Table of Content

20 February 2024, Volume 19 Issue 2

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“Multi-System Dialogue” and “Multi-Disciplinary Co-Management” of Cerebro-Metabolic Disease

XU Jie, WANG Yongjun

2024, 19(2):  125-129.  DOI: 10.3969/j.issn.1673-5765.2024.02.001

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Cerebro-metabolic disease is a recently proposed concept primarily referring to cerebrovascular injury caused by both traditional and residual metabolic risk factors. It represents a clinical syndrome in which intervention in metabolic risk factors can effectively improve the prognosis. Metabolic pathways do not exist independently. Various metabolic pathways in multiple organs such as the brain, heart, liver, kidneys, and intestines interact, collaborate, and intertwine to form the metabolic network of the human body. The abnormality in the metabolic network leads to the occurrence of cerebro-metabolic disease. Moreover, the presence of metabolic risk factors can simultaneously cause injury to multiple target organs, and the nervous system interacts with the cardiovascular system, endocrine system, digestive system, and others through various pathophysiological processes. Therefore, future research on cerebro-metabolic disease will gradually tend to multi-organ level in mechanism exploration and disease treatment, and develop into a multidisciplinary management approach.

Cerebro-metabolic disease

XU Jie

2024, 19(2):  130. 

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Research Progress on the Influence of Intervening Metabolic Risk Factors on Cerebrovascular Disease

ZHANG Fangyuan, XUE Jing, XU Jie, WANG Yongjun

2024, 19(2):  131-137.  DOI: 10.3969/j.issn.1673-5765.2024.02.002

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Metabolic risk factors play a significant role in the development of cerebrovascular diseases. With the concept of cerebro-metabolic disease proposed, how to improve the prognosis of patients with cerebro-metabolic disease by intervening metabolic risk factors is an important research direction in the future. Metabolic risk factors can interact and act synergistically. Intervention measures for traditional metabolic risk factors such as blood pressure lowering, lipid regulating, and blood glucose controlling can effectively reduce the incidence and recurrence rate of cerebrovascular diseases. Intervention measures for residual metabolic risk factors such as anti-inflammation, vitamin supplements, and regulation of intestinal flora are also key to affecting the incidence and prognosis of cerebrovascular diseases. The characteristics of new metabolic drugs with “one specialization and multiple capabilities” provide new ideas for the treatment and management of cerebro-metabolic disease. This review aims to provide more theoretical support for the management of cerebro-metabolic disease by summarizing evidence from evidence-based medicine on the influence of intervening metabolic risk factors on cerebrovascular diseases. 

Obesity-Related Chronic Inflammation and Cerebro-Metabolic Disease

LIANG Xiaoxue, GUO Li

2024, 19(2):  138-144.  DOI: 10.3969/j.issn.1673-5765.2024.02.003

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Cerebrovascular disease has become the second cause of death worldwide, and its risk is mainly attributed to metabolic disorders. This paper reviewed the pathogenesis of obesity-related chronic inflammation and cerebro-metabolic disease. The aggregation of immune cells, heightened secretion of pro-inflammatory factors and vascular endothelial injury are important pathogenic mechanisms of cerebro-metabolic disease in obesity state. New and effective prevention and treatment strategies such as lifestyle intervention, drug immunotherapy and weight reduction anti-inflammatory therapy targeting inflammation are expected to provide reference for reducing the incidence of cerebro-metabolic diseases while enhancing both patient survival rates and quality of life.



Application of Metabolomics in Cerebro-Metabolic Disease

ZHONG Wenhua, XUE Jing, XU Jie

2024, 19(2):  145-149.  DOI: 10.3969/j.issn.1673-5765.2024.02.004

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Cerebrovascular diseases are the leading cause of death and disability worldwide. A high proportion of cerebrovascular diseases is correlated with metabolism disorder. Cerebro-metabolic disease refers to a clinical syndrome with cerebrovascular injury caused by traditional metabolic risk factors and residual metabolic risk factors, vascular structural injury and dysfunction as the main pathophysiological manifestations, and intervention of metabolic risk factors can effectively improve the prognosis. Metabolomics is a scientific method that uses high-throughput omics technology to identify and quantify all metabolites, which is an important starting point for future research on cerebro-metabolic disease. This paper summarizes the studies of metabolomics and lipidomics in cerebro-metabolic disease and cardiometabolic disease, aiming to provide references for the development of metabolomics studies and clinical prevention and treatment of cerebro-metabolic disease. 

