Objective To investigate the effects of preconditioning with extract of Ginkgo Biloba (EGB) on the tourniquet-induced ischemia-reperfusion (I/R) injury to the limb. Methods Forty ASA Ⅰ or Ⅱ patients aged 17-64 yr weighing 46-72 kg undergoing lower limb operation under combined spinal-epidural anesthesia (CSEA) were randomly divided into 2 groups (n = 20 each) : group A control and group B EGB. CSEA was performed at L2,3 or L3,4 interspace. The height of sensory block was kept below T10. Group B received EGB 0.3 mg/kg in 100 ml normal saline (NS) injected over 20 min via an intravenous line in the forearm as soon as the tourniquet was inflated while control group received plain NS 100 ml without EGB. Venous blood samples were obtained before tourniquet was inflated (To baseline) and at 5, 10, 20 min after tourniquet was released (T_1 , T_2, T_3) for measurement of blood lactate and MDA concentrations and SOD activity. BP (SP, DP) and HR were continuously monitored and recorded at the above time points. Results In control group DP and SOD activity were significantly decreased while blood lactate and MDA concentrations were significantly increased after tourniquet release as compared with the baseline values before tourniquet was inflated. In EGB group there was no significant change in DP, blood lactate and MDA concentrations and SOD activity after tourniquet was released as compared with the baseline. Conclusion Pretreatment with EGB can protect against tourniquet-induced I/R injury to the limb.

Objective To observe the effect of sevoflurane inhalation anesthesia and propofolsevoflurane combined anesthesia on glucose concentrations.Methods Thirty patients undergoinggeneral anesthesia were randomly divided into two groups with 15 cases each.The patients in group Awere anesthetized with sevoflurane inhalation and those in group B with sevoflurane combined withprovofol.Blood concentration of glucose was measured before operation and at 2 h during surgery.Results The blood glucose concentrations in groups of A and B were significantly increased at 2 h during surgery than those before[(6.23±1.45)mmol/L vs.(4.86±0.85)mmol/L and(6.66±blood glucose between the two groups.Conclusion Both sevoflurane inhalation anesthesia and combined propofol and sevoflurane anesthesia can not inhibit the increase of blood glucose duringoperation.

Objective To investigate the median effective plasma target concentration of propo-fol (Cp50 )needed for lumbar surgery during inhalation-intravenous balanced anesthesia when BIS is 50.Methods Patients aged 40-56 years,scheduled for vertebral pulp ectomy were included.Anesthe-sia were maintained by TCI of propofol,sevoflurane 0.5 MAC,remifentanyl 0.2 μg·kg-1 ·min-1 , and vecuronium 0.08 mg·kg-1 ·h-1 .The target plasma concentration of propofol was initially set at 1.8 μg/ml,and adjusted by the sequential up-and-down methods,based on BIS index.The Cp50 of propofol and its 95% confidence interval (CI)were calculated.Results Twenty-six patients were en-rolled in this study.The median effective plasma target concentration of propofol was 1.61 μg/ml (95%CI 1.52-1.70)μg/ml.Conclusion The Cp50 of propofol needed for maintaining the BIS index of 50 is 1.61 μg/ml during the anesthesia with 0.5 MAC of sevoflurane combined with remifentanyl in lumbar surgery.

Objective To investigate the effects of electroacupuncture (EA) of different intensities on cerebral energy metabolism in a rat model of global cerebral ischemia-reperfusion (I/R) . Methods Forty male SD rats weighing 200-230 g were randomized into 5 groups ( n = 8 each) : group A sham operation; group B global cerebral I/R and C, D, E groups cerebral I/R+ 5, 3, 1 mA EA. Global cerebral I/R was induced by 4-vessel occlusion technique. Bilateral vertebral arteries were permanently occluded by cauterization.Bilateral common carotid arteries were clamped. When the bilateral pupils were completely dilated, the arteries were unclamped. Baihui,Mingmen and Zusanli were electrically stimulated with 5,3,1 mA (30-50 Hz) for 20 min at 1 h of reperfusion in C, D, E groups. The EA was repeated at 12 h of reperfusion. The animals were sacrificed at 24 h of reperfusion.The activities of Na+ -K+ -ATPase, succinodehydrogenase (SDH) and lactic dehydrogenase(LDH) in brain tissue were measured.Results Cerebral I/R significantly increased LDH activity and decreased Na+ -K+ -ATPase activity in group B as compared with group A. EA with 5 mA significantly decreased LDH activity and increased SDH and Na+ -K+ -ATPase activities in group C compared with group B. Conclusion EA can improve the cerebral energy metabolism in a rat model of global cerebral I/R and it is related to the intensity, which may be the mechanism by which EA reduces the global cerebral I/R injury.

