Cerebral small vessel disease(CSVD)refers to a series of clinical imaging pathological syndromes caused by various etiologies affecting cerebral small vessels,which have the characteristics of insidious onset,high inci-dence and easy recurrence.Insulin resistance(IR)is a decrease in the body's sensitivity to insulin.In recent years,more and more studies have confirmed that IR is associated with the occurrence and development of imaging features of CS-VD,but the mechanism is still unclear.This article reviews the relationship between IR and cerebral small vessel disease and its possible mechanism,in order to provide reference for the prevention and treatment of cerebral small vessel disease.

Objective:To evaluate the clinical efficacy of single-stage total hip arthroplasty (THA) combined with intra-articular antibiotic injection in managing postoperative infections following internal fixation of hip fractures.Methods:A retrospective analysis was conducted on 25 patients who underwent single-stage THA for infection following internal fixation of hip fractures from January 2013 to January 2021 at the Department of Joint Surgery, First Affiliated Hospital of Xinjiang Medical University. The cohort comprised 15 males and 10 females, with an average age of 61.52±13.06 years (range, 32-89 years) and an average body mass index of 24.04±3.84 kg/m 2 (range, 18-34 kg/m 2). The fractures included 13 femoral neck fractures, 6 intertrochanteric fractures, 4 acetabular fractures, 1 proximal femoral fracture, and 1 combined acetabular and intertrochanteric fracture. Preoperative joint cavity puncture or intraoperative joint fluid extraction, biochemical analysis, microbial culture, and drug sensitivity tests were performed. During surgery, infected internal fixation devices were removed, and hip prostheses were implanted following thorough debridement. Postoperatively, patients received intravenous and intra-articular sensitive antibiotics based on bacterial culture and drug sensitivity results. Joint stability was evaluated according to the Engh standard, and hip function was assessed using the Harris score. Results:Microbial cultures were positive in 12 cases, identifying Staphylococcus epidermidis (4 cases), Staphylococcus aureus (2 cases), Escherichia coli (2 cases), Enterobacter cloacae (1 case), Pseudomonas aeruginosa (1 case), Corynebacterium striatum (1 case), and a mixed infection of Staphylococcus epidermidis and Enterococcus faecalis (1 case). All 25 patients were followed for an average of 56.64±26.38 months (range, 24-123 months). Intravenous and intra-articular antibiotic treatment was administered to all patients. One case experienced sinus tract formation and pus discharge on the 20th postoperative day, diagnosed as periprosthetic infection, resulting in treatment failure, yielding an infection control rate of 96% (24/25). All patients demonstrated stable prosthesis fixation with no subsidence, loosening, or osteolysis. At the final follow-up, the Harris hip score improved significantly from a preoperative score of 26.69±13.47 to 92.30±5.60 ( t=22.882, P<0.001). Complications included 2 cases of hip dislocation, 2 cases of deep venous thrombosis in the lower extremities, 1 case of poor wound healing, and 1 case of periprosthetic fracture. Conclusion:Single-stage THA combined with intra-articular antibiotic injection is effective in controlling infections following internal fixation of hip fractures. This approach not only achieves a high infection control rate but also reconstructs hip joint function, resulting in satisfactory postoperative outcomes.

