Objective To explore the relationship between the expression levels of serum cingulate protein(CGN)and polyligand glycan 1(SDC-1)and the disease condition and outcome of hypertensive basal ganglia hemorrhage(HBGH).Methods A total of 123 patients with HBGH admitted to the Second People's Hospi-tal of Lianyungang from February 2019 to February 2022 were selected as the study objects,and 120 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the health group.Serum CGN and SDC-1 expression levels were detected in the two groups.According to the dis-ease outcome,the patients were divided into the improved group(92 cases)and the deteriorated group(31 ca-ses).Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to analyze the predictive value of serum CGN and SDC-1 expression levels on the disease outcome of patients with HB-GH.Results Serum CGN and SDC-1 expression levels in the severe group were higher than those in the mod-erate group and the mild group,and serum CGN and SDC-1 levels in the moderate group were higher than those in the mild group,and the differences were statistically significant(P＜0.05).Serum CGN and SDC-1 expression levels in HBGH patients in three groups were higher than those in health group,and the differences were statistically significant(P＜0.05).Serum CGN and SDC-1 expression levels in the deteriorated group were higher than those in the improved group,and the differences were statistically significant(P＜0.05).The AUC of serum CGN and SDC-1 for predicting the disease outcome of HBGH patients was 0.742(95％CI:0.792-0.697)and 0.861(95％CI:0.906-0.910),respectively,and the AUC of the combination of the two was 0.917(95％CI:0.962-0.870).The amount of blood loss and ventricular rupture in the deteriorated group were higher than those in the improved group,and the Glasgow Coma Scale(GCS)score on admission was lower than that in the improved group,and the differences were statistically significant(P＜0.05).Multi-variate Logistic regression analysis showed that serum CGN≥51.63 pg/mL(OR=3.815),serum SDC-1≥450.67 μg/L(OR=4.230)and GCS score ≤8(OR=5.333)were the influencing factors for disease outcome of HBGH patients(P＜0.05).Conclusion The increased expression levels of serum CGN and SDC-1 are closely related to the disease aggravation and the deterioration of the disease outcome in patients with HBGH,and they have certain predictive value for the disease outcome in patients with HBGH.

Objective:To investigate the clinical value of ultrasound in evaluating pharyngeal dysphagia after stroke.Methods:Thirty stroke survivors with dysphagia formed the patient group, and 30 healthy persons formed the healthy group. All received pharyngeal ultrasound examinations by the same sonographer. The maximum distance from the hyoid bone to the mandible, the minimum distance, and the required time were measured or calculated. The hyoid bone′s motion, distance shortening rate, geniohyoid muscle activity, activity time, and activity speed were calculated. The differences in each value were compared, and the values were correlated with the videofluoroscopic swallowing study (VFSS) score using Spearman rank correlation. Receiver operating characteristics curves (ROC curves) were used to evaluate the value of hyoid bone and geniohyoid muscle activity for evaluating the severity of pharyngeal swallowing disorders after a stroke.Results:The average range of activity, activity time, and activity speed of the geniohyoid muscle in the patient group were all significantly different from the healthy group′s averages. The hyoid bone′s range of activity, activity time, activity speed, and the rate of shortening of its distance from the mandible were also significantly different, on average. The patients′ VFSS grades correlated strongly with the activity of the geniohyoid muscle, moderately with the geniohyoid muscle′s speed, and weakly with the duration of hyoid bone activity.Conclusion:The speed of geniohyoid muscle activity and hyoid bone activity time can be used to evaluate the severity of pharyngeal swallowing dysfunction after a stroke. Geniohyoid muscle activity is the best indicator.

