1.Investigation of molecular markers of in-hospital death related to acute myocardial infarction
Xuexue HAN ; Tianxing ZHANG ; Hao ZHANG ; Xue LI ; Xingzhu ZHOU ; Shuhui FENG ; Chunlin YIN ; Jinggang XIA
Chinese Journal of Postgraduates of Medicine 2025;48(1):66-75
Objective:To investigate the molecular markers involved in death related to acute myocardial infarction (AMI) and provide new targets for early intervention.Methods:Consecutive patients who hospitalized in department of cardiology, Xuanwu Hospital, Capital Medical University from January 2017 to December 2021 and diagnosed with AMI were enrolled. The clinical factors and markers associated with in-hospital death after AMI were analyzed. In addition, patients diagnosed with AMI hospitalized in department of cardiology, Xuanwu Hospital, Capital Medical University from September 2022 to April 2023 were enrolled. We prospectively analyzed the plasma protein of death related to AMI via Olink Precision Proteomics based on proximity extension assay (PEA) technology.Results:In the retrospective study, 2 325 patients with AMI were analyzed, including 75 patients in the in-hospital death group and 2 250 subjects in the survival group. The overall mortality rate during hospitalization was 3.23% (75/2325). The patients in the death group were older: 72 (64, 80) years vs. 63 (55, 71) years. And Interleukin-6 (IL-6), hypersensitive C-reactive protein (Hs-CRP), leukocyte counts and neutrophil counts were markedly higher in the death group than those in the survival group: 69.0 (26.7, 136.6) ng/L vs. 18.2 (9.4, 36.5) ng/L, 45.7 (28.7, 50.5) mg/L vs. 5.5 (2.0, 17.2) mg/L, 12.0 (9.8, 14.1) ×10 9/L vs. 8.9 (7.2, 11.2) × 10 9/L, 9.8 (7.8, 12.1) ×10 9/L vs. 6.5(4.7, 8.8) ×10 9/L ( P<0.01). In this prospective study, 86 patients with AMI were analyzed. 61 proteins including Insulin-like growth factor-binding protein 1, 2 (IGFBP-1, IGFBP-2), Chitotriosidase-1 (CHIT1), Complement component C1q receptor (CD93) were independently associated with in-hospital death related to AMI ( P<0.05). The differential proteins were mainly enriched in inflammatory response, cell adhesion, cytokine signaling pathway and apoptosis. Moreover, 22 proteins including Urokinase plasminogen activator surface receptor (U-PAR), Trefoil factor 3 (TFF3), Perlecan (PLC), Growth differentiation factor 15 (GDF-15), Junctional adhesion molecule A (JAM-A) were plotted according to a logistic regression model, and the area under the curve (AUC) was more than 0.9, showing the high accuracy in predicting in-hospital death after AMI. Conclusions:Molecular markers of the inflammatory response, cell adhesion, cell growth and apoptosis might be involved in death related to AMI, which provides new targets for early intervention.
