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Promoting the Stroke Prevention Project, National Health Commission: current status and strategy of stroke prevention and treatment in China Stroke Prevention Project, National Health Commission, Ji Xunming Journal of Capital Medical University    2025, 46 (1): 11-14.   DOI: 10.3969/j.issn.1006-7795.2025.01.003 Abstract （2094）      PDF（pc） （392KB）（65）       Knowledge map    Save In China, stroke has become a major public health issue. In response to the growing high-risk population and the substantial health and economic burden, the National Health Commission initiated “the Stroke Prevention Project, National Health Commission” in 2021. This program aims to systematically enhance the stroke prevention and control capacities, therebyreducing the harm caused by stroke. This report offers an overview of the program’s background and strategic implementation from a policy and governance perspective. Reference | Related Articles | Metrics

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The application of artificial intelligence in the diagnosis and treatment of cerebrovascular disease Zhang Wanwan, Dong Xiao, Yu Erlan, Ji Xunming, Wu Chuanjie Journal of Capital Medical University    2025, 46 (1): 6-10.   DOI: 10.3969/j.issn.1006-7795.2025.01.002 Abstract （2013）      PDF（pc） （413KB）（39）       Knowledge map    Save With the rapid development of artificial intelligence (AI) technology and its extensive application in the medical field, AI has gradually been applied to all aspects of cerebrovascular disease diagnosis and treatment, including but not limited to prevention, prediction, diagnosis, treatment, and prognosis assessment. This article reviewed the current application of AI technology in the field of cerebrovascular disease diagnosis and treatment and discussed the improvement of the diagnostic and therapeutic process with AI technology application. It provides novel insights and strategies for the clinical management of cerebrovascular diseases. Reference | Related Articles | Metrics

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The expressions of CD62P, CD40L, and Rev-erbα after ischemic stroke on different onset times Wang Yinping, Meng Cancan, Wu Wenjuan, Yang Zhitang Journal of Capital Medical University    2025, 46 (1): 34-40.   DOI: 10.3969/j.issn.1006-7795.2025.01.006 Abstract （1704）      PDF（pc） （1815KB）（13）       Knowledge map    Save Objective  To investigate the expression levels of platelet activating factor and rhythm nuclear receptor Rev-erbα in patients after ischemic stroke on different onset times. Methods  A total of 158 patients after ischemic stroke admitted from June 2022 to May 2023 were divided into four groups according to the onset time T1 (0-6 o'clock), T2 (6-12 o'clock), T3 (12-18 o'clock), and T4 (18-24 o'clock). Matched to the ischemic stroke groups, 126 patients hospitalized at the same time with non-ischemic stroke were divided into four groups. General data and serum samples of the subjects were collected, and the expression levels of CD62P, CD40L and Rev-erbα were detected with enzyme-linked immunosorbent assay (ELISA). Results  The expressions of platelet activating factor CD62P, tumor necrosis factor CD40L, and rhythm nuclear receptor Rev-erbα in T2 group after ischemic stroke were significantly higher than that in the other groups (P< 0.05), whilst no significant difference were observed in other three groups （P>0.05). The expression of CD62P, CD40L and rev-erbα in ischemic stroke groups were significantly higher than that in control groups. Conclusion  The expression levels of the rhythm nuclear receptor Rev-erbα, CD62P, and CD40L in ischemic stroke groups is higher than that in control groups, and the expression of these cytokines is more significant in T2 group (i.e. early in the morning) than other time slot. On the other hand, the expressions of CD62P and CD40L are consistent with Rev-erbα on the time slots, indicating a clear correlation. It is indicated Rev-erbα and platelet activation play a key role on attacking of ischemic stroke. Reference | Related Articles | Metrics

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Advances in the application of antiplatelet therapy in intravenous thrombolysis for acute ischemic stroke patients Zi Xiaohui, Xia Xue, Li jing, Zhang Xiaoli, Zhou Quan, Wang Anxin, Wang Yilong Journal of Capital Medical University    2025, 46 (2): 234-242.   DOI: 10.3969/j.issn.1006-7795.2025.02.009 Abstract （1673）      PDF（pc） （553KB）（18）       Knowledge map    Save Acute ischemic stroke (AIS) is associated with high mortality and disability rates, presenting a substantial challenge to global public health challenge. Intravenous thrombolysis (IVT) is recognized as a cornerstone of early AIS treatment and is recommended as the standard therapeutic approach by both national and international guidelines. However, the clinical efficacy of IVT remains suboptimal due to several limitations, including a narrow therapeutic time window and the inevitable activation of the coagulation system and platelet aggregagation during thrombolysis. These factors may contribute to adverse outcomes such as early neurological deterioration (END) and vascular re-occlusion. Antiplatelet therapy (APT), which inhibits platelet aggregations, reduces microthrombus formation, and stabilizes the vascular endothelium with multifaceted mechanisms, has emerged as a promising adjunctive strategy to IVT, offering potential synergistic effects. This review summarized the latest evidence from both domestic and international studies, focusing on the mechanisms of APT, recent clinical advancements in IVT combined with APT, and the safety and efficacy of APT administration at different time windows relative to IVT. Emphasis is placed on the influence of various antiplatelet agents, dosing regimens, and initiation timing on therapeutic outcomes, alongside a comprehensive evaluation in the context of current guideline recommendations and clinical practice. Current guidelines recommend initiating APT 24 h after IVT, following imaging confirmation to exclude the risk of intracranial hemorrhage. However, the efficacy and safety of earlier APT initiation remain inconclusive. Individualized treatment strategies, such as early administration of low-dose, short-acting APT or combination therapy in specific patient subgroups, may effectively balance therapeutic benefits and risks. The adjunctive use of APT in IVT holds promise for enhancing efficacy and improving clinical outcomes, but precise stratification of safety and efficacy is essential. Future research should focus on optimizing combination IVT and APT strategies through individualized patient profiling, appropriate drug selection, and dynamic imaging monitoring to achieve precision management in AIS treatment. Reference | Related Articles | Metrics

