Objective:To investigate the efficacy and safety of tirofiban versus argatroban in the treatment of acute ischemic stroke. Methods:This study was a retrospective cohort study. Sixty-eight patients with acute ischemic stroke who were continuously admitted to Department of Neurology of The Third People's Hospital of Hubei Province from August 2022 to September 2023 were divided into tirofiban group ( n = 33) and argatroban group ( n = 35) according to the treatment regimen. Both groups were treated according to their respective treatment protocols for 7 days. Clinical outcomes were assessed based on the modified Rankin Scale (mRS) scores. The excellent clinical outcome (mRS score 0-1 points), good clinical outcome (mRS score 0-2 points), symptomatic intracranial hemorrhage, and mortality rates were compared between the two groups at 90 days post-treatment. Results:In the tirofiban group, the proportion of excellent clinical outcomes was 30.3% (10/33), which was significantly lower than the 65.7% (23/35) in the argatroban group (χ2 = 8.53, P = 0.003). However, the difference in the proportion of good clinical outcomes between the two groups was not statistically significant [54.5% (18/33) vs. 74.3% (26/35), χ2 = 2.90, P = 0.089]. There were no statistically significant differences between the two groups regarding symptomatic intracranial hemorrhage and mortality rates (both P > 0.05). Conclusion:For patients with acute ischemic stroke, the use of tirofiban or argatroban is effective and safe. Patients treated with argatroban are more likely to achieve excellent clinical outcomes; however, larger randomized controlled trials are needed for further confirmation.

Objective:To investigate the prevalence and risk factors of stroke in residents of Hanzhong community, Wuhan city, Hubei province, and develop subsequent prevention and treatment measures.Methods:A questionnaire survey, physical examination, and laboratory tests were conducted from May 1 to July 31, 2023, among a population of 801 residents aged 40 years and older in Hanzhong community, Wuhan city, Hubei province, using multi-stage whole cluster random sampling.Results:Among the 801 residents surveyed, 28 were found to have suffered from stroke, yielding a prevalence rate of 3.5%. Additionally, there were 255 individuals identified as high-risk, accounting for 31.8% of the population. The risk factors for stroke, ranked from highest to lowest in prevalence, were as follows: hypertension (24.3%), dyslipidemia (23.6%), lack of exercise (17.6%), smoking (13.1%), diabetes (12.0%), family history of stroke (9.0%), obesity or overweight (8.6%), and atrial fibrillation or valvular heart disease (3.0%). The prevalence of stroke is higher in men than in women, and it continues to increase with advancing age (χ 2 = 33.95, P < 0.001). Homocysteine is likely to contribute to the occurrence of stroke through its association with hypertension (χ2 = 42.63, P < 0.001). Additionally, homocysteine levels have emerged as another significant risk factor for stroke among individuals who are at high risk (χ2 = 5.74, P < 0.05). Conclusion:In Hanzhong community, Wuhan city, Hubei province, smoking, hypertension, overweight, and obesity are the major risk factors for stroke among residents aged 40 years and older. Homocysteinemia is closely related to these high-risk factors for stroke. Therefore, screening and prevention of elevated homocysteine levels will be one of the critical indicators for the subsequent screening and prevention of stroke.

