目的 观察百令胶囊辅助缬沙坦治疗IgA肾病效果及对患者肾功能、细胞免疫调节、尿足细胞标志蛋白的影响。方法 选取2019年5月—2021年5月西部战区总医院肾内科收治经肾活检确诊为IgA肾病,筛选治疗方案中尚未使用激素及免疫抑制剂的80例患者,按住院先后顺序随机分为观察组和对照组,每组各40例。对照组给予缬沙坦治疗,观察组给予百令胶囊辅助缬沙坦治疗,治疗12周后,比较2组的疗效、治疗前后肾功能指标[24 h蛋白尿(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、尿红细胞(RBC)计数]、1型/2型辅助性T细胞(Th1/Th2)代表细胞因子[γ-干扰素(IFN-γ)、白介素-4(IL-4)]、尿足细胞标志蛋白[尿足萼糖蛋白(PCX)、尿足细胞B7-1分子(B7-1)]水平。结果 治疗12周后,观察组的治疗总有效率为95.0%,高于对照组的82.5%;观察组的24 h Upro、BUN、SCr、尿RBC计数低于对照组,IFN-γ、Th1/Th2低于对照组、IL-4高于对照组,尿PCX、B7-1水平低于对照组;差异均有统计学意义(P<0.05)。结论 百令胶囊辅助缬沙坦治疗IgA肾病患者,可以提高临床疗效,有效保护患者肾功能,调节其免疫状态,减轻肾损伤。

Objective To observe the effects of Bailing capsules assisting valsartan in the treatment of IgA nephropathy and its influence on renal function, cellular immune regulation and urine prodocytes marker protein. Methods From May 2019 to May 2021, 80 patients with IgA nephropathy confirmed by renal biopsy in the Nephrology Department of Western Theatre Command General Hospital, who had not used hormones or immunosuppressants in the treatment were selected.Patients were divided into observation group and control group according to the order of hospitalization, 40 cases in each group.The control group was given valsartan, and the observation group was given Bailing capsules and valsartan.After 12 weeks of treatment, the efficacy, the levels of renal function indexes [24 h proteinuria (24 h Upro), urea nitrogen (BUN), serum creatinine (SCr), urinary red blood cell (RBC) count], type 1/type 2 helper T cells (Th1/Th2) represent cytokines [interferon-γ (IFN-γ), interleukin-4 (IL-4)], urine prodocytes marker protein [urine podocalyxin (PCX), urinary podocyte B7-1 molecule (B7-1)] before and after treatment were compared between the two groups. Results After treatment, the total effective rate in observation group was higher than that in control group (95.0% vs 82.5%).The 24 h Upro, BUN, SCr levels and urine RBC count in observation group were lower than those in control group, IFN-γ and Th1/Th2 levels were lower than those in control group, the IL-4 level was higher than that in control group, and the levels of urine PCX and B7-1 were lower than those in control group.Those differences were statistically significant (P<0.05). Conclusions Bailing capsules assisting valsartan in the treatment of IgA nephropathy can improve clinical efficacy, effectively protect the renal function of patients, regulate the immune status, and alleviate renal injury.

目的 探讨桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响,以便临床寻找出更有效的治疗方案,进而改善患者预后。方法 本次研究对象为赣州市人民医院2017年6月—2022年1月收治的82例桥小脑角肿瘤患者,用随机数字表法将其分为对照组（41例）和实验组（41例）。对照组患者给予常规显微手术治疗,实验组患者给予神经内镜辅助常规显微手术治疗,2组患者均于术后观察8周。比较2组患者肿瘤全切率,手术时间、住院时间及住院费用,术前及术后2、4、8周格拉斯哥预后量表（GOS）评分,以及术后8周内并发症发生情况。结果 肿瘤全切率：实验组患者术后8周（90.24%）与对照组（73.17%）相比,处于更高水平;手术时间、住院时间：实验组患者与对照组相比,处于更短水平;GOS评分：术前至术后2周,2组患者评分均呈下降趋势,术后2周至8周,2组患者评分呈升高趋势,其中实验组术后2、4、8周与对照组相比,处于更高水平,差异有统计学意义（P<0.05）;并发症总发生率：术后8周内,实验组患者（4.88%）与对照组（17.07%）相比,差异无统计学意义（P>0.05）。结论 桥小脑角肿瘤微创切除术中应用神经内镜,可有效缓解患者的临床症状,优化手术相关指标,减轻神经功能受损,提高肿瘤全切率,改善预后,且安全性高。

