Objective To evaluate the clinical efficacy of ganglioside combined with edaravone in the treatment patients with acute cerebral infarction,to assess the improvement of neurological function and prognosis.To provide the evidence for the clinical treatment of acute cerebral infarction.Methods 126 patients with acute cerebral infarction were selected.According to the digital table,they were randomly divided into the control and the study group,with 65 cases in each group.The control group was given edaravone based on the conventional treatment,the study group was treated with ganglioside and edaravone.The treatment effect was assessed,and the National Institutes of Health Stroke Scale(NIHSS),Fugl -Meyer motor function score,Barthel Index(BI)to assess the improvement of the situation neurological,physical function and daily life were applied.Results The total effective rate of the study group was 82.54%,which was higher than 71.43% of the control group,the difference was statistically significant(χ2 =9.63, P <0.05).The NIHSS score of the study group after treatment was (24.60 ±5.81 )points,which was lower than (27.74 ±5.93)points of the control group,the difference was statistically significant(t =9.97,P <0.05).The FM and BI scores of the study group after treatment were (78.62 ±8.46)points and (72.89 ±8.03)points,which were higher than (73.58 ±8.09)points and (68.30 ±7.45)points of the control group,the differences were statistically significant(t =10.16,11.42,all P <0.05).Conclusion It has better clinical effect on ganglioside and edaravone for the patients with acute cerebral infarction,which can significantly improve neurological function and limb motor function,and significantly improved prognosis of patients.

Objective To study the clinical application and value of transcranial Doppler (TCD) monitoring senile cerebral blood flow autoregulation in elderly.Methods Two hundred cases patients with elderly hypertension and 200 cases normal eldly from May 2011 to December 2014 in the Second People 's Hospital of Fengrun District of Tangshan were chosen as hypertension group and control group.Cerebral artery peak systolic velocity,supine with a vertical artery in the brain(MCA) cerebral blood flow difference (CBFV) and X-W wave duration, cerebrovascular hemodynamic parameters of two group were monitored by TCD method and compared.Results The peak values of left vertebral artery (LVA), right vertebral artery (RVA), the left coronary artery(LCS), and right vertebral artery(RCS) of hypertension group were significantly lower than those in the control group((38.01±12.42) cm/s vs (45.21±8.95) cm/s, (35.54±13.25) cm/s vs (43.52±7.06) cm/s, (66.12±9.52) m/s vs (76.54±8.19) cm/s, (71.24± 11.25) cm/s vs (77.98± 10.74) cm/s, (55.34 ±14.52) cm/s vs (61.24±12.58) cm/s,(48.12±15.24) cm/s vs (58.46±18.85) cm/s;t=4.6821, 5.6987,6.2589,4.3671,2.2854,4.9875;P＜ 0.01).The peak Vp, the difference between the horizontal and vertical position CBFV, X-W wave duration, the parameter of DR, Cp, C, Co, Zc, Wv of arterial blood vessels (left internal carotid artery (LICA), right internal carotid artery (RICA), left middle cerebral artery (LMCA), right middle cerebral artery(RMCA) ,left anterior cerebral artery(LACA), right anterior cerebral artery(RACA), left anterior cerebral artery (LOA), right middle cerebral artery (ROA)) of hypertension group were significantly higher than those of control group((96.38±18.85) cm/s vs (83.56±13.41) cm/s, (103.04±35.42) cm/s vs (85.62±29.63) cm/s, (99.85±23.54) cm/s vs (83.12±22.67) cm/s, (102.84± 16.42) cm/s vs (86.23 ±21.34) cm/s, (85.06± 15.36) cm/s vs (73.16± 10.35) cm/s, (85.64± 15.34) cm/s vs (70.52± 18.56) cm/s, (34.85±8.74) cm/s vs (28.56±7.85) cm/s, (35.12± 11.20) cm/s vs (30.05± 6.88) cm/s, (7.22 ± ±2.54) cm/s vs (2.78± 1.87) cm/s, (23.74±5.23) cm/s vs (20.85±4.35) cm/s, (378.35±35.12) Pa? s/cm vs (314.53±36.21) Pa? s/cm, (8.16± 0.62) P/kPa vs (7.25± 0.68) P/kPa, (0.41 ± 0.05) ml/kPa vs (0.33±0.06) ml/kPa, (1.15±0.16) mL/kPa vs (0.84±0.13) ml/kPa, (346.13±42.63) dyn? s/cm5 vs (241.68±50.21) dyn? s/cm5, (21.47± 3.85) V/(cml? s) vs (11.24 ± 3.67) V/(cml? s);t =5.8954, 4.2589,4.8792,6.3985,6.3874,6.9852,5.6387,4.6892,6.0387,4.8562, 11.475,8.041,12.422, 11.820, 12.854,20.412;P＜0.01).Conclusion The function of automatic adjustment shows obvious abnormal cerebral blood flow in patients with hypertension, andthe TCD technology can response of cerebral blood flow autoregulation,which has important clinical value for diagnosis and treatment of cerebral infarction, stroke and other cardiovascular and cerebrovascular diseases.

