To investigate the clinical predictive value of optic nerve sheath ultrasound combined with transcranial color-code Doppler （TCCD） ultrasound for malignant middle cerebral artery infarction （MMI）.
Methods
A retrospective analysis was performed on 102 patients with large cerebral infarction in the cerebral hemisphere， admitted to the Second Affiliated Hospital of Xi'an Medical University from June 2021 to April 2023， who met the inclusion and exclusion criteria of the study.Bedside ultrasound measurements of optic nerve sheath diameter （ONSD） and TCCD were performed.The enrolled patients were categorized into MMI （n=44） and non-MMI （n=58） groups according to MMI occurrence.Independent sample t tests were used to compare the differences of bilateral ONSD values and TCCD parameters［systolic velocity （Vs）， diastolic velocity （Vd）， mean velocity （Vm）， and pulsatility index （PI）］ between the two groups.Pearson correlation was used to assess the correlation between ONSD and TCCD parameters with the Glasgow coma scale （GCS）， National Institute of Health stroke scale （NIHSS） scores， and cerebral infarction volume in MMI patients.Receiver Operating characteristic （ROC） curves were plotted to evaluate the predictive efficacy of ONSD and TCCD， individually and in combination， for MMI.
Results
MMI patients exhibited significantly higher mean ONSD and PI values on the affected side compared to the non-MMI group ［（5.53±0.39）mm vs （4.97±0.35）mm； 0.89±0.16 vs 0.72±0.18］， while Vd， Vs， and Vm on the affected side were significantly lower than those in the non-MMI group ［（20.58±9.54）cm/s vs （32.12±9.87）cm/s； （57.50±10.59）cm/s vs （72.58±11.35）cm/s； （30.85±10.2）cm/s vs （51.72±12.33）cm/s］， all with statistical significance （t=7.617， 4.953， -5.933， -6.839， -9.098， all P＜0.05）.ONSD and PI on the affected side were negatively correlated with GCS score （r=-0.568， -0.539， all P＜0.05）， and positively correlated with NIHSS score （r=0.606， 0.549， all P＜0.05） and cerebral infarction volume （r=0.637， 0.561， all P＜0.05），respectively.Vd， Vs， and Vm on the affected side were positively correlated with GCS score （r=0.512，0.501， 0.522， all P＜0.05）， and negatively correlated with NIHSS score （r=-0.554， -0.534， -0.529， all P＜0.05） and cerebral infarction volume （r=-0.567， -0.545， -0.537， all P＜0.05）.The combined ONSD and TCCD ROC curve area under the curve for predicting MMI occurrence was 0.926， superior to each index alone （0.796-0.871）， indicating a significant improvement in predictive value.
Conclusion
ONSD and TCCD， as measured by ultrasound， can serve as predictive markers for MMI occurrence.They are significantly correlated with GCS score， NIHSS score， and cerebral infarction volume.The combined predictive value of ONSD and TCCD parameters for MMI occurrence is significantly higher than that of individual indicators， facilitating early risk assessment of MMI progression.
To explore the application value of artificial intelligence-assisted oral environment management mode in patients with carotid artery stenosis and periodontitis.
Methods
80 patients were enrolled with carotid artery stenosis and periodontitis hospitalized in the vascular surgery department of Nanjing Drum Tower Hospital from January 2022 to May 2023.Using artificial intelligence to identify unstable plaques， they were randomly assigned to either an intervention group or a control group， each with 40 cases.The control group implemented a standard health education model， while the intervention group implemented an oral environment management model based on the health education model.We employed repeated measures ANOVA to compare the scores of the Oral Health Literacy Scale， Beck Oral Score， and Plaque Index between the two groups at different time points： admission， pre-discharge， and at 3 and 6 months post-discharge； The rank sum test was used to compare the changes in inflammatory markers between the two groups 3 days post-surgery， and the χ2 test was used to compare the incidence of restenosis and stroke between the two groups at 3 and 6 months post-discharge.