Objective To investigate the effect of neuroendoscope on functional recovery and prognosis of patients with cerebellopontine angle tumor after microinvasive resection,so as to find out more effective treatment and improve the prognosis of patients．Methods The subjects were 82 patients with cerebellopontine angle tumors admitted to Ganzhou People's Hospital from June 2017 to January 2022．They were divided into control group（n = 41）and experimental group（n = 41）by random number table method．Patients in the control group were treated with conventional microsurgery,while patients in the experimental group were treated with neuroendoscope assisted conventional microsurgery．All patients were observed for 8 weeks after operation．The total tumor resection rate,operation time,hospitalization time,hospitalization expense,Glasgow Outcome Scale（GOS）score before and 2,4,8 weeks after operation,and complications within 8 weeks after operation were compared between the two groups．Results Compared with the control group（73.17%）,the patients in the experimental group had a higher resection removal rate of tumor after 8 weeks of operation（90.24%）．Patients in the experimental group had a shorter operation time and hospital stay than those in the control group．From pre-operation to 2 weeks after operation,the GOS scores of patients in both groups showed a downward trend,and from 2 weeks to 8 weeks after operation,the scores of patients in both groups showed an upward trend,and the patients in the experimental group were at a higher level than those in the control group at 2,4,8 weeks after operation,the difference were statistically significant（P < 0.05）．Within 8 weeks after surgery,there was no significant difference in total incidence of complications between the experimental group（4.88%）and the control group（17.07%,P > 0.05）．Conclusions The application of neuroendoscope in the minimally invasive surgery of cerebellopontine angle tumor can effectively relieve the clinical symptoms of patients,optimize the operation-related indexes,reduce the damage of nerve function,increase the total resection rate of tumor,improve the prognosis,and with high safety．

目的 分析精神分裂症患者体内的肌酸激酶（CK）、肌红蛋白（MYO）、β₂微球蛋白（β₂-MG）、细胞间黏附分子（ICAM）水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤（AKI）可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组（同期我院门诊健康体检者）20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β₂-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β₂-MG值高于健康对照组及肾功能正常组,差异具有统计学意义（F=623.534,30.437,636.776,88.283,P<0.05）,精神分裂症AKI 1期组到AKI 3期组CK、MYO、β₂-MG、ICAM数值均比对照组升高（P<0.05）,3组之间如上指标的比较差异有统计学意义（P<0.05）。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β₂-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。

Objective To study the changes of serum creatine kinase（CK）,myoglobin（MYO）,β₂ microglobulin（β₂-MG）,intercellular adhersion molecule（ICAM）with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury（AKI）in patients with schizophrenia．Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls（who underwent physical examination during the same period）were included．At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β₂-MG level in each group．The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed．Results The serum CK,MYO,ICAM and β₂-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant（F=623.534,30.437,636.776,88.283,P<0.05）,and the comparison of the above indexes among the three groups was statistically significant（P<0.05）．Conclusions The abnormal increase of serum CK,MYO,ICAM and β₂-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis．

目的 探讨乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病疗效及对患者肺功能的影响。方法 以2020年4月—2022月4月在本院诊治的84例慢性阻塞性肺疾病患者作为研究对象,根据1∶1简单分配原则把患者分为联合组与对照组各42例。对照组行传统治疗,联合组在对照组治疗的基础上,再给予乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗,联合组与对照组都治疗观察4周。检测患者的疗效、肺功能与血清超敏C反应蛋白（hs-CRP）与降钙素原（PCT）含量变化情况。结果 联合组治疗后的总有效率与对照组相比有提高（P<0.05）。治疗后,联合组与对照组的第一秒用力呼气容积占用力肺活量百分比（FEV₁/FVC）、第一秒用力呼气容积占预计值百分比（FEV₁%）更高（P<0.05）,且联合组与对照组对比有提高（P<0.05）。联合组治疗后的疾病影响、活动能力、症状部分等SGRQ生活质量评分与对照组相比降低（P<0.05）。联合组与对照组治疗后的血清 hs-CRP与 PCT含量低于治疗前（P<0.05）,联合组与对照组相比也降低（P<0.05）。结论 乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病能有效抑制hs-CRP、PCT的表达,能促进改善患者的肺功能,提高治疗效果与生活质量。

