Objective To investigate the changes in the expression of complement C3,high mobility group protein B1(HMGB1),and glutathione peroxidase 4(GPX4)in brain tissue at different time points after cerebral ischemia-reperfusion injury in rats.Methods A total 72 SPF male SD rats were randomly divided into a sham operation group(36 rats)and a model group(36 rats).A rat model of middle cerebral artery occlusion was established using thread occlusion,and then the rats from the model group were further assigned into 4 subgroups with reperfusion time for 3,6 and 24 h and 3 d,respectively,with 9 rats in each subgroup.Zea Longa scoring was used to assess neu-rological function.R2StarMap imaging,diffusion-weighted imaging(DWI),T1 weighted imaging,and T2 weighted imaging were performed on all the rats.The volume of abnormal DWI signals were detected and the volume of cerebral infarction was measured.The original R2StarMap images were post-processed to generate R2*pseudo color images,and then the R2*values of the areas with blood supply from bilateral middle cerebral artery were measured to detect iron deposition in the brain.The protein expression of C3,HMGB1,and GPX4 was detected by Western blotting.Results The sham operation group showed no neurological damage,while the model group had a significant increase in neurological function scores at 3,6 and 24 h and 3 d after modeling when compared to the sham surgery group(P＜0.05).While the size of right cerebral infarct was in-creased significantly at 3,6 and 24 h and 3 d in the rats of the model group(P＜0.05).The R2*value of the area with blood supply from the right middle cerebral artery in the model group was significantly higher than that in the left side at 3,6 and 24 h and 3 d(P＜0.05,P＜0.01),and it was also obviously higher than that in the right side of the sham operation group at these time points(P＜0.05,P＜0.01).The R2*ratio of the right and left blood supply areas in the model group at 3,6 and 24 h and 3 d was also statistically higher than that in the sham operation group at corresponding time points(1.82±0.82 vs 1.12±0.31,P＜0.05;1.31±0.26 vs 1.04±0.14,P＜0.05;1.94±0.74 vs 1.06±0.10,P＜0.01;1.99±0.39 vs 1.02±0.11,P＜0.01).Compared with the sham operation group,the expression levels of C3 and HMGB1 was significantly increased in the model group at 3,6 and 24 h and 3 d,while that of GPX4 was notably reduced(P＜0.01).Conclu-sion Cerebral ischemia-reperfusion injury impairs the neurological function of rats and signifi-cantly affects the cerebral expression of complement C3,HMGB1,and GPX4.

Objective To investigate the clinical and magnetic resonance imaging(MRI)features of Trousseau's syndrome(TS)with acute cerebral infarction,so as to improve the accuracy of diagnosis of this disease.Methods Fifty-three cases of TS with clinically confirmed acute multiple brain infarction(AMBI)and 52 cases of TS without AMBI were enrolled,and the head MRI,primary tumor imaging and clinical data of the patients were retrospectively analyzed.The clinical and MRI features and thrombus types of the 2 groups were compared.Results There were significant differences in the types of thrombus between the 2 groups(P=0.001),while there were no significant differences in gender,age,whether they had hypertension,diabetes mellitus,hyperlipidemia,basic cardiovascular diseases or not,preventive medication use,abnormal coagulation function,or D-dimer level(all P＞0.05).The primary tumor type of 105 TS patients was mainly adenocarcinoma.MRI of the head of 53 TS with AMBI patients showed that the distribution area of acute and subacute infarct foci was bilateral anterior circulation in 16 cases,bilateral anterior circulation+bilateral posterior circulation in 17 cases,bilateral anterior circulation+unilateral posterior circulation in 4 cases,and unilateral anterior circulation in 16 cases.Enhancement scans were performed in 23 cases,of which 11 cases showed some infarct foci appeared enhanced and 12 cases did not show significant enhancement.Twenty-eight cases did not show meaningful stenosis of the cerebral arteries,4 cases showed stenosis occlusion of the cerebral arteries,and all lesions did not conform to cerebrovascular distribution.Twenty-four cases of arterial thrombosis(10 cases of carotid artery thrombosis,3 cases of lower-extremity arterial thrombosis,5 cases of cerebral arterial ring thrombosis,1 cases of pulmonary artery thrombosis,1 case of renal artery thrombosis,and 4 cases of subclavian artery thrombosis)and 3 cases of venous thrombosis(deep vein thrombosis of the lower extremities)were found among the patients with visualized thrombosis.The D-dimer level was increased in different degrees.Conclusion Multiple speckled and patchy acute anterior and posterior cerebral infarcts involving bilateral cerebral and cerebellar cortex,subcortical areas and hemi-oval centers with lesions not conforming to cerebrovascular distribution are the characteristic manifestations of MRI of the head in the combination of malignant tumors with TS.Adenocarcinoma is the main malignant tumor,and the combination of D-dimer index can improve the accuracy of diagnosis.

