Brain Diseases Department 1 (Neurology Department 1)

Department One of Encephalopathy of Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine was founded in 1970. It is a member of the Encephalopathy Professional Committee of the World Federation of Chinese Medicine Societies; the National Advanced Cognitive Impairment Diagnosis and Treatment Center; the National Advanced Stroke Center; a key discipline of the National Administration of Traditional Chinese Medicine’s 12th Five-Year Plan key discipline, Collateral Disease in Traditional Chinese Medicine; a key discipline of Xinjiang Uygur Autonomous Region, Encephalopathy in Traditional Chinese Medicine; a key specialty of encephalopathy in traditional Chinese medicine in Xinjiang Uygur Autonomous Region; the chair unit of the Xinjiang Uygur Autonomous Region Stroke Society; a stroke screening, prevention and treatment base of the former National Health and Family Planning Commission; a member unit of the China Parkinson Alliance; a member of the Northwest Parkinson’s Disease Alliance; a member of the Xinjiang Uygur Autonomous Region Neurology Professional Quality Control Center; a member of the Xinjiang Uygur Autonomous Region Stroke Diagnosis and Treatment Quality Control Center; a cerebrovascular disease base of the National Drug Clinical Trial Institution; and a clinical, teaching and research base for traditional Chinese medicine and integrated traditional Chinese and Western medicine encephalopathy research of Xinjiang Uygur Autonomous Region and Xinjiang Medical University. Its academic adviser is Professor Shen Baofan, a National Master of Traditional Chinese Medicine and a nationally renowned veteran traditional Chinese medicine physician; Director Meng Xinling is the academic leader. The department has outpatient and inpatient services. Outpatient services include specialty clinics for stroke and screening, memory, Parkinson’s disease, vertigo and epilepsy. It has 179 authorized beds, 2333982 outpatient visits/year and 7713 inpatient visits/year. There are 36 physicians: 4 chief physicians, 9 associate chief physicians, 20 attending physicians and 3 resident physicians; 1 doctoral supervisor, 4 master’s supervisors, 6 doctoral students and 23 master’s students. There are 63 nurses: 3 associate chief nurses, 21 charge nurses, 31 nurses and 8 assistant nurses. It is equipped with FDG-PET, SPECT, MRI (including two 3.0T MRI scanners) and CT. MRI examinations include DWI, GRE(SWI/T2*WI), MRA, MRP(PWI), MRV, MRS and diffusion tensor imaging, as well as an AI post-processing workstation for stroke. Multimodal imaging can be used to jointly assess vascular lesions such as large-vessel occlusion, vascular malformations, aneurysms and arteriovenous fistulas. Equipment includes neuropsychological assessment, carotid vascular color Doppler ultrasound, transcranial color Doppler ultrasound, cardiac color Doppler ultrasound (transthoracic and transesophageal echocardiography), right-heart contrast echocardiography, bubble testing, electroencephalography, neuromyography, (visual, auditory and brainstem) evoked potentials, vestibular function testing and endovascular intervention equipment, providing support for the smooth operation of the Encephalopathy Center. The department has strengthened subspecialty development and currently has groups for cerebrovascular disease; dementia and cognitive impairment; movement disorders; neuroimmunity and infection; peripheral nerve disease; and vertigo. Its diagnostic and treatment capabilities in each subspecialty have reached a high level. The advantages of integrated traditional Chinese and Western medicine are fully reflected in diagnosis and treatment, giving the department considerable influence throughout Xinjiang. It has strengthened the regional hierarchical diagnosis-and-treatment and rescue network medical alliance, jointly establishing rescue-network medical alliances and long-term remote consultation and assistance programs with numerous primary medical institutions, and continually improving the ability of primary hospitals to diagnose and treat nervous-system diseases.