Results
Repeated measures ANOVA revealed statistically significant difference in the Oral Health Literacy Scale scores between the intervention group and the control group at various time points， groups， and time points （P＜0.05）.The difference between the groups at 6 months post-discharge was statistically significant ［（172.35±27.73） points vs （160.17±23.36） points；t=-2.124， P=0.037］.Beck Oral Score also showed significant differences at different time points， groups， and time points （P＜0.05）， with significant differences at 3 and 6 months post-discharge ［（7.58±1.32） points vs（8.43±1.50） points］， t=-2.692， P=0.009； （6.43±1.28） points vs （7.28±1.36） points， t=-2.881， P=0.005］.Plaque Index differences were significant at various groups and time points （P＜0.05）， with a significant difference at 6 months post-discharge （1.60±0.67 vs 1.95±0.50， t=-2.636， P=0.010）.Intragroup comparison of the scores of the Oral Health Literacy Scale， Beck Oral Score， and Plaque Index showed statistically significant differences at 6 months post-discharge compared to admission， discharge， and 3 months postdischarge （all P＜0.05）.Interleukin-6 and neutrophil counts 3 days post-surgery were significantly different between the two groups ［3.24 （2.09， 5.60） pg/ml vs 6.65 （4.70， 8.50） pg/ml； 3.60 （3.20， 4.00）×109/L vs 5.25（4.40， 7.50）×109/L］， with significant differences （Z=2.990， P=0.003； Z=-4.266， P=0.001）.The incidence of complications at 6 months post-discharge was significantly different between the groups ［0 （0.00%） vs 6（15.00%）］， with significant differences （χ2=4.505， P=0.034）.
Conclusion
Artificial intelligence-assisted identification of patients with unstable plaques， coupled with targeted oral environment management， can effectively reduce plaque， improve oral health， enhance oral health literacy， and reduce the incidence of postoperative infections and complications.
To evaluate the effects of digital therapy on cognitive function， daily living ability， and quality of life in non-dementia patients with cognitive impairment due to small cerebral vascular disease.
Methods
Ninety patients with non-dementia cognitive impairment associated with cerebral small vessel disease， admitted to Beijing Shunyi Hospital from January 2022 to August 2023， were enrolled and randomly assigned to either the conventional group （44 cases） or the digital therapy group （44 cases）.The conventional group received standard risk factor management， while the digital therapy group received digital therapy in addition to standard care.SPSS 26.0 software was used to analyze the overall cognitive function scores， Digital Breadth Test （DST） scores， Stroop Word Colour Interference Test （CEST） scores， Visual Matching and Reasoning scores， Colour Digit Connectivity Test （TMT） scores， Activities of Daily Living（ADL） scores， and Comprehensive Quality of Life Inventory 74 （CQOLI-74） in both groups.
Results
Prior to treatment， no significant differences were observed in the Montreal Cognitive Assessment Scale （MoCA），Brief Mental Status Examination （MMSE）， DST score， CEST score， Visual Matching and Reasoning Score，TMT-A score， TMT-B score， ADL score， and CQOLI-74 score when comparing the two groups （all P＞0.05）.Post-treatment， both groups showed improved overall cognitive function scores， DST scores， visual matching and reasoning scores， ADL scores， and CQOLI-74 scores， and reduced TMT-A scores， TMT-B scores， and CEST scores （P＜0.05）.The digital therapy group demonstrated higher post-treatment overall cognitive function scores ［MoCA score （24.96±1.51）， MMSE score （26.67±1.16）］， DST score （12.82±1.08），Visual Matching and Reasoning score （6.33±1.37）， ADL score （86.41±8.71）， CQOLI-74 score ［ somatic functioning （74.48±7.03）， psychological functioning （75.41±7.09）， social functioning （75.84±8.55）， and material status of life （62.22±7.14）］， compared to the conventional group.Conversely， the TMT-A score（61.41±8.73）， the TMT-B score （117.14±24.54）， and the CEST score （14.21±1.95） were lower than in the conventional group （t=3.208， 3.522， 2.473， 2.606， 6.159， 4.481， 5.334， 4.816， 6.138， 2.891， 2.359， 4.812；P=0.002， =0.001， =0.015， =0.011， ＜0.001， ＜0.001， ＜0.001， ＜0.001， ＜0.001， =0.005， =0.021， ＜0.001）.
