Objective To investigate the change regulation of the serum ferritin level and its correlation with the clinical outcomes.Methods The patients with spontaneous intracerebral hemorrhage were enrolled.Their clinical data were collected.The serum ferritin levels were detected within 24 h after admission and on day 3,7,and 14,respectively.The modified Rankin Scale (mRS) were used to evaluate the clinical outcomes at day 90 after onset.mRS 0 to 2 was defined as good outcome and ＞ 2 was defined as poor outcome.Results A total of 32 patients with spontaneous intracerebral hemorrhage were enrolled,including 18 in the good outcome group and 14 in the poor outcome group.There were significant differences in age (66.33 ±12.57 years vs.76.50 ±6.55 years;t =-2.908,P =0.007),baseline National Institutes of Health Stroke Scale (NIHSS) scores (median [interquartile range];9.50 [4.75-11.25] vs.15.00 [11-20];Z=-3.499;P=0.001),diastolic blood pressure (82.16± 13.79 mmHg vs.94.76± 12.17mmHg,1 mmHg=0.133 kPa);t=-1.145,P=0.045),amount of bleeding (4.50 [2.75-9.00] mlvs.11.00 [7.50-15.00] ml;Z=-2.613,P=0.008],blood glucose (5.82±0.87 mmoFL vs.7.09±1.72 mmoFL;t =-2.548,P =0.020),and white blood cell count ([7.26 ± 2.36] × 109/L vs.[10.94 ±5.83] × 109/L;t =-2.440,P =0.021) between the good outcome group and the poor outcome group.The serum ferritin levels of the good outcome group were 139.81 ± 98.50 μg/L,181.77 ± 97.29 μg/L,198.17 ±96.63 μg/L,and 159.59 ±72.43 μg/L,respectively,within 24 h on admission and at day 3,7,and 14.There were no significant differences at each time point (F=1.397,P =0.251),and those of the poor outcome group were 226.07 ± 119.22 μg/L,297.36 ± 81.48 μg/L,305.45 ± 97.05 μg/L,and 307.74 ± 82.54 μg/L,respectively,and they increased progressively over time (F =4.245,P =0.044);at each time point,the good outcome group was significantly lower than the poor outcome group (within 24 hon admission:t =-2.242,P=0.033;at 3 days after onset:t =-3.234,P =0.003;at 7 days after onset:t =-3.149,P =0.004;at 14 days after onset:t =-3.628,P =0.001).Multivariate logistic regression analysis showed that the serum ferritin level within 24 h on admission (odds ratio 1.048,95％ confilence interval 1.004-1.095;P=0.034)and baseline NIHSS score (odds ratio 1.021,95％ confidence interval 1.004-1.039;P =0.016) were the independent risk factors for affecting the outcomes in patients with acute intracerebral hemorrhage.Conclusions The serum ferritin level increases in the poor-outcome patients with acute intracerebral hemorrhage.The increased serum ferritin level is an independent risk factor for poor outcome in patients with acute intracerebral hemorrhage.

Objectve To investigate the correlation between vertebral artery hypoplasia (VAH) and posterior circulation ischemic stroke (PCIS).Methods The patients who were diagnose as ischemic cerebral stroke and underwent brain magnetic resonance imaging and cervical three-dimensional contrast-enhanced magnetic resonance angiography from March 2012 to March 2014 were enrolled.VAH was defined as vertebral artery diameter ＜ 2 mm and thin or did not develop.They were divided into either an anterior circulation ischemic stroke (ACIS) group or a PCIS group according to the sites of disease.The clinical and imaging data were compared.Results A total of 137 patients were enrolled,including 96 patients (70.07％) with ACIS and 41 (29.93％) with PCIS.Thirty-seven patients were (27.01％) diagnosed as VAH,including 13 on the left and 24 on the right; 14 females and 23 males.The detection rate of females (29.17％) was higher than that of males (25.84％),but the difference was not statistically significant (x2 =0.175; P =0.676).There were significant differences in TOAST classificanon (x2 =6.710; P =0.035),combined with ischemic heart disease (14.6％ vs.61.5％ ; x2 =25.262,P ＜ 0.001) and VAH (58.5％ vs.13.5％ ; x2 =9.505,P ＜0.001) between the PCIS group and the ACIS group.Multivariable logistic regression analysis showed that VAH was independently correlated with PCIS (odds ratio 10.788,95％ confidence interval 3.863-30.131; P ＜ 0.001),and combined with ischemic heart disease was independently correlated with ACIS (odds ratio 0.082,95％ confidence interval 0.024-0.278; P ＜ 0.001).Conclusions VAH is not rare in patients with ischemic stroke.It may promote the occurrence of PCIS.

Stroke seriously endangers people's life and health because of its high prevalence, disability and recurrence rate. Among them, large vessel occlusive stroke (LVOS) has the worst outcome. Rapid recovery of cerebral perfusion is the key to improve the outcomes of patients with LVOS. As a new type of treatment, endovascular treatment can effectively recanalize the occluded blood vessels and extend the treatment time window. The level of collateral circulation determines the severity of symptoms, treatment choices, treatment effects and outcomes in patients with LVOS. This article summarizes the clinical factors related to collateral circulation compensation in patients with LVOS, and focuses on the application value of imaging technology in the evaluation of collateral circulation.

