Analysis of postoperative complications of orbital fracture.

OBJECTIVE: To analyze the types and causes of complications following orbital fracture reconstruction and enhance clinicians' capacity to manage or prevent such complications. METHODS: We conducted a retrospective case series analysis, retrospectively collecting and analyzing clinical data of patients with orbital fractures who received surgical treatment at the Affiliated Eye Hospital of Nanchang University from May 2012 to May 2022. Descriptive statistics were employed to document common postoperative complications, and we recorded complications persisting after a minimum 6-month follow-up period. RESULTS: Among the 227 patients who underwent orbital fracture surgery, they were followed up for 6 to 36 months, and complications occurred in 15 cases, resulting in an incidence rate of 6.61%. These complications included implant material infections and rejections (4 cases), persistent diplopia (3 cases), intraorbital hematomas (2 cases), epiphora (2 cases), lower eyelid eversion or retraction (2 cases), and skin scars (2 cases). The primary cause of postoperative infection was chronic inflammation in the paranasal sinuses or closed cavities within the fracture area. Postoperative complications in orbital fractures were associated with various factors, including the timing of surgery, surgical approach, repair materials, surgical skills, and auxiliary techniques. CONCLUSION: Standardizing surgical techniques and implementing precise auxiliary technologies may reduce the incidence of complications and enhance the operation's success rate.

[Distribution Characteristics, Ecological Risk Assessment, and Source Tracing of Heavy Metals in the Sediments of Typical Lakes in the Middle Reaches of the Yangtze River].

In this study, surface sediment samples were collected from Dongting Lake, Honghu Lake, and Chihu Lake, and the concentrations of 10 heavy metals were measured. Then, the potential risk of heavy metal accumulation was evaluated using the cumulative pollution index (Igeo), the enrichment factor (EF), and the potential ecological risk index (RI), and the sources were traced using correlation analysis (Pearson) and principal component analysis (PCA). The results showed that the pollution and potential ecological risk of Cd were the most serious. The mean values of Cd in East Dongting Lake, Honghu Lake, and Chihu Lake were 2.85, 1.59, and 3.57 mg·kg-1, respectively. The concentrations of Cd were 25.87, 11.36, and 37.58 times higher than the soil background values of the corresponding provinces, which exceeded the risk screening value (0.6 mg·kg-1). Particularly, the Cd concentration of Chihu Lake exceeded the risk control value (3.0 mg·kg-1). Besides Cd, the concentration of As in Honghu Lake was also of concern. At the same time, the Cu, As, Zn, and Pb in Chihu Lake should not be neglected. The potential ecological risks of the three lakes were ranked as follows:Chihu Lake (RI=1 127)>East Dongting Lake (RI=831)>Honghu Lake (RI=421). The primary sources of heavy metals were industrial mining, agricultural production, and aquaculture, and some heavy metals (Mn and Cu) were from natural sources. This study was of great significance for the prevention and control of heavy metals in the sediments of typical lakes in the middle reaches of the Yangtze River.

ATGL promotes colorectal cancer growth by regulating autophagy process and SIRT1 expression.

CRC is a common malignant tumor in the gastrointestinal tract, and its incidence has increased significantly in recent years. Several studies revealed that lipid metabolism reprogramming contributed to tumorigenicity and malignancy by interfering with energy production, membrane formation, and signal transduction in cancers. ATGL is a kind of hydroxy fatty acid ester of fatty acid synthase, and its role in tumor remains controversial. We compared levels of adipose triglyceride lipase (ATGL) in human CRC specimens to adjacent specimens. To validate the effect of ATGL on the proliferation ability of CRC, CCK8 assay and clone formation assay were performed. To evaluate whether autophagy process takes part in the effect of ATGL on CRC proliferation, the value of LC3-II/LC3-I was detected by western blot and we blocked the SIRT1 to detect value of LC3-II/LC3-I and p62 via western blot. In the end, we detected the value of SIRT1 in CRC specimens. We found that ATGL showed high expression in CRC and positively correlated with clinical stage, indicating poor prognosis of CRC. Moreover, ATGL significantly promoted tumor cell proliferation in vitro. Mechanistically, ATGL promoted CRC cells proliferation by blocking mTOR signaling pathway and activating autophagy process. Further, ATGL regulated autophagy process through triggering SIRT1 expression. Our results reveal that ATGL promotes colorectal cancer growth by up regulating autophagy process and SIRT1 expression.

