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脑血流自动调节（cerebral autoregulation，CA）是血压变化时大脑维持足够脑灌注的内在能 力。过去的30年，研究者已经提出了诸多分析CA的方法，但至今无公认的金标准，采用什么方法定量 CA仍是个人主观的选择。尽管如此，由于CA的概念代表了血压（刺激或者输入信号）与脑血流（反应 或者输出信号）之间的动态关系，故目前最通用的研究血压自发波动的分析方法是传递函数分析。虽 然理论上可行，但是文献显示，传递函数分析方法在实践中存在相当大的主观性，这限制了研究之 间的比较，也阻碍了其临床应用。因此，本白皮书旨在规范化研究动态CA的传递函数分析方法的参 数及设置，建立标准，以利于其临床应用，该推荐的研发始于（但不限于）脑血流自动调节研究网络 （CARNet-www.car-net.org）。

肺叶楔形切除术后围手术期并发急性缺血性卒中的发生率虽然不高，但严重者可导致终身残疾甚至死亡，影响患者预后，其发病机制目前仍不明确。本文报道了2例肺癌手术后并发急性缺血性卒中经介入取栓治疗的病例，病例1行胸腔镜下左肺上叶楔形切除术后当天，左侧大脑中动脉急性栓塞导致左侧大脑半球大面积梗死，经介入取栓治疗血管再通[脑梗死溶栓分级（TICI 3级）后，患者预后良好（NIHSS评分4分）。病例2行胸腔镜下右下肺楔形切除术后当天，基底动脉闭塞导致小脑大面积梗死，经介入取栓治疗后血管再通良好（TICI 3级），但患者术后脑水肿严重，最终放弃治疗。本文通过总结诊疗经验并回顾相关文献，分析肺叶楔形切除术后并发急性缺血性卒中的可能机制，以供临床参考。 Abstract: The incidence of acute ischemic stroke during the perioperative period after wedge resection of pulmonary lobes is not high, but it may lead to life-long disability and even death in severe cases, thus affecting the prognosis of patients. At present, the pathogenesis is still unclear. This paper reported two cases of interventional thrombectomy in patients with acute ischemic stroke after lung cancer surgery. Patient 1 underwent wedge resection of the upper lobe of the left lung under thoracoscope. On the same day, acute embolism of the left middle cerebral artery caused extensive infarction in the left cerebral hemisphere. After interventional thrombectomy and recanalization (TICI grade 3), the patient had a good prognosis (NIHSS score of 4). Patient 2 underwent the right inferior pulmonary wedge resection under thoracoscope. On the same day, basilar artery occlusion caused extensive cerebellar infarction. After interventional thrombectomy, the blood vessels reopened well (TICI grade 3), but the patient had severe postoperative brain edema and ultimately gave up treatment. This paper summarized the experience, reviewed relevant literature and analyzed the high-risk factors for acute ischemic stroke after wedge resection of pulmonary lobes, to provide a reference for clinical practice.

可逆性后部脑病综合征（posterior reversible encephalopathy syndrome，PRES）是一种以可逆性神经系统损害和特异性影像学表现为主的临床-影像学综合征，阵发性睡眠性血红蛋白尿症（paroxysmal nocturnal hemoglobinuria，PNH）是临床上的罕见疾病。本文介绍1例有PNH的老年男性患者，患者长期慢性溶血性贫血，不规律服用小剂量免疫抑制剂，短期间断输入共计10 U洗涤红细胞后，出现伴有头痛、痫性发作、精神行为异常、血压异常增高及微量蛛网膜下腔出血的PRES，此病需与脑静脉及静脉窦血栓形成和可逆性脑血管收缩综合征等疾病相鉴别。本文旨在提高临床医师对此类患者的预防、早期识别及应对能力。 Abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinical-imaging syndrome dominated by reversible neurological damage and specific imaging manifestations, and paroxysmal nocturnal hemoglobinuria (PNH) is a clinically rare disease. This paper described a case of an elderly male patient with PNH who had long-term chronic hemolytic anemia. After irregularly taking low-dose immunosuppressants and short-term intermittent infusion of 10 U of washed erythrocytes, he developed a PRES with headache, seizures, mental behavioural abnormalities, abnormally high blood pressure, and trace subarachnoid hemorrhage. It should be differentiated from diseases such as cerebral venous and venous sinus thrombosis and reversible cerebral vasoconstriction syndrome. The aim of this paper is to improve the clinicians’ ability to prevent and identify this type of patients at an early stage.

摘要： 预测模型是用来预测个体发生目标事件概率或预测结局值的统计模型。预测模型结果可视化展现是开发预测模型全流程中必不可少的一部分。良好的预测模型展现形式不仅可以使预测结果具有更好的可读性、可解释性，也在很大程度上决定了其使用方式和便利性。本文将详细介绍各种预测模型的展现形式，并阐述各自的优缺点。随后结合脑血管病临床预测模型研究，通过研究示例逐一介绍不同展现形式在脑血管病研究中的应用。 Abstract: A prediction model is a statistical model used to predict the probability of an individual with a target event or to predict the outcome value. Visualization of prediction model results is an essential part of the whole process of developing a prediction model. A good presentation of a prediction model can not only make the prediction results more readable and interpretable, but also determine its use and convenience to a large extent. This paper provided a detailed introduction to various forms of prediction model presentation and reported their advantages and disadvantages. Combining clinical prediction model research on cerebrovascular disease, this paper introduced the application of each presentation in cerebrovascular disease research through research examples.

目的 对卒中和血脑屏障相关文献进行文献计量学分析得到研究图谱，探索热点和发展趋势，为临床治疗和研究提供参考。 方法 在Web of Science核心数据库中检索2001年1月1日—2023年2月28日关于卒中和血脑屏障的文献，采用文献计量学方法，运用CiteSpace V6.1.R6对年份分布、国家/地区、研究机构/体系、作者、发行刊物、被引文献、关键词和研究趋势进行分析。 结果 筛选后共纳入文献5028篇，发文量整体呈上升趋势，美国对此的研究最多，其次是中国大陆、德国等。发文量排名前10位的研究机构/体系大多来自美国、法国和中国，各国家/地区和研究机构/体系之间的合作很紧密。在研究作者中，来自美国的Chopp Michael发表文章49篇，位列第1位。在研究趋势中，缺血性卒中、非编码RNA中miR-126、血脑屏障功能障碍和药物递送是近3年的热点。 结论 血脑屏障和卒中密不可分，卒中时血脑屏障的功能障碍和修复机制、血脑屏障所释放的循环生物标志物及利用血脑屏障开放时间增加药物吸收值得进一步研究。 Abstract: Objective A bibliometric analysis of the literature related to stroke and the blood-brain barrier was conducted to obtain a research map, explore hotspots and trends, and provide references for clinical treatment and research. Methods The literature related to stroke and blood-brain barrier from 1 January 2001 to 28 February 2023 was explored in the Web of Science core database. Using bibliometrics, CiteSpace V6.1.R6 was used to analyze the distribution of years, countries/regions, research institutions/system, authors, publications, cited literature, keywords and research trends. Results A total of 5028 papers were included after screening, with an overall upward trend in the number of published papers. The United States had the most research on this topic, followed by China’s mainland and Germany. Most of the top 10 research institutions/system were from the United States, France and China, with strong collaboration between countries/regions and research institutions/system. Among the authors, Chopp Michael from the United States ranked first with 49 papers. Among the research trends, ischemic stroke, miR-126 in non-coding RNA, blood-brain barrier dysfunction and drug delivery were the hot spots in the last three years. Conclusions Blood-brain barrier and stroke are inextricably linked. The dysfunction and repair mechanism of blood-brain barrier during stroke, the circulation biomarkers released by blood-brain barrier and the use of blood-brain barrier opening time to increase drug absorption are worthy of further study.

超声由于其独特的优势已逐渐应用于脑小血管病领域。本文汇总了超声在脑小血管病中应用的相关研究，概述了脑小血管病与血管超声各类评估指标之间的关系，并描述了超声在与脑小血管病并存的心、脑、肾等多系统疾病中的评估、诊断作用，为应用超声对脑小血管病进行全面有效评估提供了理论依据。 Abstract: Ultrasound has been gradually applied to the field of cerebral small vessel disease (CSVD) due to its unique advantages. This paper summarized the studies related to ultrasound in CSVD, and summarized the relationship between CSVD and various evaluation indicators of vascular ultrasound. What’s more, this paper described the role of ultrasound in the evaluation and diagnosis of multi-system diseases such as heart, brain, and kidney coexisting with CSVD, and provided a theoretical basis for comprehensive and effective evaluation of CSVD by ultrasound.

血管性认知障碍是脑血管病变及其危险因素导致的认知功能下降，已逐渐成为当代社会的重大公共卫生问题。神经心理学和影像学表现是血管性认知障碍诊断和分型的“金标准”。本文将回顾神经心理学和影像学在血管性认知障碍精准诊断和进展预测等临床应用方面的研究进展，除了卒中后认知障碍和皮质下缺血性血管性认知障碍外，本文还关注了低灌注性认知障碍和混合型认知障碍的研究进展。 Abstract: Vascular cognitive impairment (VCI) is a decline in cognitive function caused by cerebrovascular disease and its risk factors, which has gradually become a major public health problem in the society. Neuropsychology and imaging findings are well-recognized standards of diagnosis and classification of VCI. This paper reviewed the advances in neuropsychology and imaging in clinical applications to accurately diagnose and predict the progression of VCI. In addition to post-stroke cognitive impairment and subcortical ischemic VCI, this paper also discussed the research advances in hypoperfusion cognitive impairment and mixed cognitive impairment.

