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Luo X, Yang B, Yuan J, An H, Xie D, Han Q, Zhou S, Yue C, Sang H, Qiu Z, Kong Z, Shi Z. Decompressive craniectomy for patients with malignant infarction of the middle cerebral artery: a pooled analysis of two randomized controlled trials. J Stroke Cerebrovasc Dis 2024:107719. [PMID: 38604351 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Decompressive craniectomy (DC) reduces mortality without increasing the risk of very severe disability among patients with life-threatening massive cerebral infarction. However, its efficacy was demonstrated before the era of endovascular thrombectomy trials. It remains uncertain whether DC improves the prognosis of patients with malignant middle cerebral artery (MCA) infarction receiving endovascular therapy. METHODS We pooled data from two trials (DEVT and RESCUE BT studies in China) and patients with malignant MCA infarction were included to assess outcomes and heterogeneity of DC therapy effect. Patients with herniation were dichotomized into DC and conservative groups according to their treatment strategy. The primary outcome was the rate of mortality at 90 days. Secondary outcomes included disability level at 90 days as measured by the modified Rankin Scale score (mRS) and quality-of-life score. The associations of DC with clinical outcomes were performed using multivariable logistic regression. RESULTS Of 98 patients with herniation, 37 received DC surgery and 61 received conservative treatment. The median (interquartile range) was 70 (62-76) years and 40.8% of the patients were women. The mortality rate at 90 days was 59.5% in the DC group compared with 85.2% in the conservative group (adjusted odds ratio, 0.31 [95% confidence interval (CI), 0.10-0.94]; P=0.04). There were 21.6% of patients in the DC group and 6.6% in the conservative group who had a mRS score of 4 (moderately severe disability); and 10.8% and 4.9%, respectively, had a score of 5 (severe disability). The quality-of-life score was higher in the DC group (0.00 [0.00-0.14] vs 0.00 [0.00-0.00], P=0.004), but DC treatment was not associated with better quality-of-life score in multivariable analyses (adjusted β Coefficient, 0.02 [95% CI, -0.08-0.11]; p=0.75). CONCLUSIONS DC was associated with decreased mortality among patients with malignant MCA infarction who received endovascular therapy. The majority of survivors remained moderately severe disability and required improvement on quality of life. CLINICAL TRIAL REGISTRATION The DEVT trial: http://www.chictr.org. Identifier, ChiCTR-IOR-17013568. The RESCUE BT trial: URL: http://www.chictr.org. Identifier, ChiCTR-INR-17014167.
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Affiliation(s)
- Xiaojun Luo
- Department of Cerebrovascular Diseases, Guangyuan Central Hospital, Guangyuan, China
| | - Bo Yang
- Department of Neurology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), Jiaozuo, China
| | - Junjie Yuan
- Department of Neurology, The 925th Hospital of The People's Liberation Army, Guiyang, China; Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
| | - Huijie An
- Department of Pharmacy, General Hospital of Southern Theatre Command, PLA, Guangzhou, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
| | - Qin Han
- Department of Neurology, The 903rd Hospital of The People's Liberation Army, Hangzhou, China
| | - Simin Zhou
- Department of Neurosurgery, The 904th Hospital of The People's Liberation Army, Wuxi, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongfei Sang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhenyu Kong
- Department of Neurology, The First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People's Hospital), Jiaozuo, China.
| | - Zhonghua Shi
- Department of Neurosurgery, The 904th Hospital of The People's Liberation Army, 101 North Xinyuan Road, Wuxi, China.
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Yang Q, Guo C, Yue C, Song J, Yang J, Peng Z, Yu N, Huang J, Li L, Huang J, Chen Y, Zheng C, Jiang S, Ruan Z, Zhang M, Song D, Luo X, Tian Y, Yang M, Deng S, Wei S, Wu Y, Tang Y, Yang D, Tan X, Zeng G, Cheng D, Liu W, He W, Cai T, Pan C, Liao J, Lei B, Pu S, Jin Z, Li J, Xia Z, Zhang G, Luo J, Sun Y, Xiong X, Wang J, Li B, Peng Y, Chen K, Shan Y, Zhou P, Huang X, Luo S, Zhang J, Liu C, Jiang L, Yang D, Tian Y, Hu J, Qiu Z, Ma J, Xu X, Fan S, Liu X, Xie D, Niu J, Zheng H, Ouyang Q, Wang D, Nguyen TN, Saver JL, Nogueira RG, Li F, Zi W. Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke: The MARVEL Randomized Clinical Trial. JAMA 2024; 331:840-849. [PMID: 38329440 PMCID: PMC10853866 DOI: 10.1001/jama.2024.0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023. Interventions Eligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability. Trial Registration ChiCTR.org.cn Identifier: ChiCTR2100051729.
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Affiliation(s)
- Qingwu Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhouzhou Peng
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Nizhen Yu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiandi Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yifei Chen
- Department of Neurology, Qujing No. 1 Hospital Affiliated Hospital of Kunming Medical University, Qujing, China
| | - Chong Zheng
- Department of Neurology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Shunfu Jiang
- Department of Neurology, Jingdezhen No. 1 People's Hospital, Jingdezhen, China
| | - Zhongfan Ruan
- Department of Neurology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Min Zhang
- Department of Neurology, Jiangmen Central Hospital, Jiangmen, China
| | - Dengwen Song
- Department of Neurology, Hospital 302 Attached to Guizhou Aviation Group, Anshun, China
| | - Xiaojun Luo
- Department of Cerebrovascular Diseases, Guangyuan Central Hospital, Guangyuan, China
| | - Yaoyu Tian
- Department of Neurology, Qian Xi Nan People's Hospital, Xingyi, China
| | - Mei Yang
- Department of Neurology, Dali Bai Autonomous Prefecture People's Hospital, Dali, China
| | - Shenglin Deng
- Department of Neurology, People's Hospital of Wushen County, Guang'an, China
| | - Shirong Wei
- Department of Neurology, The People's Hospital of Hechi and the Hechi Hospital Affiliated to Youjiang Medical University for Nationalities, Hechi, China
| | - Youlin Wu
- Department of Neurology, Chongzhou Hospital, Chongzhou, China
| | - Yufeng Tang
- Department of Neurology, Mianyang Central Hospital, Mianyang, China
| | - De Yang
- Department of Neurology, Chongqing University Fuling Hospital, Fuling, China
| | - Xiaolin Tan
- Department of Neurology, Meishan Second People's Hospital, Meishan, China
| | - Guoyong Zeng
- Department of Neurology, Ganzhou People's Hospital, Ganzhou, China
| | - Daoyou Cheng
- Department of Neurology, Xingyi People's Hospital, Xingyi, China
| | - Wenhua Liu
- Department of Neurology, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Wencheng He
- Department of Neurology, Guiping People's Hospital, Guiping, China
| | - Tieying Cai
- Department of Neurology, Yunyang County People's Hospital, Yunyang, China
| | - Chengde Pan
- Department of Neurology, People's Hospital of Chongqing Banan District, Banan, China
| | - Jiasheng Liao
- Department of Neurology, Suining First People's Hospital, Suining, China
| | - Bo Lei
- Department of Cerebrovascular Diseases, The People's Hospital of Leshan, Leshan, China
| | - Shengxiong Pu
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zhenglong Jin
- Department of Neurology, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Jinglun Li
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhongbin Xia
- Department of Neurology, Jiujiang University Affiliated Hospital, Jiujiang, China
| | - Guling Zhang
- Department of Neurology, The People's Hospital of Danzhai, Danzhai, China
| | - Jun Luo
- Department of Neurology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Yaxuan Sun
- Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, China
| | - Xiaoping Xiong
- Department of Neurology, Chongqing University Qianjiang Hospital, Qianjiang District, China
| | - Jian Wang
- Department of Neurology, Yaan People's Hospital, Ya'an, China
| | - Bo Li
- Department of Neurology, Bazhong Central Hospital, Bazhong, China
| | - Yuqi Peng
- Department of Neurology, Sichuan Science City Hospital, Mianyang, China
| | - Kechun Chen
- Department of Neurology, Zhangjiagang First People's Hospital, Zhangjiagang, China
| | - Yuanjun Shan
- Department of Neurology, Xiangzhou District People's Hospital, Xiangyang, China
| | - Peiyang Zhou
- Department of Neurology, Xiangyang No. 1 People's Hospital, Xiangyang, China
| | - Xinyuan Huang
- Department of Neurology, The Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang, China
| | - Shiwei Luo
- Department of Neurology, Jieyang People's Hospital, Jieyang, China
| | - Jie Zhang
- Department of Neurology, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, China
| | - Chang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, China
| | - Lin Jiang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dahong Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yan Tian
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinfu Ma
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xu Xu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shitao Fan
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiang Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jianqin Niu
- Department of Histology and Embryology, Army Medical University, Chongqing, China
| | - Hongting Zheng
- Department of Endocrinology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qin Ouyang
- Department of Medicinal Chemistry, Army Medical University, Chongqing, China
| | - Duolao Wang
- Global Health Trials Unit, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Thanh N Nguyen
- Department of Neurology, Radiology, Boston Medical Center, Boston, Massachusetts
| | - Jeffrey L Saver
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles
| | - Raul G Nogueira
- Department of Neurology and Neurosurgery, University of Pittsburgh, UPMC Stroke Institute, Pittsburgh, Pennsylvania
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Sang H, Cao Z, Du J, Nguyen TN, Saver JL, Mao A, Nogueira RG, Tao Z, Zhou S, Han Q, Sun D, Lei B, Liu S, Zeng G, Yin C, Xie D, Luo W, Jin Z, Qiu Z. Intravenous Tirofiban Versus Alteplase Before Endovascular Treatment in Acute Ischemic Stroke: A Pooled Analysis of the DEVT and RESCUE BT Trials. Stroke 2024. [PMID: 38362756 DOI: 10.1161/strokeaha.123.044562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND The present study aimed to evaluate the efficacy and safety of intravenous tirofiban versus alteplase before endovascular treatment (EVT) in acute ischemic stroke patients with intracranial large vessel occlusion. METHODS This was a post hoc analysis using data from 2 multicenter, randomized trials: the DEVT trial (Direct Endovascular Treatment for Large Vessel Occlusion Stroke) from May 2018 to May 2020 and the RESCUE BT trial (Intravenous Tirofiban Before Endovascular Thrombectomy for Acute Ischemic Stroke) from October 2018 to October 2021. Patients with acute intracranial large vessel occlusion within 4.5 hours from last known well were dichotomized into 2 groups: tirofiban plus EVT versus alteplase bridging with EVT. The primary outcome was functional independence (modified Rankin Scale score of 0-2) at 90 days. Safety outcomes included symptomatic intracranial hemorrhage and 3-month mortality. Multivariable logistic regression (adjusting for baseline systolic blood pressure, occlusion site, onset-to-puncture time, anesthesia, and first choice of EVT) and propensity score overlap weighting (balance in demographic covariates, stroke characteristics, and initial management between groups) were performed. RESULTS One-hundred and eighteen alteplase-treated patients in the DEVT trial and 98 tirofiban-treated patients in the RESCUE BT trial were included (median age, 70 years; 115 [53.2%] men). The rate of functional independence was 60.2% in the tirofiban group compared with 46.6% in the alteplase group (adjusted odds ratio, 1.25 [95% CI, 0.60-2.63]). Compared with alteplase, tirofiban was not associated with increased risk of symptomatic intracranial hemorrhage (6.8% versus 9.2%; P=0.51) and mortality (17.8% versus 19.4%; P=0.76). The propensity score overlap weighting analyses showed consistent outcomes. CONCLUSIONS Among patients with intracranial large vessel occlusion within 4.5 hours of onset, tirofiban plus EVT was comparable to alteplase bridging with EVT regarding the efficacy and safety outcomes. These findings should be interpreted as preliminary and require confirmation in a randomized trial. REGISTRATION URL: https://www.chictr.org.cn; Unique identifiers: ChiCTR-IOR-17013568 and ChiCTR-INR-17014167.
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Affiliation(s)
- Hongfei Sang
- Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, China (H.S., C.Y.)
| | - Zhihua Cao
- Xiangyang No. 1 People's Hospital, Hubei University of Medicine, China (Z.C.)
| | - Jie Du
- Kaizhou District People's Hospital, Chongqing, China (J.D.)
| | | | - Jeffrey L Saver
- David Geffen School of Medicine at University of California at Los Angeles (J.L.S.)
| | - An Mao
- The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China (A.M., Z.T., S.Z., Q.H., Z.Q.)
| | - Raul G Nogueira
- UPMC Stroke Institute, University of Pittsburgh School of Medicine, PA (R.G.N.)
| | - Zhaojun Tao
- The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China (A.M., Z.T., S.Z., Q.H., Z.Q.)
| | - Simin Zhou
- The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China (A.M., Z.T., S.Z., Q.H., Z.Q.)
| | - Qin Han
- The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China (A.M., Z.T., S.Z., Q.H., Z.Q.)
| | - Dong Sun
- Zhongnan Hospital, Wuhan University, China (D.S.)
| | - Bo Lei
- Leshan People's Hospital, China (B.L.)
| | - Shudong Liu
- Yongchuan Hospital of Chongqing Medical University, Chongqing Key Laboratory of Cerebrovascular Disease Research, China (S.L.)
| | | | - Congguo Yin
- Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, China (H.S., C.Y.)
| | - Dongjing Xie
- Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (D.X., W.L., Z.Q.)
| | - Weidong Luo
- Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (D.X., W.L., Z.Q.)
| | - Zhenglong Jin
- Department of Neurology, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, China (Z.J.)
| | - Zhongming Qiu
- Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (D.X., W.L., Z.Q.)
