Objective To investigate the clinical effect of continuous language rehabilitation nursing on the language function in patients with stroke motor aphasia. Methods A total of 60 motor aphasia patients with a brain stroke were recruited and divided into experimental group and control group with 30 cases each by random digits table method. The control group was treated with the routine stroke care in traditional Chinese medicine, while the experimental group with the continuing language rehabilitation nursing base on the routine stroke care. The language function of both groups were detected by the Chinese Rehabilitation Research Center Standard Aphasia Examination before and after 3 months treatment, and a survey of nursing satisfaction of patients when discharged was conducted. Results The right rate of hear and understand, retelling, say, read aloud, reading comprehension, transcription, description, dictation, calculation in the Chinese Rehabilitation Research Center Standard Aphasia Examination was (44.35 ± 18.69), (32.37 ± 22.25), (21.49 ± 14.91), (27.63 ± 12.54), (46.87 ± 15.30), (14.25 ± 6.11), (7.33±3.23), (11.63±4.82), (18.93±6.82)%before the treatment and (62.14±10.81), (55.36±19.53), (41.42 ± 13.75), (59.16 ± 11.05), (55.57 ± 13.90), (32.39 ± 7.12), (9.73 ± 3.92), (27.45 ± 4.71), (37.46 ± 6.91)%after the treatment in the experimental group, except for description, the differences were significant ( t=2.096-14.540, P<0.01 or 0.05). The right rate of hear and understand, retelling, say, read aloud, reading comprehension, transcription, description, dictation, calculation in the Chinese Rehabilitation Research Center Standard Aphasia Examination was (43.86±15.89), (34.28±20.27), (22.84±15.40), (28.63±12.45), (47.23±11.30), (13.40±6.24), (7.27±3.70), (11.10±4.73), (19.50±6.80)%before the treatment and (49.46± 14.27), (42.36±20.58), (30.33±13.36), (40.31±11.88), (49.97±10.13), (15.37±5.59), (8.50±3.74), (12.83± 4.36), (21.47 ± 7.74)% after the treatment in the control group, the differences of hear and understand, retelling, say, read aloud were significant (t=2.263-3.991, P<0.05 or 0.01). There were significant differences in hear and understand, retelling, say, read aloud, transcription, dictation, calculation after the treatment between two groups (t=2.510-10.298, all P<0.05). The score of satisfaction was (94.36 ± 5.55) in the experimental group and (88.25 ± 5.46) points in the control group, and there was significant difference (t=4.299, P<0.01). Conclusions Continuing language rehabilitation nursing can improve the recovery of the language function of the motor aphasia patients with a brain stroke.

Objective:To investigate the clinical features of Epstein-Barr virus associated lymphoproliferative disease in children and to improve the understanding of this disease.Methods:This study included the children with Epstein-Barr virus associated lymphoproliferative disease admitted to the First Affiliated Hospital of College of Medicine of Zhejiang University from January 2014 to December 2018.Data of these children were collected, including age, clinical manifestations, laboratory results, treatment and outcome.The clinical features and therapeutic effects were analyzed.Results:A total of 114 cases(mean age 6 years, 0~17 years)were enrolled in this study, including 53 males and 61 females.There were 107 cases(93.86%) in the mild group (38 cases of EBV infection and 69 cases of infectious mononucleosis) and 7 cases in the severe group (6.14%). Six cases of the severe group were T cell or NK cell proliferation.Compared with the mild group, the load of EBV-DNA was higher in the severe group, but there was no significant difference( χ2=0.957, P>0.05). The IgM in severe group was significantly lower( Z=-2.041, P<0.05). But the differences in the level of immune function including IgA, IgG, CD4 + cell and CD8 + cell between the severe group and the mild group were not significant.The cases in the mild group had improved after antiviral treatments.Among the severe group, 3 cases survived after treatment, another 1 case was diagnosed as hydroa vacciniforme-like EBV-related proliferative disease (HV-like LPD). After antiviral treatment, the effect was not good, then after high-dose IVIG treatment and Bortezomib combined with methylprednisolone treatment, the EBV-DNA load decreased and the condition improved.While 1 case lost to follow-up, there were 2 cases with EBV-associated hemophagocytic syndrome and 1 case with EBV-associated lymphoma died after chemotherapy or transplantation. Conclusion:EBV-associated lymphoproliferative disease may manifest as a condition similar to infectious mononucleosis.High IgE, low IgM or high DNA load may indicate poor prognosis.Immune function after EBV infection may have different effects on prognosis.When the infected lymphocyte types are NK or T cells, it may indicate poor prognosis.The efficacy of transplantation and chemotherapy in severe cases is still uncertain.

