Abstract:Vascular cognitive impairment（VCI） is a kind of disease caused by cerebrovascular diseases and other related risk factors，ranging from mild cognitive impairment to dementia. The pathological features of VCI mainly include white matter lesions，demyelination and neuroinflammation. Glial cells are the most numerous cells in the brain，and play an important role in maintaining the normal function of the central nervous system. Recent studies have found that glial cells play an important role in the pathogenesis of vascular cognitive impairment. Exploring the role of glial cells will help improve our understanding of VCI and provide new ideas for the prevention and treatment of the disease.

Abstract:According to the latest survey report on disability and death of residents in our country，the incidence of stroke ranks first. Although the probability of death from stroke has decreased in recent years，the disability of the disease and the huge social expenditures caused by subsequent rehabilitation make the exploration and related research of the stroke still urgent. Acute ischemic stroke（AIS) accounts for 85% of all strokes，and wake-up（WUS） strokes account for about 20% of them. Because of the onset during sleep，the specific time of onset is unknown. In fact，many patients have the onset within a short period of time before waking up，and they have missed opportunities for thrombolysis or endovascular treatment，which ultimately leads to a poor prognosis. At present，there are more and more researches on the onset time of WUS，among which，imaging methods to predict the onset time of stroke after waking up to guide the treatment of WUS are particularly popular. This article is a review of recent advances in iconography of WUS.

Abstract:Objective To investigate the clinical effect of high frequency repetitive transcranial magnetic stimulation（rTMS） on cognitive function in patients with post-stroke cognitive impairment（PSCI） based on electroencephalogram（EEG） nonlinear analysis technology.Methods Forty patients with PSCI were randomly divided into the rTMS group and the control group，with 20 cases in each group. Both groups were given routine drugs and cognitive rehabilitation training. On this basis，the rTMS group were stimulated with 5 Hz rTMS to the dorsolateral prefrontal cortex（DLPFC） once a day for 20 min each time for 4 weeks. Before and 4 weeks after treatment，the cognitive function of the patients was assessed by Montreal cognitive assessment（MoCA），Stroop color-word test（SCWT），trail making test（TMT） and P300. At the same time，EEG signals were collected in the quiet state of closed eyes. The changes of functional connection in cognitive areas and other brain areas were observed through nonlinear analysis indexes including correlation dimension（D2） value and approximate entropy（ApEn） value.Results Compared with the control group，the MoCA score of rTMS group was significantly higher after 4 weeks of treatment（P<0.05）； in SCWT，the time consumption of card A，card B，the time consumption of interference and the correct number of interference decreased significantly（P<0.05）； in TMT，the time consumption of card A，card B and the amount of interference decreased significantly（P<0.05）； P300 latency was significantly shortened in rTMS group（P<0.05）； in rTMS group，D2 value and ApEn value increased significantly（P<0.05）. There was no significant difference in D2 value between rTMS group and control group in F4，O1 and F8 leads（P=0.074，0.179，0.120），there were significant differences in other leads（P<0.05），and there were significant differences in ApEn value between rTMS group and control group in FP1，FP2，F3，C4，P4，O2，F7 and T3 leads（P<0.05）.Conclusion High frequency rTMS treatment can effectively improve the cognitive function of patients with PSCI，affect the local neural circuit and compensate the cognitive function.

Abstract:Objective To investigate the relationship between early seizures in patients with cerebral venous sinus thrombosis（CVST）and the serum D-dimer level，and discuss the effects on the prognosis.Methods The CVST patients who were treated in the wards of Neurological and Cerebrovascular Departments of The First Affiliated Hospital of Naval Medical University from November 2010 to March 2021 were reviewed，and the general information，diagnosis and treatment of CVST and related hematological indicators of the patients were collected. Then the patients were divided into two groups according to the presence or absence of early seizures，the differences of related indicators between the two groups were analyzed，and the influencing factors of early seizures were studied by logistic regression analysis. The patients were divided into good and poor prognosis group by modified Rankin scale（mRS） score，and the relationship between serum D-dimer level and prognosis of CVST patients was analyzed.Results A total of 60 patients with CVST were included，including 22（36.7%） with seizure and 38 without seizure. The results of comparing the baseline data and hematological indexes of the two groups showed that mRS score and D-dimer level in the seizure group were significantly higher than those in the non-seizure group，and the incidence of poor prognosis was significantly higher than that of the non-seizure group； logistic regression analysis showed that D-dimer level might be a risk factor for early seizures in CVST（OR=1.513，95%CI=1.022-2.241，P=0.039）；early seizures were related to the poor prognosis of CVST patients，and serum D-dimer level before and after treatment and its decreasing range were not significantly related to disease prognosis.Conclusion High serum D-dimer levels are associated with early seizures in CVST，and early seizures affect the prognosis of CVST patients. Therefore，early intervention in CVST patients with elevated serum D-dimer on admission is expected to prevent early seizures and improve outcomes of CVST patients.

