Objective To explore the influence of function-oriented training combined with proprio-ceptive neuromuscular facilitation(PNF)technique on stroke patients during convalescence.Methods A total of 106 patients with cerebral infarction during convalescence admitted to the First Hospital of Hebei Medical University and Hebei provincial of Tradifional Chinese Medicine Hospital from January 2021 to December 2023 were recruited and then randomly divided into combined group(53 cases)and control group(53 cases).The control group only received function-oriented training,while the combined group received function-oriented training combined with PNF technique.The neurological function,balance function,walking ability and motor function were compared before and after intervention and between groups.Results After intervention,the NIHSS score and central nervous system specific protein(S100β)and neuron specific enolase(NSE)levels were significantly lower in the two groups than those before intervention(P＜0.05),and the score and levels after intervention were significantly lower in combined group than the control group(13.28±0.86 vs 15.76±0.94,P＜0.01;1.56±0.24 μg/L vs 1.79±0.23 μg/L,P＜0.0 1;20.46±3.12 μg/L vs 24.75±3.69 μg/L,P＜0.01).The Berg balance scale(BBS)score,step speed and step length in 10-meter walking test(10 MWT)and Fugl-Meyer assessment score were significantly higher in both groups after intervention than those before intervention(P＜0.05),and the above indicators in the combined group were obviously higher than those in refer-ence group after intervention(P＜0.05,P＜0.01).Conclusion For the patients during cerebral infarction convalescence,function-oriented training combined with PNF technique can not only promote the recovery of neurological function,but also enhance the balance ability and walking a-bility,and improve the limb motor function.

Objective To explore the influence of function-oriented training combined with proprio-ceptive neuromuscular facilitation(PNF)technique on stroke patients during convalescence.Methods A total of 106 patients with cerebral infarction during convalescence admitted to the First Hospital of Hebei Medical University and Hebei provincial of Tradifional Chinese Medicine Hospital from January 2021 to December 2023 were recruited and then randomly divided into combined group(53 cases)and control group(53 cases).The control group only received function-oriented training,while the combined group received function-oriented training combined with PNF technique.The neurological function,balance function,walking ability and motor function were compared before and after intervention and between groups.Results After intervention,the NIHSS score and central nervous system specific protein(S100β)and neuron specific enolase(NSE)levels were significantly lower in the two groups than those before intervention(P＜0.05),and the score and levels after intervention were significantly lower in combined group than the control group(13.28±0.86 vs 15.76±0.94,P＜0.01;1.56±0.24 μg/L vs 1.79±0.23 μg/L,P＜0.0 1;20.46±3.12 μg/L vs 24.75±3.69 μg/L,P＜0.01).The Berg balance scale(BBS)score,step speed and step length in 10-meter walking test(10 MWT)and Fugl-Meyer assessment score were significantly higher in both groups after intervention than those before intervention(P＜0.05),and the above indicators in the combined group were obviously higher than those in refer-ence group after intervention(P＜0.05,P＜0.01).Conclusion For the patients during cerebral infarction convalescence,function-oriented training combined with PNF technique can not only promote the recovery of neurological function,but also enhance the balance ability and walking a-bility,and improve the limb motor function.

