Objective To observe the treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia,and to explore its possible mechanism.Methods One hundred cases of acute cerebral infarction hemiplegia in our hospital from January 2013 to June 2016 were selected and divided into the rehabilitation training group (50 cases) and control group (50 cases).The control group was given the routine medication therapy and the rehabilitation training group was given early rehabilitation training on the basis of conventional medication therapy.The functional independence assessment (FIM),Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) were used to evaluate the therapeutic effect of early rehabilitation training.The level of stromal cell-derived factor-1α (SDF-1α) in peripheral blood was measured by enzyme linked immunosorbent assay,and the level of CD34+KDR+ in peripheral blood was measured by flow cytometry.Results There was no statistically significant difference in the FIM total score,FIM sports function score,FMA score,MBI score,SDF-1α and CD34+KDR+ levels before treatment between the rehabilitation training group and the control group (P>0.05).After treatment,the FIM total score,FIM sports function score,FMA score,MBI score and SDF-1α and CD34+KDR+ levels of the rehabilitation training group were higher than those of the control group,the differences were statistically significant (P<0.05).Conclusion The effect of early rehabilitation training on acute cerebral infarction patients with hemiplegic is remarkable.The mechanism may be related to promoting the expression of SDF-1α and CD34+KDR+ in peripheral blood.

Objective To investigate the calcium dobesilate tablets combined with mecobalamin injection in treatment of diabetic peripheral neuropathy and effects on oxidative stress and neurotrophic factor.Methods 82 cases of diabetic peripheral neuropathy(DPN) patients from February 2015 to October 2016 in our hospital were selected and randomly divided into observation group and control group with 41 cases in each group.The control group was treated with mecobalamin injection, the observation group were treated with calcium dobesilate tablets.The course of treatment was two weeks in two groups.Results The total efficiency of the observation group (90.24%) was higher than the control group (68.29%) , the difference was statistically significant ( P<0.05 ) , patients in the observation group after the treatment of common peroneal nerve and median nerve SCV and MCV higher than the control group, the difference was statistically significant (P <0.05), the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control group and the level of superoxide dismutase ( SOD) in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05), the levels of serum NGF and BDNF in the observation group were higher than those in the control group, the difference was statistically significant (P<0.05), the two groups were no obvious adverse reactions.Conclusion Calcium dobesilate tablets and mecobalamin injection curative effect in the treatment of diabetic peripheral neuropathy , and patients could improve oxidative stress and neurotrophic factors, and the safety is good, has the important research significance.

Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.

Objective:To observe the clinical effect of vitrectomy, inner limiting membrane (ILM) peeling, subretinal injection of compound electrolyte intraocular irrigation solution (CEIIS) and conbercept in the treatment of diabetic macular edema (DME) with hard exudate (HE) (DME-HE).Methods:A prospective clinical study. Thirty-three patients with DME-HE diagnosed by examination in Weifang Eye Hospital from June 2020 to February 2022 were included in the study. Among them, there were 15 males (16 eyes) and 18 females(20 eyes), with the mean age of (62.00±6.54) years. All patients underwent the examinations of best corrected visual acuity (BCVA), scanning laser ophthalmoscope, optical coherence tomography (OCT), and multifocal electroretinography (mf-ERG). Snellen visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for statistic analysis. Macular foveal retinal thickness (CMT) and macular volume (MV) were measured by OCT. The 1 ring P1 wave amplitude density was measured by mf-ERG. The patients were randomly divided into group A and group B, with 17 patients (18 eyes) and 16 patients (18 eyes), respectively. There were no significant differences in age, logMAR BCVA, HE area, CMT, MV, and 1 ring P1 wave amplitude density between the two groups ( t=0.403, 0.972, 0.291, 0.023, -0.268, -0.206; P>0.05). Group A was treated with vitrectomy, ILM peeling, and subretinal injection of CEIIS and conbercept (combined therapy). Group B was treated with intravitreal injection of conbercept (IVC). Follow-up was 12 months after treatment. The changes of BCVA, HE area, CMT, MV, 1 ring P1 wave amplitude density were compared between groups and groups after treatment. The times of injection and complications after treatment were observed. Independent sample t test was used for comparison between the two groups. Results:At 12 months after treatment, compared to before treatment, there were significant differences in logMAR BCVA ( F=14.837), HE area ( χ2=94.522), CMT ( χ2=199.212), MV ( χ2=81.914) and 1 ring P1 wave amplitude density ( F=8.933) in group A ( P<0.05); there were significant differences in CMT ( F=5.540) and MV ( F=7.836) in group B ( P<0.05). Compared between the two groups, logMAR BCVA: 1 week and 6 and 12 months after treatment, the difference was statistically significant ( t=2.231, -2.122, -3.196; P<0.05); HE area: except 1 week after treatment, there were statistically significant differences at other times after treatment ( t=-2.422, -3.107, -3.540, -4.119; P<0.05). CMT, MV, 1 ring P1 wave amplitude density: 12 months after treatment, the differences were statistically significant ( t=-2.653,-2.455, 2.204; P<0.05). During the follow-up period, the injection times of group A and group B were (3.06±1.89) and (5.56±2.04), respectively, and the difference was statistically significant ( t=-3.815, P<0.05). Macular hole and vitreous hematoma were found in 1 eye in group A and 1 eye in group B. Conclusion:Vitrectomy, ILM peeling, subretinal injection of CEIIS and conbercept to treat DME-HE can effectively remove HE, alleviate macular edema, improve BCVA, and reduce CMT and MV. Combination therapy can reduce the number of IVC re-treatments.

