10.3969/j.issn.2095-4344.2013.24.022

Objective To investigate the influence of enteral nutrition (EN) via feeding pump-based continuous infusion (FPBCI) on nutrition support-associated complications in stroke patients. Methods Totally 53 patients were randomized into BPBCI group (n = 28) and control group (bolus feeding) (n = 25 ). The nutrition support-associated complications including bloating, diarrhea, hyperglycemia, and regurgitation-associated low respiratory tract infection were compared between these two groups. Results The incidences of nutrition support-associated complications were significantly lower in BPBCI group than in control group (bloating: 14.3%vs. 64.0%, P=0.0002; diarrhea: 25.0% vs. 52.0%, P=0.0429; hyperglycemia: 17.9% vs. 44.0%, P=0. 0385 ). There was no significant difference in regurgitation-associated lower respiratory tract infection between these two groups (32. 1% vs. 40.0% , P = 0. 5516). Conclusion Compared with conventional bolus feeding,BPBCI may greatly decrease tube-feeding related complications.

Abstract Diagnosis-related groups (DRGs), designed to reflect the complexity of grouped cases and the consumption of medical resources, has been utilized for evaluating hospital specialty capabilities and assessing performance. A provincial tertiary hospital in Zhejiang Province has developed a management model based on DRGs performance evaluation with strengthening the medical record quality control, optimizing disease admission structures, and refining data analysis. This article introduced the application of DRGs performance evaluation in this hospital, and proposed suggestions for improvement, including leveraging artificial intelligence and big data and integrating clinical pathway management to further enhance medical care quality. These insights provided the reference for high quality development of hospitals.

A quantitative method using ultrahigh-performance liquid chromatography was established to simultaneously determine ten ginsenoside active ingredients including ginsenoside Rg6, F4, Rk3, Rh4, 20(S) -Rg3, 20(R) -Rg3, Rk1, Rg5, 20(S)-Rh2 and 20(R)-Rh2 in steamed notoginseng. The ten ginsenosides of steamed notoginseng with different head numbers, parts, and steaming time were determined by this method. An Acquity BEH C18 chromatographic column (2.1 mm x 100 mm, 1.7 microm) was used to perform the determination, which was maintained at 35 degrees C throughout the analysis. Mobile phase was composed of water and acetonitrile with flow rate at 0.3 mL x min(-1) under gradient elution, and detection wavelength was set to 203 nm for monitoring the separation. The results demonstrate ginsenoside Rg6, F4, Rk3, Rh4, 20 (S)-Rg3, 20 (R) -Rg3, Rk1, Rg5, 20 (S)-Rh2 and 20(R) -Rh2 have shown good linearity (R2 > or = 0.999 8) within 0.46-115, 2.06-515, 1.632408, 3.216-804, 1.392-348, 1.4-350, 0.496-248, 3.012-1 506, 0.82-205 and 0.832-208 mg x L(-1), and their average recoveries were 97.00%, 97.96%, 98.86%, 95.27%, 98.67%, 98.02%, 95.53%, 96.63%, 99.57% and 103.6%, respectively. The proposed approach was quick and accurate and portrayed excellent repeatability and determination efficiency. The quality of steamed notoginseng was effectively controlled, which served as a foundation for establishing a normalized processing technique and quality standard for ensuring the reliability and consistency of its clinical efficacy.
Chromatography, High Pressure Liquid ; methods ; Ginsenosides ; analysis ; Panax notoginseng ; chemistry ; Reproducibility of Results ; Steam

Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP).Methods A total of 56 patients with symptomatic benign prostatic hyperplasia(BPH) underwent the PKRP.The weight of the prostate ranged 36~110 g(mean,50.3?26.4 g).All the patients were followed for 1~6 months postoperatively.Results The duration of the procedure was 25~100 min(mean,56?26 min),the weight of resected prostate was 10~89 g(mean,50?22 g),and the intraoperative blood loss,35~200 ml(mean,75?49 ml).No transurethral resection syndrome occurred.On 1,3,and 6 postoperative months of follow-up,the peak flow rate(Qmax) increased from 6.7?2.9 ml/s preoperatively to 17.4?5.1 ml/s,20.8?3.9 ml/s,and 21.6?4.6 ml/s,respectively,the international prostate symptom score(IPSS) decreased from 23.2?3.8 preoperatively to 6.9?1.7,6.1?2.1,and 5.9?1.5,respectively,and the quality of life(QOL) decreased from 5.7?1.5 preoperatively to 2.7?0.7,2.4?0.5,and 1.9?0.9,respectively.The differences between pre-and post-operative periods in the three indicators were all statistically significant(P

60 years) received parenteral nutritional support in the period of perioperation.When parenteral nutrition was applied,average non protein calorie intake was 85.4 kJ/(kg?d), and NPC∶N value was 118∶1. Results:PA,TRF and electrolyte were significantly increased after parenteral nutritional support.The nutritional indices did not change and were kept within normal range during parenteral nutrition. Conclusions:Parenteral nutrition is one of the important perioperative treatments in elderly patients with obstruction caused by colon cancer.It is safe and effective to use parenteral nutrition with low fat and glucose in elderly patients.

Face ; surgery ; Humans ; Mouth ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies

OBJECTIVETo compare the difference in clinical efficacy on post-stroke motor aphasia among the combined therapy of acupoint application of jieyu plaster and acupuncture, simple acupuncture and simple acupoint application of jieyu plaster.

