The incidence of psychiatric dizziness is high. If clinicians do not have enough knowledge about it, they are prone to misdiagnose psychiatric dizziness as posterior circulation ischemic attack, cervical dizziness, vestibular peripheral vertigo or other diseases, thus leading to inappropriate examinations and treatments. With the increasing emphasis on psychosomatic diseases, the Holistic Health Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association formulated the Chinese Expert Consensus on Diagnosis and Treatment of Psychiatric Dizziness in combination with the latest evidence in relevant fields at home and abroad, as well as the opinions of experts in psychosomatic health, mental disorders, vertigo and other fields. This consensus elaborated the concept, etiology and pathogenesis, clinical characteristics, diagnosis and evaluation, and various treatment approaches of psychiatric dizziness, and formulated the final expert consensus after multidisciplinary expert communication, aiming to provide a reference basis for standardized diagnosis and treatment of psychiatric dizziness.

Stroke is an acute cerebrovascular disease in which blood fails to flow into the brain, resulting in damage to brain tissue, with high rates of disability, death, and recurrence, and most of the related studies in Ningxia region are clinical analyses of strokes, which lack trend analysis of stroke hospitalization in Ningxia in recent years.

To analyze the disease prevalence characteristics and distribution of stroke hospitalized patients in Ningxia, and provide a basis for the development of comprehensive prevention and treatment measures for stroke.

The case home page data of 55 hospitals of traditional Chinese medicine (TCM) and western medicine in Ningxia region were collected, and the data discharged from 2013 to 2019 with a primary diagnosis of stroke [International Classification of Diseases (ICD) -10 coded as I60-I63] were screened and analyzed. SPSS 24.0 software was applied to analyze the differences in gender and age using the chi-square test, and a geographic information system (GIS) was applied to analyze the distribution of stroke hospitalization rate data across Ningxia from 2013 to 2019 using global spatial auto correlation analysis.

A total of 190 634 stroke patients were finally included. The hospitalization rate of stroke in Ningxia region showed an increasing trend year by year from 2013 to 2019 (hospitalization rates of 24.302/10 000, 30.045/10 000, 34.949/10 000, 39.397/10 000, 44.049/10 000, 47.617/10 000, and 52.944/10 000, respectively, χ²_trend=5.982, P=0.014) , and the hospitalization rates were higher during the cold season of each year, with a significant peak in March and a slight decline thereafter. Among the stroke inpatients in Ningxia from 2013 to 2019, there were 167 194 cases of ischemic stroke and 23 440 cases of hemorrhagic stroke; there was significant difference between ischemic stroke and hemorrhagic stroke patients in gender and age (χ²=473.533, 7 518.543, P<0.05) ; and the proportion of male, ≥60 years old hospitalized patients in ischemic stroke and hemorrhagic stroke exceeded 50% from the data. The results of global auto correlation analysis showed spatial aggregation of stroke hospitalization rates in 2013, 2018 and 2019 (P<0.05) . The spatial distribution map showed that the hospitalized stroke patients in Ningxia were mainly concentrated in north-central Ningxia.

From 2013 to 2019, the hospitalization rate of stroke patients in Ningxia showed increasing and varying degrees of aggregation, and the areas with higher hospitalization rates were concentrated in north-central Ningxia.

Middle-aged and elderly ischemic stroke patients suffer from multiple co-morbid chronic diseases, and this co-morbidity status has a great impact on the patients' healthy living standard. Currently, there are few studies on the current status of ischemic stroke co-morbidities and the analysis of co-morbidity patterns.

To understand the current status of ischemic stroke co-morbidities in middle-aged and elderly people in Henan Province, and explore the association between ischemic stroke co-morbidities, so as to provide a reference basis for the management of ischemic stroke co-morbidities, as well as the preventive and control measures.

Ischemic stroke patients over 45 years of age attending Henan Provincial People's Hospital from January 2021 to December 2022 were selected for the study, with their chronic disease prevalence counted, the status of ischemic stroke co-morbidities was compared by different demographic characteristics, and the co-morbidity patterns of ischemic stroke in the middle-aged and elderly population were investigated using cluster analysis.

A total of 1 685 middle-aged and elderly ischemic stroke patients were enrolled in this study, of whom 90.0% (1 516/1 685) had at least 1 co-morbid chronic disease; 13.6% (230/1 685) had 2 co-morbid chronic diseases, 26.9% (454/1 685) had 3 co-morbid chronic diseases, and 49.4% (832/1 685) had 4 or more co-morbid chronic diseases. The chronic diseases with high prevalence were hypertension in 1 047 cases (62.1%) and dyslipidemia in 755 cases (44.8%). Among ischemic stroke patients, the prevalence of co-morbidities was higher in females compared with males (χ²=14.516, P<0.05) ; the prevalence of co-morbidities tended to increase with age (χ²_trend=148.889, P<0.001) ; and the prevalence of co-morbidities tended to decrease with higher education (χ²_trend=30.890, P<0.001). Cluster analysis showed four patterns of co-morbidity, which were cardiovascular-metabolic patterns (hypertension, dyslipidemia, heart attack, and diabetes mellitus), patterns characterized by hepato-pulmonary-gastrointestinal-urinary disorders (chronic lung disease, renal disease, hepatic disease, gastrointestinal disorders, and urinary disorders), psychiatric-degenerative patterns (neurological or psychiatric problems, arthritis or rheumatism, disorders related to memory), and cancer.

The prevalence of co-morbidities of ischemic stroke in middle-aged and elderly people in Henan province is high, and their co-morbidity patterns include cardiovascular-metabolic patterns, patterns characterized by hepato-pulmonary-gastrointestinal-urinary disorders, psychiatric-degenerative patterns, and cancers, among which cardiovascular-metabolic patterns are more associated with ischemic stroke, and the screening and prevention of which should be better controlled.

Stroke is one of the major public health problems affecting human health in current. Longitudinal check up data has accumulated a large amount of health information. However, the utilization rate of the longitudinal check up data is low and important information has not been fully extracted due to many problems such as missing data and small sample size, which brings difficulties to the effective prevention and control of common chronic diseases.

To explore the risk factors of stroke in check-up population based on Bayesian multivariate joint model, so as to provide a new approach for the analysis of risk factors for chronic diseases.

In this study, the data were collected from the Center for Health and Medicine, Xijing Hospital, Air Force Military Medical University from 2008 to 2015. Follow-up status: the follow up was conducted with the first occurrence of stroke as the outcome event and stopped at the occurrence of outcome event or ended when the collection of medical examination information was completed by 2015 if the outcome event did not occur. The interval between physical examinations was 1 year. The participants were divided into the stroke group and the non-stroke group according to whether stroke occurred during follow-up. Longitudinal variables observed in this study included total cholesterol (TC) , triglyceride (TG) , low density lipoprotein cholesterol (LDL-C) , high density lipoprotein cholesterol (HDL-C) , body mass index (BMI) and systolic blood pressure (SBP) . Multivariate Cox regression model was used to analyze the influence of baseline conditions on stroke outcome events. Bayesian multivariate joint model was used for analyzing the effect of longitudinal trajectory of TC, TG, LDL-C, HDL-C, BMI and SBP on the incidence of stroke during follow-up.

A total of 234 subjects with 1 581 longitudinal follow-up records were included in this study, with the mean follow-up time of (7.4±1.2) years, of which 70 cases (29.9%) developed stroke during the follow-up. The results of multivariate Cox proportional hazards model showed that there was no effect of baseline values including TC, TG, LDL-C, HDL-C, BMI and SBP on the incidence of stroke (P>0.05) . The results of Bayesian multivariate joint model showed that the risk of stroke was 1.863 times higher for per longitudinal increase of 1 mmol/L TG level 〔95%CI (1.018, 3.294) , P=0.042〕 and 1.347 times higher for per longitudinal increase of 1 mmol/L LDL-C level〔95%CI (1.045, 1.863) , P=0.046〕.

The longitudinal increase of TG and LDL-C levels over time is a risk factor for stroke in check-up population. Bayesian multivariate joint model can be used to explore the risk factors of chronic diseases in check-up population.

In recent decades, ischemic stroke is increasingly prevalent, which has become the second leading cause of death and disability in the world. Insulin resistance and obesity are closely related to the development of ischemic stroke. At present, a number of studies have confirmed that obesity is associated with a variety of metabolic diseases and the role of insulin resistance played in the pathogenesis. But it is still unclear whether TyG, an indicator of insulin resistance, and TyG combined with obesity indicators can be used to predict ischemic stroke.

To assess the influencing factors of TyG, and its combination with different obesity indicators for new-onset ischemic stroke in a cohort of middle-aged and elderly people during a 10-year follow-up .

A prospective cohort design was used. The cohort included 9 406 middle-aged and elderly individuals who attended the 2011 Epidemiological Survey on Cancer Risk in Type 2 Diabetics conducted in six communities in Luzhou (including Qiancao, Xiaoshi, Longmatan, Baolaiqiao, Dashanping and Yutang) . Baseline data were collected, including TyG and its combination with different obesity indicators〔TyG-waist circumference (WC) , TyG-waist-to-height-ratio (WHtR) , TyG-body mass index (BMI) , and TyG-waist-to-hip-ratio (WHR) 〕. A 5-year follow-up initiated since June to November 2016, and a 10-year follow-up initiated since April to June 2021 were conducted, with new-onset ischemic stroke incidence (obtained through Luzhou Health Commission and Luzhou Center for Disease Control & Prevention) as an endpoint. For assessing the predictive value of baseline TyG, TyG-WC, TyG-WHtR, TyG-BMI, and TyG-WHR for new-onset ischemic stroke, patients were divided into quartiles of TyG〔Q1 (n=2 351) , Q2 (n=2 351) , Q3 (n=2 352) , Q4 (n=2 352) 〕, quartiles of TyG-WC〔Q1 (n=2 351) , Q2 (n=2 352) , Q3 (n=2 352) , Q4 (n=2 351) 〕, quartiles of TyG-WHtR〔Q1 (n=2 349) , Q2 (n=2 349) , Q3 (n=2 348) , Q4 (n=2 348) 〕, and quartiles of TyG-BMI〔Q1 (n=2 351) , Q2 (n=2 352) , Q3 (n=2 352) , Q4 (n=2 351) 〕, quartiles of TyG-WHR〔Q1 (n=2 343) , Q2 (n=2 343) , Q3 (n=2 342) , Q4 (n=2 342) 〕, respectively. Multivariate Logistic regression analysis was used to explore the relationship between TyG, TYG-WC, TYG-WTHR, TYG-BMI, TYG-WHR and new ischemic stroke in the elderly.

During the follow-up period, 527 (5.6%) of the 9 406 middle-aged and elderly people had new-onset ischemic stroke. After adjusting for multiple confounding variables, multivariate Logistic regression analysis showed that the risk of new ischemic stroke in the fourth quartile group of TyG was 1.569 times higher than that in the first quartile group of TyG〔OR=1.569, 95%CI (1.007, 2.437) , P=0.046〕. The risk of new ischemic stroke increased by a factor of 1.467, 2.012, and 2.132 in the second, third and fourth quartile groups of TyG-WC〔 OR=1.467, 95%CI (1.010, 2.131) , P=0.044; OR=2.012, 95%CI (1.270, 3.187) , P=0.003; OR=2.132, 95%CI (1.119, 4.063) , P=0.021〕compared with that in the first quartile group of TyG-WC. The risk of new ischemic stroke increased by a factor of 1.481, 1.548, and 1.705 in the second, third and fourth quartile groups of TyG-BMI 〔OR=1.481, 95%CI (1.071, 2.048) , P=0.018; OR=1.548, 95%CI (1.066, 2.247) , P=0.022; OR=1.705, 95%CI (1.054, 2.759) , P=0.030〕compared with that in the first quartile group of TyG-BMI.

