Objective:To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on awakening of cerebrum frontal lobe area and neural function in the patients with brain injury.Methods:The clinical data of 70 patients with brain injury in Zhejiang Xin′an International Hospital from March 2020 to July 2021 were retrospectively analyzed. Among them, 34 cases were treated with conventional awakening rehabilitation (control group), and 36 cases were treated with rTMS combined with conventional awakening rehabilitation (observation group). The efficacy was evaluated after treatment, the cure and effective were taken as total effective. The Glasgow coma scale (GCS) was used to evaluate the conscious state; the modified coma recovery scale (CRS-R) was used to evaluate the neural function; the brainstem auditory evoked potential (BAEP) classification criteria was used to evaluate the conscious state, the electroencephalogram powers of five channels FP1, F3, C3, F7 and T3 were measured; and the adverse reactions were recorded.Results:The total effective rate in observation group was significantly higher than that in control group: 94.44% (34/36) vs. 76.47% (26/34), and there was statistical difference ( χ2 = 4.61, P<0.05). The eye opening response, motor response, language response and total score of GCS after treatment in observation group were significantly higher than those in control group: (4.28 ± 0.57) scores vs. (3.03 ± 0.59) scores, (4.57 ± 0.85) scores vs. (3.24 ± 0.67) scores, (3.99 ± 0.92) scores vs. (3.01±0.48) scores and (12.85 ± 2.01) scores vs. (10.47 ± 1.95) scores, and there were statistical differences ( P<0.01). The CRS-R score after treatment in observation group was significantly higher than that in control group: (15.28 ± 3.17) scores vs. (12.33 ± 3.09) scores, and there was statistical difference ( P<0.01). The BAEP classification after treatment in observation group was significantly better than that in control group, and there was statistical difference ( P<0.05). The powers of F3, C3, F7 and T3 after treatment in observation group were significantly lower than those in control group: (41.25 ± 6.35) μV 2/Hz vs. (53.19 ± 10.37) μV 2/Hz, (39.17 ± 5.61) μV 2/Hz vs. (48.94 ± 6.63) μV 2/Hz, (63.94 ± 7.57) μV 2/Hz vs. (69.85 ± 7.35) μV 2/Hz and (51.76 ± 6.84) μV 2/Hz vs. (62.47 ± 7.62) μV 2/Hz, and there were statistical differences ( P<0.01); there was no statistical difference in power of Fp1 after treatment between two groups ( P>0.05). No serious complications such as epilepsy occurred in two groups. There was no statistically significant difference in the incidence of adverse reactions between two groups ( P>0.05). Conclusions:The rTMS can improve the excitability of brain cells and the degree of brain injury in patients with brain injury, improve the CRS-R score, promote waking up and the recovery of cognitive functions, with safety and efficiency.

Objective:To study the effect of early hyperbaric oxygen combined with rehabilitation training on neurological rehabilitation and prognosis of patients with hypertensive intracerebral hemorrhage after borehole drainage.Methods:Eighty-five patients with hypertensive intracerebral hemorrhage admitted to Zhejiang Xin'an International Hospital from January 2018 to March 2020 were enrolled, and all of them were treated with minimally invasive drilling and drainage and they were divided into two groups by the order of admission. The control group (41 cases) received rehabilitation training after 48 h of stable vital signs. The research group(44 cases) was treated on the base of the control group combined with early hyperbaric oxygen therapy. The levels of neuron-specific enolase (NSE), S100β and scores of National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Barthel index, cerebral blood flow, and Glasgow Outcome Scale (GOS) were observed in the two groups before and after treatment.Results:After treatment, the levels of NSE and S100β in the two groups were decreased and those in the research group were lower than those in the control group: (14.38 ± 1.47) μg/L vs. (18.04 ± 2.95) μg/L, (0.24 ± 0.03) μg/L vs. (0.32 ± 0.04) μg/L, the differences were statistically significant ( P<0.05). The scores of NIHSS in the two groups were decreased, while the scores of FMA and Barthel index were increased, while the scores of NIHSS in the research group was lower than that in the control group: (9.18 ± 1.02) scores vs. (11.85 ± 1.47) scores; the scores of FMA and Barthel index in the research group were higher than those in the control group: (68.38 ± 8.93) scores vs.(61.42 ± 8.01) scores, (63.25 ± 7.65) scores vs. (56.11 ± 6.04) scores, the differences were statistically significant ( P<0.05). The average cerebrovascular blood flow and flow rate of patients in both groups were higher than those before treatment, and the peripheral cerebrovascular resistance of patients in both groups was lower than that before treatment, while the average cerebrovascular blood flow and flow rate in the research group were higher than those in the control group: (17.85 ± 2.48) ml/s vs. (15.12 ± 2.01) ml/s, (20.61 ± 2.88) cm/s vs. (17.04 ± 2.47) cm/s; the peripheral cerebrovascular resistance in the research group were lower than that in the control group: (1 328.95 ± 114.29) kPa·s/m vs. (1 558.13 ± 157.21)kPa·s/m, the differences were statistically significant ( P<0.05). The good prognosis rate of research group was higher than that of control group: 84.09%(37/44) vs. 60.98%(25/41), the difference was statistically significant ( χ2 = 4.634, P<0.05). Conclusions:Early hyperbaric oxygen combined with rehabilitation training can promote the recovery of neurological function of patients with hypertensive intracerebral hemorrhage after borehole drainage, and can improve cerebral blood flow and prognosis.

