Ischemic stroke （IS） is a serious cerebrovascular disease with high clinical incidence. Cerebral ischemia and hypoxia can induce metabolic reprogramming of cellular glycolysis. Hypoxia-inducible factor-1α （HIF-1α） serves as the core transcription factor in the hypoxic response. This article systematically reviews the molecular mechanisms of HIF-1α-mediated glycolytic reprogramming， elaborates on the effects of this metabolic alteration on the functional status of different immune cells， and summarizes the research progress of traditional Chinese medicine （TCM） interventions in this pathological process. HIF-1α reshapes glucose metabolic flux and shifts cellular metabolism toward glycolysis by regulating the transcription of key genes， including glucose transporters， glycolytic rate-limiting enzymes， and mitochondrial oxidative inhibitors. This metabolic disturbance can regulate the activation status， phenotypic differentiation， and functional remodeling of microglia， astrocytes， and peripherally infiltrated immune cells， thereby participating in the mediation of neuroinflammatory responses after IS. Moreover， multiple signaling pathways and the metabolite of glycolysis lactate can exert feedback regulation on this metabolic-immune process. Various active components of TCM and herbal formulas， such as astragaloside Ⅳ， salvianolic acid C， Ginkgo biloba extract， and Mailuo shutong pills， can inhibit abnormal glycolysis， reduce lactate accumulation， and restore the homeostasis of glucose oxidative metabolism by regulating signaling pathways including AMP-activated protein kinase/mammalian target of rapamycin/HIF-1α， HIF-1α/pyruvate kinase M2， and HIF-1α/lactate dehydrogenase A. Consequently， they effectively alleviate neuroimmune inflammation and attenuate ischemic brain injury.

ObjectiveTo clarify the relationship between childhood maltreatment and insomnia in middle school students， and to explore the mediating role of post-traumatic stress disorder （PTSD） symptoms and the moderating role of mental resilience involvement. MethodsFrom April to May 2021， a total of 3 412 students in 3 middle schools in a city in western China were selected using convenient sampling method， and all students were assessed by Childhood Trauma Questionnaire （CTQ）， Post Traumatic Stress Disorder Scale （PCL）， Insomnia Severity Index （ISI） and mental resilience scale. The moderated mediating effect analysis was conducted using Process v3.4. ResultsAmong the middle school students， CTQ scores were positively correlated with PCL and ISI scores （r=0.540， 0.320， P<0.05）， and the scores of CTQ， PCL and ISI were negatively correlated with the score of mental resilience scale （r=-0.049， -0.193， -0.132， P<0.05）. PTSD symptoms exhibited a partial mediating effect on the relationship between general childhood maltreatment and insomnia （β=0.161， P<0.05）， accounting for 80.5% of the total effect. ConclusionAmong the middle school students， the relationship between childhood maltreatment and insomnia is partially mediated via PTSD symptoms， and mental resilience exerts a moderating role between childhood maltreatment and PTSD symptoms.

Objective To compare the effect between Mammotome minimally invasive surgery and traditional surgery in resection of youth giant breast fibroadenoma (YGBF).Methods We randomly selected 73 patients who had YGBF and already accepted surgical treatment in our hospital from Jul.2009 to Jan.2016.The 75 patients recruited from screening programmes were alloted to either treatment according to their choice (37 cases in MS and 38 cases in traditional surgery).The median follow-up was 18 months (from 6 to 36 months).Comparative analysis was done between the two groups in operation time,incision healing time,incision length,intraoperative bleeding,wound infection,subcutaneous hematoma,residual tumor,breast deformation,scar size,and patient satisfaction degree.Results There was no statisticaly significant difference betwen these two groups in operation time,intraoperative blood loss,incision infection,subcutaneous hematoma,or residual tumor (P＞0.05),however,MS group was superior to traditional surgery group in the incision healing time,incision length,breast deformation,scar size and postoperative satisfaction degree,and the difference was statistically significant(P＜ 0.05).Conclusion The advantage of Mammotome minimally invasive operation auxiliary for YGBF is obvious,such as fast wound healing,small incision,infection rate,small breast without deformation and scar etc.,also higher satisfaction degree to the treatment,which is regarded as the preferred surgical treatment for YGBF patients.