In this article we reviewed Gastrointestinal disorders (FGIDs) complicated with Psychological problems and proposed the strategies for the intervention and management of FGIDs with Psychological problems,including awareness-cultivating,skill-learning,treatment and follow-up in clinical practice.

OBJECTIVE To investigate the clinical features of nosocomial acquired pneumonia in elderly patients with apoplexy.METHODS A retrospective study was carried out to investigate the clinical data of 724 elderly patients with apoplexy in Department of Neurology during Jan 1st,2003 to Dec 31st,2005.RESULTS The nosocomial acquired pneumonia rate was 12.26%.The nosocomial infection rate in patients with cerebral hemorrhage and cerebral infarction was 23.79% and 6.48%,respectively.The incidence rate of nosocomial acquired pneumonia was related positively to long time in hospital,underlying disease severity,consciousness,swallow,preventive antibiotic therapy and diabetes.CONCLUSIONS More attention should be paid in clinical treatment and nursing care in order to lowering the occurrence of the nosocomial acquired pneumonia.

Objective To explore the effect of compound sophora flavescens injection on intraperitoneal chemotherapy of cisplatin in malignant ascites of gastric cancer patients and its influence on immune function.Methods 90 cases with malignant ascites of gastric cancer failures were researched,who from May 2014 to May 2016.According to random number table, they were divided into observation group and control group, 45 cases in each group.The control group was treated with intraperitoneal chemotherapy of cisplatin alone, and the treatment group was treated by intraperitoneal chemotherapy with compound Kushen injection combined with cisplatin.The two groups of patients before and after treatment, compared the level of immune function indicators, while observing the two groups of patients after treatment, short-term efficacy, quality of life improvement and adverse reactions.Results Observation group of patients with efficient and control rates were higher than the control group patients, but no obvious difference between groups.The stability factor of 55.55%of patients with observation group was obviously higher than that of control group 22.22%of the patients, the clear difference between groups (P<0.05).Before the treatment, two groups of patients of CD3 +, CD4 +, CD8 +and CD4 +/CD8 +T cell subsets and NK cells was no significant difference.After treatment, two groups of patients of CD3 +, CD4 +, CD4 +/CD8 + T cell subsets and NK cells were significantly increased than before treatment ( P<0.05 ) , and CD8 + than before treatment significantly reduced ( P <0.05 ) , while the observation group of CD3 +, CD4 +, CD4 +/CD8 +T cell subsets and NK cells was significantly higher than that of control group ( P <0.05 ) , and CD8 + was significantly lower than control group (P <0.05).The control group in the improvement of quality of life of patients with effective rate of 35.55%compared with 80.00% of the observation group of patients, significantly lower, more obvious differences between groups (P <0.05).Observation group of patients the incidence of gastrointestinal reaction and liver function abnormalities were 0.00%, 8.88%, significantly lower than the control group patients were 11.11%, 22.22%, there exists significant difference between groups (P <0.05).Fatigue, nausea, vomiting and 2 groups of patients compared the incidence rate of no significant difference.Conclusion The combined use of compound Kushen injection combined with cisplatin intraperitoneal perfusion chemotherapy in patients with malignant ascites of gastric cancer for treatment,effect is remarkable,Can effectively improve the patient's T cell subsets and NK cells,Improve the patient's immune function.

Objective To study the efficacy and safety of short segmental pedicle instrumentation via the paraspinal approach for the management of neurologically intact patients with thoracolumbar burst fracture and posterior ligamentous complex injury.Methods From October 2008 to June 2010,70 such patients were treated in our department.They were 44 males and 26 females,with an average age of 33.4 years (range,from 19 to 55 years).They were divided into 2 groups according to 2 different operative methods.In group A,35 patients were treated via the paraspinal approach while 35 patients in group B were treated via the traditional open approach.The 2 approaches were compared in terms of operation time,intraoperative bleeding,postoperative ambulant time,hospital stay,changes in local kyphosis angle (LKA) and vertebral body height (VBH) at preoperation,postoperation and the last follow-up,postoperative complications and accuracy of screw insertion.Results The time for follow-up ranged from 24 to 36 months (mean,29.3 months).The operation time,intraoperative bleeding,postoperative ambulant time and hospital stay in group B were significantly more than in group A(P ＜ 0.05).No implant failure occurred in either group.There was no significant difference in pedicle screw cut-out between the 2 groups [7 (5.0％) versus 6 (4.3％)] (P ＞0.05).The LKA and VBH increased significantly at postoperation and the last follow-up compared with the preoperation in both groups (P ＜ 0.05),but there was no significant difference between the postoperation and the last follow-up (P ＞ 0.05).There were no significant differences between the 2 groups regarding LKA and VBH at preoperation,postoperation and the last follow-up (P ＞ 0.05).Conclusion The paraspinal approach may result in a good and safe clinical outcome in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury,because it can maintain the fracture reduction effectively and minimize the iatrogenic injury to soft tissues.