Abstract:Objective To explore the risk factors for early impairment in patients with mild aneurysmal subarachnoid hemorrhage（ASAH） after endovascular treatment.Methods From a retrospectively collected institutional database，we investigated 80 mild ASAH patients who had endovascular treatment between December 2015 and December 2021. All patients were followed up with the mini-mental state examination（MMSE） and modified Rankin scale（mRS） at one month and three months after endovascular treatment respectively. The patients were classified into normal group and cognitive impairment group according to cognitive status. The clinical baseline data of the two groups of patients were collected and the risk factors of cognitive impairment were analyzed by univariate and multivariate analysis.Results Among the 80 patients，41 had cognitive impairment one month after treatment，accounting for 51.25% of the total number. The univariate analysis of the risk factors for cognitive impairment showed that education level（P=0.000），age（P=0.020），modified Fisher scale（mFS） at admission（P<0.001），Hunt-Hess grade（P<0.006），location of aneurysm（P=0.023），intraventricular hemorrhage（P=0.043） were risk factors for cognitive impairment； the multivariate analysis showed that the mFS，the location of aneurysm，Hunt-Hess scale and intraventricular hemorrhage were independent risk factors for postoperative cognitive impairment（P<0.05），and the cognitive function of all patients returned to normal 3 months after surgery.Conclusion This study found that the incidence of cognitive impairment at 1 month after endovascular treatment for mild ASAH patients was 51.25%. Education level，age，mFS at admission，Hunt-Hess grade，the location of aneurysm，intraventricular hemorrhage are risk factors for cognitive impairment after the surgery. mFS，aneurysm location，Hunt-Hess grade，and intraventricular hemorrhage are independent risk factors for cognitive impairment.

Abstract:Objective To explore whether rescue stenting can efficiently recanalize embolic cerebral artery occlusion after failed thrombectomy or iatrogenic cerebral artery embolism in nerve intervention.Methods The clinical data of 6 patients with failed thrombectomy and 4 patients with iatrogenic cerebral middle and distal artery embolism received rescue stenting in Shanghai Ninth People's Hospital，Shanghai Jiaotong University School of Medicine from January 2020 to November 2021 were analyzed retrospectively. The preoperative National Institutes of Health Stroke Scale（NIHSS），the NIHSS score at 24 h after procedure，the postoperative stent patency，the type of hemorrhagic transformation and prognosis were recorded.Results There were 6 cases receiving rescue stenting after failed thrombectomy for embolic occlusion of middle cerebral artery. All of them（100%） had modified thrombosis in cerebral infarction score（mTICI 2b-3），3 cases had hemorrhagic transformation after the surgery （1 case of PH2 type，and 2 cases of HI2 type），5 cases （83%） had patent bleeding at 24 h after operation，one did not undergo repeated angiography examination，and 3 cases（50%） died during hospitalization. Among the 4 cases of iatrogenic cerbral middle and distal artery occlusion，one was primarily high vertebrobasilar artery stenosis，and had right anterior inferior cerebellar artery embolism during the stenting. The recanalization occurred after the rescue stenting. At 24 h after operation，all stents were unobstructed，no patients had no cerebral hemorrhage，and the prognosis was good after 3 months （modified Rankin score，mRS： 1 point）. Three cases had iatrogenic ipsilateral anterior cerebral artery embolism during thrombectomy for middle cerebral artery embolism，the blood flow recovered immediately after direct stent implantation，among which，one case underwent cerebral computed tomography angiography（CTA） at 24 h after operation showing the patent stent and hemorrhagic transformation（type HI2）. The other 2 cases did not have repeated examination because of disease severity.Conclusion Rescue stenting can rapidly and efficiently recanalize embolic occlusion of cerebral artery due to failed thrombectomy or iatrogenic middle and distal embolism，but its effectiveness and safety need to be further studied.

