Objective:To investigate the effect of upper limb pillow position on hemodynamic and safety of patients undergoing cerebellopontine angle tumor resection.Methods:Eighty-four patients receiving cerebellopontine angle tumor resection in our hospital from January 2016 to December 2019 were randomly divided into the experimental group (42 cases) and the control group (42 cases). Patients in the control group were placed in routine upper limb position, while patients in the experimental group were placed in upper limb pillow position. The data including systolic pressure, diastolic pressure, heart rate, saturation of blood oxygen were recorded on admission of operation room, completing placing body position, 30 minutes and 60 minutes after operation and after finishing the operation. The numbness/soreness of upper limbs and pressure injury rate was compared between the experimental group and the control group.Results:The rate of numbness/soreness of upper limbs were 2.4% (1/42) in the experimental group, 19.1%(8/42) in the control group, the differences were statistically significant ( χ2 value was 6.098, P<0.05). The stage 1 pressure injury were 2 cases in the experimental group, stage 1 and 2 pressure injury were 6 cases and 2 cases, respectively in the control group, the differences were statically significant ( Z value was 2.039, P<0.05). Conclusion:Upper limb pillow position of the operation side can reduce postoperative complication of patients undergoing cerebellopontine angle tumor resection, but will not increase the risk of abnormal hemodynamic fluctuation.

Objective To evaluate the role of P2Y12 receptor in microglia in central post-stroke pain(CPSP)in mice and its mechanism.Methods Thirty-two specific pathogen-free(SPF)-grade male C57BL/6J mice were selected,aged 7 to 8 weeks,weighing 25 to 30 g,were divided into four groups using a random number table method:C group(sham operation group,n=8),CPSP group(n=8),CPSP-M group(CPSP plus P2Y12 receptor inhibitor MRS2395,n=8)and C-M group(sham operation plus P2 Y12 receptor inhibitor MRS2395,n=8).CPSP model was induced by injec-ting 10 nL type Ⅳ collagenase(0.001 U/nL)into the right ventral posterior medial nucleus andven-tral posterior lateral nucleus.MRS2395(1.5 mg/kg)was injected intraperitoneally at 30 min before model preparation in CPSP-M group and C-M group and then injected once a day for 5 consecutive days,mice in C group and CPSP group were given saline at the same volume.Before the modeling(T0)and 3,7 and 14 days(T1,T2,T3)after the establishment of the model,the thermal withdrawal latency(TWL),cold withdrawal latency(CWL)and paw withdrawal frequency(PWF)were measured.The mice were then sacrificed and the brain tissues were obtained for observing the location of P2Y12 receptor by double immunofluorescence staining and the pathological changes by HE staining,and for determination of the expression levels of P2Y12 receptor,toll-like receptor 4(TLR4),phospho-nuclear factor-κB p65(p-NF-KB p65)and NF-κB p65 by western blot.Results P2Y12 receptor was co-localized only with microglia,but not with neurons or astrocytes in brain tissue of CPSP group.Compared with C group,the TWL and CWL were significantly reduced and the PWF was sig-nificantly increased at T1 to T3,cerebral injury was aggravated significantly and the expressions of P2Y12 receptor,TLR4 and p-NF-κB p65 in brain tissue were up-regulated in CPSP group and CPSP-M group(P＜0.05).There was no statistically significant difference between C group and C-M group in the above indicators(P＞0.05).Compared with CPSP group,the TWL and CWL were significantly prolonged and the PWF was significantly reduced at T,to T3,cerebral injury was relieved significantly and the expressions of P2Y12 receptor,TLR4 and p-NF-κB p65 in brain tissue were down-regulated in CPSP group and CPSP-M group(P＜0.05).Conclusion P2Y12 receptors in microglia may be in-volved in the development of CPSP by activating TLR4/NF-κB signaling pathway in mice.

Objective To evaluate the role of P2Y12 receptor in microglia in central post-stroke pain(CPSP)in mice and its mechanism.Methods Thirty-two specific pathogen-free(SPF)-grade male C57BL/6J mice were selected,aged 7 to 8 weeks,weighing 25 to 30 g,were divided into four groups using a random number table method:C group(sham operation group,n=8),CPSP group(n=8),CPSP-M group(CPSP plus P2Y12 receptor inhibitor MRS2395,n=8)and C-M group(sham operation plus P2 Y12 receptor inhibitor MRS2395,n=8).CPSP model was induced by injec-ting 10 nL type Ⅳ collagenase(0.001 U/nL)into the right ventral posterior medial nucleus andven-tral posterior lateral nucleus.MRS2395(1.5 mg/kg)was injected intraperitoneally at 30 min before model preparation in CPSP-M group and C-M group and then injected once a day for 5 consecutive days,mice in C group and CPSP group were given saline at the same volume.Before the modeling(T0)and 3,7 and 14 days(T1,T2,T3)after the establishment of the model,the thermal withdrawal latency(TWL),cold withdrawal latency(CWL)and paw withdrawal frequency(PWF)were measured.The mice were then sacrificed and the brain tissues were obtained for observing the location of P2Y12 receptor by double immunofluorescence staining and the pathological changes by HE staining,and for determination of the expression levels of P2Y12 receptor,toll-like receptor 4(TLR4),phospho-nuclear factor-κB p65(p-NF-KB p65)and NF-κB p65 by western blot.Results P2Y12 receptor was co-localized only with microglia,but not with neurons or astrocytes in brain tissue of CPSP group.Compared with C group,the TWL and CWL were significantly reduced and the PWF was sig-nificantly increased at T1 to T3,cerebral injury was aggravated significantly and the expressions of P2Y12 receptor,TLR4 and p-NF-κB p65 in brain tissue were up-regulated in CPSP group and CPSP-M group(P＜0.05).There was no statistically significant difference between C group and C-M group in the above indicators(P＞0.05).Compared with CPSP group,the TWL and CWL were significantly prolonged and the PWF was significantly reduced at T,to T3,cerebral injury was relieved significantly and the expressions of P2Y12 receptor,TLR4 and p-NF-κB p65 in brain tissue were down-regulated in CPSP group and CPSP-M group(P＜0.05).Conclusion P2Y12 receptors in microglia may be in-volved in the development of CPSP by activating TLR4/NF-κB signaling pathway in mice.

Objective:To evaluate the role of silent information regulator 1 (SIRT1) in electroacupuncture (EA)-induced reduction of central post-stroke pain (CPSP) and the relationship with nod-like receptor pyrin domain containing 3 (NLRP3) in rats.Methods:Fifty SPF healthy male Sprague-Dawley rats, aged 6 weeks, weighing 180-220 g, were divided into 5 groups ( n=10 each) using a random number table method: sham operation group (group Sham), CPSP group, CPSP+ sham EA group (group SEA), CPSP+ EA group (group EA) and CPSP+ EA+ SIRT1 inhibitor EX527 group (group EX527). Type Ⅳ collagenase was injected into the right ventral posterolateral nucleus to establish the model of CPSP in CPSP, SEA, EA and EX527 groups.At 24 h after the model was established successfully, 30 min EA (frequency 2/15 Hz) stimulation of Neiguan, Renzhong and Sanyinjiao was performed once a day for 5 consecutive days in EA group.EA was performed at the points 5 mm lateral to the acupoints of Neiguan, Renzhong and Sanyinjiao in group SEA, and the other procedures were similar to those previously described in group EA.SIRT1 inhibitor EX527 5 mg/kg was injected intraperitoneally at 30 min before EA stimulation in group EX527, and the other procedures were similar to those previously described in group EA.At 1 day before the establishment of model (T 0) and at 1, 3 and 5 days after the establishment of model (T 1-3), the thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) were measured.The animals were then sacrificed and brain tissues were taken for determination of the expression of SIRT1, NLRP3 and interleukin (IL)-18 and IL-1β. Results:Compared with Sham group, the TWL was significantly shortened and the MWT was decreased at T 1-3, the expression of SIRT1 was down-regulated, and the expression of NLRP3, IL-18 and IL-1β was up-regulated in CPSP, SEA, EA and EX527 groups ( P<0.05). Compared with CPSP group, the TWL was significantly prolonged and the MWT was increased at T 1-3, the expression of SIRT1 was up-regulated, and the expression of NLRP3, IL-18 and IL-1β was down-regulated in EA group ( P<0.05), and no significant change was found in the parameters mentioned above in group SEA ( P>0.05). Compared with EA group, the TWL was significantly shortened and the MWT was decreased at T 1-3, the expression of SIRT1 was down-regulated, and the expression of NLRP3, IL-18 and IL-1β was up-regulated in EX527 group ( P<0.05). Conclusion:SIRT1 is involved in the process of EA-induced reduction of CPSP, which is related to inhibiting NLRP3 expression in rats.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.