The safety and efficacy of albumin combined with endovascular therapy for participants with acute ischemic stroke is unknown. This randomized, double blinded, multicenter study was conducted in China and completed in 2025. Eligible participants were randomly assigned in a 1:1 ratio to albumin group (0.5 g/kg; maximum dose 150 mL; intravenously infusion once daily for 4 days) or placebo group (equivalent volume of placebo). The primary endpoint was the change in infarct volume from baseline to day 5. A total of 134 patients were randomized (66 in albumin group and 68 in placebo group) and 134 patients were included in the final analysis. Albumin reduced infarct volume growth from baseline to day 5 compared with placebo (median growth 7.5 mL vs 16.5 mL, adjusted median difference -8.63, 95%CI (-13.85 to -5.07); P = 0.003). The safety outcomes did not differ between the two groups. This work suggests that albumin plus endovascular therapy could significantly reduce infarct volume growth compared with the placebo group, without raising safety concerns. (Funded by the National Natural Science Foundation of China and others; ClinicalTrials.gov registration: NCT06538844.).

Background A considerable number of patients with acute ischaemic stroke (AIS) are ineligible for standard reperfusion therapy due to time window constraints and contraindications. Human urinary kallidinogenase (HUK), a tissue kallikrein, has been demonstrated to promote vasodilation and improve cerebral blood flow (CBF) in ischaemic regions. Although clinical evidence suggests its favourable efficacy in such patients with AIS, the specific effects of HUK on early cerebral perfusion and its correlation with functional outcomes remain incompletely elucidated.Aim TK-SPEED aims to investigate the effects of HUK on early cerebral perfusion improvement and functional outcomes in patients with AIS, providing robust evidence for HUK.Methods and design TK-SPEED is a multicentre, prospective, randomised, open-label, blinded-endpoint controlled trial. Approximately 540 participants with acute anterior circulation ischaemic stroke will be recruited from about 20 participating sites across China. Eligible patients will be randomly assigned in a 1:1 ratio to either the intervention group (HUK plus standard therapy) or the control group (standard therapy).Study outcomes The primary endpoint is the proportion of patients with a modified Rankin Scale (mRS) of 0–2 at day 90. The secondary outcomes include changes in the Tmax (time-to-maximum)>6 s volume and regional CBF in the Tmax>6 s area on CT perfusion from baseline to day 5 after treatment, the ordinal distribution of mRS, the proportion of patients with mRS of 0–1 at day 90 and changes in the National Institutes of Health Stroke Scale score from baseline to days 5 and 10 after treatment.Discussion This trial will provide crucial evidence elucidating the impact of HUK on early cerebral perfusion and its correlation with the 90-day neurological outcomes in patients with AIS, offering guidance for optimising AIS treatment strategies and improving patient prognosis.Trial registration number NCT06132880.

Background Despite aggressive medical management, patients with symptomatic intracranial artery stenosis (sICAS) have a markedly elevated risk of recurrent stroke. Regular physical exercise is associated with a reduced risk of stroke recurrence. However, the superiority of physical exercise plus usual care over usual care for sICAS in terms of effectiveness and safety still lacks evidence. Moreover, gym‐based physical exercise has multiple constraints, making it suboptimal for sustaining lifelong self‐directed physical exercise required after stroke. Methods This study was conducted to determine the effectiveness and safety of home‐based structured physical exercise plus usual care versus usual care in reducing stroke recurrence in patients with sICAS. The RESIST (Structured Physical Exercise for Symptomatic Intracranial Atherosclerotic Stenosis) trial is a multicenter, prospective, randomized, controlled, open‐label, blinded end point assessment trial conducted in China. A total of 1300 patients with recent sICAS will be recruited from multiple study centers. Participants will be randomly assigned in a 1:1 ratio to receive home‐based structured physical exercise plus usual care or usual care. The primary outcome is new ischemic stroke within 1 year. Secondary outcomes assessed at 1 year include any ischemic stroke or transient ischemic attack in the qualifying artery territory, any ischemic stroke or transient ischemic attack, hemorrhagic stroke, myocardial infarction, the rate of modified Rankin scale 0 to 1, the EuroQoL 5‐Dimensions 5‐Level, and the mini Montreal Cognitive Assessment. Safety outcomes include fall rate and all‐cause mortality. Conclusions The RESIST trial will provide crucial evidence on the potential benefits of home‐based, structured physical exercise for preventing stroke recurrence in patients with sICAS. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT06615726.

