Objective:To investigate the application value of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function.Methods:The clinical data of 84 patients with ischemic stroke treatment in the Xining Third People′s Hospital from September 2020 to September 2022 were selected retrospectively, and they were divided into the conventional group (42 cases) and experimental group (42 cases) according the treatment methods. Interventional thrombectomy was performed in both groups. Propofol combined with remifentanil was used in the conventional group, and sevoflurane combined with remifentanil was used in the experimental group. The excellent and good rate of anesthesia was compared between the two groups; the hemodynamic indexes before anesthesia induction (T 1), at the beginning of surgery (T 2), after thrombectomy and extubation (T 3) and at the end of surgery (T 4) were compared between the two groups; the brain injury indexes were compared before and 12, 24 and 48 h after surgery were compared between the two groups; the National Institutes of Health Stroke Scale (NIHSS) score, Simple Mental State Examination Scale (MMSE) score, postoperative cognitive dysfunction (POCD) and anesthesiation-related adverse reactions were compared between the two groups. Results:The excellent and good rate of anesthesia in the experimental group was higher than that in the conventional group:100.00% (42/42) vs. 83.33% (35/42), there was statistical difference ( χ2 = 5.61, P<0.05). The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO 2) in the two groups at T 2, T 3 and T 4 were higher than those at T 1 ( P<0.05); the MAP, HR and SpO 2 in the experimental group at T 2, T 3 and T 4 were lower than those in the conventional group ( P<0.05). The serum neuron-specific enolase (NSE) and S100β protein were significantly increased at 12 and 24 h after surgery in both groups ( P<0.05); serum NSE and S100β proteins in the experimental group at 12, 24 and 48 h were lower than those in the conventional group: (30.12 ± 4.26) μg/L vs. (35.64 ± 5.70) μg/L, (22.69 ± 4.01) μg/L vs. (26.81 ± 5.53) μg/L, (18.71 ± 2.92)μg/L vs. (21.34 ± 4.02) μg/L, (1.19 ± 0.20) μg/L vs. (1.37 ± 0.24) μg/L, (0.96 ± 0.13) μg/L vs. (1.13 ± 0.16) μg/L, (0.80 ± 0.11) μg/L vs. (0.94 ± 0.15) μg/L, there were statistical differences ( P<0.05). The NIHSS score was significantly higher and the MMSE score was significantly lower in both groups at 12 and 24 h after surgery ( P<0.05); the NIHSS score and MMSE score in both groups recovered to preoperative level at 48 h after the operation ( P>0.05). The NIHSS score in the experimental group at 12 and 24 h after surgery was lower than that in the conventional group, and the MMSE score was higher than that in the conventional group ( P<0.05). The incidence of anesthesia-related adverse reactions in the experimental groups was lower than that in the control group: 4.76%(2/42) vs. 21.43%(9/42); and the incidence of POCD was lower than that in the conventional group: 19.05%(8/42) vs. 2.38%(1/42), there were statistical differences ( χ2 = 5.13, 4.48, P<0.05). Conclusions:Sevoflurane combined with remifentanil has a significant anesthetic effect in interventional thrombectomy of ischemic stroke patients, which can stabilize hemodynamics, reduce the degree of brain injury, promote cognitive function recovery, and reduce POCD and adverse reactions.

