Objective To explore the clinical effect of neurointervention assisted alteplase thrombolysis in the treatment of acute ischemic stroke(AIS).Methods A total of 104 AIS patients admitted to Beijing Shunyi Hospital from June 2022 to June 2023 were selected as the research subjects,and they were divided into observation group and control group according to the treatment method,with 52 cases in each group.The patients in the control group were treated with alteplase thrombolysis,and the patients in the observation group were treated with neurointervention assisted alteplase thrombolysis.The therapeutic effect of patients in the two groups was evaluated according to the National Institutes of Health stroke scale(NIHSS)score at two weeks after treatment.Before treatment and 3,7 days after treatment,the serum nerve growth factor(NGF),neuron specific enolase(NSE),central nervous system specific protein S100β levels of patients in the two groups were detected by enzyme-linked immunosorbent assay;the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients in the two groups were detected by ultrasound transcranial Doppler blood analyzer;the degree of neurological damage of patients in the two groups was evaluated by NIHSS scores.The occurrence of drug-related adverse reactions during treatment of patients in the two groups were recorded;the comprehensive living ability of patients in the two groups was evaluated by improved Rankin score at three months after treatment.Results The total effective rates of patients in the control group and the observation group were 80.77％(42/52)and 96.15％(50/52),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(x2=6.029,P＜0.05).There was no significant difference in the serum NGF,NSE,S100β levels of patients between the two groups before treatment(P＞0.05).Compared with before treatment,the serum NGF level of patients in the two groups increased,and the serum NSE,S100β levels decreased at 3,7 days after treatment(P＜0.05).At 3,7 days after treatment,the serum NGF level of patients in the observation group was significantly higher than that in the control group,and the serum NSE,S100β levels were significantly lower than those in the control group(P＜0.05).There was no significant difference in the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients between the two groups before treatment(P＞0.05).The peak systolic velocities of common carotid artery,basilar arteryand vertebral artery of patients at 3,7 days after treatment were significantly lower than those before treatment in the two groups(P＜0.05).After 3,7 days after treatment,the peak systolic velocities of common artery,basilar artery,and vertebral artery of patients in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in NIHSS score of patients between the two groups before treatment(P＞0.05).The NIHSS score of patients at 3,7 days after treatment was significantly lower than that before treatment in the two groups(P＜0.05).At 3,7 days after treatment,the NIHSS score of patients in the observation group was significantly lower than that in the control group(P＜0.05).The total incidence of adverse reactions of patients during treatment in the control group and observation group was 7.69％(4/52)and 9.62％(5/52),respectively;there was no significant difference in the total incidence of adverse reactions during treatment of patients between the two groups(x2=0.000,P＞0.05).At 3 months after treatment,the comprehensive living ability of patients in the observation group was better than that in the control group(P＜0.05).Conclusion Neurointer-vention assisted with alteplase thrombolysis in the treatment of AIS patients can significantly improve the treatment efficacy and the expression of neurolin,reduce the degree of neurological impairment and improve comprehensive living ability,and has a certain degree of safety.

Objective:To explore the clinical effects of a single stage reconstruction and revascularization using a free Flow-through chimeric anterolateral thigh perforator (ALTP) flap in Gustillo III C limb injuries.Methods:From January, 2010 to December, 2017, 17 patients with Gustillo III C injury of extremities were repaired with Flow-through chimeric ALTP in emergency surgeries. The patients were 16 males and 1 female with mean age of 32.4 (19-55) years. The size of wounds ranged from 16 cm×8 cm-45 cm×30 cm. The injured arteries were Flow-through anastomosed with the descending branch of the lateral circumflex femoral artery to regain blood flow. The deep dead space was filled with vastus lateralis flap, and the skin flap and fascia flap were used for superficial covering. The donor site was closed directly in 6 patients, simultaneous skin grafts were applied in 11 patients.Results:The followed-up time ranged 5 to 60 (average 21.8) months, and conducted by clinic visits and by telephone or WeChat interviews. Fifteen flaps survived, and 2 flaps failed with limb amputated. Six patients were repaired with skin and fascia flaps and 11 patients received flaps comprising the skin, fascia and vastus lateralis muscle. Four flaps healed in stage I. Partial necrosis were observed in 11 flaps. Of which, 1 healed by change of dressing and 10 healed by skin grafting. No complications occurred in donor site in all patients.Conclusion:The Flow-through chimeric ALTP flap can be used in stage I reconstruction of the blood supply of limbs and meanwhile achieve the 3-D repair of defects. It is one of the reliable methods in the reconstruction of Gustillo III C injuries in the extremities.

