Objective To investigate risk factors of Alzheimer's patients with aspiration pneumonia and inter-vention,to provide a reference for clinical treatment.Methods From January 2013 to June 2014,322 patients with Alzheimer's disease were selected,the incidence of aspiration pneumonia was analyzed,and the age,gender,depression Tian water test grading,underlying diseases,aspiration and other potential factors were analyzed to get risk factors of aspiration pneumonia,and summarized countermeasures.Results Multivariate analysis showed that underlying disea-ses (95%CI =1.694 -5.319,P =0.011),invasive procedures(95%CI =1.884 -6.362,P =0.001),depression Tian water test grade(95%CI =2.184 -9.636,P =0.000),malnutrition(95%CI =2.501 -11.114,P =0.000), Glasgow Coma Scale(95%CI =1.271 -3.569,P =0.011),were risk factors for Alzheimer patients with aspiration pneumonia(P <0.05).Conclusion Alzheimer's patients with inhalation pneumonia have multiple risk factors,more expectoration should be done for caring,e.g.oral care,in order to reduce the probability of pneumonia.

Objective To investigate the inhibition effect of insulin on apoptosis of myocardial mitochondria in type 2 diabetic rats and its anti-apoptotic mechanism through its action on the mitochondria.Methods Type 2 diabetes mellitus (T2DM) was reproduced in male Wistar rats by intraperitoneal injection of streptozotocin (STZ,25mg/kg) and feeding with a high-fat diet.Twenty-two rats were randomly divided into three groups:the early treatment group (IE,n=7),the late treatment group (IL,n=7) and the diabetic group (DM,n=8).Another eight rats were chosen to constitute the control group.Novolin 30R was hypodermically injected into the rats in IE group in the first week and in IL group in the 4th week.Rats in DM group and control group were subcutaneously injected with an equivalent volume of normal saline.All groups were treated for eight weeks.At the end of the experiment,SOD,MDA,GSH levels,apoptotic index,mitochondrial membrane potential (?m),active oxygen and the changes in myocardial ultrastructure were compared among different groups.Results Compared with control group,blood glucose and HW/BW were higher (P

Objective To investigate the rituximab plus bendamustine (R-Benda) therapeutic effect for relapsed extragastric mucosa-associated lymphoid tissue (MALT) lymphoma.Methods Ten patients (three females and seven males) with relapsed extragastric MALT lymphoma undergoing therapy with R-Benda were defined.Bendamustine was given at a dose of 90 mg/m2 on days 2 and 3 in nine patients and at 70 mg/m2 in one patient, while all received 375 mg/m2 rituximab on day 1.Results Nine patients received six courses of therapy,while one patient discontinued therapy after five courses for personal reasons, while one elderly patient had progressive disease after three courses.Tolerance of therapy was excellent, and all except one patient responded.Eight patients achieved the complete remission, one achieved the partial remission, and one patient progressed.Toxicities were mild and mainly hematological.After a median follow-up of 24 months (range, 5-43 months), 9 patients were alive.Conclusion R-Benda regime has high activity and good tolerance for patients with relapsed extragastric MALT lymphoma.

OBJECTIVE:To promote rational drug use clinically. METHODS:Sampling rate of prescriptions in outpatient and emergency departments was no less than 1‰ of total prescriptions and no less than 100 prescriptions were reviewed every month;the sampling rate (according to the hospital records of discharge) of ward (district) doctor’s advice was no less than 1% and no less than 30 prescriptions were reviewed every month. According to drugs evaluation indicators of rational drug use,the prescrip-tions were analyzed statistically,immediate intervention and administrative intervention were adopted for irrational prescriptions and medical orders. RESULTS:The average qualified rate of outpatient prescriptions was 97.86%and 0.92%was non-standard prescrip-tions,1.20% was inappropriate prescriptions and 0.01% was extraordinary prescriptions. The non-standard prescriptions in the sec-ond half year were significantly lowered,with statistical significance(P<0.05). The inappropriate usage and dosage was not effec-tively controlled. The average qualified rate of medical orders was 96.30% and drug replacement withont any reference and incom-plete diagnosis in the second half year were significantly lowered,with statistical significance(P<0.05). The utilization rate of an-tibiotics in emergency department was 41.51%and the other indicators were basic standard. The qualified rate of Majing drugs’pre-scriptions was 81.60%and non-standard prescriptions accounted for 88.37%in the irrational prescriptions. CONCLUSIONS:Imme-diate intervention and administrative intervention have achieved some success. Immediate intervention has mainly reduced the non-standard prescriptions and administrative intervention has controlled some specific irrational prescriptions.

