascular recanalization in patients with severely disabling non-acute ischemic stroke.

BACKGROUND: It is unclear whether patients with severely disabling ischemic stroke (SDIS-that is, modified Rankin scale (mRS) scores of 3-5) benefit from non-acute endovascular recanalization (ER). OBJECTIVE: To determine the effect of non-acute ER or medical treatment in severely disabled patients with non-acute ischemic stroke (mRS scores of 3-5). METHODS: Between January 2018 and August 2021, non-acute patients with SDIS and large vessel occlusion were collected from two regional stroke centers. Patients who met the inclusion and exclusion criteria were assigned to two groups based on whether they underwent ER (ER group) or not (medical group). The primary functional outcome was the mRS score at 90 days. The primary safety outcomes were the recurrence of stroke and mortality. RESULTS: Of the 325 patients with hypoperfusion cerebral infarction caused by large vessel occlusion, 63 met the inclusion criteria (32 patients in the ER group, 31 patients in the medical group). A favorable outcome (mRS score ≤2) occurred more often in the ER group than in the medical group (59.4% vs 22.6%, respectively; OR=0.12, 95% CI 0.02 to 0.58; P<0.01). There were no significant differences in new-onset ischemic stroke (6.3% vs 3.2%, respectively; P=1.000), symptomatic intracerebral hemorrhage (12.5% vs 0%, respectively; P=0.113), or mortality within 90 days (6.3% vs 6.5%, respectively; P=1.000) between the two groups. Preoperative mRS scores (OR=7.34, 95% CI 1.56 to 34.5; P=0.02) and ER (OR=0.12, 95% CI 0.02 to 0.58; P<0.01) were significantly associated with outcome. CONCLUSION: Our data suggest that patients with SDIS (mRS score 3-5) with smaller infarct cores and better collateral circulation can benefit from non-acute ER, with no additional perioperative complications or mortality.

Ioversol Induced Microglia Proinflammatory Activation and Oxidative Stress in Rats.

Contrast-induced encephalopathy (CIE) following angiography, though not often and reversible, can in some cases lead to permanent neurological dysfunction. To identify how neuroinflammation is involved in CIE, we investigated microglia responses to a bolus injection of ioversol in the internal carotid artery (ICA) in rats. MicroCT scanning indicated that the injected ioversol was cleared from the rat's brain within 25 min. However, proinflammatory activated and significantly increased microglia were found in the rat occipital cortex at 1 day, and the number of blood vessel-associated microglia was still significantly higher at 3-day post-injection, compared with sham- and PBS-treated rats. Moreover, significantly upregulated malondialdehyde (MDA), downregulated superoxide dismutase (SOD) levels, and elevated proinflammatory cytokines were observed in the brain of rats treated with ioversol. Ioversol administration decreased cell viability of primarily cultured microglia and induced significant proinflammatory activation. Furthermore, ioversol remarkably upregulated astrocytic aquaporin (AQP) 4 expression in the rats brain, and transwell cultures showed significantly enhanced microglia migrating to ioversol-treated endothelial cells. Immediate injection of edaravone dexborneol, a novel antioxidative drug, after ioversol injection effectively rescued ioversol-induced neuroinflammation. Together, these findings suggest that ioversol induced neuroinflammation and oxidative stress in the brain via microglia activation in a direct and indirect manner, which might contribute to the pathogenesis of CIE.

Metformin treatment and acute ischemic stroke outcomes in patients with type 2 diabetes: a retrospective cohort study.

BACKGROUND AND PURPOSE: Preclinical studies have shown that metformin has neuroprotective actions in stroke. However, the optimal treatment timing and duration remain unknown. Herein, we examined the efficacy of metformin treatment on prognosis in acute ischemic stroke (AIS) patients, and assessed the optimal treatment timing and duration. METHODS: AIS patients with type 2 diabetes mellitus were retrospectively enrolled. Patients were grouped into those who never received metformin (MET - group), those who received metformin continuously before stroke and after admission (pre-stroke + /post-stroke + group), those who only received metformin before stroke onset (pre-stroke + /post-stroke - group), and those who only received metformin after admission (pre-stroke - /post-stroke + group). The all MET + group represents the sum of the three metformin treatment groups. The efficacy outcome was the 90-day modified Rankin Scale (mRS) score. RESULTS: In total, 309 eligible patients were included (MET - [N = 130], pre-stroke + /post-stroke + [N = 94], pre-stroke + /post-stroke - [N = 30], pre-stroke - /post-stroke + [N = 55]; all MET + [N = 179]). The all MET + group had a trend toward a lower 90-day mRS score compared with that in the MET - group (1 [0-2] vs 1 [0-3], unadjusted odds ratio [OR] = 0.652, P = 0.041; adjusted OR = 0.752, P = 0.218). In the three metformin treatment groups, only the pre-stroke + /post-stroke + group had a significantly lower 90-day mRS score (1 [0-1] vs 1 [0-3], adjusted OR = 0.497, 95%CI = 0.289-0.854; P = 0.011) and higher proportion of mRS score 0-1 (78.7% vs. 61.5%, adjusted OR = 2.278, 95%CI = 1.108-4.680; P = 0.025) than the MET - group. CONCLUSION: AIS patients with type 2 diabetes mellitus who receive continuous metformin treatment before stroke onset and after admission have improved functional outcome at 90 days.

Molecularly imprinted polymers enhanced peroxidase-like activity of AuNPs for determination of glutathione.

An elaborate composite of molecularly imprinted polymer (MIP)-modified gold nanoparticles (AuNPs)@silica dioxide (SiO2) was designed and prepared for real-time colorimetric determination of glutathione (GSH) in serum. Firstly, the MIPs were synthesized on the surface of SiO2 utilizing GSH as template molecules. Then, AuNPs were synthesized on the surface of MIPs@SiO2 to produce a composite of MIPs modified by AuNPs@SiO2. Compared with plain AuNPs, the composite possessed better peroxidase catalysis activity due to stabilization and protection from hydrophilic SiO2, which can catalyze H2O2 to·OH oxidizing 3,3,5,5-tetramethylbenzidine (TMB) to the colored product. In addition, its selectivity was enhanced by MIP modification with special recognition cavities. With the composite as the sensor, GSH was precisely and sensitively detected in the range 5 ~ 40 µM with a limit of determination of 1.16 µM according to the principle of inhibitive peroxidase catalysis activity by GSH. The proposed colorimetric detection was successfully utilized for selective, convenient, and rapid determination of GSH in serum. It provided a new strategy for drug real-time monitoring and has high potential in clinical drug analysis.