Neural oscillatory changes play a critical role in pain and analgesia research. Previous studies on pain-related neural oscillations have primarily utilized electroencephalogram (EEG) power spectral analysis, revealing a strong correlation between alpha ( α) power and subjective pain perception. However, alpha power may be influenced by the baseline of the power spectrum, making it difficult to accurately capture the true changes in alpha oscillations. This study employed power spectral analysis and further applied a power spectral parameterization method, which decomposed the power spectrum into periodic and aperiodic components, to compare EEG α power in 50 primiparous women who underwent severe pain during the first stage of labor before and after epidural analgesia. The results indicated no significant differences in α power between pre- and post-analgesia conditions. However, following power spectral parameterization, the aperiodic component of the EEG significantly decreased after analgesia, whereas the periodic component of α power showed a significant increase. This study not only validates the effectiveness and validity of the power spectral parameterization method in analgesia research but also uncovers the differential regulatory mechanism by which analgesia modulates the periodic and aperiodic components of α oscillations.
Humans ; Electroencephalography/methods* ; Female ; Adult ; Alpha Rhythm ; Pregnancy ; Young Adult ; Analgesia, Epidural

Objective:To evaluate the feasibility and safety of performing multi-procedure remote urological surgeries by integrating 5G communication technology with domestically manufactured robotic surgical systems.Methods:Patients requiring urological laparoscopic surgery for benign lesions or tumors were prospectively enrolled at Gansu Provincial Hospital from May 2023 to June 2024. Inclusion criteria included age ≥18 years, body mass index (BMI) between 18 and 30 kg/m 2, and American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅲ. Tumor-related surgical indicators were as follows: renal tumors staged ≤T 2, solitary tumors, or maximum diameter ≤10 cm; intermediate- to low-risk prostate cancer (clinical stage ≤T 2b), with preoperative prostate-specific antigen (PSA) ≤20 ng/ml or Gleason score ≤7; adrenal tumors with a diameter ≤7 cm or ≥3 cm for non-functional adenomas; and bladder tumors staged ≤T 2. Exclusion criteria included participation in other investigational drug or device clinical trials within the past 1 month, pregnancy or breastfeeding, and patients requiring emergency surgery. Patients with severe cardiovascular or circulatory diseases contraindicating surgery, and individuals with epilepsy, psychiatric disorders, or cognitive impairments were also excluded. Additionally, patients with active bleeding, coagulation disorders, or platelet counts <80×10 9/L were excluded. A 5G communication link was established between the main campus and the new branch of Gansu Provincial Hospital, approximately 70 km apart. Remote surgeries were performed using the domestically manufactured robotic surgical system (Toumai MT-1000). Perioperative key indicators, intraoperative network conditions, and robotic system performance were systematically recorded. Results:This study involved 14 patients, comprising 3 cases of renal cysts, 3 cases of renal tumors, 3 cases of nonfunctional kidneys, 2 cases of adrenal tumors, 1 case of bladder tumor, 1 case of prostate cancer, and 1 case of ureteral-bladder wall thickening with pelvic ureteral stones. The cohort included 7 male and 7 female patients, with an average age of (57.4±12.3) years, a BMI of (24.6±3.0) kg/m 2, and ASA classifications of grade Ⅱ in 9 cases and grade Ⅲ in 5 cases. All remote surgeries were successfully completed without the need for conversion to alternative surgical methods. Three renal cyst unroofing decompression procedures were performed, with an average console operation time of (32.0±6.6) minutes and intraoperative blood loss of (13.3±2.9) ml. Two partial nephrectomies were conducted, with console operation times of 140 and 160 minutes, intraoperative blood loss of 20 ml each, and warm ischemia times of 19 and 25 minutes, respectively. The preoperative estimated glomerular filtration rates (eGFR) for these cases were 115.2 and 107.3 ml/(min·1.73m 2), and postoperative eGFR were 102.0 and 95.5 ml/(min·1.73m 2), respectively. Four radical nephrectomies were completed, with an average console operation time of (50.2±13.7) minutes and intraoperative blood loss of (20.5±13.2) ml. Two adrenal tumor resections were performed, each with console operation times of 45 and 50 minutes and intraoperative blood loss of 10 ml. Additionally, one partial bladder resection was conducted, requiring a console operation time of 60 minutes and resulting in intraoperative blood loss of 10 ml. A single radical prostatectomy was carried out, with a console operation time of 180 minutes, intraoperative blood loss of 120 ml, and pre- and postoperative PSA levels of 11.7 ng/ml and 0.06 ng/ml, respectively. One ureteral-bladder reimplantation was also performed, with a console operation time of 240 minutes and intraoperative blood loss of 10 ml. The average total delay for the 14 remote surgeries ranged from 194 to 250 ms, while the average network transmission delay ranged from 13 to 55 ms. During the procedures, six instances of sudden large fluctuations in network transmission delay were observed, ranging from 333 to 654 ms. These fluctuations resolved automatically within approximately 10 seconds but resulted in temporary disruptions: 2 cases of master-slave console lock (reset process lasted around 5 seconds) and 1 case of switching to the local console for emergency hemostasis (lasting approximately 7 minutes). These interruptions did not significantly affect the surgical process. Postoperative complications in all patients were classified as Clavien-Dindo grade Ⅰ and were unrelated to the surgical procedures or equipment. No cancer was detected in the resection margins of malignant tumors. Follow-up evaluations at three months, including blood tests, liver and kidney function tests, and CT scans of the surgical sites, revealed no significant abnormalities or adverse events. Conclusions:5G communication technology, with an average total latency of less than 250 ms, enables domestic surgical robots to perform multi-procedural remote urological surgeries effectively. However, during procedures requiring extensive suturing for urological reconstruction or managing unplanned intraoperative bleeding, network latency fluctuations exceeding 333 ms can extend the operation time and may necessitate switching to local control for emergency hemostasis.