Miller-Fisher综合征（Miller-Fisher syndrome，MFS）和Bickerstaff脑干脑炎（Bickerstaff brainstem encephalitis，BBE）临床较为罕见。近两年，国外可见散在病例报告MFS叠加格林巴利综合征（Guillan-Barré syndrome，GBS）或BBE，共同影响外周和（或）中枢神经系统，并伴有单相症状。然而，三种疾病叠加的临床症状或体征十分罕见，迄今为止国内未见报道。因此，本研究报告1例64岁男性椎动脉术后亚急性起病，表现为典型的对称性四肢无力、眼外肌麻痹、双下肢腱反射消失，同时伴有嗜睡等意识障碍表现，病程在2周时到达高峰。肌电图检查结果呈神经源性损害，脑脊液和血清学结果提示蛋白-细胞分离现象，GQ1b抗体（anti-GQ1b IgG antibody，GQ1b-IgG）和GT1a抗体（anti-GT1a IgG antibody，GT1a-IgG）阳性，临床确诊为MFS叠加BBE。本研究结果强调了MFS、BBE、GBS可能是同一疾病的不同亚型，GQ1b和GT1a抗体进一步揭示了这些疾病亚型的共同免疫相关病理生理机制。临床上，遇到MFS、BBE和GBS叠加、交叉的临床表现，周围和中枢神经系统同时受累时，要考虑到GQ1b抗体综合征可能，尽快给予免疫球蛋白治疗以改善患者预后。 Abstract: Miller-Fisher syndrome (MFS) and Bickerstaff brainstem encephalitis (BBE) are extremely rare in clinical practice. In recent years, MFS together with Guillan-Barré syndrome (GBS) or BBE has been reported abroad sporadically, possibly affecting the peripheral and/or central nervous systems, with monophasic symptoms. However, the frequency of overlapping clinical symptoms and signs of these three diseases is very low, and there was no report in China so far. Therefore, this paper described a 64-year-old male who presented with subacute onset, bilateral symmetrical weakness of limbs, paralysis of extraocular muscles, disappearance of tendon reflexes of both lower limbs, accompanied by drowsiness and other disturbances of consciousness after vertebral artery stenting surgery. The course of disease peaked at 2 weeks. The results of electromyography suggested neurogenic damage, and the finding of cerebrospinal fluid (CSF) and serological results showed a significant increase in protein but a decrease in cell count. It was supported by positivity for anti-GQ1b IgG antibody (GQ1b-IgG) and anti-GT1a IgG antibody (GT1a-IgG) in serum and CSF. Thus, this patient was diagnosed as MFS overlapping BBE. The results of this paper emphasizes that MFS, BBE, and GBS may be different subtypes of the same disease, and GQ1b-IgG and GT1a-IgG further reveal the common immune related pathophysiological mechanisms of these disease subtypes. It prompts clinicians to consider the presence of GQ1b-IgG syndrome and give immunoglobulin therapy as soon as possible to improve the patients’ prognosis when they presented with the overlapping and cross clinical manifestations of MFS, BBE, and GBS, especially involved peripheral and central nervous systems.

目的 分析国家自然科学基金脑血管病领域面上项目结题情况，探讨该领域研究现状和存在问题，预测发展趋势，为决策提供参考。 方法 通过国家自然科学基金大数据知识管理服务门户网站获得2019—2021年申请代码为H0906（脑血管结构、功能异常及相关疾病）结题面上项目的基本信息，采用Excel软件、Power Query组件对结题项目的成果产出、依托单位分布、地域分布、研究方向分布进行分析，使用VOSviewer软件对研究热点进行分析。 结果 2019—2021年申请代码为H0906的结题项目有177项，依托于51家单位（其中14家承担110项，占62.15%），产出学术论文1532篇，培养人才324名。依托单位中综合类院校承担96项（54.24%），每项产出论文9.52篇，较医科类院校多1.91篇。依托单位所属19个省（直辖市），其中上海市、江苏省、北京市、广东省、湖北省、重庆市等6省（直辖市）结题113项（63.84%），授权专利数30项（90.91%），参加国际会议27人次（75.00%）。H0906下设18个研究方向，涉及缺血性脑血管病研究107项（60.45%）。关键词聚类分析显示，脑血管病领域基础研究热点是炎性反应、小胶质细胞、神经保护及神经再生等。 结论 国家自然科学基金脑血管病领域面上项目成果产出类型多样，以论文和人才培养为主，依托单位以综合性院校为主，地域分布不均衡，研究方向相对集中，以缺血性脑血管病为主。 Abstract: Objective To analyze the completion condition of general projects in the field of cerebrovascular diseases of National Natural Science Foundation of China, and discuss the status and existing problems of basic research in this field. Predict the development trend and provide reference for decision-making. Methods Through the big data knowledge management service portal of the National Natural Science Foundation of China, the basic information of the concluding projects with application code H0906 (cerebrovascular structure, function abnormalities and related diseases) during 2019 to 2021 were obtained. Excel software and Power Query components were used to analyze the research achievements, supporting institution distribution, regional distribution and research direction distribution of the concluding project, and VOSviewer software was used to analyze research hotspots. Results There were 177 concluding projects with code H0906 during 2019 to 2021, supported by 51 institutions (14 of which undertook 110 projects, 62.15%). 1532 academic papers were produced and 324 talents were cultivated. Among the supporting institutions, comprehensive colleges and universities undertook 96 projects (54.24%), and each project produced 9.52 academic papers, with 1.91 papers more than that from medical colleges and universities. Among the supporting institutions from 19 provinces and cities, Shanghai, Jiangsu, Beijing, Guangdong, Hubei, Chongqing 6 provinces and cities completed 113 projects (63.84%), the number of authorized patents was 30 (90.91%), and 27 person-time participated in international conferences (75.00%). There were 18 research directions under H0906, involving 107 projects of ischemic cerebrovascular diseases (60.45%). Keyword cluster analysis showed that the basic research hotspots in the field of cerebrovascular diseases were inflammatory response, microglia, neuroprotection and nerve regeneration. Conclusions Research achievements of general projects in the field of cerebrovascular diseases of National Natural Science Foundation of China were of various types, were mainly papers and talent training, supported by comprehensive colleges and universities with unbalanced geographical distribution, and research directions were relatively concentrated, which were mainly ischemic cerebrovascular diseases.

目的 对人类基因组工作草图公布以来卒中遗传学、基因组学领域已发表的论文进行文献计量学研究，分析该领域的研究现状、热点及发展趋势。 方法 以一代测序（2000—2007年）、全基因组分型芯片（2008—2015年）和二代测序（2016年至今）为代表性技术，将2000年至今划分为3个阶段。在Web of Science核心合集检索脑血管病领域发表的遗传学、基因组学方面的英文文献，对文献的发表时间、地区、研究机构等信息进行汇总，使用VOSviewer 1.6.18进行统计分析并对结果进行可视化。使用H指数评估论文产出数量与论文水平。 结果 共纳入8833篇英文文献。美国是卒中遗传学、基因组学领域文献的最主要贡献者，发文量高达3291篇，H指数为182，发文量和H指数在所有国家/地区中均居首位。中国发文1765篇，H指数为66，分别排名第2位和第10位。国际卒中遗传学联盟是该研究领域的重要参与者，联盟和主要负责人的发文量居所有作者的前20名。卒中遗传学、基因组学的研究热点从早期的关联分析和荟萃分析，逐步过渡到近几年兴起的孟德尔随机化研究。 结论 在卒中遗传学、基因组学领域，我国虽然起步较晚，但在发文总量上有赶超的趋势。我国卒中相关的临床和科研人员应积极参与国内和国际学术合作，进一步提升我国在该领域的影响力。 Abstract: Objective To explore the research status, hotspots, and trends in the field of stroke genetics and genomics according to bibliometric analysis on published literature since publication of the working draft of human genome. Methods The last two period (from 2000 to the present) was divided into 3 stages based on representative genomic technologies, namely first-generation sequencing (2000—2007), whole-genome genotyping microarray (2008—2015), and next-generation sequencing (2016—now). All of the published literature (written in English) on cerebrovascular disease genetics and genomics were retrieved from core collection of Web of Science. Year of publication, country/area, and institution of the literature were summarized. VOSviewer 1.6.18 was used for statistical and visual analysis. The H-index was used to evaluate the quantity and the impact of the literature. Results A total of 8833 English literature was included in this analysis. The United States was the main contributor to the literature on stroke genetics and genomics, and published 3291 articles with an H-index of 182, both ranking first in the quantity and H index of papers. China published 1765 papers with an H-index of 66, ranking second in the quantity and tenth in H-index. The International Stroke Genetics Consortium (ISGC) was an important contributor in this field of stroke genetics and genomics. ISGC and its principal directors ranked among the top 20 authors in the number of publications. The hotspots gradually shifted from association analysis and meta-analysis in the early stage to Mendelian randomization in recent years. Conclusions In the field of stroke genetics and genomics, although our country started late, there is a trend of catching up in the total number of publications. Clinical and scientific researchers in China should strengthen domestic and international academic cooperation to further enhance the China’s influence in this field.

