Objective:To evaluate the effect of preoperative oral carbohydrate intake on postoperative nausea and vomiting (PONV) in elderly patients undergoing gynecological laparoscopic surgery.Methods:This study was a randomized controlled trial. One hundred elderly patients, aged≥65 yr, with a body mass index of 18-30 kg/m 2, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent gynecological laparoscopic surgery at the Baoding First Central Hospital from March 2023 to June 2024, were selected. Stratification was conducted by age (65-74 yr/≥75 yr) using an online randomization tool, and the patients were randomly divided into conventional fasting group (group C) and oral carbohydrate group (group P), with 50 cases in each group. Patients took oral carbohydrate drinks of 4 ml/kg at 2 h before operation, with total amount ≤400 ml in group P, while patients received conventional preoperative fasting protocols in group C. The occurrence and severity of PONV within 48 h postoperatively were observed. The visual analogue scale scores for hunger and thirst, State-Trait Anxiety Inventory scale scores, length of stay in the postanesthesia care unit, duration of hospital stay, time to first flatus, time to first ambulation, and patient′s satisfaction were recorded in the two groups. Results:Compared with group C, the incidence and severity of PONV were significantly decreased within 48 h after surgery, the visual analogue scale scores for hunger and thirst and State-Trait Anxiety Inventory scale scores were significantly decreased after entering the operating room, the length of stay in the postanesthesia care unit, time to first flatus and time to first ambulation were significantly shortened, and the patient′s satisfaction was significantly increased in group P ( P<0.05). Conclusions:Oral carbohydrate intake before operation can effectively reduce the occurrence and severity of PONV and improve the quality of postoperative recovery in elderly patients undergoing gynecological laparoscopic surgery.

Objective:To explore the mechanism of Ginkgo biloba extract(EGb)on cerebral ischemia reperfusion injury(CIRI)in rats via the advanced glycation end products(AGEs)/receptor for AGEs(RAGE)pathway.Methods:SD rats were randomly divided into sham operation group(Sham group),CIRI group,CIRI+EGb pretreat-ment group(CIRI+EGb group),CIRI+AGEs inhibitor alagebrium chloride(ALT711)group(CIRI+ALT711 group)and CIRI+EGb+ALT711 group.HE,Nissl and Prussion blue staining were used to observe pathological chan-ges in the cerebral cortical area.The expression of AGEs,RAGE and nicotinamide adenine dinucleotide phosphate oxi-dase 4(NOX4)in the cerebral cortical area was detected by immunohistochemistry,the expression of AGEs,RAGE,NOX4,ferritin heavy chain 1(FTH),glutathione peroxidase 4(GPX4)and solute carrier family 7 member 11(SLC7A11)in the cerebral cortical area was detected by Western blot,and the expression of RAGE and NOX4 mRNA in the cerebral cortical area was detected by RT-qPCR.Results:Compared with the Sham group,the pathological dam-age in the brain tissue of rats in the CIRI group was observed;the expression of AGEs,RAGE and NOX4 was increased(P<0.01),the expression of FTH,GPX4 and SLC7A11 was reduced(P<0.01),the expression of RAGE and NOX4 mRNA was increased(P<0.01);compared with the CIRI group,the pathological damage in the brain tissue of rats in the CIRI+EGb group and CIRI+ALT711 group was reduced,the expression of AGEs,RAGE and NOX4 was reduced(P<0.01),the expression of FTH,GPX4 and SLC7A11 was increased(P<0.01),the expression of RAGE and NOX4 mRNA was reduced(P<0.05);compared with the CIRI+ALT711 group,the pathological damage in the brain tissue of rats,as well as the expression of AGEs,RAGE and NOX4 in the CIRI+EGb+ALT711 group were re-duced(P<0.01),the expression of FTH,GPX4 and SLC7A11 was increased(P<0.01),the expression of RAGE and NOX4 mRNA was reduced(P<0.01).Conclusion:EGb could protect CIRI by inhibiting NOX4 and ameliorating ferroptosis through the AGEs/RAGE pathway.

