Objective To explore the safety of enteral nutrition(EN)support in non-blood circulation disorders of elderly patients with intestinal obstruction.Methods A total of 40 patients (22 men and 18 women aged 62-84 years)with intestinal obstruction were enrolled in this study.Ileus tubes were rapidly placed in these patients with the assistance of endoscopy and X-ray.Afterwards patients were equally randomized into parenteral nutrition(PN)and EN(PN+EN)group and PN only group.The clinical outcomes and complications were recorded and compared.Results The average time for catheter placement was(24.83 4±7.95)minutes.Abdominal pain were relieved within 1-2 hours in26 pafienta(65.0%)and within 48 hours in 11 patients(27.5%).In the PN+EN group,EN was provided(25.25±8.17)hours after catheter placement,and most patients could tolerate EN.Laboratory findings were not significantly different at admission between two groups.The mean prealbumin leveh were below than normal level at admission but returned normal after one week,which were significantly different inside each group(P<0.05)but were not significantly different between these two groups.The triglyceride leveh were higher than the normal level at admission but returned normal after treatment;however,the difference between the two groups was not significant.The laboratories tests were also not significantly different between two groups one week after admission.Conclusion EN support is safe for elderly patients with intestinal obstruction after effective gastrointestinal decompression.

Objective To observe the clinical efficacy of acupuncture by stages in treating post-stroke swallowing dysfunction. Method Sixty eligible patients were randomized into a staging-acupuncture group and an ordinary-acupuncture group, to respectively receive acupuncture by the stage of swallowing and ordinary acupuncture in addition to the basic treatments. Function estimation was conducted before and after intervention in both groups to compare the therapeutic efficacies.Result According to the water drinking test, the total effective rate was 83.3% in the staging-acupuncture group versus 53.3% in the ordinary-acupuncture group, and the difference was statistically significant by rank sum test (P＜0.05), and the staging-acupuncture group was superior to the ordinary-acupuncture group especially in the pharyngeal stage (P＜0.05); the differences were statistically insignificant in the oral stage and esophageal stage (P>0.05); regarding the video fluoroscopic swallowing study (VFSS), the staging-acupuncture group was significantly better than ordinary-acupuncture group in improving swallowing function (P＜0.05).Conclusion Acupuncture by swallowing stages is effective in treating post-stroke swallowing dysfunction, especially in improving the swallowing function in pharyngeal stage.

Objective To investigate the levels of lipoprotein associated phospholipase A2(Lp-PLA2),D-dimer(D-D),antithrombin Ⅲ (AT Ⅲ) in acute cerebral infarction (ACI)patients,and to analyzed their correlation with ACI.Methods Sixty-nine patients with ACI(ACI group) and 40 individuals undergoing healthy physical examination(control group) were selected in this study.The levels of Lp-PLA2,D-D and ATⅢ were compared between the two groups and their positive rates were statistically analyzed.Then the correlation between Lp-PLA2,D-D and ATⅢ with ACI was analyzed.Results The levels of Lp-PLA2 and D-D in the ACI group were higher than those in the control group,while the ATⅢ level was lower than that in the control group(P<0.05).Their positive rates in the ACI group were higher than those in the control group (P<0.05).Lp-PLA2,D-D and ATⅢ were correlated with ACI occurrence and had mutual correlation (all P<0.05).Conclusion Lp-PLA2,D-D and AT Ⅲ participate in the occurrence process of ACI,and their detection can be applied to screen out ACI high-risk groups,and may guide early prevention and early diagnosis of ACI.

Objective To explore the neural mechanism underlying the craving of heroin addicts induced by picture-cue and the correlation between the brain activation degree in nucleus accumbens (NAc)/the ventral striatum and the scores of patients' self-report craving. Methods Twelve active heroin addicts and 12 matched healthy controls underwent fMRI scan while viewing drug-related pictures and neutral pictures presented in a block design paradigm after anatomical scanning in GE 3.0 T scanner. The fMRI data were analyzed with SPM 5. The change of craving scores was tested by Wilcoxon signed rank test. The Pearson correlation between the activation of NAc/the ventral striatum and the heroin craving score was tested by SPSS 13.0. Results The craving scores of heroin addicts ranged from 0 to 3.70(median 0.15) before exposed to drug cue and 0 to 5.10(median 3.25) after viewing drug-related pictures and showed statistical significance(Z = -2.666, P < 0.05). There were 16 activated brain areas when heroin dependent patients exposed to visual drug-related cue vs. neutral visual stimuli. The activation brain regions belonged to two parts, one was limbic system (amygdale, hippocampus, putamen, anterior cingulate cortex and caudate), another was brain cortex (middle frontal cortex, inferior frontal cortex, precentral gyrus, middle temporal cortex, inferior temporal cortex, fusiform gyrus, precuneus and middle occipital gyrus). The MR signal activation magnitude of heroin addicts ranged from 0.19 to 3.50. The result displayed a significant positive correlation between the cue-induced fMRI activation in NAc/the ventral striatum and heroin craving severity (r=0.829, P < 0.05). Conclusion Heroin shared the same neural circuitry in part with other drugs of abuse for cue-induced craving, including brain reward circuitry, visualspatial attention circuit and working memory region. In addition, the dysfunction of NAc/the ventral striatum may attribute to heroin-related cue induced craving.

