Objective To investigate the change and its clinical significance of serum erythropoietin(EPO) content in the patients with acute cerebral stroke.Methods The serum EPO content in 60 patients with acute cerebral infarction(ACI),45 patients with cerebral hemorrhage(CH) and 40 patients with other nervous system diseases(control group) were detected by radio-immunity means.The patients with acute cerebral stroke were evaluated by National Institute of Health Stroke Scale(NIHSS).Results The serum EPO content in ACI group and CH group [(1.64?0.41)ng/ml,(1.59?0.54)ng/ml] were significant higher than that in the control group [(1.17?0.86)ng/ml](all P

Objective Analysis and investigate the suitable method and results of auxiliary diagnostic test applicated in newly di‐agnosed patients with multiple myeloma(MM) .Methods The auxiliary diagnostic test results of the 171 patients newly diagnosed with MM were analyzed retrospectively .Results In bone marrow smear examination ,the percentages of plasma cell in all the 171 patients increased and were 5 .0% -88 .0% ,while the morphology of plasma cells was abnormal .The levels of immunoglobulin in 112 patients increased in different degrees .81 patients had different degrees of renal function damage .110 patients had different de‐grees of anemia and reduction of white blood cells and platelets .Conclusion Comprehensive considerate all the results of auxiliary diagnostic tests and the clinical manifestations could improve the detection rate of MM.

Objective To explore the impact of a“one-week”staged multivessel percutaneous coronary intervention (PCI) versus culprit-only PCI on deaths and major adverse cardiac events (MACE). Methods We retrospectively analyzed 447 patients with multivessel disease who experienced a ST-segment elevation myocardial infarction (STEMI) within 12 h before undergoing PCI between July 26, 2008 and Septem-ber 25, 2011. After completion of PCI in the infarct artery, 201 patients still in the hospital agreed to undergo PCI in non-infarct arteries with more than 70%stenosis for a“one-week”staged multivessel PCI. A total of 246 patients only received intervention for the culprit vessel. Follow-up ended on September 9, 2014. This study examined the differences in deaths from any cause (i.e., cardiac and noncardiac) and MACE between the two treatment groups. Results Compared to a culprit-only PCI treatment approach, the“one-week”staged multivessel PCI was strongly associated with greater benefits for 55-month all cause death [41 (16.7%) vs.13 (6.5%), P=0.004] and MACE [82 (33.3%) vs. 40 (19.9%), P=0.002] rates. In addition, there were significant differences in the number of myocardial infarctions [43 (17.5%) vs. 20 (10.0%), P=0.023], coronary-artery bypass grafting [CABG;20 (8.1%) vs. 6 (3.0%), P=0.021], and PCI [31 (12.6%) vs. 12 (6.0%), P=0.018]. Patients undergoing culprit-only PCI compared to“one-week”PCI had the same number of stent thrombosis events [7 (2.8%) vs. 3 (1.5%), P=0.522]. Conclusions Compared to a culprit-only PCI treatment approach,“one-week”staged multi-vessel PCI was a safe and effective selection for STEMI and multi-vessel PCI.

Objective To evaluate the performance of UW2000 automatic urine system .Methods Using UW2000 automatic u‐rine system ,to evaluate intra ,inter batch precision ,linear ,carryover ,and the accuracy of the urine visible components(RBC ,WBC);at the same time intra ,inter batch precision and accuracy of of urine dry chemistry component .Results The within‐run coefficients of variation(CV% ) of RBC in high ,middle and low‐value samples were 15 .6% ,6 .8% ,20 .3% ,WBC were 16 .4% ,10 .5% ,24 .6% , respectively .Inter‐run precision of variation(CV% ) of RBC in middle and low‐value were 12 .8% ,13 .2% ,WBC were 15 .3% , 22 .8% ,respectively .The correlation coefficient of RBC was 0 .991 and the linear range was 88-19 513/μL .The correlation coeffi‐cient of WBC was 0 .997 and the linear range was 7-8 254/μL .And carryover rate was 0 .00% for RBC and 0 .06% for WBC ;The coefficient of UW2000 and microscopy on RBC and WBC were 0 .992 ,0 .995 .Within‐run precision ,inter‐run precision and accuracy for urine dry chemical composition of high ,low controls were all within the requirements of standards .Conclusion UW2000 auto‐matic urine analyzer workstation was not only save manpower ,but also with high detection speed and save cost .Importantly ,the re‐sults are reliability .In addition ,it could meet the working requirement in the general hospital ,and has great application value .