2.Safety and accuracy of robotic-assisted screw placement in the treatment of adolescent idiopathic scoliosis
Xinuo ZHANG ; Qingjun SU ; Dongyue LI ; Luming TAO ; Yong HAI
Chinese Journal of Postgraduates of Medicine 2025;48(1):17-23
Objective:To compare the safety and accuracy between robotic-assisted screw placement and free-hand screw placement in adolescent idiopathic scoliosis (AIS) surgery.Methods:The clinical data of 69 AIS patients underwent posterior spinal scoliosis orthomorphia from December 2021 to October 2023 in Beijing Chaoyang Hospital, Capital Medical University were retrospectively analyzed. Among them, 37 patients underwent robot-assisted screw placement (robot group), and 32 patients underwent fluoroscopy-assisted free-hand screw placement (free-hand group). The basic information of surgery (operation time, intraoperative blood loss, intraoperative radiation exposure time, postoperative hospital stay and postoperative complications), screw placement indexes (single screw placement time and accuracy of screw placement) and imaging indexes (main curve correction rate, kyphotic change and lumbar lordosis change) were compared between two groups. The ln curve regression analysis method was used to evaluate the learning curve of robot-assisted screw placement therapy for AIS.Results:A total of 716 screws were placed in 32 patients of free-hand group, and 766 screws in 37 patients of robot group. The operation time, intraoperative radiation exposure time, single screw placement time and accuracy of screw placement in robot group were significantly higher than those in free-hand group: (272.30 ± 67.98) min vs. (221.66 ± 67.32) min, (149.81 ± 57.21) s vs. (116.03 ± 63.10) s, (497.97 ± 51.74) s vs. (381.47 ± 46.58) s and 97.91% (750/766) vs. 91.48% (655/716), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in intraoperative blood loss, postoperative hospital stay, incidence of neurological complications, incidence of incision infection and number of screw between two groups ( P>0.05). There were no statistical differences in the main curve correction rate, kyphotic change and lumbar lordosis change between two groups ( P>0.05). When the fitting degree was the highest ( R2 = 0.729, P<0.01), the fitting equation was y = - 50.93ln x + 634.7 ( x was the number of operation, and y was the single screw placement time), and the number of vertices was 12 cases. The robot group was divided into three subgroups according to the order of surgery, subgroup A consisted of 12 patients who underwent the surgery from first to twelfth, subgroup B consisted of 12 patients who underwent the surgery from thirteenth to twenty-fourth, and subgroup C consisted of 13 patients who underwent the surgery from twenty-fifth to thirty-seventh. Among them, the single screw placement time in subgroup A was significantly longer than that in subgroup B and subgroup C: (560.92 ± 35.03) s vs. (465.75 ± 21.20) and (469.62 ± 24.94) s, and there was statistical difference ( P<0.05); there was no statistical difference between subgroup B and subgroup C ( P>0.05). Conclusions:Robot-assisted screw placement for AIS can effectively improve the accuracy of screw placement without affecting deformity correction, but it can increase screw placement time, operation time and radiation exposure time. A smooth learning curve is obtained after performing 12 procedures.
3.Correlation between D-dimer, antithrombin Ⅲ levels and multiple organ dysfunction syndrome in patients with severe multiple trauma
Kang TOU ; Laifa KONG ; Zhi WANG ; Yong′an XU
Chinese Journal of Postgraduates of Medicine 2025;48(7):577-584
Objective:To explore the correlation between D-dimer (D-D), antithrombin Ⅲ (AT-Ⅲ) at admission, and multiple organ dysfunction syndrome (MODS) in patients with severe multiple trauma.Methods:A retrospective study was conducted to collect data from 80 patients with severe multiple trauma admitted to Jinhua Central Hospital from April 2021 to April 2024. According to the occurrence of MODS within 1 week of treatment, the patients were divided into an occurrence group with 25 cases and a non-occurrence group with 55 cases. The general data, plasma D-D, serum AT-Ⅲ levels and other laboratory indexes at admission were compared between the two groups. The correlation between D-D, AT-Ⅲ at admission and MODS in patients with severe multiple trauma was analyzed.Results:The injury severity rating score (ISS) in the occurrence group was higher than that in the non-occurrence group: (29.12 ± 3.84) points vs. (26.18 ± 3.12) points, the proportion of damage control surgery was lower than that in the non-occurrence group: 32.00% (8/25) vs. 65.45% (36/55), the platelet, AT-Ⅲ and albumin at admission were lower than those