Objective To investigate the correlation between levels of intercellular adhesion molecule-1 (ICAM-1), platelet surface P-selectin (CD62P), and inflammatory factors and cerebral artery stenosis in patients with acute cerebral infarction (ACI). Methods A total of 305 patients with ACI complicated with cerebral artery stenosis admitted to Zhongwu Hospital of Suqian City and Xinyi People's Hospital from January 2021 to December 2023 were selected as the research subjects. According to the degree of cerebral artery stenosis, they were divided into grade I group (stenosis degree<50%, n=85), grade II group (stenosis degree of 50%-75%, n=128), and grade III group (stenosis degree>75%, n=92). Sixty-eight ACI patients without cerebral artery stenosis during the same period were included in the reference group. The levels of serum inflammatory factors [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8)], ICAM-1 and CD62P were compared among the four groups. Spearman analysis was used to analyze the correlation between each factor and degree of cerebral artery stenosis. Results The levels of CRP, TNF-α, IL-6, IL-8, ICAM-1 and CD62P in the grade I, II and III groups were higher than those in the reference group. The levels of these factors were higher in the grade II and III groups than those in the grade I group, while the levels of various factors were higher in the grade III group than those in the grade II group (P<0.05). Spearman analysis showed that CRP, TNF-α, IL-6, IL-8, ICAM-1, and CD62P were positively correlated with the degree of cerebral artery stenosis in patients with ACI complicated with cerebral artery stenosis (P<0.05). Conclusion The levels of serum inflammatory factors, ICAM-1 and CD62P are significantly correlated with cerebral artery stenosis degree in patients with ACI.

ObjectiveTo explore the longitudinal measurement invariance of standardized Constitution in Chinese Medicine Questionnaire （CCMQ） among Chinese adult populations， and to provide evidence for the longitudinal effect analysis of this questionnaire. MethodsA total of 509 adults who voluntarily received 26 weeks of comprehensive traditional Chinese medicine （TCM） constitution fitness intervention were included （3 time points： before intervention， 13 weeks intervention， and 26 weeks intervention）， evaluated by CCMQ with 9 subscales. A single-group confirmatory factor analysis was performed to establish a single-group baseline model with a well-fitting model， and then nested models， that is multiple groups of confirmatory factors analysis， are used to analyze the longitudinal measurement invariance， followed by configural invariance， metric invariance， scalar invariance， and strict invariance. Comparative Fit Index （CFI）， Root Mean Square Error of Approximation （RMSEA）， and Standardized Root Mean Square Residual （SRMR） were used as model fit indicators for the analysis. ResultsThe single-group confirmatory factors analysis proved that the 9 subscales of CCMQ fit well at the three time points （CFI： 0.933~0.992， RMSEA： 0.027~0.080， SRMR： 0.022~0.045）. The multiple-group confirmatory factors analysis showed that the configural， metric， scalar， and strict invariance across time of qi-stagnation and special diathesis constitution were established （ΔCFI＜0.01， ΔRMSEA＜0.01）； the configural， metric， scalar， and partial strict invariance across time of phlegm-dampness constitution subscale were established （ΔCFI＜0.01， ΔRMSEA＜0.01）； the configural， metric， partial scalar and partial strict invariance of 6 subscales， including gentleness， qi-deficiency， yang-deficiency， yin-deficiency， dampness-heat， and blood-stasis constitutions， were all established （ΔCFI＜0.01， ΔRMSEA＜0.01）. ConclusionThe CCMQ met at least metric invariance at 3 time points， which can be applied to the study of whether different time points have the same unit or meaning. The measurement invariance of the 3 subscales of phlegm-dampness， qi-stagnation and special diathesis， special diathesis have longitudinal measurement invariance， so the mean comparison over time could be made； while the 6 subscales of gentleness， qi-deficiency， yang-deficiency， yin-deficiency， dampness-heat， and blood-stasis constitutions meet partial scalar and partial strict invariance， which could be explained partially for the difference in the comparison of the mean over time.

To observe whether PCSK9 inhibitor combined with statin therapy can bring additional benefits on near-term clinical prognosis in patients with acute cerebral infarction，in order to provide clinical data on the effects of PCSK9 inhibitors in the early treatment of patients with cerebral infarction. Methods124 patients with acute cerebral infarction admitted to the neurology ward of our hospital from December 2020 to July 2021 were included as study subjects. A 90-day clinical follow-up was used to compare the differences in hematological indices，clinical neurological function scores，documentation of recurrent cerebral infarction and other thrombotic events during the follow-up period and differenses in the time to recurrence between the PCSK9 inhibitor combined with statin treatment and standard statin treatment groups. ResultsThe levels of hs-CRP，IL-6，Lp-PLA2，HCY，TC and LDL-C，NIHSS score and mRS score in the PCSK9 inhibitor combined with statin treatment group and the standard statin treatment group were all decreased before and after treatment（P<0.05），and there was a statistically significant difference in the combined treatment group（P<0.05），and lowered TG（P<0.05），while the level of HDL-C was improved（P<0.05）. There was no statistical significance in fasting plasma glucose of both groups before and after treatment（P>0.05）. Compared with the combined treatment group，the recurrence rate of cerebral infarction in the standard treatment group was obviously high（χ2=7.694，P=0.006），while the time to cerebral infarction recurrence was significantly longer in the combined treatment group（P<0.05）. ConclusionPCSK9 inhibitors can effectively reduce peripheral inflammatory response，promote neurological function recovery，significantly reduce stroke recurrence rate，and significantly prolong the recurrence time.

