Objective:To investigate the efficacy and safety of sequential treatment with tirofiban and argatroban in acute isolated pontine infarction (AIPI) caused by branch atheromatous disease (BAD).Methods:Consecutive patients with AIPI caused by BAD within 48 h of onset and admitted to Zhengzhou Central Hospital from April 2021 to April 2022 were enrolled retrospectively. The patients were divided into sequential treatment group and tirofiban group according to their therapeutic modalities. In the tirofiban group, tirofiban was pumped intravenously within 48 h after admission, and dual antiplatelet therapy with aspirin and clopidogrel was added 4 h before tirofiban was discontinued. On the basis of tirofiban treatment, the sequential treatment group was followed by argatroban for 5 days when tirofiban is discontinued. The main outcome measure was the modified Rankin Scale (mRS) score at 3 months after the onset . A score of <2 was defined as a good outcome. The secondary outcome measure was all the adverse events during the treatment and follow-up. Multivariate logistic regression analysis was used to determine the independent factors of the outcomes. Results:A total of 64 patients with AIPI caused by BAD were enrolled, including 32 in the sequential treatment group and 32 in the tirofiban group. There was no statistical difference in baseline data between the two groups, but the rate of good outcomes at 3 months after onset in the sequential treatment group was significantly higher than that in the tirofiban group (78.1% vs. 50.0%; χ2=5.497, P=0.019). Multivariate logistic regression analysis showed that after adjusting for low-density lipoprotein cholesterol, the higher baseline National Institutes of Health Stroke Scale score was independently associated with the poor outcomes (odds ratio 2.067, 95% confidence interval 1.343-3.182; P=0.001), while the sequential treatment was independently associated with the good outcomes (odds ratio 0.248, 95% confidence interval 0.064-0.957; P=0.043). Conclusion:Early application of sequential treatment with tirofiban and argatroban in AIPI caused by BAD may effectively improve the outcomes of patients, and the safety is good.

Objective To investigate clinical significance of combined detection of serum C 3bR and IL-6 in patients with traumatic brain injury.Methods 48 patients with TBI admitted in 371 Central Hospital of PLA from May 2016 to May 2017 were randomly selected as the subjects,including 26 males and 22 females,aged 25 to 60 years,with an average age of(43.7 ± 5.8)years.Admission according to the injury by Glasgow coma score(GCS):≤7 points in 18 cases,≥8 points in 30 cases.Another 30 healthy people who were admitted to the hospital for the same period were selected as the control group.Serum C3bR and IL-6 levels were meas-ured by ELISA in the study group at 1,3 and 7 days after admission,and the expression of C3bR and IL-6 were analyzed.Results The level of serum C3bR in the first and the third day after traumatic brain injury was significantly lower than that in the control group,and the level of IL-6 after craniocerebral injury was signifi-cantly higher than that of the control group(P<0.05).In the observation group,the level of C3bR was signif-icantly higher than that of ≤ 7,and the level of IL-6 was significantly lower than that of the severe GCS score ≥8(P<0.05).In this study,the serum C3bR,IL-6 and the two joint tests were 0.624,0.641 and 0. 900,respectively area.Conclusion Serum C3bR and IL-6 combined detection can significantly improve the sensitivity of traumatic brain injury diagnosis,so as to understand the severity of traumatic brain injury,w hich could help to assess the disease and determine the prognosis,and have important clinical value.

Objective To study the change of serum lipoprotein-associated phosphorlipase A2 (Lp-PLA2) and neuron specific enolase (NSE) and its clinical significance in patients with acute cerebral infarction (ACI).Methods Fifty-two ACI patients served as ACI group and 45 subjects undergoing physical examination served as control group.The patients in ACI group were further divided into mild ACI group (n =10),moderate ACI group (n =26) and severe ACI group (n =16) according to their NIHSS score.Relationship of serum Lp-PLA2 and NSE levels with NIHSS score in ACI patients was analyzed.Results The serum Lp-PLA2 and NSE levels were significantly higher in ACI group than in control group (289.3±19.4 μg/L vs 123.4±28.4 μg/L,22.1±2.8 μg/L vs 7.2±1.9 tμg/L,P＜0.05),and in moderate and severe ACI group than in mild ACI group (P＜0.05).The serum Lp-PLA2 and NSE levels and NIHSS score were significantly higher on days 2-7 than on day 1 after treatment (P＜0.05) and significantly lower on days 6 and 7 than on day 5 after treatment (P＜0.05).Pearson correlation analysis showed that serum Lp-PLA2 and NSE level were positively related with NIHSS score in ACI group (r =0.788,P =0.035;r=0.950,P=0.001).Conclusion Lp-PLA2 and NSE play an important role in the occurrence and progression of ACI,and are closely related with the severity and outcome of ACI,which can thus provide reference for the treatment,outcome and assessment of ACI.