METHODSEighty-six patients of post-stroke motor aphasia were randomized into an acupuncture group (28 cases) , an acupoint application gruop (29 cases) and the combined therapy group (29 cases). In the acupuncture group, acupuncture was applied at the Speech No. 1 area and three-tongue needling points, once a day, 6 times a week. In the acupoint application group, jieyue plaster was applied to Yongquan (KI 1) and Laogong (PC 8), once a day, and the bilateral acupoints were selected alternatively. In the combined therapy group, the therapeutic methods of the first two groups were used in combination. The treatment lasted for 4 weeks in the three groups. The speech function score was observed and compared before and after treatment in the three groups and the efficacy was compared among the three groups.

RESULTSThe total effective rate was 86.2% (25/29) in the combined therapy group, which was better than 67.9% (19/28) in the acupuncture group and 69.0% (20/29) in the acupoint application group (both P < 0.05). After treatment, the scores of spontaneous conversation, restatement and nomenclature in the speech function were all improved as compared with those before treatment in the three groups (all P < 0.01). The results in the combined therapy group were apparently better than those in the acupuncture group and the acupoint application group (all P < 0.01).

CONCLUSIONThe combined therapy of acupoint application of jieyu plaster and acupuncture apparently improves the speech function in the treatment of post-stroke motor aphasia and the efficacy is better than that of simple acupuncture or simple acupoint application.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aphasia, Broca ; drug therapy ; etiology ; therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

Objective To assess the role of the combination of Helicobacter pylori (H.polyri)antibody detection and serum pepsinogen (PG) examination (ABC method) in risk prediction of gastric cancer.Methods From July 2014 to July 2015,a total of 320 patients underwent gastroendoscopy examination because of stomach discomfort were enrolled.According to the results of serum H.polyri antibody test,PG Ⅰ and PG Ⅰ/PG Ⅱ ratio (PGR),patients were divided into four groups:group A was both H.polyri and PG negative,group B was H.polyri positive and PG negative,group C was both H.polyri and PG positive,group D was H.polyri negative and PG positive.The incidence rates of gastric cancer were compared among the groups.PG positive was defined as PG Ⅰ ≤70 μg/L and PGR≤3.0.And according to the results of gastroendoscopy examination and histopathology,the levels of gastrin 17,PG Ⅰ,PG Ⅱ and PGR of different atrophic regions with different pathological changes and atrophic degree were compared.Chi-square test and analysis of variance were performed for statistical analysis.Receiver operating characteristic(ROC) curve was used to calculate the optimal cut-off value of serum PG Ⅰ and PGR in gastric cancer diagnosis.Results Among the 320 patients,there were 159 patients in group A,124 patients in group B,23 patients in group C and 14 patients in group D,respectively.The incidence of gastric cancer in group A,group B,group C and group D were 0.63％ (1/159),4.03％ (5/124),13.04％ (3/23) and 3/14,respectively.The incidences of gastric cancer in group C and D were much higher than those in group A and B (x2 =11.700 and 21.900,both P＞0.01).Among the 320 patients,there were 179 cases in non-atrophic gastritis group,129 in atrophic gastritis group and 12 in gastric cancer group.The PG Ⅰ and PGR levels of gastric cancer group were (46.84 ± 24.07) μg/L and 3.21 ±1.45,which were lower than those of atrophic group ((100.09±48.15) μg/L and 9.78±7.32) and nonatrophic group ((103.97 ± 44.72) μg/L and 13.09 ± 9.05),and the differences were statistically significant (F=12.460 and 30.290,both P＜0.01).The PGR level of severe atrophy group was 5.62±3.00,which was significantly lower than those of moderate atrophy group (10.04 ± 6.08) and mild atrophy group (11.61±4.05).And the PGⅡ level of severe atrophy group was (18.85±10.54) μg/L,which was much higher than those of moderate atrophy group ((14.63 ± 11.19) μg/L) and mild atrophy group ((10.88 ± 7.41) μg/L),and t he differences were statistically significant (F=8.057,P＜ 0.01;F =3.374,P=0.021).The gastrin 17 level of antrum atrophy group was 2.16 pmol/L (1.12 pmol/L to 4.15 pmol/L),which was lower than those of gastric body atrophy group (4.49 pmol/L,1.88 pmol/L to 18.71 pmol/L) and whole gastric atrophy group (6.18 pmol/L,2.63 pmol/L to 17.82 pmol/L),and the differences were statistically significant (H=13.408,P＜0.01).The optimal cut-off values of PG Ⅰ and PGR for the diagnosis of gastric cancer were 66.7 μg/L and 4.45.Conclusions ABC stratification has certain value in gastric cancer screening in China,however,it still needs improvement.For patients with digestive symptoms,PG Ⅰ ≤ 66.7 μg/L and PGR ≤4.45 can be considered as high risk of gastric cancer and suggested to receive gastroendoscopy examination.

Cardiovascular disease is the most important factor that affect the lifetime of uremia patients. Recently, scientists pay closer attention to study the mechanism of cardiac injury in uremia patients. In this article, we will make an overview on mechanism of cardiac injure caused by uremia toxin, secondary hyperparathyroidism, calcium-phosphorus metabolic disorder, rennin-angiotensin-aldosterone system.