Objective: To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH). Methods: Seventy-six HICH patients treated in Zhejiang Xin'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared. Results: The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P < 0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84%(33/38) vs. 65.79% (25/38)] (P < 0.05). Conclusions 3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.

Objective: To explore the effects of minimally invasive intracranial hematoma removal in the treatment of cerebral hemorrhage, and its influence on neurological functional recovery, serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8(IL-8), tumor necrosis factor-alpha (TNF-α). Methods: From January 2016 to December 2017, 100 patients with cerebral hemorrhage admitted to Zhejiang Xin'an International Hospital were selected and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group was given routine symptomatic treatment, the observation group received minimally invasive intracranial hematoma removal combined with conventional treatment.The curative effect, restoration of nerve function, the levels of hs-CRP, IL-6, IL-8 and TNF- were observed in the two groups. Results: After treatment, the blood loss and edema volume around the hematoma in the two groups were declined significantly (t=5.74, 9.32, 7.41, 9.32, all P<0.05), and the improvements of the observation group was better than those of the control group (t=8.29, 5.28, all P<0.05). The excellent and good rate of the observation group was 90%(45/50), which was significantly higher than 72%(36/50) of the control group (χ²=3.62, P<0.05). After treatment, the NDS scores of the two group were significantly lower than those before treatment (t=4.64, 5.75, all P<0.05), the GCS scores of the two groups were significantly improved (t=5.41, 7.86, all P<0.05). The NDS score of the observation group was significantly lower than that of the control group (t=5.31, P<0.05), the GCS score of the observation group was significantly higher than that of the control group(t=3.84, P<0.05). After treatment, the levels of inflammatory factors in the two groups were significantly reduced compared with those before treatment (t=3.27, 3.75, 3.38, 3.61, 5.74, 4.39, 6.52, 8.26, all P<0.05), the levels of inflammatory factors in the observation group were significantly lower than those in the control group (t=4.37, 3.92, 8.52, 4.28, all P<0.05). Conclusion Minimally invasive removal of intracranial hematoma combined with conventional treatment in the treatment of patients with cerebral hemorrhage can obtain satisfactory clinical effect, can promote neural functional recovery, improve inflammatory factor levels (hs-CRP, IL-6, IL-8, TNF alpha), it is worthy of application.

Objective Analysis of hybrid cardiac and non-cardiac operations.Methods 11 patients received hybrid operations during 2000 ～2016 in our hospital were summarized, meanwhile another 11 patients undergoing only cardiac sur-gery served as controls.The level of CK-MB, TNI and visual analogue pain scores were recorded.The hospitalization expenses and postoperative hospital time were compared between the two groups .Results There was no death during hospitalization . There were no serious complications such as wound infection, delayed wound healing, postoperative bleeding requiring re-thora-cotomy and hemostasis, malignant arrhythmia, cerebral infarction and so on.Longer operation time[(358 ±79)min vs.(224 ±56)min, P<0.01], more allogeneic red blood cells transfusion[(3.2 ±1.6)U/case vs.(1.1 ±0.8)U/case, P<0.05] and more plasma transfusion[(515 ±234)ml/case vs.(284 ±92)ml/case, P<0.01]in hybrid operation group than those in the control group.There was no significant difference about CK-MB and TNI between two groups perioperatively(P>0.05). The wound pain was mild after cardiac surgery , and the wound pain was moderate after hybrid operation , which had little effect on rehabilitation exercises such as cough.4 days longer of postoperative hospital stay and 23 thousand yuan of hospitalization cost in hybrid operation group than those in the control group.One patient diagnosed of unstable angina pectoris and sigmoid colon cancer with intestinal obstruction was failed to resection of the tumor after received pericardial stripping and coronary ar-tery bypass surgery.The patient died three weeks after surgery due to intestinal obstruction and cachexia .The remaining 10 pa-tients were underwent successful surgery, cured and left hospital.No serious cardiovascular events, tumor recurrence and me-tastasis were found as followed up for 6-20 months.Conclusion Our practices show that hybrid cardiac and non-cardiac op-erations can be done safely and effectively.

