Dyslipidemia is a recognized risk factor for ischemic stroke. As an important component of lipids, lipoprotein(a) (Lp [a] ) was first found within the atherosclerotic plaques which is similar to the lipid body of the low-density lipoprotein cholesterol? Studies have showed that Lp (a) is involved in the formation of atherosclerosis and thrombosis through a variety of mechanisms, and then triggers cardio-cerebrovascular diseases. Identifying its relation with ischemic stroke and other risk factors may provide references for early prevention and treatment of ischemic stroke.

Objective To evaluate the effectiveness of arthroscopically assisted percutaneous screw fixation for treating patella fractures.Methods A total of 14 cases of patella fractures were treated by percutaneous reduction and internal fixation with screws under arthroscope from November 2001 to June 2004 in this hospital.The fracture was reduced by closed manipulation or percutaneous leverage force using the Kirschner wire.Then the patella was temporarily fixed by using a large-sized towel clamp or Kirschner wires.Under the guidance of knee arthroscopy or C-arm fluoroscopy,a micro-incision was made at the site of screw placement,the pilot holes were drilled at a proper depth,and the thread was configured.Two titanium screws or absorbable screws were inserted parallelly.Results Follow-up checkups for 6~18 months(mean,10 months) in 13 cases showed a satisfactory recovery of knee functions.According to the Xu Shaoding's standard,excellent effects were obtained in 11 cases(84.6%) and good effects,2 cases(15.4%).Conclusions Treatment of patellar fractures by percutaneous screw fixation under arthroscope offers advantages of minimal invasion,accurate reduction,reliable fixation,and excellent recovery of joint functions.

Objective To investigate the relationship between the interleukin-17 (IL-17),interleukin23 (IL-23) and carotid artery sclerosis in patients with cerebral infarction.Methods One hundred and twentyfive cerebral infarction patients in the first affiliated hospital of Shantou University medical college from June 2010 to June 2012 were recruited.All the subjects were examined with carotid ultrasonography.According to the results of carotid ultrasonography,all patients were divided into carotid atherosclerosis group(86 cases) and non carotid atherosclerosis group(39 cases).Patients with carotid atherosclerosis were divided into soft plaque group (35 cases),hard plaque group (21 cases),mixed plaque group (30 cases) based on plaque feature.Carotid atherosclerosis patients with cerebral infarction plaque determined by semi-quantitative method were grouped into Ⅰ grade(29 cases),Ⅱ grade (43 cases),Ⅲ grade (14 cases) according to the severity atherosclerosis.Serum levels of IL-17 and IL-23 were measured.Results The levels of IL-17 and IL-23 in patients with carotid atherosclerosis group were (31.42 ± 8.73) μg/L and(21.79 ± 9.34) μg/L,higher than that of non-carotid atherosclerosis group((22.81 ±6.52) μg/L,t =5.15,P ＜0.01 ; (14.33 ±6.21) μg/L,t =4.99,P ＜0.01).The IL-17 and IL-23 levels in patients with soft plaque,hard plaque and mixed plaque group were significant different (F =10.181,3.835,P ＜0.05).Serum IL-17 in soft plaque and mixed plaque expression group was higher than that of hard plaque group (P =0.001,P=0.007).IL-23 level in soft plaque group was higher than mixed plaque and hard plaque groups(P =0.017;P =0.045).The IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were markedly different (F =41.046,3.739 ; P ＜ 0.05),and there was significant difference between Ⅱ,Ⅲ and Ⅰ group(P ＜0.01,P ＜0.05).The correlation between IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were 0.892 and 0.420 (P =0.000 ; P =0.041).Conclusion IL-17 and IL-23 play important roles in the pathologic progress of artery sclerosis and are helpful for early diagnosis of the disease.

