Table of Content

20 May 2021, Volume 16 Issue 05

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Overviews on Etiology and Pathogenesis of Ischemic Stroke Based on Magnetic Resonance Imaging

LOU Xin

2021, 16(05):  423-425.  DOI: 10.3969/j.issn.1673-5765.2021.05.001

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Association between Perfusion Defect and Collateral Circulation in Patients with Symptomatic Intracranial Artery Occlusion

HAN Dong-Shan, LYU Jin-Hao, LIN Lan, WANG Liu-Xian, LUO Chun-Cai, ZHANG Sen-Hao,WEI Meng-Ting, WANG Xin-Rui, LIN Jia-Ji, LOU Xin

2021, 16(05):  427-432.  DOI: 10.3969/j.issn.1673-5765.2021.05.002

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Objective To explore the relationship between perfusion defect and collateral circulation in patients with symptomatic intracranial artery occlusion. Methods This retrospective analysis enrolled the patients with symptomatic unilateral intracranial artery occlusion who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2017 to October 2018. The occluded intracranial arteries included internal carotid artery (ICA) and middle cerebral artery (MCA) M1/M2 segment. The patients were divided into ICA group and MCA group. Clinical and imaging data were collected. The volume of hypoperfusion areas which was defined as Tmax>4 s or Tmax>6 s were obtained by auto-quantitative software. Collateral circulation score was assessed based on multiphase CTA. The hypoperfusion area volume and collateral circulation score were compared between the two groups, and the correlation between hypoperfusion area volume and collateral circulation score in the two groups were analyzed. Results A total of 42 patients were included in this study, with an average age of 54.9±13.9 years and 29 males (69.0%), including 19 patients with ICA occlusion and 23 with MCA occlusion. The volume of hypoperfusion areas in ICA group was larger than that in MCA group (Tmax>4 s: 163.1±98.6 mL vs 64.6±54.2 mL, P <0.001; Tmax>6 s: 92.4±87.1 mL vs 13.0±27.6 mL, P <0.001). The collateral circulation score were lower in ICA group than that in MCA group [3 (2-4) vs 4 (3-4), P =0.021]. The volume of hypoperfusion areas was negatively correlated with collateral circulation score in ICA group (Tmax>4 s: r =-0.667, P =0.002; Tmax>6 s: r =-0.717, P <0.001, respectively); both of them also showed negative correlation in MCA group (Tmax>4 s: r =-0.498, P =0.016; Tmax>6 s: r =-0.494, P =0.017, respectively). Conclusions The volume of hypoperfusion area was associated with collateral circulation and the site of artery occlusion in patients with symptomatic intracranial artery occlusion. Patients with ICA occlusion showed larger hypoperfusion area and poorer collateral circulation compared with those with MCA occlusion.

Correlation between Plaque Features and Downstream Perfusion in Symptomatic Middle Cerebral Artery Stenosis

WEI Meng-Ting, LYU Jin-Hao, WANG Liu-Xian, ZHANG Sen-Hao, HAN Dong-Shan, WANG Xin-Rui,DUAN Cao-Hui, LOU Xin

2021, 16(05):  433-439.  DOI: 10.3969/j.issn.1673-5765.2021.05.003

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Objective To explore the relationship between plaque features and downstream perfusion in patients with severe middle cerebral artery stenosis. Methods This retrospective analysis enrolled consecutive patients with severe symptomatic unilateral middle cerebral artery stenosis who were admitted to the First Medical Center of Chinese PLA General Hospital from August 2013 to January 2016. The early-arriving blood flow proportion and late-arriving retrograde blood flow proportion were obtained by ASL perfusion imaging with a double post-labeling delay (PLD) of 1.5 s and 2.5 s, respectively, which represent antegrade and collateral blood flow. Meanwhile, the plaque features were obtained by high-resolution vessel wall imaging (HR VWI), including plaque enhancement, plaque area, plaque burden and remodeling index. The patients were divided into high and low burden groups according to whether the plaque burden was ≥50% or not. The relationship between plaque features and downstream perfusion was analyzed. Results A total of 58 patients were enrolled in this study, with the average age of 47.17±11.67 years and 39 males (67.2%). Plaque burden was negatively correlated with early-arriving blood flow proportion (r =-0.362, P =0.005), but not correlated with late-arriving retrograde blood flow proportion (r =-0.008, P =0.951). Compared with low burden group, the high burden group had elder age (50.38±11.33 vs 43.23±11.04, P =0.019), and the lower early-arriving blood flow proportion (72.13%±14.86% vs 83.00%±15.67%, P =0.009); multivariate regression analysis showed that the age (OR 1.056, 95%CI 1.000-1.115, P =0.050) and early-arriving blood flow proportion (per 1 quartile: OR 0.561, 95%CI 0.328-0.957, P =0.034) were independently related to the high burden of plaque. Conclusions Plaque burden is related to downstream antegrade blood flow perfusion. The higher the plaque burden is, the lower the antegrade blood flow proportion is, while the plaque is not obviously related to collateral blood flow.

