Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on normal intestinal flora,fecal SIgA and infectious complications in patients with hypertensive intracerebral hemorrhage.Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition group (control group,n =26) and early enteral nutrition combined with synbiotics group (study group,n =27).The patients in control group started receiving enteral nutrition (RuiSu) within 24 to 48 hours after injury ; Patients in study group received a enteral nutritional support which as well as control group,but added synbiotics (Golden Bifid) in the first 14 days of enteral nutritional support.Stool specimens were Collected on day 0,day 4,day 8,day 15 of enteral nutrition support for quantitative analysis of normal intestinal flora and detection of stool SIgA through enzyme-linked immunosorbent assay.The difference of two groups in infectious complications were observed.Results On nutritional support day 8 and day 15,escherichia coli (P =0.004,P =0.004) and enterococci (P =0.032,P =0.048) expression were lower in study group than the control group,bifidobacteria (P =0.046,P =0.024) expression were higher in study group than the control group.During the study period lactobacillus,bacteroides and clostridium were no statistically significant between the two groups (P ＞ 0.05).Fecal SIgA expression in study group was higher than control group (P =0.035) on nutritional support dayl5.The incidence of infectious complications in study group was lower than the control group (33.33％ vs.46.15％),but there was no significant difference (P =0.230).Conclusion compared with ordinary enteral nutrition,enteral nutrition combined with synbiotics agents can be effective in improving intestinal flora imbalance and increase intestinal immune function in patients with hypertensive intracerebral hemorrhage.

Objective: To investigate association between psychosocial factors and anxious and depressive disorders in patients with diabetes mellitus. Methods: 172 patients with type 2 diabetes were inquired with a self-administered questionnaire about their socio-demographic characteristics, perceived stress caused by the disease, coping styles, social support. At the same time, anxious and depressive disorders were assessed with HAD.Results:Among our sample, 35 (20.3%) patients with anxiety, 33 (19.2%) with depression. After adjusting for gender, age, marital status, educational level and income, multivariate logistic regression analysis found the following results. Perceived stress from "Worrying about to be harmed by the disease"(OR=1.76,95%CI 1.12~2.77),"Social/family crisis caused by the disease"(OR=1.85, 95%CI 1.18~2.92),"Worrying about declining in body/physical function"(OR=2.16, 95%CI 1.28~3.67), "Declined economic condition"(OR=2.03,95%CI 1.27~3.26)and "Negative coping styles"(OR=1.94,95%CI 1.26~2.97)were significantly associated with anxious disorders. The perceived stress from "Social/family crisis caused by disease"(OR=1.79, 95%CI 1.09~2.96), "Worrying about declining in body/physical function"(OR=2.89, 95%CI 1.59~5.24)and "Negative coping styles"(OR=1.95,95%CI 1.23~3.11)were significantly associated with depressive disorders, while patients "Taking avoidant measures"(OR=0.52, 95%CI 0.30~0.90)were less depressive disorders.Conclusion: Anxious and depressive disorders in patients with 2 type diabetes were significantly associated with patients' perceived stress from the disease and their coping styles.

Objective To evaluate the effects of transtheoretical model and motivational interviewing on medication?compliance in patients with percutaneous coronary intervention (PCI) post-operation. Methods One hundred patients with PCI post-operation were randomized into the observation group (n = 50) and the control group (n = 50). The medication compliance, 6-min walk test and major adverse cardiovascular events (MACE) were compared between two groups. Results At 1 month, 3 months and 6 months post-intervention, the medication compliance in the observation group was significantly increased (P < 0.05, respectively). The 6-min walk test in the observation group was significantly increased compared with the control group. The MACE rate in the observation group and the control group was 10.0% and 36.0%, respectively, with significant difference (P< 0.05). Conclusion The transtheoretical model and motivational interviewing can effectively increase the medication compliance, improve the postoperative rehabilitation, and decrease the MACE rate.

Human height, a complex trait with over 80% heritability, is determined by genetic and environment factors. Currently, a certain amount of specific variants about human height have been found, especially with the widely used of genome-wide association studies (GWAS) in genetics research, making it a great progress for the discovering of height associated genes. However, single nucleotide polymorphisms (SNPs) found by GWAS can only explain a minority of the heritable. This article reviews the progress of GWAS about height associated genes and missing heritability domestic and overseas.