- The 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China (A.M., Z.T., S.Z., Q.H., Z.Q.)
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Li H, Guo W, Li S, Sun B, Li N, Xie D, Dong Z, Luo D, Chen W, Fu W, Zheng J, Zhu J. Alteration of the gut microbiota profile in children with autism spectrum disorder in China. Front Microbiol 2024; 14:1326870. [PMID: 38420215 PMCID: PMC10899803 DOI: 10.3389/fmicb.2023.1326870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024] Open
Abstract
Background Autism spectrum disorder (ASD) is associated with alterations in the gut microbiome. However, there are few studies on gut microbiota of children with ASD in China, and there is a lack of consensus on the changes of bacterial species. Purpose Autism spectrum disorder (ASD) is associated with alterations in the gut microbiome. However, there are few studies on gut microbiota of children with ASD in China, and there is a lack of consensus on the changes of bacterial species. Methods We used 16S rRNA sequencing to analyze ASD children (2 to 12 years), HC (2 to 12 years). Results Our findings showed that the α-diversity, composition, and relative abundance of gut microbiota in the ASD group were significantly different from those in the HC groups. Compared with the HC group, the α-diversity in the ASD group was significantly decreased. At the genus level, the relative abundance of g_Faecalibacterium, g_Blautia, g_Eubacterium_eligens_group, g_Parasutterella, g_Lachnospiraceae_NK4A136_group and g_Veillonella in ASD group was significantly increased than that in HC groups, while the relative abundance of g_Prevotella 9 and g_Agathobacter was significantly decreased than that in HC groups. In addition, KEGG pathway analysis showed that the microbial functional abnormalities in ASD patients were mainly concentrated in metabolic pathways related to fatty acid, amino acid metabolism and aromatic compound metabolism, and were partially involved in neurotransmitter metabolism. Conclusion This study revealed the characteristics of gut microbiota of Chinese children with ASD and provided further evidence of gut microbial dysbiosis in ASD.
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Affiliation(s)
- Hui Li
- Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Wei Guo
- Stroke Center, Puyang People's Hospital, Puyang, China
| | - Sijie Li
- Department of Pediatrics, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Bishao Sun
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ningshan Li
- Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zongming Dong
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Dan Luo
- Department of Neurology, Yunyang People's Hospital, Yunyang, China
| | - Wei Chen
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Weihua Fu
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ji Zheng
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jingzhen Zhu
- Department of Urology, Urologic Surgery Center, Xinqiao Hospital, Army Medical University, Chongqing, China
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Zhou G, Xie D, Fan R, Yang Z, Du J, Mai S, Xie L, Wang Q, Mai T, Han Y, Lai F. Comparison of Pulmonary and Extrapulmonary Models of Sepsis-Associated Acute Lung Injury. Physiol Res 2023; 72:741-752. [PMID: 38215061 PMCID: PMC10805253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/09/2023] [Indexed: 01/14/2024] Open
Abstract
To compare different rat models of sepsis at different time points, based on pulmonary or extrapulmonary injury mechanisms, to identify a model which is more stable and reproducible to cause sepsis-associated acute lung injury (ALI). Adult male Sprague-Dawley rats were subjected to (1) cecal ligation and puncture (CLP) with single (CLP1 group) or two repeated through-and-through punctures (CLP2 group); (2) tail vein injection with lipopolysaccharide (LPS) of 10mg/kg (IV-LPS10 group) or 20 mg/kg (IV-LPS20 group); (3) intratracheal instillation with LPS of 10mg/kg (IT-LPS10 group) or 20mg/kg (IT-LPS20 group). Each of the model groups had a sham group. 7-day survival rates of each group were observed (n=15 for each group). Moreover, three time points were set for additional experimental studying in each model group: 4 hours, 24 hours and 48 hours after modeling (every time point, n=8 for each group). Rats were sacrificed to collect BALF and lung tissue samples at different time points for detection of IL-6, TNF-alpha, total protein concentration in BALF and MPO activity, HMGB1 protein expression in lung tissues, as well as the histopathological changes of lung tissues. More than 50 % of the rats died within 7 days in each model group, except for the IT-LPS10 group. In contrast, the mortality rates in the two IV-LPS groups as well as the IT-LPS20 group were significantly higher than that in IT-LPS10 group. Rats received LPS by intratracheal instillation exhibited evident histopathological changes and inflammatory exudation in the lung, but there was no evidence of lung injury in CLP and IV-LPS groups. Rat model of intratracheal instillation with LPS proved to be a more stable and reproducible animal model to cause sepsis-associated ALI than the extrapulmonary models of sepsis.
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Affiliation(s)
- G Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Zhao L, Wu HY, Xie D, Mo LM, Yang FF, Gao Y, Zhao XL, He YZ. Investigations of clinical characteristics and inflammatory markers of febrile seizures induced by coronavirus infection. Trop Biomed 2023; 40:439-443. [PMID: 38308831 DOI: 10.47665/tb.40.4.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
The study of children who experienced with febrile seizures(FS) as a result of COVID-19 infection to gain insight into the clinical characteristics and prognosis of neurological damage, with the aim of improving prevention, diagnosis, and the treatment of neurological complications. This study investigated the clinical features of 53 children with FS who were admitted to Sanya Women and Children's Hospital from December 1, 2022, to January 31, 2023. The results indicated that the duration of convulsion in the case and control group was 7.90±8.91 and 2.67±1.23 (minutes) respectively. The analysis reveals that convulsions occurred within 24 hours in 39 cases (95.12%) of the case group, and in 8 cases (66.7%) of the control group. The difference was statistically significant (P<0.05). Additionally, the case group presented lower counts of WBC and NEU compared to the control group (p<0.05). The findings indicate that convulsions manifest at earlier stages of COVID-19 in children and the last longer than in the control group. It is therefore crucial for healthcare workers to remain attentive to patients with COVID-19 who report fever within 24 hours, and act promptly to implement preventive measures, particularly in cases of prolonged fever. It is essential to integrate the clinical manifestation, particularly convulsions, and the continuous numerical changes of inflammatory factors to assess COVID-19 linked with febrile seizures. In addition, larger-scale multi-center and systematic research are necessary to aid clinicians in monitoring neuropathological signals and biological targets, enabling more equitable diagnosis and treatment plans.
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Affiliation(s)
- L Zhao
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - H Y Wu
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - D Xie
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - L M Mo
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - F F Yang
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - Y Gao
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - X L Zhao
- Department of Pediatric intensive care unit, Sanya Women and Children's Hospital/AffIliated to Shanghai Jiao Tong University School of Medicine Shanghai Children's Medical Center Hainan Branch, Sanya 572000, China
| | - Y Z He
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Han YY, Zhang QH, Chen WS, Li ZL, Xie D, Zhang SL, Lu H, Wang LW, Xu ZH, Zhang LZ. Fermented rape pollen powder can alleviate benign prostatic hyperplasia in rats by reducing hormone content and changing gut microbiota. Benef Microbes 2023; 14:503-524. [PMID: 38656098 DOI: 10.1163/18762891-20230039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/22/2023] [Indexed: 04/26/2024]
Abstract
Benign prostatic hyperplasia (BPH) can cause urethral compression, bladder stone formation, and renal function damage, which may endanger the life of patients. Therefore, we aimed to develop plant-based preparations for BPH treatment with no side effects. In this study, the Lactiplantibacillus plantarum 322Hp, Lactobacillus acidophilus 322Ha, and Limosilactobacillus reuteri 322Hr were used to ferment rape pollen. The fermented rape pollen was subsequently converted into fermented rape pollen powder (FRPP) through vacuum freeze-drying technology. After fermenting and drying, the bioactive substances and antioxidant capacity of FRPP were significantly higher than those of unfermented rapeseed pollen, and FRPP had a longer storage duration, which can be stored for over one year. To investigate the therapeutic effect of FRPP on BPH, a BPH rat model was established by hypodermic injection of testosterone propionate. The BPH rats were treated differently, with the model group receiving normal saline, the positive control group receiving finasteride, and the low, medium, and high dose FRPP group receiving FRPP at doses of 0.14 g/kg/d, 0.28 g/kg/d, and 0.56 g/kg/d, respectively. The results indicate that medium dose FRPP reduced the levels of hormone such as testosterone, dihydrotestosterone, and oestradiol in rats with BPH by about 32%, thus bringing the prostate tissue of BPH rats closer to normal. More importantly, medium dose FRPP treatment had a significant effect on the composition of gut microbiota in rats with BPH, increasing the levels of beneficial genera (such as Coprococcus and Jeotgalicoccus), and decreasing the levels of harmful pathogens (such as Turicibacter and Clostridiaceae_Clostridium) in the gut. This study showed that medium dose FRPP reduced the hormone level and regulated the unbalanced gut microbiota in BPH rats, thereby alleviating BPH.
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Affiliation(s)
- Y Y Han
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - Q H Zhang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - W S Chen
- Nanjing Jiufengtang Bee Products Co., Ltd, Nanjing, 210000, China P.R
| | - Z L Li
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - D Xie
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - S L Zhang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - H Lu
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - L W Wang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - Z H Xu
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - L Z Zhang
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang, 330045, China P.R
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Huang S, Xu F, Zhu W, Xie D, Lou K, Huang D, Hu H. Multi-dimensional radiomics analysis to predict visceral pleural invasion in lung adenocarcinoma of ≤3 cm maximum diameter. Clin Radiol 2023; 78:e847-e855. [PMID: 37607844 DOI: 10.1016/j.crad.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 06/20/2023] [Accepted: 07/21/2023] [Indexed: 08/24/2023]
Abstract
AIM To explore the value of radiomics analysis in preoperatively predicting visceral pleural invasion (VPI) of lung adenocarcinoma (LAC) with ≤3 cm maximum diameter and to compare the performance of two-dimensional (2D) and three-dimensional (3D) computed tomography (CT) radiomics models. MATERIALS AND METHODS A total of 391 LAC patients were enrolled retrospectively, of whom 142 were VPI (+) and 249 were VPI (-). Radiomics features were extracted from 2D and 3D regions of interest (ROIs) of tumours in CT images. 2D and 3D radiomics models were developed combining the optimal radiomics features by using the logistic regression machine-learning method and radiomics scores (rad-scores) were calculated. Nomograms were constructed by integrating independent risk factors and rad-scores. The performance of each model was evaluated by using the receiver operator characteristic (ROC) curve, decision curve analysis (DCA), clinical impact curve (CIC), and calculating the area under the curve (AUC). RESULTS There was no difference in the VPI prediction between 2D and 3D radiomics models (training group: 2D AUC=0.835, 3D AUC=0.836, p=0.896; validation group: 2D AUC=0.803, 3D AUC=0.794, p=0.567). The 2D and 3D nomograms performed similarly regarding discrimination (training group: 2D AUC=0.867, 3D AUC=0.862, p=0.409, validation group: 2D AUC=0.835, 3D AUC=0.827, p=0.558), and outperformed their corresponding radiomics models and the clinical model. DCA and CIC revealed that the 2D nomogram had slightly better clinical utility. CONCLUSION The 2D radiomics model has a similar discrimination capability compared with the 3D radiomics model. The 2D nomogram performs slightly better for individual VPI prediction in LAC.
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Affiliation(s)
- S Huang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Radiology, Ningbo Medical Center LiHuili Hospital, Ningbo, Zhejiang, China
| | - F Xu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - W Zhu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - D Xie
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Radiology, Shaoxing Second Hospital, Shaoxing, Zhejiang, China
| | - K Lou
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - D Huang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - H Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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9
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Guo C, Song J, Li L, Yang J, Huang J, Xie D, Yue C, Kong W, Luo W, Liu S, Wang X, Peng Z, Fan S, Xie Y, Alawieh AM, Spiotta AM, Li F, Zi W. Association of Procedure Time With Clinical and Procedural Outcome in Patients With Basilar Occlusion Undergoing Embolectomy. Neurology 2023:WNL.0000000000207395. [PMID: 37202165 PMCID: PMC10382271 DOI: 10.1212/wnl.0000000000207395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/23/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies have demonstrated the association between the procedure time (PT) and outcomes for patients with proximal large vessel occlusion (LVO), however, whether the relationship remains for patients with acute basilar artery occlusion (ABAO) was not clear. We aimed to characterize the association between PT and other procedure-related variables on clinical outcomes among patients with ABAO that underwent endovascular treatment (EVT). METHODS Patients with ABAO that underwent EVT with a documented PT in the BASILAR study from January 2014 to May 2019 among 47 comprehensive centers in China were included. Multivariable analysis was performed to reveal the association between PT and 90-day modified Rankin Scale score, mortality, complications, and all-cause death at one year. RESULTS Of the 829 patients from the BASILAR registry, 633 eligible patients were included. Longer procedure time were associated with a lower rate of favorable outcome (by 30min, adjusted OR 0.82 [95% CI 0.72 - 0.93], p = 0.01). Additionally, a PT ≤ 75 min was associated with a favorable outcome (adjusted OR 2.03[95% CI 1.26- 3.28]). The risk of complications and mortality increased by 0.5% and 1.5% with every 10 min increase in PT, respectively (R2 = 0.64 and R2 = 0.68, P <0.01). The cumulative rates of favorable outcomes and successful recanalization plateaued after 120 min (2 attempts). Restricted cubic spline regression analysis for the probability of favorable outcomes had an L-shape association (P non-linearity = 0.01) with PT with significant benefit loss before 120 min and then appeared relatively flat. DISCUSSION For ABAO patients, procedures that exceeded 75 min were associated with an increased risk of mortality and lower odds of a favorable outcome. A careful assessment of futility and the risks of continuing the procedure should be made after 120 min.