目的 以文献计量学为基础，应用CiteSpace软件对国内外卒中患者照顾者领域研究现状及热点问题进行分析，为深入开展该领域的研究提供参考。 方法 在中国知网和Web of Science数据库中检索从建库至2021年12月31日卒中患者照顾者领域的中英文文献，文献类型包括论著、综述、学位论文、会议论文。去除重复文献后，从发文量、作者、机构、国家、关键词等方面进行文献计量学分析。 结果 共纳入1298篇中文文献（中国知网），1763篇英文文献（Web of Science）。对于卒中患者照顾者的研究，中英文文献发表均整体呈逐年上升趋势，中国知网数据库中，发文量从2002年的4篇增至2021年的164篇；郑州大学张振香是发文量最多（48篇）的作者，郑州大学护理与健康学院（50篇）是该领域发文量最多的机构；除主题词外，“影响因素”“照顾能力”“照顾负担”“抑郁”“焦虑”“自我感受负担”等为高频关键词。在Web of Science数据库中，发文量从2009年的103篇增至2021年的201篇；美国发文量最多（565篇），约翰霍普金斯医学院的Roth在作者中发文量最多，Univ Toronto（55篇）在发文机构中居首位；“quality of life”“rehabilitation”“support”“burden”“care”“depression symptom”“survivor”等为高频关键词。 结论 国内外卒中患者照顾者领域的研究处于稳定发展阶段，发文作者、发文机构均呈现以高校和地域为中心的特点，但缺乏跨区域和跨单位合作；国内外研究热点不同，照顾负担及照顾能力的影响因素、卒中照顾者负性情绪为国内研究热点，照顾者生活质量的影响因素、照顾负担和抑郁症状、照顾者主导的康复对卒中患者的影响是国外研究热点。临床或科研工作者应加强各研究机构之间的合作，关注该领域的研究前沿和热点，提高研究深度和广度。 Abstract: Objective Based on bibliometrics, CiteSpace software was used to analyze the current research status and hot issues in the field of caregivers of stroke patients at home and abroad, to provide reference for further research in this field. Methods The relevant literature in the field of caregivers of stroke patients was retrieved from the China National Knowledge Network (CNKI) and Web of Science database from the database inception to December 31, 2021. The types of articles included clinical trials, reviews, dissertations and conference papers. Bibliometric analysis was conducted in terms of the number of papers, authors, institutions, countries and keywords. Results A total of 1298 Chinese and 1763 English literature were included. The number of these published articles is on the rise year by year both at home and abroad. In the database of CNKI, the number of published articles increased from 4 in 2002 to 164 in 2021. Zhang Zhenxiang of Zhengzhou University published the most (48 articles), and the Nursing and Health College of Zhengzhou University published the most (50 articles). In addition to the subject words, "influencing factors" "caring ability" "caring burden" "depression" "anxiety" and "self-perceived burden" were high-frequency keywords. In the Web of Science database, the number of published articles increased from 103 in 2009 to 201 in 2021, and the United States published the most (565 articles); Dr. ROTH D L of Johns Hopkins School of Medicine published the most; the Univ Toronto had the most publications (55 articles). "Quality of life" "rehabilitation" "support" "burden" "care" "depression symptom" and "survivor" were high-frequency keywords. Conclusion The research on caregivers of stroke patients at home and abroad was in a stable development stage in the recent ten years. The authors and institutions of these papers were all characterized by universities and regions, and lack of cross-regional and cross-unit cooperation. Domestic and foreign research hotspots were different. The influencing factors of caring burden and caring ability, and negative emotion of stroke caregivers were hot issues in China. The influencing factors of stroke caregivers' quality of life, caring burden and depressive symptoms of caregivers, and the influence of rehabilitation led by caregivers on stroke patients were hot issues abroad. The clinical and research workers should strengthen the cooperation among research institutions, pay attention to the research frontiers and hotspots, to improve the depth and breadth of research.

脑血流自动调节（cerebral autoregulation，CA）功能可维持正常脑血流灌注，对确保人正常生活及工作至关重要。CA障碍可发生在任何年龄段，在脑血管病或神经退行性疾病患者中尤为常见。TCD卧立位试验是一种运用TCD评估CA的无创、便捷方法，其关键在于监测患者从卧位到立位过程中脑血流速度和血管阻力的变化。TCD卧立位试验在脑血管病及自主神经功能障碍性疾病的诊断、治疗和预后评估方面具有重要临床应用价值，但标准化操作、结果解读和个体差异等挑战制约着其临床推广。未来，随着技术的进步和研究的深入，TCD卧立位试验有望在个体化医疗和早期诊断方面发挥更大作用。本综述旨在为更好地发挥其临床价值提供参考依据。 Abstract: Cerebral autoregulation (CA) is essential for maintaining normal cerebral blood perfusion, which is crucial for ensuring people’s normal daily life and work. CA disorders can occur at any age but are particularly common in patients with cerebrovascular diseases or neurodegenerative diseases. The recumbent-upright test using TCD is a non-invasive and convenient method to assess CA. The key is to monitor the changes in cerebral blood flow velocity and vascular resistance during the transition from supine to upright position. The recumbent-upright test using TCD has significant clinical value in the diagnosis, treatment, and prognostic assessment of cerebrovascular diseases and autonomic dysfunction. However, challenges such as standardized operation, result interpretation, and individual variability hinder its clinical application. In the future, with the advancement of technology and in-depth research, the recumbent-upright test using TCD is expected to play a greater role in individualized treatment and early diagnosis. This paper aims to provide a reference for maximizing its clinical utility.

Cerebral revascularization is constantly being updated and iterated, but there are still many challenges: how to regulate the bypass flow quantitatively, how to reconstruct cerebral artery perforator vessels with diameter less than 0.5 mm, etc.. This paper reviews the birth of revascularization and the development of cerebral revascularization, focusing on the basic principle and innovative technology of cerebral revascularization, application and effect of cerebral revascularization in the treatment of complex intracranial aneurysms, current situation and development trend of cerebral revascularization iteration. The aim is to promote the iteration of cerebral revascularization and its application in the treatment of complex intracranial aneurysms.

缺血性卒中是致死致残的重症疾病之一。缺血性卒中患者预后不理想的重要原因之一是缺血级联反应造成的脑组织损伤。因此，积极的脑细胞保护治疗对改善缺血性卒中的预后至关重要。近年来，国内外大量临床前和临床研究证据层出不穷。基于更多新治疗靶点的涌现以及更多治疗方式的突破，结合最新卒中治疗学术产业圆桌会议的内容，本声明对缩小目前缺血性卒中研究临床转化鸿沟的探索、脑细胞保护的临床研究，以及如何有助于实现更多治疗方式的临床转化做一科学声明，旨在推进缺血性卒中脑细胞保护临床前及临床研究的开展，进一步改善缺血性卒中患者的临床预后。 Abstract: Ischemic stroke is one of the serious diseases that cause death and disability. One of the important reasons for the unsatisfactory prognosis of patients with ischemic stroke is the damage to brain tissue resulting from the ischemic cascade reaction. Therefore, active brain cytoprotection therapy is essential for ischemic stroke treatment. In recent years, evidence from many preclinical studies and clinical research has emerged at home and abroad. With the emergence of new therapeutic targets and breakthroughs in treatment approaches, combined with the content of the latest Stroke Treatment Academic Industry Roundtable, this paper makes a scientific statement on the exploration of strategies to bridge the gap of clinical transformation in ischemic stroke, clinical research on brain cytoprotection, and how can exploration contribute to the clinical transformation of more treatment approaches. The objective is to promote the development of preclinical studies and clinical research in brain cytoprotection for ischemic stroke, and further improve the clinical prognosis of patients with ischemic stroke.

近10年来，高场强MRI系统在医学领域的应用和研究不断深入，但其安装和扫描条件要求较高，运行成本昂贵，限制了其在基层医院的普及。相比之下，低场强（0.01～1.0 T）MRI虽然成本较低，但因其成像性能欠佳，也未能在临床实践中发挥更大的作用。随着技术的不断发展，目前低场强MRI有望实现类似于高场强MRI系统的各种应用，通过优化软件、硬件设计和技术革新，低场强MRI可以在保持成本经济、便于转运优势的同时提高信噪比，达到提高诊断性能，更广泛地应用于临床实际场景的目标。特别是在急重症诊断方面，低场强MRI有望成为脑血管疾病诊断和监测的重要工具之一。本文追溯了低场强MRI的发展历程，对其在神经系统疾病临床应用中的进展进行了综述，旨在为未来低场强MRI技术的发展探寻方向。 Abstract: In the past decade, the application and research of high-field MRI systems has deepened in the medical field. However, its installation and operating conditions are demanding, and its running cost is high, which limits its popularity in grassroots hospitals. In contrast, low-field (0.01-1.0 T) MRI, although relatively cheaper, has not been effective in clinical practice due to its poor performance. With the continuous development of technology, low-field MRI is now expected to achieve various applications similar to high-field MRI systems. Through software optimization, hardware design, and technical innovation, low-field MRI can improve the signal-to-noise ratio while maintaining the advantages of cost economy and easy transport, improve diagnostic performance, and be more widely used in practical clinical scenarios. Especially in critical illness diagnosis, low-field MRI is expected to become one of the important tools for the diagnosis and monitoring of cerebrovascular diseases. This paper reviewed the development of low-field MRI and its clinical application in neurological diseases, aiming to explore the future development direction of low-field MRI technology.

