Objective To explore the mechanism of the effect of itraconazole ethanolamine tablets on the CD40/CD40L axis in children with idiopathic thrombocytopenic purpura(ITP).Methods 80 children with ITP were selected as the study subjects.They were divided into a control group(n=40)and a study group(n=40)using a digital random table method.The control group was treated with cyclosporine,while the study group was treated with itraconazole ethanolamine tablets.Both groups were treated continuously for 3 months.Compare the clinical efficacy of two groups of patients T lymphocyte subpopulation levels[CD3+CD4+and CD4+/CD8+,as well as adverse reactions.Detect CD40 on the surface of lymphocyte membrane and platelet membrane in two groups of patients CD40L level,plasma sCD40 and sCD40L levels were detected using ELISA.Results The total effective rate of the study group(92.50%)was significantly higher than that of the control group(75.00%)(P<0.05).CD3+CD4+,CD4+/CD8+,The expression levels of sCD40 in plasma were higher than before treatment,CD8+and peripheral blood CD19+CD40+The expression levels of CD3+,CD40L+cells,and plasma sCD40L were lower than before treatment;Research group CD3+CD4+,CD4+/CD8+,The expression level of sCD40 in plasma was higher than that in the control group,CD8+,And peripheral blood CD19+CD40+The expression levels of CD3+CD40L+cells and plasma sCD40L were lower than those of the control group(P<0.05).The CD40L+cells on the surface of peripheral blood platelet membranes after two treatment groups were lower than before treatment;The CD40+on the surface of peripheral blood platelet membrane in the study group was higher than that in the control group,CD40L+cells were lower than those in the control group(P<0.05).The total adverse rate of the study group(15.00%)was lower than that of the control group(22.50%),but there was no significant difference between the two groups(P>0.05).Conclusion The treatment of ITP in children with eltrombopag olamine tablets has good clinical effi-cacy,regulates the level of T lymphocyte subsets,and is safe.

Objective:To understand the current status of transition shock and risk perception of nursing profession among undergraduate nursing students, and to explore the correlation between transition shock and risk perception of nursing profession.Methods:In May 2023, convenience sampling was employed to survey 140 undergraduate nursing students from the School of Nursing, Anhui Medical University as the research subjects. A cross-sectional survey was conducted using a general information questionnaire, Nurse Risk Perception Questionnaire and Transition Shock Scale.Results:The final valid questionnaire was 133 copies. Among 133 internship nursing students, there were 23 males and 110 females. The total score of risk perception of nursing profession among undergraduate nursing students was (90.77 ± 16.48), while the total score for transition shock was (47.22 ± 7.14). A significant positive correlation was found between risk perception of nursing profession and transition shock ( r=0.589, P<0.01). Transition shock was identified as a factor influencing risk perception of nursing profession among undergraduate nursing students ( t=8.47, P<0.01). Conclusions:The risk perception of nursing profession and transition shock among undergraduate nursing students were at a moderate level and positively correlated. Nursing managers should take proactive measures to alleviate the challenges faced by interns during the transition process, diminish their apprehension towards the nursing profession risk, and improve the quality of clinical internships.

Objective To investigate the efficacy and the collective brain responses of acupuncture for post-stroke limb numbness.Methods A total of 24 patients with post-stroke limb numbness and 23 matched healthy participants were recruited.Both groups received coordinated acupuncture treatment to regulate their physical and mental state,three times a week for 4 weeks.Changes in limb numbness assessed by the visual analog scale(VAS)were observed before and after acupuncture.Functional magnetic resonance imaging(fMRI)scans were conducted on the participants during the scanning process with acupuncture intervention.Blood oxygen level-dependent(BOLD)data were collected in three states:resting state,acupuncture task state,and needle retention state.Data processing was performed using software such as fMRIPrep and brainIAK.Intersubject correlation(ISC)analysis was conducted to compare the ISC values of different brain regions between the two groups under different conditions.Results Acupuncture treatment significantly reduced the VAS scores of limb numbness.No significant changes in ISC values in both groups during resting state.Under acupuncture conditions,the patient group exhibited significantly increased ISC values in the left precentral gyrus,left paracentral lobule,left postcentral gyrus,left insula,left anterior cingulate gyrus,right middle frontal gyruss and right anterior cingulate gyrus.Under the needle retention condition,a slight negative activation was observed in the bilateral precentral gyrus of the control group.In the patient group,the ISC values of the left superior frontal gyrus,left precentral gyrus,left paracentral lobule,left precuneus,left postcentral gyrus,left insula,left anterior cingulate gyrus,left thalamus,right superior frontal gyrus,right middle frontal gyrus,right precentral gyrus,and right anterior cingulate gyrus showed a significant increase compared to the resting state.Conclusion Acupuncture can improve post-stroke limb numbness symptoms and induce a specific pattern of collective brain activation in patients.This activation involves the precentral gyrus,postcentral gyrus,thalamus,insula,frontal lobe and cingulate gyrus.Acupuncture may enhance the processing of sensory information by activating the somatosensory-motor network and the cortical-thalamic-cortical loop.It may also modulate the central executive network and the descending pain control pathway to promote the relief of pain symptoms.