in the non-occurrence group: (112.28 ± 20.12) ×10 9/L vs. (123.56 ± 23.47) ×10 9/L, (133.79 ± 18.21) mg/L vs. (148.26 ± 19.57) mg/L, (35.12 ± 6.35) g/L vs. (38.47 ± 5.88) g/L, the D-D at admission was higher than that in the non-occurrence group: (11.36 ± 3.35) mg/L vs. (8.18 ± 2.83) mg/L, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that the occurrence of MODS in patients with severe multiple trauma may be related to the ISS at admission, the status of receiving damage control surgery, and the D-D, AT-Ⅲ, albumin at admission ( OR = 1.29, 0.14, 1.34, 0.95 and 0.87; P<0.05). Restrictive cubic spline analysis showed that the risk of MODS in patients with severe multiple trauma showed a non-linear dose-response relationship with D-D and AT-Ⅲ at admission ( P<0.05). When D-D at admission ≥ 9.25 mg/L, the risk of MODS increased with increasing levels, while when AT-Ⅲ at admission ≤ 143.49 mg/L, the risk of MODS increased with decreasing levels. The D-D and AT-Ⅲ at admission had a negative interactive effect on the occurrence of MODS in patients with severe multiple trauma. By drawing decision curves and column charts, it was found that D-D and AT-Ⅲ at admission, as well as other major indicators, had high predictive power for the occurrence of MODS in patients with severe multiple trauma. Conclusions:The occurrence of MODS in patients with severe multiple trauma may be related to the levels of D-D and AT-Ⅲ, and the risk of MODS increases with the increase of D-D and the decrease of AT-Ⅲ at admission. Both can effectively assist other indicators in predicting the risk of MODS in patients.
4.The relationship between neutrophil-to-lymphocyte ratio and the levels of inflammatory factors in peripheral blood and the brain injuries of suppurative meningitis in neonates and the value of joint prediction of hydrocephalus
Yanhua CHANG ; Yayan WANG ; Weiwei XU
Chinese Journal of Postgraduates of Medicine 2025;48(6):489-493
Objective:To analyze the relationship between neutrophil-to-lymphocyte ratio(NLR) and the levels of inflammatory factors in peripheral blood and the brain injuries of suppurative meningitis in neonates (NPM) and the value of joint prediction of hydrocephalus.Methods:Ninety-five children with NPM diagnosed and treated in the Affiliated Hospital of Jining Medical College from January 2020 to December 2022 were retrospectively selected, including 31 children with non-cerebral parenchymal injury (group A), accounting for 32.63%(31/95); 36 children with parenchymal injury and no hydrocephalus (group B), accounting for 37.89%(36/95); 28 children with brain parenchymal injury and hydrocephalus (group C), accounting for 29.47%(28/95). The clinical data, peripheral blood levels of NLR, interleukin 6(IL-6), hyper-sensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) were compared among the three groups, and the influencing factors of hydrocephalus were analyzed by Logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the value of changes(△, representing the absolute value of the difference between the corresponding indexes and 3 d after admission) in NLR, hs-CRP, IL-6 and PCT in predicting hydrocephalus in NPM alone and combination.Results:The incidence of respiratory failure and convulsion and the levels of NLR, hs-CRP, IL-6 and PCT in the group C were higher than those in the group B and A: 42.86%(12/28) vs. 13.89%(5/36), 6.45%(2/31); 42.86%(12/28) vs. 16.67%(6/36), 3.23%(1/31); 3.91 ± 0.71 vs. 3.12 ± 0.64, 2.16 ± 0.58; (98.21 ± 10.17) mg/L vs. (86.74 ± 9.30), (75.18 ± 8.42) mg/L; (40.73 ± 7.88) ng/L vs. (31.26 ± 6.45), (25.01 ± 5.19) ng/L; (13.26 ± 2.04) ng/L vs (11.83 ± 1.91), (9.45 ± 1.67) ng/L; the levels of NLR, hs-CRP, IL-6 and PCT in the group B were higher than those in the group A, there were statistical differences ( P<0.05). Logistic regression analysis showed that the levels of peripheral blood NLR and serum hs-CRP, IL-6 and PCT at admission were independent risk factors for hydrocephalus in children with NPM ( P<0.05). The △NLR, △hs-CRP, △IL-6 and △PCT of the children with hydrocephalus were lower than those without hydrocephalus: 0.73 ± 0.24 vs. 1.02 ± 0.31, (42.73 ± 13.08) mg/L vs. (69.56 ± 18.19) mg/L, (13.43 ± 4.22) ng/L vs. (19.86 ± 6.43) ng/L, (4.35 ± 1.34) ng/L vs. (6.58 ± 2.03) ng/L, there were statistical differences ( P<0.05). ROC curve analysis results showed that the AUC of △NLR, △hs-CRP, △IL-6 and △PCT combined to predict hydrocephalus in children with NPM was 0.903, which was greater than each single index ( P<0.05). Conclusions:The levels of NLR, hs-CRP, IL-6 and PCT in peripheral blood of children with NPM are significantly correlated with brain injuries, and have certain predictive efficacy in predicting the risk of hydrocephalus.