烟雾血管病是一类病因不明的颅内大动脉闭塞性疾病，主要表现为颈内动脉系统慢性狭窄、闭塞和异常血管网的形成。临床和流行病学研究发现，烟雾血管病患者具有较高的免疫相关疾病患病率，提示免疫因素在烟雾血管病的发生、发展中扮演了重要角色。本文旨在对烟雾血管病与感染、血管炎及自身免疫性疾病等免疫相关疾病的相关性研究展开综述，探讨免疫相关疾病参与烟雾血管病发病的潜在机制。 Abstract: Moyamoya angiopathy (MMA) is an intracranial large artery occlusive disease of unknown etiology, characterized by chronic stenosis/occlusion of the internal carotid artery system and the formation of abnormal vascular networks. Clinical and epidemiological studies have demonstrated that patients with MMA have a higher prevalence of immune-related diseases, suggesting that immune factors play an important role in the occurrence and progression of MMA. This paper aims to review the correlation between MMA and immune-related diseases such as infections, vasculitis, and autoimmune diseases, and explore the potential mechanisms of immune-related diseases involved in the pathogenesis of MMA.

对于出血性脑血管病，目前临床上采用外科手术干预较多，但是患者在治疗后仍不可避免地出现不同程度的神经功能损伤。因此，寻求一种能够有效减轻患者继发性损伤的治疗手段至关重要。随着再生医学的发展，外泌体概念的引入为出血性脑血管病的诊疗提供了新的理念与方向。外泌体作为一种细胞外囊泡，能够携带细胞内物质，在细胞间发挥信息传递功能，更重要的是外泌体能自由穿过血脑屏障，在神经系统相关疾病中发挥调控作用。本综述主要介绍外泌体减轻出血性脑血管病后继发性损伤的4种病理生理机制——抑制炎症反应、减少细胞程序性死亡、保护血脑屏障以及减轻氧化应激损伤，并总结了其在临床诊断和治疗中的应用前景。 Abstract: At present, there are many surgical interventions in the clinical practice for hemorrhagic cerebrovascular diseases, but patients still have different degrees of neurological damage after treatment. Therefore, it is very important to find a way to reduce the secondary injury of patients effectively. With the development of regenerative medicine, the introduction of the concept of exosomes provided new ideas and directions for the diagnosis and treatment of hemorrhagic cerebrovascular diseases. As a kind of extracellular vesicle, exosomes can carry intracellular substances and play a role in information transmission among cells. More importantly, exosomes can freely cross the blood-brain barrier, thus playing a regulatory role in nervous system-related diseases. Therefore, this paper mainly reviewed four pathophysiological mechanisms of exosomes in alleviating secondary injury of hemorrhagic cerebrovascular diseases, including inhibiting inflammatory reaction, reducing programmed cell death, protecting the blood-brain barrier, and alleviating oxidative stress damage, and summarized their application prospects in clinical diagnosis and treatment.

随着人口老龄化，长期接受抗血小板治疗的患者在神经外科手术治疗人群中的比例不断增加。抗血小板药物导致的潜在血小板功能低下会影响术中止血效果，并增加术中大出血和术后出血并发症风险。因此，如何在术前快速准确地评估血小板功能，对于全面评估患者止血功能具有重要意义。本文通过总结相关文献，结合血小板功能检测在神经外科的使用现状，分析目前常用血小板功能检测方法的优缺点，介绍改善血小板功能的相关疗法，以期提高神经外科医师对血小板功能的认识。 Abstract: With the aging of the population, the proportion of patients receiving long-term antiplatelet therapy among those undergoing surgical treatment is increasing. Potential platelet hypofunction caused by antiplatelet drugs can affect intraoperative hemostasis and increase the risks of massive intraoperative hemorrhage and postoperative bleeding complications. Therefore, a quick and accurate assessment of platelet function before surgery is of great significance in comprehensively evaluating a patient’s hemostatic function. Based on the summary of relevant literature and the current status of the application of platelet function tests in neurosurgery, this paper analyzed the advantages and disadvantages of the currently commonly used platelet function tests, and introduced relevant therapies to improve platelet function, with the aim of improving the understanding of platelet function among neurosurgeons.

交叉性小脑神经机能联系不能（crossed cerebellar diaschisis，CCD）是指当一侧大脑半球发生病变时，病灶对侧小脑半球出现血流量减少、葡萄糖氧化代谢水平下降的功能障碍，严重时甚至可能出现交叉性小脑萎缩的现象。CCD在临床工作中易被忽略或误诊。本文报告1例因左侧幕上脑梗死出现CCD导致左侧肢体共济失调以及认知功能障碍加重的病例，通过文献综述，阐明CCD的发生机制、临床特点及影响因素，为临床提供借鉴。 Abstract: The crossed cerebellar diaschisis (CCD) is a condition characterised by reduced blood flow and decreased oxidative metabolism of glucose in the contralateral cerebellar hemisphere following a lesion in one cerebral hemisphere, potentially resulting in crossed cerebellar atrophy in severe cases. It is easy to be overlooked or misdiagnosed in clinical practice. This paper presents a case of ataxia on the left side and worsening cognitive dysfunction resulting from left supratentorial cerebral infarction-induced CCD. The pathogenesis, clinical characteristics, and influencing factors of CCD were elucidated through the literature review to provide references for clinical practice.

Deep brain stimulation (DBS) has been widely used for Parkinson's disease, essential tremor, dystonia, drug - resistant epilepsy and other diseases. The operation procedure of this surgical method is complicated, and it also has certain complications in clinical application, including surgical complications such as intracranial hemorrhage and infection, hardware complications such as lead fracture and displacement, and stimulation complications such as paresthesia and muscle spasm, in which lead fracture and erosion and infection of the skin behind the ear are common and troublesome complications. In clinical practice, we found that lead fracture and erosion and infection of the skin were mainly located behind the ear. Since 2012, Beijing Tiantan Hospital, Capital Medical University had applied the retroauricular bone grinding groove technology in DBS, which significantly reduced the incidence of lead fracture and erosion and infection of the skin. Therefore, the retroauricular bone grinding groove technology can effectively solve the above problems. This paper mainly introduces the retroauricular bone grinding groove technology and the clinical application attention matters, providing references for colleagues.

数字健康广义上是指发展和利用数字技术提高健康的知识和实践领域，包括智能设备、数字消费者、物联网等相关的健康服务等。近年来，数字健康技术在脑血管病领域发展迅速，在脑血管病的一级预防、二级预防及急性期和康复阶段的诊疗中均有应用。相关研究结果提示，开发良好的数字健康产品可预测脑血管病的发生风险，助力脑血管病急性期远程医疗，提高患者二级预防的依从性，辅助患者出院后的功能康复训练。数字健康可使更多临床数据得到即时共享，让患者得到更及时的救治，同时也在一定程度上降低医疗成本。本文讨论数字健康在脑血管病领域的应用现状，展望其未来的发展趋势。 Abstract: Digital health broadly refers to the development and use of digital technology to improve health knowledge and practice areas, including smart devices, digital consumers, the internet of things and other related health services. In recent years, digital health has developed rapidly in the field of cerebrovascular diseases. It has been applied in primary prevention and secondary prevention, as well as in the diagnosis and treatment of cerebrovascular diseases in the acute phase and rehabilitation. The related studies show that well-developed digital health products can predict the risk of cerebrovascular disease, help patients in the acute phase through telemedicine, enhance the compliance of patients with secondary prevention, and assist rehabilitation training after discharge. Digital health allows more clinical data to be shared instantly, patients to be treated more timely, and can reduce medical costs to some extent. This paper discussed the application of digital health in cerebrovascular disease and its possible development trend in the future.

心脑血管疾病是全球主要的致死和致残病因之一。尽管医疗技术不断进步，心脑血管疾病的诊治仍存在许多亟待解决的问题，人工智能与机器学习的出现为应对这些问题提供了新途径。美国心脏学会2024年发布的科学声明从影像分析、心电图判读、床旁监护、可穿戴设备、基因组学及电子健康记录等方面介绍了人工智能与机器学习在临床中的应用及面临的挑战。本文对该指南进行介绍，并分析人工智能与机器学习在脑血管病领域中应用的优势，为我国未来在这一领域的研究提供参考。 Abstract: Cardiovascular and cerebrovascular diseases are among the leading causes of death and disability worldwide. Despite continuous advancements in medical technology, the diagnosis and treatment of these diseases still face many unresolved challenges. The emergence of artificial intelligence and machine learning provides new approaches to addressing these issues. The American Heart Association’s 2024 scientific statement highlights the applications and challenges of artificial intelligence and machine learning in clinical scenarios, including imaging analysis, electrocardiogram interpretation, bedside monitoring, wearable devices, genomics, and electronic health records. This paper aims to introduce these aspects and analyze the advantages of artificial intelligence and machine learning in the field of cerebrovascular diseases, providing a reference for the future development of artificial intelligence and machine learning in this area in China.

