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Traumatic central nervous system injury, including traumatic brain injury and spinal cord injury, has extremely high disability and mortality rates. The huge medical expenses and sequelae further aggravate the economic and psychological burden of patients and their families. Current treatments for traumatic central nervous system injury include surgical therapy, physical therapy, medication and post-rehabilitation treatment, but none of them can achieve ideal efficacy, and more effective treatment is urgently needed. Ferroptosis, as one of the newly discovered modes of programmed cell death, has been shown to play a crucial role in secondary injury to the traumatic central nervous system, but its clinical transformation is limited. This article summarizes the research results of ferroptosis inhibitors, points out the types and effects of them, to provide new ideas for clinical treatment of traumatic central nervous system injury and drug development.

Based on the data from conventional observation, ground intensive observation, and the Doppler weather radars in Suqian, Huai'an and Yancheng, Jiangsu Province, the present study analyzed the tornado that happened on July 22, 2020 in northern Jiangsu Province. The research shows that: (1) The favorable environmental fields of this tornado included a strong 0~1 km vertical wind shear in the lower layer, sufficient water vapor in the middle and lower layers, low uplift condensation height, and strong convergence and upward movement. At the early stage, the continuous precipitation and cold air intrusion in the middle layer strengthened the stratification instability, providing a humid and unstable environment for the tornado. (2) The convective storm that caused the tornado originated near the surface convergence line. There were small-scale local vortices in the vicinity of the tornado and the ground convergence center moved eastward along the ground convergence line. Before and after the tornado, the surface wind speed near the surface vortex suddenly increased, the wind direction suddenly changed, the air pressure significantly decreased, and there was short-term heavy precipitation. (3) The supercell that caused the tornado had a life history of 3 hours. During its eastward movement, it was accompanied by deep mesocyclone and showed tornadic vortex signature (TVS). The first mesocyclone was detected in the middle of the storm, about 2.6 km in height, and then it gradually stretched vertically. The TVS bottom height was maintained at about 1km, and the intensity was maintained at about 60 ×10-3 s-1. When the base height of the mesocyclone is low and the shear value continues to be strong, combined with the evolution of the ground mesoscale system, it is possible to provide effective early warning of tornadoes. [ABSTRACT FROM AUTHOR]

Objective The study is to observe the effect of nitric oxide (NO) donor and scavenger to the hypo-glossal motor nucleus (HMN) activity and explore the underlying mechanism. Methods Male adult anesthetized Wis-tar rats were anesthetized. The activity of genioglossus (GG), diaphragma, blood pressure (BP) and respiratory rate (RR) were recorded when constant microdialysis perfusion of artificial cerebrospinal fluid (ACSF) to HMN as control, fol-lowed with diethylamine NONOate sodium salt hydrate (DEA), a NO donor, and 2-(4-carboxyphenyl) -4,4,5,5-tetra -methylimidazoline -1 -oxyl -3 -oxide potassium salt (carboxy-PTIO), a NO scavenger. Results Compared with ACSF, application of DEA and carboxy-PTIO at HMN increased and decreased the GG activity respectively and significantly (P<0.05), mainly respiratory-related activity. The tonic GG, diaphragma activity, BP and RR had not been affected statistically between 30-120 min when microdialysis perfusion of both DEA and carboxy-PTIO were delivered. Con-clusion Acting as an excitatory neurotransmitter of HMN, NO may contribute to the patency of upper airway phy-siologically. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical manifestations and genetic characteristics of patients with congenital central hypothyroidism due to variants of IGSF1 gene., Methods: Clinical data, results of genetic testing, and follow-up of four patients admitted to Children's Hospital of Soochow University during 2017 to 2021 were retrospectively analyzed., Results: All of the four patients were males. Patient 1 had presented neonatal jaundice, patients 2 and 3 were admitted for growth retardation during childhood, and thyroid function test indicated slightly low free thyroxine (FT4), patient 4 was found to have reduced FT4 in the neonatal period. Genetic testing revealed that all of the four patients have harbored pathogenic variants of the IGSF1 gene, which were all inherited from their mothers. The thyroid functions in all patients were well controlled with oral levothyroxine and regular follow-up., Conclusion: Pathogenic variants of the IGSF1 gene probably underlay the congenital central hypothyroidism with a variety of clinical manifestations, and genetic testing can facilitate the diagnosis at an early stage.

