Objective To compare the effects of aspirin and clopidogrel on platelet aggregation function by TEG,and to study the antiplatelet agents tailored therapy of Thrombelastography(TEG)in treatment of cerebral infarc-tion patients.Methods 100 patients with acute cerebral infarction were included in two groups:aspirin group and clopidogrel group.The inhibitory rates of AA and ADP receptor pathway in platelets were detected by TEG.The effect of inhibitory rates in group aspirin and clopidogrel was compared with nerve function and the recurrence rate of stroke. Results The inhibitory rates of group aspirin (85.23 ±21.98)% was higher than group clopidogrel (47.31 ± 22.37)% (t =7.340,P =0.005).The patients with which the inhibitory rates showed goodby TEG in group aspirin and clopidogrel got better neurological recovery,and the patients showed goodby TEG in group aspirin got lower stroke recurrence rate within 1 year(χ2 =4.460,P =0.035;χ2 =7.232,P =0.007).Conclusion TEG had guided the antiplatelet individual therapy for cerebral infarction patients,and can be used to predict and confirm the efficacy of antiplatelet drug.

Objective:To evaluate the lung protection of pressure-controlled ventilation volume guaranteed (PCV-VG) in elderly patients undergoing laparoscopic surgery in Trendelenburg position.Methods:Sixty patients of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, aged 65-80 yr, with body mass index of 19-27 kg/m 2, scheduled for elective laparoscopic radical prostatectomy or laparoscopic radical cystectomy, were allocated into 2 groups ( n=30 each) by a random number table method: VCV group (group V) and PCV-VG group (group P). Tracheal intubation was performed after induction of anesthesia.The anesthesia machine was connected to perform mechanical ventilation with tidal volume of 7 ml/kg (corrected body weight), positive end-expiratory pressure at 5 cmH 2O, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 50%, fresh gas flow at 2 L/min and respiratory rate 12-15 breaths/min in two groups.Recruitment maneuver was performed with a pressure of 30 cmH 2O, lasting for 30 s, starting from 5 min before the end of administration.The airway peak pressure (P peak), airway plateau pressure (P plat), driving pressure (DP), and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T 1), 5 min after changing position (T 2), 5, 30, 60, 90 and 120 min of pneumoperitoneum (T 3-7) and 5 min after restoring the supine position and after the end of pneumoperitoneum (T 8). Blood samples were collected from the radial artery for blood gas analysis at T 1, T 4 and T 6 and when modified Aldrete score reached 10 in postanesthesia care unit, and pH value, partial pressure of arterial oxygen (PaO 2), partial pressure of arterial carbon dioxide (PaCO 2), arterial oxygen saturation (SaO 2) and alveolar-arterial oxygen gradient (P A-aO 2) were recorded.Blood samples were collected from the radial artery before induction of anesthesia and at the end of surgery for determination of concentrations of Clara cell protein (CC-16), interleukin-6 (IL-6) and neutrophil elastase (NE) in serum by enzyme-linked immunosorbent assay.The development of pulmonary complications was recorded within 7 days after surgery. Results:Compared with group V, P peak was significantly decreased at T 1-8, P plat and DP were decreased at T 5-7, Cdyn was increased at T 2-7, P A-aO 2 was decreased at T 1, 4, 6, serum CC-16, IL-6 and NE concentrations were decreased at the end of surgery ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group P ( P>0.05). Conclusion:PCV-VG can produce lung protection to some extent in elderly patients undergoing laparoscopic surgery in Trendelenburg position.

The diagnosis of chronic pain requires a true and reliable pain assessment, which relies on timely self-reporting. Ecological momentary assessment (EMA) is a method of repeated dynamic sampling through patient self-report to minimize recall bias. This review introduces and analyzes the concept and application of EMA, and expounds the feasibility and limitations of EMA in chronic pain management, aiming to provide reference for medical and nursing staff to evaluate chronic pain management efficiently.