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Affiliation(s)
- Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Weilin Kong
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Weidong Luo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Xiaoman Wang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Zhouzhou Peng
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Shitao Fan
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Yuqian Xie
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - Ali Mostafa Alawieh
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Alejandro M Spiotta
- Department of Neurosurgery, Medical University of South Carolina,Charleston, South Carolina,USA
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400037, China
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10
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Miao J, Sang H, Li F, Saver JL, Lei B, Li J, Nogueira RG, Song B, Liu S, Nguyen TN, Jin Z, Zeng H, Wen C, Yuan G, Kong W, Luo W, Liu S, Xie D, Huang J, Liu C, Yang J, Hu J, Song J, Yue C, Li L, Tian Y, Zhang X, Feng D, Gao Y, Fu H, Zi W, Yang Q, Qiu Z, Wang S. Effect of Imaging Selection Paradigms on Endovascular Thrombectomy Outcomes in Patients With Acute Ischemic Stroke. Stroke 2023; 54:1569-1577. [PMID: 37165864 DOI: 10.1161/strokeaha.122.042203] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The effect of imaging selection paradigms on endovascular thrombectomy outcomes in patients with acute ischemic stroke with large vessel occlusion remains uncertain. The study aimed to assess the effect of basic imaging (noncontrast computed tomography with or without computed tomographic angiography) versus advanced imaging (magnetic resonance imaging or computed tomography perfusion) on clinical outcomes following thrombectomy in patients with stroke with large vessel occlusion in the early and extended windows using a pooled analysis of patient-level data from 2 pivotal randomized clinical trials done in China. METHODS This post hoc analysis used data from 1182 patients included in 2 multicenter, randomized controlled trials in China that evaluated adjunct therapies to endovascular treatment for acute ischemic stroke (Direct Endovascular Treatment for Large Artery Anterior Circulation Stroke performed from May 20, 2018, through May 2, 2020, and Intravenous Tirofiban Before Endovascular Treatment in Stroke from October 10, 2018, through October 31, 2021). Patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery (M1/M2 segments) were categorized according to baseline imaging modality (basic versus advanced) as well as treatment time window (early, 0-6 hours versus extended, 6-24 hours from last known well to puncture). The primary outcome was the proportion of patients with functional independence (modified Rankin Scale score of 0-2) at 90 days. Multivariable Poisson regression analysis was performed to determine the association between imaging selection modality and outcomes after endovascular treatment at each time windows. RESULTS A total of 1182 patients were included in this cohort analysis, with 648 in the early (471 with basic imaging versus 177 advanced imaging) and 534 in the extended (222 basic imaging versus 312 advanced imaging) time window. There were no differences in 90-day functional independence between the advanced and basic imaging groups in either time windows (early window: adjusted relative risk, 0.99 [95% CI, 0.84-1.16]; P=0.91; extended window: adjusted relative risk, 1.00 [95% CI, 0.84-1.20]; P=0.97). CONCLUSIONS In this post hoc analysis of 2 randomized clinical trial pooled data involving patients with large vessel occlusion stroke, an association between imaging selection modality and clinical or safety outcomes for patients undergoing thrombectomy in either the early or extended windows was not detected. Our study adds to the growing body of literature on simpler imaging paradigms to assess thrombectomy eligibility across both the early and extended time windows. REGISTRATION URL: http://www.chictr.org.cn; Unique identifiers: ChiCTR-IOR-17013568 and ChiCTR-INR-17014167.
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Affiliation(s)
- Jian Miao
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Hongfei Sang
- Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, China (H.S.)
| | - Fengli Li
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | | | - Bo Lei
- Cerebrovascular Diseases, Leshan People's Hospital, China (B.L.)
| | - Jinglun Li
- Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, China (J.L.)
| | | | - Bo Song
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
| | - Shudong Liu
- Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing Key Laboratory of Cerebrovascular Disease Research, China (S.L.)
| | | | - Zhenglong Jin
- Neurology, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China (Z.J.)
| | | | | | | | - Weilin Kong
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Weidong Luo
- Neurology, The General Hospital of Tibet Military Area Command, Lhasa, China (W.L.)
| | - Shuai Liu
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Dongjing Xie
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Jiacheng Huang
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Chang Liu
- Neurology, The Second Affiliated Hospital of Chongqing Medical University, China (C.L.)
| | - Jie Yang
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Jinrong Hu
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Jiaxing Song
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Chengsong Yue
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Linyu Li
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Yan Tian
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Xiao Zhang
- Neurology, The Affiliated Hospital of Northwest University Xi'an No.3 Hospital, China (X.Z.)
| | - Dan Feng
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
| | - Yani Gao
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
| | - Huiying Fu
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
| | - Wenjie Zi
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Qingwu Yang
- Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China (J.M., F.L., W.K., S.L., D.X., J.H., J.Y., J.H., J.S., C.Y., L.L., Y.T., W.Z., Q.Y.)
| | - Zhongming Qiu
- Neurology, The 903rd Hospital of The People's Liberation Army, Hangzhou, China (Z.Q.)
| | - Shaojun Wang
- Neurology, Xianyang Hospital of Yan'an University, China (J.M., B.S., D.F., Y.G., H.F., S.W.)
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11
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Sang H, Xie D, Tian Y, Nguyen TN, Saver JL, Nogueira RG, Wu J, Long C, Tian Z, Hu Z, Wang T, Li R, Ke Y, Zhu X, Peng D, Chang M, Li L, Ruan J, Wu D, Zi W, Yang Q, Li F, Qiu Z. Association of Tirofiban With Functional Outcomes After Thrombectomy in Acute Ischemic Stroke Due to Intracranial Atherosclerotic Disease. Neurology 2023; 100:e1996-e2006. [PMID: 36941074 PMCID: PMC10186214 DOI: 10.1212/wnl.0000000000207194] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/01/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVE To investigate the efficacy and safety of IV infusion of tirofiban before endovascular thrombectomy for patients with large vessel occlusion due to intracranial atherosclerotic disease. The secondary objective was to identify potential mediators for the clinical effect of tirofiban. METHODS Post hoc exploratory analysis of the Endovascular Treatment With versus Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) trial, which was a randomized, double-blinded, placebo-controlled trial at 55 centers in China from October 2018 to October 2021. Patients with occlusion of the internal carotid artery or middle cerebral artery due to intracranial atherosclerosis were included. The primary efficacy outcome was the proportion of patients achieving functional independence (defined as modified Rankin scale 0-2) at 90 days. Binary logistic regression and causal mediation analyses were used to estimate the treatment effect of tirofiban and the potential mediators. RESULTS This study included 435 patients, of whom 71.5% were men. The median age was 65 (interquartile range [IQR] 56-72) years, with a median NIH Stroke Scale of 14 (IQR 10-19). Patients in the tirofiban group had higher rates of functional independence at 90 days than patients in the placebo group (adjusted odds ratio 1.68; 95% CI 1.11-2.56, p = 0.02) without an increased risk of mortality or symptomatic intracranial hemorrhage. Tirofiban was associated with fewer thrombectomy passes (median [IQR] 1 [1-2] vs 1 [1-2], p = 0.004), which was an independent predictor of functional independence. Mediation analysis showed tirofiban-reduced thrombectomy passes explained 20.0% (95% CI 4.1%-76.0%) of the effect of tirofiban on functional independence. DISCUSSION In this post hoc analysis of the RESCUE BT trial, tirofiban was an effective and well-tolerated adjuvant medication of endovascular thrombectomy for patients with large vessel occlusion due to intracranial atherosclerosis. These findings need to be confirmed in future trials. TRIAL REGISTRATION INFORMATION The RESCUE BT trial was registered on the Chinese Clinical Trial Registry: chictr.org.cn, ChiCTR-INR-17014167. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that tirofiban plus endovascular therapy improves 90-day outcome for patients with large vessel occlusion due to intracranial atherosclerosis.
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Affiliation(s)
- Hongfei Sang
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Dongjing Xie
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Yan Tian
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Thanh N Nguyen
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Jeffrey L Saver
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Raul G Nogueira
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Junxiong Wu
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Chen Long
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Zhenxuan Tian
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Zhizhou Hu
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Tao Wang
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Rongzong Li
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Yingbing Ke
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Xiurong Zhu
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Daizhou Peng
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Mingze Chang
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Lingfei Li
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Jie Ruan
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Deping Wu
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Wenjie Zi
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Qingwu Yang
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Fengli Li
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China
| | - Zhongming Qiu
- From the Department of Neurology (H.S., L.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine; Department of Neurology (D.X., Y.T., D.W., W.Z., Q.Y., F.L.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA; Department of Neurology and Neurosurgery (R.G.N.), University of Pittsburgh School of Medicine, PA; Department of Emergency (J.W., C.L.), Xiangtan Central Hospital; Department of Neurology (Z.T.), Sichuan Mianyang 404 Hospital; Department of Neurology (Z.H.), Longyan First Hospital of Fujian Medical University; Department of Neurology (T.W.), Huainan First People's Hospital; Department of Neurology (R.L.), The 924th Hospital of The People's Liberation Army, Guilin; Department of Neurology (Y.K.), Yangluo Branch of Hubei Zhongshan Hospital, Wuhan; Department of Neurology (X.Z.), Chongzhou People's Hospital; Department of Neurology (D.P.), Qianxinan People's Hospital; Department of Neurology (M.C.), Xi'an Third Hospital; Department of Clinical Pharmacy (J.R.), Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, the First Affiliated Hospital, Zhejiang University School of Medicine; and Department of Neurology (Z.Q.), The 903th Hospital of The People's Liberation Army, Hangzhou, China.
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12
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Zhang X, Miao J, Yang J, Liu C, Huang J, Song J, Xie D, Yue C, Kong W, Hu J, Luo W, Liu S, Li F, Zi W. DWI-Based Radiomics Predicts the Functional Outcome of Endovascular Treatment in Acute Basilar Artery Occlusion. AJNR Am J Neuroradiol 2023; 44:536-542. [PMID: 37080720 PMCID: PMC10171394 DOI: 10.3174/ajnr.a7851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/15/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND AND PURPOSE Endovascular treatment is a reference treatment for acute basilar artery occlusion (ABAO). However, no established and specific methods are available for the preoperative screening of patients with ABAO suitable for endovascular treatment. This study explores the potential value of DWI-based radiomics in predicting the functional outcomes of endovascular treatment in ABAO. MATERIALS AND METHODS Patients with ABAO treated with endovascular treatment from the BASILAR registry (91 patients in the training cohort) and the hospitals in the Northwest of China (31 patients for the external testing cohort) were included in this study. The Mann-Whitney U test, random forests algorithm, and least absolute shrinkage and selection operator were used to reduce the feature dimension. A machine learning model was developed on the basis of the training cohort to predict the prognosis of endovascular treatment. The performance of the model was evaluated on the independent external testing cohort. RESULTS A subset of radiomics features (n = 6) was used to predict the functional outcomes in patients with ABAO. The areas under the receiver operating characteristic curve of the radiomics model were 0.870 and 0.781 in the training cohort and testing cohort, respectively. The accuracy of the radiomics model was 77.4%, with a sensitivity of 78.9%, specificity of 75%, positive predictive value of 83.3%, and negative predictive value of 69.2% in the testing cohort. CONCLUSIONS DWI-based radiomics can predict the prognosis of endovascular treatment in patients with ABAO, hence allowing a potentially better selection of patients who are most likely to benefit from this treatment.