A new combination and a new synonym of Gesneriaceae in China.

Didymocarpussubpalmatinervis W.T.Wang was shown to be conspecific with Petrocodonlithophilus Y.M.Shui, W.H.Chen & Mich.Möller, by checking original literature, examining specimens, tracing specimen collecting history, and conducting field surveys. The results show morphological characteristics and geographical distribution overlaps between these two species. The transfer of Didymocarpussubpalmatinervis to Petrocodon as a new combination with Petrocodonsubpalmatinervis (W.T.Wang) F.Wen & Z.L.Li is proposed here, and P.lithophilus is synonymized with P.subpalmatinervis. Color photographs and essential information are also provided, including a detailed comparison of description, distribution, habitat, and the proposed IUCN conservation status.

Aerobic bacteria produce nitric oxide via denitrification and promote algal population collapse.

Microbial interactions govern marine biogeochemistry. These interactions are generally considered to rely on exchange of organic molecules. Here we report on a novel inorganic route of microbial communication, showing that algal-bacterial interactions between Phaeobacter inhibens bacteria and Gephyrocapsa huxleyi algae are mediated through inorganic nitrogen exchange. Under oxygen-rich conditions, aerobic bacteria reduce algal-secreted nitrite to nitric oxide (NO) through denitrification, a well-studied anaerobic respiratory mechanism. The bacterial NO is involved in triggering a cascade in algae akin to programmed cell death. During death, algae further generate NO, thereby propagating the signal in the algal population. Eventually, the algal population collapses, similar to the sudden demise of oceanic algal blooms. Our study suggests that the exchange of inorganic nitrogen species in oxygenated environments is a potentially significant route of microbial communication within and across kingdoms.

Establishment and Validation of Nomogram Based on Combination of Pretreatment C-Reactive Protein/Albumin Ratio-EBV DNA Grade in Nasopharyngeal Carcinoma Patients Who Received Concurrent Chemoradiotherapy.

BACKGROUND: A higher ratio of pretreatment C-reactive protein/albumin ratio (CAR) is associated with poor prognosis in nasopharyngeal carcinoma (NPC), and Epstein-Barr virus (EBV) DNA level is known to not only participate in the occurrence of nasopharyngeal carcinoma but also affect the development and prognosis of the disease. Herein, we proposed that a combination of both these markers could improve the predictive prognostic ability. METHODS: In all, 842 NPC patients who received concurrent chemoradiotherapy (CCRT) were entered in this study. We collected all patients' blood samples and EBV DNA copy numbers within one week before any treatment. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off. We employed the Kaplan-Meier method for survival analyses and the univariate and multivariate analyses (Cox proportional hazards regression model) for statistical analysis. A nomogram was constructed based on multivariate analyses results of the validation set. The model was internally validated using 1000 bootstrap samples to avoid overfitting. Another validation of 10-fold cross-validation was also applied. Calibration curves and concordance index (C-index) were calculated to determine predictive and discriminatory capacity. RESULTS: In the whole cohort, we observed that higher CAR, EBV DNA level, and CAR-EBV DNA (C-E) grade were associated with shorter overall survival (OS) and distant metastasis-free survival (DMFS) (all P<0.05). In univariate and multivariate analyses, C-E grade was an independent prognostic factor (all P<0.05). In the training set, we gained the similar results with the whole set. According to multivariate analyses of the training set, we constructed a nomogram. The results of bootstrap samples and 10-fold cross-validation showed favorable predictive efficacy. And calibration curves of the model provided credibility to its predictive capability. CONCLUSION: C-E grade was confirmed as an independent prognostic predictor in patients with NPC who received CCRT. Higher level of pretreatment C-E grade could signify a higher risk of metastasis and shorter OS. The prognostic nomogram based on C-E grade was dependable in nasopharyngeal carcinoma patients.

Identification of a new azoreductase driven prodrug from bardoxolone methyl and 5-aminosalicylate for the treatment of colitis in mice.

