Clinical Focus

Left atrial volume index predicts atrial fibrillation recurrence after radiofrequency ablation: A meta-analysis

Li Weiwei, Li Yanan

2022, 37(11): 965-968. doi:10.3969/j.issn.1004-583X.2022.11.001

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Objective To evaluate the clinical value of left atrial volume index (LAVI) in predicting recurrence in patients with atrial fibrillation (AF) after radiofrequency ablation (RFA). Methods PubMed, the Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), China Biomedical Literature Database, VIP database, etc. were performed a computer search to find relevant literature regarding LAVI predicting recurrence after RFA in AF patients. Meta-analysis was performed using STATA 12.0. Results A total of 13 studies involving 1519 patients were eligibly included in this meta-analysis. The results of meta-analysis showed that patients with AF recurrence had a higher mean LAVI compared to patients with no recurrence ( $S M D$ =2.51, 95% $C I$ : 1.61-3.41, $P$ =0.001). After RFA, there was a statistically significant difference in LAV/LAVI between non-recurrence patients and recurrence patients ( $O R$ =2.88, 95% $C I$ : 2.68-3.10, $P$ =0.001). This suggested that close monitoring of LAVI changes after RFA could effectively assess the possibility of postoperative recurrence. Conclusion Patients with AF recurrence following RFA have a higher mean LAVI compared to patients with no recurrence, which can be used as an effective index to evaluate AF recurrence after RFA. The conclusion still needs to be verified by more multi-center, large-sample randomized controlled trials.

Computed tomography values of lumbar spine in diagnosing osteoporosis: A meta-analysis

Chen Jie, Chen Shu, Yin Yufeng, Chang Xin, Wu Jian

2022, 37(11): 970-976. doi:10.3969/j.issn.1004-583X.2022.11.002

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Objective To assess the efficacy of computed tomography (CT) values of lumbar spine in diagnosing osteoporosis (OP) by meta-analysis. Methods PubMed, Cochrane Library, Web of Science, CNKI, Wanfang and VIP Data (from the date of each database established to December, 2021) were searched for the studies regarding diagnostic accuracy of CT values of lumbar spine for OP, and the general information and the fourfold table data were extracted. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the risk of bias of the included studies. Meta-analysis was performed using Review Manager 5.4 and Meta-Disc 1.4. Results According to the vertebral bodies size, the eligible 13 studies were assigned to 6 groups of L1, L2, L3, L4, L5, and the L1-L4 mean Hounsfield units (HU) values. Since only one set of data was included for L5 and the L1-L4 mean HU values, no effect size combination was performed. The pooled sensitivity, pooled specificity, and areas under curve (AUC) of summary receiver operating characteristic (SROC) for L1 were 0.75 (95%

C I

: 0.72-0.77), 0.72 (95%

C I

: 0.70-0.73), and 0.8126 respectively; these values for L2 were 0.73 (95%

C I

: 0.70-0.77), 0.75 (95%

C I

: 0.73-0.77), 0.8010, respectively; and these for L3 were 0.78(95%

C I

: 0.75-0.81), 0.72(95%

C I

: 0.70-0.74), 0.7935, respectively. The pooled sensitivity and pooled specificity for L4 were 0.76 (95%

C I

: 0.73-0.79) and 0.73(95%

C I

: 0.70-0.75), respectively. Conclusion CT value of lumbar spine has certain significance in screening OP in different populations, however, its diagnostic ability is poor, the OP diagnosis should be analyzed comprehensively combined with other inspection results.

