Inflammation response is an important pathological process of neuronal cell death after stroke.Interleukin (IL)-33/ST2 system is involved in the inflammatory response process of ischemic stroke and has been proved to be a protective factor.This article reviews the role and mechanism of IL-33/ST2 system in the regulation of immune inflammation after ischemic stroke.

Objective:To explore the probability, influencing factors, and management strategies of the re-increase of parathyroid hormone (PTH) in patients with primary hyperparathyroidism (pHPT) after successful surgery.Methods:A retrospective analysis of the clinical data of 40 pHPT patients treated at Beijing Tsinghua Chang Gung Hospital from Jan 2016 to Mar 2021 was conducted.Results:Of the 40 pHPT patients, 21 (53%) experienced a re-increase of PTH after surgery, but their serum calcium levels were normal and no new parathyroid lesions were found on neck ultrasonography. Univariate analysis showed that there were significant differences in tumor diameter, preoperative PTH level, preoperative serum calcium level, and preoperative alkaline phosphatase level between the postoperative PTH re-increase group and the normal group ( t=-2.042, P=0.045; t=-2.600, P=0.013; t=-2.223, P=0.043; t=-2.162, P=0.037). Regression analysis showed that preoperative PTH level >236 ng/L was an independent risk factor for postoperative PTH re-increase ( OR=5.180, 95% CI: 1.032-25.995). Vitamin D deficiency was common among pHPT patients (88%), and there was a negative correlation between preoperative PTH and 25-hydroxy vitamin D levels. After vitamin D supplementation, the PTH levels of four patients with postoperative PTH re-increase returned to normal. Conclusions:The probability of PTH re-increase in pHPT patients after successful parathyroidectomy was 53%, and most cases occurred in the short term after surgery (within 8 weeks), but it did not indicate disease recurrence. A higher preoperative PTH level was an independent risk factor for postoperative PTH re-increase. Vitamin D deficiency was more common among pHPT patients, and correction of vitamin D deficiency can help restore normal PTH levels after surgery.

Objective:To explore the clinical application value of sound touch elastography (STE) in the evaluation of the curative effect of acupuncture and moxibustion in the treatment of stroke patients with upper limb spasm.Methods:Fifty-five patients with upper limb spasm after stroke were selected as stroke group, and thirty healthy volunteers matched with age, gender and body mass index (BMI) were selected as control group between September 2020 and March 2021. The shear wave velocity (SWV) of biceps brachii and triceps brachii were measured in both groups. In stroke group, the SWVs of biceps brachii and triceps brachii on spastic side and non-spastic side were measured before and after acupuncture treatment, and the correlations between SWV and spastic grade (X), muscle response angle (R1), passive range of motion (R2), spastic angle (R2-R1) of modified Tardieu scale (MTS) were analyzed.Results:At 0 degree, the SWV of spastic biceps brachii (3.85±0.62)m/s was significantly higher than those of the non-spastic side [(3.34±0.35)m/s] and control group [(3.15±2.66)m/s] (all P<0.001), and decreased [ (3.45±0.47)m/s] after acupuncture treatment ( P<0.001). At 90 degree, the SWV of non-spastic biceps brachii was larger than those of spastic side and control group [1.98(1.92, 2.14)m/s vs 1.98(1.92, 2.11) m/s, 1.95(1.86, 2.05)m/s, all P<0.05], and there was no significant difference between the SWV of spastic side and control group ( P>0.05). There were no significant differences in SWV of triceps brachii between the spastic side and control group at both 0 degree or 90 degree ( P>0.05). At 0 degree, SWV positively correlated with MTS (x) ( rs=0.639, P<0.001) and negatively with R1 ( rs=-0.527, P<0.001) and R2 ( rs=-0.825, P<0.001) on the spastic biceps brachii. Conclusions:STE can provide quantitative index for the objective evaluation of the curative effect of acupuncture in upper limb spasm after stroke, and it is proposed to be an effective means of clinical diagnosis and efficacy evaluation in patients with upper limb spasm after stroke.

Objective:The Chinese pediatric mesh-type reference phantoms were developed and applied in the dose assessment of X-ray radiography.Methods:The 5- and 10-year-old Chinese pediatric mesh-type reference phantoms were developed based on the CT data. Based on the phantoms, the Monte Carlo method was applied to simulate the X-ray radiography to calculate the organ dose conversion coefficient and the effective dose conversion coefficient in different radiography conditions.Results:The 5- and 10-year-old Chinese pediatric mesh-type reference phantoms were developed, and the physical parameters were consistent with the national standard. The differences of the organ mass between the established phantoms and reference data were within 2%. The database of the pediatric chest posteroanterior projection and abdominal anteroposterior projection, tube voltage 60-90 kVp, total filtration 2.5~4 mmAl were simulated, and the difference between the effective dose conversion factor and the literature result was within 3%.Conclusions:The established Chinese pediatric mesh-type reference phantoms can be applied in the studies of radiation protection and clinical medicine and their result can provide an important reference for the dose assessment of the pediatric X-ray radiography.

Objective To prepare and characterize caspofungin acetate-loaded solid lipid nanoparticles using glycerol monostearate （CAS-SLNs）, and investigate the antifungal effect of potentiation on Candida albicans in vitro and in vivo. Methods A high performance liquid chromatography method was established for the determination of caspofungin acetate （CAS）. CAS-SLNs were prepared by the melt-emulsification method and characterized. The minimum inhibitory concentration （MIC） and the inhibitory effect on Candida albicans biofilm were determined. A systemic infection model of Candida albicans was established in mice, and the growth curve models for body weight and fungal load of kidneys of the animals were investigated after intravenous infection. Results The retention time of CAS was 6.8 min. The calibration curve showed good linearity, and the precision and stability met the requirements of the assay. Transmission electron microscopy revealed that CAS-SLNs were spherical, with a particle size of （135.97±1.73） nm. The Zeta potential was （19.33±0.37） mV, drug loading was （7.55±0.68）%, and encapsulation efficiency was （67.71±1.74）%. CAS-SLNs showed significant in vitro antifungal inhibition with a MIC of 9.78×10⁻⁴ g/ml, which was significantly better than CAS group and the physical mixture group of CAS and GMS, as well as the same biofilm inhibition was observed （P<0.001）. Pharmacodynamic studies demonstrated that CAS-SLNs maintained stable body weight gain compared to the control （P<0.01） and CAS groups in Candida albicans invasive infection model, and that CAS-SLNs significantly reduced renal fungal burden load relative to the CAS group （P<0.05）. In vivo study revealed that a stable body weight was maintained in CAS-SLNs group compared to the control group （P<0.01） in Candida albicans invasive infection model. CAS-SLNs also significantly reduced renal fungal load compared to the CAS group （P<0.05）. Conclusion CAS-SLNs significantly enhanced the antifungal effects of CAS in vitro and in vivo, which provided a valuable insight for the research of new formulation of CAS.