The risk of new-onset ischemic stroke in middle-aged and elderly type 2 diabetics in Luzhou increased with the elevation of TyG-WC and TyG-BMI, so TyG-WC and TyG-BMI may be predictors of new-onset ischemic stroke in this population.

Somatosensory and motor dysfunctions are common after stroke, both lead to limitations in activities of daily living and social participation, there is still a lack of research evidence to analyze the relationship between the two from multiple perspectives.

To investigate the relationship between somatosensory and motor function among overall, upper and lower extremities in different-age-group patients within one year after stroke.

This prospective study enrolled the poststroke patients within one year from several hospitals in Fujian Province from October 2022 to April 2023. The sensory subscale of the Fugl-Meyer assessment (FMA-S) and the sensory subitem of National Institute of Health Stroke Scale (NIHSS) were used to evaluate the patient's somatosensory function. The motor subscale of the Fugl-Meyer assessment (FMA-M), Brunnstrom assessment, Berg Balance Scale (BBS) and the motor subitem of NIHSS were used to evaluate the patient's motor function. Modified Barthel Index (MBI) was used to evaluate the patient's activities of daily living (ADL). Hospital Anxiety and Depression Scale (HADS) was used to evaluate the patient's psychosomatic function. They were divided into two groups (the elderly group/the young and middle-aged group) according to their age, we compared the differences in general information and rehabilitation assessments between the two groups. And we analyzed the correlation between somatosensory function and motor function/ADL/psycho-psychological function.

A total of 254 patients were included, with an average age of (61.0±12.3) years and an average disease course of 30.0 (17.0, 65.5) days. There were 112 cases (44.1%) in the elderly group and 142 cases (55.9%) in the young and middle-aged group. FMA-S and FMA-M scores were positively correlated in both groups (r_s values were 0.313 and 0.171, both P<0.05), NIHSS sensory items were all negatively correlated with FMA-M scores (r_s values were -0.199 and -0.177, both P<0.05). In the elderly group, FMA-S-UE related scores were positively correlated with FMA-M-UE, Brunnstrom-UE, and Brunnstrom-HAND scores; they were negatively correlated with NIHSS-UE score (all P<0.05). In the young and middle-aged group, FMA-S-UE total and light-touch scores were positively correlated with FMA-M-UE and Brunnstrom-HAND scores; FMA-S-UE proprioception score was positively correlated with FMA-M-UE, Brunnstrom-UE scores (all P<0.05). In the older group, FMA-S-LE related scores were positively correlated with FMA-M-LE, Brunnstrom-LE, and BBS scores; FMA-S-LE total and light touch scores were negatively correlated with NIHSS-LE scores (all P<0.01). In the young and middle-aged group, FMA-S-LE total and proprioception scores were positively correlated with FMA-M-LE, Brunnstrom-LE, and BBS scores; FMA-S-LE light touch score was positively correlated with Brunnstrom-LE and BBS scores; FMA-S-LE total and proprioception scores were each negatively correlated with NIHSS-LE score (all P<0.05). In the elderly group, FMA-S was positively correlated with MBI (r_s=0.270, P<0.05), FMA-S score was negatively correlated with HADS-A and HADS-D scores (r_s were respectively -0.300 and -0.374, P<0.01), NIHSS sensory item was positively correlated with HADS-D score (r_s=0.235, P<0.01) .

There is a positive correlation between somatosensory and motor function in different-age-group patients within one year after stroke, and age may affect the correlation between somatosensory function and motor function/ADL/psychosocial function.

Post-stroke cognitive impairment (PSCI) can significantly limit the recovery of stroke patients at all stages and lead to a decline in activity participation and quality of life.

Based on the concept of full-cycle rehabilitation in stroke, by investigating the incidence of PSCI, to analyzed the differences of PSCI in different age and disease period and its potential influencing factors.

Stroke patients were hospitalized in the rehabilitation departments of 27 hospitals in different regions of China from October 2022 to July 2023 using simple random sampling method for cross-sectional analysis. A total of 402 patients were finally included according to the study criteria, and categorized into the young and middle-aged group (18-64 years old, n=234) and the elderly group (≥65 years old, n=168) according to the criteria of the National Bureau of Statistics of China, and the patients were also categorized into the acute-phase group (1-7 d, n=25), subacute-phase group (8-180 d, n=338), and the chronic-phase group (>180 d, n=39) according to the International Stroke Rehabilitation Alliance. Baseline information on patients was collected through interviews, assessments, and an electronic case system. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and subscores and total scores were calculated for each cognitive domain. Using the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Hospital Anxiety Scale (HADS-A), and the Hospital Depression Scale (HADS-D) were used to assess the disease conditions and physical functioning of the patients. Spearman's rank correlation analysis was used to investigate the correlation between cognitive function levels and other clinical indicators at different ages and different stages of disease.

The prevalence of PSCI in stroke patients was 76.4% (307/402), including 81.0% (136/168) in elderly patients and 73.1% (171/234) in young and middle-aged patients; the prevalence of PSCI in stroke patients was 56.0% (14/25) in the acute phase, 78.4% (265/338) in the subacute phase, and 71.8% (28/39) in the chronic phase. The results of grouping by age and disease period showed that the elderly group had lower visuospatial and executive function, attention, numeracy, delayed recall scores and total MoCA scores than those in the young and middle-aged group (P<0.05). Patients in the subacute-phase group had lower visuospatial and executive function, language, delayed recall scores and total MoCA scores than those in the acute-phase group (P<0.05). Correlation analysis showed that the total MoCA score was positively correlated (P<0.001) with educational level (r_s=0.314), stroke type (r_s=0.114), FMA-UE (r_s=0.245), FMA-LE (r_s=0.242), BBS (r_s=0.265), MBI (r_s=0.293), and was negatively correlated (P<0.05) with gender (r_s=-0.107), age (r_s=-0.103), history of hypertension (r_s=-0.112), hemiplegic side (r_s=-0.139), disease duration (r_s=-0.135), NIHSS (r_s=-0.107), HADS-A (r_s=-0.239), HADS-D (r_s=-0.280). Further stratified analyses showed that the young and middle-aged and elderly groups were correlated with the total MoCA score in terms of the educational level, NIHSS and physical function indicators such as FMA-UE, FMA-LE, BBS, MBI, HADS-A, and HADS-D (P<0.05). In the acute-phase group, disease duration, FMA-UE, and HADS-A were related to total MoCA score (P<0.05). In the subacute-phase group, age, education level, hypertension, history of alcohol consumption, type of stroke, hemiplegic side, disease duration, NIHSS, and physical function indicators such as FMA-UE, FMA-LE, BBS, MBI, HADS-A, HADS-D were correlated with the total MoCA score (P<0.05), and only educational level, hypertension, and HADS-D were correlated with the total MoCA score in the chronic-phase group (P<0.05) .

PSCI is closely related to age, disease development period, education level, physical function, balance, activities of daily living, anxiety and depression levels in stroke patients, and individualised preventive strategies and interventions should be developed for patients based on different stratified cognitive potential influencing factors, as well as increased screening and attention to cognition in the early stages of the disease to the later stages of rehabilitation.

Wrist motor dysfunction is a common sequela at post-stroke, and the wrist has an important role in improving hand practicality. Therefore, improving the range of motion of the wrist can effectively promote the activities of daily life in post-stroke patients. Although repetitive peripheral magnetic stimulations (rPMS) have been shown to have a significant effect on improving the range of motion of the wrist, the therapeutic effect of different stimulation sites still needs to be further explored.

To investigate the effect of rPMS on wrist extensor muscle and radial nerve for the motor function of wrist of subacute stroke patients.

A total of 60 subacute stroke patients with wrist motor dysfunction admitted to Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study subjects. The included patients were randomly divided into control group (20 cases), muscle stimulation group (20 cases) and nerve stimulation group (20 cases) by simple randomized grouping method using a random number table. Patients in all the three groups received routine rehabilitation training, and those in the muscle stimulation group and nerve stimulation group were additionally managed by rPMS on the wrist extensor muscle and the radial nerve, respectively. Before and after the interventions for 10 times of rPMS, integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) on the surface of the wrist extensor muscle, the Fugl-Meyer Assessment for upper extremity (FMA-UE), the Action Research Arm Test (ARAT) and the modified Barthel Index (MBI) were measured to assess the upper limb function of the affected side.

During the intervention period, there were 2 cases of data loss due to voluntary withdrawal or forced termination of the trial, and finally 20 cases were included in the control group, 19 cases in the muscle stimulation group, and 19 cases in the nerve stimulation group. There were no significant differences in iEMG, RMS and MF of wrist extensor muscle among three groups before treatment (P>0.05). After treatment, iEMG, RMS and MF of wrist extensor muscle in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The iEMG, RMS and MF of wrist extensor muscle in nerve stimulation group were significantly higher than those of muscle stimulation group (P<0.05). The iEMG, RMS and MF of the wrist extensor muscle after treatment were higher than those before treatment in the three groups (P<0.05). There were no significant differences in FMA-UE, ARAT and MBI scores among the three groups before treatment (P>0.05). After treatment, FMA-UE, ARAT and MBI scores in muscle stimulation group and nerve stimulation group were significantly higher than those of control group (P<0.05). The scores of FMA-UE, ARAT and MBI in nerve stimulation group were significantly higher than those in muscle stimulation group (P<0.05). The scores of FMA-UE, ARAT and MBI in three groups were significantly higher after treatment than before treatment (P<0.05) .

rPMS on the wrist extensor muscle and the radial nerve can improve the wrist motor dysfunction after stroke, and the effect on the radial nerve is more significant than that on the wrist extensor muscle.

In the current rehabilitation environment, emotional issues and cognitive dysfunctions in stroke patients are often overshadowed by physical, speech, and swallowing difficulties, leading to their underestimation in clinical rehabilitation. This oversight can result in adverse outcomes, impacting the overall success of rehabilitation. Currently, clinical treatments primarily rely on pharmacotherapy to alleviate symptoms, which has limited effectiveness and can cause a range of adverse reactions.

To observe the efficacy of precision exercise prescriptions on anxiety, depression, and cognitive functions in stroke patients and to preliminarily analyze the underlying mechanisms of action.

A total of 84 stroke patients hospitalized in the Rehabilitation Department of Changzhou Dean Hospital from January 2022 to March 2023 were selected. They were randomly divided into a control group (42 patients) and an experimental group (42 patients). The control group received standard rehabilitation treatment, while the experimental group received precision exercise prescriptions based on cardiopulmonary exercise testing (CPET) results in addition to standard rehabilitation, over 12 weeks. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Mini-mental State Examination (MMSE) scores, and Homocysteine (Hcy) levels were compared before and after rehabilitation training in both groups. A Pearson correlation analysis was conducted between pre-rehabilitation Hcy levels and SAS, SDS, MMSE scores.