OBJECTIVE To investigate the intervention effect and potential mechanism of breviscapine on hepatic fibrosis （HF） in rats based on the transforming growth factor-β（1 TGF-β1）/Smad2/extracellular signal-regulated protein kinase 1（ERK1） and Kelch-like epichlorohydrin-associated protein 1（Keap1）/nuclear factor-erythroid 2-related factor 2（Nrf2）/heme oxygenase-1（HO-1） pathways. METHODS Totally 60 rats were randomly divided into normal control group， model group， breviscapine low-dose， medium-dose and high-dose groups （5.4， 10.8， 21.6 mg/kg）， and colchicine group （positive control， 0.45 mg/kg）， with 10 rats in each group， half male and half female. Except for the normal control group， HF model of the other groups was induced by carbon tetrachloride. Subsequently， each drug group was given corresponding medicine by gavage once a day for 28 days. The liver appearance of rats in each group was observed and their liver coefficients were calculated. The levels of alanineaminotransferase （ALT） and aspartate aminotransferase （AST）in serum， those of ALT， AST， superoxide dismutase （SOD），malondialdehyde （MDA） and glutathione peroxidase （GSH- Px） in liver tissue were detected. The liver tissue inflammatory and fibrotic changes were observed. The protein and mRNA expressions of TGF-β1， Smad2， ERK1， Nrf2， Keap1 and HO-in liver tissue were detected. RESULTS Compared with the normal control group， the model group showed large areas of white nodular lesions in the liver， obvious inflammatory cell infiltration and collagen fiber deposition. The body weight， the levels of SOD and GSH-Px in liver tissue， the protein and mRNA expressions of Nrf2 and HO-1 were significantly lowered in the model group （P＜0.05）； the liver coefficient， the percentage of Masson staining positive area， ALT and AST levels of serum and liver tissue， MDA level of liver tissue， the protein and mRNA expressions of TGF-β1， Smad2， ERK1 and Keap1 were significantly increased （P＜0.05）. Compared with the model group， the liver lesions of rats in each drug group were improved， and the above quantitative indexes were generally reversed （P＜0.05）. CONCLUSIONS Breviscapine has a good intervention effect on HF rats， which may be related to inhibiting TGF-β1/Smad2/ERK1 pathway for anti-fibrosis and regulating Keap1/Nrf2/HO-1 pathway to inhibit oxidative stress.

Objective To determine the median effective plasma concentration (Cp50) of remifentanil inhibiting cardiovascular response to CO2 pneumoperitoneum stimulus when combined with propofol in patients undergoing laparoscopic gynaecological surgery.Methods Twenty-two female patients scheduled for elective laparoscopic gynaecological surgery under general anesthesia, aged20-60 years, with a BMI 18-30 kg/m2, falling into ASA physical statusⅠ orⅡ, were enrolled in this study.Anesthesia was induced with propofol and remifentanil target-controlled infusion and iv injection of rocuronium 0.6 mg/kg.The target plasma concentration (Cp) of remifentanil and propofol were set at 5 ng/ml and 4μg/ml respectively.3 minutes after endotracheal intubation, the Cp of remifentanil was adjusted.The target Cp was set at 6 ng/ml in the first patient.CO2 pneumoperitoneum was performed after the target effect-site concentration and Cp were balanced.Each time Cp increased/decreased by 20％in the next patient depending on whether or not the cardiovascular response to CO2 pneumoperitoneum occurred.The positive cardiovascular response was defined as HR and/or MAP increasing by 20％ within 3 minutes after CO2 pneumoperitoneum.The Cp50 and 95％ confidence interval (CI) of remifentanil required to inhibit cardiovascular response to CO2 pneumoperitoneum stimulus when combined with propofol in patients undergoing laparoscopic gynaecological surgery were calculated.Results The Cp50 (95％ CI) of remifentanil required to inhibit cardiovascular response to CO2 pneumoperitoneum stimulus was 4.58 (4.14-5.08) ng/ml when combined with propofol in patients undergoing laparoscopic gynaecological surgery.Conclusion The Cp50 of remifentanil required to inhibit cardiovascular response to CO2 pneumoperitoneum stimulus was 4.58 ng/ml when combined with propofol in patients undergoing laparoscopic gynaecological surgery.