Relationship between Morphology of Intracranial Vertebral-basilar Artery Dissection and Degree of Posterior Circulation Ischemia

BIAN Xiang-Bing, LIN Jia-Ji, ZHANG Sen-Hao, DONG Xiao-Nan, LIU Tie-Fang,DUAN Cao-Hui, LOU Xin, LYU Jin-Hao

2021, 16(05):  440-445.  DOI: 10.3969/j.issn.1673-5765.2021.05.004

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Objective To investigate the relationship between the morphology feature of vertebral-basilar artery dissection (VBD) and the degree of posterior circulation perfusion defect in patients with symptomatic intracranial VBD. Methods A retrospective analysis was performed for the multi-modal magnetic resonance imaging data of consecutive patients with intracranial VBD diagnosed by DSA at the First Medical Center of Chinese PLA General Hospital from December 2015 to December 2019. Based on MRA, the morphology of VBD was classified as the following types: artery ectasia type, pearl-and-string type, stenosis-occlusion type; based on MRA and high-resolution vessel wall imaging (HR VWI), the artery stenosis degree was classified as no, mild, moderate and severe, the volume of hypoperfusion area was compared among the above groups based on the morphology and stenosis degree. Results A total of 34 patients were enrolled in this study, including 11 cases (32.3%) of artery ectasia type (volume of hypo-perfusion area: 18.99±21.63 mL), 15 cases (44.1%) of pearl-andstring type (78.31±85.64 mL) and 8 cases (23.5%) of stenosis-occlusion type (28.91±16.88 mL). There was statistical difference in the volume of hypo-perfusion area among the morphology groups, of which the pearl-and-string type group had the most severe perfusion defect. There was no statistical difference in the volume of hypo-perfusion area among the different stenosis degree groups based on MRA or HR VWI. Conclusions The morphology feature of symptomatic intracranial VBD was associated with the changes of brain perfusion defect, and the pearl-and-string type VBD tended to cause more severe perfusion defect in post circulation territory.

A Case of Children Cerebellar Hemisphere Infarct with Dystaxia as the Initial Symptom

LAN Yi-Na, LYU Jin-Hao

2021, 16(05):  446-448.  DOI: 10.3969/j.issn.1673-5765.2021.05.005

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Research on Standard for Construction of Cerebrovascular Disease Biobank

LIN Jin-Xi, LIANG Xian-Hong,LI Shang-Zhi, LIU Li, MENG Xia, WANG Yi-Long, WANG Yong-Jun

2021, 16(05):  449-456.  DOI: 10.3969/j.issn.1673-5765.2021.05.006

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Objective To develop construction and management standards for cerebrovascular diseases (CVD) biobank for CVD precision medicine research in China, and provide technical support for building CVD biobank that can be shared. Methods With reference to the international large-scale biobanks construction experience, and based on the standardization ideas of international organization for standardization and other institutions, a framework of standard for constructing CVD biobank in China was formulated. From the perspectives of multi-dimensions such as site facilities, equipment, operating procedures, data standard and information technology, technical requirements for constructing CVD biobank were put forward. Results According to the construction standards proposed in this article, the operation and quality management system of Tiantan Cerebrovascular Disease Biobank that is in line with international standard has been established, and a biobank resource platform for CVD clinical research, containing over 100 000 biological samples that can be collected, processed, and stored in standardized norms, has been built. Conclusions Tiantan Cerebrovascular Disease Biobank has a sufficient, diversity, and multipletime collection biological samples resource, and has realized standardized information storage, which can provide technical support for CVD precision medicine research on the docking of omics research, accurate screening, early warning, diagnosis and intervention of CVD.

