Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China: A Real-World Nationwide Registry.

BACKGROUND AND PURPOSE: The benefit of endovascular treatment (EVT) for large vessel occlusion in clinical practice in developing countries like China needs to be confirmed. The aim of the study was to determine whether the benefit of EVT for acute ischemic stroke in randomized trials could be generalized to clinical practice in Chinese population. METHODS: We conducted a prospective registry of EVT at 111 centers in China. Patients with acute ischemic stroke caused by imaging-confirmed intracranial large vessel occlusion and receiving EVT were included. The primary outcome was functional independence at 90 days defined as a modified Rankin Scale score of 0 to 2. Outcomes of specific subgroups in the anterior circulation were reported and logistic regression was performed to predict the primary outcome. RESULTS: Among the 1793 enrolled patients, 1396 (77.9%) had anterior circulation large vessel occlusion (median age, 66 [56-73] years) and 397 (22.1%) had posterior circulation large vessel occlusion (median age, 64 [55-72] years). Functional independence at 90 days was reached in 45% and 44% in anterior and posterior circulation groups, respectively. For anterior circulation population, underlying intracranial atherosclerotic disease was identified in 29% of patients, with higher functional independence at 90 days (52% versus 44%; P=0.0122) than patients without intracranial atherosclerotic disease. In the anterior circulation population, after adjusting for baseline characteristics, procedure details, and early outcomes, the independent predictors for functional independence at 90 days were age <66 years (odds ratio [OR], 1.733 [95% CI, 1.213-2.476]), time from onset to puncture >6 hours (OR, 1.536 [95% CI, 1.065-2.216]), local anesthesia (OR, 2.194 [95% CI, 1.325-3.633]), final modified Thrombolysis in Cerebral Infarction 2b/3 (OR, 2.052 [95% CI, 1.085-3.878]), puncture-to-reperfusion time ≤1.5 hours (OR, 1.628 [95% CI, 1.098-2.413]), and National Institutes of Health Stroke Scale score 24 hours after the procedure <11 (OR, 9.126 [95% CI, 6.222-13.385]). CONCLUSIONS: Despite distinct characteristics in the Chinese population, favorable outcome of EVT can be achieved in clinical practice in China. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03370939.

[Bioaccumulation of Halogenated Flame Retardants in Fish of Dongjiang River].

Bioaccumulation factor (BAF) plays a key role in identification of bioaccumulative substance and in assessment of chemical risks.In order to reveal the bioaccumulation behavior of fish in Dongjiang River,sediment,water and fish samples were collected from Dongjiang River and PBDEs,DBDPE,DP,TBBPA and HBCDs were measured.The ranges of lgBAF were 5.0-7.4,6.1-7.1,4.6-7.9,2.6-4.6 and 4.8-7.7,respectively.In the present study,most HFRs had a lgBAF of higher than 3.7,which suggested that they might be bioaccumulative.The BAF values of HFRs increased with increasing lgKow,when lgKow>7,the bioaccumulation extent decreased with the increase of lgKow.Biotransformation of γ-HBCD toward α-HBCD and the metabolism of BDE66 and BDE99 of these isomers might attribute to the deviation from the general trend predicted by Kow.More attention should be paid to DBDPE,since its BAF value was higher than that of BDE209.The BSAF values of most PBDEs,DBDPE,DP,TBBPA and HBCDs congeners in three fish species were less than 1,indicating that these compounds were unlikely to become a source of pollution to the aquatic organisms due to the poor bioavailability.

[Bioaccumulation and Correlation of Heavy Metals in Human Hairs From Urban and Rural Areas of Chongqing].

