Objective To explore the association between maternal methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and neural tube defects (NTDs). Methods CBM, VIP, CNKI, Wanfang, PubMed and Web of Science databases from set up to March, 2014 were electronically searched to identify case-control studies on the relationship between maternal MTHFR C677T polymorphism and NTDs. The data were quantitatively analyzed by RevMan 5.0 software. Results A total of 25 studies were selected including 2 282 cases and 3 420 controls. Overall, the pooled OR (with 95%CI) under co-dominant model and allele contrast were 2.28(1.60-3.24), 1.25(1.02-1.53) and 1.42(1.21-1.67). Subgroup analysis showed significant association between maternal MTHFR C677T polymorphism and NTDs susceptibility in Asian populations. Conclusion The present meta-analysis suggests that MTHFR C677T polymorphism is significantly associated with maternal risk for NTDs, especially in Asian populations.

Objective To observe the effect of strict designed form for chewing gum on the first anus exhaust and defecation after laparoscopic surgery,and the actual compliance of chewing gum was investigate.Methods Totally 106 patients with abdominal operation in gynaecology department of Shaanxi Provincial People's Hospital from August to December 2016 were classified into chewing gum group and control group according to stratified random sampling.Chewing gum group had 53 cases,and the principle and requirement of chewing gum in patients and relatives were explained before operation.The xylitol chewing gum was chosed and chewed 2 to 3 gums in the 2 hours after operation,chewed about 30 times every minute and last for 15 to 20 minutes each time.From 7∶00 to 22∶00 the interval was 2 hours, and the interval at the rest time must not exceed 3 hours until exhaust.Fifty-three cases in control group received routine nursing,and started to drink a small amount of water 6 hours after operation,and gradually started to eat.Other dietary guidance and medical care measures were identical in both groups.Compared the first anus exhaust time,defecation time,abdominal distension and postoperative hospitalization time in two groups,and the actual compliance of chewing gum was investigated.Results The first anus exhaust time and the first defecation time of chewing gum group were (19.60±7.59) hours and (36.77±17.16) hours respectively,while those of the control group were (33.79±10.54)hours and (53.25±16.92) hours,and the differences were statistically significant(P<0.05).No abdominal distension occurred in chewing gum group,8 cases (15.1%) in control group had abdominal distension,the difference was statistically significant(P<0.05).The postoperative hospitalization time of chewing gum group and control group were (3.94±1.87) days and (4.42±1.26)days respectively,and the difference was statistically significant(P>0.05).The actual compliance investigation of chewing gum was selected in 53 cases with the actual completion of 48 cases(90.6%).The averaged actual chewing number was (4.39±1.35) times,the averaged actual chewing time in each duration was (16.16±2.05) minutes,the average actual chewing interval was (2.38±0.26) hours.Conclusion The well designed form of chewing gum postoperative can shorten the postoperative anus exhaust and defecation time, and it can reduce postoperative abdominal distention.

To investigate whether chemotherapy could prolong the postoperative survival time in patients with early stages pancreatic ductal adenocarcinoma (PDAC). A total of 5280 stage ⅠA -ⅡB PDAC patients diagnosed from 2010 to 2015 were selected from surveillance，epidemiology，and end results (SEER) database. Propensity score matching (PSM) analysis was adopted to reduce the baseline differences between the groups. Univariate survival analysis was conducted with the Kaplan-Meier method. Multivariate survival analysis was performed with the Cox proportional hazards model. Univariate and multivariate survival analyses showed that age, differentiation, stage, chemotherapy were independent risk factors for the survival of PDAC patients. After PSM, it is found that adjuvant chemotherapy could prolong the median overall survival time (mOS) for stage ⅠB, ⅡA and ⅡB patients. However, for stage ⅠA patients, there were no significant differences in 3-year survival rate and mOS between patients with chemotherapy (=283) and without chemotherapy (=229) (57.4% vs 55.6%, vs all >0.05). Further analyses show that among 101 patients with well differentiated PDAC and 294 patients with moderately differentiated PDAC, there were no significant differences in survival rate and mOS between patients with and without chemotherapy (all >0.05). Among 117 patients with low-differentiated + undifferentiated PDAC, 3-year survival rate and mOS in patients with chemotherapy were significantly better than those without chemotherapy (48.5% vs 34.1%, vs all <0.05). Chemotherapy regimen used currently is not beneficial for patients with moderately and well differentiated stage ⅠA PDAC, but it is an independent prognostic factor for low-differentiated + undifferentiated PDAC patients.
Adenocarcinoma/pathology* ; Carcinoma, Pancreatic Ductal/surgery* ; Chemotherapy, Adjuvant ; Humans ; Neoplasm Staging ; Pancreatic Neoplasms/drug therapy* ; Prognosis ; Propensity Score