Background and purpose:The aim of this study was to analyze the prognostic factors in uterine adenocarcinoma and adenosquamous carcinoma treated with a combination of neoadjuvant chemoradiotherapy and surgery.Methods:Clinicopathologic data from 50 patients with stageⅠB2-ⅡA2 uterine cervical cancer were collected from the First Afifliated Hospital of Bengbu Medical College between Apr. 2005 and Oct. 2011. All patients underwent neoajuvant chemoradiotherapy, followed by radical hysterectomy and pelvic lymph node dissection. Before surgery, an intravenous chemotherapy was given. A particular vaginal brachytherapy was given to those with tumor diameter≥6 cm. The survival and recurrence in patients were analyzed retrospectively to investigate the prognostic factors. Results:In 50 patients withⅠB2-ⅡA2 uterine adenocarcinoma and adenosquamous carcinoma, 15 died during the follow-up period. The 2-year and 5-year progression-free survival rates were 80.12% and 72.24%, respectively, and median progression-free survival was 68 months. The 2-year and 5-year overall survival rates were 95.38% and 73.56%, respectively, and median overall survival was 80 months. Univariate analysis revealed that pelvic lymph node metastasis, cervical stromal invasion, parametrial infiltration, tumor diameter reduction <3 cm and advanced stage were the prognostic factors in patients with cervical cancer (P<0.05). Age, postoperative radiochemotherapy, lymphatic clearance involvement, FIGO stage, preservation of ovary and pathologic type were not associated with prognosis (P>0.05). Multivariate Cox proportional analysis revealed that pelvic lymph node metastasis and tumor diameter reduction after radiation and chemotherapy were the independent prognostic factors in patients with cervical cancer. Conclusion:The combination of neoadjuvant chemotherapy and surgery improves the resectable rate of patients withⅠB2-ⅡA2 uterine adenocarcinoma and adenosquamous carcinoma. Pelvic lymph node metastasis and tumor diameter reduction after radiation and chemotherapy are the independent prognostic factors in patients with cervical cancer.

ObjectiveTo explore the construction of a machine learning model for the diagnosis of traditional Chinese medicine （TCM） syndromes in chronic cough and the optimization of this model using the Voting ensemble algorithm. MethodsA retrospective analysis was conducted using clinical data from 921 patients with chronic cough treated at the Respiratory Department of Dongfang Hospital， Beijing University of Chinese Medicine. After standardized processing， 84 clinical features were extracted to determine TCM syndrome types. A specialized dataset for TCM syndrome diagnosis in chronic cough was formed by selecting syndrome types with more than 50 cases. The synthetic minority over-sampling technique （SMOTE） was employed to balance the dataset. Four base models， logistic regression （LR）， decision tree （dt）， multilayer perceptron （MLP）， and Bagging， were constructed and integrated using a hard voting strategy to form a Voting ensemble model. Model performance was evaluated using accuracy， recall， precision， F1-score， receiver operating characteristic （ROC） curve， area under the curve （AUC）， and confusion matrix. ResultsAmong the 921 cases， six syndrome types had over 50 cases each， phlegm-heat obstructing the lung （294 cases）， wind pathogen latent in the lung （103 cases）， cold-phlegm obstructing the lung （102 cases）， damp-heat stagnating in the lung （64 cases）， lung yang deficiency （54 cases）， and phlegm-damp obstructing the lung （53 cases）， yielding a total of 670 cases in the specialized dataset. High-frequency symptoms among these patients included cough， expectoration， odor-induced cough， throat itchiness， itch-induced cough， and cough triggered by cold wind. Among the four base models， the MLP model showed the best diagnostic performance （test accuracy： 0.9104； AUC： 0.9828）. Compared with the base models， the Voting ensemble model achieved superior performance with an accuracy of 0.9289 on the training set and 0.9253 on the test set， showing a minimal overfitting gap of 0.0036. It also achieved the highest AUC （0.9836） in the test set， outperforming all base models. The model exhi-bited especially strong diagnostic performance for damp-heat stagnating in the lung （AUC： 0.9984） and wind pathogen latent in the lung （AUC： 0.9970）. ConclusionThe Voting ensemble algorithm effectively integrates the strengths of multiple machine learning models， resulting in an optimized diagnostic model for TCM syndromes in chronic cough with high accuracy and enhanced generalization ability.