More than 70% of patients who survive the acute phase of intracerebral hemorrhage continue to experience impairments in consciousness, motor function, cognition, speech, or swallowing. Following acute treatment, rehabilitation practice is often affected by inconsistent timing of initiation, non-uniform assessment standards, poor coordination between inpatient and post-discharge care, and regional disparities in rehabilitation resources, all of which may hinder long-term functional recovery. Rehabilitation for intracerebral hemorrhage should not be limited solely to short-term training following hospital discharge; instead, patients' functional impairments should be assessed from multiple perspectives, with continuous management throughout the acute, subacute, and chronic phases. Clinical decisions should be based on high-quality evidence, supported by multidisciplinary teamwork, and care should be delivered through an integrated system linking hospitals, rehabilitation centers, communities, and patients' homes, so as to avoid interruptions in rehabilitation after discharge. Neuromodulation may serve as an adjunct to conventional rehabilitation, but patient selection, timing of initiation, and safety limits should be determined according to hematoma resolution, postoperative status, seizure risk, and the stability of vital signs. Based on randomized controlled trials, systematic reviews, and clinical guidelines on rehabilitation after intracerebral hemorrhage published between 2019 and 2025, this article reviews advances in post-acute functional recovery, neuromodulation, and continuous rehabilitation management and integrates them into a multidimensional functional rehabilitation approach. Since most of the available evidence comes from patients with ischemic stroke or mixed stroke populations, further prospective studies are needed to determine the effectiveness of this approach specifically in patients with intracerebral hemorrhage

Endovascular treatment (EVT) has become the standard treatment for acute ischemic stroke caused by large vessel occlusion, and the field of neurointervention in China has achieved rapid development in the past decade. The publication of the "Chinese guidelines for endovascular treatment of acute ischemic stroke 2023" laid the evidence-based foundation for this field, while the publication of the "Chinese expert consensus on endovascular treatment techniques for acute ischemic stroke 2025" (hereinafter referred to as the "Consensus") marks a further step towards "technical refinement" and "operational standardization" in the field of EVT in China. Based on the core content of the Consensus and combined with the latest evidence, this article reviews and comments on six aspects: consensus highlights, vascular access selection, optimization of thrombectomy techniques, etiology-directed strategies, thrombectomy for medium vessel occlusion, and challenges and prospects, in order to clarify the practical value of the consensus and the future development direction of this field.

To compare the long-term differences in hemorrhagic stroke or death between palliative embolization and conservative management in adult patients with brain arteriovenous malformations (AVM), and to evaluate the effectiveness of different treatment strategies.

This study was conducted within the prospective, nationwide multimodality treatment for brain arteriovenous malformations in Chinese mainland (MATCH) registry, and consecutive AVM patients were enrolled from August 2011 to December 2025. Patients receiving conservative management were assigned to the conservative management group, while those receiving palliative embolization were assigned to the palliative embolization group. Propensity score matching (PSM) was used to balance baseline differences between groups. Survival analyses were performed in the overall cohort and in strata defined by hemorrhage status (unruptured vs ruptured) to compare long-term rates of hemorrhagic stroke or death, as well as neurological outcomes. Subgroup analyses were conducted for the primary outcome (hemorrhagic stroke or death) to test robustness. Poisson regression was used to compare the risk of the primary outcome between the matched groups, with risk differences (RD) and their 95% confidence intervals (CI) calculated. Multivariable Cox proportional hazards regression models were constructed in the matched cohorts, and results were reported as adjusted hazard ratios (HR) with 95%CI. Cumulative incidence curves for the 10-year primary outcome were plotted, and between-group differences were assessed using the Log-Rank test. For the secondary functional outcome (modified Rankin scale score 0-1), relative risks (RR) were estimated using modified Poisson regression or log-binomial models.