The Effect of Oxyhemoglobin in Delayed Cerebral Vasospasm after Subarachnoid Hemorrhage in Rats

WANG Yu-Mei, TANG Si-Wei, ZHANG Shao-Lan, WU Lei, SHI Guang-Zhi

2021, 16(05):  457-462.  DOI: 10.3969/j.issn.1673-5765.2021.05.007

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Objective To observe the effect of different concentrations of oxyhemoglobin on delayed cerebral vasospasm (DCV) after subarachnoid hemorrhage (SAH) in rats. Methods 24 Sprague-Dawley (SD) rats were divided into three groups: control group (n =8), arterial blood SAH group (n =8) and venous blood SAH group (n =8). SAH models were established by the following methods: 0.3 mL normal saline, 0.3 mL autogenous arterial blood and 0.3 mL autogenous venous blood were injected into the cisterna magna with double injection of blood, respectively. After 7 days, the swelling and blood clots around basilar arteries, wall area and wall thickness of basilar artery , and the ultrastructural changes were observed among the three groups. Results Some blood clots around basilar arteries and brain swelling were observed in arterial and venous blood SAH groups. Under the light microscope, compared with the control group, basilar artery wall area was reduced and vessel wall was thickened in arterial and venous blood SAH groups; compared with venous blood SAH group, basilar artery wall area was reduced (40 816.09±10 410.51 nm2 vs 68 480.89±12 687.4 nm2, P <0.001), the vessel wall was thickened in arterial blood SAH group (3.07±0.59 μm vs 2.36±0.25 μm, P =0.007). The disordered smooth muscle cells and endothelial cells vacuolar degeneration were observed under electron microscope in arterial and venous blood SAH groups, both of which were more worse in arterial blood SAH group than in venous blood SAH group. Conclusions The DCV after SAH induced by different concentrations of oxyhemoglobin can be simulated by injecting autogenous arterial and venous blood. Reducing the concentration of oxyhemoglobin can attenuate DCV after SAH.

The Value of Automated ASPECTS Scoring in Imaging Assessment of Early Ischemic Changes in Acute Ischemic Stroke

JING Li-Na, GAO Pei-Yi, DU Wan-Liang, SHEN Mi, QIN Hai-Qiang, KE De-Na, MA Guo-Feng, ZHOU Jian

2021, 16(05):  463-469.  DOI: 10.3969/j.issn.1673-5765.2021.05.008

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Objective To assess the application value of automatic ASPECTS scoring in early imaging assessment of acute ischemic stroke (AIS) in the real clinical setting. Methods This retrospective analysis enrolled consecutive AIS patients admitted to Beijing Tiantan Hospital between 2020 June and 2020 October. The data of automated ASPECTS scores extracted by RAPID software were collected, and the DWI ASPECTS scores were obtained based on the hyperintensities (as infarct core standard) on DWI. The automated ASPECTS and DWI ASPECTS were compared by using interclass correlation coefficient (ICC) and Cohen's kappa analysis, then the sensitivity, specificity and accuracy of automated ASPECTS scoring were calculated. Results Seventy-two cases with AIS in middle cerebral artery territory were included. The ICC between score-based automated ASPECTS and DWI ASPECTS was 0.746 (P <0.001). In the dichotomization analysis of ASPECTS ≥6 and ASPECTS <6, the two scoring tools showed good agreement (kappa=0.742). The total sensitivity, specificity and accuracy of region-based automatic ASPECTS scoring were 53.64%, 85.99% and 73.33%, respectively; those were 47.61%, 98.47% and 78.94% in the cortical region, respectively, and those were 62.68%, 67.27%, 64.93% in the deep brain region, respectively. Conclusions The score-based automated ASPECTS scoring can reflect the size of infarct region in AIS. The sensitivity, specificity and accuracy of region-based automatic ASPECTS scoring varied in different brain regions, thereby the involved region in AIS need to be identified by combing clinical symptoms and signs.

