RIC-specific cytoprotective profile mediated by microglia in a mouse model of acute ischaemic stroke

急性缺血性中风小鼠模型中由小胶质细胞介导的远程缺血预适应（RIC）特异性细胞保护特征

Remote ischaemic conditioning (RIC) is an endogenous neuroprotective strategy involving repeated, transient occlusion of a limb artery to reduce ischaemic injury at a distant site. We investigated the effects of RIC in a mouse model of focal cerebral ischaemia induced by distal transient middle cerebral artery occlusion (tMCAO). Animals were randomised into three groups: Stroke (tMCAO, 60 min), Stroke+remote ischaemic preconditioning (RIPerC) (RIC applied during ischaemia) and Stroke+remote ischaemic postconditioning (RIPostC) (RIC initiated 10 min after reperfusion). The RIC protocol consisted of three cycles of 5-minute hindlimb ischaemia followed by 5-minute reperfusion. The findings reveal sex-specific efficacy of RIC, with mechanistic insights obtained in male animals suggesting a dual mode of action via modulation of microglial function and promotion of endogenous neurorepair pathways.

远程缺血预处理（RIC）是一种内源性神经保护策略，包括反复短暂阻断肢体动脉，以减轻远处部位的缺血性损伤。我们在远端短暂性大脑中动脉阻塞（tMCAO）诱导的局灶性脑缺血小鼠模型中研究了RIC的作用。将动物随机分为三组：中风组（tMCAO，60分钟）、中风+远程缺血预适应（RIPerC）组（在缺血期间应用RIC）和中风+远程缺血后适应（RIPostC）组（在再灌注10分钟后启动RIC）。RIC方案包括三个循环的5分钟后肢缺血，随后是5分钟的再灌注。研究结果揭示了RIC的性别特异性疗效，在雄性动物中获得的机制性见解表明，其通过调节小胶质细胞功能和促进内源性神经修复途径发挥双重作用。

REF: Torres-Querol C, Arqué G, Purroy F. RIC-specific cytoprotective profile mediated by microglia in a mouse model of acute ischaemic stroke. Stroke Vasc Neurol. Published online December 31, 2025. doi:10.1136/svn-2025-004465 PMID: 41475890

Loberamisal for Acute Ischaemic Stroke (LAIS): a multicentre, randomised, double-blind, parallel, placebo-controlled phase III clinical trial

洛贝米萨尔治疗急性缺血性卒中（LAIS）：一项多中心、随机、双盲、平行、安慰剂对照的Ⅲ期临床试验

Loberamisal, a novel agent that dissociates the post-synaptic density protein 95/neuronal nitric oxide synthase complex and potentiates the α2-containing γ-aminobutyric acid type A receptors, is a potential neuroprotectant that is effective in preclinical studies for acute ischaemic stroke. This trial aims to demonstrate the efficacy and safety of intravenous loberamisal in patients with acute ischaemic stroke (AIS) within 48 hours of onset. The LAIS trial will evaluate the potential of loberamisal as a novel neuroprotectant in acute ischaemic stroke.

洛贝米萨尔是一种新型药物，它能解离突触后致密蛋白95/神经元型一氧化氮合酶复合物，并增强含α2亚基的γ-氨基丁酸A型受体的活性，是一种潜在的神经保护剂，在急性缺血性中风的临床前研究中显示出有效性。本试验旨在验证静脉注射洛贝米萨尔对发病48小时内急性缺血性中风（AIS）患者的有效性和安全性。LAIS试验将评估洛贝米萨尔作为急性缺血性中风新型神经保护剂的潜力。

REF: Li S, Wang X, Feng B, Li H, Wang Y. Loberamisal for Acute Ischaemic Stroke (LAIS): a multicentre, randomised, double-blind, parallel, placebo-controlled phase III clinical trial. Stroke Vasc Neurol. Published online December 4, 2025. doi:10.1136/svn-2025-004582 PMID: 41344725

Chinese expert consensus on the treatment and diagnosis of moyamoya disease and moyamoya syndrome (2024)

中国烟雾病和烟雾综合征诊疗专家共识（2024）

Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disorder with no unified management guidelines. This consensus aims to provide updated, evidence-based recommendations for the diagnosis and treatment of MMD. This updated consensus underscores the value of early diagnosis using advanced imaging, personalised interventions and standardised perioperative care. This initiative aims to enhance clinical outcomes and health-related quality of life in MMD patients, offering a contemporary, evidence-based approach to managing MMD.

烟雾病（MMD）是一种慢性闭塞性脑血管疾病，目前尚无统一的管理指南。本共识旨在为烟雾病的诊断和治疗提供最新的、基于循证医学的建议。这份更新后的共识强调了采用先进影像学技术进行早期诊断、实施个性化干预以及标准化围手术期护理的价值。这一举措旨在改善烟雾病患者的临床结局和与健康相关的生活质量，为烟雾病的管理提供一种符合当代医学发展、基于循证医学的方法。

REF: Ni W, Su J, Fei Y, et al. Chinese expert consensus on the treatment and diagnosis of moyamoya disease and moyamoya syndrome (2024). Stroke Vasc Neurol. Published online December 4, 2025. doi:10.1136/svn-2024-003925 PMID: 41344724

Clinical utility of measuring circulating glial fibrillary acidic protein in severe stroke

重度卒中患者测量循环胶质纤维酸性蛋白的临床应用价值

Stroke is a global health concern, requiring early and accurate diagnosis for effective treatment. Differentiating between ischaemic stroke and haemorrhagic stroke is critical, as treatment strategies differ significantly. While neuroimaging is the gold standard for differential diagnosis of stroke code patients, blood biomarkers could be a promising and cost-effective diagnostic method for earlier diagnosis in the prehospital setting, where neuroimaging is unavailable. Studies demonstrate that the biomarker glial fibrillary acidic protein (GFAP) can distinguish ischaemic and haemorrhagic stroke with high specificity, though sensitivity varies based on sampling timing and assay methodology. This narrative review explores the potential of GFAP as a diagnostic biomarker in severe strokes and in identifying large vessel occlusions (LVOs). While studies suggest a correlation between higher GFAP levels and stroke severity in haemorrhagic stroke, evidence for this in ischaemic stroke is inconclusive. Combining GFAP with clinical stroke scales and additional biomarkers has shown promise in identifying LVO. Future research should focus on refining the diagnostic role of GFAP in severe strokes, optimising sample timing and including large cohorts representing the full spectrum of stroke severities.

中风是一个全球性的健康问题，需要早期准确诊断以进行有效治疗。区分缺血性中风和出血性中风至关重要，因为治疗策略差异显著。虽然神经影像学是中风代码患者鉴别诊断的金标准，但在无法进行神经影像学检查的院前环境中，血液生物标志物可能是一种有前景且经济有效的早期诊断方法。研究表明，生物标志物胶质纤维酸性蛋白（GFAP）能够高度特异性地区分缺血性中风和出血性中风，不过其敏感性会因采样时间和检测方法而异。这篇综述性文章探讨了GFAP作为严重中风诊断生物标志物以及识别大血管闭塞（LVO）的潜力。虽然有研究表明在出血性中风中GFAP水平升高与中风严重程度相关，但在缺血性中风中这一证据尚不明确。将GFAP与临床中风量表和其他生物标志物相结合，在识别LVO方面显示出了前景。未来的研究应着重于明确GFAP在严重中风中的诊断作用，优化采样时间，并纳入能代表各种中风严重程度的大规模队列。

REF: Gjordeni M, Pansell J, Thelin EP, et al. Clinical utility of measuring circulating glial fibrillary acidic protein in severe stroke. Stroke Vasc Neurol. Published online December 3, 2025. doi:10.1136/svn-2025-004645 PMID: 41339083

Burden of stroke and its subtypes in young adults in Asia, 1990–2021: risk factors and future predictions

1990 - 2021年亚洲年轻人中风及其亚型的负担：危险因素与未来预测

Stroke remains a major global public health challenge, with persistent disparities in its burden across countries, and an increasing burden among young adults aged 15-49 has emerged as a growing concern. However, comprehensive evaluations of stroke and its subtypes among young adults in Asia remain limited. This study utilizes data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), covering the period from 1990 to 2021, to assess the burden of stroke in Asia and provide evidence-based policy and resource allocation. Overall, from 1990 to 2021, the burden of stroke and its subtypes among young adults in Asia has increased significantly, with notable differences across age groups and sex, and with population growth and demographic changes, this burden is expected to further intensify in the future. Therefore, future research and public health policies should focus more on targeted interventions addressing the specific needs of young adults to effectively control and alleviate the burden of stroke.