Objective To investigate the application and effects of navigation guidance in the diagnosis and treatment of patients so as to standardize the process of medical activities,provide convenience for patients and improve the quality of clinical service. Methods A total of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from May 2015 to June 2015 in Hu'nan People's Hospital were randomly selected as control group. A number of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from July 2015 to August 2015 were randomly selected as experimental group. Patients in control group went for waiting doctor,treatment,examination and taking medicine with the guidance of responsible nurses. Patients in experimental group were guided with additional navigation guidance which was designed depend on the hospital. Treatment time of patients from outpatient clinic,MRI examination time of hospitalized patients,satisfaction of patients and medical staff to treatment time,treatment procedure and clinical service were compared between two groups. Results After the usage of navigation guidance,treatment time of patients from outpatient clinic in experimental group (63.53±32.97) was shorter than that in control group (67.94±39.44). The difference was statistically significant (P < 0.05). MRI examination time of hospitalized patients in experimental group (30.90±12.19) was shorter than that in control group (33.75±13.38), with significant difference (P<0.05). Satisfaction rates of patients to waiting time,treatment procedure and clinical service in experimental group were higher than those in control group (t=-3.977,-3.355,-4.843,P<0.001). Average satisfaction rate of medical staff to treatment procedure in experimental group (84.26±9.80)% was significant higher than that in control group (80.27±9.40)% (P<0.05). Conclusions Application of navigation guidance improves the standardization and specification of diagnosis and treatment procedure and clinical service levels. It is an effective management method which could significantly short patients' treatment and examination time so as to promote the satisfaction rate of medical staff and patients.

Objective To evaluate the impact of the professional knowledge and skills of hospital attendants on the quality of hospital care and its training effect. Methods200 accompanists from a Class ⅢGrade A hospital in Xi'an from January 2017 to December 2018 were selected as the subjects by convenient sampling. 100 accompanists from January to December 2018 were used as observation groups to develop their professional knowledge and skills training; 100 accompanists who did not carry out professional knowledge and skills training during from January to December 2017 were the control group. The professional knowledge and skills, quality of care were compared between the two groups before and after training. ResultsThe scores of basic care, daily life care, psychological care, functional rehabilitation, cleansing care, and communication in the observation group were higher than those in the control group, and the differences between the two groups were statistically significant (P＜ 0.05). After training, the patients' health education awareness rate, complication rate, safety incident rate, and satisfaction were better than before training, and the differences were statistically significant (P＜0.05). ConclusionsDue to the limitation of professional knowledge and skill level, the comprehensive quality of hospital accompanists needs to be improved. Strengthening the training of accompanists can not only improve the comprehensive quality of the accompanists themselves, but also improve the quality of hospital care, which is beneficial to the health and rapidity of the medical care industry.

The comprehensive detection and identification of active ingredients in complex matrices is a crucial challenge.Liquid chromatography coupled with high-resolution mass spectrometry(LC-HRMS)is the most prominent analytical platform for the exploration of novel active compounds from complex matrices.However,the LC-HRMS-based analysis workflow suffers from several bottleneck issues,such as trace content of target compounds,limited acquisition for fragment information,and uncertainty in interpreting relevant MS2 spectra.Lycibarbarspermidines are vital antioxidant active ingredients in Lycii Fructus,while the reported structures are merely focused on dicaffeoylspermidines due to their low content.To comprehensively detect the new structures of lycibarbarspermidine derivatives,a"depict"strategy was developed in this study.First,potential new lycibarbarspermidine derivatives were designed according to the biosynthetic pathway,and a comprehensive database was established,which enlarged the coverage of lycibarbarspermidine derivatives.Second,the polarity-oriented sample prep-aration of potential new compounds increased the concentration of the target compounds.Third,the construction of the molecular network based on the fragmentation pathway of lycibarbarspermidine derivatives broadened the comprehensiveness of identification.Finally,the weak response signals were captured by data-dependent scanning(DDA)followed by parallel reaction monitoring(PRM),and the efficiency of acquiring MS2 fragment ions of target compounds was significantly improved.Based on the integrated strategy above,210 lycibarbarspermidine derivatives were detected and identified from Lycii Fructus,and in particular,170 potential new compounds were structurally characterized.The integrated strategy improved the sensitivity of detection and the coverage of low-response components,and it is expected to be a promising pipeline for discovering new compounds.

OBJECTIVE To evaluate the pharmacodynamics of Wujiashen Gejiejing on rats with deficiency of lung qi. METHODS The rat model of deficiency of lung qi was established by sawdust fumigation. By comparing the general activity state, blood acid-alkali indexes, biochemical indexes related to chronic bronchitis and airway histological characteristics of rats in each group, the pharmacodynamics of Wujiashen Gejiejing on rats with deficiency of lung qi was evaluated. RESULTS Compared with model group, after the Wujiashen Gejiejing intervention, the body weight of the rats significantly increased; the levels of p(O2) and SaO2 in blood were significantly increased(P<0.001), p(CO2) was significantly decreased(P<0.05), and pH had a tendency to increase; the levels of endothelin(ET) and IL-1β in serum were significantly decreased(P<0.01 or P<0.05), and the levels of TNF-α in serum had a decreasing trend. The damaged lung structures were significantly improved. CONCLUSION Wujiashen Gejiejing can significantly improve the activity state and improve hypoxemia and hypercapnia of lung qi deficiency syndrome, improve the damaged lung structure and the function of lung ventilation, and has obvious anti-inflammatory effect. Its mechanism may be related to regulating the expression of inflammatory cytokines IL-1β, TNF-α and ET.