Twenty - one cases of chronic heart failure were treated with Xinshuailing, a compound recipe consisting of Chinese drugs. After the therapy, all patientswere markedly improved in signs and symptoms, with a total effective rate of 90. 4%. 90. 5% of the cases were improved in their heart functions. The changes in the indices of heart rate a'nd heart functions were all significant statistically (P

Transient ischemic attack(TIA) is one frequent type of acute ischemic cerebral vascular disease.Much advancement has been made in the definition,aetiology,diagnosis and therapy of TIA in recent years.Carotid endarterectomy and carotid angioplasty and stenting is the latest therapy of carotid artery stenosis.

Cervical arterial dissection is an important cause resulting in stroke, particularly in young adults. The clinical manifestation of cervical arterial dissection may be various, and imaging examinations have a great value in the diagnosis of cervical arterial dissection. At present, anticoagulation and anti-platelet aggregation are the most important medication, while intravascular intervention is a new option for patients failed to respond to medical treatment. This article reviews the recent progress in the diagnosis and treatment of cervical arterial dissection.

Cerebral venous sinus thrombosis (CVST) in children has been previously regarded as a rare cerebrovascular disease. With the development of neuroimaging, we have more knowledge and understanding about CVST in children. The etiologies of CVST can be divided into infectious and noninfectious. Its clinical manifestations are various and lack of specificity. These characteristics make the clinical diagnosis of CVST have some difficulties.Now, it is considered that in combination with magnetic resonance imaging and magnetic resonance venography is the best means of diagnosis of CVST. Anticoagulation is the preferred treatment for CVST. Interventional thrombolysis, mechanical thrombectomy or decompressive craniotomy can be used for children whose symptoms continue to deteriorate after systematic anticoagulation therapy. The prognosis of CVST is relatively good if it is diagnosed and treated in time.

Endovascular intervention is an effective method in the treatment of cerebrovascular stenosis. With the advancement of techniques and improvement of equipment, the application area of this treatment is expanding and the number of patients treated is increasing. Accordingly, the use of contrast media is improving continuously in endovascular intervention. An increasing number of contrast media-related complications have also been reported. This paper briefly reviews the contrast media-related complications and their management in endovascular intervention.

Cerebral venous thrombosis is a rare cerebral venous occlusive disease. Its clinical manifestations are variable, and this may lead to misdiagnosis or mistreatment. Prompt treatment is essential to improve its prognosis. This article reviews the recent treatment methods, especially the interventional endovascular treatment.

Objective To evaluate the clinical usefulness of determining the liver reserve function by estimating the retention rate of indocyanine green at fifteen minutes(ICGR15) before interventional chemoembolization in treating patients with primary hepatocellular carcinoma(HCC).Methods Forty-three patients with HCC were enrolled in this study.Before interventional chemoembolization ICGR15 and Child-Pugh classification were estimated in all patients.Based on the ICGR15,the patients were divided into three groups.After chemoembolization,all the patients were divided into two groups according to liver function condition: group M(showing mild hepatic dysfunction) and group S(developing severe hepatic dysfunction).The occurrence of postoperative hepatic dysfunction and the difference in the hepatic function changes between three groups were analyzed.Results After interventional chemoembolization the occurrence of hepatic dysfunction were significantly different between three groups divided by ICGR15 test(P

Cerebral hemodynamic changes are an important pathophysiologic process for the occurrence and development of Moyamoya disease. Cerebral hemodynamic changes of Moyamoya disease have been a research focus. This article mainly reviews the cerebral hemodynamic parameters and detecting methods, characteristics of cerebral hemodynamic changes in patients with Moyamoya disease and their new progress.

