Objective:To investigate the correlation between heart rate variability (HRV) and cerebral small vessel disease (CSVD) in patients with obstructive sleep apnea (OSA).Methods:Patients with OSA received polysomnography and brain MRI examination in Weihai Municipal Hospital from July 2019 to July 2020 were consecutively collected for cross-sectional analysis. The 5 min HRV before sleep (awake state) was analyzed. The patients were divided into CSVD group and non-CSVD group according to the overall burden of CSVD. The demographic data, clinical data, polysomnography parameters and HRV time domain and frequency domain parameters were compared between the two groups. Multivariate logistic regression analysis was used to determine the correlation between the HRV parameters and CSVD in patients with OSA. Results:A total of 100 patients with OSA were enrolled, including 79 males (79.0%), aged 52.36±8.66 years, apnea hypopnea index (AHI) 38.70±24.65/h. There were 46 patients (46.0%) in the CSVD group and 54 (54.0%) in the non-CSVD group. Univariate analysis showed that there were significant differences in age, AHI, oxygen desaturation index (ODI), percentage of blood oxygen saturation <90% in total sleep time (T90), square root of the mean of the sum of the squares of the difference between adjacent RR intervals (RMSSD), power in high frequency range (HF), power in low frequency range (LF) to HF ratio (LF/HF) between the CSVD group and the non-CSVD group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for age, body mass index, systolic blood pressure, AHI, ODI, and T90, RMSSD (odds ratio 0.625, 95% confidence interval 0.389-0.981; P=0.041) and LF/HF ratio (odds ratio 1.429, 95% confidence interval 1.011-2.020; P=0.043) were the independent influencing factors of CSVD in patients with OSA. Conclusion:Increased LF/HF and decreased RMSSD in OSA patients with CSVD suggest that the increased sympathetic excitability and decreased vagus function, which may be one of the pathophysiological mechanisms of occurring CSVD in patients with OSA.

Objective:To investigate the correlation between heart rate variability (HRV) and cognitive impairment in patients with obstructive sleep apnea (OSA).Methods:Patients received polysomnography in Weihai Municipal Hospital from June 2019 to November 2020 were enrolled as the subjects of cross-sectional analysis. According to the Montreal Cognitive Assessment score, the patients with OSA were divided into a cognitive impairment group and a non-cognitive impairment group. Multivariate logistic regression analysis was used to determine whether HRV parameters were the independent influencing factors of cognitive impairment in patients with OSA. Multiple linear regression analysis was used to determine the independent correlation between HRV parameters and overall cognition as well as each cognitive domain in patients with OSA. Results:A total of 115 patients with OSA were included, including 80 males (69.6%), aged 58.25±9.88 years. Among them, there were 61 in the cognitive impairment group (53.0%) and 54 in the non-cognitive impairment group (47.0%). The standard deviation of the R-R interval in normal sinus beats (SDNN), the square root of the mean of the sum of the squares of the difference between adjacent NN intervals (RMSSD), the percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms (pNN50) and the power in high-frequency range (HF; 0.15-0.40 Hz) in the cognitive impairment group were significantly lower than those in non-cognitive impairment group (all P<0.05). Multivariate logistic regression analysis showed that SDNN (odds ratio [ OR] 0.551, 95% confidence interval [ CI] 0.380-0.798; P=0.002), RMSSD ( OR 0.516, 95% CI 0.342-0.779; P=0.002), pNN50 ( OR 0.900, 95% CI 0.834-0.971; P=0.006), LF ( OR 0.821, 95% CI 0.687-0.982; P=0.030) and HF ( OR 0.687, 95% CI 0.525-0.899; P=0.006) were the independent protective factors of cognitive impairment in patients with OSA. Multiple linear regression analysis showed that SDNN ( β=0.208, P=0.023), RMSSD ( β=0.228, P=0.011), pNN50 ( β=0.186, P=0.040), HF ( β=0.235, P=0.010) is independently correlated with overall cognitive function in patients with OSA. Conclusion:The decline of HRV parameters SDNN, RMSSD, pNN50 and HF is independently correlated with cognitive impairment in patients with OSA, suggesting that the decline of vagus nerve function may be involved in the mechanism of cognitive impairment in patients with OSA.

Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods:A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac. The length of hospital stay, mass absorption time and menstrual recovery time of the patients were recorded. Postoperative complications and serum human chorionic gonadotropin (HCG) negative conversion time were observed. At 3 months after the operation, hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes, all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results:All the 8 patients were successfully treated with radiofrequency ablation, and postoperative ultrasonography showed that the mass remained unenhanced. The length of hospital stay was (3.0±0.8)d. The packet absorption time was (32.4±14.3)d. The recovery time of menstruation was (39.6±2.7)d. There were no serious complications.Blood HCG levels decreased rapidly within a week, and all returned to normal level of non-pregnancy 2-3 weeks after the operation. Three months after the operation, the salpingogram showed that the fallopian tubes were recanalized in 3 patients. After a follow-up of 1 year, 1 patient had a natural intrauterine pregnancy, and there was no case of recurrent ectopic pregnancy.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery, and can retain the reproductive ability of patients to some extent, which is worth popularizing in clinical application.

