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.

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

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.

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.

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.

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 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.

Objective To investigate the relationship between serum levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and Suzuki' s grading system in adult moyamoya disease (MMD).Methods Fifty-two adult patients with MMD,who were diagnosed in Jinling hospital between April 2009 and January 2010,were retrieved from the Nanjing Stroke Registry Program (NSRP).Sixteen sex- and age-matched healthy individuals with MMD patients consisted of the control group.Using enzyme-linked immunosorbent assay,serum concentrations of VEGF and MMP-9 were compared between adult MMD patients and healthy individuals.By Suzuki' s six-grading system,patients were divided into different subgroups,and the correlation of serum levels of VEGF and MMP-9 corresponding to different subgroup and Suzuki's grading was respectively analyzed.In addition,the correlation of serum levels of VEGF and MMP-9 was also evaluated.Results Serum VEGF concentrations in ischemic and hemorrhagic MMD patients was respectively ( 289.4 + 69.2 ) pg/ml and ( 324.3 ± 95.6 ) pg/ml and were significantly higher compared to those in healthy controls ( ( 63.5 ± 7.6 ) pg/ml; F =69.43,P ＜ 0.01 ).Similar findings were observed for MMP-9 ( ( 499.4 ± 76.2 ) ng/ml and ( 531.2 + 100.2 ) ng/ml versus (257.1 ±30.7) ng/ml; F =66.023,P ＜0.01 ).With the increase of Suzuki' s grading,serum levels of VEGF and MMP-9 respectively showed a high trend ( r =0.879,P ＜ 0.01:r =0.838,P ＜ 0.01 ).In addition,a positive correlation between serum levels of VEGF and MMP-9 was found in the MMD group( r =0.590,P ＜0.01 ).Conclusion The results show that serum levels of VEGF and MMP-9 in adult MMD are higher than those in healthy controls,which may play a role in neovascularization in MMD,and moreover,serum levels of VEGF and MMP-9 show a high trend with the progression of MMD,which suggest that serum levels of VEGF and MMP-9 can reflect the severity of MMD.