All 42 patients in the experimental group completed the CPET and the 12-week precision exercise prescription rehabilitation without any adverse events. Before rehabilitation training, there were no statistically significant differences in SAS, SDS, MMSE scores, and Hcy levels between the two groups (P>0.05). After rehabilitation training, the scores of SAS, SDS, and Hcy levels in the experimental group were significantly lower compared to pre-treatment values (P<0.05), and which were significantly lower than those of the control group (P<0.05). The MMSE score in experimental groups increased significantly after interventions compared to pre-treatment value (P<0.05), and it was significantly higher than that of the control group (P<0.05). There were no significant differences in SAS, SDS, MMSE scores, and Hcy levels before and after rehabilitation training in the control group (P>0.05). Pearson correlation analysis revealed a positive correlation between Hcy levels and SAS, SDS scores (r-values of 0.420 and 0.507, respectively, P<0.05) and no correlation with MMSE scores (r=0.079, P=0.473) .

Our findings suggest that precision exercise prescriptions significantly improve anxiety, depression, and cognitive functions in stroke patients, suggesting their potential as a novel therapeutic approach in clinical applications. Hcy may be one of the mechanisms through which precision exercise prescriptions improve anxiety and depression in stroke patients. Further research is needed to determine whether Hcy is related to the improvement of cognitive functions through this prescription.

With the accelerated aging process, the incidence of dementia is increasing year by year, but there is no effective cure and the prognosis is poor. The cognitive function is still plastic during subjective cognitive decline (SCD) , which as a preclinical stage of dementia, it is of great significance for the prevention and management of dementia to investigate the prevalence and influencing factors of SCD.

To investigate the prevalence and risk factors of SCD, MCI and dementia in population aged 60 and above in Baotou, Inner Mongolia.

From June 2021 to September 2022, a cross-sectional survey was conducted involving 1 120 objects in 21 neighborhood councils and 17 village committees randomly selected from 3 banner counties (Hondlon District, Jiuyuan District and Guyang County) of Baotou City, Inner Mongolia Autonomous Region by using the combination of multistage sampling, cluster sampling and random sampling. General information of the study subjects were collected by questionnaire and their cognitive function was assessed. According to cognitive function, the study subjects were divided into the normal group (n=206) , SCD group (n=491) , MCI group (n=320) and dementia group (n=103) . Multivariate Logistic regression was used to analyze the influencing factors of cognitive function.

The median age of the study subjects was 68.0 (63.0, 73.0) years and the median number of years of education was 9.0 (5.0, 11.4) years. Absence of spouse〔OR=2.542, 95%CI (1.139, 5.674) , P=0.023〕, obesity〔OR=6.058, 95%CI (2.281, 16.093) , P<0.001〕, predominant vegetarian type of diet〔OR=3.037, 95%CI (1.868, 4.936) , P<0.001〕, nightly sleep duration <6 hours〔OR=1.662, 95%CI (1.099, 2.516) , P=0.016〕, smoking history〔OR=1.971, 95%CI (1.231, 3.157) , P=0.005〕, diabetes history〔OR=1.975, 95%CI (1.140, 3.422) , P=0.015〕, coronary heart disease history〔OR=3.501, 95%CI (1.016, 12.062) , P=0.047〕, and vision loss history〔OR=2.454, 95%CI (1.638, 3.677) , P<0.001〕were risk factor for the prevalence of SCD in population aged 60 and above. Rural residence〔OR=2.636, 95%CI (1.231, 5.641) , P=0.013〕, absence of spouse〔OR=2.843, 95%CI (1.228, 6.582) , P=0.015〕, obesity〔OR=5.626, 95%CI (2.046, 15.475) , P=0.001〕, predominant vegetarian type of diet〔OR=3.832, 95%CI (2.212, 6.640) , P<0.001〕, predominant meat type of diet〔OR=2.619, 95%CI (1.536, 4.465) , P<0.001〕, smoking history〔OR=1.912, 95%CI (1.133, 3.227) , P=0.015〕, diabetes history〔OR=2.544, 95%CI (1.378, 4.697) , P=0.003〕, coronary heart disease history〔OR=3.945, 95%CI (1.110, 14.016) , P=0.034〕, and vision loss history〔OR=2.846, 95%CI (1.780, 4.551) , P<0.001〕were risk factors for the prevalence of MCI in population aged 60 and above, education level of junior high school〔OR=0.180, 95%CI (0.103, 0.314) , P<0.001〕, high school and above〔OR=0.075, 95%CI (0.041, 0.136) , P<0.001〕were protective factors for MCI in population aged 60 and above. Rural residence〔OR=5.511, 95%CI (2.306, 13.170) , P<0.001〕, absence of spouse〔OR=2.987, 95%CI (1.152, 7.746) , P=0.024〕, obesity〔OR=7.303, 95%CI (2.436, 21.890) , P<0.001〕, predominant vegetarian type of diet〔OR=7.025, 95%CI (3.626, 13.609) , P<0.001〕, predominant meat type of diet〔OR=2.255, 95%CI (1.102, 4.616) , P=0.026〕, nightly sleep duration<6 hours〔OR=2.164, 95%CI (1.206, 3.883) , P=0.010〕, smoking history〔OR=2.661, 95%CI (1.415, 5.004) , P=0.002〕, diabetes history〔OR=2.186, 95%CI (1.033, 4.624) , P=0.041〕, coronary heart disease history〔OR=6.830, 95%CI (1.809, 25.783) , P=0.005〕and vision loss history〔OR=3.267, 95%CI (1.785, 5.979) , P<0.001〕were risk factors for the prevalence of dementia in population aged 60 and above. Age 60-69 years〔OR=0.211, 95%CI (0.074, 0.597) , P=0.003〕, 70-79 years〔OR=0.218, 95%CI (0.077, 0.620) , P=0.004〕, education level of junior high school〔OR=0.473, 95%CI (0.229, 0.977) , P=0.043〕, high school and above〔OR=0.227, 95%CI (0.105, 0.493) , P<0.001〕were protective factors for the prevalence of dementia in population aged 60 and above.

The prevalence rates of SCD, MCI and dementia among the older adults aged 60 and above in Baotou region of Inner Mongolia is at a high national level. Rural residents, old age, absence spouse, low education level, obesity, predominant vegetarian or meat type of diet, sleep less than 6 hours per night, smoking, diabetes, coronary heart disease and vision loss are the main risk factors of the prevalence of SCD, MCI and dementia among the older adults in this region.

As one of the important evaluation indicators of rehabilitation effect in stroke survivors, social participation has gradually attracted attention. Understanding the cognition and experience of social participation in stroke survivors is beneficial in helping stroke survivors recover quickly, return to families and reintegrate into society. However, the results of single qualitative studies may not be generalisable and representative.

To systematically review the qualitative studies on cognition and experience of social participation in stroke survivors by meta-synthesis methods, so as to provide a reference for further improving the rehabilitation effect of stroke survivors.

PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, JBI evidence-based health care database, CNKI, Wanfang Data, VIP and CBM were searched by computers to screen qualitative studies on cognition and experience of social participation in stroke survivors from inception to November 2022. Pooled meta-integration method was used to perform the meta-synthesis of research themes, implications, classifications and so on.

A total of 14 papers were included, involving 183 stroke survivors, and 26 findings were derived from meta-synthesis, which were summarized into 8 new categories, and 3 integrated findings were finally synthesized, including cognition and experience of social participation in stroke survivors, multiple social participation were limited in stroke survivors by multiple factors, multiple support for social participation was essential in stroke survivors.

Stroke survivors have new insights into social participation, and it is necessary to correct and eliminate the self-identification disorder and limiting factors of social participation, and focus on multi-party support of social participation in stroke survivors.

Acute Myocardial Infarction (AMI) remains one of the leading threats to global public health. Despite available reperfusion therapies, major adverse cardiovascular and cerebral events (MACCEs) associated with AMI continue to be a leading cause of death worldwide. This is particularly true for patients with AMI and concomitant diabetes mellitus, where coronary artery disease is more complex and severe, making early detection and prognosis of long-term outcomes for these patients challenging. Therefore, the identification of simple and accessible laboratory markers could facilitate the prediction of post-percutaneous coronary intervention (PCI) MACCEs in patients with type 2 diabetes mellitus (T2DM) and AMI.

To investigate the predictive value of the serum C-reactive protein (CRP) /albumin (Alb) ratio (CAR) for long-term MACCEs following PCI in patients with T2DM and AMI.

A total of 1 683 patients with T2DM and AMI treated at the Department of Cardiovascular Medicine, General Hospital of Ningxia Medical University between 2014 and 2019 were enrolled. General clinical data and test results were collected for these patients. Follow-ups were conducted via telephone or outpatient visits, with a median follow-up period of 5.6 years. MACCEs were defined as all-cause mortality, non-fatal myocardial infarction, recurrent unstable angina, non-fatal stroke, new-onset heart failure, or rehospitalization for worsening heart failure, and revascularization. Patients were divided into the MACCEs group (508 cases) and the non-MACCEs group (1 175 cases) based on the occurrence of MACCEs during the follow-up period. Univariate and multivariate Logistic regression analyses were performed to identify factors influencing MACCEs in patients with T2DM and AMI. Kaplan-Meier survival curves were plotted, and the Log-rank test was used for comparisons. Receiver operating characteristic (ROC) curve analysis assessed the predictive efficacy of CAR for long-term MACCEs in patients with T2DM and AMI, while the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices evaluated the improvement in prognostic assessment provided by CAR.

Among the 1 683 patients, 508 (30.18%) experienced MACCEs. Multivariate Logistic regression analysis indicated that hypertension [OR (95%CI) =1.994 (1.142-3.483) ], length of coronary stent implanted [OR (95%CI) =1.031 (1.002-1.062) ], CRP [OR (95%CI) =0.950 (0.915-0.986) ], Alb [OR (95%CI) =0.933 (0.880-0.989) ], and CAR [OR (95%CI) =5.582 (1.705-18.277) ] were significant predictors of post-PCI MACCEs in patients with T2DM and AMI (P<0.05). Based on the median CAR level (0.86), patients were divided into two groups: CAR<0.86 and CAR≥0.86. The log-rank test showed that the incidence of MACCEs was significantly higher in the CAR≥0.86 group compared to the CAR<0.86 group (52.68% vs. 22.92%; χ²=65.65, P<0.001). The ROC curve indicated that the area under the curve (AUC) for CAR in predicting MACCEs in patients with T2DM and AMI was 0.728 (95%CI=0.702-0.754), with an optimal cut-off value of 0.576, sensitivity of 0.617, and specificity of 0.747. Compared to baseline models, CAR significantly improved the prediction of adverse cardio-cerebral events (NRI=0.377, IDI=0.166, C-index =0.690; P<0.05) .

CAR is an effective predictive marker for the risk of long-term MACCEs in patients with T2DM and AMI following PCI.

Systemic inflammatory response index (SIRI) is an emerging biomarker associated with ischemic stroke (IS) , but its correlation with recurrent IS remains unclear.

To investigate the correlation between SIRI and one-year recurrence of IS.

Patients diagnosed with IS and hospitalized in the First Affiliated Hospital of Nanchang University, the Second Affiliated Hospital of Nanchang University, the Second Hospital of Nanchang, and the Third Hospital of Nanchang between March 2019 and March 2021 were enrolled into the cohort. All patients were followed up for one year. Relevant clinical information within 48 hours of admission was collected. The recurrence of IS was recorded during the 1-year follow-up. The correlation between SIRI and one-year recurrence of IS was examined using Cox regression model, restricted cubic splines (RCS) , and subgroup analysis.

