Objective:The purpose of this study was to assess the outcome of intestine fistula patients treated with home enteral nutrition(HEN) support before definitive operation.Methods:Fifty-eighty patients were divided into HEN support group and hospital enteral nutrition support group when their illness were stable and total enteral nutrition(TEN) were full resumed.All the patients were supervised by the members of nutrition support team.Days of TEN and hospital stay and medical cost was recorded.Plasma protein,body weight and body mass index were measured on the first day of full enteral nutriton and the day enteral nutrition was stop for operation preparation.Results:Nutritional status of the patients improved.There was no significant difference between two groups in nutritional status,complications and duration of TEN.The time patients in HEN group stayed at home was(61.11?27.71) d and in hospital(60.79?17.11) d.The cost in HEN group was less than that in hospital EN support group(140.21?61.2 vs 189.2?72.2 thousand Chinese dollar).Conclusion:Under the close supervise of nutrition support team,HEN is of the same safety and effect and can reduce the time of hospital-stay and medical cost when compared hospital EN.

Objective:To discuss the effect of individualized physical exercise prescription on patients’ nutrition status, physical ability and self-care ability in patients with intestinal fistula and severe malnutrition. Methods:Twenty-four patients were divided randomly into two groups, the experiment group exercised according to physical exercise prescription, control group exercised in a routine way. The patients’ weight, physical ability and self-care ability were measured on the day before exercise and the 28th day after exercise. Results:Patients in the exercise group had significant more exercise than those in the routine group, and the physical ability and self-care ability were significant better that those in the routine group. Conclusion:Individualized physical exercise prescription can accelerate the recovery of physical ability and self-care ability, it can be used safely and effectively in patients with intestinal fistula and severe malnutrition.

BACKGROUND:Human umbilical cord mesenchymal stem cels (hUC-MSCs) can obviously relieve liver cirrhosis, and thereby repair liver injury. However, the molecular mechanism of hUC-MSCs therapy for liver cirrhosis is limited at present, and especialy the non-coding RNA regulation of hepatic gene changes has not been detailed. OBJECTIVE:To investigate the changes of microRNA after hUC-MSCs therapy in rats with liver cirrhosis. METHODS:Liver cirrhosis models were established in rats using carbon tetrachloride subcutaneous injection plus oral administration of alcohol. At 8 weeks after modeling, hUC-MSCs were injectedvia the tail vein once a week for 4 consecutive weeks. At 1 week after the last injection, rat liver tissues were colected for paraffin embedding. Liver RNA was extracted for gene chip analysis. Blood samples were colected and analyzed using an automatic biochemical analyzer to detect the changes of liver function. RESULTS AND CONCLUSION:Alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transpeptidase were improved significantly after hUC-MSCs therapy. Fat lesions and necrosis of hepatocytes were significantly reduced. MicroRNA expression microarray hybridization analysis and PCR results showed that rno-miR-369-5p, rno-miR-3584-5p and rno-miR-153* were down-regulated during modeling and increased after hUC-MSCs therapy. And rno-miR-93, rno-miR-199a-3p, rno-miR-195, rno-let-7a and rno-miR-19a were firstly up-regulated in the process of modeling and then down-regulated obviously after hUC-MSCs therapy. These results suggest that hUC-MSCs may reverse liver cirrhosis and liver cel damage through up-regulation of rno-miR-369-5p, rno-miR-3584-5p and rno-miR-153*, and down-regulation of rno-miR-93, rno-miR-199a-3p, rno-miR-195, rno-let-7a and rno-miR-19a.

Objective:To investigate the mainstream view and statusof people on body donation in Yunnan province, and provide references. Methods:Random sampling questionnaire survey was used, the obtained data was statistically analyzed. Results:Only 48. 0% of the people understand the body donation, 20. 6% of people know body donation ways and procedures, 27. 8% of people have heard of body receiving station, 11. 4% of people know the body receiving station in yunnan province, 17. 2% of the people to understand body donation of relevant laws and regulations. 47. 4% of people that are willing to donate his body. Conclusion:Make perfect laws and reg-ulations, respect for the body, giving donors and their families allowance, body donation monument, to carry out education and publicity of the body donation form to the whole society support and participate in the good atmos-phere of body donation has great benefits.

Objective To understand the mainstream view of ethnic minorities and Han nationality in Yunnan province on Body donation, understand the present status and possible issues about body donation in Yunnan province, so as to provide reference for Yunnan province on body donation. Methods We conducted questionnaire survey by random sampling. Results Yi,Dai,Han on the body donation knowledge and Donation rate was low,and the Yi, Dai was lower than Han.promoting development of medicineandthat is the continuation of lifebecame the main factors affecting the willing to donate body,there was significant difference between the three ethnic groups ( <0.05) .After death should be laid to rest,family and public pressure,fear of being free to use,religious beliefbecome the main factors affecting the unwilling to donate body, three nations also had significant difference ( <0.05) .Conclusions Most people think that the whole society should pay close attention to body donation, that body donation is a very meaningful thing. Joint effort should be made by both the government and civil society for body donation programs in Yunnan Province.