Objective:To evaluate the feasibility and safety of performing multi-procedure remote urological surgeries by integrating 5G communication technology with domestically manufactured robotic surgical systems.Methods:Patients requiring urological laparoscopic surgery for benign lesions or tumors were prospectively enrolled at Gansu Provincial Hospital from May 2023 to June 2024. Inclusion criteria included age ≥18 years, body mass index (BMI) between 18 and 30 kg/m 2, and American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅲ. Tumor-related surgical indicators were as follows: renal tumors staged ≤T 2, solitary tumors, or maximum diameter ≤10 cm; intermediate- to low-risk prostate cancer (clinical stage ≤T 2b), with preoperative prostate-specific antigen (PSA) ≤20 ng/ml or Gleason score ≤7; adrenal tumors with a diameter ≤7 cm or ≥3 cm for non-functional adenomas; and bladder tumors staged ≤T 2. Exclusion criteria included participation in other investigational drug or device clinical trials within the past 1 month, pregnancy or breastfeeding, and patients requiring emergency surgery. Patients with severe cardiovascular or circulatory diseases contraindicating surgery, and individuals with epilepsy, psychiatric disorders, or cognitive impairments were also excluded. Additionally, patients with active bleeding, coagulation disorders, or platelet counts <80×10 9/L were excluded. A 5G communication link was established between the main campus and the new branch of Gansu Provincial Hospital, approximately 70 km apart. Remote surgeries were performed using the domestically manufactured robotic surgical system (Toumai MT-1000). Perioperative key indicators, intraoperative network conditions, and robotic system performance were systematically recorded. Results:This study involved 14 patients, comprising 3 cases of renal cysts, 3 cases of renal tumors, 3 cases of nonfunctional kidneys, 2 cases of adrenal tumors, 1 case of bladder tumor, 1 case of prostate cancer, and 1 case of ureteral-bladder wall thickening with pelvic ureteral stones. The cohort included 7 male and 7 female patients, with an average age of (57.4±12.3) years, a BMI of (24.6±3.0) kg/m 2, and ASA classifications of grade Ⅱ in 9 cases and grade Ⅲ in 5 cases. All remote surgeries were successfully completed without the need for conversion to alternative surgical methods. Three renal cyst unroofing decompression procedures were performed, with an average console operation time of (32.0±6.6) minutes and intraoperative blood loss of (13.3±2.9) ml. Two partial nephrectomies were conducted, with console operation times of 140 and 160 minutes, intraoperative blood loss of 20 ml each, and warm ischemia times of 19 and 25 minutes, respectively. The preoperative estimated glomerular filtration rates (eGFR) for these cases were 115.2 and 107.3 ml/(min·1.73m 2), and postoperative eGFR were 102.0 and 95.5 ml/(min·1.73m 2), respectively. Four radical nephrectomies were completed, with an average console operation time of (50.2±13.7) minutes and intraoperative blood loss of (20.5±13.2) ml. Two adrenal tumor resections were performed, each with console operation times of 45 and 50 minutes and intraoperative blood loss of 10 ml. Additionally, one partial bladder resection was conducted, requiring a console operation time of 60 minutes and resulting in intraoperative blood loss of 10 ml. A single radical prostatectomy was carried out, with a console operation time of 180 minutes, intraoperative blood loss of 120 ml, and pre- and postoperative PSA levels of 11.7 ng/ml and 0.06 ng/ml, respectively. One ureteral-bladder reimplantation was also performed, with a console operation time of 240 minutes and intraoperative blood loss of 10 ml. The average total delay for the 14 remote surgeries ranged from 194 to 250 ms, while the average network transmission delay ranged from 13 to 55 ms. During the procedures, six instances of sudden large fluctuations in network transmission delay were observed, ranging from 333 to 654 ms. These fluctuations resolved automatically within approximately 10 seconds but resulted in temporary disruptions: 2 cases of master-slave console lock (reset process lasted around 5 seconds) and 1 case of switching to the local console for emergency hemostasis (lasting approximately 7 minutes). These interruptions did not significantly affect the surgical process. Postoperative complications in all patients were classified as Clavien-Dindo grade Ⅰ and were unrelated to the surgical procedures or equipment. No cancer was detected in the resection margins of malignant tumors. Follow-up evaluations at three months, including blood tests, liver and kidney function tests, and CT scans of the surgical sites, revealed no significant abnormalities or adverse events. Conclusions:5G communication technology, with an average total latency of less than 250 ms, enables domestic surgical robots to perform multi-procedural remote urological surgeries effectively. However, during procedures requiring extensive suturing for urological reconstruction or managing unplanned intraoperative bleeding, network latency fluctuations exceeding 333 ms can extend the operation time and may necessitate switching to local control for emergency hemostasis.

