Table of Content

20 June 2019, Volume 14 Issue 06

Previous Issue    Next Issue

Wise Men Who Have Insights to the Future

WANG Yong-Jun

2019, 14(06):  521-522.  DOI: 10.3969/j.issn.1673-5765.2019.06.001

Asbtract ( )   PDF (2006KB) ( )  

Related Articles | Metrics

Predictive Model of Prognosis after Recanalization in Patients with Acute Ischemic Stroke

NIE Zhi-Yu

2019, 14(06):  523-526.  DOI: 10.3969/j.issn.1673-5765.2019.06.002

Asbtract ( )   PDF (1513KB) ( )  

References | Related Articles | Metrics

Predictive Value of pc-ASPECTS Based on Susceptibility Weighted Imaging for Prognosis of Patients with Posterior Circulation Acute Ischemic Stroke

ZHANG Pan-Pan, LIU Yuan-Hong, YAN Bin, LIU Su-Mei, GE Xiao-Hang, NIU Zhi-Ling, LIU Le-Xi, NIE Zhi-Yu

2019, 14(06):  527-532.  DOI: 10.3969/j.issn.1673-5765.2019.06.003

Asbtract ( )   PDF (2205KB) ( )  

References | Related Articles | Metrics

Objective To assess the value of posterior circulation ASPECTS (pc-ASPECTS) based on SWI in predicting the clinical outcome of patients with posterior circulation acute ischemic stroke (AIS). Methods The clinical and imaging data of posterior circulation AIS patients who were not treated with endovascular recanalization and intravenous or intra-arterial alteplase were analyzed. The prognosis at 3 months after symptom onset was assessed by mRS, good prognosis was defined as mRS 0-2, and poor prognosis was defined as mRS 3-6. Multivariate logistic regression analysis was used to determine the independent predictors of clinical outcome. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the pc-ASPECTS based on SWI for the prognosis of patients with posterior circulation AIS. Results A total of 63 patients with posterior circulation AIS were included in the study, 42 (66.7%) patients had a good prognosis, and 21 (66.7%) patients had a poor prognosis. The univariate analysis showed that there was significant difference in the NIHSS on admission (P <0.001) and pc- ASPECTS (P <0.001) between good and poor prognosis groups. The multivariate logistic regression analysis showed that the pc-ASPECTS≥6 could independently predict favorable outcome in posterior circulation AIS patients (OR 2.03; 95%CI 1.04-3.95, P =0.039). ROC analysis indicated that the area under the ROC curve of the pc-ASPECTS based on SWI was 0.80 (95%CI 0.69-0.91). Conclusions The pc-ASPECTS based on SWI can independently predict clinical outcome at 3 months after symptom onset in patients with posterior circulation AIS.

Predictive Value of ASPECTS, DRAGON and SEDAN Scores for Hemorrhagic Transformation after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke in China

ZHENG Guo-Jiang, MAO Xiang-Ru, DING Gang-Yu,WANG Xing, XU Jian-Hua, JIN Ling-Jing, NIE Zhi-Yu

2019, 14(06):  533-540.  DOI: 10.3969/j.issn.1673-5765.2019.06.004

Asbtract ( )   PDF (2190KB) ( )  