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Affiliation(s)
- X Zhang
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Neurology (X.Z.), The Affiliated Hospital of Northwest University Xi'an No.3 Hospital, Xian, China
| | - J Miao
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Neurology (J.M.), Xianyang Hospital of Yan'an University, Xianyang, China
| | - J Yang
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - C Liu
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - J Huang
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - J Song
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - D Xie
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - C Yue
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - W Kong
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - J Hu
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - W Luo
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - S Liu
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - F Li
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - W Zi
- From the Department of Neurology (X.Z., J.M., J.Y., C.L., J.H., J.S., D.X., C.Y., W.K., J.H., W.L., S.L., F.L., W.Z.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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13
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Manrique K, Raphael K, Griffiths S, Miano T, Kalman L, Oyster M, Xie D, Clausen E, Shah P, Lama V, Dhillon G, Snyder L, Cantu E, Diamond J, Christie J, Shashaty M. Preoperative Plasma SuPAR Levels are Associated with AKI after Lung Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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14
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Peng Z, Song J, Li L, Guo C, Yang J, Kong W, Huang J, Hu J, Liu S, Tian Y, Yang D, Li F, Zi W, Xie D, Yang Q. Association between stress hyperglycemia and outcomes in patients with acute ischemic stroke due to large vessel occlusion. CNS Neurosci Ther 2023. [PMID: 36914967 DOI: 10.1111/cns.14163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/08/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
AIMS This study aimed to evaluate the association between stress hyperglycemia ratio (SHR) and clinical outcomes at 90 days in acute ischemic stroke due to large vessel occlusion receiving endovascular treatment. METHODS The RESCUE BT trial was a multicenter, randomized, double-blind, placebo-controlled clinical trial, consisting of 948 stroke patients from 55 centers in China. A total of 542 patients with glucose and glycated hemoglobin (HbA1C) values at admission were included in this analysis. SHR, measured by glucose/HbA1C, was evaluated as both a tri-categorical variable (≤1.07 vs. 1.08-1.29 vs. ≥1.30) and a continuous variable. The primary outcome was a favorable functional outcome (modified Rankin Scale [mRS] score ≤2) at 90 days. The secondary outcome included excellent functional outcome (mRS score ≤1) and safety outcomes, such as 90-day mortality and intracranial hemorrhage. The study was registered with Chictr.org.cn (ChiCTR-INR-17014167). RESULTS Compared with patients in the lowest tertile of SHR, the highest tertile group had significantly lower odds of achieving favorable functional outcome of mRS score of 0-2 (adjusted odds ratio, 0.44; 95% confidence interval, 0.28-0.69; p < 0.001) and excellent clinical outcome of mRS score of 0-1 (adjusted odds ratio, 0.48; 95% confidence interval, 0.29-0.79; p = 0.004) at 90 days after adjusting for potential covariates. Similar results were observed after further adjustment for preexisting diabetes and Alberta Stroke Program Early Computed Tomography Score (ASPECTS). CONCLUSION Stress hyperglycemia ratio, as measured by the glucose/HbA1C, was associated with a decreased odds of achieving a favorable functional outcome in patients with acute large vessel occlusion stroke at 90 days.
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Affiliation(s)
- Zhouzhou Peng
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Weilin Kong
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yan Tian
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Dahong Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China
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15
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Sang H, Zi W, Wu J, Luo J, Hu Z, Wang T, Li R, Ke Y, Zhu X, Xie D, Li F, Yang Q, Qiu Z. Abstract TMP6: Association Of Tirofiban With Outcomes After Thrombectomy In Stroke Due To Atherosclerosis: An Exploratory Analysis Of The RESCUE BT Placebo-controlled Randomized Trial. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tmp6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
The efficacy and safety of tirofiban, as an adjuvant medication of endovascular therapy (EVT), in patients with large vessel occlusion due to atherosclerotic thrombosis was still unclear.
Methods:
The Endovascular Treatment With versus Without Tirofiban in Stroke (RESCUE BT) trial was a randomized, double-blinded, placebo-controlled trial that was performed at 55 centers in China from October 10, 2018 to October 31, 2021. This was a post hoc exploratory analysis of the RESCUE BT trial and 435 patients were included in the intention-to-treat analysis. The primary outcome was the proportion of functional independence (defined as modified Rankin Scale 0-2) at 90 days. We estimated the efficacy and safety of EVT plus placebo versus EVT plus tirofiban using binary logistic regression analysis. A causal mediation analysis was also performed to assess the potential mediators of tirofiban on functional outcome.
Results:
This study included 435 patients, including 197 patients assigned to the tirofiban group and 238 patients assigned to the placebo group. The median age was 65 [IQR, 56-72] years, and 311 (71.5%) patients were men. Tirofiban was associated with higher rates of functional independence at 90 days compared with the placebo (adjusted odds ratio with 95% CI, 1.68 [1.11–2.56],
P
= 0.014). There was no significant difference in mortality and symptomatic intracranial hemorrhage between the two groups, thought the rate of intracranial hemorrhage was numerically higher in the tirofiban group (29.1% versus 23.2%,
P
= 0.165). Tirofiban was also associated with fewer number of thrombectomy passes (beta, -0.48; 95% CI, -0.62 to -0.34;
P
< 0.001). Treatment-reduced passes explains 20.0% (95% CI, 4-76) of the beneficial effect of tirofiban on functional independence.
Conclusion:
Tirofiban plus EVT might be an effective and well-tolerated option for patients with anterior large vessel occlusion due to atherosclerosis. These findings are needed to be confirmed in future trials.
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Affiliation(s)
| | | | | | - Jun Luo
- Sichuan Mianyang 404 Hosp, mianyang, China
| | - Zhizhou Hu
- Longyan First Hosp of Fujian Med Univ, longyan, China
| | - Tao Wang
- Huainan First People's Hosp, Huainan, China
| | - Rongzong Li
- The 924th Hosp of The People’s Liberation Army, Guilin, China
| | - Yingbing Ke
- Yangluo Branch of Hubei Zhongshan Hosp, wuhan, China
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16
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Qiu Z, Yuan J, Xie D, Wu D, Luo W, Zhaojun T, Liu S, Han Q, Sun D, Lei B, Li J, Miao J, Liu S, Jin Z, Zeng G, Wen C, Yuan G, Yang Q, Nguyen T, Saver JL, Nogueira RG, Li F, Sang H, Zi W. Abstract 100: Endovascular Treatment With Intravenous Tirofiban Or Alteplase Versus Endovascular Treatment Alone For Acute Ischemic Stroke With Large Vessel Occlusion: A Pooled Analysis Of The Devt And Rescue Bt Trials. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
In acute ischemic stroke patients with large vessel occlusion, the role of intravenous tirofiban or alteplase as an adjunct to endovascular treatment (EVT) is still uncertain.
Methods:
This post hoc analysis used data from 467 patients included in two multicenter, randomized clinical trials that assessed intravenous adjunctive medications in stroke thrombectomy (DEVT and RESCUE BT). Patients were treated with EVT alone (EVT-alone group), intravenous tirofiban plus EVT (tirofiban+EVT group), and intravenous alteplase plus EVT (alteplase+EVT group). The primary outcome was functional independence (modified Rankin scale score 0-2) at 90 days. Safety outcomes included intracranial hemorrhage and mortality.
Results:
Of 467 patients included in the cohort, there were 172, 172, and 123 patients in EVT-alone, tirofiban+EVT, and alteplase+EVT group, respectively. Patients in the alteplase+EVT group were less likely to achieve functional independence than patients in the tirofiban+EVT group (adjusted risk ratio [RR], 0.80; 95% confidence interval [CI], 0.65-0.99;
P
= 0.04). Patients in the EVT-alone group compared with the tirofiban+EVT group (adjusted RR, 1.12; 95% CI, 0.92-1.36;
P
= 0.27) or the alteplase+EVT group (adjusted RR, 0.81; 95% CI, 0.65-1.02;
P
= 0.07) were similarly likely to obtain functional independence. Patients in the alteplase+EVT group had a higher risk of any intracranial hemorrhage than in the EVT-alone group (adjusted RR, 1.49; 95% CI, 1.03-2.14;
P
= 0.03) and tirofiban+EVT group (adjusted RR, 1.49; 95% CI, 1.02-2.18;
P
= 0.04). No significant difference was detected in the incidence of symptomatic intracranial hemorrhage and mortality among the three groups.
Conclusions:
Tirofiban before thrombectomy is associated with a better functional outcome and lower risk of any intracranial hemorrhage than alteplase among patients with large vessel occlusion treated within 4.5 hours after stroke onset.
Trial Registration:
chictr.org.cn, ChiCTR-IOR-17013568 and ChiCTR-INR-17014167.
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Affiliation(s)
- Zhongming Qiu
- Xinqiao Hosp and The Second Affiliated Hosp, Army Med Univ (Third Military Med Univ), Chongqing, China
| | - Junjie Yuan
- The 925th Hosp of The Chinese People’s Liberation Army, Guiyang, China
| | - Dongjing Xie
- Xinqiao Hosp and The Second Affiliated Hosp, Army Med Univ (Third Military Med Univ), Chongqing, China
| | - Deping Wu
- Huaian Med District of Jingling Hosp, Med Sch of Nanjing Univ, Huaian, China
| | - Weidong Luo
- The General Hosp of Tibet Military Area Command, Lhasa, China
| | - Tao Zhaojun
- The 903rd Hosp of The Chinese People’s Liberation Army, Hangzhou, China
| | - Shuai Liu
- Xinqiao Hosp and The Second Affiliated Hosp, Army Med Univ (Third Military Med Univ), Chongqing, China
| | - Qin Han
- The 903rd Hosp of The Chinese People’s Liberation Army, Hangzhou, China
| | - Dong Sun
- Zhongnan Hosp, Wuhan Univ, Wuhan, China
| | - Bo Lei
- Leshan People's Hosp, Leshan, China
| | - Jinglun Li
- Affiliated Hosp of Southwest Med Univ, Luzhou, China
| | - Jian Miao
- Xianyang Hosp of Yan'an Univ, Xianyang, China
| | - Shudong Liu
- Yongchuan Hosp of Chongqing Med Univ, Chongqing Key Laboratory of Cerebrovascular Disease Rsch, Chongqing, China
| | - Zhenglong Jin
- Wuyi Hosp of Traditional Chinese Medicine, Jiangmen, China
| | | | | | | | - Qingwu Yang
- Xinqiao Hosp and The Second Affiliated Hosp, Army Med Univ (Third Military Med Univ), Chongqing, China
| | | | | | | | - Fengli Li
- Xinqiao Hosp and The Second Affiliated Hosp, Army Med Univ (Third Military Med Univ), Chongqing, China
| | - Hongfei Sang
- Affiliated Hangzhou First People’s Hosp, Zhejiang Univ Sch of Medicine, Hangzhou, China
| | - Wenjie Zi
- Xinqiao Hosp of Army Med Univ, Chongqing, China
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17
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Zhai G, Song J, Yu N, Guo C, Liu S, Yue C, Yang D, Xie D, Liu X, Yu S, Lei L. Predictors of Mechanical Thrombectomy for Anterior Circulation Emergent Large-Vessel Occlusion in the Older Adults. Clin Appl Thromb Hemost 2023; 29:10760296231184219. [PMID: 37386776 DOI: 10.1177/10760296231184219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
Few studies have reported the clinical outcomes of older adult patients with acute anterior circulation large-vessel occlusion (LVO) who underwent mechanical thrombectomy (MT). Therefore, we investigated the safety, functional outcomes, and predictors of MT for anterior circulation LVO in older adults. We enrolled patients with acute anterior circulation LVO from May 2018 to October 2021 in this retrospective study. Patients were divided into older (≥80 years) and young (<80 years) groups. Multivariable logistic regression analyses determined the safety, functional outcomes, and predictors of MT for anterior circulation LVO. We divided 1182 patients with acute ischemic stroke into young (18-79 years; 1028 patients) and older (≥80 years; 154 patients) groups. Compared with the young group, the older group had more unfavorable functional outcomes and increased mortality (P = .003). In the older adult patients, lower initial NIHSS score and higher ASPECTS were correlated with good outcomes. On the contrary, higher initial NIHSS score and lower ASPECTS were related to increased mortality. No difference was detected in symptomatic intracranial hemorrhage within 48 h between two groups. Increasing age was associated with lower rates of favorable functional outcomes and higher mortality rates. The lower initial NIHSS score combined with the higher ASPECTS may predict functional outcomes post-thrombectomy in older adults.
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Affiliation(s)
- Guojie Zhai
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Nizhen Yu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dahong Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiang Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuye Yu
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Lei Lei
- Department of Neurology, Xianyang Hospital of Yan'an University, Xianyang, China
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Yang J, Jin Z, Song J, Guo C, Xie D, Yue C, Kong W, Hu J, Luo W, Liu S, Huang J, Zeng G. Futile Recanalization After Endovascular Treatment in Patients With Acute Basilar Artery Occlusion. Neurosurgery 2022; 92:1006-1012. [PMID: 36700757 DOI: 10.1227/neu.0000000000002313] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/19/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND It is estimated that >50% of acute basilar artery occlusion (ABAO) patients with successful reperfusion after endovascular treatment (EVT) have futile recanalization. However, few studies investigated the reasons behind this. OBJECTIVE To identify the factors associated with futile recanalization in ABAO after successful reperfusion. METHODS We recruited patients with successful reperfusion (expanded Thrombolysis In Cerebral Infarction score of ≥2b) after EVT from the Basilar Artery Occlusion Study registry. Patients were divided into meaningful recanalization (90-day modified Rankin Scale 0-3) and futile recanalization (90-day modified Rankin Scale 4-6) groups. Multivariable logistic regression analyses were used to identify the predictors of futile recanalization. RESULTS A total of 522 patients with successful reperfusion were selected. Of these, 328 patients had futile recanalization and 194 had meaningful recanalization. Multivariable logistic regression shows that higher neutrophil-to-lymphocyte ratio ( P = .01), higher baseline National Institutes of Health Stroke Scale score ( P < .001), longer puncture to recanalization time ( P = .02), lower baseline posterior circulation Alberta Stroke Program Early CT score ( P < .001), lower posterior circulation collateral score ( P = .02), incomplete reperfusion ( P < .001), and diabetes mellitus ( P < .001) were predictors of futile recanalization. CONCLUSION Higher neutrophil-to-lymphocyte ratio, longer puncture to recanalization time, incomplete reperfusion, stroke severity, lower baseline posterior circulation Alberta Stroke Program Early CT score, poor collaterals, and diabetes mellitus were independent predictors of futile recanalization in patients with ABAO with successful reperfusion after EVT. Moreover, multiple stent retriever passes were associated with a high proportion of futile recanalization in patients with late time windows.
