Background
The long-term outcomes of acute large vessel occlusion (LVO) in anterior circulation treated by endovascular treatment (EVT) remains to be determined. The aim of this study was to assess ...the 5-year outcomes of patients with LVO who underwent EVT.
Methods
This study was an observational, nationwide registry of consecutive patients with acute LVO who received EVT in 28 comprehensive stroke centers in China. The primary outcome was the proportion of favorable outcome modified Rankin Scale score (mRS) 0–2 at 5 years. Secondary outcomes included proportions of patients with excellent outcome (mRS 0–1), all-cause mortality and risk of stroke recurrence at 5 years.
Results
A total of 807 patients were included into the study and had 90-day follow-up data, 657 patients had 5-year follow-up data. At 90 days, 218 patients (27.0%) had an excellent outcome, 349 patients (43.2%) had a favorable functional outcome. 199 patients (24.7%) died. At 5 years, 190 patients (28.9%) had an excellent outcome, 261 patients (39.7%) had a favorable functional outcome, 317 patients (48.2%) died and 129 (28.2%) had stroke recurrence. Because of missing 5-year follow-up data, among available 269 patients who achieved functional independence at 90 days, 208 (77.3%) maintained favorable outcome, 19 (7.1%) had disability (mRS 3–5) and 42 (15.6%) died at 5 years. Furthermore, among available 189 patients with mRS 3–5 at 90 days, 53 (28.0%) patients achieved favorable functional outcome, 60 (31.7%) patients maintained unfavorable functional outcome and 76 (40.2%) patients died within 5 years. Multivariate analyses identified that younger age odds ratio (OR): 0.96; 95% CI, 0.93–0.99;
P
= 0.009, lower mRS at 90 days (OR: 0.15; 95% CI, 0.10–0.23;
P
< 0.001) and absence of stroke recurrence (OR: 0.001; 95% CI, 0.000–0.006;
P
< 0.001) were significantly associated with favorable outcome at 5 years. Advanced age (OR: 1.06, 95% CI, 1.04–1.08;
P
< 0.001), higher mRS at 90 days (OR: 0.84; 95% CI, 0.73–0.98;
P
= 0.021) and atrial fibrillation (OR: 1.63; 95% CI, 1.02–2.60;
P
= 0.04) were independent factors for stroke recurrence.
Conclusion
Our results indicated that the beneficial effect of EVT in patients with acute LVO can be sustained during the course of at least 5 years. Reducing the risk of stroke recurrence by anticoagulation for atrial fibrillation may be a crucial strategy to improve long-term outcome.
Deacetylated cellulose acetate/thermoplastic polyurethane@graphene oxide (DA/TPU@GO) nanofibrous membranes were prepared through the combination of electrospinning, deacetylation, and ...ultrasound-assisted surface treatment techniques. The morphology, wettability, and mechanical properties of composite nanofiber membranes were studied via SEM, TEM, water contact angle measurements, and mechanical tests. Moreover, the adsorption capacity and mechanism of DA/TPU@GO nanofiber membranes for methylene blue and chromium (Cr (VI)) were analyzed. The introduction of active sites from GO led to a significant increase in the adsorption capacity of the DA/TPU@GO composite membranes compared with the DA/TPU composite nanofiber. The composite membrane featured adsorption capacities of 152.7 mg/g (25degreesC, pH 3) and 122.1 mg/g (25degreesC, pH 7) for Cr (VI) and methylene blue, respectively, which are higher than most other composite GO-based adsorbents. The adsorption mechanism of the DA/TPU@GO composite membrane was consistent with the Langmuir isotherm and second-order kinetic models. Therefore, the DA/TPU@GO composite nanofiber membrane served as an effective adsorbent with broad application prospects in the sewage treatment field owing to its excellent adsorption capacity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Deacetylated cellulose acetate/thermoplastic polyurethane@graphene oxide (DA/TPU@GO) nanofibrous membranes were prepared through the combination of electrospinning, deacetylation, and ...ultrasound-assisted surface treatment techniques. The morphology, wettability, and mechanical properties of composite nanofiber membranes were studied via SEM, TEM, water contact angle measurements, and mechanical tests. Moreover, the adsorption capacity and mechanism of DA/TPU@GO nanofiber membranes for methylene blue and chromium (Cr (VI)) were analyzed. The introduction of active sites from GO led to a significant increase in the adsorption capacity of the DA/TPU@GO composite membranes compared with the DA/TPU composite nanofiber. The composite membrane featured adsorption capacities of 152.7 mg/g (25degreesC, pH 3) and 122.1 mg/g (25degreesC, pH 7) for Cr (VI) and methylene blue, respectively, which are higher than most other composite GO-based adsorbents. The adsorption mechanism of the DA/TPU@GO composite membrane was consistent with the Langmuir isotherm and second-order kinetic models. Therefore, the DA/TPU@GO composite nanofiber membrane served as an effective adsorbent with broad application prospects in the sewage treatment field owing to its excellent adsorption