Objective To investigate the effects of remote ischemic conditioning(RIC)on neurological function,brain injury markers and vascular inflammatory mediators in patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods Ninety AIS patients admitted to the Department of Neurology of Zhengzhou Central Hospital Affiliated to Zhengzhou University from May 2022 to October 2022 were selected as the research subjects.The patients were divided into the RIC group(n=29),the pseudo-RIC group(n=30)and the control group(n=31)according to the treatment method.All patients in the three groups were treated with intravenous thrombolysis with alteplase.After 24 hours of thrombolysis,the patients in the RIC group were given RIC treatment,the patients in the pseudo-RIC group were given pseudo-RIC treatment,and the patients in the control group were not given RIC treatment.All patients in the three groups were treated for 14 days.Clinical data of patients in the three groups were collected,including age,gender,and history of smoking,drinking,hypertension,diabetes mellitus,coronary artery disease and stroke.About 4-5 mL of the fasting peripheral venous blood was drawn from the patients within 24 hours after admission to the hospital and was centrifuged to obtain the serum.The levels of triacylglycerol(TG),total cholesterol(TC),glycated hemoglobin(HbA1c)and serum creatinine(Scr)were detected;the levels of fibrinogen(FIB)and D-dimer were detected by using a blood coagulation analyzer.The peripheral venous blood(4-5 mL)was drawn from the patients in the three groups before treatment and on the 7th and 14th days of treatment and was centrifuged to obtain the serum.The levels of S100 calcium-binding protein β(S100β),lipoprotein-associated phospholipase A2(Lp-PLA2)and interleukin(IL)-6 were detected by using the enzyme-linked immunosorbent assay(ELISA).The neuron specific enolase(NSE)level was detected by using the double antibody sandwich ELISA.The National Institutes of Health Stroke Scale(NIHSS)and the modified Rankin scale(mRS)were used to assess the neurological impairment of patients in the three groups.The adverse reactions during RIC treatment in the three groups were recorded.Results The overall effective rates of patients in the control group,pseudo-RIC group and RIC group were 90.32％(28/31),90.00％(27/30)and 100.00％(29/29),respectively;there was no statistically significant difference in the overall effective rate among the three groups(x2=3.059,P＞0.05).There was no statistically significant difference in the serum TG,TC,HbA1c,Scr,FIB and D-dimer levels of patients among the control group,pseudo-RIC group and RIC group before treatment(P＞0.05).Before treatment,there was no statistically significant difference in the serum Lp-PLA2,IL-6,S100β and NSE levels among the three groups(P＞0.05).The serum Lp-PLA2,IL-6,S100β and NSE levels of patients on the 7th and 14th days of treatment were significantly lower than those before treatment in the three groups(P＜0.05).On the 7th and 14th days of treatment,the serum Lp-PLA2,IL-6,S100β and NSE levels of patients in the RIC group were significantly lower than those in the pseudo-RIC group and control group(P＜0.05),and these indexes showed no statistically significant difference between the control group and the pseudo-RIC group(P＞0.05).There was no statistically significant difference in the NIHSS and mRS scores of patients among the three groups before treatment(P＞0.05).The NIHSS scores on the 7th and 14th days of treatment and the mRS scores on the 14th,90th days of treatment of patients were significantly lower than those before treatment in the three groups(P＜0.05).The NIHSS score on the 14th day of treatment and the mRS score on the 90th day of treatment in the RIC group were significantly lower than those in the pseudo-RIC group and control group(P＜0.05);there was no significant difference in the NIHSS and mRS scores between the control group and the pseudo-RIC group at each time points(P＞0.05).In the RIC group,2 patients developed upper limb pain and numbness during the treatment,and the symptoms disappeared after the treatment was suspended;no adverse reactions occurred in the pseudo-RIC group and the control group.Conclusion RIC therapy after intravenous thrombolysis can significantly promote neurological recovery,attenuate brain damage,and reduce the expression levels of vascular inflammatory mediators and brain damage markers in patients with AIS.