Objective:To study the safety and efficacy of ultrasound-guided radiofrequency ablation in treatment of gallbladder polyps.Methods:The clinical data of 13 patients who underwent ultrasound-guided radiofrequency ablation for gallbladder polyps at the First Affiliated Hospital of Zhengzhou University from April 2019 to March 2020 were retrospectively analyzed. These were 8 males and 5 females, with ages ranging from 20 to 49 years. The incidence of adverse reactions and complications after treatment, the complete ablation rate of polyps and the absorption of postoperative lesions were studied, and the gallbladder systolic function of patients before and after treatment were compared.Results:Of 13 patients, surgery was successfully carried out and there was no serious complications of gallbladder perforation, bleeding and collateral organ injury. The median radiofrequency ablation time was 30 s, and the complete ablation rate was 100.0%(13/13). After 6 months of follow-up, the rate of reduction of lesion volume was 100.0(98.0, 100.0)% at 6 months after surgery, which was significantly higher than the rates of 46.0(40.0, 54.0)%, 72(64.0, 100.0)% and 87.0(81.0±100.0)% at 1, 2 and 3 months after surgery ( P<0.05). The gallbladder contractility rate at 3 months after operation was (78.38±10.83)% compared with that before operation (77.46±11.28)%, and there was no significant difference ( P>0.05). Conclusion:Ultrasound-guided radiofrequency ablation for gallbladder polyps was safe. It had a significant short-term efficacy for treatment of gallbladder polyps.

Objective:To investigate the effect of the possibility of sleep-disordered breathing (SDB) as assessed by the four-variable score on the platelet function and the risk of stroke recurrence in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, Weihai Municipal Hospital from January 2020 to January 2021 were enrolled prospectively. Main inclusion criteria: admission within 24 h of onset; National Institutes of Health Stroke Scale score ≤3; Receiving aspirin + clopidogrel dual antiplatelet therapy. All patients were divided into a high possibility group and a low possibility group of SDB according to the four-variable score. 7±2 d after dual antiplatelet therapy, PL-12 multi-parameter platelet function analyzer was used to detect the maximum aggregation rate (MAR). The patients were followed up for 6 months after discharge and the recurrence of ischemic stroke was observed. The mediating effect model was established with the high possibility of SDB as the independent variable, MAR as the intermediary variable and stroke recurrence as the dependent variable. Firstly, MAR as the dependent variable and high probability of SDB as the independent variable were analyzed by linear regression; then, a binary logistic regression analysis was performed with ischemic stroke recurrence as the dependent variable and the high probability of SDB and MAR as independent variables. Results:A total of 213 patients were enrolled in the study. The average age of the patients was 62.70 ± 10.04 years old. There were 146 male (68.5%) and 121 patients (56.8%) were in the high possibility group (56.8%). During the follow-up period, 24 patients (11.3%) had stroke recurrence. Univariate analysis showed that arachidonic acid (AA) induced MAR (MAR-AA) and adenosine diphosphate (ADP) induced the MAR (MAR-ADP) in the high possibility group of SDB were significantly higher than those in the low possibility group (all P<0.05); MAR-AA and MAR-ADP in the recurrent group were significantly higher than those in the non-recurrent group (all P<0.05), and the proportion of high possibility of SDB in the recurrent group was significantly higher ( P=0.008). Binary logistic regression analysis showed that homocysteine (odds ratio 1.132, 95% confidence interval 1.048-1.223; P=0.002) and having high possibility of SDB (odds ratio 6.351, 95% confidence interval 1.134-35.566; P=0.035) were the independent risk factors for stroke recurrence in patients treated with dual antiplatelet therapy. Intermediary effect analysis showed that MAR had a significant intermediary effect on the risk of stroke recurrence in patients with high probability of SDB. Conclusion:The MAR and stroke recurrence rates in the high possibility group of SDB were significantly higher than those in the low possibility group, and its stroke risk was probably mediated by platelet hyperreactivity.

Objective To observe the effect of proprioceptive neuromuscular facilitation (PNF) technology combined with core stability training on the rehabilitation of patients with functional ankle instability (FAI).Methods Twenty FAI patients were randomly divided into an experimental group and a control group,each of 10.The control group was given routine rehabilitation together with ankle strengthening training and proprioception training.The experimental group was provided with PNF combined with core stability training in addition to the routine rehabilitation.Before and after the 12 training sessions,both groups were evaluated using the Cumberland ankle instability tool (CAIT).The strength of their ankle flexors and extensors was measured in isokinetic concentric contraction,ankle proprioception was tested and the star excursion balance test (SEBT) was administered.Results Before the intervention there were no significant inter-group differences in any of the measurements.Afterward,significant improvements were observed in the first three tests,with the experimental group's average improvement significantly better than that of the control group.All of the SEBT measurements were significantly better than before the treatment,with significant differences between the two groups in the posterolateral,posterior,posteromedial,medial and anteromedial directions.Conclusion PNF technology combined with core stability training can improve ankle strength and proprioception and the dynamic balance of FAI patients.

