In resent years,brain parenchyma and cerebrovascular sonography have received considerable attention.Monitoring of cerebral vessels and their blood flow velocities and pulsation indexes may reflect the intracranial vascular lesions.However,there are a few studies about transcranial color-code duplex sonography (TCCD) in the monitoring of space-occupying stroke.This technology has the non-invasive,convenient,and economical advantages,and can timely provide clinical information.Using TCCD to monitor pace-occupying stroke may play a positive role in prevention of the diseases and prognosis.

Obective To study the association between vertebral artery hypoplasia (VAH) and acute posterior circulation ischemic stroke (APCIS).Methods Of the 718 patients admitted to our hospital for carotid artery ultrosonography and head MRI included in this study,381 with unilateral or bilateral VAH served as an observation group and 337 without unilateral or bilateral VAH served as a control group.The incidence of APCIS in two groups was retrospectively analyzed.The risk factors for APCIS were analyzed by multivariate logistic stepwise regression analysis.Results The incidence of embryonal posterior cerebral artery hypoplasia was significantly higher in observation group than in control group (48.03％ vs 15.13％,P=0.000).No significant difference was found in the incidence of APCIS between the two groups (14.16％ vs 10.00％when the age was ≤ 55 years,7.84％ vs 11.24％ when the age was＞＞55 years,xMH2 =0.310,P=0.578).Hypertension and hyperlipidaemia were the risk factors for APCIS (OR=1.913,P=0.019;OR=1.875,P=0.015).Conclusion VAH is rather common in APCIS patients.However,its accomplanied embryonal posterior cerebral artery hypoplasia does not incease the risk of APCIS.

Objective:To investigate the risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection.Methods:From November 2013 to December 2019, patients with spontaneous extracranial vertebral artery dissection admitted to the Department of Neurology, Baotou Central Hospital were enrolled retrospectively. According to whether they had ischemic stroke or not, they were divided into ischemic stroke group and non-ischemic stroke group. The independent risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection were identified by binary logistic regression analysis. Results:A total of 39 patients were enrolled, 25 were female (64.1%), 14 were males (35.9%), their age was 51.51±14.98 years old, 16 of them (41.0%) had ischemic stroke. The proportion of patients with double-lumen sign, intimal flap sign of occluded lumen (37% vs. 4%; P=0.013) and specific initial symptoms (56% vs. 9%; P=0.003) of the ischemic stroke group were significantly higher than those of the non-ischemic stroke group. Multivariate logistic regression analysis showed that double-lumen sign and intimal flap sign of occluded lumen (odds ratio 47.951, 95% confidence interval 26.284-87.478; P<0.001), and specific initial symptoms (odds ratio 19.232, 95% confidence interval 10.695-34.587; P<0.001) were independently associated with ischemic stroke in patients with spontaneous extracranial vertebral artery dissection. Conclusions:Double-lumen sign, intimal flap sign of occluded lumen and specific clinical symptoms are the independent risk factors for ischemic stroke in patients with spontaneous extracranial vertebral artery dissection.

Based on the requirement of the ongoing healthcare reform on the performance appraisal for public hospitals, Shanghai Tenth People′s Hospital explored the performance appraisal system oriented by clinical ability and cost control from the perspective of medical administration and finance. Performance appraisal programs were made from five aspects: clinical development ability, key efficacy indicators, clinical path, disease-entity structure, cost control, aiming to highlight the functional positioning of tertiary hospitals, change doctors′ behaviors of diagnosis and treatment, lead clinical improvement and maintain healthy economy development.