ObjectiveTo explore the characteristics of the cognitive changes in patients with lacunar infarction(LI) after carotid artery stenting(CAS).MethodsNeuropsychological tests were conducted in 43 patients with LI and carotid stenosis before and 1 month,6 months,12 months after CAS and the scores were compared with those of 41 healthy cases.ResultsCompared with control group,MMSE scores ( 26.33 ± 1.94),memory and executive function in therapy group lowered obviously.There was statistical difference (P＜ 0.05 or P＜ 0.01 ).Compared with before CAS,MMSE scores of 1 month (27.17±2.15),6 months (27.17 ±2.15),12 months (28.15±1.98) after CAS,memory and executive function in therapy group were all better obviously.There was statistical difference (P＜0.05 or P＜0.01).ConclusionIn acute stage of patients with LI (with in 1 week),most cognitive impairment was severe. Most cognition disorders was improved to normal level 12 months after CAS.The mechanism may be associated with the improvement of chronic cerebral insufficiency.

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 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.

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 a more effective method of detecting sleep respiratory events in children. METHODS Thirty-eight children were tested with HypnoPTT and 31 with polysomnography (control). The test parameters and operative methods were compared. RESULTS In addition to the parameters comm.on to both HypnoPTT and polysomnography, inspiratory flow limitation and spontaneous microarousal can be measured using HypnoPTT and fewer electrodes were needed. CONCLUSION HypnoPTT is a convenient method characterized by less sleep disturbance and credible results, rendering it is especially suitable for pediatric cases. Pulse transit time is a useful parameter for diagnosing the sleep respiratory disease.

Objective: To evaluate the effect of immune response of cryoablation combined with anti-CTLA-4 mAb against murine tumor draining lymph nodes (TDLNs) of prostate cancer (PCa). Methods: PCa-bearing murine models were established and mice were divided randomly into 4 groups-control (A), cryoablation treatment (B), cryoablation combined with anti-CTLA-4 mAb treatment (C), and anti-CTLA-4 mAb treatment (D). TDLN specimens were obtained from 5 mice of each group at 4 time points before treatment, and 7, 14, and 21 days after treatment. Tumor size was measured at each time point. Flow cytometry was utilized to detect changes inTreg and CTL proportions in TDLNs. LDH was utilized to detect killing activity for tumor cells of CTL. Overall survival (OS) of each group was recorded. Results: Fourteen days after treatment, compared with that of group A, Treg proportion in group B (9.78%±1.88% vs. 6.02%±0.44%) and C (9.78%±1.88% vs. 6.03%±0.45%) was decreased (both P<0.05); compared with that of group A, CTL proportion of group B (27.34%±2.13% vs . 34.23%±1.15%), C (27.34%±2.13% vs. 52.21%±2.53%), and D (27.34±2.13% vs. 33.99±1.21) was increased (P<0.05, P<0.001, P<0.05); compared with those of group A, CTL killing activities of group B (13.32%±3.39% vs . 26.36%±2.95%), C (13.32%±3.39% vs . 45.25%±3.27%), and D (13.32%±3.39% vs. 25.31%±3.24%) were improved (P<0.05, P<0.001, P<0.05). Survival analysis showed that the OS of PCa-bearing mice were prolonged (P<0.05, P<0.001) in group B (25.60 d±1.52 d vs. 34.20d±6.98 d) and C (25.60 d±1.52 d vs. 43.60 d±2.88 d) compared with that of group A; OS was prolonged (P<0.05) in group C compared with that of group B (34.20d±6.98 d vs. 43.60d±2.88 d). Conclusions: Cryoablation combined with anti-CTLA-4 mAb can reduce the proportions of Tregs in the TDLNs, increase the proportions of CTL as well as killing activities, and significantly prolong OS of mice. However, the specific mechanism needs further study.