Transient ischemic attack(TIA)is a common ischemic cerebrovascular disease,and the incidence of secondary ischemic stroke and cardiovascular events is very high.It needs to be assessed and managed urgently.The article presents the contents of emergency assessment of TIA,and emphasizes the importance of overall assessment.

Objective:To investigate the possibility of predicting facial nerve involvement in the pa-tients with parotid tumors using facial electroneurography (ENoG).Methods:In the study, 53 patients with primary parotid tumors were included in the study , 28 were benign tumors and 25 were malignant . There was no significant difference of tumor locations and sizes between the two groups . House-Brackmann facial nerve function evaluation was gradeⅠin all the patients who received examination of fa-cial electroneurography , including stimulation strength , amplitude , and latent time bilaterally .The facial electroneurography results in the affected side were compared with the results of contralateral normal side , intraoperative appearance and postoperative histopathological diagnosis .The facial electroneurography results were analyzed by Wilcoxon signed rank test and receiver operator characteristic ( ROC) curve. Results:During the facial electroneurography examination , the mean stimulation strength in the patients with benign parotid tumor was 20.0 mA.There was significant decrease in the amplitude at the affected side compared with the normal side upon posterior auricular stimulation ( P<0 .05 ) .But there was no significant difference in the latent time between the bilateral sides (P>0.05).However, in the patients with malignant parotid tumor , the mean stimulation strength was higher at 24.5 mA.There was signifi-cant decrease in the amplitude or even no response at the affected side compared to the normal side upon posterior auricular stimulation ( P<0 .05 ) .No response was detected in the multiple branches of facial nerve of affected sides in 36 .0%patients upon posterior auricular stimulation .The amplitude of branchesⅢand Ⅳwas significantly lower at the affected side than that at the normal side upon anterior auricular stimulation (P<0.05).The area under the ROC curve for ENoG was 0.884.Conclusion: When the facial nerve was involved by the parotid tumors , the stimulation strength in the electroneurography was larger .There was significant difference in the amplitude and the latent time of the facial nerve between the affected side and the normal side upon the posterior auricular stimulation .The rate of absence of reac-tion wave was higher in the patients with malignant tumors .It was feasible to predict the facial nerve in-volvement by ENoG for the parotid gland tumor patients without clinical appearances of facial paralysis .

Objective To investigate the prognostic value of heart rate turbulence (HRT) in patients with chronic heart failure (CHF). Methods From October 2006 to May 2009, a total of 96 elderly CHF inpatients were selected, and the clinic data were recorded. Based on the echocardiogram and dynamic electrocardiogram, the differences of sinus HRT index of patients with different cardiac function classification were analyzed. During 9-28 months medical follow-up, the treatment endpoint was death from heart disease. Based on Logisitc regression, the prognostic values of HRT, age, hypertension, diabetes, myocardial infarction (MI), left ventricular ejection fraction, ACEI and β- adrenergic blocker for death of CHF patients were analyzed.Results There was no significant difference in HRT between grade Ⅱ and grade Ⅲ cardiac function (χ~2 = 1.60, P>0. 05), and between grade Ⅲ and grade Ⅳ cardiac function (χ~2 = 1.43, P>0. 05). But there was significant difference in HRT between grade Ⅱ and grade Ⅳ cardiac function patients χ~2 =9.84, P<0. 05), and HRT was weaken in grade Ⅳ group. The average follow-up time was (18. 0±9.6) months. Of all 96 patients, there were 34 dead of heart disease. There were correlations of death of CHF with HRT, low LVEF (≤ 45%), age (≥65 years), diabetes, MI and classification of heart function. Conclusions The sinus HRT in CHF patients has a favorable prognostic value.

Objective To explore the trends and influencing factors of woman′s menarche age in Shigatse area of Tibet .Methods Totally 2 492 cases of female outpatients been surveyed from July to December 2010 ,of which 1 492 cases of Tibetan and 941 ca‐ses of Han ,and the relationship between their menarche age and nationality ,altitude and residence were analyzed .Results The‐woman′s menarche age of Tibetan was significantly higher than that of Han women(15 .090 ± 1 .898 vs .13 .920 ± 1 .538 ,P<0 .05);the woman′s menarche age were significantly different among the different altitude groups (P<0 .01) ,the age of menarche increa‐ses gradually along with the altitude increasing ,and Pearson correlation value was 0 .323 .Menarche age of Tibetan women living in the town was significantly less than that of rural women (14 .760 ± 1 .784 vs .15 .580 ± 1 .873 ,P< 0 .05) .Conclusion Menarche age of Tibetan were later than Han women ,and were gradually delay with the elevation increase .

