Objective To investigate the correlation between thrombelastogram (TEG)parameters and plasma D-dimer (D-D) and platelet aggregation rate (PAgT)in patients with acute cerebral infarction (ACI).Methods From January 2015 to Jan-uary 2016,120 patients with ACI (ACI group),and 60 healthy subjects (healthy group)were enrolled in the study.The TEG parameters were detected by thromboelastography,including blood coagulation time (R),blood clotting time (K),rate of blood clotting (αangle),coagulation comprehensive index (CI)and the maximum intensity of blood clotting (MA).Blood coagulation indexes also were detected,including prothrombin time (PT),fibrinogen (FIB,detected by automatic coagulation analyzer),plasma D-D (detected by colloidal gold method)and PAgT (detected by blood aggregation tester).Results R (5.36±0.95 min),K (2.34±0.98 min)and PT (11.88±1.67 s)in the ACI group were shorter than those in the healthy group (6.20±1.28 min,2.87±0.87 min,12.40±1.82 s),(t=4.962,3.547,1.911,all P<0.05).Theαangle (61.65± 7.84)degrees,CI (-0.21±1.11),MA (58.94±6.14 mm),D-D (0.34±0.08 mg/L),PAgT (66.9±6.8)% and FIB (4.41±0.96 g/L)in the ACI group were higher than those in the healthy group [(56.02 ± 6.94)degrees,(-1.50 ± 1.30),(53.86±7.85 mm),(0.24±0.06 mg/L),(55.4±7)%,(2.87±0.88 g/L)],(t=4.714,6.209,5.583,8.550, 10.592,7.039,all P<0.05).In ACI group,D-D,PAgt and the TEG parameters (αangle,CI,MA)were significantly nega-tively correlated (r=-0.481,-0.470,-0.504,-0.488,all P<0.05).D-D,PAgt and the TEG parameters (αangle,CI, MA)were significantly positively correlated (r=0.338,0.395,0.427,0.391,0.436,-0.482,all P<0.05).Conclusion TEG parameters can reflect the severity of ACI to some extent,and they were significantly correlated with plasma D-D and PAgt.

Objective To evaluate the effects of a single preoperative dose of gabapentin on buprenorphine patient controlled intravenous analgesia after modified radical mastectorny. Methods Sixty female patients,ASA physical starus Ⅰ and Ⅱ undergoing modified radical mastectomy under general anesthesia were divided into two groups of 30 each group by random digits table to receive either gabapentin 1200 mg (gabapentin group) or a matching placebo (control group), administered orally 2 h before the induction of anesthesia. Subjects received patient controlled intravenous buprenorphi(n)e analgesia during thepostoperative period. Fifty-three patients finished this study, 28 cases in control group,25 cases in gabapentin group. Postoperative pain (static and dynamic),postoperative nausea and vomiting,anxiety,sedation were assessed by pain visual analogue scale(VAS), four-point ordinal scale, anxiety visual analogue scale, Ramsay sedation scale respectively. Postoperative buprenorphine consumption and time to first patient controlled analgesia were observed. Results Postoperative VAS (static and dynamic) was lower in gabapentin group than that in control group (P ＜0.05). Postoperative buprenorphine consumption was (506.1 ±37.9)μg , time to first patient controlled analgesia was (21.1 ±2.3)min,incidence rate of postoperative nausea and vomiting was 40.0% (10/25), antemetic rate was 12.0% (3/25), grade of anxiety was (28.5 ± 12.1) scores in gabapentin group, (699.8 ± 87.8)μ g, (4.3 ±0.8) min,64.3% (18/28),32.1%(9/28) and (66.3±15.7) scores in control group respectively. There were significant differences between two groups (P ＜ 0.05). Conclusion A single preoperative oral dose of gabapentin 1200 mg can effectively attenuate postoperative pain,reduce the consumption of buprenorphine,decrease the incidence rate of postoperative nausea and vomiting,improve patients' anxiety in patients undergoing modified radical mastectomy under general anesthesia.