The Predictive Value of ¹⁸F-FDG PET/CT on Acute Ischemic Stroke in Patients with Active Cancer

LI Aiyuan, FAN Ping, LI Xianjun, ZHAO Zhe, ZHAN Tongxia, XIE Hai

2024, 19(2):  150-157.  DOI: 10.3969/j.issn.1673-5765.2024.02.005

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Objective  To explore which indicators of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging can be used as markers for predicting acute ischemic stroke (AIS) in active cancer (AC) patients. 
Methods  Inpatients with AC who underwent 18F-FDG PET/CT in the First Affiliated Hospital of Weifang Medical University from January 2021 to May 2022 were retrospectively included, and divided into AIS group and non-AIS group according to whether they developed AIS within 1 year after the examination. According to the basic characteristics of the patients (gender, age, weight, cancer site, fasting blood glucose before PET/CT examination) by 1∶1 propensity score matching, clinical and 18F-FDG PET/CT imaging data of both groups of patients were analyzed, mainly including the target to background ratios (TBRs) of carotid arteries (CA), ascending aorta and aortic arch (AAO-AOA), descending aorta (DAO), iliac artery and femoral artery (IA-FA), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total bowel (TB), the area of VAT and SAT and the ratio between the two. For variables with P<0.1 in univariate logistic regression, stepwise backward logistic regression was used to analyze the independent risk factors for AIS in AC patients. ROC curve was used to evaluate the predictive value of combined independent risk factors for AIS.
Results  A total of 88 patients were included (44 in the AIS group and 44 in the non-AIS group), with a mean age of (69.8±8.8) years and 72.7% (64 cases) of males. The proportion of coronary heart disease in AIS group was higher than that in non-AIS group, the TBRs of CA, AAO-AOA, DAO, IA-FA, VAT, SAT and TB were increased compared with non-AIS group, while the VAT area was lower than that in AIS group, and the differences were statistically significant. Multivariate logistic regression showed that coronary heart disease (OR 3.92, 95%CI 1.11-13.87, P=0.034), CA TBR≥1.80 (OR 2.90, 95%CI 1.04-8.10, P=0.042), DAO TBR≥2.30 (OR 4.13, 95%CI 1.45-11.75, P=0.008), TB TBR≥3.34 (OR 2.87, 95%CI 1.01-8.12, P=0.047) and VAT TBR≥0.44 (OR 3.92, 95%CI 1.39-11.09, P=0.010) were independent risk factors for AIS in AC patients. The AUC of ROC curve combined with these five indexes was 0.821 (95%CI 0.736-0.906, P<0.001), and the sensitivity and specificity of AIS prediction in tumor patients were 68.2% and 81.8%.
Conclusions  Coronary heart disease and the increased  TBR of CA, DAO, VAT and TB are independent risk factors for AIS in AC patients, and the combination of these 5 indicators has certain predictive value for AIS in AC patients.




Establishment and Verification of Nomogram of Early Neurological Deterioration in Patients with Acute Penetrating Artery Infarction