Objective To investigate the effect of different modes of administration of dexmedeto-midine pre-nasal spray combined with pumping and conventional pumping on remifentanil and heart rate var-iability(HRV)in patients undergoing oral and maxillofacial surgery.Methods Ninety patients undergoing elective oral and maxillofacial surgery,43 males and 47 females,aged 18-64 years,BMI 18-25 kg/m2,ASA physical status Ⅰ or Ⅱ,were selected.The patients were divided into three groups by random number table method:pre-nasal spray combined with pump injection group(group PP),conventional pump injection group(group CP),and control group(group C),30 cases in each group.Patients in group PP were given a nasal spray of dexmedetomidine at a dose of 0.5 μg/kg,group CP and group C were given the same amount of normal saline by the same method 45 minutes before entering the room on the day of surgery.Dexmedetomidine was injected intravenously in group PP at doses of 0.5 μg/kg and in group CP at dose of 1 μg/kg for 10 minutes,and group C was given the same amount of normal saline 10 minutes before induc-tion of anesthesia.Ramsay sedation score on admission,duration of surgery,the dose of remifentanil during induction and maintenance of anesthesia,room admission(T1),induction intubation(T2),10 minutes after skin incision(T3),and extubation(T4),RMSSD,SDNN,LF,HF,TP,LF/HF ratio and other HRV analysis indicators,HR,MAP,and BIS values were recorded.The incidence of PONV and the use of analgesics within 24 hours after operation were recorded.Results Compared with group C,the MAP was significantly reduced,RMSSD,SDNN,and logTP were significantly increased,and LF/HF was significantly decreased in group PP at T,(P＜0.05),the LF/HF were significantly reduced in groups PP and CP at T2-T4(P＜0.05),the dosage of remifentanil during the anesthesia induction,the incidence of PONV,and the use rate of analgesic drugs in 24 hours were significantly reduced in groups PP and CP(P＜0.05).Compared with group CP,the RMSSD,SDNN,logLF,logHF,and logTP were increased sig-nificantly in group PP at T,(P＜0.05),the logHF were increased significantly in group PP at T2 and T4(P＜0.05),the Ramsay sedative evaluation was increased significantly,the dosage of remifentanil was sig-nificantly reduced during the maintenance of anesthesia in group PP(P＜0.05).Conclusion After the use of dexmedetomidine,the indicators related to stress level in HRV analysis were significantly reduced,and the dosage of opioids was significantly reduced.The use of dexmedetomidine pre-nasal spray combined with pump injection can further reduce the dosage of opioids during the anesthesia maintenance phase.

Objective To investigate the diagnostic value of multimodal MRI for dual pathology (DP)in temporal lobe epilepsy (TLE).Methods The methods of voxel based morphometry (VBM)and voxel based analysis (VBA)had been employed to study the difference between 36 patients (20 cases left group and 16 cases right group)with TLE caused by DP and 36 healthy subjects on the grey matter (GM)volume,exponential apparent diffusion coefficient (eADC)and cerebral blood flow (CBF)value.The corresponding statistical study had also been conducted.Results There were significant statistical differences (FDR correction,P=0.001)between healthy subj ects and patients on the GM volume,eADC and CBF value.Those values decreased with diseased laterality and wider range in functional imaging.These overlaying abnormal brain regions were located in the temporal pole (superior temporal gyrus), temporal pole (middle temporal gyrus),middle temporal gyrus,inferior temporal gyrus,fusiform gyrus,hippocampus and parahippocampal gyrus which represented in all examination results.Conclusion The combined findings of multimodal MRI can improve the localization ability of seizure focus in TLE,which caused by DP,before surgery.

Objective To explore the application of ultrasound-guided femoral and sciatic nerve blocks combined with general anesthesia in lower limb fracture surgery.Methods Sixty four patients who received orthopaedics surgerywere randomly divided into two groups including combined group(n =32),control group (n =32).Control group was given general anesthesia alone,combined group was givengeneral anesthesia combined with ultrasound-guided femoral and sciatic nerve blocks.The intraoperative hemodynamic state at different time,anesthetic dosage,and agitation after waking upbetween two groups were compared.Results Compared with T1 moment,HR and MAP at T2 moment in both groups were significantly decreased (P ＜ 0.05),while all these indicators at T3-T5 moment had no significant difference compared with the T1 moment in combined group (P ＞ 0.05),while the difference was significant in control group (P ＜ 0.05).Compared with control group,combined group had less intraoperative propofoland fentanyl dosage during the surgery,shorter awakening timeand extubation time,and the difference had statistical significance (P ＜ 0.05).The incidence of agitation after waking up and degree of agitation was significantly decreased in combined group than that in control group (P ＜ 0.05).Conclusion Ultrasound-guided nerve blockade combined with general anesthesia for lower limb fracture surgery,canmaintain the stability of intraoperative hemodynamics,reduce the dosage of analgesic drugs,and promote early awakening and extubation.

