Objective Aδ and C fiber nociceptors can be excited when people received contact heat stimulation(CHS) and this excitation may be reflected by functional magnetic resonance imaging(fMRI).The aim of this study was to observe the different fMRI characteristics in CHS with distinct temperatures in healthy people and to explore the pain related functional network.Depending on the fMRI results,we can evaluate the values of CHS-fMRI during the research of brain functional connectivity.Methods Twenty-two healthy volunteers were recruited to this study.During the acquisition of fMRI,the right dorsal forearm received two different CHS in 41 and 51 degree respectively(41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group),and two series of fMRI data were obtained for each subject.The brain activation was obtained by using one sample t test for the 41 ℃CHS-fMRI group and 51 ℃CHS-fMRI group separately.The difference between 41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group was analyzed by paired-sample t-test.Result These activated brain areas in 41 ℃ CHS-fMRI group included bilateral superior temporal gyrus (STG),contralateral transverse temporal gyrus,contralateral amygdala,bilateral insula,bilateral inferior frontal gyrus (IFG),contralateral hippocampus,bilateral putamen,contralateral supramarginal,ipsilateral postcentral,ipsilateral inferior parietal lobule,ipsilateral middle temporal gyrus (MTG),bilateral cerebelum,bilateral middle cingulate cortex and bilateral posterior cingulate cortex.These activated brain areas in 51 ℃ CHS-fMRI group included bilateral STG,bilateral amygdala,contralateral hippocampus,bilateral thalamus,contralateral putamen,bilateral insula,bilateral IFG,bilateral cerebellum,contralateral postcentral,contralateral superior parietal lobule,bilateral MTG,bilateral precuneus,and contralateral cuneus.Compared with 41 ℃ CHS-fMRI group,the 51 ℃ CHS-fMRI group showed higher brain activation in bilateral cerebellum (right:4.455,left:3.891),ipsilateral precuneus (4.150),contralateral insula (3.530),contralateral IFG (3.530),and contralateral postcentral (3.530; t =2.83,P ＜ 0.01).Conclusions There are common brain activated areas and specific areas for each group,which suggested that existence of two central pathways activated by Aδ and C fiber which have different effects in perception of pain and have their brain network responsively.It may become one of the ideal pain stimulation methods with CHS-fMRI,which warrant worth further research.

Objective To explore the features of activation mapping induced by olfactory stimulation with functional magnetic imaging (fMRI), which will help to reveal the neural mechanism of olfactory dysfunction and contribute to the earlier diagnosis and treatment of neural degenerative disorders.Methods In this prospective study, 21 healthy volunteers were recruited in the Affiliated Hospital of North Sichuan Medical College from March to October 2015.Olfactory function was evaluated by using Visual Analogue Scale (VAS).During the fMRI scanning, all subjects received olfactory stimulation of rose and lavender odor.The brain activation was obtained by using softwares matlab2008a and SPM8.Results All subjects had normal olfactory function evaluated by VAS score (4.86±0.07).The activated brain areas included: bilateral inferior parietal lobule, bilateral inferior frontal gyrus-orbitofrontal gyrus, left insula, bilateral inferior temporal gyrus, left putamen, bilateral hippocampus, bilateral cingulate cortex, bilateral piriform cortex, bilateral amygdale, left lingual gyrus, bilateral cerebellum (t=2.62, P<0.01).Conclusions Olfactory is associated with multiple brain regions.The combination of olfactory event-related design and fMRI, as an objective measurement of olfactory, can be applied to investigate the olfactory cortical brain mapping.

Objective To study the changes of cognitive function and brain microstructure of patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) from neuropsychological test and voxel-based morphometry.Methods Sixteen patients with BECTS and 16 healthy volunteers,who were matched in gender,age and education,were enrolled in this study from May 2014 to May 2015 in the Affiliated Hospital of North Sichuan Medical College.The cognitive function and morphometry of the subjects were evaluated by neuropsychological test (full scale intelligence quotient (FSIQ),verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ)) and high-resolution T1-weighted imaging scanning.Thereafter,these data were analyzed with Student's t test,Chi-squared test and correlation analysis.Results (1) FSIQ(79.3±13.3),VIQ(82.3±12.1) andPIQ(81.3±10.3)ofBECTS group were significantly lower than the control group (107.0 ± 6.4,101.6 ± 6.5,114.8 ± 6.2;t =9.511,7.521,16.360,all P ＜0.01).(2) Patients with BECTS showed significantly increased gray matter volume in the bilateral putamen,paracentral lobule and right supplementary motor area (P ＜ 0.05,FDR-corrected).(3) A significant negative correlation was found between the gray matter volume of the left putamen and age of epilepsy onset (r=-0.586,P=0.017).Conclusions (1) There is a certain degree of cognitive impairment in patients with BECTS.(2) Patients with BECTS have some changes in brain microstructure.Genetic factors could indirectly influence the children's brain developmental trajectory,and the age of onset may be associated with the changes on the brain microstructure.