Objective:To report the clinical characteristics, diagnosis, and treatment of 2 cases of X-linked acrogigantism(X-LAG).Methods:The clinical information of two patients were retrospectively reported, and peripheral blood DNA was collected for copy number variations detection.Results:Both patients had onset at age of two, with common clinical characteristics including linear growth acceleration, mild facial coarsening, enlargement of hands and feet, increased appetite, and snoring, etc. The heights Z scores of the two patients before treatment were + 6.86 and + 6.53, respectively. Growth hormone(GH) glucose inhibition test showed that GH nadir values were over 1 ng/mL and insulin-like growth factor-Ⅰ(IGF-Ⅰ) were 586.0 ng/mL and 1 042.0 ng/mL, respectively. Patient 1 received three cycles of octreotide microspheres therapy followed by surgery, and achieved clinical and biochemical remission. Patient 2 had lanreotide for 5.5 years but failed biochemical remission. Microduplication of Xq26.3, which contained pathogenic gene G-protein coupled receptor 101(GPR101), was found in germline DNA of two patients through copy number variation detection, leading to the diagnosis of X-LAG.Conclusion:It should be cautious of X-LAG when children below 2 years old presents symptoms such as overgrowth and so on. Medication combined with surgery is effective.

Objective: This article reported the clinical characteristics and gene mutations of two pseudoachondroplasia cases, and made a literature review in order to improve clinicians′ understanding of the disease. Methods: Clinical features of two patients who were short stature accompanied with skeletal deformities were summarized, and they accepted whole exome sequencing. We also reviewed literature to summarize the clinical characteristics and known gene research progress of all reported Chinese pseudoachondroplasia cases. Results: The two patients′ clinical characteristics were short limbdwarfism with skeletal deformity. Genetic results showed that there were two heterozygous mutations in the cartilage oligomeric matrix protein (COMP) gene of the two patients, c. 1417_1419delGAC and c. 1552G>A, respectively. Up to March 2019, a total of 58 cases of pseudoachondroplasia have been reported in China. The median height of these patients is -5.03 SDS. The clinical features include abnormal gait, short limbs, short fingers/toes, scoliosis, bracelet sign, ankle sign and other skeletal deformities. COMP is the pathogenic gene and mutations mainly located in calmodulin-like domains. The hotspot mutation is c. 1417_1419delGAC. Conclusions Pseudoachondroplasia is a kind of rare genetic disease characterized by short stature and skeletal deformities. The clinical and genetic characteristics of the disease were summarized, which may improve the early diagnosis rate.

Fifty-three patients with facial spasm were treated by acupuncture therapy. Taichong (LR 3), Fengchi (GB 20), Yifeng (TE 17), and Sanyinjiao (SP 6) were selected as main points, and others points were selected based on symptom. Of the 53 cases, 9 cases were cured,13 cases were markedly effective, 27 cases were effective, and 4 cases were ineffective, with an effective rate of 92.5%.

Seven cases of tic of limbs caused by an intravenous drip of penicillin combined with kfloxcin were treated by puncturing acupoints Neiguan (PC 6),Hegu(LI 4) and Taichong (LR 3).After the symptoms were relieved,the patients were again given an intravenous drip of penicillin or kfloxcin,no side effects was found.

Objective: To investigate the efficacy of earth-reinforcing and wood-reducing acupuncture for child Tourette's syndrome. Methods: Forty-five children with Tourette's syndrome were randomly allocated, according to a random number table, into an acupuncture group (23 cases) and a Western medicine group (22 cases). Points Zhongwan (CV 12) and Siguan were selected in co-operation with acupuncture of other routine points in the acupuncture group. Haloperidol was orally administered for routine treatment in the Western medicine group.Results: The cure rate was 65.2% in the acupuncture group and 31.8% in the Western medicine group. There was a significant difference in cure rate between the two groups (P＜0.05).Conclusion: Earth-reinforcing and wood-reducing acupuncture has an exact curative effect on child Tourette's syndrome.

In the treatment of 12 patients with facial paralysis in the second trimester of pregnancy by puncturing Yifeng (TE 17), Yangbai (GB 14), Yingxiang (LI 20), Chengjiang (CV 24), Jiache (ST 6), Dicang (ST 4), Cuanzhu (BL 2), Heliao (LI 19) and others on the sick side plus TDP radiation and massaging on the affected face. Eleven cases were cured and one case was remarkably effective after 20 treatments.

Objective: To observe the clinical therapeutic efficacy of treatment of prolapse of lumbar intervertebral disc with lumber vertebral traction plus Ding's Rolling Technique.Methods: 133 cases of prolapse of lumbar intervertebral disc were randomly divided into two groups. There were 68 cases in the treatment group, which were treated with lumber vertebral traction plus Tuina. There were 65 cases in the control group, which were treated with simple lumber vertebral traction. Results: There were statistic differences in the two groups (x2=6.86,P＜0.01). The therapeutic efficacy in the treatment group was better than the control group.Conclusion: The clinical therapeutic efficacy treated with lumber vertebral traction plus Ding's Rolling Technique was better than simple lumber vertebral traction in treating prolapse of lumbar intervertebral disc.

Seventy-three patients with bed sores were treated by warming moxibustion. Of the 73 cases, 58 cases were cured, 12 cases improved and 3 cases ineffective, with an effective rate of 95.9%.