Objective:To investigate the characteristics of gut microbiota in children with sepsis and the effects of probiotic intervention.Methods:Thirty-four children with sepsis admitted to the Pediatric Intensive Care Unit of Henan Provincial People′s Hospital were enrolled in this prospective study from May 2019 to July 2020. They were randomly divided into two groups and received conventional treatment (conventional treatment group, n=17) and conventional treatment combined with probiotics (probiotics group, n=17), respectively. Twenty healthy children were selected as healthy control group. The baseline characteristics and sequential organ failure assessment (SOFA) score of all children with sepsis were recorded within 24 h after recruitment. Stool samples were collected 5-7 d after recruitment. High-throughput 16S rRNA gene sequencing was used to detect gut microbiota. Bioinformatic analysis and predictive functional profiling of microbial communities were performed to analyze the differences between groups. Results:The α-diversity and β-diversity indexes showed compared with the healthy control group, the two sepsis groups had lower abundance of gut microbiota, but greater individual differences in bacteria structure. These indexes were improved significantly following probiotic intervention ( P<0.05). At the level of phylum, the proportions of Bacteroidota and Actinobacteriota in the conventional treatment group were the lowest among the three groups, while the proportion of Proteobacteria increased significantly ( P<0.05). At the level of genus, Enterocoddus was the predominant bacterium in the conventional treatment group, while the abundance of Bifidobacterium, Faecalibacterium, Erysipelotrichaceae and Rumimococcus- torques in the probiotics group showed an upward trend ( P<0.05). Differences in the abundance of metabolic pathways, including mitochondrial synthesis, exosomes, mRNA transcription and degradation and cysteine metabolism, could be found between the two sepsis groups. Conclusions:This study revealed that children with sepsis exhibit a dysbiotic microbial community with reduced microbial diversity, declined structural stability, decreased abundance of Bacteroidota and enrichment of Proteobacteria. Probiotic supplementation could elevate the percentage of beneficial symbiotic bacteria and reduce the number of pathogenic bacteria. The differential metabolic pathways might be associated with the mechanism of probiotics in practice.

Objective:To investigate the uncoupling protein 2 (UCP2) expression and its relations with apoptosis, oxidative stress and mitochondrial division/fusion in HT22 cell model with intracerebral hemorrhage.Methods:HT22 cells cultured in vitro were divided into control group, and groups of 3, 6, 12 and 24 h after modeling; cells in the later 4 groups were given 10 μmol/L hemin for 3, 6, 12 and 24 h, respectively, and cells in the control group were given the same equivalent solvent for 24 h. The apoptosis of HT22 cells in these 5 groups was detected by Annexin V-FITC/propidium iodide Apoptosis Detection Kit. The reactive oxygen species (ROS) expressions in these 5 groups were detected by fluorescence probe method. Western blotting was used to detect the protein expressions of UCP2, apoptosis-related protein cleaved caspase 3, anti-apoptosis protein B cell lymphoma/leukemia2 (bcl2), and mitochondrial division/fusion proteins (Fis1, Drp1, Opa1, and Mfn2). Results:As compared with the control group, groups of 3, 6, 12 and 24 h after modeling had significantly increased apoptosis rate, ROS level, and UCP2, cleaved caspase 3, Fis1 and Drp1 expressions, and statistically decreased bcl2, Opa1, and Mfn2 expressions. Groups of 3, 6, 12 and 24 h after modeling had successively increased apoptosis rate, successively increased ROS levels, and successively increased UCP2, cleaved caspase 3, Fis1 and Drp1 expressions, and successively decreased bcl2, Opa1, and Mfn2 expressions, with significant differences ( P<0.05). Conclusion:UCP2 expresses in HT22 cell model with intracerebral hemorrhage in time-dependent manner, and it has close relations with apoptosis, oxidative stress, and dynamic balance of mitochondrial division/fusion of HT22 cells.

Objective:To explore the characteristics of cognitive function in patients with early onset and adult onset schizophrenia.Methods:In this cross-sectional study, 546 patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected.Among them, 62 cases were defined as early onset schizophrenia (EOS, age of onset＜18 years) and 175 patients were defined as adult onset schizophrenia (AOS, age of onset≥25 years).Patients underwent clinical assessments with the Positive and Negative Symptom Scale (PANSS) and the Personal and Social Performance Scale (PSP), and comprehensive neuropsychological assessments.Results:The EOS patients got lower scores in motor function-PEGDOM T score [ (26±12) vs. (30±11), P＜0.01], working memory-average T score of PASAT and WMSSP[ (34±12) vs. (38±10), P＜0.05]and executive function (inhibition) -Stroop T score [ (35±12) vs. (39±10), P＜0.05]than AOS patients.No differences were fund in processing speed, verbal memory and learning, visual memory and learning (Ps＞0.05) between the two groups.Conclusion:It suggests that the EOS patients have worse motor function, working memory and inhibition.