Objective: To explore the mediating effects of self-focused attention between social anxiety and interpersonal needs. Methods: Totally 467 college students [159 males and 221 females, mean age (21 ±2)] were assessed with the Social Anxiety Scale (SAS), Self-Focused Attention Scale (SFAS) and Interpersonal Needs Questionnaire (INQ ). The bootstrap method was used to test the mediating effect Results: The SFAS and INQ scores were higher in female students than in males (Ps <0.01). The scores of SAS, SFAS, and INQ were positively correlated each other (r = 0.20 - 0.90, Ps < 0.01). Self-focused attention has a full mediating effect between social anxiety and interpersonal needs, and the 95％ confidence interval was (0.34, 0.59). Conclusion: It suggests that the effect of interpersonal needs on social anxiety may be achieved through self-focused attention in college students. Reducing the level of self-focused attention may be an important way to alleviate social anxiety among college students.

Objective To investigate the clinical effect of Salvia Ligustrazine Injection in the treatment of hypertensive intracerebral hemorrhage.MethodsFrom February 2013 to May 2016, 118 patients with hypertensive intracerebral hemorrhage admitted in our hospital were randomly divided into Danshen ligustrazine group, conventional group and 59 cases.2 groups of patients were treated with the same basic treatment after surgery, Salvia Ligustrazine group also received Danshen ligustrazine injection, compared the two groups after treatment of clinical effects, nerve defect function recovery.ResultsAfter 14 days of treatment, the Glasgow Coma Scale (GCS) GCS score, neurological deficit score, C reactive protein (CRP) and ET-endothelin-1 were lower in the Salvia Ligustrazine group (13.56%), brain edema in grade 1 (83.05%), 2 cases of brain edema in grade 2 (3.39%), and 9 cases of cerebral edema in grade 2 (79.66%), 9 cases (15.25%) in grade 2 brain edema, the difference was statistically significant (P<0.05), and the treatment group was significantly higher than that in the control group After 3 months, the prognosis of patients with Salvia miltiorrhiza was good (49.05%), and the prognosis was good in 39 cases (66.10%), the difference was statistically significant (P<0.05).ConclusionSalvia Ligustrazine Injection is an effective method for the treatment of hypertensive intracerebral hemorrhage in patients with cerebral edema as soon as possible.It can promote the recovery of neurological function and benefit the patients' long-term recovery.

Objective To investigate effects of acute normovolemic hemodilution(ANH) used in on-pump coronary artery bypass graft(CABG) surgery.Methods 60 patients had received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients using no ANH techniques.A series of index were observed and compared between the two groups after operation.Results All patients had been revascularized completely with stable surgical procedure,no serious complications,no operative mortality.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of myocardial protective effect,coagulation,kidney function,degree of systemic inflammatory reaction and postoperative drainage volume were not significantly different between the two groups(P ＞ 0.05).Allogeneic blood transfusion volume of the study group was significantly lower than that of the control group [(1.1 ± 0.8) U vs.(2.3 ± 1.1) U,P ＜ 0.05].Condusion The ANH technique used in CABG operation on appropriate patient is feasible and safe,with satisfactory clinical result.

Objective To investigate effects of acute normovolemic hemodilution (ANH) used in coronary artery bypass graft (CABG) surgery in elderly patients.Methods 60 elderly patients (aged ≥65 years) received CABG surgery under cardiopulmonary bypass,of which 30 patients using ANH techniques and 30 patients without ANH techniques.Results All patients were revascularized completely with stable surgical procedure,no serious complications and no operative mortality were found.Oxygen supplying was balanced with demanding,without tissue hypoxia.Indicators of the myocardial protective effect,coagulation,liver function,kidney function,glucose metabolism,negative nitrogen balance,and postoperative drainage volume were not significantly different between the two groups (P＞0.05).Allogeneic blood transfusion volume was significantly lower in study group than in control group[(0.9±0.9)U vs.(2.5±1.2)U,t=2.704,P＜0.01].Conclusions The ANH technique used in CABG operation in appropriate elderly patient is feasible and safe,with satisfactory clinical results.

Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB (NF-κB) and vascular cell adhesion molecule 1 (VCAM-1) in great saphenous vein(GSV) among the patients with diabetes mellitus undergoing coronary artery bypass grafting(CABG).Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin (HE) staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.