Objective To investigate the efficacy of acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of chronic obstructive pulmonary disease（COPD）and its effect on the pulmonary function of patients．Methods From April 2020 to April 2022,a total of 84 patients with COPD diagnosed and treated in our hospital were selected as the research objects,and the patients were divided into the combination group and the control group with 42 cases in each group,according to the 1∶1 simple allocation principle．The control group were given traditional treatment,and the combination group were given acetylcysteine effervescent tablets combined with budigraf aerosol additionally．Both the combined group and the control group were observed for 4 weeks．The efficacy of patients,lung function and serum hypersensitive C-reactive protein（hs-CRP）and procalcitonin（PCT）levels were detected．Results The total effective rates after treatment in the combination group were higher than the control group（P<0.05）．After treatment,The forced expiratory volume in 1 second/forced vital capacity（FEV₁/FVC）,FEV₁% value of the two groups were higher（P<0.05）,and the combination group had greater improvement（P<0.05）．The SGRQ quality of life scores,such as disease impact,activity ability,and symptom in the combination group were lower（P<0.05）．After treatment,the serum high-sensitivity C-reactive protein（hs-CRP）and procalcitonin（PCT）levels in the two groups were significantly lower（P<0.05）,and the combined group decreased more（P<0.05）．Conclusions Acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of COPD can effectively inhibit the expression of hs-CRP,PCT,promote the improvement of lung function,improve the treatment effect and quality of life．

目的 探讨苏黄止咳胶囊联合多索茶碱对慢性持续期支气管哮喘的疗效及对肺功能、呼出气一氧化氮（FeNO）的影响。方法 选择2020年3月—2022年3月70例慢性持续期支气管哮喘患者,随机分为2组各35例,对照组仅予以多索茶碱治疗,研究组在对照组基础上加服苏黄止咳胶囊治疗。治疗3个月,采用哮喘控制测试（ACT）对患者进行评估,记录哮喘急性加重、急救药物使用情况及急诊入院情况,测定肺功能和呼出FeNO。结果 2组治疗1月的ACT评分比较无统计学意义（P>0.05）,治疗2、3个月时研究组的ACT评分高于对照组（P<0.05）。研究组哮喘急性加重次数、急救药物使用次数均少于对照组（P<0.05）,而2组急诊入院次数比较差异无统计学意义（P>0.05）。与基线值相比,2组治疗3个月时的肺功能指标无改变（P>0.05）且组间比较差异亦无统计学意义（P>0.05）;2组治疗3个月时的FeNO无改变（P>0.05）,而研究组的FeNO低于对照组（P<0.05）。结论 苏黄止咳胶囊联合多索茶碱治疗慢性持续期支气管哮喘可降低FeNO,提高哮喘控制水平。

Objective To investigate the effect of Suhuang Zhike capsule combined with doxofylline on chronic persistent bronchial asthma, pulmonary function and exhaled nitric oxide（FeNO）．Methods Seventy patients with chronic persistent bronchial asthma from March 2020 to March 2022 were randomly divided into two groups, 35 cases in each group．The control group was only treated with doxofylline, and the study group was treated with Suhuang Zhike capsule additionally．After 3 months of treatment, the patients were evaluated by asthma control test（ACT）, the acute exacerbation of asthma was recorded, and the pulmonary function and exhaled FeNO were measured．Results There was no statistical significance in the ACT score of the two groups after one month of treatment（P>0.05）．The ACT scores of the study group after two months and three months of treatment were significantly higher than those of the control group（P<0.05）．The times of acute exacerbation of asthma and the use of emergency drugs in the study group were less than those in the control group（P<0.05）, but there was no significant difference in the number of emergency hospitalizations between the two groups（P>0.05）．Compared with the baseline value, there was no significant change in lung function indexes in the two groups after 3 months of treatment（P>0.05）．Compared with the baseline value, there was no significant change in FeNO in the two groups after 3 months of treatment（P<0.05）, while FeNO in the study group was lower than that in the control group（P<0.05）．Conclusions Suhuang Zhike capsule combined with doxofylline in the treatment of chronic persistent bronchial asthma can reduce FeNO and improve the level of asthma control．

