Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Objective To investigate the correlation between Traditional Chinese Medicine(TCM)constitution types and disease progression in elderly patients with hypertension complicated by heart failure(HF).Methods A total of 200 eligible elderly patients treated in our hospital from June 2021 to June 2023 were recruited,and based on TCM constitution types,they were classified as balanced constitution(n=20,10.0％),qi-deficiency(n=35,17.5％),yang-deficiency(n=30,15.0％),yin-deficiency(n=21,10.5％),phlegm-dampness(n=35,17.5％),damp-heat(n=16,8.0％),blood-stasis(n=25,12.5％),qi-stagnation(n=11,5.5％),and inherited special constitu-tion(n=7,3.5％).TCM constitution,blood pressure,and cardiac function indicators were as-sessed.All patients were followed up for 1 year,and acute exacerbations was recorded to analyze disease progression.Blood pressure,cardiac function indicators,and acute exacerbation frequency were compared among different TCM constitution types,and Spearman correlation analysis was used to assess the relationship between TCM constitution types and the frequency of acute exacer-bations.Results Significant differences were observed in SBP,DBP and frequency of acute exacer-bations among elderly hypertension patients with HF having different TCM constitution types(P＜0.01).The patients with a phlegm-dampness constitution had obviously higher SBP,DBP,mean arterial pressure,stroke volume,central venous pressure and frequency of acute exacerba-tions than those with other constitution types,while the patients with a balanced constitution had the notably highest left ventricular ejection fraction(P＜0.01).Spearman correlation analysis showed that balanced,phlegm-dampness,and blood-stasis constitutions were positively correlated with the frequency of acute exacerbations in these patients(r=0.480,r=0.375,r=0.295,P＜0.01),whereas qi-deficiency constitution was negatively correlated(r=-0.235,P＜0.01).Conclusion Elderly patients with hypertension and HF are predominantly of the qi-deficiency,phlegm-dampness,and yang-deficiency constitution types.Among them,the patients with phlegm-dampness constitution exhibit notably higher blood pressure and cardiac function indicators.TCM constitution types such as balanced and phlegm-dampness are closely related to disease progres-sion in these patients.

Objective To investigate the correlation between Traditional Chinese Medicine(TCM)constitution types and disease progression in elderly patients with hypertension complicated by heart failure(HF).Methods A total of 200 eligible elderly patients treated in our hospital from June 2021 to June 2023 were recruited,and based on TCM constitution types,they were classified as balanced constitution(n=20,10.0％),qi-deficiency(n=35,17.5％),yang-deficiency(n=30,15.0％),yin-deficiency(n=21,10.5％),phlegm-dampness(n=35,17.5％),damp-heat(n=16,8.0％),blood-stasis(n=25,12.5％),qi-stagnation(n=11,5.5％),and inherited special constitu-tion(n=7,3.5％).TCM constitution,blood pressure,and cardiac function indicators were as-sessed.All patients were followed up for 1 year,and acute exacerbations was recorded to analyze disease progression.Blood pressure,cardiac function indicators,and acute exacerbation frequency were compared among different TCM constitution types,and Spearman correlation analysis was used to assess the relationship between TCM constitution types and the frequency of acute exacer-bations.Results Significant differences were observed in SBP,DBP and frequency of acute exacer-bations among elderly hypertension patients with HF having different TCM constitution types(P＜0.01).The patients with a phlegm-dampness constitution had obviously higher SBP,DBP,mean arterial pressure,stroke volume,central venous pressure and frequency of acute exacerba-tions than those with other constitution types,while the patients with a balanced constitution had the notably highest left ventricular ejection fraction(P＜0.01).Spearman correlation analysis showed that balanced,phlegm-dampness,and blood-stasis constitutions were positively correlated with the frequency of acute exacerbations in these patients(r=0.480,r=0.375,r=0.295,P＜0.01),whereas qi-deficiency constitution was negatively correlated(r=-0.235,P＜0.01).Conclusion Elderly patients with hypertension and HF are predominantly of the qi-deficiency,phlegm-dampness,and yang-deficiency constitution types.Among them,the patients with phlegm-dampness constitution exhibit notably higher blood pressure and cardiac function indicators.TCM constitution types such as balanced and phlegm-dampness are closely related to disease progres-sion in these patients.