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Clinical observation on the efficacy and safety of intravenous thrombolysis in the treatment of acute mild non-disabling ischemic stroke: a single-center retrospective observational study Zhang Meng, Ma Yongxin, Jia Qiong , Zhang Dongwei, Zhang Xinhong, Xu Yaoming Journal of Capital Medical University    2025, 46 (1): 56-62.   DOI: 10.3969/j.issn.1006-7795.2025.01.009 Abstract （1664）      PDF（pc） （867KB）（22）       Knowledge map    Save Objective  To explore the clinical efficacy and safety of intravenous thrombolysis and dual antiplatelet therapy in the treatment of acute mild non-disabling ischemic stroke.  Methods  A retrospective cohort study was conducted, including 138 patients with acute mild non-disabling ischemic stroke［National Institutes of Health Stroke Scale（NIHSS） score≤5］from January 2022 to March 2024, within 6 h of onset. Patients were divided into an intravenous thrombolysis group (66 cases) and a dual antiplatelet group (72 cases). Propensity score matching was used to match patients 1∶1, resulting in 44 patients in each group after matching. Demographic data, clinical data, clinical outcome indicators, and adverse events were collected. The primary outcome was defined as a good functional outcome［modified Rankin Scale(mRS) score 0－2］ at 90 d post-onset. Secondary outcomes included NIHSS scores at 24 h, 72 h, and 7 d post-onset; the proportion of early neurological deterioration; intracranial and systemic hemorrhagic events within 90 d post-onset; and death within 90 d. Results  ①Before matching, the intravenous thrombolysis group had a lower age and admission mRS score than that of the dual antiplatelet group, with statistically significant differences (all P<0.05). After matching, there were no statistically significant differences between the two groups in terms of age, gender, hypertension, diabetes, cardiac disease, atrial fibrillation, hyper low density lipoprotein -cholesterol (LDL-C), hyperhomocysteinemia, prior stroke, prior smoking, admission NIHSS score, admission mRS score, location of stroke and TOAST classification (all P>0.05); ②There was no statistically significant difference in the proportion of patients with a good functional outcome at 90 d post-onset and the mRS score at 90 d between the intravenous thrombolysis group and the dual antiplatelet group［88.6% (39/44) vs 93.2% (41/44), P=0.458, P=0.308］; ③ The intravenous thrombolysis group had significantly lower median NIHSS scores at 24 h and 72 h post-onset compared to the dual antiplatelet group, with statistically significant differences［1 vs  2.5, 1 vs  2, P=0.018, 0.043］. There were no statistically significant differences in the other efficacy and safety outcomes. Conclusions Intravenous thrombolysis therapy can bring significant short-term benefits to patients with acute mild non-disabling ischemic stroke, helping to shorten the time to recovery to a good neurological functional outcome, and does not increase the risk of bleeding and mortality. However, in terms of good functional outcomes at 90 d post-onset, its effects are similar to those of dual antiplatelet therapy. Nevertheless, there is an urgent need for larger sample, higher quality clinical studies to further validate these findings. Reference | Related Articles | Metrics

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Statistical methods and application cases examples for multiplicity issues in multiple endpoints clinical trials Bai Xiudan, Xu Qin, Wang Anxin Journal of Capital Medical University    2025, 46 (2): 184-190.   DOI: 10.3969/j.issn.1006-7795.2025.02.002 Abstract （1651）      PDF（pc） （1550KB）（26）       Knowledge map    Save Performing multiple tests without adjusting the test level results in a higher-than-intended overall familywise error rate (FWER). This phenomenon is known as the multiplicity problem. In this paper, we  first introduced the mechanism of multiplicity problem based on the classification and characterization of clinical endpoints. Then,  strategies and methods to solve the multiplicity problem were introduced, including the parallel strategy/single-step method, the sequential strategy/multistep method/stepwise method, and their combinations. The results of different analytic strategies may vary. The practical application of the above common strategies and statistical methods were introduced through the case studies of domestic and foreign investigator initiated clinical trial. Multiplicity adjustment for multiple endpoints in clinical trials can be achieved by a single strategy or a combination of strategies. Depending on the selected strategy or combination, the statistical  methods and significance level (denoted as α) for each test hypothesis are determined to effectively control the multiplicity problem. Reference | Related Articles | Metrics

