ABSTRACT
Objective:To investigate the clinical characteristics of acute ischemic stroke with anterior circulation large vessel occlusion caused by cardioembolism (CE) and large artery atherosclerosis (LAA) and the efficacy of endovascular treatment.Methods:Patients with acute ischemic stroke caused by large vessel occlusion in anterior circulation and received endovascular treatment in the Stroke Center of the 971 st Hospital of the PLA Navy from April 2014 to April 2021 were retrospectively enrolled. The etiological classification of stroke was CE or LAA. According to the modified Rankin Scale score at 90 d after onset, the patients were divided into good outcome group (0-2) and poor outcome group (>2). The demographic and clinical data between the groups were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcome. Results:A total of 106 patients were enrollded. Their age was 61.39±13.73 years and 70 (66.0%) were males. Seventy-four patients (69.8%) were in the CE group and 32 (30.2%) were in the LAA group. Sixty-six patients (62.3%) had good outcomes. Univariate analysis showed that there were significant differences in gender, age, smoking, systolic blood pressure, diastolic blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) score, time from onset to femoral artery puncture, time from puncture to vascular recanalization, and the number of retrieval attempts between the CE group and the LAA group (all P<0.05), and there were no significant differences in the incidences of poor outcome, hemorrhagic transformation, and symptomatic intracranial hemorrhage. There were significant differences in systolic blood pressure, diastolic blood pressure, baseline NIHSS score, time from onset to femoral artery puncture, and blood perfusion grade after treatment between the good outcome group and the poor outcome group (all P<0.05). Multivariable logistic regression analysis showed that higher systolic blood pressure (odds ratio [ OR] 1.046, 95% confidence interval [ CI] 1.014-1.078; P=0.004), higher baseline NIHSS score ( OR 1.117, 95% CI 1.037-1.203; P=0.003), longer time from onset to femoral artery puncture ( OR 1.008, 95% CI 1.001-1.015; P=0.019) and poor blood perfusion after treatment ( OR 8.042, 95% CI 1.532-42.215; P=0.014) were significantly and independently associated with the poor outcomes. Conclusions:Compared with LAA, CE do not increase the risks of hemorrhagic transformation and symptomatic intracranial hemorrhage. The safety and efficacy of the two are similar.
ABSTRACT
Objective: To study the therapeutic effect of secondary lymphoid tissue chemokine (SLC) combined with CpG oligodeoxynucleotide (CpG-ODN) in treatment of implanted mouse melanoma and the possible mechanism. Methods: SLC-Fc fusion protein was prepared and its chemotaxis of lymphocytes was detected by chemotaxis assay. Implanted melanoma mouse models were established and randomly divided into 4 groups: control group, SLC-Fc group, CpG-ODN group, and SLC-Fc+CpG-ODN group. The growth of implanted tumors in each group was observed after treatment. Subtype and infiltration of lymphocytes in implanted tumor tissues were examined by flow cytometry. Results: SLC-Fc protein was successfully prepared, and it dose-dependently attracted lymphocytes (0.03, 0.3, and 3 μg/L). Intra-tumor injection SLC-Fc and CpG-ODN alone or in combination significantly inhibited growth of B16-implanted tumors. Tumor size in SLC-Fc+CpG-ODN group was significantly smaller than that in control group (P<0.01), and animals in SLC-Fc+CpG-ODN group survived longer. Tumor-infiltrated CD4~+ T, CD~8+ T, and dendritic cells (DCs) in SLC-Fc+CpG-ODN group were markedly increased as compared with those in control group (P<0.05), and tumor draining lymph nodes were dramatically enlarged. Conclusion: SLC combined with CpG-ODN can inhibit the growth of implanted melanoma by attracting CD4~+ T and CD8~+ T and promoting proliferation of DCs.