Objective To investigate the efficacy of acupuncture combined with doctor-nurse cooperation mode on stroke-associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treat-ment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium=19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P<0.05). In the test of dilute barium, the aspiration rate was lower in the treatment group than in the control group (χ2=4.03, P=0.044), however, there was no significant difference between 2 groups in the test of thick bari-um and solid food (P>0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.

Objecfive To analyze the relationship between aortic root dimension(ARD)and anterior circulation infarction(ACI)by measuring ARD of ACI patients.Methods The ARD of 110 ACI patients(56 men and 54 women)were measured with 2-dimensional uhrasonography during ventricular systole.66 control subjects(32 men and 34 women)without the clinical signs of cerebral infarction or organic heart disease and cardiac insufficiency were selected after carrying out detailed cage history inquiring.physical examination,CT or MRI and ultrasonic examination.ResultsARD in men and women Was respectively(29.80±2.35)mm and(28.88±3.06)mm in the ACI group.While it was(27.64±1.70)mm and(26.98±1.60)mm respectively in the control subjects.ARD in men and women was significantly higher in the ACI group as compared with the control subjects(P＜0.01).Logistic regression analysis indicated that the odds ratio(confidence interval)associated with ARD Was 1.630(1.205-2.204)in men and 1.494(1.098-2.033)in women for ACI.Conclusions There is a close relationship between ARD and ACI.ARD is an important risk factor of ACI.

Objectives To detect the carotid artery intima-media thickness (CIMT)with color Doppler ultrasound and to investigate the relationship between CIMT and new ischemic cerebrovascular disease. Methods From May 2012 to October 2013,the cluster random sampling method was used to consecutively enroll 4 412 60 -70 year old residences in Reqiu City for prospective study,including face to face health questionnaire survey,human body measurement,laboratory test,and neck vascular color Doppler ultrasonography. According to whether having new ischemic cerebrovascular disease,the patients who had ischemic cerebrovascular disease in 2013 were divided into either a case group (n = 251)or a control group (n =4 161). The single factor analysis,such as baseline data and CIMT levels in both groups were compared, and the related risk factors for ischemic cerebrovascular disease were analyzed. Results (1)The detection rates of hypertension,cerebrovascular disease,taking antiplatelet agents,carotid artery plaque of the case group were higher than those of the control group (62. 2% [n = 156]vs. 44. 2% [n = 1 838],45. 0%[n = 113]vs. 14. 9% [n = 622],55. 0% [n = 138]vs. 40. 0% [n = 1 663],and 65. 7% [n = 165]vs. 54. 5% [n = 2 266],all P < 0. 05). The systolic blood pressure,insulin,and CIMT levels were higher than those of the control group (158 [141,177]mmHg vs. 152 [137,169]mmHg,8. 07 [4. 77,12. 48]μU/ L vs. 6. 93 [4. 27,11. 60]μU/ L,0. 950 [0. 900,1. 000]mm vs. 0. 925 [0. 900,1. 000]mm,all P <0. 05). The cholesterol level was lower than that of the control group (4. 59 [4. 17,5. 26]mmol/ L vs. 4. 78 [4. 20,5. 36]mmol/ L,P < 0. 05). There were significant differences between the 2 groups. (2)Multivari-ate logistic regression analysis showed that histories of hypertension and cerebral vascular disease and CIMT thickening were the independent risk factors for new ischemic cerebrovascular disease (hypertension:OR, 1. 534,95% CI 1. 166 -2. 017,P = 0. 002;history of cerebral vascular disease:OR,3. 940,95% CI 2. 997 -5.180,P =0.000;and CIMT thickening:OR,12.122,95%CI 2. 327 -63. 163,P =0. 003). Conclusion CIMT, hypertension,and cerebrovascular disease are the independent risk factors for ischemic cerebrovascular disease in Renqiu City,and the monitoring of CIMT is very important.