Analysis on Risk Factors for Total Cerebral Small Vessel Disease Burden in Young Patients with Ischemic Stroke

QIN Wei, HU Hong-Mei, LI Xuan-Ting, WANG Yun, YANG Shu-Na, HU Wen-Li

2021, 16(05):  470-474.  DOI: 10.3969/j.issn.1673-5765.2021.05.009

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Objective To explore the risk factors for the total cerebral small vessel disease (CSVD) burden in young patients with ischemic stroke. Methods From January 2016 to October 2020, the clinical and imaging data of young patients with acute ischemic stroke hospitalized in Department of Neurology of Beijing Chaoyang Hospital, Capital Medical University, were retrospectively analyzed. The total score of CSVD of all the patients were evaluated by assessing the four imaging markers of CSVD, including lacune, white matter hyperintensity, enlarged perivascular space and cerebral microbleed. According to the total score, these patients were divided into four groups of 0 point, 1 point, 2 points, and 3-4 points, respectively. Ordinal logistic regression analysis was used to identify the risk factors for the total CSVD burden in young patients with ischemic stroke. Results A total of 272 patients were enrolled, with the average age of 39.55±5.19 years and 230 males (84.6%), including 146 (53.7%) in 0 score group, 71 (26.1%) in 1 score group, 40 (14.7%) in 2 score group and 15 (5.5%) in 3-4 score group. Univariate analysis showed that there were statistical differences in age, hypertension and creatinine among the four groups. Ordinal logistic regression analysis showed that the aging (OR 1.110, 95%CI 1.048-1.175) and hypertension (OR 2.649, 95%CI 1.537-4.559) were independently associated with the total CSVD burden. Conclusions The increasing age and hypertension were independent risk factors for the total CSVD burden in young patients with ischemic stroke.

Comparison of Imaging Characteristics of Large Artery Atherosclerotic Ischemic Stroke between Young and Elderly Patients

YANG Dan-Dan, HAN Yong-Jun, LI Dong-Ye, QIAO Hui-Yu, HAN Hua-Lu, SHEN Rui, NING Zi-Han, ZHAO Xi-Hai

2021, 16(05):  475-481.  DOI: 10.3969/j.issn.1673-5765.2021.05.010

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Objective To compare the distribution pattern of infarct lesions in large artery atherosclerotic ischemic stroke (IS) based on DWI in young and elderly patients. Methods The imaging data of IS lesions on DWI of the patients with symptomatic intracranial large artery atherosclerotic stenosis or occlusion were retrospectively analyzed. The distribution pattern of IS lesions on DWI were classified as single lesion, multiple lesions in one vascular territory and multiple lesions in multiple vascular territories. The condition of involved anterior and posterior circulation was also investigated. All patients were divided into young patient group (18-50 years) and elderly patient group (51-80 years). The number and location distribution patterns of IS lesions were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to investigate the association between age group and the distribution pattern of IS lesions. Results A total of 146 patients were included, including 69 (47.3%) young patients [mean age: 40.5±8.4 years, 54 (78.3%) men] and 77 (52.7%) elderly patients [mean age: 62.4±7.1 years, 42 (54.5%) men]. There were significant differences in the number and vascular territory distribution pattern between the two groups (P =0.033), young patients mainly showed multiple IS lesions in multiple vascular territories (50.7%), while elderly patients mainly had multiple IS lesions in one vascular territory (37.7%). Univariate logistic regression analysis showed young patients were more prone to have multiple IS lesions in multiple vascular territories compared to elderly patients (OR 2.72, 95%CI 1.17-6.29, P =0.020), after adjusting for confounding factors including history of hypertension, antihypertension medication, statin use and stenosis rate of intracranial artery, the difference in the prevalence of multiple IS lesions in multiple vascular territories between the two group remained statistically significant (OR 2.73, 95%CI 1.04-7.12, P =0.041). No significant difference was found in the distribution of anterior and posterior circulation territory between the two groups, the only anterior circulation involved was most common in both young and elderly patients (69.6% vs 75.3%), most of which were subcortical lesions (56.2% vs 55.2%); for the only posterior circulation territory involved, the most involved region was the brainstem in the two groups (young: 81.2%, elderly: 89.5%). Conclusions For IS patients with symptomatic intracranial large artery atherosclerotic stenosis or occlusion, young patients were more prone to have multiple IS lesions in multiple vascular territories compared to elderly patients. The only anterior circulation territory involved and subcortical lesions were most common in both young and elderly patients, and the brainstem was the most involved region for the only posterior circulation territory involved.

