Objective To study the effect of homecare on the health of diabetic patients in China. Methods A retrieval was done all on CNKI, Wanfang database, VIP database, China Biological Medicine. After excluding the literature out of the criteria, the meta-analysis was performed to compare the intervention group and control one in terms of the fasting plasma glucose , 2-hour postprandial blood glucose , quality of life , treatment compliance , standardized mean difference ( SMD ) and risk ratio ( RR ) . Results 12 RCTs, which involved 1,193 participants including 596 patients in the intervention group and 597 patients in the control group, were included in the final analysis. The fasting plasma glucose, 2-hour postprandial blood glucose, the quality of life, treatment compliance of the intervention group were significantly better than those of the control group , with effect size and 95% CI: SMD =-1.77, 95%CI (-2.28,-1.26);SMD=-1.62, 95%CI (-2.28,-0.95);SMD=1.31, 95%CI (0.50, 2.13);RR=1.27, 95%CI (1.13, 1.43) (P<0.01). Conclusion Homecare can improve the plasma glucose and quality of life of patients with diabetes and can help them to develop a healthy lifestyle.

Objective To compare the efficacy of vidarabine monophosphate and ribavirin for treating hand-foot-mouth disease (HFMD) in children.Methods 120 children with HFMD and admitted to a hospital from April 2013 to April 2015 were randomly divided into observation group and control group,60 cases in each group,observation group treated with vidarabine monophosphate,control group treated with ribavirin,the therapeutic efficacy between two groups were compared.Results After treatment,the negative conversion rate of intestinal virus EV and EV71,as well as Coxsackie virus A16(CA16) in observation group were 87.0％,85.7％,and 93.1％ respectively,in control group were 64.0％,69.8％,and 78.6％ respectively,difference between two groups was statistically significant (all P＜0.05).The average length of hospital stay in observation group was shorter than control group ([4.5 ± 1.3] days vs [6.2 ± 1.2] days,P＜0).05),symptom(fever,stomatitis,skin rash) control time in observation group were all shorter than control group(all P＜0.05).Whether patients with or without complication,therapeutic effect of the observation group was better than that of control group;myocardial enzyme data,C reactive protein (CRP),and white blood cell(WBC) in observation group were all lower than control group(all P＜0.05).Conclusion Efficacy of vidarabine monophosphate for treating children with HFMD is better than ribavirin,but it needs further study.

Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; Death, Sudden ; Humans ; Male ; Middle Aged

Objective To study the inconsistent relation of twin discordancy and the umbilical artery blood flow parameter of systolic/diastolic ratio.Methods 358 pregnant women were divided into the two groups of develop-mental nonidentity( n=67 ) and developmental identity ( n=291 ) according to the criterion that the differences of twins weight exceeded 25 percent.The umbilical artery blood flow parameter of systolic/diastolic ratio were observed. Meanwhile,the difference of weight and the umbilical artery blood flow parameter of systolic/diastolic ratio in the group of developmental nonidentity were observed.Results A significant difference of the umbilical artery blood flow parameter of systolic/diastolic ratio were found in the two groups of developmental nonidentity and developmental identity(7.81%vs 32.56%,P<0.05).There were 56 cases that twins weight exceeded from 25 to 35 percent,7 cases that twins weight exceeded from 35 to 45 percent and 4 cases that twins weight exceeded 45 percent in the group of developmental nonidentity which the umbilical artery blood flow parameter of systolic/diastolic ratio were (23.66 ± 5.78)%,(27.16 ±7.25)% and (33.16 ±4.23)% correspondingly with significant difference(F=23.21,P<0.05 ) .Conclusion The umbilical artery blood flow parameter of systolic/diastolic ratio has significance in diagnosis of twin discordancy.

Objective To study the expression of Bcl-2 and E2F-1 in human adenomyosis and to explore the correlation between the expression and pathogenesis of human adenomyosis. Methods Immunohistochemical S-P method was employed to detect the expression of Bcl-2 and E2F-1 in 58 specimens of ectopic endometrium, eutopic endometrium of adenomyosis and 30 specimens of normal endometrium. Results The expression of Bcl-2 and E2F-1 in ectopic and eutopic endometrium of adenomyosis were significantly higher than those of normal endometrium (P

Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

Objective To assess the sleep disturbance in patients with early-stage idiopathic Parkinson's disease of different clinical subgroups. Methods Four hundred and eighty-six Chinese PD patients were selected as our subjects. Their clinical data including demographics,a broad spectrum of motor variables and non motor features,including tremor,rigidity,hypokinesia,PIGD,motor phenotypes,disease progression,fatigue, constipation,apathy,depression,global cognitive function and L-dopa complications were collected and analyzed by cluster analysis. The PD subtypes were classified by using k-means cluster analysis according to the clinical data. The cluster analysis indicated four main subtypes:subtype 1 was mildly affected in all domains;subtype 2 was severely affected on all motor and non motor symptoms;subtype 3 showed intermediate severity in most domains;subtype 4 characterized by short disease duration and rapid disease progression. Then compared the sleep disturbance among different subtypes with Pittsburgh Sleep Quality Index( PSQI). Results Two hundred and thirty-six cases(48. 6%)were identified as suffering from sleep disturbance. Of which,female PD with sleep disturbance rate was 55. 1%( 130/236 )and male was 44. 9%( 106/236 ). Female was prone to develop sleep disturbance at early stage than male. PSQI scores in subtype 1,2,3 and 4 were(6. 09 ± 3. 72),(9. 36 ± 4. 24), (7. 82 ±4. 35)and(9. 09 ± 4. 73)respectively and the difference was significant(F =14. 503,P =0. 000) . Conclusion Sleep disturbance occurs frequently in patients with early-stage Parkinson's disease and exist clinical heterogeneity.

Objective To explore pre-hospital delay factor of coronary reperfusion therapy for ST-elevation acute myocardial infarction (STEAMI) patients presenting with non-chest pains. Methods A retrospective observation was conducted. The clinical data of STEAMI patients underwent emergency percutaneous coronary intervention (PCI) admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from August 2013 to August 2015 were analyzed. The patients were divided into chest pain group and non-chest pain group according to the presence of chest pain or not. Clinical characteristics were compared between the two groups, and incidence of major adverse cardiac events (MACE), door-to-balloon time, door-to-electrocardiograms (ECG) time and ECG-to-balloon time were evaluated. Influencing factors of pre-hospital delay was analyzed by logistic multiple stepwise regression. Results A total of 259 patients with STEAMI were enrolled, including 154 patients with chest pain and 105 presented with non-chest pains. Compared with chest pain group, the patients in the non-chest pain group were older (years: 68.12±8.93 vs. 62.34±7.12, P < 0.05), less female (26.67% vs. 42.20%, P< 0.05), and had a higher past history of angina, stroke and heart failure (27.61% vs. 13.63%, 31.42% vs. 18.83%, 26.67% vs. 11.68%, respectively, all P < 0.05), and higher percentage of Killip ≥ Ⅲ patients (15.24% vs. 6.49%, P < 0.05), the lower ambulance use (26.67% vs. 44.81%, P < 0.01), longer hospitalization time (days: 12.50±2.89 vs. 9.50±2.67, P < 0.05), higher incidence of MACE (19.05% vs. 9.09%, P < 0.05), longer door-to-balloon time and door-to-ECG time (minutes: 159.01±51.21 vs. 115.31±36.74, 53.06±18.17 vs. 30.35±9.93, both P < 0.01). It was shown by logistic multivariate regression analysis that no-chest pain [odds ratio (OR) = 5.14, 95% confidence interval (95%CI) = 2.34-10.81, P < 0.001], age ≥ 65 years old (OR = 1.43, 95%CI = 0.93-2.99, P = 0.022), diabetes (OR = 1.57, 95%CI = 0.66-2.15, P = 0.015) and no-ambulance transport (OR = 1.55, 95%CI = 0.73-2.75, P < 0.001) were risks factors of coronary reperfusion delay ≥ 2 hours. Conclusions STEAMI patients presenting without chest pain showed higher incidences of MACE, longer time of ECG obtained and initial PCI time delay. Clinicians should try to reduce the delay time of the patients in order to improve patient survival rates.

This study aims to synthesize cis-butenedioic anhydride modified epoxy dimethacrylate resin and evaluate their physico-mechamical properties.Stoichiometric amounts of E51 type epoxy resin,methacrylate acid and cis-butenedioic anhydride were reacted with N,N-dimethylbenzylamine as a catalyst.The compressive strength,diametral tensile strength,surface hardness,cured depth,water uptake,and water solution of the composite resin with EAM monomers and those of EMA were measured.The composite resin with EAM monomers gave high value of compressive strength,diametral tensile strength,surface hardness and lower water uptake and water solution compared to EMA monomers.