Conclusion
Digital therapy can significantly enhance the cognitive function， daily living ability， and quality of life in non-dementia patients with cognitive impairment due to small cerebral vascular disease.
To explore the effects of edaravone injection combined with butylphthalide on serum inflammatory factors， oxygen free radicals， and endothelial function in patients with acute highaltitude cerebral infarction （AHACI）.
Methods
A total of 90 AHACI patients treated at Qinghai Provincial Fifth People's Hospital from June 2021 to June 2022 were included.Patients were randomly assigned to either a butylphthalide group or a combination group， with 45 patients in each.The butylphthalide group received butylphthalide treatment alone， while the combination group received edaravone injection in addition to butylphthalide treatment.Both groups underwent a 2-week treatment regimen.The National Institutes of Health Stroke Scale （NIHSS） was used to evaluate the degree of neurological deficit before and after treatment.The efficacy of the treatment was assessed， and the chi-square test was applied to compare the efficacy between the two groups.Serum inflammatory factors ［high-sensitivity C-reactive protein （hs-CRP），interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）］， oxygen free radicals ［superoxide dismutase （SOD），malondialdehyde （MDA）， advanced oxidation protein products （AOPP）］， vascular endothelial growth factor（VEGF）， and endothelin-1 （ET-1） levels were measured before and after treatment.Paired t-tests were used to assess changes within the groups， and independent sample t-tests were used to compare differences between the groups.
Results
The combination group demonstrated a higher total effective rate of clinical treatment compared to the butylphthalide group （80.00% ［36/45］ vs 95.56% ［43/45］； χ2 = 5.075， P = 0.024）.After treatment， hs-CRP， IL-6， and TNF-α levels significantly decreased， with lower levels in the combination group［（7.35±2.01） mg/L vs （9.56±2.09） mg/L； （8.03±2.56） μg/L vs （9.68±2.11） μg/L； （46.37±10.23） ng/ml vs（52.83±12.55） ng/ml］， with statistically significant differences （t = 5.113， 3.336， 2.676， P ＜ 0.001， = 0.003，= 0.014）.The NIHSS score in the combination group was lower than that in the butylphthalide group［（8.56±1.34） points vs （11.32±1.12） points］， with a statistically significant difference （t = 10.602， P ＜0.001）.After 2 weeks of treatment， serum SOD levels increased significantly in both groups， with higher levels in the combination group ［（324.12±18.65） U/ml vs （246.13±19.35） U/ml］.MDA and AOPP levels decreased significantly in both groups， with lower levels in the combination group ［（5.63±0.73） μg/L vs （7.19±0.95） μg/L； （72.14±6.25） ng/ml vs （98.16±9.26） ng/ml］， with statistically significant differences （t =19.467， 8.735， 15.624， P ＜ 0.001 for all）.After treatment， serum VEGF levels increased in both groups，with higher levels in the combination group ［（502.36±60.13） ng/ml vs （422.34±60.12） ng/ml］， while ET-1 levels decreased significantly in both groups， with lower levels in the combination group ［（63.13±4.31） ng/L vs （70.26±4.28） ng/L］， with statistically significant differences （t = 6.313， 7.874， P ＜ 0.001 for both）.
Conclusion
The combination of edaravone injection and butylphthalide can reduce serum inflammatory factors， oxygen free radicals， and ET-1 levels， while increasing VEGF levels in AHACI patients， leading to effective improvement in treatment outcomes.