References | Related Articles | Metrics

Objective To investigate the predictive value of ASPECTS, DRAGON and SEDAN scores for hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke (AIS). Methods The baseline data of consecutive AIS patients treated with intravenous thrombolysis from Department of Neurology of Tongji Hospital of Tongji University from December 2012 to December 2017 were retrospectively collected, and all patients were scored with ASPECTS, DRAGON and SEDAN scales. The primary endpoint was hemorrhagic transformation during hospitalization. The receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the three scales, and the area under the ROC curve was expressed by C value; the goodness of fit of the three scales were judged by Hosmer-Lemeshow (H-L) goodness-offit test; and the correlation between the three scales and outcome events was evaluated by logistic regression analysis. Results A total of 199 patients were included in this study. The C value of ASPECTS, DRAGON and SEDAN scores in all patients were 0.889, 0.810 and 0.793, respectively; in anterior circulation were 0.889, 0.823 and 0.788, respectively; in male patients were 0.893, 0.788 and 0.818, respectively; in female patients were 0.882, 0.808 and 0.720, respectively (all P <0.05). The χ2 value of H-L goodness-of-fit test of the three scales in all patients were 8.253, 2.685 and 7.511, respectively; in anterior circulation were 9.875, 4.330 and 6.441, respectively; in male patients were 8.966, 1.697 and 3.049, respectively; in female patients were 4.284, 6.548 and 7.669, respectively (P <0.05 were only for ASPECTS in anterior circulation and male groups, and all the rest P >0.05). The OR in logistic regression analysis of the three scales in all patients were 0.588, 1.839 and 2.229, respectively; in anterior circulation were 0.567, 1.951, 2.198, respectively; in male patients were 0.595, 1.969 and 2.675, respectively; in female patients were 0.573, 1.833 and 1.787, respectively (all P <0.05). Conclusions ASPECTS, DRAGON and SEDAN scales all have strong predictive ability for the risk of hemorrhagic transformation after intravenous thrombolysis in AIS patients, and ASPECTS is superior to the other two prediction models.

Predictive Value of ASPECTS, DRAGON and THRIVE Scores for 3-month Poor Prognosis after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke in China

ZHENG Guo-Jiang, ZHUO Zi-Liang, YU Ting,LIU Yuan-Hua, XU Jian-Hua, LI Yun-Xia, NIE Zhi-Yu

2019, 14(06):  541-548.  DOI: 10.3969/j.issn.1673-5765.2019.06.005

Asbtract ( )   PDF (2583KB) ( )  

References | Related Articles | Metrics

Objective To investigate the predictive value of ASPECTS, DRAGON and THRIVE scores on the adverse prognosis at 3 months after intravenous thrombolysis in patients with acute ischemic stroke (AIS). Methods Clinical data of consecutive 214 AIS patients treated with intravenous thrombolysis from Department of Neurology of Tongji Hospital of Tongji University from December 2012 to December 2017 were retrospectively collected. All the patients were scored with ASPECTS, DRAGON and THRIVE scales. The primary endpoint was the prognosis at 3 months after symptoms onset, and the poor prognosis was defined as mRS ≥3. The predictive value of the three scales were compared by the area under the receive operating characteristic (ROC) curve (C value).The goodness of fit of the three scales were judged by Hosmer-Lemeshow (H-L) goodness-of-fit test. The correlation between actual and predictive outcome was evaluated by Spearman correlation analysis. Results 207 patients were enrolled in the final analysis, of which 58 (28%) patients had poor prognosis. The C value of ASPECTS, DRAGON and THRIVE scales in all patients were 0.825, 0.800 and 0.765, respectively; in anterior circulation were 0.850, 0.817 and 0.797, respectively; in man patients were 0.764, 0.736 and 0.697, respectively; in female patients were 0.909, 0.878 and 0.861 (all P ﹤0.05). The χ2 value of H-L goodness-of-fit test of the three scales in all patients were 4.865, 6.758 and 7.836, respectively; in anterior circulation were 3.932, 6.060 and 4.328, respectively; in man patients were 7.021, 6.631 and 4.647, respectively; in female patients were 2.493, 2.972 and 10.788, respectively (all P >0.05). Spearman correlation coefficient (r ) of the three scales in all patients were -0.532, 0.473 and 0.418, respectively; in anterior circulation were -0.572, 0.501 and 0.471, respectively; in man patients were -0.427, 0.359 and 0.300, respectively; in female patients were -0.688, 0.626 and 0.601, respectively (all P ﹤0.05). Conclusions ASPECTS, DRAGON and THRIVE all can predict the risk of 3-month poor prognosis after intravenous thrombolysis in AIS patients, of which ASPECTS is superior to the other two predictive models.

