Objective Many studies have proved that the ABCD 2 score can be used to predict early stroke risk after transient ischemic attack ( TIA) , but few reports are seen on its predictive value for early stroke risk after TIA in different types of circulation . This article aimed to evaluate the ABCD 2 score in predicting early stroke risk following anterior or posterior circulation TIA . Methods Patients with definitely diagnosed TIA consecutively included in Nanjing Stroke Registration System from September 2011 to December 2012 were classified into anterior and posterior circulation TIAs .Various risk factors were collected and a 90-day follow-up was conduc-ted.The ABCD2 score was obtained from each patient and its predictive value assessed using the receiver operating characteristic curve. Results A total of 204 patients were analyzed in the study , including 59 (28.9%) females, 143 with anterior and 61 with posterior circulation TIA, aged 63.7 ±11.2 years.There were no statistically significant differences in the incidence rate of stroke within 90 days between the anterior and posterior circulation TIAs (11.2% vs 9.8%, P=0.776).The mean ABCD2 score was re-markably higher in the anterior than in the posterior circulation TIA (3.7 ±1.5 vs 2.5 ±1.3, P<0.001).The area under the curve (AUC) in predicting stroke risk was 0.711 for the former (95%CI:0.575-0.847, P=0.006) and 0.555 for the latter (0.298-0.820, P=0.637). Conclusion The ABCD2 score can predict early stroke risk in anterior but not in posterior circulation TIA .

At present,intravenous thrombolysis within 4.5 h is still the most effective method in treatment of acute ischemic stroke.For those who do not meet the criteria of intravenous thrombolytic therapy,do not have significant improvement after intravenous thrombolysis and even worse,endovascular interventional therapy is a safe alternative treatment method.Arterial mechanical thrombectomy devices can achieve rapid and complete recanalization and provide more treatment options for patients with acute ischemic stroke.This article reviews the related technical evolution and clinical trials of mechanical thrombectomy devices.

Objective To study the relationship between knee osteoarthritis progression and the ration of fat,lean,or bone mineral content(BMC).Methods 36 joints of knee with osteoarthritis in 31 women were divided into two groups according to the knee joint space,joint space narrowing group and non-narrowing group.The body mass index(BMI)was calculated.The X-ray(weight bearing)of knee joint was taken.The fat,lean,BMC and mass of leg were detected with the dual energy X-ray absorptiometry(DXA).Results There was no distinct difference between sides and age distribution for the tested groups(P>0.05).The BMI and fat/mass ratio of leg in the joint space narrowing group were obviously higher than that of the non-narrowing group(P<0.05),while the lean/mass ratio of leg in the joint space narrowing group was distinctly lower than that of the non-narrowing group(P<0.05).Conclusion The deterioration of the female knee osteoarthritis can be mainly attributed to the increase of the BMI and fat/mass ratio as well as the decrease of the lean/mass ratio of leg.

Objective To evaluate the safety and efficacy of low-dose platelet glycoprotein Ⅱb/Ⅲa antagonist tirofiban on preventing reocclusion during mechanical thrombectomy (MT) for in situ thrombosis(IST).Methods It is a retrospective cohort study, and 112 patients treated with MT, from the Nanjing Prospective Stroke Registration, were enrolled from February 2014 to October 2014. During MT, if angiography after a successful recanalization(defined as Thrombolysis In Cerebral Infarction(TICI) 2b/3) showed residual stenosis at the site of occlusion, additional angiographies were made every 10 min for 30 min.Then, if angiography displayed reocclusion in the corresponding vessels, a repeat recanalization was operated, followed by a low dose intra-arterial tirofiban infusion. MRA or CT angiography (CTA) was implemented to identify intracranial atherosclerosis (ICAS) 5-7 days after the procedure. The patients with confirmed ICAS were enrolled in the IST group. The rest were enrolled in the non-in situ thrombosis (NIST) group.Results A total of 80 patients with acute cerebral infarction were enrolled in the study. IST rate was 32.5%(26/80).All IST patients were confirmed ICAS by follow-up vascular imaging. Instant reocclusion after successful recanalization was significantly more common in the IST group(57.7%(15/26) vs 3.7%(2/54);χ2=30.568, P=0.000) than in the NIST group.In the case of the efficacy and safety of low-dose intra-arterial tirofiban infusion, 82.6%(19/23) of the reocclusion patients eventually accomplished TICI 2b/3, the rest 17.4%(4/23) of the cases were intractable to the procedure and needed rescue stent implantation.The modified Rankin Scale scores in patients infusing tirofiban were superior to the unused patients in 90 days. There was no patient with symptomatic intracranial hemorrhage after the procedure. Conclusions Patients with IST have higher cerebrovascular reocclusion rate during MT. After MT, low-dose intra-arterial tirofiban infusion may prevent reocclusion, and the prognosis is better.

BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.

Objective To investigate the clinical effect of angioplasty for symptomatic intracranial atherosclerotic stenosis. Methods Eighty-two patients with symptomatic intracranial atherosclerotic stenosis whom underwent angioplasty after the failure of standard medical therapy were enrolled from Nan-jing Stroke Registry Program from September 2010 to June 2013.Nine of them underwent routine balloon angioplasty alone and 73 underwent intracranial stenting.The median time from onset to surgery was 24.5 days.The occurrence of endpoint events (any stroke ≤30 d after procedure,death and ischemic stroke >30 d in guilty vessels or original stenosis had restenosis and needed to be treated again)was assessed. The incidence of restenosis was followed up with imaging (CTA or DSA). Results (1)In the 82 patients, the success rate of operation was 92.7%(n=72 ),and 78 (95.1%)received follow-up,4 were lost to follow-up.The median follow-up time was 22.5 months (range 9 to 29 months ).Ten patients had an endpoint event,7 of them were ischemic stroke,1 was cerebral hemorrhage,and two were severe asymptomatic restenosis who underwent stenting again.The endpoint events of 3 patients occurred at day 30 after procedure (at ≤24 h after procedure).Kaplan-Meier curves showed that the incidences of cumulative endpoint events at 1,6,12,and 24 months were 3.7%,8.6%,11%,and 13%,respectively.(2)60 patients (73.2%)received imaging examination (11 CTA and 49 DSA ).Restenosis occurred in 17 patients (28.3%),among them the incidence of symptomatic restenosis was 5%(n =3 ),and asymptomatic restenosis was 23.3%(n=14). Conclusion After a comprehensive assessment and a rigorous screening, the safety is high and the mid- and long-term efficacy are satisfactory in patients with symptomatic intracranial arterial stenosis who are treated with angioplasty when their medical treatment is invalid.