Mesenchymal-epithelial transition factor (MET) gene mutation is a large class of mutations commonly seen in non-small cell lung cancer (NSCLC). MET mutation includes subtypes such as MET exon 14 skipping mutation (METex14m) and MET amplification (METamp). For advanced NSCLC with METex14m, Savolitinib has a high sensitivity as a member of tyrosine kinase inhibitors (TKIs). METamp is a relatively rare genetic mutation type which can serve as a driver gene to mediate primary and later acquired drug resistance of epidermal growth factor receptor (EGFR)-TKIs. For advanced NSCLC with secondary METamp, EGFR-TKIs combined with MET-TKIs are usually used in clinical treatment, while the optimal treatment strategy for advanced NSCLC with primary METamp has not yet been determined. For locally advanced NSCLC patients with positive driver gene mutations such as EGFR, anaplastic lymphoma kinase (ALK) fusion and METex14m, there have been relevant cases reported that neoadjuvant targeted therapy could achieve a good prognosis, but there have been no cases of neoadjuvant targeted therapy for locally advanced NSCLC patients with METamp. This report describes a case of a locally advanced NSCLC patient with dual driver gene mutations (EGFR L858R combined with primary METamp), the tumor did not shrink after 1 month of Gefitinib monotherapy, but significantly subsided after 4 months of Savolitinib monotherapy. After radical surgery, the pathological results proved pathological complete response (pCR) of the tumor, and the patient had a good response to postoperative continual Savolitinib treatment, with no recurrence nor metastasis observed to date. This case reports the feasibility and effectiveness of neoadjuvant targeted therapy for locally advanced NSCLC with primary METamp, aiming to provide effective reference for perioperative treatment of locally advanced NSCLC with primary METamp.
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Humans ; Acrylamides/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Gene Amplification ; Lung Neoplasms/pathology* ; Protein Kinase Inhibitors/therapeutic use* ; Proto-Oncogene Proteins c-met/genetics* ; Triazines

Objective To investigate the popularization of cardiopulmonary resuscitation(CPR)knowledge and science popularization needs among urban and rural residents in Tonghai County,Yuxi City,Yunnan Province,so as to explore the establishment of an efficient and appropriate science popularization model.Methods A total of 300 residents aged 15-60 years old were selected from Tonghai County,Yuxi City,Yunnan Province using stratified and simple random sampling methods.A self-designed questionnaire was used to conduct an anonymous questionnaire survey.Results Only 20.3%of Tonghai County residents master CPR skills,and 26.2%of Tonghai County residents have never heard of CPR.There is a statistically significant difference in the awareness rate of CPR between rural residents and non-rural residents(P<0.01).There are differences in residents'age and CPR awareness(P<0.01),the age and CPR are inversely proportional.The residents have a higher willingness to perform chest compressions and mouth-to-mouth resuscitation on strangers,66.2%and 68.6%respectively.63.79%of residents have never attended relevant training.But 92.76%of the people said they were willing to participate in the relevant training when they learned the training news.Conclusion Residents in Tonghai County generally lack knowledge of CPR first aid,but the demand for first aid knowledge of residential CPR is high and the attitude towards rescue is positive.It is recommended that relevant departments increase CPR science popularization and training efforts,and popularize CPR into villages.

This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.