Objective To investigate the hyperuricemia(HUA)and the correlation of blood lipids of the 60 -70years peple in Renqiu area,and to provide the basis for guiding prevention and treatment of the elderly disease the region.Methods According to the cluster random sampling method,Renqiu permanent residents with the age of 60 to 70 years were selected as a screening object.In the total 5 010 cases screened object,2 163 were male(43.2%),2 847 were female(56.8%),with an average age of(64.29 ±3.05)years.The data of blood uric acid and total cholesterol(TC), triglyceride(TG),high -density lipoprotein(HDL -C),low -density lipoprotein(LDL -C)were collected.The rela-tionship between blood uric acid and blood lipids were analyzed.Logistic regression method was used to analysis the relationship between the hyperuricemia and lipids components.Results The overall prevalence of hyperuricemia in Renqiu was 6.1%(9.8% in male,3.2% in female).In men HUA group,the levels of blood uric acid,TG and LDL-L were 464.10(438.00 -508.65)μmol/L,1.54(1.00 -2.19)mmol/Land 2.66(2.25 -3.22)mmol/L,which were higher than those of normal uric acid group of 294.00(249.90 -338.08)μmol/L,1.13(0.84 -1.65)mmol/L and 2.57(2.12 -3.01)mmol/L(P <0.05).In women HUA group,the levels of blood uric acid,TG and LDL -L were 454.15(434.15 -480.78)μmol/L,2.14(1.47 -3.18)mmol/L and 2.96(2.52 -3.76)mmol/L,which were higher than those of normal uric acid group of 250.80(209.00 -299.80)μmol/L,1.53(1.10 -2.20)mmol/L and 2.87(2.40 -3.33)mmol/L(P <0.05).Logistic multi -factor regression analysis showed that TG was an independ-ent risk factor for hyperuricemia,and that HDL -L and gender were protective factors.Conclusion Hyperuricemia is closely associated with blood lipid,especially with TG and HDL -L,so we could screening HUA by blood lipid,which can reduce the occurrence of cardiovascular disease effectively.

Objective To investigate waist-to-height ratio(WHtR) and body mass index(BMI) for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome(MS) in the elderly.Methods A cluster random sampling method was used.5 010 cases aged 60-70 years old of Renqiu permanent residents were selected as a screening subjects.The face to face health questionnaires,anthropometric measurements,and laboratory testing were conducted.Receiver operatiug characteristic (ROC) was used to analyze and calculate the area under the curve(AUC).Results WHtR predict the best point of tangency of MS were 0.54 (men),0.5 5 (women),BMI predict the best point of tangency of MS were 25.25kg/m2 (men),2 5.0 5 kg/m2 (women).In the same gender,the contrast of WHtR and BMI in predicts MS area under the curve,WHtR area under the curve of the larger,WHtR was higher than BMI,WHtR was a better indicator in predicted of MS.Conclusion WHtR and BMI have important roles in the screening and prediction of MS,and WHtR seems to be the best parameter in the screening and prediction of MS in the elderly.

Objective To investigate the relationship between snoring and newly-diagnosed type 2 diabetes mellitus among elderly urban and rural residents in Renqiu of Hebei province.Methods By random clustered sam-pling inspection,the residents aged 60 to 70 years old were selected in the study,the questionnaire investigation by an-thropometric measurements and laboratory tests were performed in 5 010 elderly people.Screen for 3 604 people who had no previous history of diabetes and currently not to control blood sugar by diet,exercise,medication.The average age was (64.32 ±3.06)years,including 1 608 male(44.6%) and 1 996 female cases(55.4%),snorers 994 cases (27.6%),non-snorers 2 610 cases(72.4%).The patients were followed up for one year.The correlation between snoring and newly-diagnosed type 2 diabetes mellitus was analyzed.Results There were 217 cases(6.0%) of new-ly-diagnosed type 2 diabetes mellitus,which accounted for 79 cases of snoring(36.4%),3 387 cases of non-dia-betic group,which accounted for 915 cases of snoring(27.0%),the difference between the two groups was significant (χ2 =9.003,P<0.05).Took the newly-diagnosed type 2 diabetes mellitus as the dependent variable,univariate analysis showed that gender(OR=0.479,95% CI:0.639~0.852),history of hypertension(OR=1.463,95% CI:1.111~1.927),family history of diabetes(OR=1.768,95% CI:1.259~2.183),history of stroke or TIA(OR=1.549,95%CI:1.106~2.168),central obesity(OR=1.658,95% CI:1.016 ~1.448),BMI≥28kg/m2 (OR=1.063,95% CI:1.025 ~1.102),fasting glucose(OR=2.065,95% CI:1.854 ~2.299),fasting insulin levels (OR=1.021,95%CI:1.008 ~1.035),cholesterol(OR=1.216,95% CI:1.051 ~1.407),triglycerides(OR=1.188,95%CI:1.089~1.296),snoring(OR=1.547,95% CI:1.161 ~2.060) were related with newly-diag-nosed type 2 diabetes mellitus.Multivariate logistic regression analysis showed that gender(OR=0.595,95% CI:0.368~0.963),history of stroke or TIA(OR=1.586,95%CI:1.085~2.318),fasting glucose(OR=2.059,95%CI:1.833~2.312),snoring(OR=1.592,95% CI:1.089~2.328) were independent risk factor for newly-diag-nosed type 2 diabetes mellitus.Conclusion People aged 60 to 70 in Renqiu suffered newly-diagnosed type 2 diabe-tes mellitus population prevalence of snoring, snoring is closely related to the occurrence and development of type 2 diabetes,type 2 diabetes is increased independent risk factor.Positive and effective screening and control on snoring can effectively reduce the incidence of type 2 diabetes.

