BACKGROUND:Stress shielding in the Achil es tendons induces over-expression of tumor necrosis factor-α. The degree of tendon contracture remains unclear after the intervention with tumor necrosis factor inhibitor.
OBJECTIVE:To investigate the effects of tumor necrosis factor-αon tendon contracture and the preventive effects of tumor necrosis factor inhibitor (etanercept) on tendon contracture by observing the morphological changes of the stress-shielded Achil es tendons after the intervention with etanercept.
METHODS:A total of 20 healthy male Sprague-Dawley rats were randomly divided into experimental and model groups after stress shielding in Achil es tendons of rat left hind limb. Five rats from either group were randomly selected, and their right hind limbs were considered as normal controls. Immediately after model induction, the rats in the experimental group were subjected with 0.6 mg/kg etanercept, and those in the model group were subcutaneously treated with 1 mL phosphate buffered saline. According to half-life of etanercept, the two groups were separately injected three times. At 2 weeks after intervention, the morphological changes of the Achil es tendons were observed using gross examination and transmission electron microscope.
RESULTS AND CONCLUSION:On gross examination, the Achil es tendons in the experimental group were significantly smoother and smal er than those of the model groups, but thicker than those of the normal control group. Under a transmission electron microscope, the col agen fibrils of the model group were looser and more disordered than those of the experimental group. The col agen fibrils of the experimental group were similar to those of the normal control group in cross section and longitudinal section. These indicated that tumor necrosis factor-αantagonist can obviously prevent stress shielding-induced tendon contracture at 2 weeks.

Objective To study the blood routine tests results change after therapy of chlorpromazine ,clozapine ,perphenazine changed to risperidone in schizophrenic patients .Methods 100 schizophrenic patients in the hospital from March 2014 to March 2015 for treatment were enrolled in the study ,who were treated with chlorpromazine ,clozapine or perphenazine respectively for one course ,and then the therapies were replace by risperdal .Results After treatment ,mean corpuscular volume was significantly grea‐ter ,the number of lymphocytes was significantly higher and intermediate cell number was significantly lower than that before treat‐ment ,the difference was statistically significant(P<0 .05) .Conclusion Leukocyte differentiation change and mean corpuscular vol‐ume increased obviously after therapy of chlorpromazine ,clozapine or perphenazine changed to risperidone in schizophrenic patients .

Objective To investigate the effectiveness and safety of carotid stenting for progressive cerebral watershed infarction (PCWI) patients with ipsilateral internal carotid stenosis or occlusion during the progressive stage. Methods The clinical data of 23 PCWI patients with ipsilateral internal carotid stenosis or occlusion treated with carotid stenting during the progressive stage were analyzed retrospectively. Among them, 18 were severe internal carotid artery stenosis, and 5 were carotid artery occlusion. Carotid artery stenting were performed in patients with severe internal carotid artery stenosis. The first-stage angioplasty and second-stage stenting were performed in patients with internal carotid artery occlusion. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin scale (mRS) were used to evaluate preoperative and postoperative neurologic deficits. Results Twenty-two of 23 patients were stented successfuly, the Thrombolysis In Myocardial Infarction (TIMI) flow grade was 3, and the technical success rate was 95. 7% . None of the patients demonstrated hyperperfusion in the ipsilateral hemisphere. At day 30 postprocedure, the NHISS scores were significantly improved compared with before procedure (4. 41 ± 1. 88 vs. 10. 00 ± 1. 47; t = 11. 234, P < 0. 001). The preprocedural TIMI flow grade was 3 in 12 patients (52. 2% ). Proportion of patients with TIMI flow grade 3 after procedure was significantly increased compared with before procedure (95. 7% vs. 52. 2% ; χ2 = 11. 274, P = 0. 002). The proportion of patients with mRS scores 0-2 at day 90 after procedure was significantly increased compared with before procedure (69. 6% vs. 0% ; χ2 = 24. 533, P < 0. 001). Conclusions Carotid stenting during the progressive stage is safe and it may improve the prognosis in PCWI patients with ipsilateral internal carotid stenosis or occlusion.

Objective To evaluate the safety and efficacy of early carotid artery stenting in treating cerebral watershed infarction patients with carotid artery stenosis. Methods A total of 33 patients with acute cerebral watershed infarction complicated by carotid artery stenosis received carotid artery stenting within one week after the onset of the disease. The clinical safety and efficacy were evaluated. Results The carotid artery stenting was successfully accomplished in all 33 patients with a success rate of 100%. After the procedure, different degree of bradycardia and hypotension was seen in 23 patients, which restored to normal after prompt medication with atropine, dopamine, etc. During the procedure, one patients developed cerebral embolism due to dislodgment of emboli, resulting in contralateral hemiparalysis, and the contralateral limb muscle strength returned to preoperative status after proper treatment. After the treatment, no ipsilateral hemisphere excessive perfusion or cerebral hemorrhage occurred. Thirty days after the treatment, NHISS scores of the patients were obviously improved, which were significantly different from those determined before the treatment (P<0.05). Conclusion For the treatment of acute cerebral watershed infarction, early carotid artery stenting to relieve carotid artery stenosis is quite safe and it may improve the prognosis as well.

Capsule warning syndrome (CWS) is a special clinical subtype of transient ischemic attack involving internal capsule, no cortical involvement and showing stereotyped attack. Although CWS is rare in clinical practice, most patients have poor outcomes. Therefore, a comprehensive and in-depth understanding of CWS is helpful to improve the outcomes and quality of life of patients. This article reviews the recent research progress of CWS.

