Background Although the early behavioral symptoms of behavioral variant frontotemporal dementia (bvFTD) are prominent, early diagnosis for bvFTD is difficult due to confusion with other mental disorders, and lack of sensitivity and specificity of diagnostic criteria, etc. In this paper, we summarized the important reviews in recent years and analyzed the clinical characteristics of bvFTD patients to improve the detection of early symptoms in bvFTD. Methods Twenty-three possible or probable bvFTD patients were diagnosed according to International Behavioral Variant Frontotemporal Dementia Criteria Consortium (FTDC). Self-designed questionnaires designed by Shanghai Mental Health Center were used to collect sociodemographic data and general information of patients. Their clinical characteristics were summarized, including abnormal behaviors, cognitive impairment, psychotic symptoms and other symptoms. Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL) and Clinical Dementia Rating Scale (CDR) were used to make neuropsychological tests and compare with similar overseas studies (control group, N = 66). Results Eleven male patients and 12 female patients were included in our study. Compared with control group, the average age of onset [(50.83 ± 11.55) years vs. (57.00 ± 10.00) years; t = 3.863, P = 0.000] and average age of diagnosis [(53.22 ± 11.55) years vs. (61.00 ± 9.00) years; t = 13.423, P = 0.000] of bvFTD patients were smaller. The study showed that bvFTD patients had more apathy or indolence [95.65% (22/23) vs. 65.15% (43/66); χ 2 = 8.057, P = 0.005], loss of sympathy or empathy [95.65% (22/23) vs. 33.33% (22/66); χ 2 = 26.499, P = 0.000], while patients in control group showed more derepression behavior [98.48% (65/66) vs. 52.17% (12/23); χ 2 = 27.514, P = 0.000] and continuous, stiff, obsessive and/or ritualized behavior [95.45% (63/66) vs. 30.43% (7/23); adjusted χ 2 = 39.159, P = 0.000]. For cognitive impairment, bvFTD patients presented apraxia [69.56% (16/23) vs. 22.73% (15/66); χ 2 = 16.484, P = 0.000] and executive dysfunction [82.61% (19/23) vs. 59.09% (39/66); χ 2 = 4.156, P = 0.041]. In psychotic symptoms, patients in control group showed hallucination and delusion [33.33% (22/66) vs. 4.35% (1/23); χ 2 = 7.477, P = 0.006]. Conclusions While the behavioral symptoms of bvFTD patients are varied, memory disorder can be one of the primal symptoms. Compared with similar foreign studies, the different composition of behavior symptoms of our bvFTD patients may be caused by cultural differences among evaluators in the understanding of some clinical symptoms in patients. DOI: 10.3969/j.issn.1672-6731.2017.11.010

Objective To discuss the damage effect of Solitaire stent on tunica intima during thrombectomy, so as to evaluate the safety of thrombectomy. Methods Twelve healthy male New Zealand rabbits were randomly divided into 4 groups (3 rabbits in each group), including control group and 3 thrombectomy groups. Microcatheter was used instead of stent in control group. The other 3 groups underwent mimic thrombectomy for 1, 3 and 5 times in the same position, respectively. The procedure was performed at both sides of carotid artery of each rabbit. Immediately after operation, bilateral carotid arteries of each rabbit were removed, performed HE staining and examined the ultrastructure under microscope. Semi?quantitative analysis was used to evaluate the damage of carotid artery. Results During the model preparation, DSA showed the diameter of vascular wall was 2.10-2.90 mm, and there was no vascular spasm, bleeding, perforation or arterial dissection. Therefore, the model was successfully established. The difference of carotid artery damage among different groups was statistically significant ( F = 119.108, P = 0.000). Compared with control group, the carotid artery damage of 3 thrombectomy groups was more serious ( q = 3.136, P = 0.001; q = 7.463, P = 0.000; q = 10.682, P = 0.000). The carotid artery damage of the second and third thrombectomy group was more serious than the first group ( q = 3.330, P = 0.000; q = 8.160, P = 0.000). The carotid artery damage of the third thrombectomy group was more serious than the second group ( q = 4.830, P = 0.000). Optical microscope observation showed that with the increase of times of thrombectomy, carotid intimal injury was more extensive and intimal reaction was more severe. Scanning electron microscopy showed that with the increase of times of thrombectomy, the degree of carotid artery injury was increased. Conclusions Solitaire stent may injure tunica intima, and with the increase of times of thrombectomy, the damage to vascular wall will increase. DOI: 10.3969/j.issn.1672-6731.2017.11.008