Objective To compare the effect of postoperative between total intravenous anesthesia(TIVA)use of alfentanil and remifentanil undergoing endoscopic sinus surgery.Methods A total of 130 and thirty patients scheduled for endoscopic sinus surgery,62 males and 68 females,aged 18-64 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomly divided into two groups:alfentanil group(group A)and remifentanil group(group R).Midazolam 0.02 mg/kg,propofol target-controlled infusion(TCI)3 μg/ml,alfentanil 20 μg/kg,and rocuronium 0.6 mg/kg were injected intravenously in group A,and target-controlled infusion of propofol combined with alfentanil was used to maintain anesthesia.Midazo-lam 0.02 mg/kg,propofol TCI 3 μg/ml,remifentanil 1 μg/kg,and rocuronium 0.6 mg/kg were injected intravenously in group R,and target-controlled infusion of propofol combined with remifentanil was used to maintain anesthesia.The number of intraoperative hemodynamic adverse reactions such as hypertension,tachycardia,hypotension,bradycardia during operation,and pain degree at 30 minutes,60 minutes,24 hours after operation,extubation time,and rescue analgesia and adverse reactions such as nausea and vomi-ting,skin pruritus,respiratory depression within 24 hours after operation were recorded.Results Compared with group R,the incidence of intraoperative hypotension in group A was significantly lower(P＜0.05),the incidence of painless in group A 30 and 60 minutes after operation was significantly higher(P＜0.05),the incidence of mild and moderate pain was significantly decreased(P＜0.05),and the recovery time was significantly prolonged(P＜0.05).There was no significant difference in rescue analgesia within 24 hours after operation.There were no significant differences in the incidence of postoperative nausea and vomiting,postoperative skin pruritus,and respiratory depression between the two groups.Conclusion In endoscopic sinus surgery,the effect of total intravenous anesthesia with alfentanil on postoperative analgesia is better than that of remifentanil,and the incidence of perioperative and postoperative adverse reactions in alfentanil is lower than that of remifentanil,while the recovery time of alfentanil is slightly longer than that of remifentanil.

OBJECTIVE: To analyze the effect of bronchoalveolar lavage( BAL) on respiratory function and arterial blood gas of pneumoconiosis patients. METHODS: The published literatures about relationship between BAL and respiratory function and arterial blood gas in pneumoconiosis patients from China National Knowledge Internet,Wanfang Database,Chinese Biomedical Literature Database,Chinese Journal Database,Pub Med,Embase,Web of Science Database and the Cochrane Library Database and so on from 2000 to 2016 were retrieved,collected,and screened by using bibliometric method. The data was analyzed by Meta analysis with the help of Rev Man 5. 0 software. The weighted mean difference( MD) and 95%confidence interval( CI) were calculated on selected literatures. RESULTS: A total of 20 articles were selected and used.The forced vital capacity( FVC)( MD = 0. 21,95% CI: 0. 04-0. 37),the forced expiratory volume in one second( FEV1)( MD = 0. 12,95% CI: 0. 01-0. 23),the maximum ventilatory volume( MD = 10. 73,95% CI: 3. 48-17. 98) and partial pressure of oxygen( MD = 8. 85,95% CI: 0. 30-17. 39) in the patients after BAL were higher than before( P < 0. 05),while the partial pressure of carbon dioxide in artery( MD =-3. 58,95% CI:-5. 61--1. 55) decreased( P < 0. 01).Both of the FEV1/FVC( MD = 2. 08,95% CI:-6. 27-10. 43) and the FEV1%( MD = 0. 86,95% CI:-0. 55-2. 28)had not statistically significance before and after BAL( P > 0. 05). CONCLUSION: BAL can improved respiratory function and arterial blood gas in pneumoconiosis patients.

ObjectiveTo investigate the social support status and influencing factors of schizophrenics in remission in Northeast Sichuan， and to provide ideas for improving their social support. MethodsFrom May to September 2020， a total of 533 patients who met the diagnosis criteria of the International Classification of Diseases， tenth edition （ICD-10） for schizophrenics in remission at the mental health institutions in Guangyuan， Bazhong and Dazhou cities were selected for the survey， and patients were assessed by self-made demographic and clinical data inventory and Social Support Rating Scale （SSRS）. Then the social support status of schizophrenic in remission and influencing factors were analyzed， meantime， the impact of the second round reimbursement policy of medical insurance benefits on their social support was addressed particularly. Results①The SSRS total score， objective support， subjective support， and utilization of support scores of schizophrenics in remission were lower than those of the national norm （t=5.065~30.382， P<0.01）. ②Univariate analysis showed that SSRS score was relatively high among patients with female gender （t=-3.632）， retired status （F=5.951）， married status （F=5.951）， spouse as primary caregiver （F=23.841）， annual household income >5 000 yuan （F=15.892）， patient's economic income （t=4.083）， and outpatient or online follow-up （F=3.954）， with statistically significant differences （P<0.05 or 0.01）. ③The total and dimensional scores of SSRS in patients with access to the second round medical insurance reimbursement were significantly higher than those without （t=10.195~25.103， P<0.01）. ④Multiple linear regression analysis denoted that gender， work status， marital status， primary caregivers， annual family income， economic income， follow-up visits and the second round medical insurance reimbursement were the factors influencing social support status of schizophrenics in remission （β=0.201~2.115， P<0.05 or 0.01）. ConclusionThe social support of schizophrenics in remission in Northeast Sichuan is below the national average， furthermore， their social support levels are affected by the gender， work status， marital status， primary caregivers， annual family income， economic income， follow-up visits and the second round medical insurance reimbursement， and the second round medical insurance reimbursement may ameliorate the social support status of patients.