capacity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Solar-driven water evaporation is a promising approach to solve the issue of water resource shortage. Herein, a cellulose acetate (CA)/graphene(G) nanofiber membrane evaporator with superior oil ...resistance was prepared by electrospinning and subsequently with the deacetylation process. The as-fabricated d-CA/G composite nanofiber membranes possess high solar absorption, high porosity, and low thermal conductivity. The evaporation rate of d-CA/G composite nanofiber membrane with a graphene concentration of 3 % for pure water can reach 1.38 kg m−2 h−1 with the corresponding efficiency of 88.4 % under one sun illumination. Moreover, the d-CA/G composite nanofiber membrane possesses super hydrophilic and underwater superoleophobicity. Thus, the d-CA/G composite nanofiber membrane can resist fouling by oils and dissolve the concentrated salt back into bulk water, resulting in efficient purification capacity for oil-in-water emulsion and stable desalination performance for seawater in the long term. The evaporation rate of the d-CA/G evaporator can approach 1.37 kg m−2 h−1 when used for the purification of oil-in-water emulsion. This study provides a facile way for the development of multifunctional nanofiber membrane evaporators with highly efficient and sustainable for seawater desalination and wastewater treatment.
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•A super hydrophilic cellulose acetate/graphene nanofiber membrane was prepared through a simple strategy.•The effect of graphene concentration, spinning time, and deacetylation time on the solar-driven water evaporation rate was investigated.•The d-CA/G-3% membrane evaporator possesses high efficiency for seawater desalination and wastewater treatment.•The d-CA/G-3% membrane can be used for the treatment of oil-in-water emulsion.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Solar interfacial water evaporation is an environmentally friendly and potential approach to producing fresh water. Herein, a PAN/CNTs-foam (PCF) evaporator with high porosity, hierarchical pore ...structure, and excellent solar absorption was successfully prepared by the vacuum casting method. The PCF prepared with a CNTs content of 17 % and NaCl particle size of 150–300 μm possessed an evaporation rate of 2.04 kg m−2 h−1 for pure water under 1 sun illumination. The PCF-2 showed a maximum evaporation rate of 5.60 kg m−2 h−1 for real seawater in outdoor experiments, and the quality of the produced clean water was also demonstrated. The purification ability of PCF for organic dyes further confirmed the potential usage in wastewater treatment. Particularly, the PCF-2 exhibited efficient and stable desalination performance for hypersaline water even in 25 wt% simulated brine due to the hierarchical interconnected channels. Our work offers a robust method for the construction of a 3D foam evaporator with hierarchical interconnected channels for efficient and sustainable hypersaline water desalination.
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•A 3D PCF evaporator with hierarchical pore structure and controllable pore size was successfully prepared by the vacuum casting method.•The prepared PCF-2 evaporator showed a high evaporation rate and evaporation efficiency.•The PCF-2 evaporator possesses excellent salt resistance and can be for the treatment of hypersaline water.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Stroke and major depression disorder are common neurological diseases, and a large number of clinical studies have shown that there is a close relationship between the two diseases, but whether the ...two diseases are linked at the genetic level needs to be further explored. The purpose of this study was to explore the comorbidity mechanism of stroke and major depression by using bioinformatics technology and animal experiments. From the GEO database, we gathered transcriptome data of stroke and depression mice (GSE104036, GSE131712, GSE81672, and GSE146845) and identified comorbid gene set through edgR and WGCNA analyses. Further analysis revealed that these genes were enriched in pathways associated with cell death. Programmed cell death gene sets (PCDGs) are generated from genes related to apoptosis, necroptosis, pyroptosis and autophagy. The intersection of PCDGs and comorbid gene set resulted in two hub genes, Mlkl and Nlrp3. Single-cell sequencing analysis indicated that Mlkl and Nlrp3 are mainly influential on endothelial cells and microglia, suggesting that the impairment of these two cell types may be a factor in the relationship between stroke and major depression. This was experimentally confirmed by RT–PCR and immunofluorescence staining. Our research revealed that two specific genes, namely, Mlkl and Nlrp3, play crucial roles in the complex mechanism that links stroke and major depression. Additionally, we have predicted six possible therapeutic agents and the outcomes of docking simulations of target proteins and drug molecules.