Analysis of Clinical Characteristics and Risk Factors of New-onset Intracranial Hemorrhage: a Large Prospective Community-based Study

WANG Dan-Dan, WANG An-Xin, ZHANG Qian, ZHANG Yi-Jun, ZHAO Xing-Quan

2019, 14(06):  549-554.  DOI: 10.3969/j.issn.1673-5765.2019.06.006

Asbtract ( )   PDF (1823KB) ( )  

References | Related Articles | Metrics

Objective To investigate the clinical characteristics and risk factors for new-onset intracranial hemorrhage (ICH) among physical examination population in Northern China. Methods Basic data of physical examination people in Kailuan community from June 2006 to October 2007 were collected by questionnaires, physical examination and laboratory examination. A face-to-face follow-up for all subjects were taken every 24 months, until the end of 2015. The newonset stroke during the whole follow-up were recorded. Comparing the relevant data between the new-onset ICH group and the control group, cox regressive analysis was used to assess the relevant factors of new-onset hemorrhagic stroke. Results A total of 94 993 participants without a history of stroke completed the follow-up and were included in the final analysis. Stroke occurred in 3568 (3.8%) participants during the followup, including 746 (0.8%) ones with intracranial hemorrhage. There were significant difference in the percentage of male, old age, low income, low level of education, high BMI, and history of hypertension, diabetes, hyperlipidemia, atrial fibrillation between the hemorrhage group and the control group, and all the above rates were higher in the ICH group (P <0.05). After adjusting for the confounding factors, high systolic blood pressure (HR 1.026, 95%CI 1.018-1.035, P <0.0001), high diastolic blood pressure (HR 1.040, 95%CI 1.026-1.055, P <0.0001) and high glucose (HR 1.127,95%CI 1.046-1.215, P =0.0017) were all the independent risk factors of intracranial hemorrhage. Conclusions Male, old age, low income, low level of education, high BMI and hyperlipidemia, hypertension, diabetes were related with the risk of ICH, of which hypertension and high glucose were the independent risk factors of ICH.

Effect of Multiple Intracranial Atherosclerotic Stenosis on the Risk of Recurrent Stroke in Patients with Transient Ischemic Attack and Minor Stroke

JING Jing, MENG Xia, WANG An-Xin, ZHAO Xing-Quan, WANG Yi-Long, LIU Li-Ping, WANG Yong-Jun

2019, 14(06):  555-560.  DOI: 10.3969/j.issn.1673-5765.2019.06.007

Asbtract ( )   PDF (1879KB) ( )  

References | Related Articles | Metrics

Objective To investigate the effect of multiple intracranial atherosclerotic stenosis (ICAS) on early stroke recurrence in patients with TIA and minor ischemic stroke. Methods 1089 patients with noncardioembolic high-risk TIA and minor ischemic stroke in the imaging subgroup of the Clopidogrel in High-risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) randomized clinical trial were included in this study. Based on MRA results after admission, ICAS status were grouped into no ICAS, single ICAS and multiple ICAS. The outcomes were recurrent stroke (including ischemic or hemorrhagic stroke) during 90- day follow-up. Cox proportional hazards models were used to assess the association of ICAS status and stroke recurrence. Results 608 patients had no ICAS, 298 patients had single ICAS and 183 patients had multiple ICAS, and their corresponding risk of recurrent stroke was 5.43%, 9.06% and 18.03%, respectively. Patients with ICAS (including single and multiple ICAS) had a significantly higher risk of s recurrent stroke than patients without ICAS (12.50% vs 5.40%, P <0.0001). The risk of recurrent stroke in patients with mutiple ICAS was the highest (18.03%) and was 3.578 times higher than that of patients without ICAS (HR 3.578, 95%CI 2.189-5.850).Conclusions Multiple intracranial arterial stenosis was an independent risk factor of 90-day recurrent stroke in patients with noncardioembolic high-risk TIA and minor ischemic stroke.

