MASTRO I: Meta-Analysis and Systematic Review of thrombectomy stent retriever outcomes: comparing functional, safety and recanalization outcomes between EmboTrap, Solitaire and Trevo in acute ischemic stroke.

Aim: Stent-retriever (SR) thrombectomy has demonstrated superior outcomes in patients with acute ischemic stroke compared with medical management alone, but differences among SRs remain unexplored. We conducted a Systematic Review/Meta-Analysis to compare outcomes between three SRs: EmboTrap®, Solitaire™, and Trevo®. Methods: We conducted a PRISMA-compliant Systematic Review among English-language studies published after 2014 in PubMed/MEDLINE that reported SRs in ≥25 patients. Functional and safety outcomes included 90-day modified Rankin scale (mRS 0-2), mortality, symptomatic intracranial hemorrhage (sICH), and embolization to new territory (ENT). Recanalization outcomes included modified thrombolysis in cerebral infarction (mTICI) and first-pass recanalization (FPR). We used a random effects Meta-Analysis to compare outcomes; subgroup and outlier-influencer analysis were performed to explore heterogeneity. Results: Fifty-one articles comprising 9,804 patients were included. EmboTrap had statistically significantly higher rates of mRS 0-2 (57.4%) compared with Trevo (50.0%, p = 0.013) and Solitaire (45.3%, p < 0.001). Compared with Solitaire (20.4%), EmboTrap (11.2%, p < 0.001) and Trevo (14.5%, p = 0.018) had statistically significantly lower mortality. Compared with Solitaire (7.7%), EmboTrap (3.9%, p = 0.028) and Trevo (4.6%, p = 0.049) had statistically significantly lower rates of sICH. There were no significant differences in ENT rates across all three devices (6.0% for EmboTrap, 5.3% for Trevo, and 7.7% for Solitaire, p = 0.518). EmboTrap had numerically higher rates of recanalization; however, no statistically significant differences were found. Conclusion: The results of our Systematic Review/Meta-Analysis suggest that EmboTrap may be associated with significantly improved functional outcomes compared with Solitaire and Trevo. EmboTrap and Trevo may be associated with significantly lower rates of sICH and mortality compared with Solitaire. No significant differences in recanalization and ENT rates were found. These conclusions are tempered by limitations of the analysis including variations in thrombectomy techniques in the field, highlighting the need for multi-arm RCT studies comparing different SR devices to confirm our findings.

Serological biomarkers in autoimmune GFAP astrocytopathy.

Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a newly defined meningoencephalomyelitis. The pathogenesis of GFAP-A is not well understood. The present study measured the expression levels of 200 serological cytokines in GFAP-A patients, NMOSD patients and healthy controls (HCs). The correlations between serum cytokine levels and clinical information in GFAP-A patients were analyzed. A total of 147 serological proteins were differentially expressed in GFAP-A patients compared to HCs, and 33 of these proteins were not observed in NMOSD patients. Serum levels of EG-VEGF negatively correlated with GFAP antibody titers, MIP-3 alpha positively correlated with clinical severity in GFAP-A patients, and LIGHT positively correlated with WBC counts and protein levels in the CSF of GFAP-A patients. These results suggest that GFAP and AQP4 astrocytopathy share some common pathology related to TNF signaling. Serum MIP 3 alpha may be a biomarker to assess clinical severity and a potential target for therapy of autoimmune GFAP astrocytopathy.