It has been known that the Alzheimer's disease(AD)is related closely with a synaptic failure,and the p21-activated kinase(PAK)is well documented to play an important role in the regulation of the synaptie functions.However,the relationship between thePAK and the pathology of AD is unclear.In the present study,we examined the expressions of the PAK3(one subtype ofPAK),phospho-rylated-PAK(pPAK) and β-amyloid42(Aβ42,β-amyloid with 42 peptides)in an APP/PS1 double transgenie mouse model of AD andthe morphologies of geurOtlS in the hippocampus at different ages.The Western Blot results showed that the expression of PAK remainedunchanged,while,the expression of pPAK decreased largely at the age of 32 weeks and further decreased significantly with aging in thehippocampus of the APP/PS1 transgenic mouse.A1342 levels in the hippocampus were detected to increase as early as the age of 22 weeks,and kept the increase to continue with aging.The morphological results showed no obvious neuron loss in the sections of Nissl staining,while serious distonion and disorder of the dendrites of the hippocampal neurons were observed on the sections of Gelgi staining in theAPP/PS1 transgenic mouse.The present results suggested that it seemed something wrong in the processes of phospholization of PAK,butnot in the expression of the PAK itself;the toxic Aβ42 might affect the PAK in its phospholization,which in turn directly influence thedendritic development in the hippocampal neurons and cause the dendrites distorting and disordering.

Objective:To explore the effect of evidence-based nursing based on the ACE-Star model as the theoretical framework for incision management of patients undergoing transoral endoscopic thyroidectomy.Methods:Convenience sampling was used to select 40 patients with thyroid tumor in General Surgery of Nanyang Central Hospital in Henan Province from June 2019 to June 2020 as the control group, and received routine thyroidectomy nursing. A total of 32 patients admitted from July 2020 to June 2021 were selected as the observation group, and were given evidence-based nursing with the ACE-Star model as the theoretical framework, including body position management, incision anti-infection management, and headgear usage management. The total drainage volume, extubation time, hospital stay, Visual Analogue Scale (VAS) score, incidence of complications (infection, facial edema, subcutaneous congestion) , and patient satisfaction were compared between the two groups, and the implementation rate of evidence-based items in the observation group was recorded.Results:The total drainage volume, extubation time, hospital stay, and VAS score of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant (χ 2=6.57, P<0.05) . The patients in the observation group had higher satisfaction with nursing than the control group, and the difference was statistically significant (χ 2=6.68, P<0.05) . In the observation group, the implementation rates of three evidence-based management items, including body position management, incision anti-infection management, and headgear usage management, were 96.88%, 96.88%, and 93.75%, respectively, and the implementation rates were all higher than 90%. Conclusions:Evidence-based nursing with the ACE-Star model as the theoretical framework is used for the incision management of transoral endoscopic thyroidectomy, which is beneficial to reduce postoperative complications and improve patient satisfaction, and has certain clinical guiding significance.

The automatic detection of tuberculosis lesions based on medical imaging has become a research hotspot in medical image processing.A comprehensive review of relevant researches and applications pertaining to deep learning in tuberculosis lesion detection is provided,which elucidates the experimental benchmarks in tuberculosis analysis,covering public datasets of pulmonary medical images and recent research advancements in tuberculosis detection and classification competitions,introduces emerging trends in deep learning methods and applications in tuberculosis detection,and analyzes the challenges existing in tuberculosis diagnosis using deep learning.The review summarizes and provides insights into the research advances and challenges of these technologies from the aspects of technical characteristics,performance advantages,and application prospects.

