Cerebral small vessel disease is a group of diseases mainly affecting intracranial small artery and arteriole.The main characteristic changes of cerebral small vessel disease on MRI are diffuse white matter hyperintensities,lacunar infarcts,cerebral microbleeds,and enlarged perivascular spaces.These changes may be correlated with cognitive impairment.At present,many scales are available and can be used to evaluate cerebral small vessel disease caused cognitive inpairment.

Moyamoya angiopathy is a chronic progressive occlusive intracranial vasculopathy, and CT angiography, MRI, digital subtraction angiography are the auxiliary examinations. Headache is a common symptom in Moyamoya angiopathy (MMA ) patients, and the phenotypes of headache attributed to MMA mainly include migraine-like headache and tension type-like headache; mechanism involves in dilatation of intracranial and extracranial arteries and leptomeningeal collaterals, cerebral hypoperfusion, vascular endothelial damage, genetic susceptibility, and mental stress. Strategies such as surgical revascularization and medical treatment are given. This article focuses on clinical manifestations, pathogenesis, diagnoses, treatments and prognoses of headache attributed to MMA, in order to deepen the understanding of clinical workers on this symptom.

Objective To investigate the influencing factors for direct-acting antiviral agent (DAA) therapy failure in the treatment of hepatitis C by comparing baseline clinical data and resistance-associated substitution (RAS) in sequencing data between the patients with HCV RNA reactivation after DAA therapy and the patients with successful DAA treatment. Methods A total of 13 patients from multiple centers who failed DAA therapy from November 2019 to October 2021 were enrolled as treatment failure group, and sequencing was performed for their positive serum samples. A total of 51 patients with successful DAA treatment were enrolled as control group, and baseline clinical data and sequencing results were compared between the treatment failure group and the control group. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; univariate and multivariate logistic regression analyses were performed to calculate odds ratio ( OR ) and investigate the influencing factors for treatment failure. Results All 12 patients with complete treatment data experienced recurrence within 1 year after the end of medication. The male patients with treatment failure had significantly higher baseline total bilirubin, direct bilirubin, and creatinine than their female counterparts ( Z =-2.517, -2.440, and -2.132, P =0.010, 0.010, and 0.038), and the patients with an age of ≤55 years ( OR =5.152, 95% confidence interval [ CI ]: 1.116-23.790, P =0.036) or genotype 3b ( OR =9.726, 95% CI : 1.325-71.398, P =0.025) had a higher probability of treatment failure. There were differences in the incidence rates of major RAS mutations on three gene fragments between the treatment failure group and the treatment success group, and the common RAS mutations detected in the treatment failure group were not detected in the treatment success group. Conclusion Age, genotype, and RAS in serum virus gene sequence are influencing factors for DAA treatment failure.