Objective To investigate the influence of enteral nutrition (EN) via feeding pump-based continuous infusion (FPBCI) on nutrition support-associated complications in stroke patients. Methods Totally 53 patients were randomized into BPBCI group (n = 28) and control group (bolus feeding) (n = 25 ). The nutrition support-associated complications including bloating, diarrhea, hyperglycemia, and regurgitation-associated low respiratory tract infection were compared between these two groups. Results The incidences of nutrition support-associated complications were significantly lower in BPBCI group than in control group (bloating: 14.3%vs. 64.0%, P=0.0002; diarrhea: 25.0% vs. 52.0%, P=0.0429; hyperglycemia: 17.9% vs. 44.0%, P=0. 0385 ). There was no significant difference in regurgitation-associated lower respiratory tract infection between these two groups (32. 1% vs. 40.0% , P = 0. 5516). Conclusion Compared with conventional bolus feeding,BPBCI may greatly decrease tube-feeding related complications.

10.3969/j.issn.2095-4344.2013.24.022

Abstract Diagnosis-related groups (DRGs), designed to reflect the complexity of grouped cases and the consumption of medical resources, has been utilized for evaluating hospital specialty capabilities and assessing performance. A provincial tertiary hospital in Zhejiang Province has developed a management model based on DRGs performance evaluation with strengthening the medical record quality control, optimizing disease admission structures, and refining data analysis. This article introduced the application of DRGs performance evaluation in this hospital, and proposed suggestions for improvement, including leveraging artificial intelligence and big data and integrating clinical pathway management to further enhance medical care quality. These insights provided the reference for high quality development of hospitals.

A quantitative method using ultrahigh-performance liquid chromatography was established to simultaneously determine ten ginsenoside active ingredients including ginsenoside Rg6, F4, Rk3, Rh4, 20(S) -Rg3, 20(R) -Rg3, Rk1, Rg5, 20(S)-Rh2 and 20(R)-Rh2 in steamed notoginseng. The ten ginsenosides of steamed notoginseng with different head numbers, parts, and steaming time were determined by this method. An Acquity BEH C18 chromatographic column (2.1 mm x 100 mm, 1.7 microm) was used to perform the determination, which was maintained at 35 degrees C throughout the analysis. Mobile phase was composed of water and acetonitrile with flow rate at 0.3 mL x min(-1) under gradient elution, and detection wavelength was set to 203 nm for monitoring the separation. The results demonstrate ginsenoside Rg6, F4, Rk3, Rh4, 20 (S)-Rg3, 20 (R) -Rg3, Rk1, Rg5, 20 (S)-Rh2 and 20(R) -Rh2 have shown good linearity (R2 > or = 0.999 8) within 0.46-115, 2.06-515, 1.632408, 3.216-804, 1.392-348, 1.4-350, 0.496-248, 3.012-1 506, 0.82-205 and 0.832-208 mg x L(-1), and their average recoveries were 97.00%, 97.96%, 98.86%, 95.27%, 98.67%, 98.02%, 95.53%, 96.63%, 99.57% and 103.6%, respectively. The proposed approach was quick and accurate and portrayed excellent repeatability and determination efficiency. The quality of steamed notoginseng was effectively controlled, which served as a foundation for establishing a normalized processing technique and quality standard for ensuring the reliability and consistency of its clinical efficacy.
Chromatography, High Pressure Liquid ; methods ; Ginsenosides ; analysis ; Panax notoginseng ; chemistry ; Reproducibility of Results ; Steam

Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP).Methods A total of 56 patients with symptomatic benign prostatic hyperplasia(BPH) underwent the PKRP.The weight of the prostate ranged 36~110 g(mean,50.3?26.4 g).All the patients were followed for 1~6 months postoperatively.Results The duration of the procedure was 25~100 min(mean,56?26 min),the weight of resected prostate was 10~89 g(mean,50?22 g),and the intraoperative blood loss,35~200 ml(mean,75?49 ml).No transurethral resection syndrome occurred.On 1,3,and 6 postoperative months of follow-up,the peak flow rate(Qmax) increased from 6.7?2.9 ml/s preoperatively to 17.4?5.1 ml/s,20.8?3.9 ml/s,and 21.6?4.6 ml/s,respectively,the international prostate symptom score(IPSS) decreased from 23.2?3.8 preoperatively to 6.9?1.7,6.1?2.1,and 5.9?1.5,respectively,and the quality of life(QOL) decreased from 5.7?1.5 preoperatively to 2.7?0.7,2.4?0.5,and 1.9?0.9,respectively.The differences between pre-and post-operative periods in the three indicators were all statistically significant(P