To explore the predictive value of quantitative susceptibility mapping（QSM） combined with susceptibility weighted imaging （SWI） for neurological function in patients with acute ischemic stroke （AIS） after endovascular treatment （EVT）.
Methods
One hundred and sixty nine AIS patients admitted to our hospital from February 2020 to October 2023 were included.Demographic data and imaging examination results of patients were collected at admission.All patients undewent EVT and were followed up for 3 months after treatment.Patients were categorized into two groups based on the modified Rankin Scale （mRS） score： good neurological function group （mRS ≤2） and poor neurological function group （mRS＞2）.Multivariate Logistic regression was used to analyze the factors influencing patients'neurological function， and receiver operating characteristic （ROC） curve was drawn to evaluate the predictive value of QSM combined with SWI on neurological function.
Results
A total of 156 patients were included，comprising 99 patients with good prognosis and 57 with poor prognosis.The NIHSS score was significantly higher in patients with good neurological function compared to those with poor neurological function （P＜0.05）.The coefficient of variation （CV）， median， maximum， and minimum value of QSM were higher in patients with good neurological function， with the average value also being higher than in those with poor neurological function.Lesion volume， the diameter of magnetic sensitive vessel sign （SVS）， and the SVS positivity were lower than those in patients with poor neurological function （P＜0.05）.There was no significant difference in skewness， kurtosis and standard deviation between the two groups （P＞0.05）.In multivariate Logistic analysis，with mRS score as the dependent variable （1=good， 0=bad）， the CV （OR=3.574， 95%CI： 1.228-10.400）， median（OR=0.018， 95%CI： 0.001-0.621）， lesion volume （OR=1.125， 95%CI： 1.024-1.235）， SVS positivity （OR=55.304，95%CI： 1.609-1900.426）， and SVS diameter （OR=1.287， 95%CI： 1.032-1.604） were all predictive factors for postoperative neurological function （P＜0.05）； ROC curve showed that the area under curve （AUC） for SVS positivity， SVS diameter， CV， lesion volume， and median on postoperative neurological function were 0.616，0.836， 0.859， 0.803， and 0.867， respectively， and the AUC of QSM combined with SWI （0.985） was higher than that of individual parameters （0.935 and 0.912， P＜0.05）.
Conclusion
The CV， median of QSM parameters，SVS positivity and diamete of SWI parameters， and lesion volume are all Influential factors affecting postoperative neurological function， with high predictive value.The combination of QSM with SWI offers superior predictive value for neurological function following EVT in patients with AIS.
To investigate the correlation between body fat percentage （BF） and gait parameters during single task walking （STW） and dual task walking （DTW） in patients with cerebral small vessel disease （CSVD）， and to determine whether BF is associated with the risk of falls in CSVD patients.
Methods
A total of 95 hospitalized patients diagnosed with CSVD in Neurology Department of Seventh Medical Center of PLA General Hospital from January 1， 2022， to June 1， 2023，were collected.Data on their fat mass and BF were collected.High BF was defined as exceeding 25.7% in males and 35.9% in females.Based on this criterion， the enrolled patients were categorized into a normal BF group （46 cases）and a high BF group （49 cases）.Additionally， gait parameters such as cadence， stride time， speed， and stride length， as well as phase coordination index （PCI）， coefficient of variation （CV）， and gait asymmetry （GA）were measured during both STW and DTW conditions.The number of falls was also recorded.Generalized estimating equations （GEE） and binary Logistic regression analyses were conducted to explore the relationship among these parameters.
