Objective To explore the effects of non-invasive mechanical ventilation combined with caf-feine citrate treatment on newborn respiratory distress syndrome(NRDS).Methods A total of 120 infantile patients with NRDS treated in this hospital from February 2021 to February 2023 were selected and divided into the two groups by using the random number table method,60 cases in each group.The control group re-ceived the non-invasive mechanical ventilation treatment,while the experimental group received the non-inva-sive mechanical ventilation combined with caffeine citrate treatment.The clinical improvement statuses inclu-ding the mechanical ventilation usage rate,pulmonary surfactant(PS)superaddition rate,mechanical ventila-tion time,oxygen therapy time and hospitalization time,meanwhile the blood gas analysis indicators before and after treatment[blood pH value,oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2)],in-flammatory markers[nuclear factor-kappa B(NF-κB),procalcitonin(PCT),interferon-gamma(IFN-γ),in-terleukin-6(IL-6),IL-10],myocardial injury and oxidative stress markers[creatine kinase isoenzyme(CK-MB),superoxide dismutase(SOD),malondialdehyde(MDA)]and the incidence rates of complications(vomi-ting,abdominal distension,nasal mucosa injury,necrotizing enterocolitis(NEC)and bronchopulmonary dys-plasia)were compared between the two groups.Results Compared to the control group,the mechanical venti-lation time,oxygen therapy time and hospitalization time in the experimental group were significantly de-creased(P＜0.05).After treatment,the blood oxygen partial pressure(PaO2)and blood pH values were in-creased,and the carbon dioxide partial pressure(PaCO2)was decreased(P＜0.05).The levels of inflammato-ry markers NF-κB,PCT,IFN-γ and IL-6 were decreased,while the IL-10 level was increased(P＜0.05).The myocardial injury index CK-MB was decreased and the oxidative stress index SOD level was increased and MDA level was decreased(P＜0.05).The incidence rate of complications in the experimental group was low-er than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion Non-in-vasive ventilation combined with caffeine citrate in treating NRDS could improve the clinical status,blood gas indexes and reduce the inflammation and myocardial injury of the infantile patients,which is worthy of clinical promotion and application.

Background: and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS. Methods: We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences. Results: From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence. Conclusions The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.

OBJECTIVETo observe changes of brain glucose metabolism by needling at Waiguan (SJ5) in cerebral infraction (CI) patients using 18F-fluorodeoxyglucose (FDG) positron-emission computer tomography (PET/CT), thus exploring its effect and mechanisms.

METHODSA total of 21 patients with CI were recruited in this study. The location of lesion was limited to the left basal ganglia by CT or MRI scan. All patients were randomly assigned to three groups. i.e., the acupoint group (Group A), the non-acupoint group (Group B), the blank control group (Group C), 7 in each group. Patients in Group A were needled at right Waiguan (SJ5). Those in Group B were needled at non-acupoint [10 mm beside Waiguan (SJ5)], whereas those in Group C did not receive any treatment. All patients underwent PET/CT head scan. All data were statistically analyzed using SPSS 13.0 Software and SPM8 Software.

RESULTSCompared with Group C, glucose metabolism increased in bilateral superior temporal gyrus (BA38), right superior frontal gyrus (BA9), left cingulate gyrus (BA24), left culmen and pyramid of cerebellum, and right cerebellar tonsil of cerebellum in Group A. Compared with Group C, glucose metabolism increased in bilateral superior frontal gyrus (BA6, BA9, BA10), bilateral middle frontal gyrus (BA6, BA10), left middle frontal gyrus (BA4), bilateral uncus of limbic lobe (BA36, BA38), left cingulate gyrus (BA24, BA31), left posterior cingulate gyrus (BA30), left precuneus (BA7), left inferior parietal lobule (BA4), and left lingual gyrus of occipital lobe (BA18) in Group B. Compared with Group B, glucose metabolism increased in bilateral superior temporal gyrus (BA22, BA38), right inferior frontal gyrus (BA47), left culmen and cerebellar tonsil of cerebellum in Group A. Activated encephalic regions of needling at Waiguan (SJ5) were mainly dominated in the healthy side, bilateral superior temporal gyrus, and right inferior frontal gyrus. Activated encephalic regions of cerebellum were located at the left cerebellar hemisphere, left culmen of anterior cerebella lobe, and bilateral cerebellar tonsil of posterior cerebella lobe.

CONCLUSIONSNeedling at Waiguan (SJ5) of CI patients induced increased glucose metabolism in local cerebral regions. Functional neuroimaging using PET/CT could directly reflect changes of brain glucose metabolism by acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Brain ; metabolism ; Cerebral Infarction ; metabolism ; therapy ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged