Objective:To explore the correlation between frailty and carotid plaque stability in patients with ischemic stroke.Methods:This study was a cross-sectional study. From May to December 2023, convenience sampling was used to select 360 patients with ischemic stroke in the Department of Neurology of Affiliated Hospital of Jining Medical University and underwent carotid artery color Doppler ultrasound examination as the study subject. Patients were surveyed using the General Information Questionnaire, Barthel Index and the Edmonton Frail Scale. Carotid artery color Doppler ultrasound was used to evaluate the stability of carotid plaques in patients. Multivariate Logistic regression was used to explore the correlation between frailty and carotid plaque stability.Results:A total of 360 questionnaires were distributed, and 352 valid questionnaires were collected, with a valid response rate of 97.78%. The incidence of frailty in 352 ischemic stroke patients was 44.89% (158/352). Multivariate analysis showed that compared to stable plaques, unstable carotid plaques were an independent risk factor for frailty in patients with ischemic stroke ( OR=2.127, 95% confidence interval: 1.247-3.626) . Conclusions:Compared to stable plaques, unstable carotid plaques increase the risk of frailty in patients with ischemic stroke. Strengthening the assessment of carotid plaques in patients with ischemic stroke by nursing staff can early identify high-risk individuals for frailty, and timely carry out personalized interventions, thereby reducing the occurrence of adverse health events in patients.

Objective:To explore stigma and related factors among family members of patients with mental disorders in psychiatric hospitals.Methods:Totally 1 365 family members of inpatients with mental disorders were-surveyed,and were assessed with the Perceived Devaluation-Discrimination Scale and a self-made demographic characteristics questionnaire.Results:The screening rate of stigma among the patient's family members was 61.5％.Males(OR=2.26,95％CI:1.06-5.01),age group of 18-29 years(OR=1.91,95％CI:1.15-3.20),monthly income ≥500 yuan(P＜0.05),disease duration of 0.5-＜lyear(OR=3.14,95％CI:1.66-6.03),care for patients within＜lyear(P＜0.05),teachers(OR=2.32,95％CI:1.24-3.44),self-employed person(OR=1.63,95％CI:1.02-2.24),civil servants(OR=1.77,95％CI:1.09-2.45),schizophrenia(OR=1.87,95％CI:1.32-2.42),affective disorders(OR=1.52,95％CI:1.03-2.016)were the main riskfactors of stigma.Conclusions:Family members of patients with mental disorders generally have a severe stigma,especially of patients with schizophrenia and affective disorders.

Objective:To explore the influence of chronic rhinitis on depressive symptoms of college freshmen and the mediating effect of avoidant personality.Methods:A cluster sampling method was used to survey 8 079 college freshmen from April 2018 to October 2018 using the Beck depression inventory and the avoidant personality diagnosis questionnaire based on DSM-Ⅳ.SPSS 25.0 software was used for descriptive statistics and Spearman correlation analysis, and the macro program PROCESS version 3.3 was used for the mediating effect.Results:(1) The detection rates of chronic rhinitis, avoidant personality and depressive symptoms were 22.90% (1 850/8 079), 19.22% (1 553/8 079) and 6.28% (507/8 079). The scores for avoidant personality disorder and depressive symptoms were 1.00 (0, 3.00) and 1.00 (0, 4.00), respectively. (2) The chronic rhinitis, avoidant personality and depressive symptoms were positively correlated ( rchronic rhinitis-avoidant personality=0.094, rchronic rhinitis-depressive symptoms=0.095, ravoidant personality-depressive symptoms=0.416, all P<0.001). (3) Chronic rhinitis could positively predict depressive symptoms ( β=1.113, P<0.001). (4) Avoidant personality played a mediating role between chronic rhinitis and depressive symptoms ( β=1.094, P<0.001), and accounted for 44.92%(0.500/1.113) of the total effect. Conclusion:Chronic rhinitis directly affect the depressive symptoms of college freshmen, and indirectly affect the depressive symptoms of college freshmen through the mediating role of avoidant personality.

Objective:To evaluate the effect of oxygen supply via the transnasal self-made pharyngeal oxygen catheter on the safe apnea time in pediatric patients undergoing tonsil surgery. Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either sex, aged 2-6 yr, weighing 10-20 kg, scheduled for elective tonsillectomy under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: transnasal self-made pharyngeal oxygen catheter for oxygen supply group (group NO) and control group (group C). Anesthesia was induced with intravenous midazolam, propofol, fentanyl and cis-atracurium, and then ventilation was performed with a mask, and the mask was removed when the exhaled oxygen concentration (C ETO 2) reached more than 90%.In group NO, the self-made oxygen catheter was implanted into the oropharynx through the nose, and the 100% oxygen at 10 L/min was aspirated through the humidification bottle until the intubation was successful.In group C, the transnasal self-made oxygen catheter was not implanted, and the rest of the protocol was similar to those previously described in group NO.The visual laryngoscope was implanted to simulate difficult airways.When SpO 2 ≤ 95% or the safe apnoea time reached 600 s, the observation of apnea was stopped, and mechanical ventilation was started after successful rapid endotracheal intubation.The safe apnea time (from removing the mask until SpO 2 decreased to 95%), value of C ETO 2 at the end of mask ventilation, and the minimum value of SpO 2 after stopping mask ventilation were recorded.Heat rate and mean arterial pressure were observed and recorded on admission to the operating room, immediately after onset of apnea and immediately after successful endotracheal intubation.The SpO 2, P ETCO 2 and cross-sectional area of gastric antrum were also recorded immediately after onset of apnea and immediately after successful endotracheal intubation, and the rate of increase in P ETCO 2 was calculated.The nasal bleeding, nasal dryness, postoperative pharyngeal discomfort and other adverse reactions were recorded when the self-made pharyngeal oxygen catheter was placed. Results:Compared with group C, the safe apnea time was significantly prolonged, the rate of increase in P ETCO 2 was decreased, the minimum value of SpO 2 after stopping mask ventilation was increased, and the heat rate, mean arterial pressure, SpO 2 and P ETCO 2 were increased immediately after successful intubation ( P<0.05), no significant change was found in C ETO 2 after stopping mask ventilation and cross-sectional area of gastric antrum at each time point in group NO ( P>0.05). No adverse reactions such as nasal bleeding, nasal dryness and postoperative pharyngeal discomfort were found when the self-made pharyngeal oxygen catheter was inserted in group NO. Conclusions:The oxygen supply with the transnasal self-made pharyngeal oxygen catheter technique can prolong the safe apnea time in the pediatric patients undergoing tonsil surgery.

AIM: To investigate the effective dose of esketamine for prevention on propofol injection pain in painless abortion. METHODS: From November 2021 to December 2021, thirty patients undergoing painless abortion, aged 20 to 40 years old, ASA physical status or Ⅱ, BMI 19-26 kg/m

Objective To evaluate the efficacy of ultrasound-prepositioned four-point method for right internal jugular vein ( IJV) catheterization in the parturients at high risk of bleeding. Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱparturients diagnosed as having perni-cious placenta previa, aged 25-38 yr, weighing 60-90 kg, scheduled for elective cesarean section under general anesthesia, were divided into 2 groups ( n=40 each) using a random number table method: real-time ultrasonic guidance group ( group UG ) and ultrasound-prepositioned four-point method group ( group UF) . In group UG, the right IJV catheterization was performed under real-time ultrasound guidance: mov-ing the ultrasonic probe to make the mid-line of the cross section image of the right IJV overlap with the mid-line of the ultrasonic display screen, and the intersection of the mid-line of the IJV and the horizontal line of the annular cartilage was selected as the puncture point. In group UF, the right IJV catheterization was per-formed by using ultrasound-prepositioned four-point method as follows: moving the ultrasonic probe to make the midline of the right IJV cross-sectional images overlap with the midline of the ultrasound display screen, and marking the skin where the midpoint of the probe's long-axis was located as point A;transversely mov-ing the probe to the inside so that the tangent line of its inner edge overlapped with the midline of the ultra-sonic display screen, marking the skin where the midpoint of the probe's long-axis was located as point B ( the puncture site);at the proximal cardiac end of the right IJV, making point C at 2 cm from point B, and making point D ( the indicator point, direction of the puncture needle) at 2 cm from point A. After lo-cal infiltration anesthesia was performed in point B, the puncture needle was inserted towards the point D. The success rate of puncture, success rate of catheterization, catheterization operation time and complica-tions such as hematoma, intravascular catheter insertion or hemopneumothorax were recorded. Results The success rate of total catheterization was 100％ in two groups. Compared with group UG, the catheteriza-tion operation time was significantly shortened ( P<0. 01) , and no significant change was found in the suc-cess rate of puncture at first attempt, success rate of catheterization at first attempt or intravascular catheter insertion in group UF ( P>0. 05) . Conclusion Compared with real-time ultrasound guidance, ultrasound-prepositioned four-point method produces better efficacy when used for the right IJV catheterization in the parturients at high risk of bleeding.

