Objective To investigate the severity of white matter lesions （WML） in patients with right-to-left shunt （RLS）-positive migraine. Methods A total of 415 patients with RLS-positive migraine who were consecutively admitted to Department of Neurology， The First Affiliated Hospital of Soochow University， from January 2022 to January 2025 were enrolled， and all these patients met the diagnostic criteria in The International Classification of Headache Disorders， 3 rd edition. RLS was diagnosed based on contrast-enhanced transcranial Doppler and contrast-enhanced transesophageal echocardiography， and the type and grade of RLS were assessed. After a series of statistical analyses was conducted， the factors with P<0.05 in the univariate logistic regression analysis were included in the multivariate binary logistic regression analysis to investigate the risk factors for the onset and severity of WML， with P<0.05 indicating statistical significance. Results The analysis of the baseline data of patients with different grades of WML showed that the grade of WML increased with age in the patients with RLS-positive migraine （P<0.05）. Comparison of multimodal ultrasound findings between the patients with different grades of WML showed that there were significant differences between the patients with different grades of WML in the factors such as large RLS， potential RLS， prolonged PFO tunnel， higher PFO at the right atrial side in resting state and after Valsalva maneuver， higher PFO at the left atrial side after Valsalva maneuver， early appearance of shunt， and longer duration of shunt （P<0.05）. For the establishment of a predictive model， large RLS shunt （P=0.037）， higher PFO at the right atrial side after Valsalva maneuver （P=0.018）， and longer duration of shunt （P<0.001） were independent risk factors for the onset of WML in patients with RLS-positive migraine， and further research showed that prolonged PFO tunnel （P<0.001） was a risk factor for the onset of moderate-to-severe WML in patients with RLS-positive migraine. Conclusion The predictive model established based on the ultrasound factors including large RLS shunt and prolonged PFO tunnel can be used as an imaging method to screen for WML， especially moderate-to-severe WML， which provides a theoretical basis for subsequent treatment.

Objective: To investigate the prevalence and risk factors of dyslipidemia among residents in Haining City, Zhejiang Province, so as to provide into the management of dyslipidemia. Methods: Totally 1 953 residents at ages of 15 to 69 years were recruited using a multi-stage stratified cluster sampling method in 5 townships (streets) of Hainan City. Subjects' demographic features, smoking status, alcohol consumption, family history of diseases and development of chronic diseases were collected. The height, body weight, waist circumstance and blood pressure were measured, and the fasting blood glucose, serum uric acid and blood lipid levels were determined. The prevalence of dyslipidemia was analyzed and standardized by the 7th population census data. The factors affecting dyslipidemia were identified using a multivariable logistic regression model. Results: Totally 1 893 valid questionnaires were recovered. The respondents included 949 males (50.13%) and 944 females (49.87%), and had a mean age of (47.90±14.34) years. A total of 513 participants were detected with dyslipidemia, and the prevalence and standardized prevalence of dyslipidemia were 27.10% and 27.01%, respectively. The prevalence of hypertriglyceridemia, hypercholesterolemia, hyperlipoproteinemia and hypolipoproteinemia was 16.53%, 3.22%, 1.74% and 15.27%, respectively. Multivariate logistic regression analysis showed that male (OR=1.571, 95%CI: 1.268-1.947), family history of stroke (OR=1.645, 95%CI: 1.192-2.270), hyperuricemia (OR=1.809, 95%CI: 1.370-2.388), central obesity (OR=1.423, 95%CI: 1.066-1.900), obesity (OR=1.736, 95%CI: 1.335-2.257), underweight (OR=0.171, 95%CI: 0.049-0.593) significantly correlated with dyslipidemia. Conclusions The prevalence of dyslipidemia is lower than the national level among residents at ages of 15 to 69 years in Haining City, and hypertriglyceridemia and hypolipoproteinemia are predominant types of dyslipidemia. Male, obesity, family history of stroke and hyperuricemia are risk factors of dyslipidemia.

To investigate the clinical value of transcranial Doppler ultrasound （TCD） in evaluating intracranial collateral circulation in patients with extracranial segment of unilateral internal carotid artery occlusion （ICAO）. Methods A total of 145 patients with ICAO，109 in the symptomatic group and 36 in the asymptomatic group，who were diagnosed by cervical vascular ultrasonography and confirmed by digital subtraction angiography （DSA） in the Stroke Center of the First Affiliated Hospital of Soochow University from January 2018 to December 2020，were retrospectively enrolled. TCD was recorded to evaluate intracranial collateral circulation types and performed consistency test with DSA.The hemodynamic parameters of bilateral middle cerebral artery （MCA） and CT perfusion （CTP） parameters of bilateral basal ganglia and temporal lobe were recorded. According to the Collateral circulation assessment system of the American Society for Interventional and Therapeutic Neuroradiology/Society for Interventional Radiology （ASITN/SIR），patients were divided into poor collateral circulation（grade 0～2） and good collateral circulation （grade 3～4），and the differences of MCA parameters and CTP parameters were compared between the two groups. The differences in bilateral MCA blood flow parameters between the asymptomatic group and the symptomatic group and the early CT scores （ASPECTS） of the Alberta Stroke Project were compared.Results （1） Consistency analysis：The coincidence rates of anterior communicating artery （ACoA），posterior communicating artery （PCoA），ocular artery （OA） and DSA evaluated by TCD were：93.1%，91.0%，80.7%，with good consistency （Kappa value=0.84，0.78，0.66，all P<0.05）.（2）Collateral circulation compensation：The mean flow rate（Vm），peak systolic flow rate （Vs），end diastolic flow rate （Vd） and pulsation index （PI）of the affected middle cerebral artery in the poor collateral circulation group were lower than those in the good group，and the differences in Vm，Vs and Vd were statistically significant （P<0.05）. CBF and CBV in basal ganglia and temporal lobe were decreased，while MTT and TTP were prolonged，with statistically significant differences（all P<0.05）.（3）ASPECTS in asymptomatic group were significantly higher than those in symptomatic group，and blood flow parameters in MCA of healthy side were less different than those in symptomatic group （all P<0.01）.Conclusion TCD is consistent with DSA in evaluating intracranial collateral circulation in patients with intracranial extracranial occlusion of unilateral internal carotid artery.MCA blood flow parameters can reflect the perfusion in the blood supply area，and TCD is an effective tool for evaluating intracranial collateral circulation.

Objective: To investigate the differences in the intake of macronutrients between boarders and resident students in China, and to provide a scientific reference for relevant policies and preventive measures. Methods: The difference of macronutrients level between boarders and resident students were analyzed with the multilevel model (MLM) by using the data from Chinese Health and Nutrition Survey and the indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results: The daily intake of energy, carbohydrate, fat and protein were (1 597.59±557.15)kcal, (216.2±84.66)g, (57.88±31.96)g, (52.69±21.2)g respectively, with a rate of meeting DRIs of 17.32%, 84.17%, 50.30% for energy, carbohydrate and protein. There were significant differences in amount of energy, carbohydrate between boarders and resident students, but no significant difference in rate of meeting DRIs (15.09%, 87.28%, 17.54%, 83.86%, P>0.05 ). No difference in the amount of fat and protein intake between boarders and resident students, but the protein rate of meeting DRIs among resident students was significantly lower than that in boarders(34.91% vs 51.82%, χ2=4.45, P<0.01). Conclusion The results revealed an imbalanced intake of macronutrients among primary and secondary school students, which highlight the insufficiency in energy intake and the worse meeting rate of DRIs for protein among resident-student. The nutritional education targeting at boarder-students should be strengthened.