Objective To explore the clinical effect of neurointervention assisted alteplase thrombolysis in the treatment of acute ischemic stroke(AIS).Methods A total of 104 AIS patients admitted to Beijing Shunyi Hospital from June 2022 to June 2023 were selected as the research subjects,and they were divided into observation group and control group according to the treatment method,with 52 cases in each group.The patients in the control group were treated with alteplase thrombolysis,and the patients in the observation group were treated with neurointervention assisted alteplase thrombolysis.The therapeutic effect of patients in the two groups was evaluated according to the National Institutes of Health stroke scale(NIHSS)score at two weeks after treatment.Before treatment and 3,7 days after treatment,the serum nerve growth factor(NGF),neuron specific enolase(NSE),central nervous system specific protein S100β levels of patients in the two groups were detected by enzyme-linked immunosorbent assay;the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients in the two groups were detected by ultrasound transcranial Doppler blood analyzer;the degree of neurological damage of patients in the two groups was evaluated by NIHSS scores.The occurrence of drug-related adverse reactions during treatment of patients in the two groups were recorded;the comprehensive living ability of patients in the two groups was evaluated by improved Rankin score at three months after treatment.Results The total effective rates of patients in the control group and the observation group were 80.77％(42/52)and 96.15％(50/52),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(x2=6.029,P＜0.05).There was no significant difference in the serum NGF,NSE,S100β levels of patients between the two groups before treatment(P＞0.05).Compared with before treatment,the serum NGF level of patients in the two groups increased,and the serum NSE,S100β levels decreased at 3,7 days after treatment(P＜0.05).At 3,7 days after treatment,the serum NGF level of patients in the observation group was significantly higher than that in the control group,and the serum NSE,S100β levels were significantly lower than those in the control group(P＜0.05).There was no significant difference in the peak systolic velocities of common carotid artery,basilar artery and vertebral artery of patients between the two groups before treatment(P＞0.05).The peak systolic velocities of common carotid artery,basilar arteryand vertebral artery of patients at 3,7 days after treatment were significantly lower than those before treatment in the two groups(P＜0.05).After 3,7 days after treatment,the peak systolic velocities of common artery,basilar artery,and vertebral artery of patients in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in NIHSS score of patients between the two groups before treatment(P＞0.05).The NIHSS score of patients at 3,7 days after treatment was significantly lower than that before treatment in the two groups(P＜0.05).At 3,7 days after treatment,the NIHSS score of patients in the observation group was significantly lower than that in the control group(P＜0.05).The total incidence of adverse reactions of patients during treatment in the control group and observation group was 7.69％(4/52)and 9.62％(5/52),respectively;there was no significant difference in the total incidence of adverse reactions during treatment of patients between the two groups(x2=0.000,P＞0.05).At 3 months after treatment,the comprehensive living ability of patients in the observation group was better than that in the control group(P＜0.05).Conclusion Neurointer-vention assisted with alteplase thrombolysis in the treatment of AIS patients can significantly improve the treatment efficacy and the expression of neurolin,reduce the degree of neurological impairment and improve comprehensive living ability,and has a certain degree of safety.

Objective:To analyze the effects of different courses of hyperbaric oxygen combined with sertraline on sleep disorders and serum neurologic injury factors in patients after cerebral hemorrhage.Methods:A total of 120 patients with sleep disorders after cerebral hemorrhage were divided into control group ( n=60) and observation group ( n=60) by random number table method. The control group was treated with sertraline only, while the observation group was treated with hyperbaric oxygen on the basis of the treatment in the control group. The sleep quality, clinical efficacy, the levels of serum neuron-specific enolase (NSE), intercellular adhesion molecule-1 (ICAM-1), and tumor necrosis factor-α (TNF-α) before and 10, 20, and 30 d after treatment were compared between the two groups. Results:The scores of Pittsburgh sleep quality index (PSQI) of the observation group were significantly lower than those of the control group at every time point of treatment ( P<0.05); the total sleep time, total deep sleep time, total light sleep time, and rapid eye movement (REM) sleep time of the observation group were significantly longer than those of the control group ( P<0.05); and the sleep latency of the observation group was significantly shorter than that of the control group ( P<0.05). With the prolongation of the treatment course, the PSQI scores of both groups showed decreasing trends ( P<0.05); the total sleep time, total deep sleep time, total light sleep time, and REM sleep time of both groups tended to prolong ( P<0.05); and the sleep latency tended to be shorter ( P<0.05). The total effective rate of the observation group was significantly higher than that of the control group at 10, 20, and 30 d after treatment ( P<0.05). With the prolongation of the treatment course, the total effective rates of the two groups showed increasing trends ( P<0.05); the levels of serum NSE, ICAM-1, and TNF-α in the observation group were significantly lower than those in the control group at every time point of treatment ( P<0.05); and with the prolongation of the treatment course, the above indicators of the two groups showed decreasing trends ( P<0.05). Conclusion:Hyperbaric oxygen therapy combined with sertraline can improve the sleep quality and clinical efficacy of patients after cerebral hemorrhage with sleep disorders.