Objective To investigate the effects of dedicator of cytokinesis 1 (Dock180) knockout on proliferation and apoptosis in rat derived H9C2 cardiomyocytes and their mechanisms.Methods A single guide RNA (sgRNA) targeting rat Dock180 gene was designed and constructed using CRISPR/Cas9 system.A plasmid contained above sgRNA was packaged into lentivirus and selected to knockout Dock180 in the cardiomyocytes.A single clone of cardiomyocyte with Dock180 knockout was established.Cardiomyocytes were divided into negative lentivirus group (Cas9, A group), Dock180 knockout group (B group), Cas9 lentivirus hypoxia group (C group), Dock180 knockout hypoxia group (D group).The expression of Dock180 mRNA was examined by RT-PCR, and relevant proteins were detected by Western blot.The cell proliferation rate of the cardiomyocytes was determined by MTT, and the apoptotic rate was measured by flow cytometry.Results Dock180 mRNA and protein were absent in B andD groups.Compared with A and C groups, p-ERK1/2 and Bcl-2 protein expression and cell proliferation rate were lower in B and D groups respectively (P<0.01), while Bax protein expression and cell apoptosis rate were higher in B and D groups respectively (P<0.05, P<0.01);Compared with A group, Dock180 mRNA and protein, p-ERK1/2 and Bcl-2 proteins and cell proliferation rate were reduced, while Bax protein and cell apoptosis rate were increased in C group(P<0.05,P<0.01).Compared with B group, p-ERK1/2 and Bcl-2 proteins and cell proliferation rate were decreased, while Bax protein and cell apoptosis rate were increased in D group(P<0.05,P<0.01).Conclusions Dock180 knockout with CRISPR/Cas9 can inhibit proliferation and promote apoptosis via p-ERK1/2, Bcl-2 and Bax in H9C2 cardiomyocytes.

Objective To observe the effects of modifiedDanshen Decoction on spermidine/spermine acetyltransferase (SSAT) /polyamine pathways of SD rats with IRI; To investigate its protective mechanism. Methods The model of IRI was established by ligating left anterior descending coronary artery for 30 min followed by reperfusion for 90 min. The SD rats were randomly divided into the control group, sham-operation group, model group and modifiedDanshen Decoction group, with 10 rats in each group. The myocardial infarction size was measured by using TTC staining. The contents of SSAT were measured by ELISA. The SSAT mRNA and SSAT protein expression level were detected with real-time fluorescent quantitative PCR method and Western blot, respectively. The contents of polyamines (putrescine, spermidine, spermine) in cardiac tissue were detected by HPLC. Results Compared with sham-operation group, the myocardial infarction size, the SSAT content, the SSAT mRNA and SSAT protein expression levels of model group increased significantly, the contents of polyamines decreased significantly, with statistical significance (P<0.01); Compared with model group, the myocardial infarction size of modifiedDanshen Decoction group was significantly reduced, while the SSAT content and SSAT mRNA and protein expression level decreased significantly, the contents of polyamines increased, with statistical significance (P<0.05, P<0.01).ConclusionModifiedDanshen Decoction can adjust the SSAT polyamine pathways and increase polyamine content in cardiomyocytes, and thus play a role of protection of myocardial ischemia-reperfusion injury.

Based on the clinical skill competition of college students of the advanced medical colleges and universities nationwide,we aimed at the analysis on the weaknesses of medical emergency clinical practical teaching and emphasis on the theoretical education and neglect the practical education,and humanistic care,etc.In the clinical practice teaching of emergency,we combined the clinical skill training with physician occupation quality training,pay attention to the practice of advanced simulation exercises,gradual transition,clinical thinking,training medical students hands-on,team cooperation ability and humane accomplishment,to improve their ability of analyzing and solving problems and eventually optimize medical emergency clinical practical teaching,formulate the clinical practice standards as well as promote the reform and innovation of clinical teaching.

Objective To evaluate the effect of exercise on the relationship between body mass index (BMI) and health-related quality of life (HRQOL).Methods A total of 1 114 participants were recruited from the Physical Examination Center of two hospitals.SF-36 was used to measure HRQOL,and the classification of sports level was done according to the subjective evaluation of participants.Results The total score of HRQOL,physical component summary and mental component summary were 76.26± 16.10,75.97 ± 16.67 and 76.55± 18.33 respectively.The results of correlation analysis were as following:the positive correlation between BMI and general health (r=0.109),vitality (r=0.116),social functioning (r=0.092),role emotional (r=0.122),mental health (r =0.145) were significant (P＜ 0.01).The negative correlation between BMI and PF(r=-0.07,P=0.019)was significant.The mediation effects of exercise in was relationship between BMI and general health,vitality,mental health were significant,and the mediating effect were 5.84％,9.14％ and 6.58％.Conclusion This study demonstrates that mediation effects of the exercise are significant in some dimensions of HRQOL,but the direct influence of BMI on the HRQOL plays a leading role.And BMI is a protective factor under certain conditions.