Correlation between Thyroid Hormones Level and Cognitive Function in Convalescent Stroke Patients

LI Hong,MA Jiang, SHI Wan-Ying, TAO Xiao-Lin, ZHANG Jun, MEI Hao-Nan, YANG Lei, GUO Zheng-Rong

2021, 16(05):  482-486.  DOI: 10.3969/j.issn.1673-5765.2021.05.011

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Objective To investigate the correlation between serum thyroid hormones level and cognitive function in convalescent stroke patients, and to provide reference for cognitive function rehabilitation. Methods This prospective study consecutively enrolled the convalescent stroke patients at Department of Rehabilitation of Shijiazhuang People's Hospital from December 2018 to January 2020. The patients were divided into cognitive impairment and no cognitive impairment groups according to MMSE score. The level of serum thyroid hormones, including triiodothyronine (T3), thyroxine, free triiodothyronine (FT3), free thyroxine and thyroid stimulating hormone were compared between the two groups. The correlation between serum thyroid hormones level and MMSE score was analyzed by multivariate linear regression. Results Finally, 210 patients were included, with a mean age of 59.97±7.12 years old and 138 males (65.7%), including 146 patients with cognitive impairment and 64 patients without cognitive impairment. The levels of T3 and FT3 in cognitive impairment group were lower than those in no cognitive impairment group, with statistical difference. Linear regression analysis showed that serum T3 and FT3 levels in convalescent stroke patients were positively correlated with MMSE score (β =0.389, P <0.001; β =0.237, P =0.014). Conclusions The lower the serum T3 and FT3 levels in convalescent stroke patients, the more severe the cognitive impairment.

Effect of Early Systematic Rehabilitation Intervention on Dysphagia and Neurotrophy in Patients with Acute Ischemic Stroke

LIU Jia, SUN Ran

2021, 16(05):  487-491.  DOI: 10.3969/j.issn.1673-5765.2021.05.012

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Objective To analyze the early systematic rehabilitation intervention on swallowing dysfunction, serum albumin (ALB), serum fraction prealbumin (PA), hemoglobin (Hb), nerve growth factor (NGF) and serum brain-derived neurotrophic factor (BDNF) in patients with acute ischemic stroke (AIS). Methods AIS patients admitted to Beijing Tongren Hospital of Capital Medical University from January 2017 to January 2019 were included in this study, and all the patients were randomly divided into the control group and observation group. The control group received routine rehabilitation intervention, the observation group received early systematic rehabilitation intervention, and the treatment time was 3 months for both groups. The changes of NIHSS score, motor function, neurotrophic indicators (ALB, PA, Hb, NGF, BDNF) level, swallowing dysfunction improvement (water swallow test) of the two groups were compared before and after intervention. Results Finally, A total of 80 patients were included, with 40 in control group and 40 in treatment group. After the 3-month intervention, all the indicators improved in the observation group compared to the control group (control vs observation for all the following indicators): NIHSS score (4.59±1.98 points vs 4.14±1.73 points, P =0.027), ALB (34.13±5.01 g/L vs 38.76±5.73 g/ L, P <0.001), PA (241.56±30.21 mg/L vs 279.63±35.47 mg/L, P <0.001), Hb (131.57±16.42 g/L vs 140.38±18.36 g/L, P <0.001), NGF (54.28±6.39 pg/mL vs 68.73±8.92 pg/mL, P <0.001), BDNF (5.84±0.62 ng/mL vs 7.98±0.95 ng/mL, P <0.001) and the Fugl-Meyer score (50.17±16.48 points vs 72.28±22.39 points, P <0.001). The improvement rate of swallowing dysfunction in observation group was also higher than that in control group (95.0% vs 80.0%, P =0.001). Conclusions Early systematic rehabilitation intervention can effectively improve the AIS patient's neurotrophic condition and swallowing function.