BACKGROUND:Intracranial atherosclerotic stenosis is a prevalent cause of stroke worldwide and carries a high risk of recurrence. This study aimed to develop and validate a simple and effective model for predicting individualised risks of recurrent ischaemic stroke in patients with symptomatic intracranial atherosclerotic stenosis (ICAS). METHODS:This multivariable prediction model was built and validated using participants with symptomatic ICAS within 30 days of symptom onset from a large randomised controlled trial (RICA). The trial enrolled 3033 participants across 84 hospitals in China between Oct 28, 2015, and Feb 28, 2019. Participants were non-randomly divided by hospitals location into training and validation sets. Eligible participants were aged 40-80 years and had experienced an ischaemic stroke or transient ischaemic attack attributable to 50-99% stenosis of a major intracranial artery. The primary outcome of the model was time to first ischaemic stroke recurrence within 1 year. A Cox proportional hazards model was developed using the Akaike information criterion and validated both internally and externally. Model performance was assessed by discrimination (Harrell's concordance index [C-index]), calibration (modified Hosmer-Lemeshow test and calibration plots), and clinical utility (decision curve analysis and Kaplan-Meier curves). FINDINGS:2995 participants from the RICA trial were divided into the training (n=2137) and validation (n=858) sets. The PROMISE model included age, BMI, hypertension, type 1 and type 2 diabetes, current smoking status, LDL cholesterol, location of symptomatic stenosis, and stenosis degree of qualifying artery as predictors. The C-index for the prediction model was 0·81 (95% CI 0·80-0·83) in the training set and 0·78 (0·77-0·84) in the validation set. Model calibration was satisfactory across the full risk profile (modified Hosmer-Lemeshow test χ2=5·32, p=0·38). Furthermore, decision curve analysis curves indicated that this prediction model provided clinical benefits. Additionally, participants were classified into three distinct risk groups (low, medium, and high) by Kaplan-Meier curves based on the prediction model. The corresponding C-indices for these groups were 0·80 (95% CI 0·80-0·86), 0·68 (0·67-0·77), and 0·71 (0·69-0·81) in the training set, and 0·76 (0·75-0·88), 0·67 (0·65-0·82), and 0·68 (0·67-0·86) in the validation set. Based on the final model, an online risk calculator was developed. INTERPRETATION:We developed the PROMISE model and an online calculator using accessible clinical variables to predict ischaemic stroke recurrence, identify individuals at high risk, and support symptomatic ICAS patient management. The model had a strong discriminative ability and good calibration. Further validation and model optimisation should be conducted to support stroke care. FUNDING:National Natural Science Foundation of China, Beijing Natural Science Foundation, Noncommunicable Chronic Diseases-National Science and Technology Major Project, and Beijing Physician Scientist Training Project.

Background: Accurate diagnosis of cerebral amyloid angiopathy (CAA) in surviving patients is indispensable for making treatment decisions and conducting clinical trials. We aimed to evaluate the diagnostic value and clinical utility of the simplified Edinburgh computed tomography (CT) criteria for CAA-related hemorrhage in Chinese patients. Methods: We analyzed 212 patients with lobar hemorrhage who underwent brain CT and magnetic resonance imaging (MRI) from a multicentre cohort. Using the Boston criteria version 2.0 (v2.0) as the gold standard, we assessed the application value of the simplified Edinburgh CT criteria, and investigated whether the Edinburgh CT criteria predict patient outcomes. Results: Patients with probable CAA accounted for 36.6% according to the Boston criteria v2.0. The Edinburgh CT criteria indicated an area under the receiver operating characteristic curves (AUC) of 0.735 for the diagnosis of probable CAA, and it performed better when there was a high-risk threshold of CAA in the decision curve analysis. Patients with a high risk of CAA based on the Edinburgh CT criteria had poorer outcomes at 90-day after adjusting for confounding factors ( p = 0.034). Finger-like projections in the Edinburgh CT criteria were associated with lobar microbleeds, cortical superficial siderosis, and multispot white matter hyperintensity according to the Boston criteria. Conclusions: Taking the Boston criteria v2.0 as the gold standard, the Edinburgh CT criteria demonstrated good diagnostic value and predicted outcomes well at 90-day in Chinese patients with lobar hemorrhage. Further studies with larger sample sizes are required to confirm these findings.

