Early diagnosis and timely treatment are two critical factors in reducing the cerebral damage and improving prognosis for ischemic stroke patients.The only proved effective way is to intravenously administer recombinant tissue plasminogen activator for thrombolytic therapy.However,the narrow time window restricts its application.One rapid and effective blood test,or auxiliary examinations such as computer tomography which may aid early diagnosis of ischemic stroke would contribute to treatment and intervention promptly,then take a pivotal role for the disease prognosis.Herein,the reported proteins and RNA markers are summarized and analysed in clinical application of acute ischemic stroke likewise.

Paraneoplastic neurological syndromes (PNS) were defined as neurological syndromes associated with cancer.In many cases,autoantibodies against neural antigens expressed by the tumor (paraneoplastic neurological antibody or onconeural antibodies) were detected.The neuronal antibodies,which were associated with syndromes resulting from central nervous system neuronal dysfunction,were classified into two groups according to the location of the antigen:inside the neuron or in the cell membrane.Group Ⅰ antibodies targeted on intracellular antigens and were predominantly dependent on T-cell-mediated responses.Group Ⅱ antibodies recognized neuronal surface antigens and were predominantly dependent on B-cell-mediated responses.Onconeural antibodies were useful diagnostic markers of the brain disease,and in some cases,they might reveal an underlying malignancy.Moreover,the presence of antibodies against surface(group Ⅱ) antigens might predict a more favorable response to immunotherapy than that against intracellular (group Ⅰ) antigens.

Comparison of rCBF SPECT imaging and clinical visual function of 12 cases with complete homonymous hemianopia (CHH) were taken before and after a course of oriented dynamic color photic stimulation (ODCPS ). It was suggested that ODCPS in patients with CHH was an effective met hod for increasing visual field and improving visual function. Cerebral metabolic patterns of increasing rCBF reflected the mechanism of ODCPS effecting the patients with CHH. The rgtinal- midbrain-occipital visual path way may play an important role in mediating the increase of visual field and restoration of visual function.

Objective To discuss current detection of food intolerance in health check-up populations and the influence of food intolerance on immune system and inflammation parameters.Methods Serum levels of 14 kinds of food-specific IgG antibodies were analyzed by using enzyme linked immunosorbent assay (ELISA) among 257 healthy check-up adults.White blood cell count,eosinophils,globulin,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),rheumatoid factor (RF),antinuclear antibodies (ANA) and T cell function were compared between the positive group and the negative group.Student's t test and Chi-square test were used for data analysis.Results Food-specific IgG antibodies were found in 134 participants (52.14％).The most common intolerant foods were egg,crab and milk.Moderate to severe food intolerance was caused by egg or milk.There was significant difference in eosinophils and serum globulin between the positive and the negative group (t =-0.07,x2 =8.91,both P ＜0.05).However,no difference was observed in white blood cell count,ESR,CRP,RF,ANA and T cell function between two groups (all P ＞ 0.05).Conclusion Eosinophils and serum globulin may significantly increased in people with food intolerance,although white blood cell count,ESR,CRP,RF,ANA and T cell function could be normal.

Objective To evaluate the accuracy and value of measurement of left ventricular systolic function in dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) patients with stereo three-dimensional echocardiography (S3 DE). Methods End-diastolic volume (EDV), end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF) of the left ventricle were measured with M-mode echocardiography(ME),two-dimensional echocardiography(2DE) and S3DE in DCM patientsC20 cases). HCM patients(20 cases),and normal controls(20 cases). The different results among the three groups or three methods were analyzed. Results (①In all the three groups,the results of EDV,ESV,and SV obtained with ME were significantly higher than those obtained with S3DE( P <0. 01). Only in normal group( P <0. 01) and HCM group ( P <0. 05) ,the results of EF obtained with ME and 2DE were significantly higher than that obtained with S3DE. ②By S3DE,compared with normal group,EDV,ESV were increased and EF was decreased obviously in DCM group (all P <0. 01); while in HCM group, only SV was significantly higher( P < 0. 01). ③EDV, ESV, and EF measured by S3DE were correlated and fit well with those measured by 2DE(r = 0.778,0.876, 0.932;R2 =0.605,0.767,0.869;all P <0.01). ④Within HCM group,excluding the impact of heart rate,cardiac output (CO) was highly correlated with SV( r = 0. 987,P < 0. 01). Conclusions S3DE can real-time display the stereo structure of the heart, and accurately and reliably assess the left ventricular systolic function, with a priority over traditional ME and 2DE methods. EDV,ESV, and EF are still effective indicators for the clinical assessment of left ventricular systolic function. SV obtained with S3DE will be expected to be the more sensitive and accurate value in assessing left ventricular systolic function in patients with early-stage cardiomyopathy.