Objective:To analyze the effects of different courses of hyperbaric oxygen combined with sertraline on sleep disorders and serum neurologic injury factors in patients after cerebral hemorrhage.Methods:A total of 120 patients with sleep disorders after cerebral hemorrhage were divided into control group ( n=60) and observation group ( n=60) by random number table method. The control group was treated with sertraline only, while the observation group was treated with hyperbaric oxygen on the basis of the treatment in the control group. The sleep quality, clinical efficacy, the levels of serum neuron-specific enolase (NSE), intercellular adhesion molecule-1 (ICAM-1), and tumor necrosis factor-α (TNF-α) before and 10, 20, and 30 d after treatment were compared between the two groups. Results:The scores of Pittsburgh sleep quality index (PSQI) of the observation group were significantly lower than those of the control group at every time point of treatment ( P<0.05); the total sleep time, total deep sleep time, total light sleep time, and rapid eye movement (REM) sleep time of the observation group were significantly longer than those of the control group ( P<0.05); and the sleep latency of the observation group was significantly shorter than that of the control group ( P<0.05). With the prolongation of the treatment course, the PSQI scores of both groups showed decreasing trends ( P<0.05); the total sleep time, total deep sleep time, total light sleep time, and REM sleep time of both groups tended to prolong ( P<0.05); and the sleep latency tended to be shorter ( P<0.05). The total effective rate of the observation group was significantly higher than that of the control group at 10, 20, and 30 d after treatment ( P<0.05). With the prolongation of the treatment course, the total effective rates of the two groups showed increasing trends ( P<0.05); the levels of serum NSE, ICAM-1, and TNF-α in the observation group were significantly lower than those in the control group at every time point of treatment ( P<0.05); and with the prolongation of the treatment course, the above indicators of the two groups showed decreasing trends ( P<0.05). Conclusion:Hyperbaric oxygen therapy combined with sertraline can improve the sleep quality and clinical efficacy of patients after cerebral hemorrhage with sleep disorders.

Objective:To explore the clinical effects of a single stage reconstruction and revascularization using a free Flow-through chimeric anterolateral thigh perforator (ALTP) flap in Gustillo III C limb injuries.Methods:From January, 2010 to December, 2017, 17 patients with Gustillo III C injury of extremities were repaired with Flow-through chimeric ALTP in emergency surgeries. The patients were 16 males and 1 female with mean age of 32.4 (19-55) years. The size of wounds ranged from 16 cm×8 cm-45 cm×30 cm. The injured arteries were Flow-through anastomosed with the descending branch of the lateral circumflex femoral artery to regain blood flow. The deep dead space was filled with vastus lateralis flap, and the skin flap and fascia flap were used for superficial covering. The donor site was closed directly in 6 patients, simultaneous skin grafts were applied in 11 patients.Results:The followed-up time ranged 5 to 60 (average 21.8) months, and conducted by clinic visits and by telephone or WeChat interviews. Fifteen flaps survived, and 2 flaps failed with limb amputated. Six patients were repaired with skin and fascia flaps and 11 patients received flaps comprising the skin, fascia and vastus lateralis muscle. Four flaps healed in stage I. Partial necrosis were observed in 11 flaps. Of which, 1 healed by change of dressing and 10 healed by skin grafting. No complications occurred in donor site in all patients.Conclusion:The Flow-through chimeric ALTP flap can be used in stage I reconstruction of the blood supply of limbs and meanwhile achieve the 3-D repair of defects. It is one of the reliable methods in the reconstruction of Gustillo III C injuries in the extremities.