A total of 824 patients received either conservative treatment or palliative embolization. After PSM, the overall matched cohort comprised 608 patients (304 pairs). The median follow-up duration for the primary outcome endpoint was 1.67 years (IQR 0.36, 6.03). The palliative embolization group had a higher incidence of long-term hemorrhagic stroke or death than the conservative group (3.71 per 100 patient-years vs 1.71 per 100 patient-years; RD=2.00, 95%CI: 0.24 to 3.77, P=0.007). In subgroup analyses, palliative embolization was not superior to conservative treatment in unruptured AVM (2.47 per 100 patient-years vs 1.52 per 100 patient-years; RD=0.95, 95%CI: -0.91 to 2.81, P=0.255), while comparable outcomes were observed in ruptured AVM (6.06 per 100 patient-years vs 3.35 per 100 patient-years; RD=2.71, 95%CI: -2.04 to 7.47, P=0.183). Stratification by embolization extent showed that patients achieving ＞50% nidus volume reduction experienced no hemorrhagic stroke or death, regardless of rupture status. In the overall cohort, patients in the palliative embolization group were less likely to have favorable functional outcomes (mRS score of 0 to 1) compared to those in the conservative treatment group [74.67% (227/304) vs 81.91% (249/304), RR=0.91, 95%CI: 0.84 to 0.99, P=0.030].

Palliative embolization was overall inferior to conservative treatment in preventing long-term hemorrhagic stroke or death in adult patients with brain AVM.

To investigate the efficacy and safety of the Chinese Tulip intrasaccular flow disruption device in the treatment of wide-necked bifurcation aneurysms of the middle cerebral artery (MCA).

A total of 43 consecutive patients with saccular MCA bifurcation aneurysms were prospectively enrolled from eight medical centers in China between March and November 2023 and completed the full follow-up protocol. Among the 43 aneurysms, 40 were classified as wide-necked. All patients underwent endovascular treatment with the Tulip device. The technical success rate, degree of aneurysm occlusion (Raymond-Roy classification), neurological functional outcomes [modified Rankin scale (mRS)], and perioperative complications were recorded. Digital subtraction angiography follow-up was completed at 12 months post-procedure.

The technical success rate was 100.00% (43/43), with a total of 44 Tulip devices successfully implanted. At the 12-month follow-up, the complete occlusion rate was 44.19% (19/43) and the adequate occlusion rate was 95.35% (41/43), and the mRS scores were 0 in 40 patients, 1 in 2 patients, and 2 in 1 patient. There were no intraoperative adverse events, and a total of 3 postoperative events including transient ischemic attack and thrombosis occurred.

The Tulip device is easy to use in the treatment of wide-necked MCA bifurcation aneurysms. Short-term follow-up reveals satisfactory occlusion rates and a low complication rate.

To compare the clinical efficacy of robot-assisted catheter drainage and craniotomy hematoma evacuation for spontaneous intracerebral hemorrhage (sICH).

This study retrospectively collected data from patients with sICH treated in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, from January 2023 to November 2025. Based on comprehensive neurosurgical assessment and patient or family preference, patients underwent either robot-assisted catheter drainage (robot-assisted group) or craniotomy for hematoma evacuation (craniotomy group). Propensity score overlap weighting was used to balance baseline differences between groups. The primary outcome was functional independence at 6 months, defined as a modified Rankin scale (mRS) score of 0-2. Secondary outcomes included functional independence at postoperative 3 months, favorable functional outcome (mRS score 0–3) at postoperative 3 and 6 months, Barthel index at postoperative 6 months, and mortality. After overlap weighting, binary outcomes were analyzed using weighted Logistic regression and continuous outcomes using weighted linear regression, with robust sandwich variance estimates for 95% confidence intervals (95%CI) and P values. Sensitivity analyses were performed by re-estimating propensity scores and weights after removing admission-to-surgery time from the propensity score model and, separately, after excluding infratentorial and mixed hemorrhages.

