OBJECTIVE: To study the influence of Jieyu Huoxue Decoction on rehabilitation of patients with depression after cerebral infarction. METHODS: Fifty four patients suffered from the depression after acute cerebral infarction were randomly divided into three groups: depression control group, fluoxetine treated group and Jieyu Huoxue Decoction treated group. Eighteen patients of cerebral infarction without depression were enrolled in the no depression control group randomly. The Zung self-rating depression scale (SDS), the modified Edinburgh-Scandinavia stroke scale (MESSS) and the activities of daily living (ADL) were evaluated before treatment, 30 and 60 days after treatment. RESULTS: After 30 and 60 days of treatment, SDS evaluation of the Jieyu Huoxue Decoction treated group showed significant difference as compared with the condition before treatment and that of the depression control group (P < 0.05 or P < 0.01), MESSS evaluation and ADL evaluation also showed significant difference as compared with the condition before treatment and that of the depression control group (P < 0.05 or P < 0.01); there was no obvious difference between the fluoxetine treated group and the Jieyu Huoxue Decoction treated group, but the Jieyu Huoxue Decoction treated group showed fewer symptoms and less side effect. CONCLUSION: Jieyu Huoxue Decoction can not only relieve depression after cerebral infarction, but also improve neurological functions.

Objective:To investigate the efficacy of nourishing feeding in patients with acute respiratory failure.Methods:One hundred patients with acute respiratory failure who received treatment in the First Affiliated Hospital of Wenzhou Medical University, China from December 2018 to March 2020 were included in this study. They were randomly divided into a control group and an observation group ( n = 50/group). After admission, all patients were actively treated and given enteral nutritional support. The gastric tube was indwelled. The head of the bed was elevated by 30-40°. The control group was given enteral nutrition which could reach the target dose within 2 days. The observation group was given nourishing feeding. Before and after 7 days of treatment, serum levels of hemoglobin (Hb), albumin (ALB) and total plasma protein as well as white blood cell and lymphocyte counts were determined. Intestinal tolerance was monitored during the treatment period. Mechanical ventilation time, length of intensive care unit stay, total hospital stay, and infection were compared between the control and observation groups. The number of deaths within 60 days after admission was recorded. Results:After treatment, serum levels of ALB, Hb and total plasma protein in the observation group were (49.86 ± 2.41) g/L, (134.96 ± 9.23) g/L, (54.18 ± 3.96) g/L, respectively, which were significantly higher than those in the control group [(42.34 ± 2.29) g/L, (127.49 ± 6.11) g/L, (42.86 ± 2.88) g/L, ( t = 15.99, 4.77, 16.35, all P < 0.01). After treatment, serum levels of ALB, Hb and total plasma protein in each group were significantly increased compared with before treatment (all P < 0.05). After treatment, white cell count in the observation group was significantly lower than that in the control group [(7.96 ± 1.06) × 10 9/L vs. (10.27 ± 2.35) × 10 9/L, t = 6.34, P < 0.01]. Lymphocyte count in the observation group was significantly higher than that in the control group [(1.19 ± 0.47) × 10 9/L vs. (1.02 ± 0.34) × 10 9/L, t = 2.07, P = 0.04]. After treatment, white cell count in each group was significantly decreased, and lymphocyte count in each group was significantly increased compared with before treatment (both P < 0.05). Intestinal intolerance rate in the observation group was significantly lower than that in the control group (22.0% vs. 52.0%, χ2 = 9.65, P < 0.01). The duration of mechanical ventilation, intensive care unit stay and total hospital stay in the observation group were (14.75 ± 5.36) d, (15.81 ± 6.28) d and (24.94 ± 7.18) d, respectively, which were significantly shorter than those in the control group [(18.69 ± 8.64) d, (27.96 ± 8.44) d and (29.84 ± 8.65) d, t = 2.74, 8.17 and 3.08, all P < 0.01]. The infection rate in the observation group was significantly lower than that in the control group (24.0% vs. 44.0%, χ2 = 4.46, P = 0.03). Conclusion:Nourishing feeding for enteral nutrition in patients with acute respiratory failure can better improve the nutritional status, reduce the level of systemic inflammation, improve the immune function, can be tolerated by the intestine, avoid infection, and promote the rehabilitation of patients with acute respiratory failure.

Objective To deepen and promote the development of nursing higher education internationalization through the analyzation of the status,existing problems and future trends of research about nursing higher education.Methods Searching literatures in China National Knowledge Infrastructure (CNKI),VIP and WANFANG databases from 1984 until 2014.Results 79 references were selected from 44 journals and the numbers increased each year.69.62％ (55/79) of them were accepted by statistical source core journals and 54.43％ (43/79) of them were funded.The authors came from 19 provinces.There were only 4 articles reported international education about graduates and most of them were about undergraduate students.The main reformation measures included curriculum and english teaching reform et al.Conclusions The educator paid more attention to nursing higher education internationalization than before,also the policy's support and the quality of literatures were optimistic.However,the breadth,depth and integrity of research should be strengthened in future.

