Ya An Shi

Stroke is the second leading cause of death worldwide, with ischemic stroke being the most common type. The current best treatment for acute ischemic stroke is intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) given within 4.5 hours of symptom onset. However, some patients experience stroke progression or early blood vessel reocclusion after thrombolysis, which worsens neurological function and outcomes. This is believed to be caused by increased platelet activation after thrombolysis, which peaks within the first 2 hours. This clinical trial is testing whether starting oral aspirin early after intravenous thrombolysis can improve functional outcomes without causing more bleeding problems. Patients are randomly assigned to receive either 300 mg aspirin tablets or matching placebo tablets as soon as possible after enrollment. If swallowing is difficult, tablets can be crushed and given through a nasogastric tube. Both groups receive best medical management according to guidelines. The study is a Phase 3, multicenter, randomized, placebo-controlled trial. Participants will be followed for 90 days after stroke to measure their functional recovery using the modified Rankin scale (mRS). Researchers will check if patients have a good outcome defined as an mRS score of 0 or 1 at 90 days. During the study, patients undergo assessments including neurological exams and imaging to confirm eligibility and monitor safety. The trial aims to determine if early aspirin treatment after thrombolysis is safe and can help prevent neurological decline and improve recovery.

Researchers are investigating whether providing vision correction through glasses can slow down cognitive decline in older adults living in rural areas. The study focuses on individuals aged 60 to 79 who have vision problems but normal cognitive function and hearing at the start. The main goal is to see if giving free prescription glasses to those with refractive errors or uncorrected vision can reduce the rate of cognitive decline over 36 months in a cost-effective way. Participants who receive the intervention will be able to select from various frames, and their glasses will be custom-made to fit their pupillary distance and prescription. They will receive instructions for proper use, and replacements will be provided if the glasses are lost or damaged. Each year, participants in the glasses group will have an eye exam to check for changes in vision and update their prescription if needed. The study compares these participants to those who do not receive vision correction. During the 36-month study, cognitive assessments using the Chinese version of the Global Cognitive Score Scale will be conducted at the start and annually to evaluate changes. Researchers will monitor vision, adherence to glasses use, and cognitive function over time. The study includes regular follow-up to measure the impact of vision correction on cognitive decline in this population.

Researchers are investigating the safety and effectiveness of remote ischemic conditioning (RIC) in patients with acute ischemic stroke caused by large vessel blockage in the brain. While endovascular thrombectomy is effective in reopening blocked vessels, many patients still suffer poor outcomes due to brain tissue damage during and after the procedure. The study aims to see if RIC, a noninvasive therapy involving brief cycles of arm blood flow restriction, can protect the brain and improve recovery in these patients. The study compares two durations of remote ischemic conditioning: one lasting 14 days and another lasting 30 days after mechanical thrombectomy. RIC is performed using an automatic device that inflates and deflates a cuff on the upper arm, with five cycles of 5-minute inflation and 5-minute deflation. This procedure is done once before thrombectomy and then twice daily during the assigned post-thrombectomy period. All patients also receive best medical management according to guidelines. Mechanical thrombectomy is done following standard practices to reopen blocked vessels safely. Participants will be monitored for 90 days after their stroke to assess recovery and safety. The main measure is the proportion of patients who achieve a good functional outcome, defined as a modified Rankin Scale score of 0 to 2 at 90 days. Throughout the study, medical evaluations, imaging, and clinical assessments will be conducted to track progress and any side effects. The study also explores how the length of RIC treatment affects patient outcomes, aiming to find the best approach to protect the brain after stroke treatment.