ObjectiveTo explore the role of autofluorescence bronchoscopy in lung cancer operation and the meaning of choice lung cancer operation mode.MethodsTo retrospectively analyze 32 non-small cell lung cancer patients.Before lung cancer operation,white light bronchoscopy (WLB) and autofluorescence bronchoscopy (AFB) had been done routinely.Compared the different invasive tumor conditions by WLB and AFB,operation modes were decided by the edge of the tumor which were proved by biopsy pathology.ResultsIn 32 cases,19 cases underwent pulmonary lobectomy.One case underwent carinal resection and reconstruction.8 cases underwent sleeve lobectomy.4 cases underwent other therapy because of tumor airway metastasis.In 8 cases which underwent sleeve lobectomy,3 ca ses were found by WLB and AFB together,5 cases were found only by AFB.In 4 cases who had no operation chance,2 cases were found by WLB and AFB together,2 cases were only by AFB.The sensitivity for the detection of bronchial premalignant lesions was extremelyhigher withthe addition of AFB than WLBalone ( P ＜ 0.05 ).ConclusionAutofluorescence bronchoscopy is a safe and efficient technique which could improve the sensitivity of diagnosis in lung cancer than WLB.It is important to select operation mode.

Combined with the features of neurology,this article discussed the assessing processes for quality postgraduates in neurology from four aspects: clinical skills,creative ability,ability in using English,ability of communication between doctors and patients.It also elaborated the purpose and meanings of setting the assessing goal,selecting assessing items and establishing criterion of the assessing items.

Objective:To describe the status of subjective well-being among junior high school students in a city of Jiangxi Province and to explore the relationship between family functioning and subjective well-being.To explore the relationship between growth environment and subjective well-being among ju-nior high school students in the perspective of family functioning and to provide basis and data for the mental health education among junior high school students.Methods:630 students in a junior high school in Jiangxi Province were sampled by stratified cluster sampling,and 103 junior high school students from 18 villages were sampled by household survey.They were investigated by subjective well-being scale for adolescents and Family Assessment Device.Results:(1)The overall subjective well-being of junior high school students was in the lower-middle level.Regarding all the dimensions of subjective well-being,they had the highest satisfaction on family and friendship,lowest academic satisfaction,low positive as well as passive emotion.(2)Girls had higher satisfaction on friendship and freedom than that of boys;children from families with more than one kids had more negative emotion than that of single child;boarding students had higher satisfaction on family,academics and freedom than that of non-boarding students;family residence and structure affected the satisfaction on family;grade and learning achievement affected some dimensions of subjective well-being among junior high school students.(3)Pearson correlation analysis and multiple linear regression analysis showed that some dimensions of family functioning were related to certain dimensions of subjective well-being among junior school students,and family functioning could predict the level of subjective well-being.Conclusion:The overall subjective well-being of junior high school students is in the lower-middle level,and further improving is needed.Family functioning has a great influence on junior school students' subjective well-being.Junior high school students who have healthy family functioning are more likely to have higher life satisfaction,and tend to experience higher subjective well-being.

