Endovascular treatment vs drug therapy alone in patients with mild ischemic stroke and large infarct cores

BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascular treatment may be accompanied by safety issues.Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies.AIM To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores.METHODS Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021.Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods.In the endovascular therapy group,there were 28 patients with minor stroke and 22 patients with large infarct cores.The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores.The National Institutes of Health Stroke Scale(NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation.The modified Rankin scale(m RS) and/or activity of daily living were assessed at hospital discharge.RESULTS There was no significant difference in NIHSS scores between the two groups before the operation(P > 0.05).NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge(all P < 0.05).The incidence of early neurologic deterioration was significantly lower in the endovascular therapy group than in the drug therapy group(P < 0.05).At hospital discharge,the m RS score was lower in the endovascular treatment group than in the drug therapy group,and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group(all P < 0.05).During a follow-up of 3 mo,17 patients(34.0%) had good prognosis(m RS ≤ 2),33 patients(66.0%) had poor prognosis(m RS > 2),and 11 patients(22.0%) died.In the medical treatment group,16 patients(m RS ≤ 2) had good prognosis(32.0%),34 patients(m RS > 2) had poor prognosis(68.0%),and 14 patients(28.0%) died.There was no significant difference in prognosis and mortality between the two groups(P > 0.05).CONCLUSION Endovascular therapy can improve NIHSS score and m RS score in patients with mild ischemic stroke and large infarct cores.It is suitable for clinical application.

On the Inertia Index of a Mixed Graph in Terms of the Matching Number

A mixed graph G^(-) is obtained by orienting some edges of G, where G is the underlying graph of G^(-) . The positive inertia index, denoted by p~+( G), and the negative inertia index, denoted by n~-(G^(-) ), of a mixed graph G^(-) are the integers specifying the numbers of positive and negative eigenvalues of the Hermitian adjacent matrix of G^(-) , respectively. In this paper, the positive and negative inertia indices of the mixed unicyclic graphs are studied. Moreover, the upper and lower bounds of the positive and negative inertia indices of the mixed graphs are investigated, and the mixed graphs which attain the upper and lower bounds are characterized respectively.

Ordering Trees by Their Spectral Radii

Let T be a tree with n vertices and let A（T） be the adjacency matrix of T. Spectral radius of T is the largest eigenvalue of A（T）. Wu et al. [Wu, B.F., Yuan, X.Y, and Xiao, E.L. On the spectral radii of trees, Journal of East China Normal University （Natural Science）, 3：22-28 （2004）] determined the first seven trees of order n with the smallest spectral radius. In this paper, we extend this ordering by determining the trees with the eighth to the tenth smallest spectral radius among all trees with n vertices.

Multigraphic Degree Sequences and Hamiltonian-connected Line Graphs

Let G be a multigraph.Suppose that e=u1v1 and e′=u2v2 are two edges of G.If e≠e′,then G(e,e′)is the graph obtained from G by replacing e=u1v1 with a path u1vev1 and by replacing e′=u2v2 with a path u2ve′v2,where ve,ve′are two new vertices not in V(G).If e=e′,then G(e,e′),also denoted by G(e),is obtained from G by replacing e=u1v1 with a path u1vev1.A graph G is strongly spanning trailable if for any e,e′∈E(G),G(e,e′)has a spanning(ve,ve′)-trail.The design of n processor network with given number of connections from each processor and with a desirable strength of the network can be modelled as a degree sequence realization problem with certain desirable graphical properties.A sequence d=(d1,d2,⋯,dn)is multigraphic if there is a multigraph G with degree sequence d,and such a graph G is called a realization of d.A multigraphic degree sequence d is strongly spanning trailable if d has a realization G which is a strongly spanning trailable graph,and d is line-hamiltonian-connected if d has a realization G such that the line graph of G is hamiltonian-connected.In this paper,we prove that a nonincreasing multigraphic sequence d=(d1,d2)⋯,dn)is strongly spanning trailable if and only if either n=1 and d1=0 or n≥2 and dn≥3.Applying this result,we prove that for a nonincreasing multigraphic sequence d=(d1,d2,⋯,dn),if n≥2 and dn≥3,then d is line-hamiltonian-connected.