For local treatment of ulcerative colitis, a new azoreductase driven prodrug CDDO-AZO from bardoxolone methyl (CDDO-Me) and 5-aminosalicylate (5-ASA) was designed, synthesized and biologically evaluated. It is proposed that orally administrated CDDO-AZO is stable before reaching the colon, while it can also be triggered by the presence of azoreductase in the colon to fragment into CDDO-Me and 5-ASA, generating potent anti-colitis effects. Superior to olsalazine (OLS, a clinically used drug for ulcerative colitis) and CDDO-Me plus 5-ASA, CDDO-AZO significantly attenuated inflammatory colitis symptoms in DSS-induced chronic colitis mice, which suggested that CDDO-AZO may be a promising anti-ulcerative colitis agent.

Performance Comparison between the Nanoporous NiO x Layer and NiO x Thin Film for Inverted Perovskite Solar Cells with Long-Term Stability.

The development of hole-transport layers (HTLs) that elevate charge extraction, improve perovskite crystallinity, and decrease interfacial recombination is extremely important for enhancing the performance of inverted perovskite solar cells (PSCs). In this work, the nanoporous nickel oxide (NiO x ) layer as well as NiO x thin film was prepared via chemical bath deposition as the HTL. The sponge-like structure of the nanoporous NiO x helps to grow a pinhole-free perovskite film with a larger grain size compared to the NiO x thin film. The downshifted valence band of the nanoporous NiO x HTL can improve hole extraction from the perovskite absorbing layer. The device based on the nanoporous NiO x layer showed the highest efficiency of 13.43% and negligible hysteresis that was better than the one using the NiO x thin film as the HTL. Moreover, the PSCs sustained 80% of their initial efficiency after 50 days of storage. This study provides a powerful strategy to design PSCs with high efficiency and long-term stability for future production.

Chayamaritia vietnamensis (Gesneriaceae), a new species from Son La Province, northern Vietnam.

Chayamaritia vietnamensis, a new species from Son La Province, northern Vietnam, is described and illustrated. The phylogenetic study revealed that the new species is most closely related to C. banksiae and C. smitinandii. The morphological comparison suggests it as the third new species of Chayamaritia and distinguished from C. banksiae and C. smitinandii by a combination of morphological characters of leaf blades, bracts, calyx and corolla, especially its peltate leaf blades. This species is provisionally assessed as endangered (EN B1ab(iii), B2ab(iii)) using IUCN Categories and Criteria. Information on ecology, phenology and an identification key for the known Chayamaritia species are also provided.

The complete chloroplast genome sequence of Achimenes cettoana (Gesneriaceae).

Achimenes Pers. is well known for its floral diversity and widely used in horticulture, but its phylogenetic position is still poorly understood. And most research about the complete chloroplast genome sequence focused on the Old World species; therefore, we think it is necessary to examine taxa of the New World in more detail. This study determined the complete chloroplast genome of Achimenes cettoana H.E. Moore. The cp genome was 153,011 bp in a total length containing two inverted repeats (IRs) of 25,162 bp separated by a large single-copy (LSC) region of 84,669 bp and a small single-copy (SSC) region of 18,018 bp. The whole cp genome of A. cettoana contains 112 genes, including 79 protein-coding genes, 29 tRNA genes, and four rRNA genes. This plastid genome is firstly reported in the New World Gesneriaceae, which will be a valuable resource for future studies on breeding, conservation genetics, and phylogeny of Gesneriaceae.

The complete chloroplast genome of Damnacanthus indicus C.F.Gaertn. (Rubiaceae).

Damnacanthus indicus C.F.Gaertn. is an understorey shrub widely distributed in East Asia. In this study, the complete chloroplast genome of D. indicus was assembled and annotated. The chloroplast genome is 153,997 bp in total length, consisting of a large single-copy region (LSC 85,159 bp), a small single-copy region (SSC 17,584 bp) and two inverted repeat regions (25,627 bp for IRA and IRB,respectively). It contains 134 genes, including 89 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. The phylogenetic analysis indicated that D. indicus is sister to Mitchella repens, suggesting a close relationship of the two genera.

An image-based approach for quantitative assessment of uniformity in particle distribution of noise reduction material.

