Objective:To the investigate the predictive value of preoperative systemic inflammatory response index (SIRI) for postoperative clinical outcome in patients with spontaneous intracerebral hemorrhage (ICH) in basal ganglia region.Methods:Patients with ICH in basal ganglia region underwent surgical treatment at the Department of Neurosurgery, the Affiliated Hospital of Qingdao University from January 2015 to December 2021 were retrospectively included. At 3 months after surgery, the modified Rankin Scale was used to evaluate the clinical outcome, with a score of 0-2 defined as good outcome and >2 defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent correlation between SIRI and poor outcome in patients with ICH. Receiver operating characteristic (ROC) curve analysis was used to identify the predictive value of SIRI. Results:A total of 258 patients with ICH in basal ganglia region underwent surgical treatment were enrolled, including 176 males (68.22%), aged 57.00 years (interquartile range, 49.00-65.25 years); median hematoma volume was 50.00 ml (interquartile range, 40.00-70.00 ml), and median SIRI was 4.12 (interquartile range, 2.28-7.30); 143 patients (55.43%) had poor outcome. Multivariate logistic regression analysis showed that older age (odds ratio [ OR] 1.070, 95% confidence interval [ CI] 1.030-1.111; P<0.001), lower Glasgow Coma Scale score ( OR 0.669, 95% CI 0.575-0.779; P<0.001), higher platelet count ( OR 1.010, 95% CI 1.003-1.017; P=0.004), and higher SIRI ( OR 1.434, 95% CI 1.255-1.638; P<0.001) were the independent predictors of poor outcome. ROC curve analysis showed that the area under the curve for predicting poor outcome by SIRI was 0.791 (95% CI 0.737-0.845; P<0.001), with an optimal cutoff value of 4.53. The predictive sensitivity and specificity were 67.8% and 81.7%, respectively. Conclusion:Preoperative SIRI can effectively predict the clinical outcome of patients with ICH in basal ganglia area at 3 months after surgery, and SIRI >4.53 indicates poor outcome.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.

Insomnia has become a common central nervous system disease. At present, the pathogenesis of insomnia is not clear. Animal models can help us understand the pathogenesis of the disease and can be used in transformational medicine. Therefore, it is very necessary to establish an appropriate model of insomnia. Clinical data show that insomnia patients with high levels of thyroxine and often accompanied by cardiovascular problems, a common mechanism underlying all of these physiological disruptions is the sympathetic nervous system. Combined with the characteristics of chronic onset of clinical insomnia, an insomnia model induced by long-term intraperitoneal injection of thyroid hormone has been created in our laboratory. In this paper, the insomnia-like state of the model was evaluated based on three validity criteria. Face validity has been demonstrated in metabolism, the Morris water maze, electrocardiogram (ECG) and electroencephalogram (EEG). Structure validity has been proved by the results of targeted metabolomics. After treatment with diazepam, a commonly used clinical anti-insomnia drug, the above physiological and pathological disorders were reversed. The results of comprehensive analysis show that the established thyrotoxicosis-associated insomnia model meets the validity requirement to establish an appropriate animal model of insomnia. The model presented in this article might help to study pathogenetic mechanisms of clinical insomnia, as well as to test promising methods of insomnia treatment.

Objective To evaluate the efficacy of airway topical anesthesia with combination of su-perior laryngeal nerve block ( SLNB) and thyrocricoid membrane puncture for tracheal intubation in the ped-iatric patients with Pierre Robin Sequence. Methods Thirty-two American Society of Anesthesiologist physical statusⅠorⅡpediatric patients with Pierre Robin Sequence, aged 5-12 months, weighing 5-13 kg, scheduled for elective cleft palate repair under general anesthesia, were divided into 2 groups ( n=16 each) using a random number table method: control group ( group C) and airway topical anesthesia with SLNB-thyrocricoid membrane puncture group ( group ST) . After anesthesia was induced by inhaling sevoflu-rane by mask on admission to the operating room, 2％ lidocaine 0. 5 ml was injected around the bilateral su-perior laryngeal nerve under ultrasound guidance, and then 2％ lidocaine 1 ml was injected via the thyrocri-coid membrane in group ST, and the root of tongue, pharynx and larynx were sprayed with 2％ lidocaine by using a laryngotracheal mucosal atomization device in group C. The pediatric patients were tracheally intuba-ted guided by a video laryngoscope 3 min later. The development of cardiovascular responses, vocal cord activity and body movement was recorded during intubation. The intubation time, success rate of intubationat first attempt and patient′s tolerance to tube were recorded. The occurrence of postoperative hoarseness was also recorded. Results Compared with group C, the incidence of cardiovascular responses, vocal cord activity and body movement was significantly decreased, the intubation time was shortened, the suc-cess rate of intubation at first attempt was increased, and the patient′s tolerance to tube score was decreased in group ST ( P<0. 05) . Conclusion Airway topical anesthesia with combination of SLNB and thyrocricoid membrane puncture can provide better intubation conditions when used for the pediatric patients with Pierre Robin Sequence.