Objective:To explore the latent categories of child security and analyze domain-specific roles of child neglect on security among children aged 10-13 years.Methods:From October to December 2019, the security questionnaire (SQ), child neglect scale (CNS) and Buss-Perry aggression questionnaire (BPAQ) were used to investigate 577 children aged 10-13 years. Mplus 7.0 software was used for latent profile analysis (LPA) to explore the latent categories of child security. SPSS 22.0 software was used for multinomial Logistic regression to examine the effects of different domains of child neglect on the child security categories.Results:(1) Child security was divided into three categories named "medium-slightly low-security subgroup (48.9%)" , "high-security subgroup (31.8%)" , and "inability control subgroup (19.3%)" (entropy = 0.90, Lo-Mendell-Rubin likelihood, and Bootstrapped likelihood ratio test, all P<0.01). (2) Child security(35.06±6.08, 51.49±4.99, 69.67±6.13, F=1 378.09, P<0.01), neglect(71.09±20.58, 59.96±12.90, 50.76±9.27, F=74.50, P<0.01), and aggression(54.31±15.23, 46.44±12.46, 34.19±12.61, F=90.95, P<0.01) were significantly different among the "medium-slightly low-security subgroup" , "high-security subgroup" , and "inability control subgroup" . (3)Compared with "high-security subgroup" , the proportion of children with poor parental relationship and low paternal education level were higher in the other two subgroups(all P<0.05), while the proportion of children in the fifth grade were lower(all P<0.05). (4)In " inability control subgroup" , safe neglect had no impact on security( B=0.01, OR=1.02, 95% CI=0.91-1.13, P>0.05), while physical neglect ( B=0.13, OR=1.14, 95% CI=1.01-1.28), affection neglect( B=0.14, OR=1.15, 95% CI=1.07-1.23), and communication neglect( B=0.15, OR=1.16, 95% CI=1.03-1.30) predicted the "inability control subgroup" (all P<0.05). Only communication neglect predicted the "medium-slightly low-security subgroup" ( B=0.16, OR=1.17, 95% CI=1.07-1.28, P<0.01). Conclusion:Security is heterogenous with three latent categories among Children aged 10-13 years. Child neglect plays domain-specific roles in different child security categories.

Objective:To investigate the function of the expression rate of vitamin D, T helper cell 17 (Th17) and regulatory T cells (Tregs) and the serum level of tumor necrosis factor-α (TNF-α) and monocyte chemotactic protein-1 (MCP-1) in the pathogenesis of adolescents with multiple sclerosis (MS).Methods:Thirty-eight adolescent patients diagnosed with MS in the Department of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from January 2010 to December 2020 were selected as the MS group, and 38 healthy adolescents matched with age and body mass index were selected as healthy control group.The level of 25-hydroxyvitamin D 3 [25-(OH)D 3] was measured by liquid chromatograph; the expression rates of Th17 and Tregs were measured by flow cytometry; the serum levels of TNF-α and MCP-1 were measured by immunofluorescence.SPSS 22.0 statistical software was adopted to analyze the differences between the above indicators and their correlation in the MS group and the healthy control group. Results:There was no difference in the level of 25-(OH)D 3 in peripheral blood between the MS group and the healthy control group( P>0.05). As for the MS group, the expression rate of Th17 was significantly higher than that in the healthy control group [(3.02±0.20)% vs.(1.99±0.16)%, t=12.03, P<0.05]; the expression rate of Tregs in peripheral blood was significantly lower than that in the healthy control group [(4.63±0.77)% vs.(5.10±0.90)%, t=14.65, P<0.05]; the ratio of Th17 to Tregs was significantly higher than that in the healthy control group (0.25±0.07 vs.0.17±0.05, t=16.89, P<0.05); the levels of TNF-α and MCP-1 in peripheral blood were higher than those in the healthy control group [(26.13±5.98) ng/L vs.(24.45±3.01) ng/L; (122.26±37.71) ng/L vs.(87.95±17.66) ng/L, t=1.986, 47.650, all P<0.05]. In the MS group, 25-(OH)D 3 in peripheral blood was not correlated with other test indicators; the levels of TNF-α and MCP-1 were higher in patients with relapsing or progressive disease than in patients with stable disease in remission [(17.49±3.94) ng/L vs.(14.45±3.81) ng/L; (90.42±23.06) ng/L vs.(77.55± 20.56) ng/L, t=1.990, 2.472, all P<0.05]; the expression rate of Th17 cells was positively correlated with the level of TNF-α and MCP-1 in peripheral blood ( r=0.478, 0.442, all P<0.05); the expression rate of Tregs was negatively correlated with the level of TNF-α and MCP-1 in peripheral blood ( r=-0.318, -0.356, all P<0.05). Conclusions:Th17 and Tregs may be involved in the immunopathological mechanisms in the pathogenesis of adolescents with MS; changes in associated cytokines may be involved in the regulation of Th17 and Tregs changes and the inflammatory response; Th17 and Tregs and associated cytokine changes may play an important role in the occurrence, progression, and relapse progression of MS as an immunopathological mechanism.

