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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.

Scar endometriosis is uncommon and defined as the presence of ectopic endometrial glands in abdominal soft tissues after a gynecological operation. Malignant transformation has been reported but remains rare. Carcinogenesis occurs in ectopic endometrial tissue with repeated hormone stimulation during the menstrual cycle. We present a case of clear cell carcinoma directly arising from scar endometriosis after a cesarean section and review all 16 cases reported.

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..

Our previous studies showed that the transcription factor early growth response-1 (EGR1) may play a role in keeping the brain cholinergic function intact in the preclinical stages of Alzheimer's disease (AD). In order to elucidate the mechanisms involved, we first performed data mining on our previous microarray study on postmortem human prefrontal cortex (PFC) for the changes in the expression of EGR1 and acetylcholinesterase (AChE) and the relationship between them during the course of AD. The study contained 49 patients, ranging from non-demented controls (Braak stage 0) to late AD patients (Braak stage VI). We found EGR1-mRNA was high in early AD and decreased in late AD stages, while AChE-mRNA was stable in preclinical AD and slightly decreased in late AD stages. A significant positive correlation was found between the mRNA levels of these two molecules. In addition, we studied the relationship between EGR1 and AChE mRNA levels in the frontal cortex of 3-12-months old triple-transgenic AD (3xTg-AD) mice. EGR1- and AChE-mRNA were lower in 3xTg-AD mice compared with wild type (WT) mice. A significant positive correlation between these two molecules was present in the entire group and in each age group of either WT or 3xTg-AD mice. Subsequently, AChE expression was determined following up- or down-regulating EGR1 in cell lines and the EGR1 levels were found to regulate AChE at both the mRNA and protein levels. Dual-luciferase assay and electrophoretic mobility shift assay in the EGR1-overexpressing cells were performed to determine the functionally effective binding sites of the EGR1 on the AChE gene promoter. We conclude that the EGR1 can upregulate AChE expression by a direct effect on its gene promoter, which may contribute significantly to the changes in cholinergic function in the course of AD. The 3xTg-AD mouse model only reflects later stage AD. This article is protected by copyright. All rights reserved.

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.

Cystic nephroma of childhood is a rare renal tumor. It is generally considered as a benign end of the spectrum with cystic partially differentiated nephroblastoma and nephroblastoma (Wilms tumor). Most of the cases are unilateral and sporadic. However, bilateral and familial cases have also been reported. The clinical presentation is usually as an asymptomatic abdominal mass. It is almost impossible to differentiate cystic nephroma from cystic partially differentiated nephroblastoma or other cystic renal tumor on radiological studies. The final diagnosis depends on the histopathologic examination. We present a case of an 8-month-old female baby with a left renal tumor. The patient accepted left total nephrectomy after physical examinations and radiological studies. Microscopically, the tumor was composed of variable-sized cysts separated by fibrous septa without blastemal elements. A diagnosis of cystic nephroma was made.

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.

Background Primary jejunal gastrinomas are exceedingly rare, and data for long-term follow-up is limited. Until now, only six cases of gastrinomas arising from the jejunum have been reported in the English literature. Case Presentation Presented is a case of a primary gastrinoma located in the proximal jejunum. After surgical resection of the tumor, eugastrinemia was quickly achieved and after a 10-year follow-up period, the patient was still disease-free. Conclusions This case report demonstrates that surgical resection of a primary jejunal gastrinoma without evidence of metastasis can be curative, with a good long-term prognosis.

“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.