Objective To investigate the effects of electroacupuncture (EA) of different intensities on cerebral energy metabolism in a rat model of global cerebral ischemia-reperfusion (I/R) . Methods Forty male SD rats weighing 200-230 g were randomized into 5 groups ( n = 8 each) : group A sham operation; group B global cerebral I/R and C, D, E groups cerebral I/R+ 5, 3, 1 mA EA. Global cerebral I/R was induced by 4-vessel occlusion technique. Bilateral vertebral arteries were permanently occluded by cauterization.Bilateral common carotid arteries were clamped. When the bilateral pupils were completely dilated, the arteries were unclamped. Baihui,Mingmen and Zusanli were electrically stimulated with 5,3,1 mA (30-50 Hz) for 20 min at 1 h of reperfusion in C, D, E groups. The EA was repeated at 12 h of reperfusion. The animals were sacrificed at 24 h of reperfusion.The activities of Na+ -K+ -ATPase, succinodehydrogenase (SDH) and lactic dehydrogenase(LDH) in brain tissue were measured.Results Cerebral I/R significantly increased LDH activity and decreased Na+ -K+ -ATPase activity in group B as compared with group A. EA with 5 mA significantly decreased LDH activity and increased SDH and Na+ -K+ -ATPase activities in group C compared with group B. Conclusion EA can improve the cerebral energy metabolism in a rat model of global cerebral I/R and it is related to the intensity, which may be the mechanism by which EA reduces the global cerebral I/R injury.

The information-knowledge-intelligence transformation rules were introduced as the theory for the transformation of information service main body for evidence-based medicine according to the analysis of domestic and foreign institutional main body and personal main body for the information service of evidence-based medicine.It was proposed that medical library as the institutional main body should be transformed into information repository + thinking library and clinical medical librarians as the personal main body should be transformed into evidence witness + decision making adviser with associated literacy.

Objective To compare effectiveness,performance,and complications between ultrasound-guided selective cervical nerve root block and interscalene brachial plexus block for patients undergoing arthroscopic surgery in perioperative period.Methods Seventy patients scheduled for arthroscopic surgery,25 males and 45 females,aged 18-75 years,were randomly divided into two groups.They were given either selective cervical nerve root block (group S,n =35) or interscalene brachial plexus block (group ISB,n=35).In group S,C5 and C6 nerve roots were given 0.5％ ropivacaine 5 ml respectively;In group ISB,patients were given 0.5％ ropivacaine 10 ml under ultrasound guidance.The primary outcome:VAS score and forearm modified Bromage scale (MBS) score were recorded at 4,12 and 24 hours after surgery;Secondary outcomes:cumulative tramadol consumption,the patients' satisfaction rate and adverse effects were recorded.Results The VAS scores in group S was significantly lower than that in group ISB at 12 hours after surgery (1.7±0.8 vs 3.6±0.7,P＜0.05).The forearm MBS scores in group S was significantly higher than that in group ISB 4 hours after surgery (P＜0.01).Compared with group ISB,the amount of tramadol consumption was lower at 24 hours after surgery [(37.5±35.9) mg vs (112.5±43.5) mg,P＜0.05)].The satisfaction rate of group S was higher than group ISB (88％ vs 56％,P＜0.05).There was no significant difference in side effects between the two groups.Conclusion In arthroscopic surgery,the selective cervical nerve root block is superior to the brachial plexus block.

Objective To investigate the effects of dynamic lung compliance(Cdyn)-guided indi-vidual positive end-expiratory pressure(PEEP)titration on pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods Sixty-eight elderly patients were selected for laparoscopic radical resection of colorectal cancer,37 males and 31 females,aged 65-79 years,BMI<30 kg/m2,ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the random number table method:individualized PEEP group(group P)and control group(group C),34 patients in each group.In group P,the patients received recruitment maneuvers and PEEP titration test at immediately after intubation,immediately after establishing pneumoperitoneum-Trendelenburg position and immediately after pneumoperitoneum.The patients in group C received PEEP 5 cmH2 O during procedure.The three best titra-tion PEEP and the actual tidal volume(VT)in group P were also recorded.PaO2,PaCO2,PETCO2 10 mi-nutes after the tracheal intubation(T1),10 minutes(T2)and 1 hour(T3)after establishing pneumoperito-neum-Trendelenburg position,at the end of the surgery but before extubation(T4)were recorded,and the oxygenation index(OI),physiological dead space to tidal volume(Vd/VT),alveolar arterial oxygen differ-ence(A-aDO2),driving pressure,and Cdyn were calculated.Concentrations of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),Clara cell secretoyr protein(CC16)and lung alveolar surface active sub-stances-D(SP-D)in the serum samples were determined by ELISA before anesthesia induction(T0)and 10 minutes after extubation(T5).Postoperative pulmonary complications(PPCs)were also recordrd.Results The individualized PEEP of Cdyn?guided PEEP titration was 4 cmH2O. Compared with group C, the PaO2 and OI in group C were significantly increased at T4, the Cdyn was significantly increased at T1,T3, and T4, the driving pressure was significantly decreased at T1 -T4, the serum concentration of CC16 was significantly decreased at T5 ( P < 0. 05). There were no significant differences in PaCO2, PET CO2,A?aDO2, and Vd/ VT between the two groups. There was no severe PPCs in the two groups. Conclusion Pressure?controlled ventilation modes combined with Cdyn?guide PEEP titration can increase the Cdyn, reduce thedriving pressure, and improve OI at the end of the operation, reduce the concentrations of CC16 at postop?eration, improve pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.

Objective To systematically evaluate the clinical effect of transcutaneous electrical acupoint stimulation(TEAS)on promoting postoperative gastrointestinal function recovery.Methods Randomized controlled trials(RCTs)related to postoperative gastrointestinal function using TEAS were re-trieved from the CNKI,WanFang,VIP,Embase,and PubMed database.RCTs on the effects of TEAS on postoperative gastrointestinal function were included.Methodological quality was evaluated using the quality evaluation tools recommended in Cochrane evaluation manual 5.1.Meta-analysis was performed using Rev-Man 5.3 and Stata 15.Results Thirty-four RCTs involving 3 593 patients were included.There were 1 781 patients in the TEAS group and 1 812 patients in the non-TEAS group.Compared with the non-TEAS group,the incidence of nausea(RR = 0.46,95%CI 0.36 to 0.59,P＜0.001)and vomiting(RR = 0.47,95%CI 0.37 to 0.59,P＜0.001)within 24 hours after surgery was significantly reduced in the TEAS group,and the postoperative recovery time of bowel sound(MD =-6.42 hours,95%CI-8.53 to-4.32 hours,P＜0.001),first exhaust time(MD =-8.72 hours,95%CI-10.64 to-6.80 hours,P＜0.001),andfirstdefecationtime(MD =-11.83hours,95%CI-14.67 to-8.98 hours,P＜0.001)were significantly shortened.Conclusion TEAS can promote postoperative gastrointestinal function recovery,significantly reducing the incidence of postoperative nausea and vomiting within 24 hours after sur-gery,and shortening the time of first anal exhaust and defecation after surgery.