Changes in Early Nutritional Status in Chinese Stroke Inpatients

QIN Hai-Qiang, WANG An-Xin, ZUO Ying-Ting,ZHANG Ya-Qing, YANG Bo, YU Dan-Dan, WEI Na, ZHANG Jing

2021, 16(05):  492-496.  DOI: 10.3969/j.issn.1673-5765.2021.05.013

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Objective To evaluate the changes in the early nutritional status in Chinese stroke inpatients by different nutrition parameters. Methods Patients with ischemic stroke or cerebral hemorrhage within 7 days after stroke onset were consecutively admitted in multiple medical centers. Nutritional status at admission was assessed by using BMI, mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), serum albumin and prealbumin. The above nutritional parameters were assessed again after 14 days. The changes in nutritional status of the stroke patients within 14 days were analyzed. Results A total of 760 stroke patients were included. BMI (24.3±3.5 kg/m2 vs 24.7±3.6 kg/m2), MUAC (28.3±13.5 cm vs 28.8 ±3.3 cm), TSF (17.0±7.4 mm vs 17.9±7.6 mm), serum albumin (39.3±4.7 g/L vs 40.6±4.3 g/L) at 14 days after admission were significantly lower than those at admission (all P <0.0001). The proportion of low BMI (4.0% vs 2.9%, P =0.0455), MUAC (9.7% vs 6.8%, P =0.0004), TSF (11.8% vs 10.0%, P =0.0164), serum albumin (9.2% vs 6.2%, P <0.0001) and prealbumin (17.6% vs 12.1%, P <0.0001) at 14 days after admission were higher than those at admission. Conclusions The early nutritional status of stroke patients tended to deteriorate, and the malnutrition rate detected by different nutritional parameters varied widely. It should be emphasized that nutritional status after stroke onset was assessed by different nutrition parameters.

Effects of Electronic Inspection Sheet on Nursing Quality Improvement in the Optimization of Infusion Process in Emergency Cerebrovascular Disease

LI Nan, DU Yue, YU Qiu-Yun, ZHANG Chun-Hua

2021, 16(05):  497-501.  DOI: 10.3969/j.issn.1673-5765.2021.05.014

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Objective To evaluate the effect of electronic inspection sheet on nursing quality improvement in the optimization of infusion process in emergency cerebrovascular disease patients. Methods The consecutive cerebrovascular disease patients who received intravenous infusion in Department of Emergency of Beijing Tiantan Hospital, Capital Medical University from January 2020 to December 2020 were included in this study. In June 2020, the patrol module was added to the personal digital assistant (PDA) of emergency nursing to optimize the emergency infusion process. Based on this, all the patients were divided into the pre-optimization process group (January to June 2020) and post-optimization process group (July to December 2020). The overall satisfaction, nursing service, professional level and service attitude were investigated and compared using self-made questionnaires in the two groups. Results A total of 3000 patients were included, with 1400 cases in pre-optimization process group and 1600 cases in post-optimization process group. The overall satisfaction rate of the postoptimization process group was higher than that of the pre-optimization process group (98.75% vs 90.29%, P <0.0001); the evaluation scores of nursing service (86.21±3.64 points vs 85.84±5.47 points, P <0.0001) and professional level (87.24±3.70 points vs 86.73±5.49 points, P =0.0069) of post-optimization process group were also higher than those of pre-optimization process group, but there was no statistical difference in the evaluation for nursing service attitude between the two groups (85.27±3.42 points vs 84.81±4.96 points, P =0.4832). Conclusions The optimization of infusion process based on electronic inspection sheet for emergency cerebrovascular disease patients can improve emergency nursing quality, and significantly improve the patient's satisfaction for nursing. However, it still needs to pay attention to the improvement of nursing service attitude, to provide better nursing for the patients.

Mindfulness Training on Post-stroke Depression: A Meta Analysis

LI Li-Jun, ZHANG Ning, CHEN Qi, WANG Chun-Xue

2021, 16(05):  502-507.  DOI: 10.3969/j.issn.1673-5765.2021.05.015

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Objective To evaluate the efficacy of mindfulness training on post-stroke depression. Methods The published randomized controlled trials (RCTs) of mindfulness for post-stroke depression were searched in scientific databases [Cochrane Library, PubMed, Embase, British Medical Journal (BMJ), China National Knowledge Infrastructure (CNKI), Chinese science and technology data and Wanfang Data] from inception to January 20, 2021. The efficacy of mindfulness training was analyzed, and the outcome indicators were evaluated by Hamilton depression scale (HAMD) or self-rating depression scale. The data of eligible RCTs were analyzed using RevMan 5.3. Results A total of 10 RCTs were included. The HAMD score [weighted mean difference (WMD) -4.06, 95%CI -4.70--3.42, P <0.000 01) and SDS score (WMD -6.32, 95%CI -7.75--4.90, P <0.000 01] in intervention group were lower than that in control group. Conclusions Mindfulness training with conventional treatment can further improve the symptoms of post-stroke depression.