BU Hongjing, MA Na, ZHANG Panpan, LIU Yuanhong

2024, 19(2):  158-166.  DOI: 10.3969/j.issn.1673-5765.2024.02.006

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Objective  To investigate the risk factors for early neurological deterioration (END) in patients with acute penetrating artery infarction (PAI) and to develop and evaluate a nomogram model.
Methods  Patients with acute cerebral infarction of lateral lenticulostriate artery and paramedian pontine artery in Puyang people’s hospital from January 2021 to February 2023 were retrospectively included. Patients with NIHSS score increased by≥2 points within 5 days after admission were included in the END group. Patients with NIHSS score increased by≤2 points within 5 days after admission were included in the non-END group. The data set was randomly divided into a training set and a test set according to the ratio of 7∶3, and the test set was used to evaluate the model performance. In the training set, univariate analysis was performed with R software, and for variables with P<0.10, least absolute shrinkage and selection operator (LASSO) regression and logistic regression analysis were used to screen out the independent risk factors for the occurrence of END in PAI patients, and finally a nomogram prediction model was constructed. The ROC curve and AUC were used to evaluate the discrimination of the model for the training set and the test set, respectively. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model, and calibration chart was used to evaluate the accuracy of the model.
Results  A total of 400 patients with acute cerebral infarction of lateral lenticulostriate artery and paramedian pontine artery were included, including 261 males (65.25%). The median age was 
64 (56-70) years. There were 135 cases (33.75%) in the END group and 265 cases (66.25%) in the non-end group. Of 280 acute PAI patients in the training set, 94 cases (33.57%) had END. Of 120 patients in the test set, 41 cases (34.17%) had END. In the training set, 11 variables (P<0.10) were entered into LASSO regression and 5 variables were screened out: diastolic blood pressure at admission, history of diabetes, history of smoking, neutrophil to lymphocyte ratio (NLR), maximum diameter. Multivariate logistic regression analysis showed that NLR (OR 40.85, 95%CI 13.34-196.43, P<0.01), history of diabetes (OR 24.10, 95%CI 6.92-106.30, P<0.01), history of smoking (OR 6.16, 95%CI 1.54-28.39, P=0.01) and maximum diameter (OR 4.93, 95%CI 1.35-19.82, P=0.02) are independent risk factors for the occurrence of END in acute PAI patients, and they are included in the nomogram. Bootstrap method was used for internal verification, and ROC curve, calibration curve and DCA curve of training set and test set were drawn respectively. The AUC of ROC of the training set and the test set were 0.88 and 0.87, respectively. The predicted value of calibration chart is in good agreement with the actual value, and the DCA curve shows that the prediction model has high clinical practicability.
Conclusions  NLR, history of smoking, history of diabetes and maximum diameter are independent risk factors for the occurrence of END in acute PAI patients, and the nomogram prediction model has certain clinical practical value.




Relationship between Visual Impairment and Cognitive Function in Elderly Patients with Post-Stroke Mild Cognitive Impairment

FU Chunling, SONG Biying, YANG Dahui

2024, 19(2):  167-172.  DOI: 10.3969/j.issn.1673-5765.2024.02.007

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Objective  To investigate the correlation between visual impairment and cognitive function in elderly patients with post-stroke mild cognitive impairment (PSMCI). 
Methods  Patients with acute ischemic stroke admitted to Chongqing University Three Gorges Hospital from February 2020 to February 2022 were prospectively and continuously included. MMSE and MoCA were used to evaluate the cognitive function of the patients, and binocular visual acuity, eye movement, visual field, visual perception and visual attention were measured. According to the occurrence of PSMCI at 6 months follow-up, the patients were divided into PSMCI group and non-PSMCI group. Clinical data were collected and the risk factors of PSMCI in patients with acute ischemic stroke were analyzed by multivariate logistic regression. 
Results  A total of 157 patients were included, of which 71 cases (45.22%) developed PSMCI, 108 cases (68.79%) developed visual impairment, of which 58 cases (53.70%) had central visual impairment, 30 cases (27.78%) had visual field loss, 41 cases (37.96%) had abnormal eye movement, and 30 cases (27.78%) had visual perception deficit. The total incidence of visual impairment, the incidence of central visual impairment, abnormal eye movement, visual field loss and visual perception deficit in the PSMCI group were higher than those in the non-PSMCI group  (P<0.05), the age was higher than that in the non-PSMCI group (P<0.05). The difference was statistically significant. Older age, (OR 1.919, 95%CI 1.310-2.813, P<0.001) higher NIHSS score (OR 2.291, 95%CI 1.423-3.689, P<0.001), large infarction (OR 1.669, 95%CI 1.203-2.315, P<0.001) and visual impairment (OR 1.998, 95%CI 1.363-2.928, P<0.001) were risk factors for PSMCI in patients with acute ischemic stroke (all P<0.05). 
Conclusions  Visual impairment is associated with PSMCI in patients with acute ischemic stroke. Visual impairment may aggravate cognitive impairment. 


