The Alberta Stroke Program Early CT Score (ASPECTS) is a simple, reliable and systematic approach for evaluating early ischemic changes in middle cerebral artery territory in patients with ischemic stroke. It can be used to conduct rapid semi-quantitative evaluation of ischemic lesions and help to determine the thrombolytic effect and long-term prognosis. The development of multimodal CT and MRI techniques have enriched the application scope of ASPECTS and have improved the validity and reliability of disease judgment. The development of the posterior circulation Acute Stroke Prognosis Early CT Score has made the fast scores extend to posterior circulation stroke, which is beneficial for all the patients with ischemic stroke to conduct early imaging scores. This article reviews the principle of the ASPECTS system, composition, its application in multimodal CT and MRI, as well as the posterior circulation scores.

Objective To observe the expression of glial fibrillary acidic protein ( GFAP), and the pathological and ultrastructnral changes of astrocytes in the CA1 subfield of the hippocampus following global cerebral ischemia and reperfusion, and to explore the neuroprotective mechanism of mild hypothermia. Methods Global cerebral ischemia was established in rats by a modified version of Pulsinelli's method. Ninety-six rats were divided into three groups including a sham-operated group, a normothermic ischemic reperfusion (IR) group and a hypothermic ischemic reperfusion (HIR) group. Each group had four subgroups which were sacrificed for 6, 12 or 24 hours, or 4 days after reperfusion (for each subgroup n = 8 ). Hematoxylin-eosin (HE) staining was used to observe morphological changes in neurons in the CA1 subfield of the hippocampus. TUNEL methods were used to detect apoptosis among those neurons. Immunohistochemical staining was used to detect the expression of GFAP in the CA1 subfield and the mechanism of astrocyte pathology. GFAP TUNEL double-labeled immunohistochemistry was used with both the shamoperated and experimental groups. Electron microscopy was also used to evaluate morphological changes in astrocytes 24 hours and 4 days after ischemia and reperfusion. Results Compared with the sham-operated group, expression of GFAP immunoreactive positive cells increased gradually in the CA1 subfield of the IR group rats. Compared with the IR group, expression of GFAP immunoreactive positive cells was significantly lower in the HIR group at all time points. Microscopic observation at the 4th day showed that some astrocytes in the CA1 subfield had died through oncosis. Conclusions Mild hypothermia can significantly decrease the expression of GFAP immunoreactive positive cells and the number of apoptotic neurons in the CA1 subfield of the hippocampus, minimize cell oedema and provide protection for neurons. Oncosis kills astrocytes following global cerebral ischemia and reperfusion.

Objective To investigate the value of modified NIHSS and MRI-PC-ASPECTS for the long-term prognosis in posterior circulation ischemic stroke. Methods Seventy eight patients with posterior circulation ischemic stroke were divided into two groups depended on MRS: good outcome group and bad outcome group. General information of patients was collected and vascular risk factors, NIHSS, MRI-PC-ASPECTS of the two groups were compared. Results The scores of admission NIHSS and highest NIHSS of bad outcome group were higher than that of good outcome group. The scores of MRI-PC-ASPECTS, T admission NIHSS (42-admission NIHSS) and T highest NIHSS of bad outcome group were lower than that of good outcome group (P<0.05). The areas under the ROC curves of MRI-PC-ASPECTS+T highest NIHSS, MRI-PC-ASPECTS, T highest NIHSS and T admission NIHSS were 0.907, 0.821, 0.870, 0.744, respectively (P<0.05). Conclusion NIHSS and MRI-PC-ASPECTS can predict the functional prognosis in patients with posterior circulation ischemic stroke.

Objective To evaluate the surgical procedures and clinical results to treat the bleph arochalasis.Methods A series of 43 blepharochalasis in 23 patients were surgically treated.A double eyelid fold incision was made.Surgeon clippd redundant skin of upper eyelid with forceps,so that would be excised was marked out.Then redundant skin and muscles as well as hernia septal fat were removed.The lacrimal glands were found and repositioned into lacrimal glands fossa behind superolateral orbital rim.We choose different methods to perform plastic operation in 23 cases of blepharochala sis according to different topographic anatomic characteristics.Results Postoperatively,not only the patients recovered in a followed-up period of 1-3 years,but all lacrimal glands were normally rep soitioned.Conclusions These methods are effective in patients with blepharochalasis and meet the cosmetic demands.Good clinical results in both function and appearance are achieved.