Clinical and Imaging Characteristics in Acute Ischemic Stroke Patients with Complete Reversible Diffusion Weighted Imaging Hyperintensities: a Retrospective Analysis

YANG Rong, JING Li-Na, GAO Pei-Yi, SUI Bin-Bin,SHEN Mi, WANG Hai-Kuo, QIN Hai-Qiang, CHEN Li

2019, 14(06):  561-567.  DOI: 10.3969/j.issn.1673-5765.2019.06.008

Asbtract ( )   PDF (4261KB) ( )  

References | Related Articles | Metrics

Objective To analyze the clinical and imaging characteristics in acute ischemic stroke (AIS) patients with complete reversible DWI hyperintensities. Methods Data of nine AIS patients with complete reversible DWI hyperintensities from January 2012 to December 2015 were collected retrospectively. Clinical and imaging characteristics in these patients were evaluated through baseline and follow-up information. Results The median baseline NIHSS was 1 (1-2.5), the mean baseline volume of DWI hyperintensities was 0.94 (0.28-2.39) mL and the median mRS at 90 days was 0 (0-1) in the nine patients. Complete reversible DWI hyperintensities could be found in cortex, subcortical white matter, and deep white matter. Conclusions Complete reversible DWI hyperintensities were usually found in minor stroke with small infarct volume, and such patients usually had good clinical outcome.

Relationship between Plasm Homocysteine Level and Carotid Intima-media Thickness in Cerebral Infarction Patients

ZHONG Qi, LAN Xiang-Lin, TANG Ge-Xiu, LI Wei-Ping, PAN Peng-Ke, WEI Shi-Rong

2019, 14(06):  568-572.  DOI: 10.3969/j.issn.1673-5765.2019.06.009

Asbtract ( )   PDF (1815KB) ( )  

References | Related Articles | Metrics

Objective To investigate the correlation between carotid intima-media thickness (cIMT) and plasma Hcy concentration in patients with acute cerebral infarction. Methods Clinical data of consecutive patients with acute cerebral infarction from Department of Neurology, Guangxi Hechi People's Hospital from January 2017 to December 2018 were collected. cIMT was measured using Doppler ultrasound. According to whether the cIMT ≥1 mm or not, these patients were divided into cIMT thickening group and cIMT no-thickening group. Plasma Hcy concentration in all patients were measured. Multivariate logistic regression analysis was used to investigate the correlation between cIMT and plasma Hcy level. Results A total of 226 patients were enrolled in this study, with 34 patients in cIMT no-thickening group and 192 patients in cIMT thickening group. The median plasma Hcy level in cIMT nonthickening group was 11.2 μmol/L, and that in cIMT thickening group was 13.0 μmol/L, with statistically significant difference (P =0.012). In addition, age (69.1±9.7 years vs 58.2±1.2 years, P <0.001), pulse pressure (64.0±17.4 mm Hg vs 53.6±13.6 mm Hg, P <0.001), hs-CRP [3.78 (1.5- 10.6) mg/L vs 1.5 (0.9-4.2) mg/L, P =0.010)] in cIMT thickening group were all significantly higher than that in cIMT no-thickening group. After adjusting for age, pulse pressure, and hs-CRP level,the logistic regression analysis showed that plasma Hcy level was an independent risk factor of cIMT. For every 10 μmol/L increase in plasma Hcy level, cIMT increased by 0.037 mm (95%CI 0.0075-0.068, P =0.002). Conclusions Plasma Hcy level was an independent risk factor of cIMT in patients with acute cerebral infarction.