5.Effect of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis with high-risk bleeding treated with continuous renal replacement therapy
Luheng GUO ; Jing LI ; Xuan ZHOU ; Lin LIU ; Zongke WANG ; Bing YU ; Rongqiang LIU
Chinese Journal of Postgraduates of Medicine 2025;48(12):1082-1086
Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.
6.Clinical observation of Jingling oral liquid combined with methylphenidate hydrochloride and thiopride hydrochloride in the treatment of attention deficit hyperactivity disorder co-induced by epilepsy
Min LIU ; Weihong HAO ; Ying CHENG ; Xiaoning GUAN ; Sujing JING
Chinese Journal of Postgraduates of Medicine 2025;48(12):1086-1091
Objective:To analyze the clinical effect of Jingling oral liquid combined with methylphenidate hydrochloride and thiopride hydrochloride in the treatment of children with attention deficit hyperactivity disorder (ADHD) and its influence on serum dopamine transporter (DAT), interleukin-6 (IL-6) and 8 isoprostaglandin F2α[8-iso-PGF-(2α)] levels.Methods:A total of 120 children with ADHD co-induced by epilepsy diagnosed and treated in Handan Second Hospital from May 2022 to June 2023 were retrospectively selected and divided into observation group and control group according to treatment method, with 60 cases in each group. The control group was treated with methylphenidate hydrochloride tablets and tiapride hydrochloride, and the observation group was treated with Jingling oral liquid on the basis of the control group. Both groups were treated continuously for 16 weeks. The clinical efficacy and number of seizures of the two groups were compared, the clinical symptoms of the two groups were assessed by the Conner Parent Symptom Questionnaire (PSQ) and the Swanson Nolan and Pelham Version Ⅳ(SNAP-Ⅳ), and the intelligence level of the two groups was assessed by the Wechsler Intelligence Scale. The serum levels of DAT, IL-6, 8-iso-PGF-(2α), neurotrophic factors before and after treatment and the occurrence of adverse reactions were compared between the two groups.Results:After treatment, the effective rate in the observation group was higher than that in the control group: 93.33% (56/60) vs. 80.00% (48/60), there was statistical difference ( χ2 = 4.62, P<0.05). After treatment, the number of seizures in the observation group was less than that in the control group at 3, 4 to 6, 7 to 12 months: (10.78 ± 1.45)times vs.(14.18 ± 1.56) times, (4.86 ± 0.53) times vs.(8.63 ± 0.89) times, (2.64 ± 0.32) times vs. (4.11 ± 0.45) times, there were statistical differences ( P<0.05). After treatment, the scores of PSQ and SNAP-Ⅳ in the observation group were lower than those in the control group: (13.67 ± 1.48)scores vs. (15.18 ± 1.59) scores, (22.12 ± 2.35) scores vs. (25.37 ± 2.68)scores; while the scores of Wechsler intelligence scale was higher than that in the control group: (93.65 ± 9.77)scores vs.(89.42 ± 8.89) scores, there were statistical differences ( P<0.05). After treatment, the serum levels of DAT, IL-6 and 8-iso-PGF-(2α) in the observation group were lower than those in the control group: (0.46 ± 0.05) μg/L vs. (0.52 ± 0.06) μg/L, (8.26 ± 0.89) ng/L vs. (8.74 ± 0.92) ng/L, (60.38 ± 6.46) ng/L vs.(79.25 ± 8.14) ng/L, there were statistical differences ( P<0.05). After treatment, the serum levels of S100βprotein, brain-derived nerve growth factor and prolactin in the observation group were higher than those in the control group: (41.55 ± 4.28) ng/L vs. (37.26 ± 3.87) ng/L, (498.33 ± 54.26) ng/L vs.(442.15 ± 45.78) ng/L, (10.18 ± 1.14) μg/L vs. (9.69 ± 0.97) μg/L, there were statistical differences ( P<0.05).There was no significant difference in gelatinous-derived nerve growth factor level between the two groups after treatment ( P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Jingling oral liquid combined with methylphenidate hydrochloride and thiopride hydrochloride in the treatment of ADHD co-induced by epilepsy has good efficacy, and can significantly improve their clinical symptoms, regulate the levels of serum DAT, IL-6, 8-iso-PGF-(2α). It is safe and reliable.