A total of 1 023 eligible patients were enrolled in the cohort, including 107 (10.46%) experiencing a recurrence of IS during the one-year follow-up period. After adjusting for confounders, multivariable Cox regression analysis showed that an elevated SIRI was a risk factor for IS recurrence (HR=1.06, 95%CI=1.01-1.10, P<0.05) . Categorized into quartiles, patients in the highest quartile (fourth quartile, Q4 subgroup, n=256) of SIRI exhibited a significantly higher risk of IS recurrence compared to those in the lowest quartile (first quartile, Q1 subgroup, n=256) (HR=1.80, 95%CI=1.08-3.00, P<0.05) . RCS analysis demonstrated a J-shaped dose-response relationship between SIRI and the risk of IS recurrence (P_Nonlinear=0.025) . Subgroup analyses stratified by gender, age, history of stroke, and the National Institutes of Health Stroke Scale (NIHSS) score at admission were performed. A significant correlation was identified between SIRI and NIHSS score (P<0.001) . Specifically, for patients with an NIHSS score of 0-1 point, an elevated SIRI was significantly correlated with an increased risk of IS recurrence (HR=1.25, 95%CI=1.04-1.51, P=0.020) . For those with an NIHSS score of 5-15 points, an elevated SIRI was significantly correlated with a higher recurrence risk (HR=1.20, 95%CI=1.12-1.28, P<0.001) . It was indicated that a higher SIRI was significantly correlated with an increased risk of IS recurrence within these score ranges.

A higher SIRI is significantly correlated with an increased risk of IS recurrence. A J-shaped association is observed between SIRI and IS recurrence risk. Notably, in IS patients with NIHSS scores of 0-1 and 5-15, elevated SIRI is significantly correlated with an increased risk of recurrence.

Acute ischemic stroke (AIS) is characterized by high rates of disability, mortality, and recurrence, posing a significant burden on patients and society. In the era of big data, predictive models are increasingly used in patient diagnosis, treatment decisions, prognosis management, and healthcare resource allocation, highlighting their growing importance. Machine learning methods have become a crucial tool for predicting the prognosis of AIS patients and have been widely applied. This review explores recent advancements in the study of AIS prognosis prediction, focusing on machine learning methods. It discusses current issues and challenges faced by machine learning models, aiming to provide new insights and references for methods of early assessment and prediction of prognosis outcomes in AIS patients.

Patients with stroke often experience sleep disturbances and imbalances, which are easily overlooked in clinical treatment. Moreover, there is currently limited research on whether sleep status affects the prognosis of such diseases.

Exploration of factors influencing sleep state changes and prognosis in patients with acute posterior circulation ischemic stroke.

A total of 60 patients with acute posterior circulation ischemic stroke, admitted to Kailuan General Hospital Affiliated to North China University of Science and Technology, from December 2019 to December 2023, were selected as the case group. Based on the modified Rankin Scale (mRS) score at discharge, the case group was divided into a good prognosis subgroup (45 cases) and a poor prognosis subgroup (15 cases) . Additionally, 52 patients without cerebral vascular stenosis and acute ischemic stroke during the same period were selected as the control group. General and clinical data of the patients were collected to compare the circadian sleep-wake rhythms, daytime sleep-wake rhythms, nighttime sleep-wake rhythms, and the distribution of infarcted brain regions between the good prognosis subgroup and the poor prognosis subgroup. Multivariate Logistic regression analysis was used to identify the prognostic factors influencing the outcomes of patients with acute posterior circulation ischemic stroke.

The apnea-hypopnea index (AHI) in the case group was higher than in the control group (P<0.05) . The proportions of patients in the case group with reversed sleep cycles, increased daytime sleep, and difficulty falling asleep were higher than those in the control group, with statistically significant differences (P<0.05) . The case group showed higher total daytime sleep time, wake time after sleep onset, light sleep duration, deep sleep duration, NREM sleep duration, REM sleep duration, REM sleep proportion, and deep sleep proportion compared to the control group, whereas the proportions of NREM sleep and light sleep were lower, all with statistically significant differences (P<0.05) . The case group also exhibited longer total nighttime sleep time, light sleep duration, and NREM sleep duration than the control group, with statistically significant differences (P<0.05) . The proportion of pontine infarction in the poor prognosis subgroup was higher than in the good prognosis subgroup, with a statistically significant difference (P<0.05) . Multivariate Logistic regression analysis showed that daytime deep sleep duration (OR=1.203, 95%CI=1.032-1.401) and pontine infarction (OR=16.497, 95%CI=1.142-238.391) were influencing factors for the prognosis of acute posterior circulation ischemic stroke (P<0.05) .

Patients with acute posterior circulation ischemic stroke exhibit an increased AHI and present with sleep characteristics such as reversed sleep cycles, increased daytime sleep, and difficulty falling asleep at night. Additionally, daytime deep sleep duration and pontine infarction are factors that adversely affect the prognosis of these patients.

The incidence of acute ischemic stroke (AIS) remains high, and a timely restoration of cerebral blood flow is crucial for its prognosis. There are less therapeutic approaches to promote recovery of cerebral blood flow in AIS patients treated beyond a limited time window. The analysis of remote ischemic postconditioning (RIPostC) on the efficacy, complications and prognosis of AIS patients beyond the time window is of great significance.

To investigate the role of RIPostC on the prognosis of AIS beyond time window, thus providing a safe and effective cerebral blood flow restoration way for AIS beyond time window.

It was a randomized, parallel group, placebo-controlled trial involving AIS patients beyond time window (onset time > 6 h) of thrombolysis who were hospitalized in the Department of Neurology, Beijing Aerospace General Hospital from September 2, 2021 to August 31, 2022. They were randomly assigned into the control group and experimental group, and treated and followed up for 90 days. General treatment and conventional treatment of cerebrovascular disease were performed in both groups. RIPostC and simulated RIPostC were respectively given 28 times within 14 days in the experimental group and control group, respectively. Before the intervention, and 30 days and 90 days after the intervention, neurological function was assessed using the modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Cognitive function was assessed by the Mini-mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Daily living ability was assessed by the Instrumental Activity of Daily Living (IADL). Mental status was assessed by the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Cerebral blood flow velocity was assessed by the transcranial Doppler ultrasound (TCD). Inflammatory response was assessed by measuring interleukin 6 (IL-6) levels.

Ninety-nine out of 122 AIS patients finally completed the trial and follow-up, including 49 patients in the experimental group and 50 in the control group. There were no significant differences in gender, age, underlying diseases (hypertension, diabetes, coronary heart disease) and baseline NIHSS scores between the two groups (P>0.05). Repeated measures analysis of variance showed that there was an interaction between time and group on MMSE, MoCA, mRS, NIHSS, cerebral blood flow velocity, and IL-6 (P<0.05). Specifically, the main effects of time and group on MMSE, MoCA, NIHSS, cerebral blood flow velocity, and IL-6 were significant (P<0.05), and the main effects of time on mRS, SAS, SDS, and IADL were significant (P<0.05). The MMSE and MoCA scores and cerebral blood flow velocity on 30 days and 90 days after the intervention were significantly higher in the experimental group than those of the control group, while the mRS and NIHSS scores were significantly lower (P<0.05). The SDS and IADL scores on 30, 90 days after the intervention were significantly lower than those of control group (P<0.05). On 30 days after the intervention, AIS patients in the experimental group had significantly higher SAS score and lower IL-6 level than those of control group (P<0.05). Adverse events were reported in 23 AIS patients, including 17 in the experimental group and 6 in the control group. There was no significant difference in the incidence of skin petechiae, dizziness, palpitation, chest tightness between the two groups (P>0.05). The incidence of skin ecchymosis [4.00% (2/50) vs. 12.24% (6/49) ] and the overall incidence of adverse events [12.00% (6/50) vs. 34.69% (17/49) ] in the control group were significantly lower than those of the experimental group (P<0.05) .

RIPostC can reduce the inflammatory response in AIS patients, and protect neurological function, cognitive function, depression and intracranial blood flow velocity.

Multimorbidity accelerates cognitive decline and leads to an increased risk of cognitive impairment. However, existing studies have mainly explored the cognitive status of patients with a single or specific chronic disease, and the patient with multimorbidity remains to be urgently explored. The present study describes the epidemiological characteristics of cognitive impairment in multimorbidity, summarizes the influencing factors, organizes the association patterns between multimorbidity and cognitive impairment, elucidates the mechanisms underlying their occurrence, and finally proposes preventive and control strategies. The findings of this study are intended to serve as a valuable reference for future efforts in preventing and treating cognitive impairment in multimorbidity.

Stroke is featured by high mortality and recurrent rate worldwide. Serum uric acid (SUA) is the product of purine metabolism that has been identified as a risk factor for cardiovascular disease. The serum uric acid/serum creatinine ratio (SUA/Scr) is a renal function-normalized SUA. The role of SUA/Scr in acute cerebrovascular disease remains controversial.

To identify the correlation of SUA/Scr with the recurrence and mortality of cerebrovascular events in patients with acute cerebrovascular disease.

This was a prospective cohort study involving patients with the initial cerebrovascular event consecutively admitted in Tianjin Huanhu Hospital from September 2006 to September 2019. All patients were followed up in the outpatient clinic combined with telephone contact until September 2020. The primary outcome was all-cause mortality. The secondary outcomes were recurrent cerebrovascular events, recurrent cardiovascular events and other vascular events (e.g., arteriovenous thrombosis of lower extremities). Cox proportional hazard models were used to explore the correlation of SUA/Scr with the recurrence and mortality of cerebrovascular events in patients with acute cerebrovascular disease.

According to the quartiles of SUA/Scr levels, patients with acute cerebrovascular disease were divided into Q1 group (SUA/Scr≤3.16, n=3 520), Q2 group (3.16<SUA/Scr≤3.94, n=3 280), Q3 group (3.94<SUA/Scr≤4.92, n= 3 270) and Q4 group (SUA/Scr>4.92, n=3 243). At the end of the follow-up, 774 (5.8%) patients died, while 2 064 (15.5%) reported recurrences of cerebrovascular events. In Q1-Q4 groups, there were 302, 375, 408 and 337 male cases of recurrences of cerebrovascular events, and 99, 125, 169 and 249 female cases of recurrences of cerebrovascular events, respectively. There were 261, 314, 345 and 283 male cases of recurrences of cerebral infarction, and 90, 101, 142 and 205 female cases of recurrences of cerebral infarction in Q1-Q4 groups, respectively. There were 154, 191, 214 and 183 male cases of recurrences of large atherosclerotic cerebral infarction, and 58, 52, 45 and 31 female cases of recurrences of large atherosclerotic cerebral infarction in Q1-Q4 groups, respectively. All-cause mortality in men was 165, 128, 131 and 88 cases in Q1-Q4 groups, respectively, and 57, 63, 62 and 80 cases in women. The mortality of men due to cerebral infarction was 93, 72, 70, and 46 cases in Q1-Q4 groups, respectively, and 31, 33, 36, and 44 cases in women. The mortality of men due to large artery atherosclerotic cerebral infarction was 58, 52, 45, and 31 cases in Q1-Q4 groups, respectively, and 17, 18, 27 and 24 cases in women. After adjusting for multiple confounding factors, SUA/Scr in Q4 compared with Q1 was an influencing factor for the recurrence of acute cerebral infarction in men (HR=0.690, 95%CI=0.500-0.953, P=0.026). SUA/Scr in Q4 compared with Q1 was an influencing factor for the recurrence of large artery atherosclerotic cerebral infarction in the male cerebral infarction subgroup (HR=0.740, 95%CI=0.578-0.947, P=0.017). SUA/Scr in Q4 compared with Q1 was an influencing factor for all-cause mortality (HR=0.575, 95%CI=0.368-0.901, P=0.003) and death from cerebral infarction in men (HR=0.610, 95%CI=0.353-0.814, P=0.011). SUA/Scr in Q3 (HR=0.656, 95%CI=0.476-0.904, P=0.010) and Q4 (HR=0.582, 95%CI=0.409-0.829, P=0.001) compared with Q1 was an influencing factor for male death after discharge. SUA/Scr in Q4 compared with Q1 was an influencing factor for death due to large artery atherosclerotic cerebral infarction in the male cerebral infarction subgroup (HR=0.580, 95%CI=0.386-0.873, P=0.007) .