Objective: To investigate the awareness of nutrition and health knowledge among adult residents in Hangzhou City, so as to provide insights into improving human nutrition and health. Methods: The permanent residents at ages of 18 to 64 years were sampled using a multi-stage stratified random sampling method from 13 counties (districts) of Hangzhou City from June to July, 2021. Participants' demographics and awareness of nutrition and health knowledge were collected using the Questionnaire on Nutrition and Health Knowledge among Chinese Adult Residents, and the awareness of nutrition and health knowledge was analyzed among participants with different demographic features. Results: A total of 5 106 questionnaires were allocated, and 4 920 valid questionnaires were recovered, with an effective recovery rate of 96.36%. The respondents included 2 575 men (52.34%) and 2 345 women (47.66%), and had a mean age of (39.89±12.85) years. The median score of nutrition and health knowledge was 67.50 (interquartile range, 16.50) points, and the awareness of nutrition and health knowledge was 24.49%, while the awareness of dietary recommendation, food characteristics, nutrition and disease, food choice and food safety was 15.89%, 16.77%, 54.17%, 26.36% and 60.69%, respectively. The awareness of nutrition and health knowledge was significantly lower among men than among women (21.01% vs. 28.32%, P<0.05), and among urban residents than among rural residents (22.94% vs. 27.34%, P<0.05). There were significant differences in the awareness of nutrition and health knowledge among residents in terms of age, occupation and educational level (P<0.05). Conclusions Age, gender, region, occupation and educational level may affect the awareness of nutrition and health knowledge among adult residents in Hangzhou City. Health education about nutrition and health knowledge requires to be reinforced with adaptations to characteristics of residents.

Objective To analyze the balance function of injured lower lim b by dynam ic posturography. Methods Using the dynam ic posturography instrum ent, the postural evoked responses of sixty-two norm al people and two hundred and fifty-eight people with injured lower lim b bones and joints were detected. The test was included sensory organization test(SO T) and adaption test(ADT).The results of two groups were com pared by t test. Results Com pared with the norm al people, the im paired people had significant statistical differences in balance scores of SO T3-SO T6 and proportion score of dynam ic proprioception (P<0.05). There was no obvious decrease in ADT. Conclusion The balance function of injured lower lim b significantly decreases.

Objective To evaluate proximal gastric function in patients with functional dyspepsia (FD) met Rome Ⅲ criteria and its subtypes.Methods Thirty FD patients were enrolled,including 15 patients with postprandial distress syndrome (PDS) and 15 patients with epigastric pain syndrome (EPS).A total of 30 healthy volunteers were recruited as control.All the subjects received barostat examination.Minimal distending pressure (MDP),pressure and volume of thresholds for first sensation and maximal tolerance for gastric sensitivity were recorded.When the pressure level was MDP+2 mmHg (1 mmHg=0.133 kPa),average volume at 30 minutes before meal,averaged volume at 60 minutes after meal and maximum accommodation volume after meal were recorded,and receptive diastolic volume was calculated.The gastric hypersensitivity and impaired accommodation were observed.Student's t test or x2 test was performed for statistical analysis.Results MDP,pressure of first-sensation,maximum sensation pressure,volume of first sensation and maximal sensation volume of FD group were (6.17 ±1.95) mmHg,(8.44±2.01) mmHg,(14.62±3.72) mmHg,(123.59±53.26) mL and (451.26±140.44) mL,respectively; which were lower than those of healthy control group ((9.27±1.99) mmHg,(12.04±2.66) mmHg,(19.74±4.18) mmHg,(168.41±73.06) mL and (556.89±124.07) mL),and the differences were statistically significant (t=-6.080,-5.900,-5.011,-2.723 and-2.995,all P＜0.01).The averaged volume at 30 minutes before meal and 60 minutes after meal was (212.19±120.82) mL and (333.97±121.86) mL while those of healthy control group was (191.69±66.19) mL and (385.58±83.05) mL,and there were no significant differences between the two groups (both P＞0.05).The maximum postprandial accommodation volume and receptive diastolic volume of FD group were (405.10±111.29) mL and (190.16±97.22) mL,which were lower than those of healthy control group ((461.10±87.60) mL and (262.83±78.39) mL),and the differences were statistically significant (t=-2.599 and-3.187,both P＜0.05).The maximum postprandial accommodation volume of FD patients was at 15 to 20 minutes after meal and in healthy control it was at five to ten minutes after meal.Among the 30 FD patients,12 patients (40 ％) had gastric hypersensitivity,including eight PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞0.05) ;nine patients (30 ％) had impaired accommodation,including five PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞ 0.05).Conclusions Gastric hypersensitivity and impaired accommodation often appear in FD patients,and there is no significant difference between PDS and EPS subtypes.FD patients with different pathophysiologic mechanisms cannot be efficiently distinguished according to Rome Ⅲ criteria.