Objective To investigate the short-term prognosis of acute severe stroke patients treated with early partly of enteral nutrition followed by parenteral nutrition,only early enteral nutrition or only conventional family feeding.Methods According to stratified random method,97 severe acute stroke patients were divided into three groups,including early partly enteral nutrition and parenteral nutrition therapy group (study group,33 cases),only early enteral nutrition group (32 cases),and only conventional family feeding group (32 cases).The nutritional status,mortality,and incidence of infection were observed in the three groups at 21 days; NIH Stroke Scale (NIHSS) and Barthel Index at 21 days were compared among the three groups,and Modificied Rankin Scale (mRS) were compared at 90 days.Results At 21 days,the nutritional parameters including triceps skinfold thickness,mid-arm muscular circumference,hemoglobin,serum albumin,serum prealbumin and triglycerides in the study group were better than that in the other two groups.The incidence of malnutrition(10.0％ (3/30),37.5％ (9/24),12/19) and infection (18.2％ (6/33),40.6％ (13/32),56.3％ (18/32)) among the three groups were significantly different (x2 =15.2417,P =0.0005 ; x2 =10.1030,P =0.0064).The mortality (9.1％ (3/33),25.0％ (8/32),40.6％(13/32); x2 =8.6777,P =0.0131) and the NIHSS score (11.51 ±2.68,13.22 ±2.71,14.48 ± 2.55 ;F =7.86,P =0.0008) in the intervention group were lower than that in the other two groups.However,the Barthel Index had no significant difference among the three groups.At 90 days,the mRS grade 0 to l and the mRS grade 2 to 3 had no significant difference among the three groups; However,the mRS grade 4 to 5 among the three groups were statistical difference.Conclusion The early partly enteral nutrition combined with the stage of parenteral nutrition therapy can improve the short-term prognosis of severe acute stroke,though it cannot improve the Barthel Index on the 21th day.

Objective To investigate the effects of general anesthesia and hard epidural anesthesia on the incidence of postoperative cognitive dysfunction (POCD),serum S-100β and Aβ1-42 protein in elderly patients with transurethral resection of the prostate (TURP).Methods 120 cases of elderly male patients who wanted to implement TURP were enrolled in this study.From March 2014 to August 2016,60 patients underwent general anesthesia (general anesthesia group) and 60 patients underwent epidural anesthesia (hard epidural Group).The effects of two anesthesia methods on the cognitive function,serum S-100 β and Aβ1-42 protein were compared.Results There was no significant difference in mini-mental state examination (MMSE) score in preoperative,postoperative 12 h,postoperative 24 h,postoperative 72 h,and postoperative 1 week between hard epidural group and general anesthesia group (P ＞ 0.05).The MMSE scores at 12 h,24 h and 72 h after operation in both groups were significantly lower than those before operation in both groups (P ＜0.05).There was no significant difference in clock drawing task (CDT) score in preoperative,24 h after operation,72 h after operation and one week after operation (P ＞ 0.05).The CDT scores of both groups at 12 h,24 h,72 h after operation were significantly lower than those before operation (P ＜0.05).There was no significant difference in serum S-100β levels between the two groups at preoperative and 12 h,72 h after operation (P ＞0.05).Serum S-100β levels at 12 h and 72 h after surgery in both groups were significantly higher than those before surgery (P ＜ 0.05).There was no significant difference in preoperative and postoperative 12 h,postoperative between hard epidural group and general anesthesia group (P ＞ 0.05).Serum Aβ1-42 levels at preoperative,12 h and 72 h after operation in both groups were significantly lower than those before operation (P ＜ 0.05).There was not statistically significant in the incidence of POCD between hard epidural group [28.33 ％ (17/60)] and general anesthesia group [35％ (21/ 60)] (P ＞ 0.05).Conclusions There was no significant difference in the incidence of POCD between general anesthesia and hard epidural anesthesia group in elderly patients with TURP.The incidence of POCD in elderly patients was related to the decrease of serum S-100β and the decrease of Aβ1-42.