Within a certain range, the increased SUA/Scr ratio in the acute stage of cerebrovascular disease has a certain protective effect on the recurrence and death of cerebrovascular events in male patients. Low SUA/Scr ratio is associated with the increased risk of death and recurrence of male patients with large artery atherosclerotic cerebral infarction, but not correlated with small artery occlusion cerebral infarction and cardiogenic stroke. SUA/Scr is not correlated with cerebrovascular event recurrence or death in female patients.

The incidence of Parkinson's disease (PD) is increasing year by year, which has increased the disease burden of medical insurance, and the current chronic disease management model has not played a role in the community management of PD patients.

To explore the effect of PD management model led by a movement disorders specialist and centered on community doctors, in order to improve the comprehensive management ability of community doctors for PD patients and improve the quality of life of PD patients.

One hundred and two PD patients who were treated at the Neurology Department of the Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from January 2022 to May 2023 were selected as the research subjects and were divided into the control group and the active intervention group by random digit table method, with 51 cases in each group. The control group received conventional community management, while the active intervention group received proactive management by community doctors specializing in PD. The management content included drug adjustment, exercise rehabilitation, dietary nutrition, cognitive function and psychological function management. Evaluations were conducted for the patients within one week of their return to the community (before intervention) and six months later (after intervention). The evaluation included a single day equivalent dose of levodopa, UPDRS-Ⅲ, UPDRS-Ⅳ, Hoehn-Yahr (H-Y) staging, and 39-item Parkinson's Disease Quality of Life Questionnaire (PDQ-39) .

At 6 months, the levodopa equivalent dose in the active intervention group was higher than before management, and the UPDRS-Ⅲ score, other complication dimensions of UPDRS-Ⅳ, and PDQ-39 score were lower than before (P<0.05). The Spearman rank correlation analysis results showed that the difference in PDQ-39 scores between the active intervention group and the control group before and after management was positively correlated with their scores in mental health, humiliation, cognition, social support, communication, and physical discomfort (r_s values ranged from 0.651 to 0.893, P<0.05), positively correlated with the score of other complication dimensions of UPDRS-Ⅳ (r_s=0.338, P<0.05), but not correlated with the UPDRS-Ⅲ score (P>0.05). The results of the univariate Logistic regression analysis showed that the probability of PDQ-39 reduction in the active intervention group was 11.769 times that of the control group (95%CI=4.340-31.918, P<0.001) .

The PD management model led by movement disorder specialists and centered on community doctors can improve the quality of life of patients, which provides a reference for PD community management.

With the aging population in China, the incidence of vascular cognitive impairment (VCI) will increase year by year. Non-dementia vascular cognitive impairment (VCIND) is the most common form of VCI. At present, the research shows that glycolipid metabolic diseases will accelerate the process of VCI, and the treatment of VCI focuses on controlling risk factors, but there is a lack of relevant research on VCIND caused by glycolipid metabolic diseases.

To analyze the factors influencing the occurrence of VCIND with glycolipid metabolic disease, construct a regression model, and conduct risk prediction.

A total of 410 patients with glycolipid metabolic diseases who were hospitalized in the encephalopathy center of Guangdong Provincial Hospital of Traditional Chinese Medicine from March to December 2023 were selected. Patients were divided into a cognitive normal group (MMSE>26 points) and a VCIND group (MMSE≤26 points) according to the Mini-mental State Examination Scale (MMSE). Multivariate Logistic regression was used to evaluate the influencing factors of VCIND in middle-aged and elderly patients with glycolipid metabolic diseases, and the risk prediction model of VCIND in glycolipid metabolic diseases was constructed. The predictive value of the model was evaluated via the receiver's operating characteristic (ROC) curve, and the area under the ROC curve (AUC) was calculated.

Among the 410 patients, there were 209 cases in the cognitively normal group and 201 cases in VCIND. The results of multivariate Logistic regression analysis showed that low education level [below primary school (OR=25.989, 95%CI=5.656-119.427), primary school (OR=6.839, 95%CI=3.919-11.933) ], Fazekas grade (OR=1.700, 95%CI=1.124-2.570) were independent influencing factors for the occurrence of VCIND in patients with glycolipid metabolism (P<0.05). Based on the results of multivariate Logistic regression analysis, the prediction model was logit (P) =-1.608+ primary school×1.923+ below primary school×3.285+Fazekas grading×0.531. The AUC of this risk prediction regression model was 0.767 (95%CI=0.721-0.813, P<0.001). Hosmer-Lemeshow goodness-of-fit test showed that the model has a good fitting effect (χ²=13.404, P=0.099) .

Low literacy and Fazekas classification are independent influencing factors for the development of VCIND in a population of patients with glycolipid metabolism. Establishing a risk prediction regression model based on the above risk factors has a good predictive value and helps to identify the high-risk group of developing VCIND in patients with glycolipid metabolism disease at an early stage.

The incidence rate of stroke is high and the risk of recurrence is substantial. Most stroke patients need to transition to home after treatment, and the experience during this period is complex. Therefore, there is an urgent need to comprehensively understand experiences and feelings of patients during hospital to home transition through Meta-integration.

To systematically evaluate qualitative studies on stroke patients' hospital to home transition experiences.

A computerized search was undertaken for qualitative studies on the hospital to home transition experience of stroke patients in the PubMed, Web of Science, Scopus, Embase, CINAHL, PsycINFO, CNKI, and Wanfang Data from inception to July 11, 2023. The quality of the final included literature was evaluated using the Joanna Briggs Institute (JBI) Quality Evaluation Criteria for Qualitative Research (2016), Australia, and the results were combined using a pooled integration approach.

A total of 13 studies were included, and 46 findings were distilled and categorized into 7 categories, yielding three final integrative findings: dynamic changes in the physical and psychosocial dimensions have interactive effects; a strong need for holistic caregiving; and active coping with illness and gradual transition to a new life norm.

During the period of transition from hospital to home, stroke patients face complex physical and mental challenges as well as multi-level care needs. Healthcare providers should pay attention to the real experiences and unmet needs of stroke patients throughout the hospital to home transition, provide holistic and continuous care services, and facilitate the comprehensive physical, psychological and social transition for patients.

Post-stroke cognitive impairment (PSCI) brings a heavy burden to patients and their families. An early recognition and intervention can help delay the occurrence and development of PSCI. Therefore, the use of accurate neuropsychological assessment tools to screen for PSCI is essential for the management and treatment of PSCI.

To analyze the screening accuracy of assessment tools for PSCI by meta-analysis, thus providing references for an accurate screening of PSCI.

Diagnostic trials on screening tools of PSCI published from the establishment of the database to December 2022 were searched in CNKI, VIP, Wanfang Data, SinoMed, PubMed, Embase, Web of Science, Cochrane Library. Two researchers respectively screened literatures, extracted data, and assessed the risk of bias. Stata 17.0 software was used to analyze the data.

A total of 57 articles were included, involving 7 assessment tools [the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network 5-Minute Battery (NINDS-CSN 5-Minutes), the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Addenbrooke's Cognitive Examination-Revised (ACE-R), the Telephone Interview for Cognitive Status Modified (TICS-m) and the Montreal Cognitive Assessment 5-minute protocol (MoCA-5 min) ] to screen 12 113 patients. Meta-analysis results showed that the combined sensitivity and specificity of MoCA in screening PSCI were 0.84 (95%CI=0.80-0.87) and 0.74 (95%CI=0.67-0.80), respectively, with a combined area under the curve (AUC) of 0.87 (95%CI=0.84-0.90). The combined sensitivity and specificity of MMSE in screening PSCI were 0.73 (95%CI=0.67-0.79) and 0.76 (95%CI=0.69-0.82), respectively, with a combined AUC of 0.81 (95%CI=0.77-0.84). The combined sensitivity and specificity of IQCODE in screening PSCI were 0.73 (95%CI=0.48-0.89) and 0.95 (95%CI=0.75-0.99), respectively, with a combined AUC of 0.91 (95%CI=0.88-0.93). The combined sensitivity and specificity of the NINDS-CSN 5-min in screening PSCI were 0.83 (95%CI=0.78-0.87) and 0.69 (95%CI=0.60-0.76), respectively, with a combined AUC of 0.85 (95%CI=0.81-0.88). The combined sensitivity and specificity of the ACE-R in screening PSCI were 0.90 (95%CI=0.80-0.95) and 0.61 (95%CI=0.19-0.91), respectively, with a combined AUC of 0.90 (95%CI=0.87-0.92). The combined sensitivity and specificity of TICS-m in screening PSCI were 0.84 (95%CI=0.75-0.91) and 0.67 (95%CI=0.61-0.74), respectively, with a combined AUC of 0.66 (95%CI=0.60-0.71) .

The combined AUC of IQCODE and ACE-R is larger, and the former as a higher combined specificity and the latter has a higher combined sensitivity. Therefore, IQCODE and ACE-R are optimal assessment tools to accurately screen PSCI. Due to the limited number of literatures reporting the IQCODE and ACE-R in screening PSCI, our conclusions still need to be validated by multicenter and large-sample studies.

Previous studies have found that inter-arm blood pressure difference (IAD) and mild cognitive impairment (MCI) are both associated with cardiovascular risk factors, but it is unclear whether there is an association between IAD and MCI.

To explore the relationship between IAD and MCI in rural elderly persons and to provide a scientific basis for clarifying the mechanisms of cognitive decline in elderly persons.

From July to August 2019, the rural elderly residents aged 60 years and older were selected using the multi-stage cluster sampling method from 5 townships in 2 counties (districts) of Guizhou Province, and questionnaire surveys, general physical examinations, cognitive function assessments, and bilateral arm blood pressure measurements were carried out among them. Cognitive function was evaluated using the Mini-mental State Examination (MMSE) scale, and activities of daily living were assessed using the Activities of Daily Living Scale (ADL). Spearman rank correlation analysis and binary Logistic regression model were used to investigate the association between IAD and MCI in the elderly persons.