Symptomatic carotid stenosis is closely associated with ischemic stroke,its treatment strategies include risk factor control,medical therapy,and revascularization.This article reviews and summarizes the clinical research of treatment methods in recent years,such as symptomatic carotid stenosis related antiplatelet therapy,antihypertensive treatment,lipid-lowering therapy,carotid endartereetomy and stenting,as well as the treatment strategies recommended by the guidelines.

Objective To investigate the biodistribution of intratumoral administerd~(131)Ⅰ-labeled human-mouse chimeric monoclonal antibody (chTNT) in patients with advanced lung carcinoma. Methods Eleven patients enrolled had cytological and histological confirmed diagnoses of either stage Ⅲ b or stage Ⅳ inoperable lung carcinoma. Intratumoral injection was directed by thoracic CT-guided catheter using a multi-holed needle. The dose for each patient was 18.5 - 37 MBq/cm~3 tumor mass. Blood samples were drawn at different time intervals for up to 13 days, and urine samples were collected for up to 11 days after injection for pharmacokinetic studies. In vivo stability was examined by HPLC by analyzing serum and urine, which were found to contain~(131)Ⅰ-chTNT. Whole body images were taken for quantitative organ and tumor biodistribution studies. Results In all 11 patients,~(131)Ⅰ-chTNT was the major component of the radiolabel in serum. Within 96 hours after administration, it was 100% stable. Plasma disappearance curves of ~(131)Ⅰ-chTNT were best fit by a two-exponential model in all patients with T_(1/2kα) of (0. 89±0. 17) h and T_(1/2β) of (86.88 ± 25.97)h. Free Ⅰ was the only metabolite of Ⅰ-chTNT that appeared in urine. A biodistribution study demonstrated excellent localization of the radioactivity in tumors. The accumulated radioactivity in urine at 264 h was (58.37 △Corresponding author E-mail:chen. shaoliang@zs-hospital. sh. cn±17.45) % of the injection dose. There was (51.05±8.41)%ID ,~(131)Ⅰ-chTNT in the tumor at 30 min after injection, and the tumor/lung (T/N) ratio was 63.87 ± 25.71. It remained (3.47 ± 3.27) %ID at 264 h,and the T/N ratio was 9. 61 ± 11.00. Among the main target organs, accumulation of the radiolabeled antibody was mainly found in lungs, liver, heart, kidneys, spleen and thyroid.Conclusions Pharmacokinietics of ~(131)Ⅰ-chTNT follows a two-exponential model. According to its long preservation in tumor tissue, intratumoral injection of~(131)Ⅰ-chTNT is good for tumor therapy.

Objective To investigate the application of radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy in the diagnosis of peripheral pulmonary lesions (PPLs),assess its safety and diagnostic value,and explore the influencing factors.Methods Clinical data of 140 patients who underwent R-EBUS transbronchial biopsy (TBB) and brush biopsy in our department of respiratory endoscopy from January 2015 to March 2017 were collected and retrospectively analyzed in the study.Eighty-three cases were diagnosed as PPLs.The detection rate,ability to locate the peripheral lesions,and influencing factors of EBUS were analyzed.The incidence rate of complications was observed to assess its safety.Results Of the 83 PPLs patients,they were 55 males and 28 females,and at a mean age of 59.81 ± 11.85 years.The total success rate of EBUS-guided bronchoscopic diagnosis was 59.04％ (49/83),and the diagnostic rate was 50.94％ (27/53) for malignant lesions,and 73.33％ (22/30) for benign diseases.The rate of EBUS-TBB (56.92％,37/65) was significantly higher than that of brush biopsy (30.12％,25/83,Chi square =10.76,P =0.001).EBUS-guided diagnostic methods had an accuracy of 60.00％ (45/75),while the EBUS-guided bronchoscopy had a rate of 50.0％ (4/8),but no significant difference was seen between the 2 methods (Chi square =0.03,P =0.87).The sizes of the lesions ranged from 10.0 to 52.4 mm,and the diagnostic yield for PPLs ≤20 mm in diameter (36.84％,7/19) was lower than that for those ＞20 mm (65.62％,42/64,Chi square =5.02,P =0.003).There was no significant difference (Chi square =10.05,P =0.07)in the diagnostic yield for different sites,with that of right upper lobe of 46.15％ (12/26),right middle lobe 100.00％ (8/8),right lower lobe 53.85％ (7/13),left upper lobe 37.50％ (3/8),left lingula lobe 63.64％ (7/11),left lower lobe 70.59％ (12/17).But the detection rate was obviously lower in the upper lobe (22/45,48.89％) than the middle/lower lobe (27/38,71.05％,Chi square =5.02,P =0.003).Of all the 83 patients,74 ones (89.16％) were successfully identified using radial probe EBUS,but the lesions were not found in 9 patients.When the radial probe position was within the target lesion,the diagnostic yield was 81.58％ (31/38),notably higher than that when the probe was positioned adjacent to the lesion (50.00％,18/36,Chi square =8.24,P =0.004).Mild bleeding was observed when performing biopsy under bronchoscope,and no pneumothorax,or other serious complications were observed.Conclusion Radial EBUS is a safe and feasible nethod to accurately identify PPLs and improve its diagnostic rate.EBUS-guided bronchoscopy has higher positive detection rate for PPLs,and is cost saving.The relationship of the probe and the site of lesion is the main factor influencing the diagnostic rate.