Objective To study influence of nursing intervention on pain and satisfaction degree of pa-tients after lower limb fracture. Methods 200 patients of lower limb fracture were divided into the experi-mental group and the control group randomly with IOO patients in each group. Routine nursing was given to the contrtol group and special nursing intervention besides routine nursing to the experimental group. Pain and sat-isfaction degree was compared between the two groups and the results underwent χ2 test. Results The pain degree in the experimental group was much less than that of the control group, the satisfaction degree of the ex-perimental group was much higher than that of the control group. Conclusions Nursing intervention can re-liege pain degree of patients with lower limb fracture,make them go through postoperation pain stage and in-crease satisfaction degree with nursing.

Objective To investigate the relationship between serum prolactin(PRL) level and neonatal seizures and to evaluate the clinical significance of PRL as a neonatal seizures marker to diagnose neonatal seizures. Methods Thirty five newborn infants with acute encephalopathy were divided into two groups: the ictal group included infants with typical clinical symptom and/or electrographic seizures and the nonictal group are those without electrographic seizures or clinical behaviors. The control group included 17 newborns. Serum PRL levels were determinded by immulite assay system at 15～30 min postictally; 2 h postictally and 2～4 days after the end of seizures. Results In the ictal group, serum PRL levels were significantly higher at 15～30 min[(302.6?93.5) ?g/L] than that of 2 h [(128.1?71.4) ?g/L], nonictal[(101.2?31.4)?g/L and (89.9?36.2) ?g/L] and control group[(73.3?20.7) ?g/L and (68.6?29.5)?g/L], P

Objective: To study the preoperative blood glucose management model and its implementation effect in the multidisciplinary team of ophthalmology under the background of diagnosis related groups (DRGs). Methods: A total of 170 patients underwent vitrectomy, vitreous injection, and cataract extraction surgery were enrolled in the CS03Z and CS09A groups from January 1, 2018 to December 31, 2018. The cases from January 1, 2018 to June 31, 2018 were in the control group, accounting for 76 cases, and routine blood glucose management was performed. The cases from July 1, 2018 to December 31, 2018 were observed in the observation group, and 94 cases were implemented. The multidisciplinary blood glucose management model was implemented. The average hospitalization days, average hospitalization costs, preoperative blood glucose management quality, and hospitalization satisfaction were compared between the two groups. Results: In the control group, the average hospitalization cost of the three operations (PPV/IV/Phaco group) was (13 949.71±2 099.36) yuan, (4 933.22±2 269.33) yuan, (6 521.16±1 006.40) yuan, the average hospitalization cost of the three operations of the observasion group was (12 937.37±1 447.33) yuan, (2 649.53±1 105.92) yuan, (5 315.76±1 037.02) yuan, the difference between the two groups was statistically significant (t=2.266, 3.818, 4.074, all P<0.05 or 0.01) . The average hospitalization day of the 3 operation group was (9.98±3.91) d, (9.63±5.46) d, (7.65±3.88) d, and the observation group was (6.37±3.54) d, (3.97±2.29) d, (4.17±2.23) d,the difference between the two groups was statistically significant (t=3.980, 3.979, 3.632, all P<0.01). The preoperative blood glucose accident rate in the control group was 14.47% (11/76), The observation group was 2.13% (2/94), the difference between the two groups was statistically significant (χ²=11.642, P<0.01). The surgical delay rate of the control group was 2.63% (2/76) ; the surgical delay rate of the observation group was 0(0/94), the difference between the two groups was statistically significant (χ²=7.045, P<0.01) .The nurse blood glucose management of the control group was 66.67% (24/36) , and that in the second half was 97.22% (35/36) ,the difference between the two groups was statistically significant (χ²=9.005, P<0.01). The satisfaction rate of the patients in the control group was 82.89% (63/76), and that of the observation group was 94.68% (89/94). the difference between the two groups was statistically significant (χ²=6.166, P<0.05). Conclusion Under the background of DRGs, the preoperative multidisciplinary blood glucose management team with clinical pathway as the core can effectively reduce the average hospitalization cost and average hospitalization day, improve the quality of blood glucose management, and improve the hospitalization satisfaction of the patients.

