Ischemic stroke is a major neurological disease with limited effective therapeutic options except for thrombolysis and thrombectomy. Remote ischemic conditioning (RIC) is an approach that promises an alternative to the current treatment portfolio. As an easy-handled, non-invasive regimen, it takes advantage of transient ischemia (currently often made through inflation and deflation of limb blood pressure cuff) to enhance the tolerance of vital organs to ischemia. RIC can be executed before, during and after the onset of stroke. The mechanisms of action of RIC employed at different stroke stages are similar and may involve humoral, neurological and inflammatory pathways. As new mechanisms underlying RIC-induced neuroprotection continue to be revealed, we review in this article some of the latest development in this field, including: ① RIC and RIC-induced fundamental change, hypoxia, as well as the role of hypoxia inducible factors against stroke; ② Potential role of RIC-induced extracellular vesicles in neuroprotection; ③ RIC-induced metabolic changes in tissue protection; ④ Potential effect of RIC on red blood cells (RBC) oxygen delivery; and ⑤ RIC and its anti-inflammatory potential.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a complex syndrome with heterogeneous aetiologies, pathogenesis and manifestations. Patients with PD may present with motor symptoms and various non-motor symptoms (NMSs). NMSs have been reported in almost every diagnosed case of PD and usually precede motor symptoms. Multiple factors have been proved to be associated with the occurrence of NMSs in PD, among which genetic differentiation is a featured one. With the development of sequencing techniques, an increasing number of NMS-related genetic factors have been identified. This article reviews some of the latest discoveries in this regard.

Medical artificial intelligence (AI) in China is now on the eve of a massive surge. Despite great promise from this emerging field, there remain formidable pitfalls and obstacles, especially the challenges to current legal rules. We review the development of legal rules concerning medical AI in China, discuss risks of liability of commercial organizations and health care providers and whether current rules should be amended, and if so, what are the key issues to be addressed. Finally, we close by sketching possible ways forward for the legal and regulatory system.

Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disorder characterized by a variable combination of autonomic failure, parkinsonism with poor response to levodopa, cerebellar ataxia and pyramidal symptoms. The pathological hallmark of MSA is the oligodendrocytic glial cytoplasmic inclusions (GCIs) consisting of α-synuclein, and so MSA, together with Parkinson’s disease (PD) and dementia with Lewy bodies (DLB), is an α-synucleinopathy. Currently few effective biomarkers have been identified for the diagnosis or prognosis of MSA, and there is no established therapy to delay its progression. In this review, we discuss the epidemiology, neuropathology, genetics, clinical presentation and diagnostic biomarkers of MSA, as well as recent advances in its treatment.

The multifocal glioblastomas (GBM) are tumors with multiple discrete areas of contrast enhancing tumors which have considerably poorer prognosis than solitary GBM. Median overall survival of diagnosed patients almost twice as less than solitary presentation. We present a case report of multifocal GBM. A 72-year old right-handed male was evaluated at the Neuro-Oncology Clinic of Baylor Scott and White Hospital (Central Division). Patient presented at this hospital because of persistent progressive headaches, confusion, and an incident of fall. Physical evaluation revealed neurological impairments. Brain magnetic resonance imaging (MRI) revealed heterogeneous contrast enhancing lesions with associated vasogenic oedema. Patient underwent a stereotactic biopsy analysis of the larger lesion and pathology evaluation concluded an isocitrate dehydrogenase 1 and 2 wild type GBM with unmethylated O-6-methylguanine-DNA methyltransferase. Treatment remedies: Patient received 4 weeks concurrent radiation therapy along with combination of temozolomide at dose of 75 mg/m2 followed adjuvant temozolomide for 10 cycles with bevacizumab at 10 mg/kg every 2 weeks and Optune treatment. Post treatment evaluation: Repeat MRIs showed near complete resolution of the tumors at 26 months of treatment along with improvement of neurological status. Conclusion: Due to limitations of surgical manipulations in multifocal GBM diagnosed patients, combinational chemo and radiation therapy is the treatment of choice for most cases. Using additional novel treatment with non-invasive therapeutic device proven to be effective is another excellent approach to the established practice. Therefore, combination therapy of Optune plus temozolomide and bevacizumab might be a promising remedy for newly diagnosed multifocal glioblastomas.