Data of patients with maxillofacial and jugular venous malformations involving isthmus faucium area from January 2012 to July 2016 were collected. Patients were questioned about the medical history before operation, and the airway was adequately evaluated. The patients diagnosed as having non-difficult airways were endotracheally tubed using fast induction of anesthesia. Tracheal intubation was per-formed using fast induction of anesthesia combined with topical anesthesia after visual laryngoscopy in the patients assessed as having difficult airways. Endotracheal intubation was guided with a visual hard endo-scope or a fibrobronchoscope in the patients with difficulty in opening mouth after multiple treatments. Post-operative airway management was as follows: the tracheal tube was removed after extubation, the tracheal tube was retained for 24-48 h, or preventive tracheotomy was performed. Oxygen was inhaled by mask. A total of 157 patients were included in this study, 55 patients diagnosed as having difficult airways, and a-mong the 55 patients, 87％ cases were intubated after visual laryngoscopy and 13％ cases received tracheot-omy. There were 10 patients with difficulty in opening mouth after multiple treatments and 5 cases under-went tracheotomy in the outer hospital. Sixteen patients presented with a transient increase in airway pres-sure during intraoperative injection of anhydrous ethanol. There were 106 cases in whom the tracheal tube was removed immediately after emergence, and among them, 32. 1％ cases needed tongue traction and 2. 8％ cases underwent emergency tracheotomy after extubation. Thirty-eight patients needed to retain the tracheal tube for 24-48 h after operation, and among them, 37％ cases needed tongue traction and 3％ ca-ses required emergency tracheotomy after extubation. Thirteen cases underwent preventive tracheotomy. The preoperative visit and assessment are especially important, appropriate airway management strategies should be developed, vital signs should be closely observed during operation, and the timing of extubation should be grasped for this type of patients, and the SpO2 and airway pressure should be mainly observed during op-eration especially for the patients who underwent anhydrous ethanol injection.

Subarachnoid hemorrhage (SAH) is a common hemorrhagic cerebrovascular disease with high mortality and disability rate. Intracranial aneurysm is the major cause of SAH,severe and unbearable headache with meningeal irritation is the typical clinical manifestation of it,and the diagnosis is mainly confirmed by neuroimaging. The purpose of SAH treatment is to eradicate bleeding causes such as aneurysms and brain arteriovenous malformation (bAVM), eliminate brain edema and control intracranial pressure, prevent cerebral vasospasm and secondary cerebral ischemia, and deal with complications such as hydrocephalus actively. Two international multicenter randomized controlled trials, ISAT (International Subarachnoid Aneurysm Trial) and BRAT (Barrow Ruptured Aneurysm Trial), have provided new evidences for the treatment of aneurysmal subarachnoid hemorrhage. Multidisciplinary collaboration,consisting of neurosurgery, intervention and neurology departments, is an important guarantee for good clinical outcomes.

ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection. MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects. ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P<0.001）， headache （OR=0.320， P<0.001）， and peak body temperature （β=-0.446， P<0.001）. ConclusionFollowing the COVID-19 policy adjustment as a category B notifiable disease， healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms. Reinfection results in milder clinical manifestations， with a lower proportion of being asymptomatic.

Receptor-interacting serine/threonine-protein kinase 1 (RIPK1) functions as a key regulator in inflammation and cell death and is involved in mediating a variety of inflammatory or degenerative diseases. A number of allosteric RIPK1 inhibitors (RIPK1i) have been developed, and some of them have already advanced into clinical evaluation. Recently, selective RIPK1i that interact with both the allosteric pocket and the ATP-binding site of RIPK1 have started to emerge. Here, we report the rational development of a new series of type-II RIPK1i based on the rediscovery of a reported but mechanistically atypical RIPK3i. We also describe the structure-guided lead optimization of a potent, selective, and orally bioavailable RIPK1i, 62, which exhibits extraordinary efficacies in mouse models of acute or chronic inflammatory diseases. Collectively, 62 provides a useful tool for evaluating RIPK1 in animal disease models and a promising lead for further drug development.