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Purpose This study aimed to investigate the relationship between the artery diameter ratio (ADR) after recanalization and clinical outcomes. Methods Patients with middle cerebral artery occlusion confirmed by DSA from 1 January 2018, to 31 December 2019, were retrospectively analyzed. All patients confirmed TICI grade 2b or 3. The ADR was calculated as M2 segment diameter/M1 segment diameter. Multivariate regression analysis was used to describe clinical outcomes of two groups (ADR Results A total of 143 patients were included in the study, including 77 males and 66 females, with an average age of 67.79 ± 12 years. The NIHSS at discharge was significantly higher in the ADR 2 (AUC = 0.851) and DC (AUC = 0.805), and the best cutoff value are 0.6 (specificity 85.19%, sensitivity 75.81%) and 0.58 (specificity 65.96%, sensitivity 100%), respectively. Conclusion The low ADR is associated with poor outcomes. The decrease in ADR may be an indirect manifestation of the loss of cerebrovascular autoregulation.

In this study, the facile synthesis and electroluminescent perovskite light-emitting diodes (PeLEDs) of highly luminescent Cs4PbBr6/CsPbBr3 nanocomposite has been demonstrated. With the addition of...

BackgroundCapsular warning syndrome (CWS) is defined as recurrent episodes of transient ischaemic attacks ≥3 times during a short time frame. There is no effective therapy to stop these attacks. We, herein, report our experience of using intravenous tirofiban to treat CWS.MethodsAll patients with CWS in our hospital from January 2013 to September 2017 were reviewed. Patients in tirofiban group (T-group) were treated by intravenous tirofiban at 0.4 μg/kg/min for 30 min followed by 0.1–0.15 µg/kg/min infusion. Other treatments (non-T-group) included thrombolytic, oral antiplatelet agents and anticoagulant. Intracerebral haemorrhage (ICH), systematic bleeding, new attacks after treatment, National Institutes of Health Stroke Scale (NIHSS) scores at 24 hours and modified Rankin Scales (mRSs) at 3 months were recorded. Descriptive statistics were used for analysis.ResultsOf 23 patients qualified (15 in T-group, 8 in non-T-group), the duration of symptoms ranged from 2 to 100 min before treatments. After treatment, in T-group, four patients (26.7%) had recurrent attacks, and NIHSS scores were 0 in 11 patients (73.3%) at 24 hours. All patients reached a favourable outcome (mRS ≤2 at 3 months. In non-T-group, five patients (62.5%) had new attacks. NIHSS scores were 0 in two patients (25%) at 24 hours. At 3 months, seven patients (87.5%) reached a favourable outcome. Neither ICH nor systematic bleeding or thrombocytopaenia occurred in both groups of patients.ConclusionsIntravenous tirofiban can be a potentially effective and safe therapy to stop early symptomatic fluctuations and shorten the duration of functional deficits in patients with CWS.

Background There has been no effective treatment for acute ischemic stroke (AIS) patients who presented to the Emergency Department > 4.5 h without a visible arterial occlusion on the neurovascular imaging studies. In this study, we aimed to investigate whether intravenous antiplatelet agent tirofiban was safe and potentially effective in AIS patients who had no visible arterial occlusion and was outside of treatment window for Alteplase. The goal of this study was to collect preliminary data to plan a future phase II study. Method Twenty-five patients received intravenous tirofiban therapy. The safety outcomes were assessed by the incidence of symptomatic intracerebral hemorrhage (sICH), systematic bleeding and mortality. Efficacy outcomes were evaluated with National Institutes of Health Stroke Scale (NIHSS) score at day 7 (or discharge) and modified Rankin Scale (mRS) at 90 days. Outcomes for these patients were compared with a historical age-gender-admission-NIHSS matched cohort treated with aspirin and/or clopidogrel. Results The rate of intracerebral hemorrhage, systematic bleedings, and death were not found in both groups. At day 7 or discharge, the neurological function improved significantly in both treatment groups. However, the NIHSS score was lower in tirofiban group compared with the control group (2 vs.3, p = 0.045). At 3 months, more patients in tirofiban group had favorable outcomes (mRS 0–1) compared with control group (84% vs. 52%; adjusted odds ratio: 10.57; 95% CI: 1.54–72.33; p = 0.016). Conclusions Intravenous tirofiban appears to be safe and potentially effective for the ischemic stroke patients with no artery occlusion on neurovascular imaging studies and being out of the window for thrombolytic therapy. A next logic step is to plan for a phase II study.

Inflammatory Myofibroblastic Tumor (IMT) is a very rare neoplasm usually seen in young people and children [1]. While the lung is the most common site..