Under the background of noise pollution caused by railway development, noise reduction material is worthy of in-depth study. A uniform distribution of particles in the material has an important influence on sound absorption property. In this article, the relevant image processing technology is applied to get structure information to quantify the uniformity. The main contributions of this study are: (a) In the preprocessing stage, SEM cross-sectional image of material is processed by mean filter and histogram equalization. Therefore, the grayscale and the contrast between target and background are enhanced, and a low-quality image is transformed into a high-quality one. (b) In the locating stage, local details of the image are considered to discriminate each particle from the whole image. When a global threshold is combined with the local iteration threshold, an improved Otsu algorithm is designed to binarize the image. Through morphology transforming, area filtering, and hole filling, the connected domain of target can be found and particles are located. (c) In the assessing stage, area index, number index and local distance index are established for assessing the uniformity of pore distribution. The experimental results indicate that statistical analysis is consistent with human visual observation. The smaller the porosity is, the better the uniformity is. Compared with some important methods, the effectiveness and efficiency of the proposed approach could be illustrated.

A carrier-free anti-inflammatory platinum (II) self-delivered nanoprodrug for enhanced breast cancer therapy.

Cisplatin is one of the most used first-line anticancer drugs for various solid tumor therapies. However, cisplatin-based chemotherapy can induce tumor cells to secrete excessive prostaglandin E2 (PGE2) catalyzed by cyclooxygenase-2 (COX-2), which, in turn, counteracts its chemotherapeutic effect and further accelerates tumor metastasis. Here, we report a carrier-free self-delivered nanoprodrug based on platinum (II) coordination bonding coupled with tolfenamic acid (Tolf) (named Tolfplatin). Tolfplatin can spontaneously assemble into uniformly sized nanoparticles (NPs) with a high drug-loading capacity. Compared with cisplatin, Tolfplatin NPs can facilitate cellular uptake, significantly decrease PGE2 secretion by COX-2 inhibition, which further downregulate tumorous anti-apoptotic and metastasis-associated proteins, thereby efficiently inducing apoptotic cell death and significantly inhibit tumor metastasis in vitro and in vivo. Therefore, as the carrier-free nanoprodrug, Tolfplatin NPs are promising anti-tumoral agents to inhibit tumor proliferation and metastasis by enriching the function and promoting the anti-tumor activity of cisplatin.

Effect of Capecitabine Maintenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment: The SYSUCC-001 Randomized Clinical Trial.

Importance: Among all subtypes of breast cancer, triple-negative breast cancer has a relatively high relapse rate and poor outcome after standard treatment. Effective strategies to reduce the risk of relapse and death are needed. Objective: To evaluate the efficacy and adverse effects of low-dose capecitabine maintenance after standard adjuvant chemotherapy in early-stage triple-negative breast cancer. Design, Setting, and Participants: Randomized clinical trial conducted at 13 academic centers and clinical sites in China from April 2010 to December 2016 and final date of follow-up was April 30, 2020. Patients (n = 443) had early-stage triple-negative breast cancer and had completed standard adjuvant chemotherapy. Interventions: Eligible patients were randomized 1:1 to receive capecitabine (n = 222) at a dose of 650 mg/m2 twice a day by mouth for 1 year without interruption or to observation (n = 221) after completion of standard adjuvant chemotherapy. Main Outcomes and Measures: The primary end point was disease-free survival. Secondary end points included distant disease-free survival, overall survival, locoregional recurrence-free survival, and adverse events. Results: Among 443 women who were randomized, 434 were included in the full analysis set (mean [SD] age, 46 [9.9] years; T1/T2 stage, 93.1%; node-negative, 61.8%) (98.0% completed the trial). After a median follow-up of 61 months (interquartile range, 44-82), 94 events were observed, including 38 events (37 recurrences and 32 deaths) in the capecitabine group and 56 events (56 recurrences and 40 deaths) in the observation group. The estimated 5-year disease-free survival was 82.8% in the capecitabine group and 73.0% in the observation group (hazard ratio [HR] for risk of recurrence or death, 0.64 [95% CI, 0.42-0.95]; P = .03). In the capecitabine group vs the observation group, the estimated 5-year distant disease-free survival was 85.8% vs 75.8% (HR for risk of distant metastasis or death, 0.60 [95% CI, 0.38-0.92]; P = .02), the estimated 5-year overall survival was 85.5% vs 81.3% (HR for risk of death, 0.75 [95% CI, 0.47-1.19]; P = .22), and the estimated 5-year locoregional recurrence-free survival was 85.0% vs 80.8% (HR for risk of locoregional recurrence or death, 0.72 [95% CI, 0.46-1.13]; P = .15). The most common capecitabine-related adverse event was hand-foot syndrome (45.2%), with 7.7% of patients experiencing a grade 3 event. Conclusions and Relevance: Among women with early-stage triple-negative breast cancer who received standard adjuvant treatment, low-dose capecitabine maintenance therapy for 1 year, compared with observation, resulted in significantly improved 5-year disease-free survival. Trial Registration: ClinicalTrials.gov Identifier: NCT01112826.

