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Wenhong Chen,1 Yunping Chen,2 Wenjuan Ye,3 Ting Wang1 1Department of Pediatric Neurology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 3Department of Pediatric, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of ChinaCorrespondence: Ting Wang, Department of Pediatric Neurology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, 745 Wuluo Road, Hongshan District, Wuhan, Hubei, People’s Republic of China, Tel +86-27-87169308, Email 67722896@qq.comPurpose: The study aims to identify the characteristics of SSR in patients with AICVD and their correlation with clinical presentations.Methods: SSR of the upper limbs, the National Institute of Health stroke scale (NIHSS), the Barthel index (BI), the Essen stroke risk score (ESRS), and imaging examinations, was evaluated in 30 healthy subjects and 66 patients with AICVD. All results were recorded and analyzed via Statistical Package for the Social Sciences (SPSS 22.0) software. t-test and Spearman rank correlation were used.Results: Compared to the control group, SSR of upper limbs in patients with AICVD showed prolonged latency, reduced amplitude, and disappeared waveform (p=0.000, p=0.015, p=0.004), No statistically significant difference was observed between the affected side and the healthy side (p=0.068, p=0.661). In the case group, the higher the abnormal rate of SSR, the more severe the neurological impairment (NIHSS and ADL scores) and the worse the long-term prognosis. Specific results are as follows: Firstly, the total abnormality rate of SSR, prolonged SSR latency were positively related to the NIHSS, also the ESRS (r=0.347, p=0.004; r=0.437, p< 0.001), (r=0.371, p=0.005; r=0.433, p=0.001), the reduced amplitude was positively related to the NIHSS (r=0.341, p=0.012) while the disappeared waveform was positively related to the ESRS (r=0.299, p=0.015); Secondly, the total abnormality rate of SSR, prolonged SSR latency and reduced amplitude were negatively related to the BI (r=− 0.346, p=0.004) (r=− 0.426, p=0.001) (r=− 0.316, p=0.020).Conclusion: There may be inhibition of sympathetic reflex activity in patients with AICVD, SSR abnormality rate in patients with AICVD may be correlated with the degree of neurological impairment and long-term prognosis.Keywords: acute ischemic cerebrovascular disease, AICVD, sympathetic skin response, SSR, autonomic nervous system, ANS

Objective To evaluate the treatment effectiveness and safety of eptifibatide injection in the treatment of acute ischemic cerebrovascular disease （ICVD）. Methods Clinical data of 34 ICVD patients treated with eptifibatide injection were retrospectively analyzed. The indexes of blood rheology, blood coagulation and blood lipid before and after treatment were detected. The dose-effect relationship between the cumulative injection dose and each index was established, and the effective cumulative dose was predicted by the normal index values. The effectiveness were verified by comparing National Institute of Health Stroke Scale （NIHSS） and digital subtraction angiography（DSA） score before and after treatment, and the safety were evaluated after treatment. Results The indexes of blood rheology, blood coagulation and blood lipid were improved to different degree before and after treatment, and the differences were statistically significant （all P < 0.05）. The blood rheology index could be simulated as a quadratic equation of one variable, and R2 was greater than 0.95; in the simulation of blood coagulation indexes, the amount of eptifibatide exerted mild effect on thrombin time. Hence, the corresponding equation could not be simulated, and the remaining indexes could be simulated with a quadratic equation with one variable, and all R2 were greater than 0.95. All patients did not develop symptomatic intracranial hemorrhage after administration. The scores of NIHSS were significantly decreased after one week of treatment （P < 0.05）. Conclusion It is safe and effective to strengthen the anti-platelet aggregation therapy with eptifibatide injection in ICVD patients.

ObjectiveTo comprehensively evaluate the characteristics of the circulating microRNA expression profile in type 2 diabetic patients with acute ischemic cerebrovascular disease by systematic evaluation and meta-analysis.MethodsThe literatures up to March 2022 related to circulating microRNA and acute ischemic cerebrovascular disease in type 2 diabetes mellitus were searched and screened from multiple databases. The NOS quality assessment scale was used to evaluate methodological quality. Heterogeneity tests and statistical analyses of all data were performed by Stata 16.0. The differences in microRNA levels between groups were illustrated by the standardized mean difference (SMD) and 95% confidence interval (95% CI).ResultsA total of 49 studies on 12 circulating miRNAs were included in this study, including 486 cases of type 2 diabetes complicated with acute ischemic cerebrovascular disease and 855 controls. Compared with the control group (T2DM group), miR-200a, miR-144, and miR-503 were upregulated and positively correlated with acute ischemic cerebrovascular disease in type 2 diabetes mellitus patients. Their comprehensive SMD and 95% CI were 2.71 (1.64~3.77), 5.77 (4.28~7.26) and 0.73 (0.27~1.19), respectively. MiR-126 was downregulated and negatively correlated with acute ischemic cerebrovascular disease in type 2 diabetes mellitus patients, its comprehensive SMD and 95% CI were -3.64 (-5.56~-1.72).ConclusionIn type 2 diabetes mellitus patients with acute ischemic cerebrovascular disease, the expression of serum miR-200a, miR-503, plasma and platelet miR-144 was upregulated and the expression of serum miR-126 was downregulated. It may have diagnostic value in the early identification of type 2 diabetes mellitus with acute ischemic cerebrovascular disease.