Objective To compare the analgesic effect and the effect on the success rate of reduc-tion of three doses of remifentanil combined with dexmedetomidine in the clamping reduction of cricoarytenoid joint dislocation.Methods Fifty-one patients with cricoarytenoid joint dislocation,30 males and 21 females,aged 18-80 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were selected from April 2021 to December 2022 in the department of otolaryngology,head and neck surgery.The patients were randomly divided into three groups according to remifentanil dose:remifentanil 0.5 μg·kg-1·min-1 group(group A,n=17),remifentanil 1.0 μg·kg-1·min-1 group(group B,n=18),and remifentanil 1.5 μg·kg-1·min-1 group(group C,n=16).After admission,dexmedetomidine 0.6 μg·kg 1·h-1 was injected intravenously,and an ear,nose and throat anesthetic spray(2％lidocaine 2 ml)was used to administer surface anesthesia to the base of the tongue.A second surface anesthesia was administered to the throat at 5 minutes,and dexmedetomidine was stopped at 10 minutes.The supraglottic and periarticular cri-coarytenoid joints were subjected to superficial anesthesia for a third time under visual laryngoscope,and then remifentanil at corresponding doses was injected intravenously in three groups for 5 minutes,and the reduction operation began after the pumping was stopped.The success of the first reduction,the anesthesia quality satisfaction score of the surgeon and the recovery of remifentanil during the operation were recorded.VAS pain scores were recorded at the time of entry,3 minutes,30 minutes,and 6 hours after operation.The adverse reactions during operation and recovery were recorded.Results Compared with group B,the success rate of first reduction and the score of anesthesia quality satisfaction were significantly decreased in groups A and C(P＜0.05).Compared with group A,the ratio of additional remifentanil supplementation in groups B and C was significantly reduced,and the VAS pain score 3 minutes after surgery was significant-ly decreased(P＜0.05).Compared with group C,the proportion of mandibular manipulation ventilation in groups A and B was significantly reduced(P＜0.05).There was no significant difference in the incidence of bradyheart rate,nausea and vomiting,agitation,delirium and laryngeal spasm between the three groups.Conclusion Compared with remifentanil 0.5 and 1.5 μg·kg-1·min-1,remifentanil 1.0 μg·kg-1·min-1 combined with dexmedetomide sequential pumping provided good analgesic effect for the clamping reduction of cricoarytenoid joint dislocation,improved the success rate of the first reduction,more stable respiratory circulation and fewer perioperative adverse reactions.

Objective To explore the effect of oral-muscle biofeedback system training on the rehabilitation of cognitive dysfunction in patients with obstructive sleep apnea (OSA) after ischemic stroke.Methods A total of 60 cases of poststroke OSA patients with cognitive dysfunction admitted to the rehabilitation center of deAn hospital in changzhou city from June 2017 to March 2018 were selected.On the basis of routine rehabilitation treatment,the control group was given positive pressure ventilation treatment,and the observation group was given oral muscle biofeedback system training.The changes of polysomnography (PSG) parameters,Montreal cognitive assessment (MoCA) score,serum matrix metalloproteinase-9 (MMP-9) and plasma homcysteinemia (Hcy) expression levels in the two groups before and after treatment were compared.Results Apnea hypopnea index and maximum apnea time of the two groups were significantly decreased after treatment compared with those before treatment,and the lowest SpO2 and average SpO2 were significantly higher than those before treatment(P＜0.05).After treatment,MoCA total score and the dimensions score of patients in the observation group were significantly higher than those in the control group at the same time (P＜0.05).After treatment,the levels of Hcy((12.38±4.54) μmol/L) and MMP-9((124.52± 12.94) μg/L) in the observation group were significantly lower than those in the control group at the same time(Hcy(17.52±6.27) μmol/L,MMP-9(268.25±20.5 7)μg/L),and the difference was statistically significant (Hcy:t=3.637,P＜0.05;MMP-9:t =32.395,P＜0.05).Conclusions Positive pressure ventilation and oral muscle biofeedback system training have the same effect on OSA after stroke,but oral muscle biofeedback system training can also effectively improve patients' cognitive function.

Objective:To improve awareness of the diagnosis and treatment of splenic histiocytic sarcoma.Methods:The clinical data of one patient with splenic histiocytic sarcoma who was admitted to First Teaching Hospital of Tianjin University of Traditional Chinese Medicine in July 2020 were retrospectively analyzed, and the relevant domestic and foreign literature was reviewed.Results:The patient was diagnosed as splenic histiocytic sarcoma by histopathological and immunohistochemical examinations. The methylprednisolone combined with cyclosporine was ineffective. The patient received a total splenectomy, followed by chemotherapy with VECD and CHOP regimens. The patient's condition was stable during the 5-month follow-up after the operation. The result of bone puncture showed that there was no infiltration of histocytic sarcoma, and hematological remission was obtained.Conclusions:Splenic histocytic sarcoma is a highly malignant tumor with insidious onset, unclear pathogenesis, and lack of specificity in clinical manifestations and imaging examinations. The diagnosis depends on pathological biopsy and immunohistochemistry, and needs to be differentiated from other malignant tumors of lymphoid hematopoietic tissue. At present, there is no best treatment for splenic histiocytic sarcoma, and most patients have a poor prognosis.