Objective:To evaluate the effect of preoperative oral carbohydrate intake on postoperative nausea and vomiting (PONV) in elderly patients undergoing gynecological laparoscopic surgery.Methods:This study was a randomized controlled trial. One hundred elderly patients, aged≥65 yr, with a body mass index of 18-30 kg/m 2, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent gynecological laparoscopic surgery at the Baoding First Central Hospital from March 2023 to June 2024, were selected. Stratification was conducted by age (65-74 yr/≥75 yr) using an online randomization tool, and the patients were randomly divided into conventional fasting group (group C) and oral carbohydrate group (group P), with 50 cases in each group. Patients took oral carbohydrate drinks of 4 ml/kg at 2 h before operation, with total amount ≤400 ml in group P, while patients received conventional preoperative fasting protocols in group C. The occurrence and severity of PONV within 48 h postoperatively were observed. The visual analogue scale scores for hunger and thirst, State-Trait Anxiety Inventory scale scores, length of stay in the postanesthesia care unit, duration of hospital stay, time to first flatus, time to first ambulation, and patient′s satisfaction were recorded in the two groups. Results:Compared with group C, the incidence and severity of PONV were significantly decreased within 48 h after surgery, the visual analogue scale scores for hunger and thirst and State-Trait Anxiety Inventory scale scores were significantly decreased after entering the operating room, the length of stay in the postanesthesia care unit, time to first flatus and time to first ambulation were significantly shortened, and the patient′s satisfaction was significantly increased in group P ( P<0.05). Conclusions:Oral carbohydrate intake before operation can effectively reduce the occurrence and severity of PONV and improve the quality of postoperative recovery in elderly patients undergoing gynecological laparoscopic surgery.

Objective:To explore the mechanism of Ginkgo biloba extract(EGb)on cerebral ischemia reperfusion injury(CIRI)in rats via the advanced glycation end products(AGEs)/receptor for AGEs(RAGE)pathway.Methods:SD rats were randomly divided into sham operation group(Sham group),CIRI group,CIRI+EGb pretreat-ment group(CIRI+EGb group),CIRI+AGEs inhibitor alagebrium chloride(ALT711)group(CIRI+ALT711 group)and CIRI+EGb+ALT711 group.HE,Nissl and Prussion blue staining were used to observe pathological chan-ges in the cerebral cortical area.The expression of AGEs,RAGE and nicotinamide adenine dinucleotide phosphate oxi-dase 4(NOX4)in the cerebral cortical area was detected by immunohistochemistry,the expression of AGEs,RAGE,NOX4,ferritin heavy chain 1(FTH),glutathione peroxidase 4(GPX4)and solute carrier family 7 member 11(SLC7A11)in the cerebral cortical area was detected by Western blot,and the expression of RAGE and NOX4 mRNA in the cerebral cortical area was detected by RT-qPCR.Results:Compared with the Sham group,the pathological dam-age in the brain tissue of rats in the CIRI group was observed;the expression of AGEs,RAGE and NOX4 was increased(P<0.01),the expression of FTH,GPX4 and SLC7A11 was reduced(P<0.01),the expression of RAGE and NOX4 mRNA was increased(P<0.01);compared with the CIRI group,the pathological damage in the brain tissue of rats in the CIRI+EGb group and CIRI+ALT711 group was reduced,the expression of AGEs,RAGE and NOX4 was reduced(P<0.01),the expression of FTH,GPX4 and SLC7A11 was increased(P<0.01),the expression of RAGE and NOX4 mRNA was reduced(P<0.05);compared with the CIRI+ALT711 group,the pathological damage in the brain tissue of rats,as well as the expression of AGEs,RAGE and NOX4 in the CIRI+EGb+ALT711 group were re-duced(P<0.01),the expression of FTH,GPX4 and SLC7A11 was increased(P<0.01),the expression of RAGE and NOX4 mRNA was reduced(P<0.01).Conclusion:EGb could protect CIRI by inhibiting NOX4 and ameliorating ferroptosis through the AGEs/RAGE pathway.

