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 whether iron mass induces HO-1 overexpression and explore the role of HO-1 in rat intracerebral hemorrhage(ICH). Methods In this study,144 hydrated chloride aldehyde-anesthetized Sprague- Dawley rats were used,autologous blood were injected into the right caudate nucleus to establish the ICH model.Saline injection and health were served as controls.Deferoxamine(DFO)with an intraperitoneal injection served as intervention group.Enhanced Perl's reaction was used for iron staining and brain iron deposits were determined.Brain HO-1 level were examined by immunohistochemical analysis and reverse transcription polymerase chain reaction(RT-PCR). Results There was a 21-fold increase in iron deposits around the hematoma 7 days after the infusion of 100 μl of autologous blood.Markedly increased levels of perihematomal HO-1 immunoreactivity and HO-1 mRNA in all ICH rats were detected at 3-14 days.The addition of DFO significantly reduced iron deposits in the ipsilateral basal ganglia at 7-14 days after ICH.DFO also inhibited HO-1 overexpression at day 7,14.Correlations test showed that there were positive correlations of iron sediments with HO-1mRNA(r=0.647)and HO-1 immunopositive cells(r=0.209). Conclusions ICH causes iron accumulation in the brain.Iron overloading may induce HO-1 upregulation after ICH.Ratherly,the HO-1 moderate increasing possibly fits with the events,whereas HO-1 overexpression may result in its dysfunction.It may be prudent to intervene ICH with HO-1 inhibitor.

Objective To investigate the iodine nutrition status of school-age children in Anyang,and analyze its related influencing factors.Method Monitoring data on urinary iodine of school-aged children and iodized salt were collected from 2011 to 2015,its general situation was described,and differences in age,sex,residential area type and year were compared.Results Totally 13 371 iodized salt samples were collected in Anyang City from 2011 to 2015,and 12 205 were qualified iodized salt.The median of iodized salt was 26.91 mg/kg.Totally 1 282 urinary iodine samples of school-age children were monitored in Anyang City,and its median of urinary iodine was 237.0 μg/L,the constituent ratio of urinary iodine of children under 100 μg/L and above 300 μg/L was 14.5％(186/ 1 282) and 35.3％ (452/1 282),respectively,the results of urinary iodine were different in different years,and the differences were statistically significant (x2 =36A1,P＜ 0.05);the differences of the residential area type,sex and age had no influence on the urinary iodine of school-age children,and the differences were not statistically significant (Z =-1.07,-0.94,x2 =6.50,P ＞ 0.05).Conclusion The iodine-nutritional status of school-age children is more than adequate,the concentration of urinary iodine is high,and the differences of the residential area type,sex and age have no influence on the urinary iodine of school-age children.

Intracranial arterial dolichoectasia, also known as dilated cerebral artery disease, is characterized by an increase in the length and diameter of at least one intracranial artery, and the involved intracranial arteries enlarge and dilate. Cerebral small vessel disease mainly refers to diseases caused by small vessel lesions in the brain. It is usually used to describe a series of imaging changes of white matter and subcortical gray matter, including recent subcortical small infarction, lacuna, white matter hyperintensity, enlarged perivascular space, cerebral microhemorrhage, and cerebral atrophy. Recently, more and more studies have shown that there is a certain correlation between intracranial arterial dolichoectasia and cerebral small vessel diseases.

Objective To investigate the iodine nutritional status of rural residents in Anyang City of Henan Province,and to provide theoretical basis for making policy adjustment on iodine supplement. Methods In 2015, Tangyin County and Anyang County were chosen from Anyang City, one township was selected from each county based on five orientations of east, west, south, north and centre, four villages were chosen from each township,15 households were taken from each village, and kitchen salt samples were collected to detect salt iodine;tap water samples were collected to detect water iodine.In the selected county,one medical institution was selected, 100 women of childbearing age,pregnant women,lactating women and infants aged 0-2 years old were selected to detect urinary iodine; one primary school was selected in the selected township, and 20 children aged 8 - 10 years old were selected to detect urinary iodine. Salt iodine was determined using direct titration (GB/T 13025.7-1999);urinary iodine and water iodine were determined using arsenic cerium catalytic spectrophotometry(WS/T 107-2006). Results A total of 600 salt samples were collected, half from Anyang County and half from Tangyin County, the medians of salt iodine were 27.59,29.15 mg/kg,respectively,the difference was statistically significant(Z = - 4.92, P <0.05).A total of 47 water samples were collected,21 from Anyang County and 26 from Tangyin County,the medians of water iodine were 9.44,5.37 μg/L,respectively,the difference was not statistically significant(Z=-0.30, P > 0.05). A total of 985 key people were surveyed, children, women of childbearing age, pregnant women, lactating women and infants were 200, 205, 197, 187, 196, respectively, the medians of urinary iodine were 253.05, 249.80, 177.10, 266.40, 247.85 μg/L, respectively, the differences were statistically significant (χ2=29.76, P < 0.05). Urinary iodine levels of childbearing age women (226.60,313.85 μg/L),lactating women(230.85,286.20 μg/L) and infants (222.35, 275.35 μg/L) were compared between Anyang County and Tangyin County, the differences were statistically significant (Z=3.33,2.21,3.13,P<0.05).Conclusion The iodine nutritional status of rural residents in Anyang City is basically good,but the urinary iodine levels of general population are high.

With the development of imaging, molecular biology, and pathology, the pathogenesis of cerebral small vessel disease (CSVD) has been deeply understood, but the exact pathogenesis is still unclear. This article reviews the pathogenesis of CSVD, including oxidative stress, inflammatory reaction, amyloid beta amyloid deposition, vascular endothelial dysfunction, and blood-brain barrier damage.

Objective To explore the sleep structure characteristics and risk factors in patients with Parkinson disease psychosis (PDP).Methods Fifty-one patients with Parkinson disease were enrolled.Sixteen cases met the diagnostic criteria of Parkinson disease psychosis were included in the PDP group,while the remaining 35 cases were included in the PD group as the control group.Sleep status was monitored by polysomnography.Neuropsychological assessment of patients with Parkinson disease was performed by Parkinson quality of life questionnaire,Montreal cognitive assessment(MoCA)and Hoehn-Yahr state (H-Y) of Parkinson disease.Results There were statistically significant differences in age of onset in PD group and PDP group (64.11±8.87,57.44±10.07,t=1.242),course of disease (2 (1,4),6 (4,7),Z=-3.888),HY stage (2 (1.5,2.5),3 (2,3),Z=-2.487)(all P＜0.05).The total sleep time in the PDP group was lower than that in the PD group ((344.06±26.39)min,(361.74± 17.16)min,P＜0.05).Compared with the PD group,the proportion of slow wave sleep phase Ⅰ in the PDP group was bigger ((42.88 ± 7.99) ％,(37.14±5.21) ％,t=-3.065),and the proportion of slow wave sleep phase Ⅱ in the PDP group was smaller ((31.19±5.92) ％,(37.51±5.70) ％,t=3.634) (P＜0.05).Single factor binary logistic regression analysis showed that the course of disease,age of onset,RBD,HY stage,PDQ-39 questionnaire score,total sleep time,slow wave sleep stage Ⅰ (％) and slow wave sleep stage Ⅱ (％) were the risk factors of PDP (P＜0.05).Multivariate binary logistic regression analysis showed that the course of disease and RBD were independent risk factors for patients with PDP (P＜ 0.05).Conclusion Sleep structure changes in patients with PDP,and RBD is the independent risk factor for patients with Parkinson's psychotic disorders.