Abstract:Objective To observe and evaluate the clinical efficacy of systemic anticoagulation combined with endovascular treatment of cerebral venous sinus thrombosis（CVST）.Methods CVST patients who were treated in our hospital from June 2008 to August 2021 were retrospectively enrolled，and divided into anticoagulation treatment（AT）group and endovascular treatment（EVT）group according to different treatment methods. Additionally，the clinical data and treatment effects of the two groups were analyzed.Results A total of 54 patients were enrolled, including 27 patients in the AT group and 27 patients in the EVT group. Compared with the AT group, the proportion of patients with thrombosis involving superior sagittal sinus and straight sinus, amount of involved sinus and modified Rankin scale (mRS) scores of patients were significantly higher in EVT group（P<0.05）. After treatment，prothrombin time and activated partial thrombin time in two groups were significantly increased，and the level of D-dimer in AT group was significantly reduced（P<0.05）. The recanalization rate of the EVT group was significantly higher than that of the AT group（P<0.05），and there were no significant differences in total duration of hospital stay，duration of ICU stays，incidence of complications，survival rate and neurological prognosis between the EVT group and the AT group（P>0.05）. The mRS scores of patients after treatment were significantly lower than those before treatment in both groups（P<0.05）.Conclusion For severe CVST patients with extensive thrombus involvement and poor anticoagulant efficacy，standard anticoagulant therapy combined with endovascular treatment could be a safe and effective potential option.

Abstract:Objective To explore the therapeutic mechanism of Bu-Yang-Huan-Wu decoction（Qi-Long-Qu-Yu mixture） in the treatment of acute cerebral infarction from the changes of serum procalcitonin（PCT）and homocysteine（Hcy）.Methods A total of 219 patients with acute cerebral infarction were selected from June 2018 to December 2020. And 128 patients with qi deficiency and blood stasis type in traditional Chinese medicine were randomly divided into control group（n=64，conventional treatment of Western medicine）and treatment group（n=64，conventional treatment of Western medicine plus Bu-Yang-Huan-Wu decoction）for clinical treatment and observation，with 4 weeks of the treatment observation. The changes of National Institutes of Health Stroke Scale（NIHSS）score and stroke-specific quality of life scale（SS-QOL） score at admission，10th day and 4th week were evaluated clinically. Serum PCT and Hcy levels were detected at the three time points，and clinical adverse reactions and laboratory adverse reactions were counted.Results Compared with before treatment，NIHSS scores of 2 groups at 4th week were significantly lower after treatment，and the NIHSS scores of treatment group were lower than that of control group，and the treatment group had lower scores than the control group（P<0.01）. Compared with before treatment，the SS-QOL scores of 2 groups at 4th week were higher than before treatment，and those of the treatment group were higher than those of the control group（P<0.01）. At 4th week，there were significant differences in Hcy and PCT of the two groups compared with before the treatment. In addition，Hcy and PCT in the treatment group were lower than those in the control group at 4th week，with statistical differences.Conclusion Bu-Yang-Huan-Wu decoction is safe and effective in the treatment of patients with acute cerebral infarction，and may improve the symptoms of neurological impairment by reducing the levels of PCT and Hcy in serum.