INTRODUCTION:The rapidly expanding population of ageing and older adults with disability has been a continuing public health priority in recent decades. The first step towards solving this issue is to assess disability accurately and identify high-risk factors and individuals for early prevention. We aim to establish a prospective cohort, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE), using multidimensional disability assessments and to develop multifactorial models for disability prediction among community-dwelling older adults. METHODS AND ANALYSIS:The BLINDSCE is a prospective cohort study that includes community-dwelling older adults aged ≥65 years with or without disability from urban and rural areas in Beijing. Participants complete structured questionnaires and undergo assessments of disability, cognition and disability-related factors and outcomes. Disability is assessed using the WHO's Disability Assessment Schedule 2.0, activities of daily living, the Barthel index, locomotor function and physical function. Based on baseline cross-sectional information, the relationships between multiple factors and disability can be initially screened using logistic regression. Every 1-1.5 years, participants will receive a follow-up survey to remeasure disability, cognitive function and other disability-related factors and outcomes. At least three follow-ups are scheduled. The primary outcome of this study is disability. The secondary outcomes include cognition and many disability-related conditions, such as falls, pain, poor health, decreased intrinsic capacity, frailty, sarcopenia, hospitalisation and death. Cox proportional hazards or logistic regression will be used to analyse follow-up data and construct prediction models, which will be validated internally and externally. ETHICS AND DISSEMINATION:The Ethics Committee of Xuanwu Hospital, Capital Medical University, approved this study (No: [2023]129). The results will be published in peer-reviewed journals focusing on geriatric medicine and presented at related scientific conferences. TRIALS REGISTRATION NUMBER:NCT06863727. Stage of study: recruiting.

While existing studies have linked declines in intrinsic capacity (IC) to adverse health outcomes, the role of potentially modifiable lifestyle factors in this pathway, especially sedentary behavior, remains critically underexplored. Using data from the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE) cohort (2023–2024), this study investigated both cross-sectional and 1-year longitudinal associations between sedentary time and IC in community-dwelling older adults. Of the 2044 participants (≥ 65 years) enrolled at baseline, 1576 completed 1-year follow-up assessments through face-to-face interviews. Multivariable linear regression analyses revealed that each additional hour of daily sedentary time was associated with a 1.18-point lower baseline IC score (95

Remote ischemic conditioning (RIC) is a novel and promising therapeutic intervention for symptomatic intracranial atherosclerotic stenosis (sICAS). This study aimed to evaluate sex differences in stroke recurrence among patients with sICAS and assess the efficacy of RIC in the RICA (chronic remote ischemic conditioning in patients with symptomatic intracranial atherosclerotic stenosis) trial. The RICA trial was a multicenter, randomized clinical trial conducted across 84 stroke centers in China. Patients with sICAS were randomly assigned on a 1:1 ratio to receive either RIC intervention or sham RIC intervention once daily for 12 months. The primary endpoint was ischemic stroke recurrence. The median follow-up duration was 3.5 years. Of the 3,033 patients enrolled in the RICA trial, 1,079 (35.58%) were women. Female patients were generally older (mean [SD] age 62.9 [8.8] years versus 60 [9.2] years) and had a higher prevalence of hypertension, diabetes, and a higher body mass index than male patients. No significant difference was observed in ischemic stroke recurrence risk between female and male patients during a median follow-up of 3.5 years (20.5% versus 16.6%, adjusted hazard ratio, 1.18; [95% CI, 0.97 to 1.42]). However, RIC significantly reduced the risk of ischemic stroke recurrence in male patients, while no similar effect was observed in female patients (adjusted hazard ratio, 0.88; [95% CI, 0.58 to 1.32]; P for interaction = 0.379). No significant sex-based differences were observed in ischemic stroke recurrence among patients with sICAS over the 3.5-year follow-up period. RIC may have better therapeutic benefits for male patients with good compliance.