MDM4rs4245739 gene polymorphism and breast cancer susceptibility:A meta-analysis

Jiang Yan, Li Jiayang, Wu Hongyu, Chen Baolin, Cheng Xiaoming, Lyu Junyuan

2022, 37(11): 977-984. doi:10.3969/j.issn.1004-583X.2022.11.003

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Objective To explore associations between MDM4rs4245739 gene polymorphism and breast cancer susceptibility. Methods The papers related to polymorphisms of MDM4rs4245739 and breast cancer susceptibility were searched in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang electronic database. Odds ratios (ORs) and 95% confidence intervals (CIs) were adopted to assess the strength of associations. Publication bias was evaluated by Begg's funnel plot and Egger's linear regression test. Results A total of 6 studies involving 9 814 breast cancer patients and 45 202 healthy individuals were included in the present study. MDM4rs4245739 in the allelic (C vs A: OR=0.84, 95%CI: 0.67-1.05, P =0.118), dominant (AC+CC vs AA: $O R$ =0.86, 95% CI: 0.67-1.11, P =0.245), recessive (AC+AA vs CC: OR=0.90, 95%CI: 0.61-1.32, P =0.585), heterozygous (AC vs AA: OR =0.88, 95%CI: 0.69-1.12, P=0.305), homozygous (CC vs AA: OR =0.90, 95% CI: 0.59-1.39, $P$ =0.649) genetic models show no association with the susceptibility to breast cancer. Moreover, GEPIA data confirmed that the expression level of MDM4 was not associated with the tumor staging and prognosis of breast cancer. Conclusion Neither MDM4rs4245739 gene polymorphism nor MDM4 expression level is associated with the susceptibility and prognosis in breast cancer patients.

The correlation between the prognosis of lung adenocarcinoma with acquired resistance to the first-generation EGFR TKI and the T790M mutation

Li Shufan, Wang Yuxiu, Jiang Zhenghua

2022, 37(11): 985-991. doi:10.3969/j.issn.1004-583X.2022.11.004

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Objective To prospectively analyze the correlation between the prognosis of lung adenocarcinoma with acquired resistance to the first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) and the T790M mutation. Methods A total of 93 eligible patients with lung adenocarcinoma were selected. The EGFR-sensitive mutation and T790M mutation status were detected by the next-generation sequencing (NGS). Osimertinib was used as the EGFR-TKI treatment in the second or third-line treatment, and patients in the control group were given chemotherapy and/or radiotherapy. Objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS) of the second and third-line treatment were evaluated.Results The ORR was comparable between lung adenocarcinoma patients with positive or negative T790M mutation ( $P$ =0.084); while a significant difference was detected in the DCR ( $P$ =0.01). There were significant differences in the ORR ( $P$ =0.022) and DCR ( $P$ =0.016) in lung adenocarcinoma patients with positive or negative T790M mutation who were treated with the second-line treatment of osimertinib; similar results were obtained in the third-line treatment of osimertinib as well (ORR [ $P$ =0.016] and DCR [ $P$ =0.011]). The Mann-Whitney U test showed that the mutation status of T790M was significantly correlated with PFS in all lung adenocarcinoma patients ( $P$ <0.01), and those treated with the second-line treatment ( $P$ =0.022) and the third-line treatment ( $P$ =0.016). Kaplan-Meier survival analysis showed that the T790M mutation significantly influenced the overall PFS in lung adenocarcinoma patients ( $P$ <0.01). In the T790M-positive group, there was a significant difference in the PFS between those with EGFR exon 19 mutation and exon 21 mutation ( $P$ =0.05). Multivariate Cox proportional hazards regression analysis showed significant differences in EGFR exon 21 vs exon 19 ( $H R$ =0.551, 95% $C I$ =0.357-0.853, $P$ =0.007), T790M-positive mutation vs T790M-negative mutation ( $H R$ =2.972, 95% $C I$ =1.643-5.379, $P$ <0.01), and tumor diameter ≥5 cm vs tumor diameter <5 cm ( $H R$ =0.575, 95% $C I$ =0.373-0.085, $P$ =0.012). Conclusion The prognosis of T790M mutation-positive lung adenocarcinoma patients is better than that of T790M mutation-negative patients. PFS is comparable in T790M-positive lung adenocarcinoma patients treated with the second or third-line treatment of osimertinib. Advanced lung adenocarcinoma patients with the T790M mutation can be treated with the third-generation EGFR-TKI after the development of first-generation EGFR-TKI resistance.