目的 探讨不同贫血类型患者铁蛋白水平、甲状腺功能检测结果对比分析。方法 前瞻性选取2018年11月—2021年11月我院收治的240例贫血患者作为研究对象。将患者分为小细胞低色素性贫血组（n=75）,正细胞性贫血组（n=100）和大细胞性贫血组（n=65）。检查患者甲状腺功能[甲状腺素（TSH）、游离三碘甲腺原氨酸（FT₃）、游离甲状腺素（FT₄）]和铁蛋白（SF）表达水平。采用Spearman检验进行相关性分析;采用Logistics回归模型进行回归分析。结果 3组患者红细胞（RBC）、血红蛋白（Hb）、平均红细胞容积（MCV）、红细胞平均血红蛋白浓度（MCHC）、平均红细胞血红蛋白含量（MCH）、血清肌酐（Scr）间存在差异（P<0.05）;大细胞性贫血组TSH、FT₃和SF低于正细胞性贫血组和小细胞低色素性贫血组（P<0.05）,而FT₄高于正细胞性贫血组和小细胞低色素性贫血组（P<0.05）;贫血类型与TSH、FT₄、FT₃和SF呈正相关（P<0.05）;多因素Logistics回归分析结果显示,TSH、FT₄、FT₃和SF在3个模型中均为独立危险因素（P<0.05）。结论 不同贫血类型患者间甲状腺功能和铁蛋白表达水平存在显著差异,大细胞性贫血组TSH、FT₃和SF低于正细胞性贫血组和小细胞低色素性贫血组,而FT₄更高,甲状腺功能指标和铁蛋白均是各种类型贫血发生的危险因素。

Objective To explore the comparative analysis of ferritin level and thyroid function detection results in patients with different types of anemia．Methods A total of 240 anemia patients admitted to our hospital from November 2018 to November 2021 were prospectively selected as research objects．The patients were divided into microcytic hypochromic anemia group（n=75）,normocytic anemia group（n=100）,and macrocytic anemia group（n=65）．The expression levels of thyroid function[thyroxine（TSH）,free triiodothyronine（FT₃）,free thyroxine（FT₄）]and ferritin（SF）were examined．Correlation analysis was performed by Sperman test．The logistic regression model was adopted for regression analysis．Results There were significant differences in red blood cell,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin concentration,mean corpuscular hemoglobin content and serum creatinine among three groups（P<0.05）．TSH,FT₃ and SF in macrocytic anemia group were significantly lower than those in normocytic anemia group and microcytic hypochromic anemia group（P<0.05）,while FT₄ was significantly higher than that in normocytic anemia group and microcytic hypochromic anemia group（P<0.05）．The type of anemia was positively correlated with TSH,FT₄,FT₃ and SF（P<0.05）．The results of multi-factor logistics regression analysis showed that TSH,FT₄,FT₃ and SF were independent risk factors in the three models（P<0.05）．Conclusions There were significant differences in thyroid function and ferritin expression levels among patients with different types of anemia．Macrocytic anemia group TSH,FT₃ and SF were lower than those in normocytic anemia group and microcytic hypochromic anemia group,while FT₄ was higher．Both thyroid function indexes and ferritin were risk factors for various types of anemia．

目的 探究新斯的明拮抗顺阿曲库铵的时机对患者腹腔镜结直肠癌根治术后肌松残留和早期肺功能的影响。方法 选取于2021年2月—2022年9月在我院行结肠癌根治手术的194例患者为研究对象,以随机数字表法将患者分为空白对照组和试验组,然后结合给予新斯的明治疗时所体现的4个成串刺激（TOF）比值将试验组患者分为试验组A（TOF≤0.1）、试验组B（0.10.8）。对比组间肌松残余情况以及肺功能情况。结果 插管前,试验组A患者TOF比值低于其他组（P<0.01）,空白对照组患者TOF比值高于其他组（P<0.01）;空白对照组分别与试验组A~E在复苏室接受观察的时间比较,差异无统计学意义（P>0.01）;试验组A患者肌松恢复指数低于其他组（P<0.01）,空白对照组患者肌松恢复指数高于其他组（P<0.01）。插管前、拔管0.5 h以及拔管24 h时,组间1秒用力呼气容积（FEV1）、用力肺活量（FVC）和FEV1/FVC比较差异无统计学意义（P>0.05）。结论 结直肠癌根治术后给予新斯的明,有助于加快肌松恢复,但不会影响复苏室停留时间与肺功能水平。