Results
The GEE results indicate significant interaction effects for all gait parameters except for GA， both between and within groups.Therefore， post-hoc analyses were conducted to further investigate these differences： between-group comparison showed that during STW， the high BF group had significant differences in the basal gait parameters （STW， cognitive DTW， motor DTW） and indirect gait parameters （STW， cognitive DTW， motor DTW CV） compared to the normal BF group （all P＜0.05）；within-group comparison indicated that during DTW， particularly cognitive DTW， all basal and indirect gait parameters in normal BF and high BF groups compared with STW， the differences were significant （all P＜0.05）.Additionally， regardless of gender， BF was identified as an independent risk factor for falls （male：odds ratio=1.132， 95% confidence interval： 1.009-1.270； female： odds ratio=1.145， 95% confidence interval：1.058-1.239）.
Conclusion
There is a significant correlation between BF and gait parameters during STW and DTW in patients with CSVD.Additionally， BF has been identified as an independent risk factor for fall accidents in this patient population.
To explore the association between fundus retinal characteristics and the prevalence of cardiovascular and cerebrovascular diseases through screening in extremely high-altitude regions（Tibet Autonomous Region）.
Methods
A total of 2 712 Tibetan residents living permanently at high altitude（4 500 metres above sea level） across 51 villages in 8 townships of 3 counties （Nyima， Shuanghu， and Amdo counties） in Nagchu region of the Tibet Autonomous Region were included as the study population.Data from 1 919 301 health checkups conducted in lower altitude areas were used as a control group.Fundus photographs of the study population under the natural pupil conditions were coptured using the Canon Dilution-Free Fundus Camera CR-2AF from Japan， and key structural features， such as age-related macular degeneration （AMD）， cup-to-disc ratio， similar manifestations of diabetic retinopathy， retinal vein occlusion，anterior optic disc， and other anomalies were recorded in detail.
Results
（1） No statistically significant difference in the incidence of AMD was found between extremely high-altitude areas and plain areas populations across different age groups （P＞0.05）； （2） Within the extremely high-altitude areas， individuals aged 20-29 had the highest incidence of enlarged cup-to-disc ratio compared to other age groups， with a statistically significant difference （χ²=60.502， P＜0.001）.Comparatively， the 30-39 age group in extremely high-altitude areas had a higher incidence of enlarged cup-to-disc ratio than the plain areas group， with a statistically significant difference （χ²=230.325， P＜0.001）； （3） The incidence rates of diabetic retinopathylike manifestations in the 30-39 and 40-49 age groups showed statistically significant differences （χ²=5.390，P=0.020； χ²=8.830， P=0.003）； （4） No statistically significant differences in the incidence rates of vein occlusion were observed between the two groups in the 30-39， 40-49 age groups （χ²=0.071， P=0.190； χ²=0.853，P=0.356）， but a statistically significant difference was found in the 50-59 and over-60 age group （χ²=10.400，P＜0.001； χ²=31.848， P＜0.001）； （5） Statistically significant differences in the incidence rates of anterior optic disc were found between the two groups in the 30-39 age groups （χ²=3.850， P=0.016）； （6） Statistically significant differences in the incidence rates of other macular abnormalities were found between the two groups in the 50-59 and over-60 age groups （χ²=5.080， P=0.024； χ²=10.500， P=0.001）.
Conclusion
There are notable differences in the spectrum of fundus photographic characteristics between populations in extremely highaltitude areas and those in low-altitude regions.
To investigate the prevalence of early-onset post-stroke cognitive impairment（PSCI） in elderly ischaemic stroke patients and to identifying the influencing factors.
Methods
A crosssectional study was used to randomly include 745 patients admitted the Department of Neurology of Rugao People's Hospital and Taixing People's Hospital from August 2021 to March 2023， who had completed the clinical follow-ups within 3-6 months post-stroke onset.A questionnaire was used to collect basic patient demographics， and disease-related information was collected from the hospital case system， including clinical data， laboratory indicators and imaging data.The National Institute of Health stroke scale （NIHSS）was used to determine the severity of stroke， and the mini-mental state examination （MMSE） was used to assess the cognitive function.Logistic multiple regression analysis was employed to identify factors influencing early concurrent cognitive deficits in elderly ischemic stroke patients.