A total of 138 patients were included, with 79 in the robot-assisted group and 59 in the craniotomy group. Baseline covariates were balanced after overlap weighting. Before weighting, the postoperative 6-month functional independence rates were 40.51% (32/79) and 10.17% (6/59), the postoperative 6-month favorable functional outcome rates were 55.70% (44/79) and 25.42% (15/59), and the postoperative 6-month Barthel index scores were 57.85±42.20 and 29.83±34.23 in the robot-assisted and craniotomy groups, respectively, with significant differences between groups (χ²=15.578, 12.647, t=4.303; all P＜0.001). All-cause mortality at 3 and 6 months postoperatively did not differ significantly between groups (both P＞0.05). After overlap weighting, robot-assisted catheter drainage was associated with higher odds of functional independence at 6 months postoperatively for sICH patients (OR=4.25, 95%CI: 1.60-11.28, P=0.004). Compared with the craniotomy group, the robot-assisted group had shorter operative time [geometric mean ratio (GMR)=0.27, 95%CI: 0.24-0.32, P＜0.001], length of intensive care unit stay (GMR=0.73, 95%CI: 0.60-0.90, P=0.003), and total length of hospital stay (GMR=0.77, 95%CI: 0.64-0.94, P=0.008), as well as less intraoperative blood loss (GMR=0.03, 95%CI: 0.02-0.05, P＜0.001) and a lower incidence of pulmonary infection (OR=0.40, 95%CI: 0.19-0.83, P=0.014). No significant differences were observed in other safety outcomes (all P＞0.05).

In the overlap-weighted population, robot-assisted catheter drainage was associated with better mid-term functional outcomes and lower perioperative resource utilization for sICH patients, whereas its advantages in survival benefit and overall safety remain uncertain.

To observe the clinical efficacy of stereotactic-guided neuroendoscopic hematoma evacuation surgery in patients with hypertensive intracerebral hemorrhage (HICH) and its impact on complications.

A retrospective study was conducted on 60 patients with HICH who were admitted to Beijing Puren Hospital from January 2024 to December 2024. The patients were divided into the control group (30 cases, stereotactic hematoma evacuation) and the treatment group (30 cases, stereotactic-guided neuroendoscopic hematoma evacuation) based on different surgical methods. The independent samples t-test was employed to assess differences in surgical duration, intraoperative blood loss, hematoma evacuation rate, hospitalization duration, intensive care unit (ICU) stay duration, 3-month postoperative National Institutes of Health Stroke Scale (NIHSS) scores, and modified Rankin scale (mRS) scores. The χ² test was employed to assess differences in the 3-month Glasgow outcome scale (GOS) favorable rate, the proportion achieving the minimum clinically important difference (MCID) for NIHSS and mRS scores, and complication incidence between groups. Pearson correlation analysis or Spearman rank correlation analysis was used to evaluate the correlations between hematoma clearance rate and the improvement values of NIHSS score, the reduction values of mRS score, and the overall excellent rate of GOS.

The operative time of treatment and control groups was (83.54±13.57) and (56.39±11.28) min, respectively; the hematoma clearance rates were (88.39±6.21)% and (75.28±7.18)%, respectively; the postoperative hospitalization duration was (16.37±2.30) and (23.57±2.64) d, respectively; and the ICU stay was (2.28±0.64) and (3.54±1.14) d, respectively, and the differences were statistically significant (t=8.427, 7.564, 11.282, 5.279, all P＜0.001). At 3 months postoperatively, the NIHSS scores of treatment and control groups were 7.33±2.17 and 10.37±2.47, respectively; the mRS scores were 2.57±1.07 and 3.97±1.27, respectively; the MCID achievement rates for NIHSS scores were 96.67% and 73.33%, respectively; the MCID achievement rates for mRS scores were 90.00% and 63.33%, respectively; and the favorable GOS rates were 90.00% and 60.00%, respectively; and the differences were statistically significant (t=5.052, P＜0.001; t=4.607, P＜0.001; χ²=4.706, P=0.026; χ²=4.565, P=0.033; χ²=7.200, P=0.007). The total complication rate in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (10.00% vs 33.33%, χ²=4.812, P=0.028). Pearson correlation analysis and Spearman rank correlation analysis showed that the hematoma clearance rate was positively correlated with the improvement in NIHSS score (r=0.611), the reduction in mRS score (r_s=0.753), and the favorable GOS rate (r_s=0.405; all P＜0.001).