Objective:To investigate the correlation between white matter hyperintensities (WMHs) and stroke etiology classification in patients with acute isolated penetrating artery territory infarction.Methods:Patients with first-ever acute isolated penetrating artery territory infarction admitted to the Department of Neurology, the Affiliated Hospital of Xuzhou Medical University from January 2017 to May 2020 were enrolled retrospectively. According to the Chinese Ischemic Stroke Subclassification (CISS) system, they were divided into large artery atherosclerosis (LAA) and perforating artery disease (PAD). According to the distribution of infarcts, they were divided into lenticulostriate artery (LSA) territory infarction and paramedian pontine artery (PPA) territory infarction. The demographics, vascular risk factors, baseline clinical data, WMHs location, and Fazekas Scale scores were documented. Multivariate logistic regression analysis was used to identify the independent influencing factors of stroke etiology classification. Results:A total of 440 patients with acute isolated penetrating artery territory infarction were enrolled, including 120 (27.3%) in the LAA group, and 320 (72.7%) in the PAD group; 213 (48.4%) with LSA territory infarction, and 227 (51.6%) with PPA territory infarction. The proportion of patients with total Fazekas score 3-6 and periventricular WMHs (PWMHs) score 2-3 in the PAD group was significantly higher than those in the LAA group (all P<0.05). In patients with LSA territory infarction, the proportion of the patients with hypertension, WMHs total Fazekas score 3-6 and PWMHs score 2-3 in PAD subgroup was significantly higher than those in the LAA subgroup, while the proportion of the patients with hyperlipidemia was significantly lower than that in LAA subgroup (all P<0.05). In patients with PPA territory infarction, the levels of low-density lipoprotein cholesterol and homocysteine in the PAD subgroup were significantly lower than those in the LAA subgroup. Multivariate logistic regression analysis showed that PWMHs score 2-3 was an independent correlation factor of PAD (odds ratio [ OR] 2.220, 95% confidence interval [ CI] 1.085-4.541; P=0.029). In patients with LSA territory infarction, hyperlipidemia was independently correlated with LAA ( OR 0.432, 95% CI 0.192-0.972; P=0.042), and PWMHs score 2-3 was independently correlated with PAD ( OR 3.846, 95% CI 1.193-12.397; P=0.024). In patients with PPA territory infarction, higher low-density lipoprotein cholesterol ( OR 0.660, 95% CI 0.494-0.883; P=0.005), homocysteine ( OR 0.958, 95% CI 0.930-0.987; P=0.005) and C-reactive protein ( OR 0.987, 95% CI 0.977-0.997; P=0.008) were independently correlated with LAA. Conclusions:WMHs are common in patients with acute isolated perforating territory infarction caused by LAA and PAD, and more severe PWMHs suggest that PAD is more likely to be the cause of the acute isolated perforating territory infarction, especially in patients with LSA territory infarction.

Two kinds of β2-agonistresidues in sheep plasma and urine were disposed by enzymolysis and organic solvent extraction pretreatment methods, and UPLC-MS/MS was used for the qualitative and quantitative analysis. Detection results were compared to study the influences of two pretreatment methods. The experimental results showed that more than 95% of Ractopamine and 40% of Salbutamol exist in the conjugated form in sheep plasma. The detection results of 2 kinds of β2-agonist residues were significantly enhanced when adding β-glucuronidase/aryl sulfatase. The experimental repeatability is very poor ( RSD>40%) when the enzymolysis was not carried out. There were 57% of Ractopamine and less than 1% of Salbutamol exists in the conjugated form in sheep urine. Enzymolysis pretreatment method was useful for the Ractopamine residues determination in urine, and Enzymolysis pretreatment method was useless for Salbutamol determination in urine. Matrix effect of plasma was less than the effects of urine. The influence of organic solvent extraction pretreatment method on the detection results was unremarkable, and there was the possibility that organic solvent extraction could lead partial loss of target compound in extraction process. However, it did not influence the detection results by using internal standard calibration.