Background and objective A reasonable and standardized dietary plan and procedure can help patients recovering quickly from lung cancer surgery.The aim of this study is to optimize the diet plan and procedure mainly based on medium chain triglyceride(MCT)diet and explore its clinical advantages for postoperative lung cancer patients.Methods From October 2023 to December 2023,a total of 156 patients were collected,who underwent lung cancer surgery in Lung Cancer Cen-ter,West China Hospital of Sichuan University.The patients were randomized into MCT group(76 cases)and routine diet(RD)group(80 cases).Clinical symptoms,biochemical index,postoperative hospitalization time and cost,dietary satisfaction and hospitalization comfort between the two groups were analyzed.Results The mean anus exhausting time in MCT group[24.00(9.75,36.97)h]was significantly shorter than that in RD group[28.50(24.00,48.00)h](P＜0.001).And the incidence of dizzi-ness(18.42％),nausea and vomiting(6.58％)in MCT group were remarkably lower than those in RD group(51.25％,31.25％)(P＜0.001).Hospitalization comfort score in MCT group[(16.74±1.70)]was significantly higher than that in RD group[(14.83±2.34)](P=0.016).Meanwhile,the average hospitalization cost in MCT group[(39,701.82±8105.47)￥]showed an obvious decrease compared with RD group[(44,511.79±9593.19)￥](P=0.007).Conclusion Optimizing the dietary plan and procedure mainly based on MCT diet for postoperative lung cancer patients can help the recovery of gastrointestinal function and improve hospitalization comfort,which promoted overall postoperative rehabilitation of patients with lung cancer surgery.

Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia (PCIA) after double lung transplantation.Methods Thirty-two patients of both sexes,aged 33-64 yr,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,with body mass index of 18-29 kg/m2,were divided into 2 groups (n=16 each) using a random number table:sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS).PCIA was performed after operation in both groups.The PCIA solution contained sufentainl 3.0 μg/kg and tropisetron 10 mg (diluted to 100 ml in normal saline) in group S and sufentainl 3.0 μg/kg,dexmedetomidine 1.0 μg/kg and tropisetron 10 mg (diluted to 100 ml in normal saline) in group DS.Visual analogue scale score was maintained less than or equal to 3 during postoperative analgesia period,and sufentainl 5 μg was intravenously injected when visual analogue scale score was more than or equal to 4.The requirement for rescue analgesics and development of adverse reactions were recorded.The pulmonary arterial pressure was recorded at the end of surgery (T0) and at 2,4,8,24 and 48 h after surgery (T1-5).Results Compared with group S,the requirement for rescue analgesics,incidence of nausea and vomiting and pulmonary arterial pressure at T1-5 were significantly decreased in group DS (P＜0.05).Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy for PCIA with fewer adverse reactions and decreases the pulmonary arterial pressure after double lung transplantation.

Objective To investigate the efficacy of dexmedetomidine on sedation in post-cardiac surgery patients with NIV intolerance.The changes of respiratory function and hemodynamics of the patients as well as non-invasive ventilation (NIV) failure rate were also under evaluation.Methods Thirty-five post-cardiac surgery patients with NIV intolerance and hypoxemia were enrolled in this prospective study.All patients were sedated with dexmedetomidine.NIV was standardized according to the uniform protocol.The main outcome was NIV success (avoiding endotracheal intubation) or NIV failure (requiring endotracheal intubation or die).The cardiorespiratory parameters (BP,HtR and RR) and artery blood gas analysis were prospectively recorded before and after sedation.The respiratory function and hemodynamics changes in both groups (NIV success group and NIV failure group) were then evaluated.Factors independently associated with NIV failure were identified using a logistic regression model.Results Twenty out of 35 patients (57.14％) survived while 15 (42.86％) patients failed NIV.After 1 h and 4 h of NIV with dexmedetomidine sedation,respiratory rate in both groups were decreased compared with baseline,especially in NIV success group.The PaO2/FiO2 was also improved after 1h and 4h of NIV treatment compared with baseline.The improvement was more significantly in NIV success group.The heart rate was decreased compared with baseline with no differences between two groups.There were no significant changes on PaCO2 and mean arterial pressure (MAP) during the treatment.The respiratory and hemodynamics variables identified as predictors of NIV failure were included in a multivariate logistic regression.RR ＞ 23 time/min (OR =3.2,95％ CI:2.043 ～ 4.301,P ＜ 0.01) 1 h after NIV,RR ＞ 20 time/min (OR =2.1,95％ CI:1.659～3.231,P=0.025) 4 h after NIV,PaO2/FiO2 ＜178 mmHg (OR=2.4,95％CI:1.892 ～ 3.287,P ＜0.01) 1 h after NIV and PaO2/FiO2 ＜ 185 mmHg (OR =1.7,95％ CI:1.243 ～ 2.365,P =0.041) 4 h after NIV independendy predicted NIV failure.Conclusions Dexmedetomidine might be considered as an effective and safe sedative for post-cardiac surgery patients with NIV intolerance.Early identification of predictors of NIV failure may facilitate early intervention.