Objective:To investigate whether celastrol can increase the cytotoxic activity of γδ T cells against osteosarcoma (OS) cells line HOS through TRAIL way. Methods:The death receptors 4/5 (DR4/5) protein levels in the OS cell lines HOS was in-vestigated by Western blot analysis. Zoledronate ( ZOL) was used to induceγδT cells from PBMCs of healthy volunteers.γδT cell cy-totoxicity against HOS cells was investigated by a standard lactate dehydrogenase release assay ( LDH ) . Results:Celastrol increased DR4/5 protein expression in HOS ( P<0. 05 ) .γδ T cells from PBMCs of healthy volunteers showed cytotoxicity against HOS ( P<0. 05). Following co-culture with HOS pre-treated with celastrol (1 μmol/L) for 24 h,γδ T cells showed significantly higher cytotoxicity against HOS (P<0. 05). The induction of DR4/5 molecules increased lysis of HOS by γδ T cells which was abolished by addition of a blocking TRAIL antibody. Conclusion:Celastrol can enhance γδ T cells'cytotoxic activity against OS cells line HOS through TRAIL way.

BACKGROUND:There are less studies on static magnetic field, and its biological effects are stil unclear. OBJECTIVE:To investigate the static magnetic field effect on the secretion of nerve growth factor from Schwann cel s. METHODS:Schwann cel s were randomly assigned into three groups:0.05 mT sciatic magnetic field group, 0.1 mT sciatic magnetic field group and control group. At 2 days of inoculation, the cel s were exposed to the sciatic magnetic field, 12 hours per day. Cel s in the control group were not exposed to the sciatic magnetic field. After 6 days of exposure, RT-PCR method was used to detect nerve growth factor mRNA expression in Schwann cel s, and ELISA was adopted to detect the level of nerve growth factor secreted from Schwann cel s. RESULTS AND CONCLUSION:The mRNA expression and secreted level of nerve growth factors in the culture supernatant were significantly higher in the two sciatic magnetic field groups than the control group (P<0.05), especial y in the 0.1 mT group. However, there was no difference between the 0.05 mT and 0.1 mT groups (P>0.05). These findings indicate that the static magnetic field with certain intensity can promote the secretion of nerve growth factors from Schwann cel s.

Objective To investigate the cytotoxic activities of γδT cells against methotrexate (MTX)-resistant osteosarcoma (OS) cells.Methods The MTX-resistant U2OS cell line (U2OS/MTX) was established by in vitro exposing the parental cells to MTX at stepwise-increasing concentrations.Periph-eral blood mononuclear cells ( PBMCs) were isolated from healthy subjects and stimulated with zoledronate ( ZOL) in combination with IL-2 to induce the proliferation ofγδT cells.The cytotoxicity ofγδT cells against U2OS/MTX cells was analyzed by using a standard lactate dehydrogenase release assay (LDH).Flow cy-tometry analysis and ELISA were performed to detect the expression of CD69 and IFN-γby γδT cells, re-spectively.Results The γδT cells derived from healthy subjects showed cytotoxicity against the U2OS/MTX cells.Moreover, stronger cytotoxic activities of γδT cells were detected after pretreatment of U2OS/MTX cells with ZOL (1 μmol/L) for 24 hours (P<0.01).Stimulation with U2OS or U2OS/MTX cells in-creased the expression of CD69 onγδT cells and enhanced the secretion of IFN-γbyγδT cells (P<0.05). Increased expression of CD69 and enhanced secretion of IFN-γwere induced in γδT cells in response to stimulation with ZOL-pretreated U2OS/MTX cells (P<0.01).Conclusion TheγδT cells showed cytotox-icity against U2OS/MTX cells.Pretreatment of U2OS/MTX cells with ZOL could enhance the cytotoxic ac-tivity of γδT cells.

Objective To evaluate the clinical efficacy of Qilinxintongshu pill for treatment of critical patients with unstable angina pectoris (UAP) accompanied by upper alimentary tract damage.Methods A prospective randomized controlled trial was conducted. A total of 60 critical outpatients or inpatients with confirmed diagnosis of UAP accompanied by upper alimentary tract damage in Cardiology Department of Hospital of Traditional Chinese Medicine of Qionghai City from November 2011 to January 2015 were enrolled in the study, and they were assigned to a therapy group (30 cases) and a control group (30 cases) by table of random number. The conventional medical basic therapy was given to both groups, in addition, the patients in therapy group took Qilinxintongshu pill (made of notoginseng, dragon's blood, fruit of immature citron, etc.) 5 g once, three times a day, and the patients in control group orally administered clopidogrel 75 mg once a day, the therapeutic course being consecutive 30 days. After treatment, the rates of main cardiovascular events [including death, a newly-happened myocardial infarction (MI), and obstinate ischemia] and events of alimentary damage were compared between the two groups, and adverse effects were observed.Results There was no statistically significant difference in incidence of cardiovascular events between the therapy group and control group [6.7% (2/30) vs. 16.7% (5/30),P > 0.05]. The incidence of massive hemorrhage of gastrointestinal tract was significantly lower in therapy group than that in control group [10.0% (3/30) vs. 36.7% (11/30),P < 0.05]. In the treatment process, there was no significant untoward side effect, and no abnormalities in routine blood and urine tests, liver and renal functions were found.Conclusion Qilinxintongshu pill for treatment of critical patients with UAP accompanied by upper alimentary damage is safe and effective, and does not enhance the incidence of massive hemorrhage of gastrointestinal tract.