Objective:To explore the association of inflammatory markers and thromboinflammatory factors before and after thrombolytic intervention with functional outcomes in elderly patients with acute cerebral infarction.Methods:392 patients with acute cerebral infarction admitted to our hospital were randomly selected as study subjects and divided into an observation group(196 cases)treated with arterial thrombolytic therapy and a control group(196 cases)treated with intravenous thrombolysis.Functional outcomes of patients were assessed 72 hours after thrombolysis using the activities of daily living(ADL)scale and, based on the results, patients were divided into a poor functional outcome group and a good functional outcome group.Inflammatory markers such as neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)and thromboinflammatory factors such as monocyte chemoattractant protein-1(MCP-1), tissue plasminogen activator(t-PA), soluble CD40 ligand(sCD40L)and P-selectin before and after thrombolysis were measured.The relationship of these inflammatory markers and thromboinflammatory factors before thrombolysis with functional outcomes 72 hours after thrombolysis was analyzed.Results:NLR and PLR levels in the two groups after thrombolysis were significantly lower than those before thrombolysis(all P<0.05); Their levels in the observation group were lower than those in the control group(all P<0.05). After thrombolysis, MCP-1 levels in both groups were significantly higher and t-PA, sCD40L, P-selectin levels were significantly lower than pre-thrombolysis levels(all P<0.05); After thrombolysis, the observation group had better results than the control group(all P<0.05). Correlation analysis showed that NLR, PLR, MCP-1 and t-PA were positively correlated with NIHSS score( r=0.336, 0.264, 0.483, 0.549, all P<0.05). NLR, PLR, MCP-1, t-PA and sCD40L levels were significantly lower and P-selectin levels were significantly higher in the good functional outcome group than in the poor functional outcome group both before and 72 hours after thrombolysis( t=13.850, 18.208, 23.636, 22.371, 59.868, 96.646, 378.112, 141.213, 131.160, 110.039, 10.716, 11.108, P<0.05 for all). Logistic regression analysis showed that abnormal levels of NLR, PLR, MCP-1 and t-PA before and after thrombolysis were risk factors for adverse outcomes with thrombolytic intervention( P<0.05). ROC curves showed that the levels of NLR, PLR, MCP-1, t-PA, sCD40L and P-selectin before thrombolysis had a certain predictive value for the risk of adverse functional outcomes with thrombolysis. Conclusions:The levels of these inflammatory markers and thromboinflammatory factors before and after thrombolytic intervention have varying degrees of correlation with functional outcomes in elderly patients with acute cerebral infarction.

Diabetic nephropathy （DN） is one of the most serious microvascular complications of diabetes and the leading cause of end-stage kidney disease. The onset and progression of DN are linked to the progression of renal fibrosis which is an important pathological feature and final pathological result of various chronic kidney diseases. As a result， therapies against renal fibrosis can help delay the progression of DN. The transforming growth factor-β₁ （TGF-β₁）/Smad signaling pathway is one of the key pathways in renal fibrosis. TGF-β₁， a crucial mediator of renal fibrosis， is highly expressed in the case of fibrosis-associated kidney diseases， and Smads are the main effectors in the TGF-β₁ signal transduction pathway. By activating Smads， TGF-β₁ transports signals from the cytoplasm to the nucleus and regulates the transcription of fibrosis-related target genes， thus exerting the biological effects and promoting the progression of renal fibrosis. In recent years， Chinese medicine has become prominent in the prevention and treatment of DN， and there has been an explosion of research on Chinese medicine in the prevention and treatment of DN through the TGF-β₁/Smad signaling pathway. Based on literature research， this paper reviewed the basic structure of the TGF-β₁/Smad signaling pathway， the relationship with DN， and monomers and extract of Chinese medicine， Chinese patent medicine， and compound Chinese medicine prescriptions in improving and delaying the renal fibrosis based on the TGF-β₁/Smad signaling pathway， and in alleviating inflammatory response and oxidative stress， reducing the accumulation of extracellular matrix， and inhibiting epithelial-mesenchymal transition by regulating the TGF-β₁/Smad signaling pathway. Thereby， this study is expected to provide new mindset for the treatment of DN.