A total of 1 795 questionnaires were distributed, and data from 1 088 participants were finally included in the study after excluding subjects with incomplete information on the questionnaires, those who did not undergo blood pressure measurements, and those who did not undergo blood tests. Among the 1 088 rural elderly residents, 138 patients (12.68%) with MCI, 99 patients (9.10%) with systolic inter-arm blood pressure difference (sIAD) ≥10 mmHg, and 80 patients (7.35%) with diastolic inter-arm blood pressure difference (dIAD) ≥10 mmHg were detected. Individuals with IAD ≥10 mmHg had a higher prevalence of MCI and lower MMSE scores, orientation scores, language scores, and delayed recall scores compared to those with IAD <10 mmHg (P<0.05). The results of correlation analysis showed that the sIAD was significantly negatively associated with the total MMSE score (r_s=-0.094), orientation score (r_s= -0.082), verbal ability score (r_s=-0.065) and delayed recall score (r_s=-0.104) ; and the dIAD was significantly negatively associated with the total MMSE score (r_s=-0.080), orientation score (r_s=-0.094), and attentional calculation score (r_s= -0.063) (all P<0.05). Multivariate Logistic regression analysis showed that the risk of MCI increased by 8.80% for each 1 mmHg increase in sIAD (OR=1.088, 95%CI=1.046-1.131, P<0.001) ; sIAD≥10 mmHg (OR=2.169, 95%CI=1.262-3.728, P<0.05) and dIAD ≥10 mmHg (OR=1.926, 95%CI=1.047-3.542, P<0.05) were the influencing factors for the occurrence of MCI in the elderly.

The prevalence of MCI in rural elderly is 12.68%, and their elevated IAD is associated with an increased risk of MCI. And the risk of MCI is higher in elderly with IAD ≥10 mmHg than in those with IAD <10 mmHg.

The glial lymphatic system is a recently discovered anatomical structure in the field of neuroscience, with functions such as regulation of interstitial fluid movement, waste removal and potentially brain immunity, playing an important role in physiology and pathology of the central nervous system. With the development of imaging technology, more and more magnetic resonance imaging (MRI) techniques have been applied to the study of the glial lymphatic system of the human brain. Currently, the commonly used imaging techniques include dynamic contrast-enhanced MRI, diffusion tensor image analysis along the perivascular space, and novel multimodal ultra-fast magnetic resonance techniques, etc. This article summarizes and reviews the application of these techniques in the brain glymphatic system, in order to provide a reference for the imaging study of the glymphatic system.

Maintenance hemodialysis (MHD) patients have a high incidence of silent brain infarction (SBI) and are in the preclinical stage of symptomatic stroke and vascular dementia. Therefore, there is a great need to explore the risk of SBI in patients with MHD for early detection and reduction of poor prognosis.

To explore the risk factors for the occurrence of SBI in MHD patients, a predictive model was constructed and its performance was evaluated.

486 MHD patients from 4 centers (Nanchong Central Hospital Affiliated to North Sichuan Medical College, Guangyuan Central Hospital, Suining Central Hospital, and Pengan County People's Hospital) from January 2017 to October 2022 were included. Patients with MHD were divided into an SBI group (n=102) and a non-SBI group (n=384) using the presence or absence of SBI as the outcome event, and the baseline characteristics of the two study groups were compared. Patients were randomized in a 7∶3 ratio to the modeling set (n=340) and the validation set (n=146). The predictor variables were identified through LASSO regression and multifactorial Logistic regression analyses, and a risk prediction model for the occurrence of SBI in patients with MHD was constructed and presented as a nomographic chart. The predictive performance, accuracy, and clinical utility of the model were evaluated using area under the ROC curve, calibration curve, and decision curve analysis.

In the modeling set, 70 cases (20.6%) of MHD patients experienced SBI, while in the validation set, 32 cases (21.9%) of patients experienced SBI. The results of LASSO regression combined with multifactor logistic regression analysis showed that age (OR=1.027, 95%CI=1.005-1.050), history of alcohol consumption (OR=4.487, 95%CI=2.075-9.706), BMI (OR=1.082, 95%CI=1.011-1.156), insufficient sleep or excessive sleep (OR=6.286, 95%CI=3.560-11.282), history of chronic disease (chronic obstructive pulmonary disease, diabetes, chronic hepatitis B) (OR=1.873, 95%CI=1.067-3.347), serum lactate level (OR=1.452, 95%CI=1.152-1.897), urea reduction ratio (URR) (OR=0.922, 95%CI=0.875-0.970), and history of antiplatelet medication (OR=0.149, 95%CI=0.030-0.490) were independent influences on the occurrence of SBI in MHD patients (P<0.05). A predictive model incorporating the aforementioned 8 influencing factors was constructed, and a nomographic chart was developed. The area under the ROC curve of the predictive model in the modeling set and validation set were 0.816 (95%CI=0.759-0.873) and 0.808 (95%CI=0.723-0.893), respectively, and the calibration curves show good consistency. DCA curve suggested that this model could provide maximum clinical benefit to patients.

A prediction model for the risk of SBI in MHD patients based on age, history of alcohol consumption, BMI, insufficient sleep or excessive sleep, history of chronic disease (chronic obstructive pulmonary disease, diabetes, chronic hepatitis B), serum lactate level, URR, and history of antiplatelet medication demonstrated good predictive performance and clinical utility. It is expected to accurately and individually assess the risk of SBI in MHD patients and implement early interventions to reduce the incidence rate.

In recent years, physical impairment (PI) combined with cognitive impairment (CI) is a common comorbidity in the elderly. An early detection of PI combined with CI in the elderly and timely interventions may help to improve the quality of life of the elderly and reduce the burden on their families and society. However, relevant studies on the comorbidity of PI and CI in the elderly and its influencing factors have been rarely reported.

To observe the clinical characteristics of the comorbidity of PI and CI in the elderly and the influencing factors.

Elderly patients hospitalized in Peking University People's Hospital from September 2018 to November 2019 were selected. A total of eligible 244 subjects meeting the inclusion criteria were surveyed for the physical function and cognitive function using the Short Physical Performance Battery (SPPB) and the Mini-mental State Examination (MMSE), respectively. PI was diagnosed with lower than 10 points of the SPPB, and CI was diagnosed with lower than 27 points of the MMSE. Patients were divided into non-PI+non-CI, PI+non-CI, non-PI+CI, PI+CI. Social demographic, anthropometric, laboratory examination and other indicators of patients were collected, and Logistic regression analysis was used to explore the influencing factors for PI combined with CI in the elderly.

Among the 244 patients, there were 102 (41.80%), 64 (26.23%), 26 (10.66%) and 52 (21.31%) cases of non-PI+non-CI, PI+non-CI, non-PI+CI and PI+CI, respectively. Multivariate binary Logistic regression analysis showed that compared with non-PI+non-CI cases, age (P<0.001, OR=1.216, 95%CI=1.217-1.312) and grip strength (P<0.001, OR=0.875, 95%CI=0.813-0.941) were independent influencing factors for PI+CI cases. Compared with PI+non-CI cases, fatty liver disease (P=0.007, OR=0.200, 95%CI=0.062-0.646), hypertension (P=0.007, OR=3.596, 95%CI=1.414-9.143), and grip strength (P=0.038, OR=0.943, 95%CI=0.891-0.997) were independent influencing factors for PI+CI cases. Compared with non-PI+CI cases, age (P=0.008, OR=1.104, 95%CI=1.026-1.189) and grip strength (P=0.004, OR=0.889, 95%CI=0.821-0.963) were independent influencing factors for PI+CI cases.

Grip strength is the independent influencing factor for PI combined with CI in the elderly. Among the elderly patients without PI and CI, age and grip strength were the influencing factors of PI and CI. In elderly patients with PI and no CI, fatty liver, hypertension and grip strength were the influencing factors of PI and CI.

Serum remnant cholesterol (RC) is associated with the onset of ischemic stroke (IS). However, studies on the correlation between RC levels and recurrent IS are limited, and the predictive value of RC in recurrent IS has not been analyzed.

To investigate the correlation between serum RC and the recurrence of IS, and to evaluate the predictive value of RC levels in recurrent IS by detecting serum RC levels in patients with IS.

Patients diagnosed as IS and hospitalized in the First Affiliated Hospital of Nanchang University, the Second Affiliated Hospital of Nanchang University, the Second Hospital of Nanchang, and the Third Hospital of Nanchang from March 2019 to March 2021 were included in the study. Relevant clinical information within 48 hours of admission was collected. All patients were followed up for 12 months to record the cases of recurrent IS. Cox regression and Restricted Cubic Spline (RCS) were performed to identify the correlation between RC levels and recurrent IS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of RC levels in recurrent IS.

A total of 1 023 eligible patients were included in the study, and 107 (10.46%) of them experienced IS recurrence within 1 year. Multivariable Cox regression analysis showed that high RC was an independent risk factor for recurrent IS (HR=2.709, 95%CI=1.150-6.382; P<0.05). There was a nonlinear positive dose-response relationship between RC levels and the risk of recurrent IS (P-Nonlinear=0.019 3). The area under the curve (AUC) of RC in discriminating 1-year recurrence of IS was 0.687 (95%CI=0.631-0.743), with the optimal cutoff of 0.58 mmol/L. There was a significant difference in the AUC between the combination detection of RC and the Essen Stroke Risk Score (ESRS) versus ESRS alone in discriminating 1-year recurrence of IS (Z=2.356 2, P<0.05) .

High RC is an independent risk factor for recurrent IS, showing a predictive value in the recurrence of IS.

Stroke, as a major chronic non-communicable disease, seriously affects the health of the nation and imposes a heavy burden on patients, families and society. Alcohol consumption is common in China, and there is a close relationship between alcohol intake and stroke incidence, but the relationship between alcohol intake and stroke incidence is still controversial.

To investigate the relationship between alcohol intake and risk of stroke.

PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, Wanfang Data, and SinoMed were searched for prospective cohort studies on the relationship between alcohol intake and risk of stroke from inception to December 2023. Literature screening, data extraction, and literature quality evaluation were performed independently by 2 researchers. Stata/MP 17.0 was used for dose-response meta-analysis.

A total of 16 papers with 548 595 study subjects were included. Meta-analysis results showed that alcohol intake was associated with the risk of stroke (RR=1.17, 95%CI=1.10-1.26, P<0.05). The results of the subgroup analysis showed that the risk of stroke was increased by 10% for alcohol intake <20 g per day (RR=0.90, 95%CI=0.85-0.95, P<0.05) ; alcohol intake >40 g increased the risk of stroke by 35% (RR=1.35, 95%CI=1.23-1.49, P<0.05) ; alcohol intake increased the risk of hemorrhagic stroke by 49% (RR=1.49, 95%CI=1.14-1.95, P<0.05), alcohol intake ischemic stroke risk increased by 20% (RR=1.20, 95%CI=1.00-1.43, P<0.05) ; alcohol intake in Asian populations increased the risk of stroke incidence by 27% (RR=1.27, 95%CI=1.14-1.40, P<0.05) ; intake alcohol in men increased the risk of stroke by 19% (RR=1.19, 95%CI=1.09-1.29, P<0.05). Dose-response Meta-analysis showed a J-shaped nonlinear relationship between alcohol intake and risk of stroke (P=0.018), and the relative risk ratios of stroke for alcohol intake in drinkers compared with never-drinkers were 1 g/d: RR=0.97, 95%CI=0.96-0.98; 2 g/d: RR=0.96, 95%CI=0.94-0.97; 3 g/d: RR=0.95, 95%CI=0.93-0.97; 4 g/d: RR=0.94, 95%CI=0.91-0.96; 5 g/d: RR=0.91, 95%CI=0.88-0.94; 6 g/d: RR=0.90, 95%CI=0.86-0.93; 7 g/d: RR=0.88, 95%CI=0.84-0.92; 8 g/d: RR=0.88, 95%CI=0.83-0.92; 9 g/d: RR=0.88, 95%CI=0.83-0.92; 10 g/d: RR=0.88, 95%CI=0.83-0.93; 11 g/d: RR=0.88, 95%CI=0.83-0.93; 12 g/d: RR=0.90, 95%CI=0.85-0.95; 13 g/d: RR=0.91, 95%CI=0.85-0.95; 14 g/d: RR=0.92, 95%CI=0.86-0.95; 15 g/d: RR=0.93, 95%CI=0.86-0.96; 16 g/d : RR=0.95, 95%CI=0.88-0.96; 17 g/d: RR=0.96, 95%CI=0.88-0.97; 18 g/d: RR=0.98, 95%CI=0.89-0.97; 19 g/d: RR=0.98, 95%CI=0.89-0.98; 20 g/d: RR=0.99, 95%CI=0.90-0.99, and drinkers with an average alcohol intake of <20 g per day showed a reduced risk of stroke (P<0.001) .