Compared with stereotactic hematoma evacuation, stereotactic-guided neuroendoscopic hematoma evacuation demonstrates superior clinical efficacy in treating patients with HICH. The latter approach more effectively improves neurological function, shortens postoperative recovery time, and reduces the risk of complications in patients.

To investigate the relationship of serum vascular endothelial cadherin (VE-cadherin) and sphingosine-1-phosphate (S1P) levels with coagulation function and short-term prognosis in patients with hypertensive intracerebral hemorrhage (HICH).

A total of 134 HICH patients admitted to Handan Central Hospital from January 2022 to September 2024 were prospectively enrolled as the study group, and 134 healthy volunteers from the same period were enrolled as the control group in a 1∶1 ratio. The independent-samples t-test or Mann-Whitney U-test was used to compare serum levels of VE-cadherin, S1P, and coagulation function [including D-dimer (D-D), fibrinogen (FIB), prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT)] between the two groups. HICH patients were divided into the mild deficit group (≤ 4, n=41), the moderate deficit group (5-15, n=33), the moderate-to-severe deficit group (16-20, n=35), and the severe deficit group (≥21, n=25) based on the National Institutes of Health stroke scale (NIHSS) score at admission (severity of illness). Pearson or Spearman correlation analysis was used to analyze the correlation between serum VE-cadherin and S1P levels and disease severity as well as coagulation function in HICH patients. Based on the modified Rankin scale (mRS) at 6-month follow-up, HICH patients were divided into the poor outcome group (mRS score ＞ 2 or death, n=60) and the good outcome group (mRS score ≤ 2, n=74). Univariate and multivariate Logistic regression analyses were used to identify factors influencing short-term prognosis in HICH patients, and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum VE-cadherin and S1P levels for short-term prognosis. The area under the curve was compared using the DeLong test.

Compared with the control group (healthy volunteers), the treatment group (HICH patients) showed significantly higher serum levels of VE-cadherin [5.81 (4.55, 6.97) ng/mL vs 3.08 (2.77, 3.43) ng/mL, Z=-11.919, P＜0.001], D-D [0.67 (0.53, 0.85) mg/L vs 0.29 (0.23, 0.37) mg/L, Z=-13.495, P＜0.001], S1P [(287.43±39.42) ng/mL vs (210.06±28.01) ng/mL, t=18.519, P＜0.001], and FIB [(3.96±0.53) g/L vs (2.66±0.40) g/L, t=22.708, P＜0.001], as well as significantly prolonged TT [24.80 (22.95, 26.33) s vs 16.98 (15.16, 18.73) s, Z=-13.512, P＜0.001], PT [(15.58±3.44) s vs (12.00±0.97) s, t=11.638, P＜0.001], and APTT [(35.12±5.49) s vs (28.00±2.91) s, t=13.279, P＜0.001]. All differences were statistically significant. Serum levels of VE-cadherin, S1P, D-D, and FIB progressively increased, while PT, TT, and APTT progressively prolonged across the mild, moderate, moderate-to-severe, and severe deficit groups (all P＜0.05). Serum VE-cadherin and S1P levels in HICH patients were positively correlated with disease severity, D-D, FIB, PT, TT, and APTT (all P＜0.05). Multivariate Logistic regression analysis showed that increased hematoma volume, higher NIHSS score at admission, elevated VE-cadherin, and elevated S1P were independent risk factors for poor short-term prognosis in HICH patients (all P＜0.05), while a higher Glasgow coma score at admission was an independent protective factor (P＜0.05). The areas under the ROC curves for serum VE-cadherin, S1P levels, and their combination in predicting short-term prognosis in HICH patients were 0.824 (95%CI: 0.755-0.892), 0.815 (95%CI: 0.743-0.887) and 0.901 (95%CI: 0.851-0.952), with sensitivities of 55.0%, 73.3% and 91.7%, and specificities of 94.6%, 75.7% and 74.3%, respectively. The combined predictive efficacy was significantly better than that of serum VE-cadherin or S1P levels alone (Z=2.946, 3.061, P=0.003, 0.002).

