Objective:To investigate the effects of a perioperative whole course composite thermal insulation strategy on complications of cesarean section, maternal coagulation function and serum inflammatory indexes.Methods:A total of 250 pregnant women who were subjected to cesarean section in Zhoushan Hospital between June 2020 and August 2021 were included in this study. The 125 pregnant women who gave birth using a routine simple thermal insulation strategy from June to November 2020 were assigned to the routine simple thermal insulation group, and those who gave birth using a perioperative whole course composite thermal insulation strategy were assigned to whole course composite thermal insulation group. Two groups of pregnant women underwent cesarean section under subarachnoid block. Volume of intraoperative blood loss was recorded. The incidence of complications such as shivering and postoperative infection was calculated. Platelet count, prothrombin time, activated partial thromboplastin time, thrombin time measured before surgery and 48 hours after surgery were compared between the two groups. Peripheral blood white blood cell count, neutrophil count (N%), C-reactive protein, procalcitonin, interleukin-6 measured 48 hours after surgery were compared between the two groups.Results:Volume of intraoperative blood loss in the whole course composite thermal insulation group was significantly lower than that in the routine simple thermal insulation group [(393.84 ± 79.78) mL vs. (434.80 ± 123.49) mL, t = 3.11, P < 0.05). The incidence of shivering and postoperative infection in the whole course composite thermal insulation group was 10.4% (13/125) and 7.2% (9/125), respectively, which was significantly lower than that in the routine simple thermal insulation group [25.6% (32/125), 18.4% (23/125), χ 2 = 9.78, 7.02, both P < 0.05]. At 48 hours after surgery, prothrombin time, activated partial thromboplastin time, thrombin time in the whole course composite thermal insulation group were (10.28 ± 0.48) seconds, (26.97 ± 2.27) seconds, and (14.09 ± 1.36) seconds, respectively, which were significantly shorter than those in the routine simple thermal insulation group [(11.71 ± 0.27) seconds, (27.96 ± 2.25) seconds, (15.91 ± 1.09) seconds, t = 7.34, 3.43, 11.66, all P < 0.05]. At 48 hours after surgery, white blood cell count, neutrophil count, C-reactive protein, procalcitonin, and interleukin-6 in the whole course composite thermal insulation group were (10.38 ± 2.38) ×10 9/L,(0.79 ± 0.06), (52.79 ± 20.73) mg/L, (0.13±0.42) μg/L, and (55.73 ± 24.38) ng/L, respectively, which were significantly lower than those in the routine simple thermal insulation group [(12.24 ± 7.05) × 10 9/L, 0.81 ± 0.05, (65.38 ± 25.92) mg/L, (0.20 ± 0.97) μg/L, (76.22 ± 39.08) ng/L, t = 2.79, 2.92, 4.24, 8.12, 4.97, all P < 0.05]. Conclusion:Perioperative whole course composite thermal insulation strategy can improve the coagulation function of pregnant women who are subjected to cesarean section under subarachnoid block, reduce volume of intraoperative blood loss, and decrease incidence of shivering, inflammatory reaction, and postoperative infection.

Pyroptosis is a type of programmed cell death distincted from apoptosis and necrosis, which is accompanied by the lysis of cell membranes and the release of cell contents. Pyroptosis occurs as mediated by Gasdermin protein family and is dependent on the activity of caspase. GSDME is one of the most important members of the Gasdermin protein superfamily. GSDME-mediated pyroptosis relies on the activity of caspase-3. In recent years, with further research on pyroptosis, the mechanism of GSDME-induced pyroptosis is becoming clear. Numerous studies have shown that GSDME-mediated pyroptosis plays an important role in the occurrence and development of tumors, as well as chemotherapy resistance. However, GSDME-mediated pyroptosis has no specificity and can induce pyroptosis of normal cells in the body while inducing tumor cell pyroptosis, thus causing different degrees of damage to various organs of the body. Further study on the mechanism of GSDME-induced pyroptosis, the role of GSDME in malignant tumors and the adverse reactions of chemotherapy can provide new ideas for tumor monitoring, treatment and prognosis judgment.

Exosomes are membranous vesicles secreted by most eukaryotic cells, which are approximately 30-150 nm in diameter and contain RNA, proteins and lipids closely related to their function and origin, playing an important role in cell-to-cell communication. It can promote tumor progression by promoting the proliferation and migration of tumor cells, improving the tumor microenvironment and inhibiting the immune response. In addition, exosomes are expressed at high levels in certain tumors and can be used as predictors of cancer for early diagnosis. It can also be used as a carrier to carry targeted drugs to the local tumor to exert an inhibitory effect.

ObjectiveTo observe the effect of the enhanced external counterpulsation （EECP） combined with drug on social function and efficacy in patients with depressive episodes， so as to provide references for the treatment of depressive episodes. MethodsA total of 66 hospitalized patients who was in hospital at department of psychiatry of the Second Xiangya Hospital of Central South University， met the criteria of Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5） diagnosis of depressive episode or bipolar disorder depressive episode from May 2019 to March 2020 were included by simple random sampling. The participants were divided into study group （n=36） and control group （n=30） according to the random number table method. Both groups received conventional drug treatment， and the study group recieved the EECP intervention at same time. The Depression symptoms and social function were assessed before and after treatment by using Hamilton Depression Scale-24 item （HAMD-24） and Sheehan Disability Scale （SDS）. Treatment efficacy of the two groups was compared. ResultsAfter the intervention， the HAMD-24 and SDS scores in both groups were lower than those before treatment， the differences were statistically significant （t=8.149， 5.791， 8.016， 3.488， P˂0.01）. And the SDS score of the study group was siginficantly lower than that of the control group （t=-3.008， P<0.05）. The total effective rate of treatment in the study group was higher than that of the control group， and the difference was statistically significant （90.63% vs. 63.33%， χ²=8.725， P˂0.05）. ConclusionEECP therapy combined with drug has better efficacy on the patients with depressive episodes， and it can improve social function effectively.