Clinical and Imaging Features of Dural Arteriovenous Fistula in Craniocervical Junction

LI Li, LIU Jun,YANG Zhi, LAN Ya

2019, 14(06):  573-577.  DOI: 10.3969/j.issn.1673-5765.2019.06.010

Asbtract ( )   PDF (2418KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the imaging and clinical features of myelopathy caused by dural arteriovenous fistula (DAVF) in craniocervical junction. Methods The clinical and imaging data (including DSA, CTA and MRI) of 16 patients with DAVF in craniocervical junction from Chengdu Fifth People’s Hospital from August 2005 to July 2016 were retrospectively analyzed. All patients were diagnosed by digital subtraction angiography (DSA). 4 cases underwent CTA and 12 cases underwent MRI. According to the time of onset, 16 patients were divided into acute (within 7 days of onset), subacute (within 1 month of onset) and chronic (beyond 1 month of onset) groups. Results 4 cases in acute group, 4 cases in subacute group and 8 cases in chronic group. The proportions of male in acute and chronic patients were both 75.0%, which was higher than that in subacute patients (50.0%). In terms of the direction of venous drainage, 87.5% of chronic patients (7 cases) had ascending venous draining, while 75.0% of acute and 50.0% of subacute patients had similar direction pattern. Nonspecific symptoms, such as headache, dizziness, nausea and vomiting were observed in all patients. DSA images showed that DAVF was primarily located in C1 nerve root, right dural arteriovenous fistula, bilateral sigmoid sinus, transverse sinus, right posterior meningeal artery near transverse sinus, right dural arteriovenous fistula orifice, left/right vertebral artery area, occipital foramen area, right middle meningeal artery branch, sinus confluence area, tentorium area and bilateral cavernous sinus. 4/5 patients who underwent CTA examination showed positive, and the CTA displayed subarachnoid hemorrhage, as well as the number, shape and thickness of the vessels. 12 patients received MRI scan, abnormal vessel flow void signal and abnormal signal in brain parenchymal area were displayed on MRI. Conclusions The clinical characteristics of DAVF in craniocervical junction is related to the direction of venous drainage, not the location of arteriovenous fistula; CTA and MRI are helpful to diagnose DAVF, while the final diagnosis of DAVF is confirmed by DSA.

Clinical Characteristics and 1-Year Prognosis in Elderly Acute Ischemic Stroke Patients with Atrial Fibrillation in Xi'an Area

LIU Zhong-Zhong, LIN Xue-Mei, DUAN Kang-Li, LU Qing-Li, CAO Huan, WANG Jing, WANG Fang,SHI Ya-Ling, WANG Qing, WU Song-Di

2019, 14(06):  578-584.  DOI: 10.3969/j.issn.1673-5765.2019.06.011

Asbtract ( )   PDF (1876KB) ( )  

References | Related Articles | Metrics

Objective To investigate the clinical characteristics and 1-year prognosis of elderly acute ischemic stroke (AIS) patients with atrial fibrillation (AF) in Xi'an area. Methods Clinical data of elderly patients with AIS (≥65 years) who were consecutively admitted to four tertiary-grade A class hospitals from January 2015 to December 2015 in Xi'an Stroke Data Bank were collected. The clinical characteristics of elderly AIS patients with and without AF were compared, and the outcome events of 1 year follow-up (including stroke recurrence, death and poor prognosis) were analyzed. Multivariate logistic regression analysis was used to find the independent risk factors for poor prognosis of 1 year in elderly AIS patients with AF in Xi'an area. Results Total 1239 elderly AIS patients were enrolled in this study, including 133 (10.7%) patients with AF. Comparing with the non-AF group, the elderly AIS patients in AF group showed older [(77.7±6.3) years vs (74.0±6.1) years, P =0.019], higher mRS score at discharge (median 2.0 vs 1.0, P <0.001), higher rate of NIHSS score ≥14 at discharge (16.5% vs 3.1%, P <0.001), higher rate of patients with pneumonia (21.1% vs 5.8%, P <0.001), more patients unable to walk within 48 h at admission (63.0% vs 36.1%, P <0.001), higher fasting blood glucose level [6.3±3.0) mmol/ L vs (5.8±2.0) mmol/L, P =0.037] and lower LDL-C level [(2.4±0.7) mmol/L vs (2.5±0.8) mmol/L, P =0.031] at admission. At 1 year follow-up, the elderly AIS patients in AF group had higher stroke recurrence rate (15.8% vs 5.9%, P =0.020), higher mortality (32.3% vs 9.2%, P <0.001) and higher rate of poor prognosis (51.9% vs 25.9%, P <0.001) than that in non-AF group. After adjustment for the related confounders, multivariate logistic regression analysis result showed that AF was an independent risk factor for 1 year mortality in elderly AIS patients (OR 2.45, 95%CI 1.26-4.78, P =0.008), but not an independent risk factor for stroke recurrence and poor prognosis at 1 year (P >0.05). Conclusions Comparing with the elderly AIS patients without AF, the elderly AIS patients with AF in Xi'an area were older, had more severe stroke, higher rate of pneumonia and higher rate of losing the ability to walk within 48h at admission, and higher risk of death at 1 year.

