Ischemic stroke is the leading cause of death and disability in the global population, Its pathological mechanism is complex and related to multiple risk factors. Zinc, as a key trace element, plays a dual role in maintaining neurological function and ischemic brain injury. It not only mediates toxic damage but also promotes neuroprotection. This article explores the role of zinc in the pathogenesis of stroke, summarizes the therapeutic potential of zinc chelators and related intervention strategies, and analyzes its value in stroke prevention. Future research should focus on zinc metabolism mechanisms and clinical translation to improve stroke outcome.

Osteopontin (OPN) is a secreted extracellular matrix glycoprotein that exists in body fluids and mediates multiple biological functions. The expression of OPN is particularly critical and active after ischemic stroke, and has dual significance for the body. The rapid increase of OPN has certain protective effects on the body, such as anti-inflammatory and promoting wound healing; if the rate of increase is relatively slower, it will have adverse effects on the body, such as promoting thrombosis and inducing inflammatory reactions. This article reviews the research progress of OPN in ischemic stroke.

In recent years, post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) have gradually attracted the attention of scholars as common stroke-related non-motor symptoms. As an emerging non-invasive neuroimaging tool, functional near-infrared spectroscopy (fNIRS) has been widely used in the study of neurological diseases, which can evaluate the functional status and recovery of these patients by monitoring changes in cerebral blood circulation and oxygenation signals; fNIRS is now being increasingly used in PSD and PSCI studies. This review mainly focuses on the research progress of fNIRS in identifying PSD and PSCI, exploring their neural mechanisms, and evaluating treatment effects, as well as advantages, disadvantages and future development prospects of fNIRS in clinical application, so as to provide some references for research on rehabilitation of affective disorders and cognitive disorders in stroke patients.

Objective:To predict the risk of cryptogenic stroke (CS) patients with right-to-left shunt (RLS) by machine learning, and provide potential solutions for accurate and efficient prediction of CS.Methods:A retrospective analysis of clinical data on 289 subjects with positive RLS detected by contrast-enhanced transcranial Doppler tests (c-TCD) treated in the Department of Neurology at Laoshan Campus, the Affiliated Hospital of Qingdao University, from January 2018 to September 2023, including demographic information, medical history, laboratory test indicators, diagnosis, and treatment.The dataset was randomly divided into a training set and a testing set by the machine learning function train_test_split(), with a ratio of 8∶2.Risk prediction models for CS in RLS subjects were constructed by algorithms such as Logistic regression, decision trees, random forests, extreme gradient boosting, artificial neural networks, gradient boosting, extra trees, and adaptive Boosting.The model performance was evaluated by receiver operating characteristic curves (ROC), area under curve (AUC), confusion matrix, precision, recall, accuracy, F1 score, calibration curves, and decision curve analysis.The optimal model was subjected to interpretability analysis by feature importance and SHAP values.The t-test, Mann-Whitney U test and χ2 test were used for data analysis by SPSS 25.0 software.Delong test was used to compare the differences in AUC between the two models. Results:In 289 RLS subjects, there were 166 cases of CS (57.5%) and 123 cases of non-CS (42.5%).The statistical analysis results showed that blood biochemical indicators such as D-dimer, mean platelet volume, and fibrinogen in CS patients were higher than those in non-CS patients (all P<0.01).There were no statistically significant differences in variables between the training and testing sets(all P>0.05).Random forest model achieved the highest AUC (0.885), precision (0.806), recall (0.879), accuracy (0.810), and F1 score (0.841) for CS risk prediction in the testing set.The calibration curve showed that the random forest model was closest to the reference line, and the decision curve analysis indicated that it had a greater net benefit.The interpretability analysis revealed that high-risk factors included mean platelet volume, D-dimer, international normalized ratio, body mass index, and age. Conclusion:The random forest-based prediction tool exhibits excellent performance, demonstrating high accuracy in predicting CS risk in RLS population.

White matter hyperintensities (WMHs) were once thought to be a normal aging phenomenon. However, the available evidences suggest that WMHs are an indicator of poor brain and cardiovascular health, indicating an increased risk of ischemic stroke, cognitive impairment, depression, and death. This article reviews the effects and mechanisms of physical activity and exercise on WMHs, so as to provide a basis for better prevention of WMHs.