Primary gastrointestinal T-cell lymphoma is an uncommon entity and primary colon T-cell lymphoma is even rarer. The majority of enteropathy-associated T-cell lymphomas present predominantly as ulcers or strictures in the endoscopic examinations, while primary B-cell lymphomas commonly present as exophytic lesions. Ulcerative colon T-cell lymphoma may mimic Crohn's disease (CD), which is a chronic inflammatory disease of the intestines with ulcer and fistula formations difficult for clinicians to diagnose based on endoscopic observations alone. Like CD, T-cell lymphoma may be characterized by the presence of multiple skipped ulcers distributed from the terminal ileum to the descending colon. Furthermore, it is difficult to diagnose this unusual lymphoma by a single endoscopic biopsy. Typically, the histological composition of T-cell lymphoma is made of medium to large atypical cells located in the base of the ulcer with extension to the muscle layer and the adjacent mucosa. However, it is common that biopsy specimens show only mixed inflammatory changes where the lymphoma cells are hard to be identified. The differential diagnosis of malignant lymphoma must be considered when clinically diagnosed CD is refractory to the medical treatment or when its clinical behavior becomes aggressive. The current study presents a rare case of primary colon T-cell lymphoma in a 56-year-old male with marked recent weight loss, watery diarrhea and bilateral neck lymphadenopathy, who received a laboratory checkup and endoscopic workup for colon biopsy. The initial pathological report was consistent with mucosal inflammation and benign colon ulcers. Interestingly, the blood test showed a prominent eosinophilia. A biopsy of the enlarged neck lymph nodes done approximately 1 month after the colon biopsy unexpectedly showed T-cell lymphoma, which led to a review of the initial colonic biopsy specimens. Additional immunohistochemical stains were used accordingly, which showed positive results for CD3, CD45RO and LCA antibodies confirming the diagnosis of lymphoma. The endoscopic diagnosis of ulcerative colon T-cell lymphoma is frequently confused with inflammatory conditions of the large bowel such as CD, and tuberculosis colitis. Our study aims to emphasize the difficulty in differentiating this ulcerative form of colon T-cell lymphoma from the inflammatory bowel diseases and the importance of its differential diagnosis due to the much more aggressive clinical behavior of the T-cell lymphoma.

Background and Purpose— We investigated whether early initiation of tirofiban, a glycoprotein IIb/IIIa antagonist, is safe, can reduce the risk of reocclusion, and improve outcomes in acute ischemic stroke patients after alteplase. Methods— Forty-one patients received alteplase followed by intravenous tirofiban infusion for at least 24 hours. The incidence of symptomatic intracranial hemorrhage, systematic bleedings, and death was recorded. The National Institutes of Health stroke scale score was evaluated at 24 hours and at day 7 (or discharge). Modified Rankin scale was assessed at 3 months. Outcomes for these patients were compared with a propensity score–matched historical cohort with alteplase only. Results— The incidence of symptomatic intracranial hemorrhage, death, or systematic bleedings ( P =1.00) was not increased in the alteplase/tirofiban group. At 24 hours, fewer patients experienced reocclusion in the alteplase/tirofiban group (2.4% versus 22.0%; P =0.025). At day 7 or discharge, the median National Institutes of Health stroke scale score was significantly lower in the alteplase/tirofiban group (1 versus 6; P =0.002). At 3 months, more patients had favorable outcomes of modified Rankin scale 0 to 1 (70.7% versus 46.2%; P =0.026). Conclusions— Intravenous tirofiban immediately after alteplase seems to be safe and potentially more effective when compared with alteplase alone for selected stroke patients. Clinical Trial Registration— URL: http://www.chictr.org.cn/ . Unique identifier: ChiCTR-TRC-14004630.

Introduction: All over the world, Each year twelve million people develop ischemic stroke and 30-40% of them do not have visible arterial occlusions at presentation. Hypothesis: In this study, we aim to investigate whether intravenous antiplatelet agent tirofiban in acute ischemic stroke(AIS) patients without large arterial occlusion(LAO) is effect or safe. Material and methods: We performed an open-label study to collect data of patients without LAO and without thrombolytic therapy within 24 hours from the symptom onset.These patients were divided into 2 groups: those who received tirofiban(tirofiban group) and those who did not received tirofiban(control group).The safety endpoint was the incidence of symptomatic intracranial hemorrhage(SICH) within 72 hours. The efficacy outcome measure was the National Institutes of Health Stroke Scale (NIHSS) score improvement at 24 hours and 7 days and modified Rankin Scale (mRS) score ≤1 or return to baseline mRS at 90 days. Results: Of 105 subjects, 53 received Intravenous tirofiban and 52 did not receive it. No patients in our trial had SICH. At 90 days, 67.9%(36/53)of the tirofiban group had mRS ≤1 or return to baseline mRS versus 53.8%(28/52)in control group(P=0.032). At 24 hour in the hospital, the NIHSS score improvement was significantly higer in the tirofiban group compared with control group(p=0.004). At hospital day 7 or hospital discharge, the NIHSS score improved significantly in the tirofiban group compared with the control group (p=0.009). Conclusions: This study provided data that patients with ischemic stroke who did not have LAO and not receive thrombolysis therapy may benefit from Intravenous Tirofiban.

“Carbon source transfer” is a phenomena that High-carbon industries transfer from Annex I countries to Non-annex I countries. It's caused by the defect of international carbon emissions trading market. In this paper, on the background that the “common but differentiated responsibilities” of the “Kyoto Protocol”, we analyze the root cause and the mechanism of carbon source transfer, dissect the industrial transfer with the phenomenon that the “carbon flow” under the market mechanism, and put forward that the increase in carbon emissions of Non-annex I countries are caused by carbon source transfer of Annex I countries to some extent. Finally, it makes some comments and suggestions on decreasing the phenomenon of the international carbon source transfer, building a scientific, rational and equitable international carbon emissions trading market, and facing to the climate change together.

Basaloid follicular hamartoma (BFH) is a rare, benign, skin adnexal tumor. Several clinical patterns have been reported, but they all share the same histopathological features. BFH may be hereditary or nonhereditary and can be accompanied by systemic diseases. Microscopic examination of BFH shows branching cords and anastomosing strands of basaloid cells in a loose, fibrous stroma. The most important pathological differential diagnosis is infundibulocystic basal cell carcinoma. These two lesions must be differentiated carefully based on clinical presentation and histopathological picture, and even molecular studies may be needed. We present a report of a 78-year-old woman with a solitary, asymptomatic, slow-growing skin tumor on her left scalp. No associated systemic disorders were found. On the basis of an excisional biopsy performed on the tumor, a pathological diagnosis of sporadic BFH was made.