Objective　To investigate the expression level of serum microrna-493 (mir-493) in patients with acute cerebral infarction (ACI) and its relationship with the prognosis after thrombolysis.Methods　Seventy patients with ACI in our hospital from October 2019 to March 2021 were selected as the study group,and 70 patients with healthy physical examination during the same period were selected as the control group.The serum miR-493 levels of the study group before treatment,3 d,7 d after treatment were detected.Results　The serum miR-493 levels in the study group were higher than that before treatment at 3 days after treatment,however,the serum miR-493 levels in the study group were lower in each time period (P<0.05).Serum miR-493 levels before treatment and neurological deficits in ACI patients Degree,serum VEGF,Ang-2,CRP,and IL-6 levels were negatively correlated (P<0.05).Serum miR-493 levels before treatment,3 d,and 7 d after treatment in the study group with good prognosis were higher than those with poor prognosis patients (P<0.05).The area under the curve (AUC) of serum miR-493 predicting poor prognosis of ACI patients with thrombolytic therapy before treatment,3 d and 7 d after treatment were 0.748,0.851,0.879,respectively,and 7 d after treatment serum miR-493 predicted the largest AUC,and the best prediction sensitivity and specificity were 73.68% and 88.24%,respectively.Conclusion　The expression levels of serum miR-493 in patients with acute cerebral infarction are significantly reduced,and related to the prognosis of patients after thrombolysis,and has certain value in assisting clinical prediction of the prognosis of patients.

Life monitoring technology as the basis of health evaluation, in recent years, its related technology research also has new development, in which cardiopulmonary parameters are the core physiological indicators to measure the basic state of vital signs, the analysis of its monitoring technology is particularly important. In this study, the main means of life monitoring are analyzed, and the monitoring technology of cardiopulmonary parameters is the main focus. What is more, the research status and development of contact and non-contact cardiopulmonary monitoring technology at home and abroad were also considered. Lastly, this study will be combined with the radar wave vital signs monitoring technology, which has been achieved good results in the field of cardiopulmonary monitoring, in order to provide a reference for the long-term development of life monitoring field and the technology integration of intelligent pension, intelligent automobile and other related industries.
Algorithms ; Heart Rate ; Monitoring, Physiologic ; Radar ; Respiratory Rate ; Technology ; Vital Signs

Objective:To analyze the clinical effect of TREVO stent thrombectomy combined with tirofiban on patients with acute large-artery occlusion of the anterior circulation.Methods:Seventy-two patients with acute large-artery occlusion of the anterior circulation accepted thrombectomy in our hospital from November 2016 to May 2020 were divided into two groups according to different treatment methods: 35 patients in the control group were treated with TREVO stent thrombectomy, and 37 patients in the treatment group were treated with TREVO stent thrombectomy combined with tirofiban via intra-variceal injection. The success rate of recanalization, specific conditions of thrombolysis, improvement degrees of nerve defect, coagulation function, prognoses 90 d after thrombectomy, and complications were compared between the two groups.Results:The success rate of postoperative vascular recanalization in the treatment group and control group was 91.89% (34/37) and 88.57% (31/35), respectively, without statistically significant difference ( P>0.05). The time and times of thrombotomy in the treatment group were significantly shorter/smaller than those in the control group (P<0.05). The National Institute of Health stroke scale (NIHSS) scores of patients from the treatment group 14 d after thrombectomy were significantly lower than those of the control group ( P<0.05). The postoperative thrombin time, prothrombin time, and activated partial thrombin time of the treatment group were significantly longer than those of the control group ( P<0.05). The good prognosis rate of patients in the treatment group and control group 90 d after thrombectomy was 86.49% (32/37) and 60.0% (21/35), with significant differences ( P<0.05); and the incidence of complications was 8.11% (3/37) and 14.29% (5/35), without significant differences ( P>0.05). Conclusion:TREVO stent thrombectomy combined with tirofiban has a significant effect on treatment of acute large-artery occlusion of the anterior circulation, enjoying high safety.