CTA Combined with Clinical Characteristics to Predict the Risk of Cerebral Infarction in TIA Patients with Head and Neck Atherosclerosis at Middle and High Altitude Areas

YANG Lin, ZHANG Yonghai, XIE Luling, XIE Chun, LANG Xiaomei, WANG Runqiang

2024, 19(2):  173-180.  DOI: 10.3969/j.issn.1673-5765.2024.02.008

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Objective  Based on the head and neck CTA combined with clinical characteristics to explore the risk factors of cerebral infarction within 1 year in patients with TIA from middle and high altitude areas with head and neck atherosclerosis, and construct a risk prediction model to evaluate its predictive effectiveness.
Methods  A retrospective analysis was performed to continuously select TIA patients (living at an altitude of 2000-3000 m) admitted to the Fifth People’s Hospital of Qinghai Province from January 2018 to September 2021. All patients were confirmed to have atherosclerotic plaques by CTA with head and neck. The patients were followed up for 1 year and divided into the non-infarction group and the infarction group according to whether there was a cerebral infarction. Firstly, the clinical data and CTA test results of the two groups of patients were analyzed by univariate analysis to screen out meaningful variables. Then, the independent influencing factors of cerebral infarction were analyzed by multivariate logistic regression, and the risk prediction model of cerebral infarction within 1 year after TIA was constructed to plot the ROC curve.  
Results  A total of 111 patients were initially included. During follow-up, 9 cases were lost to follow-up, 1 case had carotid artery stenting in other hospital, and 1 case had subdural hematoma, all of which did not meet the final inclusion criteria. Finally, 100 patients were included, including 26 patients in the infarction group and 74 patients in the non-infarction group. Univariate analysis showed that the ABCD2 score of the infarction group was higher than that of the non-infarction group[4.00 (3.75-5.00) points vs. 3.00 (2.00-4.00) points, P=0.004]. The proportion of patients with hypertension grade>1 (69.23% vs. 41.89%, P=0.022), unstable plaque (88.46% vs. 67.57%, P=0.039), moderate to severe stenosis of vascular (53.85% vs. 12.16%, P<0.001), and unstable plaque involving more than 1 vessel (69.23% vs. 31.08%, P=0.001) in the infarction group were higher than those in the non-infarction group, and the differences were statistically significant. Logistic regression analysis showed that hypertension grade>1, high ABCD2 score and moderate to severe stenosis of vascular were independent risk factors for cerebral infarction within 1 year after TIA. The risk prediction model was P=1/[1+exp (-4.782+1.407×hypertension grade+0.574×ABCD2 score+2.734×vascular stenosis degree)]. The AUC value of this model was 0.848 (95%CI 0.763-0.933), the sensitivity was 92.31% and the specificity was 70.27%. 
Conclusions  The risk factors for cerebral infarction within 1 year in TIA patients with head and neck atherosclerosis at middle and high altitude areas are hypertension grade>1, high ABCD2 score and moderate to severe stenosis of vascular. The prediction model constructed by the combination of these three factors together has good predictive value for cerebral infarction.




Construction of Core Competency Evaluation Index System for Brain and Heart Health Managers

QIAN Jinping, WU Dan, GUO Xiaoling

2024, 19(2):  181-189.  DOI: 10.3969/j.issn.1673-5765.2024.02.009

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Objective  The core competency evaluation index system for brain and heart health managers was established to provide reference for the training and evaluation of brain and heart health managers. 
Methods  Literature review and panel discussion were used to establish the preliminary index of the core competency for brain and heart health managers. From July to December 2022, the Delphi method was adopted to determine the final evaluation index system after two rounds of correspondence with 21 experts from 13 provincial administrative regions in China, and the weight of each index was determined by analytic hierarchy process.
Results  The number of participants and effective recovery rate of the two rounds of expert consultation were 22 (100%) and 21 (95.45%), respectively. The expert authority coefficient of the first round of consultation was 0.883, and that of the second round of consultation was 0.880. The Kendall’s concordance coefficient of the first round of consultation was 0.307, and that of the second round of consultation was 0.243. The experts in the two rounds of correspondence tended to agree on the indicators. Finally, the core competency evaluation index system for brain and heart health managers was formed, including 5 first-level indicators (knowledge comprehensive ability, professional practice ability, interpersonal communication ability, professional development ability, professional humanistic traits), 17 second-level indicators and 51 third-level indicators. 
Conclusions  The core competency evaluation index system for brain and heart health managers established in this study is scientific and reliable, which can provide a reference for further analysis of the current situation of core competency of brain and heart health managers.


Predictive Value of Systemic Immune-Inflammatory Index on Post-Stroke Depression in Patients with Acute Ischemic Stroke

LUO Dong, LI Guoliang, WEN Huijun, WANG Junwen

2024, 19(2):  190-196.  DOI: 10.3969/j.issn.1673-5765.2024.02.010

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Objective  This study explored the correlation between systemic immune-inflammatory index (SII) and post-stroke depression (PSD) and the predictive value of SII for PSD diagnosis.
Methods  Patients diagnosed with acute ischemic stroke for the first time in the Department of Neurology of Baoji Central Hospital from February 2019 to February 2021 were consecutively enrolled. The patients were divided into PSD group and non-PSD group according to the results of the HAMD-17, 30 days after onset. The two groups’ demographic characteristics, imaging data, baseline clinical data, and SII were compared, and multivariate logistic regression analysis was used to explore the correlation between SII and PSD. 
Results  A total of 307 patients were included in this study, including 103 patients in the PSD group and 204 patients in the non-PSD group. The SII in the PSD group was significantly higher than that in the non-PSD group[518.89×109/L (478.20×109/L-559.12×109/L) vs. 448.15×109/L 
(407.88×109/L-490.16×109/L), P﹤0.001]. HAMD-17 score was positively correlated with SII in PSD patients (r=0.364, P﹤0.001). Multivariate logistic results indicated that increment of SII was an independent risk factor for PSD (middle tertile: OR 1.170, 95%CI 1.325-2.364, P=0.003; highest tertile: OR 2.472, 95%CI 1.747-3.469, P=0.001). ROC analysis showed that the AUC of PSD predicted by SII was 0.765 (95%CI 0.709-0.820, P﹤0.001) , the cut-off point for predicting PSD was 478.18×109/L, the sensitivity was 75.7%, and the specificity was 67.6%. 
Conclusions  Increased SII is an independent risk factor for PSD, which has a potential predictive value for diagnosing PSD.




A Case Report of “Heart” Shaped Primary Medullary Hemorrhage

ZHANG Qing, WANG Xu, ZHANG Qing

2024, 19(2):  197-201.  DOI: 10.3969/j.issn.1673-5765.2024.02.011

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In clinical practice, medullary hemorrhage is very rare in intracerebral hemorrhage, and literature often presents it in the form of case reports. Bilateral medial medullary hemorrhage is even rarer. This paper presents a case of an elderly male patient with a long history of hypertension and poorly controlled blood pressure. This time, the patient developed an acute onset of “dizziness, headache accompanied by nausea, vomiting”, and later developed symptoms such as difficulty in swallowing, dysphagia, aphasia, quadriplegia. Cranial CT scan showed a high density area on both sides of the medulla oblongata with a “heart” shape, diagnosed as medullary hemorrhage, and it was considered that this onset is related to hypertension. The full text first introduces the diagnosis and treatment process of the patient, and then discusses the etiology, clinical manifestations, auxiliary examinations, treatment and outcome, aiming to increase clinical experience of clinicians in diagnosis and treatment of this disease.