1. Equal emphasis on inheritance and innovation in integrated traditional Chinese and Western medicine As a key discipline of the National Administration of Traditional Chinese Medicine, the Encephalopathy Center has always adhered to the development direction of giving priority to traditional Chinese medicine characteristics while integrating traditional Chinese and Western medicine. It regularly updates the traditional Chinese medicine diagnosis and treatment standards for stroke, dementia, tremor disease, vertigo and headache, and optimizes departmental protocol prescriptions. Under the guidance of Professor Shen Baofan, it applies the distinctive advantages of treating phlegm and blood stasis together and the methods of lowering, clearing and transforming. Based on the theory of treating phlegm and blood stasis together, it developed the hospital preparations Pinggan Maitong Tablets, Buqi Maitong Tablets and Huatan Maitong Tablets for stroke, expanded the clinical application of the ancient formulas Tianma Gouteng Decoction and Buyang Huanwu Decoction, and incorporated the hospital preparations into stroke diagnosis and treatment standards. Good clinical efficacy has been achieved during both the recovery and sequelae stages of stroke. Quyu Zhixue Decoction has distinctive therapeutic characteristics and effectively reduces encephalopathy complications, mortality and disability. Through years of combining theory with clinical practice, the team developed the clinical empirical formulas Yinao Huichun Formula, Jiannao Tongluo Paste Formula, Xingnao Kaiqiao Decoction, Yizhi Zhidai Formula and Pingzhen Decoction, which have achieved good clinical efficacy in treating many difficult and complicated neurological diseases. The department’s characteristic traditional Chinese medicine paste formulas highlight the distinctive implementation and application of traditional Chinese medicine in nervous-system diseases. For chronic nervous-system diseases, especially stroke, they provide characteristic paste formulas and syndrome-based treatment while continually emphasizing traditional Chinese medicine characteristics. Through the Collateral Disease specialty base, it develops the basic theory of collateral disease and strengthens its application in difficult and complicated diseases including stroke, dementia, tremor disease and headache. It also develops diversified characteristic comprehensive traditional Chinese medicine treatments, such as Chinese herbal medicine package therapy, acupoint application, auricular point pressing with beans, external washing with Chinese herbs, Chinese herbal foot baths and umbilical therapy. Multidisciplinary diagnosis and treatment centers have been established with the departments of acupuncture, massage and rehabilitation, creating a precise diagnosis-and-treatment platform, formulating individualized systematic treatment plans and establishing a patient-centered diagnosis-and-treatment model, greatly improving clinical efficacy and patient satisfaction.

2. Construction and development of the Advanced Stroke Center The center has formulated diagnosis-and-treatment standards and clinical pathways for various acute cerebrovascular diseases, strengthened standardized thrombolytic treatment and green-channel construction for ischemic cerebrovascular disease, and strengthened MDT multidisciplinary collaboration related to stroke. A 24h×7-day green channel for thrombolytic treatment of cerebral infarction has been opened; patients receive thrombolysis whenever they are admitted, with timely condition analysis and combined intra-arterial thrombolysis and thrombectomy when appropriate, thereby minimizing stroke mortality and disability. Multimodal imaging (MR/CT) joint assessment and post-processing with stroke artificial-intelligence software provide strong support for the green channel. The number of cerebral angiography and endovascular treatments has increased annually, and the range of treatments that can be completed independently has continued to expand, including intravenous thrombolysis and emergency endovascular treatment for acute ischemic stroke (intra-arterial thrombolysis, mechanical thrombectomy and balloon angioplasty), head-and-neck vascular stent angioplasty, cerebral venous-system vascular stent angioplasty, spinal cord endovascular intervention, endovascular treatment of intracranial aneurysms and endovascular treatment of intracranial arteriovenous malformations. After years of effort, DNT time has been reduced to within 50 minutes, with the fastest being 15 minutes, laying a solid foundation for timely treatment, reducing neurological deterioration, improving prognosis and lowering mortality in stroke patients. A stroke screening, prevention and treatment clinic has been established to strengthen stroke prevention and treatment management for patients at high risk of cerebrovascular disease and reinforce patients’ knowledge of the three levels of stroke prevention. Weekly stroke health education lectures are conducted. For outpatients, screening, early standardized intervention and management of high-risk groups are provided to reduce stroke risk. Cooperation with rehabilitation, acupuncture, massage and other traditional Chinese medicine specialty departments has also been strengthened, establishing a distinctive integrated traditional Chinese and Western medicine stroke unit for whole-course management of stroke patients.

3. Construction of the National Advanced Cognitive Impairment Diagnosis and Treatment Center Since establishing the Alzheimer’s Disease Diagnosis and Treatment Center and Memory Clinic in June 2013, the department established Xinjiang’s first neuropsychological assessment room and took the lead in conducting neurocognitive function examinations throughout Xinjiang. It added a clinical pathway and quality-control system for Alzheimer’s disease and established a clinical database system for Alzheimer’s disease, collecting and organizing clinical data on Alzheimer’s disease and other cognitive impairment diseases. By December 2021, 5798 patients had been assessed, and more than 10 disease categories had been clearly identified, including AD, pure VaD, AD+VaD, VCI, PDD, DLB, SNPH, frontotemporal dementia, multiple system atrophy, autoimmune encephalitis, delayed encephalopathy after carbon monoxide poisoning, cerebral small-vessel disease with dementia, primary progressive aphasia, infectious, toxic, traumatic and other conditions. In July 2022, it became the only Advanced Cognitive Impairment Diagnosis and Treatment Center in Xinjiang among the first group nationwide, providing whole-course management for patients with cognitive impairment, improving their quality of life, and further strengthening the cognitive specialty of the hospital so that it continues to lead in Xinjiang.