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Affiliation(s)
- Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhenglong Jin
- Department of Neurology, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weilin Kong
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weidong Luo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Guoyong Zeng
- Department of Neurology, Ganzhou People's Hospital, Ganzhou, China
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Chen Q, Meng R, Wu D, Hu J, Tao Z, Xie D, Tian Y, Han Q, Fu Y, Zuo L, Zhang M, Dai W, Deng W, Huang X, Sang H, Feng X, Qiu Z, Wang T, Yuan J. Association of Intravenous Tirofiban with Functional Outcomes in Acute Ischemic Stroke Patients with Acute Basilar Artery Occlusion Receiving Endovascular Thrombectomy. Cerebrovasc Dis 2022; 52:451-459. [PMID: 36481613 PMCID: PMC10568592 DOI: 10.1159/000527483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/05/2022] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION The aim of this study was to test the hypothesis that intravenous tirofiban improves functional outcomes without promoting the risk of intracranial hemorrhage (ICH) in stroke secondary to basilar artery occlusion (BAO) receiving endovascular thrombectomy. METHODS Patients with acute BAO stroke who were treated with endovascular thrombectomy and had tirofiban treatment information were derived from "BASILAR": a nationwide, prospective registry. All eligible patients were divided into tirofiban and no-tirofiban groups according to whether tirofiban was used intravenously. The primary endpoint was the 90-day severity of disability as assessed by the modified Rankin scale score. Safety outcomes were the frequency of ICH and mortality. RESULTS Of 645 patients included in this cohort, 363 were in the tirofiban group and 282 were in the no-tirofiban group. Thrombectomy with intravenous tirofiban reduced the 90-day disability level over the range of the modified Rankin scale (adjusted common odds ratio, 2.08; 95% confidence interval (CI), 1.45-2.97; p < 0.001). The 90-day mortality of patients in the tirofiban group was lower than that in the no-tirofiban group (41.6% vs. 52.1%; adjusted hazard ratio, 0.60; 95% CI, 0.47-0.77; p < 0.001). The frequency of any ICH (6.7% vs. 13.7%; p = 0.004) and symptomatic ICH (4.8% vs. 10.1%; p = 0.01) in the tirofiban group was significantly lower than that in the no-tirofiban group. CONCLUSIONS In patients with acute BAO stroke who underwent endovascular treatment, intravenous tirofiban might be associated with favorable outcome, reduced mortality, and a decreased frequency of ICH.
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Affiliation(s)
- Qiong Chen
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Guangyang Bay Laboratory, Chongqing Institute for Brain and Intelligence, Chongqing, China
| | - Renliang Meng
- Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Deping Wu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Huaian Medical District of Jingling Hospital, Medical School of Nanjing University, Huaian, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhaojun Tao
- Department of Medical Engineering, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yan Tian
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qin Han
- Department of Neurology, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Yuan Fu
- Department of Second Outpatient, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Ling Zuo
- Central Sterile Supply Department, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Min Zhang
- Department of Neurology, Chinese Medical Hospital of Maoming, Maoming, China
| | - Weipeng Dai
- Department of Neurology, Jiangmen Central Hospital, Jiangmen, China
| | - Wei Deng
- Department of Neurology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Xianjun Huang
- Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Hongfei Sang
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinggang Feng
- Department of Neurology, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Zhongming Qiu
- Department of Neurology, The 903rd Hospital of The Chinese People’s Liberation Army, Hangzhou, China
| | - Tao Wang
- Department of Neurology, The First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People’s Hospital), Huainan, China
| | - Junjie Yuan
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Neurology, The 925th Hospital of The Chinese People’s Liberation Army, Guiyang, China
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Xie D, Murray J, Lartey R, Gaj S, Kim J, Li M, Eck BL, Winalski CS, Altahawi F, Jones MH, Obuchowski NA, Huston LJ, Harkins KD, Friel HT, Damon BM, Knopp MV, Kaeding CC, Spindler KP, Li X. Multi-vendor multi-site quantitative MRI analysis of cartilage degeneration 10 Years after anterior cruciate ligament reconstruction: MOON-MRI protocol and preliminary results. Osteoarthritis Cartilage 2022; 30:1647-1657. [PMID: 36049665 PMCID: PMC9671830 DOI: 10.1016/j.joca.2022.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/12/2022] [Accepted: 08/01/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the protocol of a multi-vendor, multi-site quantitative MRI study for knee post-traumatic osteoarthritis (PTOA), and to present preliminary results of cartilage degeneration using MR T1ρ and T2 imaging 10 years after anterior cruciate ligament reconstruction (ACLR). DESIGN This study involves three sites and two MR platforms. The patients are from a nested cohort (termed as Onsite cohort) within the Multicenter Orthopaedic Outcomes Network (MOON) cohort 10 years after ACLR. Phantoms and controls were scanned for evaluating reproducibility. Cartilage was automatically segmented, and T1ρ and T2 were compared between operated, contralateral, and control knees. RESULTS Sixty-eight ACL-reconstructed patients and 20 healthy controls were included. In phantoms, the intra-site coefficients of variation (CVs) of repeated scans ranged 1.8-2.1% for T1ρ and 1.3-1.7% for T2. The inter-site CVs ranged 1.6-2.1% for T1ρ and 1.1-1.4% for T2. In human subjects, the intra-site scan/rescan CVs ranged 2.2-3.5% for T1ρ and 2.6-4.9% for T2 for the six major compartments. In patients, operated knees showed significantly higher T1ρ and T2 values mainly in medial femoral condyle, medial tibia and trochlear cartilage compared with contralateral knees, and showed significantly higer T1ρ and T2 values in all six compartments compared to healthy control knees. The patient contralateral knees showed higher T1ρ and T2 values mainly in the lateral femoral condyle, lateral tibia, trochlear, and patellar cartilage compared to healthy control knees. CONCLUSION A platform and workflow with rigorous quality control has been established for a multi-vendor multi-site quantitative MRI study in evaluating PTOA 10 years after ACLR. Our preliminary report suggests significant cartilage matrix changes in both operated and contralateral knees compared with healthy control knees.
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Affiliation(s)
- D Xie
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - J Murray
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - R Lartey
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - S Gaj
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - J Kim
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - M Li
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - B L Eck
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - C S Winalski
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - F Altahawi
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - M H Jones
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - N A Obuchowski
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - L J Huston
- Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - K D Harkins
- Departments of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - H T Friel
- MR Clinical Science, Philips Healthcare, Highland Heights, OH, USA.
| | - B M Damon
- Departments of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University, Columbus, OH, USA.
| | - C C Kaeding
- Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH, USA.
| | - K P Spindler
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
| | - X Li
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
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Luo J, Wu D, Li Z, Xie D, Huang J, Song J, Luo W, Liu S, Li F, Zi W, Huang Q, Luo J, Kong D. Which is the most effective rescue treatment after the failure of mechanical thrombectomy for acute basilar artery occlusion? Front Neurol 2022; 13:992396. [DOI: 10.3389/fneur.2022.992396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of this study was to evaluate the effectiveness and safety of rescue therapy, a therapy in which rescue devices such as balloon angioplasty, Apollo stent, Wingspan stent, Solitaire stent, or other self-expanding stents are used after the failure of mechanical thrombectomy (MT) and to determine the most effective rescue measure for acute basilar artery occlusion (BAO) after the failure of MT.MethodsFor this study, we recruited patients from the BASILAR registry. All participants were divided into three groups: the recanalized with rescue therapy group, the recanalized without rescue therapy group, and the non-recanalized group. Clinical outcomes at 90 days and 1 year were compared. The association of rescue measures with favorable outcomes (modified Rankin Scale [mRS] score of 0–3) in patients achieving successful recanalization via rescue therapy was estimated using multivariate logistic regression analyses.ResultsAmong the participants, recanalization failure was found in 112 patients and successful recanalization in 473 patients, with 218 patients receiving rescue therapy and 255 patients without rescue therapy. Of these, 111 (43.5%) patients in the recanalized without rescue therapy group, 65 (29.8%) patients in the recanalized with rescue therapy group, and nine (8.0%) patients in the non-recanalized group achieved favorable outcomes at 90 days. Both the recanalization with rescue therapy and the recanalization without rescue therapy groups were associated with favorable outcomes at 90 days and 1 year compared with the non-recanalized group. Moreover, in patients receiving rescue therapy, Wingspan stents, Apollo stents, and balloon angioplasty were associated with higher rates of favorable outcomes at 90 days and 1 year than Solitaire stents.ConclusionWhether rescue therapy is administered or not, recanalization leads to favorable outcomes in patients with acute BAO. For acute BAO after MT failure, balloon angioplasty, Wingspan stenting, and Apollo stenting could be considered effective and safe rescue options but not Solitaire stenting.
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22
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Ma B, Zhang TT, Jia YD, Wang H, Zhu XY, Zhang WJ, Li XM, Liu HB, Xie D. Characteristics of vertical drop jump to screen the anterior cruciate ligament injury. Eur Rev Med Pharmacol Sci 2022; 26:7395-7403. [PMID: 36314309 DOI: 10.26355/eurrev_202210_30008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To clarify the characteristics of vertical drop jump (VDJ) for screening athletes at high risk of ACL injury by comparing the kinematic, kinetic and electromyographic variables of different VDJ. SUBJECTS AND METHODS Thirty male soccer players were recruited to measure parameters of knee kinematics, kinetics, and surface electromyograph during VDJ in four kinds of movements measured (the distance between the take-off feet is 5 cm or 30 cm, and the distance between the landing feet is 5 cm or 30 cm) using the Vicon motion capture system, Kistler3-D dynamometer, and Noraxon surface electromyograph test system. RESULTS The peak knee abduction moment was significantly greater for landing feet distance of 30 cm compared to landing feet distance of 5 cm, regardless of whether the distance between take-off feet was 5 cm (0.58 vs. 0.44) or 30 cm (0.61 vs. 0.40); regardless of whether the distance between landing feet was 5 cm (22.78 vs. 20.45) or 30 cm (24.32 vs. 21.87), the peak vertical Ground Reaction Force was significantly increased for the take-off feet distance was 5 cm compared to take-off feet of 30 cm. CONCLUSIONS In the test of VDJ, athletes will adopt different landing strategies for different movement instructions, and the VDJ with the distance of 5 cm between the take-off feet and the distance of 30 cm between the landing feet may be the better maneuver to screen for risk of ACL injury.
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Affiliation(s)
- B Ma
- School of Sports Medicine and Rehabilitation, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian city, Shandong Province, China.
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Wang Q, Xie D, Li FY, Liu HL, Chen GX, Yu MG. Aqueous construction of raspberry-like ZIF-8 hierarchical structures with enhanced superhydrophobic performance. Nanoscale 2022; 14:13308-13314. [PMID: 36063419 DOI: 10.1039/d2nr03377a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Materials with super-wetting ability have attracted wide attention from both academia and industry due to their great potential applications. A straightforward and versatile route was proposed for the large-scale synthesis of a monodisperse raspberry-like metal-organic framework (ZIF-8) using zinc nitrate as a zinc source and dimethylimidazole as an organic ligand in aqueous solution. After hydrophobic treatment with hexadecyltrimethoxysilane, the ethanolic suspension of three-dimensional raspberry-like ZIF-8 showed excellent superhydrophobic properties. Furthermore, commercial adhesives were used to blend with the suspension to improve the bonding strength to different substrates. These surfaces retained their water resistance after 50 finger-wipe cycles, 40 sandpaper abrasions and knife scratches. Moreover, the prepared hydrophobic surface can withstand the impact of water flow for 10 minutes. The formulations developed can be used for superhydrophobic coating applications on different substrate surfaces such as aluminum foil, glass, paper and cotton.
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Affiliation(s)
- Q Wang
- Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangdong Biomaterials Engineering Technology Research Center, Guangzhou 510316, China.
| | - D Xie
- Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangdong Biomaterials Engineering Technology Research Center, Guangzhou 510316, China.
| | - F Y Li
- Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangdong Biomaterials Engineering Technology Research Center, Guangzhou 510316, China.
| | - H L Liu
- Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangdong Biomaterials Engineering Technology Research Center, Guangzhou 510316, China.
| | - G X Chen
- State Key Laboratory of Pulp and Paper Engineering, South China University of Technology, Guangzhou 510640, China
| | - M G Yu
- School of Materials Science and Hydrogen Energy, Foshan University, Foshan 528000, China
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Liao M, Li F, Hu J, Yang J, Wu D, Xie D, Song J, Huang J, Tian Y, Luo W, Yue C, Liu S, Kong W, Huang L, Zi W, Li F. High neutrophil counts before endovascular treatment for acute basilar artery occlusion predict worse outcomes. Front Aging Neurosci 2022; 14:978740. [PMID: 36118699 PMCID: PMC9475290 DOI: 10.3389/fnagi.2022.978740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposeIschemic stroke is related to inflammation. We investigated leukocyte counts, neutrophil counts, and NLR (neutrophil-to-lymphocyte ratio) to explore their prognostic potential and determine if high neutrophil counts before endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO) are associated with worse outcomes at 90 days post-EVT.MethodsLeukocyte and neutrophil counts and NLR were determined in eligible patients from the Acute Basilar Artery Occlusion Study (BASILAR). Patients were divided into four groups according to leukocyte and neutrophil counts and NLR quartiles. The primary outcome was a favorable outcome based on the modified Rankin Scale (mRS: 0–3). The secondary outcome was functional independence (mRS 0–2). The safety outcome was mortality, and an unfavorable outcome was mRS 4–6. Successful reperfusion was mTICI (modified Thrombolysis in Cerebral Infarction) of 2b or 3. All the data were collected within 90 days after EVT.ResultsWe enrolled 586 patients in the study. The leukocyte and neutrophil counts and NLR were significantly associated with clinical outcomes in all patients though no effects were seen in some intervals. Of these three parameters, the neutrophil count had the most significant impact, negatively affecting the outcome. The findings were similar in patients who were successfully recanalized.ConclusionHigher neutrophil counts predicted worse clinical outcomes 90 days after EVT. This finding supports the deleterious role of inflammation in patients with acute BAO despite EVT or successful recanalization.
