Image-based visualization of stents in mechanical thrombectomy for acute ischemic stroke:Preliminary findings from a series of cases

BACKGROUND Mechanical thrombectomy is the most effective treatment for great cerebral artery embolization within a set time window.Typically,an arteriogram does not show the localization of the stent after release and whether a thrombus is captured or not.Thus,improving the visualization of a stent in interventional therapy will be helpful for clinicians.AIM To analyze stent imaging findings to enhance clinicians’understanding of a special circumstance,wherein a Solitaire AB retrievable stent was visible during the imaging of a thrombus capture that improved the success rate of stent-based mechanical thrombectomy.METHODS This was a retrospective study with four acute ischemic stroke(AIS)patients who underwent stent-based mechanical thrombectomy.RESULTS Patient 1 was a 64-year-old man admitted after 5 h of confusion;angiography revealed basilar artery occlusion.We inserted a stent into the left posterior cerebral artery-P2 segment and visualized the expanded stent that successfully captured a thrombus.Patient 2 was a 74-year-old man admitted with confusion,which lasted approximately 3 h.Angiography revealed a left middle cerebral artery(MCA)-M1 segment occlusion.A stent was deployed in the distal M2 segment,and we could visualize the stent by capturing the thrombus.Patient 3 was a 74-year-old woman admitted after experiencing left hemiplegia for 3 h.We deployed a stent at the distal right MCAM2 segment,and the developing stent captured a large thrombus.Patient 4 was an 82-year-old man who presented with confusion for 3 h.A developing stent was placed in the distal left MCA-M1 segment,which captured a large thrombus and several fragmented thrombi.CONCLUSION To the best of our knowledge,this is the first report of stent imaging in patients with AIS.We demonstrated the usefulness and substantial potential of stent imaging in stent-based mechanical thrombectomy for AIS.

Recent advances in recurrent hepatocellular carcinoma therapy

Hepatocellular carcinoma(HCC)is the most prevalent form of primary liver cancer,accounting for 75%-85%of cases.Although treatments are given to cure early-stage HCC,up to 50%-70%of individuals may experience a relapse of the illness in the liver after 5 years.Research on the fundamental treatment modalities for recurrent HCC is moving significantly further.The precise selection of individuals for therapy strategies with established survival advantages is crucial to ensuring better outcomes.These strategies aim to minimize substantial morbidity,support good life quality,and enhance survival for patients with recurrent HCC.For individuals with recurring HCC after curative treatment,no approved therapeutic regimen is currently available.A recent study presented novel approaches,like immunotherapy and antiviral medication,to improve the prognosis of patients with recurring HCC with the apparent lack of data to guide the clinical treatment.The data supporting several neoadjuvant and adjuvant therapies for patients with recurring HCC are outlined in this review.We also discuss the potential for future clinical and translational investigations.

X-linked Charcot-Marie-Tooth disease after SARS-CoV-2 vaccination mimicked stroke-like episodes: A case report

BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) vaccinations have been administered worldwide, with occasional reports of associated neurological complications. Specifically, the impact of vaccinations on individuals with Xlinked Charcot-Marie-Tooth disease type 1(CMTX1) is unclear. Patients with CMTX1 can have stroke-like episodes with posterior reversible encephalopathy syndrome on magnetic resonance imaging(MRI), although this is rare.CASE SUMMARY A 39-year-old man was admitted with episodic aphasia and dysphagia for 2 d. He received SARS-CoV-2 vaccination 39 d before admission. Physical examination showed pes cavus and reduced tendon reflexes. Brain MRI showed bilateral, symmetrical, restricted diffusion with T2 hyperintensities in the cerebral hemispheres. Nerve conduction studies revealed peripheral nerve damage. He was diagnosed with Charcot-Marie-Tooth disease, and a hemizygous mutation in the GJB1 gene on the X chromosome, known to be pathogenic for CMTX1, was identified. Initially, we suspected transient ischemic attack or demyelinating leukoencephalopathy. We initiated treatment with antithrombotic therapy and immunotherapy. At 1.5 mo after discharge, brain MRI showed complete resolution of lesions, with no recurrence.CONCLUSION SARS-CoV-2 vaccination could be a predisposing factor for CMTX1 and trigger a sudden presentation.

Polypeptide from Moschus Suppresses Lipopolysaccharide-Induced Inflammation by Inhibiting NF-κB-ROS/NLRP3 Pathway

Objective To examine the anti-inflammatory effects and potential mechanisms of polypeptide from Moschus(PPM)in lipopolysaccharide(LPS)-induced THP-1 macrophages and BALB/c mice.Methods The polypeptide was extracted from Moschus and analyzed by high-performance liquid chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE).Subsequently,LPS was used to induce inflammation in THP-1 macrophages and BALB/c mice.In LPS-treated or untreated THP-1 macrophages,cell viability was observed by cell counting kit 8 and lactate dehydrogenase release assays;the proinflammatory cytokines and reactive oxygen species(ROS)were measured by enzyme-linked immunosorbent assay and flow cytometry,respectively;and protein and mRNA levels were measured by Western blot and real-time quantitative polymerase chain reaction(qRT-PCR),respectively.In LPS-induced BALB/c mice,the proinflammatory cytokines were measured,and lung histology and cytokines were observed by hematoxylin and eosin(HE)and immunohistochemical(IHC)staining,respectively.Results The SDS-PAGE results suggested that the molecular weight of purified PPM was in the range of 10–26 kD.In vitro,PPM reduced the production of interleukin 1β(IL-1β),IL-18,tumor necrosis factorα(TNF-α),IL-6 and ROS in LPS-induced THP-1 macrophages(P<0.01).Western blot analysis demonstrated that PPM inhibited LPS-induced nuclear factorκB(NF-κB)pathway and thioredoxin interacting protein(TXNIP)/nucleotide-binding oligomerization domain,leucine-rich repeat and pyrin domain containing 3(NLRP3)inflammasome pathway by reducing protein expression of phospho-NF-κB p65,phospho-inhibitors of NF-κB(IκBs)kinaseα/β(IKKα/β),TXNIP,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and pro-caspase-1(P<0.05 or P<0.01).In addition,qRT-PCR revealed the inhibitory effects of PPM on the mRNA levels of TXNIP,NLRP3,ASC,and caspase-1(P<0.05 or P<0.01).Furthermore,in LPS-induced BALB/c mice,PPM reduced TNF-αand IL-6 levels in serum(P<0.05 or P<0.01),decreased IL-1βand IL-18 levels in the lungs(P<0.01)and alleviated pathological injury to the lungs.Conclusion PPM could attenuate LPS-induced inflammation by inhibiting the NF-κB-ROS/NLRP3 pathway,and may be a novel potential candidate drug for treating inflammation and inflammation-related diseases.