Objective To observe the preventive effect of Anduolin(ADL) on radiation-induced lung injury in mice.Methods Totally 180 of Kunming mice were randomly classified into six groups:normal control group ( N ),irradiation control group ( R),irradiation plus low dose ADL group ( L),irradiation plus middle dose ADL group ( M),irradiation plus high dose ADL group ( H),and irradiation plus Dexamethasone group (D).The mice except group N were irradiated with 20 Gy of 6 MV X-rays on whole lung.The mice in group L,M and H were given with ADL 1 d before irradiation and continued for 6 weeks after irradiation.At 2,4 and 6 weeks after irradiation,the general situation and the lung pathological changes of mice were observed.The lung wet weight,collagen contents of the whole lung tissue,hydroxproline concentration,and TGF-β1 expression in the lung were also delected.Results Compared to the group R,the mice breathing rate,hydroxproline concentration,and TGF-β1 expression in the group L were not significantly changed.While in the groups M,H and D,the breathing rate,the generation of hydroxproline and the expression of TGF-β1 were decreased significantly ( F =2.668-161.646,P ＜0.05).In addition,ADL alleviated the pathological changes on radiation-induced lung injury in mice.Conclusions ADL might have the preventive effect on radiation-induced lung injury in mice.

Objective To evaluate the clinical value of multiplex ligation-dependent probe amplification (MLPA) technique used in karyotype analysis of chorionic villi from missed abortion. Methods Feb 2008 to Oct 2008, 91 patients with missed abortion diagnosed by hormonal measurement, type B ultrasound and physical exam matched with 20 normal pregnant women undergoing artificial abortion were enrolled in this study. Chorionic villi was obtained by suction dilation and curettage in aseptic condition, then those villi was cultured and analyzed by traditional cytogenetic karyotyping method, in the mean time, the DNA extracted from villi was detected by MLPA. The results of chromosomal G-banding of chorionic villi were compared between two methods. Results The diagnostic concordance of MLPA and traditional karyotyping was observed in 92% (84/91) cases, there were 84 cases in the case group with diagnostic concordance by traditional karyotyping and MLPA except 7 cases of euploidy could not be detected by MLPA. The 84 cases included 40 normal karyotype,29 trisomy of euchromosome, 1 double trisomy of euchromosome, 10 monosomy X , 1 monosomy X combined with trisomy of euchromosome, 2 chimaera of X chromosome, 1 structural abnormity of euchromosome. Among 7 cases with discordance diagnosis, 2 cases with trisomy and 5 cases with tetrasomy of euchromosome were identified in traditional karyotyping, however, they were all diagnosed with normal disomy by MLPA. Of 20 villi from normal pregnancy, two methods got the consistent results. Conclusion The MLPA was rapid and efficacy method used for analyzing aneuploids in chorionic villi.

Objective:To investigate the efficacy and safety of endovascular treatment (EVT) in patients with acute ischemic stroke due to acute primary medium vessel occlusion (MeVO).Methods:Patients with primary MeVO received EVT in the stroke center of Jining First People's Hospital from January 2019 to January 2022 were enrolled retrospectively. MeVO was defined as occlusion of M2/M3 segment of middle cerebral artery, A2/A3 segment of anterior cerebral artery and P2/P3 segment of posterior cerebral artery. The symptoms, vascular recanalization and surgical complications were documented. The National Institutes of Health Stroke Scale (NIHSS) score at discharge and the modified Rankin Scale (mRS) score at 90 d after onset were followed up.Results:A total of 17 patients with primary MeVO were included, among them 16 successfully achieved vascular recanalization, 1 had distal emboli escape, and 1 had asymptomatic intracranial hemorrhage. There was significant difference in NIHSS scores before and after thrombectomy ( P<0.01). Ten patients (62.5%) had good functional outcome (mRS score 0-2), and 1 died of secondary pulmonary infection at 20 d after procedure. Conclusion:After strict risk/benefit evaluation and screening, EVT of acute ischemic stroke due to primary MeVO was technically feasible, and had good efficacy and safety.

Objective : To identify spatio-temporal distribution patterns of mumps in Zhejiang Province from 2008 to 2019, so as to provide insights into precise control of mumps. Methods : The epidemiological data pertaining to mumps in Zhejiang Province from 2008 to 2019 were collected from the China Information System for Disease Control and Prevention. The time- and region-specific incidence of mumps was descriptively analyzed, and the spatio-temporal clustering characteristics of mumps incidence were identified using global and local spatial autocorrelation analyses and spatio-temporal scan analysis. Results : A total of 167 196 cases of mumps were reported in Zhejiang Province from 2008 to 2019, and the incidence of mumps reduced from 56.08/105 in 2008 to 11.35/105 in 2019, with a reduction of 79.76%. There was no remarkable mumps seasonality since 2017; however, spatial autocorrelation was seen in mumps incidence in 2008, 2011 and 2012, respectively ( Moran's I coefficient=0.16, 0.18, 0.16; all P<0.05 ). Spatio-temporal scan analysis identified five spatio-temporal clusters of mumps incidence in 2008, 2011 and 2012, and the most likely spatio-temporal cluster was mainly concentrated in Cangnan County of Wenzhou City, covering 17 counties clustered in the time frame from 15 January 2008 to 28 February 2009, while the other four clusters were concentrated in Pinghu City of Jiaxing City, Kaihua County of Quzhou City, Fuyang District of Hangzhou City and Zhuji City of Shaoxing City, clustered in the time frame from 15 January 2008 to 30 June 2012. Conclusion The incidence of mumps appeared a tendency towards a reduction in Zhejiang Province from 2008 to 2019, and rebounded in some regions. No remarkable mumps seasonality was seen since 2017. The spatio-temporal clusters of mumps incidence were concentrated in Wenzhou and Jiaxing cities of Zhejiang Province in 2008, 2011 and 2012; however, no spatial cluster was identified since 2012.