Objective To investigate the clinical efficacy of dl-3n-butylphthalide and its effect on NT-proBNP levels and inflammatory cytokines of patients with acute cerebral infarction.Methods Total 118 patients with acute cerebral infarction in Hengshui Fifth People's Hospital were randomly divided into control group and observation group.Sixty patients in control group were treated with conventional medication,and 58 patients in observation group were treated with dl-3n-butylphthalide injection based on conventional medication.The NT-proBNP levels,score of neurological deficits (NIHSS),inflammatory cytokines including hypersensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6),and tumor necrosis factor-cα (TNF-α) before and after 7 and 14 d of treatment,and adverse reaction were observed and analyzed.Results Before treatment,differences in the NT-proBNP levels,NIHSS score,hs-CRP,IL-6,and TNF-α between two groups were not obvious.After 7 and 14 d of treatment,NT-proBNP levels in observation group were significantly lower than those in control group (P ＜ 0.05).And after treatment for 14 d,NIHSS score in observation group were conspicuously lower than those in control group (P ＜ 0.05).Additionally,the levels of hs-CRP,IL-6,and TNF-α in observation group were markedly lower than those in control group (P ＜ 0.05).Conclusion D1-3n-butylphthalide injection has a good ability in inhibiting NT-proBNP levels and inflammatory cytokines,and improves the neurological function of patients with acute cerebral infarction.

Objective To improve detectable rate of gastric schwannoma by endoscopic ultrasonography (EUS). Method Clinical data and endoscopic ultrasonography (EUS) imaging features of 4 cases were retrospectively ana-lyzed which diagnosed as gastric schwannoma pathologically and immunohistochemically while diagnosed as gastric stromal tumor by EUS from May 2008 to June 2015 and reviewed the literature. Results 4 cases of gastric schwan-nomas are female and benign, all 4 lesions are solitary, 3 in gastric body, and 1 in fundus by endoscopic. By EUS, all lesions are originated from muscularis propria, hypoechoic change, even echoes and clear board without calcifica-tion or cystic changes. 2 cases have halo artifacts around the lesion. Literature review found that gastric schwannoma tended to occur in female, halo artifacts could be the feature of gastric schwannoma, calcification or cystic changes were rare in gastric schwannoma which were common in gastric stromal tumors. Conclusion It was difficult to distin-guish gastric schwannoma and gastric stromal tumors that originated from muscularis propria by EUS. For female patients with lesions originated from muscularis propria, originated from muscularis propria and occurred in gastric body, it was necessary to observe lesions whether there was being calcification or cystic and halo artifacts. Integrated all these performance, we should be in consideration of gastric stromal tumors, meanwhile, excluding the possibility of gastric schwannoma.

Objective To study the imaging finding of the coracoclavicular ligament.Methods 400 cases of normal chest films 200 men and 200 women were collected.The presented rates of pseudoarthrosis of the coracoclavicular joints and the clavicular tuberosities which are the coracoclavicular ligament attachment were evaluated and the distances between the clavicle and coracoid process interval were measured.There were 30 cases of normal shoulder MRI,the displaying rate of coracoclavicular ligament, the length and width of the coracoclavicular ligament were measured at MR imaging.8 case with type Ⅱ(n=5) and type Ⅲ(n=3)of acromioclavicular injury were also included in this study.Results Among 400 cases(800 sides),one pseudoarthrosis(0.25%)and 198 clavicular tuberosities(24.8%)were found.The normal distance between the clavicle and coracoid process interval was (6.92±3.16)mm.On MRI study,30 cases of coracoclavicular ligament were all showed on oblique coronal slices. The acromioclavicular ligament and coracoclavicular ligament tear were found in type Ⅱ and type Ⅲ,of acromioclavicular injury respectively on MRI.The length and width of conoid ligament were(11.48±1.43) mm and (4.82±1.21) mm respectively,and the length and width of trapezoid ligament were(9.09±0.84) mm and (5.10±0.87) mm respectively.Conclusion The normal anatomic measurement standards of the coracoclavicular ligament are established on X-ray and MRI,which is important for diagnosis of coracoclavicular ligament lesions.The coracoclavicular ligament torn is showed in typeⅢ of acromioclavicular dislocation.

Objective:To investigate the expressions of tissue inhibitor of matrix metalloproteinase-1 (TIMP1) and fibronectin 1 (FN1) in pregnancy associated breast cancer (PABC) and their correlations with expression of E-cadherin (E-cad).Methods:The clinicopathological data of 55 PABC patients in Binzhou People's Hospital Affiliated to Shandong First Medical University from January 2011 to December 2020 were retrospectively analyzed. Immunohistochemistry was used to detect expressions of TIMP1, FN1 and E-cad in cancer tissues and corresponding paracancerous tissues (>3 cm from the edge of the tumor foci). The expressions of TIMP1 and FN1 proteins in fresh intraoperative frozen cancer tissues and paracancerous tissues of 10 PABC patients were detected by Western blotting. The correlations of TIMP1 and FN1 expressions with clinicopathological characteristics of patients were analyzed by χ2 test, the correlation of TIMP1 and FN1 expressions with E-cad expression was analyzed by Spearman method, and the correlation of TIMP1 and FN1 expressions with survival was analyzed by Kaplan-Meier method. Results:The positive rates of TIMP1 and FN1 in PABC tissues were 72.7% (40/55) and 58.2% (32/55), and 25.5% (14/55) and 18.2% (10/55) in paracancerous tissues, and the differences were statistically significant ( χ2 values were 24.59 and 18.64, both P < 0.001). The results of Western blotting showed that the relative expressions of TIMP1 and FN1 proteins in the fresh cancer tissues of 10 PABC patients was higher than those in the corresponding paracancerous tissues (1.60±0.76 vs. 0.62±0.29, 1.31±0.62 vs. 0.44±0.15), and the differences were statistically significant ( t values were 5.92 and 4.86, both P < 0.001). The expressions of TIMP1 and FN1 in PABC tissues were correlated with estrogen receptor expression, Ki-67 positivity index, TNM stage and lymph node metastasis (all P < 0.05). The expressions of TIMP1 and FN1 were negatively correlated with expression of E-cad in PABC ( r values were -0.471 and -0.432, both P < 0.001). Five cases were lost to follow-up, and the remaining 50 cases had a median follow-up time of 43 months (12-90 months). Among the 50 cases, 36 cases were TMP1-positive and 29 cases were FN1-positive. The overall survival of TIMP1-negative group and FN1-negative group were better than those of the corresponding positive group ( χ2 values were 4.49 and 6.06, both P < 0.05); the median overall survival time of TIMP1-positive group and FN1-positive group were 51 months (95% CI 37-65 months) and 43 months (95% CI 32-53 months), while that of TIMP1-negative group and FN1-negative group were 89 months (95% CI 84-93 months) and 87 months (95% CI 85-92 months). Conclusions:TIMP1 and FN1 expressions are elevated in PABC tissues and negatively correlated with E-cad expression, TIMP1 and FN1 may be involved in PABC invasion through epithelial-mesenchymal transition and affect the prognosis of patients.