Serum molecular biomarkers in neuromyelitis optica and multiple sclerosis.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a rare and severe inflammatory demyelinating disorder of the central nervous system (CNS), which mainly affects the optic nerves and spinal cord. The aims of this study were to determine whether the expression levels of serological cytokines could distinguish 1) NMOSD from healthy controls (HCs); and 2) NMOSD patients with and without the aquaporin-4 (AQP4) antibody biomarker from each other; and 3) NMOSD patients without the antibody to AQP4 from MS patients. METHODS: The expression levels of 200 proteins in serum from 41 NMOSD (32 with antibodies to AQP4, 9 without antibodies to AQP4), 12 MS patients, and 34 HCs were measured using glass-based antibody arrays. None of the patients received any immunosuppressive treatment. In parallel, the correlation between protein expression in NMOSD/MS patients and clinical traits was determined with Weighted Gene Co-expression Network Analysis (WGCNA). RESULTS: Thirty-nine serological proteins were differentially expressed in NMOSD patients compared to HCs, with 29 of these proteins not observed in MS patients. In addition, the data reveal 15 differentially-expression proteins (DEPs) between AQP4-IgG seronegative and AQP4-IgG seropositive NMOSD patients, and 9 DEPs between NMOSD and MS patients who did not have AQP4-IgG. CONCLUSION: Serological IL-17B is significantly upregulated in both NMOSD and MS patients compared to HCs, and could be a key biomarker of NMOSD and MS. Serological VEGF, MPIF-1 and NrCAM were positively associated with AQP4-IgG titer. We also demonstrate that EGF may be involved in the breakdown of the BBB by downregulating Claudin-5.

[Characteristics of grassland degradation and its relationship with climate factors on Qinghai-Tibetan Plateau, China]. / é’è—é«˜åŽŸè‰åœ°é€€åŒ–ç‰¹å¾åŠå ¶ä¸Žæ°”å€™å› å­çš„å ³ç³».

Understanding the distribution, characteristics, and changing trend and persistence of grassland degradation and revealing its mechanism on the Qinghai-Tibetan Plateau can provide scientific basis for effective grassland management and conservation. We selected grassland coverage as the remote sensing monitoring index to establish the remote sensing monitoring and evaluation index system of grassland degradation and evaluate grassland degradation during 2016 to 2020 on the Qinghai-Tibet Plateau. The changing trend and persistence of grassland coverage were analyzed using linear regression and Hurst index analysis on a long time series scale (1982-2020). The partial correlation analysis was used to examine the influence of climate on grassland degradation. The results showed that grassland degradation reached 24.3% during 2016 to 2020, which was mainly light and moderate degradation, and largely distributed in low altitude and high fractional vegetation cover areas. From 1982 to 2020, grassland coverage tended to increase in the north, west and southwest, and decreased in the east and center of the Qinghai-Tibetan Plateau. The Hurst index of grassland coverage was less than 0.5 in 98.1% of the total grassland, indicating grassland coverage showed negatively persistent. The partial correlation coefficient between grassland coverage and precipitation (0.096) was higher than that of temperature (-0.033). About 16.0% area was dominated by temperature, which was mainly distributed in the central and southeast. About 12.2% area was dominated by precipitation, which was distributed in the northeast and west of the Qinghai-Tibetan Plateau.

[Responses of Different Degradation Stages of Alpine Wetland on Soil Microbial Community in the Yellow River Source Zone].

MiSeq sequencing technology was used to analyze the microbial community diversity of soil in alpine wetlands to understand the degradation processes and environmental factors in these areas. The results showed that the severity of soil degradation changed the species diversity of soil microorganisms at the level of OTUs, and grass patches contained more species than frozen-thawing patches. The soil fungi species of OTUs changed significantly. The diversity indexes of bacteria (between the frozen-thawing patches and the grass patches) were higher than that of fungi. The dominant microbial species were consistent among different degradation stages. The dominant species of bacteria and fungi were Proteobacteria and RB41, and Ascomycota and Mortierella, respectively. The abundance of dominant microorganisms was significantly between un-degraded and heavily degraded areas, except for RB41 (P<0.05). The dominant microorganisms in the grass patches were more sensitive than those in the frozen-thawing patches. It was found that the main factors affecting the microbial community structure of soil were water content, organic carbon, microbial biomass carbon, microbial biomass nitrogen, and sedge coverage. Microbial diversity may decrease in heavily degraded alpine wetlands. Thus, the frozen-thawing patches and sedge species should be first protected, and the supplements of soil water content, soil organic carbon, microbial biomass carbon, and nitrogen should be strengthened for alpine wetland restoration.

Diagnostic ability of ganglion cell complex thickness to detect glaucoma in high myopia eyes by Fourier domain optical coherence tomography.

