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 explore the effect of cognitive therapy for gastrointestinal carcinoma postoperative pstients to relieve nausea and vomiting.Methods 80 patients with gastrointestinal carcinoma were randomly divided into intervention group(n=40)and control group(n=40).The degree of nausea and vomiting and symptom were compared between the two groups.Results The incidence of nausea and vomiting in the intervention group was lower than that in the control group.So did the degree of nausea and vomiting.The difference was significant(P＜0.05).In SCL-90,the scores of the somatization,obsessive-compulsiwe,depression and anxiety phobicanxiety,parsnoid,psychofism were significantly different with that of the Chinese normal(P＜0.05).The scores in the intervention group were lower than that of the control group after cognitive therapy(P＜0.05).Conclusion Cognitive therapy can help to alleviate psychological health score,nausea and vomiting from gastrointestinal carcinoma postoperative,so as to improve the quality of life for patients with gastrointestinal carcinoma.

Objective To compare the ability of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in screening cognitive impairment in early stage of Parkinscn disease (PD). Methods The cognitive function of 101 patients with Parkinson disease (Hohen-Yahr stage 1-3) was assessed with MMSE. Ninety-six patients defined as having a normal age- and education-adjusted MMSE score were assessed subsequently with MoCA. The 96 patients were divided into two groups according to cut-off points of 26 of MoCA. The performance of cognitive domain was compared between PD-MCI group (MoCA <26) and control group (MoCA≥26). Results Mean MMSE and MoCA scores (standard deviation) were 27.17 (2.69) and 22.60(4.42) , respectively. 75% of the patients with normal MMSE scores had cognitive impairment according to their MoCA score. The PD-MCI group had lower scores in numerous cognitive domains (visuospatial and executive abilities, naming, attention,language, ab-straction, delayed memory) compared with control group (PD-MCI group: 3.11±1.40,2.56±0.69,5.07±1.05, 1.69±0.85,1.08±0.84, 1.08±1.31 ;Control group:4.75±0.61,2.92±0.28,5.88±0.45,2.46±0.66, 1.92±0.28,3.50±0.78, P<0.05). Predictors of cognitive impairment on the MoCA using univariate analyses were gender, age, education, Hoehn-Yabr stage, Unified Parkinscn Disease Rating Scale, depression severity (HAMD) and hallucination (r was-0.205,-0.209,0.263,-0.352,-0.225,-0.293 and-0.218, respectively). Condusions The MoCA is a more sensitive screening than the MMSE for cognitive impairment in early stage of PD.

Objective To assess cognitive impairment of patients with idiopathic Parkinson's disease(PD)of different clinical subgroups. Methods The cluster analysis approach was used to classify PD patients on the basis of their clinical features, and then compare their cognitive function according their Montreal Cognitive Assessment (MoCA)score. Results One-hundred and six patients were divided into 5 groups by means of cluster analysis:A. young-onset(n = 35), B. rapid disease progression(n = 6); C. tremor dominant(n = 36), D. haplo-non-tremor dominant(n =18),E. non-tremor dominant with depression(n = 11). The MoCA score and proportion of abnormal scores differed among the 5 groups significantly,especially between the subgroup E(19.00 ±5.47)and the subgroup A(23. 66 ± 3.51)(P ＜ 0. 05), the former was more seriously impaired in clock drawing task(1.73 ± 1. 01 vs.2. 66 ±0. 59 ,t = -2. 904,P =0. 013), alertness(0. 55 ±0. 52 vs. 0. 91 ±0. 28 ,t = -2. 241 ,P =0. 045),semantic fluency(0. 64 ±0. 51 vs. 0. 97 ±0. 17 ,t = -3. 429,P =0. 001)and orientation domains than the latter(4. 91 ± 1.38 vs. 5.80±0.47,t = -3.321,P =0.020). Conclusions The cognitive impairment in PD patients are common as well as heterogeneous.

Objective To investigate the risk factors of Parkinson's disease(PD)with mild cognitive impairment and mode of cerebral glucose metabolism. Methods One hundred and one non-dementia PD patients were assessed with Montreal Cognitive Assessment(MoCA)and divided into the PD with mild cognitive impairment (PD-MCI)group and the PD non-cognitive impairment(PD-NC)group. The demographic details, clinical features,Unified Pakinson's Disease Rating Scale(UPDRS), Hohen-Yahr rank and Hamilton Depression Scale(HAMD)were compared between the two groups. Patients in Hohen-Yahr stage 1 underwent positron emission tomography(PET)with 18F-fluorodeoxyglucose(18F-FDG)to show glucose metabolism. Results Seventy-seven(74. 3%)PD patients had mild cognitive impairment PD-MCI group had higher score in UPDRS 1st(mentation ,behavior and mood),2nd (activity of daily living)and 3rd(motor examination)subscale(2.48 ± 1.51,10. 71 ± 4. 88,22.31 ± 12.70)than PD-NC group(1.65 ± 1.29,8.15 ±2. 20,15.92 ±7.56,P ＜0.05)respectively. The FDG metabolism ratio of frontal cortex,parietal cortex and occipital cortex decreased more significantly in PD-MCI than in PD-NC(P ＜ 0.05).Conclusions The risk factors of mild cognitive impairment in PD include moter dysfunction, clinical stage and depression. The metabolic dysfunction of cortex may be the mechanism of mild cognitive impairment in PD.