Objective To evaluate the effects of hearing disorder factors on analgesic efficacy of propofol. Methods Ninety?five patients with hearing disorders, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective ear surgery, served as test group(group T). Ninety?five patients with normal hearing function, of Ameri?can Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective non?ear surgery, served as control group(group C). Propofol was given at the initial target plasma concentration of 1.2 μg∕ml. When the target plasma concentration was achieved, 1 min later the concentration was increased in increments of 0.3 μg∕ml. When the patients lost eyelash reflex and had no responses to clapping on the shoulder, bispectral index value and target plasma and effect?site concentrations of propofol, consumption of propofol and time for loss of consciousness were recorded. Re?sults Compared with group C, no significant change was found in bispectral index value at baseline or at loss of consciousness(P>0.05), the target plasma and effect?site concentrations and consumption of propofol were significantly decreased, and the time for loss of consciousness was shortened in group T(P<0.05). The consumption of propofol required at loss of consciousness was gradually reduced with the aggra?vated severity of hearing disorders in group T(P<0.05). Conclusion The analgesic efficacy of propofol is enhanced in the patients with hearing disorders.

Objective To evaluate the effect of dexmedetomidine on postoperative pain in rats with preoperative sleep deprivation. Methods Fifty healthy adult male Sprague-Dawley rats, aged 12 - 14 weeks, weighing 200-300 g, were divided into 5 groups ( n = 10 each) using a random number table:control group (group C), sleep deprivation group (group SD), incisional pain group (group IP), sleep deprivation plus incisional pain group ( group SD + IP) and sleep deprivation plus incisional pain plus dexmedetomidine group (group SD+IP+DEX). Sleep deprivation was induced by the flower pot technique, and then the incisional pain model was carried out on first day after completion of sleep deprivation. Dexme-detomidine 50 μg∕kg was intraperitoneally injected for 3 consecutive days before establishing the model of in-cisional pain in group SD+IP+DEX, and the equal volume of normal saline was given in the other groups. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal threshold ( TWT) were measured before operation or at 1 day before sleep deprivation and after operation or at 12, 24 and 72 h af-ter sleep deprivation. Blood samples were collected and spinal cord tissues were removed after the end of be-havior test for determination of serum corticosterone concentrations (by enzyme-linked immunosorbent assay and content of 5-hydroxytryptamine (5-HT) in spinal dorsal horns (by high-performance liquid chromatogra-phy). Results Compared with group C, the MWT and TWT were significantly decreased, and the serum corticosterone concentrations and content of 5-HT in spinal dorsal horns were increased in the other 4 groups(P<0. 05). Compared with group IP, the MWT and TWT were significantly decreased, and the serum cor-ticosterone concentrations and content of 5-HT in spinal dorsal horns were increased in group SD+IP, and the MWT and TWT were significantly increased (P<0. 05), and no significant change was found in the ser-um corticosterone concentrations or content of 5-HT in spinal dorsal horns in group SD + IP + DEX ( P >0. 05). Compared with group SD+IP, the MWT and TWT were significantly increased, and the serum cor-ticosterone concentrations and content of 5-HT in spinal dorsal horns were decreased in group SD+IP+DEX (P<0. 05). Conclusion Dexmedetomidine can reduce postoperative pain in rats with preoperative sleep deprivation, and the mechanism may be related to inhibiting stress responses and levels of 5-HT in spinal dorsal horns.

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia (PCIA) in the patients undergoing transcatheter hepatic arterial chemoembolization (TACE).Methods One hundred and twenty patients of both sexes,aged 40-65 yr,weighing 45-80 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective TACE under monitored anesthesia care,were divided into 2 groups (n =60 each) using a random number table:sufentanil group (S group) and dexmedetomidine mixed with sufentanil group (DS group).At 15 min prior to surgery,0.1 μg/kg sufentanil and 5 mg tropisetron were intravenously injected in both groups.In addition,dexmedetomidine 0.6 μg/kg was intravenously infused for 15 min in DS group,while the equal volume of normal saline was given instead in S group.PCIA solution contained sufentanil 2 μg/kg and tropisetron 5 mg in 100 ml of normal saline in S group.PCIA solution contained sufentanil 2 μg/kg,dexmedetomidine 2.μg/kg and tropisetron 5 ng in 100 ml of normal saline in DS group.The PCIA pump was programmed to deliver a 0.5 ml bolus dose with a lockout interval of 15 min and background infusion of 2 ml/h.Observer's Assessment of Alertness/Sedation Scale scores and scores for patient's satisfaction with analgesia were recorded at 30 min and 2,6,12,24 and 48 h after surgery.The pressing times of PCIA,total consumption of sufentanil and requirenent for morphine as rescue analgesics were recorded.The development of requirement for antiemetics,nausea and vomiting,bradycardia,respiratory depression and agitation was also recorded during analgesia.Results Compared with S group,the pressing times of PCIA,total consumption of sufentanil and requirement for morphine were significantly reduced,scores for satisfaction with analgesia were increased,and Observer's Assessment of Alertness/Sedation Scale scores were decreased (P＜0.05),and no significant change was found in the incidence of nausea and vomiting,additional requirement for antiemetics,bradycardia,respiratory depression or agitation in DS group (P＞0.05).Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy than sufentanil alone when used for PCIA in the patients undergoing TACE.