AIM: To evaluate the ability of macular ganglion cell complex (GCC) thickness using Fourier domain optical coherence tomography (FD-OCT) to detect glaucoma in highly myopic eyes. METHODS: Cross-sectional study. A total of 114 participants, consecutively were enrolled. Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were obtained with RTVue FD-OCT. Receiver operating characteristics curves were constructed for each measurement parameter, and areas under the curves (AUCs) were compared. RESULTS: Both the average GCC and average RNFL thickness showed negative correlations with axial length (rGCC=-0.404, P=0.001; rRNFL=-0.561, P<0.001). The largest AUCs from GCC, and RNFL parameters were 0.968 [global loss volume (GLV)], and 0.855 (average RNFL), respectively. GLV was significantly better for detecting high myopic glaucoma than average RNFL (P<0.001). CONCLUSION: Macular GCC thickness has higher diagnostic power than peripapillary RNFL thickness to discriminate glaucoma patients from non-glaucoma subjects in high myopia.

A pilot study of intraocular lens explantation in 69 eyes in Chinese patients.

AIM: To study the effects of intraocular lens (IOL) explantation and demographic characteristics. METHODS: Retrospective non-comparative case series. Clinical data recorded from patient charts included the following: demographic, preoperative and postoperative characteristics; complications; surgical methods, and changes in visual acuity. RESULTS: A total of 69 eyes in 67 Chinese patients who received IOL explants were studied. The patients' mean age at the time of explantation was 46.1 years old [SD 22.5 (6-85)], and 37 patients were female (55.2%). Regarding employment, 47.8% were farmers, 23.9% were retired, 16.4% were students, 4.5% were unemployed, 3% were workers, and 4.5% were other (including staff members, teachers and officers). The main reasons for explantation were dislocation/decentration in 41 cases (59.4%) and retinal detachment in 10 cases (14.5%). The third most prevalent cause was incorrect lens power in 7 eyes (10.1%). The remaining reasons were endophthalmitis in 6 cases (8.7%), posterior capsular opacity in 3 eyes (4.3%), and impacting retinal surgery operation in 2 cases (2.9%). The main comorbidities were high myopia in 18 eyes (26.1%), trauma in 8 eyes (11.6%), retinal detachment in 6 eyes (8.7%), congenital cataracts in 8 eyes (11.6%), and Marfan's syndrome in 2 eyes (2.9%). The mean time from implantation to explantation was 4.0y [SD 4.2 (0.005-15)]. Treatment after explantation included posterior chamber IOL implantation in 44 eyes (63.8%) and aphakia in 25 eyes (36.2%). After surgery, the best corrected visual ability (BCVA) was improved in 50 cases (72.5%), including 28 patients (40.6%) in whom visual ability was improved by more than two lines. CONCLUSION: Dislocation/decentration is the main cause for explantation, and high myopia is a main risk factor. Posterior chamber IOL implantation remains the most elected treatment after explantation.

Exome sequencing identifies a novel mutation in GJA8 associated with inherited cataract in a Chinese family.

BACKGROUND: Congenital cataract is a clinical and genetic heterogeneous group of eye disorders that causes visual impairment and childhood blindness. In this study, a Chinese family with congenital cataract is studied. METHODS: In order to identify the genetic defects which were associated with congenital cataract, a whole-exome sequencing approach is performed to screen for the potential mutation-causing disease. RESULTS: The result revealed a novel heterozygous mutation (c.433G > T; p.G145W) in exon 2 the of GJA8 gene, which can be detected in all affected individuals, but not the unaffected family members. Meanwhile, this novel mutation cannot be retrieved in 100 healthy local Chinese controls and five other SNPs databases (dbSNP, ESP, ExAC, HTD and HGVD). Moreover, p.G145W was predicted as a mutation with pathogenicity by using bioinformatics methods, including PolyPhen-2, SIFT, PROVEAN, SNPs3D and the mutation significance cutoff (MSC). However, molecular function analysis of this novel mutation (p.G145W, GJA8) indicated that it did not affect the subcellular distributions and the trafficking of GJA8 protein to the plasma membrane. The truth of pathogenic significance with this novel mutation in GJA8 gene needed to be further studied. CONCLUSIONS: The c.433G > T (p.G145W) mutation in the GJA8 gene was first reported to our best knowledge. The results of our study would further broaden the mutation spectrum of GJA8 associated with congenital cataract.