Post-stroke gait disturbance is one of the core issues leading to impaired motor function and decreased quality of life. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive brain regulation technique, has shown unique potential in the field of stroke rehabilitation. rTMS can improve gait and balance function by enhancing neural plasticity, regulating neurotransmitter metabolism, regulating cerebral blood flow, and improving cortical excitability and ion balance. Future research should focus on the development of individualized treatment plan, treatment plan optimization, and the synergistic effect of rTMS combined with other rehabilitation methods, in order to provide more effective treatment strategies for patients with post-stroke gait disturbance.

Objective:To study the risk factors of acute stroke within 1 year after hip fracture in the elderly and its effect on prognosis.Methods:From January 2018 to December 2020, 278 elderly hip fracture patients undergoing surgery were retrospectively analyzed, including 101 males and 177 females, aged from 60 to 99 years with an average of(78.9±8.7)years.According to whether acute stroke occurred within 1 year after operation, the patients were divided into stroke group and non-stroke group.A multivariate Logistic regression was used to evaluate the risk factors for acute stroke within 1 year after hip fracture, and the prognosis was analyzed.Results:Acute stroke occurred in 28 patients(10.1%)within 1 year after operation, and the peak of stroke onset occurred in the third months after operation.Patients in the stroke group were older, and had a higher proportion of hypertension, arrhythmia, previous stroke history, and use of anticoagulant or antiplatelet drugs before fracture( P<0.05 for all). Multivariate Logistic regression analysis showed that advanced age( OR=1.078, 95% CI=1.007-1.153, P=0.030), male( OR=2.643, 95% CI=1.060-6.742, P=0.037)and previous stroke history( OR=12.202, 95% CI=4.662-31.940, P<0.001)were independent risk factors for stroke in elderly patients with hip fracture within 1 year after operation.The 1-year mortality, complication rate and readmission rate in the stroke group were significantly higher than those in the non-stroke group( P<0.05 for all). Conclusions:The incidence of stroke is high in elderly patients with hip fracture within 1 year after operation.Older age, male, and previous stroke history were independent risk factors for acute stroke.The prognosis of stroke was poor in elderly patients with hip fracture, and the 1-year mortality, complication and readmission rates were high.

Stroke is a cerebrovascular disease that damages brain tissue due to blockage or rupture of blood vessels, and is one of the leading causes of death and disability worldwide. Diagnosing, monitoring stroke and the treatment effects all rely on neuroimaging that detects changes in the brain. Near-infrared spectroscopy (NIRS) is a novel neuroimaging technique which is based on the non-invasively measuring of concentration changes of oxyhemoglobin and reduced hemoglobin. This review summarizes the underlying mechanisms of NIRS and its current clinical application in stroke, as well as the limitations of NIRS in broader clinical applications.

Neuroinflammatory response may accelerate tissue damage after ischemic stroke and affect neuronal death and neurogenesis. Microglia are an important line of defense against central nervous system injury, which are rapidly activated after cerebral ischemia and exert their effects by releasing various inflammatory mediators. Therefore, promoting the transition of microglia from M1 phenotype to M2 phenotype or maintaining dynamic balance between the two during the inflammatory process after ischemic stroke may be the important therapeutic targets for reducing inflammation after cerebral ischemia.

The main functional ingredients of hot water extract of Chlorella pyrenoidosa (CPE) were investigated through a bioassay-guided fractionation based on free radical scavenging and macrophage proliferation effects. The main functional ingredients of CPE were polysaccharides (PS) that were isolated by high pressure extraction, Sevag method, ethanol precipitation and ultrafiltration separation. Crude polysaccharides were further separated and purified by ion exchange chromatography DEAE52 and size exclusion chromatography Sephadex G-100. The purified fractions were analyzed by gel permeation chromatography. Molecular weights of the purified fractions PS-1-4-2, PS-1-3-2 and PS-2-3-3 were 3.97×10⁴, 2.28×10⁴ and 4.1×10³ Da, respectively. Bioassay-guided fractionation results indicated that CPE could remove free radicals and promote Ana-1 cells proliferation, mainly due to its various components working together. The components of free radicals scavenging mainly concentrated in PS-1-3, PS-1-4, PS-2-3 and PS-2-4. The components of Ana-1 proliferation mainly concentrated in PS-1-3, PS-1-4 and PS-2-3. This study established the activity screening method of main functional component from CPE, and got three new functional ingredients. It can be used to guide the development of high value products, further promote the industrialization process of microalgae energy, and realize microalgae 'high value products, microalgae energy and microalgae carbon' integration of exemplary role.