Objective To evaluate the effectiveness and safety of ultrasound-enhanced thrombolysis for acute ischemic stroke.Methods Fifty stroke patients with acute middle cerebral artery occlusion were randomly divided into either a ultrasound-enhanced thrombolysis group (recombinant tissue-plasminogen activator [rtPA] +2 MHz ultrasound monitoring for 2 h) or a standard thrombolysis group (rtPA alone).The demographic characteristics,vascular risk factors,blood pressure before treatment,thrombolysis in brain ischemia (TIBI) grade before thrombosis,and vascular occlusion site of the patients were collected.The primary outcome endpoint was the good outcome rate (defined as the modified Rankin Scale score 0-1) at 3 months.The secondary outcome endpoints were complete recanalization at 2 h after thrombolysis,sustained complete recanalization,symptomatic intracerebral hemorrhage,and mortalitY.Results The good outcome rate of the ultrasound-enhanced thrombolysis group at 3 months after treatment was significantly higher than that of the standard thrombolysis group (64％ vs.36％;P=0.011).The sustained complete recanalization rate (40％ vs.8％;P =0.018) and complete recanalization rate (48％ vs.12％;P =0.012) of the ultrasound-enhanced thrombolysis group were significantly higher than those of the standard thrombolysis group,but there were no significant differences in the reocclusion rate (8％ vs.12％;P =0.637),incidence of symptomatic intracerebral hemorrhage (4％ vs.4％;P=1.000),and mortality (4％ vs.4％;P=1.000) compared with the standard thrombolysis group.Conclusions Ultrasoundenhanced thrombolysis can improve the sustained complete recanalization rate,complete recanalization rate,and good outcome rate after using rtPA within 2 h,and it does not increase the risks of symptomatic cerebral hemorrhage and death.It is a safe and effective adjunctive thrombolytic therapy.

Painful diabetic peripheral neuropathy(PDPN)is a chronic complication of diabetes mellitus.The proportion of patients with PDPN is relatively high in China.At present,the latest guidelines recommend a batch of first-line analgesic drugs for PDPN treatment.Many large-scale randomized trials have confirmed the effectiveness of combination therapy.However,the pathological and physiological mechanisms of PDPN are not fully understood.The clinical treatment effect is still not ideal.This article reviews the research progress on the mechanism of PDPN occurrence.

Objective To investigate the effect of recombinant human growth hormone (rhGH) on the growth rate, glucose and lipid metabolism and bone metabolism in children with idiopathic short stature (ISS). Methods The clinical data of 150 children with ISS admitted to the hospital from January 2010 to January 2015 were collected. The children were divided into the routine group (68 patients) and rhGH group (82 patients) according to the treatment methods. The routine group was given enhanced nutritional guidance, enhanced protein and calcium intake, and guidance for exercise. On this basis, rhGH group was additionally treated with rhGH. The intervention lasted for 12 months, and changes of height, weight, bone age (BA) and growth velocity (GV) in two groups were statistically analyzed. Changes in fasting blood glucose (FBG), insulin (INS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and other glucose and lipid metabolism indicators before and after treatment were detected. The insulin sensitivity index (ISI) was calculated, and changes in serum insulin-like factor 1 (IGF-1), osteocalcin (OC), bone alkaline phosphatase (BAP), typeⅠprocollagen amino-terminal propeptide (PINP), β-collagen degradation products (β-CTX) and other bone metabolism parameters before and after treatment were determined. The incidence of adverse reactions in both groups was statistically analyzed. Results There were no significant differences in height, weight, BA or GV between two groups before treatment (P>0.05). After 12 months of treatment, the above indicators in both groups were increased (P<0.05). The height, weight, BA and GV were (132.12 ± 7.26) cm, (26.21 ± 1.74) kg, (9.41 ± 0.37) years old and (10.03 ± 2.41) cm/year of the rhGH group, which were significantly higher than those of the routine group [(124.22 ± 6.31) cm, (24.13 ± 1.92) kg, (8.96 ± 0.42) years old and (5.85 ± 1.76) cm/year (P<0.05)]. There were no significant differences in glucose and lipid metabolism levels between two groups before and after treatment (P>0.05). There was no statistical difference in bone metabolism indexes between two groups before treatment (P>0.05). After 12 months of treatment, PINP, IGF-1, OC and BAP in both groups increased while β-CTX decreased (P<0.05). PINP, IGF-1, OC and BAP in rhGH group [(598.21 ± 78.57) μg/L, (301.23 ± 51.45) μg/L, (78.52 ± 12.65) μg/L, (171.26 ± 42.17) U/L] were higher than those in routine group [(520.14 ± 47.55)μg/L, (244.35 ± 46.38)μg/L, (70.25 ± 9.77) μg/L, (120.55 ± 38.42) U/L] (P<0.05), whileβ-CTX was lower than that in routine group [(0.48 ± 0.26)μg/L vs (0.63 ± 0.24) μg/L] (P<0.05). There were no significant difference in adverse reaction between two groups [3.66％(3/82) vs. 0, P>0.05]. Conclusions The rhGH treatment of children with ISS can obviously promote the growth and improve bone metabolism and growth rate of children, without significant adverse effect on their glucose and lipid metabolism and with certain safety.

Objective : To study the effect and mechanism of high glucose on mesothelial-mesenchymal transition (MMT) of peritoneal mesothelial cells (HMrSV5) , and the protective effect of pharmacological blocking of signal transducer and activator of transcription 3 (STAT3) on rat peritoneal fibrosis (PF) model . Methods : The animals were divided into three groups : the sham group , the model group , and the STAT3 inhibitor group . A miniature per- itoneal dialysis catheter was implanted under the dorsal skin of rat and the rat peritoneal fibrosis model was induced by daily injection of high glucose dialysate . After 10 weeks , HE staining was used to evaluate the histology of the peritoneum , and the level of transforming growth factor-β1 (TGF-β1) in the peritoneum was measured by immuno- histochemistry . HMrSV5 was cultured in high glucose and the optimal stimulation concentration of high glucose was determined by Western blot. High glucose was used to stimulate HMrSV5 after successful transfection with si - STAT3 and Western blot was used to measure the protein level of STAT3 , p-STAT3 , and the key enzymes of glycol- ysis 6-phosphofructo-2-kinase/fructose-2 , 6-biphosphatase 3 (PFKFB3) and lactate dehydrogenase A (LDHA) . Results : HE staining showed that administration of STAT3 inhibitor ( BP-1-102) could inhibit the thickening of subperitoneal tissue and the proliferation of vessels in HG dialysis rats . The expression of TGF-β1 in the rats perito- neum of the model group was significantly higher than that in the sham group , and the level of TGF-β1 was marked- ly lower in the STAT3 inhibitor group compared to the model group (P < 0. 05) . Compared to the control group , high glucose induced the up-regulation of α-smooth muscle actin ( α-SMA) , the down-regulation of E-cadherin and STAT3 activation in HMrSV5 (P < 0. 05) . Mesothelial cells treated with high glucose also exhibited high expres- sion of the key enzymes of glycolysis ( PFKFB3 , LDHA) ( P < 0. 05) , and si-STAT3 can effectively inhibit the overexpression of PFKFB3 and LDHA induced by high glucose ( P < 0. 05) . Conclusion STAT3 is involved in high glucose-induced HMrSV5 hyperglycolysis and MMT , and targeting STAT3 alleviates peritoneal fibrosis and an- giogenesis during peritoneal dialysis treatment in rats .