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Vascular calcification occurs highly prevalent, which commonly predicts adverse cardiovascular events. The pathogenesis of calcification, a complicated and multifactorial process, is incompletely characterized. Accumulating evidence shows that mitochondrial dysfunction may ultimately be more detrimental in the vascular smooth muscle cells (VSMCs) calcification. This review summarizes the role of mitochondrial dysfunction and metabolic reprogramming in vascular calcification, and indicates that metabolic regulation may be a therapeutic target in vascular calcification.

Stroke is the second highest cause of death globally and a leading cause of not only physical disability but also cognitive. Approximately two-thirds of Ischemic Stroke patients, who represent the most common type of stroke are found to have mild deficits. Minor stroke, sometimes also referred to as “mild stroke”, is often defined in research studies as a National Institute of Health Stroke Scale (NIHSS) score of 5 or less, although, the cut point for NIHSS score or standardized criterion to define minor stroke has not been established. In the past, many studies have been focusing on the definition of the minor stroke to better stabilize the acute treatment guidelines, to predict the functional outcome, and also for early risk factors stratification. Different studies use different criteria or different cut-points of NIHSS scores to define minor stroke. Aside from indecision of acute management of minor stroke, many other questions have been raised regarding minor strokes, for example, the interaction of large vessel occlusion with minor stroke, the prevalence rate of depression, anxiety, cognitive dysfunction, chronic head after minor stroke, and so on. Finding a universal definition for minor stroke is the key to establish the guideline for management for this group of patients. However, the guidance of treatment of minor stroke is not the focus of this review. The review will focus on the deep comprehension of minor stroke characteristics, summarizing the new findings related to minor stroke, and highlight the essential points to consider for characterizing mild stroke symptoms for a new direction guide for future studies.

Ischemic strokes (IS), also referred to as cerebral ischemia or brain ischemia, is a significant cause to the brain cells damage or death. Approximately, 10% - 14% of ischemic strokes cases occurred in young adults. Hence, we conducted a meta-analysis to find the effective interventions to prevent the best strokes caused by cerebral infarction in young adults. The search was done in different databases, including Google scholar, PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database, Scopus, and Web of Science from January 2016 to April 2020, and only English published articles were considered. Our analysis included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. Further, random effects model was used to estimate the summary annual rate of IS. Pooled relative risks and odds ratios, with their 95% confidence intervals, were calculated, respectively. The analysis was conducted using STATA (version 12), pooled effect sizes were calculated using the random-effects model and heterogeneity was tested for using the I2 statistic. The analysis included 13 studies. The analysis shows that diabetes, high blood pressure, ischemic heart disease, atrial fibrillation, hypercholesterolemia, alcohol consumption and smoking are significant risk factors. In Caucasian and Chinese ischemic stroke patients, the risk factor associations associated with ischemic stroke subtypes are similar. Compared to all other ischemia subtypes, diabetes is more familiar with aortic stroke, atrial fibrillation, ischemic heart disease (with obstruction), hypertension and diabetes. Our research shows that atrial fibrillation, ischemic heart disease, and hypercholesterolemia are low in patients with ischemic stroke and the risk factors are higher. Further analysis of each patient’s data is required to enable confounders’ adjustments to confirm and expand these findings.