Objective To investigate the influence of body mass index (BMI) and abdominal girth index (AGI) on the location and etiology of ischemic stroke in order to determine whether they can predict the etiology and pathogenesis of ischemic stroke. Methods A total of 185 patients with acute ischemic stroke and 155 cases of normal controls matched in sex, age and past medical history were enrolled in this study. Their height and weight were measured to calculate BMI, and abdominal circumference was measured to calculate AGI. Oxfordshire Community Stroke Project (OCSP) and TOAST classification were carried out. Results BMI of overweight (BMI 24.00-27.90 kg/m 2 ) subgroup ( t = 2.060, P = 0.000) and obesity (BMI ≥ 28 kg/m 2 ) subgroup ( t = 2.315, P = 0.000) in patients with ischemic stroke was significantly higher than that in control group. AGI of abnomaly (AGI > 1 cm/kg) subgroup in patients with ischemic stroke was significantly higher than that in control group ( t = 1.021, P = 0.000). Based on OCSP classification, 185 patients with ischemic stroke were classified into 10 (5.41%) of total anterior circulation infarct (TACI), 81 (43.78%) of partial anterior circulation infarct (PACI), 56 (30.27%) of lacunar infarct (LACI) and 38 (20.54%) of posterior circulation infarct (POCI). Only the PACI ratio among different BMI subgroups had statistical significance ( H = 7.041, P = 0.011). PACI ratio in BMI 24.00-27.90 kg/m 2 subgroup was significantly higher than that in BMI 1 cm/kg subgroup was significantly higher (χ 2 = 11.461, P = 0.001), while SOE ratio was significantly lower ( χ 2 = 4.558, P = 0.033) than that in AGI ≤ 1 cm/kg subgroup. Conclusions BMI and AGI can influence the location and etiology of ischemic stroke, which can be used to predict the etiology and pathogenesis of ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2017.11.011

Objective To investigate the management of stenosis lesions during endovascular treatment for acute ischemic stroke. Methods A total of 36 acute ischemic stroke patients combined with intracranial/extracranial arterial stenosis were treated with endovascular treatment or bridging treatment. Time from aggravation on admission or in hospital stay to femoral artery puncture, from femoral arterypuncture to recanalization were recorded. Modified Thrombolysis in Cerebral Infarction (mTICI) was usedto assess the recanalization immediately after operation. Modified Rankin Scale (mRS) was used to evaluate prognosis at 90 d after operation. Occurrence rate of symptomatic intracranial hemorrhage and mortality were recorded. Results Among 36 patients, 13 patients (36.11%) underwent intravenous thrombolysis and then endovascular thrombectomy. In all patients, there were 21 (58.33%) with intracranial stenosis and 15 (41.67%) with extracranial stenosis, 16 (44.44%) with anterior circulation stenosis and 20 (55.56%) with posterior circulation stenosis. Stent thrombectomy was used in 25 patients (69.44% ), while balloon dilatation and/or stent implantation was used in 11 patients (30.56% ). For 21 patients with intracranial arterial stenosis, 4 were treated with balloon dilatation only, 9 with Wingspan self-expandable stents and 8 with Apollo balloon-expandable stents. Fifteen patients with extracranial arterial stenosis were treated with balloon dilatation and stent implantation. A total of 33 patients (91.67%) achieved recanalization (mTICI 2b-3 grade), 21 patients (58.33% ) had good outcomes (mRS ≤ 2 score), while symptomatic intracranial hemorrhage occurred in 2 patients (5.56%) and 5 (13.89%) died. There were no statistically significant differences in the rate of good prognosis, symptomatic intracranial hemorrhage and mortality between intracranial and extracranial arterial stenosis, anterior and posterior circulation stenosis (Fisher exact probability: P > 0.05, for all). Conclusions For acute ischemic stroke patients combined with intracranial/extracranial arterial stenosis, endovascular treatment is safe and effective. DOI: 10.3969/j.issn.1672-6731.2017.11.007

Small fiber neuropathy (SFN) is a kind of peripheral neuropathy in which the thinly myelinated A δ fibers and unmyelinated C fibers are predominantly affected, characterized by allodynia, analgesia, thermoanesthesia and/or autonomic nerve dysfunction. Nerve conduction velocity (NCV) detection can detect the pathological changes of large fibers (Aα and Aβ fibers) but not of small fibers, which lack of value in the diagnosis of SFN. Progress of the examinational and diagnostic methods for the neuropathological, neuroelectrophysiological and autonomic nerve functions of SFN in recent years were introduced in this paper. DOI: 10.3969/j.issn.1672-6731.2017.11.013