Objective: To analyze the clinical and genetic characteristics of five Chinese pedigrees affected with short stature., Methods: A retrospective analysis was carried out for the clinical data and results of genetic testing for the probands. A literature search was also conducted., Results: The five probands have all featured short stature with a family history. Genetic testing has revealed that they have harbored variants of the ACAN gene, including p.Val2042Argfs*6, p.Val1597del, c.630-1G>A, c.23delT and c.2026+1G>A(previously reported)., Conclusion: Except for short stature, children harboring heterozygous variants of the ACAN gene may have no involvement of other systems. Some of these children may response to short-term growth hormone treatment.

Objective: To investigate the effects of nicotinamide (NAM) on blood glucose level and anti-oxidative enzyme activity in gestational diabetic (GDM) rats. Methods: GDM model was induced by injection of STZ (35 mg/kg) in pregnant female Sprague-Dawley rats. Nicotinamide was given to GDM rats by gavage at 50, 100 or 200 mg/kg q.d from gestational d 6 to d 20. The rats were divided into normal control group, GDM group (0 mg/kg), low-dose NAM group (50 mg/kg), middle-dose NAM group (100 mg/kg) and high-dose NAM group (200 mg/kg) with 8 animals in each group. When rats were sacrificed at d 21, the blood glucose level was measured; skeletal muscle and fetal brain samples were collected. The expression and activity of anti-oxidative enzymes, including superoxide dismutase (SOD1, SOD2), catalase (CAT) and sirtuin-3 (SIRT3) were measured by RT-PCR and Western blot. Results: Nicotinamide significantly lowered the blood glucose in GDM rats and decreased mitochondrial superoxide level in the fetal cortical neurons. SOD2 was induced in skeletal muscle by nicotinamide in GDM rats ( P <0.05), while no significant change was observed in the expression of CAT ( P >0.05). Nicotinamide increased SIRT3 expression ( P <0.05) and decreased deacetylation of SOD2 in skeletal muscle of GDM rats ( P <0.05). Conclusion: Nicotinamide can lower the blood glucose level in GDM rats, and decrease mitochondrial superoxide level, which is associated with promoting SIRT3 activity to deacetylate SOD2 and elevate SOD2 activity in GDM rats.

Objective: To evaluate efficacy and outcome of endovascular therapy for complex arteriosclerosis obliterans of the lower extremities., Methods: In this single-center retrospective study, the clinical data of consecutive 114 cases with TASC II type C/D lower extremity obstructive disease and clinical stage of Fontaine ≥ IIb and ankle brachial index <0.9 underwent endovascular therapy from December 2011 to January 2013 were collected. Telephone or clinic interviews were conducted to investigate the clinical outcomes., Results: There were 39 TASC II type C patients and 75 TASC II type D patients, 78 patients were in Fontaine IIb, 30 patients in Fontaine III and 6 patients in Fontaine IV stages. Immediate procedural success rate was 94.9% (131/138). Ankle brachial index was increased from 0.54 ± 0.26 at baseline to 0.83 ± 0.30 at discharge (P < 0.01). No adverse event was observed during the perioperative period. During (15.7 ± 8.7) months follow-up, cumulative patency rate of 6, 12 and 18 months was 75.8% (94/124) , 68.7% (68/99) and 39.2% (20/51) respectively and limb salvage rate was 100%., Conclusion: Endovascular therapy for complex arteriosclerosis obliterans of the lower extremities is effective and safe.