Advances in Predicting Adverse Prognosis after Vascular Recanalization in Acute Ischemic Stroke

ZHENG Guo-Jiang, ZHUO Zi-Liang, NIE Zhi-Yu

2019, 14(06):  586-593.  DOI: 10.3969/j.issn.1673-5765.2019.06.012

Asbtract ( )   PDF (1600KB) ( )  

References | Related Articles | Metrics

The key of acute ischemic stroke (AIS) treatment is early vascular recanalization to save ischemic penumbra. However, the effect of early recanalization has individual differences, which is difficult to predict early, and the risk of hemorrhagic transformation often increases after recanalization. In order to predict the prognosis and risk of hemorrhagic transformation early in AIS patients, scholars at home and abroad have been devoting themselves to the development and application of prediction models in this field for many years, and related scoring prediction models have emerged in endlessly. This paper reviewed the progress of some prediction models in recent years in order to provide help and inspiration for future clinical work and scientific research.

Chinese Experts Consensus on Clinical Application of PCSK9 Inhibitor in Secondary Prevention of Ischemic Stroke

Chinese Stroke Association

2019, 14(06):  594-599.  DOI: 10.3969/j.issn.1673-5765.2019.06.013

Asbtract ( )   PDF (1650KB) ( )  

References | Related Articles | Metrics

Avellis’ Syndrome: a Case Report

LANG Xiao-Lan, YU Jian, LI Xiao-Hong

2019, 14(06):  600-602.  DOI: 10.3969/j.issn.1673-5765.2019.06.014

Asbtract ( )   PDF (2464KB) ( )  

References | Related Articles | Metrics

Limb-shaking Transient Ischemic Attack: a Case Report and Literature Review

YIN Shun-Xiong, MIN Lian-Qiu,TANG Yan-Yan

2019, 14(06):  603-606.  DOI: 10.3969/j.issn.1673-5765.2019.06.015

Asbtract ( )   PDF (1804KB) ( )  

References | Related Articles | Metrics

Pocock Cardiovascular Score: a Tool of Screening Cerebral Microemboli High-risk Patients after Catotid Endarterectomy

WU Jia-Ling

2019, 14(06):  607-608.  DOI: 10.3969/j.issn.1673-5765.2019.06.016

Asbtract ( )   PDF (1667KB) ( )  

References | Related Articles | Metrics

Telemedicine and the “Weekend Effect”

LIU Jing-Yi

2019, 14(06):  609-611.  DOI: 10.3969/j.issn.1673-5765.2019.06.017

Asbtract ( )   PDF (1697KB) ( )  

References | Related Articles | Metrics

Advance in Pathophysiological Mechanism of Subarachnoid Hemorrhage

ZHANG Chang-Lin, NI Xiao-Jia,LIN Hao, WU Jun-Biao, LI Chun-Hua, LI Shao-Xue, CAI Ye-Feng

2019, 14(06):  612-618.  DOI: 10.3969/j.issn.1673-5765.2019.06.018

Asbtract ( )   PDF (1597KB) ( )  