Objective To investigate the inhibitory effect of Tongsai Granules(TSG)on macrophage-mediated inflammatory response to alleviate acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in rats and explore the underlying mechanism.Methods Twenty-four rats were divided into control group,AECOPD model group,TSG treatment group,and moxifloxacin+salbutamol(MXF+STL)treatment group.In the rat models of COPD,AECOPD was induced by nasal instillation of Klebsiella pneumoniae on day 3 of week 9 after modeling,and saline,TSG or MXF+STL were administered via gavage on days 1 and 2 and days 4 to 7 of week 9.After the treatments,lung tissues were collected for examining for pathologies and expressions of inflammatory markers,MMP2,and MMP9.In cultured macrophage MH-S cells with LPS stimulation,the effect of TSG-medicated serum on IL-1β,IL-6,TNF-α,COX-2,and iNOS expressions and phosphorylation levels of p38,p-p62,LC3,FoxO3a,and mTOR were evaluated.Results TSG significantly improved lung pathologies and lung function in AECOPD rats by reducing bronchial wall thickness and mean alveolar linear intercept,increasing alveolar numbers,and reducing pulmonary expression of IL-1β,IL-6,TNF-α,MMP2 and MMP9.In MH-S cells,TSG significantly suppressed LPS-induced expressions of inflammatory cytokines,COX-2 and iNOS.Serum pharmacology coupled with network pharmacology identified 10 chemical components in TSG-medicated serum,and functional analysis of their 466 targets suggested that the therapeutic effect of TSG on AECOPD was mediated primarily by luteolin and quercetin,which regulate the MAPK,mTOR,FoxO,and autophagy pathways.In MH-S cells,luteolin significantly inhibited LPS-induced inflammatory responses and expressions of p-p38,FoxO3a,mTOR,p-p62 and LC3.Conclusion TSG reduces macrophage-mediated inflammatory responses to alleviate AECOPD in rats possibly by modulating p38,mTOR,and FoxO3a pathways and inhibiting autophagy.

Objective To investigate the inhibitory effect of Tongsai Granules(TSG)on macrophage-mediated inflammatory response to alleviate acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in rats and explore the underlying mechanism.Methods Twenty-four rats were divided into control group,AECOPD model group,TSG treatment group,and moxifloxacin+salbutamol(MXF+STL)treatment group.In the rat models of COPD,AECOPD was induced by nasal instillation of Klebsiella pneumoniae on day 3 of week 9 after modeling,and saline,TSG or MXF+STL were administered via gavage on days 1 and 2 and days 4 to 7 of week 9.After the treatments,lung tissues were collected for examining for pathologies and expressions of inflammatory markers,MMP2,and MMP9.In cultured macrophage MH-S cells with LPS stimulation,the effect of TSG-medicated serum on IL-1β,IL-6,TNF-α,COX-2,and iNOS expressions and phosphorylation levels of p38,p-p62,LC3,FoxO3a,and mTOR were evaluated.Results TSG significantly improved lung pathologies and lung function in AECOPD rats by reducing bronchial wall thickness and mean alveolar linear intercept,increasing alveolar numbers,and reducing pulmonary expression of IL-1β,IL-6,TNF-α,MMP2 and MMP9.In MH-S cells,TSG significantly suppressed LPS-induced expressions of inflammatory cytokines,COX-2 and iNOS.Serum pharmacology coupled with network pharmacology identified 10 chemical components in TSG-medicated serum,and functional analysis of their 466 targets suggested that the therapeutic effect of TSG on AECOPD was mediated primarily by luteolin and quercetin,which regulate the MAPK,mTOR,FoxO,and autophagy pathways.In MH-S cells,luteolin significantly inhibited LPS-induced inflammatory responses and expressions of p-p38,FoxO3a,mTOR,p-p62 and LC3.Conclusion TSG reduces macrophage-mediated inflammatory responses to alleviate AECOPD in rats possibly by modulating p38,mTOR,and FoxO3a pathways and inhibiting autophagy.

P2X7 receptor is an ion channel receptor with adenosine triphosphate (ATP) as its ligand, which is widely expressed in various immune cells and tissues. Activated P2X7 receptor is involved in a variety of physiological and pathological processes. P2X7 receptor is abnormally expressed in colon cancer, and plays a duel role of cancer-promoting and cancer-suppressing in colon cancer progression. When P2X7 receptor is activated by extracellular ATP, it can effectively inhibit proliferation and induce apoptosis of colon cancer cells through various mechanisms. In addition, P2X7 receptor can also promote the growth, invasion and metastasis of colon cancer. Understanding the activation of P2X7 receptor and its effect mechanism is of great significance for the treatment of colon cancer.

