Remote ischemic postconditioning (RIP) refers to a transient and non-lethal ischemic adaptation in non-vital organs after the vital organs having experienced long-term lethal ischemic injury. Relative to the remote ischemic preconditioning (RIPC),RIP has more value in clinical application. However,RIP is still in the cognitive stage of research. This article reviews the advances in research on RIP of each system.

Objective To investigate the changes of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP)in acute phase of cerebral infarction. Methods From March 2011 to June 2012,95 patients with early cerebral infarction from the Neurology Clinic,the Emergency Department and the Cerebral Apoplexy Screening Project Base,and the Neurology Ward of Renhe Hospital were used as an infarction group;61 non-stroke subjects received physical examination in the Physical Examination Center of our hospital in the same period were used as a control group. The cerebral infarction group and the patients with cerebral infarction in different onset of time groups (an onset < 12 h group and an onset 12-24 h group),the different National Institutes of Health Stroke Scale (NIHSS)score groups (NIHSS 0 -4 group and NIHSS 5 -19 group),and the levels of UCH-L1 and GFAP in the control group were measured and compared among the groups. The receiver operating characteristic (ROC)curve was established. The cut-off values of the relevant parameters in the diagnosis of cerebral infarction,and the sensitivity and specificity of diagnosis were obtained. Results The UCH-L1 and GFAP values of the cerebral infarction group were all higher than those of the normal control group (0. 13[0. 09,0. 21]μg/ L vs. 0. 05[0. 02,0. 13]μg/ L,0. 030[0. 008,0. 130]μg/ L vs. 0. 004[0. 004,0. 020]μg/ L,Z values were 3. 62 and 4. 95 respectively;all P < 0. 01). The UCH-L1 and GFAP values of the NIHSS score 5 -19 group were higher than those of the NIHSS score 0 -4 group (0. 12[0. 08,0. 21]vs. 0. 09[0. 08,0. 18],0. 07 [0. 01,0. 11]vs. 0. 04[0. 01,0. 10];all P < 0. 05). There was no significant difference in the UCH-L1 and GFAP values between the onset 12 -24 h group and the onset < 12 h group (0. 12[0. 08,0. 21]μg/ L vs. 0. 09[0. 08,0. 18]μg/ L,0. 030[0. 010,0. 110]μg/ L vs. 0. 040[0. 008,0. 100]μg/ L;all P > 0. 05). The analysis results of ROC curve of UCH-L1 and GFAP for diagnosis of acute cerebral infarction showed that when the plasma UCH-L1 was ≥0. 18 μg/ L,the sensitivity and specificity of UCH-L1 were 68% and 74%respectively;When the plasma GFAP was ≥0. 11 μg/ L,the sensitivity and specificity of GFAP were 70% and 86% respectively. The area under the ROC curve of UCH-L1 and GFAP diagnosis of cerebral infarction were 0. 64 and 0. 71 respectively. Conclusions UCH-L1 and GFAP have obvious change in acute phase of cerebral infarction. UCH-L1 and GFAP may have certain correlation with the severity of stroke.

Objective To investigate the therapeutic method and effect of thrombolysis via super-selective ophthalmic artery catheterization treating central retinal artery occlusion (CRAO). Methods 9 patients with CRAO were treated by urokinase infusion via super-selective ophthalmic artery catheterization with Seldinger technique. Results In the 9 patients, the visual acuity was improved to different extent in 8, and remained unchanged in 1. No complications was found during the treatment in any patients. Conclusions Thrombolysis via super-selective ophthalmic artery catheterization for CRAO can improve the visual acuity of most of the patients in different degrees. No positive relation exists in clinical therapeutic effect, time of onset, quantity of urokinase and the visual acuity before the treatment. The method of thrombolysis via super-selective ophthalmic artery catheterization for CRVO is safe and reliable.

The pathogenesis of cerebral ischemia is extremely complicated.In vitro models have better controllability.They have important significance for the study of the pathogenesis.This article reviews the commonly used In vitro models and provides references for the future study of the pathogenesis of cerebral ischemia.

With the wide development of intra-arterial thrombolysis,the risk factors and the occurrence mechanism of hemorrhagic transformation have drawn great attention.Hemorrhagic tramformation is the most dangerous complication of intra-arterial thrombolysis.The understanding of the occurrence mechanism of hemorrhagic transformation from macroscopic tO microscopic,it is attributed ultimately to the destruction of vascular wall structure or function.The related mechanisms include oxidative stress reaction,leukocyte infiltration and inflammatory reaction,vascular reaction,and extracellular proteolysis.