60 years) received parenteral nutritional support in the period of perioperation.When parenteral nutrition was applied,average non protein calorie intake was 85.4 kJ/(kg?d), and NPC∶N value was 118∶1. Results:PA,TRF and electrolyte were significantly increased after parenteral nutritional support.The nutritional indices did not change and were kept within normal range during parenteral nutrition. Conclusions:Parenteral nutrition is one of the important perioperative treatments in elderly patients with obstruction caused by colon cancer.It is safe and effective to use parenteral nutrition with low fat and glucose in elderly patients.

Objective To investigate the common etiologies,sports and learning situation of children in Nantong with short stature,and discuss the relationship between the two. Methods Did a retrospective analysis of 108 cases of children with short stature in Nantong University′s affiliated hospital since January 2012. Through detailed past illnesses, physical examination, laboratory tests, diagnose short stature and clarify the cause. Did a questionnaire to these children with short stature about sports and learning situation. Use statistical methods like multivariate Logis-tic regression analysis and link analysis to analyze sports and learning situation of children in Nantong with short sta-ture and find the relation with the etiology. According to the principle of group matching,the control group elected representative of 108 children. Results In 108 cases, 61 cases were because of growth hormone deficiency (GHD), accounting for 56. 5% ; 47 cases were because of non-growth hormone deficiency (NGHD), accounting for 43. 5% . Logistic regression analysis showed that participation in physical exercise was a protective factor. Rest-less anxiety and inattention were as risk factors,and these make a lot(P < 0. 001, OR = 7. 483, 95% CI = 2. 620 ~21. 374). There was no significant relation between common cause and sports, learning situation ( P > 0. 05). Conclusion Various types of sports (basketball, badminton, running, cycling) are protective factors for children of short stature. Restless anxiety and inattention are risk factors for children with short stature. Whether there is growth hormone deficiency or not, children with short stature should increase the right exercise as much as possible and avoid or reduce exposure to these risk factors.

Objective:To investigate microRNA-29b ( miR-29b) expression in cerebral cortex , spinal cord, fore limb muscle, and serum of SOD1-G93A amyotrophic lateral sclerosis ( ALS) mice, and to identify the biomarker and to assess diagnostic values for ALS .Methods:Cerebral cortex , spinal cord , fore limb muscle and serum from 16 SOD1-G93 A ALS mice and 16 wild-type mice were taken and then microRNA extracted , detecting the expression of miR-29 b by real-time quantitative polymerase chain re-action ( RT-qPCR ) .The diagnostic performance of miR-29b for ALS was estimated by the receiver operating characteristic ( ROC ) curve . Results: The results from the validation indicated that the differences in miR-29b between the cerebral cortex of SOD1-G93A ALS and the healthy control subjects were statistically significant (P=0.001).Meanwhile, the expressions 8, 12, and 16 weeks later were higher than those of the controls ( ALS vs.Control: 8 weeks, P=0.044; 12 weeks, P=0.018; 16 weeks, P=0.045).When the relative expression level of miR-29b was used to diagnose ALS in SOD1-G93A ALS mice, the area under the ROC (area under the curve, AUC) was 0.885, if the diagnostic threshold was set at 0.185 6, the sensitivity and specificity were 92.9%and 71.4%.Conclusion:MiR-29 b may act as medical monitoring indices of ALS in early time .

Objective To assess the role of the combination of Helicobacter pylori (H.polyri)antibody detection and serum pepsinogen (PG) examination (ABC method) in risk prediction of gastric cancer.Methods From July 2014 to July 2015,a total of 320 patients underwent gastroendoscopy examination because of stomach discomfort were enrolled.According to the results of serum H.polyri antibody test,PG Ⅰ and PG Ⅰ/PG Ⅱ ratio (PGR),patients were divided into four groups:group A was both H.polyri and PG negative,group B was H.polyri positive and PG negative,group C was both H.polyri and PG positive,group D was H.polyri negative and PG positive.The incidence rates of gastric cancer were compared among the groups.PG positive was defined as PG Ⅰ ≤70 μg/L and PGR≤3.0.And according to the results of gastroendoscopy examination and histopathology,the levels of gastrin 17,PG Ⅰ,PG Ⅱ and PGR of different atrophic regions with different pathological changes and atrophic degree were compared.Chi-square test and analysis of variance were performed for statistical analysis.Receiver operating characteristic(ROC) curve was used to calculate the optimal cut-off value of serum PG Ⅰ and PGR in gastric cancer diagnosis.Results Among the 320 patients,there were 159 patients in group A,124 patients in group B,23 patients in group C and 14 patients in group D,respectively.The incidence of gastric cancer in group A,group B,group C and group D were 0.63％ (1/159),4.03％ (5/124),13.04％ (3/23) and 3/14,respectively.The incidences of gastric cancer in group C and D were much higher than those in group A and B (x2 =11.700 and 21.900,both P＞0.01).Among the 320 patients,there were 179 cases in non-atrophic gastritis group,129 in atrophic gastritis group and 12 in gastric cancer group.The PG Ⅰ and PGR levels of gastric cancer group were (46.84 ± 24.07) μg/L and 3.21 ±1.45,which were lower than those of atrophic group ((100.09±48.15) μg/L and 9.78±7.32) and nonatrophic group ((103.97 ± 44.72) μg/L and 13.09 ± 9.05),and the differences were statistically significant (F=12.460 and 30.290,both P＜0.01).The PGR level of severe atrophy group was 5.62±3.00,which was significantly lower than those of moderate atrophy group (10.04 ± 6.08) and mild atrophy group (11.61±4.05).And the PGⅡ level of severe atrophy group was (18.85±10.54) μg/L,which was much higher than those of moderate atrophy group ((14.63 ± 11.19) μg/L) and mild atrophy group ((10.88 ± 7.41) μg/L),and t he differences were statistically significant (F=8.057,P＜ 0.01;F =3.374,P=0.021).The gastrin 17 level of antrum atrophy group was 2.16 pmol/L (1.12 pmol/L to 4.15 pmol/L),which was lower than those of gastric body atrophy group (4.49 pmol/L,1.88 pmol/L to 18.71 pmol/L) and whole gastric atrophy group (6.18 pmol/L,2.63 pmol/L to 17.82 pmol/L),and the differences were statistically significant (H=13.408,P＜0.01).The optimal cut-off values of PG Ⅰ and PGR for the diagnosis of gastric cancer were 66.7 μg/L and 4.45.Conclusions ABC stratification has certain value in gastric cancer screening in China,however,it still needs improvement.For patients with digestive symptoms,PG Ⅰ ≤ 66.7 μg/L and PGR ≤4.45 can be considered as high risk of gastric cancer and suggested to receive gastroendoscopy examination.

[Objective]To study the screw trajectory in the posterior atalanto-axial transarticular screw fixation.[Methods](1)The anatomical parameters related to the screw fixation were measured on 30 paired dry atlantoaxial specimens;(2)The X ray and CT scan were taken after C1、2 was fixed by posterior transarticular screws on 6 cadavers.These iterms were used to explore the anatomical relation of the vertebral artery and the screw trajectory in the posterior C1、2 fixation.[Results]The depth of the vertebral artery groove on the inferior surface of the superior facet of the axial was(5.86 1.45)mm;the vertebral artery groove extented the superior facet up to its medial third in 15 sides,up to the middle third and its lateral third respective in 35 and 9 sides,and the ideal screw trajectory medial angle of these specimens were(26.4?3.44)?,(16.1?2.44)?,(15.1?2.24)? respectively。The shortest distance between the vertebral artery and the screw trajectory lied in the topmost point of the vertebral artery groove of the axial on CT images,and the interval was(2.75～5.78)mm.[Conclusion]The position of vertebral artery groove of the axial is the key to decide the angle of the screw trajectory.The shortest interval between screw trajectory and vertebral artery,safe for posterior atalanto-axial transarticular screw fixation,locates on the inferior surface of the superior facet of the axial.