As an inflammatory disease, atherosclerosis is associated with acute ischemic stroke (AIS), but its early identification and intervention efficacy remain suboptimal. A new research direction may be to explore peripheral atherosclerotic biomarkers from the perspective of mitochondrial dysfunction, which can induce inflammatory cell activation. Moreover, the degree of overall cervicocephalic atherosclerosis (namely, atherosclerotic burden) is more closely related to AIS prognosis than local atherosclerotic lesions. Therefore, this study investigated the relationship between mitochondrial dysfunction in peripheral blood mononuclear cells (PBMCs), including monocytes and lymphocytes, and overall cervicocephalic atherosclerotic burden and AIS outcome. Patients with AIS and cervicocephalic atherosclerosis were enrolled and followed up for 90 days. The reactive oxygen species (ROS) and the mitochondrial deoxyribonucleic acid copy number (mtDNA-CN) in PBMCs were measured respectively through a fluorescence probe and a droplet digital polymerase chain reaction to evaluate mitochondrial function. The overall intracranial and cervical atherosclerotic burden (ICAB) was quantified by summing up the atherosclerosis degree points in each arterial segment as assessed by computed tomography angiography. A modified Rankin Scale (mRS) score >2 was considered a 90-day unfavorable functional outcome. Five (4.9%) of the 103 patients with AIS were lost to follow-up. mtDNA-CN [adjusted β = -0.099, 95% confidence intervals (CIs) = -0.153 ∼ -0.044, p < 0.001] and ROS content (adjusted β = 1.275, 95%CI = 0.885 ∼ 1.665, p < 0.001) were correlated with ICAB. The risk of a 90-day unfavorable functional outcome increased with higher ROS content [adjusted odds ratio (OR) = 1.523, 95%CI = 1.172 ∼ 1.981, p = 0.002] and decreased with higher mtDNA-CN (adjusted OR = 0.911, 95%CI = 0.850 ∼ 0.976, p = 0.008). PBMC mitochondrial dysfunction was found to be independently associated with extensive and severe cervicocephalic atherosclerosis and a 90-day unfavorable functional outcome in patients with AIS, which may provide a novel approach to improving the early identification and risk stratification of cervicocephalic atherosclerosis, along with the prediction of the outcome of atherosclerotic AIS.

Remote ischemic conditioning (RIC) is a novel and promising therapeutic intervention for symptomatic intracranial atherosclerotic stenosis (sICAS). This study aimed to evaluate sex differences in stroke recurrence among patients with sICAS and assess the efficacy of RIC in the RICA (chronic remote ischemic conditioning in patients with symptomatic intracranial atherosclerotic stenosis) trial. The RICA trial was a multicenter, randomized clinical trial conducted across 84 stroke centers in China. Patients with sICAS were randomly assigned on a 1:1 ratio to receive either RIC intervention or sham RIC intervention once daily for 12 months. The primary endpoint was ischemic stroke recurrence. The median follow-up duration was 3.5 years. Of the 3,033 patients enrolled in the RICA trial, 1,079 (35.58%) were women. Female patients were generally older (mean [SD] age 62.9 [8.8] years versus 60 [9.2] years) and had a higher prevalence of hypertension, diabetes, and a higher body mass index than male patients. No significant difference was observed in ischemic stroke recurrence risk between female and male patients during a median follow-up of 3.5 years (20.5% versus 16.6%, adjusted hazard ratio, 1.18; [95% CI, 0.97 to 1.42]). However, RIC significantly reduced the risk of ischemic stroke recurrence in male patients, while no similar effect was observed in female patients (adjusted hazard ratio, 0.88; [95% CI, 0.58 to 1.32]; P for interaction = 0.379). No significant sex-based differences were observed in ischemic stroke recurrence among patients with sICAS over the 3.5-year follow-up period. RIC may have better therapeutic benefits for male patients with good compliance.