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Exploring the causal relationship between extensive perivascular space burden and ischemic stroke and its subtypes and transient ischemic attack based on Mendelian randomization Chu Xuehong, Shen Yingjie, Wang Yaolou, Dong Xiao, Liu Yuanyuan, Feng Yan, Jiang Miaowen, Li Ming, Ji Xunming, Wu Chuanjie Journal of Capital Medical University    2025, 46 (1): 22-33.   DOI: 10.3969/j.issn.1006-7795.2025.01.005 Abstract （1631）      PDF（pc） （23858KB）（20）       Knowledge map    Save Objective  To investigate the association between extensive perivascular space (EPVS) burden in different locations and ischemic stroke (IS), its subtypes, and transient ischemic attack (TIA) through Mendelian randomization (MR) analysis. Methods  The summary data from large-scale Genome-wide Association Studies (GWAS) and various MR methods were employed. We applied multivariable MR to mitigate potential confounding factors and conduct sensitivity analyses to enhance result robustness. Subsequently, meta-analysis was utilized to integrate causal relationships between EPVS burden in different locations and IS from various sources. Additionally, reverse MR was employed to observe the impact of various IS types on EPVS burden. Finally, linkage disequilibrium score regression was conducted to assess genetic correlations between exposures and outcomes.  Results  EPVS burden in both the white matter (OR=1.12, 95% CI: 1.01-1.25; P = 0.04) and basal ganglia (OR=1.57, 95% CI:1.30-1.89; P < 0.01) are significant risk factors for IS. EPVS burden in the basal ganglia is also a risk for IS (small-vessel) (OR=4.56,95% CI:2.57-8.27; P = 5.95×10-7). After IS and TIA there seems to be a potential increase in extensive basal ganglia perivascular space burden. Conclusions  Extensive white matter perivascular space burden and extensive basal ganglia perivascular space burden may serve as important indicators to predict IS. Reference | Related Articles | Metrics

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Transition of body mass index and metabolic syndrome in patients with major depressive disorder Qi Han, Dong Chengcheng, Liu Rui, Zhu Xuequan, Lin Xuzhou, Qin Yanshu, Yu Zibo, Wang Haining, Li Lei, Feng Yuan, Zhang Ling, Yan Fang Journal of Capital Medical University    2025, 46 (2): 202-209.   DOI: 10.3969/j.issn.1006-7795.2025.02.005 Abstract （1498）      PDF（pc） （1780KB）（19）       Knowledge map    Save Objective  To evaluate the transition rules of   normal body mass index (BMI), overweight and metabolic syndrome (MetS) in patients with major depressive disorder (MDD). Methods  Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital, Capital Medical University were included. Based on the overweight and metabolic syndrome status assessed at each admission, the patients were categorized into three states: normal BMI, overweight and metabolic syndrome. A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions. Results  A total of 892 records of 398 subjects were included, with a median age of 56 years old and 31.4% males. The median follow-up period was 40 months. The multi-state model showed that there were 494 transitions between the three states, of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS. The intensity of transition was the highest from overweight to MetS, 9.52 times greater than overweight to normal BMI. After 48.53 months, MDD patients with normal BMI began to transition to MetS. For overweight MDD patients, the transition to MetS started after 8.77 months. MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months. For MDD patients comorbid with MetS, the probability of staying at MetS was 51.2% after 36 months. Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients, while  a higher level of education was a protective factor against developing MetS in overweight MDD patients. Conclusion  MDD patients exhibited a higher intensity and risk of developing MetS, and it is not easy to reverse MetS, suggesting that BMI management and MetS intervention should be strengthened in MDD patients. Reference | Related Articles | Metrics

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Effect of large artery atherosclerosis subtype on the efficacy of Ginkgo Diterpene Lactone Meglumine in acute ischemic stroke Jing Jiao, Zhang Siyao, Liu Yanling, Wang Fen, Xiao Wei, Wang Zhenzhong Journal of Capital Medical University    2025, 46 (2): 228-233.   DOI: 10.3969/j.issn.1006-7795.2025.02.008 Abstract （1494）      PDF（pc） （1286KB）（9）       Knowledge map    Save Objective  To investigate the effect of large artery atherosclerosis (LAA) and non-LAA subtypes on the efficacy of Ginkgo Diterpene Lactone Meglumine (GDLM) in patients with acute ischemic stroke. Methods  This was a post-hoc analysis of multicenter, randomized, double-blind, placebo-controlled, and  parallel-group trial. A total of 3 448 patients who had acute ischemic stroke were randomly assigned in a 1∶1 ratio  to receive the injection of GDLM or the placebo once day within 48 h after symptoms and continued for 14 d. The primary outcome was the proportion of patients with a modified Rankin Scale (mRS) of 0 or 1 on day 90 after randomization. Results  A total of 3 448 patients were enrolled, with 1 604 (46.52%) patients with non-LAA and 1 844 (53.48%) with LAA. Compared to the placebo treatment. GDLM  injection effectively improve the functional prognosis, with a higher proportion of mRS score of 0-1 in both non-LAA (OR=1.24, 95% CI: 1.02-1.51; P=0.03) and LAA (OR=1.37, 95% CI:1.14-1.65; P<0.001) group. There was no significant interaction between LAA subtypes with treatment (P=0.48 for interaction). Conclusion  Among patients with acute ischemic stroke  in this randomized clinical trial, GDLM might improve the  favorable clinical outcomes at 90 d compared with placebo, regardless of LAA subtypes. Nevertheless, it is necessary to confirm the findings  in the future. Reference | Related Articles | Metrics

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The current status and future directions of reperfusion therapy for acute ischemic stroke Qiao Yue, Li Chuanhui, Zhao Wenbo Journal of Capital Medical University    2025, 46 (1): 68-70.   DOI: 10.3969/j.issn.1006-7795.2025.01.011 Abstract （1483）      PDF（pc） （369KB）（31）       Knowledge map    Save Intravenous thrombolysis and mechanical thrombectomy are well-established reperfusion therapies for acute ischemic stroke, which can significantly improve clinical outcomes compared to conventional treatments. However, both strategies face the following challenges: although it is the first-line treatment, intravenous thrombolysis suffers from low recanalization rates and a narrow therapeutic time window (3-4.5 h), which limits its clinical benefit. Mechanical thrombectomy, while achieving over 80% recanalization, still results in disability or death in more than 50% of patients. Future efforts should focus on optimizing thrombolytic drugs by developing novel agents with higher fibrin specificity and safety profiles, thus expanding the population benefiting from thrombolysis. Moreover, reperfusion therapy based on the “tissue window” could be achieved with utilizing advanced imaging techniques to break the traditional time window limitation. The promotion of mobile stroke units could facilitate ultra-early reperfusion treatment. Additionally, optimization of post-thrombolysis antithrombotic strategies is essential to prevent neurological deterioration. For mechanical thrombectomy, it is crucial to enhance perioperative management and actively explore neuroprotective strategies for further improvement of outcomes. Reference | Related Articles | Metrics

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Speech recognition for standard Chinese-speaking bimodal cochlear implant users in competitive noise Zhang Xinyi, Chen Jingyuan, Chen Biao, Zou Xinyue, Shi Ying, Zhang Lifang, Liu Ping, Kong Ying, Li Yongxin Journal of Capital Medical University    2024, 45 (6): 938-945.   DOI: 10.3969/j.issn.1006-7795.2024.06.002 Abstract （1432）      PDF（pc） （928KB）（13）       Knowledge map    Save Objective  To investigate the utilization of competitive speech by standard Chinese bimodal cochlear implant (BIM) users under  talker sex and spatial.Methods  The speech reception thresholds (SRT) of 11 standard Chinese BIM users were tested under 4 different spatial competitive speech noises. The four spatial competitive speech noise environments were recorded as middle male voice, middle female voice, two sides male voice and two sides female voice according to the gender and orientation of the masked noise. Subjects were assessed with BIM and cochlear implantation (CI) alone hearing assistance. The target sound is one male voice directly in front (0°), and the masking sound is two male or two female voices, coming from separately directly in front (0°) or from both sides (±90°).Results  There was no significant difference in SRT between the two groups (P> 0.05). The BIM group obtained masking release (MR) under talker sex cues, spatial cues, and talker sex+spatial cues, while the CI group obtained MR under talker sex, but masking inhibition under spatial cues and talker sex + spatial cues. There were no significant differences in MR between the three cues. There was no significant difference in MR between BIM group and CI group under talker sex cues and spatial cues, but there was difference between BIM group and CI group under talker sex+spatial cue (P= 0.013).Conclusions  Standard Chinese BIM users can use talker sex cues and spatial cues to separate competitive noise, but there is no significant difference in the ability to use talker sex and spatial cues between BIM and CI alone hearing aid, and the ability to use talker sex + spatial cues under BIM is better than that of cochlear alone hearing aid. Reference | Related Articles | Metrics

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Analysis of the current status and efficacy of acute ischemic stroke treatment based on hierarchical medical service network Zhan Yanli, Li Yiyin, Li Ping, Sun Jingping, Huang Liangtong, Cai Xueli Journal of Capital Medical University    2025, 46 (1): 41-47.   DOI: 10.3969/j.issn.1006-7795.2025.01.007 Abstract （1392）      PDF（pc） （706KB）（23）       Knowledge map    Save Objective  To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis, to optimize the stroke treatment models, and to improve stroke treatment efficiency. Methods  Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui, Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data. Based on whether they received endovascular treatment at a high-level stroke center, they were divided into an effective referral group (261 cases) and an ineffective referral group (312 cases). Demographic data, influencing factors, clinical characteristics, and laboratory tests were compared between the two groups, and the differences were analyzed by using single-factor analysis, and prognosis of the two groups of patients was assessed. Results  Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy. The effective referral rate was 45.55%. The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher（χ2 =5.34,8.67，P＜0.05), more likely to show dysarthria, gaze, and consciousness disorder（χ2=130.1,22.12,22.96，P ＜0.05), and the baseline NIHSS score was higher (F =3.25，P ＜0.05). Comparing the baseline blood cells counts of the two groups of patients at admission, the effective referral group showed lower eosinophil count, basophil count and lymphocyte (Z=－8.86,－5.39,F=0.598，P ＜0.05).  As for the prognosis, the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group. Binary Logistic regression analysis showed that baseline NIHSS score (OR=1.122, 95% CI:1.074-1.172), eosinophil (OR=0.085, 95% CI:0.013-0.564), and neutrophil count (OR=1.088, 95% CI:1.011-1.172) were independent influencing factors for effective referrals. Conclusions  The efficiency of the current regional stroke classification and treatment network needs to be further improved. Developing predictive models that include demographic characteristics, risk factors, symptoms, signs, and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency. Reference | Related Articles | Metrics

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Effect of CD38 expression of tumor-infiltrating immune cells on the prognosis of esophageal squamous cell carcinoma with lymph node metastasis Shi Feng, ZhaoYanjie, Gao Ying, Song Qingkun Journal of Capital Medical University    2025, 46 (2): 210-215.   DOI: 10.3969/j.issn.1006-7795.2025.02.006 Abstract （1358）      PDF（pc） （3878KB）（124）       Knowledge map    Save Objective  To investigate the prognostic effect of CD38 in patients with esophageal squamous cell carcinoma patients (ESCC). Methods  A retrospective cohort study with 142 ESCC patients was performed. The clinicopathological features and expression of CD38, CD4, CD8, Ki-67, programmed cell death ligand 1(PD-L1) and programmed cell death 1(PD-1) in tumor and immune cells were evaluated. Results  Among ESCC patients with lymph node metastasis, the expression of CD38 had a significant association with the overall survival (P=0.037). The median overall survival was 14 months and 38 months among patients with low and high expression of CD38, respectively. The crude and adjusted hazard ratio of high CD38 expression was 0.46 (95%CI： 0.21-0.98) and 0.32 (95%CI： 0.13-0.76) respectively. The expression of CD38 had a negative correlation with PD-L1 expressed in tumor cells. Conclusion  The high expression of CD38 was associated with a better survival for ESCC with lymph node metastasis.  Reference | Related Articles | Metrics

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Comparison of the prognostic value of 15 nutritional/inflammatory indicators in postoperative cancer patients Liu Xiaoqian, Sun Kai, Wang Xiaolin, Zhao Qianqian, Wu Xiaoxiao, Shen Fangqi, Chen Xi, Tian Chenxu, Wu Di, Song Chunhua, Xu HongXia, Cong Minghua, Shi Hanping, Jia Pingping Journal of Capital Medical University    2025, 46 (3): 410-419.   DOI: 10.3969/j.issn.1006-7795.2025.03.003 Abstract （1354）      PDF（pc） （6110KB）（30）       Knowledge map    Save Objective  To explore and identify the nutritional/inflammatory indicator with the highest predictive potential for overall survival (OS) in postoperative tumor patients so as to provide guidance for postoperative rehabilitation of tumor patients. Methods  Data from 3 191 surgical patients were collected, including 15 nutritional/inflammatory indicators. The maximum selection rank statistic method was used to calculate the optimal cut-off values for continuous indicators. The Kaplan-Meier method was used to assess OS, and Cox proportional hazards models were used to analyze the association between the aforementioned 15 indicators and survival. The predictive value of these 15 indicators was evaluated with receiver operating characteristic (ROC) curves and C-index. Results  Multivariate analysis showed that all 15 indicators were significantly associated with poorer OS in surgical patients (P<0.05 for all). Time-dependent area under the curve (AUC) and C-index analysis indicated that 3 indicators with the highest predictive potential in OS in postoperative tumor patients were the nutritional risk index (NRI) (C-index: 0.597), C-reactive protein-to-albumin ratio (CAR) (C-index: 0.587), and C-reactive protein-to-lymphocyte ratio (CLR) (C-index: 0.587). The optimal cut-off value for NRI was determined to be 104.31 (i.e., NRI<104.31 suggests malnutrition) with the maximum selection rank statistic method, the optimal cut-off value for CAR to be 0.05 (i.e., CAR≥0.05 suggests a strong inflammatory response, often accompanied by malnutrition), and the optimal cut-off value for CLR to be 1.18 (i.e., CLR≥1.18 suggests a strong inflammatory response). Subgroup analysis indicated that NRI, CAR, and CLR had good correlation with tumor staging, and there were significant differences between tumor node metastasis (TNM) Ⅲ/Ⅳ stage patients and TNM Ⅰ/Ⅱ stage patients when there was a strong inflammatory response or malnutrition. Conclusion In postoperative tumor patients, NRI, CLR, and CAR have high prognostic value. Combining  these with the patient's clinical stage, it enables more precise guidance for clinical diagnosis and treatment strategies.  Reference | Related Articles | Metrics

