Objective To investigate the effect of extracorporeal diaphragmatic pacing(EDP)on wea-ning patients undergoing mechanical ventilation after acute Stanford type A aortic dissection(ATAAD)sur-gery.Methods A total of 80 patients who underwent ATAAD surgery and required mechanical ventilation in the cardiac intensive care unit(CCU)of our hospital from October 2023 to October 2024 were selected as the study subjects.They were randomly divided into a control group and an intervention group using a random number table method,with 40 patients in each group.Both groups of patients received conventional clinical drug therapy,mechanical ventilation support,and rehabilitation exercises after surgery.The intervention group additionally underwent EDP therapy on this basis.The clinical data,mechanical ventilation time,weaning out-comes,oxygenation index,tidal volume,and changes in diaphragm function parameters were compared be-tween two groups of patients.Results Compared with the control group,the intervention group had a shorter mechanical ventilation time[77.00(59.00,133.63)h]vs.54.50(49.00,105.25)h],offline success rate(72.5％vs.90.0％),oxygenation index[202.90(178.63,240.05)mmHg vs.236.50(196.00,293.75)mm-Hg],higher tidal volume[(496.00±111.95)mL vs.(563.23±133.98)mL],with a statistically significant difference(P＜0.05).Compared with the control group,diaphragmatic excursion(DE)of both sides[11.90(8.50,16.50)mm vs.15.30(12.20,19.80)mm;12.60(10.80,14.90)mm vs.14.70(11.43,19.20)mm]and diaphragmatic thickening fraction(DTF)of left and right side[21.75％(17.53％,27.13％)vs.26.30％(21.10％,32.40％);24.00％(17.68％,29.35％)vs.28.30％(22.43％,33.40％)]of the intervention group were higher,and the differences were statistically significant(P＜0.05).Conclusion EDP can enhance the function of the diaphragm in patients,shorten the duration of mechanical ventilation,improve the success rate of wea-ning,and improve the weaning outcomes of mechanically ventilated patients after ATAAD surgery.

We have studied mainly the distribution of this ~3H-labelled schistosomicidal drug in the livers and brains of the albino mice. In livers the ~3H-labelled substances were localized in greater quantity in the liver cell trabecula than in the sinusoids, and were taken up by the Kupffer's cells too. But the most prominent condense localization of the ~3H-labelled substances were in the interlobular bile ducts indicating that the original agent and its metabolites were excreted through the bile ducts system. The nuclei of the liver cells contained a certain amount lof the ~3H-labelled substances, about 7 silver grains in each nucleus with a diameter of about 10.7? seen in 2? thick freezing sections. One of the metabolites of this schistosomicidal drug being a mutagenic agent, the appearance of ~3H-labelled substances in the cell nuclei attracts our great attentions. As for the genesis mechanism of jaundice after administration of this schistosomicidal drug, our opinion is that it might be chiefly the result of drug sensitizied allergy reaction in accordance with a lot of works in the clinics, immunological test, pharmacological principles and our present studies. In the brains, the ~3H-labelled substances distributed much more in the white substances than in the gray substances, with the exception of the substantia nigra which had the same density of number of silver grains as the white substances. With these findingsthe clinical symptoms of the nervous system and their recovery were reviewed.