The relationship between CEA, CA125 and NSE and the pathological characteristics of patients with NSCLC and the value of combined detection

Jia Chengbang, Shen Lijuan, Sun Zhigang

2022, 37(11): 992-995. doi:10.3969/j.issn.1004-583X.2022.11.005

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Objective To analyze the relationship between carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), neuron-specific enolase (NSE) and the pathological characteristics of patients with non-small cell lung cancer (NSCLC) and the value of combined detection. Methods Totally 175 NSCLC patients (NSCLC group) who were treated in Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine (January 2018-January 2022), and 180 patients with benign pulmonary diseases during the same period (no-NSCLC group) were retrospectively enrolled. The clinical data, the level of CEA, CA125, and NSE of patients at different stages were included as comparators. Spearman correlation analysis was conducted to assess the association between serum indexes and staging system. the diagnostic value of CEA, CA125 and NSE of NSCLC patients, alone and in combination, were analyzed by the receiver operating characteristic (ROC) curve.Results The serum levels of CEA, CA125 and NSE in NSCLC group were markedly higher than those in no-NSCLC group ( $P$ <0.05). The significant increasing trend for serum levels of CEA, CA125 and NSE were found in patients with classification grades Ⅰ-Ⅲ( $P$ <0.05). The results of Spearman correlation analysis showed that CEA, CA125, NSE were positively correlated with the clinical stage of patients with NSCLC ( $r$ =0.579, 0.437, 0.686, $P$ <0.05). The ROC curve was drawn with NSCLC as positive and benign lung disease as negative, the area under the curve (AUC) of CEA, CA125, and NSE for predicting NSCLC, alone and in combination, were 0.809, 0.842, 0.867, and 0.910, respectively ( $P$ <0.05). Conclusion The increased expressions of CEA, CA125 and NSE are detected in NSCLC patients, and increasing trend with the disease progression, the detection of serum levels of CEA, CA125 and NSE alone and in combination had certain diagnostic value for NSCLC.

Effect of semaglutide on total myocardial ischemic burden and serum inflammatory factors in patients with type 2 diabetes mellitus complicated with coronary heart disease

Wang Wenqi, Zhang Tao

2022, 37(11): 996-1000. doi:10.3969/j.issn.1004-583X.2022.11.006

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Objective To investigate the effects of semaglutide, a once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA), on total myocardial ischemic burden and inflammatory factors in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD). Methods From June 2021 to June 2022, totally 96 patients with T2DM and CHD admitted to the First Affiliated Hospital of Jinzhou Medical University were retrospectively recruited. They were randomized 1∶1 to the conventional treatment group and the semaglutide treatment group. Patients in the conventional treatment group were treated with standard hypoglycemic, hypotensive, lipid-regulating, and antiplatelet medications. According to blood glucose target, insulin glargine was applied and adjusted. Semaglutide injection 1.0 mg subcutaneously, once a week, was additionally given to those in the semaglutide treatment group. The clinical manifestations, body mass index (BMI), blood pressure, fasting blood glucose (FPG), blood lipids, glycosylated hemoglobin A₁c (HbA₁c) and other indicators were observed in the two groups before and 3 months after treatment, and the total myocardial ischemia burden and serum inflammation indicators were detected. Results One case was lost to follow-up in both groups. At the end of the trial, clinical symptoms, FPG, blood lipid and HbA₁c were significantly improved in the both groups. BMI and low-density lipoprotein cholesterol (LDL-C) in the semaglutide treatment group were significantly decreased than those in the conventional treatment group. The dosage of insulin glargine and incidence of hypoglycemia were significantly lower in the semaglutide treatment group than in the conventional treatment group. The total load of myocardial ischemia was significantly reduced in the both groups and the effect of semaglutide treatment group was better than that of the coventional treatment group. The serum levels of high sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the semaglutide treatment group were significantly decreased than those in the conventional treatment group. Conclusion Semaglutide provides clinical benefits to T2DM patients by lowering glucose, regulating lipid and reducing body weight. It delays the progression of coronary atherosclerosis in patients with T2DM and CHD, and improves myocardial ischemia and prognosis by inhibiting inflammatory response and reducing total myocardial ischemic load.