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Cerebral angiographic features and prognostic study in patients with central retinal artery occlusion Ya• Naren, Liu Yan, Zhou Xia, Zhu Dekun, Chen Feng, Ma Zhengfei, Li Chuanhui, Sun Zhongwu Journal of Capital Medical University    2025, 46 (1): 15-21.   DOI: 10.3969/j.issn.1006-7795.2025.01.004 Abstract （1318）      PDF（pc） （767KB）（24）       Knowledge map    Save Objective  To analyze the cerebral angiographic characteristics of patients with central retinal artery occlusion (CRAO) and to study their prognosis.  Methods  A retrospective study was conducted, with 182 CRAO patients enrolled, who were treated at Xuanwu Hospital, Capital Medical University, the First Affiliated Hospital of Anhui Medical University, the Affiliated Suzhou Hospital of Anhui Medical University, and the People's Hospital of Shihezi City from January 1, 2014, to June 1, 2024. All patients underwent cerebral angiography within one month of onset. The baseline characteristics, treatment details, and follow-up data were collected. The Spearman rank correlation coefficient was used to evaluate the correlation between the characteristics of the ophthalmic artery and the ipsilateral carotid artery angiography, and Logistic regression analysis was performed to explore factors related to patient prognosis. Results  Cerebral angiography results showed that 81.3% of patients had ocular blood supply from the ipsilateral internal carotid artery, 12.1% from the ipsilateral external carotid artery, and 6.6% from the ipsilateral middle cerebral artery. Among the patients, 80 (44.0%) had varying degrees of stenosis or occlusion of the affected ophthalmic artery, with 69 patients (86.3%) showing stenosis at the origin of the ophthalmic artery. Additionally, 135 patients (74.2%) had varying degrees of stenosis or occlusion of the ipsilateral carotid artery, with 110 patients (60.4%) showing stenosis at the carotid bulb, 88 patients (48.3%) having unilateral carotid lesions, and 41 patients (22.5%) having multiple lesions. Correlation analysis indicated a significant correlation between the degree of stenosis in the ophthalmic artery and the carotid artery (r =0.76, P =0.006). Univariate and multivariate Logistic regression analyses revealed that the time from symptom onset to hospital admission (OR=0.93, 95% CI: 0.85 － 0.98, P=0.018), the grading of oxygenation-based hypoperfusion maculopathy (OHM) (OR=3.12, 95% CI: 1.09 － 6.34, P=0.005), intravenous thrombolysis (IVT) (OR=2.75, 95% CI: 1.08 － 5.35, P=0.031), and the absence of stenosis in the ophthalmic artery (OR=1.33, 95% CI: 1.02 － 3.41, P=0.026) were independent predictors of prognosis for CRAO patients. Conclusions  The degree of stenosis in the ophthalmic artery is significantly correlated with the degree of stenosis in the carotid artery in CRAO patients. Time from symptom onset to hospital admission, OHM grading, IVT, and the absence of stenosis in the ophthalmic artery are independent factors influencing the prognosis of CRAO patients. Reference | Related Articles | Metrics

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The progress in the role and application of neutrophils in glioma Jiang Haiping, Yin Shuo, Li Shenglan, Li Wenbin Journal of Capital Medical University    2025, 46 (3): 448-454.   DOI: 10.3969/j.issn.1006-7795.2025.03.008 Abstract （1293）      PDF（pc） （482KB）（13）       Knowledge map    Save Neutrophils are the most abundant white blood cells in the human body and play different roles in various diseases. The studies have shown that inflammation is closely related to the occurrence and development of tumors. As an important component of the tumor microenvironment (TME), neutrophils play a crucial role in tumors and have a dual effect of promoting and inhibiting tumor growth. This article  deeply discusses the recruitment and subtypes of neutrophils, as well  their dual effects on tumors. Meanwhile,  it  illustrates   the role and clinical significance of neutrophils in gliomas. The therapeutic approach of targeting neutrophils in tumors provides a new direction for subsequent tumor treatment. Especially for central nervous system tumors, neutrophils as carriers can transport chemotherapeutic drugs across the blood-brain barrier to reach the tumor tissue, offering new hope for the subsequent treatment of brain tumors.  Reference | Related Articles | Metrics