Objective To perform a preclinical test of a delineation software based on atlas-based auto-segmentation (ABAS),to evaluate its accuracy in the delineation of organs at risk (OARs) in radiotherapy planning for nasopharyngeal carcinoma (NPC),and to provide a basis for its clinical application.Methods Using OARs manually contoured by physicians on planning-CT images of 22 patients with NPC as the standard,the automatic delineation using two different algorithms (general and head/neck) of the ABAS software were applied to the following tests:(1) to evaluate the restoration of the atlas by the software,automatic delineation was performed on copied images from each patient using the contours of OARs manually delineated on the original images as atlases;(2) to evaluate the accuracy of automatic delineation on images from various patients using a single atlas,the contours manually delineated on images from one patients were used as atlases for automatic delineation of OARs on images from other patients.Dice similarity coefficient (DSC),volume difference (Vdiff),correlation between the DSC and the volume of OARs,and efficiency difference between manual delineation and automatic delineation plus manual modification were used as indices for evaluation.Wilcoxon signed rank test and Spearman correlation analysis were used.Results The head/neck algorithm had superior restoration of the atlas over the general algorithm.The DSC was positively correlated with the volume of OARs and was higher than 0.8 for OARs larger than 1 cc in volume in the restoration test.For automatic delineation with the head/neck algorithm using a single atlas,the mean DSC and Vdiff were 0.81-0.90 and 2.73％-16.02％,respectively,for the brain stem,temporal lobes,parotids,and mandible,while the mean DSC was 0.45-0.49 for the temporomandibular joint and optic chiasm.Compared with manual delineation,automatic delineation plus manual modification saved 68％ of the time.Conclusions A preclinical test is able to determine the accuracy and conditions of the ABAS software in specific clinical application.The tested software can help to improve the efficiency of OAR delineation in radiotherapy planning for NPC.However,it is not suitable for delineation of OAR with a relatively small volume.

Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.

Objective To study the relationship between metabolic syndrome (MS) and anterior circulation infarction (ACI). Methods 271 ACI patients (166 men and 105 women) who fulfilled the diagnostic criteria of China Guideline for Cerebrovascular Disease Prevention and Treatment were enrolled. 147 control subjects (67 men and 80 women) without the clinical signs of cerebral infarction but with detailed case history, physical examination and CT or MRI were also selected. The prevalence and risk of MS were observed in the ACI and control group. MS was defined with the modified criteria in Chinese. Results The prevalence of MS in the ACI group and control subjects was respectively 43.17% and 19.05%. The prevalence of MS was significantly higher in the ACI group as compared with the control subjects (P<0.01). The component level of MS were significandy different between the two groups (P< 0.05). MS was associated with a 3.7 fold higher risk of ACI (P<0.01). Conclusions There is a close relationship between MS and ACI. MS is an important risk factor of ACI.

Objective To investigate the interconnection of the executive control network in major depressive disorder when they recognized the sad facial stimuli,and to discuss the aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteers participated in the experiment.The brain actions of all subjects were recorded by the magnetoencephalography (MEG) when they were required to distinguish the emotion face.Based on prior knowledge,the interested brain area consisted of the primary visual cortex (V1),the orbitofrontal cortex(OFC),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulated cortex (ACC).Then constructing three competing models to select an optimal model by the method of dynamic causal model(DCM),finally the differences of the effective connections of the optimal model between the depressed patients and healthy controls were analyzed.Results According to the results of Bayesian model selection (BMS),model 1 had the most exceedance probability of 0.80 with the features that there were bidirectional modulatory connections between the OFC,ACC and DLPFC.Given the best model,the parameters of effective connectivity of the optimal model were extracted,and then two-sample t-test over the model 1 was adopted.The modulatory effective connectivity from the OFC to the DLPFC in both hemisphere(t=-2.73,P=0.0096;t=-3.01,P=0.0046) and the OFC to the ACC (t=-2.93,P=0.0057) in the left hemisphere were significantly reduced in MDD.Conclusion There exists abnormal function of executive control network in depressed patients,the decreased effective connections between the OFC and the DLPFC,as well as the OFC and the ACC,may have correlation with the negative