中风仍然是一项重大的全球性公共卫生挑战，各国之间中风负担存在持续差异，且15 - 49岁年轻人的中风负担不断增加，这已成为一个日益受到关注的问题。然而，对亚洲年轻人中风及其亚型的全面评估仍然有限。本研究利用2021年全球疾病、伤害和危险因素负担研究（GBD）中1990年至2021年期间的数据，评估亚洲中风的负担，并为政策制定和资源分配提供循证依据。总体而言，从1990年到2021年，亚洲年轻人中风及其亚型的负担显著增加，不同年龄组和性别之间存在显著差异，并且随着人口增长和人口结构变化，预计未来这一负担将进一步加重。因此，未来的研究和公共卫生政策应更多地关注针对年轻人特定需求的干预措施，以有效控制和减轻中风负担。

REF: Li W, Guo Q, Gao C, et al. Burden of stroke and its subtypes in young adults in Asia, 1990-2021: risk factors and future predictions. Stroke Vasc Neurol. Published online December 3, 2025. doi:10.1136/svn-2025-004206 PMID: 41339084

Chemical Optimization of Cerebral Embolectomy 2 (CHOICE 2) trial: study protocol

大脑取栓术化学优化 2（CHOICE 2）试验：研究方案

The potential value of rescue intra-arterial thrombolysis in patients with large vessel occlusion (LVO) stroke treated with mechanical thrombectomy (MT) remains to be validated in randomised trials. This trial will provide evidence whether rescue intra-arterial thrombolysis improves clinical outcome in patients with LVO stroke who achieve successful or complete angiographic reperfusion following MT.

对于接受机械取栓术（MT）治疗的大血管闭塞（LVO）性卒中患者，挽救性动脉内溶栓的潜在价值仍有待随机试验验证。本试验将为挽救性动脉内溶栓是否能改善在MT后实现成功或完全血管造影再通的LVO性卒中患者的临床结局提供证据。

REF: Renú A, de la Riva P, Delgado-Mederos R, et al. Chemical Optimization of Cerebral Embolectomy 2 (CHOICE 2) trial: study protocol. Stroke Vasc Neurol. Published online December 3, 2025. doi:10.1136/svn-2025-004279 PMID: 41339082

Rationale and design of a PROBE trial comparing continuous enteral nutrition to time-restricted enteral nutrition in severe stroke

一项比较重症卒中患者持续肠内营养与限时肠内营养的前瞻性、随机、开放、盲法终点（PROBE）试验的原理与设计

Continuous enteral nutrition treatment is routinely provided in the intensive care unit (ICU) for patients with critically ill stroke and contributes to circadian rhythm disruption because a time-limited diet is part of the normal biological rhythm of diurnal species. Our study aims to evaluate the safety as well as the effectiveness of time-restricted enteral nutrition in ICU patients who have had a severe stroke. Clinical evidence for the safety as well as effectiveness of time-restricted enteral nutrition in persons with severe stroke will be provided by this TENET study.

在重症监护病房（ICU）中，对于重症卒中患者通常会进行持续肠内营养治疗，而这会导致昼夜节律紊乱，因为限时饮食是昼行性物种正常生物节律的一部分。我们的研究旨在评估限时肠内营养对重症卒中ICU患者的安全性和有效性。这项TENET研究将为重症卒中患者采用限时肠内营养的安全性和有效性提供临床证据。

REF: Yu T, Shi G, Ye Z, et al. Rationale and design of a PROBE trial comparing continuous enteral nutrition to time-restricted enteral nutrition in severe stroke. Stroke Vasc Neurol. Published online December 3, 2025. doi:10.1136/svn-2025-004382 PMID: 41339081