Objective To investigate the imbalance of T helper 17 (Th17) / CD4 + CD25 + regulatory cell (Treg) in HAM/TSP patients.Methods Enzyme linked immunosorbent assay (ELISA) was performed to measure the levels of interleukin (IL-17) and IL-10 in CSF,and flow cytometry to determine the percentage of Th17 and Treg cells in peripheral blood of patients with HAM/TSP.Results There was a significant increase in the level of IL-17 [(4.58 ± 0.70)pg/ml vs (0.76 ± 0.17)pg/ml,P ＜ 0.01] in CSF and the percentage of Th17 cells [(2.00 ± 0.64) ％ vs (0.41 ± 0.24) ％,P ＜ 0.01],but a decrease in the level of IL-10 in CSF and the percentage of Treg cells in peripheral blood of patients with HAM/TSP compared with the control group.The ratio of Th17/Treg cell (0.55 ±0.10 vs 0.06 ±0.03) in the peripheral blood of patients with HAM/TSP increased significantly compared with control group (t =12.11,P ＜0.01).Conclusions The imbalance between Thl7 and Treg cells may play an important role in the pathogenesis of the disease.

Objective To investigate the correlation between serum lipoprotein (a) (Lp(a)) level andischemic stroke and its etiological subtypes. Methods The consecutive inpatients with acute ischemic stroke (case group) and age-and sex-matched healthy subjects (control group) over the same period were enrolled retrospectively. The demographic and baseline clinical data, as well as fasting blood glucose, fibrinogen,homocysteine, total cholesterol, triacylglycerol, high-densitylipoprotein cholesterol, low -density lipoprotein cholesterol, and Lp(a) concentration of the case group and the control group were collected. According to TOAST classification criteria, the patients in the case group were divided into large artery atherosclerosis (LAA), small artery occlusion (SAO) and cardioembolism (CE), and the patients with other determined etiology and undetermined etiology were excluded. Multivariate logistic regression analysis was used to make clear the correlation between serum Lp(a) and acute ischemic stroke and its etiological subtypes. Results A total of 214 patients with ischemic stroke were enrolled. Ninety-seven had LAA (45.33%), 64 (29.91%) had SAO, and 53 (24.77%) had CE. There were 118 subjects in the control group. There were significant differences in the proportions of hypertension, diabetes, hyperlipidemia, atrial fibrillation and alcohol consumption, as well as systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low -density lipoprotein cholesterol, Lp(a), fibrinogen, and homocysteine between the case group and the control group (all P <0.001). Multivariate logistic regression analysis showed that after adjustment for age and sex, Lp(a) is an independent risk factor for ischemic stroke (odds ratio [OR] 2.014, 95% confidence interval [CI ] 1.273-3.092, P = 0.036). The independent risk factors for LAA included hypertension (OR 3.353, 95% CI 1.714-6.558, P = 0.001), systolic blood pressure ( OR 2.786, 95% CI 1.136-5.538, P =0.016), homocysteine ( OR 1.108, 95% CI 1.031-2.191, P = 0.005), total cholesterol (OR 2.169, 95% CI 1.599-4.943, P = 0.001), low -density lipoprotein cholesterol ( OR2.782, 95% CI 1.093-5.238, P =0.024), and Lp(a) (OR 3.072, 95% CI 1.907-8.064, P =0.001). Theindependent risk factors for SAO included hypertension ( OR 7.042, 95% CI 3.189-25.55, P =0.001), diabetes mellitus (OR 5.162, 95% CI 2.372-11.23, P =0.001), fibrinogen (OR 1.667, 95% CI 1.434-2.025, P = 0.045), and homocysteine (OR 1.967, 95% CI 1.859-1.995, P =0.036). The independent risk factors for CE included atrial fibrillation (OR 13.340, 95% CI 4.637-39.20, P = 0.001), fibrinogen (OR 2.365, 95% CI 1.147- 4.904, P =0.029), and Lp(a) (OR 1.656, 95% CI 1.996-3.001, P = 0.035). Conclusions Lp(a) is an independent risk factor for ischemic stroke, and can be used as a serum biomarker for predicting the risk of the onset of ischemic stroke. There are differences in independent risk factors between the different stroke etiological subtypes. Lp(a) is independently associated with LAA and CE; however, it has no independent correlation with SAO.