Objective:To investigate the molecular mechanism of antiglioma effect of curcumin.Methods:Cell experiment: (1) U251MG and SHG-44 cells at logarithmic growth phase were treated with 10 μmol/L curcumin (curcumin group) or same volume of dimethyl sulfoxide solution (control group); cells were transfected with negative control small interfering RNA (siRNA) and long non-coding RNA (lncRNA) H19 siRNA (negative control siRNA group and H19 siRNA group); cells were transfected with negative control siRNA and H19 siRNA, respectively, and then, they were treated with 10 μmol/L curcumin (negative control siRNA+curcumin group and H19 siRNA+curcumin group); the H19 siRNA was co-transfected with negative control miR inhibitor or miR-491-5p inhibitor into these cells (H19 siRNA+negative control inhibitor group and H19 siRNA+miR-4915p inhibitor group); H19 siRNA+negative control miR inhibitor or H19 siRNA+miR-491-5p inhibitor were co-transfected into the cells, and then, they were treated with 10 μmol/L curcumin (H19 siRNA+negative control inhibitor+curcumin group and H19 siRNA+miR-491-5p inhibitor+curcumin group); the cells were co-transfected with miR-491-5p mimic+blank plasmid or miR-491-5p mimic+HOXA9 overexpression plasmid, and then they were treated with 10 μmol/L curcumin (miR-491-5p mimic+blank plasmid+curcumin group and miR-491-5p mimic+HOXA9 overexpression plasmid+curcumin group); real-time fluorescent quantitative PCR (qRT-PCR) was used to detect the mRNA expressions of H19, miR-491-5p, and HOXA9; CCK-8 assay was used to detect the cell proliferation; flow cytometry was used to detect the cell apoptosis; plate cloning method was employed to detect the number of cell clone formation; Transwell assay was used to detect the cell migration; and the HOXA9 protein expression was measured by Western blotting. (2) The 293T cells at the logarithmic growth phase were chosen; the negative control miRNA mimics or miR-491-5p mimics combined with wild-type H19, wild-type HOXA9 3'-UTR plasmid vectors were co-transfected into the cells, respectively (negative control mimic+wild type H19 group and miR-491-5p mimic+wild type H19 group, negative control mimic+wild type HOXA9 3'-UTR group and miR-491-5p mimic+wild type HOXA9 3'-UTR group); the luciferase activity was detected by dual luciferase reporter experiment. (3) Thirty specimens from glioma patients (glioma group) underwent surgical resection and pathologically confirmed in our hospital from May 2017 to May 2019 and 30 normal brain tissue specimens obtained during decompression (normal group) at the same period were chosen; the mRNA expressions of H19, miR-491-5p, and HOXA9 were detected by qRT-PCR, and the HOXA9 protein expression level in these specimens was detected by Western blotting. (4) Twenty-four nude mice were randomly divided into negative control short hairpin RNA (shRNA) group, H19 shRNA group, negative control shRNA+curcumin group, and H19 shRNA+curcumin group ( n=6); U251MG cells stably transfected with negative control shRNA or H19 shRNA were intraperitoneally injected, respectively, into the mice; and 60 mg/kg curcumin was injected on the next d; the tumor volume was measured on the 7 th, 11 th, 15 th, 19 th, 23 rd, and 27 th d of rearing; and the H19, miR-491-5p and HOXA9 mRNA expressions in the tumor tissues were detected by qRT-PCR; the HOXA9 protein expression was detected by Western blotting. Results:(1) When curcumin group comparing with control group, and H19 siRNA group comparing with negative control siRNA group, U251MG and SHG-44 cells had significantly decreased miR-491-5p mRNA and protein expressions, and significantly increased miR-491-5p mRNA expression ( P<0.05); as compared with that in the H19 siRNA+negative control inhibitor group, the HOXA9 mRNA and protein expressions in U251MG and SHG-44 cells of H19 siRNA+miR-491-5p inhibitor group were significantly higher ( P<0.05). When curcumin group comparing with control group, H19 siRNA group comparing with negative control siRNA group, H19 siRNA+curcumin group comparing with negative control siRNA+curcumin group, the U251MG and SHG-44 cells after 72 h of culture had significantly decreased cell proliferation rate, significantly increased apoptosis rate, significantly reduced number of cell clone formation, and significantly reduced cell migration number ( P<0.05). When H19 siRNA+miR-491-5p inhibitor+curcumin group comparing with H19 siRNA+negative control inhibitor+curcumin group, miR-491-5p mimic+HOXA9 overexpression plasmid+curcumin group comparing with miR-491-5p mimic+blank plasmid+curcumin group, the U251MG and SHG-44 cells after 72 h of culture had significantly increased cell proliferation rate, significantly reduced apoptosis rate, significantly increased number of cell clone formation, and significantly increased cell migration number ( P<0.05). (2) When miR-491-5p mimic+wild-type H19 group comparing with negative control mimic+wild-type H19 group, miR-491-5p mimic+wild-type HOXA9 3'-UTR group comparing with negative control mimic+wild-type HOXA9 3'-UTR group, the cell luciferase activity was significantly reduced ( P<0.05). (3) As compared with those in the normal group, the H19 and HOXA9 mRNA expressions and HOXA9 protein expression in the glioma group were significantly increased, and the miR-491-5p mRNA expression was significantly reduced ( P<0.05). (4) On the 27 th d of rearing, when H19 shRNA group comparing with negative control shRNA group, and H19 shRNA+curcumin group comparing with negative control shRNA+curcumin group, the tumor volume was significantly reduced, the miR-491-5p mRNA expression in the tumor tissues was significantly increased, and the H19 mRNA, HOXA9 mRNA and protein expressions were significantly reduced ( P<0.05). Conclusion:Curcumin may inhibit the cell proliferation and migration and promote the apoptosis of glioma cells through lncRNA H19/miR-491-5p/HOXA9 axis.

