Objective To investigate the effect of enteral nutrition on the improvement of the nutritional status and prevention of complications in elderly stroke patients with eating difficulties,and provide theoretical guidance for clinical treatment.Methods Eighty-two cases of elderly stroke patients with eating difficulties after stroke were randomly divided into two groups by the time of admission,41 cases in control group were given with parenteral alimentation,and 41 cases in treatment group were given with enteral nutrition.Before treatment and 3 weeks after treatment triceps skinfold (TSF),arm muscle circumference (AMC),serum hemoglobin (Hb),albumin (ALB),serum total protein (TP),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),total cholesterol (TC) and fasting plasma glucose (FPG) was measured,and the incidence of complications was observed.Results The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in control group was significantly lower than that before treatment (P ＜ 0.05),but in treatment group compared with that before treatment there was no significant difference (P ＞ 0.05).The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in treatment group was significantly higher than that in control group (P ＜ 0.05).The incidence of complications in treatment group was signifcanfly lower than that in control group [36.6％ (15/41) vs.78.0％ (32/41)] (P ＜ 0.05).Conclusions Enteral nutrition is conducive to the nutritional status of elderly stroke patients with dysphagia improvement,and can greatly reduce the incidence of complications,and improve survival rate.It is worthy of promotion.

Objective:To analyze the ultrasound and CT imaging findings of medullary soonge kidney, to improve the diagnosis level of medullary soonge kidney.Methods: Fourty cases confirmed by pathology or clinical were divided into two groups, group A: 20 cases by B ultrasonic examination, group B: 20 cases by CT examination, The two groups of imaging data were retrospectively analyzed.Results: Ultrasound examination reveals strong echo mass or strong echo plague in the renal medulla, radiate out along the renal pyramid, Strong echo edge is coarse, same size, within small anechoic areas. MSCT finds multiple small mottled stones in the cone. Enhanced scan finds contrast agent filling around renal collecting duct stones, presents visible stripes or small cystic contrast agent accumulation when no stones in renal collecting duct. CT diagnosis coincidence rate is slightly higher than that of ultrasounds, but there was no significant differences in positive rate(x2=2.057,P>0.05).Conclusion: Medullary sponge kidney has a typical ultrasound, CT performance. A combination of them is conducive to clinical diagnosis.

Aim: To develop marine microporous osmotic pump tablets and to investigate drug release in vitro of the optimized formulation and the release mechanism.Methods: Wet granulation and film-coating were used to develop marine micro-osmotic pump tablets.In vitro release studies were applied to evaluate the impacts of various factors on the release of the formulation.Central-composite design was exploited to aid the optimization of the formulation,and the mechanism of in vitro release was characterized.Results: There existed fairly good reproducibility in the preparation of marine micro-osmotic pump tablets.It was found that no change in the release rate of the tablets were elicited by the pH of the release media,the rotating speed selected,the hardness of the tablet core,and the amount of the plasticizer incorporated into the coating formulation.It was proved that the release of marine micro-osmotic pump tablets was closely related to the magnitudes of NaCl amount in the tablet core and the pore former in the coating formulation as well as the coating level.In addition,there existed 12-hr zero-order kinetics in the in vitro release study of the tablets.Moreover,it was shown that the osmotic pressure-controlled delivery is greatly responsi-ble for the release of the developed tablets.Conclusion: The prepared marine microporons osmotic pump tablets are expected to be a new sustained-release medication.

Objective Study the imaging characteristics of spontaneous intracranial hypotension(SIH) and the effect of epidural infusion treatment.Methods Clinical data of one patient with SIH was retrospective analysis.Results The patient presented with symptoms of postural headache,nausea,vomiting;pressure of cerebrospinal fluid(CSF) couldn't be measured.Cranial MRI found typical subdural fluid collections,diffuse thickening of the pachymeninges with enhancement,engorgement of venous sinuses,enlargement of the pituitary gland,and downward displacement of the brain.High-resolution CT myelography precisely located the site of CSF leak.Epidural infusion of normal saline relieved immediately the symptom of intracranial hypotension.Conclusions The imaging characteristics of SIH includes engorgement of venous sinuses,diffuse thickening of the pachymeninges with Gd enhancement,subdural fluid collections.The treatment with epidural infusion for SIH is very effectual.