Experimental teaching occupies an important position in the teaching of medical laboratory technology. At present, many experimental projects cannot be carried out due to the high cost and the long process of the experiment, the difficulty of morphology teaching and the biological safety of clinical specimens. Virtual simulation experiment platform can break through the limitations of conventional experimental teaching in time, space and safety by integrating course experiment, increasing the experiment test item, building morphological inspection data repository, the virtual operation platform for inspection instrument and equipment and the virtual experiment assessment operation platform, and play an important role in the experimental teaching. This paper reviews the current situation of experimental teaching of medical laboratory technology, the construction and application, the existing problems and countermeasures of virtual simulation experiment platform, and expects to provide reference for the construction and application of virtual simulation experiment platform for medical laboratory technology in the future.

Objective To investigate the effect of nucleus localization signal linked nucleic kinase substrate short peptide-conjugated chitosan (NNSCS)-mediated human miR-140 gene local transfection on the repair of articular cartilage defect in rabbits.Methods Eukaryotic expression plasmid GV268-miR-140 was constructed,and then negative controls GV268 and GV268-miR-140 were respectively combined with NNSCS to form NNSCS/GV268 and NNSCS/GV268-miR-140 complexes.Eighteen healthy male New Zealand white rabbits were randomly divided into transgenic group (Group A),negative control group (Group B),and sham operation group (Group C),with 6 rabbits per group.Both Groups A and B were prepared for the total cartilage damage model of femur trochlear,and Group C only exposed the articular surface of the femur trochlear.One week after operation,Group A was treated with NNS CS/GV268-miR-140 complex,Group B was given NNS CS/GV268 complex,and Group C was given equal amount of isotonic saline,twice a week for 7 weeks.The experimental animals were sacrificed at the end of the eighth week after operation.Real time fluorescence quantitative PCR (RT-qPCR) was used to detect the expression of miR-140,Sox9,Aggrecan and Hdac4 in the defect area.HE staining,safranine O/fast green staining,and Aggrecan immunohistochemical staining were used to evaluate cartilage repair in the defect area.Results RT-qPCR showed the expression of miR-140 in Group A (3.16 ± 0.37) was significantly higher than that in Group B (1 ± 0.24) and in Group C (1.24 ± 0.18) (P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of SOx9 gene (4.38 ± 0.66) compared with Group B (1.04 ± 0.04) and Group C (1.19 ± 0.3),(P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of Aggrecan gene (3.63 ± 0.58) (P ＜0.05) compared with Group B (1.21 ± 0.14) and Group C (1.34 ± 0.13).The miR-140 expression in Group A obviously down-regulated the expression of Hdac4 (0.37 ±0.06) compared with Group B (0.81 ± 0.06) (P ＜ 0.05).According to results of HE staining,safranine O/fast green and Aggrecan,cartilage repair was evident in Group A,while fibrous tissue proliferation and inflammatory cell infiltration were seen in the defect region in Group B,showing no cartilage repair.Conclusions NNS CS can carry exogenous genes into chondrocytes and the genes can abundantly express locally.High expression of miR-140 might significantly improve the repair of articular cartilage defect in vivoby up-regulating expressions of Aggrecan and Sox9 as well as down-regulating Hdac4 expression.

Objective To investigate the clinical efficacy of intermittent liver-nourishing and mind-regulating acupuncture in preventive treatment of migraine. Method One hundred and twenty migraine patients were randomly allocated to treatment and control groups, 60 cases each. The treatment group received intermittent liver-nourishing and mind-regulating acupuncture and the control group took flunarizine hydrochloride capsules orally. The migraine score, the visual analogue scale (VAS) score and the headache severity rating score were recorded in the subjects before treatment and at the end of treatment and the 4-week, 8-week, 12-week, 16-week and 20-week follow-ups. The Self-Rating Anxiety Scale (SAS) score and the Self-Rating Depression Scale (SDS) were recorded before and after treatment.Result After one course of treatment, the total efficacy rate was 98.3% in the treatment group and 89.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant difference in the migraine score between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups at the same follow-ups (P<0.05). There was a statistically significant difference in the VAS score between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups at the same follow-ups (P<0.05). There were statistically significant differences in the SAS and SDS scores between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups after treatment (P<0.05).Conclusion Intermittent liver-nourishing and mind-regulating acupuncture has marked efficacy in preventive treatment of migraine. It can increase the total efficacy rate and reduce the number of relapses.

