Neurologic Dysfunction is one of the main factors contributing to poor outcomes in cardiac surgery patients, except for heart failure. Atherosclerosis of the aorta, a history of cerebral infarction, and cervical artery disease are common clinical risk factors for cerebral neurological dysfunction after cardiac surgery. Results of preclinical studies suggested that Angong Niuhuang Pills (ANPs), a traditional Chinese patent medicine, including realgar, cinnabaris, Bovis Calculus, artificial Moschus, and powdered buffalo horn extract, decreased infarct volume and cerebral edema, and presented anti- atherosclerosis and cardio-protective effects in clinical and preclinical studies. The PANDA X trial is designed as a pilot study to explore the safety and efficacy of ANP in patients with moderate-to-severe neurologic dysfunction after cardiovascular surgery.

Inclusion Criteria:

• (1) an age > 18 years,
• (2) underwent cardiovascular surgery,
• (3) diagnosis of acute neurologic dysfunction, including but not limited acute cerebral infarction of the internal carotid artery system,
• (4) a National Institutes of Health Stroke Scale (NIHSS) score ranging from 10 to 20,
• (5) a time from symptom onset to randomization within 36 h,
• (6) provision of informed consent.

Exclusion Criteria:

• (1) not suitable for taking ANP after the dialectical process by a traditional Chinese medical doctor,
• (2) received ANP within 1 month before stroke onset,
• (3) liver failure,
• (4) declined to participate in this study.