Objective To investigate the clinical effect of psychological intervention combined with insulin, glimepiride in the treatment of patients with diabetes mellitus. Methods 60 cases of patients with diabetes treated in our hospital from January 2015 to January 2017 were divided into two groups.The control group was treated with routine nursing intervention and insulin treatment, the observation group was treated with psychological intervention+insulin+glimepiride therapy; The clinical efficacy and clinical symptoms in the two groups were compared. Results The clinical effect of the observation group was better than that of the conventional control group,the clinical symptoms improved was better than the control group, the difference was statistically significant (P<0.05). Conclusion The clinical effect of psychological intervention+insulin+glimepiride in the treatment of diabetes is significantly, can effectively improve the clinical symptoms of patients, is widely used in clinical treatment of patients with diabetes.

Objective To explore the application and effect of psychological intervention in stimulating intravenous infusion of drugs in neurology department. Methods In the control group, the patients in the neurology department selected appropriate stimulant drugs according to their actual conditions, and the patients in the study group received psychological intervention on the basis of stimulating drugs and intravenous treatment. Records the two groups of neurology patients treatment compliance, before and after treatment of neurological function changes, the data into the SPSS software, after statistical analysis, and draw conclusions. Results Before treatment, two groups of neurology patients were compared with the NIHSS scale score; after the treatment of nerve function improvement (NIHSS scale decline) than the control group, the study group (P<0.05). Department of neurology patients with complete compliance (82.61%) was significantly higher than the control group (50.00%, P<0.05). Conclusion On the basis of stimulating drugs intravenous infusion in the treatment of Neurology, patients with targeted psychological intervention can significantly improve the treatment compliance, and is conducive to the protection of patients with drug treatment effect.

Objective To evaluate the cost-effectiveness of four therapeutic regimes in the treatment of pa-tients with initial vulvovaginal eandidiasis. Methods 160 patients who were found for the first time with vulvovagi-hal eandidiasis were divided into four groups randomly: group A is clotrimazole (500rag) vaginal tablets; group B is fluconazole eaptica;group C is clotrimazole vaginal tablets combined with flueonazole;group D is nystatin vaginal ef-fervescent tablets. Date was evaluated using clinic economies co,t-effectiveness analysis. Results Among four groups,the costs for group A,B,C and D were 167.20 yuan, 190.23 yuan,237.43 ynan and 216.40 yuan,respec-tively. The tatol effective rates were 90.88 %, 90.12 %, 91.67 % and 67.10 %, respectively. The cost-effectiveness ratio were 1.84,2.11,2.59 and 3.23, respectively. The incremental cost-effectiveness ratios of group B, C and D vs group A were 32.90,87.78 and 2.07. Conclusion Regime A was superior than the other therapeutic regimes.

Although coronary heart disease (CHD) and stroke share important risk factors,some associations differ between these two components of cardiovascular diseases.The objective of this study was to compare vascular risk factor profiles and in-hospital outcomes in acute stroke (AS) and acute myocardial infarction (AMI) patients.Methods We evaluated 383 consecutive patients who were admitted to the 94th Hospital of Chinese PLA and the Third Hospital of Nanchang with diagnoses of AS (ischemic stroke or intracerebral hemorrhage;n = 310) or AMI (n = 73) during a 2-year period.The frequency of risk factors and inhospital mortality rates were assessed in both groups.Results AS patients were significantly older than AMI patients ( 68.9 ± 9.1 years vs.62.8 ±11.7 years;P ＜ 0.01).AMI was significantly more common than AS in patients younger than 65 years;51% of this group had AMI and 26% had AS (P ＜ 0.001).Hypertension was more common in AS patients than in AMI patients (69% vs.58%;P = 0.042).Patients who died did not differ significantly in age between the groups.In-hospital mortality rates were significantly higher in AS than AMI cases (31% vs.12%,P ＜ 0.001 for all patients;37% vs.5%,P ＜ 0.001 for men).Women hospitalized for AMI were more likely to die in hospital than men (28% vs.5%;P = 0.002).Conclusions Patients with stroke and with AMI differ in their risk factor profile.Age at the time of presentation was a significant differentiating factor between patients with AS and AMI.We observed significantly higher in-hospital mortality for patients with AS (when adjusted for age) than for patients with AMI.(J Geriatr Cardiol 2008;5:223-226)

Objective To study the clinical effect of tacrolimus combined with small dose of prednisolone in treatment of IgA nephropathy.Methods 84 cases with IgA nephropathy were randomly divided into study group and the control group in accordance with the digital table method.The control group was given simple hormone treatment, while the study group was treated with tacrolimus combined with small dose of prednisolone.The clinical efficacy and safety were compared between the two groups.Results The treatment effective rate (100.00%)and complete remis-sion rate (73.81%)of the study group were significantly higher than those in the control group (76.19%, 23.81%),and the differences were statistically significant (χ2 =21.01,11.35,P <0.05 ).After treatment,24h urinary protein level was significantly decreased compared with before treatment.24h urinary protein level[(0.54 ± 0.41)g/L]of the study group was significantly lower than the control group[(1.06 ±0.62)g/L],and the difference was statistically significant (t =4.01,4.58,3.87,all P <0.05).In addition,before and after treatment,the serum creatinine,blood sugar,white blood cells,cereal third transaminase,SBP and DBP levels between two groups had no significant differences (P >0.05).When patients lighter (Lee's Ⅱ level),the team for complete response rate was significantly higher than the control group,and the difference was statistically significant (χ2 =5.01,P <0.05 ). However,with the aggravation of pathological damage (Lee),the effective rate and complete remission rate of the study group and the control group showed a downward trend.The effective rate and complete remission rate of the study group were higher than those in the control group,but the differences were not statistically significant (χ2 =1.03,2.11,1.20,1.20,all P >0.05).The incidence rate of adverse reactions in the study group (19.05%)was not significantly different from that of the control group (16.67%)(χ2 =0.08,P >0.05 ).Conclusion Tacrolimus combined with small dose hormone for the treatment of IgA nephropathy has high clinical value,it can significantly reduce the level of IgA nephropathy 24h nephropathy,and adverse reactions.

OBJECTIVE To compare mycophenolate mofetil(MMF) with azathioprine(AZA) addition to ciclosporin-prednisone protocol after kidney transplantation in aspect of infections,and to study the etiology of pulmonary infection and urinary tract infection in the two groups.METHODS Totally 249 patients with kidney transplantation were analyzed retrospectively.These patients were divided into two groups according to the immunosuppressive regimen: AZA group(89 patients),and MMF group(160 patients).The various infectious complications were analyzed during a 1-year follow-up,and the etiology of pulmonary infection and urinary tract infection was studied in the two groups.RESULTS The total incidence of the infections,the incidences of the pulmonary infection,urinary tract infecion,wound infection,and so on,during a 1-year follow-up,were equivalent between the two groups.But the incidence of ARDS and the mortality of patients with lung infection was significantly different.The etiology of pulmonary infection was different between the two groups.Cytomegalovirous and fungal infections were higher in MMF group than those in AZA group.Also the etiology of urinary tract infection was different,the incidences of Gram-positive bacterial and fungal infections were higher in MMF group than those in AZA group.CONCLUSIONS Comparing with AZA,MMF increased the opportunity of serious lung infection.The incidences of opportunistic infection and fungal and viral infections increased obviously in MMF group.So therapy should be individualized and aimed.