Background: Targeted therapy in non-small cell lung cancer (NSCLC) had become a research hotspot. Both of gefitinib and erlotinib had already been recommended as first line treatment in epidermal growth factor receptor (EGFR) mutant advanced NSCLC patients. The study aimed to compare the effectiveness and prognosis of advanced NSCLC with gefitinib or erlotinib, as well as the cost-effectiveness ratio of the two drugs., Methods: Data of 66 EGFR mutant NSCLC patients who were included in Guangzhou medical insurance were analyzed. The efficacy and adverse reactions were evaluated. All the patients were followed-up regularly and the cost of the treatment was recorded., Results: The median progression free survival (PFS) of all patients was 15.0 months. 49 patients received gefintib and 17 patients had erlotinib. The PFS for the two groups of patients was 17.5 month and 13 months, respectively (P=0.459). 31 (62.3%) patients had rash in gefitinib group, 16 (94.1%) in erlotinib group. Cost-effectiveness ratio (CER) in gefitinib group was 3,027 RMB per month, while 6,800 RMB in erlotinib group. The incremental cost-effectiveness ratio (ICEA) of erlotinib was 2.25 times of gefitinib., Conclusions: For EGFR mutant advanced NSCLC patients, equal efficacy and survival benefit were observed in patients with gefitinib and erlotinib. The adverse reaction was milder in gefitinib group than that of erlotinib group. And with Guangzhou medical insurance, gefitinib had a superior cost-effectiveness ratio.

Objective: The study is to observe the effect of nitric oxide (NO) donor and scavenger to the hypoglossal motor nucleus (HMN) activity and explore the underlying mechanism., Methods: Male adult anesthetized Wistar rats were anesthetized. The activity of genioglossus (GG), diaphragma, blood pressure (BP) and respiratory rate (RR) were recorded when constant microdialysis perfusion of artificial cerebrospinal fluid (ACSF) to HMN as control, followed with diethylamine NONOate sodium salt hydrate (DEA), a NO donor, and 2-(4-carboxyphenyl)-4,4,5,5-tetra-methylimidazoline-1-oxyl-3-oxide potassium salt (carboxy-PTIO), a NO scavenger., Results: Compared with ACSF, application of DEA and carboxy-PTIO at HMN increased and decreased the GG activity respectively and significantly (P<0.05), mainly respiratory-related activity. The tonic GG, diaphragma activity, BP and RR had not been affected statistically between 30-120 min when microdialysis perfusion of both DEA and carboxy-PTIO were delivered., Conclusion: Acting as an excitatory neurotransmitter of HMN, NO may contribute to the patency of upper airway physiologically.

Objectives: To evaluate the safety and short-term efficacy of stent revascularization as treatment for renal artery stenosis., Methods: Percutaneous transluminal renal angioplasty with stent (PTRAS) was performed on 30 consecutive patients with severe renal artery stenosis for poorly controlled hypertension or preservation of renal function. They subsequently underwent 3-month clinical follow-up for the effect of the procedure on renal function, blood pressure control and the number of antihypertensive medications used., Results: Angiographic success was obtained in 29 (96.7%) of the 30 patients after PTRAS. 3 months after the procedure systolic and diastolic blood pressures significantly decreased (from 173.5 to 135.8 mm Hg and from 95.8 to 75.6 mm Hg, respectively; P < 0.001) and less antihypertensive medications were taken (from 2.5 to 1.5). Blood pressure in 5 (16.7%) of the 30 patients became normal without taking any antihypertensive medication and blood pressure control was more facile in 22 (73.3%) of the patients. However, there was no improvement in 3 (10.0%) of the patients. Creatinine slightly decreased in 2 (6.7%) of the 30 patients and remained stable in 28 (93.3%) of the 30 patients. There was no statistical significance in this respect., Conclusions: Renal artery stent revascularization has a short-term beneficial effect on blood pressure control and a nondeleterious effect on renal function. The long-term efficacy should be investigated. The procedure is safe in usual.