Background One of the most common causes of acute cerebral infarction (ACI) is intracranial artery stenosis (ICAS). The goal of our study was to evaluate the accuracy of transcranial Doppler (TCD) compared with magnetic resonance angiography (MRA) for diagnosing ICAS in patients with ACI. Materials and Methods Consecutive patients presenting with ACI to the neurology department underwent both MRA and TCD examination within 6 hours of difference. To calculate the agreement between the results of MRA and TCD, kappa coefficient test was used. Sensitivity, specificity, and positive and negative TCD predictive values have been calculated in comparison with MRA. Results A total of 115 patients was included. There were 77 males (66.95%) and 38 females (33.04%). The mean age of patients was 68.32 ± 10.66 years (range 29–80). The agreement between TCD and MRA in detecting stenosis was 0.56 for anterior circulation artery (ACA), and 0.40 for posterior circulation artery. For the detection of ICAS, sensitivity, specificity, positive predictive value, and negative predictive values were 85.9, 90.0, 98.2, and 50.0% for anterior cerebral artery and 73.5, 86.7, 96.2, and 40.0% for posterior cerebral artery, respectively. Conclusions Moderate agreement of anterior circulation stenosis and fair agreement for posterior circulation stenosis was found between TCD and MRA in the evaluation of ICAS. In anterior circulation, the diagnostic accuracy of TCD is higher compared with the posterior circulation.

Background: Benign paroxysmal positional vertigo (BPPV) is self-limiting and recurrent but the cost is considerable. The recurrence of BPPV increased significantly under the quarantine policy in Hangzhou. The unhealthy lifestyle risk factors of the recurrence of BPPV have not yet been investigated. So, the objective is to analyze the unhealthy lifestyle risk factors of recurrent BPPV.Methods: A retrospective observational study was conducted in the Department of Neurology in Tongde Hospital of Zhejiang Province from December 2018 to March 2020. The study included 186 patients aged 23–86 years. All patients received the definitive diagnosis and canalith repositioning maneuvers (CRM) treatment and finally accomplished follow-up for one year. Demographic variables, potential recurrence risk factors, neurological examination, cranial computed tomography and lifestyle were assessed.Data Analyses: The t-test or chi-squared test was first performed for group comparison, then logistic regression analysis was performed to investigate the recurrence risk factors in all of the patients.Results: The 1-year recurrence rates of BPPV patients after reposition maneuvers were 36.02%, is significantly higher than other study especially in the first quarter of 2020 (38.8% of patients with BPPV recurrence). Logistic regression analysis shows that BPPV patients who was poor physical activities and prolonged recumbent position time have more recurrence risks. Poor physical activities (odds ratio =5.690, 95% confidence interval: 1.650-19.618, p Conclusion: We conclude that poor physical activities and prolonged recumbent position time may be independent risk factors for the recurrence of BPPV patients, but aging, Ménière’s disease, sudden deafness migraine, hypertension, hyperlipemia, diabetes, CHD, POCI, mental factors, and mental labor do not increase the recurrence risk.

“Subarachnoid Hemorrhage is non-traumatic nasty bleeding into the subarachnoid area, the territory between the arachnoid and the piamater of the central nervous system showing prompt developing signs of neurological sequelae”. It is one among the neurological emergencies which is a very distressing cerebrovascular disease with complicated mechanisms that risks brain perfusion and its function, having higher morbidity and mortality rates. Its mortality rate is still ranged between 8.3% and 66.7%, with noticeable regional variations, beside recent advances in treatment approaches. The incidence of SAH among the population of 2 - 22.5/100,000 was reported with a minimum of 60% of aneurysm ruptures occurring amid ages of 40 and 60 years with 3:2 male:female ratio. The rupture risks for unruptured aneurysms are increased by the issues like present smokers, larger size of aneurysm, and amid young population. The surgical treatment decision should be contemplated upon factors such as aneurysm’s size, aneurysm’s location, patient’s illness history, and surgeon’s operative experiences. Latest technical progresses in imaging techniques, increased consideration of illness history, more awareness of incidences of aneurysms and use of micro neurosurgery, have raised the chance for detection of subarachnoid hemorrhage (SAH) and possible better outcomes with surgical management. Factors that may affect outcome include age, size and site of aneurysm, interval between ictus and surgery, CT Fisher Grade & Hunt and Hess Grading earlier to surgery, & Glasgow Coma Scale at the while of discharge. The studies here support the wide spread concept that surgical clipping of SAH for Hunt and Hess Grade 4, 5 SAH, which is also considered as poor Grade SAH stipulates an effective treatment if done earlier provides better outcome.