Objective:To study the clinical effect and hemorheological changes of hyperbaric oxygen (HBO) combined with Tuina therapy on patients with cervical spondylosis of vertebral artery type (CSA).Methods:One hundred and ten patients with CSA, admitted to the Affiliated Hospital of Guilin Medical University from January 2018 to January 2019, were randomly divided into observation group and control group according to the random number table, with 55 cases in each group. The control group was treated with Tuina therapy of traditional Chinese medicine, while the observation group was treated with HBO based on the treatment of the control group. The clinical effect, hemorheological changes, cervical vertebral movements, the levels of neuropeptide Y (NPY) and urotensin Ⅱ(UⅡ) in plasma were tested and recorded before and after treatment.Results:After treatment, the total effective rate of the observation group (94.55%) was significantly higher than that of the control group (81.82%) ( P<0.05). The peak systolic blood flow velocity and the mean blood flow velocity of vertebrobasilar artery in the observation group after treatment were significantly increased as compared with the control group ( P<0.05). The angles to anterior, posterior, left, and right of cervical vertebral movement of the observation group after treatment were significantly larger than those of the control group ( P<0.05). The levels NPY and UⅡ in plasma of both groups after treatment were significantly lower than those before treatment ( P<0.01), and the levels NPY and UⅡ in the observation group were significantly lower than those in the control group after treatment ( P<0.05). Conclusion:HBO combined with Tuina therapy can improve the curative effect on CSA, by improving cervical vertebral movement and hemorheological characteristics, and lowering the levels of NPY and UⅡ in plasma in CSA patients.

Objective:To study the clinical effect and hemorheological changes of hyperbaric oxygen (HBO) combined with Tuina therapy on patients with cervical spondylosis of vertebral artery type (CSA).Methods:One hundred and ten patients with CSA, admitted to the Affiliated Hospital of Guilin Medical University from January 2018 to January 2019, were randomly divided into observation group and control group according to the random number table, with 55 cases in each group. The control group was treated with Tuina therapy of traditional Chinese medicine, while the observation group was treated with HBO based on the treatment of the control group. The clinical effect, hemorheological changes, cervical vertebral movements, the levels of neuropeptide Y (NPY) and urotensin Ⅱ(UⅡ) in plasma were tested and recorded before and after treatment.Results:After treatment, the total effective rate of the observation group (94.55%) was significantly higher than that of the control group (81.82%) ( P<0.05). The peak systolic blood flow velocity and the mean blood flow velocity of vertebrobasilar artery in the observation group after treatment were significantly increased as compared with the control group ( P<0.05). The angles to anterior, posterior, left, and right of cervical vertebral movement of the observation group after treatment were significantly larger than those of the control group ( P<0.05). The levels NPY and UⅡ in plasma of both groups after treatment were significantly lower than those before treatment ( P<0.01), and the levels NPY and UⅡ in the observation group were significantly lower than those in the control group after treatment ( P<0.05). Conclusion:HBO combined with Tuina therapy can improve the curative effect on CSA, by improving cervical vertebral movement and hemorheological characteristics, and lowering the levels of NPY and UⅡ in plasma in CSA patients.

Objective:To investigate whether celastrol can increase the cytotoxic activity of γδ T cells against osteosarcoma (OS) cells line HOS through TRAIL way. Methods:The death receptors 4/5 (DR4/5) protein levels in the OS cell lines HOS was in-vestigated by Western blot analysis. Zoledronate ( ZOL) was used to induceγδT cells from PBMCs of healthy volunteers.γδT cell cy-totoxicity against HOS cells was investigated by a standard lactate dehydrogenase release assay ( LDH ) . Results:Celastrol increased DR4/5 protein expression in HOS ( P<0. 05 ) .γδ T cells from PBMCs of healthy volunteers showed cytotoxicity against HOS ( P<0. 05). Following co-culture with HOS pre-treated with celastrol (1 μmol/L) for 24 h,γδ T cells showed significantly higher cytotoxicity against HOS (P<0. 05). The induction of DR4/5 molecules increased lysis of HOS by γδ T cells which was abolished by addition of a blocking TRAIL antibody. Conclusion:Celastrol can enhance γδ T cells'cytotoxic activity against OS cells line HOS through TRAIL way.