Prognostic significance of the Controlling Nutritional Status (CONUT) score in surgically treated breast cancer patients.

BACKGROUND: Breast cancer is one of the most common malignancy in women with high mortality rate. Given the growing evidence shows that immune-inflammatory system influences the survival of patients with cancer, we assessed the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in patients with breast cancer who underwent surgery. METHODS: We conducted a retrospective analysis of 1,367 breast cancer patients who underwent surgery between December 2010 and October 2012. All individual preoperative serum albumin concentration, total cholesterol concentration, and total peripheral lymphocyte count were counted to calculate CONUT. Higher CONUT score is in line with worse nutritional status. The optimal cut-off of CONUT score was set at 3 to categorize the investigated patients into two groups, namely a high- or low-CONUT score group. We adopted univariate and multivariate analyses (Cox proportional hazards regression model) statistical method. RESULTS: Patients in the high-CONUT score group had shorter overall survival (OS) and recurrence-free survival (RFS) in comparison with those in the low-CONUT score group, 66.43 vs. 69.30 months and 54.70 vs. 59.98 months respectively (all P value <0.05). Univariate and multivariate analyses revealed that the CONUT score was an independent predictor of OS (P=0.029 and 0.046, respectively) and RFS (P=0.001, P=0.013, respectively). CONCLUSIONS: The CONUT score was identified as an independent prognostic indicator in surgically treated breast cancer patients, indicating that, compared with the low CONUT score, a high CONUT score may lead to poorer prognosis.

The Prognostic Prediction Value of Systemic Inflammation Score and the Development of a Nomogram for Patients With Surgically Treated Breast Cancer.

Background: Systemic inflammation score (SIS) has been verified as a novel prognostic indicator in several cancer types. However, its prognostic value in breast cancer remains unknown. Furthermore, a nomogram based on SIS is yet to be constructed for breast cancer. We conducted this study to explore the association between SIS and prognosis of breast cancer, and to construct a good prognostic nomogram model. Methods: A total of 1,180 breast cancer patients who underwent curative surgery between December 2010 and January 2013 were recruited. They were randomly assigned to the training set (n = 944) or the validation set (n = 236). All patient blood samples were collected within 1 week prior to operation. According to previous reports, SIS was calculated for all patients, who were then classified into two groups: high-SIS and low-SIS. The Kaplan-Meier method was employed for survival analyses, and univariate and multivariate analyses (Cox proportional hazards regression model) were used for prognostic assessment. A nomogram was constructed based on the results of multivariate analysis. Calibration curves and concordance index (C-index) were compiled to determine predictive and discriminatory capacity. Results: In the training set, the median follow-up time was 6.07 years. Patients in the high-SIS group had an average OS time of 68.05 months, which is shorter than that of the low-SIS group (72.87 months; P = 0.033). Patients in the high-SIS group had average RFS and DMFS times of 56.04 and 54.46 months, respectively, which are shorter than those of the low-SIS group (60.85 and 59.47 months, respectively; P = 0.247 and P = 0.032). Univariate and multivariate analyses revealed SIS to be an independent prognostic factor for OS and DMFS time. The nomogram for the training set indicated OS and DMFS C-indexes of 0.794 (95% CI, 0.772-0.816) and 0.712 (95% CI, 0.684-0.740), respectively. In the validation set, the OS and DMFS C-indexes were 0.889 (95% CI, 0.845-0.933) and 0.696 (95%. CI, 0.611-0.781), respectively. Conclusions: SIS was confirmed as an independent prognostic predictor among patients with breast cancer who had undergone surgery with curative intent. Higher preoperative SIS may indicate higher risk of metastasis and shorter overall survival time. The prognostic nomogram based on SIS was dependable for breast cancer patients who underwent curative surgery.