4. Development of the Parkinson’s disease and movement-disorder subspecialty In 2018, together with Xuanwu Hospital, Tiantan Hospital, Xiangya Hospital, West China Hospital and other hospitals, the department jointly established the Parkinson’s Disease Alliance and became a member unit of the China Parkinson Alliance. It established management procedures for patients of multiple ethnicities with dementia and Parkinson’s disease in Xinjiang, added a clinical pathway and quality-control system for Parkinson’s disease, and established a Parkinson’s disease clinical database system. Through construction and improvement of the database, it has gradually optimized work mechanisms and diagnosis-and-treatment procedures and provided whole-course management for patients with Parkinson’s disease.

5. Development of the vertigo subspecialty The department established vertigo diagnosis-and-treatment standards and clinical pathways, formulated and implemented a development plan and work plan for the vertigo subspecialty, and adopted specific measures to use the distinctive advantages of traditional Chinese medicine and improve the clinical efficacy of integrated traditional Chinese and Western medicine. Vestibular function testing continues to be actively performed, professional capabilities are strengthened, and an MDT has been formed with otolaryngology and other disciplines to deepen the multidisciplinary diagnosis-and-treatment model and improve medical quality. Through vestibular function testing, 5202 assessments were completed in the past three years, including 821 cases of benign paroxysmal positional vertigo, 123 cases of vestibular neuritis and more than 3000 patients with low-frequency vestibular hypofunction. This has improved the diagnostic level of vertigo, determined inner-ear vestibular function and the degree and nature of lesions, and enabled effective treatment of vertigo according to examination results.

6. Equal emphasis on medical care, education and research The department has completed multiple national- and autonomous-region-level projects and new-drug clinical trials. During the past five years, it received 18 national- and provincial/ministerial-level research projects, including 4 National Natural Science Foundation projects, 2 projects of the National Administration of Traditional Chinese Medicine, 2 Xinjiang science-and-technology assistance projects and 11 autonomous-region natural science projects. It has published about 100 related academic papers, including 7 SCI papers, 35 core-journal papers and 1 outstanding paper at a national neurology academic conference. Teaching reform has been deepened and teaching quality improved. As the Fourth Clinical Medical College of Xinjiang Medical University, the hospital undertakes undergraduate and graduate teaching for Xinjiang Medical University. The department undertakes courses for the Teaching and Research Section of Internal Medicine of Traditional Chinese Medicine, the Teaching and Research Section of Integrated Traditional Chinese and Western Medicine Internal Medicine, and the Teaching and Research Section of Basic Diagnostics. It also undertakes clinical demonstration and clinical observation teaching for classes of the College of Traditional Chinese Medicine of Xinjiang Medical University. There are three master’s supervisors; 22 graduate students have successfully graduated, including 2 international students, and 13 master’s students are currently enrolled. In the past five years, approximately 200 standardized-training physicians have been received. In strict accordance with the relevant requirements of Xinjiang Medical University and the hospital’s Teaching Management Department, the department has strengthened all work of the Teaching and Research Section of Integrated Traditional Chinese and Western Medicine Internal Medicine and the Basic Diagnostics Teaching and Research Section of the College of Traditional Chinese Medicine, striving to improve teaching quality. Two teaching-reform projects have currently been applied for: the eighth-round Xinjiang Medical University education-reform approved project “Exploration of Teaching Reform of Practical Training Courses in Western Medicine Diagnostics in Schools of Traditional Chinese Medicine”; the tenth-round Xinjiang Medical University education-reform approved project “Construction and Improvement of Western Medicine Diagnostics Teaching through Scenario Simulation Teaching Combined with Mini-CEX in Schools of Traditional Chinese Medicine”; and the university student innovation project “Investigation of the Mental and Psychological Status of Standardized-Training Graduate Students.” Ten teaching papers have been published.

7. Public education and health management On World Epilepsy Day, World Sleep Day, World Parkinson’s Disease Day, Alzheimer’s Disease Day and World Stroke Day, the Encephalopathy Center actively conducts public-science education. Through online and offline free clinic and education activities, and with the help of Xinjiang Television’s Health Is Here live-streaming studio, Xinjiang News Radio FM96.1’s Xinjiang Famous Doctors Hall, Xinjiang Radio’s Conduct Hotline, Urumqi Evening News and various other media and online platforms, it publicizes and popularizes knowledge on the prevention and treatment of neurological diseases. Free clinics and education activities are held, the department’s official account has been established, popular-science short videos, finger exercises and dance exercises are produced, and educational materials are distributed. These efforts improve the public’s awareness and health literacy regarding the prevention and treatment of nervous-system diseases and provide the public with comprehensive, whole-population and whole-cycle health management. The goals are early prevention, early detection, early treatment and early rehabilitation.