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Zhao C, Luo W, Liu X, Luo J, Song J, Yuan J, Liu S, Huang J, Kong W, Hu J, Yang J, Sun R, Yue C, Xie D, Li L, Sang H, Qiu Z, Li F, Wu D, Zi W, Yang Q. Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion. Front Neurol 2022; 13:909677. [PMID: 35968276 PMCID: PMC9372365 DOI: 10.3389/fneur.2022.909677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction According to the literature on anterior circulation, comorbid atrial fibrillation (AF) is not associated with a worse functional outcome, lower reperfusion rates, or higher rates of intracranial hemorrhage after mechanical thrombectomy (MT) compared to intravenous thrombolysis (IVT) or treatment with supportive care. However, data are limited for the effect of comorbid AF on procedural and clinical outcomes of acute basilar artery occlusion (ABAO) after MT. This study aimed to investigate the effect of atrial fibrillation on outcomes after MT and long-term ischemic recurrence in patients with ABAO. Methods We performed a registered study of the Endovascular Treatment for Acute Basilar Artery Occlusion Study (BASILAR, which is registered in the Chinese Clinical Trial Registry, http://www.chictr.org.cn; ChiCTR1800014759) from January 2014 to May 2019, which included 647 patients who underwent MT for ABAO, 136 of whom had comorbid AF. Prospectively defined baseline characteristics, procedural outcomes, and clinical outcomes were reported and compared. Results On multivariate analysis, AF predicted a shorter puncture-to-recanalization time, higher first-pass effect rate, and lower incidence of angioplasty and/or stenting (p < 0.01). AF had no effect on intracranial hemorrhage incidence [adjusted odds ratio (aOR), 1.093; 95% confidence interval (CI), 0.451–2.652], 90-day functional outcomes (adjusted common odds ratio, 0.915; 95% CI, 0.588–1.424), or mortality (aOR, 0.851; 95% CI, 0.491–1.475) after MT. The main findings were robust in the subgroup and 1-year follow-up analyses. Comorbid AF was the remaining predictor of ischemic recurrence (aOR, 4.076; 95% CI, 1.137–14.612). Conclusions The study revealed no significant difference in the safety and efficacy of MT for ABAO regardless of whether patients had comorbid AF. However, a higher proportion of patients with AF experienced ischemic recurrence within 1 year after MT.
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Affiliation(s)
- Chenhao Zhao
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weidong Luo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xing Liu
- Department of Medicine, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jun Luo
- Department of Neurology, The 404th Hospital of Mianyang, Mianyang, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Junjie Yuan
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weilin Kong
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ruidi Sun
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongfei Sang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Deping Wu
- Huaian Medical District of Jingling Hospital, Medical School of Nanjing University, Huaian, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- *Correspondence: Wenjie Zi
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Qingwu Yang
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Tabernero J, Strickler J, Nakamura Y, Shitara K, Janjigian Y, Barzi A, Bekaii-Saab T, Lenz H, Yoshino T, Siena S, Garrido-Mayor J, Ubowski M, Xie D, Marshall J. P-156 MOUNTAINEER-02: Phase 2/3 study of tucatinib, trastuzumab, ramucirumab, and paclitaxel in previously treated HER2+ gastric or gastroesophageal junction adenocarcinoma: Trial in progress. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Guo J, Jiang Z, Biswal BB, Zhou B, Xie D, Gao Q, Sheng W, Chen H, Zhang Y, Fan Y, Wang J, Liu C, Chen H. Hypothalamic Atrophy, Expanded
CAG
Repeat, and Low Body Mass Index in Spinocerebellar Ataxia Type 3. Mov Disord 2022; 37:1541-1546. [PMID: 35426475 DOI: 10.1002/mds.29029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jing Guo
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Zhouyu Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Bharat B. Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Biomedical Engineering New Jersey Institute of Technology Newark New Jersey USA
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Qing Gao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Hui Chen
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Yuhan Zhang
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Yunshuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Jian Wang
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Chen Liu
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Huafu Chen
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
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Chen H, Dai L, Zhang Y, Feng L, Jiang Z, Wang X, Xie D, Guo J, Chen H, Wang J, Liu C. Network Reconfiguration Among Cerebellar Visual, and Motor Regions Affects Movement Function in Spinocerebellar Ataxia Type 3. Front Aging Neurosci 2022; 14:773119. [PMID: 35478700 PMCID: PMC9036064 DOI: 10.3389/fnagi.2022.773119] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background Spinocerebellar ataxia type 3 (SCA3) is a rare movement disorder characterized with ataxia. Previous studies on movement disorders show that the whole-brain functional network tends to be more regular, and these reconfigurations correlate with genetic and clinical variables. Methods To test whether the brain network in patients with SCA3 follows a similar reconfiguration course to other movement disorders, we recruited 41 patients with SCA3 (mean age = 40.51 ± 12.13 years; 23 male) and 41 age and sex-matched healthy individuals (age = 40.10 ± 11.56 years; 24 male). In both groups, the whole-brain network topology of resting-state functional magnetic resonance imaging (rs-fMRI) was conducted using graph theory, and the relationships among network topologies, cytosine-adenine-guanine (CAG) repeats, clinical symptoms, and functional connectivity were explored in SCA3 patients using partial correlation analysis, controlling for age and sex. Results The brain networks tended to be more regular with a higher clustering coefficient, local efficiency, and modularity in patients with SCA3. Hubs in SCA3 patients were reorganized as the number of hubs increased in motor-related areas and decreased in cognitive areas. At the global level, small-worldness and normalized clustering coefficients were significantly positively correlated with clinical motor symptoms. At the nodal level, the clustering coefficient and local efficiency increased significantly in the visual (bilateral cuneus) and sensorimotor (right cerebellar lobules IV, V, VI) networks and decreased in the cognitive areas (right middle frontal gyrus). The clustering coefficient and local efficiency in the bilateral cuneus gyrus were negatively correlated with clinical motor symptoms. The functional connectivity between right caudate nucleus and bilateral calcarine gyrus were negatively correlated with disease duration, while connectivity between right posterior cingulum gyrus and left cerebellar lobule III, left inferior occipital gyrus and right cerebellar lobule IX was positively correlated. Conclusion Our results demonstrate that a more regular brain network occurred in SCA3 patients, with motor and visual-related regions, such as, cerebellar lobules and cuneus gyrus, both forayed neighbor nodes as “resource predators” to compensate for normal function, with motor and visual function having the higher priority comparing with other high-order functions. This study provides new information about the neurological mechanisms underlying SCA3 network topology impairments in the resting state, which give a potential guideline for future clinical treatments. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [ChiCTR1800019901].
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Affiliation(s)
- Hui Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Limeng Dai
- Department of Medical Genetics, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuhan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Liu Feng
- Department of Laboratory Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Zhenzhen Jiang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xingang Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jing Guo
- Biomedical Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- *Correspondence: Huafu Chen,
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Jian Wang,
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chen Liu,
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Manrique K, Griffiths S, Miano T, Kalman L, Oyster M, Xie D, Clausen E, Shah P, Lama V, Dhillon G, Snyder L, Cantu E, Diamond J, Christie J, Shashaty M. Circulating Coagulation Regulator Levels After Lung Transplantation Are Associated with Acute Kidney Injury. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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30
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Griffiths S, Manrique K, Miano T, Kalman L, Oyster M, Xie D, Clausen E, Shah P, Lama V, Dhillon G, Snyder L, Cantu E, Diamond J, Christie J, Shashaty M. Plasma Neutrophil Gelatinase-Associated Lipocalin to Predict Acute Kidney Injury After Lung Transplantation: A Multicenter Cohort Study. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chen Y, Xiong J, Chen W, Xie D, Zhang Y, Mo Y, Gu X, Zhang L. Morphological classification and measurement of the glenoid cavity using three-dimensional reconstruction in a Chinese population. Folia Morphol (Warsz) 2022; 82:325-331. [PMID: 35187632 DOI: 10.5603/fm.a2022.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study was to examine the various shapes and record the morphometric data of the glenoid cavity in a Chinese population. MATERIALS AND METHODS A total of 501 scapulae, 247 left and 254 right, were analyzed. We classified the shape of the glenoid cavity as type Ⅰ (pear-shaped), type Ⅱ (oval-shaped), type Ⅲ (teardrop-shaped), type Ⅳ (calabash-shaped) or type Ⅴ (inverted comma-shaped). Four defined parameters, the superior-inferior glenoid diameter (AB), upper anterior-posterior glenoid diameter (CD), lower anterior-posterior glenoid diameter (EF) and glenoid index (GI), were measured, and five shapes were classified via three-dimensional reconstruction. RESULTS The mean AB, CD, EF and GI values of the glenoid were 3.51±0.41 cm, 1.95±0.28 cm, 2.60±0.34 cm, and 1.35±0.12 cm, respectively. The AB value of type Ⅱ glenoid cavities was significantly smaller than that of type Ⅰ and Ⅲ glenoid cavities (P<0.05), but the GI value of type Ⅱ glenoid cavities was larger than that of type Ⅲ cavities (P<0.05). The CD value showed a difference between type Ⅰ and type Ⅲ glenoid cavities (P<0.05). For the EF parameter, the values of type Ⅲ glenoid cavities were significantly larger than those of type Ⅰ and Ⅱ glenoid cavities (P<0.05). CONCLUSIONS Measuring and observing the variety of shapes and sizes of the glenoid cavity in Chinese people is conducive to for better understand its morphological features. This information can also guide surgeons in the design and selection of suitable prostheses for total shoulder arthroplasty in the Chinese population in order to reduce postoperative complications.
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Affiliation(s)
- Y Chen
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - J Xiong
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - W Chen
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - D Xie
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - Y Zhang
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - Y Mo
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - X Gu
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - L Zhang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China. .,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China. .,Expert Workstation in Luzhou, Luzhou, China. .,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, China.
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Xie D, Li Y, Ma S, Yang X, Mei Y, Peng L, Lang Y, Chen A, Huang B, Chen Y, Huang X, Qian CN. FLASH Mechanisms Track (Oral Presentations) BIOLOGICAL EFFECT OF MURINE VENTRAL SKIN IRRADIATION WITH PULSED FLASH RADIOTHERAPY USING A CLINICAL LINAC. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kong W, Yuan J, Huang J, Song J, Zhao C, Sang H, Luo W, Xie D, Gao F, Li H, Luo J, Liu S, Xue D, Yu Y, Li F, Qiu Z, Zi W, Yang Q. Outcomes of Endovascular Therapy in Acute Basilar Artery Occlusion With Severe Symptoms. JAMA Netw Open 2021; 4:e2139550. [PMID: 34913974 PMCID: PMC8678675 DOI: 10.1001/jamanetworkopen.2021.39550] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE Endovascular therapy (EVT) has been reported to be safe and effective in improving clinical outcomes among patients with acute basilar artery occlusion (ABAO). The benefits associated with EVT remain uncertain for patients with ABAO with severe symptoms (ie, National Institutes of Health Stroke Scale [NIHSS] score ≥ 21). OBJECTIVES To assess the outcomes associated with EVT and identify factors associated with outcomes among patients with ABAO and severe symptoms. DESIGN, SETTING, AND PARTICIPANTS This prospective, nationwide cohort study was conducted using data from January 2014 to May 2019 in China from the Endovascular Treatment for Acute Basilar Artery Occlusion Study Registry (BASILAR). Included patients had ABAO and underwent EVT or standard medical treatment (SMT) alone in routine clinical practice. Patients were dichotomized into severe symptoms (ie, NIHSS score ≥ 21) and minor to moderate symptoms (NIHSS score < 21) groups. Patients were followed up for 90 days. Data were analyzed from December 2020 through June 2021. EXPOSURES EVT with SMT vs SMT alone. MAIN OUTCOMES AND MEASURES The primary outcome was improvement in modified Rankin Scale (mRS) score at 90 days, defined as a decrease by 1 grade in mRS score. Secondary outcomes included favorable functional outcome (ie, mRS score, 0-3) and mortality. RESULTS Among 542 patients with ABAO and severe symptoms (median [IQR] age, 65 [57-74] years; 147 [27.1%] women), 431 patients (79.5%) received EVT and 111 patients (20.5%) received SMT. Compared with SMT, EVT was associated with increased odds of improved mRS score (adjusted common odds ratio [OR], 3.44 [95% CI, 2.05-5.78]; P < .001), with increased odds of a favorable functional outcome (ie, mRS score, 0-3; adjusted OR, 4.52 [95% CI, 1.64-12.43]; P = .004) and decreased odds of mortality (adjusted OR, 0.27 [95% CI, 0.15-0.50]; P < .001). Among patients receiving EVT, baseline NIHSS score was associated with decreased odds of a favorable functional outcome (adjusted OR per 1-point increase in score, 0.90 [95% CI, 0.85-0.95]; P < .001) and increased odds of mortality (adjusted OR per 1-point increase in score, 1.13 [95% CI, 1.07-1.19]; P < .001), while posterior circulation Acute Stroke Prognosis Early Computed Tomography Score (pc-ASPECTS) was associated with increased odds of a favorable functional outcome (adjusted OR per 1-point increase in score, 1.71 [95% CI, 1.41-2.07]; P < .001) and decreased odds of mortality (adjusted OR per 1-point increase in score, 0.74 [95% CI, 0.64-0.85]; P < .001). Different occlusion sites, compared with distal basilar artery, were associated with decreased odds of favorable functional outcome (eg, middle basilar artery: adjusted OR vs distal basilar artery, 0.36 [95% CI, 0.17-0.80]; P = .01). CONCLUSIONS AND RELEVANCE This study found that EVT was associated with increased odds of functional favorable outcomes among patients with ABAO and severe symptoms. Baseline NIHSS score, pc-ASPECTS, and occlusion site were independent factors associated with clinical outcomes.