Primulina jiuyishanica (Gesneriaceae), a new species from Hunan, China.

Primulina jiuyishanica K. Liu, D.C. Meng & Z.B. Xin, a new species of Gesneriaceae from Hunan, China, is described and illustrated. The new species is morphologically similar to Primulina fimbrisepala (Hand.-Mazz.) Yin Z. Wang, but differs in its elliptic to broadly elliptic leaf blade with broadly cuneate base, peduncle densely pubescent with sparse glandular hairs, corolla throat with no purple spots inside, the yellow patch in the throat densely glandular-pubescent and pistil densely glandular-pubescent. Photographs and descriptions of the new species are provided below.

Two new species of Oreocharis (Gesneriaceae) from karst regions in Yunnan and notes on O. tetraptera and O. brachypoda from China.

Two new species of Gesneriaceae, Oreocharis aimodisca and O. longipedicellata, from the limestone area of Yunnan Province, China, are described and illustrated. Their morphological relationship with similar species is discussed and colour photographs, detailed descriptions, distribution and habitat, as well as the IUCN endangered status are provided. We also discuss the accuracy of the scientific names of the described species O. tetrapterus from Guangxi, China in 2019 and O. brachypodus from Guizhou, China, in 2015, and put forward corrections related to name form.

Monitoring oxidative stress, immune response, Nrf2/NF-κB signaling molecules of Rhynchocypris lagowski living in BFT system and exposed to waterborne ammonia.

The present study was implemented to evaluate oxidative stress, immune response, Nrf2 and NF-κB signaling molecules related genes expression of Rhynchocypris lagowski living in biofloc technology (BFT) system and exposed to waterborne ammonia. According to the differences of C:N ratios, the experiment was divided into four groups: C:N 10.8:1 (control group), C:N 15:1, C:N 20: 1 and C:N 25:1. The results demonstrated that BFT can effectively regulate water quality and promote growth, and the C:N 20:1 group has the most significant effect (P < 0.05). Besides, significant increases in immune enzymes (lysozyme, complement C3, C4, immunoglobulin M and nitric oxide synthase) and anti-inflammatory factor (IL-2) activity of R. lagowski were emerged in the treatment C:N 20:1 after the 56-d growth experiment and the challenging trial (P < 0.05). Comparing the antioxidant status of R. lagowski in liver and gut before and after ammonia stress: superoxide dismutase, total antioxidant capacity and catalase activity in treatments C:N 20:1 were significant increased (P < 0.05), while the level of malondialdehyde was marked lower than that in control. Meanwhile, treatment C:N 20:1 considerably upregulated Nrf2 signaling molecules related genes and significantly down-regulated the expression of pro-inflammatory factor gene in NF-κB signaling pathway compared with the control (P < 0.05). These results indicated that BFT could enhance growth, antioxidant and immune response and regulate Nrf2 and NF-κB related genes expression in R. lagowski, with most excellent effects in fish given C:N 20:1 group.

Design, synthesis, and biological evaluation of ligustrazine/resveratrol hybrids as potential anti-ischemic stroke agents.

To search for potent anti-ischemic stroke agents, a series of tetramethylpyrazine (TMP)/resveratrol (RES) hybrids 6a-t were designed and synthesized. These hybrids inhibited adenosine diphosphate (ADP)- or arachidonic acid (AA)-induced platelet aggregation, among them, 6d, 6g-i, 6o and 6q were more active than TMP. The most active compound 6h exhibited more potent anti-platelet aggregation activity than TMP, RES, as well as positive control ticlopidine (Ticlid) and aspirin (ASP). Furthermore, 6h exerted strong antioxidative activity in a dose-dependent manner in rat pheochromocytoma PC12 cells which were treated with hydrogen peroxide (H2O2) or hydroxyl radical (·OH). Importantly, 6h significantly protected primary neuronal cells suffered from oxygen-glucose deprivation/reoxygenation (OGD/R) injury, comparable to an anti-ischemic drug edaravone (Eda). Together, our findings suggest that 6h may be a promising candidate warranting further investigation for the intervention of ischemic stroke.