Clinical determination of lymphocyte subsets in peripheral blood of patients with angioimmunoblastic T cell lymphoma

Lu Luo, Wang Fei, Gu Weiying

2022, 37(11): 1001-1007. doi:10.3969/j.issn.1004-583X.2022.11.007

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Objective To analyze the relevance between lymphocyte subsets and clinical prognosis in the peripheral blood of patients with angioimmunoblastic T cell lymphoma (AITL) during diagnosis, and to assess their dynamic changes after chemotherapy.M-ethods The clinical data of 16 initial AITL patients (treatment group) and 10 lymphocyte subsets (control group) were retrospectively analyzed, these patients visited the Third Affiliated Hospital of Soochow University between March 2016 and September 2021. Kaplan-Meier method and Cox regression were adopted for survival analysis. Receiver Operator Characteristic (ROC)curve was used to calculate the cutoff value of CD4/CD8 ratio, and the patients of the treatment group were assigned into low and high CD4/CD8 groups. Results Compared to the controls, the absolute count of CD3⁺T cells, CD4⁺ T cells, CD3⁺CD25⁺ activated T cells and CD4/CD8 ratio significantly decreased in the peripheral blood of AITL patients at the initial diagnosis. Whereas, the absolute count of CD19⁺ B cells, CD20⁺ B cells, CD5⁺CD19⁺ and CD19⁺CD23⁺ activated B cell significantly decreased. The proportion of CD3⁺ T cells after the first course of chemotherapy significantly increased than that at the initial diagnosis, and the proportion of CD4⁺ T cells, CD3⁺CD25⁺ activated T cells and CD4/CD8 significantly increased after three courses of the treatment. The survival analysis showed that the progression-free-survival (PFS) and overall survival (OS) of the low CD4/CD8 group were significantly higher than those of the CD4/CD8 group. Conclusion High CD4/CD8 ratio in peripheral blood at the initial diagnosis of AITL patients is associated with poor prognosis. CD4⁺ T cell count in the peripheral blood of patients is significantly decreased compared with healthy people, and which can be partially recovered after effective treatment. The analysis on lymphocyte subsets in AITL supports providing new ideas for identifying new prognostic markers of AITL and implementing effective individualized immunotherapy.

Curative effect of combination of eltrombopag and low-dose prednisone on refractory and relapsed primary immune thrombocytopenia in elderly patients

Wu Qiong, Sun Feng, Zhang Kai, Wang Zhiyi, Zhang Nana, Cheng Hui, Xiang Yang, Chang Xiaohui

2022, 37(11): 1008-1011. doi:10.3969/j.issn.1004-583X.2022.11.008

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Objective To observe the efficacy of eltrombopag combined with low-dose prednisone in elderly patients with refractory and relapsed primary immune thrombocytopenia (ITP). Methods A retrospective analysis of the treatment efficacy of 52 elderly patients (over 60 years old) with refractory and recurrent ITP was performed. The patients were assigned to receive either eltrombopag+low-dose prednisone (the eltrombopag treatment group, $n$ =23) or prednisone+immune stimulants (the conventional treatment group, $n$ =29). The key observation was platelet count (PLC) on day 0 and on weeks 1, 2, 4, 8, 12, bleeding risk score on day 0 and on week 2, and effective rates on weeks 4, 8, 12. Results The PLC increased in the eltrombopag treatment group on week 1, thereafter, the platelets continued to rise, and PLC on week 4 was (109.18±77.81)×10⁹/L, moreover, each cut-off point was significantly higher than the previous cut-off point ( $P$ <0.05). The platelets increased in the conventional treatment group, and with no continuous increasing trend. The bleeding risk score of the eltrombopag treatment group and the conventional treatment group after treatment was significantly lower than that before treatment ([2.91±1.92], [3.60±2.53] vs [7.64±3.77], [6.53±3.66], [ $P$ <0.05], respectively). The overall effective rate on weeks 8, 12 in the eltrombopag treatment group was 87% and 91.3%, respectively, which in the conventional treatment group was 55.2% and 55.2%, respectively, and with statistically significant differences between groups ( $P$ <0.05). Conclusion For elderly patients with refractory and recurrent ITP, eltrombopag combined with low-dose prednisone has good curative effect, and is worthy of selection application.