Objective · To investigate the effects of insulin on high glucose-cultured humanmononuclear cell line THP-1 and macrophage phenotype transformation in diabetic wounds. Methods · THP-1 cells were cultured with normal (5.6 mmol/L) and high (25 mmol/L) glucose, respectively,stimulated with PMA for differentiation, and induced to M1 macrophages with LPS. After treated with insulin for 6 h, expression changes of M1 type macrophage markers inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), and interleukin-1β (IL-1β), as well as M2 type macrophage markers arginase1 (Arg1) and IL-10 were detected using real-time PCR andWestern blotting. High fat diet feeding plus multiple intraperitoneal injections of low dose streptozotocin (STZ) were used to induce type II diabetes rat model. After blood glucose level has been stable for five weeks, two fullthickness skin wounds with the diameter of 1cm were made on the back of DM rats. Wounds were randomly assigned to being treated with insulin (0.2 U insulin /20 μL saline) or saline (20 μL saline) using the random number table. Characteristics of macrophagephenotypes were observed 3, 7, and 25days after wounds were made. Normal rats (n=3) served as controls. Results · After being cultured with high glucose, the mRNA levels of M1 markers iNOS and TNF-α were up-regulated in LPS-induced THP-1 cells, while the mRNA levels of M2 markers Arg1 and IL-10 were down-regulated.Afterbeing treated with insulin for 6 h, mRNA levels of iNOS and TNF-α weredown-regulated, protein levels of iNOS, IL-1β were down-regulated too, while mRNAand protein levels of Arg1 and IL-10 were up-regulated. In addition, the expression level of phosphorylated NF-κB-p65 was significantly increased after high glucose culture and was significantly decreased after insulin intervention. Compared to normal rat skin wounds, the expression of iNOS in macrophages was significantly increased in wounds of diabetic rats. The expression of iNOS in macrophages was high in saline treated wounds 3 and 7 days after the wounds were made and the expression of Arg1 was low 25 days after the wounds were made. In insulin treated wounds, the expression of iNOS started to decrease on day 7 after the wounds were made and the expression of Arg1 was significantly higher than that in saline treated wounds on day 25 after the wounds were made. Conclusion · Insulin can induce macrophage phenotype transformation from M1 to M2 under high glucose condition and the mechanism may be associated with the phosphorylation of NF-κB-p65.

Objective To analyze the protein expression changes of retina in diabetic mice using isobaric tags for relative and absolute quantitation (iTRAQ) approach and to study proteins of apoptosis.Methods 8 diabetic mice were chosen as the diabetic model group (DM group),8diabetic mice as the normal control group.The animals were housed in wire-bottomed cages and received normal pellet chow and tap water in a constant environment.After 10 weeks,all mice were killed,and their retina were dissected.After hematoxylin and eosin(H&E) staining,the sections of retina were examined using light microscopy.The changes of protein expression in retina were studied using iTRAQ approach.Expression of apoptosis associated proteins was analyzed using ingenuity pathway analysis (IPA).Results Compared with control group,mice retina in DM group developed looser structures,tissue edema and obvious telangiectasia under light microscopy.Using iTRAQ approach,a total of 348 differential proteins were identified.Among those proteins,16 proteins were related with apoptosis,including Ataxin-10,Protein NDRG1,mucin-4,Aquaporin-1 and annexin A4,etc.There were 8 apoptosis-related proteins in retina with up-regulation,and the other 8 proteins with down-regulation in the DM group.The relationship between these proteins were analyzed and charted by IPA.Conclusions Apoptosis may be involved in the development of diabetic retinopathy.The identification of the apoptosis-related proteins will be helpful for the further study.