A novel method for simultaneous detection of mycotoxins (e.g.,aflatoxin B1) or their metabolic residues in animal plasma with impurity adsorption purification followed ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was developed.Extraction of mycotoxins and their metabolites from animal plasma sample was performed with 0.1％ formic acid-acetonitrile solution after addition of sodium chloride and hydrous magnesium sulfate.The extract was then dehydrated and purified with hydrous magnesium sulfate,C18,primary secondary amine,and alumina-A.3 mL of the supernatant was evaporated and re-dissolved with 0.5 mL of 0.1％ formic acid aqueous solution/acetonitrile (70∶ 30,V/V) for UPLC-MS/MS detection.The analytes were separated by a C18 column utilizing gradient elution with 0.1％ formic acid aqueous solution containing 0.5 mmol of ammonium acetate and 0.1％ formic acid-methanol solution,and finally detected by tandem mass spectrometry in positive/negative ESI mode.Identification and quantification were achieved by LC-MS/MS with multi-reaction monitoring (MRM).Good linearity in response was obtained in the analytes concentration range of 0.05-100 ng/mL with correlation coefficients larger than 0.99.The limits of quantification (S/N=10) were around 0.05-0.5 ng/mL.The recoveries of mycotoxins and their metabolites spiked in blank plasma samples were in the range of 62.0％-116.4％,with relative standard deviations (RSDs) less than 19.0％.

A rapid high-throughput method for the determination of 26 mycotoxins involving multifunctional cleanup column coupled with liquid chromatography-tandem mass spectrometry ( LC-MS/MS) was developed and validated for the determination in feedstuffs. The feedstuff samples were extracted by ultrasonic treatment for 1 hour and the extraction solvent was acetonitrile/water/formic acid (84:15. 9:0. 1, V/V). 1 mL of the supernatant layer was purified by a commercial Mycospin 400 multifunctional cleanup column, then dried and re-dissolved by 0. 25 mL water/methanol/formic acid (95:4. 9:0. 1, V/V) in a vial for injection into the LC-MS/MS system. Chromatographic analyses were carried out on a reversed phase C18 column and using a gradient elution with 0. 1% formic acid aqueous solution and 0. 1% formic acid methanol solution. The mass spectrometer was operated in a multiple reaction monitoring ( MRM) mode that selected one precursor ion and two product ions for each target compound. Validation studies were carried out in maize and soybean meal as representative matrixes. The most target compounds had different level of matrix effects. So, matrix-matched calibration was adopted for quantification. Mean recoveries from spiked samples at three levels ranged from 61 . 9% to 119 . 5% with relative standard deviations of 0 . 8%-18 . 6%. Limits of quantification ranged from 0. 5 μg/kg to 25 μg/kg.

Objective To discuss a design of flap of dorsal branches of the digital proper artery to repair pediatric middle phalanx skin defects and its effect.Methods From October,2013 to March,2015,antegrade flaps were used to treat 9 pediatric patients with skin defect in middle phalanx,the dorsal branches of the digital proper artery were used as the pedicel.The dorsal branch of digital proper nerve carried by flap was sutured with digital proper nerve in wound surface of middle phalanx,flap cutting area was 3.5 cm × 1.2 cm-2.5 cm × 0.8 cm,the donor site of flap was repaired by full thickness skin graft.Results All the 9 flaps survived,and primary healing in the wound of donor and recipient site.The 9 patients were followed up for 6-12 months,with an average of 8 months.All the flaps had soft texture and full shape,the two-point discrimination was 5-9 mm,6.5 mm on average.Conclusion To repair skin defect in the middle phalanx with flap using the dorsal branches of the digital proper artery as the pedicel and sutured the dorsal branch of digital proper nerve,combine advantages of the simplicity,high skin flap survival rate,good postoperative appearance and sensation recovery.

Serum inflammatory markers have important value for screening unstable carotid atherosclerosis plaques.The current studies tend to classify inflammatory markers into vascular specificity (such as lipoprotein-associated phospholipase A2,pentraxin-3,etc.) and non-vascular specificity (such as matrix metalloproteinase-9,pregnancy-related plasma protein A,etc.).This article reviews the relationship between serum inflammatory markers and carotid plaque stability.