Diagnostic value of monosaccharide in peritoneal dialysis-associated peritonitis

Gong Zhiqing, Chen Yipeng, Lu Dongmei, Xin Lili, Guo Jing, Xing Guangqun

2022, 37(11): 1012-1016. doi:10.3969/j.issn.1004-583X.2022.11.009

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Objective Based on the fact that monosaccharide as an important component of pathogenic bacteria, this study investigated the diagnostic value of monosaccharide in peritoneal dialysate(PD)- associated peritonitis using high performance liquid chromatography (HPLC). Methods Peritoneal dialysate fluid samples were collected from 90 peritoneal dialysis patients hospitalized in the West Coast Nephrology Department, Affiliated Hospital of Qingdao University from October 1, 2020 to October 31, 2021, including 52 normal samples(non-peritonitis group) and 38 peritonitis samples(24 in Gram-positive bacteria[GPB] peritonitis group and 14 in Gram-negative bacteria [GNB] peritonitis group). HPLC was used to determine the concentration of degraded mannose, glucose and fucose in the samples. The concentrations of mannose, glucose and fucose were analyzed. Logistic regression was used to analyze the relationship between monosaccharides and peritonitis, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of monosaccharides for peritonitis. Results Monosaccharide differences levels were significant among the three groups ( $P$ <0.01). Compared with the non-peritonitis group, the glucose concentration and fucose concentration in both peritonitis groups were significantly decreased ( $P$ <0.01). Mannose concentration was different between peritonitis groups ( $P$ <0.01). Logistic regression analysis showed that fucose concentration was a risk factor for peritonitis ( $P$ <0.01), with Mannose concentration for a risk factor of GPB( $P$ <0.01).ROC curve analysis showed that the fucose concentration had high diagnostic value for PD-associated peritonitis, AUC area is 0.820, 95% $C I$ (0.732, 0.908), sensitivity is 71.05%, specificity is 84.62%, and the optimal cut-off value is 3.045 μmol/L. Similar diagnostic value for mannose concentration to GPB, AUC area for 0.863, 95% $C I$ (0.740, 0.986), sensitivity for 78.57%, specificity for 83.33%, and the optimal cut-off valuefor 0.345 μmol/L. Significant decreased mannose concentration was in GPB. Conclusion The degraded fucose concentration and mannose concentration were independent risk factors for PD-associated dialysis and GPB, respectively. The significant decreased fucose concentration can indicate the risk of peritonitis. Meanwhile, the significant decreased mannose concentration might be a certain diagnostic value for early GPB infection and guide treatment options for antibiotic use.

Exploring factors influencing adverse prognosis in children with acute encephalitis/ encephalopathy

Wang Xiaoqin, Zhou Youfeng, Lin Binrong

2022, 37(11): 1017-1020. doi:10.3969/j.issn.1004-583X.2022.11.010

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Objective To explore the prognostic factors in children with acute encephalitis/encephalopathy (AE). Methods Retrospective analysis was made on the clinical data and adverse prognosis of children clinically diagnosed as AE in the pediatrics department of Fujian Maternal and Child Health Hospital from June 1, 2018 to May 30, 2021. The following conditions were found at the time of discharge: hospital death, tracheotomy, gastroenteric tube feeding, rehabilitation treatment, and intractable epilepsy. Multivariate Logistic regression was used to analyze the factors influencing the adverse prognosis of AE.Results Among 105 children with AE included in the study, 34 (32.4%) had adverse outcomes, including 5 (4.8%) hospital deaths. Multivariate Logistic regression analysis showed that long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and combined organ dysfunction were the risk factors for adverse prognosis of AE. Conclusion Long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and organ dysfunction are closely related to the poor prognosis of AE. Early detection of high-risk children and timely intervention can improve the prognosis of children with AE.

Clinical analysis of 13 cases of brucellosis spondylitis

Liu Lifang, Wang Xiaotong, Li Zhuo, Yang Ru, Liu Hua

2022, 37(11): 1021-1024. doi:10.3969/j.issn.1004-583X.2022.11.011

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Objective To investigate the clinical characteristics of brucellosis spondylitis. Methods The clinical data, treatment and prognosis of 13 brucellosis spondylitis patients admitted to Gansu Provincial Hospital from 2015 to 2022 were analyzed retrospectively. Results All 13 cases had lumbar and back discomfort, including 8 cases with intermittent fever. All cases had increased erythrocyte sedimentation and interleukin-6, and positive the results of tiger red plate agglutination test and tube agglutination test, among which 2 cases were positive in blood culture, and their magnetic resonance imaging was involved to varying degrees. Conclusion Brucellosis spondylitis is similar to spinal tuberculosis, suppurative spondylitis, spinal tumor and other diseases in clinical manifestations, so it is easy to misdiagnosis. For patients with fever, low back and leg pain, and limb numbness, the detailed history of epidemiology should be inquired, serologic examination and spinal magnetic resonance imaging should be performed, furthermore early detection/diagnosis for the patients.