A Case Report on the Treatment of Multiple Cerebral Vascular Stenosis with Aortic Arch Ulcer Plaque Using Probucol Combined with Atorvastatin

WANG Yanling, WANG Xuemei

2024, 19(2):  202-206.  DOI: 10.3969/j.issn.1673-5765.2024.02.012

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Preventing the occurrence and recurrence of stroke is the top priority of the treatment strategy for ischemic cerebrovascular disease. Patients with multiple cerebral vascular stenosis and aortic arch ulcer plaques have a significantly increased risk of recurrent ischemic stroke. This paper introduces a case of probucol combined with atorvastatin in the treatment of multiple cerebral vascular stenosis with aortic arch ulcer plaque. This acute ischemic stroke patient presented with mild neurological impairment. During his hospitalization, multiple cerebral vascular stenosis and aortic arch ulcer plaques were discovered. After 3 months of sequential dual antiplatelet therapy, aspirin therapy was continued and combined with probucol and atorvastatin throughout the course for enhanced lipid-lowering antioxidant therapy. After 25 months of follow-up, there was no recurrence of stroke in this patient, and all imaging and hematological indicators remained stable.



Cerebral Venous Sinus Thrombosis Associated with Hyperthyroidism: A Case Report

MO Chenglong, WANG Simin, HOU Le, PENG Liebiao, WANG Rongfei, SHI Haishan, ZHENG Dong

2024, 19(2):  207-212.  DOI: 10.3969/j.issn.1673-5765.2024.02.013

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Hyperthyroidism, as an endocrine disease that may affect blood coagulation, is not commonly associated with cerebral venous sinus thrombosis in clinical practice. This paper reports the diagnosis and treatment process of a 21-year-old male patient with hyperthyroidism complicated by cerebral venous sinus thrombosis. Following comprehensive treatment, including thiamazole and anticoagulation therapy, the patient experienced significant relief from symptoms such as headaches, particularly after undergoing the crucial treatment step of endovascular interventional thrombectomy. This case emphasizes the importance of a thorough assessment of patients with hyperthyroidism and also suggests the potential value of interventional treatment in specific circumstances. Future broader research will contribute to clarifying the management and preventive measures for such complications.



Research Progress of the Correlation between Variation in the Circle of Willis and Ischemic Stroke

ZENG Chaokun, ZHAO Zhenqiang

2024, 19(2):  213-218.  DOI: 10.3969/j.issn.1673-5765.2024.02.014

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In the evaluation of autopsy and MRA technology, researchers have identified variations in the circle of Willis and classified them into different types. Based on MRA technology, the circle of Willis can be divided into four types according to the diameter of the arterial segment. Studies have revealed that different types of circle of Willis are associated with the onset, location, and recurrence of ischemic stroke. However, the correlation between different types of circle of Willis and the severity and prognosis of ischemic stroke remains controversial. This paper provides a comprehensive review on the correlation between variation in the circle of Willis and ischemic stroke. 

Research Progress of Anticoagulation Therapy during Perioperative Period for Endovascular Treatment of Acute Ischemic Stroke

XU Yaning, ZHANG Meng

2024, 19(2):  219-226.  DOI: 10.3969/j.issn.1673-5765.2024.02.015

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The safety and efficacy of anticoagulation therapy in the perioperative period of endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) are still not well defined. Current studies suggest that the use of anticoagulant drug before EVT does not increase the risk of hemorrhage or poor prognosis in AIS patients. Although anticoagulation therapy during EVT does not significantly increase the efficiency of vascular recanalization, it may have a positive effect on improving the long-term prognosis of patients. In addition, anticoagulation therapy after EVT can prevent the occurrence of intracranial arterial reocclusion while potentially improving cerebral microcirculation. Therefore, the possibility of early initiation of anticoagulation therapy in AIS patients with atrial fibrillation who have a clearer indication for anticoagulation warrants further study. More clinical studies should be conducted to further evaluate the safety and efficacy of anticoagulation therapy during perioperative period of EVT in AIS patients.