Abstract:Objective To explore the correlation between post-stroke cognitive impairment and the degree of compensation of leptomeningeal collaterals and intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods A total of 161 patients with acute anterior circulation cerebral infarction hospitalized in Shihezi People's Hospital from January 2019 to March 2021 were prospectively collected， and the demographic data at admission were obtained， including thrombolysis， gender， complications， etc. The cognitive function of patients was evaluated by Montreal cognitive assessment （MoCA） and mini mental state examination（MMSE）； the neurological deficit symptoms were obtained by the National Institute of Health Stroke Scale （NIHSS） score at admission； the ability of daily living of patients was evaluated by the score of Blessed behavior scale（BBS）； the regional leptomeningeal collateral score （rLMC） was used to evaluate the leptomeningeal collateral circulation. According to whether there was cognitive impairment 6 months after stroke， they were divided into cognitive impairment group and non-cognitive impairment group. Logistic multivariate regression method was used for statistical comparison to analyze the relationship between leptomeningeal collateral circulation， intravenous thrombolysis， complications， blood glucose， blood lipid and cognitive impairment after stroke.Results There were 161 patients with acute anterior circulation infarction， including 85 cases in cognitive impairment group and 76 cases in non-cognitive impairment group. Univariate analysis showed that there were significant differences in thrombolysis， rLMC， age and the score of BBS； multivariate binary logistic regression model showed that：①whether thrombolytic therapy had a statistically significant effect on the incidence of cognitive impairment， which was a protective factor；②age，rLMC， NIHSS score and BBS score had statistically significant effects on the incidence of cognitive impairment， and they were all risk factors；③there was no significant effect of gender and hypertension on the incidence of cognitive impairment.Conclusion Good collateral circulation and intravenous thrombolytic therapy can reduce the occurrence of post-stroke cognitive impairment in acute ischemic stroke. The older the age and the higher NIHSS score at admission， the greater the risk of post-stroke cognitive impairment in acute ischemic stroke.

Abstract:Objective To study the activation characteristics of swallowing-related brain functional areas of acute cerebral infarction（ACI）patients with dysphagia and normal adults using blood oxygenation level dependent-functional magnetic resonance imaging（BOLD-fMRI），and to explore the regulation way of relevant brain functional areas during dysphagia recovery of ACI patients.Methods One hundred and fifty ACI patients with dysphagia，who were hospitalized in Yan’an Hospital Affiliated to Kunming Medical University from July 2018 to July 2021，and 100 normal adults were selected in the study and received BOLD-fMRI. The activation volume and intensity of relevant brain functional areas during swallowing activities were recorded and the differences between them were compared.Results Among the 150 ACI patients with dysphagia collected during the study，50 cases［29 males and 21 females，averaged at （56.22±7.33） years］ old）were classified into the right ACI group，and 100 cases［61 males and 39 females，averaged at （58.07±6.84） years old］ were classified into the left ACI group. There were 100 normal adults［57 males and 43 females，averaged at （53.56±11.41） years old］ in the control group. Characteristics of relevant brain functional areas activated during swallowing activities in the control group showed that increased activation volume and intensity were observed for brain functional areas including bilateral primary motor cortex center（BA4），premotor area/supplementary motor area（BA6/8），supramarginal gyrus（BA40），insular lobe insular（BA13），superior temporal gyrus（BA22），cingulate cortex（BA24），frontal medial surface（BA32），medulla oblongata，pons，basal ganglia，thalamus and cerebellum as well as left temporal pole（BA38） and right Heschl’s gyrus（BA41），etc.，and the activation volumes of BA4，BA40 and cerebellum were significantly larger in the left than in the right（P<0.05）； there was no significant difference in activation intensity between the left and right brain areas（P>0.05）. The activation volume of each brain area of the right ACI group suggested by BOLD-fMRI showed that the activation volumes of the right BA4 and BA6/8 were smaller than those of the control group，the activation volumes of the left BA6/8 and BA4 were larger than those of the control group，and the activation volumes of the bilateral posterior cingulate cortex（BA23），the parietal medial surface（BA31） were larger than those of the control group，and in the BA18/19 of the left visual center and BA41 of the primary auditory center，the cortical activation volumes were larger than those of the control group，with statistically significant differences. The activation intensities of the right BA4，BA6/8，BA40 and BA13 were significantly lower than those of the control group. The activation volume of each brain area of the left ACI group suggested by BOLD-fMRI showed that the activation volumes of the left BA4 and BA6/8 were smaller than those of the control group，the activation volumes of the right BA4 and BA6/8 were larger than those of the control group，and the activation volumes of bilateral BA23/31，left BA41，bilateral BA7，bilateral BA18/19 and bilateral cerebellums increased compared with the control group，with statistically significant differences. The activation intensities of the left BA4，BA6/8，BA40 and BA13 were significantly lower than those of the control group.Conclusion Brain functional areas involved in regulating swallowing activities of normal people include bilateral motor，pre-motor，sensory，olfactory，auditory，brain stem，cerebellum，and basal ganglia，etc.，and the regulation is hemilateral to some extent. Decreased activation volume of the ipsilateral motor area and premotor area and increased activation volume of the contralateral motor area and premotor area are the main compensatory features of swallowing-related brain functional areas in ACI patients with dysphagia.