Serum levels of VE-cadherin and S1P are elevated in HICH patients and are significantly associated with disease severity, coagulation dysfunction, and poor short-term prognosis. The combination of serum VE-cadherin and S1P levels has high predictive value for short-term prognosis.

To investigate the impact of setting door-to-needle time (DNT) 60 min as a quality-control benchmark on 90-day post-thrombolytic therapy prognosis and length of hospital stay (LOS) in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis using alteplase or urokinase.

This study prospectively enrolled AIS patients receiving intravenous thrombolysis with alteplase or urokinase at Baotou Central Hospital from January 2020 to January 2023. The patients were divided into the target group (DNT ≤60 min) and the delay group (DNT ＞60 min) according to DNT. They were further stratified into the alteplase subgroup and the urokinase subgroup. The patients were classified into the favorable-prognosis group [modified Rankin scale (mRS) score ＜3] and the poor-prognosis group (mRS score ≥3) based on the 90-day post-thrombolysis mRS score. The χ² test or Fisher's exact test was used to compare the hemorrhagic transformation rate, in-hospital all-cause mortality and 90-day poor-prognosis rate among groups. Multivariable Logistic regression was performed only in the alteplase subgroup to identify independent influencing factors for 90-day poor prognosis. Multivariable linear regression was applied to analyze the association between DNT and LOS.

In the overall cohort, there were 92 patients in the target group and 219 patients in the delay group. Within the alteplase subgroup, there were 58 patients in the target group and 163 patients in the delay group; within the urokinase subgroup, there were 34 patients in the target group and 56 patients in the delay group. In the overall cohort, there were no significant differences between the target group and the delay group in hemorrhagic transformation rate [3.26% (3/92) vs 6.39% (14/219), χ²=1.230, P=0.267] and in-hospital all-cause mortality [2.17% (2/92) vs 3.20% (7/219), P＞0.999]. After excluding 16 patients lost to follow-up for 90-day outcome assessment, the 90-day poor-prognosis rate was 19.54% (17/87) in the target group and 22.60% (47/208) in the delay group without significant difference (χ²=0.337, P=0.561). Within the alteplase subgroup, the 90-day poor-prognosis rate of the target group was 11.11% (6/54), which was significantly lower than 23.87% (37/155) of the delay group (χ²=3.990, P=0.046). No significant inter-group differences in hemorrhagic transformation rate, in-hospital all-cause mortality and 90-day poor-prognosis rate were found in the urokinase subgroup (all P＞0.05). After adjusting for confounders including baseline NIHSS score, atrial fibrillation, gender, age, smoking history and hemorrhagic transformation in the alteplase subgroup, stratification by the DNT cutoff of 60 min was not an independent protective factor against 90-day poor prognosis (OR=1.223, 95%CI: 0.378–3.955, P=0.737). However, when DNT was analyzed as a continuous variable, the odds of 90-day poor prognosis increased with longer DNT; each additional 1-minute delay in DNT was associated with a 1.2% increment in the odds of poor prognosis (OR=1.012, 95%CI: 1.000–1.023, P=0.049). Multivariable linear regression showed an independent positive correlation between DNT and LOS (β=0.428, P＜0.001).

Among the overall AIS patients undergoing intravenous thrombolysis, using DNT ≤60 min as the quality-control benchmark, no improvement in the prognosis was observed in AIS patients at 90-day post intravenous thrombolysis. Among patients treated with alteplase, DNT as a continuous variable showed a time-dependent association with poor prognosis.

