Objective To investigate the clinical effect of low frequency electrical pulse therapy combined with α-lipoic acid on diabetic gastroparesis in elderly patients with type 2 diabetes.Methods A total of 65 patients diagnosed as diabetic gastroparesis were selected from our hospital and divided into three groups according to random number table:the control group(n =23,the α-lipoic acid treatment),the conventional treatment group (n =16),and the experimental group (n =26,treating with α-lipoic acid combined with low-frequency electrical pulse therapy).All patients received the conventional diabetic therapy.Clinical effects,gastric emptying rate and serum gastrin(GAS) and fasting blood glucose levels were compared before versus after treatment among the three groups.Results The cure and total effective rates were higher in the experimental group than in the control group [46.15％ (12 cases) vs.30.43％ (7 cases),80.76％ (20 cases) vs.65.21％ (15 cases),x2 =0.867,P＜0.05].There were significant differences in gastric emptying rate,serum gastrin and fasting plasma glucose levels among the 3 treatment groups before versus after treatment.And the gastric emptying rate and serum gastrin level were better improved in the experimental groups compared with the conventional treatment and control groups.Conclusions The low-frequency electrical pulse therapy combined with α-lipoic acid has a significant clinical efficacy,which can improve clinical effects,promote gastric emptying,decrease fasting plasma glucose levels in elderly patients with type 2 diabetes.

The antioxidative capability and Na+-K+-ATPase α1-subunit mRNA expression in myocardium of hypothyroid rats induced by low-iodine diet were observed. The results showed that the antioxidative capability of myocardium decreased, resulting in lipid peroxidative damage, atrophy of myocardial cells and chondrification of tunica intima, along with decreased expression of sodium pump α1 subunit mRNA in hypothyroid rats.

Objective To observe the association between homocysteine (Hcy)level and low limb vascular disease(LLVD) in newly-diagnosed type 2 diabetic patients. Methods The study subjects were divided into three groups : control group (NC), newly-diagnosed type 2 diabetes group without peripheral artery disease (T2DM) and peripheral artery disease with newly-diagnosed type 2 diabetes group (T2DM+LLVD).Both Hcy and the ankle-brachial index(ABI) were measured in three groups. Results Compared with NC group, clinical parameters of body mass index,waist-to-hip ratio,systolic blood pressure, total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),and glycated hemoglobin A1C (HbA1c) increased markedly,and the content of high density lipoprotein-cholesterol (HDL-C) was markedly lower in both T2DM and T2DM+LLVD groups.In T2DM+LLVD group the contents of Hcy,LDL-C and HbA1c were markedly higher than in T2DM group,but the content of HDL-C decreased significantly.Hcy was independently associated with the development of peripheral artery disease in newly-diagnosed type 2 diabetic patients by logisitic regression analysis. Conclusions Increased Hcy is an independent risk factor for peripheral artery disease in newly-diagnosed type 2 diabetes.

Objective To investigate the influence of depression on glycemic control in the patients with type 2 diabetes mellitus(T2DM).Methods The Zung self-rating depression scale(SDS) was used to assess depression.A total of 276 cases of T2DM were divided into the group A(SDS standard score ≥53 points) and B(SDS standard score ＜53points).The levels of HbA1c,FPG,HOMA-IR,etc.were compared between the two groups,and the influencing factors of glycemic control in T2DM patients were analyzed.Results In the patients with T2DM,the SDS standard score was correlated with HbA1c(r=0.26,P＜0.05).The multivariate regression analysis showed that the SDS standard score was still correlated with HbA1c (β =0.30,t =5.1,P＜ 0.05).The HbA1c level in the group A was higher than that in the group B(t=3.685,P＜0.05);after correcting the factors of sex,age and education,the HbA1c level in the group A was still higher than that in the group B(F=47.8,P＜0.05).Conclusion The depression mood is adverse to glycemic control in T2DM patients.