Crocin prevents retinal ischaemia/reperfusion injury-induced apoptosis in retinal ganglion cells through the PI3K/AKT signalling pathway.

Crocin is a pharmacologically active component of Crocus sativus L. (saffron) and has been reported to be useful in the treatment of neuronal damage. In the present study, we investigated the neuroprotective effect of crocin on retinal ganglion cells (RGCs) after retinal ischaemia/reperfusion (IR) injury, and our results show that crocin acts through the PI3K/AKT signalling pathway. Retinal IR injury was induced by raising the intraocular pressure of Sprague-Dawley rats to 110 mmHg for 60 min. The neuroprotective effect of crocin was determined by quantifying the surviving RGCs and apoptotic RGCs following IR injury by means of retrograde labelling and TUNEL staining, respectively. The phosphorylated AKT protein level was determined by western blot and immunohistochemical analysis. To determine the extent to which the PI3K/AKT pathway contributes to the neuroprotective effect of crocin, experiments were also performed using the PI3K inhibitor LY294002. Compared with the IR + vehicle group, crocin (50 mg/kg) treatment enhanced RGC survival by approximately 36% and decreased RGC apoptosis by 44% after retinal IR injury. Western blot and immunohistochemical analysis demonstrated that the PI3K/AKT pathway was activated by crocin in the ganglion cell layer after retinal IR injury. Intravitreal injection of LY294002 blocked the neuroprotective effect of crocin on IR-induced RGC death. In conclusion, crocin prevents retinal IR-induced apoptosis of RGCs by activating the PI3K/AKT signalling pathway.

[The effect of copolymer-1 on the apoptosis and the IL-6R expression of the retinal ganglion cells in chronic elevated intraocular pressure rat model].

AIM: To observe the effect of autoimmune response induced by copolymer-1 (COP-1) on apoptosis of retinal ganglion cells (RGCs) and IL-6R expression on the RGCs in chronic elevated intraocular pressure (EIOP) rat models. METHODS: Thirty SD rats were randomly divided into 3 groups, namely normal control group, mock-immunized EIOP group and COP-1-immunized EIOP group. Cauterization of episcleral vein was used to set up rat's EIOP model. The normal control rats were not immunized, whereas the rats in the other two groups were immunized via i.p injection with normal saline and COP-1 at hindfeet, respectively. The expression of the IL-6R on RGCs was detected by immunohistochemical staining. The apoptosis of the RGCs was examined by TUNEL staining. RESULTS: The number of the apoptotic RGCs in the COP-1- immunized EIOP group was notably lower than that in mock-immunized EIOP group (P<0.05). IL-6R were expressed on RGCs in all 3 groups, and expression level of IL-6R increased in the following order: normal control group, mock-immunized EIOP group and COP-1-immunized EIOP group (P<0.05). CONCLUSION: The autoimmune response induced by COP-1 protects the RGCs from apoptosis under the condition of chronic EIOP and results in increased IL-6R expression on RGCs. These results suggest that increased IL-6R expression on RGCs induced by COP-1 immunization with the protection of neurons resulted from autoimmune response is related.

[Effects of extracts of ginkgo biloba (EGB) on levels of nitric oxide and apoptosis in the retina induced by glutamate in adult rabbits].

OBJECTIVE: To study the effects of extracts of ginkgo biloba (EGB) on the levels of nitric oxide (NO) and apoptosis in the retina induced by glutamate by intravitreal injection in adult rabbit. METHOD: The model of apoptosis in retina induced by glutamate by intravitreal injection was established in adult rabbit and EGB was retrobulbarly injected. The levels of NO were measured by spectrophotometer. Retina DNA fragmentation was determined by agarose gel electrophoresis. RESULT: The levels of NO in retina in experiment groups were significantly increased compared with controls, after treatment with high dosage of EGB, and levels of NO was decreased to normal. They were not decreased by injection of small dosage of EGB. DNA fragmentation of retina apoptosis was detected in experiment groups and small dosage EGB groups. CONCLUSION: The retina apoptosis was induced by glutamate by intravitreal injection in adult rabbit and was inhibited by EGB that may be through blocking the generation of NO free radicals.