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Affiliation(s)
- Weilin Kong
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Junjie Yuan
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chenhao Zhao
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongfei Sang
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weidong Luo
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fei Gao
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Huagang Li
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Jun Luo
- Department of Neurology, 404th hospital of Mianyang, Mianyang, China
| | - Shudong Liu
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing Key Laboratory, Chongqing, China
| | - Dongzhang Xue
- Department of Neurology, 902nd Hospital of the People’s Liberation Army, Bengbu, China
| | - Yinquan Yu
- Department of Neurology, Bazhong Hospital of Traditional Chinese Medicine, Bazhong, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Chen L, Zhao C, Song J, Zi W, Sang H, Yuan J, Huang J, Li L, Luo W, Fu X, Zhou P, Wan Y, Zeng G, Xie D, Gao F, Li F, Qiu Z, Yang Q. Extended Thrombolysis In Cerebral Infarction (eTICI) grade 2c: a potential angiographic target for endovascular treatment in acute basilar artery occlusion? J Neurointerv Surg 2021; 14:1022-1026. [PMID: 34782398 DOI: 10.1136/neurintsurg-2021-018026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/27/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Higher extended Thrombolysis In Cerebral Infarction (eTICI) grades are associated with better clinical outcomes after endovascular treatment (EVT) for proximal intracranial occlusion of the anterior circulation. However, the relationship between eTICI grade and outcomes after EVT in patients with acute basilar artery occlusion (BAO) remains unclear. We aimed to explore which eTICI category was the cut-off correlating with better clinical outcomes in patients with BAO undergoing EVT. METHODS We included patients treated via EVT from the BASILAR study. Multivariable logistic regression analyses were performed to assess the impact of eTICI grades on 90-day favorable functional outcomes, defined as a modified Rankin Scale (mRS) score of 0-3. Other outcomes were functional independence (mRS 0-2), all-cause mortality, and symptomatic intracranial hemorrhage. RESULTS Among 647 patients treated with EVT, 127 (19.6%), 128 (24.5%), 110 (21.1%), and 282 (54%) patients achieved eTICI grades of 0-2a, 2b, 2c, and 3, respectively. Compared with eTICI grades 0-2a, higher rates of favorable functional outcomes (adjusted OR (aOR) 2.96, 95% CI 1.33 to 6.57, and aOR 7.40, 95% CI 3.63 to 15.09, respectively) were observed for grades 2c and 3, not 2b (aOR 1.93, 95% CI 0.86 to 4.36). The risks of mortality and symptomatic intracranial hemorrhage were also lower for eTICI grades 2c and 3 than for grades 0-2a. CONCLUSIONS An eTICI grade of 2c/3 may be a target for successful reperfusion after EVT in patients with acute BAO; however, further studies with larger sample sizes and clinical trials are needed.
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Affiliation(s)
- Luming Chen
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Chenghao Zhao
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Jiaxing Song
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Hongfei Sang
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Junjie Yuan
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Weidong Luo
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Xinmin Fu
- Xuzhou Central Hospital, Xuzhou, China
| | - Peiyang Zhou
- The First People's Hospital of Xiangyang, Hubei Medical University, Department of Neurology, Xiangyang, China
| | - Yue Wan
- Hubei Zhongshan Hospital, Wuhan, China
| | - Guoyong Zeng
- Neurology, Ganzhou People's Hospital, Ganzhou, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Fei Gao
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China.,Neurology, 903th Hospital of PLA, Hangzhou, Zhejiang, China
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital Department of Neurology, Chongqing, China
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Yang Q, Li J, Zhang Z, Wu X, Liao T, Yu S, You Z, Hou X, Ye J, Liu G, Ma S, Xie G, Zhou Y, Li M, Wu M, Feng Y, Wang W, Li L, Xie D, Hu Y, Liu X, Wang B, Zhao S, Li L, Luo C, Tang T, Wu H, Hu T, Yang G, Luo B, Li L, Yang X, Li Q, Xu Z, Wu H, Sun J. Clinical characteristics and a decision tree model to predict death outcome in severe COVID-19 patients. BMC Infect Dis 2021; 21:783. [PMID: 34372767 PMCID: PMC8351764 DOI: 10.1186/s12879-021-06478-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/18/2021] [Indexed: 12/18/2022] Open
Abstract
Background The novel coronavirus disease 2019 (COVID-19) spreads rapidly among people and causes a pandemic. It is of great clinical significance to identify COVID-19 patients with high risk of death. Methods A total of 2169 adult COVID-19 patients were enrolled from Wuhan, China, from February 10th to April 15th, 2020. Difference analyses of medical records were performed between severe and non-severe groups, as well as between survivors and non-survivors. In addition, we developed a decision tree model to predict death outcome in severe patients. Results Of the 2169 COVID-19 patients, the median age was 61 years and male patients accounted for 48%. A total of 646 patients were diagnosed as severe illness, and 75 patients died. An older median age and a higher proportion of male patients were found in severe group or non-survivors compared to their counterparts. Significant differences in clinical characteristics and laboratory examinations were found between severe and non-severe groups, as well as between survivors and non-survivors. A decision tree, including three biomarkers, neutrophil-to-lymphocyte ratio, C-reactive protein and lactic dehydrogenase, was developed to predict death outcome in severe patients. This model performed well both in training and test datasets. The accuracy of this model were 0.98 in both datasets. Conclusion We performed a comprehensive analysis of COVID-19 patients from the outbreak in Wuhan, China, and proposed a simple and clinically operable decision tree to help clinicians rapidly identify COVID-19 patients at high risk of death, to whom priority treatment and intensive care should be given. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06478-w.
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Affiliation(s)
- Qiao Yang
- Department of Ultrasound, The 941st Hospital of the PLA Joint Logistic Support Force, Xining, People's Republic of China
| | - Jixi Li
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Zhijia Zhang
- Department of Clinical Laboratory, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xiaocheng Wu
- Department of Emergency, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Tongquan Liao
- Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Shiyong Yu
- Department of Cardiology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Zaichun You
- Department of General Medicine, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xianhua Hou
- Department of Neurology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Jun Ye
- Department of Gastroenterology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Gang Liu
- Pulmonary and Critical Care Medicine Center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Siyuan Ma
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, People's Republic of China
| | - Ganfeng Xie
- Department of Oncology, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Yi Zhou
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Mengxia Li
- Cancer Center, Army Medical Center, Chongqing, People's Republic of China
| | - Meihui Wu
- Nursing Department, Army Medical Center, Chongqing, People's Republic of China
| | - Yimei Feng
- Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Weili Wang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Lufeng Li
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Yunhui Hu
- Department of Cardiology, The 958th Hospital, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xi Liu
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Bin Wang
- Pulmonary and Critical Care Medicine Center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Songtao Zhao
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Li Li
- Department of Respiratory Medicine, Army Medical Center, Chongqing, People's Republic of China
| | - Chunmei Luo
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Tang Tang
- Department of Obstetrics and Gynecology, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Hongmei Wu
- Pulmonary and Critical Care Medicine Center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Tianyu Hu
- Department of Nosocomial Infection Control, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Guangrong Yang
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Bangyu Luo
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Lingchen Li
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xiu Yang
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Qi Li
- Pulmonary and Critical Care Medicine Center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China.
| | - Zhi Xu
- Pulmonary and Critical Care Medicine Center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China.
| | - Hao Wu
- Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China.
| | - Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China.
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Strickler J, Nakamura Y, Shitara K, Catenacci D, Janjigian Y, Barzi A, Bekaii-Saab T, Lenz H, Lee J, Van Cutsem E, Chung H, Tabernero J, Yoshino T, Siena S, Garrido-Mayor J, Palanca-Wessels M, Xie D, Marshall J. P-174 MOUNTAINEER-02: Phase 2/3 study of tucatinib, trastuzumab, ramucirumab, and paclitaxel in previously treated HER2+ gastric or gastroesophageal junction adenocarcinoma: Trial in progress. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bi XG, Li ML, Xu W, You JY, Xie D, Yuan XF, Xiang Y. Helix B surface peptide protects against acute lung injury through reducing oxidative stress and endoplasmic reticulum stress via activation of Nrf2/HO-1 signaling pathway. Eur Rev Med Pharmacol Sci 2021; 24:6919-6930. [PMID: 32633385 DOI: 10.26355/eurrev_202006_21683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Acute lung injury (ALI) is a clinical problem with poor prognosis and high mortality. The purpose of this study was to explore the effects of helix B position peptide (HBSP) on ALI and its mechanism. MATERIALS AND METHODS C57/BL6 male mice were used to construct ALI models by LPS tracheal injection and detect the effect of HBSP on mouse ALI by subcutaneously injecting HBSP. In addition, normal human lung epithelial cell line (BEAS-2B) were cultured and stimulated with HBSP. Then, the effects of HBSP on oxidative stress and endoplasmic reticulum stress (ERS) in BEAS-2B cells were examined. Finally, the effect of HBSP on the Nrf2/HO-1 signaling pathway was examined, and the mechanism of action of HBSP was verified using the Nrf2/HO-1 signaling pathway inhibitor ML385. RESULTS In vitro, HBSP increased the expression of SOD1/2 and decreased the expression of ERS-related molecules such as CHOP, GRP-78, and caspase-12, indicating that HBSP effectively reduces the level of oxidative stress and ERS in BEAS-2B cells. In addition, HBSP also increased the activity of the Nrf2/HO-1 signaling pathway and ML385 reduced the protective effect of HBSP on BEAS-2B cells. In vivo, HBSP significantly reduced LPS-induced mouse ALI. W/D and inflammatory factors in the BALF of the mouse lung were significantly reduced and the level of oxidative stress was also reduced. CONCLUSIONS HBSP plays an important role in relieving ALI by activating Nrf2/HO-1 signaling pathway, which reduces the level of inflammation in lung tissue and oxidative stress and ERS in lung epithelial cells.
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Affiliation(s)
- X-G Bi
- Department of General ICU, The Third Affiliated Hospital of Sun Yat-sen University-Lingnan Hospital, Guangzhou, China.
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Hurvitz S, Harbeck N, Vahdat L, Wolff A, Tolaney S, Loi S, Masuda N, O'Shaughnessy J, Xie D, Walker L, Rustia E, Borges V. 126TiP HER2CLIMB-02: Tucatinib or placebo with T-DM1 for unresectable locally-advanced or metastatic HER2+ breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Xu L, Su H, She Y, Xie D, Chen C. MA09.05 A Comparison of the Number of Involved Nodal Stations With Currently Used Pathological N Stage on Predicting Prognosis in NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Cai Z, Zhang J, He Y, Xia L, Dong X, Chen G, Zhou Y, Hu X, Zhong S, Wang Y, Chen H, Xie D, Liu X, Liu J. Liquid biopsy by combining 5-hydroxymethylcytosine signatures of plasma cell-free DNA and protein biomarkers for diagnosis and prognosis of hepatocellular carcinoma. ESMO Open 2021; 6:100021. [PMID: 33508734 PMCID: PMC7841321 DOI: 10.1016/j.esmoop.2020.100021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/29/2020] [Accepted: 11/14/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Liquid biopsy based on 5-hydroxymethylcytosine (5hmC) signatures of plasma cell-free DNA (cfDNA) originating from tumor cells provides a novel approach for early diagnosis in hepatocellular carcinoma (HCC). Here, we sought to develop a reliable model using cfDNA 5hmC signatures and protein biomarkers for diagnosis and prognosis of HCC. PATIENTS AND METHODS We carried out genome-wide 5hmC sequencing of cfDNA samples collected from 165 healthy volunteers, 62 liver cirrhosis (LC) patients and 135 HCC patients. A sensitive 5hmC diagnostic model was developed based on 5hmC signatures selected by sparse Partial Least Squares Discriminant Analysis and cross-validation to define the weighted diagnostic score (wd-score). Then, we combined protein biomarkers with the wd-score to build a more robust score (HCC score) by logistic regression. RESULTS The distribution pattern of differential 5hmC regions could clearly distinguish HCC patients, LC patients and healthy volunteers. The wd-score based on 64 5hmC signatures in cfDNA achieves 93.24% of area under the curve (AUC) to distinguish HCC patients from non-HCC patients, and the HCC score by combing protein biomarkers achieves 92.75% of AUC to distinguish HCC patients from LC patients. Meanwhile, the HCC score showed high capacity for screening high recurrence risk patients after receiving surgical resection, and appeared to be an independent indicator for both relapse-free survival (P = 0.00865) and overall survival (P = 0.000739). Furthermore, the values of the HCC score in patients' longitudinal plasma samples were positively associated with tumor burden dynamics during follow-up. CONCLUSION We have developed and validated a novel non-invasive liquid biopsy strategy for HCC diagnosis, prognosis and surveillance during HCC progression.