Background Endovascular treatment improves the recanalisation rate for patients with acute ischaemic stroke; however, even with endovascular treatment, approximately half of patients do not have a favourable functional outcome. We aimed to evaluate the effect of normobaric hyperoxia combined with endovascular treatment on functional outcomes up to 90 days after treatment in patients who had an acute ischaemic stroke with large-vessel occlusion. Methods In this multicentre, randomised, single-blind, sham-controlled trial, patients aged 18-80 years presenting within 6 h of acute ischaemic stroke attributed to large-vessel occlusion in anterior circulation, who were candidates for endovascular treatment, were recruited from 26 comprehensive stroke centres in China. Eligible patients were randomly assigned (1:1), with an Interactive Web Response System on the basis of a minimisation process to balance assignment at each participating site both overall and according to age, sex, occlusion location, and use of intravenous thrombolytics, to receive either normobaric hyperoxia combined with endovascular treatment or sham normobaric hyperoxia combined with endovascular treatment. Participants and assessors were blinded to treatment assignment. Normobaric hyperoxia treatment involved inhaling 100% oxygen at a flow rate of 10 L/min through a non-rebreather mask for 4 h, or an inspiratory oxygen fraction (FiO(2)) of 10 in participants for whom intubation was necessary. Sham treatment was 100% oxygen delivered at a flow rate of 1 L/min or an FiO(2) of 03. The primary outcome was the comparison of the ordinal scores on the modified Rankin Scale (mRS) at 90 days assessed in the intention-to-treat population (including all patients randomly assigned to treatment). Safety was assessed in all patients who received any oxygen therapy. This trial is registered with ClinicalTrials.gov, NCT04681651, and is now complete. Findings Between April 22, 2021, and Feb 5, 2023, 473 patients were screened, of whom 282 were randomly assigned to either normobaric hyperoxia plus endovascular treatment (n=140) or sham normobaric hyperoxia plus endovascular treatment (n=142; intention-to-treat population). The median age was 65 years (IQR 57-71), 75 (27%) of 282 participants were female, 207 (73%) were male, and 282 (100%) of participants were of Chinese Han ethnicity. At 90 days, the median score on the mRS for the normobaric hyperoxia group was 2 (IQR 1-4) and it was 3 (1-4) in the sham normobaric hyperoxia group (adjusted common odds ratio 165 [95% CI 109-250]; p=0018). At 90 days, 14 (10%) of 140 patients in the normobaric hyperoxia group and 17 (12%) of 142 in the sham normobaric hyperoxia group died (adjusted risk difference -002 [95% CI -009 to 006]) and 28 (20%) and 33 (23%) had serious adverse events (adjusted risk difference -003 [-012 to 007]). Interpretation In patients with acute ischaemic stroke caused by large-vessel occlusion in the anterior circulation who were candidates for endovascular treatment, normobaric hyperoxia yielded superior functional outcomes at 90 days compared with the sham normobaric hyperoxia, without raising safety concerns.

To determine how the WHODAS 2.0 performs to detect disability against standard ADL scales in a community-dwelling geriatric population and to explore the score conversion between these two measures. WHODAS 2.0 is an applicable, sensitive, and comprehensive tool for detecting disability in community-dwelling older adults. The conversion between WHODAS 2.0 and ADL scores was built with precision. Integrating WHODAS 2.0 into routine comprehensive geriatric assessment in community practice is necessary. To compare the performance of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) with activities of daily living (ADL) scales for disability assessment and to explore the score conversion between these two measures in a community-dwelling geriatric population. Data were drawn from the observational cohort study, the Beijing Longitudinal Disability Survey in Community Elderly, including 2170 community-dwelling adults aged ≥ 65 years. The 12-item WHODAS 2.0, ADL scales, and other corresponding measurements (mobility, cognition, depression, pain, nutrition, frailty, and sarcopenia) were evaluated face-to-face by well-trained assessors. Receiver operating characteristic (ROC) curve analysis was used to assess the accuracy of discriminating participants with ADL disability. Spearman’s correlation coefficients were calculated to evaluate the associations between WHODAS 2.0, ADL scales, and other geriatric assessment tools. Equipercentile equating was performed to develop a conversion table between the WHODAS 2.0 and ADL scales. Among 2170 community-dwelling older adults, the mean (SD) age was 74.1 (7.2) years, and 867 (40.0

Background:Albumin is a multifunctional plasma protein that is mainly synthesized in the liver and may play a neuroprotective role in treating acute ischemic stroke (AIS). The efficacy of albumin in patients with AIS receiving reperfusion therapy remains unknown. Methods:ARISE is a multicenter, randomized, double-blind, placebo-controlled, phase 2 study. We will recruit 134 patients aged 18-80 years with AIS due to large-vessel occlusion in the anterior circulation, within 24 h of symptom onset, with an Alberta Stroke Program Early CT Score of 3-10 points and an infarct core volume of ≤100 mL at baseline. Eligible patients will be randomly assigned, on a 1:1 ratio, to undergo endovascular therapy (EVT) and receive albumin therapy (0.5 g/kg; intravenous injection) once daily for 4 days or to undergo EVT and receive placebo therapy once daily for 4 days. The primary efficacy outcome is the change in infarct volume from baseline to day 5. Conclusion:The ARISE trial will provide valuable evidence on the efficacy and safety of albumin in patients with AIS receiving EVT. Clinical trial registration:www.clinicaltrials.gov, NCT06538844.