代谢性脑血管病以代谢危险因素引起的脑血管损害为核心，其概念已被提出并处于早期探索阶段。代谢性脑血管病的防治重点在于控制代谢危险因素，目前临床用药策略仍是对各个代谢危险因素进行单独干预，因用药种类多和剂量大给患者带来很多困扰。因此，临床亟需一种具有多作用靶点、可协同作用的药物以减少代谢性脑血管病患者的用药负担并提高疗效。牛磺酸作为一种条件必需氨基酸，具有调节糖脂代谢、调节渗透压、稳定细胞膜、抗氧化、抗衰老等多种生物学作用，对代谢性脑血管病治疗具有潜在临床价值。本文聚焦牛磺酸多效性，探讨牛磺酸在代谢性脑血管病中的作用机制及其临床应用前景。 Abstract: The concept of cerebro-metabolic disease, which centers on cerebrovascular damage caused by metabolic risk factors, has been proposed and is in the early stages of exploration. The prevention and treatment of cerebro-metabolic disease focus on the control of metabolic risk factors. At present, the clinical drug strategy is still based on the individual intervention of each metabolic risk factor, which brings a lot of trouble to patients due to the variety of drugs used and the high dosage. Therefore, there is an urgent need for a synergistic drug with multiple targets to reduce the drug burden and improve the efficacy in patients with cerebro-metabolic disease. Taurine, as a conditionally essential amino acid, has a variety of biological effects such as regulation of glycolipid metabolism, osmotic pressure regulation, cell membrane stabilization, antioxidation, anti-aging, etc., which has potential clinical value for cerebro-metabolic disease treatment. This paper focused on the pleiotropy of taurine and discussed the mechanism of taurine in cerebro-metabolic disease and its clinical application prospects.

脑出血（intracerebral hemorrhage，ICH）的急性期治疗一直是备受关注的话题。2024年来自多个国家的ICH专家在Stroke杂志上发布了急性自发性ICH的早期综合管理方案——Code ICH。该专家共识围绕ICH的急性期脑损伤机制、早期一体化诊治方案及未来研究方向提出了详细的推荐意见。本文将对该专家共识进行解读。 Abstract: The acute treatment of intracerebral hemorrhage (ICH) has long been a focus of attention. In 2024, ICH experts from multiple countries have proposed the early comprehensive management plan for acute spontaneous ICH, termed Code ICH, which was published in Stroke. The expert consensus provided detailed recommendations on the brain injury mechanism of acute phase, early integrated diagnosis and treatment strategies, and future research directions for ICH. This paper will interpret and analyze the expert consensus.

Neurosurgical critical care is playing an increasingly pivotal role in the advancement of neurosurgery. It not only provides perioperative life support for neurosurgical patients but also addresses the treatment of severe cerebrovascular diseases and traumatic brain injury. Over the past two decades, major tertiary hospitals in China have established subspecialties dedicated to neurosurgical critical care. However, at the county level and other grassroots hospitals, the adoption of neurosurgical critical care concepts require further promotion. This paper reviews the development history of the neurosurgical critical care specialty and proposes measures to enhance the diagnostic and treatment capabilities of grassroots hospitals. These measures include standardizing core professional competencies, implementing high-quality multi - disciplinary team, and improving essential hardware configurations, with the goal of achieving standardized diagnosis and treatment in neurosurgical critical care.

临床预测模型可基于从群体获得的效应证据去预测个体的结局或风险，是链接循证医学和精准医学的强有力工具。随着数据测量、存储、互联互通及分析技术的不断进步，临床预测模型的应用前景将越来越明朗，但与此同时，也面临着诸多问题和挑战。本文对临床预测模型的基础概念、应用场景以及现在面临的困境和发展机遇做一个梳理。 Abstract: Clinical prediction models can predict individual outcomes or risks based on effect evidence obtained from the population, serving as a powerful tool linking evidence-based medicine and precision medicine. With the continuous advancement of data measurement, storage, interoperability, and analytical techniques, the application prospect for clinical prediction models is becoming increasingly clear. However, it also faces many problems and challenges. This paper aims to provide an overview of the fundamental concepts, application scenarios, current dilemmas, and development opportunities of clinical prediction models.

临床预测模型在医学领域的应用受到越来越多的关注和重视。合理且充足的样本量对预测模型研究的可行性和质量保障具有重要意义。基于此，本文总结了临床预测模型开发和验证中的样本量估算策略，提出了在样本量估算时需重点关注的问题，同时探讨了样本量不足的问题，以期能够帮助研究者合理地估算预测模型所需的样本量，从而提高临床预测模型研究的质量。 Abstract: The application of clinical prediction models in the medical field is receiving increasing attention. Reasonable and sufficient sample size is of great importance to the feasibility and quality assurance of prediction model research. Based on this, this paper summarized the strategies for sample size estimation in the development and validation of clinical prediction models, outlined the key issues that should be paid attention to in sample size estimation, and also discussed the problems related to insufficient sample size, to help researchers estimate the sample size reasonably and improve the quality of clinical prediction model research.

摘要： 临床预测模型在医学研究中的应用越来越广泛，欲达到良好的预测性能，选择正确的模型非常关键。对于预测模型类型的选择，预测结局的类型起着决定性作用。本文从数据类型的角度出发，将结局变量分为连续变量（正态分布、偏态分布）、分类变量（二分类、无序多分类、有序多分类）以及时间-事件变量（无竞争风险、有竞争风险），分别介绍不同类型结局变量的特点、对应的模型、建模案例以及SAS实现程序，以期为研究者构建预测模型提供参考。 Abstract: The application of clinical prediction models in medical research is becoming increasingly widespread. To achieve good predictive performance, selecting the correct model is crucial. Regarding the choice of prediction model, the type of prediction outcome plays a decisive role. This paper, from the perspective of data types, divided outcomes into continuous variables (normal distribution, skewed distribution), categorical variables (binary, nominal, ordinal), and time-to-event variables (with or without competing risks), introducing the characteristics of different types of outcomes, the model types, examples and SAS programs to serve as a reference for researchers to develop prediction models.

统计图表的呈现对临床预测模型研究质量的提升非常重要。本文将临床预测模型的统计图表归纳为描述基本信息、报告模型信息、评价模型表现以及展现应用模型4个方面，并配以统计图表模板进行简要概述。 Abstract: The presentation of statistical charts plays a crucial role in improving the quality of clinical prediction model research. This paper categorized statistical charts in clinical prediction models into four aspects: describing basic information, reporting model information, evaluating model performance, and demonstrating model application, accompanied by a brief overview of statistical chart templates.

摘要： 推进医保支付方式改革是医保高质量发展的需要，更是减轻人民群众就医负担、增进民生福祉的需要。近年来，我国多元复合式医保支付方式改革取得积极进展，同时也对医保基金管理和医疗机构管理提出了更高要求。在医疗健康大数据背景下，临床预测模型被成熟应用于药物试验等领域，在量化评估患者所患疾病风险程度、医疗资源消耗强度等方面展现出较好的能力。本文旨在借鉴医保风险调整机制和风险预测模型相关国际经验，研究临床预测模型应用于医保支付方式改革下疾病诊断相关分组和医保偿付风险调整的可行性，为进一步提高医疗机构服务质量，提升医保基金使用效能提供参考。 Abstract: Advancing the reform of medical insurance payment methods is not only a necessity for the high-quality development of medical insurance, but also a requirement for alleviating the burden of people’s medical expenses and enhancing their well-being. In recent years, China has made positive progress in the reform of diversified and composite medical insurance payment methods, which has also raised higher requirements for the management of medical insurance funds and medical institutions. Against the backdrop of health big data, clinical prediction models have been maturely applied in areas such as drug trials, demonstrating good capabilities in quantitatively assessing the risk level of patients’ diseases and the intensity of medical resource consumption. This paper aims to draw lessons from international experiences in medical insurance risk adjustment mechanisms and risk prediction models, explore the feasibility of applying clinical prediction models to diagnosis related groups and medical insurance reimbursement risk adjustment under the reform of medical insurance payment methods, and provide corresponding references for further improving the quality of medical institution services and enhancing the efficiency of medical insurance fund utilization.