Objective:To investigate the effect of typeⅠIFN on the cytotoxic activity ofγδT cells from peripheral blood mono-nuclear cells ( PBMCs) of healthy donors and osteosarcoma patients stimulated by zoledronate ( Zol) and IL-2 against OS.Methods:PBMCs from healthy donors and osteosarcoma patients were stimulated with Zol+IL-2 or Zol+IL-2+typeⅠIFN,respectively.After 14 days of culture,ex vivo expandedγδT cells were assessed by flow cytometry.γδT cell cytotoxicity against target cells was analyzed using a standard lactate dehydrogenase release assay.IFN-γsecreted fromγδT cells was determined by ELISA kits.Results:γδT cells from PBMCs of healthy donors and patients with OS were selectively expanded by Zol+IL-2 or Zol+IL-2+typeⅠIFN in vitro,respectively, and showed cytotoxicity against OS.In addition,γδT cells pre-treated by TypeⅠIFN showed significantly higher cytotoxicity against OS cells.Conclusion:Type I IFN can enhance humanγδT cells’ cytotoxic activity against OS.

Objective To discuss parallel fibular osteoseptocutaneous flap apply in heel defect reconstruction Methods From February,2006 to December,2011,parallel fibular osteoseptocutaneous flap were used to repair calcaneus and skin defects in 4 cases.The causes included road accident in 2 cases and strangulation in 2 cases.The defect locations were at the back of the calcaneus (1/2 of calcaneus in 2 cases and 2/3 in 2 cases,respectively).Results Followed up 24-72 months,all cases achieved bone union in allograft and had no complications of absorption,infection and repulsion.The flaps survived completely in 4 cases ; the distal flaps necrosed partly in 1 case and healed by dressing.According to USA foot-malleolus scores of AOFAS,1 case was excellent,2 good,and 1 fair.Conclusion Parallel fibular osteoseptocutaneous flap reconstruction heel defect can recover patients visage and heel function,improve their life quality.

Objective To observe the therapeutic effect of Qilin Xintongshu pill for treatment of patients with non-ST segment elevation acute coronary syndromes(NSTE-ACS)accompanied by gastrointestinal bleeding (GIB). Methods A prospective randomized controlled trial was conducted. A total of 67 hospitalized patients in Cardiovascular Department of Qionghai City Hospital of Traditional Chinese Medicine were divided into therapy group(35 cases)and control group(32 cases). Both groups were given conventional medical treatment(except anti-coagulative agent). In the therapy group,the patients received Qilin Xintongshu pill(the ingredients consisting of panax pseudo-ginsen,dragon's blood,immature orange fruit,etc.)oral administration,once 5 mg and 3 times a day,while in the control group,the patients accepted clopidogrel orally,once 75 g and once a day,the therapeutic course in both groups being 30 days. The major cardiovascular events(such as death,a newly-happened myocardial infarction(MI),MI secondary,obstinately ischemia)and incidence of massive hemorrhage of gastrointestinal tract were compared between the two groups,and the adverse events were observed. Results After treatment,the incidence of cardiovascular events and massive hemorrhage of gastrointestinal tract in the therapy group were decreased significantly compared to those in the control group 〔incidence of cardiovascular events:8.57%(3/35)vs. 28.13%(9/32), incidence of massive hemorrhage of gastrointestinal tract:2.86%(1/35)vs. 21.88%(7/32),both P<0.05〕. Adverse events were not observed in both groups,and the examinations of blood,urine,liver and renal functions were of no abnormalities before and after treatment. Conclusion Qilin Xintongshu pill can effectively reduce the incidences of cardiovascular events and massive hemorrhage of gastrointestinal tract in patients with NSTE-ACS accompanied by GIB in the therapeutic course of 30 days,therefore this traditional Chinese herbal medicine is an ideal agent for treatment of such disease.

Objective To investigate the effects of metal particles produced by metal prosthesis on oxidative stress levels in human mononuclear cells . Methods Mononuclear cells obtained from peripheral blood of 15 healthy volunteers .Coculture mononu-clear cells with iron particles , cobalt particles , chromium particles , titanium particles and physiological saline , respectively .Levels of reactive oxygen species ( ROS) , malondialdehyde ( MDA) , superoxide dismutase ( SOD) and glutathione peroxidase ( GSH) were as-sessed in mononuclear cells at 6 h, 12 h, 24 h, 36 h, 48 h, respectively . Results Levels of ROS and MDA were higher in the parti-cle groups than that in the control group at 6 h, 12 h, 24 h, 36 h, 48 h, respectively (P<0.05).Levels of ROS and MDA were higher in cobalt particle, chromium particle and iron particle groups than that in the titanium particle group (P<0.05).Levels of SOD and GSH were lower in particle groups than that in the control group (P<0.05).Levels of SOD and GSH were lower in cobalt particle , chromium particle and iron particle groups than that in the titanium particle group (P<0.05). Conclusion Oxidative stress levels increased and anti-oxidant levels decreased in mononuclear cells when cocultured with metal debris .Cobalt particles , chromium parti-cles and iron particles induced higher changes than that in titanium particles .Oxidative stress may play an important role in metal deb-ris-mediated osteolysis .