Objective:To explore the impact of multimorbidity on disability in older adults, providing a reference for formulating strategies for the management and nursing of multimorbidity and disability in older adults.Methods:Adopting the method of cross-sectional survey research, the data of 6 469 older adults (≥60 years old) were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey database in July 2023, including basic information, chronic disease prevalence, and disability measured by basic activities of daily living (BADL), and instrumental activities of daily living (IADL). They were divided into multimorbidity and non-multimorbidity groups based on whether they had two or more chronic diseases. The propensity score matching (PSM) method was used to match the basic conditions of the two groups of older adults with the proportion of 1∶1. Binary logistic regression was applied to analyze the effects of multimorbidity on BADL disability and IADL disability.Results:Among 6 469 older adults, there were 2 882 males and 3 582 females, with 3 158 aged 60-84 years old and 3 311 aged over 84 years old. BADL disability accounted for 26.5% (1 712/6 469), while IADL disability accounted for 66.8% (4 324/6 469). There were 2 335 patients in the multimorbidity group and 4 134 patients in the non-multimorbidity group. Binary Logistic regression analysis showed that the risk of BADL disability in older adults in multimorbidity group was 1.511 times higher than that in the non-multimorbidity group (95% CI 1.317-1.734, P<0.01); the risk of IADL disability in older adults in the multimorbidity group was 1.618 times higher than that in the non-multimorbidity group (95% CI 1.426-1.835, P<0.01). Conclusions:Multimorbidity would increase the risk of disability in older adults. Relevant authorities should develop relevant interventions and nursing responses to enhance the prevention and management of multimorbidity and disability in older adults.

Objective:To translate the Hip Preservation Surgery Expectations Survey (HPSES) into Chinese and test its reliability and validity.Methods:This study strictly followed the principles of Brislin translation, back translation, and cross-cultural adaptation to form a simplified Chinese version of HPSES. From September 2019 to July 2021, a survey was conducted using convenience sampling method to select 215 patients from the Department of Orthopedics of the Affiliated Hospital of Qingdao University who underwent hip preservation surgery to test the reliability and validity of the Chinese version of HPSES. This study used critical ratio determination and correlation analysis for item analysis, and used content validity index and structural validity to evaluate the validity of the scale, and the reliability of the scale was evaluated using Cronbach's α coefficients and half reliability.Results:The Chinese version of HPSES extracted 4 common factors, totaling 22 items, with a cumulative total variance contribution rate of 63.696%. The content validity index at the scale level was 0.97, and the content validity index at the item level was 0.83 to 1.00. The results of confirmatory factor analysis showed that the fit of the scale was good. The total Cronbach's α coefficient of the scale was 0.873, and Cronbach's α coefficients for each dimension ranged from 0.834 to 0.868. The overall Guttman half reliability coefficient of the scale was 0.840, and the Guttman half reliability coefficients for each dimension were 0.755 to 0.865.Conclusions:The Chinese version of HPSES has good reliability and validity, which can be used to evaluate the expected outcomes of patients undergoing hip preservation surgery, facilitating medical and nursing staffs to provide targeted preoperative health education and rehabilitation guidance to patients, and improving patients satisfaction.

The ultrasound endoscopic probes with very small size transducers are normally imaging by focused ultrasound beamforming technology. So the imaging frame rate is not very high, which cannot meet the needs of some clinical applications based on high imaging rate. In recent years, plane-wave ultrafast imaging technology can obtain high image frame rate and guarantee the image quality. In this paper, a plane wave ultra-fast imaging technique based on a home-made small line array ultrasound transducer is presented. Feasibility of the method is verified by simulation estimations and phantom experiments. The results show that for the small size transducer design of plane wave ultrafast imaging, it is necessary to fully consider the combination of the array element width and the number of array elements. So that a good plane wave imaging quality can be obtained. It lays a foundation for the ultra-fast imaging of plane wave in the interventional ultrasound imaging and ultrasound endoscopy.
Phantoms, Imaging ; Transducers ; Ultrasonography ; instrumentation