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Predictive value of atherogenic index of plasma index, triglyceride-glucose index and cerebral small vascular disease imaging markers on early neurological response after intravenous thrombolysis in patients with acute ischemic stroke Yang Xiao, Meng Yuanyuan, Yang Jingyi, Wang Shuhan, Zhang Ligong Journal of Capital Medical University    2025, 46 (1): 48-55.   DOI: 10.3969/j.issn.1006-7795.2025.01.008 Abstract （1292）      PDF（pc） （953KB）（49）       Knowledge map    Save Objective  To explore the predictive value of the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, and cerebral small vascular disease (CSVD) imaging load score regarding the early prognosis of patients with acute ischemic stroke (AIS) after intravenous thrombolysis.  Methods  A total of 379 inpatients diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023 were retrospectively analyzed. Relevant data were collected, and the CSVD imaging load score was evaluated. The patients were classified into the good prognosis group (≥18%) and the poor prognosis group (<18%) based on the early neurological improvement rate 14 d after thrombolysis. An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis. The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic (ROC) curve analysis. Results  Systolic blood pressure, AIP , TyG index , neutrophil to lymphocyte ratio (NLR), cerebral microbleeds (CMB), enlarged perivascular spaces (EPVS) and a CSVD imaging load score of 2 points or higher served as independent risk factors influencing the early prognosis in AIS patients undergoing thrombolysis. The ROC curve analysis revealed that the area under the curve (AUC) for the CSVD imaging load score was 0.821, with a sensitivity of 80.4% and a specificity of 74%. The AUC of the AIP was 0.951, with a sensitivity of 89.2% and a specificity of 91.7%. The AUC of the TyG index was 0.918, with a sensitivity of 93.1% and a specificity of 82.7%. Conclusions  The AIP , TyG index , and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy. Reference | Related Articles | Metrics

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Abnormal O-glycosylation mediated by the deficiency of molecular chaperone Cosmc or T-synthase  regulates the expression of miRNAs in colorectal cancer exosomes Gao Tianbo, Ge Yang, An Guangyu, Yao Jiannan, Jiang Yuliang, Liu Heshu, Yan Rui Journal of Capital Medical University    2025, 46 (3): 401-409.   DOI: 10.3969/j.issn.1006-7795.2025.03.002 Abstract （1290）      PDF（pc） （5271KB）（50）       Knowledge map    Save Objective  To explore the effects of aberrant O-glycosylation modifications induced by the knockout of Cosmc or T-synthase genes on the expression profiles of miRNAs in exosomes derived from colorectal cancer cells and to reveal  the molecular mechanisms of O-glycosylation in the development of colorectal cancer and  identify potential biomarkers  for early diagnosis and treatment. Methods This research specifically targets the Cosmc or T-synthase genes in the human colorectal cancer cell line HCT116 to create stable cell lines exhibiting abnormal O-glycosylation with CRISPR/Cas-9 gene editing technology. Exosomes originating from these colorectal cancer cells were isolated and authenticated. A microarray chip equipped with primer sequences for 16 miRNAs closely associated with colorectal cancer was employed to assess the differential expression of miRNAs within these exosomes with fluorescent quantitative polymerase chain reaction (PCR). And then, a cohort of miRNAs that exhibited significant and consistent changes in expression levels across the exosomes from both cell lines was selected. These miRNAs were further validated independently with traditional fluorescent quantitative PCR. Subsequently, data from  The Cancer Genome Atlas Program（TCGA） database containing patient information on colorectal cancer was harnessed. Employing R programming language, Gene Set Enrichment Analysis (GSEA) was conducted on the upregulated miRNA to investigate the downstream pathways significantly impacted and the malignant biological behaviors they may influence. Results  The absence of either Cosmc or T-synthase genes results in the dysregulation of O-glycosylation in colorectal cancer cells, leading to the exposure of Tn antigens. This, in turn, affects the expression levels of specific miRNAs in exosomes derived from these cells. Specifically, the expression of hsa-miR-125b-1-3p was downregulated, while that of hsa-miR-218-5p was upregulated. Notably, hsa-miR-218-5p were found to be closely associated with the epithelial-mesenchymal transition (EMT) process in tumor cells, which is a key mechanism in cancer progression. Conclusion  It elucidates that the aberrant O-glycosylation mediated by the knockout of Cosmc or T-synthase genes significantly influences the expression of certain miRNAs in exosomes from colorectal cancer cells, potentially affect the EMT process in colorectal cancer and thereby promoting distant metastasis. Given the inherent stability and detectability advantages of colorectal cancer-derived exosomes, the altered expression levels of miRNAs within these exosomes may serve as indicators of the stated of abnormal O-glycosylation  in colorectal cancer. These findings suggest that exosomal miRNAs have potential as biomarkers for monitoring disease progression and therapeutic efficacy. Consequently, this could pave the way for more personalized diagnostic and treatment strategies tailored to individual colorectal cancer patients, enhancing the precision and effectiveness of clinical management. Reference | Related Articles | Metrics

