BACKGROUND: Acupuncture in Chinese traditional medicine improves capacity of brain on resisting injury and accelerates injury repair in treatment of ischemic brain injury.OBJECTIVE: To observe the expressions of cerebral nerve growth factor (NGF) and choline acetyltransferase after simultaneous stimulation with electroacupuncture on Baihui (GV 20) and Dazhui (GV 14) so as to probe into the protection of electroacupuncture on hypoxia-ischemia brain injury.DESIGN: Randomized controlled experiment.SETTING: Department of Life Science in Zhengzhou Normal High Training School.MATERIALS: The experiment was performed in Human Anatomy Department of Basic Medical College of Zhengzhou University, in which, 50 cleangrade neonatal Wistar rats of 7 days old were employed and randomized into sham-operation group (10 rats), model control (20 rats) and electroacupuncture group (20 rats). Hypoxia cabin was self-made with constant pressure, 40 cm ×50 cm×60 cm in size, with two small holes of 2 cm ×2 cm for each to connect with the external. Soda lime was used to absorb moisture and CO2 in the cabin.The model was not prepared in sham-operation group. In model control and electroacupuncture group, hypoxia-ischemia model was set up. After modeling, the rats in two groups were recovered for 1 to 4 hours at room temperature; afterwards, hypoxia management was performed. The rats were placed in hypoxia cabin with constant pressure at constant temperature of 37 ℃, inputting O2 8 mL/L and mixed gas 920 mL/L, 1.5 L/minute; 2hours later, the rats were returned back to female rats for lactation continuously. In electroacupuncture group, on the 2nd day after modeling, a filiform needle of one cun was used to insert Baihui (GV 20) (midpoint of parietal bone) subcutaneously and Dazhui (GV 14) (between C7 and T1, on the midline of back). Electric stimulation was done simultaneously on two points with continuous wave, 16 Hz in frequency, 10V in intensity, retaining for 10 minutes, once per day, 10 days made 1 course, totally two courses at interval of 2 days. In model control, no any treatment was given group, 22 days after hypoxia and ischemia, the rats were anesthetized and sacrificed and brain tissue on the left side was collected to prepare paraffin slices. Immune positive cell was counted on slices of each group under optic microscope. For evaluation on the function of brain nerve cell, hippocampus was selected to count the positive cells of choline acetyltransferase. On each brain slice, 5 visual fields were randomized to calculate the average of positive cells. For evaluation on injury repair of nerve tissue, cortex and hippocampus were selected to count positive cells of cerebral NGF. The method was same as the above.MAIN OUTCOME MEASURES: Immune positive cell expressions of choline acetyltransferase and cerebral NGF in brain tissue after electric stimulation in neonatal rats.ferase in brain hippocampus: Compared with sham-operation group, that in model control was lower remarkably, but, there was no obvious change in electroacupuncture group [(24.46±8.24), (13.96±7.62), (25.54±5.05) pcs/visual field, P ＜ 0.05, P ＞ 0.05]; that in electroacupuncture group was of cerebral NGF in cerebral cortex and hippocampus: Compared with sham-operation group, that in both model control and electroacupuncture was increased remarkably [(14.14±6.11), (24.49±8.31), (31.35±9.92) pcs/visual field, P ＜ 0.05; (13.42±5.56), (21.93±5.12), (27.63±7.15) pcs/visual field, P ＜ 0.05], of which, that in electroacupuncture group was higher than model control (P ＜ 0.05).CONCLUSION: Electroacupuncture stimulates central cholinergic nerve system into positive active state in hypoxia-ischemia animals, increases cerebral nerve growth factor in quantity and enhances nerve repair of hypoxia-ischemia animals.

Objective To survey the status of nosocomial infection after total knee arthroplasty,analyze the risk factors of nosocomial infection and possible prevention measures.Methods Datas were collected retrospectively on 80pmients (80 knee joints) who were treated by total knee arthrophsly,the patients were divided into two groups,group A with nosocomial infection and group B without nosocomial infection.Statistic patient's age,basic diseases situation,preoperative hemoglobin content,serum albumin,operation time,blood transfusions,indwelling urethral catheter time,antibiotic treatment time of the two groups.And study the location,pathogenic bacteria and outcomes of the nosocomial infection patients.Results 10 patients occured nosocomial infection,the infected site in turn is urinary tract in 5 cases,respiratory tract 4 cases,skin infections in 1 case,the incidence of nosocomial infection is 12.5％.In noscomial infection group,patient's age,blood transfusions,operation time and postoperative indwelling urinary canal time significantly higher than no nosocomial infection group,anemia,hypoalbuminemia have relevance of nosocomial infection,there is no difference between the two groups in basic diseases situation.Conclusions The nosocomial infection after total knee arthroplasty caused by multiple factors,patient's age,hypoalbuminemia,anemia,operation time and indwelling urethral catheter time is closely related with nosocomial infection

【Objective】 To analyze the risk factors of venous thromboembolism (VTE) after endoscopic surgery in elderly patients with urinary system calculi, construct a prediction model and validate it. 【Methods】 A retrospective analysis was conducted on the clinical data of 402 elderly patients (≥60 years) with urinary system calculi who underwent endoscopic surgery in our hospital during Jan.2018 and Jan.2023.The patients were divided into VTE group (n=43) and non-VTE group (n=359) based on whether VTE occurred after surgery.Risk factors of VTE were screened with univariate and multivariate logistic regression analyses.Based on the screening results(P<0.05 for the factor), a nomogram prediction model was established, the receiver operating characteristic (ROC) curve was drawn, the area under the curve (AUC) was calculated to determine the efficacy of the model, and a calibration chart was drawn to determine the accuracy of the model. 【Results】 Univariate analysis showed that age >70 years, body mass index (BMI) ≥30, VTE history, history of malignant tumors, diabetes, operation time >180 min, diuretic use during operation, and postoperative ambulation time >24 h were risk factors of VTE (P<0.05).Logistic regression analysis showed that age >70 years, BMI≥30, history of VTE, history of malignant tumors, and operation time >180 min were independent risk factors of VTE (P<0.05).The AUC in the ROC curve of the validation set data was 0.789 (95%CI: 0.731—0.848, P<0.001).The calibration chart showed that the calibration curve was close to the standard curve (Brier=0.13). 【Conclusion】 Age>70 years, BMI≥30, history of VTE, history of malignant tumors, and surgery time >180 min are independent risk factors of postoperative VTE in elderly patients with urinary system calculi undergoing endoscopic surgery.The prediction model can effectively predict the risk factors of postoperative VTE.