Objective To investigate the expression and meaning of Bcl-2 and S100A6 protein in human uterine smooth muscle tumors. Methods Immunohistochemical technique was used to detect the Bcl-2 and S100A6 protein ex-pressions:30 usual leiomyoma (UL),10 leiomyosarcoma (LMS) and 30 cellular leiomyoma (CL). Results The positive Bcl-2 protein expression rate of UL and CL was apparently higher than that of LMS (P<0.05),the Bcl-2 protein ex-pression were statistical difference in UL and CL; the positive S100A6 protein expression rate of LMS was apparently higher than that of UL(P<0.05),the positive S100A6 protein expression rate of LMS was apparently higher than that of CL(P<0.05). Conclusion The expression of Bcl-2 or S100A6 protein may play an important role in the occurrence and development of human uterine smooth muscie tumors.

This study was aimed to establish a separation method for neochlorogenic acid reference substances from Lonicera japonica. Refined neochlorogenic acid inL. japonica water extract was separated and concentrated by HPD200A macroporous resin, which was isolated and purified by medium-low-pressure preparative chromatography and determined by HPLC. The structure was identified by various spectroscopic data including ESI-MS,1H-NMR and13C-NMR. The results showed that the optimal purification technology conditions were as follows: washed with 5BV of water, collected elution, concentration, drying; neochlorogenic acid crude products were eluted with acetonitrile-0.5% formic acid solution (10:90) with the flow rate of 20 mL·min-1; and the detection wavelength was 326 nm. The contents of the prepared neochlorogenic acid reached to 98.86% and the yield was 89.1%. It was concluded that the method was effective for the preparation of neochlorogenic acid with high purity. It can be used to prepare the reference substances for quantitative analysis and content determination of Chinese materia medica.

Objective To investigate the efficacy of concomitant precise hemihepateetomy for the treatment of hilar cholangiocarcinoma.Methods The clinical data of 38 patients with hilar cholangiocarcinoma who received concomitant precise hemihepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University from January 2009 to October 2012 were retrospectively analyzed.All patients were examined by B ultrasonography,computed tomography (CT),magnetic resonance cholangiopancreatography (MRCP) and CT angiography (CTA)preoperatively.The hepatic function was tested before operation.Of the 7 patients with obstructive jaundice,5 received percutaneous transhepatic cholangial drainage,and 2 received endoscopic nosalbiliary drainage.Surgical procedures were determined according to the results of imaging examination.The resection of hilar cholangiocarcinoma,postoperative histopathological examination,pre-and postoperative hepatic function and prognostic indicators were analyzed.The count data and measurement data were analyzed using the chi-square test and t test,respectively; the survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.COX proportion hazards model was used for multivariate analysis.Results The positive rates of B ultrasonography,CT and MRCP were 65.8％ (25/38),71.1％ (27/38) and 89.5％ (34/38),respectively.The results of 5 patients who received CTA were positive.Concomitant left hemihepatectomy was performed on 28 patients,concomitant right hemihepatectomy on 10 patients; concomitant caudate lobectomy on 22 patients,concomitant resection and reconstruction of portal vein on 4 patients (including 1 patient who received left hepatic vein repair),concomitant hepatic artery resection on 12 patients (including 3 patients who received hepatic artery reconstruction).Of the 38 patients,R0 resection was performed on 32 patients,R1 resection on 4 patients,R2 resection on 2 patients.Hepatic function indicators including total bilirubin,direct bilirubin,alkaline phosphatase,gamma-glutamyl-transferase,alanine aminotransferase and aspartate aminotransferase were significantly decreased after operation (t =7.799,8.445,5.697,6.633,4.469,4.140,P ＜ 0.05).Two patients died perioperatively,with the mortality rate of 5.3％ (2/38).The main postoperative complications included bile leakage and hepatic function insufficiency,with the incidences of 28.9％ (11/38) and 21.1％ (8/38),respectively.Postoperative histopathological findings included 31 patients with invasive adenocarcinoma,5 patients with nodular adenocarcinoma,1 patient with mucinous adenocarcinoma and 1 patient with adenosquamous carcinoma.The overall 1-,2-,3-year survival rates were 66％,37％ and 21％,and the median survival time was 22.0 months.There were significant differences in the survival rates between patients who received R0 resection and those with R1/R2 resection,and between patients with N0 and N1/N2 stage (x2 =4.516,10.397,P ＜ 0.05).The results of multivariate analysis showed that positive margin and lymph node metastasis were prognostic indicators.Conclusions Concomitant precise hemihepatectomy has significantly improved the radical resection rate and the efficacy of treatment for hilar cholangiocarcinoma.Comprehensive preoperative imaging examination and hepatic function test are important for the assessment for resectability of hilar cholangiocarcinoma.Selective preoperative biliary drainage are key points to decrease postoperative morbidity and morality.