Lineage switch from acute myeloid leukemia to acute lymphoblastic leukemia: A case report and literature review

Yin Lingling, Wu Wenjian, Zhu Feng

2022, 37(11): 1025-1030. doi:10.3969/j.issn.1004-583X.2022.11.012

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Objective To provide evidences for clinical diagnosis and treatment of lineage switch from acute myeloid leukemia (AML) to acute lymphoblastic leukemia (ALL) by exploring clinical features of the disease. Methods The clinical data, diagnosis and treatment process of one patient whose lineage switch from AML-M5b to B-ALL were retrospectively analyzed, the relevant literature was reviewed. Results A 4-year-old girl presented with a 5-day history of fever and abdominal pain. The medical history, physical examination and auxiliary examination of the patient suggested a diagnosis of AML-M5. Complete remission (CR) of hematology and cytogenetics was achieved after induction chemotherapy. However, one year later, disease relapsed, the morphologic and immunophenotypic features were consistent with B-ALL. She achieved CR again by adoptive immunotherapy using chimeric antigen receptor expressing T cells (CAR-T). But soon, the disease relapsed again, the second CAR-T treatment was ineffective, and the child died. Conclusion Our case suggests that lineage switch heralds a dismal clinical outcome. Therapy appropriate for the leukemic phenotype at the time of lineage switch may be advisable. For the cases in which the cell lineage switched from AML to B-ALL and CD19 is expressed, the patient may acquire CR again by CAR-T cell therapy but it is prone to secondary recurrence. Clinically, for recurrent leukemia, it is necessary to improve the detection of morphology, immunology, next generation sequencing, chromosome karyotype and other aspects of cytogenetics and molecular biology, so as to better guide the treatment and evaluate the prognosis.

Gitelman syndrome with normomagnesemia: A case report and literature review

Tong Tian, Wang Ruiying, Zhang Lihui, Liu Zhihong, Luo Jianqin, Zhao Zhansheng

2022, 37(11): 1031-1036. doi:10.3969/j.issn.1004-583X.2022.11.013

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Objective To investigate the clinical characteristics of Gitelman syndrome and evaluate the differential value of blood magnesium in Gitelman syndrome and Bartter syndrome. Methods A case of Gitelman syndrome with normomagnesemia admitted to the Department of Endocrinology of the Second Hospital of Hebei Medical University was retrospectively analyzed for its clinical manifestations, diagnosis and treatment process and treatment outcome, and the relevant literature was reviewed. Results The patient presented with hypokalemia, metabolic alkalosis, normomagnesemia, hypotension and the activation of the renin-angiotensin-aldosterone system. The diagnosis of Gitelman syndrome was confirmed by genetic testing. Conclusion The phenotype of Gitelman syndrome is heterogeneous, and the genotype-phenotype studies are not perfect. Therefore, it is not rigorous to use hypomagnemia as the criterion to distinguish Gitelman syndrome from Bartter syndrome in the suspected clinical diagnosis. Further genetic testing should be performed to confirm the diagnosis.

Comparative analysis of Chinese guidelines for the endovascular treatment of acute ischemic stroke

Tang Qiuyan, Wei Xiaofeng, Feng Qian, Yang Huizhong, Yang Xuhong

2022, 37(11): 1037-1043. doi:10.3969/j.issn.1004-583X.2022.11.014

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Cerebrovascular disease has a high incidence rate in my country, among which acute ischemic stroke (AIS) is the most common. The cerebral ischemia-induced brain injury and its complications seriously affect the quality-of-life of modern people. At present, clinical research regarding AIS interventional treatment have made new progress in terms of applicable scope, medical perspective, treatment technology. The Neurology Branch of the Chinese Medical Association organized and formulated the "Chinese guidelines for the endovascular treatment of acute ischemic stroke" in 2018 and 2022, which have great clinical significance for understanding and diagnosis of AIS. In this article, A comparative analysis will be performed in 2018 and 2022 guidelines to clarify the changes in early endovascular interventional, which might be beneficial to clinical diagnosis and treatment.

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