Objective:To study and analyze the application effect of risk prevention and quality control nursing in peritoneal dialysis patients with renal failure.Methods:From January to December 2019, a total of 86 patients with renal failure in the Affiliated Hospital of Jining Medical College were recruited as the research objects by convenient sampling method. All the objects were divided into the observation group (43 cases) and the control group (43 cases) by the random number table method. The control group was treated with traditional risk prevention and control nursing, while the observation group was treated with risk prevention and control quality control nursing. The changes of albumin, hemoglobin, creatinine, blood urea nitrogen were compared between the two groups before and after intervention, and the incidence of complications such as peritonitis, catheter outlet infection, water retention and hypokalemia were compared between the two groups.Results:After the intervention, the albumin and hemoglobin levels of the observation group were higher than those of the control group, and the levels of creatinine and urea nitrogen in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . During the intervention, the complication rate of the observation group was 23.26% (10/43) , which was lower than 46.51% (20/43) of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Risk prevention and quality control nursing in peritoneal dialysis patients with renal failure can improve renal function and reduce the occurrence of complications.

Objective:To explore the effect of case management model based on WeChat on self-care ability and condition status of patients with chronic nephritis.Methods:From January 2020 to February 2022, convenience sampling was used to select 110 patients with chronic nephritis who were treated in the Department of Nephrology, Affiliated Hospital of Jining Medical University. The patients were divided into groups according to the different wards they lived in. The control group consisted of inpatients in the first ward and the research group of inpatients in the second ward, with 55 patients in each group. The control group received routine continuous nursing guidance, while the research group adopted the case management model based on WeChat on the basis of the control group. We compared the self-care ability, negative emotions, and renal function between the two groups.Results:Before nursing, the scores of the Elderly Self-Care Ability Scale (ESCA), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the indicators of renal function [serum creatinine (Scr), blood urea nitrogen (BUN), and 24 hours urine protein (24 h UP) ] were compared between the two groups, and the differences were not statistically significant ( P>0.05). After nursing, ESCA scores such as health knowledge, self-care skills, self-care responsibility, and self-concept in the two groups were higher than those before nursing, and those of the research group were higher than those of the control group, with statistical differences ( t=4.650, 2.250, 3.052, 3.434; all P<0.05). The GAD-7 score and PHQ-9 score of the two groups after nursing were lower than those before nursing, and those of the research group were lower than those of the control group, with statistically significant differences ( t=8.207, 3.464; all P<0.05). After nursing, the renal function indicators such as SCR, BUN, and 24 h UP in the two groups were lower than before nursing, and those of the research group were lower than those of the control group, with statistically significant differences ( t=2.831, 2.797, 2.228; all P<0.05) . Conclusions:Applying the case management model based on WeChat to patients with chronic nephritis can improve their self-care ability, alleviate their negative emotions, promote improvement in their condition.