摘要： 急性缺血性卒中大血管闭塞患者在有效时间内经机械取栓治疗可改善血流动力学状态及临床症状，但机械取栓常合并血管再闭塞，影响患者预后。血小板糖蛋白Ⅱb/Ⅲa（platelet glycoprotein Ⅱb/Ⅲa，GP Ⅱb/Ⅲa）受体拮抗剂通过抑制血小板聚集过程的最后共同通路防止血管再闭塞。目前，在缺血性卒中机械取栓治疗的围手术期，辅以GP Ⅱb/Ⅲa受体拮抗剂治疗对临床结局的影响尚存争议。本文对GP Ⅱb/Ⅲa受体拮抗剂替罗非班对急性缺血性卒中机械取栓后血管再闭塞的疗效及安全性进行综述，发现替罗非班联合机械取栓治疗急性缺血性卒中是安全的，但有效性尚需要规范的临床研究证据证实。 Abstract: In acute ischemic stroke patients with large vessel occlusion, mechanical thrombectomy can improve the hemodynamic status and clinical symptoms within the effective time, but mechanical thrombectomy is often associated with vascular re-occlusion, which affects the prognosis of patients. Platelet glycoprotein Ⅱb/Ⅲa (GP Ⅱb/Ⅲa) receptor antagonists prevent vascular re-occlusion by inhibiting the last common pathway of platelet aggregation. At present, the effects of GP Ⅱb/Ⅲa receptor antagonists on the clinical outcome during the perioperative period of mechanical thrombectomy in ischemic stroke remain controversial. This paper reviewd the efficacy and safety of tirofiban, a GP Ⅱb/Ⅲa receptor antagonist, in the treatment of vascular re-occlusion after mechanical thrombectomy in acute ischemic stroke. It was found that tirofiban combined with mechanical thrombectomy was safe for the treatment of acute ischemic stroke, but its therapeutic effectiveness still needs to be confirmed by standardized clinical research evidence.

摘要： 酒精使用所致障碍作为全球第五大风险因素，是卒中预防的重要内容。近年来大量流行病学和临床研究显示，酒精使用与卒中之间存在相关性，酒精可通过多种途径影响心脑血管健康，从而引发卒中甚至死亡。同时也有研究显示，酒精使用与卒中之间或许存在不同的关联性，轻度饮酒可能是心脑血管的保护因素，中重度饮酒可能会诱发、加重卒中。本文分析了卒中合并酒精使用所致障碍的流行现状，对酒精使用所致障碍影响卒中发病的可能机制进行综述，同时总结了酒精摄入监测生物标志物和酒精使用所致障碍的治疗方式，以期进一步探讨卒中与酒精使用所致障碍之间的相关性，为临床诊疗提供思路。 Abstract: Alcohol use disorder, as the fifth largest risk factor worldwide, is an important component of stroke prevention. In recent years, a large number of epidemiological and clinical studies have shown that there is a correlation between alcohol and stroke. Alcohol can affect cardiovascular and cerebrovascular health through various ways, resulting in stroke and even death. At the same time, some studies have shown that there may be different associations between alcohol and stroke, light drinking may be a cardiovascular and cerebrovascular protective factor, and moderate and heavy drinking may induce and aggravate stroke. This paper analyzed the current prevalence of stroke complicated with alcohol use disorder, reviewed the possible pathogenesis of alcohol use disorder affecting the incidence of stroke, and summarized alcohol intake monitoring biomarkers and treatments related to alcohol use disorder, in order to further explore the correlation between stroke and alcohol use disorder and provide ideas for clinical diagnosis and treatment.

摘要： 急性脑梗死是常见的缺血性脑血管病，与血小板活性密切相关。血小板活性在急性脑梗死发病、进展、治疗及预后等环节均存在重要影响。平均血小板体积（mean platelet volume，MPV）和血小板分布宽度（platelet distribution width，PDW）是反映血小板活性的两个重要指标，体积大的血小板因能分泌更多的促血栓因子、表达更多的P-选择素和血小板糖蛋白Ⅱb/Ⅲa受体而被认为拥有更高的活性；活化的血小板因伸出大小不一的伪足而使得PDW增大，因此高MPV值和高PDW值都是血小板活化的标志。本文对血小板活化对急性脑梗死的发生、发展及预后等方面的影响进行综述，以期为后续研究血小板活性和急性脑梗死的关系提供参考。 Abstract: Acute cerebral infarction is a common ischemic cerebrovascular disease and is closely related to platelet activity. Platelet activity has significant impact on occurrence, development, treatment and prognosis of acute cerebral infarction. Mean platelet volume (MPV)and platelet distribution width (PDW) are two important indicators that reflect platelet activity. Platelets with larger volume are considered to have higher activity for they can secrete more thrombosis factors and express more P-selections and platelet glycoprotein Ⅱb/Ⅲa receptors. Activated platelets increase PDW by protruding pseudopodia of varying sizes. Thus, both high MPV and PDW are the indications of platelet activation. This paper reviewed the effects of platelet activation on the occurrence, development and prognosis of acute cerebral infarction, in order to provide references for the subsequent study of the relationship between platelet activity and acute cerebral infarction.

摘要： 目的 了解首都医科大学附属北京天坛医院神经系统领域国家自然科学基金项目申请未获资助的原因并提出对策，为同行提供借鉴。 方法 采用内容分析法，对该医院2020—2023年申请国家自然科学基金神经系统领域未获资助的289项青年、面上项目的867人次同行评议意见进行归类整理分析。 结果 本文共分析了1219条未获资助原因，发现在未获资助的青年和面上项目中，存在问题提及率及比例排名前5位的依次为“研究方案不合理”（32.65%/85.12%）、“研究基础不足”（18.54%/54.33%）、“创新性不足”（15.67%/51.21%）、“立项依据不足”（8.37%/30.10%）、“科学及临床价值不足”（7.88%/28.72%），其中青年项目“创新性不足”（提及率：17.13% vs. 13.84%；比例：53.75% vs. 48.06%）、“细节问题”（提及率：6.50% vs. 3.87%；比例：23.13% vs. 15.50%）的提及率及比例略高于面上项目，“科学问题属性选择错误”的提及率（4.28% vs. 4.06%）、“关键科学问题凝练不足”的比例（24.38% vs. 23.26%）同样在青年项目中略高，但仅“细节问题”提及率在两类项目中的差异有统计学意义（χ2=4.322，P=0.038）。专家意见一致性分析显示，3位专家意见完全一致且排名前3位的反馈意见与上述结果中的前3位一致。 结论 该医院未中标项目存在问题主要集中在“研究方案不合理”“研究基础不足”“创新性不足”3个方面。建议该医院通过开展多维度的申报培训、精细化辅导等方式帮助申请人完善方案设计，通过设立孵育基金、加强在研课题过程管理等渠道强化研究基础，通过促进学科交叉融合拓展研究领域和思路、提升源头创新能力等措施提高申请书质量及申请中标率。 Abstract: Objective To analyze the peer review feedback of the non-funding of the National Natural Science Foundation of China (NSFC) in the field of nervous system at Beijing Tiantan Hospital, Capital Medical University, and put forward countermeasures to provide references for peers. Methods The content analysis method was employed to examine the peer review opinions of youth and general projects, which were not approved by NSFC in the field of nervous system from 2020 to 2023. A total of 867 expert opinions from 289 programs were categorized and analyzed. Results A total of 1219 reasons for not being funded were analyzed in this paper. It was found that among the youth and general projects, the five expert opinions with the highest mention rate and proportion were: “unreasonable research plans” (32.65%/85.12%), “insufficient research foundation” (18.54%/54.33%), “insufficient innovation” (15.67%/51.21%), “insufficient basis for project approval” (8.37%/30.10%) and “insufficient scientific and clinical value” (7.88%/28.72%). The mention rate and proportion of “insufficient innovation” (the mention rate: 17.13% vs. 13.84%; the proportion: 53.75% vs. 48.06%), “detailed problems” (the mention rate: 6.50% vs. 3.87%; the proportion: 23.13% vs. 15.50%) in youth projects were slightly higher than that in general projects. The mention rate of “the miss-selection of scientific problem” (4.28% vs. 4.06%) and the proportion of “insufficient summary of key scientific viewpoint” (24.38% vs. 23.26%) were also slightly higher in youth projects, but only the mention rate of “detailed problems” (χ2=4.322, P=0.038) was statistically significant between the two items. The expert consensus analysis showed that the top three feedback were consistent with the top three results above. Conclusions The problems in the peer review feedback of the hospital’s unfunded projects mainly focused on three aspects: “unreasonable research plans” “insufficient research foundation” and “insufficient innovation”. To improve the quality of the application forms and increase the rate of successful applications, many measures can be taken, including conducting multidimensional application training and detailed guidance to help applicants improve the scheme design; setting up incubation funds and strengthening the management of ongoing research projects, as well as other multi-channel supports to strengthen the research foundation; and promoting interdisciplinary integration to expand the research fields and ideas, and enhance the ability of source innovation.

Background Para-infectious encephalopathy is an acute inflammatory encephalopathy secondary to a systemic infectious disease, including acute necrotizing encephalopathy (ANE) and mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). This paper reports on 3 cases of SARS-CoV-2 related to para-infectious encephalopathy diagnosed and treated in The Ordos Central Hospital of Inner Mongolia Autonomous Region from December 2022 to February 2023, and reviews relevant literature to summarize the clinical characteristics of the disease. Methods and Results The 3 patients with SARS-CoV-2 related to para-infectious encephalopathy, including 2 cases of SARS-CoV-2 related to ANE and one case of SARS-CoV-2 related to MERS were reported. Three patients developed consciousness disorder 2-4 d after fever, and still had aphasia, mental abnormality, convulsions, etc.. SARS-CoV-2 throat swab was positive. Head MRI showed one abnormal signal of brain stem and bilateral thalamus, one abnormal signal of bilateral thalamus, and one abnormal pressure of corpus callosum. All received hormone shock therapy and (or) intravenous immunoglobulin. One died, and 2 cases were recovered. Conclusions SARS-CoV-2 related to para-infectious encephalopathy including SARS-CoV-2 related to ANE and MERS and other clinical subtypes, the former has rapid progress, severe disease, high disability rate and fatality rate and poor prognosis, while the latter has relatively mild symptoms and better prognosis.