Stroke-associated pneumonia (SAP) is one of the most common complications in acute ischemic stroke (AIS) patients, affecting 8.5

Objective To develop the crosswalk between the Montreal Cognitive Assessment-Basic (MoCA-B) and Mini-Mental Status Examination (MMSE) based on a community-dwelling older population to facilitate data synthesis and comparison. Design A cross-sectional study. Setting and Participants We used baseline data of 2170 subjects with total MoCA-B and MMSE scores from an ongoing prospective cohort study, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE). Methods The MoCA-B and MMSE were administered by trained assessors. Equipercentile equating was used to develop the conversion table between MoCA-B and MMSE scores in the total sample and subgroups by age, sex, residency, and education level. The mean absolute error (MAE), intraclass correlation coefficient (ICC), and Bland-Altman plot were used to evaluate the linking performance. Results MoCA-B and MMSE scores converted bi-directionally for the overall sample and subgroups, with small standardized MAE (SMAE) and high ICC. The linking results between MoCA-B and MMSE scores were consistent across the total sample and the age and sex subgroups, while a 2-score difference was observed within the residency and education subgroups. Conclusions and Implications This study provides easy-to-use crosswalks between measures of MoCA-B and MMSE with precision among community-dwelling older adults. Our results help to compare and pool data across studies using either of the 2 cognitive screening tests and provide a useful reference to clinicians for better evidence-based practice in patients evaluated using different cognitive tests.

Background:and Purpose: Hemorrhagic transformation (HT) is one of the severe complications in acute ischemic stroke, especially for the patients who undergo recanalization treatment. It is crucial to screen patients who have high risk of HT before recanalization. However, current prediction models based on clinical factors are not ideal for clinical practice. Serum occludin, a biomarker for cerebral ischemia-induced blood-brain barrier disruption, has potential for predicting HT. This study was to investigate whether the combination of serum occludin and clinical risk factors improved the efficacy of predicting HT. Methods:This was a single-center prospective observational study. Baseline clinical data and blood samples of recanalization patients were collected upon admission to our hospital. The level of serum occludin was measured using enzyme-linked immunosorbent assay. The diagnosis of HT was confirmed by CT scans within 36 h post recanalization. Results:A total of 324 patients with recanalization were enrolled and 68 patients presented HT occurrence. HT patients had the higher level of baseline occludin than patients without HT (p < 0.001). Multivariate regression analysis showed that serum occludin level, Alberta Stroke Program Early CT Scores and endovascular therapy were independent risk factors (p < 0.05) for HT after adjusting potential confounders. The combination of serum occludin and clinical risk factors significantly improved the accuracy of predicting HT [area under the curve (AUC, 0.821 vs 0.701, p < 0.001), and net reclassification improvement (31.1 %), integrated discrimination improvement (21.5 %), p < 0.001] compared to a model employing only clinical risk factors. The modified AUC (0.806) of combined model based on 10-fold-cross-validation was still higher than clinical risk model (0.701). Conclusion:The combination of serum occludin and clinical risk factors significantly improved the prediction efficacy for HT, providing a novel potential prediction model to screen for patients with high risk of HT before recanalization in acute ischemic stroke.

