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 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.

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.

The traditional Chinese medicine safflower is mainly used to promote blood circulation and eliminate meridians obstruction and its effective ingredients,pharmacological activity and application development have attracted much attention,with broad application prospects.Safflower contains quinone chalcones,flavonoids,alkaloids,polyacetylenes,lignans,fatty acids and other chemical components.Modern pharmacological studies have shown that the various pharmacological effects of safflower have been applied in the vascular system,nervous system,immune system diseases and antioxidant,anti-inflammatory,anti-tumor and other aspects.At the same time,safflower seed oil has the function of anti-aging and preventing dietary obesity.This article mainly reviews the research progress on the chemical composition,pharmacological effects,and food health effects of safflower,and summarize the development and application prospects of safflower,in order to provide reference for further research and development of safflower.

Cancer stem cells(CSCs)are a small subgroup of cells capable of initiating cancer and are associated with chemotherapy resistance and cancer recurrence.Cervical cancer is one of the major malignant tumors threatening women's health worldwide.With the popularization of cervical cancer screening,some early cervical cancer and precancerous lesions have been discovered and timely treated,but the treatment and prognosis of mid-to late-stage cervical cancer have not been markedly improved.The treatments of mid-to late-stage cervical cancer are still surgery,radiotherapy and chemotherapy.There-fore,effective targeting strategies for cervical cancer CSCs are increasingly important for monitoring the progress of cervical cancer treatment and evaluating new treatment methods.This article provides a brief review of the role of biomarkers of cervical cancer CSCs in the progression of cervical cancer and their potential as therapeutic targets.

Chuanxiong Rhizoma,the dried rhizome of Ligusticum chuanxiong Hort.(Umbelliferae),has the effects of ac-tivating blood,promoting the circulation of Qi,dispelling pathogenic wind,and relieving pain.Chuanxiong Rhizoma contains phthalides,alkaloids,phenolic acids,and polysaccharides.Pharmacological research indicates that Chuanxiong Rhizoma has various pharmacological activities on the cardiovascular system,nervous system,and respiratory system,which are mainly manifested as anti-cerebral ischemia,anti-thrombosis,analgesia,anti-inflammation,antioxidation,and anti-asthma effects.In this paper,the chemical constituents and pharmacological effects of Chuanxiong Rhizoma are systematically summarized in order to provide references for its clinical application and resource development.

Objective:To investigate the effects of blood glucose target management combined with early hemoperfusion on inflammatory reaction and stress in patients with hyperlipidemic acute pancreatitis (HL-AP).Methods:A prospective cohort study was used. One hundred and fifty-nine patients with HL-AP from September 2019 to September 2022 in Zhoukou Central Hospital Affiliated to Xinxiang Medical University were selected. The patients were divided into group A, B and C by random number table method with 53 cases in each group. All patients were given routine treatment. On this basis, the patients in group A were given blood glucose target management, the patients in group B were given early hemoperfusion, and the patients in group C were given blood glucose target management combined with early hemoperfusion. Before treatment and 7 d after treatment, the inflammatory factors (including interleukin-10, IL-10; interleukin-18, IL-18; tumor necrosis factor-α, TNF-α; soluble intercellular adhesion molecule-1, sICAM-1; procalcitonin, PCT; high mobility group protein B1, HMGB1; nuclear factor-κB p65, NF-κB p65), stress indexes (including lipid hydrogen peroxide, LHP; advanced protein oxidation products, AOPPs; catalase, CAT; glutathione peroxidase, GSH-Px; epinephrine, E and cortisol), intestinal mucosal barrier indexes (including D-lactate; diamine oxidase, DAO; endotoxin) and hemorheological indexes (including platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length) were detected. The recovery indexes (urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time), adverse reactions and curative effect were recorded.Results:There were no statistical differences in the detection indexes before treatment among three groups ( P>0.05). Seven days after treatment, the IL-10, CAT and GSH-Px in group C were significantly higher than those in group A and group B. The IL-18, NF-κB p65, TNF-α, sICAM-1, PCT, HMGB1, LHP, AOPPs, E, cortisol, D-lactic acid, DAO and endotoxin were significantly lower than those in group A and group B with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). Seven days after treatment, the platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length in group C were significantly lower than those in group A and group B, while the indexes in group B were significantly lower than those in group A, with statistical differences ( P<0.05). The urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time in group C were significantly shorter than those in group A and group B: (5.73 ± 0.64) d vs. (7.49 ± 0.89) and (7.26 ± 0.85) d, (2.45 ± 0.31) d vs. (5.76 ± 0.73) and (5.83 ± 0.79) d, (2.69 ± 0.42) d vs. (6.04 ± 0.81) and (6.07 ± 0.82) d, (1.87 ± 0.29) d vs. (3.58 ± 0.45) and (3.65 ± 0.46) d, (15.24 ± 1.76) d vs. (18.61 ± 2.29) and (18.78 ± 2.34) d, with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). The total effective rate in group C was significantly higher than that in group A and group B: 90.57% (48/53) vs. 67.92% (36/53) and 60.38% (32/53), with statistical difference ( P<0.05), but no statistical difference in the total effective rate between group A and group B ( P>0.05). There was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:The blood glucose target management combined with early hemoperfusion in the treatment of HL-AP can effectively reduce inflammatory reaction and stress state, protect intestinal mucosal barrier function, improve blood rheology, and promote recovery.

Purpose/Significance To investigate and study the status quo and existing problems of the whole process intelligent services in outpatient department based on WeChat platform in secondary and tertiary hospitals in Henan province,so as to provide references for im-proving the level of intelligent services in hospitals.Method/Process By using literature research and network investigation methods,the service functions provided by WeChat platform are summarized,and the intelligent service provision of WeChat platform before,during and after diagnosis in 190 secondary and tertiary hospitals in Henan province is investigated and analyzed.Result/Conclusion WeChat platform has become an important tool for hospitals to practice intelligent services,but it is still necessary to further improve core services such as ap-pointment registration,strengthen the construction of intelligent services after diagnosis,promote the balanced development of intelligent services in hospitals at all levels,uphold the service concept of"whole process accompany",and optimize intelligent escort services.