Objective To investigate the possible formation mechanism and imaging features of the hyperintense vessel sign (HVS) on fluid attenuated inversion recovery (FLAIR) in patients with ischemic stroke or transient ischemic attack (TIA).Methods The baseline data of the patients with middle cerebral artery (MCA) ischemic stroke or TIA with digital subtraction angiography (DSA) showing the lesions of MCA M1 segment in clinical practice were retrospectively retrieved from Nanjing Stroke Registry Program from January 2010 to July 2011.FLAIR was used to observe HVS,and DSA was used to evaluate the degree of vascular stenosis and cerebral collateral circulation.Results A total of 101 patients were enrolled,76 (75.2％) were males,and their mean age was 53.94 ± 13.47 years; 90 patients (89.1％) with ischemic stroke and 11 patients (10.9％) with TIA; 55 patients (54.5％) were HVS negative and 46 (45.5％) were HVS positive.Among the patients whose MCA stenosis ＜50％,50％-70％,70％-90％ and ≥90％,the positive rates were 0％ (0/8),25.0％ (3/12),17.6％ (3/17),and 62.5％ (40/64),respectively.There were significant differences (Z=-4.479,P＜ 0.001).The leptomeningeal collateral circulation of the HVS positive group was significantly more than that of the HVS negative group (Z =-6.196,P ＜ 0.001).Multivariate logistic regression analysis showed that the degree of MCA stenosis was an independent risk factor for influencing the formation of HVS (odds ratio 3.943,95％ confidence interval 2.03-7.659; P ＜0.001).Conclusions The formed intracranial leptomeningeal colhteral circulation after severe intracranial vascular stenosis or occlusion is a major pathophysiological basis of HVS formation on FLAIR sequences in patients with ischemic stroke or TIA.

Objective To study the patterns of collateral circulation in adults moyamoya disease (MMD). Methods One hundred and nineteen consecutive adult patients with MMD (ischemic or hemorrhagic type) were identified by digital cerebral angiography in Nanjing Stroke Registry Program of Jinling Hospital between August 2004 and January 2010.The extracranial and (or) intracranial collateral circulations ipsilateral to stroke hemisphere were regarded as the research objects,and furthermore,these collateral circulations were divided into three different grades:Grade 1 collateral (anterior cerebral artery (ACA) → meningeal arteries (MLA) → middle cerebral artery (MCA) ),Grade 2 collateral ( dilating and extensing anterior choroidal artery beyond choroid fissure,patent posterior communicating artery → posterior cerebral artery→MLA→ ACA and(or) MCA,posterior cerebral artery→MLA→ACA and (or) MCA and posterior choroidal artery → posterior pericallosal arteries → ACA ) and Grade 3 collateral (collateral originating from the external carotid artery supplying to cerebral blood flow). The relationship between collateral distribution patterns in adult MMD and Suzuki' s classification was analyzed.Results In 117 assessed vessel units of the collateral circulation ipsilateral to stroke hemisphere,there were a total of 200 collateral circulations.The percentage of numbers in Grade 1,Grade 2 and Grade 3 collateral was 11.5％(23/200),52.0％ (104/200) and 36.5％ (73/200),respectively.The distribution percentage of Grade 1 was gradually decreased from Suzuki's Ⅰ to Ⅵ,mainly distributed in the early stage of MMD ( Suzuki's Ⅰ -Ⅱ ) and accounted for 91.3％ (21/23; Z =- 7.270,P ＜ 0.01 ).The distribution percentage of Grade 3 was gradually increased from Suzuki' s Ⅰ to Ⅵ,especially in the late stage of MMD ( Suzuki' s Ⅴ-Ⅵ) and accounted respectively for 37.0％ (27/73) and 63.0％ (46/73; Z =-7.270,P ＜0.01 ).Compared with the total distribution of Grade 1 and 3 collateral circulation,the distribution percentage of Grade 2 was 6.7％ (7/104),7.7％ (8/104),15.4％ ( 16/104),40.4％ (42/104),14.4％ (15/104)and 15.4％ (16/104) from Suzuki' s Ⅰ to Ⅶ.Although there was not significant difference,Grade 2 mainly distributed in the medium stage of MMD ( Suzuki' s Ⅲ-Ⅳ ).Conclusions The patterns of collateral distribution is various,changing with the progression of MMD. Grade 2 collateral circulation accounts for a higher proportion,especially in the medium stage of the disease,which suggests that these collaterals play an important compensatory role of blood flow.