Objective To investigate the value of high-resolution magnetic resonance imaging (HR-MRI) for assessing the plaque stability as well as the risk factors for unstable plaque and severe stenosis in patients with symptomatic carotid stenosis.Methods The patients with symptomatic carotid stenosis were enrolled.HR-MRI was use to evaluate carotid plaque compositions and identify the stability of plaques.The carotid plaques from the patients underwent carotid endarterectomy were collected for pathological examination.The consistency of the preoperative HR-MRI and the postoperative pathological findings were compared.The clinical data of all patients were collected and the risk factors for the stability of carotid plaques and the severity of vascular stenosis were analyzed.Resulls A total of 219 patients with symptomatic carotid stenosis (stenosis ＞ 50％) who underwent HR-MRI were enrolled.Among them,102 patients (46.6％) had stable plaques and 117 (53.4％) had unstable plaques;118 (53.9％) had moderate stenosis and 101 (46.1％) had severe stenosis.Thirty-fiwe patients received carotid endarterectomy,HR-MRI showed that the plaque in 19 (54.3％) of them were instable,and pathological examination showed that the plaque in 20 (57.1％) cases were instable,and both were highly consistent (κ =0.942,P ＜ 0.001).The proportions of male (P =0.007),hyperlipidemia (P =0.013),smoking (P ＜0.001),as well as the levels of total cholesterol (P =0.001),low-density lipoprotein cholesterol (P ＜0.01),and fasting blood glucose (P =0.001) in the unstable plaque group were significantly higher than those in stable plaque group.Multivariate logistic regression analysis showed that male (odds ratio [OR] 2.33,95％ confidence interval [CI] 1.08-5.04;P=0.032),smoking (OR 3.45,95％ CI 1.67-7.14;P=0.001),and higher fasting blood glucose level (OR 1.26,95％ CI 1.07-1.48;P =0.006) were the independent risk factors for unstabke plaque.All the data did not show any significant difference between the moderate stenosis group and the severe stenosis group.Conclusions HR-MRI accurately assessed the plaque stability in patients with symptomatic carotid stenosis.Sex,smoking,and fasting blood glucose level were the independent risk factors for carotid artery unstable plaque.

Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Microvessels ; diagnostic imaging ; Neovascularization, Pathologic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVEThis study aimed to investigate the effect of a lactoperoxidase-peroxidase-thiocyanate (LPO-H2O-SCN-) system with different concentrations of iodine (I-) on Streptococcus mutans (S. mutans), particularly on various parameters, including growth, adhesion, glucosyltransferase (GTF) enzyme activity, and insoluble exopolysaccharide synthesis.

METHODSS. mutans ATCC 25175 was used as experimental species. Clonal formation unit (CFU) were counted to investigate the inhibitory effect on bacterial growth. The inhibition rate of bacterial adherence was calculated to analyze the effect on adhesion. Anthrone method was used to determine the content of insoluble exopolysaccharides and the amount of reducing saccharides. GTF activity and enzyme activity were then determined.

RESULTSThe inhibitory ability of the LPO-H2O2-SCN- system with I- on the cariogenicinity of S. mutans was strengthened as I- concentration was increased. At I- concentration > or = 100 micromol x L(-1) the antibacterial effects were significantly increased compared with those of the control group (P < 0.05). At I- concentration > or = 1,000 micromol x L(-1), the antibacterial effects were significantly improved compared with those of the group with SCN-only (P < 0.05). At I- concentration > or = 100 micromol x L(-1), the inhibition rate of bacterial adherence was > 50%; insoluble exopolysaccharide synthesis and GTF enzyme activity were reduced (P < 0.05).

CONCLUSIONThe antibacterial effects of the LPO-H2O2-I- system were enhanced by adding I- to overcome the antagonistic effect of physiological SCN- concentration. LPO-H2O2-SCN- system with different concentrations of I- showed statistically significant inhibitory effects on growth, adhesion, insoluble exopolysaccharide synthesis, and GTF enzyme activity.

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons