Objective To observe the application effect of Manujet Ⅲ device combined with im-proved nasopharynx oxygen tube in painless bronchoscopy.Methods A total of 120 patients with painless bronchoscopy were selected as the research objects,and they were randomly divided into ob-servation group(treated with routine continuous nasopharynx oxygen supply and Manujet Ⅲ combined with improved nasopharynx oxygen tube)and control group(treated with routine continuous nasophar-ynx oxygen supply),with 60 cases in each group.Mean arterial pressure(MAP),heart rate(HR),the saturation of peripheral oxygen(SpO2),induction time,microscopic examination time,awakening time,success rate of examination by one time,patient's satisfaction degree,physician's satisfaction degree and incidence of adverse reactions were compared between two groups.Results Repeated measurement analysis of variance showed that there were significant differences in the time,inter-group and time to group interactions of MAP,HR and SpO2 between the two groups(P＜0.05);at the time points of 5 minutes of microscopic examination,10 minutes of microscopic examination and after micro-scopic examination,the MAP in the observation group was significantly lower than that in the control group,while HR and SpO2 were significantly higher than those in the control group(P＜0.05).There was no significant difference in induction time between the two groups(P＞0.05);in the observation group,the microscopic examination time and awakening time were significantly shorter than those in the control group,while the success rate of examination by one time was significantly higher than that in the control group(P＜0.05).The patient's satisfaction degree and physician's satisfaction degree in the observation group were significantly higher than those in the control group(P＜0.05).The incidence of adverse reactions in the observation group was 5.00％,which was significantly lower than 18.33％in the control group(P＜0.05).Conclusion The combination of routine continuous nasopharynx oxygen supply and ManujetⅢ combined with improved nasopharynx oxygen tube for su-praglottal manual assisted jet ventilation is beneficial for providing sufficient oxygen supply and re-ducing the incidence of hypoxemia.

Objective To observe the application effect of Manujet Ⅲ device combined with im-proved nasopharynx oxygen tube in painless bronchoscopy.Methods A total of 120 patients with painless bronchoscopy were selected as the research objects,and they were randomly divided into ob-servation group(treated with routine continuous nasopharynx oxygen supply and Manujet Ⅲ combined with improved nasopharynx oxygen tube)and control group(treated with routine continuous nasophar-ynx oxygen supply),with 60 cases in each group.Mean arterial pressure(MAP),heart rate(HR),the saturation of peripheral oxygen(SpO2),induction time,microscopic examination time,awakening time,success rate of examination by one time,patient's satisfaction degree,physician's satisfaction degree and incidence of adverse reactions were compared between two groups.Results Repeated measurement analysis of variance showed that there were significant differences in the time,inter-group and time to group interactions of MAP,HR and SpO2 between the two groups(P＜0.05);at the time points of 5 minutes of microscopic examination,10 minutes of microscopic examination and after micro-scopic examination,the MAP in the observation group was significantly lower than that in the control group,while HR and SpO2 were significantly higher than those in the control group(P＜0.05).There was no significant difference in induction time between the two groups(P＞0.05);in the observation group,the microscopic examination time and awakening time were significantly shorter than those in the control group,while the success rate of examination by one time was significantly higher than that in the control group(P＜0.05).The patient's satisfaction degree and physician's satisfaction degree in the observation group were significantly higher than those in the control group(P＜0.05).The incidence of adverse reactions in the observation group was 5.00％,which was significantly lower than 18.33％in the control group(P＜0.05).Conclusion The combination of routine continuous nasopharynx oxygen supply and ManujetⅢ combined with improved nasopharynx oxygen tube for su-praglottal manual assisted jet ventilation is beneficial for providing sufficient oxygen supply and re-ducing the incidence of hypoxemia.

Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.

Objective:To evaluate the effect of botulinum toxin type A (BTXA) on flap surgery in animal models.Methods:Nine databases (PubMed, Cochrane Library, Ovid, Web of Science, Embase, Scopus, CBM, CNKI, and WANFANG database) were searched for published literature comparing the effects of BTXA (BTXA group) versus saline or no treatment (control group) on flap operation in animal models from January 1979 to March 2022. The literature was screened according to inclusion and exclusion criteria. Indicators included flap survival rate, blood flow and vascular endothelial growth factor (VEGF) expression level after surgery. The subjects were divided into pre-operation injection group and intraoperation injection group according to the intervention timing, and were divided into random flap group and axial flap group according to the type of flaps, and subgroup analysis was conducted respectively. Review Manager (RevMan) 5.3 software and Stata 15.1 software were used for all statistical analysis.Results:A total of 603 animals from 19 studies were included after rigorous inclusion and exclusion screening. Compared with control group, BTXA group revealed a significantly higher flap survival rate [mean difference ( MD)=15.65%, 95% CI: 13.11%-18.19%, Z=12.08, P<0.001], blood flow [standardized mean difference ( SMD)=1.96, 95% CI: 1.39-2.54, Z=6.71, P<0.001] and VEGF expression (at mRNA level: SMD=6.01, 95% CI: 0.89-11.13, Z=2.30, P=0.020; at protein level: SMD=3.44, 95% CI: 2.44-4.43, Z=6.73, P<0.001). Subgroup analysis showed that the flap survival rate of the pre-operation injection group ( MD=21.54%, 95% CI: 16.07%-27.01%, Z=7.71, P<0.001) was significantly higher than that of the intraoperative injection group ( MD=9.40%, 95% CI: 6.79%-12.00%, Z=7.07, P<0.001). The flap survival rate of the random flap group ( MD=20.87%, 95% CI: 16.67%-25.07%, Z=9.73, P<0.001) was significantly higher than that of the axial flap group ( MD=13.11%, 95% CI: 8.91%-17.31%, Z=6.12, P<0.001). Conclusion:BTXA assisted flap surgery may have positive effects on the survival rate, blood flow and VEGF expression in animal models. In addition, injection timing and flap type may also be important factors in the effect of BTXA on flap surgery.

Objective:To evaluate the effect of botulinum toxin type A (BTXA) on flap surgery in animal models.Methods:Nine databases (PubMed, Cochrane Library, Ovid, Web of Science, Embase, Scopus, CBM, CNKI, and WANFANG database) were searched for published literature comparing the effects of BTXA (BTXA group) versus saline or no treatment (control group) on flap operation in animal models from January 1979 to March 2022. The literature was screened according to inclusion and exclusion criteria. Indicators included flap survival rate, blood flow and vascular endothelial growth factor (VEGF) expression level after surgery. The subjects were divided into pre-operation injection group and intraoperation injection group according to the intervention timing, and were divided into random flap group and axial flap group according to the type of flaps, and subgroup analysis was conducted respectively. Review Manager (RevMan) 5.3 software and Stata 15.1 software were used for all statistical analysis.Results:A total of 603 animals from 19 studies were included after rigorous inclusion and exclusion screening. Compared with control group, BTXA group revealed a significantly higher flap survival rate [mean difference ( MD)=15.65%, 95% CI: 13.11%-18.19%, Z=12.08, P<0.001], blood flow [standardized mean difference ( SMD)=1.96, 95% CI: 1.39-2.54, Z=6.71, P<0.001] and VEGF expression (at mRNA level: SMD=6.01, 95% CI: 0.89-11.13, Z=2.30, P=0.020; at protein level: SMD=3.44, 95% CI: 2.44-4.43, Z=6.73, P<0.001). Subgroup analysis showed that the flap survival rate of the pre-operation injection group ( MD=21.54%, 95% CI: 16.07%-27.01%, Z=7.71, P<0.001) was significantly higher than that of the intraoperative injection group ( MD=9.40%, 95% CI: 6.79%-12.00%, Z=7.07, P<0.001). The flap survival rate of the random flap group ( MD=20.87%, 95% CI: 16.67%-25.07%, Z=9.73, P<0.001) was significantly higher than that of the axial flap group ( MD=13.11%, 95% CI: 8.91%-17.31%, Z=6.12, P<0.001). Conclusion:BTXA assisted flap surgery may have positive effects on the survival rate, blood flow and VEGF expression in animal models. In addition, injection timing and flap type may also be important factors in the effect of BTXA on flap surgery.