Coagulation disorder is the main pathogenesis of acute ischemic stroke (AIS). As a new coagulation function testing platform, thromboelastography (TEG) can fully reflect the abnormalities of coagulation factors, platelet and fibrinogen. Studies have found that TEG shows unique significance in the prediction, treatment and prognosis of stroke. In recent years, the clinical application of TEG in AIS has been continuously expanded, and new discoveries have promoted timely, and reasonable, and individualized diagnosis and treatment of AIS. This article will give a review of the development in this field.

Objective:To investigate the effects of ketogenic diet on seizures, electroencephalogram(EEG) changes and neurobehavioral development in children diagnosed with epilepsy.Methods:A total of 122 children diagnosed with spastic epilepsy in Nanyang Central Hospital from March 2016 to March 2019 were enrolled.The patients were divided into the observation group and the control group, by the computerized random number table method with 61 cases in each group.The children in the control group were treated with conventional therapy, and the children in the observation group were combined with the ketogenic diet on the basis of conventional treatment.The Gesell developmental schedules scale scores were compared between the two groups to evaluate seizure control and EEG improvement.Results:The seizure control in the observation group was significantly better than that in the control group [78.69%(48/61 cases) vs.54.10%(33/61 cases)], and the difference was statistically significant ( χ2 = 12.114, P <0.05). The EEG improvement in the observation group was significantly better than that in the control group [81.97%(50/61 cases) vs.55.74%(34/61 cases)], and the difference was statistically significant ( χ2=13.623, P<0.05). After 12 months of treatment, the children in the observation group had significantly higher fitness, gross motor, fine motor, language, and personal social, and total development quotient scores than the control group [(56.64±13.29) scores vs.(46.04±12.86) scores, (54.84±12.18) scores vs.(47.62±11.91) scores, (54.44±10.70) scores vs.(44.31±11.56) scores, (51.48±12.99) scores vs.(42.04±11.18) scores, (57.88±11.04) scores vs.(47.42±13.16) scores, (275.28±54.71) scores vs.(227.42±55.79) scores], the differences were statistically significant ( t=5.997, 5.887, 6.003, 5.889, 6.007, 6.010, all P<0.05). Conclusion:The ketogenic diet can significantly reduce seizures, improve EEG and neurobehavioral development in children with epilepsy.