Objective To investigate the efficacy of electromyographic biofeedback therapy (EMGBFT) in treating dysphagia after stroke.Methods Patients diagnosed with dysphagia after stroke were recruited and randomly divided into a control group (n =22),an electrostimulation group (ES,n =25) and an EMGBFT group (n =23).The control group received conventional treatment,while the patients in the other groups additionally received Vitalstim ES or EMGBFT 5 times per week for 3 weeks.Before and after the trial,deglutition function was evaluated through surface electromyography (sEMG) and using a standardized swallowing assessment (SSA).Results After 3 weeks of treatment,the mean sEMG amplitude,deglutition duration and SSA score and improved significantly in comparison to the baseline in all three groups.All were also significantly better in the two treatment groups than in the control group.Importantly,the mean sEMG amplitude,deglutition duration and SSA score were all significantly better in the EMGBFT group than in the ES group.Conclusion EMGBFT can promote better deglutition among patients with dysphagia after stroke more effectively than ES or conventional treatment.

Objective To report the therapeutic results of Hybrid external fixator in treatment of open metaphyseal fractures of the tibia.Methods From March 2000 to July 2004,19 cases of proximal tibial meta- physeal fractures and six cases of Pilon fractures were treated with Hybrid external fixators.By Gustilo classification, eight cases were of typeⅡ,10 typeⅢA,five typeⅢB and two typeⅢC.The wounds were closed directly after thorough debridement in 21 cases,and closed by pedicled flap transposition or free flap transplantation in four. Fasciotomy was performed in three.Closed indirect reduction of the fractures was done in 11 cases,while open reduction was carried out through an extended wound or a limited incision in 14.Anatomical reduction was done for the articular fractures,if any,and Hybrid external fixators were employed to stabilize fractures in all the cases in this series.Results All the patients had a mean follow-up of 15.7 months (ranging from 9 to 26 months) which re- vealed bone union of the fracture in all cases with a mean healing time of 8.8 months.Two patients had their external fixators replaced with plates and iliac bone graft to get fracture union.The fixators were removed 2.9 to 21 months (mean,9.4 months) after operation.Except for two cases of secondary healing,all the wounds healed primarily without serious complication,such as infection.The final follow-up revealed a knee motion range of more than 90?in 15 cases,less than 70?in four,whose knee motion range was improved to more than 90?after knee release performed one year later.In all the six cases of Pilon fractures,the ankle joint recovered normal range of motion.Traumatic arthritis occurred in two cases of Piion fracture 11 months after operation.Evaluation by Rasmussen's functional and radiological scoring system demonstrated excellent knee function in 13 cases,good in three,fair in two and poor in one,with a good to excellent rate of 84.2%.The ankle function was excellent in three cases,good in two and poor in one,with a good to excellent rate of 83.3%.Conclusions In treatment of open tibial metaphyseal fractures, the Hybrid external fixator can well maintain the stability of the fragments with a low incidence of soft tissue com- plications and insignificant interference with the knee motion.However the bone healing time can be prolonged with a definite rate of nonunion.

ObjectiveTo study the expression of pleiotrophin (PTN) in colorectal cancer and its impact on the malignancy.MethodsRT PCR and immunoperoxidase staining were applied on the resected samples.ResultsPTN mRNA was expressed in 18 cases of 24 colorectal cancer tissues and 18 cases of 19 adjacent normal tissues. PTN protein was also found expressed in stroma, but the expression rate was higher in colorectal cancer tissues (34%) than in adjacent normal tissues (9%, P

Objective To investigate the influence of IL-8 on the tight junction of vascular endothelial cells.Methods Immunofluorescence was used to observe the modality and the distribution of three tight junction proteins (occludin,claudin-5 and ZO-1) of the EA.hy926 cells treated with IL-8 under different concentrations and different times.RT-PCR was used to measure the mRNA expression of these three proteins.Results The results demonstrated that IL-8 could change the distribution of occludin,claudin-5 and ZO-1 in EA.hy926 cells,and the mRNA expression of occludin,claudin-5 and ZO-1 decreased with the increase of IL-8 concentration and treated time.Conclusion The effects of IL-8 on the distribution and the expression of occludin,claudin-5 and ZO-1 are dose and time-dependent.