Objective:To investigate the application value of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function.Methods:The clinical data of 84 patients with ischemic stroke treatment in the Xining Third People′s Hospital from September 2020 to September 2022 were selected retrospectively, and they were divided into the conventional group (42 cases) and experimental group (42 cases) according the treatment methods. Interventional thrombectomy was performed in both groups. Propofol combined with remifentanil was used in the conventional group, and sevoflurane combined with remifentanil was used in the experimental group. The excellent and good rate of anesthesia was compared between the two groups; the hemodynamic indexes before anesthesia induction (T 1), at the beginning of surgery (T 2), after thrombectomy and extubation (T 3) and at the end of surgery (T 4) were compared between the two groups; the brain injury indexes were compared before and 12, 24 and 48 h after surgery were compared between the two groups; the National Institutes of Health Stroke Scale (NIHSS) score, Simple Mental State Examination Scale (MMSE) score, postoperative cognitive dysfunction (POCD) and anesthesiation-related adverse reactions were compared between the two groups. Results:The excellent and good rate of anesthesia in the experimental group was higher than that in the conventional group:100.00% (42/42) vs. 83.33% (35/42), there was statistical difference ( χ2 = 5.61, P<0.05). The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO 2) in the two groups at T 2, T 3 and T 4 were higher than those at T 1 ( P<0.05); the MAP, HR and SpO 2 in the experimental group at T 2, T 3 and T 4 were lower than those in the conventional group ( P<0.05). The serum neuron-specific enolase (NSE) and S100β protein were significantly increased at 12 and 24 h after surgery in both groups ( P<0.05); serum NSE and S100β proteins in the experimental group at 12, 24 and 48 h were lower than those in the conventional group: (30.12 ± 4.26) μg/L vs. (35.64 ± 5.70) μg/L, (22.69 ± 4.01) μg/L vs. (26.81 ± 5.53) μg/L, (18.71 ± 2.92)μg/L vs. (21.34 ± 4.02) μg/L, (1.19 ± 0.20) μg/L vs. (1.37 ± 0.24) μg/L, (0.96 ± 0.13) μg/L vs. (1.13 ± 0.16) μg/L, (0.80 ± 0.11) μg/L vs. (0.94 ± 0.15) μg/L, there were statistical differences ( P<0.05). The NIHSS score was significantly higher and the MMSE score was significantly lower in both groups at 12 and 24 h after surgery ( P<0.05); the NIHSS score and MMSE score in both groups recovered to preoperative level at 48 h after the operation ( P>0.05). The NIHSS score in the experimental group at 12 and 24 h after surgery was lower than that in the conventional group, and the MMSE score was higher than that in the conventional group ( P<0.05). The incidence of anesthesia-related adverse reactions in the experimental groups was lower than that in the control group: 4.76%(2/42) vs. 21.43%(9/42); and the incidence of POCD was lower than that in the conventional group: 19.05%(8/42) vs. 2.38%(1/42), there were statistical differences ( χ2 = 5.13, 4.48, P<0.05). Conclusions:Sevoflurane combined with remifentanil has a significant anesthetic effect in interventional thrombectomy of ischemic stroke patients, which can stabilize hemodynamics, reduce the degree of brain injury, promote cognitive function recovery, and reduce POCD and adverse reactions.

OBJECTIVE We designed the overall layout,formulated the functional demand,and optimized the key design and operating parameters of a new-style asepsis clean ward.The new-style ward intends to provide a higher quality environment for patient infection control and all-around protection during treatment.METHODS We applied computational fluid dynamics(CFD)simulation to optimize the design scheme according to Chinese and international hospital design specifications.RESULTS The new-style asepsis ward reflected a new idea,new technology,high standards and created a comfortable and safe,high-quality environment for the treatment of patient.The Satisfaction of patients was more than 95% and workload of nurses was alleviated obviously.CONCLUSIONS The new-style asepsis ward can significantly control the endogenous infection of patients.

OBJECTIVE To compare the computational fluid dynamics(CFD) simulated results and field test data of the new-style asepsis ward.METHODS We used various equipments to test the asepsis ward and CFD software to simulate airflow of asepsis ward.RESULTS After calculating and comparing,we found the CFD simulation results agreed well with the tested data.Key design and operating parameters were up to the standard.The new-style of asepsis ward could improve the air quality and provide a comfortable environment for patient treatment and it was of great help to decrease the infection rate of patient.CONCLUSIONS The new-style asepsis ward can significantly control the endogenous infection of patients.