Results
The prevalence of post-stroke cognitive impairment was 37.99% （283/745） in elderly stroke patients.Risk factors for earlyonset PSCI included Age ≥70 years （OR=2.152， 95%CI： 1.074-5.738）， delayed time from onset to clinic visit （OR=2.481， 95%CI： 1.204-4.708）， temporal lobe stroke location （OR=2.746， 95%CI： 1.097-7.058），infarct volume ≥1.5 cm3 （OR=1.992， 95%CI： 1.126-3.523）， high carotid plaque score （OR=2.083， 95%CI：1.201-3.613）， elevated serum C-reactive protein level （OR=2.893， 95%CI： 1.382-5.739）， increased serum homocysteine level （OR=2.847， 95%CI： 1.482-6.382）， and high NIHSS score （OR=2.501， 95%CI： 1.592-5.937）.
Conclusion
Early-onset PSCI is highly prevalent among elderly stroke patients， with age， time to consultation post-stroke onset， stroke location， infarct volume， carotid plaque score， serum C-reactive protein，serum homocysteine level and NIHSS score identified as significant influential factors.
To explore the relationship between ultrasonic optic nerve sheath diameter （ONSD）， the ratio of ONSD to eyeball transverse diameter （ETD） and the prognosis of acute hemorrhagic stroke patients.
Methods
Acute hemorrhagic stroke patients （n=97） admitted to Taixing People' Hospital from October 2021 to March 2023 were categorized into groups according to hospitalization outcomes.Patients with modified Rankin scale （mRS） ≤3 points were categorized as the good prognosis group （n=61）， while those with an mRS score ＞3 points were included in the poor prognosis group（n=36）； The beside ultrasonic measurements of ONSD， ONSD/ETD， and other clinical data of patients in the two groups were compared by t-test.Significant indicators were included in the multivariate Logistic analysis to assess their association with patient prognosis following acute hemorrhagic stroke.Receiver operating characteristic （ROC） curve was plotted to evaluate the prognostic value of ultrasonic measurement of ONSD and ONSD/ETD.
Results
The poor prognosis group exhibited significantly higher values for ONSD， ONSD/ETD， and midline displacement ［（5.54±0.48） mm， （0.25±0.02）， （5.77±3.27） mm］ compared to the good prognosis group ［（4.33±0.46） mm， （0.20±0.02）， （2.52±0.97） mm；t=12.323， 10.811， 7.262， all P＜0.001］.The Glasgow coma score （GCS） were also significantly lower in the poor prognosis group ［5.01±1.98 vs 10.85±2.67； t=11.394， P＜0.001）.Multivariate Logistic regression analysis identified ONSD， ONSD/ETD， and GCS scores as prognostic factors for acute hemorrhagic stroke（OR=3.688， 2.654， 0.282； P=0.013， ＜0.001， ＜0.001）.ROC curve analysis showed that the area under the curve （AUC） for ONSD and ONSD/ETD in predicting the prognosis of acute hemorrhagic stroke were 0.970 and 0.953， respectively.With a critical value of 4.96 mm for ONSD， the sensitivity and specificity to predict the prognosis of acute hemorrhagic stroke were 91.67% and 95.08%， respectively.For ONSD/ETD， with a critical value of 0.22， the sensitivity and specificity to predict the prognosis of acute hemorrhagic stroke were 88.89% and 90.16%， respectively.The AUC of parallel test and series test were 0.901 and 0.928， respectively，with sensitivities of 91.67% and 88.89%， and specificities of 88.52% and 96.72%.
Conclusion
Both ONSD and ONSD/ETD based on ultrasonic measurements serve as effective prognostic indicators for patients with acute hemorrhagic stroke.Especially， ONSD demonstrates superior predictive efficacy， and the potential clinical benefits of combined predictive models warrant further exploration.
To investigate the neuroprotective effect of drug-induced hypothermia in acute phase of ischemic stroke， as well as to elucidate the underlying mechanism involving DRP-1-mediated mitochondrial function.
Methods
A total of 45 adult male Sprague-Dawley rats were randomly assigned to three groups： sham operation （Sham）， middle cerebral artery occlusion （MCAO）， and MCAO with chlorpromazine and promethazine treatment （C+P） （n=15 per group）.Rats underwent 2 h of MCAO followed by 24 h or 48 h reperfusion.C+P was administered at the onset of reperfusion at a dose of 8 mg/kg，with one-third of the original dose injected 2 hours later to potentiate the drug's effects.Body temperature was monitored at pre-MCAO， initial drug， and 5 min， 10 min， 20 min， 30 min， 1 h， 2 h， 3 h， 6 h， 12 h， 24 h after administration.Infarct volumes and neurological deficits were assessed using 2，3，5-triphenyltetrazolium chloride （TTC） staining and scoring systems at 48 hours.TUNEL staining was used to detected the apoptotic cell death at 24 h.The lactate dehydrogenase （LDH）， cell death， ATP， reactive oxygen species （ROS）concentration， and mitochondrial respiratory chain complex （COX Ⅰ-Ⅳ） were evaluated by ELISA at 24 h.The mRNA and protein expressions of DRP-1 and Fis-1 were quantified by qPCR and western blotting at 24 h.LSD-t test or Dunnett's T3 method were used for inter-group comparisons.
Results
C+P administration（8 mg/kg） significantly reduced body temperature within 5 minutes post-MCAO in rats， reaching the lowest temperature ［（33.5±0.3） ℃］ after 2 hours， and maintaining a significantly reduced temperature for up to 12 hours before returning to normal.Compared to the MCAO group， C+P significantly reduced infarct volumes ［（29.73±2.32）% vs （48.46±0.48）%］ and neurological deficits［5 score： （2.0±0.1） vs （4.0±0.1）；12 score： （5.0±0.3） vs （8.0±0.2）； （5 score： t=2.917， P=0.008； 12 score： t=2.475， P=0.029）］.C+P also significantly mitigated mitochondrial dysfunction （LDH， ATP， ROS and COX I-IV） and cell death apoptosis（P＜0.05）.mRNA and protein expression of DRP-1 and Fis-1 were both significantly reduced by C+P（P＜0.05）.
Conclusion
Our findings suggest that C+P-induced hypothermia exerts neuroprotective effects after ischemic stroke by inhibiting DRP-1 phosphorylation and Fis-1 expression， and reducing mitochondrial dysfunction and apoptosis.
Interleukin-2 （IL-2）， the first successfully cloned cytokine derived from multicellular sources， is a multifunctional molecule primarily produced by CD4+ T cells.It plays a crucial regulatory role in multiple lymphocyte lineages， making it a promising therapeutic option for immune-mediated diseases.The transcriptional regulation of endogenous IL-2 involves various cis-acting elements and trans-acting factors，with the IL-2 gene promoter playing a vital role.This paper reviews the latest developments in engineered IL-2 research， and explores the molecular mechanisms regulating IL-2 transcription.It covers the expression distribution， expression patterns， epigenetic modifications of the IL-2 gene， and the diverse trans-acting factors that interact with its promoter.These insights are vital for optimizing IL-2-based therapeutic strategies and developing novel immunotherapies with higher target cell selectivity， extended half-life， enhanced stability， minimized side effects and immunogenicity， and expanded therapeutic applications.