ObjectiveTo analyze the clinical characteristic of the nasal type extranodal NK/T cell lymphoma(ENKL)as well as the therapeutic effects for different treatment methods and element that would affect prognosis.MethodsReview and analyze the 27 patients with pathologically confirmed ENKL patients received radiotherapy (3 cases),chemotherapy (9 cases),combination of radiotherapy and chemotherapy (15 cases),3 of whom received auto-HSCT.Detailed B symptoms,lactate dehydrogenase (LDH),performance status(PS)scores,international prognostic index(IPI),Ann Arbor stage and therapeutic modality were included in univariate analysis.ResultsThe average overall survival time was 32 (2-42) months.The 1,2and 3 year overall survival (OS) rates were 79.5 ％,71.6 ％,53.7 ％,respectively.The 2-year overall survival of patients who was early stage (stage Ⅰ + Ⅱ ) was 83.3 ％,and those who was advanced stage(stage Ⅲ+Ⅳ) was 62.3 ％ (P =0.368).Among the patients in early stage,after radiotherapy or chemotherapy,4 cases achieved OR (overall response) which is complete remission (CR) or partial remission (PR),9/10 in combination of radiotherapy and chemotherapy achieved OR. While among those in their advantage stage,the OR in chemotherapy is 2 cases,2/5 in combination of radiotherapy and chemotherapy.In univariate analysis,age and short-term response were main factors of survival(P ＜0.05).ConclusionTo treat the nasal ENKL in the early stage,radiotherapy can achieve a better effect,while combination of radiotherapy and chemotherapy is an important method for patients in advantage stage.Age and short-term response may be.prognostic factors of nasal type ENKL.

This study was aimed to optimize the extraction process of double-marker components for Arctium lappa L. The central composite design and response surface methodology was used. According to 3 main factors, the extraction rates of arctiin and arctigenin was used as evaluation indexes. Multiple linear regression and two-order polynomial equation were used. The binomial fitting model was performed in the optimization of arctiin and arctigenin extraction technology. The results showed that the indentified optimized extraction technology of arctiin and arctigenin was 70% ethanol, 24-fold, ultrasonic solvent extraction for 15 minutes. It was concluded that this technology was able to extract large amount of arctiin and arctigenin, which provided experiment evidences for arctiin and arctigenin preparation. It also provided references for the development and utilization of arctiin and arctigenin.

Objective:To observe the changes of the structure and visual function of the retina in patients with or without the ectopic inner foveal layers (EIFL) and to explore the factors influencing the recovery of visual function in patients with idiopathic epimacular membrane (IMEM).Methods:A retrospective clinical study. From March 2015 to June 2019, 90 patients with MEM who were diagnosed by Ophthalmic Center of the Second Hospital of Hebei Medical University were enrolled in the study. All patients were examined by best corrected visual acuity (BCVA) and frequency domain optical coherence scan. BCVA was recorded by Snellen vision table, and it was converted into the minimum resolution angle logarithm (logMAR) vision. Among 90 eyes, IMEM grade 2-4 was 68 (75.6%, 68/90), 18 (20.0%, 18/90), 4 (4.4%, 4/90), respectively. According to this, the grade 2 was set as group A, and the grade 3 and grade 4 were combined to group B. There was no significant difference in age ( t=0.015), sex composition ratio of patients between two groups ( χ2=0.060) and the average of central macular thickness (CMT) ( F=2.277) ( P=0.904, 0.809, 0.141). The difference of average logMAR and BCVA was statistically significant ( F=35.913, P=0.000). All patients underwent 25G pars plana three channel vitrectomy with simultaneous removal of epiretinal membrane and internal limiting membrane. BCVA, CMT and improvement of IMEM grading were observed at 1, 3, 6 and 12 months after operation. BCVA, EIFL thickness and CMT were compared before and after operation by single factor repeated variance analysis; Fisher exact probability method was used to compare the changes of the anatomical structure of the eyes in the two groups at 12 months after operation. Results:1, 3, 6, 12 months after operation, the average eyes of logMAR BCVA in group A were 0.50±0.13, 0.38±0.12, 0.27±0.12, 0.19±0.10. The patients in group B were 0.66±0.14, 0.60±0.13, 0.54±0.14, 0.52±0.14. CMT in group A were 364.82±81.29, 281.65±72.45, 228.55±55.34, 182.84±56.13 μm. The patients in group B were 455.88±69.60, 440.18±68.65, 383.76±65.38, 371.39±66.60 μm. The difference was statistically significant in the two groups (BCVA: F=37.913, 11.479, 24.250, 39.013; P=0.000, 0.002, 0.000, 0.000. CMT: F=10.987, 39.610, 55.789, 79.987; P=0.002, 0.000, 0.000, 0.000). In group A, IMEM was improved to 57 eyes of grade 1 on 12 months after operation. Among the 18 eyes in group B, IMEM was improved to 1 and 3 eyes in level 1 and level 2, respectively, and no improvement was found in 4 eyes in grade 4. The difference was statistically significant ( P=0.000) in the improvement of the number of eyes in the two groups. Conclusions:The patients with IMEM without EIFL have better visual prognosis and reversible anatomical changes. EIFL is an important factor affecting the visual function and anatomical structure recovery after operation.