Objective To investigate the clinical effect of edaravone combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction.Methods From January 2016 to September 2017,100 patients with acute cerebral infarction in Xin'an International Hospital were selected.According to digital table method,the patients were divided into observation group and control group,with 50 cases in each group.The observation group was given edaravone combined with ginkgo leaf extract and dipyridamole injection.The control group received ginkgo leaf extract and dipyridamole injection treatment.The patients were treated for 20 days.The clinical effect of the two groups was compared.Results The total effective rate of the observation group was 90.0％,which was significantly higher than 70.0％ in the control group (x2 =16.265,P ＜ 0.05).Before treatment,the whole high blood viscosity,whole low blood viscosity,blood plasma viscosity,hematocrit and fibrinogen between the two groups had no statistically significant differences (t =0.156,1.563,0.156,1.563,1.263,all P ＞ 0.05).After treatment,the indicators in the two groups were declined.The whole high blood viscosity,whole low blood viscosity,blood plasma viscosity,hematocrit and fibrinogen in the observation group were (5.29 ± 1.25) mPa/s,(12.88 ± 3.35) mPa/s,(1.76 ± 0.28) mPa/s,(0.44 ± 0.48) and (3.48 ± 0.57) g/L,respectively,which were significantly better than those in the control group[(5.83 ± 1.54) mPa/s,(14.54 ±4.29) mPa/s,(1.89 ±0.32) mPa/s,(0.47 ±0.65),(3.76±0.89) g/L],the differences were statistically significant between the two groups(t =5.423,6.287,5.112,9.145,5.443,all P ＜ 0.05).Conclusion Edaravone combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction has good effect,and it is worth to be widely used in the clinical treatment.

Objective:To investigate the changes in cognitive and behavioral function in patients with cerebral small vessel disease and their correlation with serum homocysteine (Hcy) and cystatin C (CysC) levels.Methods:Ninety-four patients with cerebral small vascular disease who received treatment in Zhejiang Xin'an International Hospital from March 2019 to March 2021 were included in the observation group. An additional 80 healthy controls who concurrently received physical examination were included in the control group. The Mini-Mental State Scale (MMSE) and the Montreal Assessment Scale (MoCA) were used to evaluate cognitive function. The activity of daily living (ADL) was used to evaluate behavioral function. Enzyme-linked immunosorbent assay was used to measure serum Hcy and CysC levels. MMSE score, MoCA score, ADL score, serum Hcy and CysC levels were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of serum Hcy and CysC levels in the diagnosis of cerebral small vessel disease. Pearson correlation analysis was performed to analyze the correlation between serum Hcy and CysC levels and cognitive behavioral function.Results:MMSE score, MoCA score, and ADL score in the observation group were (21.21 ± 2.87) points, (20.18 ± 3.25) points, and (34.32 ± 5.45) points, which were significantly lower than (28.23 ± 1.02) points, (28.45 ± 0.89) points and (76.35 ± 8.29) points in the control group ( t = 20.78, 22.05, 40.03, all P < 0.05). Serum Hcy and CysC in the observation group were (16.28 ± 2.97) μmol/L and (1.21 ± 0.23) mg/L, which were significantly higher than (8.35 ± 1.76) μmol/L and (0.56 ± 0.12) mg/L in the control group ( t = 20.95, 22.77, both P < 0.05). ROC curve analysis showed that the sensitivity and specificity of serum Hcy in diagnosing cerebral small vessel disease were 85.29% and 53.85%, respectively; the sensitivity and specificity of serum CysC in diagnosing cerebral small vessel disease were 81.54% and 41.38%, respectively. Pearson correlation analysis revealed that serum Hcy level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.79, -0.68, -0.71, all P < 0.05); serum CysC level was linearly negatively correlated with MMSE score, MoCA score, and ADL score ( r = -0.67, -0.75, -0.78, P < 0.05). Conclusion:The cognitive and behavioral function of patients with cerebral small vessel disease are decreased, and serum Hcy and CysC levels are increased. Serum Hcy and CysC levels are closely related to the cognitive and behavioral function of patients with cerebral small vessel disease.

Objective To evaluate the effect of intelligentized patient-controlled analgesia ( PCA) management on the quality of postoperative analgesia in the patients. Methods A total of 6601 patients who underwent postoperative PCA from January 1, 2015 to December 31, 2017 searched from the intelli-gentized PCA system database were selected as intelligentized PCA management group ( I group) , and then were divided into 3 subgroups according to the year: 2015 subgroup ( n=2221 ) , 2016 subgroup ( n=2152) and 2017 subgroup (n=2228). A total of 1235 patients who underwent PCA which was mainly performed by a department of anesthesiology in the postoperative analgesia-related multi-center questionnaire from April 11, 2016 to April 22, 2016 in 12 grade A tertiary hospitals in Guangdong Province were select-ed as the traditional PCA management group (C group). The development of moderate and severe pain, nausea and vomiting, over-sedation at rest and during activity and patient′s satisfaction were recorded on 1st and 2nd days after operation. Results Compared with C group, the incidence of moderate and severe pain, nausea and vomiting and over-sedation at rest and during activity was significantly decreased, and the rate of patient′s satisfaction was increased at each time point after operation in I group ( P<0. 05 or 0. 01) . Com-pared with 2015 subgroup, the incidence of moderate and severe pain at rest and severe pain during activity was significantly decreased in 2016 and 2017 subgroups ( P<0. 05 or 0. 01) , and the incidence of nausea and vomiting was significantly increased in 2017 subgroup ( P<0. 05) . Compared with 2016 subgroup, the incidence of nausea and vomiting was significantly increased in 2017 subgroup (P<0. 05). Conclusion Intelligentized PCA management can improve the efficacy of PCA, mitigates the occurrence of adverse reac-tions and raise the quality of postoperative analgesia in the patients.