The prognosis in patients with cerebral hemorrhage is poor. Studies have shown that cerebral microbleeds are closely related with intracerebral hemorrhage. Cerebral microbleeds may be a precursor to the occurrence or recurrence of intracerebral hemorrhage. This article reviews the relationship between cerebral microbleeds and intracerebral hemorrhage from the aspects of epidemiology, etiology, pathophysiology, clinical observation, and complications of cerebral hemorrhage.

Objective:To analyze clinicopathological features of thyroid nodules and to assess preoperative diagnostic methods for the nature of nodules.Methods:The clinical and pathological data of 2 132 patients [456 males and 1 676 females with a mean age of (48.7±11.4) year] with thyroid nodules who underwent surgical treatment in our hospital from January 2017 to December 2019 were retrospectively analyzed. Among all patients, 433 nodules had complete fine needle aspiration biopsy cytology (FNAC) and ultrasound results were selected for further assessment. According to preoperative high-resolution ultrasound images, the nodules were classified by Kwak thyroid imaging and reporting data systems (Kwak TI-RADS) and American College of Radiology TI-RADS (ACR TI-RADS). ROC curve was used to assess the diagnostic efficacy of the two ultrasound modes and FNAC.Results:In 2 132 patients with thyroid nodules, 743 were benign and 1 389 were malignant. In all malignant cases 1 119 were females, accounting for 80.56%. In newly diagnosed benign nodules, 67.97% (505/743) were found by examination, and 32.03% (238/743) were self-found. In malignant nodules, 48.67% (676/1 389) were detected by examination, 51.33% (713/1 389) were self-found. The malignant rate of nodule diameter≤1 cm was the lowest in 1 118 patients with complete thyroid ultrasound data. In 628, 722 and 782 patients who underwent surgical treatment in 2017, 2018 and 2019, the proportion of malignant nodules was 56.37% (354/628), 66.48% (480/722) and 70.97% (555/782); the proportion of benign nodules was 43.63% (274/628), 33.52% (242/722) and 29.03% (227/782), respectively. Among all malignant nodules, papillary carcinoma accounted for 95.18% (1 322/1 389), followed by follicular carcinoma 4.32% (60/1 389), myeloid carcinoma 0.43% (60/1 389) and undifferentiated carcinoma 0.07%(1/1 389). Among all benign nodules, the proportion of nodular goiter was the highest (95.56%, 710/743). The proportion of patients undergoing preoperative FNAC in 2017, 2018 and 2019 was 57.96% (364/628), 63.43% (458/722) and 69.44% (543/782), respectively;the coincidence rate of preoperative FNAC and postoperative pathological diagnosis was 46.15% (168/364), 52.18% (239/458) and 62.06% (337/543), respectively. Among 433 nodules with both FNAC and ultrasound data, the areas under the ROC curve(AUC)of FNA, ACR TI-RADS and Kawk TI-RADS were 0.91, 0.74 and 0.59, respectively ( P<0.05). The sensitivity of ACR TI-RADS and Kawk TI-RADS was 84.34%, 37.35% ( P<0.05) and specificity was 56.29% and 79.14% ( P=0.075). Conclusions:The study reveals that from 2017 to 2019, both the number of cases and malignant rate of thyroid nodules shows a rising trend, meanwhile the application rate of preoperative FNAC and its coincidence rate with postoperative pathology shows an increasing trend. FNAC, ACR Ti-RADS and Kawk TI-RADS have certain diagnostic efficacy in differentiating benign and malignant thyroid nodules, and the diagnostic value of FNAC is the highest followed by ACR TI-RADS and Kawk TI-RADS.

Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.

OBJECTIVE： To analyze chemical components in active fraction of Xiaozhong zhitong lotion， to clarify the material basis of its efficacy， and to provide reference for the second development of ointment preparation. METHODS： UPLC-Q-TOF-MS was adopted to analyze the chemical components of active fraction （40％ ethanol elution site separated by D101 macroporous resin） of Xiaozhong zhitong lotion. The determination was performed on Hypersil GOLD aQ C18 column with mobile phase consisted of 0.1％ formic acid acetonitrile （A）-0.1％ formic acid water （B） （gradient elution） at the flow rate of 0.4       mL/min. The sample size was 4 μL， and the column temperature was 30 ℃. The condition of mass spectrometry was ESI detection in positive and negative scanning ion mode （ESI+/ESI－）. The scanning range was 100-2 000 Da. The collision energy was 45/－45 eV， and the energy of the extended collider was 10/15 eV. The accurate molecular weight， retention time and multi-stage fragment ion information of the compounds were collected after obtaining the chromatogram， and the chemical components were identified by comparing with the mass spectrum information of reference materials and references. RESULTS： A total of 48 compounds were identified， and 9 and 39 compounds were identified under ESI+/ESI－ ion mode， mainly including 10 phenolic acids， 8  phenylpropanoids， 9 anthraquinones， 3 flavones， 7 alkaloids， 5 tannins and 6 other categories. CONCLUSIONS： UPLC-Q-TOF- MS method is rapid， efficient and accurate for identify chemical components from active fraction of Xiaozhong zhitong lotion. Main chemical components of the active fraction are phenolic acids， phenylpropanoids， anthraquinones， alkaloids and tannins.

Heart failure is the leading cause of death worldwide. Compound Danshen Dripping Pill (CDDP) or CDDP combined with simvastatin has been widely used to treat patients with myocardial infarction and other cardiovascular diseases in China. However, the effect of CDDP on hypercholesterolemia/atherosclerosis-induced heart failure is unknown. We constructed a new model of heart failure induced by hypercholesterolemia/atherosclerosis in apolipoprotein E (ApoE) and LDL receptor (LDLR) dual deficient (ApoE^-/-LDLR^-/-) mice and investigated the effect of CDDP or CDDP plus a low dose of simvastatin on the heart failure. CDDP or CDDP plus a low dose of simvastatin inhibited heart injury by multiple actions including anti-myocardial dysfunction and anti-fibrosis. Mechanistically, both Wnt and lysine-specific demethylase 4A (KDM4A) pathways were significantly activated in mice with heart injury. Conversely, CDDP or CDDP plus a low dose of simvastatin inhibited Wnt pathway by markedly up-regulating expression of Wnt inhibitors. While the anti-inflammation and anti-oxidative stress by CDDP were achieved by inhibiting KDM4A expression and activity. In addition, CDDP attenuated simvastatin-induced myolysis in skeletal muscle. Taken together, our study suggests that CDDP or CDDP plus a low dose of simvastatin can be an effective therapy to reduce hypercholesterolemia/atherosclerosis-induced heart failure.