Objective To investigate the abnormal region of gray matter and its' structural changes closely related to mild cognitive impairment in patients with Parkinson's disease (PD) using voxel-based morphometry(VBM) method.Methods Thirty-seven clinically defined PD patients and 20 normal controls (NC),collected in our hospital from March 2011 to February 2013,were examined using T1WI three-dimensional brain volume sequence (3D-fast spoiled gradient echo,3D-FSPGR).We classified PD patients into 2 subgroups according to the extent of cognitive impairment:20 patients with mild cognitive impairment (MCI) and 17 patients with none mild cognitive impairment (nMCI).The data of three groups were analyzed using VBM based on SPM5 to generate gray matter map.Results As compared with NC group,PD patients showed extensively decreased gray matter volume,involving bilateral frontal,temporal,occipital and parietal lobes,insular,parahippocampal gyrus,amygdale and right uncus.As compared with PD-nMCI patients,decreased gray matter volume in PD-MCI patients was observed in bilateral midfrontal gyrus,inferior frontal gyrus,bilateral insular,left precentral gyrus,left superior temporal gyrus and right midtemporal gyrus.Conclusions Areas of decreased gray volume in PD patients locate in widespread brain regions involving limbic system and neocortex.Gray matter atrophy in bilateral midfrontal gyrus,inferior frontal gyrus,insular and left precentral gyrus is related to the mild cognitive impairment.

Objective:To investigate the coverage rate and the adverse reactions of National Immunization Program vaccines in children with spinal muscular atrophy (SMA).Methods:A cross-sectional retrospective cohort study was carried out from July 2016 to June 2019, 192 children (116 boys and 76 girls) with SMA registered by Capital Institute of Pediatrics and 191 healthy children (115 boys and 76 girls) vaccinated in Chaoyang Olympic Village Community Health Service Center from July 2016 to December 2018 were included. Questionnaire survey was designed to investigate the vaccination coverage rate and associated adverse events. The t-test and χ 2 test were used to compare the difference between SMA patients and healthy children. Results:The coverage rate of age-appropriate immunization in SMA children was 62.0% (119/192) in general, and were 52.2% (12/23), 55.7% (68/122), and 83.0% (39/47) for SMA type 1-3 patients, respectively (χ 2=12.23, P=0.002). The vaccination coverage rates of Bacillus Calmette-Guerin (BCG) vaccine, the 3 rd dose of hepatitis B, the 3 rd dose of polio, the 3 rd dose of diphtheria-pertussis-tetanus, the 1 st dose of meningococcal polysaccharide group A, the 1 st dose of measles or measles and rubella vaccine, the 1 st dose of Japanese encephalitis vaccine, hepatitis A, measles-mumps-rubella, and group A+C meningococcal polysaccharide vaccine were 100.0% (192 cases), 94.3% (181 cases), 81.8% (157 cases), 88.5% (170 cases), 83.9% (161 cases), 76.6% (147 cases), 80.2% (154 cases), 68.2% (131 cases), 69.8% (134 cases), 54.7% (105 cases), respectively. Among the 73 patients who did not have their planned immunization completed, 57 cases (78.1%) gave up the vaccination due to parents′ concern of potential aggravation of their disease, and 16 cases (21.9%) had the plan discontinued by the immunization department because of the disease. Fever, local redness and swelling were the most common side-effects after vaccination both in SMA patients and healthy children (19.8% (38/192) vs. 18.8% (36/191) , χ 2=0.055, P=0.815). The main abnormal reactions of vaccination were rash and neurovascular edema, without significant difference between these two groups (2.6% (5/192) vs. 3.7% (7/191), χ 2=0.355, P=0.551). The coverage rate of Influenza and pneumococcal vaccine in SMA patients were 22.4% (43 cases) and 31.8% (61 cases), respectively. The incidence of pneumonia in the SMA patients decreased from 59.0% (23/39) to 41.0% (16/39) after vaccination. And none of the Influenza vaccinated patients had the flu in the year of vaccination. Conclusions:The coverage rate of National Immunization Program vaccines in the SMA children is low, especially in type 1 SMA patients, which is mainly due to their guardians′ concern of potential adverse events, even though the incidence of adverse reactions is similar in SMA patients and healthy children. Influenza and pneumococcal vaccine can reduce the risk of pneumonia and flu in children with SMA effectively.