Chinese Experts Consensus on Branch Atheromatous Disease

MEN Xue-Jiao, CHEN Wei-Qi, XU Yu-Yuan,ZHU Yi-Cheng, HU Wen-Li, CHENG Xin, BAI Feng, WANG Li-Hua, MAO Ling, QU Hui, LYU Pei-Yuan, LIU Jun,SUN Zhong-Wu, SUN Li, LI Yu-Sheng, WU Zhong-Liang, WU Dan-Hong

2021, 16(05):  508-514.  DOI: 10.3969/j.issn.1673-5765.2021.05.016

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A Case of Recurrent Subacute In-stent Thrombosis after Intracranial Stenting

WANG Xiao-Ya, WU Yu-Lun, JIAN Ya-Ting, LI Tao, ZHAO Li-Li, LU Jia-Liang, LU Zi-Wei, DANG Mei-Juan, LI Ye, ZHANG Yi-Heng, WANG He-Ying,ZHANG Lei, ZHANG Gui-Lian

2021, 16(05):  516-519.  DOI: 10.3969/j.issn.1673-5765.2021.05.017

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Pure Sensory Deficit at T4 Sensory Level as an Isolated Presentation of Lateral Medullary Oblongata Infarction:A Case Report

LIU Fang, REN Rui-Fang, ZHANG Ping, GUI Yong-Kun, YAN Hai-Qing, SONG Jing-Gui

2021, 16(05):  520-523.  DOI: 10.3969/j.issn.1673-5765.2021.05.018

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Progress of Hyperuricemia Related Cerebrovascular Diseases

LU Hao-Xuan, MA Xiao-Xiao, LOU Xin

2021, 16(05):  524-528.  DOI: 10.3969/j.issn.1673-5765.2021.05.019

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Hyperuricemia is closely related to vascular endothelial dysfunction, atherosclerosis and cardiovascular and cerebrovascular events. The relationship of hyperuricemia with the occurrence and prognosis of stroke is controversial, more studies suggested that hyperuricemia increased the risk of stroke. While recent studies showed that uric acid concentration increase can improve the prognosis, which maybe be related to the antioxidant and neuroprotective effect of uric acid. Meanwhile, hyperuricemia can increase the risk of cerebral small vessel disease, resulting in the decline of cognitive function.

Thoughts on Cerebrovascular Disease Residents Standardized Training Program — Based on the Analysis of Influencing Factors for Clinical Skill Examination of Beijing Neurology Residents Standardized Training

HUO Mo-Fei, YUAN Xue-Jiao, WANG Yu-Qing, REN Yi

2021, 16(05):  529-532.  DOI: 10.3969/j.issn.1673-5765.2021.05.020

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Objective To analyze the influencing factors for comprehensive clinical skills examination of Beijing neurology residents standardized training, to explore the improvement of the training plan of cerebrovascular disease residents. Methods 2017-2020 Beijing neurology residents’ comprehensive clinical skill examination data were collected, and the possible influencing factors for the exam results were analyzed. Results Logistic regression analysis showed that gender, educational background, professional base scale were the main influencing factors for the performance and passing rate. The multivariate stepwise regression analysis showed that gender, professional base scale, trainee type, and educational background were the influencing factors for auxiliary examination result; and professional base scale was the influencing factor for case analysis assessment result; trainee type was the influencing factor for skill operation performance. Conclusions Female, trainees from large training base and trainees with doctoral degree had a higher pass rate. When formulating a training plan for cerebrovascular disease residents, we should fully consider the specific condition of the trainees, and strengthen the training of the trainees’ shortness, to improve the homogeneity of neurology resident standardized training.