脑小血管病（cerebral small vessel disease，CSVD）是一组临床、影像、病理综合征，主要累及颅内小血管，起病隐匿。CSVD与卒中、认知下降、情感障碍、步态异常及尿便失禁密切相关，给家庭和社会带来沉重的疾病负担和经济负担。但CSVD的致病机制仍不明确，临床诊断标准不统一，临床诊疗和试验研究面临重大挑战。本文旨在汇总当前CSVD的可能病因、发病机制和临床诊疗研究的进展及局限性，展望CSVD未来可能的临床研究方向。 Abstract: Cerebral small vessel disease (CSVD) is a group of clinical, imaging and pathological syndromes mainly involving intracranial small vessels. The onset of CSVD is occult. It is closely related to stroke, cognitive decline, affective disorders, gait abnormalities and urinary and fecal incontinence. It brings heavy disease burden and economic burden to the family and society. However, the true pathogenesis of CSVD is still unclear, and the clinical diagnostic criteria are not uniform, which makes clinical diagnosis and treatment and experimental research face major challenges. The purpose of this paper is to discuss the progress and limitations of the etiology, pathogenesis, clinical diagnosis and treatment of CSVD, and to look forward to the possible clinical research direction of CSVD in the future.

脑小血管病（cerebral small vessel disease，CSVD）是由各种病因影响脑内小血管所导致的一系列临床、影像、病理学综合征，其在国际上尚无统一诊断标准，症状轻微，故临床上主要根据神经影像学表现分为新近皮质下小梗死、假定血管源性腔隙、假定血管源性脑白质高信号、血管周围间隙、脑微出血、脑皮质表面铁沉积和脑萎缩。证据表明，CSVD可能与诸多神经心理学症状相关，然而，神经心理症状与CSVD发生和发展之间的关系目前尚不明确。本文对情感淡漠、疲劳、焦虑、抑郁和心理应激与CSVD影像学关系的研究进展进行了综述。 Abstract: Cerebral small vessel disease (CSVD) is a series of clinical, imaging and pathological syndrome caused by various causes affecting the small blood vessels in the brain. There is no unified diagnostic standard in the world for CSVD, and the symptoms are mild. Therefore, based on neuroimaging findings, it can be divided into recent small subcortical infarct, lacune of presumed vascular origin, white matter hyperintensity of presumed vascular origin, perivascular space, cerebral microbleed, cortical superficial siderosis, and brain atrophy. Evidence suggests that CSVD may be associated with a variety of neuropsychological manifestations. However, the relationship between neuropsychological symptoms and the occurrence and development of CSVD is not clear. In this paper, the research progress of the relationship between apathy, fatigue, anxiety, depression and psychological stress and the imaging of CSVD was reviewed.

目的 通过文献计量学的方法分析2013—2023年血管周围间隙的研究现状、热点及前沿领域。 方法 在Web of Science核心合集数据库中检索2013年1月1日—2023年6月19日血管周围间隙相关英文论著。使用CiteSpace V6.3.R1软件分析文献的发文国家、研究机构、作者的合作网络，参考文献、第一作者、期刊的共被引网络，关键词的共现网络，关键词及参考文献共被引的突现情况；使用VOSviewer 1.6.15软件对关键词进行聚类分析。 结果 共纳入1549篇文献。2013—2023年的年发文量整体呈增长趋势。美国的发文量最多，其次为中国。发文量位列前3的研究机构分别是哈佛大学、麻省总医院和爱丁堡大学。合作网络分析发现国家间合作相对紧密，国内研究机构与其他研究机构合作较少。爱丁堡大学的Wardlaw Joanna M发文量最多。关键词共现图谱显示前10个高频关键词分别为小血管病、扩大的血管周围间隙、MRI、脑、Virchow-Robin间隙、阿尔茨海默病、痴呆、风险、卒中和类淋巴系统。关键词聚类分析发现脑小血管病、痴呆、MRI 为当前研究热点，类淋巴系统为新兴的研究方向。关键词突现分析表明弥散成像从2021年至今备受关注。 结论 近10年血管周围间隙的研究热度逐年攀升。脑小血管病是主要的研究热点，类淋巴系统为新兴的研究方向，前沿领域为弥散张量成像等MRI技术。 Abstract: Objective To analyze the current research status, hotspots, and frontier fields of perivascular spaces from 2013 to 2023 based on bibliometric analysis. Methods The related English article of perivascular spaces was retrieved in the Web of Science Core Collection from January 1, 2013 to June 19, 2023. CiteSpace V6.3.R1 software was used to analyze the cooperation network among the publishing countries, institutions and authors; the co-citation network of reference, first author of reference and journals; the co-occurrence network of keywords, burst analysis of keywords and reference co-citation. VOSviewer 1.6.15 software was used for keywords cluster analysis. Results A total of 1549 papers were included. The annual publications from 2013 to 2023 showed an overall increasing trend. The United States ranked the first and China ranked the second. The top three prolific institutions were Harvard University, Massachusetts General Hospital and University of Edinburgh. Cooperative network analysis showed that the cooperation between countries was close and domestic institutions collaborated less with other institutions. Wardlaw Joanna M from University of Edinburgh ranked the first in publications. The top ten keywords in co-occurrence network were small vessel disease, enlarged perivascular spaces, MRI, brain, Virchow-Robin spaces, Alzheimer’s disease, dementia, risk, stroke and glymphatic system. Cluster analysis of keywords showed that cerebral small vessel disease, dementia and MRI were current hotspots, and glymphatic system was a new research direction. Burst analysis of keywords suggested diffusion imaging has got much attention since 2021. Conclusions The research on perivascular spaces has increased during the recent 10 years. Cerebral small vessel disease was the main hotspot and glymphatic system was a new direction. Diffusion tensor imaging was a frontier field.

伴皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy，CADASIL）是NOTCH3基因突变所致的遗传性脑小血管病，主要病变血管为颅内小动脉，累及大脑皮质和颅内大/中动脉的报道较罕见，目前缺乏特效治疗方法。本文报道1例大脑中动脉急性闭塞成功接受血管内治疗的CADASIL病例，并结合文献进行讨论，旨在引起临床医师对CADASIL可累及大脑皮质和颅内大/中动脉的重视。 Abstract: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral small vessel disease caused by mutations in the NOTCH3 gene. The main vascular pathological changes in CADASIL are intracranial small arteries, with rare reports of involvement in the cerebral cortex and intracranial large/middle arteries. There is currently a lack of specific treatment for CADASIL. This paper reported a case of CADASIL patient who successfully received endovascular treatment for acute occlusion of middle cerebral artery, and discussed the literature with the aim of raising clinical awareness of the potential involvement of CADASIL in the cerebral cortex and intracranial large/middle arteries.

目前，以缺血半暗带为靶点的再灌注治疗是急性缺血性卒中的首选治疗措施。缺血半暗带的神经影像学评估方法不断更新，为组织窗指导再灌注治疗提供了更多依据。本文对缺血半暗带理论50年来的重要进展进行梳理，重点综述了现有的缺血半暗带神经影像学评估方法（如目前被广泛使用的缺血低灌注-梗死核心或临床症状-梗死核心错配、新兴的多时相CTA及ASL等），并对目前市场上5款主流影像自动后处理软件进行对比，以期为临床再灌注诊疗工作提供参考。 Abstract: Currently, reperfusion therapy targeting the ischemic penumbra is the preferred treatment for acute ischemic stroke. The continuous advancements in neuroimaging techniques for the ischemic penumbra have provided more evidence for reperfusion therapy based on tissue window. This review summarized the significant progress of the ischemic penumbra over the past 50 years, focused on the current neuroimaging assessment methods of ischemic penumbra, including the widely used ischemic hypoperfusion-infarct core or clinical symptom-infarct core mismatch and emerging techniques such as multiphase CTA, ASL, etc. Additionally, this paper compared 5 mainstream automatic post-processing software of image in the market, aiming to provide reference for clinical reperfusion diagnosis and treatment.

成纤维细胞生长因子23（fibroblast growth factor 23，FGF23）-Klotho内分泌轴参与磷酸盐代谢，研究提示该内分泌轴与卒中的发病机制密切相关。FGF23、Klotho水平均与卒中的发病及预后有关。FGF23-Klotho内分泌轴参与调节血管壁炎症反应，并可能参与高血压、胰岛素抵抗、脂代谢及肥胖等卒中危险因素的病理过程。本文介绍FGF23-Klotho内分泌轴对卒中的影响及可能机制的相关研究进展，以期为临床治疗和预防卒中带来新的思路。 Abstract: Fibroblast growth factor 23 (FGF23) -Klotho endocrine axis is involved in phosphate metabolism, and is closely related to the pathogenesis of stroke. FGF23 and Klotho levels are associated with the incidence and prognosis of stroke. The FGF23-Klotho endocrine axis is involved in the regulation of vascular inflammation and may be involved in the pathological process of stroke risk factors such as hypertension, insulin resistance, lipid metabolism and obesity. In this paper, the influence and mechanism of FGF23-Klotho endocrine axis on stroke were reviewed in order to bring new ideas for clinical treatment and prevention of stroke.