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Affiliation(s)
- Z Cai
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China
| | - J Zhang
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Y He
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China; Laboratory of Nervous System Disease and Brain Functions, Clinical Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, P. R. China
| | - L Xia
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - X Dong
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China
| | - G Chen
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China
| | - Y Zhou
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China
| | - X Hu
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - S Zhong
- Tailai Inc., Shanghai, P. R. China
| | - Y Wang
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China
| | - H Chen
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China
| | - D Xie
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China.
| | - X Liu
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China.
| | - J Liu
- The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, P. R. China; Mengchao Med-X Center, Fuzhou University, Fuzhou, P. R. China.
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Yu YM, Li XX, Xie D, Wang H. Horizontal orientation of zygomorphic flowers: significance for rain protection and pollen transfer. Plant Biol (Stuttg) 2021; 23:156-161. [PMID: 33073503 DOI: 10.1111/plb.13197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Floral traits are recognized to have evolved under selection for abiotic and biotic factors. Complex zygomorphic flowers usually face horizontally. It has been proved that a horizontal orientation facilitates pollinator recognition and pollination efficiency, but its significance in adaptation to abiotic factors remains unknown. The floral orientation of Abelia × grandiflora naturally varies around horizontal (with an angle of -30 to +33° between the floral main axis and the horizontal). We examined whether three different floral orientations affected flower thermal conditions, response to rain and pollination. Results showed that floral orientation had no effect on diurnal variations in flower temperature. The anthers of all three flower orientations were wetted by rainfall, but the inclined upward-facing flowers contained significantly more rainwater. The horizontal flowers received significantly higher visitation by hawkmoths and had a higher stigmatic pollen load. In contrast, the upward flower orientation reduced pollination precision, while downward-facing flowers had decreased pollinator attraction. This study indicates that horizontal flowers may have evolved as a trade-off between rain protection and pollination. Zygomorphic flowers that deviate from a horizontal orientation may have lower fitness because of flower flooding by rainwater and decreased pollen transfer.
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Affiliation(s)
- Y-M Yu
- College of Horticulture & Forestry Sciences/Hubei Engineering Technology Research Center for Forestry Information, Huazhong Agricultural University, Wuhan, China
| | - X-X Li
- Institute of Wetland Research, Chinese Academy of Forestry, Beijing, China
| | - D Xie
- Co-Innovation Center for Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing, China
| | - H Wang
- College of Horticulture & Forestry Sciences/Hubei Engineering Technology Research Center for Forestry Information, Huazhong Agricultural University, Wuhan, China
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Masuda N, Hurvitz S, Vahdat L, Harbeck N, Wolff A, Tolaney S, Loi S, O'Shaughnessy J, Xie D, Walker L, Rustia E, Borges V. 67TiP HER2CLIMB-02: A randomized, double-blind, phase III study of tucatinib or placebo with T-DM1 for unresectable locally-advanced or metastatic HER2+ breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lu X, Li X, Xie D, Jiang C, Wang C, Li L, Zhang Y, Tian H, Gao H, Wang C. The Ca 2+ -regulated protein kinase CIPK1 integrates plant responses to phosphate deficiency in Arabidopsis thaliana. Plant Biol (Stuttg) 2020; 22:753-760. [PMID: 32445589 DOI: 10.1111/plb.13137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/14/2020] [Indexed: 05/22/2023]
Abstract
Phosphate (Pi) deficiency severely restricts plant growth and development, as Pi is an essential macronutrient. Calcium (Ca2+ ) is a ubiquitous second messenger in plants; calcineurin B-like proteins (CBL) and CBL-interacting protein kinases (CIPK) are signalling pathways that act as an important Ca2+ signalling network which integrates plants to fine tune the response to stress; however, whether CIPK are involved in Pi deficiency stress remains largely unknown. In this study, we carried out a reverse genetic strategy to screen T-DNA insertion mutants of CIPK isoforms under Pi deficiency in Arabidopsis thaliana. Then Pi content, transcription of phosphate starvation-induced (PSI) genes, acid phosphatase activity and hydrogen peroxide were determined in the wild-type (WT) and cipk1 mutant, respectively. The phenotype of CIPK1 complementation lines was analysed. The cipk1 mutant had a more sensitive phenotype, with lower root elongation and root length, and decreased Pi content compared with the WT under Pi deficiency. Moreover, CIPK1 mutation caused phosphate starvation-induced (PSI) genes to be significantly induced under Pi deficiency. Histological staining demonstrated that the cipk1 mutant had increased acid phosphatase activity and hydrogen peroxide concentration under Pi deficiency. By using the yeast two-hybrid system, we further demonstrated the interaction between CIPK1 and the WRKY transcription factors, WRKY6 and WRKY42. Overall, we demonstrate that CIPK1 is involved in the Pi deficiency signalling pathway in A. thaliana, revealing the important role of Ca2+ in the Pi nutrition signalling pathway, and potentially providing a theoretical foundation for molecular breeding of crops with better Pi utilization efficiency.
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Affiliation(s)
- X Lu
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - X Li
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - D Xie
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - C Jiang
- College of Innovation and Experiment, Northwest A&F University, Yangling, China
| | - C Wang
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - L Li
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - Y Zhang
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - H Tian
- College of Innovation and Experiment, Northwest A&F University, Yangling, China
| | - H Gao
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
| | - C Wang
- State Key Laboratory of Crop Stress Biology for Arid Areas and College of Life Sciences, Northwest A&F University, Yangling, China
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Amiri-Kordestani L, Xie D, Tolaney SM, Bloomquist E, Tang S, Ibrahim A, Goldberg KB, Theoret MR, Pazdur R, Sridhara R, Winer EP, Beaver JA. A Food and Drug Administration analysis of survival outcomes comparing the Adjuvant Paclitaxel and Trastuzumab trial with an external control from historical clinical trials. Ann Oncol 2020; 31:1704-1708. [PMID: 32866625 DOI: 10.1016/j.annonc.2020.08.2106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Although the Adjuvant Paclitaxel and Trastuzumab (APT) trial has been adopted clinically, single-arm trials have limitations, and interest remains whether these patients with small node-negative human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (EBC) would benefit from more intensive chemotherapy. This analysis explored whether external controls can contextualize single-arm studies to add to clinical decision making in the use of de-escalated therapy in patients with low-risk HER2-positive EBC. PATIENTS AND METHODS Patient-level data from five randomized trials supporting drug approval in adjuvant HER2-positive EBC were pooled, and patients with low-risk EBC were selected (n = 1770). Patients treated concurrently with trastuzumab and either anthracycline/cyclophosphamide/taxane/trastuzumab (ACTH) or taxane/carboplatin/trastuzumab (TCH; n = 1366) were matched (1:1) to patients treated with paclitaxel and trastuzumab (TH) in the APT trial (n = 406) using propensity scores. Patients treated with anthracycline/cyclophosphamide/taxane (ACT; n = 374) were also matched (1:1) to those treated with TH. Propensity scores were estimated using covariates of age, tumor stage, estrogen receptor status, progesterone receptor status, and histological grade. RESULTS After matching, the estimated probabilities of invasive disease-free survival (iDFS) at 3 and 5 years were 98.6% and 96.5% in the TH arm, and 96.6% and 92.9% in the ACTH/TCH arm, respectively. The estimated probabilities of overall survival (OS) at 3 and 5 years were 99.7% and 99.3% in the TH arm, and 99.0% and 97.4% in the ACTH/TCH arm, respectively. Comparing the TH arm with the ACT arm in the matched sample, the estimated difference in iDFS was 7.5% (TH 98.8% and ACT 91.3%) at 3 years and 12.6% (TH 96.1% and ACT 83.5%) at 5 years. The estimated difference in OS was 2.6% (TH 100% and ACT 97.4%) at 3 years, and 5.3% (TH 99.3% and ACT 94.0%) at 5 years. CONCLUSIONS Our analyses suggest that patients' outcomes in both arms were in general similar, thus providing additional reassurance regarding de-escalation of therapy.
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Affiliation(s)
- L Amiri-Kordestani
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring.
| | - D Xie
- Office of Biostatistics, Division of Biometrics V, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - E Bloomquist
- Office of Biostatistics, Division of Biometrics V, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA
| | - S Tang
- Office of Biostatistics, Division of Biometrics V, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, USA
| | - A Ibrahim
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring
| | - K B Goldberg
- Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, USA
| | - M R Theoret
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring; Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, USA
| | - R Pazdur
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring; Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, USA
| | - R Sridhara
- Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, USA
| | - E P Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J A Beaver
- Office of Oncologic Diseases, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring
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Wang W, Zhao Z, Liu X, Liu G, Xie D, Xu Z, Zhao J, Zhang J. Clinical features and potential risk factors for discerning the critical cases and predicting the outcome of patients with COVID-19. J Clin Lab Anal 2020; 34:e23547. [PMID: 32860454 PMCID: PMC7595899 DOI: 10.1002/jcla.23547] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/16/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate the clinical features and risk factors for discerning the critical and predicting the outcome of patients with COVID‐19. Methods Patients who were admitted to the intensive care unit (ICU) department and general infection department of TaiKang Tongji (Wuhan) Hospital from February 10 to March 27, 2020, were included. Data on clinical features, complications, laboratory parameters, chest CT, nutrient requirement, and electrolyte imbalance were analyzed retrospectively. Results A total of 123 (50 critical and 73 non‐critical) patients were enrolled. 65% of patients with comorbidities, hypertension (45.5%), diabetes (21.9%), 36.5% of patients had more than one comorbidity. The proportion of lymphocytes in critical patients was significantly lower than that of non‐critical patients. The proportion of patients with increased NLR, PLR, IL‐6, CRP levels, and chest CT score was significantly higher in the critical than that of non‐critical patients. The logistic regression analysis identified low lymphocyte count, high NLR, PLR, IL‐6, CRP levels, and CT score as independent factors for discerning critical cases and high NLR, PLR, IL‐6, and CT score could predict poor clinical outcome. Furthermore, we identified patients who needed nutrition support (HR 16.99) and with correction of electrolyte imbalance (HR 18.24) via intravenous injection were more likely to have a poor outcome. Conclusions The potential risk factors of lower lymphocyte count, high levels of NLR, PLR, IL‐6, CRP, chest CT score, and the statue of nutrient requirement or electrolyte imbalance could assist clinicians in discerning critical cases and predict the poor outcome in patients with COVID‐19.
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Affiliation(s)
- Weili Wang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongxiu Zhao
- Department of Ophthalmology, Chongqing Aier-Mega Eye Hospital, Aier Eye Hospital Group, Chongqing, China
| | - Xi Liu
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Gang Liu
- Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhi Xu
- Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinghong Zhao
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jingbo Zhang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Lu D, Yao Z, Li Y, Zhong Y, Wang X, Xie D, Xia X, Gu C, Tu J. Sodium-rich manganese oxide porous microcubes with polypyrrole coating as a superior cathode for sodium ion full batteries. J Colloid Interface Sci 2020; 565:218-226. [DOI: 10.1016/j.jcis.2020.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 01/23/2023]
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Xu L, Xie D, Griffin K, Staley B, Nichols D, Benca R, Pack A, Redline S, Walsh J, Kushida C, Kuna S. Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wehner MR, Kwong PL, Kurichi JE, Xie D, Hennessy S, Margolis DJ. Patient-reported health not associated with keratinocyte carcinoma treatment choice in a Medicare cohort of older adults. Br J Dermatol 2019; 182:1059-1061. [PMID: 31539166 DOI: 10.1111/bjd.18543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M R Wehner
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A.,Department of Health Services Research, MD Anderson Cancer Center, Houston, TX, 77030, U.S.A.,Dermatology, MD Anderson Cancer Center, Houston, TX, 77030,, U.S.A
| | - P L Kwong
- Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,, U.S.A
| | - J E Kurichi
- Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,, U.S.A
| | - D Xie
- Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,, U.S.A
| | - S Hennessy
- Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,, U.S.A
| | - D J Margolis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A.,Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,, U.S.A
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IMAIZUMI T, Hamano T, Fujii N, Maruyama S, Huang J, Xie D, He J, Ricardo C A, Fukagawa M, Feldman I H. SAT-245 CARDIOVASCULAR DISEASE HISTORY AND BETA-BLOCKER PRESCRIPTION PATTERNS FOR JAPANESE AND AMERICAN CKD PATIENTS: COLLABORATION BETWEEN CRIC AND CKD-JAC. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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ANDERSON A, Orlandi P, Wang X, Xie D, Yang W, Feldman H. SAT-175 TRAJECTORIES OF KIDNEY FUNCTION AND THEIR PREDICTORS: FINDINGS FROM THE CHRONIC RENAL INSUFFICIENCY COHORT (CRIC) STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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