To investigate the clinical efficacy of argatroban sequential therapy in the treatment of patients with progressive perforating artery lesion-type cerebral infarction and analyze the related factors influencing prognosis.

A total of 154 patients diagnosed with progressive perforating artery lesion-type cerebral infarction in Qinhuangdao Hospital of Peking University Third Hospital from June 2022 to June 2024 were retrospectively included. All patients received argatroban sequential therapy. According to the modified Rankin scale (mRS) 3 months after treatment, patients were divided into the favorable prognosis group (mRS score ≤2) and the poor prognosis group (mRS score ＞2). The differences in baseline data were compared between the two groups by independent samples t-test and Chi-square test; multivariate Logistic regression analysis was used to identify risk factors for prognosis.

Three months after treatment, among the 154 patients, 123 had a favorable prognosis and 31 had a poor prognosis, with a favorable prognosis rate of 79.87%. Univariate analysis showed that age, systolic blood pressure at admission, diastolic blood pressure at admission, history of hypertension, history of type 2 diabetes mellitus, history of coronary heart disease, smoking history, infarct volume, National Institutes of Health stroke scale score at admission, homocysteine (Hcy), low density lipoprotein cholesterol, high density lipoprotein cholesterol, and glycated hemoglobin were all correlated with the prognosis of patients with progressive perforating artery lesion-type cerebral infarction treated with argatroban (all P＜0.05). Multivariate Logistic regression analysis revealed that large infarct volume (OR=1.091, 95%CI: 1.013 to 1.175) and Hcy ≥ 15.00 μmol/L (OR=1.910, 95%CI: 1.028 to 3.548) were independent risk factors affecting the prognosis of these patients treated with argatroban (both P＜0.05).

Argatroban sequential therapy is associated with a favorable overall prognosis in patients with progressive perforating artery lesion-type cerebral infarction. Larger infarct volume and Hcy ≥15.00 μmol/L were identified as independent risk factors influencing patient outcomes. Early identification and intervention of these factors are of significant importance for optimizing the therapeutic efficacy of argatroban.

To analyze the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and postoperative 30-day prognosis in patients with hypertensive basal ganglia cerebral hemorrhage (HBGCH).

The clinical data and prognostic data of patients with HBGCH admitted to the Department of Neurosurgery of People's Hospital of Rizhao from January 2020 to December 2022 were retrospectively collected and analyzed. According to the modified Rankin scale (mRS) score 30-day after surgery, the patients were divided into good prognosis group (mRS score 0-2) and poor prognosis group (mRS score 3-6). The correlation between the preoperative NLR and clinical outcome in HBGCH patients was analyzed, and the prediction model was established by multivariate Logistic regression analysis. The predictive value of preoperative NLR was analyzed by receiver operating characteristic (ROC) curve.

A total of 178 patients were included, including 124 males (69.66%) and 54 females (30.34%), with an average age of (56.06±12.15) years. There were 73 patients in the good prognosis group and 105 in the poor prognosis group. Multivariate Logistic regression analysis showed that Glasgow coma scale (GCS; OR=0.687, 95%CI: 0.581 to 0.813, P＜0.001), hematoma volume (OR=1.028, 95%CI: 1.007 to 1.050, P=0.011) and NLR (OR=1.163, 95%CI: 1.078 to 1.254, P＜0.001) were independently associated with patient prognosis. The AUC of the preoperative NLR in predicting the short-term poor prognosis after HBGCH surgery was 0.726 (95%CI: 0.651 to 0.800, P＜0.001). The optimal cut-off value was 9.52, with a sensitivity of 65.7% and a specificity of 78.1%.

Preoperative NLR is an independent risk factor for postoperative 30-day adverse prognosis in patients with hypertensive basal ganglia cerebral hemorrhage, and preoperative NLR elevation predicts poor outcome.