Objective To evaluate the effective dose of dexmedetomidine (DEX) for prevention of emergence agitation (EA) after total intravenous anesthesia or sevoflurane anesthesia for preschool children undergoing a tonsillectomy.Methods 80 preschool children undergoing a selective tonsillectomy were randomly divided into 2 groups:intravenous group (total intravenous anesthesia,n =40) and inhalation group (sevoflurane inhaled anesthesias,n =40).According to the spot-slope method,intravenous group and inhalation group were randomly divided into 5 dose groups and given DEX in a geometric progression after induction.The EA,adverse effects,the pain score and the postoperative behavioral outcomes of each child in the two groups were recorded.Results The ED50s for prevention of EA were 0.28 μg/(kg · h) in intravenous group and 0.34 μg/(kg · h) in inhalation group.The duration of children's staying post-anesthesia care unit (PACU) and the incidence of pain were significantly greater in those with EA than those without (P ＜ 0.05),and the incidence of the postoperative behavioral outcomes were not statically different (P ＞ 0.05).No severe adverse reactions were observed in 95％ confidence limits.Conclusions 0.28 (0.22-0.35) μg/(kg · h) and 0.34 (0.27-0.43) μg/(kg · h) of DEX are safe and reliable for prevention of EA after intravenous anesthesia and sevoflurane anesthesia for preschool children undergoing a tonsillectomy.

Objective To determine the risk factors for autologous blood withdrawal-reinfusion in cesarean section. Methods Parturients who underwent cesarean section and autologous blood withdrawal from August 2012 to June 2015 in our hospital were selected. The preoperative, intraoperative and postop-erative data of the parturients were collected retrospectively from electronic medical records. The parturients were divided into reinfusion group and non-reinfusion group according to whether the parturients received au-tologous blood reinfusion. Logistic regression analysis was used to stratify the risk factors for autologous blood withdrawal-reinfusion in cesarean section. Results A total of 1604 parturients who received autolo-gous blood reinfusion were included in the study, with 757 cases in reinfusion group and 847 cases in non-reinfusion group. Placenta increta∕percreta, placenta previa with previous uterine surgery and complete pla-centa previa were the risk factors for autologous blood withdrawal-reinfusion in cesarean section (P<0. 05). The predictive model was exp( w) ÷ [1 + exp( w)],w = 1. 447 × placenta increta∕percreta ( corrected OR value)+0. 945×complete placenta previa (corrected OR value)+1. 361×placenta previa with previous uter-ine surgery (corrected OR value). The sensitivity and specificity of this model in predicting blood reinfusion were 56％ and 79％, respectively, the positive predictive value was 71％, and the negative predictive val-ue was 67％. Conclusion Placenta increta∕percreta, placenta previa with previous uterine surgery and complete placenta previa are high risk factors for autologous blood withdrawal-reinfusion in cesarean section, and routine preparation for autologous blood withdrawal-reinfusion is recommended.