Purpose: To investigate the characteristics of cervicocephalic spotty calcium (SC) and coronary atherosclerosis in patients with acute ischemic stroke (AIS) and to assess the predictive value of SC for coronary atherosclerosis using combined coronary and cervicocephalic CTA.Materials and Methods: Patients with AIS (n = 70) confirmed by brain MRI or CT and patients with asymptomatic carotid atherosclerosis (n = 58) confirmed by carotid ultrasonography were enrolled in our study. Subjects in both groups underwent combined coronary and cervicocephalic CTA. SC was used to evaluate cervicocephalic atherosclerosis. Coronary artery stenosis (CAS) ≥ 50% by segment and coronary artery calcium score (CACS) were used to evaluate coronary atherosclerosis. The SC frequency and the difference in coronary atherosclerosis between the two groups were compared, and the correlation between SC and coronary atherosclerosis was analyzed. Independent factors for CAS ≥ 50% were assessed via logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of SC for predicting CAS ≥ 50%.Results: Both SC and the CACS were significantly higher in the Stroke group than in the Control group (total SC count: 6.83 ± 4.34 vs. 2.98 ± 2.87, P < 0.05; CACS: 477.04 ± 798.01 vs. 136.31 ± 205.65, P < 0.05). There were significant differences in the presence of CAS ≥ 50% (61.4 vs. 27.6%, P < 0.001). SC and coronary atherosclerosis were significantly correlated for both the CACS and CAS ≥ 50% (r = 0.746 and 0.715, respectively; P < 0.001). SC was an independent predictor for CAS ≥ 50%.Conclusion: SC correlates significantly with the CACS and could serve as an independent predictor of CAS ≥ 50% in patients with AIS, which suggests that combined cerebrovascular and cardiovascular assessments are of importance for such patients.

Purpose: To investigate the characteristics of cervicocephalic spotty calcium (SC) and coronary atherosclerosis in patients with acute ischemic stroke (AIS) and to assess the predictive value of SC for coronary atherosclerosis using combined coronary and cervicocephalic CTA. Materials and Methods: Patients with AIS (n = 70) confirmed by brain MRI or CT and patients with asymptomatic carotid atherosclerosis (n = 58) confirmed by carotid ultrasonography were enrolled in our study. Subjects in both groups underwent combined coronary and cervicocephalic CTA. SC was used to evaluate cervicocephalic atherosclerosis. Coronary artery stenosis (CAS) ≥ 50% by segment and coronary artery calcium score (CACS) were used to evaluate coronary atherosclerosis. The SC frequency and the difference in coronary atherosclerosis between the two groups were compared, and the correlation between SC and coronary atherosclerosis was analyzed. Independent factors for CAS ≥ 50% were assessed via logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of SC for predicting CAS ≥ 50%. Results: Both SC and the CACS were significantly higher in the Stroke group than in the Control group (total SC count: 6.83 ± 4.34 vs. 2.98 ± 2.87, P < 0.05; CACS: 477.04 ± 798.01 vs. 136.31 ± 205.65, P < 0.05). There were significant differences in the presence of CAS ≥ 50% (61.4 vs. 27.6%, P < 0.001). SC and coronary atherosclerosis were significantly correlated for both the CACS and CAS ≥ 50% (r = 0.746 and 0.715, respectively; P < 0.001). SC was an independent predictor for CAS ≥ 50%. Conclusion: SC correlates significantly with the CACS and could serve as an independent predictor of CAS ≥ 50% in patients with AIS, which suggests that combined cerebrovascular and cardiovascular assessments are of importance for such patients. [ABSTRACT FROM AUTHOR]

Background: Complex aortic plaque is a potential cause of acute ischemic cerebrovascular disease, which needs timely identification. Also as a marker for systemic atherosclerosis, complex aortic plaque may be indicated by significant (≥50%) cervicocephalic atherosclerotic stenosis. We aimed at examining whether age ranges would influence their association to more accurately estimate the risk of having complex aortic plaque in acute ischemic cerebrovascular disease.Methods: Aortic arch and cervicocephalic arteries were simultaneously evaluated using computed tomography angiography. Middle-aged (45-64 years) and old-aged (65-85 years) acute ischemic cerebrovascular disease patients were divided into 2 groups according to whether there was an aortic arch plaque with thickness of greater than or equal to 4 mm or associated ulcerations or mural thrombus.Results: Old-aged patients (n = 107) had a higher prevalence of complex aortic plaque (67.3% versus 30.9%, P < .001) than those middle aged (n = 178). Among middle-aged patients, the presence of extracranial significant atherosclerotic stenosis (adjusted odd ratio = 2.89, 95% confidence interval: 1.42-5.86) rather than intracranial ones independently predicted complex aortic plaque. Regarding the extent of significant cervicocephalic atherosclerotic stenosis, the presence of multi-segment, bilateral, simultaneous extracranial and intracranial, and simultaneous anterior and posterior circulation ones were independent indicators for complex aortic plaque in the middle-aged subgroup (adjusted odd ratio = 2.42, 2.05, 2.26, 2.14, respectively). By contrast, no statistical correlation of complex aortic plaque and significant cervicocephalic atherosclerotic stenosis was found among old-aged patients.Conclusion: Considering the ranges of age was important to more precisely predict complex aortic plaque with significant cervicocephalic atherosclerotic stenosis in acute ischemic cerebrovascular disease. [ABSTRACT FROM AUTHOR]

The occurrence and development of acute cerebrovascular diseases involves an inflammatory response, and high mobility group box protein 1 (HMGB1) is a pro-inflammatory factor that is expressed not only in the early-injury stage of disease, but also during the post-repair process. In the initial stage of disease, HMGB1 is released into the outside of the cell to participate in the cascade amplification reaction of inflammation, causing vasospasm, destruction of the blood-brain barrier and apoptosis of nerve cells. In the recovery stage of disease, HMGB1 can promote tissue repair and remodeling, which can aid in nerve function recovery. This review summarizes the biological characteristics of HMGB1, and the role of HMGB1 in ischemic and hemorrhagic cerebrovascular disease, and cerebral venous thrombosis. [ABSTRACT FROM AUTHOR]

The prevalence of intracranial arterial stenosis (IAS) as well as antinuclear antibody (ANA) positivity was found to be higher in Asians than that in the Western population. To investigate the relation of ANAs with IAS in patients with acute ischemic cerebrovascular disease, we enrolled 2492 patients with acute ischemic stroke or transient ischemic attack into the study. All the patients were categorized into 3 groups according to the IAS burden. Multinomial logistic regression analyses were used in statistical analysis. The positive rate of ANAs in the IAS ≥ 2 group was higher than that in the single IAS group and the no IAS group (p<0.001). The adjusted odds ratio (OR) for IAS ≥ 2 in ANAs-positive patients was 3.737 (95%CI=2.676-5.220, p<0.001) compared with the ANAs-negative patients. ANAs were associated with multiple IAS rather than single IAS in both male and female subgroups. Besides, ANAs were significantly associated with single and multiple IAS in individuals ≤ 60 years. However, ANAs were only associated with two or more IAS in two age groups (between 61 to 75 years and >75 years old). In summary, ANAs are associated with IAS in patients with acute ischemic cerebrovascular disease.

Aim: Coronary artery stenosis (CAS) ≥ 50% frequently coexists in patients with acute ischemic cerebrovascular disease (AICVD), which portends unfavorable outcomes. We sought to examine whether patients with AICVD with CAS had more severe and more diffused cervicocephalic atherosclerosis (CA)., Methods: Patients with AICVD were consecutively enrolled and underwent simultaneous computed tomography angiography (CTA) of the coronary and cervicocephalic arteries. A total of 140 patients were divided into "AICVD＋CAS" and "AICVD only" groups according to whether CTA showed stenosis of ≥ 50% in at least one coronary arterial segment. The relationship of the presence of CAS with the severity and extent of CA were examined., Results: The CA severity characteristics, including the presence of stenosis ≥ 50% and the grade of the most severe stenotic segment, were not significantly different between the two groups. Regarding the extent of CA, the presence of stenosis ≥ 50% in both sides (adjusted odds ratio [OR]: 4.29, 95% confidence interval [CI]: 1.67-10.98), both extracranial and intracranial (adjusted OR: 5.26, 95% CI: 2.24-12.35), both anterior and posterior circulation (adjusted OR: 5.29, 95% CI: 2.22-12.64), and the number of stenotic segments ≥ 50% in cervicocephalic arteries (adjusted OR: 1.58, 95% CI: 1.28-1.96) were associated with CAS in patients with AICVD, independently of clinical demographics and CA severity characteristics., Conclusion: CA was similarly severe in patients with AICVD with and without CAS, but those with CAS had significantly more diffused CA. The extent of CA and CAS were mutual indicators in patients with AICVD, irrespective of CA severity.