5-hydroxytryptamine(5-HT)is a monoamine neurotransmitter,which plays a key role in regulating gastroin-testinal motility,antioxidation and immunomodulation.Inflammatory bowel disease(IBD)is characterized by repetitive epi-sodes of inflammation of the gastrointestinal tract,and its pathogenesis hasn't been illustrated completely.In recent years,the role of 5-HT in the development of IBD has drawn attention gradually.Therefore,this article reviews the advances of 5-HT in the pathogenesis of IBD and focuses on the pathways of autophagy,oxidative stress,inflammatory reaction,endoplasmic reticu-lum stress and gut microbiota through which 5-HT causes IBD,with the hope of providing insights for identifying novel prognos-tic biomarkers and exploring new therapies.

Radix et Rhizoma Rhei is one of the major Chinese medicinal herbs,with a long medicinal history and extensive clinical application.It has the effects of purgation,clearing heat and fire,cooling blood and detoxifying,expelling stasis and channeling meridian,diuresis and retreating yellow,etc.Its chemical constituents mainly include anthraquinones,anthrones,stilbenes,benzophenones,polysaccharides,tannins,and volatile oils.The pharmacological effects mainly include purgation,anti-inflammation,anti-tumor,lipid regulation,renal protection,liver protection,and anti-angiogenesis.This article summarizes the main chemical constituents and modern pharmacological effects of Radix et Rhizoma Rhei,aiming to provide a reference for the research of clinical use and pharmacological effects of Radix et Rhizoma Rhei.

Pulmonary hypertension(PH)is a cardiovascular disease characterized by persistent elevation of pulmonary artery pressure and pulmonary vascular resistance,and its pathological basis is remodeling of the pulmonary vasculature.Puerarin,the main active ingredient in Pueraria Mirifica,has been shown to have significant cardioprotective effects,and its mechanism may be to reduce inflammatory response,oxidative stress,and myocardial cell apoptosis.This paper reviews the research progress on the molecular mechanism of puerarin in the treatment of PH,with the aim of providing new strategies and theoretical basis for the clinical treatment of PH.

Rehmannia glutinosa,belonging to the genus Rehmannia(family Scrophulariaceae),is a widely used Chinese medical herb that is included in the list of medicine and food homology substances in China.First described in Shennong's Classic of Materia Medica,it has been widely used clinically now.Mainly produced in Henan,Hebei,Shandong and Shanxi,the Rehmannia glutinosa in Huaiqing Prefecture(an ancient administrative district)of Henan is the most authentic,and it is listed as one of the four famous Chinese herbs produced in the Huaiqing area.In recent years,with the comprehensive and in-depth study of Rehmannia glutinosa by scholars at home and abroad,its diverse chemical constituents,extensive pharmacological actions,development and application have attracted much attention.In this paper,the relevant literature on the main chemical constituents and pharmacological activities of Rehmannia glutinosa is reviewed,in order to provide references for related research.

Objective:To evaluate the effect of personalized health education on self-management of young and middle-aged patients with allergic rhinitis.Methods:From November 2018 to November 2020, convenience sampling was used to select 105 young and middle-aged patients with allergic rhinitis treated in Henan Provincial Hospital of Traditional Chinese Medicine as the research object. The patients were divided into the control group (52 cases) and the observation group (53 cases) by random number table method. The control group was given routine nursing, and the observation group carried out personalized health education on the basis of the control group. Post-nursing self-efficacy, self-care ability, quality of life and nursing satisfaction were compared between the two groups.Results:After nursing, the scores of self-efficacy, self-care ability and quality of life, and nursing satisfaction in the observation group were higher than those in the control group, with statistical differences ( P<0.05) . Conclusions:Implementing personalized health education for young and middle-aged allergic rhinitis patients can improve their self-efficacy, self-care ability, quality of life and satisfaction with nursing.