Objective To explore the clinical value of transnasal high volume oxygen therapy in the treatment of patients with acute heart failure.Methods From January 2016 to January 2018,61 cases with acute heart failure in Huxi Hospital Affiliated to Jining Medical College were selected.The patients were randomly divided into control group and treatment group according to the digital table,31 cases in the control group and 30 cases in the treatment group.The two groups were routinely given control of fluid volume,analgesia,strong heart,diuresis,vasodilator,anti-platelet aggregation,camp support and so on.The control group was given conventional oxygen therapy,and the treatment group was treated with high flow oxygen through nose.Before treatment and 12h,24h,48h,72h after treatment,the left ventricular ejection fraction (LVEF),oxygen index (PaO2/FiO2),serum lactic acid (Lac),B type sodium and titanium (BNP) in serum,and the application rate of non-invasive mechanical ventilation and invasive mechanical ventilation in 7d were observed in the two groups.Results Compared with the control group,the LVEF of the treatment group in each time point increased [(35.58 ± 3.64) ％ vs.(37.77 ± 3.76) ％,(37.87 ± 3.58) ％ vs.(40.07 ±3.36)％,(44.94 ±3.19)％ vs.(46.83 ±3.21)％,(47.55 ±3.45％)％ vs.(40.07 ±3.36％)％,t =-2.308,-2.466,-2.316,-2.487,all P ＜ 0.05].The PaO2/FiO2 of the treatment group increased significantly at each time point after treatment [(177.39 ± 10.62) mmHg vs.(184.17 ± 10.49) mmHg,(188.00 ± 11.72) mmHg vs.(198.57 ± 18.47) mmHg,(204.06 ± 17.69) mmHg vs.(221.40 ± 23.80) mmHg,(265.23 ± 34.51) mmHg vs.(290.37 ± 26.72) mmHg,t =-2.507,-2.678,-3.236,-3.174,all P ＜ 0.05].The BNP level of the treatment group decreased significantly at each time point after treatment [(2 462.90 ± 288.00) ng/mL vs.(2 264.53 ± 366.44) ng/mL,(1 646.61 ± 377.19) ng/mL vs.(1 474.07 ± 214.03) ng/mL,(991.94 ± 242.95) ng/mL vs.(811.90 ±258.67) ng/mL,(653.77 ± 147.671) ng/mL vs.(526.47 ± 127.87) ng/mL,t =2.355,2.187,2.803,3.594,all P ＜ 0.05].The Lac level of the treatment group decreased significantly at 12h and 24h after treatment [(5.05 ± 0.69) mmol/L vs.(4.55 ± 0.80) mmol/L,(3.68 ± 0.89) mmol/L vs.(3.13 ± 0.77) mmol/L,t =2.610,2.601,all P ＜ 0.05],but there were no statistically significant differences between the two groups at 48h and 72h after treatment [(1.62 ± 0.65) mmol/L vs.(1.53 ± 0.65) mmol/L,(1.36 ± 0.64) mmol/L vs.(1.26 ± 0.46) mmol/L,all P ＞ 0.05].In the control group and the treatment group,the incidence rates of non-invasive mechanical ventilation in 7d were 35.48％ (11/31),13.33％ (4/30),respetively,the difference was statistically significant (x2 =4.034,P ＜ 0.05).In the control group and the treatment group,the incidence rates of invasive mechanical ventilation in 7d were 12.90％ (4/31),3.33％ (1/30),respetively,the difference was statistically significant (x2 =4.957,P ＜ 0.05).Conclusion Nasal high flow oxygen therapy has better clinical effect on patients with acute heart failure.It is a more active treatment measure,and is worthy of clinical application.

Objective: To explore the action mechanism of electroacupuncture (EA) in improving the gastric motility of rats with diabetic gastroparesis (DGP). Methods: Forty-eight healthy Sprague-Dawley (SD) rats were randomly assigned into four groups: a normal group (group A), a model group (group B), a group of EA at acupoints (group C), and a group of EA at non-acupoints (group D), 12 rats in each group. The animal model of DGP was established by intraperitoneal injection of streptozotocin (STZ) plus high glucose and fat diet. The blood glucose, urine glucose and gastric emptying rate (GER) were observed. The content of insulin (INS) in serum and ghrelin in gastric antrum tissue were detected by enzyme linked immunoassay (ELISA). The expression of growth hormone secretagogue receptor mRNA (GHSR mRNA) in gastric antrum tissue was detected by real-time fluorescent quantitative polymerase chain reaction (PCR). Results:Compared with group A, blood glucose and urine glucose increased significantly (P<0.01), GER, content of serum insulin, the content of ghrelin and expression of GHSR mRNA in gastric antrum tissue decreased significantly (P<0.05 orP<0.01) in group B. Compared with group B, blood glucose and urine glucose decreased significantly (P<0.05), GER, the content of insulin in serum, the content of ghrelin and expression of GHSR mRNA in gastric antrum tissue increased significantly (P<0.05 orP<0.01) in group C. Conclusion: EA at acupoints can down-regulate the content of blood and urine sugar, and promote gastric emptying, which is possibly related to the regulation of serum insulin, and the expressions of ghrelin and GHSR mRNA in gastric antrum.

Objective To establish HPLC method for determination of (R,S)-epigoitrin in Banlangen granules and discuss the content limitation. Methods The samples were separated on SHIMADZU VP-ODS (150 mm×4. 6 mm, 5 μm) and the mobile phase consisted of methol-0. 02% phosphoric acid solution (7:93) at a flow rate of 1. 0 mL. min-1 . The detection wavelength was set at 245 nm and the injection volume (in automatic sampler) was 10 μL. The content limitation was assessed according to the transfer rate and statistical data of the results. Results (R,S)-epigoitrin showed a good linear relationship at concentration of 0. 058 7 – 150. 349 5 μg·mL-1(r = 0. 999 7, n = 7). The average recovery rate was 98. 72% , 98. 40% and 98. 60% , respectively; RSD was 1. 84% , 0. 50% and 1. 82% , respectively. The content limitation of (R,S)-epigoitrin was unreasonable according to the transfer rate and the statistical data of the results. Conclusion The method is easy and simple to operate, accurate and stable in results, and highly specific, thus it is applicable for the quality control of Banlangen granules. The content limitation should be determined on the basis of pharmacokinetic and pharmacodynamic data.