Stroke has become the leading cause of death in China, and carotid atherosclerosis is an important risk factor for ischemic stroke. In current carotid atherosclerosis diagnosis and treatment guidelines, patients are stratified based on the degree of vascular stenosis. However, the presence of carotid atherosclerotic vulnerable plaques can cause ischemic stroke at any time, regardless of the degree of carotid stenosis. The development of MRI technology, especially the advent of high-resolution MRI, enables non-invasive assessment of carotid plaque structure and properties, and provides optimized treatment strategies for high-risk stroke population in the early stage to achieve the goal of prevention and treatment of stroke.

Objective To analyze the clinical data and head imaging features of perioperative acute ischemic stroke(POAIS)with non-small cell lung cancer(NSCLC)and to explore the possible risk factors and pathogeneses of it,and to provide evidence for the prevention and treatment of POAIS.Methods Data of patients with primary NSCLC who underwent lung resection and had POAIS was retrospectively collected,and the clinical data of patients with cerebral infarction of large artery atherosclerosis(LAA)and stroke of undetermined etiology(SUE)was compared.Results There were 25 NSCLC patients with POAIS,some of whom had no history of cardiovascular and cerebrovascular diseases,and the proportion was higher in SUE.The most common excision site was left upper lobe,especially in SUE.The pathological stage and type were mainly early stage and adenocarcinoma.Most patients developed POAIS within 7 days after surgery,and mainly mild to moderate.Middle cerebral artery was the main responsible vessel and most patients'cerebral infarction locations≥3.SUE was the most common type of Trial of Org 10172 in Acute Stroke Treatment(TOAST),followed by LAA type.Compared with SUE,more patients had a history of type 2 diabetes(P=0.006)and higher preoperative fasting glucose level(P=0.013)with LAA type.Conclusion Attention should be paid to the prevention of LAA type cerebral infarction in NSCLC patients with type 2 diabetes or preoperative high fasting glucose level,and antithrombotic regimen is selected according to different etiological mechanisms of POAIS.The formation of pulmonary vein thrombosis after lung resection should be prevented and paid attention to.

Objective:To explore the characteristics and data related to the degradation and biocompatibility of the domestically procuded polyglycolic acid (PGA) nerve conduit.Methods:This study was conducted in the Department of Burns and Plastic Surgery, the Northern Theater General Hospital between January and August 2022. PGA nerve conduits were immersed in 15 ml normal saline for in vitro experiments of degradation. The experimental period was 12 weeks. The pH of the immersion solution were tested weekly and the rates of mass loss were calculated. The in vitro experiments for biocompatibility were conducted in both of the experimental group and the control group. In the experimental group, a DMEM solution containing 10% of fetal bovine serum was used as the extraction medium, and domestically produced PGA nerve conduit was immersed in the extraction medium in the control group. An extraction medium was firstly prepared for a controlled extraction time of 72 hours±2 hours at 37 ℃±1 ℃. The pH of both experimental and control groups were tested at 24, 48 and 72 hours. The 72-hour extracts of both experimental and control groups were used to prepare the single cell suspension. The single cell suspension containing the cultured RSC 96 were separately seeded into 96-well plates for Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay, to observe the effect of PGA nerve conduits on the proliferation of RSC 96. Then RSC 96 were incubated for 24 hours with the extracts of both experimental and control groups. The effect of PGA nerve conduits on the migration of RSC 96 was observed with Transwell assay. Twenty-four adult male SD rats were used and divided into experimental group and control group, with 12 rats per group, for the in vivo study of degradation and biocompatibility. Rats in the experimental group were implanted with domestically produced PGA nerve conduits, and Neurotubes, a US made nerve conduit, were implanted in the rats of control group. The PGA nerve conduits were implanted in a bluntly prepared gap between the biceps femoris muscle and the gluteus maximus muscle of the right hind limb of rats for the in vivo degradative experient. The degradation and biocompatibility of the PGA nerve conduit were evaluated by means of gross observation, tests of blood routine, liver and kidney functions and histological examinations at 2, 4, 8 and 12 weeks after implantation. SPSS 19.0 software was used for statistical analysis of the experimental data, and the results were expressed as Mean±SD. T test was used for inter-group comparison and Turkey method was used for intra-group and inter-group comparison. P<0.05 was used to determine whether the difference was statistically significant. Results:The rate of in vitro degradation was found at 1.470%±0.026% in week 4, and thereafter, a gradually accelerated degradation rate was observed and at a 32.180%±0.040% of degradation rate in week 12. The pH of the immersion solution decreased slowly in the first 2 weeks, with the pH at 6.200±0.061 in week 2. The pH then suddenly dropped to 3.930±0.118 in week 3, and then decreased slowly, with a pH 2.560±0.003 in week 12. Both MTT and Transwell experiments showed that the extract of PGA nerve conduits had no effect on the proliferation and migration of RSC 96, nor a significant difference existed in comparison with the corresponding control groups ( P>0.05). The experiments of in vivo degradation of PGA nerve conduits showed that the nerve conduits in both experimental and control groups had good support at week 2 after implantation. At weeks 4-12 after implantation, the nerve conduits in both groups gradually softened and collapsed, but the conduits were in one piece and not broken. The blood routine, liver and kidney functions showed no statistically significant difference between the 2 groups over the same period, and between each time point within the groups and the groups before implantation ( P>0.05). No obvious abnormal appearance of livers and kidneys was found in the rats sacrificed at each observation time point. Also, there was no obvious degeneration and necrosis of the muscle tissue around the conduits in the 2 groups, and no obvious inflammatory cells infiltration was found from the histological examinations. Morphology of the muscle tissue remained normal. Conclusion:Domestically produced PGA nerve conduit is fund good in both of biocompatibility and biodegradability. It is safe and reliable, and it provides a basis for the further experients in repair of nerve defects.