•The changes of gene expression in brain tissues of stroke and major depression have some overlap.•Programmed cell death plays an important role in molecular interactions between stroke and major depression.•Mlkl and Nlrp3 are the hub genes involved in the comorbidity mechanism of stroke and major depression.•Necroptosis and pyroptosis of endothelial cells and microglia are common pathological changes of stroke and major depression.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Post-transcriptional regulation and RNA-binding proteins (RBPs) play vital roles in the occurrence of secondary injury after intracerebral hemorrhage (ICH). Therefore, we identified RBPs ...distinctively expressed after ICH by screening and determined thioredoxin1 (Txn1) as one of the most distinctive RBPs. We employed an ICH model and in vitro experiments to investigate the role of Txn1 in ICH. Firstly, we found that Txn1 was mainly expressed in microglia and neurons in the central nervous system, and its expression was significantly reduced in perihematomal tissue. Additionally, adeno-associated virus (AAV) carrying Txn1 was injected into the ICH rat model. Our results showed that overexpression of Txn1 reduced secondary injury and improved outcome in the ICH rat model. Moreover, to understand the therapeutic mechanism of Txn1 after ICH, we performed RNA immunoprecipitation combined with high-throughput sequencing. The results showed that Txn1 binds to inflammation- and apoptosis-related mRNAs and affects gene expression through RNA splicing and translation. Finally, RNA pull-down assays and in vitro experiments confirmed that Txn1 binds to metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), leading to reduced inflammation and apoptosis. Our study suggests that Txn1 is a potential therapeutic target for alleviating ICH-induced brain injury.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Circulating factors associated with aging have been shown to be involved in the development of age-related chronic and acute brain diseases. Here, we aimed to investigate the roles and mechanisms of ...CCL12, a circulating factor that is highly expressed in the plasma of aged rodents after intracerebral hemorrhage (ICH) using parabiosis and ICH models. Neurological deficit score (NDS), mortality rate, brain water content (BWC), and levels of inflammatory factors were determined to assess the degree of ICH-induced brain injury. Peripheral inflammatory cell infiltration was examined using immunofluorescence and flow cytometry. After confirming that acute brain injury after ICH was aggravated with age, we found that brain and plasma CCL12 levels were markedly higher in old mice than in young mice after ICH, and that plasma CCL12 was able to enter the brain. Using CCL12.sup.-/- mice, we showed that the degree of damage in the brain--as determined by NDS, mortality rate, BWC, levels of inflammatory factors, and numbers of degenerative and apoptotic neural cells and surviving neurons was significantly attenuated compared to that observed in old wild-type (WT) mice. These effects were reversed in CCL12-treated old mice. The detrimental effects caused by CCL12 may involve its ability to recruit macrophages and T cells. Finally, the administration of an anti-CCL12 antibody markedly improved the outcomes of ICH mice. Our results are the first to indicate that elevated peripheral CCL12 levels in old mice aggravates ICH-induced brain injury by recruiting macrophages and T cells. Thus, CCL12 may be a new target for ICH treatment. Key words: age, CCL12, intracerebral hemorrhage, inflammation, parabiosis
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objective To investigate the cellular localization of peroxiredoxin 1 (Prdx1) in the central nervous system, and its expression changes and possible mechanisms after intracerebral hemorrhage (ICH). ...Methods Five 8~10-week old SD rats underwent cerebral perfusion, and the brain tissue was sectioned for immunofluorescence staining to observe the localization of Prdx1 in the neurons, astrocytes and microglia. A total of 35 SD rats were randomly divided into sham group, and ICH for 12 h, and 1, 2, 3, 4 and 5 d groups (n=5). The ICH model was established by autologous blood injection in the latter 5 groups, and the sham group was treated with the same amount of normal saline as the control. The expression of Prdx1 at mRNA and protein levels in each group was detected by qRT-PCR and Western blotting. Prdx1 interference plasmid or blank vector were transfected into HeLa cells, and RNA-seq was performed to detect the differentially expressed genes (DEGs) in 2 groups of cells. GO analysis was performed on DEGs to predi