Abstract:Objective The efficacy and safety of argatroban in acute ischemic stroke（AIS） remains controversial. Our study aims to conduct a systematic review and Meta-analysis on the efficacy and safety of argatroban in AIS.Methods Relevant literatures were searched from the databases of PubMed，The Cochrane Library，Embase，ClinicalTrials.gov，CNKI，CBM，VIP and Wanfang until April 2022. Two trained researchers screened the literature，extracted data and assessed the bias risk independently. The Meta-analysis was performed using RevMan 5.4 software.Results A total of 25 studies were enrolled in the Meta-analysis，including 4 696 AIS patients（2 271 cases in the argatroban group and 2 425 cases in the control group）. Overall Meta-analysis showed that argatroban significantly improved early neurological function recovery（OR=2.69，95%CI=1.66-4.34，P<0.001），and reduced early neurological deterioration（OR=0.42，95%CI=0.29-0.60，P<0.001）. However，there was no significant influence on the proportion of patients with modified Rankin Scale（mRS） score of 0-1（P=0.080），the proportion of patients with mRS score of 0-2（P=0.230） and recurrence rate of stroke（P=0.190）. The subgroup analysis showed argatroban combined with oral antiplatelet drugs was associated with higher incidence of 90-day mRS 0-2（OR=1.55，95%CI=1.17-2.05，P=0.003）. There was no significant difference in the incidence of any intracranial hemorrhage（P=0.730），symptomatic intracranial hemorrhage（P=0.990），systemic bleeding（P=0.150） and mortality（P=0.990）.Conclusion Argatroban may improve the early neurological function recovery in AIS patients without increasing the risk of bleeding and mortality.

Abstract:Objective To investigate the current situation of exercise fear and its influencing factors in patients with acute ischemic stroke combined with atrial fibrillation.Methods A total of 248 patients with acute ischemic stroke combined with atrial fibrillation who were hospitalized in the department of neurology of a 3A-grade hospital in Shanghai during January 2020 to December 2021 were selected in the study using convenience sampling method. They were investigated with the fear of heart disease exercise scale，activity-specific balance confidence scale，exercise self-efficacy scale and family care index scale，and the influencing factors were analyzed by univariate analysis and multivariate linear regression.Results Among the 248 patients included in the analysis，126（50.8%） were male and 122 （49.2%） were female，with the mean age of （74.19 ± 11.65） years old. Univariate analysis showed that factors affecting exercise fear in patients with stroke and atrial fibrillation included educational background （Z=26.326，P<0.001），occupational status （Z=9.323，P=0.009），residence（Z=26.990，P<0.001），falling history（Z=2.976，P=0.003），number of stroke relapses （Z=24.996，P<0.001），and cardiac function classification（Z=32.097，P<0.001）. The results of multiple linear regression showed that education level，falling history，number of stroke recurrences，cardiac function classification，motor self-efficacy and family care index entered the regression equation，and altogether accounted for 37.6% of the total variation in the level of exercise fear of patients.Conclusion The current situation of exercise fear in patients with acute ischemic stroke combined with atrial fibrillation is not optimistic. Clinical nursing staff should focus on them when guiding patients' exercise rehabilitation，and formulate targeted nursing measures after comprehensive evaluation of patients，in order to improve the compliance of patients with acute ischemic stroke combined with atrial fibrillation in exercise rehabilitation.

Abstract:Objective To explore the application effect of multi-functional hand exercise on patients with hand dysfunction after cerebral infarction.Methods Patients were divided into control group and intervention group by simple random sampling，and 96 patients with cerebral infarction accompanied by hand dysfunction in hospital from August 2020 to October 2021 were selected for controlled trial study. Both groups were given routine treatment nursing and rehabilitation training in clinical pathway of cerebral infarction. Based on this，the intervention group were additionally given diversified hand function exercises. At the first and third month of intervention，the intervention group went to the outpatient department for re-examination，respectively. Hand function of the objects was assessed by upper extremity function test（UEFT） proposed by Dr. Carroll，America，and the effect of hand muscle strength rehabilitation was evaluated by manual muscle testing（MMT）. Hemiplegic hand spasm was assessed using the modified Ashworth scale（MAS）.Results After 1 and 3 months of intervention，the UEFT scores of the intervention group（59.830±4.133 and 76.830±4.450）were higher than those of the conventional group（56.630±5.587 and 65.580±4.997），and the hand muscle strength recovery was significantly better than that of the conventional group，with statistically significant differences（all P<0.05）. Compared with the conventional group，there was no statistically significant difference in the MAS muscle tension of the two groups after 1 month of intervention，but after 3 months of intervention，the incidence of hand spasm decreased significantly in the intervention group，and the MAS muscle tension was significantly lower than that in the conventional group.Conclusion Diversified hand function exercise can realize the hand rehabilitation of cerebral infarction from muscle strength level M0 to level M5 continuous exercise step by step，prevent contracture，greatly accelerate the rehabilitation process of patients' hand function，reduce the hand disability rate of patients，relieve the pain of patients，and can be widely used in clinical practice.

Abstract:Objective To explore the application effect of breakthrough series（BTS） quality improvement model on patients with ischemic stroke.Methods A total of 56 patients who did not take BTS quality improvement model from June 2020 to September 2020 were selected as the control group； 56 patients who took BTS quality improvement model from March 2021 to July 2021 were selected as the observation group. The scores of National Institutes of Health Stroke Scale（NIHSS），the Barthel index of ADL，pressure ulcer prevalence，length of stay，modified Rankin Scale（mRS），nutritional indexes and satisfaction of the two groups were compared before and after the implementation of the model.Results After applying BTS quality improvement model，the NIHSS score of the observation group was significantly lower than that of the control group（P<0.05）；the mRS score of the observation group［（2.31 ± 0.43） points］ was significantly lower than that of the control group［（4.68 ± 0.85）points］（P<0.05）；there were significant differences in nutritional indexes and satisfaction between the two groups（P<0.05）.Conclusion The application of BTS quality improvement model can effectively improve the nursing quality of patients with ischemic stroke and promote the recovery of neurological function，thus improving the prognosis of patients.

Abstract:Objective To explore the effect of health literacy on self-management behavior and medication compliance one year after the first cerebrovascular stent implantation of patients.Methods A total of 127 patients who underwent cerebrovascular stent implantation for the first time in the First Affiliated Hospital of Anhui Medical University from May 2019 to May 2020 were selected. One year after surgery，they were followed up with general data questionnaire，health literacy scale for patients with chronic diseases，stroke self-management behavior scale and medication adherence scale. The effects of health literacy on self-management behavior and medication compliance were analyzed by binary logistic regression.Results The health literacy score of patients was 95.67±14.60. The score of self-management behavior and medication compliance was 197.82±23.29 and 7.29±1.18 respectively，both of which were in medium level. Binary logistic regression analysis showed that health literacy（OR=24.404，95%CI=6.122-97.279） and residence（OR=5.956，95%CI=1.640-21.633） were independent influencing factors of patient's self-management behavior； health literacy（OR=4.096，95%CI=1.254-13.375） and the number of chronic diseases（OR=0.479，95%CI=0.249-0.923） were independent influencing factors of medication compliance.Conclusion The level of health literacy of the patients with cerebrovascular stent implantation one year after surgery is insufficient. Medical staff should pay attention to people with low health literacy，formulate and implement scientific and reasonable health education programs to help patients improve self-management behavior and medication compliance.

Abstract:Ischemia stroke（IS） has high morbidity and high mortality worldwide. As effective treatments for IS remain limited，a better new therapeutic intervention target is needed. Increasing evidence suggests that long noncoding RNA（LncRNA） has protective effect on cerebral ischemia-reperfusion injury，and it is expected to be a potential target for the treatment of IS. This paper has reviewed the protective effects and the mechanism of LncRNA on IS，so as to provide ideas for further clinical research on the related fields. Additionally，this paper has pointed out that it would be necessary to study whether LncRNA could induce intracranial hemorrhage transformation in IS before further applying it to clinical research，and it would be suggested to design dosage forms and administration methods suitable for human use.

Abstract:Neural stem cells（NSCs） reprogramming technology can generate mature human neurons with disease-related phenotypes from somatic cells，bringing a prospect for cell therapy of neurological disorders. In this paper，the regulatory factors of NSCs reprogramming，the improvement of reprogramming efficiency and the application in the modeling of neurological disorders are reviewed.