Objective To explore the distribution of specific allergens for children in Sichuan Province and provide the evidences of clinical diagnosis and treatment.Methods Totally 451 cases in West China Second University Hospital,from April to August of 2016,were detected for 20 kinds of allergen-specific immunoglobulin E (IgE) by a new reverse enzyme-allergosorbent test,SPSS 18.0 statistical analysis was used to evaluate allergen-specific IgE levels in different groups of age,gender and diverse population distribution of disease.Results A total of 282 cases among 451 subjects were detected as IgE positive and the positive rate was 62.53%,among which 248 cases were positive for inhaled allergen-specific IgE,and the positive rate was 54.99%.There were 261 positive cases in food allergen-specific IgE,and the positive rate was 57.87%.For inhaled allergens,the highest positive rate was dermatophagoides pteronyssinus (n=111,24.61%),then dermatophagoides farina (n=110,24.39%),and house dust (n=108,23.95%);For food allergens,the highest positive rate was milk (n=159,35.25%),then egg (n=111,24.61%),and house dust (n=108,23.95%).Conclusions Both Inhaled allergens and food allergens were the important cause of allergic disease for children in Sichuan area.Serum allergen specific IgE determination was helpful to understand the patient′s allergy status,and diagnose the allergic disease.

Objective To investigate the effect of butylphthalide on the memory,movement and ERP (event-related potentials) in patients with cerebral infarction cognitive impairment.Methods A total of 134 patients with cerebral infarction cognitive impairment were randomly divided into treatment group (67 patients) and control group (67 patients).All patients were given conventional cerebral infarction treatment as well as cognitive improvement intervention.Oral administration of butylphthalide was added onto the patients in the treatment group.Curative effects were observed after 30 days′ continued treatment.The cognitive function scores,memory scores,movement scores,ERP test and adverse reaction were compared between the two groups before and after treatment.Results After 30 days′ treatment,two groups of the montreal cognitive assessment scale (MoCA) scores were 27.2±4.9 and 25.1±4.1 respectively;the total scores of memory were 5.5±0.5 and 4.9±0.5 respectively;the scores of motor assessment scale (Fugl-meyer) were 85.6±6.2 and 74.2±6.1 respectively and P3 amplitudes were (9.5±0.9)μV and (8.1±0.9)μV respectively.All the indexes mentioned above in treatment group were significantly increased compared with those of before treatment(P<0.05).The results of N1,N2,P2 and P3 in the latency detection were significantly decreased compared with those of before treatment(P<0.05).And the results of P2 and P3 in the latency detection of the treatment group were shorter than those of the control group(P<0.05).After treatment,no adverse reaction was observed in both groups.Conclusion Based on conventional cerebral infraction treatment,oral administration of butyraldehyde effectively improve the therapeutic effect.