Objective To study associations between manganese superoxide dismutase 9 Ala/Val (Mn-SOD 9 Ala/Val)genet-ic polymorphism and total superoxide dismutase (T-SOD)and Mn-SOD activity and the impact on coronary heart disease (CHD)were studied.Methods There were 82 CHD patients and 57 controls in this research.Sequencer was used to identify the genotype of Mn-SOD 9 Ala/Val genetic polymorphism and colorimeter was used to detect the serum T-SOD and Mn-SOD activity.Results Compared with the control group,the serum T-SOD and Mn-SOD activity of the CHD group was significantly reduced(t=4.83,6.57,P all<0.05),while the VV genotype and V allele of Mn-SOD 9 Ala/Val genetic poly-morphism of the CHD group were higher (χ2 =4.75,P <0.05).The serum T-SOD and Mn-SOD activity of the Mn-SOD 9 VV genotype was significantly lower than the Mn-SOD 9 AA genotype(t=2.96,3.11,P all<0.05).Conclusion The ser-um T-SOD and Mn-SOD activity in the CHD patients was reduced.Mn-SOD 9 Ala/Val genetic polymorphism was involved in the pathogenesis of CHD by influencing the Mn-SOD activity.

Objective:To develop a prediction model based on imaging features by contrast-enhanced MRI radiomics combined with clinical features for early recurrence of hepatocellular carcinoma (HCC) after radical resection.Methods:A retrospective study was carried out on 109 HCC patients who underwent radical resection at the Fifth Affiliated Hospital of Wenzhou Medical University from January 2015 to December 2020. Of 109 patients enrolled in this study, there were 96 males and 13 females, aged (58.3±10.7) years. Based on whether there was recurrence within 12 months after operation, the patients were divided into the early recurrence group ( n=31) and the control group ( n=78). These 109 patients were then randomly divided into the validation set ( n=23) and the training set ( n=86) at a ratio of 1∶4. Based on preoperative multi-phase contrast-enhanced MRI scanning, the tumor lesions were delineated on the Radcloud platform, and 1 409 quantitative radiomic features were extracted. Dimension reduction and screening of these features were carried out using variance threshold, SelectKBest and LASSO. Combined with clinical features (alpha fetoprotein, tumor size), several prediction model were established through machine learning. The predictive efficiencies of these models were evaluated using the area under the receiver operating characteristic (ROC) curve, accuracy rate, recall rate and balanced F score. Results:The proportions of irregular tumor shape and unclear tumor boundary, as well as maximum tumor diameter in the early recurrence group were significantly higher than that in the control group, but the proportion of pseudocapsule was significantly lower than that in the control group (all P<0.05). A total of 465 features were screened from the 1 409 features using the variance threshold method, followed by 38 features were screened using the method of SelectKBest. Finally 7 optimal radiomic features were screened based on the LASSO method. When combined with clinical features, 5 prediction models were established through machine learning. These models were support vector machine, Gaussian naive bayes, logistic regression, Multinomial naive bayes and K-nearest neighbor (KNN), respectively. Among these 5 models, the prediction efficiency of the KNN model was relatively highest, with the area under the ROC curve, accuracy rate, recall rate and balanced F score being 0.90, 0.98, 0.74 and 0.84 in the training set, and 0.76, 0.92, 0.75 and 0.83 in the verification set, respectively. Thus, the KNN model was selected as the best prediction model in this study. Conclusion:The prediction model of KNN was developed for early recurrence of HCC after radical resection based on preoperative contrast-enhanced MRI radiomics combined with clinical features.