References | Related Articles | Metrics

Subarachnoid hemorrhage (SAH) is a common cerebrovascular disease, with a high rate of mortality and disability. Despite many advances in drugs and endovascular treatment, the improvement of clinical prognosis in patients with SAH still faces many challenges. Research has shown that some pathophysiological reaction after SAH can influence the clinical prognosis, these pathophysiological mechanisms includ cerebral vascular spasm, oxidative stress, inflammation, impairment of blood-brain-barrier, brain edema, apoptosis, pyroptosis, necrocytosis and autophagy, cortical spreading depression and microthrombosis and etc. This paper reviewed the recent advance in pathophysiology mechanism in SAH, to provide reference for SAH treatment and drugs research & development.

The Role of Microparticles in Ischemic Stroke

ZHOU Lei, WU Dong-Yu, YAO Xiao-Mei, SHI Yan-Ying, ZHU Xian-Ce, HUANG Jing, WANG Chun-Xue, ZHANG Ning

2019, 14(06):  619-624.  DOI: 10.3969/j.issn.1673-5765.2019.06.019

Asbtract ( )   PDF (1581KB) ( )  

References | Related Articles | Metrics

When there appears vascular endothelial dysfunction, acute and chronic vascular inflammation and hypercoagulation, microparticles (MPs) can be released by platelets, white blood cells and endothelial cells. The roles of different kinds of MPs in the pathological process of ischemic stroke are different: the level of leukocyte-derived MPs (LMPs) is elevated in patients with ischemic stroke, the high level of LMPs can aggravate the injury of vascular endothelial cells and the high level of platelet-derived MPs in plasma for a long time can induce microvascular thrombosis. In addition, different kinds of MPs can reflect the degree of vascular endothelial injury, induce and aggravate endothelial dysfunction. At the same time, mRNA and microribonucleic acid carried in MPs can promote the proliferation of endothelial cells, promote neovascularization in atherosclerotic plaques, and make plaques more prone to rupture and bleeding.

Advance in Acute In-stent Thrombosis after Carotid Artery Stenting

WANG Pian, WANG Yan, LI Hong-Qing

2019, 14(06):  625-629.  DOI: 10.3969/j.issn.1673-5765.2019.06.020

Asbtract ( )   PDF (1648KB) ( )  

References | Related Articles | Metrics

In-stent thrombosis is a serious complication after carotid artery stenting (CAS), which may lead to severe paralysis and even death. However, till now, there is still no uniform treatment for in-stent thrombosis. Although cases reports have showed various therapy methods for in-stent thrombosis after CAS, there is still no randomized double-blind trial or large clinical trial to confirm the reliability and safety of these intervention measures. The main cause of instent thrombosis after CAS is related to surgical operation, the other causes include inadequate antiplatelet therapy or discontinuation of antiplatelet therapy, hypercoagulable state, and platelet drug resistance and etc. The treatment for in-stent thrombosis after CAS include antiplatelet and anticoagulant therapy, thrombolytic therapy, carotid endarterectomy and CAS, mechanical thrombectomy or thrombus aspiration and etc. Either way, rapid vascular recanalization is the key of treatment for in-stent thrombosis .

Neuro-ophthalmologists Training and Discipline Development Status

YANG Liu, QU Yuan-Zhen

2019, 14(06):  630-632.  DOI: 10.3969/j.issn.1673-5765.2019.06.021

Asbtract ( )   PDF (1555KB) ( )  

References | Related Articles | Metrics

Neuro-ophthalmology is an emerging ophthalmology subspecialty, which has very close and extensive relations with multisystem diseases. After decades of development, neuroophthalmology in China has achieved preliminary achievements in clinical practice and scientific research. However, systematic neuro-ophthalmologist standardization training still hasn’t been established. The development of neuro-ophthalmology still has a long way to go in China, which needs continuous exploration and more efforts in the future.