Objective To investigate the effect of location of intracranial arterial stenosis on the safety of intracranial stenting. Methods A total of 73 patients with symptomatic intracranial atherosclerotic stenosis (ICAS) were divided into intracranial internal carotid artery (IICA, N = 18), middle cerebral artery (MCA)-M1 segment (MCA-M1, N = 11), intracranial vertebral artery (IVA, N = 27) and basilar artery (BA, N = 17). All of them underwent intracranial stenting. The improvement of intracranial arterial stenosis, cerebrovascular complications including perforating events, artery dissection, in-stent thrombosis, distal stent arterial embolism and cerebral hyperperfusion, and neurological complications including transient ischemic attack (TIA), ischemic stroke and intracranial hemorrhage were recorded. Modified Rankin Scale (mRS) was used to evaluate the prognosis 30 d after operation. Results A total of 73 stents were implanted in 73 patients (35 Apollo balloon-expandable stents and 38 Wingspan self-expandable stents). Among them, 10 cases (10/18) were treated with Apollo stents and 8 cases (8/18) with Wingspan stents in IICA group, 5 cases (5/11) were treated with Apollo stents and 6 cases (6/11) with Wingspan stents in MCA-M1 group, 16 cases (59.26%, 16/27) were treated with Apollo stents and 11 cases (40.74%, 11/27) with Wingspan stents in IVA group, and 4 cases (4/17) were treated with Apollo stents and 13 cases (13/17) with Wingspan stents in BA group. No significant difference was seen in stent type among 4 groups (χ 2 = 7.422, P = 0.201). The stenosis rate of IICA group after treatment [(10.94 ± 1.99)%] was significantly improved than before treatment [(90.89 ± 7.71)%; t = 69.545, P = 0.000]. The stenosis rate of MCA-M1 group after treatment [(10.37 ± 2.14)%] was significantly improved than before treatment [(87.64 ± 9.46)%; t = 26.000, P = 0.000]. The stenosis rate of IVA group after treatment [(11.02 ± 1.99)% ] was significantly improved than before treatment [(89.11 ± 7.97)%; t = 50.726, P = 0.000]. The stenosis rate of BA group after treatment [(10.99 ± 3.39)%] was significantly improved than before treatment [(91.35 ± 5.62)%; t = 69.545, P = 0.000]. In 73 patients, cerebrovascular complications occurred in 11 cases (15.07%), including 4 cases of perforating events, 4 cases of artery dissection, one case of in-stent thrombosis and 2 cases of distal stent arterial embolism. There were 3 cases (3/18) in IICA group, including 2 cases of artery dissection and one case of distal stent arterial embolism, and 8 cases (8/17) in BA group, including 4 cases of perforating events, 2 cases of artery dissection, one case of in-stent thrombosis and one case of distal stent arterial embolism. No cerebrovascular complications occurred in MCA-M1 group and IVA group. The difference among 4 groups was statistically significant ( H = 63.134, P = 0.000). Neurological complications occurred in 6 cases (8.22%), including 4 cases of TIA and 2 cases of ischemic stroke. There was one case (1/18) of ischemic stroke in IICA group, and 5 cases (5/17) in BA group, including 4 cases of TIA and one case of ischemic stroke. No neurological complications occurred in MCA-M1 group and IVA group. The difference among 4 groups was statistically significant ( H = 65.698, P = 0.003). At 30 d after operation, there was one case with mRS 1 score in IICA group and one in BA group. The total rate of good prognosis 30 d after operation was 97.26% (71/73). Conclusions The location of intracranial arterial stenosis have a great influence on the risk of perioperative cerebrovascular and neurological complications in the intracranial stenting, and the overall prognosis is good. DOI: 10.3969/j.issn.1672-6731.2017.11.006

Stroke has become the leading common cause of disability and the second most common cause of death in China. Endovascular treatment emerged in recent years as a promising treatment method with a higher recanalization rate and better functional outcome in patients with acute ischemic stroke caused by large vessel occlusion. This paper selected 4 high-quality retrospective studies by Chinese scholars regarding endovascular treatment in patients with acute ischemic stroke, which were published in foreign journals during past 3 years, and focused on study methods and results. DOI: 10.3969/j.issn.1672-6731.2017.11.003