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Application of the win ratio method to clinical trials in cerebrovascular disease Tian Ruobing, Xu Qin, Zhou Quan, Tian Xue, Li Xinya, Zheng Manqi, Wang Anxin Journal of Capital Medical University    2025, 46 (2): 191-196.   DOI: 10.3969/j.issn.1006-7795.2025.02.003 Abstract （1275）      PDF（pc） （1777KB）（107）       Knowledge map    Save Objective  To introduce the concepts and principles of the win ratio method and to analyze it in the context of a case study of a clinical trial in cerebrovascular disease. Methods  Based on the study of clopidogrel with aspirin in high risk patients with acute non disabling cerebrovascular events 2, and key prognostic factors, the outcome events were defined sequentially as ① time to death within 90 d, ② time to recurrence of ischemic stroke within 90 d, ③ time to moderate-to-severe hemorrhage within 90 d. Using clopidogrel combined with aspirin as the reference group, the winning ratio (Rw) of ticagrelor combined with aspirin was analyzed by the win ratio method, and the 95% confidence interval (CI) of Rw was estimated by the Bootstrap method and compared with the hazard ratio (HR) calculated by the competing risk model. Results  When only fatal events were considered, the win ratio method suggested that the ticagrelor group was significantly better than the clopidogrel group, Rw=2.00 (95%CI:1.52-2.47), and after stepwise inclusion of  ischemic stroke and moderate-to-severe hemorrhage recurrence, the win ratio method yielded a value of 1.29(95% CI:1.25-1.57), and the HR value from Fine and Gray competing risk regression was 0.78 (95% CI:0.65-0.95), both of which indicated that the efficacy of the ticagrelor group was superior to that of the clopidogrel group. Conclusion  The win ratio method can be used to analyze clinical trials with composite endpoints after prioritizing multiple outcome variables, showing the advantages of win ratio and its promising application in cerebrovascular disease research. Reference | Related Articles | Metrics

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A longitudinal study on the impact of cochlear implantation on vestibular function in children with inner ear malformations: a comparative analysis based on the test of  vestibular evoked myogenic potentials Shen Mengya, Xue Shujin, Wei Xingmei, Kong Ying, Sun Jiaqiang, Li Yongxin Journal of Capital Medical University    2024, 45 (6): 980-988.   DOI: 10.3969/j.issn.1006-7795.2024.06.006 Abstract （1247）      PDF（pc） （4667KB）（14）       Knowledge map    Save Objective  To analyze the impact of cochlear implantation (CI) on vestibular evoked myogenic potentials (VEMPs) in children with congenital sensorineural hearing loss (SNHL), focusing on the potential changes in vestibular function after surgery.Methods  A total of 78 pediatric patients with SNHL, who were treated at Beijing Tongren Hospital, Capital Medical University between January 2021 and February 2023, were enrolled. The cohort was divided into two groups based on inner ear anomalies: 39 SNHL patients with normal inner ear structure and 39 patients with inner ear malformations, including 6 patients with large vestibular aqueduct syndrome, 13 patients with Mondini malformation, 5 patients with  vestibulocochlear  nerve deficiency, 2 patients with vestibular sac malformation, and 2 with narrow internal auditory canal. All patients underwent VEMPs test was performed preoperatively (T0) within one week, and at 1 month (T1), 6 months (T2), and 1 year (T3) post-CI. Chi-square tests and analysis of variance were applied to compare the differences in VEMPs parameters, including response rate, latencies, and amplitude, across all follow-up time and between the two groups.Results  Complete postoperative follow-up of cervical VEMP (cVEMP) was achieved in all 78 patients, The T0 cVEMP response rate was 69.23%, which significantly declined to 46.15%, 41.03%, and 58.97% at T1, T2, and T3, respectively (χ2=4.768, P=0.003). Notably, the P1 and N1 latencies significantly shortened at T1 (P=0.07, P=0.046). Among 48 patients who completed postoperative ocular VEMP (oVEMP) follow-up, the overall preoperative response rate was 75%, increasing to 81.25% at T1 but decreasing to 62.5% at both T2 and T3. The overall oVEMP response rate also showed a statistically significant difference pre- and post-CI (χ2=9.720, P=0.021). The duration of CI significantly influenced cVEMP-P1 latency, amplitude, and rectified amplitude (P=0.043 4, P=0.041, P=0.041, P<0.001), as well as oVEMP amplitude(P=0.043). No significant differences were observed in cVEMP response rates, latencies, or amplitudes at T3 compared to T0. However, oVEMP amplitudes at T2 and T3 were significantly different from T0 (P=0.038). No significant differences were observed in VEMP parameters between the inner ear malformation and non-malformation groups across T1-T3.Conclusions  VEMPs serve as a valuable tool for assessing vestibular function before and after CI in children with SNHL. The duration of CI is a crucial factor influencing VEMPs changes.  Inner ear malformations may impact otolithic function post-CI, with a more pronounced effect observed over time. The VEMP test results could provide insights for selecting the optimal side for CI placement. Reference | Related Articles | Metrics