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ObjectiveTo compare the relationship between the dynamic changes of cerebral blood flow(CBF) before and after carotid artery stent （CAS） placement and perioperative events in patients with unilateral symptomatic carotid artery stenosis, providing reference for patients to choose surgical methods. Methods A total of 24 patients with moderate to severe （＞50%） symptomatic unilateral carotid artery stenosis admitted in Dongfang Hospital, Beijing University of Chinese Medicine from January 2018 to June 2020 were included, all of whom underwent CAS. All patients underwent magnetic resonance imaging （including DWI and 3D quasi continuous arterial spin labeled perfusion imaging） within 3 days before and 3 days after surgery. Changes in CBF and perioperative events were measured. According to whether there were new DWI high signals, they were divided into micro-embolic group and non-embolic group. ResultsWhile the incidence of new DWI lesions was high （17/24, 70.8%） and 176 lesions were observed among the 17 cases, there was only one subject showing the symptoms. The majority of the lesions were located at the cortex/subcortex of the ipsilateral frontal and parietal lobes （60.8%）, and 92.6% of the lesions size being less than 3mm. The CBF in the frontoparietal lobe were higher than that in the temporal lobe after surgery (lesion side 50.49±8.02vs47.94±9.08, t=2.179, P＜0.05; contralateral side 50.16±5.79 vs 48.00±5.98, t=3.835, P＜0.05); the CBF of the lesion side of the frontoparietal and temporal lobes increased significantly after surgery compared to before surgery （P＜0.05）. The preoperative relative CBF in the frontal parietal lobe of the micro-embolization group was lower than that of the non-embolization group （P＜0.05）. Conclusion The high incidence rate of micro-embolism in patients receiving CAS may not be the result of direct changes of hemodynamics in the brain but rather the loss of CBF regulation due to long-term hypoperfusion prior to the stenting.

Background and Purpose: Previous studies have shown that human herpes simplex virus (HSV) infection may be associated with the onset of headache or migraine. We aimed to investigate the association between HSV infection and severe headache or migraine., Materials and Methods: The cross-sectional data on 5,730 participants aged 20-49 years were obtained from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). We used weighted logistic regression analysis to assess the association between HSV infection (HSV-1 gG-1 and HSV-2 gG-2) and severe headache or migraine, and performed subgroup analyses., Results: Our study found that women, higher education, higher body mass index, better family conditions, smoking and alcohol consumption were all associated with severe headaches or migraines. After adjusting for confounding factors such as sex, age, race, and education, HSV-2 (+) was still significantly associated with severe headache or migraine (OR = 1.22, 95%CI:1.03-1.46, p  = 0.0443). In subgroup analyses, we found that participants with HSV-1 (-) and HSV-2 (+) were also significantly associated with severe headache or migraine (OR = 1.41, 95%CI:1.04-1.91, p  = 0.0281)., Conclusion: HSV-2 gG-2(+) was significantly associated with severe headache or migraine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zheng, Jiang, Li, Zeng, Yu, Duan, Wang and Liu.)

Xiaoyukang Jiaonang (XYK) is a Chinese patent medicine approved by the National Medical Product Administration which is used to treat intracranial hematoma in China. In this study, we observed the molecular mechanism of XYK in hypoxia-inducible factor 1 α (HIF-1 α ), inflammation and angiogenesis of chronic subdural hematoma (CSDH). The CSDH model was made by using internal iliac vein blood of Wister rats, and rats were divided into sham group, CSDH group and XYK group. The rats in the XYK group were gavaged with Xiaoyukang Jiaonang (185 mg/kg) for 7 days, and rats in the CSDH group and sham group were gavaged with the same amount of physiological saline for 7 days. In the CSHD rat model, active inflammation and angiogenesis were observed around the hematoma. XYK promoted the ubiquitination and degradation of HIF-1 α , and reduced the concentration of VEGF and the ratio of angiopoietin-1/angiopoietin-2. XYK reduced proinflammatory cytokines and increased anti-inflammatory cytokine. In tissue section, XYK reduced the size of the hematoma and membrane, and reduced vWF positive cells in membrane. Furthermore, the endothelial progenitor cells in blood decreased as well. Overall, XYK shows anti-inflammatory and antiangiogenesis effects which may relate to the degradation of HIF-1 α ., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Jialin Liu et al.)

Objective: To explore the law of clinical-diffusion mismatch (CDM) among patients with acute ischemic stroke (AIS) and analyze the relationships between CDM and short-term clinical outcomes., Methods: A prospective study was conducted for 56 patients with AIS admitted into our hospital within 72 hours from March 2011 to March 2012. And brain magnetic resonance imaging (MRI) examinations were completed within one week. All cases were diagnosed with infarction in the area of middle cerebral artery (MCA). The diffusion-weighted imaging (DWI) volume was calculated by semi-automatic method. Also the scores of National Institutes of Health stroke Scale (NIHSS) and modified Rankin Scale (mRS) were scored at baseline, days 7, 15, 30 post-admission respectively. The non-parametric variables were analyzed by Spearman's rank correlation. And the differences for non-parametric variables between CDM and non-CDM groups were analyzed by Mann-Whitney rank-sum test., Results: A total of 16/56(28.6%) patients showed CDM. The CDM ratios of the patients undergoing MRI within 72 hours after onset and those beyond 72 hours after onset were 36.3% and 17.4% respectively. Also 50.0% of those with CDM had favorite neurological outcomes. While for the other group without CDM, only 6.7% did so. The differences were significant (P = 0.001). The correlations for all AIS patients between NIHSS scores and DWI volume were strong (rs = 0.721, P = 0.009). Specifically, the correlations for without CDM group (rs = 0.847, P = 0.000) were stronger than those of with CDM group (rs = 0.610, P = 0.012). No significant inter-group differences existed in favorite clinical outcome, mortality case or neurological deterioration., Conclusion: CDM still occurs within 1 week after onset among patients with AIS. Although no significant differences exist in favorite clinical outcome between patients with CDM and without CDM, the CDM group may improve more in NIHSS scores and have better neurological outcomes.