There is a J-shaped nonlinear dose-response relationship between alcohol intake and the stroke risk, with moderate alcohol intake negatively associated with stroke risk. The risk of stroke is lowest with an average alcohol intake of 7-11 grams per day.

With the intensifying trend of population aging, cognitive impairment has become one of China's significant public health challenges. The impact of lifestyle on cognitive impairment warrants further exploration.

This study aims to ascertain the prevalence of cognitive impairment among the elderly in the Baoshan District of Shanghai and analyze how educational level, economic status, lifestyle, and comorbidities affect cognitive impairment, providing a scientific basis for early prevention and control.

From July 2020 to August 2020, a stratified random sampling method was employed to survey 374 residents aged 65 and older in the Dachang Community of Baoshan District, using the Montreal Cognitive Assessment Basic Scale (MoCA-B) for cognitive evaluation. Multivariate Logistic regression analysis was used to explore the factors influencing cognitive impairment among the elderly.

A total of 374 valid questionnaires were retrieved, with a response rate of 100.0%. The prevalence of cognitive impairment among the suburban elderly population over the age of 65 in Shanghai was 37.7% (141/374). The multivariate Logistic regression analysis indicated that socializing and chatting (OR=0.574, 95%CI=0.350-0.941) were protective factors against cognitive impairment (P<0.05), while aging (OR=1.568, 95%CI=1.207-2.307), living alone (OR=3.569, 95%CI=1.079-11.807), and daily sedentary time of ≥3 hours (OR=1.944, 95%CI=1.091-3.462) were risk factors (P<0.05) .

Over one-third of the elderly in the suburban areas of Shanghai suffer from cognitive impairment; advanced age, living alone, and prolonged daily sedentary behavior are significant risk factors that should be closely monitored.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis that is a rare complication of ovarian teratoma. The primary treatment is surgical resection of the tumor combined with immunotherapy, however, the pathogenesis of ovarian teratoma associated anti-NMDAR encephalitis is still unclear. In addition, the patients present with various clinical manifestations, with neurological manifestations predominating, which is easy to be misdiagnosed and overlooked, requiring joint diagnosis and treatment by gynecologists and neurologists. This article briefly describes the structure and function of NMDAR, reviews the previous research results on ovarian teratoma associated anti-NMDAR encephalitis, and summarizes the research progress on its pathogenesis, early diagnosis, differential diagnosis, treatment, prognosis and recurrence, aiming to provide theoretical basis and ideas for better diagnosis and treatment of ovarian teratoma associated anti-NMDAR encephalitis.

Ischemic stroke is the most common cerebrovascular accident and is increasingly becoming a serious global health problem. Mitochondrial quality control disorder is an important mechanism of neuronal death induced by cerebral ischemia, and the maintenance of mitochondrial function is essential for promoting neuronal survival and improving neurological function. Mitochondrial quality control mainly involves mitochondrial oxidative stress, mitochondrial dynamics, mitochondrial autophagy, mitochondrial biogenesis, etc., which is an important condition for stabilizing the normal structure of mitochondria and exerting the normal function of mitochondria. In recent years, Traditional Chinese Medicine (TCM) has significantly improved the clinical symptoms of patients with ischemic stroke by affecting the structure and function of mitochondria through multi-perspective, multi-pathway, multi-target regulation of mitochondrial quality control, which has received extensive attention from scholars. This article summarizes the experimental studies and clinical observations on the application of effective compound components of TCM and TCM compound to regulate mitochondrial quality control in the treatment of ischemic stroke in recent years, further explains the pathogenesis of ischemic stroke, clarifies the regulatory mechanism of TCM on mitochondrial quality control, and summarizes the scientific connotation and shortcomings of TCM in the treatment of ischemic stroke, in order to provide ideas and methods for further clinical application of TCM in the treatment of ischemic stroke.

Shoulder-hand syndrome is one of the major disabling factors for stroke patients, which seriously affects their physical and psychological health as well as their quality of life. Currently, there are many non-pharmacologic treatments used to treat post-stroke shoulder-hand syndrome, but there is still some confusion about which non-pharmacologic treatment modality is more effective in clinical practice.

To provide evidence-based support for clinical decision-making, this network meta-analysis evaluates the efficacy of seven non-pharmacological treatments in improving outcomes for post-stroke shoulder-hand syndrome, pain as measured by the Visual Analogue Scale (VAS), and scores on the simplified Fugl-Meyer Assessment (FMA) .

A computerized search of databases including CNKI, Wanfang Data, VIP, China Biomedical Literature Service System, PubMed, Embase, and Cochrane Library was conducted for randomized controlled trials on non-pharmacological treatments for post-stroke shoulder-hand syndrome up to June 2023. Two researchers independently screened the literature and extracted data, performing the network meta-analysis using RevMan 5.3 and Stata 15.0.

The analysis included 62 studies involving 5 090 patients, assessing interventions such as acupuncture, herbal fumigation, extracorporeal shockwave therapy, moxibustion, herbal hot compress, electrical stimulation, and herbal soak. Results showed that all seven non-pharmacological treatments were superior to the control group in improving overall effectiveness, and FMA scores (P<0.05). Except for moxibustion, the six non-pharmacological treatments were superior to the control group in improving VAS scores in patients with shoulder hand syndrome (P<0.05). In terms of improving overall effectiveness, the cumulative ranking probability area (SUCRA) scores for the treatments were: acupuncture (86.1%), herbal soak (77.1%), herbal fumigation (54.7%), extracorporeal shockwave (53.1%), hot compress (49.0%), electrical stimulation (48.4%), and moxibustion (31.1%), with conventional control treatment at (0.4%). For VAS score improvement, the SUCRA scores were: hot compress (81.3%), herbal soak (78.4%), acupuncture (76.7%), electrical stimulation (58.4%), herbal fumigation (52.7%), extracorporeal shockwave (32.9%), moxibustion (18.1%), and conventional control (1.5%). For FMA score improvement, the SUCRA scores were: herbal soak (90.6%), acupuncture (83.5%), herbal fumigation (59.9%), electrical stimulation (59.8%), extracorporeal shockwave (42.3%), moxibustion (39.7%), hot compress (24.1%), and conventional control (0.2%) .

Compared to conventional treatments, the use or combination of non-pharmacological treatments yields better therapeutic outcomes for treating post-stroke shoulder-hand syndrome. However, due to limitations in the original studies, these conclusions need to be substantiated by further clinical trials.

Cerebral infarction is a disorder of blood supply to the local brain tissue area caused by various causes. Tongnao Decoction is approved and used in Jiangsu Province Hospital of Chinese Medicine for the treatment of cerebral infarction. However, the specific mechanisms underlying its action remain unclear.

To explain the mechanism of Tongnao Decoction in the treatment of cerebral infarction through network pharmacology and clinical trails.

From January 2019 to June 2020, a total of 199 patients with cerebral infarction admitted to Jiangsu Province Hospital of Chinese Medicine were included in the clinical study. and divided into the control group (97 cases) and experimental group (102 cases) according to the method of random number table. Both groups received standardized treatment for stable cerebral infarction, and the experimental group was treated with Tongnao Decoction. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of functional impairment caused by stroke, and the modified Rankin Scale (mRS) was used to assess the recovery of neurological function for both groups before treatment and at 2 weeks of treatment. The chemical compounds of Tongnao Decoction were screened from TCMSP and literature, and those with bioavailability (OB) ≥30% and drug-like properties (DL) ≥0.18 requirements were selected to find the active ingredient of the prescription. OMIM and GeneCards databases were used to analyze the molecular targets of Tongnao Decoction for the treatment of cerebral infarction. After screening the common targets, Cytoscape software, String database were used to plot the network of compounds and target proteins, construct protein-protein interaction (PPI) network, gene ontology (GO) function, and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis, respectively. Molecular docking experiments were finally performed to identify the main active ingredients of Tongnao Decoction for the treatment of cerebral infarction.

After treatment, the scores of NIHSS and mRS in the experimental group were lower than those in the control group (P<0.05). Finally, 60 active ingredients of Tongnao Decoction were obtained, including 147 potential targets, 5 167 disease-related targets, and 121 intersection targets of drugs and diseases. The enrichment analysis of KEGG signaling pathway obtained prostate cancer, neuroactive ligand-receptor interaction, IL-17 signaling pathway, prolactin signaling pathway, PI3K-Akt signaling pathway, calcium signaling pathway, etc. Molecular docking showed that β-sitosterol, kastricol and carotene, the main active ingredients of Tongnao Decoction in the treatment of stroke, had good binding properties to the core protein androgen receptor (AR) .

Tongnao Decoction may play a role in treating cerebral infarction by activating AR. IL-17 signaling pathway, PI3K-Akt signaling pathway and prolactin signaling pathway are potential mechanisms as well.

Craniopharyngioma-related hypothalamic obesity (CHO) has become a key issue in postoperative management of craniopharyngioma. Modified low calorie diet and exercise interventions have been found by some studies to be effective in relieving CHO, and suggested to be used as non-pharmacological treatments for weight management of craniopharyngioma patients. However, there are few relevant studies in China. We reviewed the latest developments in prevalence, hazards and risk factors as well as diet and exercise interventions towards CHO, in order to improve the outcomes and quality of life of CHO patients. In addition, we put forward recommendations on comprehensively improving the quality of life of CHO patients, such as making efforts to value CHO clinically, carrying out prospective studies on weight control in CHO, and developing rigorous diet and exercise interventions.

Post-stroke cognitive impairment, characterized by cognitive dysfunction, is a common complication of stroke and has a direct impact on the quality of life of ischemic stroke patients. Previous studies have found that astrocytes play an important role in the pathogenesis of PSCI. In addition, extracellular vesicles (EVs) have been recognized as an important medium for intercellular communication and are involved in various pathophysiological processes by carrying and transporting various cargoes. Astrocyte-derived extracellular vesicles (ADEVs) may communicate with other brain cells to improve PSCI by enhancing synaptic plasticity, modulating neuroinflammation, regulating angiogenesis and autophagy. This review clarifies the multiple effects of ADEVs on the development of PSCI, offers new strategies for studying the underlying mechanisms of PSCI, and further explores the potential uses of ADEVs as novel drugs and biomarkers in the diagnosis and treatment of PSCI.

Cerebral microbleeds (CMBs) are important diseases that seriously endanger our national health, and their incidence is positively correlated with age. Meanwhile, CMBs are also an independent risk factor for stroke recurrence and induced hemorrhagic stroke. Understanding the current prevalence of CMBs is of great practical significance for promoting healthy aging and strengthening stroke prevention and treatment in China.