7.The association between migraine and cognitive impairment
Tiantian SONG ; Ying XING ; Baiyu WANG ; Xinxiu SHI ; Xiaoxuan WU
Chinese Journal of Postgraduates of Medicine 2025;48(12):1092-1096
Objective:To investigate the characteristics of brain network reorganization in migraine patients and its relationship with the grading of right-to-left shunt (RLS) in patent foramen ovale(PFO) by integrated 3.0T structural magnetic resonance imaging (MRI),resting-state functional MRI(fMRI),and contrast-enhanced transthoracic echocardiography, thereby toexplore the mechanism underlying cognitive impairment in migraine.Methods:A total of 49 migraine patients (migraine group)and 16 demographically matched healthy subjects (healthy control group) who received diagnosis and treatment at China-Japan Union Hospital of Jilin University from September 2020 to September 2023 were selected as the study participants. Structural images (T1-weighted) and resting-state functional images were obtained from brain imaging (MRI and fMRI) data. The amplitude of low-frequency fluctuation (ALFF) algorithm was used to quantify the intensity of spontaneous neural activity in brain regions, while the Fazekas scale and the Age-Related White Matter Changes (ARWMC) scale were employed to assess white matter lesions. Participants were evaluated using the Mini-Mental State Examination (MMSE). Based on the results of contrast-enhanced transthoracic echocardiography (cTTE),the migraine group was further subdivided into A1 group (18 cases, no PFO), A2 group (17 cases, PFO with small-to-moderate RLS) and A3 group (14 case, PFO with large RLS) group, the differences in brain functional activity and cognitive function were compared among these groups.Results:By Fazekas scale scores and ARWMC scale scores, the incidence of hyperintense foci in the deep white matter regions in the migraine group were higher than those in the healthy control group: 67.3%(33/49) vs. 6/16, 61.2%(30/49) vs. 5/16, there were statistical differences ( P<0.05). Compared with the healthy control group, the migraine group exhibited higher spontaneous neural activity intensity in the brainstem,bilateral posterior cingulate cortex,left medial frontal gyrus,and left middle frontal gyrus,while showing reduced brain activity in the right angular gyrus region. The short-term delayed recall scores and total MMSE scores in the migraine group were lower than thosein the healthy control group: (1.61 ± 1.06) scores vs. (2.44 ± 0.81) scores, (25.06 ± 2.31) scores vs. (27.94 ± 1.44) scores, there were statistical differences ( P<0.05). The short-term delayed recall scores mong the A1 group, A2 group and A3 group had statistical difference( P<0.05). Conclusions:Migraine patients exhibit specific brain functional network reorganization and cognitive dysfunction, which are closely related to the degree of RLS.