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective:To investigate the therapeutic effect of the combination of mouse nerve growth factor and edaravone in the treatment of carbon monoxide poisoning and its effect on patients′ cognitive function, lactic acid clearance rate, and related indicators of oxygen free radicals.Methods:A selection of 158 patients with carbon monoxide poisoning in the Huxi Hospital Affilliated Jining Medical College from May 2017 to June 2020 were divided into study group (80 cases) and control group (78 cases) according to the treatment plan. Both groups were given conventional treatment. On this basis, the control group was given edaravone, and the study group was given mouse nerve growth factor combined with edaravone, both of which were treated for 2 weeks. The clinical efficacy of the two groups was compared with those before treatment and 1 week and 2 weeks after treatment. Neurological impairment score (NIHSS), disease severity score (APACHE Ⅱ), cognitive function score (MMSE), serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)], oxygen free radical related indicators [lipid peroxide (LPO), superoxide dismutase (SOD), gluten Glutathione peroxidase (GSH-PX), malondialdehyde (MDA)] levels, blood lactic acid levels before treatment and lactic acid clearance rates after 12 h, 24 h, 72 h treatment, and statistics of adverse reactions and 30-day mortality.Results:The total effective rate of the study group was higher than that of the control group after 2 weeks of treatment [95.00% (76/80) vs. 78.21% (61/78)] ( P<0.05); NIHSS and APACHEⅡ scores of the study group after 1 week and 2 weeks of treatment Lower than the control group: (6.08 ± 1.15) points vs. (8.94 ± 1.71) points, (4.58 ± 0.74) points vs. (6.32 ± 0.93) points and (6.79 ± 1.03) points vs. (8.02 ± 1.47) points, (5.94 ± 1.47) points vs. (7.25 ± 0.94) points, the MMSE score was higher than that of the control group: (22.09 ± 4.35) points vs. (19.34 ± 5.32) points, (26.05 ± 2.37) points vs. (22.47 ± 4.64) points ( P<0.05) After 1 and 2 weeks of treatment, the serum TNF-α, IL-6, CRP, LPO and MDA levels in the study group were lower than those in the control group: (22.62 ± 4.12) ng/L vs. (29.43 ± 4.68) ng/L and (18.21 ± 2.09) ng/L vs. (24.37 ± 3.16) ng/L, (39.67 ± 4.35) ng/L vs. (52.14 ± 5.48) ng/L and (34.83 ± 3.75) ng/L vs. (41.07 ± 4.09) ng/L, (12.63 ± 1.85) mg/L vs. (17.02 ± 2.47) mg/L and (8.27 ± 1.16) mg/L vs. (11.05 ± 1.62) mg/L, (11.06 ± 1.28) μmol/L vs. (15.97 ± 1.85) μmol/L and (8.24 ± 1.12) μmol/L vs. (12.97 ± 1.40) μmol/L, (7.15 ± 1.16) μmol/L vs. (9.02 ± 1.47) μmol/L and (6.12 ± 0.96) μmol/L vs. (7.84 ± 1.25) μmol/L, the levels of SOD and GSH-PX were higher than those in the control group ( P<0.05); the lactate clearance rate in the study group was higher than that in the control group after 12, 24 and 72 h of treatment: (18.49 ± 3.63)% vs. (14.62 ± 2.95)%, (23.19 ± 4.20)% vs. (17.42 ± 3.57)%, (29.86 ± 6.37)% vs. (25.38 ± 5.21)% ( P<0.05); the incidence of adverse reactions in the study group during treatment Compared with the control group, there was no significant difference ( P>0.05); there was no significant difference in the 30-day mortality between the study group and the control group ( P>0.05). Conclusions:The combination of mouse nerve growth factor and edaravone in the treatment of carbon monoxide poisoning can reduce the severity of disease and neurological deficits, improve cognitive function and lactate clearance rate, reduce inflammation and oxidative stress, improve efficacy, and have good safety.

Objective : To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods: A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results: Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.

Objective To examine the effect of a Caregiving Self-Management Support (C-SMS) Program on self-efficacy, social support for family caregivers of people with dementia and psychological symptom of patients. Methods Using the convenient sampling method, 41 caregivers of dementia patients were selected as the study objects from September 2016 to September 2017 in the Memory Disorders Outpatient Department of two ClassⅢ Grade A hospitals in Shanghai. They were divided into the experimental group(n=26) and control group(n=15) according to their willingness. Totally 4 participants in each of the two groups dropped out of the study in the middle. In the experimental group, a total of 6 times, once in 2 weeks social support group activities were carried out; in the control group, a total of 3 telephone instruction, once a month was carried out, all participants were distributed with the Caregiver Educational Booklet prepared by the research team and participated 3 education seminars during the follow-up visit. Self-Efficacy Questionnaire for Chinese Family Caregivers(SEQCFC) and Medical Outcome Study Social Support Survey(MOS-SSS) and Revised Memory and Behaviour Problems Checklist(RMBPC) were used to compare the effect of intervention. Results The time effect of the total score of SEQCFC was significant (P＜ 0.01). There was a statistically significance in the interaction on social support score between groups and time (P＜ 0.05). After intervention and follow-up, the self-efficacy scores of family caregivers in the experimental group were higher than the baseline (P＜0.05). There were significant time effect in the total score of behavioral and psychological symptom behavioral symptoms, memory and depression related problems (P＜0.05). The total score of behavioral and psychological symptom, score of the disruptive behaviour dimension after follow-up visit, scores of the depression dimension after intervention and follow-up visit in the experimental group were all lower than the baseline (P＜ 0.05). Conclusions The self-management support project of caregivers can improve the self-efficacy of family caregivers and alleviate the behavioral and psychological symptom of dementia patients.