As an endogenous organism protective measure in vivo, preconditioning/ postconditioning in the process of ischemia/reperfusion may play common protective mechanisms, such as reducing the generation of oxygen free radicals, activating adenosine receptor, increasing endogenous nitric oxide and heat shock protein, inhibiting immune inflammatory response and neuronal apoptosis, activating intracellular signal transduction pathways, opening mitochondrial ATP-sensitive potassium channels, as veil as closing mitochondrial permeability transition pores. Investigating the common target of these mechanisms may provide a new theoretical basis for developing new drugs and reducing ischemia/reperfusion injury.

n he found for the treatment of ischemic cerebrovas-cular disease. This article reviews the recent progress in research on cerebral ischemia-reperfusion-induced ERS.

Remote organ ischemic preconditioning is to conduct a transient and sublethal ischemic adaptation in non-vital organs before occurring cerebral ischemia/reperfusion injury in remote vital organs. Remote organ iscbemic preconditioning has been studied for as long as 15 years in the field of myocardial iscbemia. However, only recently it has become a therapeutic strategy for the treatment of cerebrovascular diseases, This article briefly reviews the methods and mechanisms involved in the protective effects of cerebral ischemia of remote organ ischemic preconditioning.

Objective To investigate the feasibility and effectiveness of internal jugular vein (IJV) intervention therapy in patients with cerebral venous sinus thrombosis (CVST)with color Doppler ultrasound (CDU). Methods Twelve patients with CVST diagnosed by CDU and the 13 IJV lesions (localized luminal stenosis in 9 cases,venous long-segment slender in 2 cases,and right IJV localized luminal stenosis,and long-segment slender on the left in 1 case)confirmed by magnetic resonance venography (MRV)and/ or digital subtraction angiography (DSA)were enrolled retrospectively. CDU examinations were used at 1 week before and after IJV intervention therapy,6 months,1 year,and 2 years. The changes of the maximum diameter and the maximum velocity (V max )of the IJV were compared. The success rate and the long-term efficacy of the intervention therapy were analyzed. Results One week after treatment,the CDU examinations showed that the diameter of IJV stenosis in 13 IJV were increased significantly compared with those before procedure (4. 7 ± 2. 1 mm vs. 2. 3 ± 1. 3 mm;t = 5. 325,P < 0. 01). The velocity of blood flow of IJV was improved compared with before procedure (localized stenosis in 10 IJV[50 ± 15 cm/ s vs. 87 ± 24 cm/ s];t = 6. 285,P < 0. 01). Six of the 12 patients were followed up for a mean of 18 ± 7 months, two patients had restenosis after balloon dilatation. Conclusions For CVST patients with IJV lesions,the preliminary observation has indicated that IJV intervention therapy may improve the lesion lumen and hemodynamics. However,the intervention therapy,especially after balloon dilatation,the incidence of restenosis is higher. CDU can be used as an objective evaluation means for the long-term efficacy of IJV stenosis.

Objective To analyze the clinical features and prognosis in adult Chinese patients with anti-γ-aminobutyric acid B receptor (GABA-BR) encephalitis.Methods We reviewed the clinical manifestations,cerebrospinal fluid (CSF) examinations,brain magnetic resonance imaging and prognosis of 12 patients who were diagnosed as anti-GABA-BR encephalitis in Capital Medical University Xuanwu Hospital from March 2013 to December 2015.Results The major clinical features of anti-GABA-BR encephalitis patients included seizures (12/12),cognitive disorder (10/12),psychiatric symptoms (10/12),sleep disorders (3/12),visual hallucination (2/12),involuntary movements (2/12),decreased consciousness (3/12),cerebellar signs (2/12),fever (2/12).GABA-BR-antibody was positive in CSF and serum of all the patients.Electroencephalogram revealed epileptic discharges in 4/12 patients.Brain MRI showed abnormal signal in up to 9/12 patients,located in the hippocampus,temporal lobes,thalamus and periventricular area.PET or SPECT indicated hypometabolism in 5/6 patients.After the average of fourteen months follow-up,9/12 patients had good prognosis,3 patients did not.Of 3 patients with poor outcome,2 had small cell lung cancer.Conclusions The predominant clinical features of the anti-GABA-BR encephalitis are seizures,cognitive disorder and psychiatric symptoms.The lesions are not only located in limbic system.Early diagnosis and immune modulation may provide a good outcome.