8.Correlation study of methylenetetrahydrofolate reductase gene polymorphism and serum homocysteine levels with spontaneous abortion in early pregnancy in patients with polycystic ovary syndrome
Yunxia SONG ; Lin SUN ; Jing CUI
Chinese Journal of Postgraduates of Medicine 2025;48(5):460-465
Objective:To explore the effects of polymorphic typing of methylenetetrahydrofolate reductase (MTHFR) and serum levels of homocysteine (Hcy) on spontaneous abortion in early pregnancy in patients with polycystic ovary syndrome (PCOS).Methods:PCOS women, treated in Dalian Women and Children′s Medical Center (Group) from January 2022 to January 2024 were included in the study. One hundred patients with previous spontaneous abortion in early pregnancy were selected as the observation group (abortion group), and 72 patients with one successful pregnancy were delivered as the control group. The difference between gene polymorphism and serum Hcy levels at the C677T locus of MTHFR gene between the two groups, and serum Hcy level with the occurrence of spontaneous abortion in PCOS patients.Results:The serum Hcy level was higher in the PCOS abortion group than in the control group: 14.70 (12.20, 18.75) μmol/L vs. 9.60 (7.62, 10.80) μmol/L, with a statistically significant difference ( P<0.05). Between the abortion and control groups, genotype CC: 23.00% (23/100) vs. 44.44% (32/72), CT: 49.00% (49/100) vs. 31.94% (23/72), TT: 28% (28/100) vs. 23.61% (17/72) ( χ2 = 9.24, P = 0.010). Genotype CT, genotype TT and allele T were all risk factors for spontaneous abortion in early pregnancy in PCOS patients. The Hcy level of each genotype in the abortion group was significantly higher than that of the control group, all statistically significant ( P<0.05), and alleles C and T had similar results ( P<0.01). There was a trend towards gradually increasing Hcy levels for the three genotypes in the same group (CC
9.Effectiveness of extracorporeal counterpulsation therapy in patients with heart failure in ischaemic cardiomyopathy
Zhongliang WANG ; Zhibin WU ; Yuhong LIU ; Wenxia ZHAO ; Ruifang CHEN
Chinese Journal of Postgraduates of Medicine 2025;48(6):493-497
Objective:To observe the effectiveness of extracorporeal counterpulsation therapy in patients with heart failure in ischaemic cardiomyopathy.Methods:A total of 112 patients with ischemic cardiomyopathy and heart failure admitted to the Second Affiliated Hospital of Xingtai Medical College from August 2020 to June 2023 were prospectively selected and divided into two groups by random number table method. The control group was treated with conventional drugs and conventional cardiac rehabilitation program, and the observation group was combined with external counterbeating therapy on the basis of the control group. The levels of N-terminal B-type brain natriuretic peptide (NTproBNP), soluble growth stimulation-expression gene-2 protein (sST2), neutrophil gelatinase-associated lipid carrier protein (NGAL), galactin-3 (Gal-3), cardiopulmonary exercise test (CPET) parameters and cardiac ultrasound indexes were compared between the two groups before and after treatment. The curative effect and the rate of re-hospitalization within 6 months were compared between the two groups.Results:After treatment, the levels of NTproBNP, sST2, NGAL and Gal-3 in the observation group were lower than those in the control group: (1941.36 ± 312.59) ng/L vs. (2674.22 ± 404.64) ng/L, (44.78 ± 3.97) ng/L vs. (52.45 ± 4.13) ng/L, (22.63 ± 3.65) μg/L vs. (26.41 ± 3.77) μg/L, (4.63 ± 1.29) ng/L vs. (6.11 ± 1.78) ng/L, there were statistical differences ( P<0.05); the maximum kilogram oxygen uptake (VO 2max/kg), maximum kilogram oxygen uptake as a percentage of predicted value (VO 2max/kg%pred), maximum minute ventilation as a percentage of predicted value (VEmax%pred) in the observation group were higher than those in the control group: (22.41 ± 2.23) ml/(min·kg) vs. (21.35 ± 2.09) ml/(min·kg), (83.79 ± 11.04)% vs. (78.74 ± 10.14)%, (88.95 ± 12.74)% vs. (75.45 ± 11.14)%, there were statistical differences ( P<0.05 or <0.01); the left ventricular ejection fraction (LVEF) in the observation group was higher than that in the control group and the left ventricular posterior wall thickness (LVPWT) and left ventricular posterior wall end-systolic thickness (PWS) were lower than those in the control group: (50.12 ± 3.87)% vs. (48.63 ± 3.74)%, (8.77 ± 1.58) mm vs. (9.63 ± 1.97) mm, (9.34 ± 1.54) mm vs. (10.14 ± 1.79) mm, there were statistical differences ( P<0.05). There was no statistical difference in the total effective rate between the two groups ( P>0.05). The patient readmission rate within 6 months of follow-up in the observation group was lower than that in the control group: 5.45%(3/55) vs. 20.00%(11/55), there was statistical difference( χ2 = 5.24, P<0.05). Conclusions:Extracorporeal counterpulsation therapy for the treatment of heart failure in ischaemic cardiomyopathy can improve the cardiorespiratory function, reduce the expression of NTproBNP, sST2, NGAL and Gal-3, and decrease the patient readmission rate.