Objective:To explore the causes of in premature infants with gestational age of 28 to 34 weeks in Neonatal Intensive Care Unit (NICU) , and to observe the influence of interruption of enteral nutrition, parenteral nutrition replacement or abandonment events on the clinical outcome of premature infants.Methods:A retrospective study was used to select 310 premature infants with gestational age of 28 to 34 weeks who were admitted to NICU of Children's Hospital of Shanxi (Women Health Center of Shanxi) and hospitalized for enteral nutrition and parenteral nutrition from January to June 2019. The effect of interruption on the clinical outcomes of premature infants was statistically analyzed.Results:All 310 preterm infants had received more than 24 hours of enteral nutrition support during the NICU. A total of 280 cases (397 times) of enteral nutrition interruption occurred, for a total of 4 367 hours. Among 280 premature infants with interruption of enteral nutrition, the interruption time of enteral nutrition in 123 premature infants was longer than 12 h/d, and the interruption time of enteral nutrition in 157 cases was less than 12 h/d. There were significant differences in time to regain birth weight, duration of ventilator use, average length of hospital stays, incidence of parenteral nutrition replacement or abandonment, and incidence of extrauterine growth retardation among premature infants with different duration of enteral nutrition interruption ( P<0.05) . Conclusions:The nutritional status of premature infants with gestational age of 28 to 34 weeks in NICU is not ideal during hospitalization. Feeding intolerance, iatrogenic manipulation, necrotizing enterocolitis, out-of-care examinations, rescue, and surgery are the main causes of nutritional interruption. Among them, the nutritional interruption time >12 h/d has a greater impact on the clinical outcome of preterm infants. It is recommended that preterm infants need reasonable and standardized enteral nutrition and parenteral nutrition during the NICU, and actively promote breastfeeding of preterm infants to promote the efficiency of enteral nutrition in preterm infants, improve the ability of preterm infants to resist infection, and reduce the occurrence of extrauterine growth retardation Rate, and ultimately achieve the goal of reducing the morbidity and mortality of premature infants.

Objective:To retrieve, evaluate, and integrate the evidence from both domestic and international sources on the management of artificial airways in children.Methods:All evidence on the management of artificial airways in children, including clinical decisions, evidence-based guidelines, expert consensus, best clinical practice manuals, evidence summaries, systematic reviews and so on was retrieved through computer on UpToDate, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-based Healthcare Center Database in Australia, Guidelines International Network, National Guideline Clearinghouse, American Association for Respiratory Care, PubMed, Medline, CINAHL, China Biomedical Medline Disc, China National Knowledge Infrastructure, WanFang Data, Medlive, and other databases and websites. The search period was from database establishment to April 30, 2022. We evaluated the quality of the included literature, extracted and integrated evidence, determined the level of evidence recommendation.Results:A total of 24 articles were included, including four clinical decisions, six evidence-based guidelines, one systematic review, six expert consensus, one evidence summary, one industry standard, four best clinical practice manuals, and one original study. Finally, 36 recommendations were summarized from five aspects, including artificial airway establishment, airbag management, airway humidification, endotracheal suction and prevention of complication.Conclusions:Artificial airway management in children is crucial for the treatment of critically ill children. The summary of the best evidence can provide a theoretical basis for the standardized management of artificial airways in children.

The impact of maintenance therapy on progression?free survival and overall survival as well as quality of life of Chi?nese patients with metastatic colorectal cancer has long been under discussion. Recently, some phase III clinical trials have revealed that maintenance therapy can signiifcantly prolong the progression?free survival while maintain an acceptable safety proifle. Based on this evidence and common treatment practice in China, we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the neces?sity of maintenance therapy, suitable candidates for such treatment, and appropriate regimens.

Epidemic cerebrospinal meningitis shows a high degree of consistency with the law of transmission among wei （卫）-qi-ying （营）-blood， in terms of the onset of the season， contagiousness， symptoms， pathogenesis， as well as characteristics of the transmission. It is proposed to use epidemic cerebrospinal meningitis as an example to explore the underlying disease of wei-qi-ying-blood syndrome differentiation system. Epidemic meningitis invades the brain from the upper respiratory tract along the nervous system， and its overall pathogenesis follows from entering the lung system （prodromal period） to entering the blood （bacteremia period， sepsis period） and then entering the brain （shock period）. According to the four-dimensional qualitative principle of epidemic pathogen tropism， it corresponds to disease of both wei and qi syndrome， then blazing of both qi and ying syndrome， and then heat blocking pericardium， exuberant heat stirring wind， and internal block and external collapse syndrome. This article explored the laws of transmission among wei-qi-ying-blood and its underlying diseases described in On Warm Heat （《温热论》）， and revealed the original appearance of the disease model under the laws of transmission among wei-qi-ying-blood to guide the clinical practice.