Objective:To compare the preventive effects of dezocine or parecoxib used alone or combination on emergence pain and agitation in the patients undergoing radical hysterectomy. Methods: Sixty ASA Ⅰ~Ⅱ patients undergoing radical hysterectomy were randomly divided into three groups. At the time of sewing incision, the dezocine group (group D, n=20) received dezocine in-travenous injection at the dosage of 0. 1 mg·kg-1, the parecoxib group (group P, n=20) received parecoxib intravenous injection at the dosage of 0.8 mg·kg-1, and the combination group (group DP, n=20) received 0.1 mg·kg-1dezocine and 0.8 mg·kg-1 parecoxib. When the operation was finished, the patients were transferred to the recovery room with endotracheal tubes, and recovered and extubated without the administration of reversal agents. Visual analogue scale ( VAS) for pain and Aono' s four-point scale for e-mergence agitation ( EA) were measured. The recovery time, extubation time, VAS, degree of EA and side effects such as nausea, vomiting, respiratory depression and hypersomnia during the emergence were also evaluated and recorded. Results:There were no sig-nificant differences in recovery time and extubation time among the three groups (P >0. 05). The VAS score and degree of EA in group DP were lower than that in group D (4. 65 ± 1. 69) and group P (5. 95 ± 1. 82) (P<0. 05), and the VAS score in group D was lower than that in group P (P<0. 05). The incidence of moderate and severe pain during the emergence in group DP (20%) was low-er than that in group D and group P (75% and 85%, respectively, P<0. 05), and that was lower in group D when compared with that in group P(P<0. 05). There were no significant differences in the incidence of degree of EA higher than 3 among the three groups (P>0. 05), and no side effects such as nausea, vomiting, respiratory depression and hypersomnia were detected during the emergence. Conclusion:Intravenous injection of 0. 1 mg·kg-1 dezocine combined with 0. 8 mg·kg-1 parecoxib at the time of sewing incision shows effective analgesia and emergence agitation reduction without obvious complications in the patients undergoing radical hysterecto-my.

Objective To study the relationship between the expressions of vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor receptor-2 (KDR) in cervical carcinoma and the formation of cervical cancer and lymph node metastasis.Methods We selected 72 cervical carcinoma tissues,their corresponding adjacent tissues and 36 normal cervical tissues which have been resected in the Maternal and Child Health Care Hospital of Baoji of Shaanxi Province from January 2010 to December 2013.The mRNA and protein expressions of VEGF-C and KDR were examined by semi-quantitative PCR and enzyme linked immunosorbent assay in these tissues.The relationships between the expressions of VEGF-C and KDR and the formation of cervical cancer and lymph node metastasis were analyzed.Results The mRNA levels of VEGF-C in 72 cases of cervical cancer tissues and its corresponding adjacent tissues were 4.67 ± 1.05 and 2.02 ± 0.65,which were significantly higher than those in normal cervical tissues (0.36 ± 0.06),with significant differences (t =2.247,P =0.025;t =1.379,P =0.027).The protein levels of VEGF-C in 72 cases of cervical cancer tissues and their corresponding adjacent tissues were 68.30 ± 17.10 and 48.20 ± 12.70,which were significantly higher than those in normal cervical tissues (18.40 ± 10.70),with significant differences (t =4.357,P =0.016;t =6.337,P =0.012).The mRNA levels of KDR in 72 cases of cervical cancer tissues and their corresponding adjacent tissues were 3.52 ± 0.95 and 1.92 ± 0.87,which were significantly higher than those in normal cervical tissues (0.72 ±0.36),with significant differences (t =3.127,P =0.023;t =1.214,P =0.028).The protein levels of KDR in 72 cases of cervical cancer tissues and their corresponding adjacent tissues were 47.20 ± 15.60 and 38.60 ± 11.30,which were significantly higher than those in normal cervical tissues (16.40 ± 9.40),with significant differences (t =3.667,P =0.020;t =0.986,P =0.032).The expression level of VEGF-C protein in 72 cases of cervical cancer tissues was not correlated with age (x2 =0.54,P =0.17),tissue type (x2 =0.34,P =0.25),depth of invasion (x2 =5.39,P =0.08),pathological grade (x2 =0.78,P =0.11),but was correlated with tumor size (x2 =22.34,P =0.02),clinical stage (x2 =32.14,P =0.01) and lymph node metastasis (x2 =15.58,P =0.03).The expression level of its receptor KDR was correlated with tumor size (x2 =13.78,P =0.04),tissue type (x2 =32.74,P =0.01),pathological grade (x2 =13.72,P =0.04),depth of invasion (x2 =10.27,P =0.04),clinical staging (x2 =20.25,P =0.02) and lymph node metastasis (x2 =19.52,P =0.02),but was not correlated with age (x2 =4.17,P =0.09).Conclusion The expression levels of VEGF-C and KDR are correlated with the growth,invasion and metastasis of cervical cancer,which are good indicators of the lymph node metastasis.