To investigate the effect of miR-186-5p regulation of the silent information regulator 1/peroxisome proliferator-activated receptor γ coactivator-1α/fibronectin type Ⅲ domain-containing protein 5 (SIRT1/PGC-1α/FNDC5) pathway on the neurological function of mice with ischemic stroke (IS).

An IS mouse model was established using the middle cerebral artery occlusion (MCAO) method, and mice were divided into five groups: model group, negative control group, miR-186-5p inhibitor group, edaravone group, and miR-186-5p inhibitor + SIRT1 inhibitor (EX527) group, with 10 mice in each group. Additionally, 10 mice were used as a sham operation group, undergoing the same procedures as the IS model group except for the absence of filament insertion. The neurological function was evaluated using the Longa scoring system; the condition of nerve injury was observed by hematoxylin-eosin and Nissl staining; the expression of neuron-specific nuclear protein (NeuN) and ionized calcium-binding adapter molecule 1 (Iba-1) was analyzed by immunofluorescence; the expression levels of miR-186-5p and Sirt1 mRNA were detected by reverse transcription polymerase chain reaction; the expression levels of proteins related to the SIRT1/PGC-1α/FNDC5 pathway were detected by Western blotting; and the targeting relationship was verified by dual-luciferase reporter assay. The independent samples t-test was used to compare the measurement data between the two groups; one-way ANOVA was used to compare the measurement data among multiple groups, and the SNK-q test was used for further pairwise comparisons.

The Longa scores of the miR-186-5p inhibitor group, the edaravone group, the miR-186-5p inhibitor + EX527 group, the negative control group, the model group, and the sham operation group were 0.86±0.10, 0.82±0.10, 1.85±0.22, 2.09±0.23, 2.15±0.26, and 0±0, respectively; the relative expression levels of SIRT1 protein were 0.77±0.08, 0.81±0.09, 0.49±0.05, 0.51±0.06, 0.48±0.05, and 0.85±0.10, respectively; the relative expression levels of PGC-1α protein were 0.51±0.06, 0.59±0.06, 0.33±0.04, 0.29±0.03, 0.24±0.03, and 0.61±0.07, respectively; the relative expression levels of FNDC5 protein were 1.11±0.12, 1.18±0.12, 0.71±0.08, 0.69±0.08, 0.61±0.07, and 1.24±0.13, respectively. The differences in the above indicators between the miR-186-5p inhibitor group and the negative control group were statistically significant (q=22.519, 11.070, 13.688, 12.921; all P＜0.001). The differences in the above indicators between the miR-186-5p inhibitor + EX527 group and the miR-186-5p inhibitor group were also statistically significant (q=18.125, 11.921, 11.199, 12.305; all P＜0.001). The number of NeuN-positive cells, the relative expression level of Sirt1 mRNA, and the number of nerve cells in the model group were significantly lower than those in the sham operation group, and the number of Iba-1-positive cells and the relative expression level of miR-186-5p in the model group were significantly higher than those in the sham operation group (all P＜0.05). The number of NeuN-positive cells, the relative expression level of Sirt1 mRNA, and the number of nerve cells in the miR-186-5p inhibitor group and the edaravone group were significantly higher than those in the negative control group, while the number of Iba-1-positive cells and the expression level of miR-186-5p were significantly lower than those in the negative control group (all P＜0.05). The number of NeuN-positive cells, the relative expression level of Sirt1 mRNA, and the number of nerve cells in the miR-186-5p inhibitor + EX527 group were significantly lower than those in the miR-186-5p inhibitor group, while the number of Iba-1-positive cells was significantly higher than that in the miR-186-5p inhibitor group (all P＜0.05).

Inhibition of miR-186-5p expression improves neurological function in IS mice, and the underlying mechanism is associated with targeted regulation of the SIRT1/PGC-1α/FNDC5 signaling pathway.

To investigate the current application status and influencing factors of we media in the continuing education of neurology residents.

An anonymous questionnaire survey was conducted among neurology residents training at Peking University Third Hospital and Peking University Sixth Hospital from February 2024 to January 2026. The survey collected demographic information, methods, duration, and preferences of continuing education, as well as evaluations of we media continuing education platforms from the study subjects. According to the primary continuing education modality reported by the study subjects, the study subjects were divided into the we-media-primary group (12 subjects) and the non-we-media-primary group (20 subjects). The independent samples t-test, Mann-Whitney U test, Chi-square test, or Fisher's exact test was used to compare the differences in characteristics between the group using we media as the primary continuing education method and the group not using we media as the primary method.

A total of 32 neurology residents participated in this study. We media was found to be the most frequently selected primary continuing education modality (12 people, 37.50%), and WeChat official accounts were the most commonly used we media platform (19 people, 59.38%). Graphic and text-based content was the most preferred form (22 people, 68.75%). In terms of evaluation, the advantages of using we media for continuing education included convenient access (30 people, 93.75%) and engaging content (17 people, 53.13%), while the main disadvantages were difficulty in distinguishing true from false information (21 people, 65.63%), highly repetitive and incomplete content (21 people, 65.63%), and easy distraction (15 people, 46.88%). There were no significant differences in gender, age, training duration, training status, job position distribution, or weekly continuing education hours between residents who primarily used we media and those who did not (all P＞0.05).

We media has become an important form of continuing education for residents. Future efforts urgently require the establishment of quality review mechanisms, the construction of systematic knowledge frameworks, ethical review, and proactive prevention of the information cocoon effect.

Astrocytes and neurons cooperate to maintain brain homeostasis through tightly regulated lipid metabolic coupling. Astrocytes deliver cholesterol to neurons via apolipoprotein E (ApoE)-containing lipoproteins to sustain synaptic function, while concurrently clearing excess neuronal fatty acids to alleviate lipotoxic stress. Distinct ApoE isoforms (e.g., ApoE4) differentially influence lipid transport and metabolic homeostasis, and their dysregulation is strongly implicated in the pathogenesis of neurodegenerative and cerebrovascular disorders, including Alzheimer's disease, stroke, and Parkinson's disease. Future studies should further elucidate the dynamic mechanisms of this coupling and its pathological associations. This article reviews the lipid metabolic coupling process between astrocytes and neurons, and disscusses potential research directions and therapeutic targets in the future, in order to provide new strategies for neuroprotective treatment.

In recent years, the correlation between patent foramen ovale (PFO) and stroke has attracted much attention from neurologists and cardiologists, especially in young patients with cryptogenic stroke, in whom PFO screening has become mandatory. For this purpose, this article reviews the formation of the foramen ovale, the incidence of PFO, the methods of PFO detection, the imaging characteristics of PFO-related stroke, and the treatment of PFO-related stroke. The aim is to enhance awareness of the correlation between cryptogenic stroke and PFO.

Non-acute subdural hematoma is a common disease in neurosurgery, and its burden of disease is increasing. Traditional trepanation and drainage can rapidly relieve the mass effect, but postoperative recurrence and retreatment remain common. Middle meningeal artery embolization provides a new therapeutic strategy for reducing the risk of recurrence by blocking the abnormal blood supply to the hematoma capsule, thereby reducing inflammatory exudation and repeated microbleeds. In recent years, a number of large randomized controlled studies in China and abroad have shown that using middle meningeal artery embolization as an adjunct to standard treatment can reduce the occurrence of hematoma recurrence, treatment failure or reoperation in specific patient populations, with an overall favorable safety profile. This article reviews the pathophysiological basis, efficacy and safety, technical points, patient selection, cost-effectiveness and long-term outcomes of middle meningeal artery embolization by synthesizing evidence from randomized controlled studies and real-world studies in order to provide a reference for the standardized and individualized application of middle meningeal artery embolization.