Objective To quantitatively analyze the fund theses published in the Journal of Practical Radiology(JPR)and Chinese Journal of Radiology(CJR)in order to detect effective approaches to the improvement of the journal quality and academic level of the JPR.Methods The number of funds-supported theses published,the ratio of fund theses,grade,regional,source of institutions and publication time-lag distribution of the fund theses were statistically analyzed by using bibliometrics in the two journals in 2013.Re-sults Six hundred and eighteen theses were published in JPR in 2013,the total number of fund theses were 137(accounted for 22.2% of total articles),the ratio of fund theses were 0.22,the provincial and municipal fund theses accounted for 59.2%.All fund theses were from 23 regions and 82 institutions throughout the country.The average of publication time-lag was 235.6 days.Three hundred and thirteen theses were published in CJR in 2013,the total number of fund theses were 97(accounted for 31.0% of total articles),the ratio of fund theses were 0.31,the provincial and municipal fund theses accounted for 32.0%.All fund theses were from 18 regions and 70 institutions throughout the country.The average of publication time-lag was 228.4 days.Conclusion JPR has its own superi-ority,meanwhile,it also has a significant disparity and insufficiency comparing to CJR.In order to further promote the quality conno-tations and the academic level of JPR,efforts should be made on subject selection and planning,initiative collection of manuscripts, priority publishment to excellent manuscripts,shortening publication time-lag,etc.Additionally,a database of core authors and ex-perts should be established.

Objective:To explore the clinical application value of limb remote ischemic postconditioning (LRIPC) in patients with acute cerebral infarction after recanalization.Methods:A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected. According to the random number table method, they were divided into the observation group with 39 cases (LRIPC + conventional medical treatment) and the control group with 39 cases (conventional medical treatment). The National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment scale (MoCA) scores, the changes of cerebral blood perfusion, cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results:After the treatment, the NIHSS scores in the observation group were lower than thosein the control group, and the MoCA scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group, while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the volume of cerebral infarction in the observation group was lower than that in the control group ( P<0.05). After the treatment, the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group: (142.45 ± 36.23) mg/L vs. (176.89 ± 42.63) mg/L, (2.52 ± 0.46) μg/L vs. (3.61 ± 0.75) μg/L; and the level of nerve growth factor was higher than that in the control group: (143.49 ± 10.58) μg/L vs. (124.96 ± 13.62) μg/L, the differences were statistically significant ( P<0.05). Conclusions:LRIPC can improve the nerve functions, cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow. It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.

OBJECTIVETo investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology, pathology, diagnosis and treatment.

DATA SOURCESThe data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed, MedSci, Google scholar. The terms "myofasial trigger points" and "myofacial pain syndrome" were used for the literature search.

STUDY SELECTIONOriginal articles with no limitation of research design and critical reviews containing data relevant to myofascial trigger points (MTrPs) and MPS were retrieved, reviewed, analyzed and summarized.

RESULTSMyofascial pain syndrome (MPS) is characterized by painful taut band, referred pain, and local response twitch with a prevalence of 85% to 95% of incidence. Several factors link to the etiology of MTrPs, such as the chronic injury and overload of muscles. Other factors, such as certain nutrient and hormone insufficiency, comorbidities, and muscle imbalance may also maintain the MTrP in an active status and induce recurrent pain. The current pathology is that an extra leakage acetylcholine at the neuromuscular junction induces persistent contracture knots, relative to some hypotheses of integration, muscle spindle discharges, spinal segment sensitization, ect. MTrPs can be diagnosed and localized based on a few subjective criteria. Several approaches, including both direct and supplementary treatments, can inactivate MTrPs. Direct treatments are categorized into invasive and conservative.

CONCLUSIONThis review provides a clear understanding of MTrP pain and introduces the most useful treatment approaches in China.