Objective Based on the 2012 Atlanta classification criteria, to study the value of C-reactive protein (CRP) and procalcitonin (PCT) in the early forecasting acute pancreatitis (AP). Methods Eighty-three patients with AP were selected. The patients were divided into mild AP (MAP) group (39 cases), moderately severe AP (MSAP) group (31 cases) and severe AP (SAP) group (13 cases) according to the 2012 Atlanta classification criteria. Twenty-seven healthy people were selected as control group. The levels of serum CRP and PCT were measured. The predictive value of serum CRP and PCT levels for SAP, infectious pancreatic necrosis (IPN), organ failure and death risk was assessed using the area under the curve (AUC). Results The serum CRP and PCT levels in MAP group, MSAP group and SAP group were significantly higher than those in control group: (49.84 ± 12.26), (89.77 ± 22.10) and (123.69 ± 37.09) mg/L vs. (3.92 ± 1.37) mg/L, (1.15 ± 0.42), (2.44 ± 0.61) and (3.27 ± 0.96)μg/L vs. (0.41 ± 0.13)μg/L, and those in MSAP group and SAP group were significantly higher than those in MAP group, those in SAP group were significantly higher than those in MSAP group, and there were statistical differences (P<0.05). The Spearman correlation analysis result showed that AP severity was positively correlated with serum CRP and PCT levels (r = 0.652 and 0.714, P<0.05). The accuracy of serum CRP level for forecasting SAP and IPN was medium (AUC = 0.73 and 0.76), and for forecasting organ failure accuracy was low (AUC = 0.67). Serum CRP showed no significance in forecasting death risk (AUC = 0.46). The accuracy of serum PCT level for forecasting SAP, IPN and death risk accuracy was medium (AUC = 0.71, 0.86 and 0.80), and for forecasting organ failure accuracy was low (AUC =0.64). Conclusions Based on the 2012 Atlanta classification criteria, the accuracy of serum CRP level for forecasting SAP is higher than that of serum PCT level, the accuracy of serum PCT level for forecasting IPN and death risk is higher than that of serum CRP level, and accuracy of serum CRP and PCT levels for forecasting organ failure are low.

Objective To study the expression of transient receptor potential channel (TRPC) isoforms (TRPC1,3,4,5,6,7) inrats with cardiac hypertrophy.Methods Thirty adult male SD rats,weighing 200-240 g were divided into surgical group (model group,20 rats) and sham group (control group,10 rats) by random number table according to body weight.Aortic coarctation surgery was performed to establish a rat model of myocardial hypertrophy and the control group did not ligate thoracic aorta,but the same surgical procedure with the model group was performed.After 10 weeks,echocardiography was used to check changes of cardiac function; cardiac tissues of rats were weighed and cardiac hypertrophy index was calculated.Cardiac HE staining was used for observation of myocardial tissue morphological changes.Quantitative RT-PCR method was used for measuring the mRNA expression of TPRC isoforms (TRPC1,3,4,5,6,7).Western blotting assay was applied to detect the protein expression of TRPC4 and TPRC5 in hypertrophic cardiac tissue of rats.The relationship between cardiac hypertrophy exponential and TRPC4,TRPC5 protein expression was studied.Results Echocardiography showed that the septal thickness and posterior wall thickness in model group increased significantly compared with those of the control group [mm:(2.64 ± 0.31) vs.(1.89 ± 0.15),(2.30 ± 0.14) vs.(1.60 ± 0.09),t =9.19,8.57,all P ＜ 0.05].Compared with the control group,cardiac hypertrophy index was significantly increased in model group [(3.21 ± 0.15)vs.(1.82 ± 0.10)mg/g,t =17.02,P ＜ 0.01].HE staining of myocardium showed that cardiomyocyte hypertrophy,abnormal nuclear morphology and significantly enlarged nuclear,and hyperplasia of myocardial interstitial fibrous connective tissue could be seen in model group.The mRNA expression of TRPC4 and TRPC5 was significantly increased in the model group as compared to those of the control group (1.51 ± 0.48 vs.1.22 ± 0.25,1.65 ± 0.35 vs.1.27-± 0.87,t =3.55,4.65,all P ＜ 0.05).The protein expression of TRPC4 and TRPC5 was significantly increased in the model group as compared to those of the control group (1.00 ± 0.54 vs.1.45 ± 0.68,1.00 ± 0.65 vs.1.58 ±0.93,t =5.51,7.10,all P ＜ 0.05).The protein expression of TRPC4 and TPRC5 were associated with cardiac hypertrophy index (r =0.728,0.681,all P ＜ 0.05).Conclusion Expression of TRPC4 and TRPC5 is increased in rats with cardiac hypertrophy.