Objective To investgate risk factors of delayed bleeding after endoscopic submucosal dissec-tion(ESD)for early colorectal tumor and precancerrous lesions. Methods We retrospectively reviewed clinical date of 138 patients with early colorectal tumor and precancerrous lesions who received ESD in Hubei Cancer Hos-pital from October 2012 to October 2016. Risk factors of delayed bleeding were analysed by univariate and multi-variable logistic regression analysis. Results Ten(7.2%)of 138 patients occurred delayed bleeding after ESD. Univariate analysis showed that there was significent difference between the bleeding group and the non-bleeding group in location of the lesion(P = 0.022),severe fibrosis of submucosa(P = 0.016),Obvious intraoperative bleeding(P = 0.032)and inadequate endosopic experience of endoscopist(P = 0.045). Multivariate Logistic re-gression analysis showed that location of lesion(P = 0.003,OR = 4.64,95%CI:1.71~12.58),severe fibrosis of submucosa(P = 0.009,OR = 4.83,95% CI:1.49~15.60)were independent risk factors of delayed bleeding after ESD for early colorectal tumor and precancerrous lesions. Conclusion Patients with early colorectal tumor and precancerrous lesions in the rectum and severe fibrosis of submucosa are prone to delayed bleeding after ESD.

Objective To investigate the influence of injection color regents concentration on completed resection rate, operation time and injection volume of patients with intestinal tumor by ESD.Methods 90 elderly patients with intestinal tumor by ESD were chosen from June 2013 to June 2016. They were randomly divided into 3 groups including A group (30 patients) with glycerin fructose used alone, B group (30 patients) with glycerin fructose combined with 2% mythylene blue on the basis of glycerin fructose and C group (30 patients) with glycerin fructose combined with 4% mythylene blue on the basis of glycerin fructose; and the completed resection rate of tumor, operation time, injection volume and complication incidence in the peri-operative period of 3 groups were compared.Results There was no signiifcant difference in the completed resection rate of tumor among the 3 groups (P < 0.05). The operation time and injection volume of C group were signiifcant better than A group and B group (P< 0.05). There was no signiifcant difference in operation time and injection volume between A group and B group (P < 0.05). There was no signiifcant difference in the complication incidence in the peri-operative period among the 3 groups (P < 0.05).Conclusion Compared with glycerin fructose used alone and glycerin fructose combined with 1% mythylene blue for 2 mg, glycerin fructose combined with 1% mythylene blue for 4 mg by intestinal submucosal injection on patients with intestinal tumor by ESD can efifciently shorten the operation time and reduce the injection volume.

Objective To investigate the clinical epidemiologic characteristics of patients with hepatitis C virus(HCV)infection post blood transfusion.Methods The polymerase chain reaction (PCR)and enzyme linked immunosorbent assay(ELlSA)were used to detect HCV RNA and antiHCV,respectively.Analysis was performed for patients' age distribution,cause of primary diseases,exposure years,ingredient and amount of transfusion,incubation period and liver function damage.The statistical processing were performed with chi-square test,t-test and correlation analysis.Results HCV RNA levels were higher than 3.0 log10 copy/mL in 85.3%infected patients with a median of 5.99log10 copy/mL,among which 19.7%patients showed viral load 3.0 to 4.0 log10 copy/mL and 69.9%showed 5.0 to 6.0 log10 copy/mL.Eighty-one point six percent(40/49)of infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis,while 99.7%(383/384)patientswere detected as anti-HCV positive by serological test.The sensitivity of serological test was higher than both HCV RNA quantitative and qualitative assays(F=57.138,P=0.000;F=63.149,P=0.000,respectively).HCV infection post blood transfusion was more common in people of 30 to 60years old.Most cases(84.4%)got the first time exposure during 1990 to 1994.More than 10%cases had primary disease as obstetrics, orthopedics or gastrointestinal tract hemorrhage. Eighty percent received whole blood product transfusion.The mean interval between transfusion and clinical diagnosis was (86.0±54.6 ) months. Eighty nine percent of infected patients had liver function damage, while most of them showed elevated alanine aminotransferase (ALT) with no more than 5 upper limits of normal (ULN). Conclusions Post transfusion HCV infection mainly happened in adulthood. Infected patients usually have liver function damage with elevated ALT with no more than 5 ULN and medium HCV RNA levels.