Objective To investigate the effect of timing of neostigmine antagonizing cisatracurium on residual muscle relaxation and early lung function in patients underwent laparoscopic radical resection of colorectal cancer．Methods February 2021 to September 2022,194 patients who underwent radical colon cancer surgery in our hospital were selected as the research subjects．The patients were randomly divided into a blank control group and an experimental group using a random number table method．Then,combined with the train-of-four（TOF）ratios observed during neostigmine treatment,the experimental group patients were divided into experimental group A（TOF≤0.1）,experimental group B（0.10.8）．The residual muscle relaxation and lung function between groups were compared．Results Before intubation,the TOF ratio of patients in experimental group A was lower than that of other groups（P<0.01）,while the TOF ratio of patients in the blank control group was higher than that of other groups（P<0.01）．There was no significant difference in the observation time between the blank control group and the experimental group A~E in the postanesthesia care unit（P>0.01）．The muscle relaxation recovery index of patients in experimental group A was lower than that of other groups（P<0.01）,while the muscle relaxation recovery index of patients in the blank control group was higher than that of other groups（P<0.01）．There were no significant differences in force expiratory volume in one second（FEV1）,forced Vital capacity（FVC）and FEV1/FVC between groups before intubation,0.5 h after extubation and 24 h after extubation（P>0.05）．Conclusions Administration of neostigmine after radical surgery for colorectal cancer can accelerate muscle relaxation recovery,but it will not affect the residence time of the postanesthesia care unit and lung function levels．

严重烧伤后患者免疫功能的失调,易导致创面感染、全身炎症反应综合征、脓毒症、感染性休克等并发症,增加患者病死率。免疫细胞功能适度的活化将有助于烧伤患者抵御外界病原体的侵袭、促进创面的愈合,但功能过度激活或者功能低下,则会引发一系列严重的后果。本文旨在归纳严重烧伤后中性粒细胞、单核/巨噬细胞、肥大细胞、NK细胞及T淋巴细胞等免疫细胞的功能变化与炎症反应之间的关系,为完善烧伤患者诊疗、减少并发症、改善预后提供新的思路。

The imbalance of immune function in severely burned patients can easily lead to wound infection,systemic inflammatory response syndrome,sepsis,septic shock and other complications,which increase the mortality of patients. Moderate activation of immune cell function will help burned patients to resist the invasion of external pathogens and promote wound healing,but excessive activation or low function can lead to a series of serious consequences. The purpose of this paper is to summarize the relationship between the functional changes of immune cells such as neutrophils,monocytes/macrophages,mast cells,NK cells,T lymphocytes and inflammatory reaction after severe burns,and to provide new ideas for improving the diagnosis and treatment of burned patients,reducing complications and improving the prognosis.

目的 探讨功能性消化不良（FD）患者应用乳果糖联合莫沙必利治疗的临床疗效及药物对肠道菌群的影响。方法 选取2019年1月—2021年12月来院诊治的180例FD患者作为研究对象,随机分为2组,每组90例,对照组口服莫沙必利片,观察组服用莫沙必利片+乳果糖口服液,4周后观察2组患者治疗后临床症状改善率及肠道菌群数量的情况。结果 治疗4周后,观察组的总有效率（86.67%）高于对照组（72.22%）,P<0.05;观察组的乳杆菌菌群数多于对照组,肠球菌、肠杆菌菌群数少于对照组,P<0.05。结论 乳果糖联合莫沙必利用于FD患者临床治疗,总有效率高于单用莫沙必利,患者症状获得有效改善,明显改善FD患者肠道菌群水平。