Objective: To analyze the status and correlation between screen time, screen behavior type, and anxiety, depression among children and adolescents in Jiangxi Province, so as to provide a basis for effective intervention measures. Methods: Using the method of stratified random sampling, 8 851 primary and secondary school students in 11 districts of Jiangxi Province were investigated by questionnaire during September to December in 2020. Anxiety and depression status were investigated using the State Trait Anxiety Inventory (STAI) and the Center for Epidemiological Studies Depression Scale for Children(CES-DC), respectively. Single factor analysis using χ 2-test, t-test,analysis of variance,and multivariate analysis using generalized linear models. Results: On school days and weekends, 4.7% and 20.4% of primary and secondary school students in Jiangxi Province had a total screen time of over 2 hours per day, respectively. The weighted scores of the total screen time (primary school students: 1.88± 0.68, junior middle school students: 1.96±0.71, high school students: 2.03±0.80) and time spent for playing video games (primary school students: 1.51±0.64, junior middle school students: 1.62±0.69, high school students: 1.68±0.75) daily showed an upward trend with the increase of educational stage ( F =31.48, 42.13), and with significantly higher in boys (1.97±0.74, 1.66± 0.72) than girls (1.93±0.72, 1.53±0.66)( t =2.48, 9.07)( P <0.05). The average scores of state anxiety and trait anxiety were (42.20±9.05) and (40.65±9.85), which showed an upward trend with the increase of educational stage ( F =168.12, 241.98 ), and were higher in girls than boys ( t =6.63, 8.48)( P <0.01). The average score of depression was (11.99±11.00), which was lower in elementary school students than middle school students and high school students ( F =136.42), with significantly higher in girls ( t =6.85)( P <0.01). On school days, with the increase of total screen time and time spent for playing video games daily, the risk of state anxiety, trait anxiety, and depression among primary and secondary school students significantly increased ( OR = 6.70- 818.98, P <0.01). On weekends, among primary and secondary school students, the total screen time of >1-2 hours daily reduced the risk of state anxiety ( OR =0.30). The risk of developing trait anxiety among students playing video games for more than 2 hours daily was 2.50 times higher than those without screen behavior ( OR =2.50). The risk of developing depression with a total screen time of more than 2 hours daily was 3.15 times higher those whithout screen behavior ( OR =3.15). The risk of developing depression among students playing video games >0-1, >1-2, >2 h daily was 2.14, 2.50, 4.90 times that of those without screen behaviors ( OR =2.14, 2.50, 4.90), and showed an upward trend with the increase of educational stage ( P <0.05). Conclusions Screen behaviors of primary and middle school students in Jiangxi Province are positively associated with the risk of anxiety and depression, but the total daily video time of >1-2 h on weekends was negatively associated with state anxiety. It is necessary to control the screen time as much as possible and reduce the risk of anxiety and depression.

Objective:To know the current situation of kinesiophobia in patients after cardiac surgery under cardiopulmonary bypass, and to clarify its influencing factors, so as to provide reference for developing intervention strategies to improve kinesiophobia level.Methods:This was a cross-sectional study. From February 2022 to September 2022, the patients after cardiac valve surgery under cardiopulmonary bypass in the Second Affiliated Hospital Zhejiang University School of Medicine were investigated by convenience sampling methods. The survey was conducted using the General Information Questionnaire, The Tampa Scale for Kinesiophobia Heart, Exercise Self-Efficacy Scale, Pain Catastrophizing Scale, and Adaptation, Partnership, Growth, Affection and Resolve(APGAR) as research tools, and the influencing factors were analyzed using univariate and binary Logistic regression analysis.Results:A total of 219 patients were included, of which 97 patients (44.3%) had kinesiophobia. The results of binary Logistic regression analysis showed that monthly family income level, first time out of bed after operation, fear of falling, the family APGAR, and pain catastrophizing were significant influencing factors of kinesiophobia in patients after heart valve surgery under cardiopulmonary bypass (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among patients after heart valve surgery under cardiopulmonary bypass. Clinicians should pay attention to patients with low monthly family income level, late first time out of bed after surgery, and fear of falling, as well as strengthen communication with patients and families, focus on the management of acute postoperative pain. In order to reduce or avoid the occurrence of kinesiophobia and enable patients to benefit from early ambulation.