The Beijing Healthy Aging Cohort Study (BHACS) was established to supplement the limited data of a large representative cohort of older people based on the general population and was designed to evaluate the prevalence, incidence, and natural history of cognitive decline, functional disability, and conventional vascular risk factors. The aim was to determine the evolution of these conditions by estimating the rates and determinants of progression and regression to adverse outcomes, including dementia, cardiovascular events, cancer, and all-cause death. It can therefore provide evidence to help policy makers develop better policies to promote healthy aging in China. BHACS consisted of three cohorts (BLSA, CCHS-Beijing, and BECHCS) in Beijing with a total population of 11 235 (6281 in urban and 4954 in rural areas) and an age range of 55 years or older (55–101 years) with a mean age of 70.35 ± 7.71 years (70.69 ± 7.62 years in urban and 69.92 ± 7.80 years in rural areas). BHACS-BLSA conducted the baseline survey in 2009 with a multistage stratification-random clustering procedure for people aged 55 years or older; BHACS-CCHS-Beijing conducted the baseline survey in 2013–2015 with a stratified multistage cluster random sampling method for people aged 55 years or older; and BHACS-BECHCS conducted the baseline survey in 2010–2014 with two-stage cluster random sampling method for people aged 60 years or older. Data were collected through questionnaires, physical measurements, and laboratory analyses. Topics covered by BHACS include a wide range of physical and mental health indicators, lifestyles and personal, family, and socio-economic determinants of health. There are no immediate plans to make the cohort data freely available to the public, but specific proposals for further collaboration are welcome. For further information and collaboration, please contact the corresponding author Yao He (e-mail: yhe301@x263.net).

Background: Exploratory studies have shown that remote ischemic conditioning (RIC) has the potential to lower blood pressure (BP). We investigated whether chronic RIC reduces BP for hypertension. Methods: This is a multicenter, randomized, double-blind, parallel-controlled trial. Patients with an office BP of 130/80 to 160/100 mm Hg and a 24-hour average BP ≥125/75 mm Hg not on antihypertensive medications were recruited. After a 1-week compliance screening phase, they were randomly assigned in a 1:1 ratio to receive RIC or sham RIC twice daily for 4 weeks. The primary efficacy outcome was the change in 24-hour average systolic BP from baseline to 4 weeks. Safety events were assessed over the study period. Results: Ninety-five participants were randomly allocated to the RIC (n=49) and sham RIC (n=46) groups. In the intention-to-treat analysis, the reduction in 24-hour average systolic BP was greater in the RIC group than the sham RIC group (−4.6±9.5 versus −0.9±6.8 mm Hg; baseline-adjusted between-group mean difference: −3.6 mm Hg [95% CI, −6.9 to −0.3 mm Hg]; adjusted P =0.035). The per-protocol analysis showed that 24-hour average systolic BP reduced −5.9±8.6 mm Hg in the RIC group and −0.7±6.7 mm Hg in the sham RIC group (baseline-adjusted between-group mean difference: −5.2 mm Hg [95% CI, −8.5 to −1.9 mm Hg]; adjusted P =0.002). No major adverse events were reported in both groups. Conclusions: RIC is safe in patients with mild hypertension and may lower BP in the absence of antihypertensive medications. However, the effects of RIC on clinical outcomes in these patients require further investigation. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04915313.

BACKGROUND AND PURPOSE:Perihematomal edema (PHE) is one of the severe secondary damages following intracranial hemorrhage (ICH). Studies showed that blood-brain barrier (BBB) injury contributes to the development of PHE. Previous studies showed that occludin protein is a potential biomarker of BBB injury. In the present study, we investigated whether the levels of serum occludin on admission are associated with PHE volumes in ICH patients.METHODS:This cross-sectional study included 90ICH patients and 32 healthy controls.The volumes of hematoma and PHE were assessed using non-contrast cranial CT within 30 min of admission. Blood samples were drawn on admission, and the levels of baseline serum occludin were detected using enzyme-linked immunosorbent assay. Partial correlation analysis and multiple linear regression analysis were performed to evaluate the association between serum occludin levels and PHE volumes in ICH patients.RESULTS:The serum occludin levels in ICH patients were much higher than health controls (median 0.27 vs. 0.13 ng/mL, p < 0.001). At admission, 34 ICH patients (37.78%) had experienced a severe PHE (≥30 mL), and their serum occludin levels were higher compared to those with mild PHE (<30 mL) (0.78 vs. 0.21 ng/mL, p < 0.001). The area under the receiver operating characteristics curve (ROC) of serum occludin level in predicting severe PHE was 0.747 (95% confidence interval CI 0.644-0.832, p < 0.001). There was a significant positive correlation between serum occludin levels and PHE volumes (partial correlation r = 0.675, p < 0.001). Multiple linear regression analysis showed that serum occludin levels remained independently associated with the PHE volumes after adjusting other confounding factors.CONCLUSION:The present study showed that serum occludin levels at admission were independently correlated with PHE volumes in ICH patients, which may provide a biomarker indicating PHE volume change.