Postural disorder is a common disabling movement complication of Parkinson's disease (PD), in which camptocormia is the most common disabling postural disorder, which further aggravates the movement disorder of PD, and seriously reduces the activities of daily living and quality of life of patients. This paper reviews the pathogenesis and treatment progress of PD with camptocormia, providing theoretical basis for further investigation of the pathogenesis of camptocormia in PD, and assisting the clinical diagnosis and treatment of the disease.

Gait disorder is one of common motor symptoms in patients with Parkinson's disease (PD), significantly affecting their quality of life and mobility. Robot ‑ assisted gait training (RAGT) can improve the motor symptoms of PD patients, particularly in terms of lower limb motor function. It corrects abnormal spatiotemporal parameters of gait, such as gait velocity, step length, and step frequency, reduces the occurrence of freezing of gait, improves endurance, enhances balance ability, and ultimately improves quality of life. This paper focuses on the classification and construction, clinical efficacy and mechanism of exoskeleton robot, which can be used to guide the rehabilitation treatment of PD.

视网膜中央动脉阻塞是血管神经眼科急症，表现为急性无痛性单眼视力丧失，是中老年致盲的主要病因之一。目前关于视网膜中央动脉阻塞的具体发病机制和病理生理机制尚不明确，选择合适的动物模型进行视网膜中央动脉阻塞发病机制的研究和治疗药物的筛选尤为重要。本文对视网膜中央动脉阻塞动物模型的造模方法和研究进展加以综述，以期为视网膜中央动脉阻塞的精准诊疗提供依据。 Abstract: Central retinal artery occlusion (CRAO) is a vascular neuro-ophthalmic emergency, characterized by acute painless monocular vision loss, which is one of the main causes of blindness in middle-aged and elderly people. Currently, the pathogenesis and pathophysiological mechanism of CRAO is unclear, making the selection of appropriate animal models particularly important for the research on CRAO pathogenesis and the screening of therapeutic drugs. This paper mainly reviews the modeling methods and research progress of CRAO animal models, aiming to provide a reference basis for accurate diagnosis and treatment of CRAO.

神经眼科急症是指如果不能及时诊断和治疗，就会严重威胁患者视力甚至危及生命的神经眼科临床疾病谱，其中血管性原因所致的神经眼科急症（血管神经眼科急症）占绝大部分。由于交叉学科的特点，血管神经眼科急症患者多首诊于眼科或急诊，首诊医师往往对疾病认识不全面，易导致该类患者诊断滞后、误诊或漏诊；当患者转诊于神经科时，神经科医师如果对疾病的诊断不能及时确定，易导致治疗延迟。本文对血管神经眼科急症疾病谱主要疾病的临床表现、检查方法和治疗方法等方面进行综述，以期为该类疾病的快速诊断和精准治疗提供依据。 Abstract: Neuro-ophthalmic emergency refers to the spectrum of neuro-ophthalmic clinical diseases that can seriously threaten patients’ vision or even endanger their lives if they are not diagnosed and treated in time, among which the neuro-ophthalmic emergency caused by vascular causes (vascular neuro-ophthalmic emergency) accounts for the vast majority. Due to the characteristics of interdisciplinary, patients with vascular neuro-ophthalmic emergency are often first referred to the department of ophthalmology or emergency, and the first doctors often have incomplete understanding of the disease, which is easy to lead to delayed diagnosis, misdiagnosis or missed diagnosis of such patients. When patients are referred to the department of neurology, if the neurologist’s diagnosis of the disease cannot be determined in time, it is easy to delay treatment. In this paper, the clinical manifestations, the examination methods and the treatment methods of the major diseases in the spectrum of vascular neuro-ophthalmic emergency were reviewed in order to provide the basis for the rapid diagnosis and accurate treatment of these diseases.

巨细胞动脉炎是一种系统性肉芽肿性血管炎，主要侵犯颞浅动脉和眼动脉。以新近出现头痛、视觉症状和下颌运动障碍三联征为典型表现。巨细胞动脉炎可对视功能造成严重损害，因此是神经眼科急症，激素冲击疗法为其主要治疗方法。本文介绍了1例罕见的表现为后部缺血性视神经病变的巨细胞动脉炎患者，对其临床表现、实验室检查、影像学检查等进行综合分析，提示对于严重视力下降伴有疼痛的老年患者，视神经无水肿、萎缩表现的，应考虑此诊断。 Abstract: Giant cell arteritis (GCA) is a systemic granulomatous vasculitis that mainly affects the superficial temporal artery and the ophthalmic artery. The typical manifestation is the triad of headache, visual symptom and mandibular movement disorder. It is a neuro-ophthalmic emergency since it can cause profound visual loss. Hormone pulse therapy is the mainstay of treatment. This paper presents a rare GCA patient manifests as posterior ischemic optic neuropathy, and makes a comprehensive analysis of its clinical manifestations, laboratory examination and imaging examination. This case suggests that the diagnosis of GCA should be taken into account for elderly patients with severe vision loss accompanied by headache and no edema or atrophy in the optic nerve.

脑梗死和急性心肌梗死均属于缺血性血管疾病，有共同的危险因素，两者可能同时或相继发病。延髓梗死诱发自主神经功能紊乱影响心脏神经，梗死后的应激反应也会导致心肌缺血梗死。本文报道1例双侧延髓内侧梗死合并急性心肌梗死患者的诊治过程，患者在疾病早期MRI检查未显影，数天后复查才呈现“心”形梗死灶，经过抗血小板聚集、调脂治疗仍有肢体偏瘫。本病例强调了脑梗死患者应进行详细的体格检查、辅助检查并全面评估心脏指标，防止误诊、漏诊。 Abstract: Cerebral infarction and acute myocardial infarction are both ischemic vascular diseases, with common risk factors, and may occur simultaneously or successively. Medullary infarction induces autonomic nervous dysfunction that affects cardiac nerves, and stress response after infarction can also lead to myocardial ischemic infarction. This paper reported the diagnosis and treatment process of a patient with bilateral medial medullary infarction complicated with acute myocardial infarction. The patient had no lesions on the MRI examination in the early stage of the disease, and the “heart” shaped infarct was found after several days of MRI reexamination. After antiplatelet aggregation and lipid-regulating treatment, there was still limb hemiplegia. This case emphasizes that patients with cerebral infarction should be given detailed physical examination, accessory examination and comprehensive evaluation of cardiac indicators to prevent misdiagnosis and missed diagnosis.

急性缺血性卒中治疗的关键在于快速恢复缺血脑组织血流，发病时间窗内可给予静脉溶栓，效果不佳则桥接血管内介入治疗。当使用常规支架取栓、抽吸取栓、球囊扩张等方法未能开通闭塞的血管时，支架置入是有效的补救方法。部分患者支架置入后可能出现血管再闭塞，如不能快速开通闭塞血管，可导致严重残疾或死亡。本文报道了1例股-颈动脉转流术补救性治疗急性颈动脉闭塞支架置入术后血管再闭塞患者的诊疗过程，为快速解决这种不常见却又非常棘手的临床情况提供思路，该术式是一种值得推广普及的手术方式。 Abstract: The key to the treatment of acute ischemic stroke is to quickly restore the blood flow of ischemic brain tissue, intravenous thrombolysis therapy can be given in the time window, and bridging endovascular interventional therapy if the effect is not good. Stent implantation is an effective remedy when conventional methods such as stent thrombectomy, aspiration thrombectomy and balloon dilatation fail to open the vessel. However, in some cases, vascular reocclusion may occur after stent implantation. If the occlusive vessel can not be revascularization quickly, the patient’s outcome can only be severe disability or death. This paper reports the diagnosis and treatment of a patient with vascular reocclusion after carotid artery stenting for acute carotid artery occlusion by femoral-carotid artery bypass. Femoral-carotid artery bypass is a new and effective surgical method, which can quickly solve this unusual but very difficult situation and is worth popularizing.

With the aggravation of population aging, the health of the elderly has become an important issue in the aging society. The Mediterranean diet (MD) contributes to healthy aging by changing dietary patterns to delay and prevent disease onset. This paper summarizes the concepts related to the MD pattern and its relationship with cardiovascular diseases, cognitive dysfunction, depression, chronic inflammation and other brain and heart comorbidity in the elderly, so as to provide thinking and reference for the optimization and upgrading of the elderly, and contribute to the development of healthy China.

The heart and brain are important organs of human body, which are closely related in genetic, structural and functional aspects. It is of great significance to elucidate the correlation between heart and brain and its mechanism for prevention and treatment of cardiovascular and cerebrovascular diseases. This paper reviews the genetic, structural and functional correlations between heart and brain, and discusses mechanisms of correlations from the perspective of common clinical heart diseases and brain diseases, so as to provide theoretical basis for the research and treatment of brain and heart comorbidity.