To systematically evaluate the current status of the occurrence of CMBs in China and to provide data support for promoting the process of healthy aging and strengthening the prevention and treatment of stroke in China.

Literature related to the occurrence of the disease of CMBs in our national population was systematically searched through Chinese and English databases such as CBM, CNKI, Wanfang Data, VIP, PubMed, Embase, and Web of Science, with a timeframe of the establishment of the database until November 2023 for all searches. Two researchers separately performed literature screening, data extraction, and evaluation of the risk of bias in the included literature, and meta-analysis was performed using Stata 16.0 software.

A total of 39 studies were included, with a total of 25 877 study subjects. Meta-analysis showed that the overall incidence of CMBs in China was 25.0% (95%CI=21.0%-29.0%). The results of subgroup analysis showed that the prevalence was 27.0% (95%CI=12.0%-44.0%) for those aged 51-60 years, 23.0% (95%CI=16.0%-30.0%) for those aged 61-70 years, and 27.0% (95%CI=20.0%-35.0%) for those aged 71-80 years; the prevalence was 21.0% (95%CI=15.0%-28.0%) in North China, 26.0% (95%CI=21.0%-33.0%) in East China, 21.0% (95%CI=8.0%-39.0%) in South China, 21.0% (95%CI=16.0%-27.0%) in Central China, 24.0% (95%CI=21.0%-27.0%) in Southwest China and 46.0% (95%CI=41.0%-51.0%) in Northwest China by geographic area; the prevalence of CMBs with a history of hypertension was 19.0% (95%CI=13.0%-26.0%) and without a history of hypertension was 8.0% (95%CI=6.0%-11.0%) ; the prevalence of CMBs with a history of smoking was 9.0% (95%CI=5.0%-14.0%) and without a history of smoking was 16.0% (95%CI=12.0%-21.0%) .

The overall prevalence of CMBs in China is high, with significant differences between different age segments, regions, and provinces. Its prevalence was higher in people of advanced age, males, Northwest China, and nationals with a history of hypertension. Due to the limitations in both quantity and quality of the included studies, further confirmation of this conclusion through additional high-quality research is required.

Type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) are common health problems in the elderly in the community. Research on the status and influencing factors of MCI in the elderly with T2DM who participate in community management is needed.

To explore the cognitive characteristics and related factors of elderly patients with T2DM complicated with MCI under community management.

From July to October 2022, a total of 399 patients with type 2 diabetes over 60 years of age in a community health service center in Shanghai were selected by systematic sampling method. General demographic data and health problems, physical examination and laboratory test results, including fasting blood glucose (FBG), total triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA_1c) were collected. They were divided into MCI group (n=157) and non-MCI group (n=242) according to the presence or absence of MCI. Binary Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with type 2 diabetes under community management.

The prevalence of MCI was 39.3% (157/399) in community-managed elderly patients with type 2 diabetes. The comparison of cognitive characteristics between MCI group and non-MCI group showed that the MCI group had higher abnormality rates in executive function, orientation, calculation, abstraction, delayed memory, visual perception, naming and attention than the non-MCI group, and the differences were statistically significant (P<0.05), and delayed memory impairment (92.4%) was the most common. There were significant differences in age, marriage, years of education, drinking, FBG, HbA_1c, TC, LDL-C between the two groups (P<0.05) ; Binary Logistic regression analysis showed that age≥80 years old (OR=3.002, 95%CI=1.379-6.534), FBG≥7.0 mmol/L (OR=2.432, 95%CI=1.436-4.119), HbA_1c 7%-9% (OR=2.349, 95%CI=1.380-3.997), HbA_1c>9% (OR=5.106, 95%CI=2.150-12.130), LDL-C (OR=2.451, 95%CI=1.266-4.743), 7-12 years of education (OR=0.419, 95%CI=0.183-0.960) and >12 years (OR=0.243, 95%CI=0.086-0.692) was the influencing factor for MCI in elderly patients with type 2 diabetes (P<0.05) .

The prevalence of MCI in community-managed elderly patients with type 2 diabetes is high, and there are multiple cognitive impairment, age≥80 years old, FBG≥7.0 mmol/L, HbA_1c 7%-9%, HbA_1c>9% and high level of LDC. High level of education is a protective factor for MCI in community-managed elderly patients with type 2 diabetes. Early cognitive impairment screening, long-term blood glucose control, and lowering LDL-C levels are helpful to improve the cognitive function of community-managed elderly patients with type 2 diabetes.

Acute ischemic stroke (AIS) is a serious cerebrovascular disease, which causes a heavy burden on society and patients. Ligustrazine injection has been widely used in the treatment of AIS with significant efficacy, but there is still a lack of direct or indirect comparison between ligustrazine injections.

To systematically evaluate the efficacy and safety of ligustrazine injection in the adjuvant treatment of AIS within 72 hours.

CNKI, Wanfang Data Knowledge Service Platform, VIP, PubMed, Cochrane Library, Embase, and Web of Science databases were searched for randomized controlled trials (RCTs) about the efficacy and safety of ligustrazine injection in the treatment of AIS from inception to April 2023. Literature was independently screened, extracted and quality assessed by 2 investigators using the Cochrane Evaluation Tool. RevMan 5.3, Stata 17, Addis and RStudio software were used to statistically compare and rank the efficacy and safety of different types of ligustrazine injection.

A total of 71 papers involving 7 304 cases were included, and the interventions included Salvia Miltiorrhiza Ligustrazine Injection (DSCXQ), Shenxiong Glucose Injection (SXPTT), Xingxiong Sodium Chloride Injection (XXLHN), Ligustrazine Phosphate Injection (LSCXQ) and Ligustrazine Hydrochloride Injection (YSCXQ) combined with conventional western medical therapy (CT), respectively, and CT alone. Direct Meta-analysis results showed that in improving all the outcome indicators of AIS, the total effective rate, NIHSS score, fibrinogen level, and incidence of adverse reactions of ligustrazine injection combined with CT were better than those of CT alone (P<0.05). The results of network Meta-analysis showed that the order of cumulative probability in total effective rate was SXPTT+CT (0.60) >YSCXQ+CT (0.20) >LSCXQ+CT (0.15) >DSCXQ+CT (0.03) >XXLHN+CT (0.02) >CT (0) ; the order of cumulative probability in improving NIHSS score was SXPTT+CT (0.55) >XXLHN+CT (0.26) >YSCXQ+CT (0.12) >DSCXQ+CT (0.07) >CT (0) ; the order of cumulative probability in reducing fibrinogen level was XXLHN+CT (0.32) >LSCXQ+CT (0.22) >DSCXQ+CT (0.17) >SXPTT+CT (0.15) >YSCXQ+CT (0.14) >CT (0) ; the order of cumulative probability in safety was SXPTT+CT (0.79) >XXLHN+CT (0.13) >CT (0.04) >DSCXQ+CT (0.03) >YSCXQ+CT (0.01) .

Ligustrazine injection is effective and safe in adjuvant treatment of AIS, among which Shenxiong glucose injection was the best in total effective rate and improving NIHSS scores, with the least adverse reactions; Xingxiong sodium chloride injection has the most advantages in fibrinogen level.

There is a close association between obstructive sleep apnea-hypopnea syndrome (OSAHS) and stroke. The coexistence of the two diseases not only affects the rehabilitation process of patients, prolongs their hospitalization time, but also may increase the risk of death. At present, there is still a lack of clinical research on continuous positive airway pressure (CPAP) combined with respiratory training for stroke patients with OSAHS.

To examine the impact of threshold inspiratory muscle training (TIMT) in conjunction with CPAP on sleep status, pulmonary function, and respiratory muscle strength in stroke patients with OSAHS.

Sixty-nine patients with stroke and OSAHS who met the enrollment criteria were selected from the Second Affiliated Hospital of Zhengzhou University from April 2022 to August 2023. The patients were divided into experimental group (n=35) and control group (n=34) by random number table method. The control group received CPAP and conventional treatment, and the experimental group received TIMT on this basis for 6 weeks. The sleep status, lung function and respiratory muscle function of the two groups were compared before and after intervention.

Six weeks after the intervention, the mean blood oxygen saturation (SpO₂), proportion of deep sleep (proportion of N3 sleep in total sleep time), minimum arterial oxygen saturation (LSaO₂), forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), one-second rate (FEV₁/FVC), maximum expiratory pressure (MEP) and maximum inspiratory pressure (MIP) were all higher than those before intervention in the 2 groups (P<0.05) ; After 6 weeks of intervention, SpO₂, proportion of deep sleep (proportion of N3 sleep in total sleep time), LSaO₂, FEV₁, FVC, FEV₁/FVC, MEP and MIP in experimental group were higher than those in control group (P<0.05). Sleep apnea hypopnea index (AHI), oxygen loss index (ODI), arousal index and Epworth lethargy scale (ESS) scores in the 2 groups were lower than those before intervention (P<0.05). After 6 weeks of intervention, the ODI, arousal index and ESS scores of experimental group were lower than those of the control group (P<0.05) .

TIMT combined with CPAP can significantly improve the sleep disorder of stroke patients with OSAHS, and improve arterial oxygen partial pressure, respiratory muscle strength and pulmonary function.

Acute cerebral infarction is a critical condition in patients with acute vestibular syndrome (AVS). AVS presents suddenly with severe symptoms. The sensitivity of CT in diagnosing acute cerebral infarction is low, and MRI, which is more accurate, is not always immediately available. This makes the diagnosis of acute cerebral infarction presenting as AVS challenging. Therefore, it is necessary to explore suitable examination and evaluation methods for patients with AVS.

To analyze the risk factors associated with acute cerebral infarction in patients with AVS, in order to provide a reference for the diagnosis of acute cerebral infarction in AVS and to maximize the critical treatment window for these patients.

A total of 102 patients with AVS admitted to the Department of Neurology, the Fourth Hospital of Harbin Medical University from April 2021 to July 2022 were included in the study. Clinical signs were recorded, and MRI results were used as the gold standard for the diagnosis of cerebral infarction. Patients were divided into the cerebral infarction group (n=16) and non-cerebral infarction group (n=86). The clinical characteristics of the two groups were compared. Univariate and multivariate Logistic regression analyses were used to explore factors influencing the occurrence of cerebral infarction in AVS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of these factors.

The proportions of patients with a history of smoking, alcohol consumption, positive Head-Impulse-Nystagmus-Test-of-Skew (HINTS) tests, and higher ABCD2 scores were significantly higher in the cerebral infarction group (P<0.05). Univariate Logistic regression analysis indicated that positive HINTS, ABCD2 scores, history of smoking, alcohol consumption, and hearing loss were factors influencing the occurrence of cerebral infarction. Multivariate analysis showed that positive HINTS (OR=99.043, 95%CI=8.120-1 208.090) and ABCD2 scores (OR=2.820, 95%CI=1.188-6.696) were the influencing factors (P<0.05). The areas under the ROC curve (AUC) for predicting cerebral infarction using combined indicators, positive HINTS, ABCD2 scores, history of smoking, alcohol consumption, and hearing loss were 0.949, 0.874, 0.734, 0.643, 0.649, and 0.604, respectively.

The proportion of non-cerebral infarction is higher in patients with AVS, with vestibular neuritis being the most common. Positive HINTS and ABCD2 scores are closely related to the occurrence of cerebral infarction in patients with AVS.