Objective To explore the clinical efficacy and effect on intestinal flora of lactulose combined with mosapride in patients with functional dyspepsia（FD）．Methods A total of 180 FD patients admitted to the hospital in January 2019 and December 2021 were selected as the study subjects and randomly divided into two groups,90 cases in each group．The control group took oxapride orally and the observation group took lactulose oral solution additionally．After 4 weeks,the improvement rate of clinical symptoms and the number of intestinal flora of patients were observed．Results After 4 weeks of treatment,the total effective rate of the observation group（86.67%）was obviously higher than that of the control group（76.67%）,P<0.05;the number of Lactobacillus in the observation group was higher than that of the control group,and the numbers of Enterococcus and Enterobacteria were less than that of the control group,P<0.05．Conclusions The total effective rate of lactulose combined with mosalabin for FD patients is higher than that of mossalapride alone．The symptoms are effectively improved,and the intestinal flora level of FD patients is significantly improved．

目的 对比颈动脉内膜剥脱术（CEA）不同时间预处理对患者术后应激反应及神经功能的影响。方法 回顾性收集2019年12月—2022年12月在我院择期行CEA术治疗的74例颈动脉狭窄（CS）患者临床资料,按远隔缺血预处理（RIPC）时间不同分成2组,其中A组37例（术前1 h进行预处理）、B组37例（术前24 h进行预处理）。对比2组术前1 d、麻醉诱导后、切皮时交感神经反应指标[收缩压（SBP）、心率（HR）、舒张压（DBP）]变化及手术前后简易精神状态评价量表（MMSE）评分、应激指标[去甲肾上腺素（NE）、白细胞介素-6（IL-6）、皮质醇（Cor）]、神经功能指标[脑源性神经营养因子（BDNF）、神经元特异性烯醇化酶（NSE）、中枢神经特异蛋白（S-100β）]水平。结果 与A组相比,麻醉诱导后B组SBP、HR、DBP水平更高,切皮时SBP、HR、DBP水平更低（P<0.05）;与A组相比,B组术后7 d、30 d MMSE评分更高（P<0.05）;术后12 h、24 h 2组血清NE、Cor、IL-6水平均较术前1 d升高（P<0.05）,但2组比较差异无统计学意义（P>0.05）;与A组相比,B组术后12 h、24 h血清S-100β、NSE水平更低,血清BDNF水平更高（P<0.05）。结论 CEA术前实施RIPC可减轻脑损伤,发挥脑保护作用,但与术前1 h实施RIPC相比,于术前24 h实施RIPC更有助于维持机体血流动力学稳定,促进认知功能及预后恢复。

Objective To compare the effects of different time preconditioning of carotid endarterectomy（CEA）on postoperative stress response and neurological function．Methods From December 2019 to December 2022,74 patients with carotid stenosis（CS）who were selected for CEA treatment in our hospital were retrospectively collected and divided into two groups according to the time of remote ischemic preconditioning（RIPC）,including 37 cases in group A（preconditioning at 1 hour before surgery）and 37 cases in group B（preconditioning at 24 hours before surgery）．The changes of sympathetic response indexes [systolic blood pressure（SBP）,heart rate（HR）,diastolic blood pressure（DBP）] in the 2 groups at 1 d before surgery,after the anesthesia induction,and at the time of skin incision before and after surgery,and the scores of the Mini-Mental State Examination（MMSE）,stress indexes [norepinephrine（NE）,interleukin-6（IL-6）,cortisol（Cor）],and neurological function indexes [brain-derived neurotrophic factor（BDNF）,neuron specific enolase（NSE）,central nervous specific protein（S-100β）]．Results Compared with group A,the levels of SBP,HR and DBP in group B after anesthesia induction were higher,and the levels of SBP,HR and DBP were lower during skin resection（P<0.05）．Compared with group A,group B had higher MMSE scores at 7 and 30 days after surgery（P<0.05）．The serum levels of NE,Cor and IL-6 in the 2 groups were increased 12 h and 24 h after surgery compared with 1 day before surgery（P<0.05）,but there was no significant difference between the 2 groups（P>0.05）．Compared with group A,serum S-100β and NSE levels in group B were lower at 12 h and 24 h after surgery,and serum BDNF level was higher in group B（P<0.05）．Conclusions The administration of RIPC before CEA can reduce brain injury and play a protective role in brain．However,compared with the administration of RIPC 1 h before surgery,the administration of RIPC 24 h before surgery is more conducive to maintaining hemodynamic stability,promoting cognitive function and prognostic recovery．