In the present study, human hair samples were collected in Chongqing to detect the concentrations of heavy metals including Cd, Cu, Ni, Pb and Zn by flame atomic absorption spectrophotometry. Meanwhile, the relationship between the content of heavy metals and age, gender and smoking habits was also analyzed, and the potential sources of the heavy metals in human hair were understood through correlation analysis and principal component analysis. The results showed that the mean concentrations of Cd, Cu, Ni, Pb and Zn were 3.1, 24.3, 9.7, 42.8 and 209.6 µg·g-1, respectively in urban areas, while the mean contents were 0.9, 15.8, 5.6, 15.2 and 173.4 µg·g-1, respectively in rural area. The residents living in urban areas exhibited significantly higher concentrations than those in rural area, revealing the same heavy metal pattern with that in soils (t-test, P<0.01). No obvious trend was observed between the contents of heavy metals and age, except that the contents of Cu and Zn were increasing with the growth of age. Significantly higher concentrations of Cd and Pb were both observed in male hair and smokers than those in female and non-smokers, respectively in urban and rural areas (P<0.01). Similar correlation patterns among Cd, Cu, Ni and Pb were found both in urban and rural areas. According to principal component analysis, Cu, Ni and Pb contaminations had similar sources in urban areas, whereas Cd, Ni and Pb had similar sources in rural area.

Levels of five metals in male hair from urban and rural areas of Chongqing, China.

Heavy metals were measured by flame atomic absorption in male hair from residents in urban and rural areas in Chongqing. The median values of the Cd, Cu, Ni, Pb and Zn were 2.90, 23.9, 9.31, 39.3 and 203 µg/g in urban areas and 0.84, 13.4, 5.56, 14.5 and 169 µg/g in rural area, respectively. The levels of Cd, Ni and Pb both in urban and rural areas lie at the high end of the worldwide figures. The differences in heavy metal distribution pattern indicated that there were more sources of Cd and Pb in urban areas. The levels of Cd were increasing along with the growth of age except for the aged people in urban areas, and no significant relationship was observed between the levels of the heavy metal and the age. It is noticed that the hair of smokers exhibited more heavy metal levels than that of non-smokers both in urban and rural areas. In addition, the hair metal levels of the smokers and non-smokers in urban areas were significantly higher than those in rural area, respectively. Significant pairwise correlations (p < 0.01) were observed among Cd, Cu, Ni and Pb in rural area and only between Cu and Ni and between Pb and Ni in urban areas, indicating the elements in these two areas might originate from different sources. The elevated levels of Cd, Pb and Ni implied that the residents both in urban and rural areas might be at high risk of toxic metal exposure, especially for the children.

[Concentrations and Partitioning of Halogenated Flame Retardants in Industrial Water of Dongjiang River].

The concentrations and partitioning of Halogented Flame Retardants (HFRs) were measured in industrial water of Dongjiang River. Polybrominated biphenyl ether (PBDEs) was the predominant pollutant accounting for 41.0% of the HFRs, dominated by BDE209 in the particulate phase, with the concentration ranging from 1102.3-3666.9 pg·L-1. The concentrations of Tetrabromobisphenol A (TBBPA) ranged from 1120.9-2856.5 pg·L-1, accounting for 32.4% of total halogenated flame retardants. The concentrations of other flame retardants, such as Decabromodiphenyl ethane(DBDPE), dechlorane plus (DP) and Hexabromocyclododecanes (HBCDs), accounting for 16.3%, 7.3% and 3.0%, were in the ranges of 397.7-1736.8, 235.7-778.1 and 9.5-266.8 pg·L-1, respectively. PBDEs, DBDPE, DP and HBCDs mainly existed in the particle phase, while TBBPA mainly existed in the dissolved phase due to its higher water solubility. Significant correlation between lgKoc and lgKow of HFRs was observed in the partitioning between the particulate phase and dissolved phase, but the observed organic carbon partition coefficients (lgKoc) were different from the predicted organic carbon partition coefficient (lgKoc), which may be controlled by the suspended particulate matter (SPM) content and dissolved organic carbon (DOC). In addition, whether the equilibrium was attained between dissolved phase and particle phase is another influencing factor for the observation.