Objective:To evaluate Zhuang medicine Fuzheng compound combined with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of advanced epidermal growth factor receptor (EGFR) sensitive mutant non-small cell lung cancer (NSCLC).Methods:A total of 120 patients with advanced NSCLC who met the inclusion criteria from June 2019 to May 2020 in Guangxi International Zhuang Medical Hospital were divided into 2 groups according to the random number table method, with 60 in each group. The control group was treated with TKIs, and the observation group was treated with Zhuang medicine Fuzheng compound combined with EGFR-TKIs. TCM syndrome scores were compared, and the quality of life of the patients was assessed by the Quality of Life Scale (QLQ-C30). The serum levels of carcinoembryonic antigen (CEA), squamous cell carcinoma associated antigen (SCC-Ag) and carbohydrate antigen 50 (CA50) were detected by radioimmunoassay, and the levels of CD3 +, CD4 +, and CD8 + were detected by flow cytometry, and the CD4 +/CD8 + ratio was calculated. The adverse reactions during the treatment were observed and recorded. Results:The objective remission rate in the observation group was 66.7% (40/60) and the disease control rate was 81.7% (49/60), while in the control group were 48.3% (29/60) and 63.3% (38/60), respectively.The differences were statistically significant ( χ2 values were 4.13 and 5.06, P values were 0.042 and 0.025, respectively). After treatment, the scores of chest tightness, shortness of breath, blood in sputum, mental fatigue in the observation group were significantly lower than those in the control group ( t values were 8.72, 5.02, 5.47, all Ps<0.001), After treatment, QLQ-C30 score in the observation group was significantly higher than that of the control group ( t=5.21, P<0.01). After treatment, CEA [(31.45±4.56) mU/L vs. (38.98±5.71) mU/L, t=7.98], SCC-Ag [(4.87±0.93) μg/L vs. (7.29±1.25) μg/L, t=12.03], CA50 [(58.27±7.14) U/L vs. (66.48±7.94) U/L, t=5.96] levels were significantly lower than those in the control group ( P<0.01); CD3 +[(52.43±5.01)% vs. (48.56±4.87)%, t=4.29], CD4 + [(54.89±5.03)% vs. (51.09±5.22)%, t=4.06], CD4 +/CD8 + [(1.95±0.28) vs. (1.65±0.27), t=5.97] significantly higher than those in the control group ( P<0.01), CD8 + [(28.12±2.70)% vs. (31.23±2.64)%, t=6.38] significantly lower than that of the control group ( P<0.01). During the treatment period, the incidence of adverse reactions in the observation group was 13.3% (8/60) and that in the control group was 8.3% (5/60), with a statistically significant difference between two groups ( χ 2=0.78, P=0.378). Conclusion:The Zhuang medicine Fuzheng compound combined with EGFR-TKIs can reduce the level of tumor markers in patients with advanced EGFR-sensitive mutant NSCLC, improve patients' TCM syndromes, quality of life, enhance patient immunity, and improve efficacy.

Hypertensive intracerebral hemorrhage is in the critical condition. Surgical treatment can promptly remove cranial hematoma, reduce the compression to the intracranial nerve, and improve the patient's neurological function and prognosis. At present, there are many operating modes, from the traditional large bone flap craniotomy to remove hematoma, to minimally invasive surgery. Each has its own advantages. This paper reviews various minimally invasive hematoma removal procedures and clinical nursing care based on traditional surgical treatment, analyzes the advantages and disadvantages of surgical treatment for patients with hypertensive cerebral hemorrhage, selects appropriate surgical methods and formulates reasonable surgical strategies.

Objective:To explore the application effect of risk management model in nursing of patients with craniocerebral trauma.Methods:A total of 300 patients with craniocerebral trauma who were admitted to Shaoxing Second Hospital from December 2017 to December 2018 were selected. According to the time of admission, 150 patients who were admitted from December 2017 to June 2018 were set as the control group and 150 patients who were admitted from July 2018 to December 2018 were set as the experimental group. The control group was given routine nursing measures while the experimental group was given risk management model on the basis of routine nursing. Glasgow Coma Score (GCS) and the incidence of adverse nursing events were compared between the two groups.Results:After the intervention, the GCS scores of patients in the two groups were higher than those before nursing ( P<0.05) . And the GCS score of the patients in the experimental group after intervention was (13.08±2.13) , which was higher than (11.32±2.05) in the control group. The incidence of adverse nursing events in the experimental group (4.67%, 7/150) was lower than that in the control group (11.33%, 17/150) . The above differences were all statistically significant ( P<0.05) . Conclusions:The risk management model can improve the conscious state and clinical prognosis of patients with craniocerebral trauma, and reduce the incidence of adverse nursing events.