Objective To evaluate the efficacy and outcomes with the use of a saline-coupled bipolar sealer during liver resection.Methods 101 patients underwent liver resection for primary hepatic carcinoma at the People's Hospital Affiliated to Zhengzhou University from August 2015 to December 2016.The patients were divided into two groups according to whether the Aquamantys(R) system was used or not.In group A (n =62) the clamp crushing technique was used for liver parenchymal transection.In group B (n =39) the Aquamantys(R) system was used.The intraoperative and postoperative complication rates were compared.Results The operation time in group B was significantly longer than group A (216.4 min vs.253.5 min,P ＜ 0.05).The intraoperaitve blood loss in group B was significantly less than group A (381.1 ml vs.257.2 ml,P ＜ 0.05),and less blood transfusion was required (211.3 ml vs.90.9 ml,P ＜ 0.05).The volume of abdominal drainage fluid in group B in the first and the 5th day was significantly less than group A (242.6 ml vs.199.2 ml,P＜0.05;84.3 ml vs.70.4 ml,P＜0.05,respectively).The drainage tube in group B was taken off earlier than in group A (8.1 d vs.7.0 d,P ＜ 0.05).The average hospitalization stay after surgery in group B was also significantly shorter (13.4 d vs.11.6 d,P ＜ 0.05).There was no significant difference in the overall postoperative complication rate (P ＞ 0.05) between the 2 groups,and no death was observed.Conclusion The use of a saline-coupled bipolar sealer (Aquamantys(R)) in liver resection for hepatocellular carcinoma was associated with less intraoperative blood loss and was better for the patients' postoperative recovery.

Objective To evaluate the effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation.Methods Fifty-six American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients,aged 18-64 yr,weighing 45-65 kg,undergoing elective bilateral lung transplantation,were divided into 2 groups (n=28 each) using a random number table:routine anesthesia group (group R) and dexmedetomidine-based anesthesia group (group D).In group D,dexmedetomidine was intravenously infused as a dose of 1.0 μg/kg for 10 min followed by an infusion of 0.5 μg · kg-1 · h-1,propofol 4-6 mg · kg-1 · h-1,cisatracurium besylate 0.05 mg · kg-1 · h-1 and remifentanil 0.1-0.3 μg · kg-1 · min-1 were intravenously infused and 1％-2％ sevoflurane was inhaled.In group R,the method for anesthesia maintenance was similar to that previously described in group D except dexmedetomidine.Before anesthesia induction,immediately after intubation,immediately after one-lung ventilation,at 30 and 60 min after one-lung ventilation,immediately after two-lung ventilation,at 30 and 60 min after twolung ventilation,at the end of surgery and at 12 and 24 h after surgery (T0-10),blood samples were collected from the radial artery for determination of serum tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-8 levels by enzyme-linked immunosorbent assay.The extubation time was recorded.Results The serum concentrations of tumor necrosis factor-alpha,IL-6 and IL-8 were significantly lower at T3-10,and the extubation time was shorter in group D than in group R (P＜0.05).Conclusion Dexmedetomidine-based anesthesia can decrease perioperative inflammatory responses and is helpful in improving prognesis in the patients undergoing bilateral lung transplantation.

Objective The fractional realization of delayed parameters will occurs when using microphone array technology in cochlear implants. To study the design and mismatch feature of fractional delay filter so as to meet the requirement of fractional delay realization in cochlear implants. Methods According to the characteristics of small cochlear implants and delay requirements, a fractional delay filter was designed by least mean square method. Results The fractional delay filtering method based on least mean square interpolation can achieve fractional delay, and can minimize the average error and the mean square error of the whole frequency band. Conclusions The fractional delay filter based on least mean square interpolation has the features of mismatch and high-order flat error, which makes it have theoretical and engineering value and providing a parameter selection method for the design of fractional delay filter.

