Cerebral small vessel disease (CSVD) is the most common vascular cause of cognitive impairment in the elderly. The lesion-symptom mapping studies found that the damage of strategically located white matter microstructure may be the potential pathogenesis of CSVD-related cognitive impairment, namely cortical-cortical or cortical-subcortical disconnection syndrome. Diffusion tensor imaging (DTI) provides a non-invasive fiber tracking method for the study of white matter microstructure damage. Therefore, this article reviews the study of disconnection syndrome in CSVD-related cognitive impairment and the correlation between fiber microstructure damage and different cognitive domain dysfunction in DTI studies.

The epidemiological characteristics of stroke in China from 2007 to 2017 were collected by consulting the global burden of disease research database and reviewing the literature, and descriptive epidemiological methods were used to analyze the characteristics of stroke in China. The results showed that, from 2007 to 2017, the prevalence trend of stroke in China mainly showed that the incidence and prevalence of ischemic stroke continued to increase, while the incidence and prevalence of hemorrhagic stroke showed a decreasing trend, and the overall mortality of stroke showed a decreasing trend. The epidemic characteristics of stroke in China are as follows: the younger-onset tendency; In terms of incidence, prevalence and mortality, more patients in males than that in females, more in rural areas than that in urban areas, and more in northern areas than in southern areas. In the most recent decade, the incidence and prevalence of ischemic stroke in China have increased significantly with lower average age at onset compared with those ten years ago, which were considered to be related to unhealthy lifestyle, such as dietary habits. The government should strongly advocate good lifestyle and dietary habits. In addition, the incidence, prevalence and mortality of stroke were significantly higher in rural areas than that in urban areas. Therefore, strengthening the prevention and control of stroke in rural areas should be the key of future work.

To evaluate the effect of mild hypothermia after stent-retrieval thrombectomy on expression of serum S100β protein in patients with acute ischemic stroke secondary to large vessel occlusion.

Sixty patients with acute ischemic stroke secondary to large vessel occlusions (AIS-LVO), who were treated in Weifang People's Hospital between March 2018 and March 2020, were randomly divided into treatment group (n=30) and control group (n=30) according to random single-blinda method. The treatment group was treated with Mild Hypothermia after stent-retrieval thrombectomy, while the control group was treated with stent-retrieval thrombectomy. The differences in expression level of serum S100β protein before treatment and 1, 3, 5, 7, 9, 11, 13, 15 days after treatment were compared between two groups by analysis of variance of repeated measures data. The differences in National Institutes of Health stroke scale (NIHSS) score before treatment and 15 days after treatment were compared between two groups by t-test. The differences in Alberta Stroke Program Early CT Score (ASPECTS) before treatment and the differences in Cerebral MRA mTICI perfusion classification 15 days after treatment were compared between two groups by t-test.

The expression level of serum S100β protein of two groups all significantly reduced on 1, 3, 5, 7, 9, 11, 13, 15 days after treatment than before treatment. Serum S100β protein concertration in the treatment group was lower than that in the control group (F=2030.805, P＜0.001). There was no statistical difference of the NIHSS score between the two groups before treatment [(14.7±4.32) vs (14.43±4.24), t=0.241, P=0.810]. The NIHSS scores of two groups both significantly reduced on 15 day after treatment than that before treatment, and the NIHSS score of the treatment group was significantly lower compared with the control group on 15 day after treatment [(3.83±2.21) vs (6.00±4.03), t=-2.579, P=0.013)]. There was no statistical difference of the ASPECTS score between the two groups before treatment, and no statistical difference of the ｍTICI perfusion classification between the two groups on 15 day after treatment (P＞0.05).

Mild hypothermia after stent-retrieval thrombectomy in AIS-LVO patients can significantly reduce the expression level of serum S100β protein and improve clinical outcomes.

Hyperglycemia is an independent risk factor for cognitive dysfunction and may accelerate the progression of mild cognitive impairment to dementia. Diabetes mellitus is one of the most serious public health problems in the 21st century around the world. With the number of diabetic patients increased, more attention has been paid to type 2 diabetes mellitus related cognitive dysfunction. The type 2 diabetes mellitus related cognitive dysfunction mainly displays in the memory, attention, information processing speed and executive functions, etc.. Magnetic resonance imaging (MRI) studies have shown that, compared with patients without diabetes, type 2 diabetes mellitus patients can be present more often with the reduction of the brain volume, the incidence of lacunar cerebral infarction, the loss of cerebral white matter fiber tracts integrity, and the diminishment of brain activation function, the decline of brain function of interval nuclear structure connection, and the change of the cerebral metabolic material level.