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation for gestational trophoblast tumor.Methods:The clinical data of 5 patients with gestational trophoblast tumor treated by ultrasound-guided percutaneous radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were retrospectively analyzed, the postoperative complications, changes in blood human chorionic gonadotropin (hCG), and the volume reduction rate of ablation lesion at 1, 3, and 6 months after surgery were observed.Results:None of the 5 patients with gestational trophoblast tumor had postoperative complications.Blood hCG decreased to normal level on 7 d, 8 d, 8 d, 12 d and 26 d, respectively. The volume reduction rates of ablation lesions 1, 3 and 6 months after operation in cases 1-5 were respectively 34.7%, 62.5%, 87.5%; 45.3%, 60.4%, 84%; 85.6%, 89.9%, 92.2%; 38.3%, 72.6%, 85.5%; 40.8%, 57.3%, 87%.Conclusions:Percutaneous radiofrequency ablation is minimally invasive, low risk, safe and effective treatment for gestational trophoblast tumors.

Objective: To investigate the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on platelet function in patients with ischemic stroke. Methods: Patients with ischemic stroke treated in the Department of Neurology, Weihai Municipal Hospital from January 2017 to November 2017 were collected prospectively. The presence or absence of OSAHS was determined by polysomnography. After oral administration of aspirin enteric coated tablets for 7±1 d, the maximum aggregation ratio (MAR) induced by arachidonic acid (AA) was determined by PL-12 Platelet Function Analyzer. MAR-AA ≥50% was defined as platelet hyperresponsiveness. Multivariate logistic regression analysis was used to evaluate the risk factors for platelet hyperresponsiveness in patients with ischemic stroke, and multiple linear regression analysis was used to determine the correlation between sleep parameters reflecting the severity of sleep apnea and MAR-AA. Results: Among the 124 patients with ischemic stroke, 58 (46.77%) complicated with OSAHS, 66 (53.23%) without complicated with OSAHS; 84 (67.74%) had platelet hyperresponsiveness, and 40 (32.26%) had not platelet hyperresponsiveness. MAR-AA in the complicated OSAHS group was significantly higher than that in the non-complicated OSAHS group (48.98%±20.61% vs. 26.45%±15.15%; t=-6.858, P<0.001). Multivariate logistic regression analysis showed that OSAHS was an independent risk factor for platelet hyperresponsiveness in patients with ischemic stroke (odds ratio 9.551, 95% confidence interval 3.051-29.905; P<0.001). Multiple linear regression analysis showed that there was a significant linear relationship between apnea hypopnea index and MAR-AA (β=0.499, P<0.001). Conclusions OSAHS is an independent risk factor for platelet hyperresponsiveness in patients with ischemic stroke. Apnea hypopnea index is significantly correlated with MAR-AA.

Objective:To investigate the safety and efficacy of transgluteal ultrasound-guided puncture and drainage in prone position in the treatment of deep pelvic abscess with pelvic adhesion.Methods:A total of 24 cases of deep pelvic abscess with pelvic adhesion treated in the ultrasound intervention room of the First Affiliated Hospital of Zhengzhou University from October 2018 to May 2021 were selected.Ultrasound-guided puncture and drainage were performed through the buttocks. The operation time, blood loss and distal limb pain during the operation were recorded. The decreasing trend of body temperature, the white blood cell, C-reactive protein and abscess size were observed. The incidence of complications such as bleeding, pain, infection and intestinal injury were counted.Results:There were 28 abscesses in 24 patients were successfully intubated through the buttocks, the abscesses disappeared after drainage, and there were no serious complications after operation. During the follow-up of 3-22 months, there was no abscess recurrence and no long-term complications.Conclusions:Ultrasound-guided transgluteal puncture and drainage is safe and effective in the treatment of deep pelvic abscess with pelvic adhesion.

Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma.Methods:A retrospective analysis was performed on 7 patients with nonmetastatic pheochromocytoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. The changes of postoperative blood pressure, improvement of symptoms, intraoperative and postoperative complications were observed.Plasma free methoxypinephrine (MN) and normetanephrine (NMN) levels were recorded before and 2 weeks after operation. The reduction rate of ablation lesion volume at 1, 3 and 6 months after operation was calculated.Results:Postoperative blood pressure of all 7 patients was reduced to the normal range within 3 days, and symptoms such as headache were significantly relieved immediately after operation.No serious complications occurred during or after operation. Plasma free MN and NMN levels decreased to normal levels 2 weeks after operation. The mean reduction rates of the ablation lesions at 1, 3 and 6 months after operation were (46.61±13.42)%, (67.21±10.54)% and (85.73±4.15)%, respectively. Postoperative follow-up of 12-30 months showed that the blood pressure, plasma free MN and NMN levels of the patients were all in the normal range, and no symptoms such as headache and palpitation occurred again. All the tumors were completely ablated, and no recurrence was observed.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma is minimally invasive, safe and effective, and can retain adrenal cortex function, which is worthy of clinical promotion.