Objective To investigate the clinical effect of modified storage type of autologous blood transfu-sion combined with shed blooding retransformation technique after OrthoPAT for artificial total knee arthroplasty. Methods 70 patients with total knee replacement were randomly divided into observation group and control group, 35 cases in each group.The observation group was treated with the modified storage autotransfusion combined shed blooding retransformation technique after OrthoPAT,while the control group was given conventional allogeneic blood transfusion.The hemoglobin values and blood coagulation function of the two groups at immediately before anesthesia and surgery,10min before autologous blood transfusion and after reinfusion of 15min,after 6h and 24h of surgery were recorded,and the drainage blood total value,allogeneic blood transfusion measurement issues and transfusion rate after 24h were recorded.Results The hemodynamics of the two groups were stable at each time,there were no difference at urine volume (all P >0.05).The coagulation conditions were normal of the two groups at each time,there were no statistically significant differences between the two groups (all P >0.05).The average volume and homologous blood transfusion rate in the observation group were (126.3 ±6.5)mL,1 /35,which were significantly lower than those in the control group [(476.4 ±10.6)mL,2 /35],the differences were statistically significant (t =10.73,χ2 =6.31,all P <0.05).The incidence rate of postoperative complication of the observation group was 5.7%,which was signifi-cantly lower than 22.9% of the control group,the difference between the two groups was statistically significant (χ2 =4.93,P <0.05).Conclusion The improved storage type of autologous blood transfusion combined with shed bloo-ding retransformation technique after OrthoPAT has exact effect for artificial total knee arthroplasty,the incidence of adverse reactions is low,as well as the low blood transfusion rate.

Objective To study the effect of total knee arthroplasty after limb position on postoperative hemorrhage,to provide basis for clinical diagnosis and treatment.Methods 270 cases of total knee arthroplasty were selected.The patients were divided into groupⅠ,group Ⅱand group Ⅲ according to the random number table method, 90 cases in each group.Patients of group Ⅰ with limb hip and knee were straight,group Ⅱ hip joint elevation of 45 degrees,70 degrees of knee flexion,group Ⅲ hip joint elevation of 45 degrees,the knee extension.All the patients were intervened for 12h after operation,were placed drainage bag 24 hours.The lead flow,preoperative,postoperative hemoglobin and 5 days after the knee joint activity were compared in the three groups.Results Induced flow after surgery in group Ⅰ was (433.4 ±25.3)mL,which was significantly higher than (402.6 ±19.6)mL and (403.5 ± 21.5)mL in group Ⅱand group Ⅲ,and the differences were statistically significant (t =5.253,5.301,all P <0.05),there was no significant difference of induced flow between groupⅡ and group Ⅲ(P >0.05).The hemoglobin levels of the three groups were (92.3 ±4.2)g/L,(114.9 ±6.4)g/L and (113.2 ±7.5)g/L,which were significantly decreased after operation,the differences were statistically significant compared with before operation (t =5.083, 6.034,7.893,all P <0.05),the hemoglobin after surgery of group Ⅰ was significantly lower than group Ⅱ and groupⅢ,the differences were statistically significant (t =6.423,7.043,all P <0.05),there was no significant difference between group Ⅱ and group Ⅲ (P >0.05).There was no significant difference of range of motion in the three groups after 5 days of operation (P >0.05).Conclusion Hip flexion can effectively reduce bleeding after total knee arthro-plasty,the flexion and extension of knee joint had no significant effect on postoperative hemorrhage.

Objective To investigate the clinical efficacy ofHejie Fenxiao Decoction on damp-heat patients with acute kidney injury (AKI).Methods Totally 68 patients were divided into the control group and the treatment group according to the patients’ willings. Both groups were given treatment, such as elimination of the incentives and symptomatic treatment. Besides, patients of the treatment group acceptedHejie Fenxiao Decoction for 30 days. The changes of renal function indexes, such as serum creatinine (SCr), blood urine nitrogen (BUN), uric acid (UA), albumin (ALB) and integral of TCM syndrome, were observed, and recovery ratio and clinical endpoints were compared.Results SCr and eGFR of both group were improved on day 14 (P<0.05). After treatment, the renal function recovery ratio and renal replacement ratio in the two groups showed obvious differences (P<0.05);although survival rate of treatment group was higher than control group, it showed no statistical significance (P>0.05);clinical endpoints analysis of the two groups showed statistical significance (P<0.05). The difference of integrals of TCM syndrome between the two groups showed statistical significance (P<0.05) on day 14.ConclusionHejie Fenxiao Decoction combined with basic regular Western medicine can better improve the clinical symptom, recover the renal function, and decrease the rate of renal replacement and death of AKI damp-heat patients.