Progress in Clinical Research of Medical Quality Improvement in Stroke

JIANG Xiaoqing, LI Zixiao, WANG Yongjun

2024, 19(2):  227-234.  DOI: 10.3969/j.issn.1673-5765.2024.02.016

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The improvement of medical quality in stroke with the goal of facilitating the translation of guideline recommendations into clinical practice, has become a priority prevention and control strategy to address the global burden of stroke. This review introduces representative studies of multi-faceted quality improvement based on the concept of learning health system, strategies continuously improving the timeliness of reperfusion therapy for stroke, and applications of mobile health and telemedicine assisting in the quality management of the whole process of stroke in the context of the digital era. This paper summarizes the current advances and potential directions in the field of stroke medical quality improvement, in order to provide references for the design and implementation of medical quality improvement programs and the development of monitoring and improvement system of stroke medical quality in China.

Analysis of the Source of Master Students in Cerebrovascular Disease Direction in Three Years before and after Online Remote Enrollment

DU Xin, ZHANG Jialiang, HUO Mofei

2024, 19(2):  235-239.  DOI: 10.3969/j.issn.1673-5765.2024.02.017

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Objective  By comparing the general situation and examination results of the master students in the field of cerebrovascular diseases between online remote enrollment and non-online remote enrollment, this paper discusses the influence of online remote enrollment on the quality of students.
Methods  The subjects of this study were the master students of cerebrovascular diseases in Beijing Tiantan Hospital, Capital Medical University from 2017 to 2022. According to the enrollment method, the master students enrolled from 2017 to 2019 are the non-online remote enrollment group, and the students enrolled from 2020 to 2022 are the online remote enrollment group. This study obtains research data through the list of reexaminations over the years, and collects basic information such as gender, age, ethnicity, graduated university, whether it is a fresh graduate, as well as preliminary examination results and reexamination results. The above indexes of the two groups are analyzed differently. 
Results  From 2017 to 2022, the number of master students in the direction of cerebrovascular diseases in Beijing Tiantan Hospital, Capital Medical University showed an overall growth trend. Among the enrolled master students, 88 are female, accounting for 33.98%, the proportion is lower than that of males. The ethnic group is mainly Han (246, 94.98%), and the source is mainly fresh graduates (203, 78.38%). The differences of the above indexes were not statistically significant between the online remote enrollment group and the non-online remote enrollment group. The mean age of online remote enrollment group was significantly lower than that of non-online remote enrollment group [(23.1±1.1) years vs. (23.5±1.3) years, P=0.014]. The reexamination results of the master students majoring in neurology and surgery (neurosurgery) in the online remote enrollment group were significantly higher than those in the non-online remote enrollment group [neurology, (255.5±12.3) points vs. (241.0±13.8) points, P<0.001; surgery (neurosurgery), (259.9±11.6) points vs. (249.3±13.1) points, P<0.001]. 
Conclusions  The reexamination results of online remote enrollment are better than those of non-online remote enrollment to some extent, which provides a reference for future graduate enrollment method.


Exploration on Multi-Model Teaching in Neurointerventional Operation Training for Ischemic Cerebrovascular Disease

HAN Lijuan, ZHANG Xi, CHEN Zhibin, JIN Jiali, WANG Chong, XU Yun, LI Jingwei

2024, 19(2):  240-244.  DOI: 10.3969/j.issn.1673-5765.2024.02.018

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Objective  To explore the application of multi-model teaching in improving the quality and efficiency of training in neurointerventional operation for ischemic cerebrovascular disease.
Methods  Subjects were selected as training doctors who received cerebrovascular interventional operation training in the Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from January 2018 to December 2022. All training doctors received multi-model training, that is, a combination of multiple teaching methods and cross-training mode for teaching. Questionnaire survey was used to evaluate the training doctors’ satisfaction of multi-model teaching and the changes in theoretical knowledge and practical ability of intervention diagnosis and treatment before and after training. 
Results  A total of 55 training doctors were included, aged from 32 to 50 years, including 51 males (92.73%). Among them, 89.09% were satisfied with the multi-model teaching. Meanwhile, 83.64% and 85.45% of training doctors believe that multi-model teaching has stimulated their learning interest and improved self-learning abilities, respectively. After training, a significant increase in the number of training doctors who can independently complete extracranial stent implantation was achieved (41.82% vs. 12.73%, P=0.001). 
Conclusions  The muti-model teaching is an effective method to improve the quality and efficiency of training in neurointerventional operation for ischemic cerebrovascular disease.