Abstract:Glioblastoma still has a high probability of recurrence even after maximum surgical resection and standardized radiotherapy and chemotherapy. Therefore， for the increasing number of recurrent glioblastoma patients， how to achieve effective treatment and improve the prognosis of patients has always been a great challenge in neuro-oncology. This paper aims to review the existing treatment methods for recurrent glioblastoma from multiple aspects， and to predict the possible treatment directions in the future.

Abstract:Multiple sclerosis （MS） is an autoimmune disease that occurs in the central nervous system（CNS），with main pathological features of inflammatory response， myelin degeneration， and gliosis. Experimental autoimmune encephalomyelitis（EAE） has been widely recognized as an ideal animal model for studying the pathogenesis and treatment strategies of MS due to its similar pathological features and clinical manifestations. Although CD4⁺ T cell-mediated autoimmunity plays a central role in the pathological process of MS/EAE， microglia （MG） as a “bridge” between CNS and the immune system has received more and more attention. In addition to the classical pathways of antigen presentation and cytokine secretion， it is proved that MG can participate in the pathological process of MS/EAE through myelin internalization and activation of intracellular NOD-like receptor family pyrin domain-containing 3（NLRP3） inflammasome. This article reviewed the role and progress of MG in MS/EAE.

Abstract:Objective To explore the clinical characteristics of chorea-acanthocytosis（ChAc）and provide ideas and methods for early diagnosis of the disease.Methods We summarized the clinical characteristics of ChAc through the retrospective cohort study.Results In all the patients diagnosed with chorea，ChAc counted for 29%. The median time of diagnosis was 5.5 years. The mean onset age was（33.57±12.23）years. Seven cases（100%） had oral dyskinesia. Epilepsy occurred in 4 cases（57%），and the seizure type was generalized tonic-clonic seizure. Hypotonia and hyporeflexia were reported in 6 cases（86%）. Plasma creatine kinase increased in 5 cases（71%）. Cranial MRI showed atrophy of caudate nucleus（57%） and pannucleus（29%），and enlargement of both anterior horns of lateral ventricle（57%）. Positron emission tomography（PET）-computed tomography（CT） showed decreased metabolism of bilateral basal ganglia（43%）. All cases were confirmed by the proportion of acanthocytes in peripheral blood smear higher than 3%，and 29% gene sequencing revealed mutation of responsible gene VPS13A.Conclusion The diagnosis time of ChAc is long，and early diagnosis depends on clinical manifestations of oral dyskinesia and creatine kinase elevation. We suggest that chorea patients routinely undergo more than twice of peripheral blood smears，followed by genetic testing to confirm the diagnosis.

Abstract:Objective To investigate and identify gene ATRNL1 function in Alzheimer’s disease（AD）.Methods Microarray data GSE36980，GSE1297，and GSE28146 were downloaded from gene expression omnibus（GEO）database. ATRNL1 differential expression of AD in Alzheimer’s disease was validated by 3 independent datasets. Meanwhile，Pearson correlation test between ATRNL1 expression and clinical data were performed. ATRNL1 co-expression gene screening and function enrichment analysis was performed by clusterProfiler，which included gene ontology（GO）and Kyoto encyclopedia of genes and genomes（KEGG）annotation. To further illustrate ATRNL1 molecule interaction detail，multiMiR package was used to download miRNA interaction，finally ATRNL1-miRNA-mRNA network was constructed for competing endogenous RNAs（ceRNA）identification of ATRNL1.Results Three isolated datasets showed ATRNL1 was significantly decreased（P<0.05）. ATRNL1 expression was significantly correlated with PMI（P<0.05），mini-mental status examination（MMSE）（P<0.001），and neurofibrillary tangles（NFT）（P<0.05）. ATRNL1 co-expression genes enrichment analysis showed that the biological process of signal release（GO：0023061），synaptic vesicle cycle（hsa04721），GABAergic synapse（hsa04727）were significantly related to ATRNL1. The constructed ATRNL1-miRNA-mRNA regulatory network found that MOAP1，WDR47，and REEP1 were found as ceRNA by competing hsa-miR-192-5p with ATRNL1.Conclusion It is discovered for the first time that ATRNL1 may affect AD occurrence through synapse signal release and GABAergic synapse，and more importantly ATRNL1 may function as ceRNA with MOAP1 by competing hsa-miR-192-5p.