10.A study on the guiding value of electroencephalogram index of consciousness and injury sensitivity index in anesthesia management of laparoscopic surgery
Lina YANG ; Naichao GUO ; Weidong ZHANG ; Guoning QI ; Haojuan JIA ; Yonggang LI
Chinese Journal of Postgraduates of Medicine 2025;48(6):502-506
Objective:To analyze the guiding value of index of consciousness 1(IoC1) and index of consciousness 2(IoC2) in anesthesia management of laparoscopic surgery.Methods:A total of 100 elderly patients undergoing laparoscopic surgery under general anesthesia in the Beijing Coal Group General Hospital from June 2022 to October 2023 were prospectively selected as research objects, and they were divided into the observation group and the control group according to random number table method, with 50 cases in each group. The observation group used IoC1 and IoC2 to monitor and guide anesthesia management, while the control group used bispectral index (BIS) to monitor the depth of anesthesia, and combined with the experience of anesthesiologists to guide anesthesia management. The changes of vital signs of patients in the two groups were compared after calm entry (T 0), induction of anesthesia (T 1), implantation of laryngeal mask 1 min (T 2), carbon dioxide (CO 2) pneumoperitoneum 1 min (T 3), and removal of laryngeal mask 1 min (T 4). The time of resuscitation extubation, dosage of anesthetic drugs, dosage of vasoactive drugs, IoC1, IoC2 and BIS were compared between the two groups. Results:The pneumoperitoneum time and incidence of circulatory instability between the two groups had no statistical differences ( P>0.05). The time of resuscitation and extubation in the observation group was shorter than that in the control group : (8.16 ± 6.08) min vs. (13.10 ± 7.09) min, the dosage of propofol and remifentanil were lower than those in the control group : (382.10 ± 201.90) mg vs. (465.48 ± 213.51) mg, (0.81 ± 0.62) mg vs. (1.17 ± 0.55) mg, there were statistical differences ( P<0.05). The amount of ephedrine and atropine between the two groups had no statistical differences ( P>0.05). The dosage of norepinephrine in the observation group was lower than that in the control group: (106.42 ± 46.12) μg vs. (147.04 ± 51.38) μg, there was statistical difference ( P<0.05). The heart rate, mean arterial pressure (MAP) and IoC1/BIS between the two groups had no statistical differences ( P>0.05). The IoC2 values of T 0, T 1, T 2, T 3 and T 4 in the observation group were 97.46 ± 2.46, 45.28 ± 5.08, 48.64 ± 4.51, 50.44 ± 4.21 and 96.08 ± 2.69, respectively. The IoC2 value of T 3 was higher than that of T 1 and T 2 in the observation group, there were statistical differences ( P<0.05). Conclusions:The application of IoC1 and IoC2 to monitor and guide the anesthesia management of laparoscopic patients under general anesthesia makes the application of anesthetic drugs more quantitative and precise, the perioperative vital signs more stable, and the recovery time faster.

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