Objective To analyze the efficacy and hemodynamic changes in patients with complex symptomatic middle cerebral artery stenosis after Solitaire AB stent implantation.Methods From June 2013 to June 2016,7 consecutive patients with complex symptomatic middle cerebral artery stenosis treated with Solitaire stents at the Department of Neurology,the Third People's Hospital of Hubei Province were enrolled retrospectively.The stenosis rate ≥70% was confirmed by digital subtraction angiography (DSA).Of the 7 patients,5 were male and 2 were female,with an average age of 70±8 years.The general data of the patients were documented,including clinical symptoms,modified Rankin scale(mRS)score,stenosis degree,vascular pathways LMA classification and Mori typing for stenosis,and postoperative residual stenosis or restenosis.The hemodynamic parameters at day 1,7,and 3 months before and after procedure were compared.Results All patients were successfully implanted with the Solitaire AB stents.(1) Of the 7 patients,the Mori type A of stenosis lesions was in 4 cases,B in 2 cases,and C in 1 case.The LMA typing of vascular approaches were Type Ⅲ in 3 cases,type Ⅱ in 4 cases.The preoperative stenosis rate was 80±7%,the residual stenosis rate was 24±13%,and there were no operation-related complications.No ischemic events occurred during the follow-up period.(2) Before stent implantation and at 1 d,7 d,and 3 months after procedure,the peak systolic velocity (PSV) were 297±41,144±34,145±27,and 143±40 cm/s,respectively,the end diastolic velocity (EDV) were 159±22,68±16,68±14,and 66±17 cm/s,respectively,and the pulse index (PI) were 0.67±0.06,0.80±0.08,0.80±0.07,and 0.82±0.06,respectively.PSV,EDV,and PI at 1 d,7 d,and 3 months were improved compared with before procedure (all P<0.05),There were no significant differences at all time points in the pairwise comparison PSV and EDV and PI at all time points after the procedure (all P>0.05).Conclusions Initial analysis showed that no procedure-related complications were observed in the treatment of vascular tortuosity and complex middle cerebral artery stenosis with the Solitaire stents.The short-term curative effect is exact;However,it still needs to be validated further.

Objective To observe the clinical efficacy of heat-sensitive moxibustion plus point-toward-point needling in treating poststroke strephenopodia.Method Eighty patients with poststroke strephenopodia were randomized into a treatment group intervened by heat-sensitive moxibustion plus point-toward-point needling and a control group intervened by rehabilitation, 40 cases in each group. In addition to the basic treatment, the treatment group was given heat-sensitive moxibustion plus point-toward-point needling, and the control group was given rehabilitation treatment. Holden's Functional Ambulation Classification (FAC), Fugl-Meyer Assessment (FMA) of the lower-limb motor function, and Tinetti Gait Assessment (TGA) were adopted for evaluation of the two groups, and the clinical efficacies were compared.ResultThe effective rate was 90.0% in the treatment group versus 77.5% in the control group, and the difference was statistically significant (P<0.05); after the treatment,there was a significant difference in comparing the Holden's FAC between the two groups (P<0.05); the FMA score changed significantly after the treatment in both groups (P<0.05), and there was a significant difference in comparing the FMA score between thetwo groups after the treatment (P<0.05); the TGA score changed significantly after the intervention in both groups (P<0.05), and there was a significant difference in comparing the TGA score between the two groups after the intervention (P<0.05).ConclusionHeat-sensitive moxibustion plus point-toward-point needling can produce a significant efficacy in treating poststroke strephenopodia, as it can enhance the effective rate and improve the lower-limb motor function.