Objective:To assess incidence of malnutrition and malnutrition risk of six department patients.Methods:The information of 1 200 patients were collected,200 in each of 6 departments in our hospital.Nutrition status was assessed according to Nutrition Risk Screening(NRS)published by ESPEN in 2001.Results:The incidence of malnutrition and malnutrition risk varied from 7.5% to 59% and 36% to 72% respectively in different department.Conclusion:The incidence of malnutrition is closely related to the kind and severity of the disease.It is nessissary to assess the nutrition status of high risk patients in time.NRS can be used simply and fastly in most inhospital patients.

Objective:To analyze the effect of individualized exercise intervention on weight loss and improvement of metabolic indexes in individuals with metabolic syndrome (MS).Methods:This study was a randomized controlled trial. A total of 1 200 MS patients who underwent health examinations in the Beijing Aerospace General Hospital Healthy Management Center from 2019 to 2022 were selected as the research subjects. The patients were randomly divided into the experimental group (600 cases) and the control group (600 cases) by random number table. Based on the patient′s physical fitness data, a 3-month personalized exercise intervention was implemented for the experimental group, which included aerobic exercise 3 to 4 times/week combined with resistance exercise≥2 times/week, and MS-related health examinations were given too. The control group only received physical examination. Paired t-test was used to compare the changes in weight and metabolic-related indicators before and after the intervention in the two groups. Two-sample t-test was used to compare the differences in intervention effects between groups. The effect of personalized exercise intervention on weight loss and improvement of metabolic indicators in the MS population was analyzed. Results:After the intervention, the weight, body mass index, waist-to-hip ratio, resting heart rate, systolic blood pressure, diastolic blood pressure, fasting glucose, low-density lipoprotein, total cholesterol esters, and triglyceride levels in the experimental group were all significantly lower than those before [(72.5±12.9) vs (74.2±13.6) kg, (27.3±3.5) vs (27.9±3.5) kg/m2, 0.87±0.08 vs 0.91±0.08, (71±7) vs (74±9) times/min, (131±11) vs (138±14) mmHg (1 mmHg=0.133 kPa), (80±8) vs (85±9) mmHg, (6.0±1.1) vs (6.9±1.6) mmol/L, (2.78±0.78) vs (3.12±0.77) mmol/L, (4.62±1.04) vs (5.22±0.97) mmol/L, (1.36±0.42) vs (2.59±2.01) mmol/L], but the high-density lipoprotein level was significantly higher than that before [(1.31±0.31) vs (1.27±0.29) mmol/L] (all P<0.05). The weight, body mass index, waist-to-hip ratio, systolic blood pressure, low-density lipoprotein, total cholesterol esters, and triglyceride levels after the intervention in the control group were all significantly higher than those before [(68.1±5.9) vs (67.1±5.9) kg, (25.3±2.4) vs (24.9±2.4) kg/m2, 0.83±0.07 vs 0.82±0.06, (127±12) vs (125±12) mmHg, (3.50±1.45) vs (3.20±1.21) mmol/L, (5.50±1.80) vs (5.30±1.52) mmol/L, (1.59±0.82) vs (1.40±0.65) mmol/L], but the high-density lipoprotein level was significantly lower than that before the intervention [(1.28±0.28) vs (1.38±0.28) mmol/L] (all P<0.05). The intervention effects on weight, body mass index, waist-to-hip ratio, heart rate, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, low-density lipoprotein, total cholesterol and triglycerides levels in the experimental group were all significantly better than those in the control group [(-1.4±13.3) vs (1.0±5.9) kg, (-0.6±3.5) vs (0.4±2.4) kg/m2, -0.04±0.08 vs 0.01±0.06, (-3±8) vs (0±7) times/min, (-7±12) vs (2±12) mmHg, (-5±9) vs (0±8) mmHg, (-0.9±1.4) vs (0±0.5) mmol/L, (0.04±0.30) vs (-0.10±0.28) mmol/L, (-0.34±0.77) vs (0.30±1.34) mmol/L, (-0.60±1.00) vs (0.20±1.66) mmol/L, (-1.23±1.45) vs (0.19±0.74) mmol/L ] (all P<0.001). Conclusion:Individualized exercise intervention can effectively promote weight loss and improve metabolic-related indicators in MS patients.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

Objective:To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China.Methods:A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ 2 test was used for categorical variables. Results:A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ 2= 6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ2=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ 2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ 2= 4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ 2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ 2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ 2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×10 9/L vs. 10.5 (2.5-32.2)×10 9/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions:The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.