Aneurysmal subarachnoid hemorrhage （aSAH） is characterized by its acute onset，rapid progression， and poor prognosis.Implementing a comprehensive approach that integrates pre-hospital and in-hospital emergency care can shorten emergency response time and improve patient prognosis.This article mainly introduces the commonly used emergency assessment tools for aSAH， the content of integrated pre-hospital and in-hospital emergency nursing， and the management and application effects of preventing rebleeding.The aim is to provide a reference for improving the quality of treatment and nursing patients with aSAH.Currently， establishing an efficient and rapid connection between pre-hospital transport and inhospital.stroke green channel through an internet platform is a key measure for effectively shorten the time from pre-hospital transport to in hospital stroke green channel.However， there are few relevant studies， which merits further investigation in future research.
Previous studies have posited that bladder function is highly dependent on the central nervous system， with the concept of the "vascular-brain-bladder axis" being widely applied to explain neurogenic urinary disorders.Cerebral small vessel disease （CSVD） represents a substantial health challenge in the elderly， with urinary dysfunction as one of its primary non-cognitive motor symptoms.These symptoms manifest diversely as urinary frequency， urgency， nocturia， and urge incontinence.The specific mechanisms underlying CSVD-related urinary dysfunction remain unclear.Recent research has identified a strong correlation between heart rate variability—a marker of autonomic function—and CSVD-related urinary dysfunction.Additionally， multiple studies have demonstrated that traditional imaging characteristics are also associated with these urinary symptoms.This paper aims to summarize the neural control and graded regulation of the micturition reflex， review the latest advancements in traditional imaging characteristics of CSVD，and propose potential neural mechanisms explaining CSVD-induced urinary dysfunction， with the goal of enhancing clinical physicians' comprehensive understanding and recognition of CSVD-related urinary issues.
Patients with malignancy exhibit a significantly elevated risk of hemorrhagic stroke compared to the general population， with this risk escalating as the malignancy progresses.This suggests that malignancy may contribute directly or indirectly to the genesis of hemorrhagic stroke.Recently， a series of studies found that many patients with malignancy who suffer from hemorrhagic stroke lack traditional stroke risk factors， implying a potential direct or indirect link between malignancy and hemorrhagic stroke， termed as malignancy-related hemorrhagic stroke.Importantly， malignancy-related hemorrhagic stroke mainly occurs in patients with brain tumors and coagulopathy， with its pathogenesis potentially involving intratumoral hemorrhage and coagulation abnormalities.The aim of this review is to provide a summary of research advances on malignancy-related hemorrhagic stroke.
Patients in intensive care unit （ICU） are often complicated with varying degrees of neurological dysfunction due to a multitude of etiologies.Electroencephalography （EEG） can dynamically evaluate the neurological function of patients in the early stage and is extensively utilized in clinical practice.Quantitative electroencephalogram （qEEG） has the advantages of simplicity in operation， strong antiinterference， and easy to read， giving it unique advantages for the diagnosing， monitoring， and evaluating common neurotogical diseases in ICU.This article aims to provide a comprehensive review of the clinical application of qEEG in adult patients， focusing on conditions such as epilepsy， delayed cerebral ischemia，ischemic stroke， traumatic brain injury， cardiac arrest， and those undergoing extracorporeal membrane oxygenation （ECMO） treatment.
Ischemic stroke （IS） is associated with a high rate of death and disability， and there is a lack of effective diagnosis and therapeutic methods.Dysfunction of cerebral vascular endothelial cells （ECs）causes ischemia and hypoxia in brain tissue， and ECs regulate the function of blood-brain barrier （BBB） and neurovascular unit （NVU） cells through cell-to-cell communication， which is an important pathological basis for the occurrence and development of IS.A growing body of evidence suggests that endothelial cell-derived extracellular vesicles （EC-EVs） are instrumental in maintaining neurovascular homeostasis and function.They facilitate communication between NVU cells and influence the function of NVU cells and BBB through the delivery of their cargo.This article reviews the role of EC-EVs in the pathogenesis， diagnosis， and treatment of IS.The potential of EC-EVs as diagnostic biomarkers and therapeutic targets for IS is also discussed， in order to provide new ideas for the clinical diagnosis and treatment strategies of IS.