Objective To analyze the occurrence status and influencing factors of esophageal stenosis after surgery for early esophageal cancer. Methods A total of 285 patients with early esophageal cancer with endoscopic submucosal dissection (ESD) in the hospital from January 2019 to January 2021 were selected as research objects, and they were divided into control group with 237 cases (without esophageal stenosis) and study group with 48 cases (with esophageal stenosis) according to the occurrence of esophageal stenosis after surgery. The operation time, intraoperative blood loss and quality of life were compared between the two groups. The influencing factors of esophageal stenosis were analyzed. Results Compared with the control group, the study group had longer operation time, more intraoperative blood loss, and lower scores in psychological, environmental, physiological and social dimensions, and the between-group differences were statistically significant (P<0.05). Univariate analysis showed that esophageal stenosis after ESD had no correlations with gender, clinical stage, pathological type, history of drinking, the American Society of Anesthesiologists (ASA) classification, and anesthesia method (P>0.05). Patients aged ≥60 years old, damage of the muscularis propria, circumferential extent of lesion >3/4, malnutrition, tissue infiltration depth of M3+SM1, and longitudinal length of lesion >40 mm had a higher incidence of esophageal stenosis (P<0.05). Multivariate Logistics regression analysis showed that malnutrition, age ≥60 years, circumferential extent of lesion >3/4, damage of the muscularis propria, tissue infiltration depth of M3+SM1, and longitudinal length of lesion >40 mm were the main influencing factors for esophageal stenosis after ESD (P<0.05). Conclusion The occurrence of esophageal stenosis after ESD in patients with early esophageal cancer is related to factors such as damage of the muscularis propria, malnutrition, age ≥60 years, tissue infiltration depth of M3+SM1, circumferential extent of lesion >3/4, and longitudinal length of lesion >40 mm. Based on these factors, early prevention and control can be carried out to reduce the incidence of esophageal stenosis after surgery.

To summarize the nursing experience of a patient undergoing laryngeal transplantation due to laryngeal cancer.The case involved the development of a critical care management plan by a multidisciplinary team.By implementing nursing measures such as refined airway care,professional neck wound complication management,precise administration of immunosuppressants,ultrasound monitoring for nutritional management assurance,individualized psychological care,early rehabilitation of swallowing,speech and body function,thyroid function and hyperglycemia monitoring and other measures,the patient stayed in ICU for 23 days post-surgery and discharged after 40 days from admission.

Objective To explore the effects of "3S2E" nursing management model in patients with severe pneumonia. Methods Totally 168 patients with severe pneumonia enrolled in the ICU of the First Affiliated Hospital of Zhengzhou University from February 2017 to February 2019 were selected by convenient sampling, and numbered according to the order of admission. Patients with odd numbers were divided into the observation group (n=84), while patients with even numbers were divided into the control group (n=84). Patients in the control group received interventions based on the routine nursing protocol for the ICU, while patients in the observation group received "3S2E" nursing model on the basis of routine nursing. Changes in respiratory function and vital signs, Self-Anxiety Scale (SAS), Self-Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI) scores, mechanical ventilation time, length of hospital stay were compared between the two groups before and after the intervention. Results After the intervention, the ventilatory capacity per minute, respiratory rate, rapid shallow breathing index (RSBI), oxygenation index, mean arterial pressure, central arterial pressure and heart rate of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). The SAS, SDS and PSQI scores of the observation group were lower than those of the control group ,the differences were statistically significant (P<0.05). The mechanical ventilation time and length of hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant (P<0.05). Conclusions The intervention of "3S2E" nursing management model in patients with severe pneumonia can effectively improve the patient's respiratory function, reduce their anxiety and depression, improve their sleep quality.

Feeding interruption related to airway procedures is a crucial factor contributing to enteral feeding disruption in critically ill patients,and it represents a significant cause of inadequate enteral nutrition delivery.Prolonged or repeated interruptions exacerbate the insufficiency of enteral nutrition,impede patient recovery,and increase the risk of adverse complications.The absence of clear guidelines and standardized protocols has led to variations in clinical practices regarding feeding interruption during airway procedures.This article provides an overview of the clinical importance and current practices associated with feeding interruption during airway procedures in critically ill patients.Additionally,potential avenues for future research are proposed with the aim of enhancing standardization,safety,and efficacy in feeding interruption practices linked to airway procedures for critically ill patients.

Parkinson's disease(PD)is the second most common neurodegenerative disease in the world;however,it lacks effective and safe treatments.Ginkgo biloba dropping pill(GBDP),a unique Chinese G.biloba leaf extract preparation,exhibits antioxidant and neuroprotective effects and has a potential as an alternative therapy for PD.Thus,the aims of this study were to evaluate the effects of GBDP in in vitro and in vivo PD models and to compare the chemical constituents and pharmacological activities of GBDP and the G.biloba extract EGb 761.Using liquid chromatography tandem-mass spectrometry,46 GBDP constitu-ents were identified.Principal component analysis identified differences in the chemical profiles of GBDP and EGb 761.A quantitative analysis of 12 constituents showed that GBDP had higher levels of several flavonoids and terpene trilactones than EGb 761,whereas EGb 761 had higher levels of organic acids.Moreover,we found that GBDP prevented 6-hydroxydopamine-induced dopaminergic neuron loss in zebrafish and improved cognitive impairment and neuronal damage in methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced PD mice.Although similar effects were observed after EGb 761 treatment,the neuroprotective effects were greater after GBDP treatment on several endpoints.In addition,in vitro results suggested that the Akt/GSK3β pathway may be involved in the neuroprotective effects of GBDP.These findings demonstrated that GBDP have potential neuroprotective effects in the treatment of PD.

To investigate the hypolipidemic effects of gypenosides granules and its combination with lipitor, a model of hyperlipidaemia C57BL/6J mice was established by high-fat diet feeding for 4 weeks. The mice were randomly divided into blank group, model group, lipitor group(10 mg/kg of lipitor), low dose group(90 mg/kg of gypenosides granules), medium dose group(120 mg/kg of gypenosides granules), high dose group(180 mg/kg of gypenosides granules)and the combination group(180 mg/kg of gypenosides granules and 10 mg/kg of lipitor). After 4 weeks of continuous administration, the contents of serum lipid indexes, serum ALT, AST and apolipoprotein B(ApoB)were measured. The liver tissues of mice were observed by H&E staining. The expression levels of key factors involved in hepatic cholesterol metabolism were observed by RT-PCR and Western blot methods, such as adenosine triphosphate combined box transporter A1(ABCA1), liver X receptor(LXRα), cholesterol 7 alpha hydroxylase(CYP7A1)and type BΙ scavenger receptor(SR-BΙ). The results revealed that gypenosides granules significantly decreased the mice body weight, total abdominal fat area and the level of serum total cholesterol(TC). The combination group showed a more significant reduction in TC level than the other administration groups. Moreover, gypenosides granules treatment remarkably increased the protein expression of ABCA1 and up-regulated the mRNA expression of ABCA1, CYP7A1 and SR-BI. The above results suggest that gypenosides granules can significantly reduce blood lipid contents, and the combination therapy with lipitor show better the lipid-lowering effect. Meanwhile, gypenosides granules can decrease the level of serum transaminase. Preliminary exploration suggests the lipid-lowering mechanism of gypenosides granules may be involved in cholesterol reversal to regulate the level of TC.

Objective:To investigate the factors contributing to in-hospital mortality among elderly patients aged 80 and above with gastrointestinal bleeding(GIB).Additionally, it seeks to assess the predictive ability of the electronic frailty index(eFI)in determining the risk of in-hospital mortality in GIB patients.Methods:A retrospective analysis was performed among 624 patients aged 80 and above with GIB who were admitted to Beijing Hospital between July 2013 and September 2019.The patients were categorized into two groups based on their discharge outcomes: those who survived and those who did not.The eFI was developed using a cumulative deficit model utilizing data from the hospital's electronic medical records.The study examined the clinical features and risk factors associated with in-hospital mortality among these elderly patients.The effectiveness of eFI in predicting in-hospital mortality in elderly patients with gastrointestinal bleeding was evaluated by calculating the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Results:Among a total of 624 patients aged between 80 and 102 years, the average age was(83.0±6.4)years, with 339 being male.A majority of the patients, 581 cases(93.1%), had an eFI ≥ 0.15.A comparison between the survival group(380 cases)and the death group(244 cases)revealed that the latter had higher eFI values(0.39±0.09 vs.0.29±0.11, t=-11.452, P<0.001), along with higher rates of heart failure, chronic kidney disease, and malignant tumors, as well as lower body mass index, hemoglobin, albumin, and total cholesterol levels, and higher alanine aminotransferase and D-dimer levels(all P<0.05).Logistic regression analysis indicated that eFI( OR=2.322, 95% CI: 1.840-2.929, P<0.001), malignant tumor( OR=1.833, 95% CI: 1.141-2.860, P<0.001), and albumin<35 g/L( OR=1.826, 95% CI: 1.200-2.777, P<0.001)were independent risk factors for in-hospital death in elderly patients aged 80 and over with gastrointestinal bleeding.With every 0.1 increase in eFI, the risk of in-hospital death rose by 1.322 times.The AUC of eFI for predicting in-hospital mortality was 0.751(95% CI: 0.713-0.789, P<0.001).An eFI of ≥0.33 demonstrated a sensitivity of 77.9% and a specificity of 60.3% in predicting in-hospital mortality in elderly patients aged 80 and over with GIB. Conclusions:The eFI serves as an important independent risk factor for in-hospital mortality among patients aged 80 and above who experience GIB.It can effectively assess the prognosis of elderly individuals facing GIB.