Objective To investigate the click and tone burst evoked auditory brainstem responses (ABR)in normal Wistar rat,and to establish the standards of ABR testing method,and to provide a reference for studies rat audition.Methods Fifteen male Wistar rats(30 ears)were used in this sutdy.The latency and amplitude of ABR e-voked by click and TB at 80,50 and 20 dB SPL were measured.Results The occurrence rate of wave Ⅱand Ⅳat low levels(20 dB SPL)was nearly the same according to the amplitude.The cABR (dB peSPL)threshold was 21.83± 4.45 and tbABR (dB SPL)thresholds were 2.02±0.09,2.88±0.16,3.77±0.25,4.69±0.29,and 5.78±0.41, respectively.80 dB stimulus evoked cABR (peSPL)wave I,I b,II,III,IV and V latency (ms)were 1.76±0.12, 2.13±0.11,2.67±0.16,3.49±0.28,4.39±0.29,and 5.45±0.41,respectively.tbABR (SPL)of wave I,Ib, II,III,IV and V latency (ms)at 4 kHz were 2.02±0.09,2.88±0.16,3.77±0.25,4.69±0.29,and 5.78± 0.41,respectively.At 8 kHz they were 1.76±0.07,2.28±0.10,2.63±0.16,3.49±0.21,4.44±0.28,and 5.48±0.43;while at 12 kHz were1.76±0.08,2.24±0.12,2.61±0.25,3.53±0.25,4.46±0.32,and 5.52± 0.45;at 16 kHz were 1.79±0.10,2.25±0.12,2.70±0.18,3.62±0.27,4.52±0.37,and 5.61±0.49;at 24 kHz were 1.75±0.09,2.27±0.11,2.67±0.16,3.60±0.27,4.52±0.38,and 5.60±0.51;at 32 kHz were 1.77±0.10,2.24±0.12,2.64±0.20,3.59±0.34,4.52±0.40,and 5.61±0.52,respectively.Conclusion Wave Ⅳ was the best wave to determine threshold of click and tone burst evoked auditory brainstem response in rat.

OBJECTIVETo observe the clinical effectiveness of warm needling combined with element calcium on postmenopausal osteoporosis, and to explore its action mechanism.

METHODSEighty-five postmenopausal patients were randomly divided into an observation group (43 cases) and a control group (42 cases). Both the two groups were treated with oral administration of caltrate-D tablet, 600 mg per day, once a day before sleep for one year. Patients in the observation group were treated with warm needling at Dazhu (BL 11), Shenshu (BL 23), Xuan-zhong (GB 39), once a day; 30 days of treatment were taken as a course, and totally 4 courses were given with an interval of 60 days between courses. The bone mineral density (BMD) of the lumbar vertebra and hip joint, and the level of serum bone gla protein (S-BGP) and hydroxyproline/creatinine (Hyp/Cr) were observed before and after treatment in the two groups.

RESULTS(1)After treatment, the BMD in the observation group was significantly increased [lumbar vertebra (0. 811±0. 024) g/cm2 vs (0. 892±0.019) g/cm2, femoral neck (0. 512±0.014) g/cm2 vs (0. 554±0. 015) g/cm2, femoral trochanter (0. 716±0. 028) g/cm2 vs (0.769±0.026) g/cm2, Ward's trigonum (0. 590±0. 013) g/cm2 vs (0. 660±0. 017) g/cm2, all P<0. 05)]; the improvement in the observation group was more significant than that in the control group (all P<0. 05). (2)After treatment, the index of bone metabolism in the control group was increased, and the serum S-BGP, the Hyp/Cr in the control group were higher than those in the observation group (both P<0. 05).

CONCLUSIONThe treatment of warm needling combined with element calcium on postmenopausal osteoporosis is significant, which is likely to be achieved by reducing the bone metabolism of postmenopausal patients.

Acupuncture Therapy ; Bone Density ; Calcium ; metabolism ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; physiopathology ; therapy