Objective To survey the attitudes and acceptance level of upper limb function reconstruction in patients with cervical spinal cord injury and analyze the related factors. Methods From October, 2013 to June, 2014, a total of 104 patients with cervical spinal cord injury were surveyed with self-designed questionnaire. Results There were 81 valid questionnaires, in which 3 patients (3.7%) heard of upper-extremity reconstructive surgery. The patients longed for upper limb function improvement most. After they had a understanding of the surgery, their willingness improved (P<0.01). No significant difference was found in the satisfaction degree and operation willingness between different hand function groups (P>0.05). The patients focused on the operation cost, the operation risk, recovery time after operation and the satisfaction of assistive devices, however, they were not correlated with the willingness of upper limb function reconstruction (P>0.05). Conclusion There is a clear gap between strong desire for functional improvement of upper limb and surgery awareness. It is important to communicate upper limb among patients with cervical spinal cord injury.

Aim To investigate the protective effects of Aplysin on ethanol-induced oxidative damage in rat pri-mary hepatocytes. Methods Rat primary hepatocytes were obtained via the portal vein collagenaseⅣin situ perfusion technique followed by a Percoll density gradi-ent centrifuge. MTT test was used to determine the op-timum dose of Aplysin and ethanol, and detect the cell vitality in primary hepatocytes. Supernatants of primary hepatocytes were harvested to measure AST and LDH level, and the SOD, GSH-PX activities and MDA con-tent in primary hepatocytes were observed. Flow cy-tometry was used to detect the cell apoptosis rate. DNA damage in primary hepatocytes was detected by single-cell gel electrophoresis assay. The level of mitochon-drial membrane potential in primary hepatocytes was tested by fluorogenic probe JC-1 . The CYP2 E1 activity in primary hepatocytes was detected by colorimetry. The proteins of CYP2 E1 were detected by Western blot. Results 300 mmol·L-1 dose of ethanol and 30 mg·L-1 dose of Aplysin were the optimal dosages and were used in the subsequent experiments. Hepatocyte vitality was significantly increased in Aplysin group compared to that in ethanol group, and Aplysin inhibi-ted the release of AST and LDH(P<0. 05). For Apl-ysin treatment group, the activities of hepatocyte SOD and GSH were significantly increased, and MDA was markedly lowered as compared with those in ethanol group( P <0. 05 ) . Aplysin could alleviate hepatocyte apoptosis significantly, and hepatocyte DNA damage rates of Ⅱ ~Ⅲ level and Ⅳ level were significantly lowered in Aplysin treatment group as compared with those in ethanol group, and Aplysin had evident im-provement in alcohol induced mitochondria damage of hepatocyte. Primary hepatocyte activities and protein expression of CYP2 E1 were markedly lowered in Aply-sin treatment group as compared with those in ethanol group(P<0. 05). Conclusion Aplysin has protective effects on liver oxidative damage induced by alcohol of primary cultured rat hepatocytes by blocking CYP2 E1 activation, relieving oxidative stress, and sharpening the oxidation resistance ability.

ObjectiveToexplorethemethodtoestablishanimalmodelofearlyosteonecrosisofthefemoralhead(ONFH)inducedby steroid.Methods20healthymaleBeagleswererandomlydividedintocontrolgroupandexperimentalgroupwith10dogsineachgroup. Theexperimentalgroupwasinjectedlipopolysaccharide10μg/kgandmethylprednisolone20mg/kgfor3daysconsecutively.Thecontrol groupwasinjectednormalsaline.2monthsand4monthsafteradministration,bothgroupswereperformedmagneticresonanceimaging (MRI).5animalsweresacrificedrespectivelyat2monthsand4monthsafteradministrationineachgroup,andbilateralfemoralheadspeci-menswereobtainedtoperformhistologicalexamination.Plasmaprothrombintime(PT),activatedpartialthromboplastintime(APTT),anti-thrombinIII(AT-III)weretestedbeforeand24hafteradministration.ResultsIntheexperimentalgroup,thepathologicalresultsshowed thattherewere4ONFH2monthsand6ONFH4monthsafteradministrationandMRIdidnotshowanyabnormality.Comparedwiththe controlgroup,thePT,APTT,AT-IIIintheexperimentgroupshortenedsignificantlyafteradministration(P<0.001).ConclusionModified steroid-inducedmethodcanestablishtheanimalmodelofearlyONFH.Hypercoagulationandlowfibrinolysismaybethereasonofste-roid-inducedosteonecrosis.